Kari,

One of the bigger problems for me, as a conservative, is that Obama is not being truthful about his true end game on health care reform.

Exibit A:

link

It's hard for the debate to be an honest one when the long term agenda is against the core of what I believe in - free choice.

Every time Obama opens his mouth on this issue I think about his non-scripted words and think here is the most powerful guy on the planet who in his heart of hearts wants a system where there is no competition at all, but instead just one entity controlling health decisions for everyone.

Conservatives are questioning the merits of entering debate and supporting change when the long term alternative is such a radical one.

I'm not saying there isn't areas of health care that can't be improved. There are. But the debate needs to be shaped into one where we are talking about specific targeted problems and solutions -- and not have an undertow that the long term intent is a complete paradigm shift on such an important facet of our economy.

BTW, not all conservatives are Republicans. Your post implies this.

Let's not pretend that real debate happens in this country. It's all about propaganda, marketing and manipulation. The important thing is to arrange the venue so that the wingnut thugs who show up are not allowed to disrupt and intimidate. Security needs to be present to escort the disruptors and screamers to the door, and a large crowd of health care supporters, who are there early, are prepared to shout them down when they try to heckle.

The Chamber of Commerce, the Insurance Industry, and the GOP are funding these roving bands of idiot teabaggers. We need to show them they can't overturn an election.

OK, I’ll bite, although I prefer to stay on issues that I am fully up to speed on, so just let me ask some basic questions.

Kari said:Should we do something to ensure health care for the 47 to 50 million uninsured Americans? JK: Some conservatives say the real number is much lower & that your number includes people who should not be included such as Illegal aliens, people who can afford insurance but choose not to and others that don’t really need help.

SO, please tell me how many of those uninsured are people, legally in this country, want but cannot afford insurance.

Kari said: What specific problems do you think we should attempt to fix? JK: How about helping only those truly in need and in this country legally?

Please make a good case for providing free food to every American, since some cannot afford food. Or, tell us why not just help the needy, instead of doing the equivalent of providing free food for all people.

If you would like to stand up agains the power and influence of the health insurance companies with your vote. Please join our voting bloc in support of single payer health care at: http://www.votingbloc.org/Health_Bloc.php

Rebuli-convicts can't have a real debate on the issues because they will lose that debate. They have nothing. All they can do is stand up, make noise and disrupt things and hope the media portrays that as some kind of 'broad based opposition' to the President's plan instead of just a small band of professionally directed agitators making a scene for the press's benefit.

Kari: My dear conservatives, either tell us that there's not a problem, or propose an alternative solution. Let's call off the mobs, put away the conspiracy theories, and have an actual debate.

J: Here are some items that pass the common sense test: 1. Get rid of all government mandates on insurance. 2. Allow purchase of insurance across state lines. 3. Put private policies on the same tax basis as employer provided. 4. Encourage health savings plans. (Why do we expect health insurance to cover routine things? It is as if car insurance should cover gas.) 5. Get states out of the regulating insurance business EXCEPT to guarantee financial soundness and honesty. 6. Frankly, I’d like to see an end to employer provided health insurance. That is probably the root cause of the problem. 7. There may be some way to stop setting rates by “pre-existing” conditions. After all few of us were born with pre-existing conditions and if we had continuous coverage, we would be covered, so how do people get “pre-existing conditions”? Probably due to their actions or actions beyond their control. Perhaps welfare can cover these gaps in coverage? That would eliminate the “pre-existing condition” excuse for insurance companies to raise rates.

And I’m not a conservative, just financially responsible.

Gordon Smith held meeting? Who knew?

Kari,

Let me ask you..honestly..and by this point I'm sure you've seen all the video clips of Obama stating his true intentions on healthcare. Do you honestly believe that Obama/Congressional Democrats (the liberals anyway) are pushing a public option only so that people will have a choice between their current, private insurance and a public plan..as opposed to pushing it as the first step to bring an end to all private insurance in this country and ultimately end up with a gov't single payer plan?
Obama has said, many many times as a candidate, as a state legislator and as a US Senator that he supports a single payer plan and that a public option would likely/hopefully lead to the end of all private insurance. See here if you need evidence http://www.breitbart.tv/uncovered-video-obama-explains-how-his-health-care-plan-will-eliminate-private-insurance/

One problem that many Americans, Democrats and Republicans alike have with Obama's plan is the incredible dishonesty with which he is trying to sell it. The plan alone is bad enough (for those of us who strongly oppose a public option), but the fact that Obama is going around the country denying that he has any intent on shutting down the private insurance industry is an undeniable lie (if you believe everything he's said on the subject up until now). I did not vote for Obama, in part due to the fact that his record in the Senate was farther left than any other member of the Senate at the time, and although he tried to portray himself as a bi-partisan kind of a guy, I never bought it...and apparently my instincts were correct. Say what you will about George Bush, or Reagan or any other president in modern history, Obama is by far the most ideological and radical president we've seen in modern times. He is a master politician who has an incredible ability to win over a crowd...but the crowd has now seen his act enough times to start looking beyond the speech and into his conduct..and the crowd is starting to realize that maybe they've been had...because when we look past the sales pitch and see what this guy is really selling, it's just not something that the American public wants to buy..

I don't care what is said or done at town hall meetings. I just want the Democrats we elected to have the balls to enact meaningful health care reform regardless of the smokescreen of bullshit being spewed by the Repiglicans and their corporate masters.

"Should we do something to ensure health care for the 47 to 50 million uninsured Americans? "

How about starting with the real objective?

Is it to make sure everyone gets health care?

No, it's about the left demanding we nationalize health care and give everyone including illegal aliens free insurance which the country cannot afford to do.

How is it that you blues have not a shred of concern over the cost and the detriment of adding yet another unfunded whopper to the bankrupt SS, Medicare and Medicade programs?

You act like funding, solvency and deficits don't matter at all.

A trillion here a trillion there and it all comes together?

Blue foolishness.

I am a Republican who doesn't support what the "mobs," as you call them are doing. However Kari, please save me the false sense of outrage. How can my friends on this blog from the other side of the aisle use words like "Repiglicans" (Gary D.) and "Rebuli-convicts" (unrepentant liberal) and then call for a debate on the issues? BTW, I find "Rebuli-convicts" really funny in the wake of the conviction yesterday and our US House Democrat with cash in the freezer but I digress.

Let's get ourselves, all of us, out of the gutter and act like we are older than 9 year olds on the playground.

So Kari, either renounce those who have taken to petty name calling or save me the false sense of outrage...

As for the healthcare plan, I oppose anything with a public option as medicare has pretty much been a failure. In many parts of Oregon it is difficult if not impossible to find a doctor who will accept new medicare patients and now we want to put more people on the public system? Doesn't make any sense.

We must move toward a system that puts HSA's on equal footing with insurance. They force people to look at costs of care and to take some responsibility for their own health. Over the top of an HSA you can lay a high-deducible, catastrophic policy to cover major accidents or diseases. We will not fix healthcare while people are disconnected from the cost of the services they are using.

Now, I am sure we are headed back to the gutter and the calls of they said this and that but thanks for reading this far.

The Unions are ready to confront the screamers. I say, Bring on the Teamsters and hard-hats!

http://www.huffingtonpost.com/2009/08/06/unions-to-take-on-conserv_n_252720.html

@ Capitol Staffer "As for the healthcare plan, I oppose anything with a public option as medicare has pretty much been a failure. We must move toward a system that puts HSA's on equal footing with insurance. "

<hr/>

At last, an honest Republican. Opposed to Medicare, believes the answer to health care is saving your money and paying out of pocket. If we could just get more honesty from your party officials.

How can one have a reasonable debate on the issues if they are married to bi-partisanship above all else? How many Republics voted in favor of Medicare...and yet it is one of history's most successful programs. I thought Ron Wyden initially ran as a Grey Panther, supporting this important program. Would he have voted against it just to garner a few Republic votes?

Is Ron Wyden ready to give up meaningful healthcare reform on the altar of bi-partisanship?

On the positive side, Wyden of all people knows how to run a town hall meeting. I've attended in the past and he gave everyone the rules and even though we were an angry anti-war, anti-torture, pro Constititution crowd, we behaved as he asked. He was masterful from the podium at keeping order.

Come on Ron, give up this silly bi-partisanship crap and go with what we the people want - Medicare for All. The insurance companies have profited off our money and suffering for long enough.

How is it that you blues have not a shred of concern over the cost and the detriment of adding yet another unfunded whopper to the bankrupt SS, Medicare and Medicade programs?

Wow, what a leap of illogic. I'm 50. I want to be on Medicare NOW. I will pay taxes for it. My employer pays 15,000 to cover my family right now. Because the insurance companies increase costs by 15-25% a year (don't tell me this isn't true - I've been a nonprofit org budget manager for decades), our employees have not gotten salary increases that have kept up with inflation. Wages are stagnant in large part because the insurance companies take the increases that should go to wages. If we took this burden off the backs of employers, gave each employee an increase, then payroll or other taxes could pay for Medicare for all on a sliding scale basis. Sure I'd pay more taxes and gladly...to ensure all Americans are covered. Plus I would have the freedom to leave my employer and do something more entreprenurial...a new for-profit business I've been wanting to do for years that would employ at least 20 people. No, we don't think it is free and we don't want to increase the budget deficit. By the way, if we cut off the criminals/no-bid-contracts of Haliburton, and Blackwater, we could pay for it without raising taxes. Funny how you people think we can afford to blow up innocent countries but not take care of our own people. For shame.

"when we got really pissed, we'd go all out: we'd schedule a meeting with a staffer and then have a discussion. except some of us on the fringe really went off the deep and (the shame) blogged. about the issues".

@ T.A. - with all due respect your statement above is complete bullshit.

I hate disruptive meetings when nothing is accomplished. I go to meetings to understand the issue so I can add to the debate. I do not support mobs sent to presentations to disrupt my chance to get information. But to suggest that this is a new tactic, thunk up by evil conservatives, is a joke.

Progressive activists had the corner on this market (for the last 8 years as a matter of fact) until only recently. There is an old saying about being able to dish it out but being unable to take it. I would hope that these mobs stand down, and progressives take a lesson from it for the future.

What was most amusing about the lead rant was that, yes, health care has been debated here to death.

And it has been filled with all manner of rancor and name-calling between proponents of different plans. Who is the traitor? Who is the sell out? Who is an impractical narcissist? It's all been "debated" here.

If this is such an important issue to get done right, why the rush? It has to be because the details absolutely suck for those Americans who have health insurance and the price tag for anyone with money sucks even harder.

The prospect of jackass patronage flunkies offing my mother-in-law through bureaucratic malpractice is about the only appealing aspect of KenyanCare to me.

"Rebuli-convicts can't have a real debate on the issues because they will lose that debate."

No, we don't debate with people who make stupid, childish comments like yours.

I love how liberals love protesting...oh wait that's only if your protest something that don't like. Oh and liberals pride themselves on tolerance...unless you disagree with them, at that point they all sudden become much less tolerant. Coming from someone who use to work in Congress, these protests, which I disagree with, are much like Code Pink's tatics, an ultra left extremist group. Code Pink would often disrupt committee hearings and act like children...all this to say it happens on both sides and protesting, like it not, is not illegal.

I think there should be an analog to the "Video the Vote" activities of last November. Videographers should attend these Town Halls and VIDEO TAPE and then POST ON YOUTUBE any and all unruly "Tea Partiers" in attendence. I know I will!

Show these bass-turds for what they really are: Anti-American insurgents trying to squelch debate.

Kari, much as I enjoy the MoveOn.org tactics being used against the dems; I agree that it is time for a meaningful debate. I am a strong advocate for healthcare reform. To me that does not mean single payor or government run health care. It also doesn't mean that I should be paying an additional $125 - $165 each year on my health insurance to fund uninsured kids in Oregon.

I welcome real debate and hope that it occurs during the break from Congress. Representative DeFazio will be down in Grants Pass next week and I will be there hoping to hear some good give and take from many sides of the debate instead of a shrill shouting down contest.

Right on Sal!

"My biggest concern is that the health care reforms we are looking at will create the illusion of cost savings as public money will be used to create sweetheart deals for insurers that may have a short-term palliative effect on costs, but will do so at the cost of additional debt that will not cure the underlying problem.

At the end of the day, I am hopeful that both parties will look to the public interest in implementing these reforms and find a way to work togeter, but I am very skeptical about the ability of congress to put the public interest ahead of the interests of the insurance lobby."

This will be a really tough fight. However, I believe we need to look at details, not just at defeating a lobbying group of one sort or another.

The "we must have public option" folks who ignore all side issues are not going to bring about an end to "fee for service" medicine which some doctors hate, an end to denial for pre-existing conditions, or all the other reforms that are needed.

Yes, public option may be a good idea to keep the insurance companies honest. But flat statements alone don't accomplish much. "We need electronic medical records" won't be worth much if the systems are poorly designed, not compatible between doctor's offices and hospitals, designed by techies who don't understand how medical offices operate, etc. The details really do matter.

And unless someone can get Sens. Kennedy and Byrd healthy enough to be present for all the votes, it will take 2 senators like Olympia Snowe or others to get to the 60 votes needed.

It would be nice to see intelligent adult behavior rather than Grassley droning on with the GOP talking points.

Speaking of public debate on policy issues, the authentic conservative voice in this country, William Buckley, modeled such a forum in his program, Firing Line. I miss those days when debates were about ideas and where reason and logic were the instruments of debate.

Public meetings in our present toxic political culture are about how to intimidate or manipulate. I wonder if there is enough maturity and mutual respect in our political culture to have an authentic town hall meeting any more? Granted the left has its share of sins in this area. But when a large share of the Republican party believes that the opposition is not simply wrong in their policy positions, but active agents of satanic forces, and the elected president, the anti-Christ, how is any mutual respect or respectful exchange possible.

Kari, don't tell me how to have a constructive debate over key policy issues...you're the biggest partisan hack West of the Mississippi. It's blind partisans like you that are driving this country further apart. I agree with your point, but coming from you, it screams irrelevancy and hypocrisy! Keep spinning...

We all need to remember that the American voters went to the polls and voted for change. Obama is the president and he is implementing change.

We all need to remember that the American voters went to the polls and voted for change. Obama is the president and he is implementing change.

Bill, I keep hearing from certain sources that Americans voted for change. Well, only about 53% of those voting voted for Obama/Biden. Based upon my unscientific polling the potential exists that a great many of the votes for President Obama were votes AGAINST the republicans, the War in Iraq and percieved over reaching by the national republican party.

Our country needs Health Care Reform. That reform does not necessarily need to include a public option, government run health care or wholesale dismantling of the current system. What would be so wrong with a national approach similar to what MS has initiated?

Kari says “It doesn't matter what the president's ‘true intentions’ are...we're debating actual language. Either it's a good idea or a bad idea. What someone's future plans may be are entirely irrelevant.”

While I always try to avoid bringing Hitler into a policy debate for fear the “other side” will think I’m tarring them with that monstrous brush, in this case I can’t help asking if Kari would have made the statement above if we were in 1933 Germany and Hitler was taking control of the government. If that's too far back, how about discussing the last president's intentions when the Patriot Act was being debated?

Again, there is no attempt here to equate anyone in today’s political world with Hitler (or Bush), but simply to make the point that intentions do matter. In this case, since very few if any individuals have read, much less understand, the full 1,000 plus page health care reform bill we’re talking about, intentions may be even more important than the actual language of the bill.

"Bill, I keep hearing from certain sources that Americans voted for change. Well, only about 53% of those voting voted for Obama/Biden. Based upon my unscientific polling the potential exists that a great many of the votes for President Obama were votes AGAINST the republicans, the War in Iraq and percieved over reaching by the national republican party."

Kurt: Did you miss the irony in my comment? Did you read the links in it? Change? What change?

"While I always try to avoid bringing Hitler into a policy debate for fear the “other side” will think I’m tarring them with that monstrous brush, in this case I can’t help asking if Kari would have made the statement above if we were in 1933 Germany and Hitler was taking control of the government. If that's too far back, how about discussing the last president's intentions when the Patriot Act was being debated?"

As a student of the two world wars of the 20th Century, I couldn't help but be reminded of the Nazi tactics in Germany in the 1930s when I read about Republican (un-republican) operatives promoting unruly and offensive behavior at town hall meetings. It would be alarmist to equate both parties in this issue at this time, but the Republicans could be putting feet on a slippery slope towards a breakdown in civil society that might lead to the current proto-fascism becoming the real thing. If our national economy expires then we could be on our way to that dismal fate.

As for the concern that Obama's "true intention" is to create a single payer system... how is that going to happen from offering a public option? Answer: only if private insurance companies offer inferior service than the federal goverment and the entire country LOVES the public plan.

Personally, my idea of reform is:

1. A public insurance option (and why have a new plan, just expand access to Medicare to anyone that wants it and make any necessary changes to Medicare).

2. Mandates for all insurance companies: a. Accept everyone (no pre-existing conditions) b. No yearly or lifetime caps c. Offer the same premiums to everyone - no group rates for big businesses and separate higher individual rates.

3. For employers still offering insurance, they should offer an insurance stipend. Then let their employees choose whatever insurance they want rather than being forced to use only certain plans chosen by the employer.

Some people talk about HSA's. Sure, keep them around for those who want them but don't force it on people. I certainly don't want anything to do with an HSA.

Capitol Staffer says:

We must move toward a system that puts HSA's on equal footing with insurance. They force people to look at costs of care and to take some responsibility for their own health. Over the top of an HSA you can lay a high-deducible, catastrophic policy to cover major accidents or diseases. We will not fix healthcare while people are disconnected from the cost of the services they are using.

So you want to force people to ration their own care? Well gee, as long as the government isn't doing the rationing...

To conservatives

You justify your actions by saying 'the liberals did it.' For years you have been telling us, at every opportunity, how morally superior you are to libruls. I personally wouldn't mind seeing you display that superiority right about now and lead by example.

@Jamie

Fantastic list and I agree with all of your points.(For what its worth)

Capitol Staffer - HSAs are not the answer. I have a private purchase HSA account health insurance plan. I am self-employed.

I constantly ask doctors before I go to the office as to how much the bill will be. For everything from a simple ear cleaning to an endoscopy.

The only place that has given me an answer other than "we won't know until the doctor sees you" was OHSU - which quoted between $1,500 and $2,500 for an endoscopy, which is a big range.

I cannot price-shop because I cannot get a straight price from a doctor. Therefore, using the HSA to force market competition is not working. Doctors want to keep prices opaque because they can charge more. In a market, like commodities, in which there is much price transparency, profit margins are razor thin.

Re: Jamie's list...

4. Encourage health savings plans. (Why do we expect health insurance to cover routine things? It is as if car insurance should cover gas.)

Wrong analogy. Gas would be equivalent to food. Routine health care checkups would be equivalent to oil changes, tuneups, etc.

The problem is, if you let your car go without regular maintenence the worst that will happen is it might crap out on you when you could have gotten another 5-10 years out of it. Go without regular medical checkups and you could end up with finding cancer at a stage where it's too late to treat it.

Are you really equating human life with a replaceable object?

I thnk that the reference is more likely to the unfortunate fact that we take better care of our cars and trucks than our bodies.

We don't expect our auto insurance to pick up the tab for oil changes and brake line repair, why should we expect medical insurance to pick up every little basic procedure as well?

Jamie's list works for me, too.

I would add that barriers do need to be in place to prevent freeloaders from gaming the system.

Your friendly, mob-avoiding, financially responsible, and conservative NAV.

I also support many aspects of Senator Wyden's plan. He has spent several years investigating, educating, and developing a workable alternative.

Kurt:

I thnk that the reference is more likely to the unfortunate fact that we take better care of our cars and trucks than our bodies. We don't expect our auto insurance to pick up the tab for oil changes and brake line repair, why should we expect medical insurance to pick up every little basic procedure as well?

You seem to contradict yourself here. If it's an "unfortunate" fact that we take better care of our vehicles, wouldn't we want to correct that?

I don't buy the health insurance/car insurance comparison. Medical checkups cost a hell of a lot more than a $25 oil change. And it's not something you can teach yourself to do in your driveway if you don't have the money to go to a professional.

Not to mention the fact that we need to encourage preventive care. The way to do that is for insurance to cover those checkups - not make it a financial burden.

Toles has a cartoon in the Washington Post,

"I'm not sure this protest is entirely spontaneous".

Of course the question is this--are the teabaggers just trying to "defeat" Obama, or do they have their own proposals on how to pay for prevention, cost cutting, whether there is a better model for primary care than fee for service, what are the best ways to deal with obesity, etc?

I'm guessing the former.

I'd love to see one of the shouters at these town hall meetings debate the fine points of the Wyden plan--if they even know it exists.

Ah, the conservative trolls with their mock outrage over “Obama” care, you have such short term memories (or ADD, I don’t know which).

Let me remind you of the Republican Healthcare Plan we have been operating under for the last 8 years:

1. 50 Million Uninsured in America

(You forgot to add another 4.3 million since the Bush recession. And to answer your question, 78% are legal American citizens per the Kaiser Family Foundation)

1. Another 25 Million Underinsured

(Per the Commonweath Foundation, as of 2007, there were an estimated 25 million underinsured adults in the United States, up 60 percent from 2003. All in all, 75 million Americans - 42% of the people in the United States under age 65- have insufficient insurance or simply none at all.)

1. Employer-Based Coverage Plummets Below 60%

(A 2007 report from the Economic Policy Institute showed a dramatic decline in employer-provided health care. That drop-off from 64.2% of Americans covered through workplace insurance in 2000 to just 59.7% in 2006 alone added 2.3 million more people to those without coverage. Census data since showed workplace coverage dipped further in 2007, down to an alarming 59.3%. A recent Thomson Reuters survey put the figure for 2009 at a stunning 54.6%.)

1. Employer Health Costs to Jump an average of 9% year after year.

2. One in Five Americans Forced to Postpone Care

(The Thomson Reuters survey released in April found that 1 in 5 Americans "have delayed or postponed medical care, mostly doctor visits, and many said cost was the main reason," a staggering jump from 15.9% in 2006.)

1. 62% of U.S. Bankruptcies Involve Medical Bills

(More than 75 percent of these bankrupt families had health insurance but still were overwhelmed by their medical debts, the team at Harvard Law School, Harvard Medical School and Ohio University reported in the American Journal of Medicine.)

I guess what I'm saying is I really don't give a flying monkey's butt what a single conservative has to say on this matter. You are the problem and from the looks of all these faux outrage teabagger group hugs, you still are.

Jim, on the off chance that you aren't being deliberately obtuse - I also mentioned brake jobs as an example of minor maintence that runs about the same cost as a visit to the primary care physician ($90 - $135). Certainly these are costs that can be borne by most people. Heck, just cut our one foo-foo coffee a day, 4 six packs of micro brews a month, put off the flat screen TV, newest cell phone, etc and basic health services could be paid for out of pocket.

Now, if we were to combine that with a true understanding of the payment schemes health care providers will actually accept (read your Regence EOB) and understand that roughly 15% to 45% of each procedure cost is NEGOTIABLE, there could be some real savings to the consumer of health services. Allow these costs to be tax advantaged (like a FSA, HRA or HSA) and there are even more savings.

The auto maintenance is even more apripo in that we actually tend to shop for good maintenance deals for our vehicles and track success of procedures. Now that would be a good thing again for health care.

Kurt,

Is that really your idea of a good system? Where:

• Only "most" (but not all) people can afford preventive care
• People who are good at negotiating and/or with inside knowledge of the medical industry get cheaper care while the rest of us suckers are stuck paying full price
• We have to wait until April 15th to recoup some of the medical costs from the previous year
• We're forced to choose between good beer and taking our kid to the doctor (sorry Jim Jr.)

Jim, some great questions. I am not saying that my points wer ecornerstones of a 'good' system. It is just beyond me, however that many feel that they can take little care of themselves and then expect a third party (insurance, medicare, charity care, etc) to cover their costs. That is where the auto insurance analogy comes from and is probably best put to rest.

Some of the rest of my points were more observations of the status quo.

I know and understand the US system very well, both as the father of a child with a chronic and expensive health condition since birt, and as my professional life of the last 3o years being in HR and Employee Relations.

The observations:

1. All people can afford 2-4 preventive visits each year to a health care provider. Some choose to spend their money on other things like micro brews (I LOVE them) flat screens, boats, etc.
2. Insider pricing is difficult at best to come by. As sUe Hagemier pointed out, most of us are unable and uncaring about major medical costs until after the fact. Actually, I challenge you to find ONE hospital in Oregon that will actually document the various negotiated provider rates of reimbursement. These are guarded more closely than the colonel's recipe. the only re-imbursement schedule documented is Medicare's and it is worfully low.
3. you do not have to wait until tax time to recoup out of pocket medical costs. Current plans for FSA' HRA and HSA's through employer based plans allow for pre-tax spending. Minor changes could make this available to ALL citizens.
4. Americans will need to face choices, for sure. Jim Jr need not be left in the cold, but a responsible parent would generally weigh their child's welfare against discretionary spending. Having written this I suggest you read yesterday's cover story in the Oregonian regarding uninsured children. they could have done a much better job picking a subject as the featured mom appears to have several choices before her that she refuses to consider, relying instead upon the rest of us. http://www.oregonlive.com/politics/index.ssf/2009/08/oregon_becomes_one_of_12_state.html

"We don't expect our auto insurance to pick up the tab for oil changes and brake line repair, why should we expect medical insurance to pick up every little basic procedure as well?"

I'm glad we can equate the rights of the automobile with the rights of humans. Who knew the great minds of the Englightenment were with founders of AAA?

Kurt, I appreciate your observations. I have Kaiser, so I'm unfamiliar with the confusing alphabet soup of private health care bureaucracy these days. I do know my father-in-law had a nightmare trying to use his HSA to cover his chemo/radiation treatments a few years ago.

I'm uneasy about the prospect of having to deal with multiple bureaucracies (FSA, HRA, HSA, etc) trying to pay for treatment - and I'm smart enough to figure it out if needed. Like it or not, a good percentage of Americans aren't. And is that really something you want to have to focus on when a major illness/injury strikes?

I think everyone is frustrated by irresponsible parents, but I for one am not willing to look a kid in the eye and tell them "tough luck, you should have been blessed with better parents". There's no fair solution to that. Either make the kids suffer for their parent's choices in life (or just rotten circumstances) or "reward" their bad behavior by helping their kids out.

An observation of my own... Why isn't there a lot of talk about how we're a "Christian Nation" when it comes to the health care debate? WWJD?

Sue, I'm trying to add reasonable voice to the topic. I fail to see the need for calling BS. Basically, there is no reason everyone can not afford 2-4 preventive visits annually. Thet could be to a regular doctor, a clinic or a health center. Perhaps some may have to re-think their cell phones, foo-foo coffees and plasma TV's.

Similarly I guess I did a poor job trying to support your statement regarding finding true costs of providing care. I agree that understanding health insurance legalese and forcing insurers to pay for treatment could be a second full time job and that isn't right. the fact that providers must negotiate the maze only adds to administrative burden and cost. Here in Medford there are a few doctors who publish their rates and point blank state they are lower than most because they REFUSE to deal with the insurance companies. Quite a concept.

Regarding published re-imbursement rates - you missed my point entirely. If we are to support a truly engaged retail approach to health care, then the true rates of reimbursement need to be known. Nobody gives a rip about what the insurance companies state they won't pay when searching for price. They want to know the real cost of services. Again, give me ONe hospital that will publish their rates here in Oregon. that would go a huge way to helping consumers/patients make informed decisions about their healthcare.

Sue, you misunderstand me. I am a strong advocate for reform. I do beleive that basic preventive visits can and should be paid by the individual. I believe that a socail safety net can and should be available for thos who need the care offered. I beleive that pre-existing conditions are unmitigated excuses and should not exist.

there are so many things wrong with out current system that need attention. I just highlight some here where some individuals elect to make other decisions with their resources. Certianly that does not detract from the real need for meaningful reform. And yes a wholesale restructuring of the current halth care via employer based health insurance is near the top of the list.

Thanks for wishing me good fortune, I don't see where my views indicate I've had much of it and actually pay over $1,300/month for family health and dental coverage.

" I do beleive that basic preventive visits can and should be paid by the individual."

Kurt, are you saying you know the contents of everyone's finances, the expense of preventative visits, and that everyone in this state/country can pay for necessities AND preventative visits?

How do you have all that information?

Or are you someone who "knows" based on surmise, not on actual fact?

@ Kurt Chapman

I fail to see how shortchanging prevention helps the health of our citizens or saves on cost. Few people can afford out of pocket expenses, so they avoid preventive care.

I have had Kaiser for 26 years and I have to say it is a progressive health care organization. They call you up to ask if you have had your colonoscopy or your mammography, remind you when it's due. I paid $10 for my colonoscopy, and three polyps were removed, potential sources of cancer. A colleague of my wife who had Blue Cross coverage chose not to do a recommended colonoscopy when she found out it would cost her $2000 all out of pocket because it is considered an elective procedure.Imagine what kind of cost is involved with treating life threatening colon cancer. Yet Kaiser, because it is non-profit, because it's not required to have corporate profits or pay out to stock holders, or pay to defeat health care reform, because it has doctors on salary, because it emphasizes prevention, is the cheapest most comprehensive health plan available to most workers in the Northwest.

I will have Kaiser now and when I go on Medicare four years from now. I wish everyone in America had access to the type of care I have with Kaiser. I should add I have ongoing access to my doctor through secure e-mail, access to my medical records, lab reports, medications, vital sign data all through my secure login.My health care record is available to any practitioner in the Kaiser system. I get my lab reports back with explanation within 24 hours. I get my medications for minimal co-pay and Kaiser purchases them at minimal cost because of their bargaining power. I should also add that over the counter meds are available at massively discounted prices. When I turn 65 Kaiser will pay for a health club membership for me to encourage fitness and good health habits.

My family also has Kaiser, and have had it for almost 34 years (less a 2yr experience with another plan that was NOT an HMO).

I'll echo Bill R's experience and recommend Kaiser highly, though I have met many people who do not care for Kaiser at all.

In our many years at Kaiser, we've had several out-of-Kaiser experiences; we needed procedures that Kaiser could not handle, so they sent us to a pre-authorized out-of-plan facility. They took care of all the billing and payments. The only out-of-pocket was the nominal co-pay.

My wife is a 5-year survivor of breast cancer. It was caught quite early, and my wife's situation was reviewed by a board with a lot of help from her doctor to take care of the situation very early.

We rarely need to go to the doctor, but it is available to us when we need it.

Many years ago we had to go to the Emergency room; rather than schlepping to Bess Kaiser on Interstate, we went to the closest hospital - St. Vincent's. Kaiser took care of all the expenses, less a nominal co-pay. This year my son used the fracture clinic. We could not be happier with the treatment and the outcome.

I do wish everyone could have access to Kaiser. It works fine for us. The co-pay and prescription fees are nominal.

A few years ago, I talked my self-employed friend to try Kaiser, but he had his doubts becuase of the stories he had heard as well. He also has several close friends who are doctors there. Well, he switched, and has never looked back. He too agrees that Kaiser is the best thing he has experienced in the Portland area.

Many people also complain about Kaiser. So I guess it is not for everyone.

In my view if there was a way to offer HMO healthcare like Kaiser offers, we all could be better off.

Is Kaiser more expensive than other options? Not from what I have seen. And we do see the options every year at renewal time. We are very fortunate to have Kaiser in the Portland metro area.

In the end,it still costs. And somehow the country will have to figure out how to pay for health care if they hope to offer a plan to everyone regardless of their ability to pay.

"Many people also complain about Kaiser. So I guess it is not for everyone."

My wife and I would switch to Kaiser in a heartbeat if they were available in Central Oregon. We had Kaiser in California where there were problems, but from what I gathered the problems were mostly at crowded facilities in congested areas with predominantly low income and less well-educated clients who probably contributed to the problems.

If Congress wanted to give the American people a sensible and sustainable health care program they would take the best of Kaiser and Medicare and build on that. But that would be the opposite of what their campaign donors would want.

"My dear conservatives, either tell us that there's not a problem, or propose an alternative solution."

Fine let's start by what we are going to have to do regardless, figure some way to control medical care costs. I'd love to see govt agency come up with a way to do that. We argue about how to pay for this, but Medicare is a huge money sink now.

Also, it'd be nice iif Mr Obama was a little open to different suggestions so far its been that any other way than his is just pure greed and that we need to pass his way now (before any congressman even understands teh issue.)

I am surprised that no one has brought up the fact that the doctors themselves are part of the problem.

If all 50 states allowed nurse practitioners, physician assistants and other alternative health care providers to diagnose, prescribe and get similar reimbursement for their services, then I guarantee you that health care costs would drop dramatically.

But no, it cannot be because the one thing that doctors do best is protect their "professional sovereignty" as highlighted by the AMA going against any significant structural change dating back to the days where they hired Ronald Reagan for radio ads against Truman's proposed single payer scheme.

In my opinion, doctors as they are represented by the AMA and other various professional organizations, which serve no greater purpose to protect the status quo system are as culpable for the costs and the crisis as the health insurance and all the various government red tape concerning health care.

@ Jim H. "An observation of my own... Why isn't there a lot of talk about how we're a "Christian Nation" when it comes to the health care debate? WWJD?"

<hr/>

I've called out my own pastor on this. The defensive answer is, "Oh, we're all in favor of universal health care. Look at our denomination's website." But you don't see any local clergy coalitions speaking out, or giving sermons on health care access. They were all willing to speak out when it came to Bill Clinton's BJ. Oh, the horror! But forget it when it comes to families getting medical coverage. And truth is, churches have a vested interest in change. Health care costs for their clergy and staff and retirees are driving them into bankruptcy. Churches would really benefit from good universal affordable health care, and so would their parishioners.

WaPo Columnist calls out GOP on their Cynical Lies on Health Care:

Republicans Propagating Falsehoods in Attacks on Health-Care Reform By Steven Pearlstein Friday, August 7, 2009

"The recent attacks by Republican leaders and their ideological fellow-travelers on the effort to reform the health-care system have been so misleading, so disingenuous, that they could only spring from a cynical effort to gain partisan political advantage. By poisoning the political well, they've given up any pretense of being the loyal opposition. They've become political terrorists, willing to say or do anything to prevent the country from reaching a consensus on one of its most serious domestic problems. " http://www.washingtonpost.com/wp-dyn/content/article/2009/08/06/AR2009080603854_pf.html

The validity of the auto insurance analogy is that YOU are going to pay for the routine things anyway, so why pass the money through the insurance companies?

(Although I do suspect that some here think that the tooth fairy will pay for their expense and that is one of the scary things about this debate - they think someone else is going to pay for their health care. That ain't gonna happen.)

One easy to implement reform is to require posting of medical providers rates and discount schedules.

Why not do a series of small reforms, instead of a grand, dangerous, rework?

Conservative/republicans/Teabaggers whatevers, are political terrorists. They have no defensible point of view; so they just throw a public tantrum like a two-year-old in the grocery store.

What a pathetic joke.

My God, republicans are dumb.

What I am looking for in this reform is a clear unambiguous practical policy statement (like Social Security, only stronger) that basic health care is a human right, and that it cannot be taken away or denied on account of lack of money.

jamie:

so why pass the money through the insurance companies?

you make a very good case for doing away with insurance companies completely. I totally agree.

Kurt Chapman -

This comparison is apples to oranges.

The car insurer pays if I crash my car or if a tree falls on it (or other accident). Not getting my car serviced, might slightly increase my chances of an accident (like my brakes fail). More likely, not servicing my car causes it to stop running, which doesn't increase the insurance company's risk at all.

If I have a boil on my leg and I say "well, the insurance company won't pay to get it checked out and I don't have the money to get it checked out" and the boil gets infected and turns into gangrene, the health insurance company is going to have a huge bill when it's time to get my leg amputated. That means that the rest of us will pay higher insurance rates. By paying for the little things up front, the insurance company is able to avoid larger payouts in the future, which reduces the cost of health care for all of us.

That's the reason why medical insurance should pick up the cost of little basic procedures and preventative care.

Don't over reach my statement. Insurance is necessary for big risks.

but are insurance companies necessary? Wouldn't it all be more efficient if everyone in the country was paying into a single non-profit pool?

So what do you consider routine things that should be paid for out of pocket? Just check-ups? Immunizations? Mammograms? Flu shots? X-Rays? Blood and other lab tests? Pre-natal exams? Ultrasounds?

Kurt seemed to only be referring to check-ups. Where do you draw the line?

Mr. Chisholm, you wrote:

"I just wish the Republicans would have the courage of their convictions to actually debate this policy straight up, head-to-head, on the merits."

Sometimes, you get what you ask for. If you tease a dog, you should not wonder in dismay why the dog bit you.

First it was the stimulus plan.Almost all members of congress openly admitted to not reading the bill, and yet it was passes with lightening speed. Where was the debate here? There was none because the tag team of Pelosi,Harry,and Obama stiffled debate. Remember?

Then there was cap and tax (trade). Remember that? The other bill that was stuck on people's desk at 3 AM and then, without reading it, and without....uh hum, debate was passied with lightening speed.

Now "Health Care reform". In spite of a clear majority of the people in this country being satisfied with their health insurance, the same tag team wants us to have health care reform. The system has its problems, but again...yes again, congress has not signaled that it is interested in debate. What world are you living in? Wasn't this the same health care reform bill that Obama and Pelosi were determined to pass before the August break and if it was not for these same angry mobs inundating their congressman, would have passed just like the previous two pieces of legislation that passsed almost overnight .....without debate.

Here this my friend. I voted for Obama. I am an independent in the strictest sense. I am sorry I voted for him. His base may firmly still be in his camp, but the undecided voters are slipping away fast. Just watch the poll numbers. Have you ever seen a president that was riding so hight just 6 months ago, almost at the popularity level Bush had when he ran for reelection and barely won? Or to put it another way, Obama's numbers are worse at this point in time than Carter's numbers were at this point in his administration. And ....we all know what happened to Carter...right?

Keep it up guys. Don't watch the polls. Keep thinking that the mere 53% of Obama's popular vote was a mandate to initiate what ever he wants, when he wants, how he wants, at lightening speed, and of cours.....without debate is going to get him reelected.

@ Steve

I'm sorry you drank the wack-jobs koolaide. But Democrats elected a president by an 8% margin and strong majorities in the House and Senate. What will sink the Democrats is failure to pass the number one issue of the 2008 election, access to health care for all. Obama is ahead of Repub Congress leaders by 20-30% in trust on health care issues. And you and your GOP crowd seem intent on defending the right of corporate insurers to steal us all blind so they can have their big bonuses and give big dividends to their stock holders. So go ahead, defend the corporate CEOs and their right to pick our pocket. It is a losing issue. The Dem. Congress is far from perfect, but they know they have to deliver or they will be gone for sure. So the likes of you are not going to intimidate them into not acting and giving up power to the GOP.

Latest GOP polling from Research 2000 Congressional GOP- 10% favorable 74% unfavorable GOP Party- 19% favorable 72% unfavorable

Your heroes!!!

The House Bill, which was put forth by all three Committees of jurisdiction, dubbed the House Tri-Committee -- Energy and Commerce, Ways and Means and Education and Labor -- (and this is very atypical) released as a single bill based on collaboration of each three Committee's majority staffs. During markup, the only Committee that allowed amendments was Energy and Commerce, and W&M and E&L simply passed the bills in a single day's work with no amendments.

While I greatly appreciate this effort to streamline the process, because I ABSOLUTELY support health reform...the original bill (HR 3200) left out MANY long-standing Medicare and health care workforce problems, and rather focused mostly on the politically relevant coverage section, which included the public option. In order to get this passed, Chairman Rangel of the Ways and Means Committee, which has Medicare jurisdiction, did not accept a single amendment during the markup, thereby throwing away any chance of addressing huge Medicare problems and gaps.

It pains me so, so much to see such a MONUMENTAL chance being squandered by both sides of the aisle for what has really come down to politics.

The current legislation, namely the House bill, is, simply put, HORRIBLE and will not amount to true "reform." Democrats were worried about the imminently huge opposition ad campaigns during the August recess, so they pushed a crappy bill in order to get it passed in time. At the same time though, Republicans and interests opposing the bill were indirectly at fault for planning the ad campaigns in the first place.

So basically, the Ds felt like they didn't have time to pass it because of imminent threats from the right. So if both sides agreed to sit down and disregard all the bs, as the Senate Finance Committee is and has been doing, we would be much closer to what we could all hail as true and meaningful reform.

Back on track with the original post though...the extreme movements like those of the birthers/insane douchebag crazies, does not represent the majority of Republicans, just as the extreme left wackos (such as ELF) do not represent the majority of Democrats. I know the numbers are probably disproportionate and off-topic of health reform with the two groups mentioned above, but my point is that most people, right or left, really do want some type of reform, and without realizing that we cannot have a true all-inclusive health reform effort.

@ DC

I wish you were right about the "vast majority" of Republicans who don't support the tea-baggers, birthers, deathers, and other nut-jobs. Except that polling from Research 2000 says a majority of Rs believe the birthers, that our president was really born in Kenya and is some kind of planted Manchurian candidate.

In a state that once had a progressive Republican party and the best governor in our state history, Tom McCall, it's a sad commentary on what has become of the GOP.

I love how Capitol Staffer uses a cheap pun by a commenter "Republiconvicts" to justify violence, mob anarchy, hanging in effigy, death threats and lynching. Great job with the moral equivalency. Oh, let's not forget Boss Limbaugh calling Democrats Nazis.

But some unknown commenter saying Republiconvict balances that all out.

How can anyone take these people seriously? They don't believe in democracy. They don't believe government. They don't believe in freedom of speech for anyone but themselves. They are disloyal if their people are not in power. They wink and nod at racism and go along with mob violence. They are not a party, they are a racketeering mob.

I'll speak to the facts from a conservative point of view(not a republican point of view).

There was a time, when I was a boy, when health insurance was defined as major medical. My parents had a hospital policy which they paid for themselves. We paid out of pocket all routine doctor visits. We had health care, it wasn't free, and there was some sacrifice. We couldn't have a new car, fancy vacations and $250/day trips to experience wine country. We managed and we were not, and are still not, wealthy.

As a conservative, I'm also compassionate. I'd like to suggest the following:

1) Let families/individuals apply for gov't provided premium vouchers. The individual can then use they voucher to purchase insurance. The policies would come with a higher deductible. If the income per capita in the household is below the povery line, they receive a tax credit/rebate for actual dollars spend in excess of some nominal amount (say $250).

2) Do not implement a "public option". This will only encourage employers to drop their employer provided coverage to earn additional profits.

3) Do not force coverage of items such as abortion. This is devisive. Let insurers that wish to offer this, offer it. This creates choice in the market.

4) Provide tax incentives for purchasing high deductible plans. Isn't the arguement in favor of national health care the fact that some huge medical outlays (heart surgery) can bankrupt a family? If you have a tax incentive to buy major medical with a $2,000 deductible and a big limit ($2,000,000) you eliminate this financial risk.

5) Create a voucher scholarship program. If you are wealthy and want to help someone out, you would donate money to a gov't pool that issues vouchers to low income un-insureds. The gift to the pool would qualify as a tax credit.

There are some suggestions (answers) Kari. You may disagree with them, but I think moderates and conservatives would get on board with this and you'd acheive the goal of insuring most of the currently uninsured without much of the backlash and national debt/higher taxes.

I'll speak to the facts from a conservative point of view(not a republican point of view).

When I was a boy health insurance was defined as major medical. My parents had a hospital policy which they paid for themselves. We paid out of pocket all routine doctor visits. We had health care, it wasn't free, and there was some sacrifice. We couldn't have a new car, fancy vacations and $250/day trips to experience "wine country".

We managed and we were not, and are still not, wealthy.

As a conservative, I'd like to suggest the following:

1) Let families/individuals apply for gov't provided premium vouchers. The individual can then use the voucher to purchase insurance. The policies would come with a higher deductible. If the income per capita in the household is below the povery line, they receive a tax credit/rebate for actual dollars spend in excess of some nominal amount (say $250).

2) Do not implement a "public option". This will only encourage employers to drop their employer provided coverage to earn additional profits.

3) Do not force coverage of items such as abortion. This is devisive. Let insurers that wish to offer this, offer it. This creates choice in the market.

4) Provide tax incentives for purchasing high deductible plans. Isn't the arguement in favor of national health care the fact that some huge medical outlays (heart surgery) can bankrupt a family? If you have a tax incentive to buy major medical with a $2,000 deductible and a big limit ($2,000,000) you eliminate this financial risk.

5) Create a voucher scholarship program. If you are wealthy and want to help someone out, you would donate money to a gov't pool that issues vouchers to low income un-insureds. The gift to the pool would qualify as a tax credit to some degree.

These are some suggestions (answers) Kari. You may disagree with them, but I think moderates and conservatives would get on board with this and you'd acheive the goal of insuring most of the currently uninsured without much of the backlash and national debt/higher taxes.

I'll speak to the facts from a conservative point of view(not a republican point of view).

When I was a boy health insurance was defined as major medical. My parents had a hospital policy which they paid for themselves. We paid out of pocket all routine doctor visits. We had health care, it wasn't free, and there was some sacrifice. We couldn't have a new car, fancy vacations and $250/day trips to experience "wine country".

We managed and we were not, and are still not, wealthy.

As a conservative, I'd like to suggest the following:

1) Let families/individuals apply for gov't provided premium vouchers. The individual can then use the voucher to purchase insurance. The policies would come with a higher deductible. If the income per capita in the household is below the povery line, they receive a tax credit/rebate for actual dollars spend in excess of some nominal amount (say $250).

2) Do not implement a "public option". This will only encourage employers to drop their employer provided coverage to earn additional profits.

3) Do not force coverage of items such as abortion. This is devisive. Let insurers that wish to offer this, offer it. This creates choice in the market.

4) Provide tax incentives for purchasing high deductible plans. Isn't the arguement in favor of national health care the fact that some huge medical outlays (heart surgery) can bankrupt a family? If you have a tax incentive to buy major medical with a $2,000 deductible and a big limit ($2,000,000) you eliminate this financial risk.

5) Create a voucher scholarship program. If you are wealthy and want to help someone out, you would donate money to a gov't pool that issues vouchers to low income un-insureds. The gift to the pool would qualify as a tax credit to some degree.

These are some suggestions (answers) Kari. You may disagree with them, but I think moderates and conservatives would get on board with this and you'd acheive the goal of insuring most of the currently uninsured without much of the backlash and national debt/higher taxes.

When will conservatives realize that the market does not work with health care because demand is inelastic. I cannot schedule my appendicitis for the January appendectomy sale or my pneumonia for the July off-season. I do not get to choose all of my providers. I cannot tell my doctor to send my blood test to Acme testing, my xrays to Xenith and my urinalysis to We <3 Urine. I cannot say I want Mr. Sleep to be my anesthesiologist and Ms. Payne to be my nurse.

There's a limit to shopping around for savings. When the cost is all up front and deeply felt, people put off treatment - which in many market situations may lead to savings but in the health care system may lead to catastrophically higher costs.

We need to stop thinking of health care as a commodity and think of it as a utility and free ourselves from the blind devotion to a market that has no connection to reality.

Sorry about the triple posts.

When a televised recent discussion of health care quotes from the Helen Hunt movie (As Good As It Gets) and audience reaction when HMOs were slammed---all these years later, it should be clear that maybe it is time to somehow regulate private insurance companies deciding what treatments are covered.

OK, let's not have a public option BUT 1) End "fee for service" and use a model like Cleveland Clinic or whatever where the health of the patient rather than just making money is what matters. 2) If "it depends on whose insurance you have" determines the cost of a medical procedure, change that or else subsidize everyone below a certain level of income so that they can purchase some sort of health care coverage. 3) Some politician was saying "in my state, the major health insurer is nonprofit". Let's have a regulation that every for-profit health insurance company provide an amount of low/no cost health insurance for needy people in the amount paid in executive salaries over a base amount not to exceed $90,000. 4) Denial/cancellation for getting sick or "pre-existing condition is outlawed.

Openly debate the points made by these 2 doctors who were practicing doctors before entering politics, one from each party. http://www.charlierose.com/view/interview/10524

Any of the anti-public option folks want to take that challenge?

Or is this all about a) "defeating Obama" is more important than health care for all Americans b) "status quo is fine, why is anyone complaining?".

Apparently the tea-baggers are asking their supporters to bring guns to town halls and "badly injury" anyone who opposes their point of view or their disruptive tactics.

http://tpmdc.talkingpointsmemo.com/2009/08/anti-health-care-reform-protester-encourages-physical-violence-use-of-firearms.php

The business columnist for the Washington Post, Steven Pearlstein, normally moderate to conservative guy says the GOP has crossed the line, they are now political terrorists and have abdicated a seat at the table.

http://www.washingtonpost.com/wp-dyn/content/article/2009/08/06/AR2009080603854.html?sub=AR

Bill R:

Quick perusal of the Research 2000 website shows no polls to support your claim of majority of Rs being birthers.

Care to provide a link?

Apologies in advance if I somehow missed it.

From their website, they don't really seem to be a serious polling source.

Like I said in another thread, with easy access to the internet, you can usually provide a poll to support whatever point of view you might have. In this particular case Research 2000 doesn't do it.

Nice name though, but they might consider calling themselves Research 2009 or something else more timely.

Jim H | Aug 6, 2009 11:00:37 PM but are insurance companies necessary? Wouldn't it all be more efficient if everyone in the country was paying into a single non-profit pool? JK: NO! Profit is what drives increased efficience in a competitive environment. Do it better and attract more customers and you make more profit. Do it cheaper and attract more customers and make more profit.

When government does it, the motive becomes dictated by who attends meetings, campaign donations, public outcry, newspaper and media attention — just about everything EXCEPT the needs of the customers who are actually willing to pay for their choices. That is why our society works and the communist doesn’t. Our stores were full, theirs empty. We have good stuff they had junk.

Jim H: So what do you consider routine things that should be paid for out of pocket? Just check-ups? Immunizations? Mammograms? Flu shots? X-Rays? Blood and other lab tests? Pre-natal exams? Ultrasounds?

Kurt seemed to only be referring to check-ups. Where do you draw the line? JK: You are going to end up paying for any routine expense anyway, so why pass it through the insurance company (hence the auto insurance analogy)?

The exception seems to be that many people, naively think someone else will be paying for their care.

Thanks JK

"Please make a good case for providing free food to every American, since some cannot afford food."

That case has been made, food stamps, WIC, and a variety of federal programs to distribute surplus foods are the result. These programs all seem to work pretty well, BTW. The US has a very efficient market system for providing nutritious food at an affordable cost to the vast majority of people, those that can't afford food have a safety net. Our present health insurance system is failing to provide affordable health care to a growing number of citizens and undercutting our ability to compete in the world economy. Comparing the insurance industry with the food industry does the insurance industry no favors...

"We don't expect our auto insurance to pick up the tab for oil changes and brake line repair, why should we expect medical insurance to pick up every little basic procedure as well?"

Because health insurance functions more like an extended warranty on a new car than it functions like collision/theft/comprehensive insurance. If you fail to do routine maintenance on your car, you void the warranty, because the warranty provider knows that more expensive repairs will follow. Delinking checkups and other non-catastrophic care from catastrophic care makes no sense from a medical stand point.

" I do beleive that basic preventive visits can and should be paid by the individual."

Of course, this is rationing under a different name. Who determines what is or is not a "basic preventive" visit? A board of doctors? A board of insurance bureaucrats? A board of libertarians? If a "routine" visit turns up nothing you pay out of pocket, but if it turns up a brain tumor (which is basically what happened to my wife) it rolls over into catastrophic care?

Let's say I can afford to pay for two to four "routine" doctor visits per year. Let's say that I have three kids (which I did). That's sixteen "routine" visits per year, or eight per parent in terms of cost (assuming both parents work for wages). That's twice as many as you're hypothesizing I can afford. I will cut back on "routine" visits based on what I can afford, and wait until one of us becomes sick enough to trigger an insured visit the rest of the time, much like the uninsured do now when they use emergency room services as primary care.

"The exception seems to be that many people, naively think someone else will be paying for their care."

Insurance is by it's nature redistributive. Any time the cost of your medical care exceeds the amount you've paid in premiums, you are benefiting from the "socialist" scheme of private insurance. That is, unless you have some sort of insurance that places a ceiling on your care based on how much money you've paid in premiums.

I agree we public option and single payer supporters should be there in force. In addition to vastly outnumbering the Tea Blobs and Tea Bags at the events, as we do in real life, we should also be a respectful contrast to their rude behavior.

This is something Spiro Agnew et al figured out a long time ago. There is a silent minority that fluctuates around 20% and tends to be moderate and independent. This group tends to vote related to how a candidate or campaign makes them feel rather than any fine points of policy. When a campaign is linked to rude and aggressive behaviors it tends to lose these voters.

As fellow McGovern campaigner Bill Clinton noted to our staff at the time, the linkage of the Democrats to the 1968 Chicago police riots doomed us in 1972, even as the vital center agreed with us on nearly all the issues.

So now this is the perfect time to let the woefully misinformed hate radio mob show it's ass in vivid contrast to the much larger and dignified health care reform audience.

Still I hope Congressman Wu, PDA and the other advocates of at least a public option will politely and repeatedly counter the industry's and their Republican toadies lies about elderly euthanasia, lack of choice and regarding the overall advantages of a public funded competitor to our economy and pocket books of reining in the greed players in our health care gambling racket called private insurance.

Yeah, I'll be there singing louder than the angry shouts.

Republicans and Illiberals on this blog

Go back and read John Calhoun's post.

This is the reality.

The insurance industry has presided over the largest mass human extermination since Buchenwald or maybe Pol Pot while pedaling lies about Medicare (and now Medicare for all) which has saved millions of lives that would have slipped through the insurance companies truck-wide cracks in coverage and greed based dubious denials of coverage.

If you have a conscience and lack insurance company stocks you have no reason to oppose Obama or Connors on this. Quit being suckers to the same old lies.