I don't know who your friend is but it sounds to me like he/she is giving you a line of b.s. Nice try Kari.

of course no one has ever run into red tape, b.s., or incompetence when dealing with the DMV, or IRS, or SSA, or VA, or DOD, or BLM, or OSHA, or DOJ, or FBI or ........

Yeah, what are we waiting for?

Bring on the government monopoly so that you won't have any options left.

So, Kari you want us to have to call our Congressman if we have trouble getting service from your golden health care bureaucracy. Is that it?

Just call the congressman's office and he'll get right on it. Right?

Can we also put government in charge of food production and distribution so that we'll all only have one number to call?

George Washington would vomit if he met you.

Legislation is economic horse trading on a grand scale. You don't trade a horse for nothing. If insurance industry is getting, at our expense, a mandate that everyone have insurance it must stop opposing public option. Coops are not a public option, they are more of the same bureaucracy, likely to perform even worse. Fax machines?

Here is a view of the French system: http://www.nytimes.com/2009/08/16/magazine/16lives-t.html

Hi Kari, thanks for the link.

@dean t. on the first comment. I know it happened because it happened to me. If you want I can come visit you and show you what has been happening to my body without the meds, it ain't pretty, it's painful and diminishes my ability to work, to concentrate for long periods of time and to enjoy the activities of daily life.

The really disturbing thing is, where does my insurance company get off on arrogating medical decisionmaking power? Especially when they are so clearly and concretely using it against me.

Kari,

Anecdotal evidence is interesting and makes for good stories. If I were in your shoes, I would not be telling stories but would be arguing all the facts and figures that prove that a government controlled health system is superior to our current system. The only problem is those facts and figures are based on medical programs that treat only a percentage of the population. The Conservatives have the same problem. The examples they give are based on a health system that only treats those not eligible for VA or Medicare or Medicaid. In both cases, those who argue their side will be making huge assumptions based on selected populations, not the entire population.

I would argue that we need to make many changes to have the best medical system possible. Chief among those would be to allow insurance companies to sell plans across state lines. If you really want competition, that would do the job. It would also pave the way to portable insurance (another needed reform).

I actually think the real reason that so many people are up in arms about a government takeover of our medical delivery system is that it is basically an irreversible one-time choice. If I choose (or my employer chooses) badly and get a healthcare insurance policy that I don't like, I can change plans. Yes, there are difficulties, especially if I have pre-existing conditions, etc. It is, however possible in most cases. I have heard of people who ended up having to change jobs to get the end result, but they were able to change. Try doing that when the only provider is the government. What most folks fear is that it will not be long before government is the only provider. Until the House and Senate address that issue, and address it honestly, they will have a hard time selling this reform.

Kari, Do not be disheartened by these predictable, trite, and moronic attacks. I like the analogy one senator made between the public option and state colleges. You can still go to Stanford if you can afford it, etc...but you also have the option of going to the University of Oregon. By the way, where were these right wing protesters during the Bush administration? The Founding Fathers would have definitely vomited seeing King George W. circumvent our system of checks and balances while diminishing our freedoms. The reason these same protesters weren't bothered by all that is simple: The propaganda machine that feeds them their thoughts okayed it. It's the same thought machine that told them Saddam was behind 9/11 and they bought that too. The difference is this healthcare nightmare won't fade from the American Public's attention like Iraq has. It'll be in everyone's face as we watch premiums continue to skyrocket while deductibles grow right along with them. I heard of a small farmer who's self-employed and has to buy his own insurance. He says between the premiums and deductibles he has to pay $17,000 in that year before his family sees one dollar of insurance coverage. Ridiculous. Then the food he sells must reflect that and on and on. It's why these people who fight so hard for the status quo just seem like such hopeless morons. Especially, when the numbers of people who actually went to Iraq and paid that price, are relatively small compared to the total population. But nobody who lives long enough can avoid healthcare problems, so most of these protesters are on a one way street to find out how dumb and misinformed they really are. See you in the waiting room!

Kari Chisholm wrote:

"Free market competition makes everyone more efficient, right?"

That's right.

But you do understand that having the government to initially fund and/or continue to subsidize a 'competitor' isn't 'free market', right?

Do you think if I had the government provide me with billions of dollars to start a construction company and subsidized my enterprise so that I could build homes at half the cost of other contractors that this would be 'free market competition'?

C'mon. You're not a very good salesman if you assume your audience is that gullible.

Here in Oregon we a have quasi-public workers comp insurance company that operates in competition with private companies. SAIF's ceo makes a fraction of the competitors' regional directors. SAIF provides good coverage for a very low rate, despite having very high thresholds of reserves and limits on the types of investments they can make (turns out to be a good thing.) Because of SAIF, we host a variety of high risk companies in firefighting and logging that would otherwise not exist, or be based in other states.

We are losing productive employment in other sectors because the current system doesn't have a low cost player to enforce market discipline on other insurers and no requirement of similar treatment.

public and private companies operate together in competition all the time. To have a public option just breaks the cycle of collusion and high salaries to have player whose purpose is to provide the same or superior services at the lowest possible cost. In contrast to our current system which presently provides rationed services at the highest price the market will bear, see the difference.

All the jobs currently wasted in private medical bureaucracies charged with denying care can be thinned out with standardizing regulation and public competition. With the costs of care reduced and de-linked from employment, think of the opportunities for entrepreneurship and international competetiveness.

People have to remember that the way insurance companies make money is by denying claims. And they do it in such an unaccountable way that they can get away with it. The horrible thing about it is that it's not just that a person is out some money, it's that their health declines or they die. However, health care bills are the leading cause of bankruptcy in America, so that impact shouldn't be minimized either.

The debate seems to be focused on the public option, which I do support, but so much else is on the table and is needed just to keep our entire economy from collapsing. We need to rein in health care costs. We need to find efficiencies in the system. We need to ensure that those cost savings don't just mean higher salaries to the execs of the insurance companies, but mean lower co-pays and premiums.

For all of you who think that the "free market" is what will save the system, you don't understand economics. A truly free market is a theoretical thing only that uses certain assumptions. One assumption that can never be attained especially in the health care insurance market is "perfect information". The free market model assumes that consumers have perfect information about the product they are looking to buy. That can never happen in reality.

That's just the first flaw of many in the free market argument for health insurance (or anything else for that matter).

Personally, I would much rather have my insurance through the government because they would be accountable in a way private companies are not, AND they wouldn't have a profit motive to deny me or my wife from getting medical treatment if we need it.

Our system is broken and getting worse. The private market has FAILED. We need regulation and the public option ASAP.

Sue,

I believe you are wrong. In my view, if the Federal Government did nothing for health care reform other than to allow Insurance Companies to write policies across state lines and established equal mandates for all health care policies, it would set off competition that would lower costs for all of us.

I can't figure out your statement that "All that would do is handicap or remove State regulation and lead to even more consolidation." Does it not seem like consolidation if we have only a single provider, the Federal Government?

What Larry doesn't mention is that at recommended maintenance doses, the annual cost of his drug of choice is more than $18,000.

C'mon Kari. Tell the whole truth.

Obama has already said he is a single payer guy.

He wants to use the ruse of 'competition' to destroy private insurance and establish a single payer monopoly.

Why can't you be honest about what your guy wants?

So what are those of us who are uninsurable supposed to do? In this debate about including a public option, I keep wondering just what it is I'm supposed to do? My situation is not unusual. Anyone who has cancer, MS, Parkinsons, etc. etc. cannot purchase a private insurance policy because insurance companies can cherry pick who they will insure. I'm fortunate to have a group insurance plan, but live in fear of losing my job, which is a distinct possibility.

Here's another issue I never hear anyone talk about -- dealing with the paperwork that comes with insurance claims and complex medical conditions. With a cancer diagnosis comes many doctors, including surgeons, oncologists, radiologists, anethesiologists, pathologists. Add in hospital rooms, in-hospital labs, out-patient labs, in-hospital radiology, in-hospital pharmacy, out-patient pharmacy . . . the list goes on and on. Then for each and every doctor, lab, film, drug, you receive an "explanation of benefits" from the insurance company, plus dozens of bills from all of the different providers. Over the course of treatment you wind up with hundreds of statements, and it is up to THE SICK PERSON to reconcile all of it. I'm a college-educated, professional woman and let me tell you the whole thing brought me to my knees. I created complex spreadsheets to try to figure it all out, and still ran into huge problems at a time I was struggling just to get through the day. I recall bursting into tears during one phone call regarding a hospital billing error, and wailing "It's bad enough having cancer without having to deal with this, too." I was immediately transferred to someone else.

So those of you who love our current system, I pray that you never become seriously ill. If you do my advice is to hire a CPA to take care of your paperwork. You're going to need some help.

Our health care system is broken on so many levels. We need to make the patient the center of the system rather than an necessary evil. We need a public option. People like me, ordinary, hardworking taxpayers who happened to get sick, need a public option. It's non-negotiable.

Joe White mentions the VA.

I went in to the local office for something unrelated and they said I should reopen my claim. I did and they then set up appointments for me, went though the comp and pen exams and was approved in 4 months.

Each time I called for an appointment it has been for the next week or sooner. I'm to get a blood sample taken and a chest x-ray. Just have to walk in for those.

Seem adequate to me.

Having worked in the health care profession I'd say this is a pretty typical story. The sabotaging bureaucracy and management system of the corporate insurer system works this way. Why do we have medical insurer companies? They don't provide medical services, they ration them. They are parasites. (The exception that I know is Kaiser who actually provides medical services.) The whole point of their existence is to divert money from medical services to increase their profits. And they do it rather stupidly I might add by provoking medical crises by denying up front inexpensive primary care and prevention treatment.

cancersurvivor wrote:

"We need to make the patient the center of the system "

sounds familiar

oh yeah its the same thing the President of the Canadian Medical Association said about their system

I have no idea who the insurer is. But here is how the person can take care of it PDQ. And, BTW, they have been far too passive for too long.

1. Take the prescription and an authorizing letter from the prescribing physician to the insurers local office.
2. Sit down with the insurance representative and explain the situation, the needless delays and the frustration.
3. Hand everything to them (keeping copies) along with a written narrative documenting everything to date.
4. Calmly ask the representative why they will not be able to authorize this prescription within the next 24 hours.
5. Have a pre-typed letter to the state insurance commissioner (cc the local paper, at least one local news station and your local representative and state senators) on hand, show it to the representative.
6. Inform the representative that enough is enough and if you don't have either the authorization or a valid alternative within 24 hours that you are sending the documentation out followed by telephone calls.

Garage Wine says that the annual cost for maintenance doses of this prescription drug is $18,000. Yep, while steep, that much can easily be spent after only about 4 days of hospitalization. SO stop being penny wise and pound foolish.

Others have correctly pointed out that the insurance company business model is about collecting premium revenue on a regular monthly basis, investing that money and then hoping to delay payment for services rendered. That is the way the game is played. Stop being such a wuss and sitting there and taking it. Stand up for your rights and DEMAND action. Get your doctor, provider, employer involved.

"Yes, this kind of nonsense is the strongest argument for a single-payer system. But since that's not going to happen - it's why we need to insist on rigorous reforms of the insurance industry and a public option."

This kind of nonsense shows the problem with the way Democrats think. They show their willingness to compromise (and surrender) before they have even begun to fight. Can you imagine where African-Americans might be today if Martin Luther King, Jr. and his colleagues said, "Equal civil rights are not going to happen so we'll settle for seats in the middle of the bus."?

As for "rigorous reforms of the insurance industry" you have to be kidding when they have bought key players on both sides of the aisle in both houses of Congress (and in the White House) who are sure to do their bidding. Witness the collapse of Wall Street and its bailout and installation of key players in the White House (Summers and Geithner. Now the White House is planning to reinstall another accomplice in the form of Ben Bernanke at the Federal Reserve. No reform there.

Compromise is almost always required in politics, but that should come after the battle has been well fought - not after the first skirmish.

Perhaps you and other Democrats sharing your attitude ought to consider Carla's words, "You can stand me up at the gates of Hell.... but I won't back down." I don't agree with that sentiment 100%, but it would do Democrats claiming to be progressives a lot of good if they borrowed some of it.

Joe White: You seem to be part of the 'private enterprise is always good and the government is always bad,' crowd. You've been sold a phony bill of goods on that respect.

All those entities you mentioned do an amazingly good job considering the enormous scope of their responsibilities. Are they perfect systems where nothing ever goes wrong? Of course not. But neither is private enterprise.

If private health insurances were so much more efficient and were able to offer a so much better product than the government, who can't do anything right (But don't you dare take away Granny's Medicare), it really shouldn't be any competition.

But it's hard to charge a 30% markup for overhead, lavish CEO salaries and profit and compete with a program that has a 3-5% overhead cost. That's 25% more money up front that can be spent on actual health care vs a new private jet for the CEO.

Private enterprise, unencumbered by regulation? Didn't we just bail out the banks? How about AIG? How about ENRON?

Deregulation of the health insurance industry? It would be like the airlines; high prices, bad service and all the companies losing money.

Medicare works. Once you reach 65, you have a great plan. Nowadays you have to keep your fingers crossed and hope you make it to 65. If you get really sick before that? All bets are off. Sick. "Sorry, you have a pre-existing condition.' Sick, "Sorry we are going to drop your coverage."

And my favorite: Sick, "Sorry you have reached the lifetime caps for your coverage and any and all further costs will be borne by you, the consumer who thought having health insurance actually protected them from catastrophic healthcare costs." "Ha, ha, ha, ha, ha."

Medicare works. Lets get everybody into the system.

For those who cannot get insurance through their employer or from a private insurer, they likely qualify for the Oregon Medical Insurance Pool.

Unrepentant liberal wrote:

"But it's hard to charge a 30% markup for overhead, lavish CEO salaries and profit "

You do understand that 'insurance companies' don't insure the majority of employees with group insurance plans, don't you?

The employer insures them.

It's called self insured.

The employer collects the premium, the employer pays the claims. If there's money left over at the end of the year (less claims than premiums) and there usually is, then the employer makes the profit.

The 'insurance company execs' that you are mad about make most of their profit as administrators (paper shufflers) for the employer.

It is the employer who carries the majority of the risk and makes most of the profit per person.

My kids and I have been fortunate enough to be on the Oregon Health Plan for many years now. For the most part, I'm very happy with it. I have two complaints though: 

1) We live in Sandy, and there are virtually no providers here that will take new OHP clients. There are some in Gresham and SE Portland, but if you lack transportation (as many low income folks do), that can be a long and sometimes harrowing trip - especially when you're ill. Fortunately, I now have decent transportation so it's not such a big issue for me anymore, but for many it is. But I'd still like to develop a relationship with a local doctor or clinic too. 

2) The godawful long and repetetive application / recertification forms. While I know I shouldn't bitch because I don't ever have to deal with the nightmares "cancer survivor" and others describe, it does get old filling out the exact same 30 page application form every 6 months. I've lived and worked at the same place for years, my income has remained the same with the exception of small cost of living increases, nothing has changed as far as my eligibility for OHP goes, yet they act as if they're just gettin to know me, you know? It is frustrating because it seems the state could save a lot of money (and dead trees!) by streamlining the recertification process.  

In my opinion, if there was single-payor, both my (relatively minor) bitches would likely go away. If the Medicaid reimbursement rate were more fair and up-to-date, or - it was the only game in town - I wouldn't have to hunt for those providers willing to take patients. 

Likewise, if everyone were covered, there'd be little need for the constant recertificarion of eligibility.      

Oh yeah. It'd be nice if the state would get into the 21st century and implement a way to pay OHP premiums online. At least they now allow you to call and pay over the phone, but again, that's unnecessarily labor intensive I would think. It is better than having to mail off a check or m.o. though.

I'll be surprised if this Congress and/or the White House comes up with a national health care reform plan. If they do, I'll be very much surprised if it improves the situation. It is completely absurd for different cabals composed of politicians tackling the problem with their own different and conflicting agendas, especially when most of the key players are owned by the medical-insurance-pharmaceutical complex. This monumental task should have been delegated from the very beginning to a non-partisan (NOT a bi-partisan) commission with all of its proceedings open to the public and covered gavel to gavel on C-Span.

The Worst and the Best Thing to Happen to the Democratic Party in Years:

Health care reform has become a sad joke, with the emerging “reform” bill looking for all the world like the Rube Goldberg creation of the Clinton era that properly went down in flames. Instead of taking on the insurance industry, the hospital companies and the pharmaceutical industry and other parts of the profit-making medical-industrial complex, Obama cut deals with all of them behind closed doors, assuring that their profits would be left untouched, and that they could essentially write their own “reform” bill through the offices of bought-and-paid members of Congress like Senator Max Baucus. Obama and his congressional allies carefully kept any discussion of the single-payer idea—essentially Medicare for all, and the approach that even Obama himself admits would be cheaper and more universal—out of sight and off the table...

"We know that simply organizing occasional polite marches in Washington, or in key cities, accomplishes nothing. We have learned that email campaigns to deluge members of Congress with canned opinions don’t work. What has worked, and will always work, is massive campaigns of civil disobedience, tent cities in Washington, organized disruption of war preparations, and door-to-door organizing. The corrupt hacks who inhabit the halls of Congress and the White House will not do the right thing just because it is the right thing, or because we ask them nicely. They may, if we make them fear that they will actually lose our votes in the next election.

No Kari, he can't. His ability to analyze and give accurate data on self insurance is limited. If you would like a very detailed understanding I'de be happy to put you in touch with a friend of mine in Eugene. He has helped numerous companies look into self insurance and helped others decide to get out of self insurance.

Most Companies will break even with self insurance after paying the overlaying catastrophic coverage, ongoing administration and mandatory set asides for reserves, trend and future costs.

Kari Chisholm wrote:

"can you provide a source for that claim you made at 1:44?"

Not sure which part you are referring to as 'that claim'.

Kurt Chapman wrote:

"Most Companies will break even with self insurance "

Even if that were true (but you've previously admitted that most companies don't self insure until they have a strong positive trend claims/premiums) the point I've made is that insurance companies make much of their margin, not by 'insuring' health (because they don't carry the majority of the risk in a self insured plan) but by simply shuffling paper (i.e. providing administrative support)

btw, as I've also mentioned, health insurance isn't the big profit item with these companies for yet another reason: that honor belongs to life insurance. This is where life/health companies make the real dough.

Unfortunately, the MSM has deceptively quoted overall profit margins for these companies and implied that it came from health insurance. It didn't.

Here are some stats for the doubters- the WHO's ranking of health care access by country. So glad I am better off here than in Slovenia- but how come we are behind Costa Rica? a country the size of a texas County with about the same budget?

1 France 2 Italy 3 San Marino 4 Andorra 5 Malta 6 Singapore 7 Spain 8 Oman 9 Austria 10 Japan 11 Norway 12 Portugal 13 Monaco 14 Greece 15 Iceland 16 Luxembourg 17 Netherlands 18 United Kingdom 19 Ireland 20 Switzerland 21 Belgium 22 Colombia 23 Sweden 24 Cyprus 25 Germany 26 Saudi Arabia 27 United Arab Emirates 28 Israel 29 Morocco 30 Canada 31 Finland 32 Australia 33 Chile 34 Denmark 35 Dominica 36 Costa Rica 37 United States of America 38 Slovenia 39 Cuba

Duncan wrote:

"Here are some stats for the doubters- the WHO's ranking of health care access"

This is simply circular argumentation, since WHO's criteria include that the government runs the health care.

WHO has an undisguised political agenda. It is part of the UN and has sacrificed any claim to objectivity by the way it has conducted itself.

Who cares how the UN ranks anybody for anything? Not me.

When we hear about the sell of illegal body parts in the United States of America,ya know something is broken and health care needs fixing ! Rest my case for Universial Health Care !Keeping an open mind for what's working and what isn't.Let's talk Hillary Clinton into a townhall! Can you imagine getting sick and going to the hospital and ending up with a bill for $200,000.00 dollars ? That's scary,to real and happening !Not to mention the thousands a day losing their health care coverage! Throw the political rhetoric in the trash and let's team up as Americans and fix it ! Where is the flow chart on the 1000 pages of this HR3200 ? We'll take the first 10 pages and you take the next 10 pages and we'll argue solutions that work !It's an American community neighborhood plan !The sounds of democracy are ringing on health care !

Unfortunately Obama and his pals don't want to throw political rhetoric in the trash, because it's all they have.

Their latest attempt is to paint political opponents as 'Domestic Terrorists' on the anniversary of 9/11.

On BarackObama.com, the perpetual campaign website, the 'community organizers' urge lefties to commemorate the attack on America by bombing the Capitol switchboard with calls supporting health care 'reform' and to fight against 'right wing Domestic Terrorists' who 'subvert' America's political process.

<h2>Has the left no shame whatsoever?</h2>