"I was under the impression that purpose of this reform was to ensure everyone had acess to health care..."

That is the impression most people appear to believe in, but it appears that health care reform is more an excuse to convert taxpayers into ATMs for the insurance corporations. If you can't afford to buy a policy the government will give money to some insurance company that will give you a policy - not that it will do you that much good. But with an election coming up it will let insurance corporations know who in Congress is on their side.

Jeff, you have hit the bulls eye. The health care debate is at its core, not so much about policy, but about values. It is about the value of the human person, every person in our country. We would rather spend our resources on military hardware we don't need, on keeping the rich wealthy and pretending that anyone can be them, and perhaps most of all on shopping, consuming.

The blue dog dems, and I include Wyden in that frankly, don't care about the powerless, they care about the powerful, and they want to be seen as caring about the deficit. But they are hypocrites. But we can't blame the political class as much as we can blame ourselves, because they are doing exactly what we collectively want them to, trying to shield us from the awareness of our own choices and values, and our unwillingness to face up to them.

And while many on this forum like to diss religion, there is a central ethos in all religions, whether it be the no-self of Buddhism, Matt 25 or the Great Commandment in Christianity, or I-Thou in Martin Buber's Judaism-that our neighbor partakes of the greater Self of which we partake of, and what we do, or fail to do, to or for another, we do to ourselves. And we will always, knowingly or not, pay the price, individually and collectively.

My sister-in-law has begun treatment for aggressive cancer. She will have a less than adequate insurance for a while under Cobra because she lost her job from being too ill to work. Eventually it will lapse, and she will go bankrupt and have to terminate treatment, and she will die, because there is no free cancer treatment in this country (unless you are a senator or congressman),and you don't even get hospital emergency room treatment until you are in a medical emergency. Her family will try to help her as best they can, but she may well die penniless and abandoned by the society she lives in, because.. that's who we are, and we are all diminished by this state of neglect of each other. What is happening to my sister in law at age 57 could well happen to any one of us if it hasn't already.

If one of the big problems with health care access and delivery in this country is the insurance companies acting as gatekeepers for medical treatments, how does issuing health insurance to people solve the health care access and delivery problem? Insurance companies being determinants of medical practice IS one of the big problems we need to reform. What happened to the Ron Wyden that knew this?

The question raised here has an answer indicated in the decision by Barack Obama to give immunity to the manufacturers of swine flu vaccines. Mercury and aluminum hydroxcide and other num nums like bird flu may be good for those who embrace population reduction. Why does BHO support this?

Rachel Maddow's segments on The Family are useful in forming an understanding of their values. Hitler. Pol Pot. Lenin. These are the good guys because according to The Family they were willing to commit genocide. Lets see. A million in Iraq. A good start from the GOP's point of view. Is there any difference with the democrats or is it all about money?

The fundamental problem with our health care system is that it has failed to control costs, leading to a host of other ills like inadequate or virtually non-existent care for millions of Americans. We spend far more than the citizens of any other nation and we get less than many. Any fix of the problem must take this into account, must figure out a way to control the cost of our health care. The problem with your formulation is that you presume the goals of universal coverage and cost control are two different entities, or that one is a fringe benefit of the other; in reality, they are mutually dependent. We cannot do one without the other. Universal coverage remains a pipe dream until we figure out how to bring down the cost of health care.

Responding to Bill, the problem is that we cannot separate policy and values. We need a policy that will actually achieve our values and be sustainable for the long run.

Health policy is very complex. It is virtually impossible (and undesirable) to just expand insurance coverage under the current regulatory framework to everyone without making other reforms. For one, we have to ensure that the insurance is worth something by having strong, national standards as to what the minimum coverage is. (When you hear Sen. Wyden saying that everyone should have the quality of coverage that Members of Congress have, he is essentially arguing that the coverage of the Federal Employees Health Benefit Plan should be the minimum standard.) We have to make sure that insurers cannot deny applicants for preexisting conditions. And it is going to be very difficult to pay for universal coverage over the long term if we don't control costs somehow.

The reality is that the US spends more per capita on health care than any other industrialized country, yet we don't cover everyone and get poor results in some categories. If we are going to subsidize insurance for the uninsured, but costs continue to skyrocket, that is not a sustainable model. Go back to Steve Novick's post and read the New Yorker article about how fee for service drives up costs. Comparative Effectiveness Research is a promising approach as well. Economists are virtually unanimous that capping or eliminating the tax exclusion for employer provided insurance would reduce systemwide costs (because right now our system, perversely, subsidizes people who have insurance, but not people who are uninsured to help them buy insurance - and even worse, the subsidy is much greater to high income people than it is for low income people).

There is a lot that needs fixing in the health care system and unfortuantely each problem (coverage, cost, technology, insurance regulation, the shortage of primary care doctors, etc.) cannot be viewed in a vacuum. Reform must be comprehensive to be successful.

@ Brian Collins

I don't separate policy from values. But I do think policy must follow from values. When the Blue Dog Dems were asked to fund the Iraq war and invasion they were more than happy to borrow the one trillion plus $. When it comes to the value of person's lives and well-being, suddenly it's not okay to raise the revenues, especially from wealthy people. Suddenly there's a concern about the deficit. They were acting from their values.

As for Ron Wyden he is showing a first concern about his patron Blue Cross under the guise of the deficit, while obstructing a public option plan that would actually make health care less expensive and more accessible to the American people. If Ron Wyden (and his senate colleagues) had any character or values, he would stop requiring citizens to fund his public option medical care until such time as his constituents can have the same for themselves.

RE: Ron Wydyn and Public Option

Update- I am informed that Ron Wyden today appeared on MSNBC and stated he is including a robust public option in his plan. ( He must be feeling the heat.Phone calls may be helping. ) He also states he has told his wife that he may be late in getting home from Aug. recess.

I still think it is morally wrong for a public official to claim a benefit from his/her constituents that they are not able to have. Especially one as vital as health coverage.

As a physician I'm strongly against UHC. Just the idea of putting all insurance companies out of business who have a whole system set up, have experience in management, contracts with doctors/hospitals and put in charge people with no experience, no sense how to run it who will raise and raise taxes and borrow money to pay for mismanagement and corruption. Anybody who really want to make medicine and everything else better will try to improve the current working system, not destroying it. There are so many normal people who talk about real reforms addressing real health care problems but nobody discusse it. 90% of all UHC changes nobody needs. The only real issues so far are cost and affordability. But unfortunately the UHC solution will only double or triple the cost and decrease quality. If you pay nothing for health insurance but pay 2 times insurance rate in taxes you are not really saving a lot plus if on top of you get fired because your employer can't afford you anymore after all this "refoms" it will not improve your financial situation either. If we just start normal reform by addressing real problems like medical fraud and medical liability law which would decrease unnecessary testing, procedures and hospitalizations which takes huge amount of healthcare money we can save a lot. Then we can address medications cost and polypharmacy problem which is not the least important thing in the total cost and healthcare affordabilty. Then step by step we can move to other issues without rushing and destroying things. The good thing I read more and more opinions againts UHC from more and more people which gives me hope that may be this nightmare will end.

The blue dog dems, and I include Wyden in that frankly, don't care about the powerless, they care about the powerful, and they want to be seen as caring about the deficit. But they are hypocrites..Miami limousine service

"I was under the impression that purpose of this reform was to ensure everyone had acess to health care"

Umm, since when have people been denied access to health care in an emregency situation. The issue always has been who will pay for what.

In spite of all the caterwauling about how terrible our medical system is, if you have a problem and can choose any country for medical care, it will be the USA.

I recently came across your blog and have been reading along. I thought I would leave my first comment. I don't know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.

Deborah

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