Universal Health Care in Oregon?

At a meeting in King City, Oregon Senator Ben Westlund desribed his hopes for establishing universal health care in Oregon. He specifically discussed the Healthy Oregon Act and the Health Fund Board which begins meeting today to create a plan for universal health care in the state that will be voted on by the Oregon Legislature in 2009.

From the Regal Courier:

Sen. Ben Westlund, at a presentation hosted by House District 35 Representative Larry Galizio in King City Sept. 26, talked about what he hopes the “roadmap” for health care reform in Oregon is going to be like when the 2009 State Assembly meets and votes on a near universal Oregon health care package.

Westlund mirroring the concerns of others in Oregon about the costs of health care, like Sen. Ron Wyden and former governor of Oregon John Kitzhaber, said that the expense of providing health care is leading Oregon into a health care crisis.

He said that not only are Americans paying twice as much for health care services than other industrialized countries such as Sweden, France, England or Canada, Americans are getting the worst outcome of that service.

During the 2007 session of the State Assembly, to address the coming crisis in health care costs, Westlund explained that the State Legislature passed the Healthy Oregon Act to address this crisis.

On Tuesday afternoon starting at 1 p.m., the Health Fund Board named by Governor Kulongoski this past August will meet for the first time to start planning what Westlund called the “blueprint” for providing Oregonians with a health care plan that includes everyone in the state while promising to reduce costs.

Westlund asserted that a state plan could be effective and lower health care costs:

Westlund said Oregon can provide health care for everyone and it would still lower costs for those that pay for their insurance right now. He said that those people who are not insured pay into their share of a plan what they can afford. He described it as mandatory, like car insurance.

“Here is what (SB)329 calls for. It is a very comprehensive look to get us to a more cost effective, affordable health care delivery system where everybody is covered and we lower costs. All medical costs in Oregon comes to about $20 billion a year and to reduce that amount several things have to occur, one is adjusting the federal plans, Medicare and Medicaid so that doctors don’t go broke treating patients on these plans and another is to offer coverage to everyone, and everyone pays into the coverage. What it takes is the political will and courage to make the hard decisions in doing the right thing, not for the hospitals, not for the insurance companies, but for Oregonians.”

The Oregon Health Fund Board is meeting for the first time Tuesday Oct. 2 starting at 1 p.m. at Clackamas Community College Wilsonville Campus, room 111. The campus is at 29353 Town Center Loop, Wilsonville.

Read the rest. Discuss.

  • Thomas Ware (unverified)
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    Ain't nuthin' east 'o The Rockies we need.

  • spore (unverified)
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    "John Kitzhaber, said that the expense of providing health care is leading Oregon into a health care crisis.

    He said that not only are Americans paying twice as much for health care services than other industrialized countries such as Sweden, France, England or Canada, Americans are getting the worst outcome of that service."

    Then why do citizens of other countries come here for medical treatment if their system is so good? There's plenty of cases where people can't afford to wait for treatment and head for the US.

  • Friends Of Wilsonville (unverified)
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    Finally, real health reform taking place outside of Portland!

  • Portland Dem (unverified)
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    I like how SB329 has nothing to do with John Kitzhaber and yet they always bring up his name when talking about SB329.

    Hmmmm?

  • Robert G. Gourley (unverified)
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    As Sicko's maker Michael Moore says, we ain't gonna fix our health care system until we remove the profit motive from the system. Authors Donald L. Barlett and James B. Steele say it best in their book "Critical Condition - To be sure, the market approach is unbeatable in most segments of the economy. Competition among multiple producers that turn out goods and services leads to innovation, better products, and lower prices. The concept works flawlessly when the commodity is cars, furniture, cereal, doughnuts, computers, clothing, gasoline, or any other consumer item.

    The glaring exception to the theory is health care. The very core principle of the market system, that companies will compete by selling more products to everyone, is actually the last thing the health care system needs. The goal should be to sell less, not more - that is, fewer doctor visits, fewer diagnostic tests, fewer hospitalizations, fewer consultations with specialists, and fewer prescription drugs."

    Design a system to seek perfect health for everyone, it will cost less than any other kind of system we could have.

  • Bert Lowry (unverified)
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    Spore:

    You should do some actual research. It turns out roughly as many Americans go to Canada for healthcare as Canadians come to America. It turns out, on average, there is a shorter wait for doctor visits in Canada. It turns out, in practically every measurable way, Canada has better medical outcomes. And Canada doesn't even have a particularly good health care system when compared to other industrialized countries. But it's better than ours.

    Those are facts. We can speculate on why, and I'm sure we will. But we're paying for a BMW and getting a Fiat.

    I would expect conservatives to be outraged at the waste of money. But then again, I expected them to be outraged at Giuliani's infidelities and Vitter's whoring.

    Conservatives are weird.

  • MCT (unverified)
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    Forcing people who are already behind the eight ball financially to pay for health care premiums, even at "discounted" rates is not the answer. If they could afford health insurance they'd be buying it now. Placing them in violation of law if they cannot pay the premiums would be a travesty...what would you do to them? Hefty fines? Jail?

    How dare government (or anyone who can afford, or has their employers provide health insurance) sit comfortably with their cush jobs and bennie packages and decide who will pay what amount for health insurance, and assume they know just how far someone else's paycheck can go? With wages so far out of parity with the ever-rising cost of living for so many workers, anyone given the power to make financial decisions on citizens' behalf should first try living a month or six on a low income wage.

    How dare they assume that anyone without insurance will be a drain on the taxpayers, or on those already insured? Uninsured foks generally go without medical care if they get sick. If they are so unfortunate they rack up an emergency medical bill, if they do not pay, their credit is destroyed, and their wages are attached, judgements placed against them. It ain't a free ride; blood will be squeezed from the stone. Do not assume the cost to the health care "consumer" will go down once everyone is forced to purchase insurance. All it means is more profit for the insurance companies, who pretty much have carte blanche when it comes to what they charge for any medical coverage. It's business for profit and they will fight very very hard to make sure profits grow.

    Say a family, or a single working person is living from paycheck to paycheck, budgeting tightly and just barely making those mandated premiums....then someone's laid off or terminated, or a vehicle breaks down and needs repair, the hot water heater breaks.... a cold winter drives up their utility bills. There are a million ways your budget can get mugged. What choice would you make? Keep the lights on and stay warm, fix your car so you can keep your job, or pay that premium?

    This plan isn't about health care for everyone, it's about health insurance premiums for everyone. How could we possibly make this a law until we had some sort of knowledge about just what sort of coverage would be provided? Sounds like insurance underwriters could just fill in the blank as to what services they will deny. If this should become law, I bet the big insurance companies will be even more bloated with gloat than they were last fall when Measure 42 didn't pass.

    Robert G. (& Michael Moore) are too right....the profit needs to be taken out of the health care system. And when you look at how the insurance industry T-boned M. 42, with their scare tactics, multi-million dollar budget and virtually no funded opposition..... we as citizens are going to have fight really hard, and see past the lies and BS before we are able to have true universal health care.

    What we've spent on the war in Iraq sure would have paid for a lot of medical care for U.S. citizens...as would the billions of dollars we flat out give to other countries every year for a myriad of reasons, and with no accountability on their part.

  • alijane (unverified)
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    I am not a fan of insurance companies, just having had my premium increase by another two hundred dollars per month, forcing me to raise my deductible. I now have what I would call only major medical insurance.

    Insurance comapanies have to complete with the quasi state funded service providers. They are not real insurance companies but they compete with them with insurance companies. The state is not buying private insurance policies, they are setting up special interest groups to compete with private insurance. The more people taken out of the private risk pool the higher the risk for insurance companies and the higher our premiums go.

    The middle class is gettng squeazed out. Anyone who has worked hard, purchased a home or has a little retirement is at risk of losing everything with a single health problem. We pay outrageous insurance premiums, for less and less insurance.

    It seems the more government meddles and tries to control cost the more things cost. I sure hope they invite accountants with sharp pencils to these meetings. I just don't see government coming up with a plan that pencils out.

  • Chris Greiveldinger (unverified)
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    The health care situation in the U.S. is frightening. The high costs, the number of uninsured Americans, and the poorer outcomes (compared to other industrialized nations) are all embarrassing.

    It seems obvious to me that the country as a whole would be better off with a healthier population. We have this hodgepodge of private insurance, Medicare, and Medicaid that has huge holes in it and leaves people uninsured. The Healthy Oregon Act tries to patch some of the holes, which is certainly beneficial, but it doesn't address the fact that the system being patched is decrepit. And unfortunately being insured doesn't guarantee access to health care.

    The health care system we have today has been put together piecemeal, and it shows. What would the health care system (not just the health insurance part of it) look like if you could design it from scratch? How can we provide excellent health care to all Oregonians? Even though SB27 didn't get passed, the Archimedes Movement still wants to know the answers to these questions. There's a better way for health care in Oregon. It'll take some work to sort it out, but Oregonians don't shy away from a little hard work.

  • alijane (unverified)
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    Chris, You have a very good point, we are putting bandaids on a broken system. What kind of system do we need? Our health care system is so complex, from understanding which doctors are in your provider network to reading the billing and the insurance payments. Simplify the paperwork and make it uniform. Maybe we need to cut out some of the billings for low income people and give them a Oregon Trail type card with a certain amount of money each month. Allow the card holder to access the medical service they need, see the doctor, see the dentist, purchase new glasses. The patient can shop for the best service at the best price and pay with their insurace card like the Oregon Trail card. I think medical service providers would be able to reduce their prices if they can reduce the cost of the paperwork and waiting to be paid for their services by the insurance company. The cards could accumulate if not used but should have not cash access, they should be for medical needs only.

    Everyone must be turned into an educated consumer when it comes to health care, whether it is employer paid or state provided. No one would place and order for food at a restaurant without knowing the cost, or get a haircut or make a purchase at a department store, but we visit the doctor or other health care provider without knowing what they charge for a visit or how many minutes of their time we are getting for the fee. The consumer is as much to blame for the health care crisis as the system.

  • Robert G. Gourley (unverified)
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    The consumer is as much to blame for the health care crisis as the system.

    Especially those consumers who are also citizens of the republic. Because as Horass Mann once said, "It may be an easy thing to make a Republic; but it is a very laborious thing to make Republicans; and woe to the republic that rests upon no better foundations than ignorance, selfishness, and passion."

    Woe seems to be a pretty good description of what we have created with our current health care system.

  • alijane (unverified)
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    Do we have any private for profit hospitals in Oregon? I thought they were all non or not for profit. What happens to the surgi-centers and other non hospital private medical service providers that offer the same services that used to only be available at the hospitals? Aren't there privately owned places to get an MRI?

  • andy (unverified)
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    I still haven't figured out why so many people seemed freaked out about this issue. 50 years ago virtually nobody had health insurance and we basically all survived. How come all of sudden we all have to have health insurance?? What exactly is the big flipping deal about this? If you want some health insurance go buy it just the same way you buy fire insurance and car insurance. My parents never had health insurance and us kids managed to become healthy adults. I recall that my mom and dad saved up some money each year so we could all go in for our annual checkups and shots. That worked just fine and that was in 70's which isn't really all that long ago. So why the hysteria? Is the present generation such a bunch of weenies that they can't deal with a few doctor bills or something?

  • Bill Bodden (unverified)
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    People pontificating about the problems of so-called socialized medicine might want to consider that two of Europe's most conservative leaders - Otto von Bismarck and Winston Churchill - were among the first proponents of national health programs because they saw the importance of having healthy citizens if their respective nations were to be strong militarily and thriving economically. A recent newspaper article referred to an estimate that ill health among its population costs the United States about a trillion dollars each year.

    Consider this as one of several plausible scenarios. A child has a respiratory problem, but the parents can't afford to take him or her to a doctor. The child, however, is able to function and go to school. Later, after all classmates have been exposed to this child a diagnosis reveals the problem is tuberculosis.

    Opponents above of a national health care program might consider that because the system they have lived by worked for them it might not be suitable for the other 350 million people living in this country.

  • alijane (unverified)
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    There was once a time when I had doctor and lawyer clients who took payment in the form of a side of beef or some chickens, fruits and vegetables when the person had no cash. One lawyers wife had to nag her husband to get some cash in payments because she couldn't pay the rent or the electric bill with the side of beef.

    We may have to go back to those times to afford health care. The more things change the more they stay the same.

  • Robert G. Gourley (unverified)
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    How come all of sudden we all have to have health insurance??

    We don't - American Indians had health care, they didn't have health insurance - by 1900 they were almost wiped out.

    We last longer with health care - there are folks around who are smart enough to understand that. We need a system designed to seek perfect health for everyone, it'll cost less than any other kind of system.

  • Robert Harris (unverified)
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    My daughter spent a year as a high school foreign exchange student in Denmark last year. She was lucky enough to be part of a family where the Mom was a primary care physician. We visited, spent time with her and she took us to her clinic in a small town on the coast and explained her how it worked over there, in very simple terms.

    She was her own boss. She started her clinic, eventually bought her clinic building, built her practice up, and competes with other physicians based on quality of her care. Her clinic was, by American standards, sparse and not fancy. No $800 waiting room chairs, no MRI's down the hall. The exam tables were simple, but certainly adequate. She had privileges at a nearby hospital that had the expensive equipment.

    She showed me her schedule for the next day. Patients every fifteen to 30 minutes. She said she saw the patients, did whatever they needed, then sent a bill in to the government agency that paid based on the procedure. No insurance companies involved, no massive forms for different companies.

    She had to deliver good quality service because her patients could go anywhere they wanted (assuming that other Dr's had time for them). So you still have competition that requires Dr's to perform. They have some incentive to keep their costs reasonable (since the Gov't does set the prices I assume, which is the only real possible issue as far as I can tell)and the Dr's don't have to spend so much staff time on billing.

    The Danes seem to love their system, and can't really understand our system. I can't either.

    Edwards is correct on this one. When you let the insurance companies at the table, we've lost, and the necessary, real reform will simply be put off for a few years.

    Is it possible that if Oregon took a drastic turn and instituted a similar single payer system that we could actually get MD's from around the country who are progressive minded and wanted a different style of practice to come here and open up clinics. Maybe even in places that are now underserved? Is it possible that manufacturers and other businesses would then locate here as they found out that they wouldn't be subject to annual 20% increases in their employees health insurance?

  • alijane (unverified)
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    The Danish system sounds interesting - but what are the tax rates to pay for it? Income taxes and/or excise taxes and how much do the Danes pay?

  • Dr. Feelgood (unverified)
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    Single-payer, non-corporate insurance is cheaper and has better outcomes than corporate, multi-payer insurance.

    Barbara Ehrenreich, Why Does Everyone Bow Down to the Health Insurance Industry?: http://www.alternet.org/story/63352/

    Sign up for Dr. Don McCanne's (Physicians for a National Health Program) "Quote of the Day":

    http://two.pairlist.net/mailman/listinfo/quote-of-the-day

    Dr. McCanne answers all of the claims of the health industry trolls who have been jamming this list.

  • Bill Bodden (unverified)
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    The Danish system sounds interesting - but what are the tax rates to pay for it? Income taxes and/or excise taxes and how much do the Danes pay?

    Whatever the Danes (and other Western European nations) pay in taxes for their health care all the reports I have read indicate they pay much less than we pay in health insurance premiums, doctor and hospital bills, and prescription costs, and they get better care. The World Health Organization report for 2000 listed the U.S. at 37th on delivery of health care. All Western European nations were above the U.S. on the list. France was first and tiny Andorra was second. Cuba, under an inhumane and illegal economic embargo by the United States, managed to make the 38th spot.

    The problem here in the United States is the perverse aversion that many people have to paying taxes. To be sure we should reject having to pay taxes that go to fraud, waste, abuse and wars, but some taxes are valid and worth the cost.

    When Hillary was bungling her first attempt to reform health care there was a series of questions placed on television to people in the street. Basically, one of the first questions was something like, "Would you be in favor of a national health plan that gave you the same care as you now get where you paid taxes for health care instead of insurance premiums?" A common answer was, "No. I don't want my taxes to be raised." This was followed by a version of the first question along the lines of, "Would you be in favor of a national health plan that gave you the same care as you now get, but instead of paying what you now pay in health insurance premiums you would pay less in taxes?" Again, the answer was, "No. I don't want my taxes to be raised?" How can we ever get the health care problem resolved if we have a large segment of the population with that kind of mentality?

  • Robert G. Gourley (unverified)
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    The problem here in the United States is the perverse aversion that many people have to paying taxes.

    Americans are paying as much as three times others are paying, per capita, and getting much worse health outcomes. So what do you call folks who pay more for less? DUMB!

    Dumber than a bag of hammers.

  • Robert G. Gourley (unverified)
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    Oregon Grassroots Health Care Reform Forum: A Focus on Vulnerable Populations

    October 11, 2007

    Thursday, 9am-4pm Flavia Hall Salon, Marylhurst campus Free and open to the public Registration opens at 8am

    Keynote Presentation: On the Road to Health Care Revolution John Kitzhaber, MD Founder, The Archimedes Movement Governor of the State of Oregon 1995 - 2003

    Additional topics Presentation by Barney Speight, Executive Director, Oregon Health Fund Board, on Passage of SB 329: A Path to Health Reform in Oregon

    Small Group Involvement and Recommendations to State Policymakers in Physical Health, Advocate/Consumers, Provider, Mental Health and Addictions, Seniors and People with Disabilities, and DD Progressive Health Care Reform: Reaching the Underserved Populations

    Movement Toward Universal Health Care

    Policy Issues That Belong in Discussions About Health Reform in Oregon: Taking Care of Vulnerable Populations

    Co-sponsors Marylhurst University, Department of Human Sciences Archimedes Movement Advocacy Coalition of Seniors and People with Disabilities Oregon State Council for Retired Citizens Governor´s Commission on Senior Services Alliance for Retired Americans Marylhurst Gerontology Association Oregon Action Oregon Health Action Campaign Oregonians for Health Security Oregon Association of Community Mental Health Programs SEIU United Seniors of Oregon

    Marylhurst University 17600 Pacific Highway (Hwy 43) / PO Box 261 / Marylhurst, OR 97036-0261 Phone: 503.636.8141 / Toll-free: 800.634.9982 / Fax: 503.636.9526

  • alijane (unverified)
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    I think the problem is the devil we know versus the devil we don't. There are many people promising savings, the moon and the stars, but no one is talking in dollars and cents or exactly how this will work.

    I can think of $650.00 toilet seats and hammers, the cost overruns of the tram, the DMV and the computer system to collect money from deadbeat parents and the Portland water billing system. Small wonder people are leary of government being in control of their health care.

    Something needs to be done, but a massive overhaul of the system needs to be broken down into small pilot projects. We did not just arrive at this crisis and we need to proceed with caution with the fixes, lest we make it worse, not better.

  • Bill Bodden (unverified)
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    I think the problem is the devil we know versus the devil we don't. There are many people promising savings, the moon and the stars, but no one is talking in dollars and cents or exactly how this will work.

    First of all, alijane, you seem not to be paying attention to what is readily available. The devil we know is the current health care system in the United States, but that doesn't mean you have to jerk out some cliche to imply that the health care system we need and can have is another devil. For many, it can be an angel of mercy.

    "There are many people promising savings... but no one is talking in dollars and cents..." Savings should be relatively easy to come by if we consider that the United States pays two and three times what other countries with better services pay. People have been talking about these dollars-and-cents issues for years. Where have you been, alijane? Have you ever compared the size of administrative staffs in doctors' offices in the U.S. with their counterparts in Western Europe? Look at the paperwork related to a visit to a doctor and try to figure out the billing system which is often irrational. Didn't you see Michael Moore's "Sicko"?

    I'm tempted to cite a truly absurd example of medical billing, but that would probably trigger a long series of horror stories with contributors outdoing the previous submissions.

    "... how this will work." You look at other systems that give better service for less cost and build on those models. If necessary, tweak them to fit conditions in this country and, if possible, improve on them.

  • Robert Harris (unverified)
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    There was an informative post a few months ago about health care talking about how whatever the proposal is for health care reform, it has to fit into our culture.

    And, our culture first asks, when proposing any type of governmental program, how much will it cost and how do we know that there won't be innefficiences, waste fraud and abuse. And what are we going to be paying in taxes.

    My answers are... well, I know that I'd prefer to pay 8-10% of what I produce to health care rather than 16-17%. I believe that American Government is no more corrupt than the Italian government, and at least as efficient as the French Government. So I believe that any US gov't administered single payer system will cost maybe 40% less than what we're paying now, and everyone will be covered.

    If we, as a culture can agree on that, then we can address the financing issue and in fact the public will demand single payer.

    For people who advocate half way measure, I also know that any pilot project, private/public partnership, mandatory insurance laws, and other similar proposals, have never ever ever been shown to have worked anywhere in the world as far as I know. Frankly, I think they are meant to fail and that they will. And they've certainly never ever shown any ability to contain costs.

  • alijane (unverified)
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    Bill, A lot of the paperwork is governmnet mandated the Medicare and Medicaid billings are a nightmare and many have sadly found ways to rip of the system. When they get caught, they get a slap on the wrist.

    I am not saying saving cannot be found, but I don't think there can be a massive overhaul to fix all the problems. Yes, we can and should look to other countries and see what would work in the US.

    I doubt the insurance companies will go away without a fight.

  • Bill Bodden (unverified)
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    A lot of the paperwork is governmnet mandated the Medicare and Medicaid billings are a nightmare and many have sadly found ways to rip of the system. When they get caught, they get a slap on the wrist.

    Paperwork for private insurance, including for people covered by the Federal Employees Health Benefits Plan, is determined by the insurance companies and is massive. Eliminate a feasible 90% of that and a fortune will be saved.

    I am not saying saving cannot be found, but I don't think there can be a massive overhaul to fix all the problems.

    Why can't there be a massive overhaul? Should we presume you are in favor of just accepting the current crap with maybe a band-aid or two applied? The United States got a wake-up call when Soviet Russia launched Yuri Gagarin in space and put them in the lead in space exploration. Fortunately, President Kennedy didn't have your attitude and see a "massive overhaul" as a discouraging factor.

    ...how do we know that there won't be innefficiences, waste fraud and abuse.

    In any government undertaking run by people there will be waste, fraud and abuse. The challenge is to keep it to a minimum, and we can do that with more Henry Waxmans in Congress and less whores acting on behalf of the medical and pharmaceutical corporations.

  • alijane (unverified)
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    Bill, I did not know the insurance industry dictated Medicare and Medicaid billing systems.

    If a change in the health care industry would take drug ads off of TV, I'd be thrilled to death.

    Maybe we should tax all advertising to pay for this new health plan and get back at the drug companies.

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