Universal health care and the 'socialism' red herring.

[pinto]

Critics of an across the board, federally-funded health care system usually raise two main talking points. And one tired red herring.

First is that the government would unilaterally decide our health care options. Not so. As with any 2nd party payer, the options are determined between the health care provider and the client, while payment is determined by the payer. All 2nd party payers have established limits on covered services. There's no less choice in a full government health care program than any private program. There is *more* access, though. That's a good thing.

Second is that a federally-funded program would be inefficient. Bogus. Overhead costs for Medicare are much less than those for privately funded insurance programs. Private insurance needs a profit, above and beyond basic costs and reimbursements to providers, to stay in business. Medicare carries an administrative overhead, of course, but doesn't carry the added burden of profit production for shareholders. Additionally, the larger the client base - i.e. us - the greater the efficiency in billing and reimbursement.

The red herring of course is that we don't want, can't have 'socialized' medicine. Bullshit, that's a tired bugaboo. Medicare, which serves millions of Americans very well, *is* socialized medicine.

I favor Medicare for all.

Universal access, equitable payments for providers and a shared load among all.

National security begins at home - health, housing, employment and education.

Thanks.

[RB TexLa]

1. Medicare and Medicaid's low cost of administration has come at a price

the fraud rate is much higher than private health insurance.

[EFerrari]

3. Paging Jeb Bush.

[RB TexLa]

6. huh?

:shrug:

[EFerrari]

7. Jeb Bush ran a scam that ripped off Medicaid with another guy

who finally had to flee the country one step ahead of the FBI. Miguel Recarey.

http://www.motherjones.com/news/feature/1992/09/bushboys.html

[Yavin4]

37. There's Tons More Fraud In Defense Spending, Yet No One Cares About That

The CPA in Iraq were literally throwing around bricks of taxpayer money, and no one cared. So, why does Medicare fraud get so much attention. In fact, Medicare fraud can be quickly detected and prosecuted.

[EFerrari]

71. I agree with you but Medicare/aid fraud isn't prosecuted

when it comes from the top. Which is where most of it comes from -- not from poor people who need care.

[SharonAnn]

50. Frist's family business, HCA, was fined more than $1.2 Billion for defrauding Medicare/Medicaid

Think of it. Fined more than $1 Billion. Unbelievable.

He was Senator, his father was Chairman of the Board of HCA and his brother was President of HCA.

[wildhorses]

5. what do you suggest?

how would you propose to solve this problem?

[pinto]

8. Fraud is not a health care issue. It's a legal issue.

I support coming down on fraud in the health care industry, wherever it exists.

[Lone_Star_Dem]

15. Exactly

One is not the other. Keep the issues separate as they should be and prosecute all cases of fraud.

[nonconformist]

10. The private health insurance industry routinely defrauds their customers by denying coverage

Which can result in death.

[truedelphi]

14. And when companies get higher insurance premiums they move out of the

Continental USA - this means that employment opportunities are stifled as well.

GM took its last remaining plants out of the USA because of the health care costs.

[mzmolly]

16. Well we can learn from that I imagine?

?

[Solon]

22. Do you have proof of that? n/t

[LostinVA]

44. Yeah, I'd like to see that, too

I'm betting it's not true.

[Solon]

52. I'm more interested in whether its per capita or total...

I imagine that in total numbers, Medicare gets a lot more fraudulent claims, but the only reason would be that it serves a LOT more people than any individual health insurance company.

[hunter]

33. Private health insurance in the USA IS A FRAUD.

The U.S. health insurance industry does everything it can to cast off and exclude people who actually NEED continuing healthcare.

If you are simply unfortunate, if you have an accident maybe -- an auto accident, an accident of birth, complications from a contagious disease --- then obtaining appropriate healthcare becomes an endless battle, especially if you are not eligible for government funded health programs.

My wife and I spend more on our healthcare than we do on our mortgage. For many years now we having been skating along a precipice of financial ruin, and I'm so tired of it. I often wish I lived in a civilized nation such as Canada where I wouldn't have to worry so much about healthcare, where I wouldn't have to worry about how I was going to pay for the meds that keep us working and out of the emergency room, where I didn't have to worry that every small medical problem might suddenly grow into the problem that finally bankrupts us.

People die in this nation because they don't go to the doctor and ignore illnesses because they can't afford appropriate medical care or they are afraid of opening their door to the financial predators who control this nations healthcare system.

The only people who can possibly believe that the healthcare system in the United States is adequate are those who haven't yet been burned by it; those who haven't yet had the misfortune of falling through the gaping holes in the safety net, and those who haven't received harmful, inappropriate treatment because that was more profitable to someone than appropriate medical care.

Fraud in Medicaid is no reason to dismiss it, and much of that fraud is committed by those who would seek to dismantle it. The FRAUD of the U.S. healthcare system itself, a FRAUD that consumes a HUGE percentage of everyone's income, more than any other nation on earth, for CRAPPY, INAPPROPRIATE, and often DEADLY medical care even for the most privileged among us, that's a fraud that should be dealt with by taking the U.S. healthcare system out of the hands of the predatory financial institutions that control it.

We need to wrest our healthcare system out of the hands of those who control the industry for their own profits in direct opposition to the welfare of our entire nation.

[blondeatlast]

36. And remains a tremendous bargain anyway. Nice try, though.

:eyes:

[Lars39]

41. Link, please.

[Canuckistanian]

67. We had that problem in Ontario

But the problem was SOLVED with personal picture ID health cards, same as a driver's license. And a good adminstration.

Now, healthcare fraud is almost unheard of.

And even if there is fraud, who cares? No citizen would be "stealing" healthcare if it's truly universal.

Even if it's an illegal alien, doesn't it benefit society to have healthy workers who contribute to the economy? Wouldn't the people that employ them be happy for that?

[eridani]

69. That's not why fraud is a problem

The problem is that Medicare uses the same micromanagement policy that private insurers do and spends less money on it. The solution is global capital and operating budgets administered regionally. The way we do it now is like trying to control the movements of a herd of cattle by hiring a bunch of cowboys with reins connected to each individual cow, and Medicare has fewer cowboys. Global budgeting is analogous to putting a fence around the cows and letting them move around freely within.

[EFerrari]

2. Exactly, pinto. Our people are our greatest resource.

It makes no sense not to take care of them. Medicare for all is only common sense.

[BlooInBloo]

4. May as well just wait for people to see sicko, and see how horrible it is in....

... Canada, England, France, and Cuba for health care.

I still get the shivers at night from nightmares of goverment-paid housecalls. Ugh.

[ChazII]

9. Selfish of me

but as one who has a progressive genetic disorder, and my son has a more severe case (btw-it is neurofibromatosis) I want to be able to see the doctors I/need want to see and the cranio-facial teams as well. We already get pushed around and it is irritating to have to fight to see the doctors on the team that need to be seen.

[JDPriestly]

32. My youngest daughter had severe, life-threatening skin problems.

She received great care. The health care plan imported special medicines for her. Actually, they were homeopathic medicines that a doctor probably would not be able to prescribe here. Worked very well. It was wonderful to see how she improved. She was sent to the best specialists, doctors we could not have afforded at we lived here.

The European doctors also will advise you to take certain vitamin supplements and even herbs if they think they will help. That is, of course, in addition to the medication you get here.

[ChazII]

65. Thank you for your support.

NF does not, at this time, have a cure.

[suffragette]

11. Happy to give the 5th rec

Agree entirely with you, Pinto.

[Solo_in_MD]

12. My biggest fear is another NCLB fiasco

Many have forgotten that NCLB was a BIPARTISAN attempt to guarantee every child in the US a quality education. We all know how well it is working. Give me a reason to believe a transition to national health care will be any better...PLEASE.

The health professionals I have discussed this with have raised similar concerns. While the easy of single payer is attractive they don't another NCLB or the Canadian/Brit fiascoes.

[JDPriestly]

18. Excuse me. NCLB was a BIPARTISAN attempt to

intimidate and punish teachers. I don't think it was ever really structured to help children.

[Solo_in_MD]

20. I disagree...we watched it carefully at the time and saw no punitive intent in the legislature

When it got to implementation things did indeed change

[Selatius]

28. Many were against NCLB from the very beginning because it ignored two issues:

1. Lack of teachers and resources for students
2. Inadequate education infrastructure in the form of too few classrooms and even too few schools for too many students.

These are MASSIVE structural problems that have been growing since the days of Carter and even beyond that. If all the students in America who dropped out in a year decided instead to stay in and try to finish like everybody else, there would not be enough teachers and schools to accomodate them. It would be a catastrophe if it weren't already so.

As it stands, the heart of NCLB is attempting to hold schools accountable by defunding them when they need the most help. The fact that it was pushed by the far right should have sent up red flags to many middle-of-the-road Democrats who fell in with the Republican Congress run by the likes of Hastert and Delay.

[Solon]

21. If the Canadian and Great Britian systems are such fiascoes, why don't they get rid of them?

Even the most conservative parties in both nations have promised to keep there respective health care systems in place, they refuse to reform them, probably because they are extremely popular.

As far as convincing you that a National Health Care system would be any better, well, 18,000 people a year will not DIE due to not having insurance.

[Solo_in_MD]

40. Same reason we keep ours...stationary inertia

[Spazito]

35. Could you please iterate for me what the Canadian "fiasco" is?

As a Canadian who has health-care coverage I very much value and appreciate, if there is a fiasco wrt our health-care I am unaware of it so would much appreciate being educated about such a fiasco.

Thanking you in advance of your response.

[Solo_in_MD]

39. Those are comments of friends in the health biz, not mine

I'll discuss it with them next chance I get. IIRC one of their practices has a sizable Canadian contingent since they can not get services in a timely manner (his words not mine). I have no direct experience with Canadian health care.

My main concern is getting it right the first time and having smooth transition. Like many Americans I have a skeptical view of Government and of politicians, regards of professed beliefs. Health care is too important to muck up. While I support the concept of universal health care, I would want to see a system laid out that had flexibility and no degradation in current service levels. I have not heard one yet that comes close to that. What I have read about the UK systems is pretty scary...

[Spazito]

45. I would have to ask if your friends are supportive of a universal

health care system or are they more supportive of a continuation of the HMO/private for-profit health care system currently in place in the US? It seems to me one would need to take into consideration which system they support when judging whether biases and the intent to influence others is inherent in their "experiences".

Thank you for your response to my previous post, I am glad to know there really isn't any "fiasco" but, rather it is simply the opinion of those in the private, for-profit system that the Canadian health care system is a "fiasco".

[Solo_in_MD]

49. Fiasco is in the eye of the beholder...

They all would prefer a single payer concept. At least one gave up private practice to work in a government installation where he treats patients without regard to cost, billing, and insurance. Said it was the only way he would continue to practice. All of them are resolute that parts of the Canadian and UK systems should not be done here for a variety of reasons. Some of them are nurses so they have no profit motive compared to the doctors and others. As I said, I am not in the medical biz, so I don't track the issues.

The UK system has gotten some bad press in the US recently for denying treatment in one region which is available elsewhere due to cost. Another recent complaint is that overweight people and smokers are being denied treatment that non obese or non smokers are getting. About Canada, the gouge is that there is local scarcity and lack of flexibility, classic symptoms of a centrally planned system. Also some comments about the lack of private options, which drives some to the US for treatment. Again, I have been fortunate enough not to need medical treatment while in the UK or Canada, so I have no direct personal experience.

There are several issues IMO that are holding back universal care in the US including:
- Stationary inertia/Fear of the Unknown. We know what we have, and are unsure what a new process would bring. The biggest fear is the loss of user choice, local control and flexibility.
- Distrust of Government Programs: Americans really don't trust what they perceive to be new *Big Government* initiatives, but are very supportive of those that we have (i.e.: public schools). Yes its a little schizoid, but we are Americans.
- Bad Press: There are horror stories out there about the UK and Canadian systems that are pretty scary. Of course we ignore the horror stories about the ones in our current system.

Americans need to be cajoled or sold on major changes, and have a stubborn independent streak. Some of the political processes in Canada and the UK would never have a chance here. The Government does not tell the people what to do here, as I perceive it can do elsewhere. We tend to say "up the system" and continue to do what we choose. Then again, as a Canadian, you have already seen that a time or two.

Right now the rank and file Americans are convinced that the UK and Canadian systems would never work here. Until that is undone, it really doesn't matter what a presidential candiate promises.

[Solon]

51. First you only provide ancedotes, second Americans hate the Insurance companies more...

than they do the Government. Capitalize on that and we can have single-payer in a year. The problem is no one in Congress, outside of 74 Congressman, wants to be a true leader on this issue. Make the proposal clear and concise, not a boondoggle that is an odd hybrid of private/public that requires a team of lawyers and accountants to even understand.

[Solo_in_MD]

53. You are overly optimistic

In a year? You must be on some seriously strong drugs. Even the 74 Congress critters know that is not possible. Its an election promise they will never have to deliver on for most of them.

It is was possible to do it simple, clear, and concise, a proposal would be out there by now. Its a complex problem with lots of angles and issues that need to be resolved. Why did HRC's team work for so long there was an easy solution readily apparent. The Canadian and UK systems are not models of simplicity either. Simple answers in this area are for simpletons.

I never claimed anything than anecdotes, I am not in the medical biz (read the sub thread)

[Spazito]

54. Thank you for your thorough and well thought out response

it is much appreciated. Our system certainly is not perfect, it is, as in any system such as this, be it education or health, in need of continuous upgrading to meet current needs.

I have had to use our system as have family and friends and none would want to toss what we have. Actually, Canadians had the opportunity to weigh in on their feelings about our health care via a Commission who's mandate was to review Canada's health care system, engage Canadians in a national dialogue on its future, and make recommendations to enhance the system's quality and sustainability.
Here is a link to the final report:

http://www.hc-sc.gc.ca/english/care/romanow/index1.html

I don't think any country should adopt, without change, any system whether it relates to education, health, social security, etc. The key question seems to be public versus private and Canadians want public and, it seems from what I have read, so do Americans.

[Solo_in_MD]

56. I think the electorate is being seriously misread

for the reasons I outlined up thread, Americans are not going to go for a massive change easily. Medical care is to close and too personal. Its going to take quite a bit of slow change to get there, not a single stroke.

I also don't think Americans are really saying they want public/single payer. Its the mantra of progressives and parts of out media only at this point. The counter campaign is yet to spool up. To many here at DU fail to realize the stationary inertia and what a large scale FUD campaign could do.

What I do see is a growing unhappiness with the current systems, not a desire for massive change. A counter campaign to single payer is yet to spool up. To many here at DU fail to realize the stationary inertia and what a large scale FUD campaign could do. Thus my belief that we may get to a single payer system, but its going to take a while.

[Solon]

59. The first meme, so to speak, to propogate is that the change would be slight...

Pretty much all we would need to do is get rid of the coverage restriction on Medicare. This would be a "first step", allow ANY citizen to enroll. The Budget of Medicare could be increased by tapping into some of the discretionary spending, specifically the Defense budget. Shrink that, and you could pay for Medicare for all without raising taxes, at least initially. Call this the transitional period. Over time, roll up Medicaid and SCHIP under the same system, to reduce costs and make the system more effective, and there you go, single-payer health insurance.

[Solo_in_MD]

60. Has anybody checked your math?

Is there enough in the DoD budget that can realistically be diverted to cover the bill?

And:
What about the growing number of health care providers are moving away from Medicare due to inadequate payments?
What about gap filler policies?
What about elective procedure coverage
What about dental coverage
What about employer paid health care. How do we divert it to Medicare
What about forced conversions by employers

This is far from a simple issue.

[Solon]

61. Well, first we would have to eliminate the Iraq war, obviously...

its a money sink, plain and simple, and costs far too much. As far as your other questions, well as far as payments, they government can negotiate for fair market value of services, all gaps in coverage can be filled, and the Government will cut away, through a gradual process, all private "middle men" in the public insurance industry.

As far as what is covered, all necessary medical procedures in addition to dental and mental health. Cosmetic surgery, any "enhancements" etc. would NOT be covered by such a system. The exceptions would be reconstruction and breast reduction surgeries to help alleviate ailments and deformities.

As far as dealing with employers or insurers, well, there are two ways to do this, one is to outright outlaw insurance companies from covering medically necessary procedures, the second is to compete directly. If we can provide Medicare without a great increase in taxes at all, which is certainly possible, if the federal budget is properly managed, then everyone could be covered by "default", and any additional insurance people buy would be for elective procedures only.

This would imitate the Canadian system the closest, and a little bit like the British, except we won't have nearly as many public hospitals.

[Solo_in_MD]

62. Go back and do the math...it should surprise you...

[Solon]

66. OK, total health care expenditures in 2005(latest data I could find), was 2 trillion dollars...

Source:

http://www.nchc.org/facts/cost.shtml

These equals about 6,700 dollars for everyone within the United States. OK, so, where are the inefficiencies in the system? Let's look, shall we?

First are administrative costs, which, for our private system is about 30%. This is money that doesn't go into medical care at all, but is eaten up by pencil pushers in the hundreds of different insurance companies, hospitals, etc. that exist in the United States. Contrast this with Medicare, with a 3% or so of overhead, and you can see where some savings can come in for a publicly funded system. In comparison, Canada's administrative costs are about 1.2%.

Source:

http://www.pnhp.org/news/2003/august/administrative_costs.php

So, let's cut 27%(30-3) off the 2 trillion dollars. So that reduces the cost to about 1,460 Billion dollars. Some progress, but not enough to alleviate some of the worse cost increases. So, let's continue...

The next big money item would be perscription drug costs, which account for about 11% of medical expenditures in the United States. Source is here:

http://www.kaiseredu.org/topics_im.asp?id=352&parentID=68&imID=1

Now, the big difference between the United States and other developed nations is that the government cannot negotiate prices nor are any price controls implemented. Compared to Canada, U.S. drug prices are about 67% more expensive on average, source here:

http://www.aarp.org/research/international/perspectives/jul_03_rxprices_canada.html

So, we take the original health care cost in my subject line, and find out what 11% of that is, which is 220 billion dollars. Now, under a Single Payer plan, I would think it would be a good idea to implement a drug pricing policy similar to Canada, so we should see similar savings. So take the 220 billion, and subtract 67% off its costs, and you reduce the drug costs to 72.6 Billion dollars, that's a savings of 147.4 Billion Dollars. This is chump change, that much is true, but then again, every little bit helps.

So far we reduced the total expenditures to about 1,312.6 billion dollars. On a per capita basis, this is about 4,375.33 dollars per person. Still not as low as Canada, which is at about 3,165 dollars per person. There are other factors that can reduce overall United States health care costs. Most lower income working families now, not being able to afford co-pays or deductibles, even if they have insurance, do not go to the doctor for regular checkups, and therefore increase total costs of health care when they don't come in until problems arise. Preventative care can be encouraged, reducing costs even more. Other ideas include negotiation, not only for drugs, but also services as well, which can contribute to other costs savings. Unfortunately, its hard to find figures for what the difference of these would be, so, as of right now, I will not claim any more savings in my current figure.

Let's compare this total Single Payer system with what we spend now, right now, combined, Medicare and Medicaid cost about 670.9 Billion dollars when taken together. Now, since the 2 trillion already takes these two systems into account, we are seeing, basically, a doubling of the Medical Health Care budget in the United States. The question now is where do we get this extra money. Well, I already mentioned taking at least some of it from the Pentagon, which has a budget of 699 Billion dollars, as of 2007. Now, we don't have to take all of it, a 2/3rds cut in the budget seems reasonable, I think they can deal with having fewer V-22 Ospreys, don't you think?

So that equals an additional 466 Billion dollars in the single payer system, add that to the current budget of 670.9 billion dollars and you get 1,136.9. Oh shit, we are short some money, the Health budget doesn't balance, a deficit, in this program, of about 175.7 Billion dollars. OK, so let's say we raise taxes to make up the difference, that would equal about 585.67 dollars that each person in the country will have to pay a year. Let's double that, to account for children and unemployed, to 1,171.33 dollars that each working person will have to pay a year. This is assuming a "flat tax" on FICA, which doesn't necessarily be the case. So, let's break it down by Month, divide by 12 and you get 97.61 dollars.

This sounds expensive, until you realize that the average payment of premiums in 2006 was 11,500 dollars for a family of four, or 4,200 dollars for an individual annually. This means that insurance premiums cost individuals an average of 350 dollars a month, more than 3 times more than a public system. Please bear in mind that the Medicare and Medicaid that people already pay will be replaced by this new tax system of a little less than 100 dollars a month. In addition, since this system is a replacement of private insurance, that means individuals will save over 200 dollars a month in premiums. This can increase spending by said people, either for luxuries, or for needs, but in either case, it would be enough money saved to help the economy overall.

The figures for the above paragraph come from the first link in this post, and the figures for the budget come from Wikipedia. One other thing to bear in mind is that the total cost for the single payer system could be less than I calculated here, as I said, preventative care, and negotiation for services can both reduce costs, possibly by a lot. So call it a "worse case" scenario, where we still couldn't be quite as cheap as Canada, but got close. The big question mark is, would we be willing to sacrifice all the pork in the Defense budget to help fund this system? That's the only thing I haven't figured out yet. But considering that we will still outspend pretty much everyone else in the world in military spending, I don't think reducing the budget by this amount would risk our National Security.

In fact, we could further reduce the Pentagon budget to help pay for Port Security, Airline safety and Security, and to increase disaster relief funding, which always needs more money, and better administration! All of these would further increase our National Security without huge, over budgeted, boondoggles that the Pentagon loves. Hell, increase pay for the troops, and get rid of the VA medical funding, our Vets would be treated like all other citizens, and since the MAJORITY of folks will be in a single-payer system, they will be the check on government waste and neglect.

[Spazito]

64. I think a big part of the problem re the public's perception has

more to do with the incredible power and influence the HMOs and pharmaceutical companies in both their ads and their ability to buy votes in your Congress.

In Canada, pharmaceutical companies are limited in the types of advertisements they can televise, etc, if the product they wish to push is solely prescriptive. We do get the unlimited advertising when watching American channels but they do not have the same influence on Canadians which, imo, is a good thing.

Add to that lobbyists have very limited influence on our politicians because our elections are primarily paid for through our tax dollars and campaign contributions are strictly limited.

[LostinVA]

55. My Canadian friends love their NHS

[Spazito]

63. I know I sure do!

I have had to access our health system more than once and have had only very positive experiences. I pay 49.00 dollars a month for my medical coverage and 29.00 dollars a month for my eye check-ups, dental check-ups, reasonably priced perscriptions if I need them, etc.

It is not perfect but it is damn good, imo!

[Canuckistanian]

68. Canadian fiasco? What Canadian fiasco?

We have our waiting time problems and sometimes family doctor availability is a problem in smaller and rural communities. But we're working on that and making progress.

But to call it a "fiasco" is a total misnomer. We're all glad that we have it and we're proud that it works as well as it does.

And trust me, those of us who've come in contact with the American system without insurance are damned grateful.

And any other "problems" you've ever heard about Canadian healthcare are propaganda.

[pinto]

13. (aside) There's legislative movement to adjust Medicare reimbursement rates.

Decades old regional reimbursement rates for health care providers no longer match cost of living, cost of doing business, etc. The result has been a loss of providers in some areas.

My county remains a 'rural' area in Medicare terms, and reimbursement is pegged to that standard. Yet, we have housing and cost of living expenses that challenge metropolitan cities in CA. Physicians leave here for better pay.

We neglect Medicare viability at our own risk.

[JDPriestly]

17. I lived in countries where we had national insurance.

Mind you, we had to pay for it -- like everyone else through taxes, but it was just wonderful. We had babies and small children. If you did your prenatal and postnatal care according to the health provider's recommendations, you also received a small monthly stipend to cover some of the baby's costs. That was a kind of incentive to follow through on the periodic check-ups for yourself and your baby and to get the baby's shots and other required medical care. Healthy babies, healthy children, healthy lives.

One great thing was that the doctor caught a back and hip problem with one of my children at a very early age. The doctor took x-rays, explained the problem and told me to put my child in ballet. He warned me that if I did not do that, my daughter would have pain when walking. I followed the doctor's advice. It worked. Today, as an adult, that child runs marathons and is very active. That doctor's advice made all the difference for her.

I absolutely recommend universal national healthcare. It is great.

When someone tells me it is socialized medicine or imagines that you don't get good care, don't have a choice of doctors, I just debunk the myth. We could choose any doctor we wanted. We did not wait as long for care as we do here. Now maybe we were just lucky. Regarding the choice of doctor argument. In the countries we lived in virtually all the doctors were on the same health care roster -- they could be paid by the same insurer. Therefore, there were no constraints on my choice of doctors. I did not have to stick with doctors on the insurance carrier's list.

One more thing -- if you wanted to, you could also pay for private insurance that gave you perks when you went to the hospital. Not only was the insurance good for any doctor within the country in which we were living, it also was effective in other countries that had reciprocal agreements. I just can't say enough good about it. Needless to say, you were insured no matter how long you were out of work. And, of course, you paid more when you earned more and vice versa because the money was in a form of a tax. That was great. You didn't mind paying a little more when you earned more. It's like saving for a rainy day.

[BlooInBloo]

19. According to oh-so knowledgeable DUers, it's a *fiasco*.

[Rosemary2205]

23. I don't care if its socialist, commie, fascist or just plain martian.

Whatever gets quality healthcare to the most people for the least money is my goal. I really don't care what the greedy assholes in big pharm and insurance want to call it.

[Solon]

24. Exactly! We need to find a way to save money, and getting rid of for-profit insurance companies...

is the key.

[focusfan]

47. I would be a happy camper if insurance goes the way of the

dinosaur

[qdemn7]

25. I don't give a crap..,.

What it's called. I want single payer NHC for every single American citizen. I'm tired of people who can't afford health insurance being forced to go the ER for their treatment, which they also can't pay for, which the taxpayer ultimately gets stuck for.

We need to quit fucking worrying about introducing Democracy in the ME, which people there apparently don't want anyway, and start using the money to care of our people HERE. Charity begins at home.

[lovuian]

26. We will have Universal Health its a matter of time

Because the system is FAILING our children and everyobdy else

and when these companies drop healthcare and these families are out of work

the system will DEMAND single payer

[Virginian]

27. I work for a doctor who wants to drop all insurance.

Not only are these insurance companies ripping off the patient with high premiums, they are not paying the doctors enough to cover the cost of certain procedures.

The boss says not to make any appointments for physicals unless it is for a long standing patient or for cash. He says he gets only the copay, nothing more. He would drop all insurance if he could. Until one of his long standing patients, an 80 year old retired school teacher, wants to see him. Then he remembers why patients have insurance.

[HCE SuiGeneris]

29. Exquisitely framed argument. Simple and succinct. Bravo!

:applause: :applause:

[Garbo 2004]

30. Public utilities, public roads, public healthcare. Why the hell not?

We subsidize private industry all the time with tax breaks, incentives, etc. Sweetheart contracts. Not necessarily all in the general public interest as we know.

Lord knows the big oil companies would just simply go out of business if we didn't give them tax breaks to "help" them along. :sarcasm: With their profits at record levels, anyone wonder why/how that happened? I don't spend a lot at the pump myself, maybe fill up every four months or so. But the fuel costs of transport effects all of us even if we don't use a lot of gasoline or diesel. We see it at the grocery store, etc.

Don't want some civil servant "bureaucrat" deciding what health care you're entitled to? Better an insurance/HMO company bureaucrat deciding that with an eye to the profit margin? Denying coverage because you're just in their view too expensive to treat or keep alive? And for those who don't have health care coverage, sorry but you're just SOL. Survival of the fittest or the best or simply survival of the ones with the resources to afford the care? Have we progressed all that much from the middle ages on this issue? Even "old Europe" is ahead of us on this.

Where are the right to lifers on this issue? Hello? Does the right to life only apply to those in the womb? After you're out of the womb it's just best of luck and all that? Maybe we'll support a bake sale if you need a bone marrow transplant? Or something like that?

Anyone remember when Social Security was the last great "socialist" evil? And what it accomplished? And they still have wanted to do away with that, privatize it with "private accounts" in which an increased overhead is profit for private entities while the costs are still out of our own earnings? Jeebus, pull the other one. How stupid do they think we are? How stupid are we?

What's gov't for anyway? Just to wage wars, take in taxes and make companies like Halliburton rich? So people can work all their lives and still get all their resources wiped out due to health issues through no fault of their own? It ain't pretty when you see it close up and personal.

For those who think it's an OK state of affairs in a nation such as the USA, IMO we haven't progressed all that much further than the dark ages or the 1800's. But nevertheless our technology has progressed. The potential quality of healthcare, when available, has progressed. But we don't all have access to it. For those who ask why should we? I ask why shouldn't we? For those who have jobs and healthcare, the loss of that job can mean the loss of healthcare. How many people has that happened to through no fault of their own? Or those who have jobs but no healthcare? And those who have neither, we just tell them they're expendible? Or are we just are OK with the fact that whatever healthcare they may get supported by public funds will cost more due to the current system?

The fact is, national healthcare for all in the USA is something that can be done. It's the old story of those who benefit most from the status quo, those who profit from the current system, are the ones who try to convince us that it's not in our best interest to have a life quality affirming system in which we all bear the burdens but also reap the rewards.

[Vinca]

31. Let's see. We have "socialized" basic education,

"socialized" fire and police protection, "socialized" highway systems, etc., etc., etc. The only difference between providing health care and the other things is that the insurance companies stand to lose money. Boo fucking hoo.

[Dragonbreathp9d]

34. We need to try to re-educate people about what socialism really is

most think totalitarian russia - not the binding of the common collective

[Solo_in_MD]

42. Its a poision pill in the US...not recoverable in our lifetimes

[blondeatlast]

38. Word. Thanks for a concise and wise post. nt

[triguy46]

43. Good points

Medicare is a sweet deal if you can get it. Your costs are defined by Medicare fee schedules and any overages are not paid, period. You have essentially open access to any physician. There are occassionally reports of areas where docs are 'not taking' new medicare patients. However, it represents 50% of the medical market. Not many are interested in eliminating half of the potential customer base.

[area51]

46. kick. (n/t)

[Polemicist]

48. Another red herring, is reduced competition....

under universal health care. I favor single payer universal health insurance over universal health care. The difference, as I understand it, is under universal health care, the government takes over the entire health care system, and owns hospitals, clinics, etc and all health care workers work for the government. This is the British system.

I favor the Canadian system, with private ownership of health care facilities, but with one single health insurance provider that covers everyone. Doctors are still typically self-employed, hospitals can be for profit or non-profit and still employ doctors, nurses, and other health care professionals. And this is the part that negates the "no competition" argument.

There will still be competition under single payer health insurance. But it will no longer be pricing competition and limiting access to services. Access will be universal and pricing will be universal. However competition will still exist, based upon service and competence. The public will be able to chose their own health care service provider, so there will still be incentives to compete for business. However that incentive will no longer be the pricing of the product.

There is less incentive for competition under the universal health care system employed by the British, which is totally socialized medicine. Health care providers will not benefit from providing superior service without free choice of medical providers offered under single payer health insurance.

[tabasco]

57. Thanks. Great post.

It is time we start providing the health care that every other modern country provides to its citizens.

I am so sick of these idiots who cheer on corporate welfare but scream "socialism" anytime government does something good for the people.

[kineneb]

58. I don't care what it is called, as long as I can get health care

Right now I am caught in a difficult spot...Hubby has ESRD(kidney failure) and SSDI, Medicare and Medi-Cal. I, on the other hand only qualify for CMSP (a state plan for the medically-indigent rural poor). CMSP has a $934 cap on income: everything above that is "share-of-cost". This means we have to pay out $280 per month before I have any medical coverage- out of $1200/mo income! I have to get two of my medications as samples, because I can't afford them. I avoid seeing doctors because I never have exceeded the $280 to get the coverage. County mental health won't even take my "coverage" so I have to pay them on a sliding scale.

All this because Hubby got laid off from WorldCom, lost his insurance and had kidney failure. Oh, and we have gone thorough Chapter 7 bankruptcy, because there was no way we could pay off our debts on SSDI, and there is no way our income will ever go up.

I frankly don't give a damn what it is called, as long as there is health care for all that doesn't bankrupt people. Universal single payer would be ideal. So what I have to wait for a proceedure; that is better than not having any care! Try being poor sometime; these minor quibbles about who runs the show become meaningless.

[Blue_Tires]

70. ttt n/t