I think it's more accurate to call these plans "universal health insurance." As many people have experienced, having insurance is different from getting care.

Once again, the main focus is on how to pay, rather than on the care. Set the goal as perfect health for everyone, then look at how to pay for such a system. As everyone knows, folks with perfect health don't pay the same for health care as those who don't.

Good health care isn't cheap. It's easy to say doctors are making too much money, or pharmaceutical companies are ripping us off, but the truth is that when we try to "manage" costs, whether it's an insurance company under our current system or the government under a "single payer" plan, health suffers.

Americans will just have to decide that top quality health care will cost a lot of money, most likely tax dollars, and suck it up. I don't have a problem paying more taxes to finance a top quality health program for all Americans. Do you?

Let's see - there's some huge number of uninsured out there (47 million*) because they can't afford to purchase health care. Hillary's, and Wyden's, proposed health care plan(s) would require the uninsured to purchase health care. You know, the health care they can't afford to purchase.

Mandatory Insurance laws have been successfully argued to be unconstitutional.

Just another represtative of the people in name only suckling at the corporations' teat.

i like wyden's plan better because it appears, from what i've perused, that he includes a plan on how to pay for the subsidies that will be required in order to make insurance affordable for everyone.

clinton's looks to have some hand-waving in there, but nothing about how it's going to get paid for. that always makes me nervous.

i just realised that my post above is kind of un-intelligible. what i meant to say is that wyden's plan DOES have provisions for how to pay for the subsidies, while i haven't seen anything in what i've read of Clinton's plan.

which doesn't mean it isn't there; if somebody can find it & point it out that would be great. otherwise, i prefer wyden's.

and stephanie, yes, bang on.

When you read the comments on this thread it becomes abundantly clear why we still don't have a comprehensive health care solution. One should be able to expect folks who post on BO, particularly on health care issues, to be familiar with a health care proposal made by one of their own Senators - particularly a proposal that has been public for almost a year. Let's see...

1) Universal "Insurance" vs. Universal "Health Care" The Wyden bill gives even the poorest the same insurance policy that members of congress have - a policy negotiated from a position of strength by the federal employees health benefits board and one that folks covered by it seem to be quite happy with - unlike the many clearly substandard plans highlighted in the first half of Sicko.

Is it universal care as in, "I can go to the mayo clinic if I need it and the government will pay?" No. Than again, neither is any of the advocated single payer proposals (ie Medicare for all) Take a poll of your favorite doctors and see how many take medicare patients - you'll have a good picture of who will be available under a single payer system and who will become a "private physician" (see Great Britain). Is it universal care as in, "I can go see almost any doctor for preventive care or care when I'm sick and Insurance will pay?" Yes

2) Focus on the sick/how to pay

Now, to be fair, it's harder to tell how much is rhetoric, but Wyden's tag line has been health care, not sick care, and there are a number of places where the bill clearly encourages wellness: coverage for preventive care, cash discounts (market incentives) for folks who get healthy or stay healthy, and full community rating - which means that it's in your insurance company's best interests to get you healthy, because they can't dump you, can't refuse coverage, and can't raise your rates. It certainly appears to be going in the right direction.

3) Mandatory Insurance?!? the poor can't AFFORD insurance!

One is left speechless. The very core of the Wyden plan (did I mention it's be available for almost a year) is the provision to make certain that every single american will be able to afford the insurance (the insurance that is as good as what members of congress currently have) From the math I've been able to do (did I mention that the plan/bill has been available for almost a year) the actual out of pocket cash money cost of the insurance would never be more than 10% of income, usually much less - $0 if you are at or below the poverty line. It looks somewhat pricey compared to today's system for folks making over $150k, but we weren't talking about them. A family of four making $40k a year (let's say two parents working 20k jobs) would pay about $200 a month for good insurance for the whole family. It's affordable (as much as anything is when you're working for a living at that income in this country) and certainly a far better deal than anyone is offering them today.

If we're going to get to work reforming the health care system in the country can we at least all agree to spend as much time learning about the issue as the insurance and drug companies spend trying to lie to us about it? Read what's out there, take any politician that glosses over the real problems to task, and let's get something done.

Neither plan is really very good, since they keep in place the existing broken system of private health insurers. Some of the cheapest ways to keep people healthy are to invest in preventative medicine, acupuncture, naturopathy, exercise regimens, yoga, etc.

Rather than rewarding companies that excel at finding ways to deny benefits to their customers, why not invest in a new system that excels in finding ways to keep its customers healthy?

I don't see this written into any of the current federal proposals.

If folks think this election is going to wave a wand over this system and make it something new and wonderful, they are fooling themselves. We need to start with getting coverage for everyone. Any attempt to totally scrap the present system will go down in flames. Actually I think Wyden's plan may have the best shot. The Repubs and the U.S. business community has a strong interest in de-linking employment with health insurance. And for the sake of global competition that is a good thing for all of us. It is also a good thing if you happened not to be employed. This plan will get significant Repub support, and have an actual chance of passing. If I understand it, it does open up the federal health insurance system and provide a pathway to a public system, which could be the framework for a real single payer system down the road. That means single payer, but choice and diversity of providers.

It's really sad that it is the Independent candidate for Senate, Frohnmayer, who believes national health care (note I did NOT say insurance) is in The Constitution. C'mon Democrats, why is he more progressive, eh? (I'm still a D, but hanging on by a thread.)

At least Wyden's plan gets it out of the employer's hands. Can you imagine how freeing it will be for workers? No longer will we convince ourselves to stick with a job just for the health insurance. Our country would become more productive and creative if workers felt free to pursue their dreams.

What I don't like (or understand) about Wyden's plan is it seems that by shifting the amount currently given to employees for h/c from employer-deductable to employee-income (and taxable) that you will be bumping all of those employees into higher tax brackets (thus lowering the net amount of income...and ability to pay for health care). Can someone correct/explain why this works for middle/working-class America?

A question, why won't Wyden and/or Clinton introduce a senate version of HR 676 (single-payer not-for-profit health care - New and Improved MediCare for All)? How much money do they get from the health insurance industry? Clinton get a lot though I don't recall the exact amount (I've seen it published). I don't know about Wyden. Eliminate insurance companies from health care. That's at the heart of the solution in my eyes. I don't like the plans of Clinton or Wyden. Of the prez. candidates only Kucinich is offering (HR 676) a single-payer plan. Get the profit motive out of health care. It'll be good for people, all will have health care, and it'll be good for business (with the exception of the health insurance business of course). Also check out http://www.pnhp.org, Physicians for a National Health Program. Cheers.

"Rather than rewarding companies that excel at finding ways to deny benefits to their customers, why not invest in a new system that excels in finding ways to keep its customers healthy?

I don't see this written into any of the current federal proposals."

Look a little harder. That is exactly what is written into the Wyden proposal - it removes the insurance companies ability to cherry pick customers, deny benefits, or drop sicker customers or raise their rates (wait, didn't I just say this?) Essentially the only way an insurance company can still be profitable is to spend their time, and money, looking for ways to make their customers healthier. It doesn't put the insurance companies out of business, but it certainly eliminates their current way of doing business. This is what first attracted me to the plan.

JTT - as I understand it the new "health care standard deduction in the wyden plan was pegged several thousand dollars higher than the cost of most current benefits for exactly this reason - the additional income will be entirely offset (and then some) but the new standard deduction - keeps folks in the same bracket or lower. Either way, the actual out of pocket for working families will be substantially lower than in the current situation when you combine that deduction with the subsidies that got to families up to $84k in income.

gotta love these single payer folks - any one who disagrees with them is a tool of the insurance companies, all evidence to the contrary. Rovian politics at its' best

"Rather than rewarding companies that excel at finding ways to deny benefits to their customers, why not invest in a new system that excels in finding ways to keep its customers healthy?

I don't see this written into any of the current federal proposals."

Look a little harder. That is exactly what is written into the Wyden proposal - it removes the insurance companies ability to cherry pick customers, deny benefits, or drop sicker customers or raise their rates (wait, didn't I just say this?) Essentially the only way an insurance company can still be profitable is to spend their time, and money, looking for ways to make their customers healthier. It doesn't put the insurance companies out of business, but it certainly eliminates their current way of doing business. This is what first attracted me to the plan.

JTT - as I understand it the new "health care standard deduction in the wyden plan was pegged several thousand dollars higher than the cost of most current benefits for exactly this reason - the additional income will be entirely offset (and then some) but the new standard deduction - keeps folks in the same bracket or lower. Either way, the actual out of pocket for working families will be substantially lower than in the current situation when you combine that deduction with the subsidies that got to families up to $84k in income.

gotta love these single payer folks - any one who disagrees with them is a tool of the insurance companies, all evidence to the contrary. Rovian politics at its' best

yes, JTT, what i heard from ron wyden at the town hall meeting i attended was that the tax code would be re-structured accordingly, to avoid the scenario you described.

speaking of which, in response to this:

One should be able to expect folks who post on BO, particularly on health care issues, to be familiar with a health care proposal made by one of their own Senators - particularly a proposal that has been public for almost a year.

well, at the town hall meeting that i went to where ron wyden wanted to talk about his new health care plan, and gladly welcomed questions on it, the majority of people in the audience wanted to focus the discussion on (1) the iraq war and (2) impeaching bush. so maybe that's part of the problem.

rscot- thanks for the clarification...I knew someone could explain it. P.S. I'm not at all for single payer...more like a Switzerland model.

Both these plans would result in vast numbers of people getting sick, being taken to emergency rooms and dying because they are not getting treatment. But guess what? we could all feel good because it was their own fault. They didn't obey the law and get the mandated health care they can't afford. Oh yeah those indigent people could have got help -- so what if they would have had to sit in offices and fill out countless forms to get it. They don't want to do that. What is their problem?

Please just give us a universal health care system -- like Obama says he will. Hillary is in the pockets of the insurance companies. And Wyden -- as good as he can be -- has been too long in Washington to say anything new.

If every other wealthy nation can do it -- without the catastrophes the right tries to scare us with -- why can't the US of A

Neither plan will work in a vacuum. Mandating insurance won't work until we have a universal living wage. Then, a sliding scale, (as i experienced in Europe) would indeed be conceivable. Then there's tort reform and the problem with expensive drugs...

Maybe we need to more faith based reform?

Chris Lowe you need to point out what provision you believe "Wyden's bill has a provision that expressly provides for the possibility of something like HR 676." since it does no such thing in any realistic sense. You seem to have a serious misunderstanding of the fundamental philosophical differences between Wyden's bill and HR-676.

Wyden's bill fragments the system and in practice further strengthens the power of private health insurers (it even abolishes Medicaid and SCHIP and obligates recipients to enroll in a Health American Private Insurance - HAPI - plan). HR-676 is explicitly based on the accurate premise that the fiduciary obligations and unelightened self-interest of the anti-trust exempt private health insurance industry are adversarial to the best interests of our society and the health of our people.

You many not appreciate this, but you should know that your use of the term "single payer" also immediately flags you as someone who apparently is not directly connected with or acceptably knowledgeable about advocacy efforts for a universal national health insurance plan. Those who claim they are "single payer" advocates are generally regarded as either being new to the issue, or disingenuous, because the term doesn't actually refer to the issues of concern to national health insurance supporters. (This may go a long way to explaining why you seem to believe Wyden's bill somehow is a path to HR 676, though.)

Wyden's plan is only transitional to something like HR-676 in ways that are irrelevant to the real social issues at the heart of the health care reform debate, at least to those seriously interested in equity. In fact, good arguments can be made it would take us further down the path of a broken health care system based on private health insurance. The real idea of private health insurance is not to actually provide health care for anyone, but in fact to impliciltly ration care in a way that those who have the least economic and political power get the least and poorest care. Wyden's plan simply provides more government subsidies for a system which, for the most part, utlimately resolves all decisions by rationing to maximize returns to the insuror rather than delivering the most health care services.

You might also read Section 303 of HR-676 before repeating Wyden's propagandistic argument about displaced workers. He's been called on this disingenuous argument many times, and he continues to repeat it for reasons only known to him.

If you want to see a plan which is potentially transitional to a national health insurance plan, it's Edwards' plan. He simply offers a national health insurance option as an alternative to the entire system of anti-trust exempt private/non-profit/not-for-profit insurers. Clinton claims to do something similar, but her plan seems to be a PR stunt in response to bad poll results and recent reporting that Americans rank health care and the war as the top two issues this election. If you don't think her plan is a PR stunt, or that maybe she is just plain unclear on the concept of universal health care and thinks we are all idiots out here, this quote attributed to her says it all:

http://news.yahoo.com/s/ap/20070918/ap_on_el_pr/clinton_ap_interview_6 "She said she could envision a day when 'you have to show proof to your employer that you're insured as a part of the job interview'".

Nobody ever seems to talk much about the actual coverage provided by these various plans. The media just tosses around the phrase "universal coverage" but they don't provide any actual substance. For instance what exactly is covered in there? Breast implants for teenagers? Hip replacements for senior citizens? Free contraceptives? Lung transplants for smokers? Knee replacements for obese people? Cancer drugs that cost $250,000 per year?

The devil is in the details. There isn't enough money to give everyone everything so the real screaming will only start once people realize that they won't be getting covered for every little thing.

Kucinich blasts Clinton health plan

t.a. wrote:

"... the reason no one is proposing to cut out the insurance companies is because we need some plan to pass. not a perfect plan; any plan."

The insurance companies are the biggest problem with the current system. They siphon off the money needed to make health care for all affordable. So, we either remove the insurance companies from the system, or we pass a plan which does little or nothing to address the problem. Sometimes the only worthwhile change is radical change.

This is how we pass it, Kari:

We stop running away from the term "socialized" and explain how it means health care for all, emergency rooms used for emergencies instead of basic health care for the poor, families saved from health problem caused bankruptcy, longer lifespans for Americans, and an overall healthier population with the economic advantages that confers.

If the insurance and pharma companies attempt to demonize single-payer, we demonize them for the killers they are.

I think it should be mandatory that every member of the house and senate watch the documentary "Sicko" before putting these plans on the table. What is it these politicians don't understand about unemployed? Not every one in America is working. There are laid off, displaced, disabled ,homeless,full time students, etc., how are they supposed to purchase these plans that are offered by employers? MOdel it after France, since they are NUMBER ONE in the world. What is so hard about giving credit to another country for doing it right? It makes me sick. These plans still put the decisions in the hands of the insurance companies. I was sent home early after surgery because my insurance company wanted me to leave against my doctor's recommendations. Unacceptable.