Health Care Politics

Health care reform is one of the most dominant political topics in the United States right now. In an effort to consolidate debate over the issue, we've closed two previously existing health care threads and we're also asking that discussion of US healthcare reform be moved from the Congress (http://www.cosforums.com/showthread.php?t=120742) and Obama (http://www.cosforums.com/showthread.php?t=121148) threads into this thread. We may add a poll to this thread at some point, but with the large variety of plans currently on the table a poll would likely be "out-of-date" rapidly.

1. What is your impression of the state of the health care system in the United States?

2. Do you think the United States could do better?

3. What countries do you think the United States may be able to look to for inspiration or lessons, good or bad? If you are covered under such systems, what are the positives and negatives of your country's system?

4. What do you think the cost of health care reform will be? Are you willing to pay the cost? If so, what costs are you willing to pay? If not, why not?

5. Any other thoughts?

Ministry of Magic Rules, 3rd edition (http://www.cosforums.com/showthread.php?t=120463) in effect.

1. What is your impression of the state of the health care system in the United States?

Having not been a victim I can't recount personal experience but my brother while in the States dislocated a shoulder while on holiday. After his insurance was verified the surgeon proceeded to make matters worse by shattering the ball of his humerus before he was discharged.

Days later he fell on the ice and broke his leg. Given the option by his insurer he chose to fly home and have his leg treated (and shoulder repaired) for free in an Australian hospital.

2. Do you think the United States could do better?

Certainly do.

3. What countries do you think the United States may be able to look to for inspiration or lessons, good or bad? If you are covered under such systems, what are the positives and negatives of your country's system?

Having only experienced Australia's system I'd say it's a good one to try and emulate.

While imperfect, it allows me to see the GP of my choice free of charge (were I in full-time employment the cost would be nominal) and after a fall which left me paralysed I received treatment from a world expert in spinal cord injury and rehab as well as the equipment necessary to live independently.

1. What is your impression of the state of the health care system in the United States?

Embarrassingly inadequate.

2. Do you think the United States could do better?

I do.

4. What do you think the cost of health care reform will be? Are you willing to pay the cost? If so, what costs are you willing to pay? If not, why not?

Whatever it takes. I've had a eight-year ride compliments of George Bush. It's now time for my family and others in our tax bracket to pay the piper.

Following is the five-page memo from 1993, in which William Kristol advised congressional Republicans to do whatever it took to kill the Clinton health care reform bill. Not because the policy proposal was a bad idea; but because passage of the bill would help the Democratic Party for years to come. The GOP, he said, for the sake of its own future, couldn't compromise or negotiate.

http://purplehawk.potterskeys.com/kristolmemo1.jpg

http://purplehawk.potterskeys.com/kristolmemo2.jpg

http://purplehawk.potterskeys.com/kristolmemo3.jpg

http://purplehawk.potterskeys.com/kristolmemo4.jpg

http://purplehawk.potterskeys.com/kristolmemo5.jpg

Here we are sixteen years later, still trying to persuade self-serving GOPers and, believe it or not, a few recalcitrant blue dog Democrats to get with the program already! Matt Ygelsias (http://yglesias.thinkprogress.org/archives/2009/07/the-political-stakes-in-health-reform.php) notes:

In 1993, we had a new president elected on a promise of providing access to high-quality affordable health care to all Americans. In 1994, that promise went down in flames. The result of that failure was not only substantively bad, but politically disastrous for Democrats. Now it's 2009 and we have a new president elected on a promise of providing access to high-quality affordable health care for all Americans. It's pretty clear that Republicans remember that dealing a humiliating blow to said president by blocking reform will be politically useful to them.

And it's curious that many centrist Democrats -- particular those now eager to delay action on a bill and give special interests and the right more time to kill it -- don't seem to remember this.

It's fair to say this message has been gotten and understood. Organizing for America, the offshoot of the massive body of volunteers who once formed the grassroots group called Obama for America, is now targeting both House and Senate blue dogs with ads running in their home districts. Here's one:

JKa-ped05Cs

Republicans don't want to reform the health care system and certainly don't want President Obama to be the president who finally delivers the overhaul Americans have been wanting for the last several decades. The GOP has every possible reason to see this initiative fail, we understand that. But we are not going to sit by and let members of the Democratic Party tank health care.

Ain't gonna happen - not without a whale of a fight.

Every thing I hear and read about the US system makes me rejoice I don't live there. I know that if you're rich you can get world class treatment but for the ordinary run of people it seems very expensive and not at all certain (An American I used to know said that in his opinion the purpose of the US healthcare system was to ensure that you died bankrupt)

3. What countries do you think the United States may be able to look to for inspiration or lessons, good or bad? If you are covered under such systems, what are the positives and negatives of your country's system?

Don't copy the sort of heavily centralised and politicised system we have in Britain. Physicians' clinical judgements are debated in the papers and the anti-government part of the press highlight every failing. This means that whilst people are very satisfied with their own treatment they think the system as a whole is on the verge of collapse.

It is interesting to me that all political parties here now support the NHS (though I am not sure about the honesty of the Tories on this - they starved the system of funds last time they were in power and were clearly trying to destroy it)

It is interesting to me that all political parties here now support the NHS (though I am not sure about the honesty of the Tories on this - they starved the system of funds last time they were in power and were clearly trying to destroy it)

Like in Australia the Conservatives realise that a policy of active destruction of the NHS would be political suicide despite their ideological position. Far better to kill it by neglect.

Does "Tory" roughly tot up to "Republican?"

Roughly. The party of the establishment but not quite as far to the right as the GOP.

Most of you who know me, at least the COS me, know of my profession in healthcare, and my passion for issues revolving around it. In the past I have made no secret of my political views concerning the money-grubbing lawyers, bureaucrats and bean counters of healthcare, and how they have practically ruined healthcare in the United States. But, I shall rehash those sentiments now for the benefit of those who have not read my views.

I must admit that those same bean counters and bureaucrats, and, to some extent lawyers, were instrumental in bringing healthcare in the USA up to acceptable standards. For that, I am grateful. However, their time has come and long since gone in the traditional sense. Yes, we will continuously have need for all three of them in the future of healthcare, but they will need to take a new path. A path that no longer revolves around greed and covering their keisters.

Healthcare in the USA is on the ropes. Lawyers are mostly to blame, along with politicians who refuse to do anything to reign the lawyers in. If healthcare is to survive and be a right for all taxpayers, then the very first step must be tort reform. We must protect our doctors, hospitals, pharamcuitical companies, and medical device manufacturers. I am not in favor of an outright ban on lawsuits against them, but the cases in which suit may be brought, and the monetary amounts that can be awarded must be strongly curtailed.

Today, the average Ob-Gyn pays over $250,000.00 in malpractice premiums. Far too many patients disregard their advice, continue to smoke, use alcohol, drugs, partake of poor diets and poor prenatal care practices, then turn around and sue their doctors when the child is born with birth defects, or something goes wrong unexpectedly. Doctors are healers, who must make tough choices, but are far too often second-guessed by lawyers, who act as armchair quarterbacks. And it isn't just Ob-Gyns, but most specialities.

Because of this, many Ob-Gyns are getting out of the field all together. Some are going overseas, some are dropping medicine completely, and fewer are electing to go to medical school in the first place. This leaves openings at top schools being filled with candidates using less selective methods. The net result being poorer clinicians.

Hospitals often bare the brunt of lawsuits too. They have deeper pockets, so the lawyers go after them. Even more so are the pharmacuitical and medical device manufacturers on the block.

The companies that make medical devices and pharmacuiticals take great financial risks to bring products to market, products that save more lives than without them. Nothing works perfectly for everyone, but if one user out of 10,000 dies, then a dozen lawyers start running ads to generate clients and a class action suit. To me, that is bonafide ambulance chasing, and unethical. The companies go to great lengths and the Food and Drug Administration provide great scrutiny before a product is approved. That doesn't mean things don't slip through the cracks. Occasionally they do. If a company knowingly puts a bad product on the market, then I have no sympathy for them. But, most of these lawyers don't care if it was intentional, only if the tree will bare fruit...meaning money in thier pockets.

By tort reform I propose that only malicious intent be grounds for a lawsuit. Yes, many have said, "But what about medical mistakes?" To this I reply "That is why what doctors do is called PRACTICE." Medicine is trial and error. Not every remedy for every known illness works the same on everyone. Some work better on certain people, and others don't work at all. And, unfortunately, some remedies have adverse affects. C'est la vie! Many lawsuits have been brought against doctors for simply following the standard of care, and that standard resulted in adverse reactions or, yes, death. Sorry, but that's life. Patients die. It sucks, but that's life.

The next thing that must be done is increased internal oversight of doctors and hospitals. To ensure good care we must have periodic and random peer reviews and Quality Assurance. If a physician is making too many mistakes, then the peer review board will have the power to suspend or revoke his or her medical license. The loss of one's license is just as strong an incentive to provide good care as the threat of lawsuits.

Once these problems are addressed, then the costs of healthcare in the USA will go down exponentially. Most costs come from huge insurance premiums for malpractice, and people skipping out on the check.

Yes, doctors need to make money to pay those huge school bills too. For this I recommend compulsory service in either the Military or some other governmental branch, or a charitable organization at the end of which their medical school bills will be paid for by Uncle Sam. Right now, the military vigorously recruits doctors, dangling the carrot of student loans being repaid. However, most doctors no longer feel the need to serve, because they have attained the training they desired. Once the student loans are taken care of, the physicians will see another reason not to charge so much. I know it is wishful thinking that doctors won't get greedy anyway...lol

Finally, the question of How to proceed in our government with National Socialized Medicine?

This is a tough one for me. I have seen good healthcare and bad healthcare around the world under National Healthcare Systems. The best way I can see moving forth is to have two choices: Private insurance coverage or Tax Paid coverage. We offer both, and the head of the household, or head taxpayer, chooses for the family. If they elect government run healthcare, then they pay additional taxes as their premiums. In exchange, they get complete healthcare including dental and vision, but must go to doctors that accept that kind of payment. Or, they choose private insurance, and go to hospitals and doctors that subscribe to those guidelines.

They are committed to their choice for the full tax year, and must submit notification prior to the beginning of the next tax year indicating which they will choose for the coming year. This notice is submitted in triplicate to the IRS, Department of Health And Human Services, and their state's department of public health. If they are on taxpayer coverage, they will be issued a card from their state indicating so. This card is good at any state's healthcare facilities. Private hospitals must only provide emergency stabilization and surgical care, afterward the patient is transported to a taxpayer hospital of their choice. Hospitals, doctors, and other providers may accept both forms if they subscribe to both.

I think it is a foregone conclusion that National Healthcare WILL be implemented during my child's generation. The gaps between rich and poor are widening too much for the old system to stand, without our country imploding.

Bri - this is a great post - thanks for summarising your views and expertise for all of us.
I totally agree on the lawsuits. This is a scandal, and it is starting to come over here to Eurpe as wel, which I find very worrying. I think there are cases of serious professional misconduct, but these are very rare, and (even more rarely) cases of harm done maliciously. But these qare exceptions. I would go a bit further than you and include 'serious professional misconduct' (i.e. unacceptable incompetence) in the failings that can be prosecuted - or there has to be a professional body to monitor this. But facetious lawsuits have to stop, as do the astronomical payouts which positively invite the vultures in.



Concerning the financing system - I think it is right that some kind of mix of public and private, with a good deal of choice is a good way to go, especially for the US.

I am not sure whether I'd suggest a total either/or syste as you seem to do, simply because even in a big country expertise can be pooled better if public healthcare is accessible to all (while your system sounds as if you choose between one set of hospitals or another, but not both).

Here in the UK the whole thing is far too centralised, I agree with Mundungus, but I think it might be a good solution to have everyone signed up by default, but with the option to opt out completely (see below). All people who are in, pay taxes on the basis of their income. This would offer a good basic service (let's say UK NHS-level: sufficient, but without bells and whistles, but usually especially good if you have something chronic), and people could opt to pay for add-ons, either individually when they want extras in a particular situation, or to take out an 'add-on' insurance for such perks, which would obviously be a lot cheaper than normal full health insurance.

At the same time people wouldbe allowed to opt out completely and to arrange theiur own healthcare finance - in this case one would have to ensure that in case of illness they can use public institutions where that is the best option for their case (and their insurance would pay), or they could go to private institutions, of course, a choice not open for those who don't have private coverage.

I would make sure that no-one goes without coverage, so if you opt out, you have to prove that you have taken out full coverage privately.


That way, you can actually make sure that the public system can develop some centres of specialisation and excellence, especially for rare problems: the system as I'd suggest it makes it worthwhile to do so, because you could attract people to come and bring their insurance money, too, if you are good enough. I think that kind of incentive may be too weak if you have a strict division between public and private systems. The boundary has to be permeable, with money flowing across where necessary (in the UK the NHS sometimes pays private institutions to take on procedures to shorten waiting lists, so it works both ways).




This is obviously a very crude sort of idea - unlike Bri, I am no expert!

That way, you can actually make sure that the public system can develop some centres of specialisation and excellence, especially for rare problems: the system as I'd suggest it makes it worthwhile to do so, because you could attract people to come and bring their insurance money, too, if you are good enough. I think that kind of incentive may be too weak if you have a strict division between public and private systems. The boundary has to be permeable, with money flowing across where necessary (in the UK the NHS sometimes pays private institutions to take on procedures to shorten waiting lists, so it works both ways).
A good example of that is Great Ormond St Children's Hospital. (NHS funded but with a private wing) If I had a very sick child however much insurance I had that is where I would want them to go

Great post, Bri! :tu:

I'm of two minds on tort reform. The frivolous lawsuits are there, obviously, but so are perfectly acceptable claims against malpractice. The woman who sued McDonalds for her burns after she spilled coffee on herself is a pretty good example of stupid lawsuits; on the other hand, the physician who amputated the wrong leg of a diabetes patient deserved to be sued. One of my sons is a physician, so health care is a frequent topic of conversation in our family. He has scaled back his practice in recent years to focus on his teaching position at a major university hospital.

I'm delighted a public option is still on the table because the competition should bring the cost of private insurance down. I'm sorry the single-payer option isn't politically feasible right now. It would make things so much easier and coverage more accessible for those who need it. The marketplace feature President Obama spoke of in his weekly address is a good stop-gap in lieu of single-payer.

Sounds similar to St Vincent's in Sydney which has both private and public facilities and requires doctors to work in both parts so that patients receive equal treatments, but with different decor.

1. What is your impression of the state of the health care system in the United States?

It's good, but could be much, much better.


2. Do you think the United States could do better?

Absolutely. Lack of cost oversight and fraud are, IMO, the two biggest problems and are why so many Americans are uninsured.


3. What countries do you think the United States may be able to look to for inspiration or lessons, good or bad? If you are covered under such systems, what are the positives and negatives of your country's system?

I am a firm believer that one can always take lessons from other bodies of work. But the solution to health care issues in America will require different thinking overall. I believe it must start with independent oversight of and control of costs by insurance companies, and the reduction of fraud and frivolous claims which raise the cost of good healthcare beyond the means of too many Americans.


4. What do you think the cost of health care reform will be? Are you willing to pay the cost? If so, what costs are you willing to pay? If not, why not?

If Obama has his way, a lot. Of course this is the socialist way...the masses pay for universal healthcare. That's un-American, and I am not willing to pay one cent until I see the cost-side of this problem brought under control. I already pay enough for Medicare and Medicaid.


5. Any other thoughts?

I sincerely hope the GOP and conservative Dems kick Obama's socialist heathcare agenda to the curb and propose a solution that makes sense and is in tune with the economic realities that face the government and ordinary people.

If Obama has his way, a lot. Of course this is the socialist way...the masses pay for universal healthcare. That's un-American, and I am not willing to pay one cent until I see the cost-side of this problem brought under control. I already pay enough for Medicare and Medicaid.
Bromides, cliches, and unfounded rumors...

I think it is a foregone conclusion that National Healthcare WILL be implemented during my child's generation. The gaps between rich and poor are widening too much for the old system to stand, without our country imploding.
Your post seems most telling of our system. I recall reading of the incredible wait-time in a Queens hospital.
Additional material:
Excellent article (http://scienceblogs.com/denialism/2009/06/the_obama_plan_-_part_i.php) on the matter. Especially when you dive (http://scienceblogs.com/denialism/2009/05/what_is_the_cause_of_excess_co.php) into other (http://www.commercialalert.org/relmanangell.pdf) attached links (http://scienceblogs.com/denialism/health_care/)

Cigna whistleblower (http://www.cnn.com/2009/US/07/02/insurance.purging/index.html) "I know from personal experience that members of Congress and the public have good reason to question the honesty and trustworthiness of the insurance industry."

We know what the problems are. But the big one is Congress' protectiveness of the insurance lobby.
:relax:

First off I will admit to being quite ignorant to the health care problems in other countries. Where I live in Canada, health care has never been an issue.

Here is a basic rundown:
In B.C., premiums are payable for MSP coverage and are based on family size and income. The monthly rates are:

$54 for one person
$96 for a family of two
$108 for a family of three or more

Assistance with the payment of premiums is available to Canadian citizens or holders of permanent resident status (landed immigrants) who have held that status and been resident in Canada for the past 12 consecutive months.

Regular premium assistance offers subsidies ranging from 20 to 100 per cent, based on an individual's net income (or a couple's combined net income) for the preceding tax year, less deductions for age, family size and disability. If the resulting amount referred to as "adjusted net income" is $28,000 or below, a subsidy is available.

The current adjusted net income thresholds are:
$20,000 - 100 percent subsidy
$22,000 - 80 percent subsidy
$24,000 - 60 percent subsidy
$26,000 - 40 percent subsidy
$28,000 - 20 percent subsidy

To verify eligibility, each person who applies for premium assistance authorizes the Canada Revenue Agency to release income information to the Ministry of Health and/or Health Insurance BC from the person's tax returns. Verification takes place each year and, where appropriate, MSP adjusts the monthly premium of beneficiaries upward or downward based on the information received

Included in our premiums is 'FairPharmacare'

Your family pays your full prescription costs until you reach a level known as your deductible (2% of you net annual income). Once you reach your deductible, PharmaCare begins assisting you with your eligible costs for the rest of the year.

British Columbians with the lowest incomes do not need to meet a deductible and receive immediate assistance.

PharmaCare will pay 70% of your family's eligible costs for the rest of the year after you reach your deductible and until you reach your family maximum (up to 4% of net income)

In addition, if your employer doesn't have a medical/ dental plan, extended medical and basic dental coverage can be purchased individually or as a group plan on top of basic medical. This extended coverage included Chiropractic, physio, etc (as well as prescription costs incurred before the pharmacare deductable is reached). The Dental covers up to 80% of basic coverage.
.

Bromides, cliches, and unfounded rumors...

I don't think so. I've read enough of the Obama plan. And so, apparently, has Congress...judging by the opposition that Obama is getting. The public sees it, too: Obama's Public Approval on Health Care Reform Slipping (http://www.foxnews.com/politics/2009/07/20/poll-obamas-public-approval-health-care-reform-slipping/)


We know what the problems are. But the big one is Congress' protectiveness of the insurance lobby.
:relax:

What? A Dem-controlled Congress protecting Big Insurance? Puh-leeese. IMO, we need a better plan than the one Obama is trying force upon us and our pocketbooks.

1. What is your impression of the state of the health care system in the United States?
My impression is that a lot of complicated policies and procedures are in place that make it difficult even for insured patients to reach their doctors and get specific care for their needs. Prescription drug policies are very complicated for patients because of people who abuse them. However, for an overall healthy person who takes care of themselves and have few healthcare needs, I believe the current system is functioning just fine.

2. Do you think the United States could do better?
Sure, there is always room for improvement. Not a complete change, but improvement in the areas that are not working. Removing the beauracracy within the system of healthcare workers, patients, and insurance companies will make care more accessible and less complicated and expensive to maintain.

3. What countries do you think the United States may be able to look to for inspiration or lessons, good or bad? If you are covered under such systems, what are the positives and negatives of your country's system?
Countries with universal or socialized healthcare may have a handful of positive things to say upon which we could build a program, but ultimately it goes against American values. Our system is based on being able to access your own healthcare system and take care of your own needs. Having a mandated system will require people to follow the fold and base their lives upon dictations from Washington DC. I don't think Americans are built that way and shouldn't have to live under the thumb of an overly powerful government. That is not to say that any country with this type of system has an overly powerful government, but I believe adding the control of healthcare to the already overflowing plate of the US government would be a huge mistake.

4. What do you think the cost of health care reform will be? Are you willing to pay the cost? If so, what costs are you willing to pay? If not, why not?
I think the burden of healthcare is mostly going to fall upon the middle class, many of whom are already at their limit and sometimes beyond taking care of their own needs. I fit into that category and no, I am not willing to pay more in order to insure someone else. I have worked hard to be in the place I am and I do not feel I should have to give parts of that up or pay more for what I do have to pay for someone who isn't in the same place. I believe that is fundamentally wrong in a free society.

5. Any other thoughts?
I believe there is too much focus on "fixing" things by completely overhauling them in a short period of time. This is all being pushed through too fast. Surely things in the healthcare system could be improved, but the solutions being proposed are not well thought out and are rather short-sighted. There are few checks and balances happening in our government right now and thus a rather one-sided plan is being shuffled through our system without the lawmakers or the people really knowing what's going on and what the details are. It's way too complicated to be considered a solution to an already complicated system.

If Obama has his way, a lot. Of course this is the socialist way...the masses pay for universal healthcare. That's un-American, and I am not willing to pay one cent until I see the cost-side of this problem brought under control. I already pay enough for Medicare and Medicaid.

Where were you six years ago when the second round of Bush's tax cuts were enacted with no way of recouping the loss of revenue? Or when we went to war in Iraq - a war that has been totally funded by money borrowed from the Chinese and Japanese?

One of the problems health care proponents are having is finding the right mix of funds to cover the program... something entirely new in Washington.

3. What countries do you think the United States may be able to look to for inspiration or lessons, good or bad? If you are covered under such systems, what are the positives and negatives of your country's system?

I am a firm believer that one can always take lessons from other bodies of work. But the solution to health care issues in America will require different thinking overall. I believe it must start with independent oversight of and control of costs by insurance companies, and the reduction of fraud and frivolous claims which raise the cost of good healthcare beyond the means of too many Americans.


4. What do you think the cost of health care reform will be? Are you willing to pay the cost? If so, what costs are you willing to pay? If not, why not?

If Obama has his way, a lot. Of course this is the socialist way...the masses pay for universal healthcare. That's un-American, and I am not willing to pay one cent until I see the cost-side of this problem brought under control. I already pay enough for Medicare and Medicaid.

I agree with your sentiments about independent oversight. That would be a HUGE improvement to our system. Right now too many expensive issues fall through the cracks and innocent people are having to pay for it.

This is why I take issue with the "czars" being hired by the current administration. They answer to no one but the President, and this goes directly against our fundamental system of Checks and Balances.

However, for an overall healthy person who takes care of themselves and have few healthcare needs, I believe the current system is functioning just fine.

And for a person who works from home LA's public transport system is perfect.

But healthcare isn't about serving the healthy and in less than a heartbeat a person can go from healthy to requiring intensive care.

This is why I take issue with the "czars" being hired by the current administration. They answer to no one but the President, and this goes directly against our fundamental system of Checks and Balances.


Well you can blame Nixon for that one. He was the first president to appoint a czar.

Where were you six years ago when the second round of Bush's tax cuts were enacted with no way of recouping the loss of revenue? Or when we went to was in Iraq - a war that has been totally funded by money borrowed from the Chinese and Japanese?

One of the problems health care proponents are having is finding the right mix of funds to cover the program... something entirely new in Washington.

The GOP response to this is that the revenue should be pulled from inefficient or wasteful programs elsewhere in the government. Bush wanted our country's tax dollars going to a movement to protect National Security rather than going to government programs that don't always benefit the greater society. Whether one agrees with his decision or not, it was valid.

My issue is that the answer funding this healthcare plan means more money out of my pocket, rather than weeding out wasteful spending to afford yet another government program.

And for a person who works from home LA's public transport system is perfect.

But healthcare isn't about serving the healthy and in less than a heartbeat a person can go from healthy to requiring intensive care.

The question was in regards to my impression of the healthcare system. My impression is that it has worked just fine for me, a person who chooses to take care of myself and work into a job that offers me health coverage. A person in another position might appreciate a healthcare plan that does all the thinking and work for them, but I like to make my own choices.

The question was in regards to my impression of the healthcare system. My impression is that it has worked just fine for me, a person who chooses to take care of myself and work into a job that offers me health coverage. A person in another position might appreciate a healthcare plan that does all the thinking and work for them, but I like to make my own choices.


Well that's great but since a successful healthcare system should really work best for people who are essentially the opposite of your situation i.e. unhealthy with recurring problems/serious diseases/ongoing conditions/inherited conditions etc then it doesn't really show off an insurance-based system as particularly good.
Healthcare is a natural monopoly anyway. At least in the case of National Insurance the providers of that insurance are answerable to their consumers rather than select shareholders.

Where were you six years ago when the second round of Bush's tax cuts were enacted with no way of recouping the loss of revenue? Or when we went to was in Iraq - a war that has been totally funded by money borrowed from the Chinese and Japanese?

One of the problems health care proponents are having is finding the right mix of funds to cover the program... something entirely new in Washington.

Back to Bush again? What does he have to do with the proverbial price of eggs? At least he delivered an affordable prescription drug benefit.

Obama is completely out of touch with the economic realities of the government and the people. He reminds me of a person who has been given a credit card and goes on a binge. This is why his honeymoon is over and his ratings are tanking.

This is why I take issue with the "czars" being hired by the current administration. They answer to no one but the President, and this goes directly against our fundamental system of Checks and Balances.

Right. It's the New Big Government that the liberals have always loved....only Bigger.

Obama just loves it even more, debt and taxes be damned. When it comes to the budget, the man is tone deaf.

Countries with universal or socialized healthcare may have a handful of positive things to say upon which we could build a program, but ultimately it goes against American values. Our system is based on being able to access your own healthcare system and take care of your own needs. Having a mandated system will require people to follow the fold and base their lives upon dictations from Washington DC. I don't think Americans are built that way and shouldn't have to live under the thumb of an overly powerful government. That is not to say that any country with this type of system has an overly powerful government, but I believe adding the control of healthcare to the already overflowing plate of the US government would be a huge mistake.

Not necessarily. We (The Netherlands) used to have a socialized healthcare system but it was privatised a few years ago. Now everyone is insured. In fact, assurance is mandatory. If you're not insured you have to pay a hefty fine. Basic healtcare insurance costs € 85,-- (well this depends on the insurance company) and if you want a better insurance you'll have to pay extra. But this isn't mandatory. If you're below a certain income you get a taxrefund. For me (I live alone) that would be € 58,--.
The only downside to the privitisation is the fact that insurance companies try to save money where ever possible. They'll often refuse to pay for certain medication, but the government has nothing to do with this.

Not necessarily. We (The Netherlands) used to have a socialized healthcare system but it was privatised a few years ago. Now everyone is insured. In fact, assurance is mandatory. If you're not insured you have to pay a hefty fine. Basic healtcare insurance costs € 85,-- (well this depends on the insurance company) and if you want a better insurance you'll have to pay extra. But this isn't mandatory. If you're below a certain income you get a taxrefund. For me (I live alone) that would be € 58,--.
The only downside to the privitisation is the fact that insurance companies try to save money where ever possible. They'll often refuse to pay for certain medication, but the government has nothing to do with this.

The government has everything to do with that! That's the problem with the proposed system -- it will drive up the cost for everyone because the insurance companies and healthcare providers have to make up for what they have to put toward the government system.

The government has everything to do with that! That's the problem with the proposed system -- it will drive up the cost for everyone because the insurance companies and healthcare providers have to make up for what they have to put toward the government system.

What you want is a system where only people who can afford a private health care system can have, even if this means a "large" group of people is uninsured because this means a cheaper insurance and more freedom in choosing... right?? Correct me if I'm wrong. Problem is, I don't.. A perfect system doesn't exist and I find this perfectly acceptable when it means everyone is insured. Even homeless people, refugees of poor people (or people without jobs for whatever reason). Since I'm not the only person who lives here I see no reason to only think of myself...

Bri - this is a great post - thanks for summarising your views and expertise for all of us.
I totally agree on the lawsuits. This is a scandal, and it is starting to come over here to Eurpe as wel, which I find very worrying. I think there are cases of serious professional misconduct, but these are very rare, and (even more rarely) cases of harm done maliciously. But these qare exceptions. I would go a bit further than you and include 'serious professional misconduct' (i.e. unacceptable incompetence) in the failings that can be prosecuted - or there has to be a professional body to monitor this. But facetious lawsuits have to stop, as do the astronomical payouts which positively invite the vultures in.

I appreciate your opinion on the idea of including professional misconduct and gross negligence as cases for which a lawsuit would be permissible, but I must respectfully disagree.

On the surface it would seem logical, but unfortunately, lawyers will try to make a case of simple malpractice or a medical mistake into something much larger than it is. If we leave the door open for them to try to make a mountain out of a mole hill, then we defeat the idea of tort reform entirely. This would render the whole thing moot.

The only thing that should be done is to suspend or revoke the license of the practitioner. It is unfortunate that the victim of a medical mistake must live with it, but for our system to survive we must protect the doctors and hospitals from the fear of litigation. The only way to do that is to truly draw the line.



Concerning the financing system - I think it is right that some kind of mix of public and private, with a good deal of choice is a good way to go, especially for the US.

I am not sure whether I'd suggest a total either/or syste as you seem to do, simply because even in a big country expertise can be pooled better if public healthcare is accessible to all (while your system sounds as if you choose between one set of hospitals or another, but not both).

That is why I suggest John Q. Taxpayer is only committed to one system or the other on an annual basis. Just like most companies that offer insurance to their employees, there would be an open enrollment period when we get to pick and choose what kind of coverage we have for the year.


This is obviously a very crude sort of idea - unlike Bri, I am no expert!

I am hardly an expert either. I am a healthcare professional, but by no means an expert.

Great post, Bri! :tu:

I'm delighted a public option is still on the table because the competition should bring the cost of private insurance down. I'm sorry the single-payer option isn't politically feasible right now. It would make things so much easier and coverage more accessible for those who need it. The marketplace feature President Obama spoke of in his weekly address is a good stop-gap in lieu of single-payer.

Ultimately, for our system to be successful, there must still be a private pay-option, which will force competition. It will force the competition even between the private pay providers and the public taxpayer one. If the services of the government paid providers dip too far below the standards of private providers, then next year more people will opt for the private pay option. This will take money away from taxpayer providers. Their bean-counters will realize this.

1. What is your impression of the state of the health care system in the United States?
My impression is that a lot of complicated policies and procedures are in place that make it difficult even for insured patients to reach their doctors and get specific care for their needs. Prescription drug policies are very complicated for patients because of people who abuse them. However, for an overall healthy person who takes care of themselves and have few healthcare needs, I believe the current system is functioning just fine.

3. What countries do you think the United States may be able to look to for inspiration or lessons, good or bad? If you are covered under such systems, what are the positives and negatives of your country's system?
Countries with universal or socialized healthcare may have a handful of positive things to say upon which we could build a program, but ultimately it goes against American values. Our system is based on being able to access your own healthcare system and take care of your own needs. Having a mandated system will require people to follow the fold and base their lives upon dictations from Washington DC. I don't think Americans are built that way and shouldn't have to live under the thumb of an overly powerful government. That is not to say that any country with this type of system has an overly powerful government, but I believe adding the control of healthcare to the already overflowing plate of the US government would be a huge mistake.

These two answers to two different questions contradict each other. On the one hand--and believe me, if anyone is interested in honoring what our Founding Parents outlined 234 years ago, it is me--you are in favor people taking care of their own needs, by their own means. However, you complain that the system is too convoluted for people to attain access to good healthcare.

Unfortunately, one is the byproduct of the other. The Constitutional question is What is a God-given right of an American? Well, we have a right to be safe. We have a right to have a vote. We have a right to have the government defend us from all enemies, foreign and domestic. Bureaucratic healthcare is an enemy of the people. I believe it is a right to have full access to healthcare, guaranteed with the wording about Life, Liberty, and The Pursuit of Happiness.


5. Any other thoughts?
I believe there is too much focus on "fixing" things by completely overhauling them in a short period of time. This is all being pushed through too fast. Surely things in the healthcare system could be improved, but the solutions being proposed are not well thought out and are rather short-sighted. There are few checks and balances happening in our government right now and thus a rather one-sided plan is being shuffled through our system without the lawmakers or the people really knowing what's going on and what the details are. It's way too complicated to be considered a solution to an already complicated system.

It is not "too fast". These problems have been growing, with space widening between the insured, uninsured, and governmentally subsidized for over four decades. Every President since Nixon has been talking about "their healthcare plan", but so far none have gotten anything pushed through. Not that I am an Obama fan, but at least he has a plan, and has demanded solid, written proposals on his desk on this matter.

What you want is a system where only people who can afford a private health care system can have, even if this means a "large" group of people is uninsured because this means a cheaper insurance and more freedom in choosing... right?? Correct me if I'm wrong. Problem is, I don't.. A perfect system doesn't exist and I find this perfectly acceptable when it means everyone is insured. Even homeless people, refugees of poor people (or people without jobs for whatever reason). Since I'm not the only person who lives here I see no reason to only think of myself...

No. Basically, I don't think ANYONE should require insurance. If a person takes care of themselves and also happens to have a job with a benefit of health insurance, then great. Theoretically, healthcare costs should be affordable enough WITHOUT insurance. My family did it for years before this whole debacle blew up onto the international stage.

I don't think it's a matter of "who should have insurance and who shouldn't," it's a matter of the cost should be affordable whether you choose insurance or not. If someone has a case of the sniffles, they shouldn't have to pay astronomical prices to see a doctor and get a prescription for antibiotics just because they don't have insurance. For our basic healthcare needs, I believe it should be affordable to get a doctor's opinion, basic care, and prescriptions without insurance being necessary.

In the case of someone who is getting older and has medical needs, then yes, getting themselves to a place where they can either afford to purchase their own insurance at an affordable cost or take advantage of an employment benefit would be ideal.

In summary, I don't think it's necessary for the nation to be requiring and supplying insurance to all Americans. If a person feels they need or want it, they should be able to make the choice, and if they choose to take advantage of insurance then it should be affordable and not astronomically priced in order to pay for everyone, including those for whom it is not necessary.

These two answers to two different questions contradict each other. On the one hand--and believe me, if anyone is interested in honoring what our Founding Parents outlined 234 years ago, it is me--you are in favor people taking care of their own needs, by their own means. However, you complain that the system is too convoluted for people to attain access to good healthcare.

Unfortunately, one is the byproduct of the other. The Constitutional question is What is a God-given right of an American? Well, we have a right to be safe. We have a right to have a vote. We have a right to have the government defend us from all enemies, foreign and domestic. Bureaucratic healthcare is an enemy of the people. I believe it is a right to have full access to healthcare, guaranteed with the wording about Life, Liberty, and The Pursuit of Happiness.

I don't see how those things are contradictory. I believe Americans have the right to choose for themselves and not have choices dictated upon them by the government. However, the government's job IS to handle issues on a national scale, of which the corruption in insurance/healthcare is one. I believe the solution for this is the government to solve the existing problems in the system rather than introduce an entire new system, which may or may not work, and will inevitably have problems of its own.

I appreciate your opinion on the idea of including professional misconduct and gross negligence as cases for which a lawsuit would be permissible, but I must respectfully disagree.

On the surface it would seem logical, but unfortunately, lawyers will try to make a case of simple malpractice or a medical mistake into something much larger than it is. If we leave the door open for them to try to make a mountain out of a mole hill, then we defeat the idea of tort reform entirely. This would render the whole thing moot.

The only thing that should be done is to suspend or revoke the license of the practitioner. It is unfortunate that the victim of a medical mistake must live with it, but for our system to survive we must protect the doctors and hospitals from the fear of litigation. The only way to do that is to truly draw the line.


Yes, I would agree with this. I am not sure whether I made it clear, but my reason for including professional misconduct etc. was to make sure that hospitals and individuals have a strong incentive to do their best.

I am less concerned with compensation (although some 'hard cases' are a tricky issue - like the example someone mentioned above where someone's healthy leg was amputated instead of the bad leg).

Thing is, that cases of removing someone's lience would still have to involve some legal process - but obviously, lawyers would have little reason for self-interested pushing for law-suits because this would not be an obvious target for the despicable 'no-win-no-fee' deals .




I also agree with the idea that a mix of public and private is better for quality because it creates some competition. I think this mechanism is probably not used enough here in Europe. However, one has to construct the system very well to make sure that competition does indeed have an effect on quality in terms of medical performance (as opposed to other things - i.e. insurance companies driving costs down, if they are essentially the 'customers' who determine the direction of the competition). Competition will always have an impact, but not necessarily the desired impact unless the system is designed well.

Yes, I would agree with this. I am not sure whether I made it clear, but my reason for including professional misconduct etc. was to make sure that hospitals and individuals have a strong incentive to do their best.

That is where "peer review" is so important.

I am less concerned with compensation (although some 'hard cases' are a tricky issue - like the example someone mentioned above where someone's healthy leg was amputated instead of the bad leg).

In that case the mistake happened at the radiologist office. They marked the leg as the wrong one, and the film was backwards. Easy mistake back then, when they didn't have wording emblazoned upon the film. Of course, the surgeon should have checked for himself. It was a series of mistakes that culminated in one huge "HOLY $%^$*#^!!!!"

Thing is, that cases of removing someone's license would still have to involve some legal process - but obviously, lawyers would have little reason for self-interested pushing for law-suits because this would not be an obvious target for the despicable 'no-win-no-fee' deals .

Sure, but why does it need to be so difficult. Lawyers have an organization called THE BAR, and to be disbarred a lawyer has his license revoked by his peers. It is a legal process, but is essentially done internally through peer review. The doctors can do the same.


I don't see how those things are contradictory. I believe Americans have the right to choose for themselves and not have choices dictated upon them by the government. However, the government's job IS to handle issues on a national scale, of which the corruption in insurance/healthcare is one. I believe the solution for this is the government to solve the existing problems in the system rather than introduce an entire new system, which may or may not work, and will inevitably have problems of its own.

There comes a point when a system is so broke that it needs replacing. My TV quit working. It was less trouble and money to replace it than to fix it. However, I don't believe that the current system is so far gone that it can't be fixed. That has to start with tort reform, but it must end in available and afford able healthcare for All Americans.

With 50 million Americans with little or no health coverage, but still having medical needs, the system needs to find a way to cover them too. Either, the government picks up the check through taxes, or the hospital eats the cost. More often, the hospital eats it, but makes up for it by raising its prices. If all providers charge similarly for the same services, then it becomes "reasonable and customary." This means the insurance company pays for it. Hence, they must raise their rates to make up for it.

Ultimately, we must find a cost-effective, yet complimentary system that will cover those 50 million uninsured and underinsured.

I get the peer review suggestion now, Bri. As long as there is due process, that would obviously be sufficient, IMHO.


With 50 million Americans with little or no health coverage, but still having medical needs, the system needs to find a way to cover them too. Either, the government picks up the check through taxes, or the hospital eats the cost. More often, the hospital eats it, but makes up for it by raising its prices. If all providers charge similarly for the same services, then it becomes "reasonable and customary." This means the insurance company pays for it. Hence, they must raise their rates to make up for it.


Thing is, that those worried about taxes are already paying so much more for insurance premiums simply for the reason that others aren't insured which drives up the costs without any controls. Any mechanism which will bring those costs under control (i.e. linking them to each person who needs the services, rather than opaque rice rises to somehow cover the shortfalls, combined with random exclusions of services from insurance policies as happens now).

I think it's very short-sighted not to see these wider implications of the system, the hidden but very high costs. This isn't at the moment the state taxing people for health care, but it's the insurance companies extracting the money (who also have to make an extra buck, or a billiion, to please their share holders).

It's similar with the protests about 'the government can't decide which treatment I can have' - well, now some insurance company is doing that for most people, with sometimes scandalous outcomes, especially when hardworking people with an insurance suddenly find that chronic deseases aren't covered.

IMHO - if such decisions really have to be made, and if money has to be handed over, I'd prefer to have those decisions and funds handled by someone with as little ouside interest (shareholders, profit, bonuses) as possible. That's why I am always surprised that so many people are SO distrustful of the state but don't seem to see a problem with the private companies. There is nothing wrong with distrusting the state, but I think it's very naive not to distrust private companies just as much, if not more.

There comes a point when a system is so broke that it needs replacing. My TV quit working. It was less trouble and money to replace it than to fix it. However, I don't believe that the current system is so far gone that it can't be fixed. That has to start with tort reform, but it must end in available and afford able healthcare for All Americans.

With 50 million Americans with little or no health coverage, but still having medical needs, the system needs to find a way to cover them too. Either, the government picks up the check through taxes, or the hospital eats the cost. More often, the hospital eats it, but makes up for it by raising its prices. If all providers charge similarly for the same services, then it becomes "reasonable and customary." This means the insurance company pays for it. Hence, they must raise their rates to make up for it.

Ultimately, we must find a cost-effective, yet complimentary system that will cover those 50 million uninsured and underinsured.

This goes back to my thoughts on WHO we're insuring and WHY. If covering all the uninsured is such a burden and requires such turmoil to establish, why not determine WHO necessitates government assistance with their healthcare and address that group? I suppose it could turn into an abuse situation such as Welfare, but I just don't understand why a program that makes blanket requirements across the country is the solution for a problem which is defined as simply insuring the quantifiable group of uninsured. There are plenty who are already insured who do not need the government's assistance with their insurance, yet will be at the mercy of this program in the name of providing insurance to others.

Yes, it is the government's responsibility to care for its citizens, but should it be at the expense of another group of citizens?

Back to Bush again? What does he have to do with the proverbial price of eggs? At least he delivered an affordable prescription drug benefit.

He did not. Like NCLB, the Medicare D program was, and is, nowhere near affordable. Conservatives like to mutter about Social Security, but Bush has made a much greater mess with Medicare in terms of financing shortfalls in the near future.

Medicaid in Crisis as Bush Administration Tries to Shift Billions in Cost to States (http://seniorjournal.com/NEWS/Medicaid/2008/8-02-21-MedicaidinCrisis.htm) Senior News, February 2008.

Geithner on the Medicare Crisis: Two Possible Solutions Worth Mentioning (http://bucknakedpolitics.typepad.com/buck_naked_politics/2009/05/geitner-on-the-medicare-crisis-three-contributory-solutions-he-didnt-mention.html) May 2009.

These two answers to two different questions contradict each other.

Good catch, Bri. There is way too much "Me, Me, Me" in some of the arguments I'm hearing from conservatives.

Yes, it is the government's responsibility to care for its citizens, but should it be at the expense of another group of citizens?

Yes. Those who've benefitted from years of tax cuts - paid for by borrowing from foreign governments - need to realize there is no such thing as a free lunch. Some of us have had the next best thing over the past eight years, but it is now time to pay the piper.

ETA:

I just read today's "Progress Report" from Think Progress and thought this particular item appropriate for those wondering about the funding of the Bush tax cuts and how that plays into the debate on health care.

RECOVERING FROM THE BUSH TAX CUTS: As House Ways and Means Committee Chairman Charles Rangel (D-NY) explained, "This is a tax on less than 1 percent of the wealthiest people (http://www.upi.com/Top_News/2009/07/19/Rangel-Small-biz-wont-bear-health-brunt/UPI-55851248034746/) in the United States of America." According to estimates from Citizens for Tax Justice (CTJ), 98.7 percent (http://www.ctj.org/payingforhealthcare/surchargeproposalwaysandmeans.pdf) of Americans will be totally unaffected by the surcharge (http://www.ctj.org/payingforhealthcare/surchargeproposalwaysandmeans.pdf). And the roughly one percent of Americans that will see their taxes increase under the surcharge have benefited from years of skyrocketing income (http://yglesias.thinkprogress.org/archives/2009/07/no-pity-for-the-rich.php) and a falling effective tax rate (http://andrewsullivan.theatlantic.com/the_daily_dish/2009/07/daily-chart-tax-the-rich-to-pay-for-health-care.html). Between 1979 and 2006, the inflation-adjusted after-tax income of the top 1 percent of households increased by 256 percent (http://www.cbpp.org/cms/index.cfm?fa=view&id=2874), compared to 21 percent for families in the middle income quintile. Meanwhile, over the ten year window from 2001-2010, the Bush tax cuts gave the richest one percent of Americans about $715 billion in tax breaks (http://www.ctj.org/pdf/gwbdata.pdf). This comes out to about $518,000 per household (http://www.ctj.org/pdf/gwbdata.pdf) over ten years or about $51,800 per year. The surcharge, meanwhile, would raise $544 billion from those same households over 10 years. So as CTJ pointed out, the surcharge "would require the richest one percent to give back some, but not all (http://www.ctj.org/payingforhealthcare/surchargeproposalwaysandmeans.pdf), of the tax cuts they received over the 2001-2010 period." "It certainly is okay for me to tell my friends on Wall Street, who just got a bonus of $600,000, that they're going to pay more in taxes so that we can lower health care costs in America (http://wonkroom.thinkprogress.org/2009/07/17/top-tax-rate/)," Sen. Bernie Sanders (I-VT) said.

This truly makes the argument for paying the piper, does it not?

:hmm: I'm already beginning to see signs of over-generalization and labeling of the other side using derogatory terms in the debate. Thus, it's already time to be a bit more careful with the posting...

Thing is, that those worried about taxes are already paying so much more for insurance premiums simply for the reason that others aren't insured which drives up the costs without any controls. Any mechanism which will bring those costs under control (i.e. linking them to each person who needs the services, rather than opaque rice rises to somehow cover the shortfalls, combined with random exclusions of services from insurance policies as happens now).

By having an OPT OUT choice, whereby the taxpayer buys their own healthcare plan, you eliminate that risk. If anyone is not insured, it is their own fault, and has nothing to do with whether or not a private or governmental agency is price gouging or price fixing.

I think it's very short-sighted not to see these wider implications of the system, the hidden but very high costs. This isn't at the moment the state taxing people for health care, but it's the insurance companies extracting the money (who also have to make an extra buck, or a billiion, to please their share holders).

What would those hidden, but high costs be?

I have mentioned two of the most prominent hidden costs that are passed along to the patient: Uninsured patients and litigation/malpractice insurance costs. What else is there that might be "hidden?" Normal employee costs, building maintenance, liablility insurance (slip/trip/fall), administrative costs...these are all normal and customary for any business, and not hidden.

It's similar with the protests about 'the government can't decide which treatment I can have' - well, now some insurance company is doing that for most people, with sometimes scandalous outcomes, especially when hardworking people with an insurance suddenly find that chronic deseases aren't covered.

Yes, this has been a problem, but more so in the private sector. HMO's come to mind. A person who is on Medicare or Medicaid (the state public aid medical coverage branch), can generally get just about any kind of healthcare needs met, upto and including major surgery. I have even treated patients who received transplants, and some experimental procedures not normally covered by private insurance.

Again, by opening up more options to taxpayers to join government funded healthcare coverage, you put private insurers to the task of bringing their coverage up to a more open standard. Otherwise, next year, when open enrollment comes around, they will lose customers to the government's plan.

IMHO - if such decisions really have to be made, and if money has to be handed over, I'd prefer to have those decisions and funds handled by someone with as little ouside interest (shareholders, profit, bonuses) as possible. That's why I am always surprised that so many people are SO distrustful of the state but don't seem to see a problem with the private companies. There is nothing wrong with distrusting the state, but I think it's very naive not to distrust private companies just as much, if not more.

Private companies are smaller entities, and thus, more susceptible to the words and threats of their clients. The government is a machine. It breaks down, it works slowly, and it goes awry...but so do private companies, from time to time. The shareholders and clients keep them in line a heck of a lot better than the government. But, by dividing the options between them, they can also keep each other in check.

Rig - one small quibble with an earlier post of yours - many of the docs who choose not to pursue Ob/Gyn are already in medical school and just deciding between their options. My wife is at that exact stage of her career now - choosing which specialty to apply to - so I hear a lot about all of the various choices :lol:.

Personally, I think we do need an overhaul that makes is harder for frivolous lawsuits to be won (while still leaving the door open for truly bad doctoring to be dealt with), that makes it easier for patients to get preventative treatment, and gets everyone insurance. I think that it's OK to criticize the proposals that are out there, but at least criticize them honestly. Ads (http://www.factcheck.org/politics/canadian_straw_man.html) that prey on people's fears of big government, rationing, and installing a Canadian style system that aren't factually accurate really bug me because it means that people who oppose the health care reform may do so because they are under a false impression. And that does no one any good. If one opposes the health care reform proposals and they have an accurate understanding of the proposal, I'm cool with that (though I certainly reserve my right to disagree!).

In general, it bugs me tremendously when in politics people are completely misrepresenting the other side's proposals and policies in order to try and win public support. There's no law against lying in ads, but I think it does a disservice to society as a whole whenever groups attacking proposals get their facts wrong, thus sowing seeds of discontent with proposals that aren't actually the true proposals.

Bri, I do like the idea with going for tort reform as part of a package. Reducing the enormous costs in this area of the medical industry seems like a valid response under the circumstances. I also like the idea of peer review boards as oversight to medical practices in the industry, and the identification of "problem" links that are truly hazardous to leave in practice.

I like the idea of holding the individuals who are making the bulk of mistakes responsible without punishing all doctors, all patients and all businesses involved. Exactly how this tort reform and peer review would be structured, is something that would need to be worked out carefully so that the public is still protected from both gross malpractice (and reparations for it) ...but also from high prices due to the legal system that threatens to cut them off from health care all together.

Also, I do like the blended public/private health care system proposition. This is one of the reasons I decided to vote for Obama over Clinton in the primaries. I can see how this is beneficial yet still catalystic to reform through natural competition.

I remember a time as a young woman where I did not have health insurance, hit my head and ended up in an ER. I was young and healthy (and not a lot of money yet), so not having insurance didn't seem like an overly big deal.

When I received the bill from the hospital for ER services, I was able to pay it in a few installments. I think it was about $400 (and I had a hairline fracture due to this hit and a severe concussion). If I remember correctly, I head head X-rays, an EKG and even crash-cart services (because I convulsed when I hit and momentarily lost heart function---yah, hit it hard!), observation and other ER considerations.

Sometimes, stuff just happens--even if you take good care of yourself, are young and healthy and don't normally need medical services.

If something similar were to happen today, it might cost as much as $10-$15K for the same care. Cat Scans and x-rays running can run about $5K all by themselves for the head, not to mention all the other charges for blood tests, etc.. For some people who are barely making it already, even in installments, this can slide them in to bankruptcy. Anyone want to calculate the increase? Is it no wonder that some doctors won't even see patients on a cash basis anymore unless they have insurance? For uninsured, that can mean "no care at all"...and again, where I live, you can walk in with $10K, cash in hand, and they still won't see you because of the financial liability you represent. Insurance has become the golden ticket..and if you are someone over 50 (even if very healthy), that can mean premiums of $1500-2,000 mo for some couples. Again, who can afford that?

And if you DO have a condition, illness or a past record of such, you might not get any insurance at all due to that dreaded "pre-existing condition"...or get it, as long as it has nothing to do with your major health issue (what's the point, then?).

Or...you may be sailing along at 45, healthy and good with your long-time insurance policy then get into an auto accident and start having seizures due to head trauma. Your long time friend, the insurance company, may suddenly decide they have made enough off you from years before and you are now a liability and drop you like a hot potato (good luck finding another, at that point--at least for any reasonable amount of money).

The Government plan for those who cannot afford it, need not be fancy--just basics. Basic prevention (checkups and routine checks) to catch minor issues before they become major and/or catastrophic and basic, reasonable treatment in the case of illness or accident. We aren't talking plastic surgery for bored housewives or hair transplants for the prematurely bald to be more attractive--I'm talking "basics". Set and monitor broken bones if you fall. Remove that appendix if it goes ballistic one day, or reasonable comfort and compassionate treatment for those who cannot be helped, but just want to leave this Earth with a bit of dignity.

Basic can be more restrictive. Frankly, that's a good incentive to work your way up to a premium private policy. But, it should allow for the basics, that the men and women who are trying to save lives can do so and receive fair compensation (because they have bills, too), and because hospitals, doctors and insurance companies no longer have to up their prices to cover those uninsured, everyone's expenses come down--especially for those who are keeping those policies they DO like.

Government spending, eventually, will also go down...The Government is already subsidizing ERs to cover those uninsured who can't pay and offering Medicare and Medicaid to low income and elderly. If the base prices go down, the government subsidies and health costs will also go down. Insurance premiums will go down, normal low income citizens don't have to worry about losing everything for a simple fall down some steps. They might actually address less serious conditions before they become calamities in an ER. People will have somewhere else to go for simple cuts, flu, minor ailments OTHER than the ER because the uninsured would now be able to make less expensive doctor office visits (and there would be doctors that would actually take them and see them!).

I really don't understand the premise of "we'll lose our choice"--because you still have it. Keep your private insurance, or shop for another private insurance if you don't like yours (or it's too expensive). There will be more choice, if you ask me.

Uninsured will actually have A choice now (other than risk bankruptcy at the ER or stay home and die). It may not be "premium"..with fancy hospital rooms and elective surgery, but it will at least save their lives and maybe allow them to get back into the work force and become actual tax payers again! More revenue INTO the system if you have a healthier, working citizenship.

Rig - one small quibble with an earlier post of yours - many of the docs who choose not to pursue Ob/Gyn are already in medical school and just deciding between their options. My wife is at that exact stage of her career now - choosing which specialty to apply to - so I hear a lot about all of the various choices :lol:.

Wowzers, do I remember those days! :hmm:

In general, it bugs me tremendously when in politics people are completely misrepresenting the other side's proposals and policies in order to try and win public support. There's no law against lying in ads, but I think it does a disservice to society as a whole whenever groups attacking proposals get their facts wrong, thus sowing seeds of discontent with proposals that aren't actually the true proposals.

They succeeded in doing just that in 1993-94. I sure don't intend for it to happen again this time around. Here's video of President Obama's words on the need to health care, and the not-so-honest folks who'd like to tank it for reasons of sheer political survival.

mSjfDyEW4nA

Red, I fell out of a tree when trying to rescue my cat three years ago. Between the life flight helicopter and all that the trauma team did for me, plus an overnight hospital stay, the total bill was about $30,000.

No. Basically, I don't think ANYONE should require insurance. If a person takes care of themselves and also happens to have a job with a benefit of health insurance, then great. Theoretically, healthcare costs should be affordable enough WITHOUT insurance. My family did it for years before this whole debacle blew up onto the international stage.Was your family completely healthy? Do any genetic conditions run in your family? Not everyone is granted that luxury. I know mine isn't. Employers now can't afford to give out healthcare and try to find ways to worm their ways out of it. For instance, as an assistant teacher, I got gypped on benefits because of a half-hour rule, meaning, I didn't qualify for it. Some places do have full time employees, but the company doesn't offer health benefits. Of course not everyone needs it, but seems the one who truly do need it, are the ones who don't.I don't think it's a matter of "who should have insurance and who shouldn't," it's a matter of the cost should be affordable whether you choose insurance or not. If someone has a case of the sniffles, they shouldn't have to pay astronomical prices to see a doctor and get a prescription for antibiotics just because they don't have insurance. For our basic healthcare needs, I believe it should be affordable to get a doctor's opinion, basic care, and prescriptions without insurance being necessary.I agree with you, but there are some cases, where one must see a doctor for routine check ups. For example, I'm a diabetic. I'm supposed to see the doctor every three or four months. I can't afford it, because I can't afford health insurance or the doctor's visit. Lucky for me, though, I found a free clinic that runs on donations.In the case of someone who is getting older and has medical needs, then yes, getting themselves to a place where they can either afford to purchase their own insurance at an affordable cost or take advantage of an employment benefit would be ideal.But some places of employment, are trying to find ways to get out of paying for healthcare benefits for their employees or find loopholes. What do you propose?In summary, I don't think it's necessary for the nation to be requiring and supplying insurance to all Americans. If a person feels they need or want it, they should be able to make the choice, and if they choose to take advantage of insurance then it should be affordable and not astronomically priced in order to pay for everyone, including those for whom it is not necessary.If we're all paying for the same thing, what's wrong with that? Why is it seen as a bad thing that we are helping our fellow Americans in need? That's pretty much how it is in other countries. EVERYONE puts into it, therefore, everyone has access to it. It's no different than schools, fire departments, police departments, highways, etc. Everyone uses these things, even those who don't have kids (schools), and therefore, everyone pays into it.I don't see how those things are contradictory. I believe Americans have the right to choose for themselves and not have choices dictated upon them by the government. However, the government's job IS to handle issues on a national scale, of which the corruption in insurance/healthcare is one. I believe the solution for this is the government to solve the existing problems in the system rather than introduce an entire new system, which may or may not work, and will inevitably have problems of its own.There's no such thing as a perfect system and what we have now, obviously isn't working effectively, so why not try something new, and hope that it does okay?

Yes, it is the government's responsibility to care for its citizens, but should it be at the expense of another group of citizens?

Yes, ofcourse.... There is always a decision made by the government that's at the expense of another group. And there is always a group complaining. Over here the government partly pays for child daycare facilities. There are people (the ones without children) who say they should not have to pay for this. At the same time they conveniently forget that todays children pay for tomorrows elderly.

IMHO there is a shared responsibility. You are responsible for yourself, but if (for whatever reason) you can't take that responsibility then the government should step in.

As for mandatory insurance. That's more than fine with me. Can't imagine what would happen if a child can't get the required medical treatment because his mom and dad don't have enough money. And I'm not just talking about antibiotics...

Basic can be more restrictive. Frankly, that's a good incentive to work your way up to a premium private policy. But, it should allow for the basics, that the men and women who are trying to save lives can do so and receive fair compensation (because they have bills, too), and because hospitals, doctors and insurance companies no longer have to up their prices to cover those uninsured, everyone's expenses come down--especially for those who are keeping those policies they DO like.
I think that in all countries with a national service there is still a private option. Here for example there are many private hospitals and almost all NHS hospitals have a private wing. You have to pay for the private room, internet access and excellent choice of food (and the clinical services) but the treatment is exactly the same as you would get on the public wards. Quite a number of people have private insurance to cover the cost.

In an emergency almost everyone would choose to go to the nearest (public) A & E department. (I don't know if there are private A & E departments here.)

:hmm: I'm already beginning to see signs of over-generalization and labeling of the other side using derogatory terms in the debate. Thus, it's already time to be a bit more careful with the posting...

Oh I don't know...

Health insurance under capitalism is great because you can incentivize denials. This leads to your claim examiners being more creative and all around excellent people. :err:

Socialized healthcare is evil because it has the word "sociali" in it, like socialism. And such systems are from foreign countries...(Ergo, not from the USA. That's always a nice dig. Although ask anyone from the usual countries demonized to switch to our current broken system and they will likely laugh at you)

Of course this is why our military has it.

:relax:

Was your family completely healthy? Do any genetic conditions run in your family? Not everyone is granted that luxury. I know mine isn't. Employers now can't afford to give out healthcare and try to find ways to worm their ways out of it. For instance, as an assistant teacher, I got gypped on benefits because of a half-hour rule, meaning, I didn't qualify for it. Some places do have full time employees, but the company doesn't offer health benefits. Of course not everyone needs it, but seems the one who truly do need it, are the ones who don't.I agree with you, but there are some cases, where one must see a doctor for routine check ups. For example, I'm a diabetic. I'm supposed to see the doctor every three or four months. I can't afford it, because I can't afford health insurance or the doctor's visit. Lucky for me, though, I found a free clinic that runs on donations.But some places of employment, are trying to find ways to get out of paying for healthcare benefits for their employees or find loopholes. What do you propose?If we're all paying for the same thing, what's wrong with that? Why is it seen as a bad thing that we are helping our fellow Americans in need? That's pretty much how it is in other countries. EVERYONE puts into it, therefore, everyone has access to it. It's no different than schools, fire departments, police departments, highways, etc. Everyone uses these things, even those who don't have kids (schools), and therefore, everyone pays into it.There's no such thing as a perfect system and what we have now, obviously isn't working effectively, so why not try something new, and hope that it does okay?

I don't know the statistics, but I would venture to guess that there is a significant number of families that do not have any hereditary conditions or problems that require insurance and therefore can do just fine by paying out of pocket for basic needs. Our attentions as a country should be focused on making insurance and more advanced medical needs affordable for those who actually need it.

Yes, ofcourse.... There is always a decision made by the government that's at the expense of another group. And there is always a group complaining. Over here the government partly pays for child daycare facilities. There are people (the ones without children) who say they should not have to pay for this. At the same time they conveniently forget that todays children pay for tomorrows elderly.

IMHO there is a shared responsibility. You are responsible for yourself, but if (for whatever reason) you can't take that responsibility then the government should step in.

As for mandatory insurance. That's more than fine with me. Can't imagine what would happen if a child can't get the required medical treatment because his mom and dad don't have enough money. And I'm not just talking about antibiotics...

Certainly the country should be working as a whole to care for all of its citizens, but I do not believe this means jacking up taxes to fund unstable programs that are abused. I think the government should be working towards a system that is logical and covers the needs, not just blanket coverage for everyone. The US simply cannot afford to cover all people all the time right now -- we need to be more choosy about how we restructure healthcare so that it is fixing the problems, not adding greater burdens.

All nations with NHS have, as indicated in a link on page one of this, a far lower cost burden than the US for better overall results based on the two key metrics of life expectancy and child mortality.

I do not believe this means jacking up taxes to fund unstable programs that are abused. I think the government should be working towards a system that is logical and covers the needs, not just blanket coverage for everyone. The US simply cannot afford to cover all people all the time right now -- we need to be more choosy about how we restructure healthcare so that it is fixing the problems, not adding greater burdens.

Jacking up taxes? I've had about enough of that meme. Honestly. Unless you're a single person making more than $250,000 a year, or a married couple making more than $350,000, you aren't going to see your tax base increased at all. If you fit into either of those categories, you've a part of the group that averaged a tax cut of $51,800 a year for the past eight years. Those cuts - in a time of two wars, no less! - were financial insanity.

ETA:

Today's "Progress Report" from Think Progress contains excellent coverage of The Right's Delay And Kill Strategy (http://pr.thinkprogress.org/) on health care. As always, this report is meticulously sourced and written so that lay people can understand the issues at stake.

Jacking up taxes? I've had about enough of that meme. Honestly. Unless you're a single person making more than $250,000 a year, or a married couple making more than $350,000, you aren't going to see your tax base increased at all. If you fit into either of those categories, you've a part of the group that averaged a tax cut of $51,800 a year for the past eight years. Those cuts - in a time of two wars, no less! - were financial insanity.

ETA:

Today's "Progress Report" from Think Progress contains excellent coverage of The Right's Delay And Kill Strategy (http://pr.thinkprogress.org/) on health care. As always, this report is meticulously sourced and written so that lay people can understand the issues at stake.

What about the small businesses that make over $250,000 and are going to have to lay off workers because of tax burdens? Taxes are and forever will be an issue, so I don't think there can ever be "enough" discussion on the matter.

What about the small businesses that make over $250,000 and are going to have to lay off workers because of tax burdens? Taxes are and forever will be an issue, so I don't think there can ever be "enough" discussion on the matter.

That's a Republican scare tactic - and a dishonest one at that.

I'm not sure the small business threshold even is $250,000, but I do know that only the dollar(s) over whatever the threshold happens to be will be taxed at the higher rate. In other words, the business would pay the existing tax rate on the first $250,000. Say the business earned $300,000. Only the $50,000 would be taxed at the higher rate. In this instance, the difference to the business owner would be roughly $512. Nowhere near enough to affect hiring.

If I can make a suggestion, please consider looking through Ezra Klein's columns (http://voices.washingtonpost.com/ezra-klein/) at The Washington Post. Klein writes five days a week, Monday through Friday, and covers all things economic (among other policy-related stuff).

Some of my favorites from his archive:

Health Reform for Beginners: The Suprisingly Important, Occasionally Controversial, Dartmouth Atlas Studies (http://voices.washingtonpost.com/ezra-klein/2009/06/health_reform_for_beginners_th_2.html).

Primary Documents: The Congressional Budget Office's Score of the HELP Bill (http://voices.washingtonpost.com/ezra-klein/2009/07/the_congressional_budget_offic_1.html).

The CBO Tells People to Calm Down About the Public Plan (http://voices.washingtonpost.com/ezra-klein/2009/07/the_cbo_tells_people_to_calm_d.html).

The Five Most Important Pieces of Health-Care Reform That Aren't the Public Plan (http://voices.washingtonpost.com/ezra-klein/2009/07/the_five_most_important_pieces.html).

The Public Plan for Beginners (http://voices.washingtonpost.com/ezra-klein/2009/06/health_care_reform_for_beginne_3.html)

The Importance of Health Exchanges (http://voices.washingtonpost.com/ezra-klein/2009/06/health_insurance_exchanges_the.html).

There's a treasure trove of good columns in that archive.

Where I live we have outstanding health care. We have universal healthcare but also the option of private health care if we want it. As I'm a student I'm still covered by my parents' private health care and thanks to the two policies combined it costs me almost nothing to go to the GP, dentist etc, my medication (I need to head to the chemist a couple of times a month) costs are almost invisible (same with prescription glasses), I can choose my own doctor, will always have the best of care, I don't have to worry about going to see a doctor because I know I will always get in and it wont break my budget. For my family it's important we also have private cover (all four of us require glasses, my sister and I have had a lot of dental work done, my sister and I both have chronic Asthma and I seem destined to have some unpredictable accident every couple of years- without fail) but for most families it doesn't seem to be an issue. Everybody is covered and while the system isn't perfect, it's a lot better than most countries have. I personally would not live in a country that didn't have universal healthcare- but that's just me.

What about the small businesses that make over $250,000 and are going to have to lay off workers because of tax burdens? Taxes are and forever will be an issue, so I don't think there can ever be "enough" discussion on the matter.

Yeah. My dad owns a small law firm dealing with developmental issues. He makes just over the 250,000 mark. But he has six employees to pay. But with the economy currently things have been bad. Just less than half of the clients aren't paying the money owed because they no longer have any. At least one employee may need to be let go and seeing as they've all worked for a long time its not simple to do. Say what you want, any tax burden will have a significant effect, adding insult to injury. Many small businesses are in a similar boat.

Borger: Congressional Democrats messing up on health care (http://www.cnn.com/2009/POLITICS/07/21/borger.health.care/index.html)

While I don't agree with every thing CNN's Gloria Borger writes here, she nails the Dems cleanly on what is wrong with Obama's misguided $1 Trillion healthcare plan.

Obama's Democrats have so far given him higher costs (according to the Congressional Budget Office) and higher taxes. Or, in technical parlance, the same-old, same-old.

Yeah. My dad owns a small law firm dealing with developmental issues. He makes just over the 250,000 mark. But he has six employees to pay. But with the economy currently things have been bad. Just less than half of the clients aren't paying the money owed because they no longer have any. At least one employee may need to be let go and seeing as they've all worked for a long time its not simple to do. Say what you want, any tax burden will have a significant effect, adding insult to injury. Many small businesses are in a similar boat.

I'm glad to see that others recognize the problem with this system in a real life scenario. It's easy to read articles and declare oneself an expert on one issue or another, but one cannot fabricate LIVING the situation.

And as far as partisan "scare tactics," I believe simply calling it some sort of tactic is the root of the problem here and the most dishonest thing of all. Liberals like to accuse Conservatives of just being obstinant because they're not "getting their way," but in reality the outspoken ones can be the ones in the trenches, so to speak, dealing with these abhorable systems on a day to day basis. Either that or they have a set of values to which they adhere in everything they do and aren't afraid to speak up when something is fundamentally wrong.

I am not a Republican. I am an American, and one of my favorite things about being an American is that I have the right to speak up when my values and rights are being infringed upon. If someone thinks it is dishonest of me to speak out against unfair or ill-conceived policy, then that person must not understand the concept of Democracy and a two party system.

1. What is your impression of the state of the health care system in the United States? Not a very good one. It's in pretty bad shape from what I can tell -- due to corporations and what not getting their greedy hands in it. Sad really :sigh:. Basically a lot of people can't get/afford health care due to it... the high costs and all of the red tape...

Also on a side note -- I saw an ad today about the health care crisis... by a lobbyist group... and it basically slammed any new changes to the industry itself -- saying that it will cost people a ton of money... taxes and all that. It was a joke really... seeing just how low people will go in terms of things :sigh:.

2. Do you think the United States could do better? Yes I do. But it'll take a lot of arm wringing and stuff though -- after what I've heard and seen on tv in terms of what congress is going through. It'll be amazing if they can even get anything halfway decent passed -- without it being affected by the corporations, and all that affecting it.

3. What countries do you think the United States may be able to look to for inspiration or lessons, good or bad? If you are covered under such systems, what are the positives and negatives of your country's system? Maybe Europe or Canada -- since it seems as if they have more socialized health care...

4. What do you think the cost of health care reform will be? Are you willing to pay the cost? If so, what costs are you willing to pay? If not, why not? Hmm... I'm not sure on that. But I do hope that it'll have the rich contribute in some way. And not just have it be on the backs of the middle class and the poor -- more of the same old, same old.

To a point. As long as it's fair enough. If it's not -- then no. Mainly for the basics, like drugs and services. But anything really expensive... no -- there should definitely be ways to help people pay that off -- since they can't always afford it.


5. Any other thoughts?

Well... I've been having a heck of a time recently when it comes down to some of my own health care... My mom and I have to go through some more red tape -- just to clear it up and get my own case opened up again. Thanks to those dear governmental bureaucrats...

The situation KDOG speaks of is not related to President Obama or health care, though. It is a direct result of the economic collapse that occurred last year.

I can empathize with his dad's situation. My son-in-law is in the exact same situation. A small business owner himself, he has seen the dreadful effects of that crash up-close and personal. His clients don't contract for as much advertising as they used to; they pay a lot slower for what little they do engage in.

On the other hand, fixing the health care system is something he's looking forward to - not just for his employees, but for his family as well. His wife (our daughter) works for a Fortune 500 company that has had to throttle the health care it provides as an employee benefit way down from what it was when I last worked there in the early 90's. I couldn't believe it when she showed me what was available there.

What I've just posted here is not uncommon. I've been all over the country over the last two years. I've talked to people from just about every walk of life and health care never failed to come up in those conversations, town halls, and canvasses. People really want relief and voted for it. I'm aware that a majority of the people who already have health care are satisfied with their existing coverage, even if the high premiums are daunting. I don't doubt, however, that many of them will switch if something just as good becomes available for a lower price.

I thought this video was worth bringing up. It's former President Ronald Reagan, obviously, warning 48 years ago about the grave danger of socialism this country would face if Medicare was approved and enacted.

fRdLpem-AAs

Jonah Goldberg (http://corner.nationalreview.com/post/?q=MTIzZmZkYTdmMjQwMGY3Y2E5OTAzNTMxYzcwOWJhOTg=), of "Liberal Fascism" infamy, writes at NRO about how "fresh" Reagan's criticism of the landmark health care program is, nearly a half-century later. Jon Chait remarked (http://blogs.tnr.com/tnr/blogs/the_plank/archive/2009/07/20/a-prescient-warning-against-socialized-medicine.aspx): "This is true - but not in the way Goldberg thinks."

It's almost embarrassing to hear Reagan say all this and then realize just how off-base his arguments actually were. According to Reagan, Medicare would lead federal officials to dictate where physicians could practice medicine, and open the door to government control over where Americans were allowed to live. He also warned that if Medicare became law, there was a real possibility that the federal government would control where Americans go and what they do for a living.

Sarah Palin must have heard this speech, or her speechwriters had, as we heard this line from her last year:

"[I]f you don't [stop Medicare] and I don't do it, one of these days you and I are going to spend our sunset years telling our children and our children's children what it once was like in America when men were free."

Hindsight is pretty remarkable. We now know just how crazy his warnings were. Chait has quite a bit to say on the subject:

"You'd think conservatives would be embarrassed about this sort of talk. After all, can there be anybody who doesn't live in a militia compound who believes the passage of Medicare represented the death knell of that freedom in America? Does anybody think this business about the government dictating what city doctors live in has come true? Yet conservatives continue to trumpet it.

"Why? Reagan's diatribe is 'still fresh' because it's exactly the same sort of rhetoric conservatives employ against health care reform today. I imagine his readers are supposed to consider it 'fresh' because they're supposed to substitute 'Obamacare' in their head every time Reagan refers to Medicare. This allows them to sustain a mental condition wherein hysterical conservative predictions about the last social reform are forgotten in the specific, but remembered in the general and applied to the next social reform."

Reagan's off-base diatribe 48 years ago should also encourage hope from sensible folks, in that it also serves as a reminder that - no matter what the debate - we hear the same tired old arguments from conservatives, over and over again, every time real reform is on the table. Republicans, Fox News, and right-wing talk radio reflexively shout "socialized medicine!" just as the right has done for 75 years (http://mediamatters.org/items/200903050012?f=h_latest).

Yeah. My dad owns a small law firm dealing with developmental issues. He makes just over the 250,000 mark. But he has six employees to pay. But with the economy currently things have been bad. Just less than half of the clients aren't paying the money owed because they no longer have any. At least one employee may need to be let go and seeing as they've all worked for a long time its not simple to do. Say what you want, any tax burden will have a significant effect, adding insult to injury. Many small businesses are in a similar boat.

Although in most systems with NHS the burden is removed from employers. Here employers don't pay for employees health insurance and Medicare is funded by a levy on employees' salaries -- one percent for most.

Health care is one of the reasons I'm ashamed to be American, we've really got to be the most backward 1st world country on the face of the planet. Sad, really, when you think about the promise that this country had at the outset.

Anyway, the GOP can pout and whine about how universal health care would supposedly "lead to socialism" as much as they want, I'm still not buying it. These kiddies need to A) look up the true definition of socialism, and B) Do their research and provide examples of modern-day nations that have universal health care, and how they have fallen from grace because of it. Have these nations become cesspools of socialist regimes? No. Is the UK socialist? No. Is Canada socialist? No.

Well, I personally don't think that creating private insurance exchanges and creating a public plan to add to it, is going to make this country any more socialist than having public fire-fighters, public paid for police, military, roads, bridges or park systems.

The "socialist" scare label has lost it's power, which happens when something is over used or misused in contexts that do not make sense.

But, anyway--the proposals on the table have much more to do with regulated "private" enterprise than they do true, socialized medicine. There will be a public option--but this really isn't much different than some of the subsidies out there (but with a ton less holes and encompassing more uninsured or under-insured) already, as far as I can see.

I'm excited about the changes and looking forward to actually seeing this manifest itself in our country after so many years of just talking about it.

Huffington reports a survey carried out for the RNC that suggests 58% of Americans are in favour of a public option. They're right of course which is why the insurance industry is so scared - public competition could well drive many of them out of business.

The Republican arguments against it all run contra to the wishes of the American citizens they purport to serve. It's not "Country First" when a bunch of old dudes operate on the paternalistic idea that they know best - and we should just take whatever crumbs they toss our way. I am so fed up with conservatives, I could spit nails. They've been mouthing the same old fill-in-the-blanks-to-suit-the-occasion scripts for three-quarters of a century. And instead of leading, the U.S. has become a middling nation on every meaningful marker but military weaponry. That's sad.

I'm not a mod so I'm not telling you what to do, but I am saying that when I opened this thread I was hoping to read more posts about health care not about Republicans being wrong or whatever else you want to say about us. I dislike universal healthcare, not because I am a Republican and just want to disagree with Dems and Obama. It's because I look at the state of the government and what happens to things they run. I don't want healthcare to turn that way.

Well, of course everyone has a right to their opinion. But, as I said before, I'm looking forward and excited about health care reform. For me, this is a real concern for much of the suffering I see around...people losing their homes over bills, others losing insurance because of job loss, premiums that have exceeded their income ability or just because they have some pre-existing conditions. This is about the suffering of people who might be in a tough place, unable to get insurance and unable to do anything to find proper health treatment and even lose their lives because of it.

I look around at the world out there...at other countries around the world, and I see that other western, industrialized nations seem to be able to deal with this issue. They've all found ways to take care of their citizens basic health needs while still running healthy democracies. In my opinion, the fears of reform are unfounded in reality. While our country may have been the top in health care and medical treatment some years ago, our ratings have slipped. Infant mortality climbed among the nations and something appears to have gone terribly off course.

I do not think there is any reason, ideological or other, that our great country can't come up with a revised system of providing quality health care to its citizens that allow access to basic health care without confiscating all they own or putting them in the poor house to do so. I'm not willing to admit that we cannot do something that other countries can.

I am also very concerned with where the health care industry is heading if we do nothing. This system cannot sustain itself and is going to break its citizenry under its weight, keep self-resticting itself until only the very poor on medicaid subsidy or the wealthy who can afford premiums that reach in the thousands, will be able to access the system. We already have millions cut off from the system and that number grows all the time...putting more stress on the system, causing more bancrupcy, suffering, and a health emergency. I can see growing numbers of the uninsured flooding ERs ...and stress on the ERs forcing them to do things to stem that tide--like hospitals shutting down ERs to save themselves....prices of medical care ballooning even more, forcing premiums going even higher, more goverment debt trying to honor subsidies to a staggaring weight and then the system simply "imploding" under it's own weight.

This is a "human" issue...a compassion issue and a hole in the American roof that has been growing for some time because no one wants to climb up there and fix the darned thing. ..meanwhile, growing numbers of cold, wet suffering people below. I would caution those who think they can't lose their insurance and end up just like the shivering, uninsured sick. It's only a serious illness/accident away....or a job loss away, or a premium increase away. And...that's not right. This is a human decency issue to many of us.

Speaking only for myself, I respect those who oppose health care reform for philosophical or personal reasons. I disagree, but I can respect that it's a personal opinion and that it's unlikely to change. But, when I see statements like Demint's, it's easy to wonder whether those who oppose the current plans are doing so to try and make Obama less popular. (Kristol's statement was taken somewhat out of context - he opposes the current plans but isn't opposed to health care reform completely - so I'll focus more on Demint). Those sort of statements I think detract from the larger debate, since it makes the differences appear to have political motives rather than philosophical motives.

My wish list for health care reform:
-Modest tort reform
-Public option (note that this is NOT single-payer: single-payer implies everyone's covered by the same insurance, where even the worst-case scenarios of some opposing health care reform still have 2/3 of americans on private coverage)
-Universal Coverage
-Outlaw rescission (aka make it illegal for insurers to cut loose someone or to deny benefits based on flimsy excuses)
-Clamp down on ridiculous billing of those who have insurance (for instance, my wife was billed $450 for 3 services for a knee physical-therapy consult. She was there for 10 minutes and got a bag of ice and instructions to keep off the knee as much as possible :rolleyes:)
-Give incentives for converting from fee-for-service to "outcome-based" practices
-Make more doctors aware of the current "best-practice" research via electronic health records, etc. And, make it easier for doctors to discuss treatment options - the most aggressive or invasive option isn't always the one with the best outcome. This is not the same as rationing, although the language in the Stimulus package and the health reform bills makes some think it's rationing. It's not - the patient still can pick the more invasive or aggressive treatment, but they should be made aware of all options, not just the surgical or high-cost drug ones. Doctors, too, should be made aware of studies, especially ones that indicate that surgery and "observation" end up with the same outcomes in the end, since reducing unnecessary surgery is an easy way to reduce system costs
-Give incentives to increase the number of general practicioners and those who can practice preventative care - this lowers everyone's costs in the end

I have more, but this list is getting long already :lol:

My wish list for health care reform:
-Modest tort reform

Love your list, Chris, and agree with so much of it! I do think we need (I like how you put it) "modest" tort reform. That's something I would like to see more of in the proposals, but have not. This is something that could seriously reduce prices for everyone.

The problem is to keep people's rights to be protected against gross negligence and the worst cases of harmful malpractice, and still cut down on frivolous lawsuit (or emotionally driven, but not true malpractice) cases. Hearing about what medical professionals have to pay in the way of malpractice insurance just to be able to see patients, is just horrendous. It explains a lot about why much of the cost of care is there. The legalities of reforming this area of the medical industry is beyond my scope, however. I would love to see some bright legal minds find a way to tackle it, though.


-Public option (note that this is NOT single-payer: single-payer implies everyone's covered by the same insurance, where even the worst-case scenarios of some opposing health care reform still have 2/3 of Americans on private coverage)
And thank you for pointing this out, as well. I think it's a possible way for capitalism to still work in the health care industry, without going to a full-bore, single payer solution. This being said, I'm still a little mystified why many conservatives (no, not all) have labeled even this as "socialistic". It seems, to me, more competitive and has a true capitalistic spirit about it that I find appealing. If the current system is not working, I see the options as slim and think this is a much more elegant and modest way of improving the issue. It uses private industry and makes it more competitive (which I can understand why they might squeal about this...it may reduce their billions in profits a bit, but I do not see them going bankrupt or going in the red if they use good business practices). They've had a fat-cat run for some time now. Given the alternatives (going to a full government system or reverting to some pre-insurance system where there is no government coverage and no insurance coverage...all become equal and pay the doc ourselves, but at much reduced costs) would seem to me less attractive by far to them. If nothing is done, those things can still happen when the industry implodes and be far worse for them, truly driving them out of all existence, than what is being proposed now. I'm not opposed to a company making a profit. When their profit needs exceed benefits to a society and actually starts causing suffering, it tells me some lines need to be drawn (as has been done in history--like child labor laws, financial regulatory rules, etc.).

-Clamp down on ridiculous billing of those who have insurance (for instance, my wife was billed $450 for 3 services for a knee physical-therapy consult. She was there for 10 minutes and got a bag of ice and instructions to keep off the knee as much as possible :rolleyes:)

While I understand they use these increased fees to cover costs incurred by the unpaid/uninsured, huge medical insurance and also being denied payments from Insurance Companies/subsidies (or such reduced payments it doesn't cover their expenses in other things)...these prices also keep this horrid spiral rising.

We have joked about taking a bottle of Tylenol down to pay a hospital bill. At $5/tablet (which is what is being charged on the bill)--it will only take a large bottle or two!

They can't take payment like that because they can't afford to. Many can't afford prices like this (or fore-mentioned case) so if they are financially stressed, don't pay. It gets added to the next patients bill to make up--$6/Tylenol next time. Or, it gets tacked on and sent to someone's insurance...the cost increase spurs a "premium" increase at the other end (or, billed to a government subsidy who then has to either cut a program or raise a tax to cover, or borrow more and pass the interest to taxpayers--and the deficit) and 50 more of their clients who were on the financial edge already drop off their ranks. Begin cycle again, but one more price step up.

The cycle must be broken somewhere. It's a spiral upward that cannot be sustained.

I could go on, but will stop as ya'll probably heard enough out of me already today. Excellent post as usual, Chris.

I forgot one for my list: ban drug advertising on television and restrict it elsewhere. I bet one would be amazed at how much that'd save in the end with people not asking their doc for a prescription for a lifestyle condition they didn't know they had nor do they actually need treatment for.

I agree with that, Chris! People think they need a drug because they see it on TV. They think they have that disease. My sister is someone who wants to take medicine so she tries to fit herself into the description given in a commercial. We all have days where we feel down. That doesn't mean we need medicine for it. Plus, to be honest, I don't like seeing the commercials for STD meds or ED meds. It just makes me uncomfortable.

Don't faint, but I agree, too. It's gone too far and, in many cases, seems to have caused a plethora of "fad drugs" to treat "fad ailments". The worst is "Bob" (cringe).

I would like to see this issue addressed in upcoming legislation, because it's pretty clear this is going to continue (and perhaps escalate) if someone (the public?) doesn't put their foot down and yell, "ENOUGH ALL READY!"

I would like to see this issue addressed in upcoming legislation, because it's pretty clear this is going to continue (and perhaps escalate) if someone (the public?) doesn't put their foot down and yell, "ENOUGH ALL READY!"

Same here. I'm no television fan and only rarely sit down to watch, but I've seen those Viagra commercials and those offering new hair for bald men. If Big Pharma can afford exprensive primetime adverts, they can afford to cut the prices we pay to fill a prescription.

Those ads haven't always been on the air. I can certainly remember when they weren't. Maybe someone here knows when it became legal.

ETA:

Ah... The Prescription Drug Marketing Act (PDMA) of 1987 (http://en.wikipedia.org/wiki/Prescription_Drug_Marketing_Act_(PDMA)). Reagan.

Just thought I'd say that I applaud that list. I agree with pretty much everything on it, especially, ban drug advertising on television and restrict it elsewhere.

Anywho, in the 90s and the 80s when I did watch television a bit more, I don't recall seeing medication commercials much at all, 'cept for the normal over the counter stuff (Tylenol, Advil, Beyer, Nyquil, etc.), but I do get sick of seeing a commercial for some medication every time I turn on the television now. Like Leah I hate those ED commercials. If someone has ED, they shouldn't be looking at a commercial...they should be going to a doctor to find the cause of the ED to fix it.

I do feel that we have so many probs with Health care because of the Pharmaceutical companies. As Sheri said...if they can afford to advertise all these medications, they can afford a decent price for prescription medications.

Chris wrote
My wish list for health care reform:
-Public option (note that this is NOT single-payer: single-payer implies everyone's covered by the same insurance, where even the worst-case scenarios of some opposing health care reform still have 2/3 of Americans on private coverage)
The worry in the health insurance business is that where a mixed system is offered (as in almost all Western democracies) the private system withers on the vine - they simply cannot offer the sort of comprehensive cradle to grave health system that a public option can. In Britain around 10% of people have some form of private insurance but everybody relies on the NHS for some things (One of the queen's grandchildren was born in an NHS hospital because of complications for example)

As a foreigner I find the advertising of prescription drugs quite extraordinary - do they also advertise surgical instruments so can tell your surgeon which sort you want them to use?

You never know. They just might. "This surgical instrument is not for everyone. May cause side effects such as dry mouth, heat failure, death..." -_- Anyway, it is terrible that they keep coming up with illnesses to make people think they have something and then they get paranoid, run to the doctor, then have to get that expensive medication.

*shrugs*
We have one of the highest infant mortality rates in the modern world and we have the worst healthcare of any western nation. We work harder, die younger and spend 40% for our substandard care and after all that money we throw at the system, it's still so screwy that not everyone has coverage.
I constantly hear about all the bureaucrats that are going to "get between me and my doctor" if Obama's ideas end up in a bill, when right now the entire purpose of private health insurance companies is to deny medical care.
As it stands right now, insurance companies have an army of folks dedicated to making sure you don't get the care you need or at the very least to make sure that they don't have to pay for it, how screwed up is it that our health care industry revolves around trying to deny as much care as possible?

As if the insurance companies aren't bad enough we have a system of incentives, in the form of per diem care, that gives doctors incentives to milk every visit for as much money as they can. Doctor's aren't compensated based on the quality of their performance but by the quantity of procedures they do. So to sum it up, we're about 50 years behind the rest of the industrialized world when it comes to health care and pretty much anyone who's in a position to change anything is receiving cash from both physician and insurance lobbyists.

By the time a bill does get passed it'll be another horrible piece like the one they passed in 2003 that served only to put more money in the pockets of pharmaceutical companies at the expense of our elderly citizens.

Obama will try, but he's got to fight his own party as well as the Republican's. At least the Republican party doesn't try to moralize their position, they just repeat word for word what the guys who write their checks tell them too. You know, "single payer is bad" "government will get in between you and your doctor" "doctors won't get paid enough and then we'll have shortages" etc, etc, all stuff that's been debunked by... well every democracy in the world that's not the United States.

:relax:

Whistleblower Tells of America's Hidden Health Nightmare for its Sick Poor (http://www.guardian.co.uk/world/2009/jul/26/us-healthcare-obama-barack-change)
What is the Current System?

It is a complex mish-mash of systems. Millions of Americans have their own private healthcare plans, either individually or through their employer. About 47 million Americans have none. However, systems do exist to cover the very poor and the old. The system is fiendishly complex and full of loopholes, so even those with coverage can have it withdrawn.
How Bad is It?
US hospitals are the best in the world if you can afford them. Many cannot, and an accident or sudden illness can often bankrupt someone.
How Does it Compare With Other Countries?
It depends how you measure things. The US spends about 16% of GNP on healthcare, far more than France and Germany, which spend 11 to 12%. Yet those countries provide universal care.
What is the Biggest Problem?
Critics say the biggest issue is the profit motive that drives US healthcare. This ensures that costs are always rising as the incentive is there to provide expensive treatment. It also gives health insurers the incentive to refuse treatment to claimants, by seeking to withdraw their cover.
What is Obama's Solution? Obama has asked Congress to draw up a government option, allowing all Americans to get some sort of cover. The sheer size of the state plan should theoretically allow it to drive down costs by economies of scale.
What's Happening Now? Obama has put his reputation on the line to persuade wavering Democrats and moderate Republicans to vote on legislation by August. The Senate has said this will not happen. That's a major blow, as it puts off the debate until September and could see the political momentum stall.

I'm not a mod so I'm not telling you what to do, but I am saying that when I opened this thread I was hoping to read more posts about health care not about Republicans being wrong or whatever else you want to say about us. I dislike universal healthcare, not because I am a Republican and just want to disagree with Dems and Obama. It's because I look at the state of the government and what happens to things they run. I don't want healthcare to turn that way.

Great post! Glenn Beck has a great perspective on the issue of "Defending the R," basically saying that we need to create a new party name for those of us who are not driven "by the R," but by our values. He calls it the Common Sense Party.

It's not about Republican vs. Democrat, it's about AMERICANS -- those who stick to our founding values and those who don't.

Those values include socialised halthcare.

"In 1799 the federal government established these hospitals, or marine hospitals, in most ports throughout the country to care for sick and disabled merchant mariners. The government financed the hospitals by a tax on sailors’ monthly wages. As ships returned to port, customs officials collected the marine hospital tax and forwarded it to the federal Treasury Department in Washington, D.C. The Treasury then distributed these funds to customs officials to hire doctors and nurses to care for merchant mariners."

Sailors’ Health and National Wealth (http://www.historycooperative.org/journals/cp/vol-09/no-01/rao/)

Which is essentially how nationalised healthcare systems operate today.

It's not about Republican vs. Democrat, it's about AMERICANS -- those who stick to our founding values and those who don't.

Common sense appears to be in the eye of the beholder, I guess. As an "AMERICAN" who's ancestors fought in the revolutionary war as well as for the freedoms and democracy they won, I recognize the right to your opinion but respectfully disagree that fixing the health care system in this country somehow disregards those freedoms won. This is very much a "human crisis" issue in this country, and an "American crisis" issue. There were several versions of health care reforms represented during the last election and everyone voted their conscience, their minds and their own perception of "common sense".

Now, that we have decided on a path and direction, we debate the details of how that path is best negotiated in the best interest and spirit of the American ideal.

Frankly, I think it's wonderful that a plan has come forward that keeps the spirit of competition and capitalism involved while still recognizing the needs of the many who suffer under a system of health care that started malfunctioning and even harming many of those who it was intended to help.

I think those who built the present system did so with best intentions. But, as with many things in the world, what sometimes looks great on paper and in theory, doesn't always work in practice.

One of the great strengths of our country and it's enterprising citizens is the ability to self-analyze, pull up its bootstraps (so to speak) and take the bull by the horns and do what needs to be done, often in a way that exemplifies the American flair.

An *exchange* of private insurance in conjunction with a public plan that fills in the hole of uninsured (or uninsured) ...competition and reform to bring down costs for everyone so that it is no longer out of the reach of millions, is a wonderful solution.

We know what doesn't work now. That's something we didn't have before. We have examples all around the world of varying types of systems...some that work well, others not so, to learn from...then do what needs to be done.

That's America...I'm proud of her. I think my ancestors would be proud of her today, too.

As Wab so aptly pointed out, this is not something that seemed to be a threat to our democracy and freedoms in the past (and even our ancestors at time saw a need for similar action), but a way to release "ourselves" from burdens and issues that have been dogging our nation for some years now.

True "AMERICANS" come from all walks, backgrounds, religions and are a many octave choir of strong voices. At times it seems we are trying to drown each other out. But in the end, when the place has been found that creates the harmony--those bases and sopranos can blend in ways to make the entire chorus stronger and more beautiful and uniquely American! :)

True "AMERICANS" come from all walks, backgrounds, religions and are a many octave choir of strong voices. At times it seems we are trying to drown each other out. But in the end, when the place has been found that creates the harmony--those bases and sopranos can blend in ways to make the entire chorus stronger and more beautiful and uniquely American! :)

Great post, Red.

One of the wonders of our country's founding is that no one individual, or political party, gets to define what constitutes "founding values" and what doesn't. Those men were liberals and conservatives who found a common place from which to build a nation. They set an example that people today find difficult to emulate. I don't believe they ever expected this.

Does anyone know when, precisely, the idea that government is somehow "bad" came into the American political lexicon? I have my own ideas on the subject, but I'd love to hear what the rest of you think.

Getting back to health care, it's going to pass one way or another. The public wants it (http://www.slate.com/id/2223560/?from=rss), for one thing, and regardless of what the right would have you think, they are a decided minority with a disproportionately loud voice.

The pundits can write all they want, but I don't believes it's particularly dark for health care. It's worth making one point on the White House's decision to largely hold the president in reserve until this past week, and its legislative hardball until conference committee: This isn't a new strategy.

Anyone who watched Obama during the campaign last fall won't be surprised at me saying that. This president and his administration have made a fine art of holding our fire long past the point where people are screaming for Obama to enter the fray. We take the long view, identify the point of maximal impact, and ignore the calls to respond to bad news cycles that precede that chosen moment. That leaves a lot of people in apoplexy at times, but no one can deny that it hasn't worked well for us so far.

Anyone who has any doubts of the need for wholesale reform could do worse than read the testimony of Wendell Potter (http://commerce.senate.gov/public/_files/PotterTestimonyConsumerHealthInsurance.pdf) before the U.S. Senate Committee on Commerce, Science and Transportation.

An senior executive in the health care industry ("the most expensive and one of the most dysfunctional in the world") for more than 20 years, Potter describes practices that are ethically bankrupt but legal, particularly rescission (cancelling policies on piddling technicalities) and purging (dumping firms whose employee's claims exceeded what was expected).

"What we have today, Mr. Chairman, is a Wall Street-run system that has proven itself an untrustworthy partner to its customers, to the doctors and hospitals who deliver care, and to the state and federal governments that attempt to regulate it."

Slate (http://www.slate.com/id/2223680/) cites two of the more egregious examples of rescission:

Robin Beaton -- a retired nurse rescinded by Blue Cross and Blue Shield after she was diagnosed with an aggressive form of breast cancer because she had neglected to state that she had been treated previously for acne. Her congressman intervened but her operation was delayed five months, vital in treating cancer.

Otto Raddatz -- rescinded after he was diagnosed with non-Hodgkins lymphoma. Fortis said this was because Raddatz had failed to disclose that a CT scan four years earlier had identified that he had an aneurism and gall stones. Raddatz had never been told about these conditions (his doctor said they were "very minor" and didn't require treatment). Fortis refused a payout until the state attorney general intervened. The delay in treatment eliminated Raddatz's chances of recovery, and he died.

Here is an intriguing bit of commentary I read earlier today (although it's almost a week old).....

http://news.bbc.co.uk/1/hi/programmes/world_news_america/8164210.stm

The interesting bit, I thought, was this one:

(Matt Frei, BBC US correspondant)

(talking about anti-reform ads...)
... The people these ads are aimed at are the ones who cannot see what is in the reform for them.

But what is in it for them, potentially, is a huge saving.

It is calculated that the annual cost of health insurance is nearly $6,000 per capita; that is nearly twice as much as France or Germany where the majority of citizens are satisfied with their care.

Since the money is deducted from Americans at source, they never really feel the pain of the cost and they rarely see how it breaks down. This has made them lazy.

America is a country where people are forever chasing deals, shaving margins and measuring bangs for bucks. And yet this country is curiously lax when it comes to the household cost of healthcare, its second biggest annual expense after the mortgage.


This is something I have been wondering about. There are so many things (many outlined by Chris above) which add extra cost to US health care, without adding extra services or quality.

And everyone with an insurance policy pays that cost. The small employers everyone is worried about (and rightly so) find those health plans unaffordable because the system is so geared towards adding useless costs. And of course, indirectly, those people with insurance have to be milked to pay for those who don't.


Everything that people criticise about the potential reformed system seems to be here already, just in a very untransparent way.... and for that reason also nreasonably expensive.

I can understand the ideological disagreements about the exact way of getting this done - but, like Matt Frei, I can't understand why people don't get the common sense notion of avoiding the incredible waste of money that's going on at the moment.

Slate (http://www.slate.com/id/2223680/) cites two of the more egregious examples of rescission:

Robin Beaton -- a retired nurse rescinded by Blue Cross and Blue Shield after she was diagnosed with an aggressive form of breast cancer because she had neglected to state that she had been treated previously for acne. Her congressman intervened but her operation was delayed five months, vital in treating cancer.

Otto Raddatz -- rescinded after he was diagnosed with non-Hodgkins lymphoma. Fortis said this was because Raddatz had failed to disclose that a CT scan four years earlier had identified that he had an aneurism and gall stones. Raddatz had never been told about these conditions (his doctor said they were "very minor" and didn't require treatment). Fortis refused a payout until the state attorney general intervened. The delay in treatment eliminated Raddatz's chances of recovery, and he died.

These cases are shocking.

See, this is why I really don't understand why some people in the US who are against "socialised" medicine cite the UK NHS as a terrible system where people die because they have to wait months for operations or scans (in fact, cases where waiting lists lead to death or serious complications are very rare in the UK - people with life-threatening conditions, or obvious symptoms thereof, usually get seen extremely quickly).

It seems, from what you've posted, that people in the US also die because they have to wait months for operations.

I have no real opinion on how the US ought to organise its health care, because it's not my country, but it does annoy me when US lobbying groups try to use the UK's system as an example of the "evils" of a public health system.

As I see it, every health system in the world rations care, to some extent or another. No system is perfect, and there will be winners and losers, and mistakes made, under any system. I'm very glad that I live in a country where the rationing prioritises those who have the greatest medical need and the best chances of recovery, not those who can pay the most or who have the best insurance deal.

Anyone who has any doubts of the need for wholesale reform could do worse than read the testimony of Wendell Potter before the U.S. Senate Committee on Commerce, Science and Transportation.
:wow: definitely an eye opener, Wab. Thanks for posting the link.

Everything that people criticise about the potential reformed system seems to be here already, just in a very untransparent way.... and for that reason also unreasonably expensive.

Exactly! People who do not wish to be taxed extra to pay for the uninsured...already are paying for the uninsured (and at a greater cost than they should be). Let's get those costs lowered and above board instead of hidden in hospital prices, premium rates and tax programs (like Medicare tax). Americans...we are already paying and it's far more than you think.


It seems, from what you've posted, that people in the US also die because they have to wait months for operations.
ahh...and even worse in some areas of the country where medical care cannot even be accessed if one has no coverage. ...no doctor will take you and even county hospitals who are supposed to take in everyone, will deny treatment to the uninsured.

The "crack" people--the ones who are not poor enough for medicaid/care but do not make enough to afford private insurance (or are lucky enough to have an employer that provides it) are truly on their own. You can imagine the mortality rate among this group.

I've talked to many in the ER of late, some of which were so afraid to go to an ER they nearly didn't for life-threatening illness. The reason? They didn't want to leave their families bankrupt, have their homes taken from around their children. A simple ER visit cost about $1K just to walk through the door. Expenses for the uninsured patient can climb very quickly in an emergency situation into the tens and hundreds of thousands of dollars.

I have to wonder how many people die simply because they choose to stay home, knowing they cannot pay and the family left will lose everything if they live?

This cannot humanely be allowed to continue...in any country, especially a great one like ours. The current estimate is 47 million people in this category, and the number increases every year.

Here's a link to a story about the little boy I mentioned earlier, who died of a severe brain infection brought on by an abscessed tooth.

Child Dies for Lack of Dental Care (http://www.associatedcontent.com/article/163856/child_dies_for_lack_of_dental_care.html)

ETA:

How do you square partisans telling lies, especially when they are representatives in the House?

In this case, we have Rep. Virginia Foxx (R-NC) saying on the House floor that health care will "put seniors in a position of being put to death by their government."

hea-4VJZXRE

It's not true.

See, this is why I really don't understand why some people in the US who are against "socialised" medicine cite the UK NHS as a terrible system where people die because they have to wait months for operations or scans (in fact, cases where waiting lists lead to death or serious complications are very rare in the UK - people with life-threatening conditions, or obvious symptoms thereof, usually get seen extremely quickly).


This is particularly infuriating, not least because we do have genuine problems with our own highly politicised health system however, the accusations that are levelled against the NHS are almost entirely unsubstantiated or heavily doctored.

Here's the latest from Gallup on what Americans think of the merits of the Obama plan:
Benefits of Healthcare Reform a Tough Sell for Americans (http://www.gallup.com/poll/121943/Benefits-Healthcare-Reform-Tough-Sell-Americans.aspx)

Less than half of Americans (44%) believe that a new healthcare reform law would improve medical care in the U.S. Americans are also more likely to believe reform would increase rather than decrease costs nationally and personally.

And Obama wonders why Congress is telling him "No Sale" on his healthcare plan?

Or, is it that Obama has ceded too much decision leeway to Pelosi and Reid? People don't have much faith (http://www.gallup.com/poll/121916/Two-Three-Doubt-Congress-Grasp-Healthcare-Issues.aspx)in the Dem-controlled Congress where healthcare is concerned.

Whatever it is, Obama and the Dems don't seem to be on the right stack of mail.

I think John McCain has it right (http://www.johnmccain.com/issues/details.aspx?id=9): let's fix and reform the aspects of the current system that aren't working well.

"the right reforms protect our American freedoms rather than creating new government controls and harness the market forces that are the hallmark of our economy: competition and choice. He believes you will know these reforms have succeeded when Americans can access affordable, quality health care coverage that meets their needs, not controlled by the federal government or only available if their employer happens to be able to provide it."

Maybe Obama is governing based on what is right, not what is popular in the polls. (At least that's how supporters of the last lot justified G.W.'s pursuit of unpopular policies.)

Stayin' the course.

I can understand the ideological disagreements about the exact way of getting this done - but, like Matt Frei, I can't understand why people don't get the common sense notion of avoiding the incredible waste of money that's going on at the moment.

The donkeys and the elephants both agree that healthcare is a money pit. No one denies that. It is the way that it is being done with the deficit already huge. As proponents of the plan have pointed out we spend more per American and recieve half the care. All fine well and dandy but much of the things that need reform have nothing to do with socializing medicine and everything to to with improper management, fraud, waste and lack of accountability. And that doesn't go just for healthcare but with every major problem facing the country.

Time has a great article that lists five hurdles (http://www.time.com/time/politics/article/0,8599,1912920,00.html)the healthcare plane faces---not just from the Reps but from within it's own party. Does it not worry people that a party cannot seem to unite? Does that not point out intrinsic flaws in the plan? As far as cost savings go I think this is one of the main sticking points:

The CBO acknowledged that the savings could turn out to be higher in the long run, but that qualifier highlighted one of the biggest problems for health-care-reform backers: the potential cost savings of overhauling the entire health-care system are unknown and impossible to predict with any accuracy. The CBO, for instance, has no real way to determine how much investments in prevention might save down the line.

Bold mine. It could save more than the CBO estimates or it could not. People are unwilling to take any sort of chance like that with the economy on the tank, imo. And it raises the issue that if the CBO, with all it's resources, can't make a prediction then how can we expect the legislators to?

Still, Democrats have said they won't pass anything that isn't fully paid for, and finding the money to plug an estimated $200 billion–to–$320 billion shortfall has been particularly tough.

I'm amazed at the lack of budgeting skills these people seem to have. To make a budget work you look at the money coming in and craft your expenses to meat that intake. You don't spend money that you don't have. That's what put the economy in this mess to begin with! Honestly if passing the bill is "an emergency" then perhaps they ought to find a way to knock out 320 billion. If the bill won't work without that money then it's not an emergency in my opinion.

The legislation includes provisions for a public plan, but such an approach would be triggered only if the co-op plan doesn't prove to work in certain states or locales — a backup model based on President George W. Bush's Medicare Prescription Drug Plan. Many wonder if that will garner enough votes in the Senate, since it will most likely lose votes from both ends of the spectrum.

Okay I just found the above funny after all the Bad Bush Mantra. If it fails we'll just fall back on the same old same old. :lol:

The House, for example, envisions giving insurance to about 10 million currently uninsured by broadening the guidelines of Medicaid, the state/federal program for the poor. The problem is that many governors of already cash-strapped states are voicing their opposition to this proposal; while the current bill says Washington would foot the bill for these new Medicaid enrollees, states that are having a hard enough time as it is paying their share of the program are wary of what might happen several years from now. At the same time, Blue Dogs in the House are upset at some of the proposed cuts to Medicare insurers. They worry that these cuts will lead to a dangerous decrease in Medicare services in already underserved rural areas.

Bold mine. Again, we have this unease due to the unknown. There is simply no way to predict the future. You can hardly blame legislators for being cautious when their states are already on the brink.

Here's another excellent excerpt from a different Times (http://www.time.com/time/politics/article/0,8599,1912283,00.html) article. That illustrates hy people are having misgivings even if they can't articulate it the way they would like.

What sacrifices will Americans have to make under his proposals? Why hasn't the White House been more transparent about the policymaking process, as then candidate Obama promised? Would he insist that members of Congress face the same limits on choice and access to care as the people getting their insurance from the new public health-care plan he advocates? Those were among the excellent questions hurled at the President, and he countered only with partial responses and vague rhetoric.

Can people honestly say that Congress or Obama would gladly do that? If they would I'd certainly be more open to the idea.

Wab, I love you. :lol:

Idiotic comments like the one Rep. Foxx made about the government putting people to death, specifically related to seniors with terminal illnesses, has had some negative impact - which is why the president spoke before the AARP this week. They'll get the message out a lot more effectively than the fear-mongerers.

Does it not worry people that a party cannot seem to unite? Does that not point out intrinsic flaws in the plan?

No and not at all.

The Democratic Party is far more diverse than the Republican Party. We are, as I've said before, a quarrelsome lot that runs the gamut from conservative to ultra-liberal. The President has empowered them to do what our founding fathers intended Congress to do: draft and pass legislation. This was not the case during the Bush administration when the majority of the legislation was written by lobbyists according to deals struck with the White House. That's why Congress was considered a White House appendage in those days.

This group of Democrats is full of ideas and legislators are vying to get his or her preferred plan deemed "It." I am not worried about health care. Honestly. It will be accomplished this year.

Maybe Obama is governing based on what is right, not what is popular in the polls. (At least that's how supporters of the last lot justified G.W.'s pursuit of unpopular policies.)

Stayin' the course.

Or maybe this illustrates that what is right does not fall along partisan divides. Simply put people don't care who is in office as long as they have good quality of life. The hypocrisy of the left is mind boggling. They are willing to poll the public when it is convenient and disavow them when it's not.

This is particularly infuriating, not least because we do have genuine problems with our own highly politicised health system however, the accusations that are levelled against the NHS are almost entirely unsubstantiated or heavily doctored.
It's because the NHS is so politically centralised - if you don't like the government (any government) you can always beat them over the head with a specific case from the NHS - in an organisation that large things will go wrong in some places some of the time. At the moment it's the Mail and the Express because they hate Labour - after the election it will be the Mirror because they will be the government. For reasons I don't understand some people believe the nonsense even though their personal experience of the system is that it works very well

Even when the government tries to keep it at arms length as with NICE (National Institute for Clinical Excellence) the media will attack. So when NICE establishes that some highly promoted and expensive new drug is merely a generic (much cheaper) drug slightly altered and with no extra clinical benefits the media will complain that care is 'being rationed' etc.

The hypocrisy of the left is mind boggling. They are willing to poll the public when it is convenient and disavow them when it's not.

Oh, I think they maintain a close eye on what the public thinks. There is also the not-so-little matter of this:

• The 40 Republican senators currently in the Senate, all of whom are expected to filibuster a public option, received 44.2 million votes in their elections.

• The 5 Democrats (Conrad, Baucus, Lincoln, Landrieu, and Nelson) who seem most likely to filibuster health care reform including a public option received 2.5 million votes in their elections.

• The remaining 55 Senators (53 Dems plus Lieberman and Sanders), all of whom would likely vote for cloture on a reform plan including a public option, received 79.8 million votes (this includes votes cast for the Democratic predecessors in CO, NY, IL, and DE).

79.8 million Americans is a pretty impressive supermajority, eh?

Figures from Daily Kos (http://www.dailykos.com/storyonly/2009/7/28/758546/-The-real-supermajority).

ETA:

Yuck. Dishonesty abounds.

In recent days, a new right-wing scare tactic on health-care has blossomed on conservative blogs and emails lists: the notion that the reform bill making its way through the House would lead to euthanasia by requiring senior citizens to submit to "end-of-life consultations."

It won't surprise you to learn this is a lie. But President Obama just got a question on it at a public event. And the idea has now made it into Politico, where a straight news story asks in its headline, all even-handed: "Will proposal promote euthanasia?" Since Politico thinks it'll be easier to "win the morning" by misleading readers into believing there's a legitimate debate over this issue, it's worth taking a minute to debunk it.

In fact, Politico's story contains pretty much all the information needed to do that. It's just that almost none of it makes it into the headline, or the first seven paragraphs of the piece, which focus on the fact that Sean Hannity, Rush Limbaugh, John Boehner, Eric Cantor, and other reforms opponents are raising the euthanasia alarm.

And here I was, just starting to like Politico again. :hmm:

Debunking The GOP's Phony Euthanasia Myth -- Since Politico Won't (http://tpmmuckraker.talkingpointsmemo.com/2009/07/debunking_the_gops_phony_euthanasia_myth_--_since.php?ref=fpa)

Polls, and it seems, voting numbers can be manipulated to fit the conclusion that people already want to make. How does that compare to the total number of voters?

I want effective health care reform, and I'm not afraid of the public option or government-run health care, but I respect those who think that the government screws up anything it ever does. I think that there have been so many government programs and initiatives over time that people on both sides of the debate can draw up endless lists of programs that have and have not worked.

Regarding the "unknown" factor in health care reform cost, I prefer to look at it this way: the current system is unsustainable over the long run. The Democrats are working on multiple drafts of plans to try and address this, and to be kind to everyone's neighbor and get them coverage in the process. If the Republicans have a better idea to accomplish both cost control and universal coverage, by all means, let's hear it. If a counterproposal, well fleshed-out (instead of just a few pages or an outline), is presented, it would go a long way towards combating the impression that's easily left that they are saying "no" for political rather than philosophical or personal reasons.

*insert radio facts, haven't been able to fact-check so can't speak truly for the reliability of them: Tort reform (which I am in favor of) would only address about 1% of the cost on the system. Thus, there needs to be more. And, ~160 amendments have been accepted by the bill makers in either the house or senate, and it was implied that many of them were proposed by Republicans - so apparently behind the scenes they are getting a say in things.

Can't take credit for this idea, but I saw a suggestion that part of the revenue generation for paying for reform could come through a tax on the profit that online casinos make. This would of course be paired with clearing up the legal issues surrounding online poker (another issue for another time!!), but I really liked that idea. Don't know how much it could generate, but it'd be another revenue source that I doubt would meet the same opposition as, say, a tax on high-end health care benefits (Sen. Kerry's idea).

Or maybe this illustrates that what is right does not fall along partisan divides. Simply put people don't care who is in office as long as they have good quality of life. The hypocrisy of the left is mind boggling. They are willing to poll the public when it is convenient and disavow them when it's not.

:tu::tu::tu:

Or maybe this illustrates that what is right does not fall along partisan divides. Simply put people don't care who is in office as long as they have good quality of life. The hypocrisy of the left is mind boggling. They are willing to poll the public when it is convenient and disavow them when it's not.

I agree, and this is what I have deduced as well in regards to polling and what we are TOLD is the "public opinion." It's like asking people in Florida what think about what's happening locally in Alaska, then saying it's what "the nation" thinks.

This is, again, why the battle lines are drawn so deep between political parties. A two party system is VITAL in our government's system, but I almost feel like we need to abandon the names for awhile because it is clouding EVERYTHING and causing people to act irrationally and hold up legislation because of petty differences like what letter, D or R, comes after your name.

I get so frustrated when I hear Congressional Democrats say that Republicans are not working toward a non-partisan decision and just saying "no" to everything because they are sore losers. The reality is that Republicans in Congress have fundamental disagreements with the legislation that is being plowed through, yet they are not truly able to voice their dissention without being accused of being petty.

For those who for the Health Care Bill (or whatever it is called) can you tell me what you like about it?

Regarding the "unknown" factor in health care reform cost, I prefer to look at it this way: the current system is unsustainable over the long run.

Indeed. But what is that old proverb? Better the enemy you know than the enemy you don't?


If the Republicans have a better idea to accomplish both cost control and universal coverage, by all means, let's hear it. If a counterproposal, well fleshed-out (instead of just a few pages or an outline), is presented, it would go a long way towards combating the impression that's easily left that they are saying "no" for political rather than philosophical or personal reasons.


Chris, I know you are liberal but try very hard to see both sides. However this remark, to me, is typical of this dispute. If you know so much better then why don't you do it? It's my opinion that the GOP ought to out with the truth. That out nation is large and our government is large and it'll take more than a few months in office to figure out the best solution. Of course that would totally ruin the next election. Since swift action is what usually tips the favor for one candidate or the other. Unfortunately swift action more often compounds the problem. Just taking a look at the Bush admin can verify that statement. Still they want to reserve the right to say it in the election and win the day. Conversely the Dems will do everything in their power to squelch that very thing. It's a no win situation, imo. But the villifying of one side by the other is just plain ridikkulus ;) . It doesn't matter, to me, that the Reps don't have a "well thought out plan" it doesn't mean that this plan is good.





*insert radio facts, haven't been able to fact-check so can't speak truly for the reliability of them: Tort reform (which I am in favor of) would only address about 1% of the cost on the system. Thus, there needs to be more. And, ~160 amendments have been accepted by the bill makers in either the house or senate, and it was implied that many of them were proposed by Republicans - so apparently behind the scenes they are getting a say in things.

Yeah behind the scenes does alot for their public image. ;)



Can't take credit for this idea, but I saw a suggestion that part of the revenue generation for paying for reform could come through a tax on the profit that online casinos make. This would of course be paired with clearing up the legal issues surrounding online poker (another issue for another time!!), but I really liked that idea. Don't know how much it could generate, but it'd be another revenue source that I doubt would meet the same opposition as, say, a tax on high-end health care benefits (Sen. Kerry's idea).

Tax tax tax. Ugh. I say budget! If you must break up the bill into installments. We only have the revenue for x amount of dollars. As a first step we will enact the most important parts of the legislation. When the economy begins to recover we will enact the next step. etc etc etc This way Obama can say that nothing was rushed through. Time to implent key components were established. Have more concrete numbers under his belt. Can reduce the tax burden in the initial stages. And if it is not fully complet by th end of his first term point to the successes already achieved in his relection campaign.

I was inspired primarily by reports (linked earlier) that the Republicans have a plan, but they may never unveil it. That and the unfortunate remarks of Inhofe and Demint were what made me note that the Republicans are making it easy for those who are in favor of reform to paint the opposition as being political and not philosophical. I do actually think that it's a philosophical disagreement, but I think that Republicans would do well to make sure that the message that's going out there is such.

Regarding taxing the casino profits - the way I figure, the online casinos would benefit from clearing up the current confusion and they'd get an increase in new players anyways, so if they lose a bit of the profit (I'm specifically saying "profit", not "revenue"), then I doubt they'd be too sad.
Then again, the likelihood of this idea ever coming to fruition is 0.01%, so it's more of a pipe dream for me now :D.

My impression of the current bills is that most of the implementation is timed for 2012 to 2013 - the economy should be more stable by then. Thus, in my view, they may already be doing what you propose - implementing it in installments. They just wrote one bill with the installment plan.

And, for me, my philosophy is the opposite sort of proverb: if you never try to change what's wrong, you'll never fix it. You have to take the risk to reap the reward.

Indeed. But what is that old proverb? Better the enemy you know than the enemy you don't?

Hmm so ousting Saddam and working against Kim and Ahmedinejad are bad ideas? Interesting.

I suppose with that outlook much money could be saved in State. All ambassadors could be recalled and staffs stripped to a few consular officials to help dopey tourists.

Of course had this been the prevailing attitude in 1776 imagine how much trouble could have been saved.

I was inspired primarily by reports (linked earlier) that the Republicans have a plan, but they may never unveil it. That and the unfortunate remarks of Inhofe and Demint were what made me note that the Republicans are making it easy for those who are in favor of reform to paint the opposition as being political and not philosophical. I do actually think that it's a philosophical disagreement, but I think that Republicans would do well to make sure that the message that's going out there is such.

Since very few people have backed Demint in his statements (I'm unfamiliar with Inhofe) means, to me, that again the left media are blowing things out of propotion. If the GOP went around trying to put out every fire that springs up they'd really look like they have something to hide. The best they could do is keep on working hard.



I was inspired primarily by reports (linked earlier) that the Republicans have a plan, but they may never unveil it.

Typical. :grumble:

Regarding taxing the casino profits - the way I figure, the online casinos would benefit from clearing up the current confusion and they'd get an increase in new players anyways, so if they lose a bit of the profit (I'm specifically saying "profit", not "revenue"), then I doubt they'd be too sad.
Then again, the likelihood of this idea ever coming to fruition is 0.01%, so it's more of a pipe dream for me now .

I think casino's, online or otherwise, would oppose any new tax or regulation on them. Once the foot gets in the door and all that.

My impression of the current bills is that most of the implementation is timed for 2012 to 2013 - the economy should be more stable by then. Thus, in my view, they may already be doing what you propose - implementing it in installments. They just wrote one bill with the installment plan.

Then they ought to be clearer in the media and also have a plan in place if their criteria for each new stage is not met.


And, for me, my philosophy is the opposite sort of proverb: if you never try to change what's wrong, you'll never fix it. You have to take the risk to reap the reward.

Very true, but in this case you are talking about a whole nation not an individual. If this plan fails more than just a few lives will be effected. There are some remedies, after all, that are worse than the disease. :lol:

Hmm so ousting Saddam and working against Kim and Ahmedinejad are bad ideas? Interesting.

I suppose with that outlook much money could be saved in State. All ambassadors could be recalled and staffs stripped to a few consular officials to help dopey tourists.

Of course had this been the prevailing attitude in 1776 imagine how much trouble could have been saved.

Interesting that you would only choose one line out of a whole post...

Regardless, there are grains of truth in every proverb when applied in certain circumstances. Follow that with the fact that the solution to one problem is not the solution to to the nextand it's not hard to see where one is coming from. If you choose to tar me with a broad brush that limits you, not me.

If saying that makes you feel better, fine by me.

But the quoted line was your response to Chris's comment about maintaining an unsustainable system which you were content to keep because it was better than the devil you don't know (to use the original proverb).

And my point remains, change takes courage which seems sadly lacking.

If this plan fails more than just a few lives will be effected.Sure, but how many lives would be effected by not doing anything?

I have the impression that quite many of our posters, also some conservatives, agree that the present system is not good. I believe it's better to do something and improve it when it becomes clear what parts are not too good than squabble endlessly while doing nothing at all.

Speaking about proverbs: Rome was not built in one day.

If saying that makes you feel better, fine by me.

Then perhaps you could move on?


But the quoted line was your response to Chris's comment about maintaining an unsustainable system which you were content to keep because it was better than the devil you don't know (to use the original proverb).

And we were talking about health care. I'm fiscally conservative, socially liberal. Call me crazy but I think the two can be married. All your examples were far off the mark in my own political views and belong in other threads.


And my point remains, change takes courage which seems sadly lacking.

I sincerely hope that you are talking of the GOP and not me individually correct? It also takes courage to right one's wrongs rather than scrapping it because you just don't like the results.

Sure, but how many lives would be effected by not doing anything?

Well that is why it is called philosophy. Nobody is advocating "doing nothing". I am only advocating doing differently.

Speaking about proverbs: Rome was not built in one day.

Quite true, so why the rush. Why, all of a sudden, is it a national emergency? Why must we impose unrealistic deadlines? Especially when we can see from other legislation that has been run through too quickly the negative results?

Listen, we are debating philosophy which is easier to do than debating merits. We are in a deficit and the bill costs money we do not have. There is no certainty that an overhaul will work and everything from medicare to tort reform is being disagreed upon, not just by the Reps but by the Dems too. In the links I shared above I deliberately did not quote things for which I feel are minor (the White House not playing enough of a role for instance). In my discussion with Chris I acknowledged the GOP lack of bringing about a better offer, but like it or not it's really the Dems boat to float. People want change, and they want it fast. It's an unrealistic expectation but it is there none the less.

Flims, your argument falls flat on its face when documents are leaked that say in no uncertain terms that the GOP's strategy is to "go for the kill (http://www.weeklystandard.com/weblogs/TWSFP/2009/07/kristol_kill_it_and_start_over.asp)" on health care, because its passage will make the Party's return to power more difficult.

A Party that is more concerned with its own prospects than those of the American people, some of whom are already in dire need of relief on health care, isn't going to win a lot of friends with a message like that. Moreover, Kristol's comment that members of our Armed Forces deserve top notch health care - while the average American does not - is an awfully hard thing to talk back.

I'm pleased to say late-breaking news has rendered one of my gripes invalid:
House Republican plan (http://www.foxnews.com/politics/2009/07/29/house-republicans-release-b-health-care-plan/)
Fox News and MSNBC both have some variation of this story up online, so CNN wins the "you're too slow" award.

I recognize the reality that the Republican bill won't make it to the signing desk of Obama. But a couple of their ideas seem to have found partners in the Blue Dog / Waxman compromise (http://www.foxnews.com/politics/2009/07/29/blue-dog-democrats-announce-deal-health-care-reform/) reported earlier today, in particular, people appear to be able to "opt-out" of buying coverage. And the Blue Dog deal raised the limits to 500K payroll before insurance offering is "mandatory".

Distractions by other issues seem to have taken away some of the "Waterloo" type of talk, so that seems to be muting another of my gripes. That, and Senators like Jon Kyl have come out and said "that's not helpful".

Thoughts on the plans? To the best of my knowledge the CBO hasn't scored either one; the latest score I'm aware of is for one of the Senate bills, and the cost of that appears to be 900ish billion.

Quite true, so why the rush. Why, all of a sudden, is it a national emergency? Why must we impose unrealistic deadlines? Especially when we can see from other legislation that has been run through too quickly the negative results?Obama explained quite simply why there are deadlines. Otherwise it will never get done since it's easier to do nothing. I've just seen several interviews with lawmakers who said that they've had lots of time and nothing has been rushed. The only complaints about rushing have been from people who don't want reform or only tepid "reform" that is really window-dressing. They are hardly reliable on this subject.

Sort of a tangent from our discussion here but interesting (http://news.yahoo.com/s/ap/20090729/ap_on_re_us/us_medicare_fraud). Glad to hear that the Holder stepped up the program started under the Bush admin to combat fraud. The $ amount for the cases is low compared to the cost of reform, but if it prevents more fraud and they recover some $ and / or stop the fraud in process, then that's only a good thing, IMO.

Obama explained quite simply why there are deadlines. Otherwise it will never get done since it's easier to do nothing. I've just seen several interviews with lawmakers who said that they've had lots of time and nothing has been rushed. The only complaints about rushing have been from people who don't want reform or only tepid "reform" that is really window-dressing. They are hardly reliable on this subject.

I see a contradiction here which is of great concern. One of Obama's campaign promises was to make government more thoughtful, transparent, and accountable. However, I do not believe that blasting a very important bill through Congress and pressuring its members to speed up the process is a step in that direction. That type of pressure sounds like something from a person who is trying to hide something or make it a law before anyone notices the true meaning.:no:

I see a contradiction here which is of great concern. One of Obama's campaign promises was to make government more thoughtful, transparent, and accountable. However, I do not believe that blasting a very important bill through Congress and pressuring its members to speed up the process is a step in that direction. That type of pressure sounds like something from a person who is trying to hide something or make it a law before anyone notices the true meaning.:no:

I've had no problem with the transparency so far, personally. If you go to www.whitehouse.gov there are many links to what is going on a multitude of issues.

As far as rushing, this has been in the works and batted around for decades. Far from a thrown together piece of legislation, groups of legislators have been working for months in committees. Two bills, one in the house and one in the senate, have been drawn and points debated on every news outlet around (not to mention the internet and blogosphere). This issue has had such a bright spot light on it for quite some time, that I doubt there is anything about the issue that has not been questioned.

Obviously, this is a work still in process so some things cannot be answered because they are still hammering out the dings and bumps.

And as far as deadlines requested, it is well known that the first year is when all presidents address the most pressing legislation, especially if they feel it will be hotly contested. Good will is at a high. In this case, we also have a growing bubble in health care and we do not really know when it will burst (my opinion) like the credit/bank bubble did or the housing bubble did. So, time is ticking.

Add to that there are millions of Americans without insurance at high risk financially (and physically in many cases) and many more Americans who are under insured, and this is adding to the financial crisis. Figures have been posted in these threads about how bankruptcies and foreclosures have increased due to medical bills. When so many Americans could use some breathing room, this is the time to start relieving some of those pressure valves on the economy. Sick people may be able to get back to work, pay taxes, pay down their debts (if they don't have thousands in uninsured/under-insured medical bills to pay off) and be a part of the solution, rather than the problem.

Seems like the perfect time to me. How many more decades do we need to think about this?

There are like three separate bills floating around; Tri-Committee Health Reform Bill, the Senate Bill, and the Kennedy bill. All three are different.

More on Health Care Reform (http://scienceblogs.com/whitecoatunderground/2009/07/more_on_health_care_reform.php)

Health Care Reform Part II (http://scienceblogs.com/whitecoatunderground/2009/07/health_care_reform_part_ii.php)

If it's good enough for our military...

.

Apologies...I stand corrected :blush:

The Tri-Committee Health Reform Bill appears good on the surface, but I am not too keen on the underlying wording. Though I have not been able to read the whole layout, I have spotted some pork-barrell spending imbedded within the writing.

On principal I won't support any bill that deviates one bit from healthcare, and redirects to any other program. This legislation will be far too important for riders, and unrelated or quazi-related funding. As if the plan won't be convoluted enough, the last thing we need is earmarks on this.

I am sure Obama is pushing on this because he does not want the issue to disappear into the sand as Clinton's efforts did. When facing radical change in any field the best thing the opponents can do is to play a long game.

Personally i believe you will get change the moment it is made illegal for the insurers to fund politicians or political causes.

I wish it was illegal for insurance companies to turn down people just for having a pre-existing condition...

I don't have much faith in the cries to "slow down" on health care. As several others have mentioned, the issue has been on the table for decades. Reminds me a bit of the passage of the Civil Rights and Voting Rights Acts in the mid-60's, when conservative legislators were urging for more time because "people weren't ready."

I wish it was illegal for insurance companies to turn down people just for having a pre-existing condition...

I do too. I could see having higher premiums because they are obviously greater risk but they should never be denied coverage....

The only complaints about rushing have been from people who don't want reform or only tepid "reform" that is really window-dressing.

I don't agree with this. People who are complaining about rushing are those who don't want the wrong reforms implemented simply for the sake of saying that some meaningless deadline was achieved. Their concerns are genuine.

Healthcare reform is a big deal with a big price tag, and many (including myself) don't think we can afford the Obama Big Government solution.

I am bothered, but not surprised, by Obama's abject lack of concern regarding the defecit. One day he says we are out of money (true!), the next he proposes spending $1 trillion (according to the budget office) on healthcare! The man seems completely tone deaf (or incompetent) when it comes to spending.

I believe the polls that suggest most Americans want healthcare reform. I do, too. But we should reform only that which we can afford. And, as much as I disagree with wealth redistribution, it might not be enough to offset what could very well be a sum which exceeds any estimate we've seen to date.

This isn't like spaghetti you toss against the wall to see what sticks and what doesn't. We could put ourselves in a massive financial hole that we might not be able to undo.

This is why I prefer to see a slower reform, with sharp focus on cost containment early on. This will help drive down the price of healthcare. From there, we can have a better idea of the organic costs that need to be rationalized to help improve coverage and quality.

Healthcare reform is a big deal with a big price tag, and many (including myself) don't think we can afford the Obama Big Government solution.
Correction, Government Option. You just can't seem to grasp that.

I am bothered, but not surprised, by Obama's abject lack of concern regarding the defecit. One day he says we are out of money (true!), the next he proposes spending $1 trillion (according to the budget office) on healthcare! The man seems completely tone deaf (or incompetent) when it comes to spending.
As tone deaf as many right-wingers were when Bush was president.

Any right-winger concerned about spending now is just hypocrisy as usual.

:relax:

I do too. I could see having higher premiums because they are obviously greater risk but they should never be denied coverage....Hey I wasn't denied coverage. Except, my insurance jumped from $100 a month to $1000 a month when I had to convert from a group plan to private insurance. It was the same as denying it since I couldn't afford it. And I've heard generic suggestions about tax credits and subsidies to help pay for costly insurance (Bill Kristol mentioned them when he described how great a public insurance plan the military received). But if insurance rates don't go down, it will be the insurance companies that are being subsidized since the money paid for tax credits and subsidies will go directly to them. They'll have no incentive to lower rates under those conditions (only loss of revenue will motivate them). A public health insurance option (which will simply be just another health insurance plan like Blue Cross) will drive down costs since it will be non-profit. If the private plans want to compete, they will just have to lower their rates. That's how costs go down.

United Health Care just made rather healthy profits during a steep economic downturn. I suspect one of the reasons they did was by removing RX coverage during the donut hole (coverage gap) in their Medicare plans (which is why I recently dropped them). Only they didn't tell me that they'd changed this important feature. Although, they did hike up my Rx co-pays for the stuff they still paid for. All I got in the mail was a bland announcement for the new year, along with a new ID card. I noticed that my plan number changed, and I looked it up on the Medicare website.

This is why I prefer to see a slower reform, with sharp focus on cost containment early on. This will help drive down the price of healthcare. From there, we can have a better idea of the organic costs that need to be rationalized to help improve coverage and quality.Without any competition, how will costs go down? What costs will be contained? We already pay a huge hidden tax supporting the people who use the emergency rooms for their primary care since they lack insurance, but aren't poor enough to be on Medicaid, or there is the added expense when the uninsured get so ill they require hospitalization. You drive down healthcare costs by keeping people healthy.

People want access to decent healthcare now, not years from now. As it stands, all the plans will be phased in anyway. Obama knows very well that this is the year to get this done. Nothing is being rushed. The Senate finance committee has been working on this thing for months and hasn't gotten anywhere because they can't agree on anything. Just getting out a rough draft of a bill from committee, isn't the same as a finished bill voted on by both Houses of Congress. Otherwise the Congress will be too focused on mid-terms next year to want to work on it.

Pensieve - hasn't Obama's stated position been that he wants reform to be deficit-neutral at 10 years? Are you just, then, projecting to what you think he really thinks, or has he come out since his "i want this deficit neutral" to go "nah, I'm cool with it not being deficit neutral"?

United Health Care is also our provider. I've mentioned before that our prescription drug co-pays increased from $298 every three months in the late 90's to $757 for our last reorder.

And why, pray tell, are anti-health care conservatives hanging effigies of two Democratic Members of Congress? What the hell is that about?

Van Hollen’s Statement on Conservative Group Hanging Effigies of Democratic Members of Congress (http://dccc.org/blog/archives/van_hollens_statement_on_conservative_group_hangin g_effigies_of_democratic_/)

ETA:

It can be challenging to keep the conservative front-groups straight when it comes to the fight over health care reform, but ThinkProgress has done some interesting research on the Coalition to Protect Patients' Rights (http://thinkprogress.org/2009/07/28/cppr-dci-astroturf/).

Hint: It's more astroturf than grassroots. :td:

Any right-winger concerned about spending now is just hypocrisy as usual.

Obama loses ground on health care (http://www.msnbc.msn.com/id/32206998/ns/politics-white_house/)

It's not just about conservatives. Why can't liberals grasp this? The American people don't agree with his plan, as the latest MSNBC poll reflects.

Obama is also losing credibility with Americans, as his plummeting approval rating shows.

Check out this observation from the poll, which supports my earlier opinion:
it shows a public that has grown increasingly concerned about the federal government's spending as the administration defends its $787 billion economic stimulus and supports a $1 trillion-plus health-care bill.



Pensieve - hasn't Obama's stated position been that he wants reform to be deficit-neutral at 10 years? Are you just, then, projecting to what you think he really thinks, or has he come out since his "i want this deficit neutral" to go "nah, I'm cool with it not being deficit neutral"?

It doesn't appear as though people are buying into the connection that "what he wants" is what we are going to get if the Obama plan is adopted. I know I don't buy into it at all.


Without any competition, how will costs go down? What costs will be contained?

All of the entities that deliver healthcare in this country are businesses. The notion of "competition" takes care of itself when the right reform drivers are introduced. The problem is, there is no incentive for cost to be contained when profits are still being realized. This is what is horrible about the healthcare system today IMO...these companies are putting profits ahead of the well-being of people.

In an earlier post, SSJ wrote that she wished it was "illegal for insurance companies to turn down people just for having a pre-existing condition". The reason these people are turned down is because they hurt the bottom line. Perhaps the "bottom line" wouldn't be as much of an issue if cost wasn't so high. In this scenario, it becomes more reasonable to expect (legislate?) companies to take on more risk.

Given that every Western country with socialised healthcare pays substantially less than the US why is it going to cost so much there?

Interesting how the WSJ (source of the original article MSNBC reprinted) analyzes poll data compared to the New York Times' analysis of a similar poll (http://www.nytimes.com/2009/07/30/us/politics/30poll.html?_r=2&hp) released the same day. While both polls accurately reflect a decline in Obama's approval ratings, the Times also notes that Obama's ratings are consistent with those of every president as far back as Ronald Reagan for the sixth month mark of their presidencies.

Mr. Obama continues to benefit from strong support for the basic goal of revamping the health care system, and he is seen as far more likely than Congressional Republicans to have the best ideas to accomplish that. But reflecting a problem that has hindered efforts to bring major changes to health care for decades, Americans expressed considerable unease about what the end result would mean for them individually.

Those fears are, of course, what Republicans are shamelessly exploiting. It also explains why the President has gone on the road to rebut these largely false statements.

Obama loses ground on health care
It's not just about conservatives. Why can't liberals grasp this? The American people don't agree with his plan, as the latest MSNBC poll reflects.
Obama is also losing credibility with Americans, as his plummeting approval rating shows.
Check out this observation from the poll, which supports my earlier opinion:
It supports your opinion...? Hmm...It also states:

But the poll — which was taken of 1,011 adults from July 17-20, and which has an overall margin of error of plus or minus 3.1 percentage points — also reveals a clear split between those who have private health insurance and those who don’t.
Americans who have private health insurance disapprove of Obama’s job on health care by a 51-38 percent margin. Those who lack insurance, however, approve of his job, 52-29 percent.
Also, when read the specifics of his goals for health care — like requiring insurers to cover those with pre-existing conditions, providing low-income families with subsidies to help them afford insurance, and raising taxes on the wealthy to pay for the subsidies — 56 percent say they support Obama’s plan. Only 38 percent oppose.

In an earlier post, SSJ wrote that she wished it was "illegal for insurance companies to turn down people just for having a pre-existing condition". The reason these people are turned down is because they hurt the bottom line. Perhaps the "bottom line" wouldn't be as much of an issue if cost wasn't so high. In this scenario, it becomes more reasonable to expect (legislate?) companies to take on more risk.
We know why costs are so high (http://scienceblogs.com/denialism/2009/05/what_is_the_cause_of_excess_co.php)

On top of that the Private, for profit corportation, who's primary source of revenue comes from denying patient claims, have the final say on what care you get and when or even if you get it. An impersonal, mega corporation, who has incentive to deny or delay your care has total control over your well being and you have zero choice. Switching carriers is not an option because they all work together to exclude people who actually use their insurance.

I tend to believe that health and well being in a nation as wealthy as ours, is close to being a right... Considering that the alternative is likley to suggest that some people just don't deserve to be born, to be vaccinated, to have basic health care. I'm just not wired that way, the idea that a country as rich as ours can allow any one of our citizens to be without any health care at all, or be financially ruined by something as arbitrary as a congenital heart defect or hell, even a bad case of the flu really, really upsets me.

For those that scream "IT'S SOCIALISM!!!11" they need to answer as to why our military has it?

A Win for Single Payer Advocates (http://www.thenation.com/blogs/thebeat/452493/a_real_win_for_single_payer_ad)

Those of us who know that the only real cure for what ails the U.S. health care system is a universal public plan that provides health care for all Americans while controlling costs recognize the frustrating reality that there are many economic and political barriers to the federal action that would create a single-payer system. This makes clearing the way experimentation at the state level all the more important.
And, remarkably, the forces of real reform have won a congressional victory on that front, a victory that ought not be underestimated.
By a 25-19 vote, the House Committee on Education and Labor on Friday approved an amendment to the House's health-care reform bill allowing states to create single-payer health care systems if they so choose.
:relax:

I wish it was illegal for insurance companies to turn down people just for having a pre-existing condition...

Worse than denial is rescission when people suddenly find that the cover they've paid through the nose for over the years is denied when needed most.

Hey I wasn't denied coverage. Except, my insurance jumped from $100 a month to $1000 a month when I had to convert from a group plan to private insurance. It was the same as denying it since I couldn't afford it.

This purging and rescission are discussed at length in the testimony (http://commerce.senate.gov/public/_files/PotterTestimonyConsumerHealthInsurance.pdf)of Potter.

It's not just about conservatives. Why can't liberals grasp this? The American people don't agree with his plan, as the latest MSNBC poll reflects.

Why was Bush's refusal to listen to polls seen as a sign of strength and Obama's as intransigence?

In an earlier post, SSJ wrote that she wished it was "illegal for insurance companies to turn down people just for having a pre-existing condition". The reason these people are turned down is because they hurt the bottom line. Perhaps the "bottom line" wouldn't be as much of an issue if cost wasn't so high.

The bottom line is the sole driver of capitalism. Lower costs and the companies won't lower prices comparably (if at all) they'll just rake in greater profits.

Given that every Western country with socialised healthcare pays substantially less than the US why is it going to cost so much there?

You know this has often been asked but never answered.

Pensieve - hasn't Obama's stated position been that he wants reform to be deficit-neutral at 10 years? Are you just, then, projecting to what you think he really thinks, or has he come out since his "i want this deficit neutral" to go "nah, I'm cool with it not being deficit neutral"?

He also said that the latest stimulus would create thousands of those shovel-ready jobs. I know plenty of people that are still standing around waiting with their shovels and have yet to see any change...

Honestly, I have no doubt that there are good intentions here, but there is also secretive agenda. For example, I heard about Ted Kennedy adding funding in the bill for parks in his district in the healthcare bill under the guise of "preventative care." I guess if the street lights are brighter, people will get out more and thus be more active and thus not need as much healthcare....:err: That's pushing it, I think, for a bill that needs to be a barebones restructure of the system.

He also said that the latest stimulus would create thousands of those shovel-ready jobs. I know plenty of people that are still standing around waiting with their shovels and have yet to see any change...

Honestly, I have no doubt that there are good intentions here, but there is also secretive agenda. For example, I heard about Ted Kennedy adding funding in the bill for parks in his district in the healthcare bill under the guise of "preventative care." I guess if the street lights are brighter, people will get out more and thus be more active and thus not need as much healthcare....:err: That's pushing it, I think, for a bill that needs to be a barebones restructure of the system.

I'm soon to be in a stimulus-funded job

Got a link for the Teddy K assertion? I did a quick couple of google searches and couldn't find the story.

As far as the larger issue of some people feeling like they're pushing this too fast, what's a more realistic timeframe? If the final votes are pushed into October or November, then we're looking at having taken over six months to get the health bill passed. That's a long time more than some bills, which take 4 days from introduction in the House to signing by the President.

As far as the larger issue of some people feeling like they're pushing this too fast, what's a more realistic timeframe? If the final votes are pushed into October or November, then we're looking at having taken over six months to get the health bill passed. That's a long time more than some bills, which take 4 days from introduction in the House to signing by the President.

1. Deficit. I too saw that article you linked to about the waxman bill. The estimates are at about 900 billion. Yet the Republican one was at about 700 billion that's a huge difference.. I'd be happy with a compromise and come in at 800 billion since the 700 billion seems a tad unrealistic. But 900 billion or a trillion or more is not something that I feel the economy can afford. Especially when it's not even full funded.

2. Some of these bills are simple matters of state, are fairly short, and easily read through even by the senators themselves. This bill is long and tedious and complicated. I don't want to have to revisit this again in four or eight years. As has been done in, oh, every election since the country was founded practically. :p

I'm soon to be in a stimulus-funded job

Got a link for the Teddy K assertion? I did a quick couple of google searches and couldn't find the story.

As far as the larger issue of some people feeling like they're pushing this too fast, what's a more realistic timeframe? If the final votes are pushed into October or November, then we're looking at having taken over six months to get the health bill passed. That's a long time more than some bills, which take 4 days from introduction in the House to signing by the President.

Well I'm glad someone is seeing some results, because all I have seen in my area is more unemployment and fewer opportunities...

http://www.thedcwriteup.com/2009/07/playgrounds-streetlights-and-farmers-markets-oh-my/

I've lost track of all the labels Republicans have used to describe the administration's stimulus package, but perhaps the most common is "failure." To hear the right tell it, the recovery initiative just hasn't done much of anything; it certainly hasn't created any jobs.

So said House Republican Conference Chairman Mike Pence about the effect the stimulus has had in his home state of Indiana. The Evansville Courier-Press (http://www.courierpress.com/news/2009/jul/20/stimulus-has-hoosiers-working/) begs to differ:

Stimulus Has Hoosiers Working

INDIANAPOLIS — More than 2,400 people are now at work on federal stimulus-funded roadway projects in Indiana, according to a state report being released today.

Covering 83 projects and listing a total payroll of $2.8 million, the Indiana Department of Transportation report details only a small fraction of the hundreds of projects so far selected for funding using the $440 million the agency received under the American Relief and Recovery Act.

Economists say it’s too early to tell whether the long-term value of President Barack Obama’s economy-boosting effort will justify its $787 billion cost. But construction executives say stimulus-funded projects certainly have created jobs and spared layoffs within the industry.

Pence isn't alone. Louisiana Gov. Gov. Bobby Jindal (R), fan ardent critic of the stimulus effort, now feels comfortable bragging to local Louisiana communities (http://thinkprogress.org/2009/07/21/jindal-stimulus-check/) about money made possible by the recovery bill he opposed. House Minority Whip Eric Cantor (R-Va.) hates the stimulus, except for the transportation money it brought to his district (http://www2.timesdispatch.com/rtd/news/state_regional/article/RAIL25_20090424-222017/263772/). Other House Republicans have bragged about recovery funds (http://www.mcclatchydc.com/251/story/62181.html) headed for their communities, thanks to a bill they voted in lock-step against.

I think some of the same arguments are in play on health care. There are two problems where Republican resistance is concerned, as I see it. One is the fact that they realize a good health care plan is going to make it much harder for them to regain ascendency in Washington. The other fact is that most of them are in over their heads on the subject of health care, the stimulus, and pretty much anything else involving finance or the economy.

I think some of the same arguments are in play on health care. There are two problems where Republican resistance is concerned, as I see it. One is the fact that they realize a good health care plan is going to make it much harder for them to regain ascendency in Washington. The other fact is that most of them are in over their heads on the subject of health care, the stimulus, and pretty much anything else involving finance or the economy.

That's quite an assertion... Are you saying that only non-Republicans are capable of handling money at this point?:huh: If so, why? Because the overall sentiment is "Stop wasteful spending." Conservatives would say the same about Liberals, feeling that more and more government programs is the sure-fire way to get us "in over our heads." It's a two-way street, depending upon your political views.

"Agree to disagree" aside, I honestly wish you would stop basically saying anyone who doesn't see it your way is wrong. You over generalize and reference politicians as the end-all-be-all description of Conservatives. It's offensive and I wish you could engage in honest debate rather than asserting that any Republican or Conservative is just incorrect.

You know what would be great? If people could see beyond party politcs and just work together towards a common goal.

All this conservatives v liberals and who is the big bad wolf is getting pretty tiring and it certainly leads to nothing.

You know what would be great? If people could see beyond party politcs and just work together towards a common goal.

All this conservatives v liberals and who is the big bad wolf is getting pretty tiring and it certainly leads to nothing.

Agreed, which is why I get tired of every reply to my views dismissing me as some right-wing crazy person. We're all crazy, so why not embrace it?:cool:

Obama loses ground on health care (http://www.msnbc.msn.com/id/32206998/ns/politics-white_house/)

It's not just about conservatives. Why can't liberals grasp this? The American people don't agree with his plan, as the latest MSNBC poll reflects. I really hate hearing that term tossed around so much. "The American people". I'm in the group of "American people" and I agree with what Obama is trying to do.In an earlier post, SSJ wrote that she wished it was "illegal for insurance companies to turn down people just for having a pre-existing condition". The reason these people are turned down is because they hurt the bottom line. Perhaps the "bottom line" wouldn't be as much of an issue if cost wasn't so high. In this scenario, it becomes more reasonable to expect (legislate?) companies to take on more risk.It's still not fair that I have to be denied coverage because of a genetic/hereditary condition I had no control over, which is why I'm all for having a public option since private failed me.

Woot, we got people offended on both sides, yay! :yuhup: [/spent too much time in the chemical lab]

I mean, if everyone's feeling offended by each other, time to take a step back and try to be more polite to each other's views and to each other in general. The health care debate is a passionate one, so try not to overgeneralize (guilty of this myself, perhaps, yesterday).

Carry on.

I'm going to take a little self-enforced break here. Seriously. I just asked a man to leave my house, instead of buying a new security system from him, because he said something to the effect of: "Don't get me wrong, I don't have anything against black people - I just don't like Obama... blah, blah, blah."

ETA:

From HealthCareNow:

EkGGDOp4uUg

I don't have much faith in the cries to "slow down" on health care. As several others have mentioned, the issue has been on the table for decades. Reminds me a bit of the passage of the Civil Rights and Voting Rights Acts in the mid-60's, when conservative legislators were urging for more time because "people weren't ready."

While I agree that care should be taken, and time should be utilized in finding the RIGHT PLAN, healthcare reform is hardly a new concept. We have needed healthcare reform for decades. So, I am not one of faith for slow-down cries either. Only slow down if it has a purpose other than political stalling or grandstanding. Slow down to ensure sensible legislation, not political survival. Then you are a servant of the people, not a self-serving bureaucrat.

Woot, we got people offended on both sides, yay! :yuhup: [/spent too much time in the chemical lab]

I mean, if everyone's feeling offended by each other, time to take a step back and try to be more polite to each other's views and to each other in general. The health care debate is a passionate one, so try not to overgeneralize (guilty of this myself, perhaps, yesterday).

Carry on.

"Anger is an emotion which causes a rational person to take irrational actions. To anger someone is to own them."

While I agree that care should be taken, and time should be utilized in finding the RIGHT PLAN, healthcare reform is hardly a new concept. We have needed healthcare reform for decades. So, I am not one of faith for slow-down cries either. Only slow down if it has a purpose other than political stalling or grandstanding. Slow down to ensure sensible legislation, not political survival. Then you are a servant of the people, not a self-serving bureaucrat.

:tu:

"Anger is an emotion which causes a rational person to take irrational actions. To anger someone is to own them."

Who said that?

Interesting article about the miscalculation of the "Clunkers" program, causing concern over the government's ability to run other programs such as universal healthcare...

http://wcbstv.com/consumer/cash.clunkers.success.2.1108544.html

To me, that tells me this program was a success and a keeper! When we find something that works, we should keep it. The other half is finding things that don't work and getting rid of, or reforming them.

I think it's great that this program was such a success.

And, less smog from the cars that are polluting less means healthier air for everyone, thus reducing health care costs incrementally.

See, I made the post about health care :D.

To me, that tells me this program was a success and a keeper! When we find something that works, we should keep it. The other half is finding things that don't work and getting rid of, or reforming them.

I think it's great that this program was such a success.

Absolutely, but it is an example of a government program that was not planned well. And I was happy to read that the $2 billion more they're putting into it is coming from the already approved stimulus. However, was that money supposed to go to something else that will now suffer? Haven't found an answer on that yet...

And, less smog from the cars that are polluting less means healthier air for everyone, thus reducing health care costs incrementally.

See, I made the post about health care :D.

Hey, it was about healthcare! The article was stating that the lack of planning for this program leads to suspicions about the government's ability to administer healthcare:p

Cash for clunkers response can be found in the Congress thread :).

Who said that?

My wise mother.

Cash for clunkers response can be found in the Congress thread :).

That Bill can have a direct and indirect affect upon healthcare in general, and the political rhetoric that most likely will be found in any Healthcare Reform Bill that makes it to the Congressional Floor. There will be discussion about adding to or taking away from the program to pay for healthcare, especially since the results of the program can positively affect general community health.

My wise mother.

She gets a vote from me, too. :tu:

That Bill can have a direct and indirect affect upon healthcare in general, and the political rhetoric that most likely will be found in any Healthcare Reform Bill that makes it to the Congressional Floor. There will be discussion about adding to or taking away from the program to pay for healthcare, especially since the results of the program can positively affect general community health.

I think every spending bill will impact health care in some form or fashion, as the President has insisted it be financed now rather than as deficit-spending.

Don't get me wrong: I think it's a good idea. I've never favored back-loaded legislation. If we hadn't been saddled with so much of that already, health care wouldn't have the delayed start that's now in place.

You know, Paul Krugman (our Nobel Laureate in Economics) had a great column today on one of the biggest hurdles health care faces (http://www.nytimes.com/2009/07/31/opinion/31krugman.html?_r=1): the mountain of misinformation the American public is saddled with.

At a recent town hall meeting, a man stood up and told Representative Bob Inglis to “keep your government hands off my Medicare.” The congressman, a Republican from South Carolina, tried to explain that Medicare is already a government program — but the voter, Mr. Inglis said, “wasn’t having any of it.”

It’s a funny story — but it illustrates the extent to which health reform must climb a wall of misinformation. It’s not just that many Americans don’t understand what President Obama is proposing; many people don’t understand the way American health care works right now. They don’t understand, in particular, that getting the government involved in health care wouldn’t be a radical step: the government is already deeply involved, even in private insurance.

And that government involvement is the only reason our system works at all. Emphasis mine.

The gent from South Carolina doesn't know that Medicare is a government-run, single-payer program. I am forever explaining to people that socialized health care has long been a staple in the United States: the Veterans' Administration health care being the obvious example.

Krugman accurately points out - as have many CoS members - that "private markets for health insurance, left to their own devices, work very badly: insurers deny as many claims as possible, and they also try to avoid covering people who are likely to need care. Horror stories are legion: the insurance company that refused to pay for urgently needed cancer surgery because of questions about the patient’s acne treatment; the healthy young woman denied coverage because she briefly saw a psychologist after breaking up with her boyfriend."

I saw my personal physician today for a regular diabetes check-up and we spent some time discussing health care. He pointed out that I am basically uninsurable if I should lose my health insurance. I'm not quite old enough for Medicare coverage. At the same time, my employer-based health insurance would not be available had the government not taken those 65 and older out of the private market.

So here’s the bottom line: if you currently have decent health insurance, thank the government. It’s true that if you’re young and healthy, with nothing in your medical history that could possibly have raised red flags with corporate accountants, you might have been able to get insurance without government intervention. But time and chance happen to us all, and the only reason you have a reasonable prospect of still having insurance coverage when you need it is the large role the government already plays. [...]

Right-wing opponents of reform would have you believe that President Obama is a wild-eyed socialist, attacking the free market. But unregulated markets don’t work for health care — never have, never will. To the extent we have a working health care system at all right now it’s only because the government covers the elderly, while a combination of regulation and tax subsidies makes it possible for many, but not all, nonelderly Americans to get decent private coverage.

Now Mr. Obama basically proposes using additional regulation and subsidies to make decent insurance available to all of us. That’s not radical; it’s as American as, well, Medicare. Emphasis mine.

To me, it's a no-brainer.

My husband, as a veteran, is currently getting his health care through the V.A.--a government run organization, of course. Just another example of how the government can actually handle programs like this on a large scale and do fairly well.

My husband, as a veteran, is currently getting his health care through the V.A.--a government run organization, of course. Just another example of how the government can actually handle programs like this on a large scale and do fairly well.

I think there is value to the government running certain programs, especially for veterans who have served our country. However, I think the sheer undertaking of reaching out to the entire nation to cover even the most minor of health issues would be too much of a burden. It would end up being a huge bureaucracy with overpaid government employees sticking their corrupt fingers into every aspect of healthcare. Perhaps that's a bit of an exaggeration, but I honestly think it is plausible. The US government is not free enough of corruption (on both sides of the aisle!) to be able to run this type of endeavor properly.

Of course, that's all my educated opinion ;)

And certainly insurance companies have their fair share of corruption and mismanagement, but that's why I support an reevaluation of the current system rather than something that is very new to most of the US.

We can do with a little less generalisation and a little more provable facts.

That civil servants in the US are generally so totally corrupt that they under no circumstances can be supposed to handle something almost all other 'western' countries handle quite well is an interesting view. But are there facts to support it?

Of course, that's all my educated opinion ;)

Hmm...:cool:

Obama Plan Part I (http://scienceblogs.com/denialism/2009/06/the_obama_plan_-_part_i.php)

Healthcare Reform part III (http://scienceblogs.com/whitecoatunderground/2009/07/health_care_reform_part_iii.php)


According to this survey (http://www.cahps.ahrq.gov/):

Chart 19. Using 0 to 10, where 0 is the worst possible and 10 is the best possible, how would you rate your health plan?
https://www.cahps.ahrq.gov/content/NCBD/Chartbook/HEALTHPLAN08/cahps08chart19.gif

George Will Admits Public Option will Cut Costs (http://www.fivethirtyeight.com/2009/06/george-f-will-admits-public-option-will.html)
:relax:

It's amazing how many people claim to have been saved by Medicare/Medicaid.

.

We can do with a little less generalisation and a little more provable facts.

That civil servants in the US are generally so totally corrupt that they under no circumstances can be supposed to handle something almost all other 'western' countries handle quite well is an interesting view. But are there facts to support it?

Nope. Both Medicare and the Veterans' Administration are doing a fine job. Medicare never had problems until Bush used the Medicare D drug program to partially privatize it. There was no real reason to do that other than conservative ideology and the wishes of the insurance company lobby.

The VA likewise never experienced problems delivering top-shelf care until the Bush administration's lack of planning for the care of vets from Afghanistan and Iraq quickly reached a crisis a few years ago. If I remember correctly, the Bush folks hadn't considered what should be done to adequately care for the head wounds suffered as a result of those IEDS. I believe the Washington Post published an expose that got the right things going in a hurry.

Some, I suppose, would say these two examples prove the point about how badly the government handles medical programs. That misses the mark by a long mile, though. Republican presidents just don't believe in good government; therefore they're never ready when government intervention on the home front is necessary. Look at the Bush administration's response to Hurricane Katrina four years ago. Then contrast that with Clinton's response to Oklahoma City. And Johnson's debut of Medicare, which launched without a hitch. Some of us do it well. Some of us don't.

ETA:

As far as corruption goes, one would have to go some to beat the private sector scams and scandals we've seen over the past few years. Look at the enormous waste of our tax dollars when we gave private companies responsibility for the rebuilding of Iraq. That one runs into the billions. I remember an horrific story of our service members being electrocuted in the showers because of shoddy wiring. Look at Blackwater's dismal record over there. I'll take my chances with a horde of salaried civil servants any day over profiteers like these.

Is it better for some to be taxed at close to 60% while others pay negative taxes? For one extremely small segment of the country to provide more than 95% of the fund this country uses? Yet that's exactly what is happening in the US.

Speaking of taxes (http://www.opednews.com/articles/The-Great-Tax-Con-Job-by-Thom-Hartmann-090721-79.html)
Republicans are using the T-word - taxes - to attack the Obama healthcare program. It's a strategy based in a lie.

A very small niche of America's uber-wealthy have pulled off what may well be the biggest con job in the history of our republic, and they did it in a startlingly brief 30 or so years. True, they spent over three billion dollars to make it happen, but the reward to them was in the hundreds of billions - and will continue to be.


Is it better for people who are sick and old to pay more to be taxed for their medical benefits? Yet that exactly what's proposed in the Presidents plan to nationalize health care.


Just about eveyone here has already debunked the tiresome "HE'S NATIONALIZING HEALTHCARE..OMG!!!11"

There is no plan whatsoever to nationalize healthcare. Obama's plan provides a public option to private insurance. And this has been stated time-after-time here. Why can't anyone get that?

And as for the elderly, the last time they were affected was when the Pharmaceutical Company Enrichment Act of 2003 was passed. Contrary to popular belief that was not a program designed to make prescription drugs easier and cheaper for people. It was pretty much hand crafted by Pharmaceuticals to make sure more government money went directly to the drug companies with little or no attention given to availability or cost for the people they claimed to be helping.

From scienceblogs:Obama's Plan Part I (http://scienceblogs.com/denialism/2009/06/the_obama_plan_-_part_i.php)

Healthcare Reform Part II (http://scienceblogs.com/whitecoatunderground/2009/07/health_care_reform_part_ii.php)

Part III (http://scienceblogs.com/whitecoatunderground/2009/07/health_care_reform_part_iii.php)

More on Healthcare Reform (http://scienceblogs.com/whitecoatunderground/2009/07/more_on_health_care_reform.php)

Is it better for the government to dictate what medical services each and every one of us can receive and when we can receive them? Yet that's exactly what the Presidents plan to nationalize health care calls for.
No...try again. With substance next time.

Where ever you're getting info from is very subjective, inaccurate and obviously a waste of energy just simply reading such stuff.

At least show me where on earth you're acquiring this...subjectivity.
People are too willing to scream THE SKY IS FALLING!!1 to actually look up and see the truth for themselves.

However perhaps you can answer if socialized medicine is so bad, why does our military have it? After all, The US military is viewed is the most god loving order of capitalist patriots in existence, yet they have socialized medicine. How can these god-loving capitalist patriots be wrong? (annual physicals, current immunizations, and get regular 6 month dental check-ups. How of an impact would this have if these basic services were 100% covered? If all preventative care was 100% covered?)

And medicare...my my...Are you actually trying to claim medicare doesn't work?

As for the few plans floating around, there is only one that has been fleshed out to any degree. And that is nowhere near to acomplishing anything significant.

:relax:

My husband, as a veteran, is currently getting his health care through the V.A.--a government run organization, of course. Just another example of how the government can actually handle programs like this on a large scale and do fairly well.

You're absolutely correct - the VA medical system is one all American's should look to when questioning just how well the government is at providing medical benefits.

According to this report from the Army, close to 16% of Army vets can't get Dr appointments from VA hospitals.

About 16% of Army patients, particularly family members, can't get appointments with their primary physicians and are sent to doctors off the installation, according to the results of a nine-month Army review finished late last year. Some of those patients end up in emergency rooms or urgent care centers, says the study, which the Army provided to USA TODAY.

Thankfully there are health providers outside the VA that those families can see, at their own personal expense. With nationalized health care those outside providers won't exist anymore.

http://www.veteransforcommonsense.org/index.php/national-security/994-gregg-zoroya

There is no plan whatsoever to nationalize healthcare. Obama's plan provides a public option to private insurance. And this has been stated time-after-time here. Why can't anyone get that?

Perhaps because we're actually reading the bill, specifically Sections 102, 201, 202, 203, and parts of 221 (http://thomas.loc.gov/cgi-bin/query/F?c111:1:./temp/~c111HHo6tA:e90210:)? Where it states that the only plans not under the control of the GOVERNMENT run Health Administration will be those plans which were in existence before the bill was signed that do not admit new members - in other words - none.


The proposed tax on so called Cadillac or gold plated plans primarily affects plans for union members and older Americans - people who are sick a pay higher premiums because they need the coverage for their illnesses. According to the Urban Institute (http://online.wsj.com/article/SB124831129083174373.html) the tax would hit about 1/2 of all middle income earners and about 2/3 of all higher income earners. Again, according to the Urban Institute, the tax would run between $650 and $3,340 per year for middle income earners.

And taxing the insurers who provide such plans would only ensure that insurers don't provide them.

At least show me where on earth you're acquiring this...subjectivity.
People are too willing to scream THE SKY IS FALLING!!1 to actually look up and see the truth for themselves.


The health care reform bill. (http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3200:) It's 1018 pages long. Feel free to read it.

Thankfully there are health providers outside the VA that those families can see, at their own personal expense. With nationalized health care those outside providers won't exist anymore.

http://www.veteransforcommonsense.org/index.php/national-security/994-gregg-zoroya

I think it's beyond funny that a veteran's group (which supports a strong military) claims to stand for the ideals of Thomas Paine who was one of the founders who opposed a standing army.

You're absolutely correct - the VA medical system is one all American's should look to when questioning just how well the government is at providing medical benefits.

According to this report from the Army, close to 16% of Army vets can't get Dr appointments from VA hospitals.

ReportAbout 16% of Army patients, particularly family members, can't get appointments with their primary physicians and are sent to doctors off the installation, according to the results of a nine-month Army review finished late last year. Some of those patients end up in emergency rooms or urgent care centers, says the study, which the Army provided to USA TODAY.

Like I said, my husband uses this system and often, this is done for many reasons. For instance, hubby's primary hospital and physician is in Los Angeles...a three hour drive for him. By using an off-installation doctor, he actually can have more access to the system easier but still is able to go to the VA hospital for more important meetings with care givers when necessary.

If the V.A. administration were not there, my husband would not have health care at all. No, it doesn't have all the frills of privatized health care, but it works. His surgery is the 20th of this month and it's most likely going to save his life. The doctors there have been very caring and dedicated to him, and all the other veterans who have served their country and come through the doors.

Some people do not mind the little inconveniences of "no frills" when their option is no health care at all and possibly death or permanent disability because of it.

Private insurance and health care is still going to be around to give those frills and fluffs for those who can pay for it. It's the ones that have been rejected by that private system, priced out of it or cannot afford private insurance (yet above poverty and Medicaide) that are at great risk.

Again, the longer our present system goes on, the more this group will grow and the current system will crash under it's own, bloated weight. Already, middle-class working Americans have had to go into bankruptcy and lose homes, adding to the foreclosure problem, because of this "hole" in the system. This hurts us all.

If the system isn't corrected and reformed, eventually it will collapse. At that point, we will probably be looking at a truly nationalized system at a much higher expense for everyone (including in lives and total financial security of our entire nation).

One way or another, it will change. Sure, we might have to bite the bullet--but we've been discussing this for decades and it shouldn't come as any surprise to anyone. Anyone that watched the corporate insurance machine attack this idea before, shouldn't be surprised to see them come out and tell the same scary stories and want to not change...after all, they've been making billions on fewer and fewer people who still have health care. They have a sweet deal right now. It's time to put our collective feet down and consider the human cost, the national cost right now and the humane crisis it's wrought that is growing each year.

Like I said, my husband uses this system and often, this is done for many reasons. For instance, hubby's primary hospital and physician is in Los Angeles...a three hour drive for him. By using an off-installation doctor, he actually can have more access to the system easier but still is able to go to the VA hospital for more important meetings with care givers when necessary.

And yet the model we're considering forces longer than acceptable waits and severely limits access.

If the V.A. administration were not there, my husband would not have health care at all. No, it doesn't have all the frills of privatized health care, but it works. His surgery is the 20th of this month and it's most likely going to save his life. The doctors there have been very caring and dedicated to him, and all the other veterans who have served their country and come through the doors.

Providing health care to the men and women who served our country in the armed services is the bare minimum we can do.

And I wouldn't call private health insurance "frills and fluff". Both my employer and I pay a significant sum for me and my family to be able to see doctors and receive medical care at facilities the insurance company has authorized. Sometimes that means that I drive 2 hours to see a participating provider (and I live a short distance outside Washington DC). Sometimes that means I wait 2 months for an appointment with a specialist.

Private insurance and health care is still going to be around to give those frills and fluffs for those who can pay for it.

No, it won't be. Read the bill. Sections 102, 201, 202, 203, 221. Every health care plan available in this country will be under the control of the GOVERNMENT Health Administration. Every single one - whether privately funded or publicly provided. Grandfathered plans will be excluded, but grandfathered plans are prohibited from accepting new patients after the bill becomes law. That means if you switch jobs or change insurance plans, you have to flip to a Government controlled plan. As most employers will not be willing to maintain and administer two different plans and have two different classes of employees based on their hire dates, every plan will be under the control of the Health Choices Administration.

It's the ones that have been rejected by that private system, priced out of it or cannot afford private insurance (yet above poverty and Medicaide) that are at great risk. Again, the longer our present system goes on, the more this group will grow and the current system will crash under it's own, bloated weight. Already, middle-class working Americans have had to go into bankruptcy and lose homes, adding to the foreclosure problem, because of this "hole" in the system. This hurts us all.

The primary reason people don't have health insurance is because their employer doesn't provide it and they can't afford an individual policy. This plan will do nothing to reduce the cost of an individual health plan. It will , however, require that everyone have at least a basic plan when some would prefer a less expensive catastrophic plan. It will mandate what services each plan must cover.

If the system isn't corrected and reformed, eventually it will collapse. At that point, we will probably be looking at a truly nationalized system at a much higher expense for everyone (including in lives and total financial security of our entire nation).

No one has said that the current system is perfect, but this proposal will make the situation much much worse. There may be more people covered, but the quality of care for all of us will decline.

Just for kicks, I searched my area for what I'd consider a medium grade health care plan. For just one person, non smoker, for a PPO plan that has a $2,500 deductible and 0% co-insurance ($20 co pay for PCP, $320 for specialist), the monthly cost would be $196. For a family of 4 the total would be $497 a month.

Contrast that with a similar plan offered to federal employees. The total monthly cost for an individual under the federal employee plan would be $305.31, of which 228.98 would be covered by the feds and 76.33 would come out of pocket from the employee. For a family the total cost would be 682.07 with the feds paying 511.55 and the employee paying 170.52.

As you can see from this very simple example, the employers contribution plays a huge role in keeping the cost to the individual low. There are ways of bringing the cost of health insurance down so that individuals whose employers can't afford health coverage and who can't afford to buy an individual plan can participate in a lower cost pool - like allowing trade organizations (like the SBA or Chamber of Commerce) or shopping clubs (like Costco or BJs), to provide a group plan that members can participate in is a start. Employers who so desire could provide their employees with a voucher the employee could use to enroll in a plan that met their needs - whether that plan was through the BJs or Costco or whatever. Heck, the government could provide vouchers to subsidized families so that they could enroll in a plan that met their needs rather than accepting the governments plan.

Edit*****

Interesting. For a Congress that says it cares so much about ensuring that American's have access to low cost, high quality health insurance, this Congress clearly believes that words go a lot further than action. Case in point was the Congressional Level Health Care Coverage for the Uninsured Amendment. This Amendment would have allowed American's access to plans offered under the Federal Health Benefits(FEHB) Plan in addition to plans offered under the Health Administration so that they could select, enroll in, and privately pay for a health plan offered through the program Members of Congress use to obtain health insurance for them and their families.

What a great idea! Every American could either be covered by a Health Administration Plan or Congresses plan. Unfortunately Congress doesn't see it that way. The bill was defeated 31 to 28 in a party line vote. Guess which party voted against it?

Here's the text of the Amendment:
http://republicans.energycommerce.house.gov/Media/file/Markups/FullCmte/071709_Health_Reform/fehb.pdf

And the record of the votes:
http://republicans.energycommerce.house.gov/news/PRArticle.aspx?NewsID=7202

No, it won't be. Read the bill. Sections 102, 201, 202, 203, 221.

Which bill? Last I heard, there were 3 different bills being kicked around.

Which bill? Last I heard, there were 3 different bills being kicked around.

HR 3200 (http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3200:) - the actual bill currently being debated and marked up in the House.

Both my employer and I pay a significant sum for me and my family to be able to see doctors and receive medical care at facilities the insurance company has authorized. Sometimes that means that I drive 2 hours to see a participating provider (and I live a short distance outside Washington DC). Sometimes that means I wait 2 months for an appointment with a specialist.

So basically, you have less choice and longer waits under your private program than I do under our nationalised system. I can see the doctor of my choice and receive treatment at the nearest hospital with an available spot.

Not the facility some faceless bean-counter has deemed "authorised".

Nope try again.
According to your link:

SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.

Hmm...Sounds clear to me.

Headings can be misleading. The devil is in the details. Like Section 201 which you highlighted and I've provided again for clarity.

SEC. 201. ESTABLISHMENT OF HEALTH INSURANCE EXCHANGE; OUTLINE OF DUTIES; DEFINITIONS.

(a) Establishment- There is established within the Health Choices Administration and under the direction of the Commissioner a Health Insurance Exchange in order to facilitate access of individuals and employers, through a transparent process, to a variety of choices of affordable, quality health insurance coverage, including a public health insurance option.[

This Section establishes the Health Insurance Exchange, under the Health Choices Administration, which will provide access to affordable health coverage for employers and individuals and will include a public health insurance option. My concern, for now, isn't with the public option, it's with which private individual or group plans would be part of the Health Insurance Exchange and controlled by the Health Choices Administration.

To determine that we have to look at more details, starting with Section 202.

SEC. 202. EXCHANGE-ELIGIBLE INDIVIDUALS AND EMPLOYERS.

(a) Access to Coverage- In accordance with this section, all individuals are eligible to obtain coverage through enrollment in an Exchange-participating health benefits plan offered through the Health Insurance Exchange unless such individuals are enrolled in another qualified health benefits plan or other acceptable coverage.

(b) Definitions- In this division:

(1) EXCHANGE-ELIGIBLE INDIVIDUAL- The term `Exchange-eligible individual' means an individual who is eligible under this section to be enrolled through the Health Insurance Exchange in an Exchange-participating health benefits plan and, with respect to family coverage, includes dependents of such individual.

(2) EXCHANGE-ELIGIBLE EMPLOYER- The term `Exchange-eligible employer' means an employer that is eligible under this section to enroll through the Health Insurance Exchange employees of the employer (and their dependents) in Exchange-eligible health benefits plans.

(3) EMPLOYMENT-RELATED DEFINITIONS- The terms `employer', `employee', `full-time employee', and `part-time employee' have the meanings given such terms by the Commissioner for purposes of this division.

(c) Transition- Individuals and employers shall only be eligible to enroll or participate in the Health Insurance Exchange in accordance with the following transition schedule:

(1) FIRST YEAR- In Y1 (as defined in section 100(c))--

(A) individuals described in subsection (d)(1), including individuals described in paragraphs (3) and (4) of subsection (d);

An individual, as defined in section (d) (1) is



(d) Individuals-

(1) INDIVIDUAL DESCRIBED- Subject to the succeeding provisions of this subsection, an individual described in this paragraph is an individual who--

(A) is not enrolled in coverage described in subparagraphs (C) through (F) of paragraph (2); and

(B) is not enrolled in coverage as a full-time employee (or as a dependent of such an employee) under a group health plan if the coverage and an employer contribution under the plan meet the requirements of section 312.

So the program applies to all individuals not enrolled in a group health plan that meets the requirements of section 312 or enrolled in a plan described in subparagraphs (C) through (F) of paragraph (2).

What are the requirements of a section 312 plan?

SEC. 312. EMPLOYER RESPONSIBILITY TO CONTRIBUTE TOWARDS EMPLOYEE AND DEPENDENT COVERAGE.

(a) In General- An employer meets the requirements of this section with respect to an employee if the following requirements are met:

(1) OFFERING OF COVERAGE- The employer offers the coverage described in section 311(1) either through an Exchange-participating health benefits plan or other than through such a plan.

(2) EMPLOYER REQUIRED CONTRIBUTION- The employer timely pays to the issuer of such coverage an amount not less than the employer required contribution specified in subsection (b) for such coverage.

(3) PROVISION OF INFORMATION- The employer provides the Health Choices Commissioner, the Secretary of Labor, the Secretary of Health and Human Services, and the Secretary of the Treasury, as applicable, with such information as the Commissioner may require to ascertain compliance with the requirements of this section.

(4) AUTOENROLLMENT OF EMPLOYEES- The employer provides for autoenrollment of the employee in accordance with subsection (c).

(b) Reduction of Employee Premiums Through Minimum Employer Contribution-

(1) FULL-TIME EMPLOYEES- The minimum employer contribution described in this subsection for coverage of a full-time employee (and, if any, the employee's spouse and qualifying children (as defined in section 152(c) of the Internal Revenue Code of 1986) under a qualified health benefits plan (or current employment-based health plan) is equal to--

(A) in case of individual coverage, not less than 72.5 percent of the applicable premium (as defined in section 4980B(f)(4) of such Code, subject to paragraph (2)) of the lowest cost plan offered by the employer that is a qualified health benefits plan (or is such current employment-based health plan); and

(B) in the case of family coverage which includes coverage of such spouse and children, not less 65 percent of such applicable premium of such lowest cost plan.

Section 311 says

SEC. 311. HEALTH COVERAGE PARTICIPATION REQUIREMENTS.

An employer meets the requirements of this section if such employer does all of the following:

(1) OFFER OF COVERAGE- The employer offers each employee individual and family coverage under a qualified health benefits plan (or under a current employment-based health plan (within the meaning of section 102(b))) in accordance with section 312.

(2) CONTRIBUTION TOWARDS COVERAGE- If an employee accepts such offer of coverage, the employer makes timely contributions towards such coverage in accordance with section 312.

(3) CONTRIBUTION IN LIEU OF COVERAGE- Beginning with Y2, if an employee declines such offer but otherwise obtains coverage in an Exchange-participating health benefits plan (other than by reason of being covered by family coverage as a spouse or dependent of the primary insured), the employer shall make a timely contribution to the Health Insurance Exchange with respect to each such employee in accordance with section 313.

So we've basically boiled an individual down to any person covered by an employer sponsored health benefits plan that meets the requirements of Section 102. And this is where the meat of the thing comes in.

What is a health benefits plan under Section 102 {bolding mine}?

SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.

(a) Grandfathered Health Insurance Coverage Defined- Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term `grandfathered health insurance coverage' means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:

(1) LIMITATION ON NEW ENROLLMENT-

(A) IN GENERAL- Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.

(B) DEPENDENT COVERAGE PERMITTED- Subparagraph (A) shall not affect the subsequent enrollment of a dependent of an individual who is covered as of such first day.

(2) LIMITATION ON CHANGES IN TERMS OR CONDITIONS- Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1.

(3) RESTRICTIONS ON PREMIUM INCREASES- The issuer cannot vary the percentage increase in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all enrollees in the same risk group at the same rate, as specified by the Commissioner.

(b) Grace Period for Current Employment-based Health Plans-

(1) GRACE PERIOD-

(A) IN GENERAL- The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.

(B) EXCEPTION FOR LIMITED BENEFITS PLANS- Subparagraph (A) shall not apply to an employment-based health plan in which the coverage consists only of one or more of the following:

(i) Any coverage described in section 3001(a)(1)(B)(ii)(IV) of division B of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5).

(ii) Excepted benefits (as defined in section 733(c) of the Employee Retirement Income Security Act of 1974), including coverage under a specified disease or illness policy described in paragraph (3)(A) of such section.

(iii) Such other limited benefits as the Commissioner may specify.

In no case shall an employment-based health plan in which the coverage consists only of one or more of the coverage or benefits described in clauses (i) through (iii) be treated as acceptable coverage under this division

(2) TRANSITIONAL TREATMENT AS ACCEPTABLE COVERAGE- During the grace period specified in paragraph (1)(A), an employment-based health plan that is described in such paragraph shall be treated as acceptable coverage under this division.

(c) Limitation on Individual Health Insurance Coverage-

(1) IN GENERAL- Individual health insurance coverage that is not grandfathered health insurance coverage under subsection (a) may only be offered on or after the first day of Y1 as an Exchange-participating health benefits plan.

(2) SEPARATE, EXCEPTED COVERAGE PERMITTED- Excepted benefits (as defined in section 2791(c) of the Public Health Service Act) are not included within the definition of health insurance coverage. Nothing in paragraph (1) shall prevent the offering, other than through the Health Insurance Exchange, of excepted benefits so long as it is offered and priced separately from health insurance coverage.

So, in short, any plan which is not grandfathered may only be offered as an Exchange-participating health benefits plan under the control of the Health Administration. Grandfathered plans are those which exist when the bill is effective and do not accept any new members. Because employers will not be willing or able to handle the cost of administering two different plans, not to mention the psychological cost of having two different health benefit plans for employees, virtually every plan will be under the control of the Government's Health Choices Administration.

You may think - but we left out Sections (C) through (F). Individuals are excluded if they have coverage listed in Sections (C) through (F) afterall.

(C) MEDICARE- Coverage under part A of title XVIII of the Social Security Act.

(D) MEDICAID- Coverage for medical assistance under title XIX of the Social Security Act, excluding such coverage that is only available because of the application of subsection (u), (z), or (aa) of section 1902 of such Act.

(E) MEMBERS OF THE ARMED FORCES AND DEPENDENTS (INCLUDING TRICARE)- Coverage under chapter 55 of title 10, United States Code, including similar coverage furnished under section 1781 of title 38 of such Code.

(F) VA- Coverage under the veteran's health care program under chapter 17 of title 38, United States Code, but only if the coverage for the individual involved is determined by the Commissioner in coordination with the Secretary of Treasury to be not less than a level specified by the Commissioner and Secretary of Veteran's Affairs, in coordination with the Secretary of Treasury, based on the individual's priority for services as provided under section 1705(a) of such title.

So there you have it, crystal clear! Once the bill has been passed and is effective, the only health care plans available will be those which are grandfathered or those which are under the control of the Health Choices Administration. As there are likely to be very few grandfathered plans because of the prohibition on new enrollees, virtually every individual, except those on Medicare, Medcaid, in the military, or covered by the VA, will have health insurance provided under a plan directed and controlled by the government.

The rest of your..."interpretation" is similar it seems.

You're either redefining the dictionary so all the words mean what you want it to, or you acquired this info from some propaganda link that's making stuff up for cheap scare tactics and thought it was legitimate. (You should have factchecked why HR3200 is called "America's Affordable Health Choices Act of 2009")

If you could point out where my reading of the Sections listed above is incorrect, I'd appreciate it.

As I have stated multiple, multiple, multiple times before, no one is proposing that we leave things unchanged. However, in my opinion, this plan goes too far and has the government dictating coverage. I don't want the government anywhere near me or my family and and our health care.

I read what Mom is claiming in a woefully, probably intentionally misleading op-ed in the Wall Street Journal last week. If I wasn't away from home I would post the link, but I'll be mostly out of touch for a couple of days.

I get so frustrated with criticism based on untruths and intentional distortions. No point bothering to tell me otherwise; one has only to recall the Birthers and the tea partiers to realize how easily the right comes by this stuff.

Midnight has done an excellent job of rebutting Mom's claims and I thank him for it.

ETA:

One more thing: there are at least three bills in the House alone. That doesn't count the Senate. And the two houses are nowhere near reconciliation between House and Senate versions. Let the process work, for God's sake. The only real danger here is that opponents will somehow prevent a health care bill from being enacted.

I'm not sure why it is a problem that those policies offered (outside the "public plan") would fall under the "Health Choices Administration". This adminstration would make sure that the private policies now offered adhere to the new rules ...like, having to enroll clients dispite pre-existing conditions and not being allowed to drop people from coverage simply because they use it.

These are still private policies offered by private Insurance Corporations. They are not "government run" except for the fact that they will have to abide by the new rules and regulations (like the ones I mentioned above).

I don't have a problem with that. In fact, I think it's great.

I have new coverage myself right now. It's a public type subsidized health plan I finally could qualify for (after being turned down twice for Medicaid and MIA programs and such). Had I not found this little known plan, I might not be sitting here. I had my operation last Thursday and am home recovering. Once I obtained approval for this plan, the county hospital was more than happy to do my surgery. The care has been excellent so far and the problem resolved. If this is what a public plan will be like...again, I'm all for it. I even have my own doctor now who is very nice. It seems to be fairly efficient. Guess who paid for it? All of us (I paid the taxes, too).

Thank you all.

Now I am worried about my friends and neighbors that are not on anything and at great risk. Like I said, I appear not to be as lucky as you, Mom, who live in a state/county where they take you no matter what your insurance status is. There are many of us here--who work hard but don't make enough to afford private (and don't have employers who offer it), but make slightly more than would qualify us for Medicaid/care. They are the walking prayers that they do not get sick because they know they will either not get treatment, or lose everything if they do because of the cost of any uninsured treatment.

Some people decide not even to try at the ER because they know their family's would be financially better off if they just die at home, rather than lose their houses and assets over a $100K ER bill. It's just not right.

You should go down to my county hospital and talk to people there. These are people that are trapped with no where to turn...not because they are lazy, but because they were dumped from an Insurance policy because cancer cropped up. Or, because they lost a job and could not find another with insurance (fewer and fewer offer it here)...or couldn't find one before they fell or were taken ill. There's the young mother who lost her job I talked to then, landed in the ER with an ectopic pregancy and was sent home wtihout treatment because she was uninsured. She nearly died. She said if it wasn't for the interceding of a doctor friend, they would not have treated her. They do this simply now by withholding any tests that could show on paper proof of needed treatment. They simply do not run the tests...therefore, are not legally liable under "the word of the law".

They have found ways.

She did get treatment and her life was saved after threats of lawsuit, but now has a $60,000.00 bill she cannot pay. They may take her house. She lamented that it might have been better if she just went home and died after all.

These stories and scenes do not have to be. They break your heart to hear them. These are people trapped in a horribly broken system who did all the right things, but got caught. Many I talked to were educated and middle Estimates are there are 47 million of them...and more each day as the system spirals out of control, premium prices continue to outprice people's means to pay them or they are simply dumped because they use the system and have become non-profitable.

Those that claim everything is fine, have not been in their situation. I have great problems understanding the mentality of worrying about a few days delay in appointments, or an extra percentage in tax, when there are people who cannot even get in and literally worried about their very lives or if their life will cost them everything they own.

I'm not sure why it is a problem that those policies offered (outside the "public plan") would fall under the "Health Choices Administration". This adminstration would make sure that the private policies now offered adhere to the new rules ...like, having to enroll clients dispite pre-existing conditions and not being allowed to drop people from coverage simply because they use it.

These are still private policies offered by private Insurance Corporations. They are not "government run" except for the fact that they will have to abide by the new rules and regulations (like the ones I mentioned above).

It's a problem because the government will be dictating what is and is not covered. Like requiring end of life counseling every 5 years for anyone over 65 with a chronic condition. Or requiring that private plans cover the cost of abortions.

Those new rules inevitably end up increasing the cost of coverage. Whenever the government steps in and begins dictating rules, costs go up for both private and public plans. And when costs go up the government looks for savings. With health care that means fewer services. Longer waits to see Doctors or receive treatment. Lower quality care.

If you think the government controlled plans are so wonderful, then perhaps you ought to ask why members of Congress won't agree to dump their gold plated plan and require themselves and their families to participate in the program. Seems rather odd, doesn't it - for Congress to develop this massive new Administration which will control health care in the country but they don't have to participate?

There are ways of providing health insurance to uninsured people without giving control over to the government. But you have to understand where most of the uninsured come from. Most live at or near the poverty level with at least one family member working full or part time. Most have been offered health insurance by their employer but they can't afford the premiums - which can run as much as $3,000 a year for a family of 4.

Under the proposed plan that won't change one bit because if your employer offers a medical plan you can't enroll in the public option whether you can afford the premiums in the employer plan or not. (FYI: That's from Section 242 of the plan). That means the plan will do NOTHING to help those people. They'll still be uninsured because they can't afford the premiums. And with the government dictating care, they'll be even less able to afford the premiums because the cost will go up.

As for the much touted 46 million American's are uninsured (15% of the population), (http://www.cbo.gov/doc.cfm?index=4210&type=0&sequence=2#pt2) let's look at those numbers a bit closer. (http://www.cnsnews.com/Public/Content/article.aspx?RsrcID=49986)

Of the 46 million uninsured people in this country, 10.7 million are eligible for Medicaid or SCHIP but haven't enrolled. Should they show up at a hospital ER they will automatically be enrolled by law. Because they're eligible for Medicaid or SCHIP, they won't be covered under the plan.

9.3 million are illegals and are excluded from the plan.

10.1 million have incomes over 3 times the poverty level and won't be eligible for assistance under the plan.

The remaining 15.6 million are childless adults or people who make too much to qualify for medicaid / SCHIP and can't afford a private plan. These are the only people who will receive help with this plan - any only if their employer doesn't offer a health care plan which they've opted out of because they can't afford the premiums.

The plan will only help 34% of the uninsured in America. The remaining 66% will still be stuck. As a percentage of the total population, 15% are uninsured (the 46 million) while only 5% (15.6 million) will have insurance as a result of this plan. A full 10% of the population will still be uninsured with no hope offered by the plan.

Maybe, just possibly, a better approach would be to reduce to cost of private insurance so that more people can afford it. Bring down the average cost for a family for 4 from $3,000 a year to $2,000 or even $1,500 a year. You do that by creating more groups so that the administrative costs are borne across a larger group and the cost of coverage comes down.

Like requiring end of life counseling every 5 years for anyone over 65 with a chronic condition.

Required? No. Offered? Yes. From factcheck (http://www.factcheck.org/2009/07/false-euthanasia-claims/) (I like facts, not rumor. Call it an addiction to the truth instead of an addiction to rumor, slander, and outright lies. Comes with being a scientist in pursuit of the the rules and facts of any given situation).

In truth, that section of the bill would require Medicare to pay for voluntary counseling sessions helping seniors to plan for end-of-life medical care, including designating a health care proxy, choosing a hospice and making decisions about life-sustaining treatment. It would not require doctors to counsel that their patients refuse medical intervention.

One thing that bugs the heck out of me in this whole thing is the sheer amount of disinformation flying around. I've had to resort to factcheck and other means just to make sure I wasn't getting yet another snow job. I like debates about the facts of the matter, not the fiction and hysteria of the matter.

Also, tangental: there have been at least three calls or attempts at Universal Health Care before (Truman 1949, Congress in 1943, and Clinton in 1993. Source = wife's med school notes). What happened to the first two; and why are people saying we need more time when it could be argued that it's been on the table for 65+ years?

Sometimes that means that I drive 2 hours to see a participating provider (and I live a short distance outside Washington DC). Sometimes that means I wait 2 months for an appointment with a specialist.

So what you're saying is that insurance-based healthcare is pretty dreadful, because that's what I'm hearing from this.

Not once have I or anybody I have met, including elderly relatives, military veterans etc have had to wait more than a week to a month for any procedure whatsoever, or been expected to travel for it. And that's procedures that are not always totally essential either.

EDIT: Oh wait, I just read this.
Under the proposed plan that won't change one bit because if your employer offers a medical plan you can't enroll in the public option whether you can afford the premiums in the employer plan or not. (FYI: That's from Section 242 of the plan). That means the plan will do NOTHING to help those people.

Which legislative wise-guy thought of this little provision?

Required? No. Offered? Yes. From factcheck (http://www.factcheck.org/2009/07/false-euthanasia-claims/) (I like facts, not rumor. Call it an addiction to the truth instead of an addiction to rumor, slander, and outright lies. Comes with being a scientist in pursuit of the the rules and facts of any given situation).

I prefer facts as well, Chris, which is why I've tried my darndest to present the actual language in the bill as opposed to someone else's interpretation of them, interpretations that more often than not are based more on marketing and simply regurgitating the lines they've been spoon fed than on the actual content of the bill.

Is it too far a stretch to believe that a government controlled health coverage plan would prefer that people choose to end their lives rather than obtaining life extending medical treatments? Not really, when you consider that the cost of life extending drugs can be several thousand dollars a month while life ending drugs only cost about $100 a pop. IS it too far a stretch to believe that government controlled health coverage plan would refuse to cover life extending treatments but be more than willing to cover the cost of hospice and assisted suicide? Not really when you consider that Oregon is doing it now (http://www.katu.com/news/26119539.html?video=YHI&t=a), or when you consider that the President suggested painkillers for an elderly woman in need of a pacemaker. (http://www.youtube.com/watch?v=xJYvaLS-xOw)

One thing that bugs the heck out of me in this whole thing is the sheer amount of disinformation flying around. I've had to resort to factcheck and other means just to make sure I wasn't getting yet another snow job. I like debates about the facts of the matter, not the fiction and hysteria of the matter.

I totally agree. I can't tell you how sick an tired I am of being lied to by politicians who haven't even bothered to read the bill or how shocked I am to learn that many of them intentionally choose not to read the bill because they don't think they'd understand it. Honestly, if they can't understand the bill and refuse to read it, then why would they vote for it? Worse yet is the hypocrisy of our elected officials who refuse to subject themselves or their families to the plan. If it's good enough for the rest of us great unwashed masses, why isn't it good enough for them? (http://thomas.loc.gov/cgi-bin/bdquery/z?d111:h.res.00615:)

Also, tangental: there have been at least three calls or attempts at Universal Health Care before (Truman 1949, Congress in 1943, and Clinton in 1993. Source = wife's med school notes). What happened to the first two; and why are people saying we need more time when it could be argued that it's been on the table for 65+ years?

Because THIS BILL hasn't been on the table for 65+ years. THIS BILL has only been on the table for a few short weeks and many many many Members fo Congress openly and willingly admit that they haven't bothered to read it.

So what you're saying is that insurance-based healthcare is pretty dreadful, because that's what I'm hearing from this.

Not once have I or anybody I have met, including elderly relatives, military veterans etc have had to wait more than a week to a month for any procedure whatsoever, or been expected to travel for it. And that's procedures that are not always totally essential either.

Not at all. It's a choice I make to have the payment to those providers subsidized by my health insurance company. The availability of participating providers varies based on what care you want to receive. If I want to go to my GP, I can typically get in that day. If I want to see a GYN for an annual exam I have to wait 2 months. If I want to see a rheumatologist I have to travel 30 mins away and wait a couple of weeks for the appointment. It's a choice I make to receive care that is subsidized by my insurance provider.

I could go to a non-participating physician, but then I'd have to pay all of the costs out of pocket. I prefer not to do so.

I read what was written (so far) in the bill and I read it as "offered". No one is mandating end of life and soylent green facilities for the elderly, here. Counseling must be "offered", that doesn't mean it's required to be accepted and it doesn't mean that they will be counseled to end their own lives. Some of the interpretive hyperbole is simply beyond comprehension, in my opinion.

What some are pointing to as "government run" insurance exchange I interpret as "government regulated" private insurance exchange. And, in my opinion, when insurance companies are bumping long time clients because they suddenly did get sick to save their profit margins, or denying coverage because someone is diabetic or has some other pre-existing condition, they need the regulation. They are not going to change their ways unless that is done.

And, from the other thread, I have read the "law" about having to accept and treat ER patients despite their financial/insurance status, but I'm telling you that they have found ways around that in many areas of our country. My proof is personal experience.

What they are doing at our local, county ER is simply cancelling any test that could determine a more costly diagnosis. Because once the tests show the proof, they ARE required by law to treat it. So...they don't run the tests.

This is what happened with my knee. Two doctors manipulated my leg and told me that they felt there was considerable cartilage damage. The ER doctor went to get an approval for the test to show exactly how extensive and if reparative surgery was indicated. This was the point the ER chief doctor came in, cancelled the test, walked over and put "two fingers" on my leg (a light touch--this is legally required to be able to say he examined it), then proclaimed it a "sprain" while the other doctor gagged in the background. He then told the nurse to give me an ace bandage and let me walk myself out (not even a wheel chair--the leg could not bear any weight).

The second incident, same hospital, the doctor himself called to them and requesting transfer for emergency surgery to remove a gall bladder (which had kicked a stone into my pancreatic duct --causing full blown, life threatening pancreatitis). He said they "refused" transfer. I asked him why. He said because I was uninsured (he was quite angry when he said this). He said he was not too surprised, it was happening all the time lately and he was very frustrated with the situation.

The legal way they can do this is that i did not show up in that hospital's ER. The loophole in the law is that they only have to treat me if I show up in their ER.

So, why not go down to their ER? They would not accept the test "proving" the condition from my doctor already taken. I show up in their ER, they don't do an ultrasound to prove the stones exist and they are not legally responsible for treating it. I would have probably been diagnosed with "gastrointestinitis" and tossed out again (my doctor agreed, going to the ER would probably have been the worst choice. He opted to put me on an IV for three days and stabilize me while helping me look for ANY coverage to get me the ticket in--AROUND the ER, not through it).

Is that a sad state of affairs? If this situation hasn't reached your area yet, it may only be a "yet" as things worsen and these sorts of situations spread as ERs struggle to survive at all under the growing burden.

Understand, it's very difficult for me to sit here, having seen and experiencing what I've been through to have someone who hasnt' been there tell me, "Can't happen. There's a law," even though it did happen (and does all the time) despite the law.

This is how they do it here. It is not just me, they have done it to several people I know. Legally, because they have covered themselves by not running the tests, malpractice isn't winnable. They worst "legally" they can be accused of is a medical "mistake" in not ordering a tests and misdiagnosing.

No, I don't have stats...I have personal experiences of my own journey through the "uninsured" ranks and those of my friends.

I've heard in Texas, they are not pulling this stuff and --if you are in that state, you are lucky indeed. More and more ERs are running these sorts of games with the uninsured to survive. They are having a hard time keeping their doors open because of the vast waves of uninsured. If you are very poor or an immigrant with Medi-Cal, they are more liable to treat you because you are at least covered partially by the government. If you aren't...well, you get the "treatment" because they seem to justify that it's better to not treat some, and be able to stay open and at least treat the rest.

Again, yes--I am aware of the laws, but like many things...loopholes in laws are found and exploited. No one wants to think that people would purposely not be treated if they walk into a county ER. But, I'm telling you from personal experience, it's happening. The weight of the system is forcing ERs to do things to survive that perhaps they would have never considered at one time. Overburdened, underfunded, tied by laws and a growing crisis...it appears they are bending the rules to survive. Unfortunately, it costs some of us dearly.

BTW, I just talked to a dear friend of mine who lives in town. She's had good health insurance for many years. Her husband was diagnosed with a brain tumor. They raised his premium from $400/mo to $1,400/mo (not including hers...which brings it up even higher). They couldn't afford it any longer and were cancelled. They now have joined the ranks of the uninsured. They have their own business and are college educated. Other companies have denied his application for other insurance. He can't even get a doctor appointment now...not even a counseling. She doesn't know what to do. She never thought it could happen to her. She did all the right things.

And...they have lost their house, btw. As I said, they were prominent business owners in our town employing many people. Those people had to be given pink slips. My kids went over and helped them move into a rental when they were foreclosed on. They have been destroyed by this...and it has rippled out to their employees and family, as well.

Anyone else outraged? The millions just grew by two more. Their insurance company needed that money to run the ads, I guess, telling Americans how reform will kill older people????

The insurance companies are out of control, in my opinion. That regulation and supervision is EXACTLY what is needed for part of this picture. I do not see this as "government running private business" anymore than having regulations on wall street after what has been happening there. I'm all for those regulations and rules. Bring them on. It's about time.

The insurance companies are out of control, in my opinion. That regulation and supervision is EXACTLY what is needed for part of this picture. I do not see this as "government running private business" anymore than having regulations on wall street after what has been happening there. I'm all for those regulations and rules. Bring them on. It's about time.

If you don't have coverage, for what ever reason, currently then the government controlled plan, assuming you qualify for assistance, is better than what you have. But if I already have a health insurance plan that I pay for that I'm satisfied with, why should I have to submit my plan to government control and the resulting higher costs?

No one has denied that something needs to be done to help the uninsured. But why does providing help to 5% of the population have to come at the expense of loss of control for the 85% who do have coverage?

You also assume that you'll qualify for assistance under the government controlled plan and that that assistance will be sufficient to enable you to afford purchasing coverage. I wouldn't be so sure and am not convinced that that assistance provided will be sufficient to purchase health insurance.

How do you know whether you qualify or not?

Do you qualify for Medicaid or SCHIP? If so then you need to enroll in and receive coverage through Medicaid or SCHIP because the government controlled plan excludes you.

Do you qualify for Medicare? If so then you need to enroll in and receive coverage through Medicare because the government controlled plan excludes you.

Are you an active duty service member or Veteran entitled to care from the VA? If so then you need to receive care from an authorized VA or military medical facility because the government controlled plan excludes you.

Are you an illegal immigrant? If so then you are on your own because the government controlled plan excludes you.

Do you make more than 4 times the federal poverty level for your area? If so then you are on your own because assistance in purchasing health insurance in the government controlled plan will not be available to you.

Does your employer or your spouse's employer offer health coverage which you've opted out of because the premiums cost too much? If so then you are on your own because, unless the annual cost of your employer sponsored premiums exceeds 11% of your annual income, assistance in purchasing health insurance in the government controlled plan will not be available to you.

Do you make more than thresholds for Medicaid / SCHIP, you don't qualify for military benefits, you make less than 4 times the federal poverty level for your area, your employer does not provide health coverage, or if your employer does provide coverage then the annual cost or premiums under your employer provided health coverage exceeds 11% of your income? Well then you're in luck! The federal government will provide you with a credit to purchase health insurance from the government controlled plan.

That credit, specified in Subsection C of Title II in Sections 241 - 243 of the bill, will provide you with a credit to help you purchase a health insurance plan from the government (the public option). You will be permitted to receive a credit if

you make less than 4 times the federal poverty level for your area and family size,
you are not enrolled in another plan as an employee,
you are not eligible for Medicaid, SCHIP, Medicare, VA, or other military medical benefits,
and you are not the full time employee of a company that offers health insurance coverage, unless the cost of that coverage exceeds 11% of your family income or other income level set by the commissioner.


How much will the credit be? It'll be the amount the average annual cost of premiums for the 3 lowest cost basic plans offered in your area exceeds 1/12 your annual income or another income level set by the commissioner.

Lets assume we have a family of 4 making 4 times the federal poverty level who qualify for assistance. For a family of 4 the Federal poverty level is 22,050. Four times that level is 88,200. If the cost of premiums under the exchange exceeds 1/12 of 88,200, then they can get that difference in a credit. 1/12 of 88,200 is $7,350. So, if the cost of their annual health insurance premiums from a family plan purchased under the government plan exceed $7,350 then they can get the difference between $7,350 and the annual cost of premiums as a credit. They will still be responsible for the $7,350.

Let's take another example, a family of 4 making 50,000 a year (just above 2 times the federal poverty level and outside SCHIP or Medicaid thresholds). 1/12 of their annual income is $4,167. If the annual cost of premiums for the family plan they purchase from the government plan exceed $4,167 then they'll get the difference between the $4,167 and the annual cost of the premiums as a credit. They'll still be responsible for the initial $4,167.

Last night I found a basic plan for a non-smoking family of 4 for about $200 a month. That's $2400 a year. Using our examples above and that coverage, neither family would be eligible to receive assistance from the government in purchasing a health insurance plan from the government.

If, however, that coverage cost $400 a month for an annual cost of $4,800, then the family earning 50,000 a year would be eligible to receive a $633 credit to assist them in purchasing a health insurance coverage from the government plan. The family earning 88,000 a year would not be eligible for assistance. Assistance in this example would be available to any family making between $57,600 and $44,000. Any family earning more than $57,600 would not be eligible for assistance.

For an individual the Federal poverty level is lower - 10,830. Any individual making more than 43,320 per year will not be eligible to receive assistance from the government. If an individual makes less than $43,320 then they will be eligible to receive assistance.

It gets complicated with families where one is entitled to medical care from the VA while the other is not. In those instances, the family income (both spouses combined) is assumed to be divided equally and attributed to each, even of one does not work and has no income.

I prefer facts as well, Chris, which is why I've tried my darndest to present the actual language in the bill as opposed to someone else's interpretation of them, interpretations that more often than not are based more on marketing and simply regurgitating the lines they've been spoon fed than on the actual content of the bill.

While I appreciate your use of unmarked-up language, your interpretations are pretty much standard-issue right-wing. They are certainly interpretations that a reasonable person might disagree with.

Folks, the Republican Party must stop health care (http://www.politico.com/news/stories/0509/22155.html) to have any chance of a quick return (http://www.ashbrook.org/publicat/onprin/v2n1/kristol.html) to power. Their arguments are, for the most part, based on self-preservation and/or self-promotion, not what is best for the country - or for you and I.

While I appreciate your use of unmarked-up language, your interpretations are pretty much standard-issue right-wing. They are certainly interpretations that a reasonable person might disagree with.

My interpretations are based on the actual language of the bill, much of which is yes or no. If you'd like to suggest an alternate interpretation to the language in the bill then I'd be more than happy to discuss those alternate interpretations.

Though, I have to admit, that I don't see much wiggle room in "Medicare recipients are excluded from this program", but I may be wrong.

If you don't have coverage, for what ever reason, currently then the government controlled plan, assuming you qualify for assistance, is better than what you have. But if I already have a health insurance plan that I pay for that I'm satisfied with, why should I have to submit my plan to government control and the resulting higher costs?

First of, you are assuming that if you cannot get coverage (for whatever reason) that you will *qualify* for a government plan currently? Not true at all. You have to be dirt poor to qualify--or, you have to sell everything off to get dirt poor and, in some cases, to qualify. For instance, the M.I.A. program will disqualify you if you have a car worth more than $2,000. That's not even a very good car out there these days. But they would have you get rid of maybe your only transportation (worse if you are rural than urban, no buses out in rural) to obtain the coverage.

Medicare has an extremely low qualification factor. Many people who have a job and want to be independent are turned down for medicare because of that low-paying job. The option? Leave work all together and go on welfare? How about we keep people working and paying taxes!?

No one has denied that something needs to be done to help the uninsured. But why does providing help to 5% of the population have to come at the expense of loss of control for the 85% who do have coverage?
5%? The figure used by all media has been 47-48 million Americans without insurance. That is closer to 15%...and growing. This figure has been posted so many times on these forums by valid sources, I'm not even going to go source it again.

You also assume that you'll qualify for assistance under the government controlled plan and that that assistance will be sufficient to enable you to afford purchasing coverage. I wouldn't be so sure and am not convinced that that assistance provided will be sufficient to purchase health insurance.

At this point, I would rather take a chance that it will because I KNOW there is no chance of it the way things are. There will be subsidies to help those who cannot afford full coverage in partial or full shares, depending on the situation.

How do you know whether you qualify or not?
It's called a "chance" at something is better than having no chance at all wtih the current system. We are simply locked out.

Do you qualify for Medicaid or SCHIP? If so then you need to enroll in and receive coverage through Medicaid or SCHIP because the government controlled plan excludes you.
No, applied twice and did not qualify. Applied for M.I.A. and didn't qualify. I had one part time job and my own, small business that is struggling. I make too much to qualify. I could just quit everything, send the kids to foster homes and sell the house and go for welfare and get it. Is that what you would have Americans do? Why is it too much to ask for some *affordable* basic, no frills health access without losing all we have because we break a leg or arm? How about we keep people working, buying food and caring for their children and being part of the *solution* rather than creating a larger problem?

Are you an active duty service member or Veteran entitled to care from the VA? If so then you need to receive care from an authorized VA or military medical facility because the government controlled plan excludes you.
My husband gets V.A. care currently. I tried to enlist, but they said they didn't need any more middle-aged grandmothers.

Do you make more than 4 times the federal poverty level for your area? If so then you are on your own because assistance in purchasing health insurance in the government controlled plan will not be available to you.
That is contrary to what Obama has said as many of these people WILL receive full or partial subsidy help in purchasing either exchange insurance or into a public plan. If not a subsidy then the full price should be low enough to be able to afford for those in this bracket...like "NOT" $1400/mo.

Some of us can actually afford a reasonable price...we just can't get a reasonable price. For instance, I had a friend over 50 years of age that was quoted a price of $40,000/yr for health insurance because of a pre-existing condition. Do you think that's reasonable? Is it any wonder hard working people who have jobs but can't afford coverage??

Most people don't want a handout, they just want a fair deal and not shut out!
That credit, specified in Subsection C of Title II in Sections 241 - 243 of the bill,
I'm going to stop you right here because there are THREE bills in various levels of legislative contemplation---all of them being pounded out, continuously changed and updrafted. These will be eventually merged into one full bill. Be clear on what you are quoting and it is but ONE DRAFT of ONE PLAN, and not the final proposition.

I have faith that Obama has set down the three main things he would like to see in the FINAL health reform proposition, that all americans would have access, that people will be able to keep their current insurance if they are happy with it, and that there will be a public plan.

Any *final* propositions risk veto if they do not deliver on what the President has asked for, no matter how they are currently written up in a legislature.

You can keep quoting sections and subsections of incomplete draft legislation all you like, but all that is likely to be different when the final comes. It doesn't matter to me. Others can decide if they want to accept half-finished bill quotes and one sided interpretations of any one of them as "proof" of some final word at this point. We can argue interpretations of any one of the three proposals, but those interpretations (like the crisis counceling offer interpretation that has been twisted of late) are in error and contrary intepretations will tell you a whole different story.

This game of "word twist" is playing right into the corporate sponsors hands of all those commercials they are spending millions on to defeat this effort, just as they did each time before any attempt to change the status quo has come before our country.

And it doesn't help those who are suffering, dying and unable to access medical care because of how broken it's all become.

I figure this is the last chance for a capitalistic system with the insurance exchange/public plan joint system. If this fails again, the next time it comes back up will be in the form of a crisis when the system totally collapses and true universal care, single payer style, will eventually be implemented at a much greater cost than anything we are talking about here. The insurance corporations are being given a last chance to "work it out" and be part of the solution. I wonder if they are truly aware that by trying to defeat this they may be providing the final stroke to their eventual, permenant downfall?

I'm at the point of saying, "good riddance" if that happens.

Not at all. It's a choice I make to have the payment to those providers subsidized by health insurance company. The availability of participating providers varies based on what care you want to receive. If I want to go to my GP, I can typically get in that day. If I want to see a GYN for an annual exam I have to wait 2 months. If I want to see a rheumatologist I have to travel 30 mins away and wait a couple of weeks for the appointment. It's a choice I make to receive care that is subsidized by my insurance provider. That's because they're specialists! That seems to always be the case. I remember I always had to make appointments way in advanced to see a specialist, like my GYN. Since it's a yearly exam anyway, I'd just make it a year in advance. If it's an emergency situation, you have the ER. For normal basic check ups with a family physician, no wait. The problem is that there's no public care available to those who aren't fortunate enough to have a job that offers insurance or those who just can't afford privatized insurance. WE NEED A PUBLIC OPTION FOR THOSE WHO CAN'T GET PRIVATE. You mentioned earlier how with a government plan, that they'll dictate who you can see and who you can't or might turn you down. How is that any different from privatized insurance companies that can deny you coverage due to prejudices?

Red, someone we know is celebrating today and tomorrow... but I'm getting a bigger high just reading how well-informed you are on the health care debate. What a joy you are!

Some interesting stuff that I heard about on Bill Moyer's Journal... a nice show that I catch from time to time on PBS...

Wendell Potter on Profits Before Patients (http://www.pbs.org/moyers/journal/07312009/profile.html)

A video about the health insurance industry...

more about health care (http://www.pbs.org/moyers/journal/07312009/watch.html)


This was an interesting thing to watch... very enlightening and what not. Not to mention scary... as to what the health care industry does to all of it's patients.

First of, you are assuming that if you cannot get coverage (for whatever reason) that you will *qualify* for a government plan currently

Not at all. I make no assumptions about current coverage or what any individual does or does not qualify for what so ever. I'm merely presenting the requirements to qualify to purchase health insurance under HR 3200, the health care reform bill currently proposed in the US House of Representatives.

I presented in a previous post the breakdowns of the uninsured - those 46 millions we keep hearing about. I'll present them here, again, for clarity.

Of the 46 million uninsured in America:

6.4 million (14%) qualify for medicaid but have not enrolled in it;
4.3 million (9%) qualify for medicaid or SCHIP but have not enrolled in it;
9.3 million (20%) are illegal aliens;
10.1 million (22%) have incomes above 4 times the federal poverty level;
5 million (11%) are childless adults with incomes above medicaid thresholds but below 4 times the federal poverty level; and,
10.6 million (23%) are families with incomes above medicaid thresholds but below 4 times the federal poverty level.


Under the government controlled plan proposed in HR 3200, the first 2 groups who qualify for medicaid or SCHIP but have not enrolled (23% of the uninsured) will be required to enroll in either Medicaid or SCHIP and will not be eligible to purchase coverage under the government controlled plan proposed in HR 3200.

The third group, the illegal aliens who make up 20% of the uninsured, are specifically excluded from the public portion of the government plan proposed in HR 3200.

The last three groups will be permitted to purchase individual coverage from the government plan codified in HR 3200 provided their employer doesn't offer a plan which they've opted out of (they will be permitted in if the premiums on their employer sponsored plan exceeds 11% of their income). If their employer offers health coverage and they are not enrolled in it and the annual cost of the premiums for that plan cost less than 11% of their annual income, then they will not be eligible to participate in the public portion of the government's plan proposed in HR 3200.

5%? The figure used by all media has been 47-48 million Americans without insurance. That is closer to 15%...and growing. This figure has been posted so many times on these forums by valid sources, I'm not even going to go source it again.

See the breakout above. That 46 million includes 20 million who currently qualify for federal health care but have not signed up for it or are illegal aliens and not permitted to sign up for taxpayer funded health coverage.

At this point, I would rather take a chance that it will because I KNOW there is no chance of it the way things are. There will be subsidies to help those who cannot afford full coverage in partial or full shares, depending on the situation.

Wouldn't it be worth looking into your situation to determine if the program will benefit you, rather than just accepting it on faith? The President himself has admitted that the public option will only cover about 1/3 of the uninsured.

It's pretty easy to figure out if the program will help you. As your beloved is covered by the VA he won't be eligible, but you might be. As a ballpark, take your combined AGI from your 2008 tax return and divide it by two. That's your "share". Now look at the federal poverty level for your area and family situation. If it's just you then you are a single person and federal poverty level is about 11,000.

If your share of your 2008 AGI is more than $44,000, then you will not receive any assistance from the government in affording health coverage and you will be expected to purchase private, individual health coverage from the Health Care Exchange. If your share of your 2008 AGI is less than $44,000 then you will be able to participate in the public option and receive assistance in purchasing health coverage from the public portion of the exchange.

The amount of assistance you'll receive will be the amount the annual average cost of the 3 lowest costing basic plans exceeds 1/12 of your AGI.

It's called a "chance" at something is better than having no chance at all wtih the current system. We are simply locked out.

No one has said that the current system is super fabulous. We need to do something to help the uninsured afford health insurance. But closing our eyes to reality and expecting that will be well just because our elected officials say it will be is insane.

Each of us needs to look at the plan, read and understand it, and then see what effect it'll have on us and our families.

No, applied twice and did not qualify. Applied for M.I.A. and didn't qualify. I had one part time job and my own, small business that is struggling. I make too much to qualify. I could just quit everything, send the kids to foster homes and sell the house and go for welfare and get it. Is that what you would have Americans do? Why is it too much to ask for some *affordable* basic, no frills health access without losing all we have because we break a leg or arm? How about we keep people working, buying food and caring for their children and being part of the *solution* rather than creating a larger problem?

No one has suggested that you send your children to foster care, Red. I've simply presented the actual plan as it's proposed in HR 3200 and it's qualifications as it exists. If you qualify for medicaid or SCHIP then, according to the plan, you need to enroll in those programs instead of the public option. If you do not qualify for medicaid, medicare, or SCHIP, then you may be eligible to purchase a health insurance plan through the exchange provided you meet the requirements.

My husband gets V.A. care currently. I tried to enlist, but they said they didn't need any more middle-aged grandmothers.

Then your beloved will not be eligible to purchase health insurance through the exchange. You, however, might be, if you meet the requirements.

That is contrary to what Obama has said as many of these people WILL receive full or partial subsidy help in purchasing either exchange insurance or into a public plan. If not a subsidy then the full price should be low enough to be able to afford for those in this bracket...like "NOT" $1400/mo.

Then I suggest that President Obama read the bill. Title II, Subsection C, Sections 241 - 243 specifically. Because that's where the subsidy is spelled out.

People who are not eligible for other taxpayer funded health coverage programs which are specifically excluded from the Heath Coverage Exchange (MediCare, Medicaide, SCHIP, VA, military medical benefits, etc) may be eligible to receive taxpayer assistance in affording a health coverage plan purchased through the exchange. Assuming they aren't eligible for one of the excluded programs listed above, or aren't illegal aliens, then they must pass the following tests in order to receive taxpayer assistance:

(1) Does their income exceed 4 times the federal poverty level for their area and family situation - Yes or No? If yes, then they can not receive taxpayer assistance. If no, proceed to (2)

(2) Does their employer provide Health coverage - Yes or No? If yes, proceed to (2 a). If no, proceed to (3).

(2 a) Is the individual (or family) enrolled in the employer provided health coverage - Yes or No? If yes, then they can neither receive taxpayer assistance nor purchase individual coverage under the exchange. If no, proceed to (2 b).

(2 b) Does the annual cost of the premiums under the employer provided health coverage exceed 11% of the individual's annual income - Yes or No? If yes, proceed to (3). If no, then they can neither receive taxpayer assistance nor purchase individual coverage under the exchange.

(3) Congratulations! You may able to receive taxpayer assistance toward the purchase of health insurance under the public option.

Note: You here is not a specific you but rather a generic reference to any individual human being above 18 years of age.

Some of us can actually afford a reasonable price...we just can't get a reasonable price. For instance, I had a friend over 50 years of age that was quoted a price of $40,000/yr for health insurance because of a pre-existing condition. Do you think that's reasonable? Is it any wonder hard working people who have jobs but can't afford coverage??

Did I say that thought it was reasonable? I've merely provided the rules as they are written in the plan. For your friend with the pre-existing condition, assuming he / she qualifies for the public option, and the cost of a similar plan under the public option would be $40,000 a year, then he / she would be eligible to receive taxpayer assistance to the extent that that $40,000 exceeded 1/12 of his / her income. For the sake of argument, if your friend had an annual income of 60,000 a year (chosen solely because it is easily divisible by 12), then he / she would be eligible to receive taxpayer assistance of about $35,000 a year to purchase their health insurance from the public portion of the exchange (60,000 / 12 = 5,000. 40,000 - 5,000 = 35,000).

Most people don't want a handout, they just want a fair deal and not shut out!

Again, no one has said that anyone should be shut out or that the current system doesn't need reform. I have simply provided the rules as they are written in HR 3200, the bill currently proposed and being debated in the House.

I'm going to stop you right here because there are THREE bills in various levels of legislative contemplation---all of them being pounded out, continuously changed and updrafted. These will be eventually merged into one full bill. Be clear on what you are quoting and it is but ONE DRAFT of ONE PLAN, and not the final proposition.

Feel free to google, Thomas, HR 3200. As the bill is revised and amended, the revisions and Amendments are reflected.

I have faith that Obama has set down the three main things he would like to see in the FINAL health reform proposition, that all americans would have access, that people will be able to keep their current insurance if they are happy with it, and that there will be a public plan.

Nothing I have presented has contradicted those three commitments. I've merely presented the bill the Congress is considering and it's implications. If you prefer to believe a politician's promises, when he admits that he hasn't read the bill, then I can't stop you. But I will read the bill and present it's reality whether anyone likes it or not.

Any *final* propositions risk veto if they do not deliver on what the President has asked for, no matter how they are currently written up in a legislature.

Line item veto. Not allowed. It's all or nothing.

You can keep quoting sections and subsections of incomplete draft legislation all you like, but all that is likely to be different when the final comes. It doesn't matter to me. Others can decide if they want to accept half-finished bill quotes and one sided interpretations of any one of them as "proof" of some final word at this point. We can argue interpretations of any one of the three proposals, but those interpretations (like the crisis counceling offer interpretation that has been twisted of late) are in error and contrary intepretations will tell you a whole different story.

Then feel free to provide your interpretations of the bill, as it is revised and amended (agian - google Thomas, HR 3200 to see the bill and all of the revisions and amendments to it). I've provided the link before, but it times out of you haven't clicked on it in a while so you'll need to google it yourself.

This game of "word twist" is playing right into the corporate sponsors hands of all those commercials they are spending millions on to defeat this effort, just as they did each time before any attempt to change the status quo has come before our country.

Kinda hard to word twist "individuals who qualify for Medicaid aren't eligible"...

Again, if you'd like to read the bill, as opposed to accepting empty promises from politician's who haven't read it, feel free to do so. Knowledge is power and ignorance is bliss. I prefer knowledge over platitudes with something this far reaching.

The problem is that there's no public care available to those who aren't fortunate enough to have a job that offers insurance or those who just can't afford privatized insurance. WE NEED A PUBLIC OPTION FOR THOSE WHO CAN'T GET PRIVATE. You mentioned earlier how with a government plan, that they'll dictate who you can see and who you can't or might turn you down. How is that any different from privatized insurance companies that can deny you coverage due to prejudices?

We seem to be confusing care with coverage. There is care available to anyone whether they have insurance or not, they just have to pay for it. Insurance coverage means that your insurance company pays a portion of the cost of your care, provided it's with a participating provider.

The public option won't change that. It'll just provide a taxpayer subsidy (see above for the amounts) for individuals who qualify to purchase an individual health insurance plan. Those individuals will have to go to participating providers and will have deductibles they'll have to meet and co-pays they'll have to make, but the insurance they have will cover a portion of the cost of their care. The only difference is that, assuming they qualify, they will receive money from the taxpayers to help them offset the cost of paying insurance premiums. They will be expected to pay premiums up to 1/12 of their annual income, will be expected to pay the cost of care until they meet their deductible, and will be expected to pay their co-payments.

Right-Wing Harassment Strategy Against Dems Detailed In Memo: ‘Yell,’ ‘Stand Up And Shout Out,’ ‘Rattle Him’ (http://thinkprogress.org/2009/07/31/recess-harassment-memo/)

Last week, Politico reported that Democratic members of Congress are increasingly being harassed by "angry, sign-carrying mobs and disruptive behavior (http://www.politico.com/news/stories/0709/25646.html)" at local town halls. For example, in one incident, right-wing protesters surrounded Rep. Tim Bishop (D-NY) and forced police officers to have to escort him to his car for his own safety. Recently, right-wing demonstrators hung Rep. Frank Kratovil (D-MD) in effigy (http://thinkprogress.org/2009/07/28/dem-effigy-afp/) outside of his office.

What we haven't seen much of is the fact that much of this is coordinated by right-wing public relations firms and lobbyists (http://pr.thinkprogress.org/2009/04/pr20090415) who have a stake in opposing President Obama's reforms.

The lobbyist-run groups Americans for Prosperity and FreedomWorks, which orchestrated the anti-Obama tea parties (http://thinkprogress.org/2009/04/09/lobbyists-planning-teaparties/) earlier this year, are now pursuing an aggressive strategy (http://politics.theatlantic.com/2009/07/lawmakers_will_face_tea_parties_and_more_in_august .php) to create an image of mass public opposition to health care and clean energy reform. A leaked memo from Bob MacGuffie (http://thinkprogress.org/wp-content/uploads/2009/07/townhallactionmemo.pdf), a volunteer with the FreedomWorks website Tea Party Patriots (http://teapartypatriots.ning.com/profile/BobMacGuffie), details how members should be infiltrating town halls and harassing Democratic members of Congress:

– Artificially Inflate Your Numbers: “Spread out in the hall and try to be in the front half. The objective is to put the Rep on the defensive with your questions and follow-up. The Rep should be made to feel that a majority, and if not, a significant portion of at least the audience, opposes the socialist agenda of Washington.”

– Be Disruptive Early And Often: “You need to rock-the-boat early in the Rep’s presentation, Watch for an opportunity to yell out and challenge the Rep’s statements early.”

– Try To “Rattle Him,” Not Have An Intelligent Debate: “The goal is to rattle him, get him off his prepared script and agenda. If he says something outrageous, stand up and shout out and sit right back down. Look for these opportunities before he even takes questions.”

The depths some of us have sunk to... :no:

^ To me, that means that the people are against this plan, not just Republicans in Congress trying to "rebuild."

I don't see how much more plain it could be.

ETA: These sure don't look like lobbyists protesting against Rep. Doggett in Austin Texas...
http://www.youtube.com/watch?v=a8UjY3YDlwA

To me, it sounds like lobbyist money wallpapering halls with disrupters to defeat a plan for their clients.

I'm sure there are true constituents in opposition...but it sure does look like the corporations are trying to inflate the true numbers "create" something theatrical.

An owl will fluff up when threatened to make itself look larger, too. But, in truth, it's also just fluff and air with not much meat beneath.

To me, it sounds like lobbyist money wallpapering halls with disrupters to defeat a plan for their clients.

I'm sure there are true constituents in opposition...but it sure does look like the corporations are trying to inflate the true numbers "create" something theatrical.

An owl will fluff up when threatened to make itself look larger, too. But, in truth, it's also just fluff and air with not much meat beneath.

!?!

So the people that are very upset with their representatives and are passionate about this issue are just "fluffed up?"

I say there are plenty of feathers in this thread on both sides, in that case...

The comments were in reference to the story and links purplehawk provided. Namely, these disruptions are "scripted" and being organized by a big money lobby firm paid for by insurance corporations. Some of these disrupters have even been bused into some these town hall meetings, according to reports.

In other words, it's supposed to look like grass roots but is actually "astroturf", farmed, rolled up and laid out by previous plan.

Again, not all opposition comes by this means. I'm sure there were genuine constituents from these meetings who truly were there on their own initiative. I would be surprised if there were not--this is America of many viewpoints and opinions. There is always opposition to anything (as well as proponents) :p But, according to the reports, they are being "added to" and fluffed up by lobbying efforts.

A quick post and run here...

To me, it sounds like lobbyist money wallpapering halls with disrupters to defeat a plan for their clients. I'm sure there are true constituents in opposition...but it sure does look like the corporations are trying to inflate the true numbers "create" something theatrical. An owl will fluff up when threatened to make itself look larger, too. But, in truth, it's also just fluff and air with not much meat beneath.
Likely...

From ScienceBlogs:
Health care Reform: How to Obfuscate, Confuse, and Inflame (http://scienceblogs.com/whitecoatunderground/2009/07/health_care_reform---how_to_ob.php)

Pretty much can apply to all of the stages of argument against Health care reform. I'll never understand why Republicans are so against it and appearing all for our current broken system. Beyond the ridculous politics. Which is a disgrace.

.

Talking about confusing and inflaming...no one has taken the links that Mom has provided and debated them on their merits. Instead someone posts a story that is likley to either inflame or guilt conservatives so that the thread falls back to partisan lines and people can inflame and guilt each other more.

I am not so eloquent as she. From what I can see Mom has some ligitemate worries about coverage. About Medicaid and Medicare and people who must use those resources--well aren't those programs riddled with their own problems? This plan seems to force some people to those programs and yet what is one way the plan is paid for (http://www.google.com/hostednews/ap/article/ALeqM5i41RM2oyMgCk3ZGKmxZ4mOvQUdhgD99PPIE00)? By cutting funding to those very programs?!


by Associated Press

CHANGES TO MEDICAID: The federal-state insurance program for the poor would be expanded starting in 2013 to cover all non-elderly individuals with incomes up to 133 percent of the federal poverty level ($14,404).

HOW IT'S PAID FOR: Revenue-raisers include $544 billion over the next decade from new income taxes on single people making more than $280,000 a year and couples making more than $350,000; $37 billion in business tax increases; about $500 billion in cuts to Medicare and Medicaid; sizable penalties paid by individuals and employers who don't obtain coverage.

Bolding mine. So they are expanding Medicaid and Medicare but they are cutting funding?

Good Job, Mom. :tu:

From MNF's link above:

You can count on the Wall Street Journal for pretty good reporting and for extremist right-wing wackaloonery on the OpEd page. Today, they deliver the latter, with bonus fear-mongering at no extra charge.

The piece is entitled, "GovermentCare's Assault on Seniors" and that pretty much sums up the content of the article. Unfortunately (at least, for the moral health of the author), there is little below the headline to justify the inflammatory headline.

What we're seeing here is an attempt to redefine the harsh realities that make heath care reform so necessary. And I guess it's time to drag this bit back into the light of day, as today's debate is hardly the first time the right has used the strategy.

The aide said that guys like me were "in what we call the reality-based community," which he defined as people who "believe that solutions emerge from your judicious study of discernible reality." ... "That's not the way the world really works anymore," he continued. "We're an empire now, and when we act, we create our own reality. And while you're studying that reality—judiciously, as you will—we'll act again, creating other new realities, which you can study too, and that's how things will sort out. We're history's actors…and you, all of you, will be left to just study what we do."

I've been a proud member of the reality-based community since I first read that bit.

To me, it sounds like lobbyist money wallpapering halls with disrupters to defeat a plan for their clients.

I'm sure there are true constituents in opposition...but it sure does look like the corporations are trying to inflate the true numbers "create" something theatrical.

Or a disinformation campaign orchestrated by liberals in the media to discredit honest citizens who are opposed to government controlled health care. :whistle:

Like the NY Times reported:
With Republicans mobilizing against the proposed health care overhaul, President Obama, Congressional Democrats and leading advocacy groups are laying the groundwork for an August offensive against the insurance industry as part of a coordinated campaign to sell the public on the need for reform.

Speaker Nancy Pelosi was open about her intention to demonize the insurance industry in an effort to sell health care reform.

“The glory days are coming to an end for the health insurance industry in our country,” Pelosi told reporters Friday afternoon.

“This is about inoculating against misrepresentations and educating about what is in the bill,” she said. “We all want bipartisanship... but you’re either with the insurance companies or you’re for something new.” …

“We know what we are going to be up against,” the speaker said. “We have no illusions about what they are willing to do and how much they want to misrepresent.”

“Health Insurance Reform To Hold Insurance Companies Accountable” is the title of pocket cards issued to Democratic members going home for the recess…

Part of that campaign appears to be claiming that those opposed to government controlled health care are insurance industry operatives. The problem is that the people opposed to government controlled health care., like me, have read the bill and do know the facts.

Pelosi and those who back the bill don't want us to know the facts - which is why they tried desperately to rush the ting through before the August recess. The last thing in the world they want is for people to read the bill and ask them to defend it. And god forbid that anyone dare ask whether they'd forgo the taxpayer funded gold plated plan they have and purchase a government controlled plan from the exchange. They wouldn't want to be out on the spot and forced to explain why government control is good enough for the rest of us, but not good enough for them or their families.

Talking about confusing and inflaming...no one has taken the links that Mom has provided and debated them on their merits. Instead someone posts a story that is likley to either inflame or guilt conservatives so that the thread falls back to partisan lines and people can inflame and guilt each other more.

I am not so eloquent as she. From what I can see Mom has some ligitemate worries about coverage. About Medicaid and Medicare and people who must use those resources--well aren't those programs riddled with their own problems? This plan seems to force some people to those programs and yet what is one way the plan is paid for? By cutting funding to those very programs?!

Thanks Flimsey!

And you are correct, my concerns aren't from some other person's conclusions about what is and is not in the bill, my concerns are with what's actually in the bill. There are some who seem to believe that the plan will provide them health care (note I didn;t say health insurance but health care) at no cost. But unless they qualify for Medicaid or Medicare, then they'll be responsible for paying the premiums on their health insurance up to 1/12 of their annual income or more if they don't qualify for assistance. In addition to paying for their premiums they'll have to meet their deductible and make co payments when they receive services.

President Obama said he believed a moderate plan would be one with a deductible of $500 and an 80/20 split with $25 copays and a $5,000 annual maximum. That means that a struggling family would be responsible for paying premiums on insurance up to 1/12 of their annual income, would have to pay the first $500 of medical expenses incurred, would have to pay $25 for every Dr visit, and would have to pay 20% for every medical treatment (outside of DR visits) after they've met their $500 deductible, up to $5,000 a year. If you assume that insurance premiums for a family of 4 is $200 a month, then that family would be on the hook for $2,400 in premiums, $500 in deductible, and up to $5,000 for medical treatment outside of DR visits (things like x-rays, mammograms, blood tests, allergy shots, mixing of allergy serums, IV drug infusions, biopsies, surgery, casts and durable medical equipment, or therapies like speech, physical, or occupational therapy).

For families struggling to make ends meet and choosing to forgo health insurance because they can't afford it, I'm not sure this program offers much in terms of real financial assistance.

And then there's the very real possibility that some of the individuals who purchase taxpayer subsidized health insurance won't pay their premiums and / or won't pay their Doctors for services before they've reached their deductible or as part of their 20% co-pay. What then? Who will be on the hook for those payments? Will the government force them into foreclosure, repossess their cars, garner their wages? Will the government allow their insurance to be canceled because of non-payment - and what will happen to that family then - would they then be permitted to purchase another insurance plan from the exchange? Will the Dr's be left with the bill and the costs will get passed down to the rest of us, just like they are now?

The only differences I can see between this plan and the plan we have now are the government will control all health coverage in the country not just those in government programs, and limited taxpayer assistance for the purchase of an individual health insurance plan will be available to those few who qualify. Beyond that it's pretty much same old same old at a heck of lot more cost.

So they are expanding Medicaid and Medicare but they are cutting funding?

Yes. Seniors have cause to be very concerned.

Those are very broad strokes you're painting there, Mom. You are no more in a position to discuss a health care bill than I am. There just isn't anything finalized enough for the kind of private interpretation you seem hell bent and determined to discuss.

I wonder. Have you ever considered the extent to which the federal government already contols health insurance in this country? If it wasn't for the feds, the health insurance market would have collapsed decades ago.

I wonder. Have you ever considered the extent to which the federal government already contols health insurance in this country? If it wasn't for the feds, the health insurance market would have collapsed decades ago.

You speak in part of the hundreds of billions (http://www.truthout.org/061609M) given to the insurance industry

:relax:

No worries there. I think expanding Medicare to provide a public option not a bad idea.

I don't have any problem with expanding Medicare to help those who can least afford health coverage. I believe the expansion, from Flimsey's post, was up to 1.33 times the poverty level. So a family of 4, federal poverty level of approx $22,000, would have to have annual income of $29,260 or less to qualify. If their income is above $29,260 or below $88,000 then they'd be eligible to participate in the public portion of the health insurance exchange and receive additional taxpayer assistance to the extent that the premiums on the plan they purchase from the exchange exceed 1/12 of their annual income.

So, on the lowest possible end, a family that earns $29,261 will be entitled to additional taxpayer assistance to the extent that the premiums for the plan they purchase exceed $2,438 a year. That family will still be responsible for paying the $2,438 in premiums, meeting their deductibles, paying any co-insurance, and making co-payments when they see a physician or obtain a prescription.

But I guess you wouldn't want to post the link since it does look at both sides.


More snark and sarcasm :no:

Really, you're not winning anyone over. You might have had a chance if the Republicans showed they cared enough about the issue to flesh out anything they've proposed. But their only strategy so far is to cloud the issue and make hysterical diatribes.
Really, what are the Republicans offering?
Nothing.
So either the system isn't broken in their eyes or they don't know its broken... One is denial, the other is ignorance. Neither offering is acceptable.
:no:

For the umpteen millionth time, no one has said that the situation we have now is acceptable. We need to do something to make health insurance coverage more affordable. Expanding access to Medicaid and Medicare are wonderful suggestions and that will help those least able to afford their premiums. But how to help those outside that expanded Medicare / Medicaid inclusion afford health insurance is another issue. And, in my opinion, HR 3200 does nothing to address it.

In fact, HR 3200 does little more than allow the government, through the Health Exchange and the Health Choices Administration, to take over control of every health care plan offered in this country, and provide a modicum of taxpayer assistance to people who don't qualify for Medicaid / Medicare but can't afford health coverage.

Those are very broad strokes you're painting there, Mom. You are no more in a position to discuss a health care bill than I am. There just isn't anything finalized enough for the kind of private interpretation you seem hell bent and determined to discuss.

I can read, purp.

The bill is available, with all of its edits and amendments, should you care to actually do so. I believe that it is important to read the bill and understand it's implications in practical terms so that we don't get lost in the marketing and platitudes. I choose to discuss the actual language in the bill because that's my right, even my responsibility as a citizen. If you choose to ignore the actual bill and focus on marketing and empty promises from politicians, that's your choice. But I have a right to discuss the actual bill currently proposed in the House and it's actual language.

Okay guys let's move to more positive areas and leave the argumentive mood behind us please!

Okay guys let's move to more positive areas and leave the argumentive mood behind us please!

Thanks Hes.

Here are the other two bills: S.703 (http://thomas.loc.gov/cgi-bin/query/z?c111:S.703:) and H.R.676 (http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.676:).

I think I like these two better.

Here are the other two bills: S.703 (http://thomas.loc.gov/cgi-bin/query/z?c111:S.703:) and H.R.676 (http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.676:).

I think I like these two better.

What makes them better, in your opinion? I'm not arguing, just trying to understand.

That's the whole point, Mom. I've told you several times now that the bill you've been harping about is nowhere near the final product. Yet you've written roughly the equivalent of the Book of Genesis complaining about it. It will all shake out in the end and we'll have a real bill to pick to pieces. I'm content to wait for it.

That's the whole point, Mom. I've told you several times now that the bill you've been harping about is nowhere near the final product. Yet you've written roughly the equivalent of the Book of Genesis complaining about it. It will all shake out in the end and we'll have a real bill to pick to pieces. I'm content to wait for it.

If that's true, that's fine. But how does that mean we don't get to pick apart the one that we are being presented with at the moment? Should we just accept it at face value and not say anything?

Isn't the point to DEBATE what has been put before us? I don't care whether or not it's the final version. What's in it already is bad, IMHO, which is why I feel that it is my First Amendment right and duty to say something about it BEFORE it gets any further.

Sorry, purp, I'm not quite understanding your "whole point".

And I'm NOT content to just "wait for it". I want my voice heard, as is the way of democratic republics. I don't just "wait" for what the gov't says is going to happen. I'm a CITIZEN, not a SUBJECT.

That's the whole point, Mom. I've told you several times now that the bill you've been harping about is nowhere near the final product. Yet you've written roughly the equivalent of the Book of Genesis complaining about it. It will all shake out in the end and we'll have a real bill to pick to pieces. I'm content to wait for it.

Thomas is being updated every time HR 3200 is amended. I prefer to keep up to date on what my Congress is considering and how they're adapting it. Thus far the sections of HR 3200 which I've presented have survived intact. The full bill only has a few more hurdles to pass before being presented to the full House for voting. As the majority in Congress has decided that allowing Members and the public time to read bills is undesirable and prefers to rush legislation through, I believe that keeping up to date on the bill most likely to be put before the House is of the utmost importance.

EDIT**

FYI: S703 was last looked at by the Senate in March of this year when it was referred to the Senate Finance Committee. Prior to that it was read twice and then referred to the Finance Committee. It was proposed by Bernie Sanders of VT and has no co-sponsors. In other words, it's DOA.

EDIT # 2 *****

FYI: HR 676 was proposed and last acted on in 2005. It's been DOA for more than 4 years.

The only "health care reform bill" currently active and being discussed in either the House or the Senate is HR 3200.

It's the only one to win a vote out of committee. The Baucus bill is again delayed. And so is the HELP bill. HR 3200 remains one of three. And anything coming out of the House will have to be reconciled with the Senate version and vice versa. I think you know that.

It's the only one to win a vote out of committee. The Baucus bill is again delayed. And so is the HELP bill. HR 3200 remains one of three. And anything coming out of the House will have to be reconciled with the Senate version and vice versa. I think you know that.

Why are you so concerned with people reading and discussing the legislation currently before Congress?

As I'm sure you know, HELP is in the Senate Health, Labor, and Education Committee (thus HELP) and the Baucus bill is still in draft in Baucus' head in the Senate Finance Committee. Both are still in committee in the Senate (though Baucus' bill hasn't even been proposed in committee so it's still in his head) and will need to be reconciled after they leave committee before they are proposed as the Senate's version of a "health care reform" bill. Thus, there's nothing to discuss about them because they haven't even been moved out of committee yet (HELP, I believe, has moved onto the Finance Committee where it's stalled).

HR 3200, the house bill, has already been proposed. Therefore the only bill we have, for which a vote could happen in the near future, is HR 3200.

Cap and Trade was discussed here, but it's version has yet to be presented in the Senate. As it hasn't passed the Senate it hasn't gone to conference committee. Yet we discussed it's requirements and implications in detail here. We even discussed it before it cleared committee and went to the House Floor for a vote.

I don't recall any cries that we were jumping the gun then. So why now?

Why are you so concerned with people reading and discussing the legislation currently before Congress?

I'm not concerned about discussing it. I don't believe you're representing it fairly, though, and I still think it's premature to be ripping apart a bill this early in the process.

I'm not concerned about discussing it. I don't believe you're representing it fairly, though, and I still think it's premature to be ripping apart a bill this early in the process.

Then feel free to suggest what I've misunderstood in the bill. I've only presented a few limited sections - those dealing with the establishment of the Health Choices Administration and the Health Insurance Exchange, and those dealing with who would qualify for the public option and what additional assistance they might receive to offset the cost of purchasing a health insurance package from the Exchange.

I'm just one person and I'm perfectly willing to accept that I may have misunderstood the aspects of those sections. So please, feel free to indicate where you believe I've misunderstood them.

Premature or not, wouldn't it be fair to at least say if you are in favor or not in favor of the way things stand as they are now propositioned? If you do not think this legislation is fair, or will remedy the situation adequately, then wouldn't it be prudent for you to talk to your legislators during recess? It's in the Dems own best interest to make sure that a viable bill sits before the President. Between the cost, defecit, and coverage concerns, I do not believe this bill is viable as it stands right now. While it can, and probably will, change somewhat between now and the time it is voted upon, I can't see how all of the issues can be satisfactorily dealt with.

MNF, I did read your posting about Medicare. What I took from it, and you can correct me if need be, is basically Americans will be getting more for less if they are in the Medicaid/Medicare programs. With the influx of people that looks like will happen, according to Mom's links, I can't see how the amount cut could be anything but a detriment. Perhaps if no extra people were on the program the cuts could be absorbed to finace other plans, but with extra people I don't see how that is possible. Slowing down payments to the doctors could a) as you said force the doctors to provide better care, or b) force doctors to take on more patients (which they will need to) which could result in worse care.

Premature or not, wouldn't it be fair to at least say if you are in favor or not in favor of the way things stand as they are now propositioned?

Not to me.

If you do not think this legislation is fair, or will remedy the situation adequately, then wouldn't it be prudent for you to talk to your legislators during recess?

It would be prudent, yes. But that is not what's happening at the townhalls. One of the instructions given in the strategy memo is to disrupt and prevent the representative from getting in a word edgewise. The protesters purpose is to intimidate and that's pretty much what they're doing. Nobody gets to talk sensibly or responsibly.

ETA:

To illustrate a bit more, The Worcester Telegram & Gazette (http://www.telegram.com/article/20090804/NEWS/908049966/1116) reports on yet another townhall disrupted by heckling, shouting and other unruly behavior from Bay Street tea partiers directed at Representatives Neal and McGovern. At one point, one heckler likened Rep. McGovern to Nazi war criminal Josef Mengele, notorious for performing macabre experiments on concentration camp inmates.

In response to a question about medical effectiveness research, the gentleman wearing a shirt with President Obama sporting a Hitler mustache called our dean "Dr. Mengele" for suggesting we compare treatments to find those that are effective, safe and better than other medical treatments treatments. The conversation reached a low at that point.

That awful bit came in response to a little old lady in her 60's who asked a question about medical effectiveness research.

Josh Marshall of Talking Points Memo has a source who ID'd LaRouche followers (http://www.talkingpointsmemo.com/archives/2009/08/teabaggerlarouche_alliance.php?ref=fpblg) posing as concerned citizens. They were identifiable by their tee-shirts, which sported a picture of President Obama with a Hitler mustache. They were also passing out literature entitled "Nazi Health Plan."

Originally posted by Purplehawk

Not to me.

Why not? I think Mom has done what alot of Americans are unwilling to do, and looked at the bill. It is very hard to follow, I will admit, but at the same time it shouldn't be ignored either.

It would be prudent, yes.

So you do have concerns? If not with the coverage, is it because of the cost, or some unknown factor?

But that is not what's happening at the townhalls. One of the instructions given in the strategy memo is to disrupt and prevent the representative from getting in a word edgewise. The protesters purpose is to intimidate and that's pretty much what they're doing. Nobody gets to talk sensibly or responsibly.

There is nothing wrong with e-mails or letters either. During recess is the time they will need to read through that mail. The townhalls have nothing to do with it since it is not in every local and using it to somehow absolve oneself from speaking to your Senators and Congressmen seems a bit *ahem* flimsy. ;) Your voice can be heard in letters and in polling numbers as well.

I'm confused. Why is it so important that I state an opinion? I will do so when I'm ready.

So you do have concerns? If not with the coverage, is it because of the cost, or some unknown factor?

You kinda truncated my quote. I didn't say anything about concerns with the legislation. My concerns at the moment have more to do with what's happening at the townhalls.

Did you see my edit above?

Well, I can tell you that I am very much in favor of a public plan. I think this will be a key to competitiveness and bringing down premium prices...at least one of the keys.

As far as comparitive research in effectiveness of different types of tests and treatments. Oh yes, I'm in favor of this and I can tell you why.

First off, the research would be "offered" to doctors and available for them to check. I did not interpret this as being "forced" to chose one. Each patient is different in history and case as well as how they respond and the best decision is for the doctor to discuss it WITH the most recent information and research available to him, to make the best decision with their patient.

From personal experience I can tell you that I actually argued with an ER doctor about a particular test when I was admitted. I had read up on my ailment and the normal testing (pros and cons) of various diagnostics. For instance, the "cat scan" was deemed of little value as it had a bad rate of actually picking up what was being looked for in this case. It is also a very expensive test. An ultrasound was the preferred and best ranked way of getting a quick diagnosis (or rule out) for the suspected ailment. It cost five times less.

When the ER doctor ordered me a cat scan I questioned her as to why and cited the information I had read. If she had given me a good reason, I might have changed my mind (for instance--perhaps she suspected something else that WOULD be picked up on cat scan). She claimed she simply knew better than I and I should trust her (even though I had never met her before that night).

Guess what? The cat scan showed nothing. The next doctor ordered the ultrasound the next day which did show the ailment clearly and provided a concrete answer as to treatment.

This being said, I now am paying $5,000 for a test that did no good, was clearly rated as "not the best diagnostic tool" for the symptoms and ailment and was a waste of my money...because, as uninsured at the time, I get the bill. I'm still kicking myself for agreeing under duress.

How many times has this same doctor charged a medicare or medicaid patient for this same test under the same conditions? How many times has she sent the claim into an insurance company and charged them...which is passed on through premiums, to their customers later?

These are things that can be fixed by offering a pool of the latest information and statistics to doctors.

Pooling information, the most recent, can streamline diagnosises and treatments to save time, money and possibly lives of patients who often are charted through test after test...often the same ones when sent to different doctors!

This is why I am for this provision and see it as a way to streamline costs in our system. I find it very logical and practical and does not "ration" care or cut out choices, but makes it more likely that the correct choices for the right patients are found much quicker and with less expense.

One item I am not sold on yet that has been proposed in some versions of legislation is the inability for a taxpayer to "opt out" of the whole insurance system if that is what they wish. I have heard some convincing arguments of those who do not go to western type doctors, do not like the western medicine philosophy and chose alternative medicine types at their own risk who have issue being a part of a system they never intend to use.

I also think I might like some plans that bypass employer offered insurance, as well. I'm still thinking about that one. I'm not sure that we should ever have had health care insurance and employers mixed up together. So many employers no longer offer insurance anymore (at least here) because of cost and burden, might it not be better to do this totally through individual plans? Again, i'm thinking about this one and have not fully decided to work that.

About cost. I think that the cost of not doing this will outweigh the cost of doing any of the current plans. I think further waiting will make sure that whatever bill there is now is bound to be exponentially higher later. I'm also convinced there will be a later. It is my opinion that the system cannot survive and will collapse eventually.

Is there anyone out there that didn't think it would have a cost? I, personally, think that's unrealistic. I bet the cost to me is cheaper per year than that erroneous catscan I am now going to have to pay for (probably for a long time). So, I may pay more out in one way--perhaps direct premiums (but at a reasonable price we can actually afford), some in tax but I will save by actually avoiding losing work time and income producing time because I will be able to actually treat minor things than wait until they require $20K in ER tests because they have reached a catastrophic point untreated.

I'm good with that.

My hospital might actually get paid a lot quicker, too--and they will be happier as well! (it's going to take me years). Maybe without having to subsidize ERs for all those uninsured who don't pay, the states, counties and feds can actually use that money for things like...schools! or...paying down the deficit!

I have heard some convincing arguments of those who do not go to western type doctors, do not like the western medicine philosophy and chose alternative medicine types at their own risk who have issue being a part of a system they never intend to use.

Oh dear god please tell me that this isn't being discussed in reference to actual legislation. Alternative medicine is untested, often based on superstitions and also totally irresponsible for anything other than perking people up who might be 'a bit down' or something similar. Whilst nobody denies the psychological effect of these remedies, they are pretty much always based on pseudo-science, total lies and misinformation.