I want my single payer fee for service health care system. I deserve it. How about you?

[John Q. Citizen]

If i had to vote against my Democratic Senator to get it, I'd do it in a second.

If I have to vote against Obama to get it, I'd do it in a second.

How do we get the news papers to report the facts? From WMD to Single Payer Fee For Service they are whores for the moneyed class.

[MercutioATC]

1. Nope. I want an expansion of FEHBP.

Give everybody the same benefits available to federal employees. It's stil for-profit, but it works (and it's an easy transition).

[Cleita]

2. OMG you are so wrong!

Please educate yourself. It's too expensive to give to everyone, which means only some would qualify.
http://pnhpnymetro.org/on_the_issues2.pdf

But this is not the worst of it: Those who
advocate an “FEHBP solution” assume that the
private insurers who participate in FEHBP would
be willing to offer the same plan that is offered to
Federal employees, at the same cost, to anyone
wishing to purchase it. However, Federal govern-
ment employees are healthier, more securely em-
ployed, and more “middle-class” than the average
person in the population. It is highly unlikely that
private insurers would be willing to offer the same
deal to any small business or individual. We know
that insurance premiums for small businesses and
individuals are much higher than for large employ-
ers, where the risk is spread far wider.

[MercutioATC]

8. Thanks, but I AM educated on this matter.

If some iteration of the FEHBP were adopted as a national health insurance plan, the insurers would HAVE to offer the benefits...to refuse would to be deprived of clients.

Want to talk about spreading risk? How about a pool that included 300+ MILLION people?

[John Q. Citizen]

10. A pool of 300 million would be by definition a single payer pool. Let's do it. Now.

Who in the congress is pushing your idea?

[elleng]

15. Several I've heard,

thru the years.

[elleng]

14. Excellent.

I'm educated too, and participate.

There are MANY choices, approved and subsidized by feds. People have to take time to study those available and applicable to them; not too much to ask, IMO. Lets do it!

[John Q. Citizen]

16. One entity that covers 300 million isn't that hard to study. Right? It's not like asking

Americans to choose a telephone carrier, right?

[elleng]

17. It won't be ONE ENTITY.

Quite a large number of suitable entities are offered; every year, pamphlets are distributed so people can determine whether or not to change from one to another.

In fact it will be like choosing telephone carriers, but format for all carriers is same, to make the choice relatively easier than the confusion offered by teles.

Process would probably change in some ways, but this is how it is now, and should remain similar, imo.

[John Q. Citizen]

18. A patchwork quilt? A chaotic conglomeration? No system? No thanks.

edited to add-

PS

I know that's the so called plan. But it's not pragmatic. It's discredited free market ideology.

It's the same idiotic concept that led to deregulation of utilities in my state. A disastrous event for Montanans.

Why choose disaster?

[elleng]

19. It is NOT deregulation.

It works well for federal employees. Feds require certain attributes, and able carriers offer their plans including those attributes. The plans compete with eachother. I'm quite familiar with deregulation, and it is NOT that.

[John Q. Citizen]

21. It's the same mindset as deregulation. Private isn't as good as public. Get used to it!

Private goes belly up and the public makes it all right again.

[elleng]

22. Been there, done that.

'Mindset?' Not at all. I lost my last/best job because of 'deregulation,' and I know what it is. I use FEHB because I used it as a federal employee and my husband is a federal employee so I use it now. I know what it is.

Feds set standards/attributes, existing carriers opt in, Feds pay some of premiums. I've explained it before. It works well because Feds require it to do so.

I don't think its likely that we'll go from zero to 100% single payer over night; in fact, its highly improbable. I'd love a Canadian type system, but I'm a realist.

[John Q. Citizen]

27. Realistically, if you don't ask for it you won't get it. Lets put the plans up side by side

instead of writing the plan you say you prefer off from the start.

It's time we put ideology behind us and examine the plans based on what works the best.


We have single payer bank account insurance. It's called FDIC.

We have single payer medicare.

How is it that single payer works so well to keep banks afloat, yet it is touted as "unrealistic" for healthcare? People love their Medicare. It works. It could even work better.

No, the time has come to evaluate plans based on outcomes instead of based on ideology.

[Cleita]

33. Very well said, but yet the same old astroturf keeps crawling back here

spread by irresponsible journalism and politicians who took money from the very parasitical industries who own our health care today and whom the politicians owe a debt. It will be hard to fight these companies, but fight we must and force our politicians to do what needs to be done.

[Hawkowl]

40. Medicare for everyone!

Instead of advocating for FEHBP for everyone. We already pay medicare insurance. Hell I'd being willing to pay double (but I doubt that it would cost that much) IF I never had to worry about medical or dental bills again. Including long term care. The key difference is PUBLIC vs. For Profit. People shouldn't be required to go to the lowest bidder for their lives. That is the crux of the argument. Lowest bidder or best life preserver?

[eridani]

52. Yes, a bunch of healthy employed people

All you are saying to sick people is fuck off and die, already.

[elleng]

74. Pardon me,

I am saying no such thing; I was discussing the attributes of the FEHB plan so we all can make educated decisions about a very important matter.

[eridani]

75. That's like making an "educated decision" about whether or not your fire department is any good

With any luck, you will never know. Similarly, it is only the 20% of the population accounting for 80% of health care costs that has a fucking clue about whether their insurance is any good. Everyone else in in blissful ignorance, and there is no such thing as an educated decision for them. Recall that all the people profiled in SiCKO thought they had insurance that would get them care when they needed it.

[eridani]

51. It is bloody well TOO too much to ask

Fuck this shit. If my house catches fire, they send a truck out. That's why I pay property taxes. I don't have to go through any bullshit about "which fire protection agency is best for my family." No reason why a heart attack should be different.

[Cleita]

31. Are you educated because you read or through experience negotiating

our business and insurance system first hand?

[MercutioATC]

43. I'm experienced because I have FEHBP and I know the power that the insurance companies have.

We're not going to get rid of insurance companies without a fight...and there's no need to.

FEHBP works just fine. Expanding it to cover all Americans would solve the problem...and it's an easy fix.

[Cleita]

44. Are you prepared then to pay the higher premium? Or do you pay into it at all?

What will happen when everyone gets included is, it's going to cut into that 30% of administrative and profit that the insurance companies take. That means getting higher premiums thrown at whoever is paying for this because the insurance companies will take their cut first. If they are required to cover everyone for everything, then they will do two things, cut down on the rates of disbursements to health care providers and raise their rates. If the federal government is covering this then, your taxes will go way up. Wouldn't it be cheaper and simpler to bypass that 30% to the industry instead?

[MercutioATC]

45. Well, it hasn't worked that way so far. I pay less than most people.

...and FEHBP participants insure ALL federal workers. That's a large pool of people.

[Cleita]

47. Apparently, they are still working though.

If you extend this to everyone, that means people with chronic disease, end stage diseases, the elderly, the homeless, and the very poor, in other words, people who can't work anymore or who are underemployed and underpaid, and who need more crisis health care than your average healthy working, middle class. The insurance companies have figured this in, a reasonably healthy, low risk pool. When that pool extends to everyone, then the risk changes. That means you will pay in your taxes, premiums or both. It means also that your doctor will be sparring with insurance company accountants to get you the health care you need.

[MercutioATC]

50. FEHBP covers all of our retirees until they die, too.

That'd be the higher-risk pool you're talking about. They pay the same amount we do.

...and the main reason the poor need more crisis health care than the affluent is that they receive no preventative care. That issue wouldn't exist under either an expansion of FEHBP or a single-payer system

[Cleita]

55. No your retirees get Medicare and the FEHBP pay for the medi-gap.

Medicare would be replaced under an extended FEHBP plan most likely because in their greed to get their hands on all health care dollars, the insurance companies would want it that way. I have already seen first hand what privatization has done to Medicare. It's not working. Most doctors in my area refuse to take Medicare advantage plans because they got stiffed too often. If the insurance companies insure the poor, they would either have high deductibles, which mean the poor still don't get preventive health care or high premiums to have low deductibles. Remember they have to pay themselves that 30% first. That's how it works. Now if private insurers are willing to extend coverage for only a 2% to 3% administrative cost like Medicare does then maybe they could work, but you and I know they won't do that.

[MercutioATC]

60. You're not thinking big enough.

If we expand FEHBP to cover everybody, private insurance companies will not be able to operate as they do now. Why?

1) Unless they can get by selling premium health insurance to the wealthy, FEHBP will be the only game in town. Want to continue to exist? Here are the new rules.

2) If the pool became THAT much larger...especially with the government footing the bill for the most disadvantaged, they wouldn't need that 30% you keep talking about.

Additionally, everybody would have a CHOICE of 10-15 different plans to choose from (HMOs, PPOs and PPV plans). They could choose which plan fit their needs best rather than being forced into a "one size fits all" package.


How much do you know about the FEHBP? It's not as bad as you seem to think, and it'd be easy to expand.

[Cleita]

63. I actually studied it a lot when John Kerry proposed it and I realized that

people who don't understand how insurance works, would think it's wonderful for everyone. I used to work in health insurance and then later for doctors doing medical billing. I know how it works. Unfortunately, John Kerry is a very wealthy guy who probably could spend some time in an inner city ER to change his mind. I think Kennedy and Daschle could use some of that education as well. If in fact the federal government pays for all these plans, it becomes single payer anyway. So why do we need the middle men in there skimming off profits, when the government can deal directly with the health care providers cutting out that 30% in administrative costs and profits? That would actually cover everyone who is unemployed for whatever reason and you could probably get dental as well. Smarter people than me have crunched the numbers and have come to the same conclusion

[backscatter712]

61. I like the word "Have to"

Quite frankly, participating in FEHBP should be the price of going into business as an insurer - it should be required - you have to join the insurance pool, you have to use one big pool for all your customers rather than subdividing to game the system and jack up premiums - they should not have a choice in the matter.

Yeah, one of my big things I think should be done to deal with health care is to regulate the hell out of insurers, or just plain regulate them out of business completely and go single-payer.

[Cleita]

64. That's what John Edward's plan was about and

look what they did to him. I really believe an intrepid journalist could find out just how the National Enquirer got that juicy tid bit about his love child leaked to them, and it would lead all the way to a "K" street firm that has insurance and health care lobbyists for clients.

[dtotire]

23. I am with you on this

I am already on it and I have been getting good service. We have a choice of plans, get regular physicals and preventive care. I had one hospital stay for pneumonia. I have a $300 annual deductable, which is affordable for me. However, to extend it to all Americans, would require additional taxes. I would suggest a Value-Added tax of 8%, and eliminate the need for employer contributions. This is rebated on exports, which would make American businesses more competitive. We could also eliminate the payroll tax for Medicare.

[John Q. Citizen]

28. How will subsidizing private insurence companies lead to cost containment? Won't

private insurance companies raise premiums since they are tax payer subsidized?

What if a major private insurance company decides to sell off their stock and then declare bankruptcy.

The taxpayers will be then expected to bail them out since we can't afford to let millions go without their coverage. That's a recipe for repeating the mistakes of the past, IMO.

[Cleita]

30. I think this would work like the prescription benefit of Medicare, part D.

Not only did the drug companies raise the price of their prescriptions, but by the time you pay a month fee for the benefit and your co-pays there is no benefit in actuality, I have found. The drug companies get federal money besides. I don't think this would be any different. The insurance companies are nothing but parasites who leech out health care dollars. It's time to cut out the middle men insurers. I have stopped taking a medication that could stop my progression to Alzheimers, and I do have a drug benefit, because it's too expensive. I'm reviewing all the other Part D plans but can't find any savings. I had been putting it on a credit card and my credit card was swelling with that drug expense. So I stopped taking it. I will be another statistic when I lose my mind of dying of a medical condition that could have been contained.

There is a solution to all this, yet people keep insisting on implementing business solutions on social problems.

[kath]

48. But under that system don't the insurance companies *still* suck 30-35 cents out of every dollar?

That amount of waste, which goes into DENYING care and coverage and into the pockets of mega-rich CEOs and administrators, is absolutely unconscionable.

[eridani]

49. Bullshit. The working age population is healthy, which is why they can make a profit

No profits at all once you start letting a bunch of sick people into their nice clean risk pool.

[sandnsea]

3. I have subsidized health insurance

It's not perfect, but it's a damn sight better than the nothing I had before. Create the govt policy, create the insurance pool with coverage mandates, subsidize both and see where people end up. It works in Germany.

[Cleita]

5. Good for you.

Wait until you get older and maybe have a few health problems down the road and see how that works for you.

[sandnsea]

6. I am older

my husband and I have a boatload of health problems. The state insurance pool for people with pre-existing conditions is around $1,000 a month. No way we could pay that. The subsidy works. We're going to need to subsidize any health plan so it's a good place to start.

[John Q. Citizen]

12. So paying more rather than less is what you want to do?

[John Q. Citizen]

11. Pragmatic or ideology. That is the question.

Is it nobler to attempt to prop up the very free market which about us is crashing like the city of Baghdad under the American bombardment, or should we just do what works?

i have a coupon for two for one at my super market. What's that got to do with pragmatic?

[slipslidingaway]

69. On Germany from the program "Sick Around the World"

it is working in Germany now, but there are signs of unrest and most of the upcoming doctors will have large loans to pay off, that needs to be considered as well.

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/etc/script.html

"...R. REID: But a lot of doctors aren't laughing. In March of 2006, they felt sufficiently angry to stop work and take to the streets in the heart of Berlin. Dr. Christina was one of them. She marched three times that spring.

Dr. CHRISTINA VON KOCKRITZ: I think about 18,000 or 20,000 doctors, and doctors don't usually demonstrate. But nothing changed.

T.R. REID: For Americans, there's nothing particularly foreign about German health care. You get health insurance through your employer and the company makes you pay for it. And the coverage is great. They got mental, they got surgical, they got dental. If your doctor says you're tired, the health insurance pays to send you to a spa. And the Germans have made this work. They provide universal coverage for a lot less money than we do. They did it by taking the profit out of health insurance, and they also pay doctors a lot less than we do. I think there's a lot here that we could learn from..."

[leftstreet]

4. Sign me up!

:thumbsup:

[mwei924]

7. It'll never happen though. The country would have to be collectively high for that to pass.

[ZombieHorde]

9. Are you suggesting that we should drug the water supplies?

[John Q. Citizen]

13. I think that's a crime, isn't it?

[ZombieHorde]

73. No, it is perfectly legal.

[Cleita]

32. Everybody says that and I find it very unAmerican.

When did Americans start become whipped before they even started? Seventy percent of the nation wants single paper. Insurance companies don't but they are the ones lobbying our Congress. It's time for pitchforks and torches. That's what the Canadians did. They forced their politicians to do the thing that they wanted.

[Lasher]

20. Single payer is the only way to go.

Traditional Medicare for all. By eliminating involvement of private insurance companies, the difference in cost would almost pay for covering all the currently uninsured.

[Vinca]

24. Not "traditional" Medicare. Keep the name, change the program.

Medicare doesn't cover everything and people usually have to buy supplemental insurance to fill the gap. Many end up paying as much as they did before Medicare kicked in.

[Lasher]

25. I can salute that.

How about Medicaid for all?

[Cleita]

34. We need Medicare to cover everything and everyone. In order for that to

happen we need the health care dollars going to the parasitical insurance companies. I would gladly give my supplemental insurance company money to Medicare to have complete medical coverage, dental and prescription drugs. It could be done too.

[Vinca]

36. If we cut out the middle man - the greedy insurance companies -

you shouldn't have to give supplemental money to Medicare to get everything covered. There's a whole lot more cash in the till if United Healthcare isn't raking in the lion's share of the premium as profit.

[Cleita]

38. Yes, you are very right.

I think what I wanted to say in that post was that the health care dollars are there but are being sucked up by the for profit health care industry especially the insurers. I would gladly give Medicare the share I pay them for Medicare to implement a fine national health care system for everyone.

[atimetocome]

26. Insurers announce health reform proposals**

I want single payer also but it looks like the Industry has the in with the new administration--which we knew before.



Insurers announce health reform proposals



Email|Link|Comments (25) Posted by Lisa Wangsness, Political Reporter December 3, 2008 04:30 PM

By Lisa Wangsness
Globe staff

WASHINGTON -- The nation's largest health insurance industry lobbying group announced a series of proposals for health reform this morning that they said would help achieve universal coverage, control costs and improve the quality of care.



..............."We call on Congress to join with President-elect Obama to enact health care reform in 2009 which puts the health of our families before the profits of the insurance industry," the coalition's director, Richard Kirsch, said in a statement.

But aides to US Senator Edward M. Kennedy, whose staff has been meeting with the insurers along with a broad array of health care advocates, employers and providers to develop a major health reform initiative for Congress to consider next year, was encouraged by the insurers' presentation.

"There's a spirit of optimism about our work to ensure quality, affordable health care for all americans -- and today's announcement adds to that optimism," said Kennedy spokesman Anthony Coley. "The insurance industry has advanced serious proposals that deserve serious analysis and consideration."

[John Q. Citizen]

29. I think every serious proposal deserves serious analysis and consideration; Including single payer.

Yes, we know this is an uphill battle.

But this time is different. This time we are going to demand that single payer be one of the plans considered.

Hey, why are they so afraid to let single payer go head to head with the hybrid schemes? If it's a bad idea, that should be simple and easy to prove.

[Cleita]

35. Sure. They'll reform for awhile and when everyone isn't looking they will go

back to their same old practices. John Edwards had the best plan, but that plan would have eventually squeezed the insurance companies out and they knew it. I suspect they were behind derailing his candidacy by finding a scandal to throw at him, just like the the neo-cons did to Bill Clinton.

[atimetocome]

41. well, I

think Edwards created his own scandal. As did Bill.
But I loved his health care plan also.

[Cleita]

42. Yes, he did but I'm sure there was knowledge about it in Washington

circles. There always is. Sometimes they are talked about and sometimes they aren't. He was outed I believe because of his populist ideas, including his health care plan.

[leftstreet]

37. Only 2 Recs? Do most people here have coverage they're happy with?

:shrug:

[MercutioATC]

46. I have FEHBP and I'm generally happy with it.

I don't support pushing for a single-payer system when we could get the job done more efficiently by simply expanding FEHBP.

[eridani]

53. Translation: I'm healthy and employed. Fuck sick people . n/t

[MercutioATC]

56. Well, since FEHBP covers our retirees too (old and unemployed)...

...you're just being childish.

[Cleita]

58. Medicare covers 80% of their medical expense. Your plan only covers the 20% which lowers

the risk for them.

[MercutioATC]

62. And how does that translate to "Fuck sick people"?

Working and healthy, unemployed and sick...nobody would be "fucked" under either an expansion of the FEHBP or a single-payer system.

The poster I responded to was being an ass.

[Cleita]

65. I didn't say that but there is an abysmal lack of empathy for the homeless.

Yes, ERs must treat them but only the barest minimum of treatment. What do you think of a homeless man being treated for cancer who was discharged from his warm hospital bed because the doctors could do nothing for him? Instead of giving him drugs to ease his pain and a bed to die in, the homeless man had to die in a wet field by the rail road tracks surrounded by other homeless people who tried to help alleviate his suffering. This happened in my community.

[MercutioATC]

66. Yes, that's very sad....and it has nothing to do with the current discussion.

The fact is that either an expansion of the FEHBP or a single-payer plan would eliminate that kind of bullshit.

[Cleita]

67. Single payer would eliminate that. Private insurance won't and never will

by it's very nature of being there to insure healthy people and not sick ones.

[MercutioATC]

86. You keep ignoring that this would provide coverage for ALL.

Yes, as things are now, many people are neglected.

We're not talking about now. Either system would eliminate the problems you bring up.

[Freddie Stubbs]

79. Why is it necessary to take away the choices of those who are happy with their current situation?

Isn't it possible to have a compromise where some people are covered by private insurance and some have government insurance?

[John Q. Citizen]

82. If you want to pay extra for private that covers what your public will, then go for it.

But you have to understand, the beauty of single payer is that everybody is always covered. So you don't need to switch policies and redo paperwork.

If you want to go sign and pay for extra and redundant paperwork, then have at it.

[GrantDem]

39. K&R

[mvd]

54. It's very important to me

Health care is too important to be decided by the market. I think health care should be a right.

[Cleita]

57. It is a right, written into the Constitutions of most industrial countries

of the world. It is a human right, IMHO morally as well, whether the Constitution says it or not. What would it take to get Congress to pass such an amendment?

[mvd]

59. I think reducing the power of the insurance company lobbyists is a start

I completetely agree - it should be stated in the Constitution.

[DCBob]

68. Obama probably needs to focus first on our collapsing economy...

Many of us may not have jobs within a few months much less healthcare benefits.

[John Q. Citizen]

70. Single payer would save the big 3 more than what they requested in bailout.

We can't afford not to do single payer fee for service now,

[DCBob]

71. I am not just talking about the auto industry. Our entire economy is on the brink.

We could easily reach double digit unemployment within a few months no matter what we do with the auto companies. It's all about retaining and creating jobs now. Heathcare will have to wait.

[John Q. Citizen]

72. The waste is killing us and we have toi stop it. We are being ripped off. on health care. It must

come first.

And it will, you watch.

You can wait but health care isn't going to wait.

[MyUserNameIsBroken]

77. Just to play advocatus diaboli...

Is there then a place for private health insurance, or are you actually describing the destruction of an industry? What would be the economic impact of displacing the tens of thousands of workers in that sector, the majority of which make much less than auto workers and have little training or skills beyond data entry?

Make no mistake, I have little sympathy for health insurance companies. I deal with them too much to have any affection at all for them. But health insurance companies aren't simply faceless robotic villains; they're also employers.

An incremental move to single payer has the advantage of winnowing the sector gradually, not catastrophically.

[John Q. Citizen]

80. Just think, all those forrmer private insurance emplyees will be able to get health care.

And they will still be processing life, property, casualty, etc.

A single payer system will require workers for data entry.

We can put them to work on the massive public works programs Obama is planning.


Forcing the country into bankruptcy over health care, killing people for lack of health care doesn't justify a make work program that could instead be put to actual productive work.

[MyUserNameIsBroken]

81. Actually..

...a lot of health insurance companies don't do life or P & C. Also, a single payer system would require far fewer people for data entry, simply because much of the data entry for any given claim is based on what would become redundant information in a single payer system. A sudden implementation is going to cause some pain for people who don't really bear much responsibility for the problem, and I don't want that glossed over. I'm not saying it shouldn't happen. I just don't think waving the "let them build light rail" magic wand is a substitute for a planned, noncatastrophic switchover.

For one thing, administering the program at the Federal level, a la Medicare, may be a mistake. Why not do something like co-opt the (more or less) non-profit BC/BS organizations that exist at the state levels already? Or expand Medicaid, which is funded federally but administered locally? There are a lot of different options under the "single payer" rubric.

[John Q. Citizen]

84. Assuming catastrophe is erroneous. Canada managed without a civil war and we will too.just as

we did for medicare which removed a large chunk of the insured population out of the public sector when it came in.

Sure, there are options. Heavily regulated BC/BS is a possibility. State administered under fed guidelines.

However, medicaid would cease to exist in that everyone would be under the same comprehensive coverage and it would be redundant to have a different separate system. And of course Medicaid is means tested.

[MyUserNameIsBroken]

85. There are still private health insurers in Canada

Providing coverage that the single-payer system doesn't. The relationship they have with it is interesting. Obviously it's a different world for them there, and I really don't know how the transition was handled, to be honest. It should be studied, though, for its good and bad points.

If you removed the means testing from Medicaid and funded it with everyone's "premiums", would you not effectively have a single payer?

[area51]

76. Kick on this life and death issue. (n/t)

[Freddie Stubbs]

78. Obama specificlly ran against this:

http://www.youtube.com/watch?v=jnk8minM3Qg&eurl=http://blog.cleveland.com/openers/2008/10/ad_health.html

[John Q. Citizen]

83. If enough people want it he may have to change his mind. We need pragmatism, not ideology.

I say put single payer up against any other plan and lets do the cost benefit analysis.

Lets see what plan delivers health care that is:

Affordable to everyone

Accessible to Everyone

People get their choice of care provider(s)