Republicans like John McCain argue that the government does not have the competence to provide health care. Really?

The Centers for Medicare and Medicaid Services report that the U.S. spent $7,439 per person on health care in 2007. Compare that to the Department of Defense (aka the government) health care budget for the 2009 fiscal year. They provide “exceptional health care” (the DoD’s own words) to 9.2 million active duty and retired military and their dependents. The annual per person cost is about $4,500.

Clearly, the goverment does have the competence to deliver quality and affordable health care, and that’s what scares the for-profit health care industry.

I find it ironic that members of congress (and many other government employees), active and retired, are able to obtain health insurance through their employer (i.e.) the U.S. Government and that this insurance is subsidized by the U.S. Government, that is to say taxpayers. Further, although it is nearly impossible to verify this because of lack of published data, my guess is that the net worth and annual income (not just their government salaries and/or pensions) of members of congress exceeds both the income and assets of the average American. Therefore, we, the average folks, are dependent upon these relatively entitled people, whom we are subsidizing, to correct a health insurance system that serves them very well indeed.

To build on what Jeanine just wrote…

I’ll have what they’re having. Whatever health plan Congress has is what the rest of us should have. I have really strong private insurance, but I’d change the structure of my coverage in a minute if it means every citizen is covered equally.

Alternately, if Congress drums up a lowest-common-denominator “solution” to health care, then that should automatically become their plan. Whatever coverage the poorest of the poor in our country will have should automatically be the health care plan for every member of Congress. Period. End of discussion. Enough already.

They’re supposed work for us, remember?

To find a good solution seems to me impossible. Imagine if we’d never had abortion: 45 million more young people and young adults would be in the U.S. today, needing health care (which would push the costs down), and relatively healthy and paying health insurance.
As with Social Security’s and Medicare’s woes, the problem is that abortion, very predictably, led to this disaster. It’s somewhat fitting that abortion, an evil perpetrated by the medical community, would end up seriously damaging the medical and health care community itself.

“I have really strong private insurance, but I’d change the structure of my coverage in a minute if it means every citizen is covered equally.”

I’ll have what LinP is having.

I too have excellent coverage but would gladly change the structure of my coverage so that everyone could have what I have or better, what Congress has.

Those asshats in Congress, including “my” asshat Chris Dodd no doubt get all kinds of perks and payoffs (Countrywide mortgage, etc.) and it’s in their personal interest to keep things as they are. This is less a Democrat/Republican problem, it’s a conflict of interest problem.

I have seen the problem and it is Congress.

By the way, Robert Reich posted an excellent essay on the public option here:

http://robertreich.blogspot.com/2009/06/why-critics-of-public-option-for-health.html

I am self-employed with Blue Cross at $650 a month, $20 co-pay — in Massachusetts. The Massachusetts Connector, I believe it is, has state-negotiated versions of the plans Blue Cross offers on its own, and careful scrutiny revealed the kind of small print the banks use (my opinion). For a savings of about $30 a month, I would be giving up what I would most need, and if I had to go the hospital, there would be a something like a $5,000 deductible. I forget the exact details, but wherever I look, cheaper plans would leave me not going to the doctor at all.
Whether it’s a Massachusetts-negotiated plan or totally private, the deductible for cheaper plans would be approximately what I end up paying per year anyway, going when I think I need to. But I’d have less security (with cheaper plans) in case of serious illness (illness for me means no income).
In short, Massachusetts isn’t much of an example.

Why is there no discussion — or furor! — over lack of dental & vision care coverage in this comprehensive health care reform effort?! Americans are being FLEECED by their dentists, periodontists, optometrists, etc. who are conveniently escaping scrutiny in the way they rake in earnings from their lucrative practices.

In the 7/2 issue of the New York Review (online), Arnold Relman lays out a very compelling argument about the relative costs of private and public healthcare.

“Profits and management expenses take at least 10 to 20 percent of the premiums charged by investor-owned plans, including the costs of selecting those they will insure, whereas the overhead costs of Medicare—a government-run insurance plan covering everyone sixty-five and older—are about 3 percent. When private insurance companies provide coverage for Medicare patients (as in the Medicare Advantage plans), they cost the US government about 13 percent more than standard Medicare coverage.

“In comparison with public insurance, a much smaller fraction of private insurance premiums goes to the actual provision of care, and the cost of providing acceptable care for those under sixty-five is probably much higher than if the same population were covered by Medicare. The private US health insurance industry has revenues from premiums of at least $500 billion, so its business overhead and profits add many billions to the cost of health care.”

I don’t honestly see how we can justify or even afford for-profit healthcare in the form that we know it. Some conservatives are queasy about “paying for others” (you know: some unknown, probably Mexican, layabouts). These people are convinced that they have always paid their own way and are proud of it. Of course, they’re nuts. The government — which is to say, all of us — have educated them, built the roads they use freely, sent the fire engine when they leave a live ember in their barcalounger, and set up special programs to protect their kids and their interests.

We have a community of interests. Among these is the development of a much, much healthier, much more responsible, and more justly treated population.

I agree with jeanine, we should all have the same health plan as the senators. Any politicians who are against government sponsor health plan, should revoke their health insurance pay by the US taxpayer. Otherwise, whatever they say, carry no weight.

Ellen I agree with you 100% the Massachusetts plan is failing as well. The state just announced that it’s making cuts to the very people it the plan was started for in the first place. This system does not work, period.

http://www.boston.com/news/health/articles/2009/06/24/
state_cuts_its_health_coverage_by_115m/

Our health care system is broken. Anything less than a complete overhaul is not going to work. The fro profit insurance companies have to be taken out of the equation.
the pharmaceutical corporations also need to be told that the party is over for them.

We demand good decent health care, period.

Jane again? Please rotate the guest hosts.

G/M,

We hear about the projected costs of a public plan over a 10-year period, approx. $1-1.5T. Can your guest tell us the costs of the current system (including all the programs, insurance, etc.), for the same time period?

Thank you,

jack

if the government takes over health care then we “will have to wait for care”??? waitng for care is better than no care at all which is what I have now.

Why are we putting up with Lindsey Graham? Who the hell cares what he has to say about anything.

Do people realize that the Democrats are now the party of the right. They will squash this like they did the Clinton plan.

The Coop plan is a joke. All of these plans are a joke.

We need a good national health care system, one that is not based on a for profit model.

I find it so rich that Lindsey Graham a man with a national health care plan that he and his family use and will continue to use long after he is voted out of office has the nerve to say to the American people that we don’t deserve the same thing he gets on our dime.

Great Gail Wilensky, now we will really get some BS.

The tax cuts GW gave out could have gone for a national health care system.

Ed helmrich , if you don’t want abortion don’t have one …..enough with your mythological obsession that a fertilized egg is a human being . Just because you believe in Santa Claus , it doesn’t make it true …..

The oath all doctor’s take says at the outset, “First, do no harm.” Sounds noble, eh?

Well, think of the harm done when the AMA, insurance companies and the pharmaceutical industry, hand in hand with conservative elements, have done for decades when they first blocked universal health care proposed by that notorious socialist, Teddy Roosevelt, followed by the equally evil socialists, Harry S. Truman and Lyndon Johnson.

While other enlightened (and some not so advanced) countries plowed ahead with universal coverage and their health statistics got better and better, thousands if not millions of people in this country died, lost homes, went into bankruptcy, despaired because they simply couldn’t afford to see a doctor, pay the premiums, pay for operations or medicine.

And that’s not to mention the unseen costs that manufacturers and other employers have to tack onto the prices of their goods and services. What moron decided that employers have to be saddled with medical coverage? When you buy a Chevy, you probably pay $1500 more than that car would cost without the medical and pension costs. No wonder manufacturers go off shore. Manufacturers in other parts of the world don’t have to worry about paying for their employees’ insurance and pension coverage. “Their taxes are too high!” shout the special interests. So you think just because your taxes are lower you’re not paying?

So, while the noble medical, pharmaceutical and insurance industries have protected you from the evils of socialized medicine, why not ask the citizens of those evil countries if they would trade systems? They wouldn’t dream of it. So we go on like lemmings following the leaders into paying twice as much for medicine that’s half as good.

See the World Health Organization 2000 report comparing health outcomes. The United States was 37th. France and Italy (those evil socialist countries) were first and second.

I would like someone to challenge Senator Graham’s comments about a “bureaucrat standing between you and your doctor” in a public health care plan. Is this his experience with the public health care plan he has as a Senator?

I am a new recipient of Commonwealth Care, and I’m already looking at my benefits being cut. Commonwealth Care in Massachusetts has been lauded nationally as a model for healthcare reform, but the costs of buying private insurance for the uninsured just are too high.

Private insurance is an unsavory business to be in. Companies in our society shouldn’t profit by effectively betting on the health and wellness of the population. As these companies make mad profits, hard working people are being bankrupted because they lack the proper coverage or were cheated by their insurers.

We need a paradigm shift to a public health insurance plan being the primary option and a movement away from letting insurance companies earn profits from our population’s wellness.

Greg
Salem, MA

I keep hearing those opposed to a public healthcare option use the term “government run” and state that the “government will determine your care.” It seems to me that this using peoples fear of “big government” and “socialization” for support of big insurance industry that is actually making a profit on the sick consumer. I think I would rather have my medical decisions being made by a not-for-profit government agency than by an insurance company paying their CFO’s enormous salaries. Our health should not be for profit!

There is an article on Slate this morning specifically talking about the failures of the MA plan.

I would not be using the MA plan as an example of what is working…

Bringing Down the House
The sobering lessons of health reform in Massachusetts.
By Darshak Sanghavi
Posted Tuesday, June 23, 2009, at 6:45 AM ET

Sen. Ted Kennedy The debate over achieving universal health care can seem hopelessly confusing. But the issues are actually pretty simple when you consider the lessons of Massachusetts.

In 2006, state lawmakers seeking to broaden health coverage made it illegal to be uninsured. It works like this: Employers have to offer you a health plan. If you are jobless or don’t like your employer’s plan, you must buy your own. If you don’t get one, you pay a stiff fine. This strategy—known as an employer and individual “mandate”—forms the backbone of the national health reform bills now making their way through Congress.

On paper, the experiment was a resounding success. According to an Urban Institute estimate, the number of uninsured residents quickly fell from 13 percent to 7 percent following the law’s passage.

And yet, something strange happened. Despite having health insurance, roughly one in 10 state residents still failed to fill prescriptions, ended up with unpaid medical bills, or skipped needed medical care for financial reasons. Hundreds of millions of dollars were spent to insure more Massachusetts citizens, but many people still weren’t getting necessary care. What happened?

Assume you’re looking to buy insurance. The state has a handy Web site where you can find the cheapest plan. For a young family of four, that plan costs roughly $9,500 per year, which doesn’t include a minimum annual deductible of $3,500 before many benefits kick in. (The state helps cover some of the premiums for those who make very little money, but many still have to pay the other fees.) And if anyone is hospitalized or needs a lot of specialized care, you also pay 20 percent of that bill. In this relatively cheap plan, the family can be liable for an extra $10,000 per year of medical costs. This sort of “high deductible” health plan is clearly structured to discourage medical care.

Imagine, for example, that your homeowner’s insurance had a $1,000 deductible. If the faucet leaks, you’ll try to fix it yourself instead of calling the plumber. The same thing applies to health care. If your newborn has a fever, you might give her Tylenol and just hope there’s no serious infection rather than head to the emergency room and face a hefty co-pay.

Why does a progressive state like Massachusetts strong-arm many individuals and businesses into buying expensive insurance plans that don’t encourage actual visits to the doctor and hospital? According to the Kaiser Family Foundation, the average person consumes more than $5,000 per year in health care resources. No matter how you slice it, some entity—government, business, or the individual—owes a boatload of cash for medical expenses. The annual costs for the 500,000 or so uninsured Massachusetts residents would run more than $2.5 billion, far in excess of the original state subsidy of $559 million.

That left billions to be paid by businesses and individuals. So for them, a high-deductible plan was a rational gamble. You (or your employer) front just enough money to get some coverage in case of catastrophe and then hope no one actually gets sick. But someone invariably does. As a result, out-of-pocket medical bills are the leading cause of bankruptcies—even though of most affected families actually have health insurance.

The expensive Massachusetts plan is not well-designed to systematically improve anyone’s health. Instead, it’s a superficial effort to clear the uninsured from the books and then clumsily limit further costs by discouraging care.

This brings us to the real task facing health reformers in our nation. Atul Gawande recently observed that for too long we’ve been “arguing about whether the solution to high medical costs is to have government or private insurance companies write the checks.” What’s more important are the doctors who write the bills. The more procedures they do, the more money they make. To fix medicine, he argues, we have to create better incentives for doctors to do right by patients instead of their own bank accounts.

But that’s not the whole story. Health care costs are rising everywhere, even in places like Minnesota, which Gawande cites as a prime example of low-cost, high-quality care that should be replicated nationwide. (Per capita health spending is actually 25 percent higher in Minnesota than in Texas, which has a hospital system that Gawande criticizes for profiteering.) In Massachusetts, some employers offering high-quality plans have annual rate increases of 10 percent to 15 percent. These jumps are certainly due to some overuse of services but also indicate increasingly high-technology care.

The lesson of Massachusetts is that really good health care is also really expensive. The concern isn’t who writes the checks or who writes the bills. The real question is who makes the tough decisions about the limits of the checks and bills—in other words, who ultimately rations the money. Not everybody can have everything, and the sooner we admit that, the sooner our health care debate will get realistic.

In the haphazard Massachusetts plan, rationing fell to individuals, who then skimped on important prescriptions and routine visits. Gawande would leave rationing to properly incentivized doctors, but we have no data about whether this can be done widely. Others advocate for bodies like the Medicare Payment Advisory Commission (an impartial medical Federal Reserve Board), which can make the hard calls to promote and limit certain kinds of medical care. Britain, for example, has a national institute that makes precisely these decisions, like limiting drug-eluting stents for coronary artery disease and certain pricey drugs for kidney cancer. And health insurance executives here are again talking about “capitation,” or fixed global budgets in which a group of health providers gets fixed monthly fees to handle all of a person’s health needs.

In the meantime, one thing is sure: Without a smart plan to ration our resources well—that is, stick to a budget—and improve health, simply mandating that employers and individuals buy health insurance will only worsen the mess.

The Massachusetts plan is a total failure; so, I’m sure that’s the one that the nation will end up following. As with most all government enterprises, it seems failure is the end goal. This nation definitely needs health care, because it certainly is “sick.”

Insurance seems to me to be the wrong model. My health insurance acts a lot like my Food Lion MVP card: i get discounts on medical procedures. These discounts aren’t available if I wanted to pay cash. How does this make sense? State Farm doesn’t give me discounts on oil changes or tires.

Change the model. Let everyone have a personal pre-tax healthcare savings account; your own money, mandatory contribution. Keep it in FDIC-insured bank accounts. Use that to pay for wellness. Make *catastrophic*, high deductible insurance available to everyone, so things like cancer and auto accidents are covered. Just like car insurance, let people pay more for a lower deductible.

Get rid of the discounts. That will force docs to compete for your money. They won’t make deals with carriers for their members.

And the gov’t is incapable of efficiently spending my money on *ANY* project, be it healthcare or defense. I don’t care if they are D or R, they are all crooks who are only concerned about power and re-election. Vote all incumbents out! Let Google take it over; they do a GREAT job on everything they touch!

“They’re supposed work for us, remember?”-Posted by LinP

I am one of those people who can actually remember a pre-Reaganite, pre-Neo-Con (stress the “con”) America.

Government has not worked FOR taxpayers and ordinary citizens for nearly 30 years, now. Proponents of the radical conservative agenda declared war upon us, their primary subsidizing constituency, quite awhile back, in favor of an elite cabal of corporate bullies dangling rich pay-offs of glitz and glamor before their greedy eyes. All an elected politician really needs to do in order to prosper, financially, is willingly sell their soul to the “devil”.

The rest of us? Well,I guess we can all just eat cake!
(in this instance, the term “cake” is a euphemism for mammalian excreta.)

We desperately need a public health insurance option and we need it now.

Every time an opponent of a public system speaks, we need to reply that under today’s Republican health-care system, my employer decides which list I can choose my doctor from, and an insurance company decides what that doctor may & may not prescribe.

The real solution: force the insurers and big pharma to cut to zero their budgets for PR & lobbying. Then we’d soon see their profits subside to something reasonable. Remember – paid speech ain’t free, and our representatives exist to represent the people, not the corporations.

QUESTION:

How does recent legislation not allowing withholding of mental health care by insurance companies affect health care costs, both now and moving forward with reform?

It is health insurance that has ruined health care and made it unaffordable! So, why do we want to make it a national mandate? The idea of health insurance was originally conceived to cover major medical crisis–and not every cut and/or bruise that occurs. Health insurance needs to return to its original purpose: major medical coverage. If this were done, then health care costs would return to affordable levels that people will be able to pay for out-of-pocket. Eliminate insurers, and you eliminate the profit-taking middle man, and prices come down–it’s as simple as that!

One thing that infuriates me about the current state of things is the lack of reward for preventative maintenance is. Obesity is one of the largest contributors to so many of the major illnesses – cancer, heart disease & diabetes come immediately to mind. For those who maintain a healthy lifestyle, the ‘reward’ will be continuing higher premiums to counterbalance those who do not engage in preventative maintenance.

For the longest time, both the insurance companies and the pharmaceuticals have been raking us over the coals while lobbying the politicians.

Does anyone know the annual costs of those who use the ER as ‘doctor’?

Having shelled out $3k for dental (after my $1k benefit), I would happily take dental coverage.

It seems to me that comparisons re always between the ideal private insurance and the less than govt. Why is a govt bureaucrat so much more dicey a manager than one in a for profit corporation? Presently most people do not have free choice for medications, MRI, PT psychiatric services under their insurance options. the physicians office needs to seek prior approval for these and many other services. the discussion needs to stop treating insurance as a monolith.
if drug companies are in trouble looking at the possibility of cost controls they should cease prime time advertising!

ps I keep hearing that the 46 million ‘uninsured’ is a bit misleading. It includes 11 million who are currently eligible for medicaid or other existing gvt programs, ~ 7 million illegal immigrants, and another 10 million or so who ‘choose’ not to opt in to insurance. Those who ‘choose’ not to opt in (while the choice is still available) should be taxed (IMHO) in the amount of annual premiums.

I believe that, even though I am relatively ‘healthy’, part of the objective of the premiums is to aid those less healthy and in need of assistance. This does not counter my other point however – people need to take responsiblity for their own health. As much as is possible.

One other thing – malpractice insurance. Frivolous lawsuits & ambulance chasers need to be squashed out. Like a fly.

Good Job Jane.. I love you present the show, a really good alternate when Tom is not around.

Keep it up, madame!!

It used to be if Congress wanted inputs, say from manufacturers, they would invite them to a hearing. Then their views make into the Federal Register (I believe). I like the idea of Julian Cole, above:

“The real solution: force the insurers and big pharma to cut to zero their budgets for PR & lobbying. Then we’d soon see their profits subside to something reasonable. Remember – paid speech ain’t free, and our representatives exist to represent the people, not the corporations.

Posted by Julian Cole, on June 24th, 2009 at 9:35 am EDT”

Note: I have had to wait 3 months to see a specialist (who couldn’t help) or months to see my primary doctor. Blue Cross can get my doctor to call me in immediately if I have called their nurses’ line for something that frightens me, which is nice.
But Massachusetts is beginning to have “Urgent Care” facilities that fill in the space between the ER and busy family practices. You can drop in. This should be part of a national plan.

Coverage does NOT equal care. Get the health insurance cartel out of the health care equation. Insurance is for accidents. Health care is no accident! Support health care for people, not for profit, by supporting H.R.676, single-payer, universal health care. The Congressional Budget Office projects that single payer would reduce overall health costs by more than $225 billion despite the expansion of comprehensive care to all Americans. No other plan projects this kind of savings. (http://www.dailykos.com/storyonly/2009/6/11/741100/-The-Truth-About-Health-Care-Reform).
Single payer Medicare for all is the ONLY real healthcare reform. Everything else is just putting lipstick on a pig. For more info on single payer, including the Mike Farrell videos:
http://www.1payer.net/

I am looking for comments relating to what I’ll call “overage,” versus “coverage.” I have a hunch that there will always be treatments that are in the category we’d call “cosmetic,” for instance, and insurers will surely be needed to offer that gold-plated insurance — or for those wanting to live to age 150 years.
If I were in Congress, I’d be wheeling and dealing about that, not whether universal coverage of some sort should be provided. So long as we have hospitals, we seem to offer care for accidents, though it may bankrupt you along the way. So we offer universal coverage (of sorts). It is the “overage,” for care that goes above and beyond, however you define that in the 21st century, that insurers should be talking about, with us and with Congress.
Why haven’t I heard?

Here’s the Canadian perspective. We so strongly believe that our national health care is a hallmark of our society, that we voted its founder Tommy Douglas as our most favoured national hero. We simply do not understand how a country as rich as the United States could fail to provide all its citizens to free health care as a necessity of life.

Under a public all inclusive health care plan the government has an interest in promoting wellness in the community. And I do believe that nutrition education and public service announcements promoting active lifestyles can go a long way in lowering healthcare costs.

Were the US to finally develop the type of public health care plan that is the norm in the rest of the developed world, it would be incumbent on the government to immediately embark on a program to promote healthy eating and physical exercise. As it stands, per capita spending on public healthcare will no doubt be more expensive in the fattest nation in the world.

To achieve the kind of per captia spending approaching international norms, their will have to be some significant changes in American dietary habits. It is however, a good thing when the health of the citizenry becomes a national concern.

Anything that’s not medically necessary (generally speaking, cosmetic surgery) should be paid for out of pocket by the patient.

So much of the health reform discussion focuses on the supposed “high cost” of passing a health care reform law… you hear numbers like $1 trillion being thrown around. In the Boston Globe today, key Beacon Hill leaders are saying Massachusetts health reform is too expensive and we can’t continue it.

At the American Cancer Society we have focused our advocacy efforts on the question of what is the cost of doing nothing? What’s the cost of treating late stage cancer diagnosis because someone was un- or even under-insured and couldn’t get a screening? What’s the cost of treating patients with minor illnesses in an emergency room because they had no insurance? Can businesses continue to compete in a global market with the same system of insuring their employees that we have now, a system that leaves almost 50 million people out?

Once again the simplest of facts about healthcare reform gets lost in the complicated weeds of the beltway politics of the issue. Look, we do not have measurably better care, perhaps not even as good care, as countries who cover all or nearly all of their people at 50 – 60 precent the cost per capita. This should be the first fact discussed when talking about reforming our system: The facts that John Boehner and Lindsay Graham and for that matter, NPR, needs to recognize:

Total health expenditures per capita, 2003
United States $5711
Australia $2886
Austria $2958
Belgium $3044
Canada $2998
Denmark $2743
Finland $2104
France $3048
Germany $2983
Iceland $3159
Ireland $2466
Italy $2314
Japan $2249
Luxembourg $4611
Netherlands $2909
Norway $3769
Sweden $2745
Switzerland $3847
United Kingdom $2317

Ms. Wilensky thinks there’s something wrong with Medicare and Medicaid. What a sad thing it is to have youth wasted on the young (or younger than I, anyway). When Ms. Wilensky the “senior citizen” comes along, she’ll look back and wonder, “What in the world was I thinking?”

There’s nothing wrong with Medicare. Some folks are simply listening to people like John McCain (who don’t need Medicare–they’re billionaires) and who also don’t know what they’re talking about. I could not and cannot to this day tell the difference between Medicare and the employer-provided system I was in more than 7 years ago. I still have the same doctor. I get prescription filled exactly as I always have. There is virtually no difference … except for the fact that it’s cheaper.

Listen to these people … people like Ms. Wilensky … and try to remember that they’ve got “skin in the game” of making sure that the rich get richer and the poor get poorer. It’s not clear in every case what “skin” it is they’re protecting, but it sure isn’t that of their children and grandchildren. They’re ready to sell this country down the river on any silly premise that comes into their heads … put there by the greedy oligarchs who truly run this country.

Medicare spends too much money on it’s patients. The customers they serve abuse office visits, free electric scooters, beds etc..etc..etc…it needs to be scaled back and just pay for major medical problems. There are alot of seniors that use Medicare with the idea of “get some” rather than they really need help.

***I keep hearing those opposed to a public healthcare option use the term “government run” and state that the “government will determine your care.”***

So true. But these same people conveniently omit that it’s now “insurance run” and “insurance will determine your care.”

I sometimes wonder about these Republicans. Have they never had a necessary medical request turned down in their whole lives? They’ve never bumped into insurers as the obstructionist middlemen that they are? Has not one person in their families ever been sick, and had to deal with insurance red tape? They have no touchstone, or direct experience with what the sick have to deal with? Are they that insulated? What kind of perfect world, completely devoid of reality do these people live in? If in fact they do inhabit such a perfect world, they are luckiest sons-of-you-know-what around. I don’t get it.

I don’t like posting other peoples essays, but this one by Dr. Reich is right on the mark.

Why the Critics of a Public Option for Health Care Are Wrong.

To get health care moving again in Congress, the president will have to be clear about how to deal with its costs and whether and how a public plan is to be included as an option. The two are intimately related. Enough talk. He should come out swinging for the public option.

David sadly you’re right about Medicare. Seniors are obsessed with their ailments which is why so many take half a dozen to a dozen pills hoping it will relieve their sedentary retiree lifestyles. Thus the Medicare part D gift to the drug companies. And Medicare does squander a lot of money on devices and treatments.

That said workers with generous private health plans that shield them from the cost of their medical services spend a lot too.

The talk of Massachusetts starting to get control of its spending is a joke. CommonwealthCare the plan for low wage workers is $115 million in the hole and is cutting the plan by this much. The Connector Board will stop automatically signing up low wage workers if they don’t ask. Well one way to save money is to cover fewer people. The state is also looking to cancel covering LEGAL immigrants.

The alleged success of the MA 2006 law is illusory. $600+ million ins federal uncompensated care funds were taken and gifted to insurance companies to create the subsidized plans.

Meanwhile the biggest and greediest beneficiaries Blue Cross/Blue Shield and for profit Partners Healthcare were colluding to drive up health care costs in the state. http://www.boston.com/news/specials/healthcare_spotlight/

Who in the world trusts Senator Chris Dodd?

Reports are coming out now that countries with state ran health care for their people are running out of money. Here is the problem that no one is talking about. Take a barrel and fill it up with all the uninsured people in America, great! you have now covered all the uninsured people at a price you think at this time will pay for it, near a trillion dollars over x amount of years. We have solved the problem. Then, good hearted politicians, looking to cement their voting base, gives amnesty with conditions to all the 20 million illegals. A sure way to get re-elected. Problem? they will need health care. Our barrel is stuffed to the rim. Where will this added burden go? Not to mention the millions more who are now lining up at the borders to come in. A barrel can only hold so much before it runs over and makes a big mess.
I will always remember the Carter days when he granted all the illegal Cubans a new place to live. Especially what one woman from Cuban said as she came on shore. The reporter ask her why she wanted to come to America? She replied, to retire on your countries social security.
Due to trying to change the world to our way of life, the world may rob us of our way of life.
The law of supply and demand. When demand for things excedes the ability to supply that need, the price will soar. Will you have enough money in your pocket to provide for this hungry plan? We need reform, but will it break the bank to get it?

Question on the Health care “reform”. President Obama says the ‘Public option” will NOT drive private insurance out of business. My question is: Will NO taxpayer money be used for the public healthcare program?
If yes, how can anyone think that is a FAIR playing field against private for profit insurance which has to live within its income.
If NO, then where is the money going to come from?

Maybe Obama will answer David Markowski’s question this evening at 10:00. The way I look at it, my income taxes (one unit in the US pot, so to speak) reflect a deduction each year of something under $10,000. Taxes on that, because I make a sort of average income, would be maybe $2,500, which is “in play” in various ways. Congress could reclaim that. It has been pointed out that the medical deduction is much more valuable to high-income earners because they would otherwise be paying higher taxes on those deducted dollars. So putatively, Congress could claim more from me if I were richer.
I don’t have a problem seeing this as a redistribution problem (not a casting of the piggy bank on the floor). If there are profits that have been jacked up (see Rick Evans’ post at 5:38 above) and administrative waste (duplication and so on), then that money as well is “on the table” so to speak.
There are possible reclaimed tax deductions, savings in costs, savings in emergency care, etc., etc., plus the monies so many of us fork over: Fleece me.
Whether or not it all balances out from day one does not matter hugely; people dedicated to making it work will have at it. Insurers will have to have a new role, one involved in holding down costs and enhancing/ complementing what a public plan has on offer. It would be hard not to improve on the status quo.

National health is dead in the water. Wait and see, this thing is going to be screwed up by congress and all the BS they get up to.

I fear that we will get something that is worse then we have now. A mess, a real cock up brought to you by our incompetent legislators.

“Suppose you were an idiot. And suppose you were a member of congress. But I repeat myself.”
–Mark Twain

“Wherefore being all of one mind, we do highly resolve that government of the grafted by the grafter for the grafter shall not perish from the earth.”
–Mark Twain

David at least the European countries have something to work with. They have breathing room and they will makes cuts. Germany is already doing this.

We on the other hand have a market based health care industry that is failing. Billions are wasted by the corporate for profit insurance companies for health care.

We are now regulated by some rube in an office making medical decisions that a doctor should. Doctors have to hire teams of people to wade through all the BS the insurance companies put up to keep all Americans from getting care. The model of the insurance industry is the antithesis to health care.

[...] [...]

If Obama can’t reform the current health-care system and/or implement some kind of universal health-care when both houses of the Congress are solidly Democratic majority (including filibuster-proof one in the Senate, pending the challenge to Al Franken’s win), then shame on him and shame on the Democrats!! It will simply expose the truth – that the Democrats are beholden to special interests and are as corrupt as the Republicans. He doesn’t have the excuse that Clinton had – that the Republican majority torpedoed his proposal.

Unfortunately, this debate has devolved into horse trading and other machinations of the political system. Obama missed an enormous opportunity by not laying out a big, challenging, results-driven goal akin to what JFK did with the space program. He should have started by asking the country to commit to being in the top ten in health outcomes for dollar spent within in a decade and in the top five within a generation (we are currently 37th, I believe).

It’s hard to oppose that goal and there is a way that everyone — individuals, doctors, hospitals, insurers, etc. — can contribute to its achievement. Then public vs. private and the other sub-issues become a debate less about ideology and more about how to achieve the goal. If private insurers think they can get us there, let’s hear how (they certainly haven’t so far) and so too would the supporters of a public plan have to make their case.

We’ve gotten too far down into the weeds and the result is not going to be pretty.

Eric I could not agree more. Obama has missed his chance of a lifetime. The democrat’s are fro the most part the new conservative party. There is no progressive part in this country. The other issue is, lobbying needs to be reformed or abolished altogether in it’s current form.

Since when is doing out money free speech?
I think to call what goes on in Washington and K street free speech is an insult to what was the founders original intent in this area. Of course the Supreme Court disagrees with me.

Are the insurance companies any more transparent than the “public option” would be? Where are the statements of the insurance industry arguing to the people (not to congressmen whom they have helped to put in office, senators they help to keep there)? The silence of that point of view is astonishing. Or maybe I hear it and it sounds so like an argument for the status quo that I completely dismiss it.
I was glad to hear Obama address the army of insurance specialists who are needed to negotiate with insurers and pay bills. Obama spoke of educating them to be healers rather than bean counters, sending them to be educated to care eventually for the 40-some million currently uninsured. Good that he focuses on it, but the insurance specialists at the doctors’ offices I deal with are preselected for keeping totally out of the way of the medical staff, not being even interested in that. They are very capable but they are not the nurse practitioners of the future.

notes:

http://www.democracynow.org/2009/5/13/baucus_raucus_caucus_doctors_nurses_and

http://www.democracynow.org/2009/6/16/report_senator_max_baucus_received_more

Also, a 2008 survey found 83 percent of psychiatrists, 69 percent of emergency medicine specialists, 65 percent of pediatricians, 64 percent of internists, 60 percent of family physicians and 55 percent of general surgeons favor a national health insurance plan.

The Washington Times ran a good story on this issue. If you take away the illegals (10 million), people eligble for exisiting programs (10 million), people that could pay on their own (20 million), it makes this problem much easier to manage. We eliminate the Earned Income Credit, WIC, payments to farmers, payments to the World Bank (108 billion this year)..and get something going.