A public option was always more pragmatic than single payer

[ProSense]

Kucinich and Conyers decided it wasn't the right time for a vote on the Weiner amendment because the CBO score showed that it will "cost way too much."

That wasn't a surprise given the details of H.R. 676. Single-payer advocates never did a good job explaining clearly what the immediate cost to transition would be. It's a fact that single payer will save money in the long run, but it involves a complete overhaul of the system: putting insurers out of business and people out of work. Medicare exists, but it serves less than 15 percent of the population (about 45 million Americans). That means ramping up and expanding Medicare to six to seven times its current capacity. Even in good economic times, the cost associated with such a transition might be a hard sell. In one of the worst recessions in history, and with the strength of the opposition, it's impossible to see how anyone could think that it was doable. On the other hand, a public option creates a new non-profit entity with the ability to expand.

Still, it would be interesting to see the CBO score of Weiner's amendment.

[Hello_Kitty]

1. I don't care if it does cost more.

It's the best and fairest plan and it will cover everyone. I'm not married to the stupid notion that health care reform has to be "revenue neutral". All that means is that any increased costs get passed onto the middle and working classes out of their disposable income.

[ProSense]

4. I know you don't, but other people do.

Otherwise Kucinich and Conyers wouldn't have factored cost into their decision.

[rurallib]

18. If people ever realized that they wouldn't have to pay premiums

any more and that in toto it costs less, not to mention the end of extra health insurance in car insurance and anachronisms like workman's comp......

[jenmito]

2. K&R.

:hi:

[Cha]

3. kr

[wroberts189]

5. One point though... we all get medicare ..biz. large and small do not have to pay and will save.

..big. Whether that is used for new jobs of higher pay who knows but health care for profit is worse.

[rollingrock]

6. Kucinich never said anything about single payer costing too much.

do you even read your own posts?

[ProSense]

7. Do you always start from the point of denial? Weiner amendment!

The Weiner amendment was scored and coming up for a vote. That is what they were talking about. The last time I checked, the Weiner amendment was a single payer proposal.

[rollingrock]

10. This is what you posted

Kucinich statement:

"The Congressional Budget Office (CBO) has scored the bill scheduled for a vote tomorrow in a manner which is at odds with many credible assumptions, meaning that it will appear to cost way too much even though we know that true single payer saves money since one of every three dollars in the health care system goes to administrative costs caused by the insurance companies."

do you understand what that means?

[ProSense]

11. This is also part of his statement

The Congressional Budget Office (CBO) has scored the bill scheduled for a vote tomorrow in a manner which is at odds with many credible assumptions, meaning that it will appear to cost way too much even though we know that true single payer saves money since one of every three dollars in the health care system goes to administrative costs caused by the insurance companies. Is this really the climate in which we want a test vote?

You seem to be focused on the rest of the statement, which addresses the cost after the system is in place, not the initial cost.

[rollingrock]

13. Kucinich was criticizing the CBO's figures

he is saying that the manner in which the CBO scores is MISLEADING and because it makes HR676 appear to cost more than it does. Kucinich is criticizing the CBO, saying it is at odds 'with many credible assumptions' about single-payer. Understand? Jesus Christ.

[ProSense]

14. The CBO is going to have to score any bill, so claiming that it's misleading

isn't relevant. Asking for a new score or revealing the assessment is the only way to know for sure what he thinks is misleading. The fact is the score showed it cost too much.

[rollingrock]

15. and Kucinich disagrees with the CBO

you can go ahead and make the case for what the CBO says, but when you claim that Kucinich & Conyers agrees with their assessment, that is false. because they don't.

[ProSense]

16. Sure he does. Everyone in the world is wrong except Kucinich.

It doesn't matter if he disagrees, unless he makes the assessment public and demonstrates why the score is flawed, it doesn't matter.

The CBO scored all the bills out of committee, and everyone, including the single payer advocates, took those scores as the last word.

[tblue]

8. How much $$ is too much to save 45,000 lives a year?

That's what I hollered to all those Republican snots on the floor of the House yesterday.

[ProSense]

9. The public option cost are ranging between $900 million and $1 trillion

Implementing single payer would likely cost substantially more.

[tblue]

12. To save lives, Its worth it to me. That's what money is for.

[dsc]

17. the 15% currently covered are, by far, the most prolific users of medical care

I highly doubt that covering everyone in Medicare would necessitate more than about a trippling of Medicare, not a sextupling or septupling.

[ProSense]

20. Medicare enrollment is about 43 million total.

The U.S. population is about 305 million. Government programs (Medicare, Medicaid, VA, etc.) cover about 30 percent. The other 70 percent are private. So that's at least four or five times larger. In any case, it's a significant overhaul.

[dsc]

31. It isn't four or five times as large in terms of dollars spent or procedures done

which is the reasonable way to consider this as that is what would determine cost. Elderly people use vastly, vastly more medical care than similarly situated young people.

[Tom Rinaldo]

19. K&R

I agree. Not because I feel it would not be worth spending the extra money now needed to convert to a single payer system as soon as possible, but because I agree with your political read. It was not in the cards to win single payer in one bold stroke from this Congress. Whether we might have ultimately gotten a stronger public option passed now had single payer gotten a serious look anyway is a different subject for discussion.

[Captain Hilts]

21. IF you want to put a price on lives and preserve a useless industry. You are such a tool. nt

[ProSense]

22. Get over your self. People got the vapors when the CBO scored the House bill at over $1 trillion.

You're delusional if you think people aren't going to discuss cost.

[Captain Hilts]

23. We didn't discuss the cost of the Iraq War, put on a credit card. Don't let 'them' guide the debate

[ipaint]

24. Load of baloney.

So you and others settle for a shit bill and now it's constant justification for selling out.

Why don't you really educate yourself and read up on how a country with an uninsured rate of 45% provided 95% of it's citizens universal coverage in one year. If these folks can come to this country to find educators to help them transform their system in 1 fucking year, we have no excuse.

This isn't rocket science, it's not impossibly complicated, there is no need for decades of incremental change, and we also have the good fortune of having the structure in place already.

You decided to support a half assed insurance industry bill with no viable public option then your going to have to take responsibility for it instead of ripping apart the only real way to universal coverage in order to justify your half assed approach.

That conclusion is not one that single payer advocates fabricated out of thin air, it is understood in every nation with a form of universal care.

We will get universal care when we demand it and not a minute sooner. The only reasons we aren't getting it anytime soon is because our leaders are corrupt and the ins. industry has a stranglehold on all of us. We don't have problem solvers for leaders, we have enablers- top to bottom. And folks like you enable them.

Until we take care of that problem please refrain from spreading lies about the only real path to universal care.




Health Care Abroad: Taiwan

Taiwan instituted universal insurance in 1995. What was the health care system like before?

Only a portion of the people were insured, including civil servants, employees of large firms and farmers. The military had its own system of coverage. But 45 percent of the population did not have insurance, and they faced financial barriers to access to health care. President Lee Teng-hui felt strongly that he wanted to do something concrete and visible for all the citizens. He thought of introducing national health insurance to touch the lives of all the people. There was a sense in Taiwan that health care is needed by everyone and a country has to assure everyone equal access.


How did you become involved in the health care reform process?

The government initially appointed four Taiwanese professors to lead a task force of technical experts. But the four professors all had different ideas. It was like a wagon drawn by four horses, with each going in a different direction and nobody driving. After a year of this, government officials realized there was a problem. In addition, they wanted someone who understood health systems and health care abroad and what lessons other countries could offer to Taiwan. The domestic experts did not have much international experience.

I was invited to a three-day workshop, where they tested me. At the end, I was put in charge of the task force of four professors and 16 other technical experts. It turned out to be a big advantage that I’m not Taiwanese and had no aspirations of getting a job in Taiwan. At the end of the day, our recommendations and findings were perceived as more objective and free of self-interest.

What was your assignment as head of this task force?


We had to design a national health insurance plan for Taiwan, based on international experience. Government officials wanted to understand how other advanced countries fund and organize health care and learn from their successes and failures, so I made a study of the systems in six high-income countries — the United States, the U.K., Germany, France, Canada and Japan.


What percent of the population is now insured?


Within the first year, Taiwan managed to insure 95 percent of the population. That increased that by another percent or so each year, until they reached 98 percent. They had trouble with that last 2 percent, because some were living overseas and others were homeless. The government literally sent people to find the homeless under bridges and enroll them. Now they have close to 99 percent enrollment.


What’s the most important lesson that Americans can learn from the Taiwanese example?

You can have universal coverage and good quality health care while still managing to control costs. But you have to have a single-payer system to do it.

http://prescriptions.blogs.nytimes.com/2009/11/03/health-care-abroad-taiwan/

[ProSense]

25. Not as easy or immediate as you think.

Taiwan started its health reform in the 1980s after experiencing two decades of economic growth.<3> In 1987, the government did away with the martial law which mobilized the governmental departments. The government set up a planning commission and looked abroad to study other countries’ health care systems. Taiwan looked at more than ten countries and combined their best qualities to form their own unique system. In 1995, Taiwan formed the National Health Insurance (NHI) model. In a 2009 interview, Dr. Michael Chen, Vice President and CFO of Taiwan's National Health Insurance Bureau explained that one of the models investigated was the United States and that fundamentally, NHI "is modeled after (U.S.) Medicare. And there are so many similarities - other than that our program covers all of the population, and Medicare covers only the elderly. It seems the way to go to have social insurance."<4><5> NHI delivers universal coverage offered by a government-run insurer. The working population pays premiums split with their employers, others pay a flat rate with government help and the poor or veterans are fully subsidized. Taiwan’s citizens no longer have to worry about going bankrupt due to medical bills.<6>

Under this model, citizens have free range to choose hospitals and physicians without using a gatekeeper and do not have to worry about waiting lists. NHI offers a comprehensive benefit package that covers preventive medical services, prescription drugs, dental services, Chinese medicine, home nurse visits and many more. Working people do not have to worry about losing their jobs or changing jobs because they will not lose their insurance. Since NHI, the previously uninsured have increased their usage of medical services. Most preventive services are free such as annual checkups and maternal and child care. Regular office visits have co-payments as low as US $5 per visit. Co-payments are fixed and unvaried by the person’s income.<7>

<...>

By 2001, 97 percent of the population were enrolled in the program. Every enrollee has a Health IC smart card. This credit-card-size card only contains a kilobyte of memory that includes provider and patient profiles to identify and reduce Insurance Fraud, overcharges, duplication of services and tests.<9> The physician puts the card into a reader and the patient’s medical history and prescriptions come up on a computer screen. The insurer is billed the medical bill and it is automatically paid. Taiwan’s single-payer insurer monitors standards, usage and quality of treatment for diagnosis by requiring the providers to submit a full report every 24 hours. This improves quality of treatment and limits physicians from over prescribing medications as well as keeps patients from abusing the system.<6>

link

Taiwan, national insurance model. Taiwan (population: 23 million) managed to increase health coverage from 57 percent of its population to about 99 percent (PDF) between 1995 and 2000. The country now spends about 6 percent of GDP on health. Its compulsory system is financed largely through shared deductions by employers and employees on a sliding income-based scale, with the government funding a portion of services through the general budget. The system has one of the lowest administrative costs in the world. Chen, of the country's National Health Institute, notes Taiwan's health system applies "information technology to the maximum" with its smart card system, which enables everything from making payments to disease monitoring to abuse detection to instant medical histories. Chen argues one of the biggest lessons for U.S. policy reform is that single-payer systems provide the best protection for the sick and the elderly because everyone is in the same risk pool. Despite its achievements, the long-term financial viability (PDF) of Taiwan's system is a concern--as of 2008 the program was running a $30 million deficit(Taiwan Review) per month, according to Chu Tzer-ming, president of the Bureau of National Health Insurance. The government is so far unwilling to raise premiums (NPR).

link

[ipaint]

26. The council on foriegn relations???

neo con/neo liberal central. You are a tool.

Besides that the article you link to says the same thing as my article does except my article interviewed the person responsible for putting together the reform.

Stop just linking to articles and try reading them first.

[ProSense]

27. Always tell when the facts are too hard to handle, fear of sources kick in.

It's true, and you can go check the embedded links.

[ipaint]

30. When you are ready to respond to my point let me know.

Until then carry on catapulting the propaganda. At this point there aren't too many here, except the perpetual obama cheerleaders, who even bother with your circular, pointless pronouncements.

[Clio the Leo]

28. A pragmatist and an ideologue are two different animals....

.... walking through life on two completely different paths .... and never the twain shall meet.

But, as always, I appreciate you trying. ;)

[optimator]

29. 2% covered vs 100% covered

of course single payer costs more because it covers more people.
And it actually costs less per person since there is no scum bag middle man insurance weasal pocketing most of it.