Universal Health Coverage

[wrobert]

I think everyone in the US of A should be able to get affordable health insurance, regardless of pre-existing conditions or whether or not s/he has ever been on antidepressants, for goodness sakes. I think Hillary is the only candidate who really cares about that issue.

So if you are a Doctor, do you think the government should be able to tell you what to charge and whom to see as a patient?

If you are healthy, should the government be able to force you to buy health insurance?

Is it fair that you pay a set premium on health insurance when you live a healthy lifestyle, yet your neighbor, who does not, pays the same amount?

[30A Skunkape]

Does anyone honestly think a government issued card guarantees decent healthcare? I fear that many providers will not want to be involved with such a beast and simply practice cash for service medicine. As it stands now, a baby insured by medicaid that comes in for a routine visit is a money loser for me...I am given about $3 to see the baby, answer questions, do paperwork and dictate, so roughly $3 for 45 minutes of work and that does not include the cost of equipment, staff, etc. All I urge people to do is be careful what they wish for...

[Camp Creek Kid]

Use this link: http://www.mittromney.com/Issues/healthcare to see Mitt's innovative approach to revamping the American healthcare system. He had success in Mass. in offering healthcare to over 300,000 previously uninsured patients.

Mitt advocates using principles of free enterprise and better fiscal responsiblity (no waste) to improve the system and make it accessible to everyone. In contrast, Hilary wants to offer healthcare to everyone using the weak system that is already in place. As Dr. Skunky pointed out, Medicaid is no good already.

[hnooe]

GOP you make a good point-- personally, I am an organic food eating, daily gym exercising, health "nut." My biggest pet peeve is people with bad cholesteral who eat Redi Whip and ice cream and ALSO take expensive anti-cholesteral drugs!!!! Why should I pay for their blissfully ignorant bad habits...

This is a hot topic issue though..this thread could go on forever, thanks for bring it up.

My View: The health Care system in the US is run by special interests pure and simple. Now which party will have the courage to fight them?

The Democrats better start fighting or they may lose the battle.

The problem in selling Universal Health Care is not making it seem like a tax increase. *Ensuring the quality doesn't decrese for the average American (avoid wait times etc). Controlling the pharmaceutical industry(you guys pay 60% on average more then the rest of the world epr dollar spent). Decide who controls Health Care spending the states or the federal governement. Finally, it's going to cost to set up. *

Now all of these problems have solutions for example in Canada health Care is RUN by the provinces but the Federal government partially funds it and provides standards for the provinces to meet. *

Now all the problems have solutions but the hardest to mount will be tackling the special interests that like the money rolling in.....you'll have ad campaigns calling universal health care the end of research in the US, you'll have families in waiting room's with a sick child with a sign saying 5 hour wait etc....it'll be nasty, but it can be done!

[Camp Creek Kid]

[QUOTE=hnooe2000;335343][Now all of these problems have solutions for example in Canada health Care is RUN by the provinces but the Federal government partially funds it and provides standards for the provinces to meet. *
QUOTE]

If Canada's healthcare system is so great, why do the Canadians come to the U.S. for specialists? This summer and fall in Alberta, the hospitals were full and they send dozens of pregnant women 200 to 300 miles south to Montana to deliver babies. The hospital WOULD NOT accomodate these women who were about to give birth, but it worked out fine because they had the U.S. to fall back on. Who will we fall back on? Are you prepared to go to Mexico for surgery (for that matter, Mexicans who can afford it also come to the U.S.)

You are a healthy person and don't like to pay for other peoples' health problems. In that same line of thinking, my husband is self employed therefore we pay for all of our own health insurance. I don't like to pay for someone else's health insurance when people, who could afford insurance CHOOSE not to buy it. There are people who can't afford it, and reforms have to be made. However, we should think of health insurance as a necessity--something we pay monthly just like our power bill.

There are obviously problems in the the healthcare industry, but the U.S. has the highest quality hospitals, the best medical schools, the most innovative research, and the most motivated doctors in the world.

[Mango]

GOP you make a good point-- personally, I am an organic food eating, daily gym exercising, health "nut." My biggest pet peeve is people with bad cholesteral who eat Redi Whip and ice cream and ALSO take expensive anti-cholesteral drugs!!!! Why should I pay for their blissfully ignorant bad habits...

First, I'm confused on your stance. Secondly, there are people who due to heredity factors or chronic diseases who may have health issues outside their control as contributing factors to high cholesterol or weight issues, etc.
Lastly, I would ask before anyone starts a new thread, they do a search for past threads. There has already been a lengthy discussion about this topic that's quite informative.
http://sowal.com/bb/showthread.php?t...sal+healthcare

[30A Skunkape]

Wouldn't it make sense to tax the living bejeezum out of organic foods and divert that money to federal healthcare? After all, people who spend all that money on expensive organic foods are obviously rich so it will not hurt them to pay for poor people to get health insurance. Right?

[hnooe]

First, I'm confused on your stance. Secondly, there are people who due to heredity factors or chronic diseases who may have health issues outside their control as contributing factors to high cholesterol or weight issues, etc.
Lastly, I would ask before anyone starts a new thread, they do a search for past threads. There has already been a lengthy discussion about this topic that's quite informative.
http://sowal.com/bb/showthread.php?t...sal+healthcare

Health care as a "personal responsility issue/preventative issue"--whoa--maybe yet another thread.

Absolutely, if there is inherited cholesteral problems in one's family they should get whatever assistance they need, be it Private or Universal--BUT if they still choose Redi Whip, Ice cream on top of their pre-exiting condition, then I have a real problem with that.

[30A Skunkape]

Health care as a "personal responsility issue/preventative issue"--whoa--maybe yet another thread.

Absolutely, if there is inherited cholesteral problems in one's family they should get whatever assistance they need, be it Private or Universal--BUT if they still choose Redi Whip, Ice cream on top of their pre-exiting condition, then I have a real problem with that.

So you would be comfortable forcing people with high cholesterol or type II diabetes to eat what you (or some government 'expert') think is appropriate for them?

[elgordoboy]

Wouldn't it make sense to tax the living bejeezum out of organic foods and divert that money to federal healthcare? After all, people who spend all that money on expensive organic foods are obviously rich so it will not hurt them to pay for poor people to get health insurance. Right?

So you would be comfortable forcing people with high cholesterol or type II diabetes to eat what you (or some government 'expert') think is appropriate for them?

I agree with you on both of these. The tax on the organic food would be a fairer way of distributing the burden to those who deserve and can afford it. Forcing people to eat certain things may be tough to actually do but you are on the right track.

[Camp Creek Kid]

Forcing people to eat certain things may be tough to actually do but you are on the right track.

You might as well be in the Soviet Union circa 1980.

[Beemn]

You got off subject fast. How about we tax the war profiteers and use that money to pay for health care? I don't think that people in this country should go without care because they don't have money, while dubya pisses away the entire countries fortune on a failed policy of lies.

[hnooe]

So you would be comfortable forcing people with high cholesterol or type II diabetes to eat what you (or some government 'expert') think is appropriate for them?

Yes, in my world view.

[JustaLocal]

You got off subject fast. How about we tax the war profiteers and use that money to pay for health care? I don't think that people in this country should go without care because they don't have money, while dubya pisses away the entire countries fortune on a failed policy of lies.

[Jennifer Steele]

Wouldn't it make sense to tax the living bejeezum out of organic foods and divert that money to federal healthcare? After all, people who spend all that money on expensive organic foods are obviously rich so it will not hurt them to pay for poor people to get health insurance. Right?

I agree with you on both of these. The tax on the organic food would be a fairer way of distributing the burden to those who deserve and can afford it. Forcing people to eat certain things may be tough to actually do but you are on the right track.

Right...and make sure the poor folks will never be able to afford organic food, thereby ensuring they will always need federal health care?

I am in no way rich, but we do spend our dollars on organic foods whenever we have the option and would hardly be able to afford it if they were even more expensive.

[Jennifer Steele]

You got off subject fast. How about we tax the war profiteers and use that money to pay for health care? I don't think that people in this country should go without care because they don't have money, while dubya pisses away the entire countries fortune on a failed policy of lies.

Yes, I would say this is fairer than taxing organic foods...

[hnooe]

Wouldn't it make sense to tax the living bejeezum out of organic foods and divert that money to federal healthcare? After all, people who spend all that money on expensive organic foods are obviously rich so it will not hurt them to pay for poor people to get health insurance. Right?

I actually love that Idea--and tax cigarettes and alcohol through the roof too!

[raven]

You got off subject fast. How about we tax the war profiteers and use that money to pay for health care? I don't think that people in this country should go without care because they don't have money, while dubya pisses away the entire countries fortune on a failed policy of lies.

despite what filmaking genius michael moore is espousing to the world, america has had socialized medical care for years. it's called the military medical system.

anyone who has experienced healthcare under the UK's NHS or the military care knows the the government having any say in healthcare does not serve the public best. many military families know that while having a base of care is important there are many cases where living in a country where privatized care is available is crucial. furthermore, most americans are so naive about what socialized medical care means. i can't tell you how many friends and family who have suffered at the hands of the NHS. waiting years to get tests that could have prevented their deaths including routine testing like pap smears, mammograms or bloodwork for heart disease. when you live in the uk or europe and see people suffering for years from treatable and preventable illnesses simply because we have no option but to wait, then perhaps you won't live in such a rose-colored view of europe. when you see a 28 year old die of stomach cancer because he can't even get an appt with a specialist, or a young woman in her 30s die of breast cancer because ob appts aren't scheduled excpet for every 3 years or when you see a guy who has been addicted to morphine for 15 years because a hernia got misdiagnosed you'll understand. and these aren't RARE or unusual cases. these are TYPICAL.

[30A Skunkape]

Right...and make sure the poor folks will never be able to afford organic food, thereby ensuring they will always need federal health care?

I am in no way rich, but we do spend our dollars on organic foods whenever we have the option and would hardly be able to afford it if they were even more expensive.

You have to realize that my tongue was planted firmly in cheek. Usually if you wait long enough somebody will come up with the proposal to tax cigarettes, booze, fatty foods, etc to pay for health care (and sure enough, Hnooe came through for us). Of course, this leads to a slippery slope of somebody else determining what we should and should not do in order to remain healthy. I know tobacoo kills people, and I urge my patients to stop smoking and offer to help...but some people actually derive pleasure from smoking...I don't get it, I hate the way cigarettes smell, but who am I to tell somebody else what they should or shouldn't do? So why not propose taxing organic foods? Of course it is absurd...and it ought to scare the living hell out of everyone that while I joke about it, some people (on this board no less) readily admit they are comfortable with somebody dictating how we should behave in the name of health.

[scooterbug44]

I don't know about sin-taxing high cholesterol, high-fat, or "unhealthy" items, but there are companies who give rewards for healthy behavior. A friend's health insurance gives her a refund/bonus if she goes to the gym a certain number of times a month.

There are a lot of unhealthy behaviors that are universally agreed upon, so I would definitely be for proactive credits or discounts that encourage healthy behavior. A lot of people will be in a great deal of medical trouble due to obesity and poor eating and exercise habits.

[elgordoboy]

You have to realize that my tongue was planted firmly in cheek. Usually if you wait long enough somebody will come up with the proposal to tax cigarettes, booze, fatty foods, etc to pay for health care (and sure enough, Hnooe came through for us). Of course, this leads to a slippery slope of somebody else determining what we should and should not do in order to remain healthy. I know tobacoo kills people, and I urge my patients to stop smoking and offer to help...but some people actually derive pleasure from smoking...I don't get it, I hate the way cigarettes smell, but who am I to tell somebody else what they should or shouldn't do? So why not propose taxing organic foods? Of course it is absurd...and it ought to scare the living hell out of everyone that while I joke about it, some people (on this board no less) readily admit they are comfortable with somebody dictating how we should behave in the name of health.

My tongue was in there with Skunkape's. I was yanking his chain a bit by acting as if his statements were his opinions/suggestions.

[wrobert]

Is this not something that competition and free markets could help? For instance, you can not open another hospital in this county without getting a certificate of need from the folks in Tallahassee. A lot of people in nowal are unhappy with hospital care in the area, and there is a place that has expressed interest and has financing to open up another health care hospital like facility. Yet without this certificate of need, they are prevented. Of course, the argument is that this is protecting the current hospital, but why is it that they enjoy this sort of monopolistic protection?

[Camp Creek Kid]

I don't know about sin-taxing high cholesterol, high-fat, or "unhealthy" items, but there are companies who give rewards for healthy behavior. A friend's health insurance gives her a refund/bonus if she goes to the gym a certain number of times a month.

There are a lot of unhealthy behaviors that are universally agreed upon, so I would definitely be for proactive credits or discounts that encourage healthy behavior. A lot of people will be in a great deal of medical trouble due to obesity and poor eating and exercise habits.

But where do you draw the line? Obesity is not the only health risk. What about sexual behaviors? Unprotected sex is risky so are people going to get discounts for practicing safe sex--who makes the judgement and how is it regulated? Having children decreases a woman's risk for ovarian cancer--are women who don't have children going to be penalized? Women who DO have children increase their risk of pregnancy complications and put themselves at risk so are they going to be penalized? The examples are endless.

I agree that it is a great for private companies to offer incentives for healthy lifestyles--this is already done in the life insurance business. However, this should not be the government's job (and I know that is not what you are saying either) because pretty soon the government is regulating every facet of our lives.

[Jennifer Steele]

My tongue was in there with Skunkape's. I was yanking his chain a bit by acting as if his statements were his opinions/suggestions.

You have to realize that my tongue was planted firmly in cheek. Usually if you wait long enough somebody will come up with the proposal to tax cigarettes, booze, fatty foods, etc to pay for health care (and sure enough, Hnooe came through for us). Of course, this leads to a slippery slope of somebody else determining what we should and should not do in order to remain healthy. I know tobacoo kills people, and I urge my patients to stop smoking and offer to help...but some people actually derive pleasure from smoking...I don't get it, I hate the way cigarettes smell, but who am I to tell somebody else what they should or shouldn't do? So why not propose taxing organic foods? Of course it is absurd...and it ought to scare the living hell out of everyone that while I joke about it, some people (on this board no less) readily admit they are comfortable with somebody dictating how we should behave in the name of health.

I'm so glad. Sorry...I was a little slow yesterday.

[Bobby J]

IMO the government should not take over health care. The only cure the government should be involved with is helping eliminate all the special interest associated with health care. The private sector will fix the rest. Listen to what skunkape says, "watch what you wish for".

I use to do insurance physicals on the road and people would often compare insurance cost being more then a car payment. They would be upset and talk about the government fixing it. I still wonder why people think the government can fix it? We need our government to fix the corruption involved in health care not take it over and dictate how we all live our lives.

[DuneAHH]

IMO the government should not take over health care. The only cure the government should be involved with is helping eliminate all the special interest associated with health care. The private sector will fix the rest. Listen to what skunkape says, "watch what you wish for".

I use to do insurance physicals on the road and people would often compare insurance cost being more then a car payment. They would be upset and talk about the government fixing it. I still wonder why people think the government can fix it? We need our government to fix the corruption involved in health care not take it over and dictate how we all live our lives.

I agree... it's always baffling to me why we'd ever think a gov't bureaucracy that can't even seem to manage the current menu of "gov't issues" would miraculously be effective administrators of such a large & complex issue as health care? Scares the zuppa out of me. I don't personally have any brilliant ideas for the fix ... but I know what I DON'T want; and that's MORE intervention by the illusive federal "THEY".

[scooterbug44]

IMO the government should not take over health care. The only cure the government should be involved with is helping eliminate all the special interest associated with health care.

We need our government to fix the corruption involved in health care not take it over and dictate how we all live our lives.

We just need to get the special interests out of EVERYTHING! Just read some article in the morning paper about how because of special interest loopholes oil and gas wells in the US are exempt from the Safe Drinking Water Act and Clean Air Act!

[seacrestkristi]

I hope one day we can all purchase health insurance without being discriminated against for a pre-existing condition. http://www.hillaryclinton.com/feature/healthcareplan/

[scooterbug44]

How is it legal to disqualify people for insurance or limit their coverage based on their medical history? Why isn't that considered discrimination?

I still think car insurance rates based on credit history are questionable too. IMO people w/ poor credit are not more likely to have accidents, the people more likely to have accidents are those ALSO more likely to have poor credit scores because of the way it is calculated.

[rapunzel]

Is this not something that competition and free markets could help? For instance, you can not open another hospital in this county without getting a certificate of need from the folks in Tallahassee. A lot of people in nowal are unhappy with hospital care in the area, and there is a place that has expressed interest and has financing to open up another health care hospital like facility. Yet without this certificate of need, they are prevented. Of course, the argument is that this is protecting the current hospital, but why is it that they enjoy this sort of monopolistic protection?

I wonder what "hospital like facility" means. Could it be a hospital without an ER? If that's the case, then the "protection" you refer to is in place to keep the playing field level. An ER is the most expensive, money-hemorrhaging endeavor in healthcare -- it must be staffed 24/7 by doctors and nurses, have a full range of expensive diagnostic equipment and medicine, and many of the people that utilize the ER are indigent. As we all know, prices on other services are raised in order to underwrite the cost of the ER that a hospital (not a surgical hospital or other outpatient or limited inpatient bed facility) is legally required to have and staff in a certain way.

The "hospital like" facility can underbid contracts with insurance companies drastically because they are operating without the burden of the ER (or ICUs). This leads insurers to contract with the secondary facility, and then offer the primary hospital a take it or leave it contract. The secondary facility is able to deliver good quality care and service at these rates, while the hospital quality suffers...more and more paying patients with choice go to the secondary facility, and then the community as a whole loses because there is no where to go for emergencies, for the major cardiac events and strokes and severe illnesses that require intensive care. While I generally agree the market is the best regulator, sometimes the "protection" isn't so soviet. The days of the corporate statesman are over, and Tallahassee does have to make sure we have access to high level care. Trust me, when Sacred Heart got it's certificate of need they had to agree to a number of beds, an ER, and JCAHO accreditation that requires all sorts of inefficiencies and redundancies that their financial people would have preferred to leave off. How fair would it be for the secondary facilities to be able to open up without the same burdens? Why would anyone ever make an initial investment to build a hospital in a medically underserved area if Florida began doing such things?

Competition and free markets are great. The real problem is that all the solutions being batted around by politicians regarding healthcare are too simple to tackle such a complex industry. Few people proposing solutions even understand the ways money flows through the system (or the ways it's diverted). Previous solutions have made things worse, and conservatives have actually put in place Soviet-era cost controls because they did not understand the implications of enacting a relative value scale for Medicare reimbursement.

You asked a few questions to open thread --
So if you are a Doctor, do you think the government should be able to tell you what to charge and whom to see as a patient?

That is precisely the system we have in place today. Doctors can charge whatever they want, but they are only paid Medicare's RVS or some regional Medicare based percentage. All doctors are paid the same, whether they are the best doctor or the worst, whether their office is pristine or filthy, whether they have a courteous staff or have to hold for 20 minutes just to get an appointment. Doctors can "fire" a patient if they do so in writing for good cause and give them a period of time to find a new provider. This opens the physician up to all kinds of lawsuits, so they have to be very careful and only do it as a last resort.

If you are healthy, should the government be able to force you to buy health insurance?
No, but the front-runners in both parties advocate this approach, and it doesn't seem to be hurting them in the polls. I still believe the best approach is the one advocated by George W. Bush -- the move to consumer driven basic healthcare vis a vis healthcare spending accounts and high-deductible/catastrophic insurance coverage. Unfortunately, the Bush administration never did anything to make this happen. They were too afraid to go up against the insurance and pharmaceutical lobbies that profit by our current system where market forces play no role in utilization decisions.

Is it fair that you pay a set premium on health insurance when you live a healthy lifestyle, yet your neighbor, who does not, pays the same amount?

Is it fair? What is this, sixth grade? Is it fair that people are allowed to have guns in this country so people get shot and ER's have to pay for all sorts of expensive equipment used to treat relatively rare gun shot wounds and therefore the costs of being prepared for GSWs is picked up by me and my health insurance even though I'd never have a gun? It's not fair, but the right to bear arms is a liberty I'd never dream of taking away from a fellow American that chooses to exercise that right.

The role of government is to protect life, liberty, and the pursuit of happiness. Nothing in there about universal healthcare, but if that is something the people want the government needs to get all in or all out. Either let the system be totally free market with a Medicaid safety net (and doctors shouldn't be forced to accept Medicaid, so that the real costs of it will be reflected in numbers reported by the government), or let the two systems of Canada and England develop here. This current hybrid system we have is too labyrinthine, and leaves so much room for the few who understand the system to manipulate the many who don't into enacting more policies and regulations that enable them to limit competition and extract even more money from the healthcare system that has nothing to do do with health.

[DuneAHH]

Rapunzel I was hoping you'd weigh in here...
I love your informative posts and wish you'd take ALL your posts on healthcare & put them into 1 Go-To blog.
Thanks.

[Mango]

Rapunzel I was hoping you'd weigh in here...
I love your informative posts and wish you'd take ALL your posts on healthcare & put them into 1 Go-To blog.
Thanks.

Excellent idea.

[bohemily]

Our government does such a bad job with managing things...the thought of them managing our health care system for me is scary.

[Bobby J]

Our government does such a bad job with managing things...the thought of them managing our health care system for me is scary.

It should be very scary.....

[hnooe]

Get off of your fantasy "Planet 30-A La-La Land" and find your place amongst the real Global Village. As soon as big corporate America realizes it has to embrace Universal Healthcare in order to survive the global competition being thrust at it, the tide will turn, with or without President Hillary Clinton.

The American taxpayer and the uninsured will not be the only beneficiaries of Universal Health care. Corporations like General Motors, Boeing, Ford and Exxon that employ millions of Americans might save billions of dollars. By reducing health care costs to our businesses, we are creating excess capital, which in turn aids corporate growth and global competitiveness. GM currently spends $1,525 per car on health care costs while its Japanese rival Toyota spends only $201 — and Japan has Universal Health Care. In other words, globalization renders it impossible for American corporations to compete as long as they must pay for employee health care. Lowering health care costs would make American corporations more profitable and could save thousands of American jobs.

Providing health care as a basic service is also in line with conservative ideology concerning personal responsibility and merit. Not worrying about escalating health care costs will allow individuals to hold steady jobs and make ends meet more easily. Uninsured families would be free to engage in private enterprise without the burden of paying for health care. They might choose to spend more money on consumer goods, thereby stimulating the economy, or to save money so they can send their kids to better schools and universities, thus making our workforce more competitive.

To ease the minds of all the conservative skeptics on 30A, Universal Health Care does not mean that the American taxpayer is going to foot the bill for 100 percent of all health care costs for all Americans. That is socialized health care, which is vastly different from universal health care. Universal Health Care only means that everyone is covered. Depending on the program we put in place, the government could be paying only for those who cannot afford health insurance on their own. I am not advocating a 100 percent government controlled and managed health care plan. I believe letting insurance companies compete to provide insurance to Americans will help to lower costs. I simply oppose the denial of care to anyone born or naturalized as an American citizen.

[30A Skunkape]

Get off of your fantasy "Planet 30-A La-La Land" and find your place amongst the real Global Village. As soon as big corporate America realizes it has to embrace Universal Healthcare in order to survive the global competition being thrust at it, the tide will turn, with or without President Hillary Clinton.

The American taxpayer and the uninsured will not be the only beneficiaries of Universal Health care. Corporations like General Motors, Boeing, Ford and Exxon that employ millions of Americans might save billions of dollars. By reducing health care costs to our businesses, we are creating excess capital, which in turn aids corporate growth and global competitiveness. GM currently spends $1,525 per car on health care costs while its Japanese rival Toyota spends only $201 — and Japan has Universal Health Care. In other words, globalization renders it impossible for American corporations to compete as long as they must pay for employee health care. Lowering health care costs would make American corporations more profitable and could save thousands of American jobs.

Providing health care as a basic service is also in line with conservative ideology concerning personal responsibility and merit. Not worrying about escalating health care costs will allow individuals to hold steady jobs and make ends meet more easily. Uninsured families would be free to engage in private enterprise without the burden of paying for health care. They might choose to spend more money on consumer goods, thereby stimulating the economy, or to save money so they can send their kids to better schools and universities, thus making our workforce more competitive.

To ease the minds of all the conservative skeptics on 30A, Universal Health Care does not mean that the American taxpayer is going to foot the bill for 100 percent of all health care costs for all Americans. That is socialized health care, which is vastly different from universal health care. Universal Health Care only means that everyone is covered. Depending on the program we put in place, the government could be paying only for those who cannot afford health insurance on their own. I am not advocating a 100 percent government controlled and managed health care plan. I believe letting insurance companies compete to provide insurance to Americans will help to lower costs. I simply oppose the denial of care to anyone born or naturalized as an American citizen.

Sounds like trickle-down economics and we ALL know that doesn't work, right? Why not do something easy like pass deep tax cuts so your theoretical families can buy health insurance without creating new politburo?

[Getabrain]

Get off of your fantasy "Planet 30-A La-La Land" and find your place amongst the real Global Village. As soon as big corporate America realizes it has to embrace Universal Healthcare in order to survive the global competition being thrust at it, the tide will turn, with or without President Hillary Clinton.

Cut and pasting blogs. At least give credit to the original author. I believe it's called PLAGIARISM. So, here is the reply to Chart Westcott's blog who is a senior in the College of Arts and Science, Vanderbilt University, the author, who probably hasn't held a job yet due to just completing potty training.

Submitted by harry on Mon, 01/29/2007 - 18:22.
Harry Faulkner
Yes, ideally everyone in the US should have access to affordable heath care and I agree with you in principle. But first let us ask who are the 46 million people so often cited as "uninsured." How many are here illegally? And how many could afford insurance but decide to "roll the dice" and hope that they don't get sick and use the money to subscribe to cable TV instead? Remember older Americans already have Medicare and the poor and disabled have Medicade, and 25% of all Tennesseans had TN Care--which by the way, was a single payer plan and a disaster because of government bureaucratic ineptitude and was the single largest item in the state budget and growing so fast that other important items, like education, were being sqeezed. The working poor, are the main problem, although even the lowest paid full-time workers at Vandy and WallMart have health care, albeit while not making a "living wage."
But my main comment about your article is that you don't define what you mean by "health care." For example, does a 90 year old man get the same liver transplant as a 3 year old? Does an overweight, smoking heavy drinker get the same plan for the same money as the health freak? I could go on but you get my drift. What if someone has worked hard all their life so that they get into and afford a really good health plan? Will they now be downgraded to the same basic plan as the guy that never saved a nickel or took care of himself?
Congratulations on a well written, well reasoned and intentioned article. But frankly, the subject is more complicated than putting a man on the moon.
__________________________________________________ _____

I'm betting Harry long past potty training and now resides in the real world.

[rapunzel]

Get off of your fantasy "Planet 30-A La-La Land" and find your place amongst the real Global Village. As soon as big corporate America realizes it has to embrace Universal Healthcare in order to survive the global competition being thrust at it, the tide will turn, with or without President Hillary Clinton.

The American taxpayer and the uninsured will not be the only beneficiaries of Universal Health care. Corporations like General Motors, Boeing, Ford and Exxon that employ millions of Americans might save billions of dollars. By reducing health care costs to our businesses, we are creating excess capital, which in turn aids corporate growth and global competitiveness. GM currently spends $1,525 per car on health care costs while its Japanese rival Toyota spends only $201 — and Japan has Universal Health Care. In other words, globalization renders it impossible for American corporations to compete as long as they must pay for employee health care. Lowering health care costs would make American corporations more profitable and could save thousands of American jobs.

Providing health care as a basic service is also in line with conservative ideology concerning personal responsibility and merit. Not worrying about escalating health care costs will allow individuals to hold steady jobs and make ends meet more easily. Uninsured families would be free to engage in private enterprise without the burden of paying for health care. They might choose to spend more money on consumer goods, thereby stimulating the economy, or to save money so they can send their kids to better schools and universities, thus making our workforce more competitive.

To ease the minds of all the conservative skeptics on 30A, Universal Health Care does not mean that the American taxpayer is going to foot the bill for 100 percent of all health care costs for all Americans. That is socialized health care, which is vastly different from universal health care. Universal Health Care only means that everyone is covered. Depending on the program we put in place, the government could be paying only for those who cannot afford health insurance on their own. I am not advocating a 100 percent government controlled and managed health care plan. I believe letting insurance companies compete to provide insurance to Americans will help to lower costs. I simply oppose the denial of care to anyone born or naturalized as an American citizen.

I may live on Planet 30-A La La Land, but which planet are you living on Hnooe2000?

First, you state that corporations will be forced to stop providing health care coverage to their employees in order to remain competitive in the global marketplace. Well, this may indeed be true. Corporations today are primarily supply-chains, and most manufacturing has already moved overseas where it can be outsourced for pennies. Many service jobs, such as customer service, have also been relocated to other countries where labor is cheap and health care as we know it is practically non-existent. As outsourcing has increased, we have seen many people who worked in middle class jobs end up low end service jobs that do not provide health care. I think that is what has gotten us into the mindset that we have a health care crisis that must be fixed. While corporations (which are not large groups of people spending their working lives in one industry under a benevolent corporate statesman to benefit its customers, employees, and America, but a supply chain working to maximize returns to investors -- the notion of an American corporation is antiquated) may be able to "create excess capital," but who will that benefit besides the shareholders? I believe something like 1% of Americans own 80% of the stocks. Lowering health care costs may indeed make corporations more profitable and save American jobs, but it will do so by lowering the average American's standard of health care to that of the average Pakistani's.

You quote the cost of health care per car for a company based in America vs. one based in Japan, but this ignores the fact that the Japanese company manufactures as many cars in the U.S. as the American company. The primary difference in the cost is due to the unions that have so far managed to keep the solidly middle class compensation and benefits historically associated with auto manufacturing jobs at the American company, while the workers at the Japanese companies' plants in this country make relatively low wages, have little room for advancement, health care benefits that require a much greater level of cost sharing, and little to no job security. The American auto-working career has been replaced by a Japanese auto-working job that does not lead to a middle class lifestyle. If we rush to embrace this migration of former members of the middle class to the ranks of the working poor in order for corporations to be more profitable, I seriously doubt that the result will be that they "might choose to spend more money on consumer goods, thereby stimulating the economy, or to save money so they can send their kids to better schools and universities, thus making our workforce more competitive."

Also, you claim that Universal Health Care will "reduce health care costs to our businesses" and provide "health care as a basic service is also in line with conservative ideology ", but then go on to state that "does not mean that the American taxpayer is going to foot the bill for 100 percent of all health care costs for all Americans. That is socialized health care, which is vastly different from universal health care. So which is it? Are you advocating we move to single payor (government) system to enable corporations doing business in America to compete by lowering labor costs to match those in China and India? Or are you advocating that we force people to buy insurance coverage through some unfunded mandate that will ultimately not result in any fundamental change to our current health care system? I remember when the government first began to discuss mandating car insurance because it would theoretically lower insurance rates for everyone. Is there any state where the cost of car insurance went down once it was mandatory? Besides, at least driving is a privilege that can be denied...what exactly is the penalty for a person who can't afford health insurance coverage? The whole mandating coverage thing is just so ridiculous...for it to have any real impact one must believe that most of the people going without health insurance are doing so by choice because they prefer to take a gamble, they have plenty of money to cover premiums but would rather spend it on shoes and satellite radio. Sure, there are probably a few people out there like that, but those are the people who pay exorbitant rates out of pocket when they do get sick so that they don't ruin their credit. The people that burden the system are the ones that can't afford the premiums, and can't afford to pay their bills when they have to seek emergency care. Further, if we were somehow able to make an affordable health insurance available to people whose employers don't offer insurance and who cannot afford a standard individual policy, how would we prevent employers from dropping health benefits en masse and swelling the program well beyond its intended scope? People seem to be up in arms when WalMart relies on the government to subsidize its employees' health care, but the mandatory subsidized health insurance program would encourage more and more companies to do the same thing.

If Universal Health Care only means that everyone is covered, someone still has to pay for that coverage. The government already pays for coverage for people that cannot afford coverage on their own, it's called Medicaid. And even though most health care providers lose money every time they see a Medicaid patient, the program is still so expensive that every attempt to expand the program to include more of those too poor to afford health insurance fails because of concerns it will result in higher taxes. Of course, health insurance companies like Medicaid because they make loads of money by contracting to administer the program for the government. And as long as the insurance companies are administering the program for the government, they can call it Universal Health Care instead of socialized health care. Instead of forcing everyone into the single payor system, they let people migrate to it as their employers drop health benefits. Regardless of the route we take to get there, taxes will still have to be raised to pay for this new coverage or the per capita spending on health care will have to be greatly reduced and the quality of health care for every American will be lowered to achieve these cost savings.

The only reference to cost-savings I see in the above post is the suggestion that "letting insurance companies compete to provide insurance to Americans will help to lower costs." How might this work? Insurance companies are simply administrators and gamblers that attempt to guess the cost of health care (and they are very, very good at making those estimates) and then tack on a fee of 3-5% of real costs to pay for their services. Today, they compete with each other to negotiate contracts with hospitals, physicians, and other ancillary providers of health care to limit the costs their commercial customers pay and in that way do work to keep the cost of health care down (today these are all negotiated as a percentage of Medicare fee schedule). If they are no longer competing with each other for group business, they will simply be bidding against each other to administer the program for the government. The government programs already pay a set rate for programs as determined by the CMS' relative value scale based fee schedule. There really isn't much cost savings to be realized from health insurance companies competing to service a single payor that sets its own prices.

Finally, we should all think about the logical consequences which would flow from the Universal Health Care proposals. I've already touched on the way it would enable employers to divest themselves of health expenses and send most Americans into public health care. Today the average doctor has a patient mix of 10-20% Medicaid/Medicare. Physicians lose money when they see a Medicaid patient, and break even when they see a Medicare patient. Most physicians do this without too much complaint out of a sense of medical altruism. It is when that patient mix gets out of whack that you see the good physicians begin to refuse to accept Medicare or Medicaid. If we begin to drastically increase the number of Americans on Medicaid, it will impact the number and quality of physicians and hospitals. Health care decisions will be made based on cost/benefit analyses that factor in the greatest good for the greatest number. In our lifetimes, we have all seen the astounding pace of innovation in medicine. Our current system rewards new and innovative treatments with high reimbursements, and is the only system in the world that does so. Americans have effectively been paying for medical innovation for the rest of the world. If we move to a single payor system, the current standard of care becomes what is good enough for everyone and the pace of innovation will lag. Universal Health Care will not take what we have and give it to everyone for the same price through some bit of magic that will be painless to everyone.

To fix our broken health care system, we need a courageous leader who will be honest about our choices. It's not a matter of mandating coverage for everyone, it's a matter of taking on special interests and making fundamental changes to the way Americans buy health care. It's a matter of fixing some of the problems that have made many of the pigs at the trough very wealthy, and they've used that wealth to buy influence. If you want to make healthcare affordable to Americans, then make it more efficient and competitive, not less. A leader would start with a few simple changes...

• Change the tax credits to employers who offer health insurance to employees to encourage employers to offer health care spending accounts in conjunction with catastrophic health insurance. This would reintroduce the notion of paying attention to what health care actually costs and making choices based on quality, services, and cost. It would also greatly reduce administrative costs on both the provider end and the insurance end. It will ultimately have a negative impact the revenue of insurance companies, pharmaceutical companies, and some hospitals -- all of which have huge lobbying and PR budgets they'd unleash like it's 1994.
• Get rid of JCAHO -- the hospital accreditation organization that causes so much inefficiency and ridiculous privacy and staffing rules in the name of insuring quality, which it fails to do. It does make it impossible for hospitals and physician groups to be innovative, and makes start up costs prohibitively high thereby limiting competition. In lieu of JCAHO, open up the National Provider Database or enact laws that will make it possible for Health Grades or some other J.D. Powers for health care to emerge so that consumers have access to information that will make it possible to make to factor quality into health care decisions. This will be opposed by physicians, nurses, large hospital groups, and unions.
• Repeal the Privacy and Security provisions of HIPAA. Replace them with laws that prohibit insurance companies from collecting and selling data about individuals health care utilization to other companies and make it illegal to commoditize individuals' medical records. This will decrease administrative and software costs for providers greatly, resulting in increased competition. It will also give Americans real security and privacy with regards to their medical history. This will be opposed by large hospital groups, health care administrators, medical software companies, insurance companies, and anyone who believes the Privacy and Security provisions of HIPAA have anything to do with privacy or security.

These things would address the costs of health care in a way that would improve the quality. It would go a long way toward putting health care within reach of almost all Americans. Unfortunately, most Americans don't have the attention span to read this post, let alone listen to a politician explain all of this and understand it enough to not be swayed by the barrage of negative PR the various groups who'd be opposed to the proposals would let loose. That is why we end up with solutions that can be explained in a sound bite, backed by inaccurate and contradictory talking points.

Lest I be accused of being a conservative skeptic, let me state clearly that I am a flaming Liberal. I, too, oppose the denial of care to anyone born or naturalized as an American citizen. I even oppose the denial of care to illegal immigrants who have an urgent need. Mercifully, I've never seen anyone denied care in all my years of working in health care based on their ability to pay. Not ever. I've found that the vast, overwhelming majority of people working in health care will find a way to help people in need. Besides, it is illegal for a health care provider to deny care in an emergent situation and opens the provider up to all kinds of lawsuits. The only reason care can be denied is if the physician is absolutely sure the patient is drug-seeking.

What can happen is that a person will receive the care they need, be unable to pay, and find their credit destroyed and never financially recover. That is an issue no one will address. A file at Equifax can be bought and sold and impact every aspect of a person's life -- the government can even use it to target surveillance -- and yet it is completely unregulated. Why does no one even talk about the huge numbers of Americans unfairly or inhumanely saddled with bad credit and the discrimination they face? Why not address the way medical debts are calculated (a bill an uninsured patient would receive from a hospital would be about four times the amount and insurance company would pay) and how much/how long they impact a credit score.

[30A Skunkape]

Well, that about covers all the bases I think

[rapunzel]

Well, that about covers all the bases I think

Hey, I spent hours on that post. I think it deserves a more thoughtful response.

[seacrestkristi]

Why can't we all talk nice about it? We are all friends, aren't we? We all want what is best and most reasonable. How can we ever come to an agreement if we're all so ? wE'RE ALL F627IN' GEENYUSES, AND ONE'S OPINION IS =TO THE OTHERS. nO ONE IS all RIGHT all THE TIME... aT LEAST WE ALL GIVE A RAT'S WE DO HAVE THAT IN COMMON.

[rapunzel]

Why can't we all talk nice about it? We are all friends, aren't we? We all want what is best and most reasonable. How can we ever come to an agreement if we're all so ? wE'RE ALL F627IN' GEENYUSES, AND ONE'S OPINION IS =TO THE OTHERS. nO ONE IS all RIGHT all THE TIME... aT LEAST WE ALL GIVE A RAT'S WE DO HAVE THAT IN COMMON.

I didn't mean for the post to come across as angry, I am certainly not angry. I do, however, believe in debate. If everyone's opinion is equal, then there is no point to discourse. If someone posts a candidates talking points on a forum, I think it's right and fair to respond to those talking points in a thoughtful manner.

Instead of calling me a GEENYUS and saying no one is right all the time, argue with me and show me where I'm wrong. I think it's far more to attack me than to attack my post.

With all due respect, and I mean all due respect, it's not enough to care, we need to have a deep understanding of the positions we take on the issues.

[scooterbug44]

Hey, I spent hours on that post. I think it deserves a more thoughtful response.

Thank you for spending the time on it! I read it ALL and it was quite informative, like all your health care posts!

[hnooe]

Happy and Healthy New Year to all! May your doctor visits be minimal in 2008!
(Don't forget to do your regular screening tests.)

[seacrestkristi]

I didn't mean just you, Rapunzel, and I am very thoughtful. I have always tried to be respectful of you and your very strong opinions and I would appreciate the same. Thanks. I you and hnooe too. It just sounded like everyone was gettin' , and putting down other's intelligence or what you feel is a lack of. Sorry, nothin' personal. You chose to take it personal.

It's really way too complicated for me, or anyone else, to understand every detail. All I know is my own 'stories' with insurance companies and how they've discriminated against me and my daughter for reasons I don't care to share. I don't think insurance companies should be allowed to 'cherry pick' only healthy peeps, or to charge more for hx of taking meds at your own choosing. That's part of what I do know.

[Miss Kitty]

Hey, I spent hours on that post. I think it deserves a more thoughtful response.

I read it and thank you. I did not see any anger or put downs of any opposing viewpoint. I need to ask some questions, though. When I find the rest of my brain cells, I will ask.

[hnooe]

I read it and thank you. I did not see any anger or put downs of any opposing viewpoint. I need to ask some questions, though. When I find the rest of my brain cells, I will ask.

You are right Kitty. I think people have just come "up to the line" of controversy on this thread--no one has crossed it, in my opinion. For example, I read and try to absorb all of Skunkape's comments ( I may not accept them though). It is all for the good.

[scooterbug44]

Slightly tangential question - has anyone tried the health care savings account/plan instead of the standard health insurance?

Since I already pay for vision and dental out of pocket, my prescription drugs aren't covered, and I am quite healthy, I am thinking that might be the best way to go.

[wrobert]

Slightly tangential question - has anyone tried the health care savings account/plan instead of the standard health insurance?

I have asked several insurance agents about this plan as I was sort of interested in starting something myself. But I have not been able to find anyone that can really explain how it works to me. I have also questioned both the county and the school district why they do not consider such an offering for employees, but again all I get is blank stares. My family is pretty healthy and I would not mind doing something that allowed me to accumulate wealth that would eventually be mine instead of Blue Cross Blue Shield.

If you find someone versed in this sort of thing, please pass along their contact info.

[Camp Creek Kid]

I have asked several insurance agents about this plan as I was sort of interested in starting something myself. But I have not been able to find anyone that can really explain how it works to me. I have also questioned both the county and the school district why they do not consider such an offering for employees, but again all I get is blank stares. My family is pretty healthy and I would not mind doing something that allowed me to accumulate wealth that would eventually be mine instead of Blue Cross Blue Shield.

If you find someone versed in this sort of thing, please pass along their contact info.

Call a hospital's insurance dept. and have them explain. It is a little complicated, and I can't remember the details, but when they explained it to me, it didn't sound like such a great deal.