OK, Let's talk about UNIVERSAL HEALTHCARE.

[Tyler Durden]

Hillary Clinton says she'll make it happen if she gets elected, and wants the system to be "...what the people want...", here words.

GOOD. I'll take her at her word.

This happens to be, as I have said elsewhere, my "hot button, one issue DEAL MAKER or BREAKER." I've heard Edwards' idea of universal "affordable INSURANCE" AND IT DOES NOT IMPRESS ME. I have been through the insurance mill too many times, and the closer any candidate gets to single payer, the better I like it.

Who ever drops the words "Single Payer Universal Health Care" in the words of Lenny Bruce, "...cops the thousand dollars."

[Kelly Rupert]

1. Hillary's only said she'd do it "by the end of [her] second term."

Not exactly an impressive claim.

[Tyler Durden]

3. Nobody else has said it AT ALL.

Even John Edwards (a fine candidate) only wants "affordable insurance."

There are people out there who cannot afford ANY amount. I know them. I WAS them.

[Kelly Rupert]

8. Unfortunately, I'm guessing that's all Hillary will give you.

Sen. Hillary Rodham Clinton of New York assailed the health insurance industry and said she would prohibit insurers from denying coverage or charging much higher premiums to people with medical problems.

That doesn't sound like single-payer; that sounds like "affordable insurance."
http://www.denverpost.com/headlines/ci_5515193

[Greyhound]

173. Sorry, but that is simply wrong.

Universal, single payer health care is one of Dennis Kucinich's central platform issues. He and John Conyers already have a bill to do just this. http://kucinich.us/issues/universalhealth.php">Here is some information on H.R. 676 for you.
:kick:

[rodeodance]

5. where did she say that please?

thanks in advance.

[Kelly Rupert]

7. Linky

http://www.signonsandiego.com/news/politics/20070222-9999-1n22dems.html

Sen. Hillary Rodham Clinton of New York took a more incremental approach to both issues, saying she hoped to implement universal health care by the end of her second term as president.

[rodeodance]

21. thanks. I recall now that she wants Children covered first.

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=504367&mesg_id=504422

That same dynamic held forth in health care as some candidates called for aggressively implementing universal coverage while others favored a more gradual approach.

“I want to have universal health care coverage by the end of my second term,” Clinton said.

Edwards wanted to move much faster. “I don't want to wait six or eight years to have universal health care,” he said. “I want to start putting universal health care in place as soon as I am sworn into office in January of 2009, which is what America needs. We can't wait.”

Edwards also challenged the contentions of Richardson and Vilsack that health care could be extended to all Americans without raising taxes. ........

[RaleighNCDUer]

37. Edwards also challenged the contentions of Richardson and Vilsack that health care could be extended

to all Americans without raising taxes. ........

So what? The cost of the raise in taxes would be more than offset by the out-of-pocket costs that we would save, not to mention that it would relieve the crush on emergency rooms because more people would catch problems sooner, which would cost them less, rather than wait for the last minute when they are in crisis, costing them more.

We don't need better insurance - we need real, universal healtcare. Healthcare as a right, not as a paid-for priviledge.

Maybe taxes would go up, but overall costs would decrease at the bottom line.

[Donnachaidh]

29. by the END of her SECOND term?

Does she have a freaking CRYSTAL BALL?

Hey *Hill* - if you don't do it in the FIRST term -- there isn't going to BE a second one!

That's why I'm NOT voting for this arrogant woman.

[Cleita]

131. And how many Americans have to die for lack of health care

until then? Thanks but no thanks.

[Deep13]

2. Except for Kucinich, none of the candidates support...

...single payer, universal health care. They all want to force people to by insurance, hopefully at reduced rates, and to increase the burden already on employers.

This is not what America wants. We want health care access that does not depend on or is any way related to employment.

[Tyler Durden]

4. The moment Clinton says "insurance," she's back in the "minors."

My opinion.

[GreenPartyVoter]

31. Exactly. Stop mollycoddling the insurance industries. Losing the healthcare

sector will not kill them. They still have auto, flood, fire, home, etc etc etc to work with.

[RaleighNCDUer]

40. Not to mention the 'supplemental health insurance' that would go

beyond what the universal healthcare plan offers - with the supplemental you get the rich paying, through the nose, for star treatment, special staff, private rooms. Since the rich want to be special, they'll pay for that, and the wannabes will too.

[Nederland]

36. That's because single payer is dumb

Any system that creates a disconnect between the person receiving the service and paying for the service is ripe for abuse and cost overruns. There simply is no substitute for millions of paying customers looking at their bills to route out fraud. Any system that doesn't include that component, such as the current system, will ultimately become inefficient and bloated.

[Rosemary2205]

39. The current system is incredibly inefficient and bloated.

40 million plus with no coverage at all. Another 40 million who have only minimal coverage and can't really afford to obtain healthcare. Uncounted millions with so called "cadillac" coverage left over from former union jobs who are now laid off and still pass up obtaining healthcare because they cannot afford the deductables and copays. Senior citizens covered by medicare who can't find a doctor who will take it and can't afford to pay out of pocket for the supplementals.

And fraud checking? -- try calling your insurance company because you know there are things on the bill that are priced wrong or were never done. Prices are bundled and contracted now to maximize profits for insurance companies. The bills are close to meaningless. Your insurance company doesn't pay for 4 bandages, 3 days of morphine, 3 days in a semi-private room, etc........ they pay for the appendectomy in total at a preset price. If you have complications the hospital and doctor lose money on you. If you get out faster they make money on you.

[Nederland]

43. Exactly

The current system is broken because, as I said in my post, there is a disconnect between the person who receives services and the person who pays for services. Eliminate that and you'll catch most of the fraud.

[Rosemary2205]

49. My point was

multi-payer or single payer makes no difference in the end result - so I have no idea why "single payer is dumb". Regardless of who pays you can EASILY set it up to give patients the power to control their own healthcare spending by allowing them to make their own decisions with their doctors.

[Nederland]

54. It makes a huge difference

Any system where the receiver of services doesn't care about the price will have inflated prices. Period.

[Tyler Durden]

82. You still haven't given the credentials that make you an expert ...

...that makes this statement true. You are also committing the logical fallacy of confusing cause and effect.

[Tyler Durden]

94. Begging the question.

[Cleita]

137. I don't know which lavander bathed planet you live on but

there is no disconnect between payer and provider and patient. The patient gives the medical facility/doctor his health card when he needs medical services. The facility/doctor bills the single payer according to pre-agreed upon payments for services between the providers and payers. Nothing could be simpler.

Our system on the other hand has been ripe for fraud especially by the middle men the insurance companies who are much better at collecting premiums than actually paying for health care.

[Tyler Durden]

44. Boy, them Japanese is STUPID, ain't they?

Them Canadians, too.

And don't start in on the Canadian System: if we weren't mining their talent away from them they'd have a system that would be the envy of the world.

[Nederland]

46. Canadian System

Yeah, funny how that works. The best doctors believe that they should get paid more than the average doctors, so they leave Canada and move to a place where they can get paid what they deserve. I guess that means the only way your system would work is if every country in the world were part of the same system so no one country could get a better system than anybody else and the whole world was forced to live in beautiful mediocrity where everything is the same and nobody is better than anybody else...

[Deep13]

48. Define "deserve."

You make it sound like they have some kind of Moaist state up there. After having opportunities provided to them by Canadian society, some doctors choose to abandon their country and opt for greed over public need. Since we (USA) always prefer to import cheap products and labor rather than paying their true cost, we are happy to be complicit in it.

[Nederland]

52. Definition

A person 'deserves' what another person is freely willing to pay them.

[Tyler Durden]

57. Deserve: verb.

1. to merit, be qualified for, or have a claim to (reward, assistance, punishment, etc.) because of actions, qualities, or situation: to deserve exile; to deserve charity; a theory that deserves consideration.

from O.Fr. deservir, from L. deservire "serve well," from de- "completely" + servire "to serve." From "be entitled to because of good service" (s sense found in L.L.), meaning generalized c.1300 to "be worthy of."

Your definition sounds like:

Merriam-Webster's Dictionary of Law - Cite This Source

Main Entry: usu·ry
Pronunciation: 'yü-zh&-rE
Function: noun
Etymology: Medieval Latin usuria interest, lending at exorbitant interest, alteration of Latin usura use, interest (i.e., sum paid for use of money), from usus use
1 : the lending of money at exorbitant interest rates; specifically : the crime of charging or contracting to charge an unlawfully high rate of interest
2 : a rate or amount of interest charged in usury

Anything the traffic will bear, right? You'd fit in just fine at Pfizer or some other big pharma.

[Nederland]

61. Yeah, the market sucks

I guess that's why the entire world is moving away from market economies and controlled economies like Cuba and North Korea are the envy of the world...

Not.

[Tyler Durden]

66. Who are you , and where do you live?

The "Market Economy" (which, freely translated, is Capitalism gone wild) has DESTROYED the state of Michigan. Bush LOVES the "Market Economy."

And I guess France, Norway, Sweden are just gone into bankruptcy, while OUR economy is SMOKIN'!!!!

NOT.

[Nederland]

90. It's about Freedom

Let France, Norway and Sweden create whatever system they want and we'll see if people are attracted enough to move. Some will, no doubt; but historically most won't. That's why a diversity of systems where people are free to choose is so important. It allows the best ideas to float to the top and the relegates the lousy ideas, like Communism, in the dustbin of history.

[Tyler Durden]

91. No, it's not. It's about LIFE.

You really are all about straw men, aren't you?

Commies suck, commies are for UC, so UC sucks.

More logical fallacies: Poisoning the well, induction, and guilt by association.

[Nederland]

107. Misunderstood

All I'm saying is that people should be free to choose--I trust we agree on that point. What I would love to see is for you to set up the system that you believe is best (Single Payer, apparently) and then see if people will choose it. I have no problem with that. The only problem I would have is a system where private medical care is illegal, as it is in Canada. So long as people are free to choose from a variety of options, I'm ok with it.

[warren pease]

127. Canada again...

>The only problem I would have is a system where private medical care is illegal, as it is in Canada.

They set it up that way because they sensibly assumed that letting for-profit medicine into the Canadian market would be sowing the seeds of Health Care Canada's destruction. It would automatically set up a two-tiered system -- one for the rich and one for everybody else -- which they actually thought was a lousy idea (imagine an American HMO being concerned about inequality of health care).

They also reasoned that docs would be lured into the for-profit sector and away from serving the majority. They assumed that would eventually stop as the docs faced the reality of mechanized medicine and began to resist being turned into HMO-driven androids, but the learning process would take some time -- time in which Health Care Canada patients would be under-served.

So you can argue that it's unfair to ban for-profit medicine throughout an entire country. Given the murderous behavior of American for-profit medicine over the years, though, I think they've amply demonstrated their contempt for their subscribers as well as their unblinking focus on making boatloads of money. They've shown that good, affordable medical care and the single-minded quest for ever-higher profit margins are mutually incompatible.

Bottom line: I hope you're a very healthy guy because, if you should become a patient, you're going to learn that the free market is fine in concept, but these rapacious managed care bastards are going to give you one hell of an education on how it plays out in practice.


wp

[Tyler Durden]

139. Your system cannot be followed: it will be two or three tiered.

As a Libertarian, you should despise that concept.

Choice between SYSTEMS will always suck the life from the least funded, and cause the spiral we see now. Can't you see how badly this has failed? Some things cannot live in competition, which always creates a winner and a ton of losers.

I'm not religious in any way shape or form, but that offends my sense of morality to the bone.

[Tyler Durden]

92. And another one: a real beaut: affirmative conclusion from a negative premise...

...followed by argument by consensus, and guilt by association...AGAIN.

[warren pease]

121. Freedom to choose....

Nederland -- Good to see you again. I have fond memories of messing with you and that other libertarian whose name escapes me at the moment. In any case, let's talk about freedom to choose countries based on their health care systems, which is what I think you're going on about.

In my case, I've tried to emigrate to Canada for that exact reason, although Canada has many other attractions: they don't want to be a world power (and couldn't pull it off even if they tried); they haven't threatened to blow up any countries lately; there are some fairly useful constraints on the kind of runaway, rapacious capitalism that passes for sound business practices in the US; the US dollar is shrinking against the Canadian buck, thanks to the geniuses now running US monetary policy, but Canada is still a bargain, even with the GST, for people who are paid in US dollars and spend them in Canada; I would say in general that their national IQ is somewhat higher than America's, and that their environmental awareness is far higher (gross generalizations, but useful as broad national indicators); and, perhaps as a result of the previous point, nobody named Bush or Cheney holds a high position in their government.

However, the point system is a bitch. I'm self-employed (one strike), middle-aged (two strikes) and don't have sufficient funds to be classified as an investor (people who buy their way through the immigration process). Even those numbers can be fiddled, however, and I found an immigration lawyer in BC who worked up a profile for me that included distortions, but no outright lies, and gave me enough points to qualify.

But the real deal-breaker was/is my wife. She wants to be around her kids and her first grandchild, and simply won't hear about swapping countries. So it's either divorce or America. Talk about a Hobson's choice.

All this by way of letting you know that the alleged freedom of choice you envision, in which people flit about the planet checking out places to live for months or years at a time -- which is only sensible, since a snap decision could really bite you in the ass -- and finally settle on their personal Eden -- this is an option only available to the rich, since most of us proles have to continue amassing money in the time-honored method of work.

It's just like the myth of Americans having their choice of doctors, which would allegedly be eliminated by the vile bureaucrats who would administer a single-payer system. Guess what: Managed care killed your freedom to choose a long time ago. If your doc is in the plan, great. If not, you’re paying a fair percentage of your own medical bills along with your bloated premiums. Single payer, on the other hand, need not place any restrictions on who you see, despite industry propaganda to the contrary. And logically, if all docs are operating under the same rules and are paid by the same entity, why should there be any questions about freedom of choice? The argument makes no sense.

As to letting the best systems float to the top, I can only say that if you set out to design a completely dysfunctional health care system, you couldn't beat this one. It costs more per capita than anywhere else in the world. It does a lousy job of providing actual health care, as measured by the US' steady decline in all commonly used efficacy indices: average life span; average disease-free life span; infant mortality rate; birth weight; access to health care; affordability; and so on. It's even designed to reward physicians for NOT seeing patients (see capitation plans). It's also designed to deliver the least possible health care to as many subscribers as possible to keep what's called the "loss ratio" (their costs incurred in providing actual health care) as low as possible. The lower the loss ratio -- which is to say, the less they spend performing their alleged function -- the better Wall Street likes them.

Asking for-profit medicine to develop a soft spot for its human victims is like asking a shark to go on a hunger strike.

So, in summary, we're not free to choose physicians, we're not really free to choose countries either, except in the abstract; we're paying more and getting less than anybody else; our overall health is declining measured by industry standards; and the fact that every single industrialized country in the world -- and quite a few, like Costa Rica, who couldn't claim to be industrialized -- has found a practical, cheaper way to provide at least baseline health care to all its citizens, regardless of their bank accounts, should at least provide some general pointers. But no. Here, as we do our ritual dance around the sacred totem of the free market (which is another myth that we can explore some other time), it's profits first, shareholder return second, exec bonuses third. And there is no fourth.

Sorry to be so long-winded. Propaganda fits on a bumper sticker. Countering propaganda takes a little more space.


wp

[Tyler Durden]

140. GAWD I miss reading your stuff.

I was staying away when I couldn't type: it was too frustrating.

LOVE your arguments. Always have.

[Lydia Leftcoast]

160. The same factors that make it impossible for me to move to Canada

or some other sensible country, are the ones that make it hard for me to get affordable health care:

1. Self-employed and middle-aged: The insurance companies therefore follow a fiction that I'm a one-person "group" for premium charging purposes, but they assume that I'm as unhealthy as the worst of other people of my age, instead of looking at my actual health. When I hit a milestone birthday, my monthly premium went up eighty dollars a month. The only way I could bring it down was to accept a $5000 deductible.

So Nederland, don't give me any of that blather about direct connection to the payment process making a person a better health care "consumer." What it does is make me reluctant to get any health care at all. There are medical tests I'm supposed to get at my age, but I can't afford them, because even though they're less than $5000, they cost between $500 and $1000. I could have cancer now and not even know it.

I have never used up my deductible, ever, so I'm giving the insurance company free money for nothing.

If I were to incur a large amount of medical bills, experience of friends shows that the insurance company would either drop me or raise my premium to such levels that I would be forced to drop them. Then I'd be stuck with 5-figure or 6-figure medical bills and thanks to the corporate errand boys and errand girls who dominate Congress, I wouldn't even be able to declare bankruptcy.

Yeah, yeah, Nederland, the Canadian system would be so much worse.

I swear, economic libertarians don't live on the same planet as the rest of us.

[Jcrowley]

171. Awesome post

The truth

[Deep13]

67. A one-liner worthy of Hannity.

If you are content to be treated as just another commodity for corporate interests to use and discard, that is up to you. I think many people think that production exists to serve humanity and that governments exist to make sure it does.

[Tyler Durden]

70. Actually I thought you were QUOTING Hannity.

I'm a leftist. You are arguing for the profit margin status quo.

[Deep13]

76. (never mind)

[Tyler Durden]

84. OOPS. wrong reply.

sorry bout that.

[Nederland]

72. I would rather be a commodity

...that has the freedom to negotiate his own salary than a pawn in a government machine where prices are set by unaccountable bureaucrats.

[Tyler Durden]

74. "All, or nothing at all...."

You sound like Bush: you're either FOR us or against us.

Who said pay doctors like janitors? Not me. I simply said make it easier to become one without being a pauper in the process, fix the liability problem, and get rid of the insurance companies.

You're the one doing the "Market Economy" shtick: what happens when you reduce OVERHEAD?

[Deep13]

81. Ah, you're a doctor.

I don't know what your individual circumstance is, but my experience is that is the case anyway. What a physician's service is worth seems to be largely dictated by what the insurer will pay. Now, maybe you bill the patient for the excess. The few non-HMO docs I have used simply ate that amount. (Except for dental implants which was a completely uninsured, private transaction.) I don't know how HMOs like Kaiser do their hiring, but I suspect they do not have a lot of flexibility.

Frankly, what you are complaining about is no different that what 90% of America's workers put up with. Most people have no real control over their salaries. Anyway, there has to be some flexibility worked into the system to prevent what you are describing. The state should be writing the checks, not managing the details in the doctors' offices. I frankly think you are more afraid of a perceived loss of control than any real possibility of being treated badly.

As a side note, I understand that the vast majority of malpractice settlements come from a tiny minority of doctors. Why don't you just do the medical equivelent of disbarring those docs?

[Tyler Durden]

95. Denying a Conjunct

[Nederland]

104. Wrong

I never said that those were the only two possibilities. I merely said that if given those two possibilities, my preference was for the freedom to negotiate my own salary.

[Tyler Durden]

133. I beg to differ.

I saw no third way: your argument was either or. the fallacy stands.

[Nederland]

144. Still wrong

I saw no third way

The fact that you saw no third way does not mean that one does not exist.

[warren pease]

124. And I would rather be a six-foot-six adonis with a 4 foot vertical leap, but...

You falsely equate freedom to negotiate salary with someone else's freedom to set prices on commodities they sell that you consume. There's absolutely no relationship between the two, except as it affects your ability to negotiate a salary high enough to pay the established price for those commodities.

That said, why is a government bureaucracy any worse than a massive industry wide bureaucracy? In one significant sense, as it relates to your ability to procure commodities, the two are poles apart. Medicare spends about 2 to 3 percent of its overall operating budget on administration. Privatized medical coverage, on the other hand, squanders between 25 and 40 percent on paper pushing, shareholder return, executive salaries and bonuses, advertising and PR campaigns, and investigators who pry into any aspect of your life in the search for the magic factoid that will allow the company to deny your claim.

All this and hyper-inflated premiums, oppressive deductibles, copays, insane prescription costs (thanks BushCo, et al, for the circle suckup to your employers in the pharmaceutical industry), 80/20 coverage (which mounts up when you get into the thousands) -- and heaven help you if you go to an "out-of-plan" doc, cuz that's really going to cost you.

People worry that universal coverage will result in health care rationing. Of course, it's already rationed, just by bank account rather than by waiting list. A late-'90s study at Tufts University turned up the rather amazing fact that the single most deadly risk factor you can have in America is poverty. Not lifestyle issues such as smoking, drinking or drug use, not genetic predisposition, not exposure to environmental toxins, not hazardous working conditions. Just money, or lack of it.

Which leads us to the inevitable: According to a study released in May 2002 by the Minnesota-based research firm Institute of Medicine, approximately 18,000 Americans die each year because they lack the basic medical coverage necessary to get proper health care. Only in America is lack of private health insurance a capital crime. There are more than 45 million of them out there, and the number grows with every job that our corporate masters export overseas.

There are some things, say air traffic control, that are too important to be left to a cost-cutting, chiseling, downsizing, profits uber alles model of capitalistic excess. Or would you prefer to be suspended seven miles in the air when the captain comes on the intercom and tells you that Glutco Air Traffic Solutions has just laid off 40 percent of its workforce, including most of the people who staffed the operation at the airport you're heading to.

But I'm sure your view is somewhat different. Please enlighten me.


wp

[Tyler Durden]

69. And YES, if you're at the bottom of the food chain, the Market SUCKS.

Obviously, your ivory tower is high above the stink of the hoi polloi.

I suggest you try like HELL to sell your house in Owosso, Michigan or Flint right now to make your family's medical bills.

You do not speak from a basis of experience; either that, or you have forgotten where you came from if you were once down here with us.

[Nederland]

103. I take it from your comments

...that you are at the bottom of the food chain? Is that why you have so much anger?

[Tyler Durden]

128. No, but I've been there a couple of times.

Obviously, you never have. Otherwise you would see the indifference and cruelty inherrent in the systems you propose. I don't think you see it that way, but to some of us, it looks for all the world like social Darwinism.

[Jcrowley]

170. Anger is a virtue

- Thomas Aquinas

[Tyler Durden]

96. Denying a Conjunct, again.

[Jcrowley]

172. You omitted

a few invasions, CIA coups and other matters of coercion to get to that "the world is moving away" rubbish.

Your in need of some political history it seems. Nothing just "moves away" by some ephemeral "natural" force of "the market" it's a matter of power politics.

But yes it is true, The market sucks.

[Deep13]

65. No, the term has a moral component.

Besides, I don't know how freely it is really paid. The medical provider market is closely regulated by licensing boards, university admissions and hospital administration. In consideration of being in a protected profession, med. providers owe a certain duty to the public. Further, payment is not exactly free if the result of refusal is physical suffering or death.

[davekriss]

79. Nonsense (n/t)

[Tyler Durden]

55. MaGill University educates doctors for $7,667 A YEAR,.

University of Michigan costs close to $30,000 and GOD knows what Ivy League is going for.

And as for your "Best Doctors" bullshit, I had a friend back in the 90's who was a specialist in Toronto. I told him I respected him more than I could say for staying in Canada to practice, and he told me:

"I live in one of the cleanest, safest large cities in the world, I work at one of the best hospitals in North America, my house is paid for, my kids go to great schools I don't have to pay for, and I drive a brand new Corvette and have no desire for anything bigger and badder. What's my downside?"

You post sounds like "MONEY TALKS." That's what has got us where we are in the first place. I suggest you do some research on the real aspects of the Canadian and Japanese systems: My Canadian relatives RAVE about their system (they live in Stratford, Ontario) and would rather eat DIRT than live in the United States.

Money is NOT everything, and it some cases it is considerably LESS than everything.

[Nederland]

56. My post reflects reality

You can dream of a place where everybody who practices medicine does so for love, but I don't think that's really realistic.

[Tyler Durden]

58. The reality of the Robber Barons.

Dynamic equilibrium is by nature unstable. We need to start charging LESS for educating these people so they don't feel it is necessary to make as much as Ken Lay.

[Nederland]

68. Markets are far more stable than controlled economies

That is a historical fact.

When prices are controlled by government bodies the realities of supply and demand do not simply disappear, they are merely ignored to the long term detriment of the system. Yes, the market is cruel at times, but there are ways government can soften the blow without completely taking over the system.

[Tyler Durden]

73. You have no historical basis for your comment.

The systems you describe have not been in an undisturbed environment for long enough to prove out.

As to Cuba, YOU try and manage ANYTHING with the richest country in the world pissing in your corn flakes. I don't hold them up as some paragon of success, but I think they've done pretty damned well seeing as the United States has tried everything they can to torpedo them.

Nobody has to CONTROL prices by the way: try making the INPUT (schooling, liability, etc.) more reasonable, and you won't get doctors who have to remove $300,000 worth of DEBT before they can make their first unassigned buck.

[bobbolink]

155. Are you really in Nederland???

All the people I know in Nederland are progressives, and proud of it.

I didn't know there was a pocket of conservatives there....

[Lydia Leftcoast]

161. He's in Nederland COLORADO, as I remember from previous years

Quite a difference from the REAL Nederland.

[bobbolink]

176. That's exactly what I was asking.

Nederland, CO is very liberal.

Even more so than Boulder, which is called "The People's Republic of Boulder".

Given that I live in Colorado, I know these things. ^_^

[davekriss]

78. I'd take that over what we have

However, do you have a cite for doctor flight and its overwhelmingly negative impact on Canadian healthcare? Sounds like a red herring to me.

Our current system of healthcare distribution is outrageous. Tying our health to our employer makes us serfs to the corporate lords.

[Greyhound]

174. It has apparently escaped to your notice that we are the only significant nation

that doesn't have this type of system. It has apparently also escaped your notice that monetary reward is not a primary motivation for the best and brightest to go into practice in the first place.

Since we do judge others by our selves, do you notice anything other than your own greed?
:kick:

[kath]

98. also stupid are the Brits, the Dutch, the French, the Swedes, the Danes, the Norwegians,

etc, etc. Virtually every other first-world nation has a single-payer system, and has for decades.

[Deep13]

47. There sure is a substitute, independent auditing.

Sorry, but I don't have any great faith in Joe and Jane Lunchbox to police either private insurers or govt. agencies. Although at least a govt. agency is responsible to elected officials who are selected by the people. Private insurers have no such accountability.

[RaleighNCDUer]

50. And when was the last time you challanged the $5 charge on your

hostpital bill for two aspirin?

SICK PEOPLE DO NOT SHOP AROUND. There is no competition in the privitized healthcare industry because when you're sick you pay what you are charged. And with the insurance industry skimming 30% off the top, that is a LOT.

I just has an appendectomy. $16,000. I have decent insurance, and only paid $2500 out of pocket. And that's supposed to be OK, because insurance paid for the rest.

When I was doubled over with pain, did I stop to consider if I'd get a better deal at Wake Medical or at Rex? No fucking way.

There already is a disconnect, and that is the disconnect between what the costs are and what we are charged. Talk about inefficient and bloated. I look at a $5 aspirin and I see fraud - but that's what the charge is. You think fraud is being charged for diagnostics or procedures that didn't happen? Fraud is when everyone in my office is paying $350/month for insurance, 12 months a year, then the insurance paying out 10% of that when one person in the office goes to the hospital - and that one person still has to pay 20% of the bill out of pocket.

Between Medicare, Medicade, the military healthcare system and the VA system we are already well on the way to single payer healthcare. I was raised with the military, and served in the military, and never saw any diminishment is the quality of care I or any of my family received from that system. OTOH, when you have a system that tries to combine 'for profit' healthcare with single-payer, THAT is when you get rampant abuse, padding of charges, denial of service.

We have to take the profit motive OUT of the healthcare system, including the insurance industry.

[Nederland]

53. Exactly

Imagine a subsidized (to help those currently uninsured) system of medical saving accounts coupled with catastrophic health insurance that allowed you to keep any money you had left over at the end of the year.

Think you still pay $5 for that aspirin? Hell no.

Like I said, any time you create a disconnect between the person receiving a service and the person paying for the service you'll have fraud. Give people an incentive to stop fraud and it will stop.

[Lydia Leftcoast]

163. I did the math on medical savings account

I'd pay a higher monthly premium AND I'd have to put aside an extra $200 a month to make it work the way it's supposed to.

NEXT!

[Tyler Durden]

93. Argumentum ad Consequentiam

[Cleita]

134. And your sources for your claims are ????

There is no proof of what you say and quite honestly the opposite is true. All industrial nations that have a national health care program, sans insurance and privatized corporate bloat, have proved that you can cover everyone with quality health care and for half the cost of our system.

Our system on the other hand collects premiums and delivers very little payment for actual health care stiffing not only the patients but the health care providers.

[Lydia Leftcoast]

159. And the current system ISN'T dumb?

:eyes:

[WinkyDink]

6. Didn't Hillary this a.m. rule out "single-payer"? I thought I heard her

criticize it as a "Government-controlled" program, and said that it was not the same as "universal health-care."

I turned the channel at that point. :)

[rodeodance]

11. see this LBN thread: (below):

Forum Name Latest Breaking News
Topic subject Clinton touts universal health care plan
Topic URL http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=102x2781586#2781586
2781586, Clinton touts universal health care plan
Posted by rodeodance on Mon Mar-26-07 08:48 AM

Source: AP

edited for correct link:



Clinton touts universal health care plan

By MIKE GLOVER, Associated Press Writer 1 hour, 18 minutes ago

DES MOINES, Iowa - Democratic presidential hopeful
Hillary Rodham Clinton vowed Monday to create a universal health care system if elected, saying she "learned a lot" during the failed health care effort of her husband's presidency.

"We're going to have universal health care when I'm president — there's no doubt about that. We're going to get it done," the New York senator and front-runner for the 2008 nomination said.

Clinton focused on health care issues during an appearance on ABC's "Good Morning America" broadcast from the state where precinct caucuses will launch the presidential nominating season.

Asked how she could improve on her failed effort to reform health care during her husband's presidency, Clinton said pressure for change has built in the last decade and that would make tackling the issue easier.

Read more: http://news.yahoo.com/s/ap/20070326/ap_on_el_pr/clinton_health_care ;_ylt=AneY3FaLGin9oZuItuQ2pfWs0NUE

[Tyler Durden]

13. From 3 hours ago:

http://news.yahoo.com/s/ap/20070326/ap_on_el_pr/clinton_health_care

SNIP
"I want the ideas that people have," said Clinton. She said any health care plan must deal with the reality that there's a unique climate in the country.

"We are bigger and more diverse and people like their choice," said Clinton.
SNIP

This gives us a MISSION, that is, anyone who like me supports SINGLE PAYER UNIVERSAL HEALTH CARE.

I don't want Kucinich's "Enhanced Medicare." I don't want Universal Medicaid. It's time we figured out that the best system (similar to the Japanese) is TAX SUPPORTED.

Maybe if we STOPPED pouring money down the immense SEWER that is the Military and the Defense Department (plus its ubiquitous suppliers), then we could start taking care of what's really important in this country.

[rodeodance]

23. Contact her (or others )--- she is asking for our INput now.

[rodeodance]

9. HIghly REC. (important topic)

[rodeodance]

10. btw---thanks for this tread. I hope we can have a good discussion.

[rodeodance]

12. Hil is asking for our input now------so lets take her up on this:

However, while Clinton said the issue continues to be a high priority for her, she has not offered up a specific plan. One questioner at the town hall meeting held up a copy of a DVD containing a detailed description of Democratic rival
John Edwards' plan for universal health care, asking Clinton if she will also offer specifics.

The reason she hasn't "set out a plan and said here's exactly what I will do," Clinton said, is that she wants to hear from voters what kind of plan they would favor.

"I want the ideas that people have," said Clinton. She said any health care plan must deal with the reality that there's a unique climate in the country.

"We are bigger and more diverse and people like their choice," said Clinton.

Edwards, a former North Carolina senator and 2004 Democratic runningmate, has said it's inevitable that taxes would have to go up to finance an expensive health care plan. Clinton disagreed.

"We've got to get the costs under control," said Clinton. "Why would we put more money into a dysfunctional system?"

[Donnachaidh]

14. Cut OUT the insurance companies

30% of the costs of health care are due to PAPERWORK.

Remove the insurance CANCER and see immediate relief.

[Deep13]

17. paperwork and the need for insurers to make a profit

That sucks resources too. There's a bit of a word-game going on here. All the candidates want "universal" health care, but not single-payer. They want to keep insurers in the loop and still base it on employment. They want to keep us divided into groups that affect what kind of care we get. This whole Walter Reed mess might have been avoided with socialized medicine. Those veterans could then have gone anywhere for treatment and not be restricted to military or VA hospitals.

We shouldn't even be debating this matter. The only question should be, will single-payer pay for dental crowns and contact lenses?

[moc]

28. ITA. The answer is not universal coverage. The only answer is single payer.

[Deep13]

18. *delete* double post

[Tyler Durden]

19. Not to mention their massive PROFITS.

Cigna is both one of the largest carriers of health insurance, AND one of the largest/most PROFITABLE corporations in the world.

As seen on every 401k mix I've ever had.

[Nederland]

41. Yes

Cut out insurance companies and let people pay their doctors directly. Subsidize those who can't afford to pay and simplify the system.

[Deep13]

51. "Subsidize those who can't afford to pay ..."

That's everyone. Who can afford anything more than a routine trip to the doctor? Well, if you can't afford your coronary by-pass.... A single payer system with co-pays that equal a typical doctor visit is, in effect, what you are describing.

[Nederland]

59. It's not everybody

Medical savings accounts coupled with catastrophic insurance policies would result in 80% of all Americans being able to pay their own way. Subsidize the rest and you'd have a system that works.

[Tyler Durden]

60. NO COPAYS.

Health Care is a HUMAN RIGHT, not a commodity.

[Nederland]

63. Why yes

Let's eliminate every possible incentive people have for reducing costs...

[Tyler Durden]

75. Oh gee, let's NOT go to the doctor for that sniffle, honey.

Let's WAIT until it's PNEUMONIA.

You know, I've seen that in the Medicare/Medicaid hospitals until it has made me furious and violently ill. You are reinforcing my opinion that you are a part of the 1%, and not down here in the trenches. You have no IDEA what people are really going through, do you?

[Deep13]

85. Some people do abuse the system.

I agree with your premise that cost should not prevent people from seeking attention when the problem is still uncomplicated. Still, there are people who bring children especially to the doctor for every little thing. Generally, a doc is going to say "bed rest and fluids" for a head cold or even the flu, though some parents seem to think antibiotics will cure everything. Most superficial cuts and scraps just need to be washed out. Part of reducing cost to individuals is reducing unnecessary burdens on the system.

[Tyler Durden]

87. Got to figure that goes back to an "Educated Public."

I know the difference between the Flu or a cold and strep throat: but I'm an ex military medic.

Community Healthcare can be part of Universal Healthcare. I see Nurse Practitioners all the time: I don't need to see a Doctor for a cold, and a nurse can refer me for pneumonia.

I guess it's all in the practice.

[Lydia Leftcoast]

164. That could be reduced by requiring people to call an advice nurse

before making an appointment.

Scenario 1:

"Nurse, Junior has a runny nose. He needs some antibiotics."

"Does he have any other symptoms?"

"No."

"Then he doesn't need to come in unless he develops other symptoms. You're not getting an appointment."

Scenario 2:

"Nurse, I'm post-menopausal, but I'm bleeding like it's my period."
"Can you come in today?"

[Deep13]

71. "Health Care is a HUMAN RIGHT, not a commodity."

Not right now it isn't. What if any co-pays exist is a detail that can be worked out later. Right now no candidate will even talk about single-payer except Kucinich.

[Tyler Durden]

83. I wish you were right...read HR676 cover to cover.

I was extremely disappointed.

[napi21]

15. One GOOD thing I heard from both Edwards & Clinton was the

elimination of the pre-existing condition exclusion or higher premium penalties that now exist!

I cannot agree with the Kucinich extention of Medicare to all as his single payer plan BECAUSE medicare is already severly underfunded, and i've not hear any solution to THAT problem, much less ADD millions to it!


Some candidates say they propose using the billions being spent on the Iraq war to fund health care, but that too is a foolish statement. We are BORROWING the billions to fund that war, so it would be self defeating to continue to borrow $$ to fund an ongoing HC plan.

[Tyler Durden]

16. Use the BILLIONS paid to CIGNA, AETNA, KAISER PERMANENTE,...

...MEMORIAL, EPIC, GENESYS, BLUE CROSS, COBRA......

[napi21]

22. Even under Universal Healath Care insurance companies don't cease

to exist! They COULD be forced to become private...MAYBE! But even in Countries with UHC, insurance companies process claims, and in some cases, offer premium policies from those with the $$ to afford them and insist on that option.

The only candidate who sppears to have really thought this out carefully is Clinton. Of course, she has been working on this issue for many many years!

[Tyler Durden]

26. Try JAPAN. And private insurance companies....

...Both HERE and those trying under NAFTA to make inroads in CANADA are the main reason for their system's troubles, both from the US mining their system for healthcare professionals and from greedy Canadians wanting to cash in on Insurance Company PROFITS.

[warren pease]

32. Also a common problem is...

..right wing governments try their best to undermine the quality of their own health care systems by cutting their budgets, the usual sleazy effort to fool people into going for a privatized system. That's what Thatcher and Major did with the NHS, and now I'm told the UK has one of the lousiest single payer systems around.

Still, UK citizens apparently still prefer to pay a little for a lousy health care system rather than paying a ton for a lousy health care system -- as we do here: More than $7,000 per year, per capita, and rising, according to PNHP.

Same in Canada when the conservative bastards slither into power. The urge to privatize in a conservative must be like the urge to pee after a pitcher of beer -- absolutely overwhelming and 100 percent predictable.

wp

[Tyler Durden]

62. I imagine Hell for Margaret Thatcher:

An unending line of red-hot demons waiting for the next lap dance from her.

[Lydia Leftcoast]

166. And Blair the slow-motion Republican is continuing the attack on the NHS

When I was in the UK in August, people were complaining about hospitals being closed, so that patients would have to transported up to 20 miles for emergencies--in a densely populated country like the UK.

Not so coincidentally, United Health (one of the worst of the insurance companies--they're headquartered in Minnesota but banned from selling insurance there) is trying to horn into the UK market.

[Deep13]

20. The solution...

...is to shift the bizzillions of dollars we waste on unproductive insurance beaurocracy to actual health care.

[rodeodance]

24. NO, I do not think having 2 systems will work either---just put all Americans

under ONE plan.

[Greyhound]

175. The only problem with the Medicare system is that we have had

corporatists from both parties actively sabotaging it for decades. If you would read HR. 676, you would find that the proposal is only to make everyone eligible and allow it to compete with private insurance.

IOW, since most people that do have health insurance get it through their workplace, instead of having only Kaiser or Blue Cross to choose from, you would also have the option to participate in the Medicare system, therefore it is self funding, provides superior service, is far less expensive, and with fewer restrictions. Of course it would be absolutely devastating to the insurance industry since there is no profit in a governmental program.
:kick:

[Tyler Durden]

25. Contact Clinton HERE:

http://www.hillaryclinton.com/help/contact/

Put an email where your mouth is.

[Tyler Durden]

27. Take the money from Medicare/Medicaid, the Military Healthcare/VA systems...

Plus some TAXES (unavoidable, but coming out to much less than Insurance premiums), Some of the glut from the OIL COMPANIES, BIG AGRICULTURE SUBSIDIES, CHEAP MINING/DRILLING LEASES, AND DEFENSE CONTRACTOR THIEVES, and you've got it paid for, maybe a couple of times over.

THEN, start funding the un-funded education programs (Michigan would pay $5000 to the education of each nurse in the state, if the damned rePukelican SENATE would let the House FUND it) for doctors, nurses, technicians....

The system would support itself.

ON EDIT: Forgot the huge blood sucking DRUG COMPANIES.

[warren pease]

30. Great single-payer resource and advocacy group...

Hey Tyler -- It's been a while. Nice to see you're still around.

And universal, single-payer is my hottest hot button as well. I'm a freelance writer, and my wife is a self-supporting artist. Both of us must purchase health care coverage on the open market, as individuals, with none of the bargaining power of a 100,000-employee corporation. Which automatically means we get screwed twice -- once by having to acknowledge the mere existence, against all logic and sanity, of a for-profit health care system, and again by having to pay insanely high premiums. Add to that the fact that we're both in our mid-50s and, not having spent the preceding years in a bubble, have a couple of pre-existing conditions.

So we're reduced to buying insurance from a state/private insurance pool that, on the one hand, at least enables us to get coverage (and considering the country we live, it's actually pretty decent coverage), and on the other hand costs a ton. To wit: we each pay $489/mo. in premiums, not to mention the usual deductibles, 80/20 coverage, stunning prescription costs and so forth.

But because I own a house, I need major medical coverage in case something really expensive happens. If it did, and I was uninsured, they'd own the house. Simple as that. So it's really protection money we're paying when you come down to it, with a little health care on the side every now and then.

All of which leads to the point of this post, which is to check these people out:

http://www.pnhp.org/

That's Physicians for a National Health Program. Their web site has a ton of well-organized information, everything from financial analysis of various countries' systems to specific, point-by-point details on how to build a single payer infrastructure here.

Of course, under the current system of campaign finance -- elsewhere known as bribery and influence peddling -- single-payer stands almost no chance of becoming a reality. In 2000 (the last year I have stats for) the health care industry was a $1.3 TRILLION business.

Estimates of money spent on things that have nothing to do with providing health care -- executive salaries and bonuses, paper shuffling, obsessive investigating in hopes of denying claims, building really cool corporate headquarters, shareholder return, etc. -- run from 25% to 40%. That means that as much as $520 BILLION went for things that didn't cure a single infection or set a single broken bone.

That's a lot of money to play house with, and these companies are simply not going to stand by and watch this pissant government cut them out of the loop. Remember the infamous $100 million Harry and Louise PR/advertising campaign they launched to counteract even the pathetic Clinton plan back in 1993? They would have spent a hundred times that if they'd had to and called it a sound investment.

To quote me from an old article: "By all means, let's continue to let the free market determine who lives or dies while the rest of the enlightened world makes no such distinction between bank accounts and medical treatment. And whenever the topic of universal coverage comes up, let's by all means hide behind such nonsensical terms as "socialized medicine" to guard against the possible intrusion of actual compassion into the American health care system.

As if anyone in his or her right mind gives a damn about ideology while they’re busy dying on a urine-soaked, feces-stained mattress because they exceeded their lifetime benefits cap and couldn’t afford a hospital bed where they might get treatment, or even a hospice where they might at least die with dignity."

And it's only gotten worse since then.

Again, nice to see you, Tyler.


wp

[Tyler Durden]

33. Thanks Warren. I shattered my right arm.

Typing has been a left hand only chore until recently. We had to purchase as well, right around the $500/month mark, thanks to the pigs I used to work for who fired me on disability.

Always was in total agreement with most of your views. Nice to see you too.

[Rosemary2205]

34. I'd like a combo of Kucinich and Richardson's plans.

Kucinich is the only one talking about single payer universal healthcare (not insurance, not coverage but HEALTHCARE) and Richardson wants to close up the VA and put all the vets into the regular system.

[Tyler Durden]

38. His "...clearest and most eloquent explanation..." is neither.

http://kucinich.us/issues/universalhealth.php

It is basically a paean to some sort of Universal Health care, but is emotional rather than explanatory.

I've now read HR676, and in my not so humble opinion, it plays too many games with public/non-public/"shall be designated as 'an insurance plan', etcetera.

I've got a simple plan:

1. EVERYONE is covered.
2. EVERYTHING is covered.
3. NOBODY fills out forms.
4. INSURANCE is restricted to cars, houses, and property.

So if you want different, go to another country where your money talks.

HEALTH CARE IS A HUMAN RIGHT.

[Nederland]

35. Political Landmine

That Universal Healthcare is a political landmine. Hillary knows this better than most. Yes, polls show that a majority of people want universal healthcare, but the devil is in the details. The minute you unveil a concrete plan there will be elements that large groups of people don't like and your majority support quickly goes out the window. It's no wonder our current crop of candidates tends to avoid speaking too much on the subject.

[Tyler Durden]

42. I do not agree.

We have seen the disaster of Health Care in this country for too long. If you offered REAL UNIVERSAL SINGLE PAYER HEALTH CARE and STOPPED the bullshit ads from the insurance companies, you'd have it in 2 years, not 8.

[Nederland]

45. Questions

To demonstrate what I mean, answer the following:

1) Would your system of Single Payer have price controls? I.e. how would the prices of services be set, by the market or by a government run bureaucracy?

2) Would people have their own choice of doctor or would one be assigned to them?

3) Would there be a list of procedures that are paid for? Who determines what is on the list and what is off the list?

4) Could people opt out of the system and get their own private care, or would they be forced to get health care from within the system?

[Nederland]

64. *Crickets*

I wonder why you are afraid to answer...

[Tyler Durden]

80. Oh how CUTE.

You know something? This is a life or death issue for millions. You denigrating it with your "Market Economy" for life is a little bit nauseating.

"To demonstrate what I mean, answer the following:

"1) Would your system of Single Payer have price controls? I.e. how would the prices of services be set, by the market or by a government run bureaucracy?"

When there is ONE price paid for the same thing across the board, THEN your precious "Market" will equalize. Try getting rid of the useless millions paid to the fatcat rePukes who own Medicare/Medicaid hospitals (research: Houston Texas. I used to work there.) THEN there will be more available public funds for preventative care. Costs will naturally go down.

"2) Would people have their own choice of doctor or would one be assigned to them?"

Stupid questions. WHY when EVERY practitioner gets paid, say, $35/patient when they walk in the door for the visit, they WHY can't you chose your doctor? WHY one earth would ANY system (except for your "Market Economy" HMO's/PPO's require that THEY chose your phyisian? MASSIVE straw man.

"3) Would there be a list of procedures that are paid for? Who determines what is on the list and what is off the list?"

Why should there be any such "list" at all? That's called "rationing" and I never advocated that.

"4) Could people opt out of the system and get their own private care, or would they be forced to get health care from within the system?"?

Opt out...NO. Go to some other country, or pay to set up your own clinics, sure. BUT THE HOSPITALS? NEVER. Why would this be necessary? Hey, you want your facelift or boob job? Go to Switzerland: Gold has always worked there.

[frankenforpres]

86. wait, no rationing

are you sure that is what the euro" have??

[Tyler Durden]

88. Japan, Holland, Denmark, Canada...

...no rationing. However, you might have to wait in line for that elective procedure if there's an emergency ahead of you.

As it should be.

[Nederland]

101. Rationing is unavoidable

Whether it is done by price, longer wait periods, or some other mechanism doesn't really matter--the fact is it will be done one way or another. The real question is whether the rationing will be under the control of individuals (as it is with pricing mechanisms) or by a government bureaucracy.

[Solon]

106. Rationing, as you put it, occurs here in the States...

Especially for elective procedures that require specialists who have limited time to see you and treat you. My grandmother had to wait a YEAR to get knee replacement surgery, and that's WITH private insurance.

[Nederland]

108. Yes

That is precisely what I said. Rationing is unavoidable regardless of what system you choose.

[Solon]

109. I thought you were saying that it was unique to nations with UHC systems...

It obviously is not, and there is no way to avoid it, however, at least under the systems of THOSE countries, you won't have to choose between your house or your life, nor will you be billed 200 bucks for a simple checkup, something that many in the middle class can barely afford now in this country.

ON EDIT: I do not understand how pricing schemes will allow "individual control" of rationing, we do not live under a system where the doctor to patient ration is 1:1, its more like 1:100 or so. In a case like that, there is no individual control of rationing, rationing is dominated by availability and severity, nothing else, and, while you can try to bribe a doctor to treat you sooner, its still "first come, first serve, unless life threatening".

[Tyler Durden]

132. Waiting your turn is NOT rationing. It's called "triage."

I did it every day when working in the NNMC ER.

The system in Canada and Japan DOES NOT refuse care: it merely sets it out to the neediest FIRST.

As it should be.

But Japan has got it nailed so well, waiting is seldom an issue. I wouldn't call them Socialist. Would you?

[Nederland]

97. Response

WHY when EVERY practitioner gets paid, say, $35/patient when they walk in the door for the visit, they WHY can't you chose your doctor?

Because with the better doctors demand will out strip supply.

It's basic economics. Start with the fact that not all doctors are equal, some are better than others. Now naturally everybody wants to go to see the "best" doctor, but s/he can't possibly see everyone. As a result you have to have some mechanism to balance out supply and demand. All I'm asking is how, in your system, supply and demand will reach equilibrium.

Now in a market system (which we do NOT have, BTW), supply and demand are equalized by varying prices. I understand that you are opposed to that solution on idealogical grounds. However, you can't simply pretend that the problem will simply go away. It won't--it's the natural result of human beings wanting the best they can possibly get.

[Tyler Durden]

135. You did not answer the question.

I will not choose the Mayo Clinic: I don't live there. I will obviously have to make do with what is available near to where I live.

You have GOT to be a libertarian. (to commit a logical fallacy myself,) only a libertarian would make an argument against his own best interest to try and prove a free market point.

[Tyler Durden]

89. By the way, I missed this one.

I was busy countering some of you other logical fallacies.

I note a certain quietness from YOU at the moment, though.

[RaleighNCDUer]

77. Replies

1) How are prices set today, in this system? By the market?

Have you ever seen a hospital advertising "This month only! Appendectomies 10% off!"

There is no market force at work in the healthcare 'system' that we have. A market system requires competition, and hospitals do no compete. People do not shop around for the best priced care - when they are sick they pay what they are charged.

2) Does it make any difference? Most people do not have their 'own doctor' as such. The just go to whatever group is handy, and see the doctor that is available. If, after the first few visits, you don't get comfortable with that doctor, you go somewhere else. Either way, no matter who you see, they don't have little plaques on the wall saying "299 in a class of 320". It's a crapshoot if you get the guy who was at the top of his class, or the bottom. A government universal healthcare system could control for that - legitimate providers have to graduate in the top 40%, or some such. In the system as it is today, there are NO guarantees of quality -- the AMA won't even 'disbar' doctors who are repeatedly charged with malpractice because it makes the profession look bad. You have to do something really egregious, like Kevorkian, to lose your license.

3) The universal system is not an HMO - covered and not-covered procedures are determined by the privitized system according to their profit. Remove the profit angle, and there is no reason to not pay for any non-optional procedure. Optional procedures could be covered by supplemental insurance. What is optional or non-optional? If you need it to be healthy, it is non-optional.

4) If you want to go outside the system, to pay for service that has no guarantees and no accountability, well, I guess that's your priviledge. Just don't expect US to pay for it. Somebody's got to employ that bottom third from med school.

[Nederland]

100. I agree

In the US health care prices are not set by the market. That is a huge part of the problem, IMHO.

[Solon]

105. Outside of prescription drugs, there is no "market" for health care...

the only other exception would be "alternative" medicine, but I don't see where you could practically set up a market for health care, most people simply don't have a choice, even in an emergency, and are billed appropriately.

Its almost like asking for a market to be set up to provide fire protection and putting them out. Having several different fire companies vying to sign you up for there "cheap" service in protecting your house just doesn't make sense. Same for medical care, I mean, imagine having a heart attack, and you have a bracelet on that says to send you to such and such hospital, let's say 20 miles further away than the nearest hospital because its cheaper, and you end up dying en route because it took an extra 15 to 20 minutes to get there, do we really want a system like that?

[Nederland]

113. No, that is not what I would like

I guess I wasn't clear. I'm not talking about 'shopping' for health care every time you break a leg or get sick. What I would like is a system of health care that maximizes individual choice.

I would love to see a the government set up a standardized set of insurance plans that insurance companies HAD to offer. They would be free to offer others, but they would have to offer the government set if they wanted to be in the business. To encourage them to set prices realistically for those plans, mandate that all federal employees would choose from those set of plans. Individuals, not corporations as is currently the case, would choose what plan they wanted and what provider they wanted. There would be no restrictions on when and why you could change plans, and insurance companies would compete to offer identical services. Subsidies would be provided for the poor.

This corrects the basic problem with the current system: there is no market. Right now individuals by and large do not choose their health insurance. Most people (those with insurance coverage at all) are forced to simply take whatever their company offers. Sure, if you are really pissed off about the service you are getting you could change jobs, but why should it be that way? Imagine if we did food the way we do health care. Imagine a system where when you started a new job, you got a list of approved grocery stores and restaurants where you could go, and if you went elsewhere you had to pay more. Would you put up with it? Hell no. The current system is insane.

When you place the power in the hands of the people, the magic of the market starts to work. When people are free to dump their insurance plan on a whim, you better believe those insurance companies would start to provide better service. Right now, insurance companies merely have to keep their corporate paymasters happy, not their real customers: the people that actually go and see doctors when they are sick. Furthermore, when you provide subsidies to the poor, you bring millions of more people into the market and thereby improve economies of scale. Insurance companies would have a reason to actually compete to win the poor as their customers!

Additionally, this method corrects another problem: lack of transparency and incentives. Right now, with corporations paying for health insurance, you don't really know how much insurance is costing you. Sure, most companies these days subtract some of the costs from your paycheck, but you don't really know what the full cost is. Not knowing the true cost of something is never a good idea. If corporations stopped buying your insurance for you and forced you to buy it yourself, you would have a great incentive to shop around. A standardized set of plans makes it easier to compare companies: all of them would basically be offering the same thing, the only difference being the price, quality of the doctors they could offer, and their overall service.

[Solon]

114. No employee is REQUIRED to use employer provided insurance...

except in Mass. and that's Romney care, not universal care. You don't HAVE to sign up to insurance at your employer, you can get it on your own, the problem is that its usually much more expensive, with high deductibles, and large co-pays. That's what the free market has wrought so far. There is no magic free market to hit here, premiums, and coverage, in insurance companies, is completely outside the control of customers. The difference between individually bought insurance and employer bought is that employers either contribute to the insurance directly, or they get a "bulk rate" discount.

Insurance premiums are governed by two primary factors, size of the risk pool, and the stock market. Insurance companies profit, not by providing funding for medical care, but through using the premiums money to invest in the stock market, if the market stagnates or takes a dive, premiums go up so the profit margin stays the same. In addition to this, the size of the risk pool is basically a zero sum game, a very limited one, therefore there is a BOTTOM limit for private, for profit companies to hit that they simply cannot go below when related to prices of premiums. This is also related to medical care, especially if catastrophic or just simply expensive. Insurance companies will fight, tooth and nail, to NOT pay for your medical care, even if you paid premiums without missing a payment for years.

This is even worse with "low cost" insurance companies, these are the types that advertise on TV that their premiums are only 50 bucks a month or less, but, what they don't mention, is that the deductibles and co-pays are so high, that there is NO chance you can afford even that, so you can't even USE the insurance itself.

Let's say that the government steps in and decides to heavily regulate these companies, so that damned near every working person can afford the premiums. Simply put, most insurance companies will go out of business, and then, you will either end up with a monopoly, or the government will have to step in and fill the gap with a government run program. Where's the choice in that?

[Nederland]

116. Sort of

except in Mass. and that's Romney care, not universal care. You don't HAVE to sign up to insurance at your employer, you can get it on your own, the problem is that its usually much more expensive, with high deductibles, and large co-pays. That's what the free market has wrought so far. There is no magic free market to hit here, premiums, and coverage, in insurance companies, is completely outside the control of customers. The difference between individually bought insurance and employer bought is that employers either contribute to the insurance directly, or they get a "bulk rate" discount.

You are leaving out an important point: yes, nobody is FORCED to accept their company's insurance provider. However, you are FORCED to pay for it. Over the years I've only heard of one company that would reimburse you for your insurance premiums if you opted out. For the vast majority, insurance premiums are simply part of the cost of employment, and if you opt out, lucky them. In reality, the "bulk" discount is a myth and even where it is real, it discrimintes against small companies where millions of Americans work.

Insurance premiums are governed by two primary factors, size of the risk pool, and the stock market. Insurance companies profit, not by providing funding for medical care, but through using the premiums money to invest in the stock market, if the market stagnates or takes a dive, premiums go up so the profit margin stays the same. In addition to this, the size of the risk pool is basically a zero sum game, a very limited one, therefore there is a BOTTOM limit for private, for profit companies to hit that they simply cannot go below when related to prices of premiums. This is also related to medical care, especially if catastrophic or just simply expensive. Insurance companies will fight, tooth and nail, to NOT pay for your medical care, even if you paid premiums without missing a payment for years.

All true. In fact, I believe that if my plan were implemented you would see insurance companies wither and die. You would see real health care providers (i.e. hospitals and clinics) offer services directly to people, cutting out the middleman. They would team up with each other to provide emergency services (establishing some sort of contractual arrangement to treat each other's patients in emergency situations much like how airlines have agreements on how they pay each other when a passenger flies on a different airline when their flight is canceled), but for the most part if you went with their plan you would have see their doctors. These direct providers might purchase some sort of catastrophic insurance to protect them from the huge unexpected costs, but for the most part they would simply let the economies of scale spread the costs around.

This is even worse with "low cost" insurance companies, these are the types that advertise on TV that their premiums are only 50 bucks a month or less, but, what they don't mention, is that the deductibles and co-pays are so high, that there is NO chance you can afford even that, so you can't even USE the insurance itself.

The fact that the government would write the standardized plans negates this possibility.

Let's say that the government steps in and decides to heavily regulate these companies, so that damned near every working person can afford the premiums. Simply put, most insurance companies will go out of business, and then, you will either end up with a monopoly, or the government will have to step in and fill the gap with a government run program. Where's the choice in that?

No, I don't believe that is what would happen. See above.

[Solon]

118. Your "solution" sounds worse than what we have now...

All true. In fact, I believe that if my plan were implemented you would see insurance companies wither and die. You would see real health care providers (i.e. hospitals and clinics) offer services directly to people, cutting out the middleman. They would team up with each other to provide emergency services (establishing some sort of contractual arrangement to treat each other's patients in emergency situations much like how airlines have agreements on how they pay each other when a passenger flies on a different airline when their flight is canceled), but for the most part if you went with their plan you would have see their doctors. These direct providers might purchase some sort of catastrophic insurance to protect them from the huge unexpected costs, but for the most part they would simply let the economies of scale spread the costs around.

First, I don't see how the "middle men" would be eliminated, these hospitals and doctors offices would have to hire financial advisers, negotiators, contract lawyers, etc. just to be able to provide "direct care". Even then, there is very little competition between hospitals, so there is no way to guarantee competitive pricing would take over. The choices for the patient are expensive, no matter where they would go. In fact, patients, in order to control individual costs, would have to try to form non-profit insurance companies to counter the large size of for profit hospitals and health care providers. Hospitals are no more altruistic than insurance companies, also its already required BY LAW that all hospitals treat emergency room patients, I don't see why that would change under your plan.

My question is, how do you control health care prices in such a system?

[Nederland]

120. Response

First, I don't see how the "middle men" would be eliminated, these hospitals and doctors offices would have to hire financial advisers, negotiators, contract lawyers, etc. just to be able to provide "direct care".

No. The fact that plans are written by the government and are all the same across the country means there is no need for contract lawyers. The plans and contracts are the same everywhere so you would quickly get an established sense of what the law required. For example, despite the fact that gasoline is a very dangerous substance, every gasoline station in the country doesn't have to have its own lawyer on staff to make sure it doesn't get sued for something. Because you are dealing with a standardized product and a standardize delivery, the legal expectations are well understood and legal overhead very low. That's the beauty of standardization.

Even then, there is very little competition between hospitals, so there is no way to guarantee competitive pricing would take over. The choices for the patient are expensive, no matter where they would go. In fact, patients, in order to control individual costs, would have to try to form non-profit insurance companies to counter the large size of for profit hospitals and health care providers. Hospitals are no more altruistic than insurance companies, also its already required BY LAW that all hospitals treat emergency room patients, I don't see why that would change under your plan.

I have no idea why you think there would be little competition. I concede that you might have to have some federal regulation in small towns with very limited number of providers. However, in larger towns and cities where the bulk of the population lives you would have thriving competition. Why wouldn't you? Everybody has to go see a doctor from time to time, so you will always have significant demand. In large towns and cities you have already have multiple hospitals and clinics, so you have plenty of supply. Supply and demand--why wouldn't there be competition to match the two?

The question is, how do you control health care prices in such a system?

The same way prices are controlled in the food industry, the clothing industry and the housing industry--the market decides prices. All of these thing are necessities of life and provided for quite well by a regulated free market. Why should health care be any different?

[Solon]

123. Only small towns, huh?

Let me give you an example of MY area, a Metro Area of over 2 million people. There are DOZENS of hospitals around here, and only two owners, BJC Healthcare and SSM Healthcare, oddly enough both are non-profits, and hence don't compete with each other directly. My question is, how would your reforms affect health care prices here? What regulations would be required for these organizations to directly get paid by patients, also, since they are ALREADY non-profits, and therefore, theoretically only charge the at-cost rate, how would YOUR system change health care prices for people living in my area?

[Nederland]

145. Simple

The usual rules regarding monopolies would apply to insure that there is adequate competition.

[Solon]

147. Anti-trust laws only apply to for profit organizations, not non-profits...

at least, as far as I can tell, that's the case. The Boy Scouts(a Non-profit organization), could be considered a "Monopoly" in the United States, yet I never heard of any lawsuits to break them up under anti-trust laws. In addition, as I said, these two healthcare providers are non-profits, hence there is NO competition, not really, they can't compete on price because drugs, equipment, etc. cost the same to them, and the literally pass the cost back to the customer with only the addition of a small overhead cost to compensate for time and to pay the bills, and to pay the staff their salaries. There is no profit that they give to stockholders, so there is no "wiggle room" in how pricing takes place. There is no "free market" of non-profits in this country, its impossible, they are forbidden by law to make a profit, basically.

So this leaves a quandary to your "free market" health care, because costs for DIRECT health care cannot go down, they can only go up, at least in my area. Since this is literally "at cost" health care, the only way to make it a market would be to increase prices, not decrease them, so where is the advantage? You must also understand that this isn't just limited to hospitals, these organizations also own hundreds of doctor's offices and clinics and are affiliated with many more.

Health care in this country is expensive, and it isn't just because of the greed of insurance, on the treatment side it can get really expensive, so expensive that even those that are middle class cannot afford certain procedures without SOME organization that is present to spread the cost around so that individual cost is blunted as much as possible. The larger the organization, the cheaper the treatments are to individuals, and the largest organization possible that can make for the cheapest medical care is the Federal Government. That's just a fact.

[Nederland]

153. Who says non-profits don't compete? (nt)

[Tyler Durden]

136. The biggest point of all is the need to REMOVE competition.

In this situation, the neediest will always become the worst served.

They can afford little, they can move little, and usually they are the worst educated and informed. Your Market System of healthcare is worse than inequitable: it is IMMORAL.

[Nederland]

146. Well that sums it up

I believe competition is a good thing, you think it's a bad thing.

Not much more to say I guess.

[Solon]

148. Competition in Health Care just isn't practical, don't you get it yet?

You complain that competition doesn't exist in Health Care and what you don't recognize is that it CAN'T exist in health care. Health care services are NOT like grocery store chains or any other market you can think of. They are, if you would realize it, more like Utilities or ESSENTIAL services like Police or Fire protection. Do you complain about not having a choice in Water or Gas Companies to pay your bills to?

[Nederland]

152. Clarification

My complaint regarding the current system is not that there is NO competition, but that competition occurs at the wrong point. Obviously there is significant competition in the health care arena. There are dozens of insurance companies that all compete against each other for customers. The problem is, as I clearly explained, they compete for corporate customers rather than individuals. If you shifted the focus away from corporations and to individuals we'd have a better system, because ultimately its individuals that are the most important.

[Solon]

102. Answers, though I doubt you'll respond...

1) Would your system of Single Payer have price controls? I.e. how would the prices of services be set, by the market or by a government run bureaucracy?

First, you make it seem like this government run bureaucracy would be expensive, I don't see why it wouldn't be any less efficient than 3-5%, the low end would be medicare's administrative costs, the high end would be Canada's.

Anyways, as far as how to set prices, NOT THROUGH PRICE CONTROLS, but rather NEGOTIATION, and independent oversight of the health care system as a whole, why the fuck do we have a GAO to begin with?

2) Would people have their own choice of doctor or would one be assigned to them?

I don't see why they couldn't choose there own doctor, if this system is the largest in the nation, then most doctors will sign on to it, or they will go out of business. You will get a list of doctors who are accepting new patients just like you do for most insurance companies now, even though those lists were traditionally more limited.

3) Would there be a list of procedures that are paid for? Who determines what is on the list and what is off the list?

First, damned near EVERYTHING that is medically necessary as recommended by a licensed doctor would be covered, the only exceptions would be cosmetic procedures that are NOT for reconstructive purposes. Cleft palates would be covered, face lifts not.

4) Could people opt out of the system and get their own private care, or would they be forced to get health care from within the system?

I will say yes they could, but good luck finding an insurance company that can even closely match the benefits of the publically provided system.

[Nederland]

115. Questions

First of all, you might want to read post 113 for my ideas.

1) Ok, so prices are set by negotiation. Negotiation with whom? Individual doctors? Would individual doctor be allowed to charge whatever they wanted, or would they only get whatever the "negotiated" price was?

2) There will always be a demand for private supplier--that's true in all countries with socialized medicine. The question is, are you forced to go with a doctor in the public system, or can you go with anyone. Sounds to me like you would be forced to go with a doctor in the system, much like today's HMOs, only with a larger base of choices (which is a good thing, I concede).

3) What about problems with two possible solutions? For example, my father, who has residence in both Canada and the US, developed a kidney condition a few years back. In the Canadian system, he would have simply been put on dialysis until his name came up on some list. In the US, he was able to have a surgeon transplant his brother's kidney into his body. In Canada, that was not an option (not fair to people without compatible brothers, you see :eyes:).

4) As I mentioned before, there will always be a demand for private services. The idea that those private services would be inferior to public services is laughable. People are not going to PAY for something inferior when something superior is FREE. That's the way it is in all of Europe: you have a small private system that is superior and available to the rich who can afford it. To assume that a US system would evolve any differently is naive.

[Solon]

117. Answers...

1) Negotiations would occur with suppliers and operators of medical equipment, hospitals, pharmaceuticals and yes, even on an individual doctor's practice level. However, the negotiations would be BASED on the actual cost of the treatment, equipment use, and the doctor's time. There would be a basic level of care that is based on standardized pricing guidelines, giving fair compensation to doctors and others as needed.

2) Let's put it this way, it would be required by law that licensed doctors will HAVE to accept patients using the public plan.

3) First, I don't believe you, second if a relative is willing, then the procedure would be done as soon as possible, depending on the surgeon's availability. Dialysis would be more expensive in the long run than actually curing the disease through a transplant, that's why I'm doubtful of your story.

4) You are referring to "special" insurance, usually this is for the SUPER rich, the top 1% of the country, these are folks that are given "first in line" status for most elective procedures by doctors. To be honest, I would call this legalized bribery, especially if you cross borders for it, but most folks in the United States couldn't afford this type of insurance, or simply paying for a procedure of this sort, so its not applicable. The super rich get there own doctors and specialists on call 24/7 as well, most of us have to do with less, that's just a fact of life. The only exception is international donor lists for organ transplants, they purposely leave OUT actual economic of recipient, they are only concerned with compatibility and severity of the case. Of course, the super rich could always pay some third world sap in selling a kidney, even though that's illegal, or they can go to the black market, if desperate.

[Nederland]

119. Responses

1) Lots of loaded words in there. "Actual Costs", "Fair Compensation", etc. Who determines these things? The bottom line is that these things are not determine by the doctors and the patients, but by some governing board--a board that would have incredible pressure on it to keep costs low even if that results in supply problems.

2) Ok, so really we are talking about price controls. The government determines the fair price for a procedure, and a doctor has to accept patients at that price regardless.

3) Well, it happened. And you are wrong about dialysis. Transplants are incredibly expensive and at his age (he's 70) it would be far cheaper to keep him on dialysis till he died (brutal calculus, but true none the less).

4) It is not only for the super rich, at least I know it is in Britain. I have a very middle class friend in Britain who gets private care from time to time. For example, she had a tooth ache and needed a root canal a few years back. She went to the NHS clinic and was told the next available slot was in two weeks and, here, take these pain meds till then. She took the med for a few days and found she was completely unable to function because they knocked her out. Keep the pain away and therefore served their function, but no exactly a practical solution for someone who has to work. She broke down and paid a private dentist for a root canal and got it right away. According to her, it happens all the time to people there. Apparently most middle class people start out and see an NHS doctor for free, find out what the problem is and how long the wait is to fix it, and then make a decision.

Take a look at this site:

http://www.privatehealth.co.uk/healthinsurance/private-medical-insurance

Does it look like it is a site designed to cater to the "super-rich", or is the fact that you can get a online quote for private insurance indicate that there is actually a sizable market for private health care in Britain? I'm tempted to walk through the forms just to find out what it means to be "super-rich"in Britain...

[Lydia Leftcoast]

162. I don't know about the others, but the "choice of doctors" line is crap

We're not talking about a UK-type system, where the doctors are government employees and you're expected to go to your nearest GP.

In Canada and Japan (the two countries I know about), you have complete freedom to choose your doctor.

I, on the other hand, am limited to those who take my flavor of insurance. (And the two other insurance companies that operate in the Twin Cities are just as bad.)

[Nutmegger]

99. Universal health care = the Mitt Romney-fication of health care.

I don't know if this is the case with Clinton, and I will look into the details, but I'm noticing more politicians using the "universal health care" to satisfy the base when, in fact, they mean a Mitt Romney-like program, which is total crap.

[Cleita]

141. You have to insist on single payer universal health care.

It operates like Medicare does except it covers more and it covers everyone. Universal health care, without the single payer, can mean that the insurance companies can lobby for a law that makes everyone buy insurance. How nice for the insurance companies and how are anyone supposed to be able to buy health insurance when they couldn't afford it in the first place?

[Czolgosz]

110. IMHO, Edwards has the best universal health care plan

See Edwards talk about universal health care here: http://www.youtube.com/watch?v=Vs_GJrovHSs, http://www.youtube.com/watch?v=-X-npqCSIwc&mode=related&search=, http://www.youtube.com/watch?v=mrczxwOyUM0&mode=related&search=

"We have to stop using words like 'access to health care' when we know with certainty those words mean something less than universal care. Who are you willing to leave behind without the care he needs? Which family? Which child? We need a truly universal solution, and we need it now.

The time has come for a universal health care reform that covers everyone, cuts costs, and provides better care. The number of uninsured Americans has risen to 47 million. Families with insurance face rapidly rising premiums and risk losing coverage when they need it most. Individuals and small businesses often face much higher premiums and sometimes cannot get coverage at any price. Our health care system is the most expensive in the world, yet the results are often disappointing."

http://johnedwards.com/about/issues/health-care-overview.pdf

"COUNCIL BLUFFS, Iowa -- Democratic presidential candidate and former North Carolina Sen. John Edwards told some Council Bluffs seniors on Friday that he is working to get them universal health care. "We have a dysfunctional health-care system," Edwards said during a campaign stop at the Council Bluffs Senior Center.

Health care is central to Edwards' campaign, and he told the assembled group that 42 million Americans have no health care coverage. He said premiums have risen 90 percent over the past six years and that the government has an obligation to make sure everyone has affordable health care. "It's based on the concept of all of us taking some responsibility so that we can make universal health care available," Edwards said.

Edwards' plan includes:

* Businesses would be required to cover their employees.
* Businesses that don't would have to pay into a fund.
* Health-care markets would allow people choose either public or private insurance.
* Chronic and long-term care would be covered 100 percent.
* Preventative care would be covered.
* Premiums would be subsidized.

"We're going to bring down the cost of health care in America dramatically," Edwards said. Edwards said his plan would cost $90 billion to $120 billion a year. He said he would be willing to raise taxes to pay for it but thinks much of the money can come from somewhere else first."

http://www.kcci.com/news/11215577/detail.html

"Democratic presidential contender John Edwards says it is more important to invest in universal health care and lifting people out of poverty than to reduce the budget deficit." http://www.foxnews.com/story/0,2933,240321,00.html?sPage=fnc.politics/youdecide2008

[Tyler Durden]

138. Sorry. Insurance has failed. It will Always fail. it is not the answer.

Any system with a middle man and his profit motive will eventually rot from the middle.

I repeat for the umteenth time: LOOK AT JAPAN. The do it, it WORKS.

[Czolgosz]

142. Here is how the Edwards plan cuts [rivate insurance out of the system over time.

For those who don't have insurance through employment, Edwards offers a "Health Market" which would allow individuals without the bargaining power of an employer as big as Wal-Mart to buy insurance on their own get the same low rates as people with employer-sponsored insurance get. To be eligible to sell in this "Health Market" private insurers would have to offer the same benefits as the local private insurance plan, and they couldn't discriminate based upon preexisting medical condition. If private insurers didn't want to compete on these terms, a government run insurer based on a Medicare model would insure these people.

Edwards would expand eligibility for Medicaid and the Children's Health Insurance Program so people too poor to benefit from tax credits could get insurance.

The Edwards plan for a Health Market has a Medicare buy-in provision so when people buy insurance through the Health Markets, they'll have the option to subscribe to government run insurance program modeled on Medicare. This but-in sets private insurers into competition with the Medicaid model. If the government run single payer system works as we advocates of the program expect, then the private insurers will not be able to compete with the government run Medicare-modeled insurance, and we'll have a single payer system. This is an intentional feature of Edwards plan: "Over time, the system may evolve toward a single-payer approach if individuals and businesses prefer the public plan."

Moreover, under the Edwards plan, the Health Markets would regulate the actions of private insurers and would negotiate and collect premiums and take on other administrative functions like billing and claims processing. In this sense, some of the saving promised by a single payer system would be realized in the Edwards plan.

[Tyler Durden]

143. People keep saying "buy Coverage." That's insurance.

"...the Health Markets would regulate the actions of private insurers..."

Health "Insurance" is an idea whose time has passed, if it ever was viable in the first place.

"Life, Liberty and the Pursuit of Happiness" includes the RIGHT to Health Care in my cosmology. I will not support another "INSURER."

[derby378]

111. When you get right down to it...

If someone held a gun to your head and demanded that you choose, which would you rather have in charge of your health care - the government, or a handful of for-profit corporations?

[Psephos]

126. I prefer the third choice

Which is, I would prefer to be in charge of my health care, not the government, and not a handful of for-profit corporations. Those other two choices aren't much of a choice at all.

Peace.

[derby378]

151. But you can't perform open-heart surgery on yourself...

That's my point. No matter how much we talk about taking charge of our own health care, ultimately it's going to boil down to who is actually making it possible for you to get that surgery in the first place.

[Psephos]

112. Is the experience at Walter Reed a preview of what it would be like?

If not, why not? It seems the country would offer soldiers better care than citizens, or at least, no worse.

I'm not against UHC (I have no insurance myself, btw), but I don't see how a medical bureaucracy humanizes treatment or avoids the kind of maddening problems we already see with government-delivered health services. When I try to discuss this with advocates of UHC I mostly hear ideological responses and insults.

In short, the present system sucks. So do the alternatives.

Peace.

[Lars39]

122. Walter Reed's services had been privatized.

[Psephos]

125. The only thing privatized was facilities maintenance -- not treatment or services

We're talking about health care providers, not building support people.

I'm not saying the WRH situation shows the failure of government-provided health care, and I'm not saying it shows the success of it, either.

I'm asking, what can we learn from what we see at WRH?

At the airport as I hand over my one-quart ziplock bag with 3 ounces of shampoo and face lotion inside to a TSA guard, I think about TSA x 1000 or x 10000. What can mega-bureaucracies we already have in place teach us what *not* to do, while we craft a plan that leaves no one in America without health care? When that much money is on the table, it is impossible to keep major-league political corruption and influence at bay, and that's bad news. DOD contracting is a case in point.

I don't have an ideology on this, and don't know the answers. The current system doesn't work when 40 million people have no coverage, and must be scrapped. I also see a lot of ways not to do things when we make changes.

Peace.

[Tyler Durden]

130. You mean where they were setting up housing for the recovering soldiers?

You mean that was the part that was privatized?

I strongly suggest you look at Japan: exactly what I had suggested to Nederland, but he hasn't done it yet.

[Solon]

150. VA is perpetually underfunded...

And can be abolished under a Single Payer system, because Veterans would be like everybody else, and pay for the same medical care as everyone else, call it Medicare for now, through taxes. There is also the advantage of numbers, under a Single Payer system, EVERYBODY is covered, so EVERYBODY has a stake in the system, instead of a minority that the government can ignore. To give an example, even the most Conservative Canadian politician wouldn't ever think of abolishing or underfunding their health care system, it would cost them an election, because pretty much all their voters use that system on a regular basis. Because of this, such a system is under a DIRECT democratic oversight, by the citizens themselves, and so the system would end up being one of the more effective government programs around, not to mention cost efficient.

[Cleita]

129. I so agree.

This is one issue where the candidates can't pander to the insurance companies. Of course they contribute nice fat checks to the candidates so there is the conundrum. How can we make it illegal for special interest corporations to contribute to campaigns? If they can't contribute you will see the Democratic candidates favoring Single Payer Universal Health Care, but I doubt if it will happen before then with a few exceptions like Dennis Kucinich.

[bobbolink]

154. I keep hoping that someone smarter than I will take on LOBBYISTS

like Al Gore has taken on Global Climate Change!!

If ONE PERSON who sees an answer to this, or at LEAST will pose the question so that ALL USIANS GET why this is destroying our country, then *maybe* we will be on the road to solving this cancer on our democracy.

Until then, all we can do is take one small part at a time.

:nuke:

[Cleita]

157. Unfortunately, everyone looks to Hillary Clinton as the guru

to solve health care and she really doesn't have the right solution. Howard Dean in the last election had a finger on it and would have sent us in the right direction. Unfortunately, no one is standing out on this issue this time.

[bobbolink]

158. Hillarycare, bah!! Edwards is very close, and can be nudged.

John Edwards has shown a willingness to listen to people, and I trust that a hell of a lot more than I do the others.

He's certainly not tied to the corporate teat like Hillary is!

[tehehehe]

149. Walter Reed has "single payer"....

Medical care for active duty military and for retired is "single-payer". It is also equivalent to an HMO and you have no choice of physicisans or where the treatment facilitiy is for you. Then you can stay in the rooms with mice and mold.

Course, those guys were wounded veterans. You won't be, so your care will not be of the same quality. Enjoy the single-payer plan that Hillary gives you. Just know that she will still have her own private doctors, but you won't be able to use them! This will perfect the "Two Americas" plan! The rich will get the best doctors and home healthcare, the rest of us will lose our company insurance (over 70% of Americans) and get to satand in line at the civilian equivalent of the VA medical clinic.

Doesn't it just give you goose-bumps all over just thinking about it! It will be "morning in America" again! Two chickens in every pot! Yummmmmmmm!

[Cleita]

156. Actually, if you kept up with the news you would know that

the parts of Walter Reed with the mold, etc. were contracted out to private companies, who apparently pocketed the money and did as little as possible to deliver what their contract called for.

[Lydia Leftcoast]

168. AND one of the worst things that Thatcher did to the NHS was

to contract cleaning and maintenance of hospitals to private companies. Rates of hospital-borne infections have gone way up since then.

[walldude]

165. Well, your grasp of the scam called the insurance industry is pathetic

at best and bullshit at worst. I posted this in another thread not long ago:

I have no insurance, I'm self-employed and I have a son with autism and another(adopted) with Muscular Dystrophy. I can't get health insurance for my family because of "pre-existing conditions". In other words, if the insurance industry can't make a fortune off you they tell you to fuck off. About a month ago my oldest son had an allergic reaction to something and I had to take him to the emergency room. The doctor examined him, gave him a couple tests, said he was fine and sent us home. Today I got a bill for $1600. For 15 minutes with a doctor, an EEG and some other test I can't remember what it is. It's going to take me a year to pay it off. Luckily it wasn't anything serious. I can only imagine what I'm going to be up against when my youngest starts showing symptoms from his MD. So when someone tells you how great America's health care system is send them my way so I can spit in their face.

So in spite of your juvenile attempts at humor and sarcasm, some of us will be happy just to be able to get insurance Oh and if you think you are getting the best care and the best doctors with your current insurance company then I have some ocean front property in Kansas you might be interested in.

Oh and BTW I'm not a Hillary supporter, I'd just like to live in a country where I don't have to explain to a 9 year old why he can't see a doctor even though he has an incurable disease.

[Jcrowley]

167. It's not health care in America it's savage capitalism

If that old lady can't compete then too bad right? If that poor baby ain't born perfectly healthy or into a wealthy family then it's adios.

American health LACKOFCARE system is about as crass and cynical an operation as you'll find out side of the mafia. Insurance companies rule the place and they are as sensitive to people's health needs as a barracuda.

Aged, Frail and Denied Care by Their Insurers


Jacqueline Wheeler with her mother Mary Derks, who bought a long-term-care policy from Conseco, which denied coverage.

By CHARLES DUHIGG
Published: March 26, 2007
CONRAD, Mont. — Mary Rose Derks was a 65-year-old widow in 1990, when she began preparing for the day she could no longer care for herself. Every month, out of her grocery fund, she scrimped together about $100 for an insurance policy that promised to pay eventually for a room in an assisted living home.

Conseco denied long-term-care payments for Mary Derks, who has early-stage dementia, hypertension and diabetes. She bought the policy to avoid burdening her family, but it sold part of its farm-equipment dealership to pay for her care.

On a May afternoon in 2002, after bouts of hypertension and diabetes had hospitalized her dozens of times, Mrs. Derks reluctantly agreed that it was time. She shed a few tears, watched her family pack her favorite blankets and rode to Beehive Homes, five blocks from her daughter’s farm equipment dealership.

At least, Mrs. Derks said at the time, she would not be a financial burden on her family.

But when she filed a claim with her insurer, Conseco, it said she had waited too long. Then it said Beehive Homes was not an approved facility, despite its state license. Eventually, Conseco argued that Mrs. Derks was not sufficiently infirm, despite her early-stage dementia and the 37 pills she takes each day.

http://www.nytimes.com/2007/03/26/business/26care.html?ex=1175486400&en=a2af82d638a30c5a&ei=5099&partner=TOPIXNEWS

The examples like above are countless. Noone should ever have to pay for healthcare. Ever!!

[Lydia Leftcoast]

169. Yes, I posted that article a couple of days ago

I wish I could find the USA Today (USA Today!) article about the woman whose annual premium was raised to $23,000 after she developed cancer.