The right has cleverly turned a debate about FINANCING for medical care into a paranoia about losing access to health care.

There's a better way:

Denmark: A Modern Beacon Excerpted from Thom Hartmann's "Threshold: The Crisis of Western Culture" Our best hope, both of a tolerable political harmony and of an inner peace, rests upon our ability to observe the limits of human freedom even while we responsibly exploit its creative possibilities-Reinhold Niebuhr, The Structure of Nations and Empires (1959) If it's happening in Danish politics (or, for that matter, Scandinavian or European politics), Peter Mogensen knows about it. An economist by training, he's the chief political editor of Denmark's second largest national newspaper, Politiken, and for four years (1997-2000) he was the right-hand man ("head of office" and "political advisor") to Denmark's then prime minister Poul Nyrup Rasmussen. A handsome man of young middle years, he also plays in a "Bruce Springsteen look-alike" rock band, and cuts a wide swath through Danish popular society. So it was particularly interesting to see this normally unflappable man with a slightly confused look on his face. We were in the studios of Danish Radio (their equivalent of BBC or NPR) in downtown Copenhagen, where I was broadcasting the week of June 23-27, 2008, and I'd just asked Mogensen how many Danes experience financial distress, lose their homes, or even declare bankruptcy because of a major illness in the family. "Why, of course ..." he blinked a few times, "none." I explained how every year in the United States millions of families lose their jobs and their homes, and must sell off their most precious possessions to satisfy the demands of creditors, because they can't afford to pay the co-pays, deductibles, and expenses associated with developing cancer, heart disease, auto accident injuries, or other serious illnesses. "Over half of all the bankruptcies in America are because people can't afford these expenses, and their insurance companies don't cover all their expenses or they don't have health insurance." Mogensen shook his head sadly. "Here in Denmark, we could not imagine living like that," he said. I asked him what the average Dane pays in taxes, and he noted that the average, middle-class taxpayer pays about 45 to 53 percent taxes, the most wealthy a bit over 60 percent, and the poorest (incomes under $31,000) around 30 percent. In exchange for this, though, Danes don't have the worries that wake so many Americans up in the middle of the night. If you lose your job, there is generous unemployment compensation while you're looking for another. All aspects of health care are free, and if you need a treatment that isn't available in the country, the government will even pay to fly you to another country where specialized health care is available, as well as covering all the costs of that health care. Education is free, from early childhood education (preschool) through public school, all the way up to Ph.D. or M.D. In fact, if you qualify to get into college or university (it's based entirely on performance/grades in high school, not on income or social class), the government even pays students a monthly stipend to cover the cost of housing, food, and books; the same applies for trade schools. When Danes reach old age (the retirement age is sixty-seven, just recently raised from sixty-five because lifespan has substantially increased in the past few decades) they get a generous pension (Social Security) that allows them to live in comfort, all health care is free, and if they need to go into an extended- or assisted-care facility, or even a hospice, it's all free. Quite literally, from birth to death, while Danes have millions of choices to make with and about their lives, from partnership (gay marriages/partnerships have been legal here since 1989) to occupation to travel, they have few worries about the things that most nations in the world consider "quality of life" issues. Water is pure. Electricity is inexpensive (20 percent of Danish electricity is produced by windmills, with a goal of 50 percent within the next decade). Sickness and old age, while inconvenient, are not the threats to comfort or survival that they are in the United States. So how, exactly, did the Danes get it so right? And why does the principle that their society is based on-higher taxes equals greater overall quality of life-seem so scary to Americans?

What if you factor in costs per person - would that change the poll results if everyone realized:

• In 2008, health care spending in the United States reached $2.4 trillion, and was projected to reach $3.1 trillion in 2012.1 Health care spending is projected to reach $4.3 trillion by 2016.

• Health care spending is 4.3 times the amount spent on national defense (the U.S. outspends all other countries military budgets COMBINED!).

• In 2008, the United States will spend 17 percent of its gross domestic product (GDP) on health care. It is projected that the percentage will reach 20 percent by 2017.

• Although nearly 46 million Americans are uninsured, the United States spends more on health care than other industrialized nations, and those countries provide health insurance to all their citizens.

• Health care spending accounted for 10.9 percent of the GDP in Switzerland, 10.7 percent in Germany, 9.7 percent in Canada and 9.5 percent in France, according to the Organization for Economic Cooperation and Development.

In conclusion, between healthcare and defense spending, we are bleeding the middle class dry.

Jeff, this is a poll about how happy you are with your health care. The premise of the poll says nothing about the personal insecurity of losing or not having health care, or about the denials of care or exclusions from insurance companies. So I fail to see the utility in posting about this poll. I am happy as a clam about the health care I get, but I realize anyone and everyone can lose their access to health care so I want a changed system.

Infant Mortality Rates by country: http://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate

Life expectancy by country: http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

Medical Bills prompt more than 60% of US bankruptcies: http://www.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bills/

We may have superior technology, but it isn't available/affordable to enough people to make our stats better than, say 30th in the world. In my mind, we have a "pay or die" healthcare system. I currently have no insurance (started new job, no coverage for 3 months). [fill in your diety] help me should I get sick...

This is a more relevant poll, insecurity about losing health care, not satisfaction with your present health care. I believe incidentally, that there is an inverse relationship in the U.S. between those who use health care the most and satisfaction.

http://www.politico.com/blogs/bensmith/0709/Insecurity_not_satisfaction_with_heath_care_system.html

The Dems have lost the senior citizens. Considering the strong support originally offered by AARP for health care reform, losing the seniors appears to be one of the Dem's greatest failures in history.

Given the failure of single payer, perhaps we are all best off to just beef up Medicare a bit by raising reimbursement rates to primary care docs in places like Oregon and forget about the rest of this mess.

Eventually we will all either die or become eligible for Medicare. Either way our heath care problems will then be solved.

Most individuals with healthcare insurance do not really know what they have, or can speak to their satisfaction with the plan until AFTER they needed it or tried to use it. I want reform; the current model is broken beyond repair. Reform It does not have include mandatory single payor or a government option. Some points to be addressed:

1. No pre-existing condition denials
2. All employers provide a minimum acceptable plan or pay a payroll tax
3. All individuals contribute a set amount based upon ability and a sliding scale
4. Health Insurance is either tax deductible for all or for none
5. Do away with duplicate medical coverage currently mandated for auto/motorcycle/ATV coverage
6. Unemployed or those who can not afford healthcare insurance provisions modeled on OHP and Medicare
7. Insurance companies allowed to operate across state lines
8. Allow national level HSA's to pay for out of pocket medical expenses pre-tax
9. Tort Reform - Do away with frivolous class action lawsuits based on supposition; institute Loser Pays and heavy fines to providers and Pharma engaged in illegal and/or unethical practices
10. Limit Big Pharma lock on proprietary medicines
11. Limit advertising like is done with Alcohol/Tobacco
12. Medicare coverage becomes means tested for eligibility
13. Show proof of ability to legally be in the country to recieve coverage; OR show coverage from some other country
14. Eliminate individual rating, however allow higher deductible and co-pay for lifestyle choices (smoking, sedentary lifestyle, dangerous hobbies, drug use, alcoholism, not using seatbelts or helmets)
15. Medicare re-imbursement based on procedure and efficacy rather than geographic region
16. Medicare cheats banned from the system for life (both providers and individuals)
17. Prescription coverage included
18. Basic Preventive Dental included
19. Inpatient treatment for alcoholism/drug addiction included, but at a lifetime cap 20 Hospice included
20. Basic Mental Health included
21. Basic minimum coverage handled through ONE universal format
22. Additional buy-up provisions allowed, but not tax deductible
23. Organ transplants included if shown medically efficable. self caused organ replacement folks denied from basic plan (think Larry Hagman and David Crosby)
24. Paid for with: Medicare tax expansion, employer play or pay tax, additional federal tax on alcohol, tobacco and fuel, add federal tax on fast food, add significant federal tax on cosmetic plastic surgery and injections

@ Jeff

I don't understand your defeatist talk. We may not be entirely happy with the result but we will get a reform bill this fall. And it will be something to build on. Single payer was never on the table either during the election or since. Remember, Dennis Kucinich lost.

That said we do have a Dem majority who do want the base to turn out next election so they can keep their majority in Congress. So they will pass something that amounts to insurance reform, with elimination of exclusions, and recision. And it will have a competitive exchange, and co-ops, if not public option, with access and subsidies for the unemployed and low income. And once the seniors realize they aren't going to be euthanized by the Dems, they will come on board with the elimination of the donut gap for their drug plan.

Regarding the PEW poll. I still think it's meaningless and doesn't merit this post. It makes no distinction between health insurance and health care. And I'm betting that the global attitude toward health care is largely a reflection of how one's own health care delivery is experienced at the moment.

Lets get employers OUT OF HEALTHCARE and make health care expenses 100% deductible.

Can someone tell me how many legal American residents want, but cannot get medical insurance?

I ask because the opponents claim that the uninsured are as follows: 1/4 illegally in this country 1/4 can afford, but choose not to. 1/4 rich, self insured (I may have this wrong) 1/4 actual needy.

If those numbers are correct, that explains why the grandiose plan is a tough sell. Only 1/4 of those claimed 42 million actually exist - about 10 million or 3% of the population.

It is simply insane to re-order a major part of our society to serve 3%. It is better and cheaper to just help the needy!

Jeff alworth:

In the end, the anti-reform forces may carry the day.

Bob T:

Don't call me an anti-reformer, and don't call millions of others anti-reformers. Many of us simply don't want your kind of reform. I'm for busting up the way insurance companies are entrenched in the system (thanks to government), as well as the way the AMA has a lock on how many physicians exist in the country (thanks to government which wants the AMA-state partnership), and many other things that need serious reform. This can be done in bits and pieces instead of in a one-thousand page bill that idiot congress-critters won't read.

But that might be too easy, and many of these reforms will improve things so they wpon't want them (and that includes Repubs as well as Democrats).

Jeff, if you oppose any changes that the Cato Institute would recommend, would that make you an anti-reformer?

Bob Tiernan Portland

Jamie:

1. the number is closer to 50 million without healthcare when you factor in the recession.

2. of that 50 million, 18% to 21% are illegal immigrants.

A few weeks back we had a blogger on this site make a post promoting health care and simultaneously attacking Christian churches on the grounds that Christians somehow hate universal health care.

Here's a little push back on that: from Jim Wallis of Sojourners http://blog.sojo.net/2009/08/13/a-truth-telling-ministry-for-people-of-faith/

http://www.umc.org/site/apps/nlnet/content.aspx?c=lwL4KnN1LtH&b=5066539&content_id={80F15261-97BF-4210-9C1E-A3E631300EE2}&notoc=1 ¶ 162 V) Right to Health Care.”Health care is a basic human right....We believe it is a governmental responsibility to provide all citizens with health care.

From The Book of Discipline of The United Methodist Church - 2008.

http://archives.umc.org/interior.asp?ptid=4&mid=976 The health care system in the United States is in need of serious systemic change. We call for legislation that will provide universal access to quality health care with effective cost controls.

President Obama To Take Part In Faith Community Conference Call On Health-Care Reform http://faithforhealth.org/

"You’re invited! 5PM EDT Wednesday, August 19th, the faith community is hosting a national call in and audio webcast on health care reform and President Barack Obama has accepted the faith community’s invitation to join the call. Click here to RSVP and get information about listening in. COMMIT TO DO YOUR PART DURING 40 DAYS FOR HEALTH REFORM

Over the next 40 days, people of faith are leading a national campaign for health care reform. While members of Congress are in their home districts, we’ll be holding hundreds of prayer vigils and in-district events. We’ll sign petitions, write our representatives, organize a nationwide conference call for people of faith, and air a national TV ad –all to say the faith community supports health care reform."

I'm all for various forms of health care reform. For instance, why not eliminate all of the government mandates about what health insurance has to cover? Our own idiots in Salem keep adding new requirements every session that drive the cost of health insurance up. Then they have the gall to pretend to not understand why people can't afford insurance.

We could cap tort claims, expand HSAs, allow insurance to compete across state lines, etc. There are lots of reforms that would be easy to implement that would quickly drop the price of insurance. For some reason, the Dems aren't talking about these possible fixes. Instead they want a "reform" that returns big bucks to people who gave them campaign cash.

Scott in Damascus | Aug 13, 2009 3:26:06 PM Jamie: 1. the number is closer to 50 million without healthcare when you factor in the recession. 2. of that 50 million, 18% to 21% are illegal immigrants.

You didn't answer the real question: How many legal residents want and are unable to afford health insurance. That is the ONLY question that matters.

Three things are losing the Dems this effort.

First off, early in the process, Obama wouldn't put the trial lawyers' or unions' skins into the game. Despite the noise at other town halls, these issues have been groaners from the moment Obama let it get out out there.

Folks out there rightfully believe that the Dems have no interest in keeping illegal immigrants out of the proposed system. Not one compelling case has been made for their inclusion or how their inclusion will not be a powerful magnet excerbating the immigration problem.

Obama unfavorably compared the Postal Service with UPS and FedEx in the course of one of his town hall answers as a metaphor for government run health care. Apparently, he has never had a sales job other than his own self-promotion or he wouldn't have painted that particular portrait.

Jeff..if you want to know who is killing healthcare reform, just take a look in the mirror...or at your party's leadership. A lot of Republicans support healthcare reform, but none of us support socialized, government run medicine. There are certainly ways to improve/reform our healthcare system...but so long as those on the left insist on including a radical, unpopular, and unwise component (the public option) into the bill...any such legislation will not be tolerated by the American people. Healthcare reform can and will happen at some point, destruction of the system and elimination of private insurance will not..at least so long as there are at least a few of us Republicans left around to stand up for the American people.

I don't want the government telling me how much I can get in a lawsuit! These conservatives keep on trying to get into our lives!

@ jj Oh, the Repubs don't like the public option, but they like Medicare, which is single payer socialized health insurance. Ya gotta love it!

Here's why we don't have good health insurance coverage in this country:

Why don't we have good health insurance policy in this country? Here's why. My sister in law, Paula, is 57 years old and single. She has life threatening cancer, and a lousy insurance policy provided by employer that is leading her to medical bankruptcy as she faces tens of thousands of medical bills not covered by her insurance. Her insurer fights coverage every step of the way. At the same time she is coming to a point where she may be too sick to work so she will lose the lousy coverage she has, and won't have the money to cover COBRA. And when COBRA runs out she will have nothing, and her treatment may be denied at that point. (She is more than aware that a person wouldn't even get in the front door to see the doctor to get a diagnosis at all or to initiate treatment). So here she is, she has paid all her life to pay for medical care for others, but when she needs it for herself, it isn't there. When she most needs a safety net, it isn't there. And she knows full well that if she lives, she will never be insurable again for the rest of her life, at least until she reaches 65, because of prior condition. Between now and then she may lose her livelihood, her home,her treatment, and her life

Why won't we get a good health insurance policy? Because too many Americans, especially those on the right, think this won't happen to them. Republicans don't get cancer or become too sick and disabled to work. And they really, really trust corporate health insurers more than the govt. (except when they want their medicare or medicaid, or run for Congress). That's why we don't get good policy.

Health care in America can be very good, if you have the money to pay for it. Otherwise it's non existent. Our problem is not health care so much, it's health insurance coverage, or the lack of it.

Bob Tiernan:

"Jeff, if you oppose any changes that the Cato Institute would recommend, would that make you an anti-reformer?"

Remind me again, are you chair of the Cato Institute or the Oregon Republican Party?

The problem with these polls is this: For those who have full time jobs and get health care added in, then they're fine! They've got theirs, why should they care about anyone else? They get to get on a group plan and get their rates cut down, so they wouldn't care less.

However, for independent consultants, contractors, the self-employed, and small businesses, and heck, even big businesses, the cost of health care is a killer. It's oftentimes more than what you'd pay for housing in a lot of states. If auto insurance costs you less than one twentieth of what health insurance costs you, then something is very wrong. It's not like hospitals are filled up with people with tummyaches, here...people are going for extended periods of time with serious problems as a result of the fear of going bankrupt if they even get it checked out.

Our health care system is costing corporations so much that by outsourcing a job overseas, they instantly save 9-10 thousand dollars per employee. But if they cut benefits to employees here, their employee turnover rate shoots up and they can't be productive.

Anyway, any general poll is going to find a lot of selfish people who don't realize that health care is a mess because they have it already. That is, until they get laid off and join reality for a bit. It's a pretty stark wakeup call, when you wake up one day and think there's something really wrong with you, but your health coverage ran out and your unemployment insurance barely covers your monthly rent. A public option is really needed for all those people who don't get nice, employee based consistent insurance, all those people that you see come and go at your company as consultants. The guy you hired to fix up your deck. The guy running the burrito stand down the street. They're all taxpaying citizens whom, if they check into a hospital, will most likely be paying for it for several years.

And if that doesn't matter to you, then hey. Maybe that public insurance as competition will add incentive to the reduction in rates of private insurance companies, meaning that you'll get less taken out of your pocketbook. The private companies can definitely save some costs...why does Kaiser have to advertise on every channel and on the radio? How much goes into paying Cigna's board members and CEO in bonuses every year? That's money coming right out of the pot that you pay into, you know.

Ron Morgan | Aug 13, 2009 4:40:51 PM Bob Tiernan: Remind me again, are you chair of the Cato Institute or the Oregon Republican Party? J: He is neither.

Andy says:

"We could cap tort claims, ..."

Can anyone name a single state that capped jury awards for malpractice and saw the cost of healthcare decrease?

(hint: this is a trick question. The answer is NONE of the states that capped awards saw a decrease in their insurance premiums)

But hey, don't let me stop you red staters from screaming "tort reform is the answer."

"any general poll is going to find a lot of selfish people who don't realize that health care is a mess because they have it already. That is, until they get laid off and join reality for a bit."

They don't even have to get laid off -- all they have to do is develop a serious illness and then discover how inadequate their coverage is and how the insurance company jerks them around, trying to delay or, if possible, deny payment. Americans have to understand that it's NOT just the uninsured who have a problem -- the whole system is rotten.

This is why insurance companies are terrified of the public option -- it will ruin their racket, giving health care consumers an alternative that offers better coverage for comparable or lower premiums.

Tort reform is not THE answer, it is a very legitimate part of a comprehensive solution to spiraling costs. BTW, it's not just torts, it's class action suits against pharma too.

When Obama won't broach the topic because lots of trial lawyers contribute to the jackass party, it does two things, a) it sorely undercuts his moral authority on shared sacrifices for the "common good," and 2) it shows him to be a run of the mill hack rather than a visionary leader.

If only Nixon (a Cold War hawk) could go to China, it's going to take a liberal willing to piss off his own constituencies to get real health insurance reform in this country. When Obama left his union and trial lawyer buddies out of the herd of sacred cows to be gored, he started out halfway to a loss by saying they were too valuable to share the pain.

jj wrote:

...but so long as those on the left insist on including a radical, unpopular, and unwise component (the public option) into the bill...any such legislation will not be tolerated by the American people.

"Public option" is not unpopular, is far from radical, and depending on one's point of view, is not unwise.

Greg D. wrote:

Eventually we will all either die or become eligible for Medicare. Either way our heath care problems will then be solved.

Gee, where should I start?

I am willing to bet that the Bob Tiernan posting on this thread is not the one in the Republican Party. I'm bettin' he's an independent.

Here are a few things I would like to see as reforms, just not the standard reforms promoted in the media.

1. Let's abolish licensing laws. They do little or nothing to protect consumers and were originally promoted to protect the M.D.s from competition. These laws were especially effective at driving midwives out of the marketplace. And today midwives find it difficult to practice in some states. You may wish to check with the AMA, but I believe they passed a resolution at their last meeting to use their influence to outlaw home births. Again intended to reduce competion from midwives who do home births.

2. Repeal the McCarran-Ferguson Act. As it is now we have 50 states each with their own insurance regulations. This has done nothing but Balkanize the insurance business. With 50 little fiefdoms. The insurance boys love this little Act. A new company has to learn the rules in each of the different states.

3. A full tax deduction on all medical expenses regardless of the form you file.

4. Repeal the laws in those states that have certificates of need. Certificates of need reduce competion and drive up costs for patients.

5. Abolish the state medical boards. They do little or nothing to protect patients. They have been captured by the MDs and are simply a scam.

How's that for a start?

Abolishing state mandates on what is or is not covered by insurance can be a two way street. Progressive states have tended to require that women's heath issues, reproductive issues, etc. are covered. Also mental health, substance abuse, etc. Subject to certain recent federal requirements, less progressive states (including my friends in Mississippi) allow health insurance to be sold in their jurisdiction which covers "none of the above".

You can debate the economic model endlessly (should an old geezer like me be forced to pay premiums to cover birth control pills?) but there are some societal benefits from having mandated coverages for certain core medical expenses. Opening coverage to the free market is risky.

(back with a new keyboard)

Real democrats are arguing here with people that don't matter, i.e., people who are trying to find some kind of middle "third way," who believe that Obama and the Democrats have moved too far to the left and now are being punished for it. If that is what you believe, there is no help for you. Lie down and await some better revelation.

It doesn't matter that Obama has lost these people because there aren't enough of them to matter.

However, Obama has lost a lot of those, perhaps most of those, who stood in Grant Park last November after the election and believed in a new beginning. My 83 year old father and mother who said: he won't fold like the other ones.

Over the past month Obama has lost or is in the process of losing most of those who believed that an Obama presidency was a disruptive moment, our collective break with the secret deals with the corporations, with the legitimization of torture, with the military state, and above all with the machinery that makes the people ashamed of their own dreams.

We waited in vain for Obama to come out and say simply:

"Health care is a human right. Full stop. End of sentence. Every civilized society understands this. And for someone to make hundreds of millions of dollars by manipulating drug patents or by denying insurance to sick people while tens of millions of our fellow Americans have little or no access to health care is a moral obscenity, and that can no longer be tolerated.

You're worried if an undocumented immigrant might get to go to doctor under this bill? Well, grab yourself a conscience Jack, because all of us are brothers and sisters, and if you don't get that, you're no American.

President Franklin D. Roosevelt knew this. President Harry Truman knew this. President John F Kennedy knew this. President Lyndon Johnson knew this and tried to do something about it when he crafted Medicare.

And starting today we are taking the next step, and every American is going to know this as a practical reality. Every American will have health care as a basic human right, health care that cannot be taken way for any reason, ever. We do this to make a more perfect union and to promote the general welfare. For, in the words of President Kennedy, "We all breathe the same air. We all cherish our children's future. And we are all mortal."

But that's not the speech we got.

We got: we'll have a public option maybe. Or maybe not.

We got: no, really, there won't be any illegal aliens.

We got: the drug companies won't have to bargain for lower prices and they'll get to charge the government for brand name drugs seven years after generic drugs are on the market.

We got: maybe we'll allow patients and doctors to talk with one another about end of life directives. Turns out we won't.

In the most noble, entirely honorable cause in the world, we got nothing, nothing, nothing but jive scraping bootlicking before the scurvy-ass blue dogs and our own Senator Wyden (let's remember this come primary time) looking out for the banks and insurance companies, which are more or less the same entities, running interference for the Fox News onslaught that we are presently enjoying.

So: Obama's lost the America that half-believed in him, that is the vast America that still hopes there is something more than craven Rove and Bush crapola to the Democratic party. The party had its moment and it chose secret deals with Big Pharma, stalling tactics to allow the insurance companies to muster their resources, and to trade the party of FDR, HST, JFK, and LBJ for the usual corporate nihilism.

Scott

But there is proof that tort reform does decrease malpractice insurance. The fact that the doctors chose not to pass along the savings shouldn't preclude us from pursuing it nationally. here

I find it strange that right-wingers don't want the government getting involved in their health-care, but they have no problems allowing the government telling them how much they can recover if they're a victim of medical malpractice.

Jeff Alworth:

The GOP had six years of unimpeded control to do your kind of reform.

Bob T:

1) It wasn't unimpeded control, and 2) it wasn't even close to my kind of reform. You're seeing things in black and white again.

Bob Tiernan Portland

Greg D:

Opening coverage to the free market is risky.

Bob T:

Ah, so you admit that this is not what we have. Thanks.

Point is that people are not able to go to an insurance company or a hospital group and get a personalized policy covering only those things the individual wants covered.

Don't support all of these mandates and then bitch about the high cost of a monthly health insurance premium.

Bob Tiernan Portland

Joe Hill: "Health care is a human right. Full stop. End of sentence. Every civilized society understands this. J: Yup. Inalienable. Right up there with freedom of the press. Freedom of speech. Right to bear arms. Right to food. Right to water.

No question. Question: Who pays for your printing press? Who pays for your bull horn & soapbox? Who pays for your gun? YOU!! Why should the right to healthcare be any different?

A right means that the government cannot deny it to you – the government cannot mess with it.

Now tell me, if healthcare is a right, how can the government mess with it?

How can they demand insurance cover certain things? They cannot demand that newspapers cover certain things!

However they can demand that you get what you pay for.

Greg D:

Opening coverage to the free market is risky.

Bob T:

Ah, so you admit that this is not what we have. Thanks.

I shudder to think how awful our health care system would be if health insurance were completely unregulated. What we have now is a travesty, what you propose would be a nightmare. Abolish licensing, abolish the ability to hold corporations accountable through the courts... Next on the agenda, abolish the FDA, abolish Medicaid and Medicare, and while you're at it, abolish the CDC because the notion that there is a "public health" to protect is a pernicious socialist myth, and we should also abolish the laws against selling your organs for cash. You don't have to stray too far down Ron Paul's Laissez Faire Health Insurance page to see where this leads...

An unregulated free market in health care would trend toward entropy and chaos in a matter of months. It may be fun to idly speculate on made-to-order individual insurance policies, bought at vending machines at gas stations no doubt, but in an unregulated market you really don't have any idea how insurance companies would market their policies. The articles I've read indicate a more sober prediction, a return to mutual aide societies and smaller less efficient communal pools, which undercut the efficiencies of spreading risk as widely as possible. People would take meds untested for safety or interaction, without recourse to the courts if they're poisoned. I suppose since we're going back to the 19th century we may as well bring back the snake oil salesman...

Ron Morgan I shudder to think how awful our health care system would be if health insurance were completely unregulated. J: How about we only regulate against fraud, lies, misrepresentation and require that all promises be kept?

@jamie "a right means the government cannot deny it to you"

No. You are confusing "negative liberty" (e.g. the Bill of Rights) with "positive liberty" (e.g. the Reconstruction Amendments). The government must provide (positive liberty) voting rights to all of its citizens; equal justice; privileges and immunities; etc.

Indeed, I would argue that the government is already obligated to provide universal health care under the 14th Amendment, but we would need a court with a majority significantly different from what we have now to hear and uphold this view.

See Isaiah Berlin on the philosophical differences, nuances, and implications between negative and positive liberty. At any rate, these categories are well understood and accepted by Constitutional scholars - even beginning history students are expected to understand this.

(This kind of thing is not generally covered by FOX news or its acolytes.)

Joe Hill is correct in theory. In 1948 the United States was instrumental in writing the UN Universal Declaration of Human Rights (with Eleanor Roosevelt leading the charge). Although not a treaty, it proclaims:

Universal Declaration of Human Rights Adopted and proclaimed by General Assembly resolution 217 A (III) of 10 December 1948

On December 10, 1948 the General Assembly of the United Nations adopted and proclaimed the Universal Declaration of Human Rights the full text of which appears in the following pages. Following this historic act the Assembly called upon all Member countries to publicize the text of the Declaration and "to cause it to be disseminated, displayed, read and expounded principally in schools and other educational institutions, without distinction based on the political status of countries or territories."

Article 25. (1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

Unfortunately the US has not ratified the International Covenant on Economic, Social and Cultural Rights, which would have been binding.

We talk the talk but don't walk the walk.

mp writes:

"The fact that the doctors chose not to pass along the savings ..."

Incorrect. Apples and oranges.

What a doctor charges and what he/she receives are two different amounts. A doctor can charge $500,000 for a simple office visit but in the end will still only receive $45 from the insurance carrier. Its called a contractual allowance, contractual adjustment, or reimbursement rates. Only a small percentage of any practice are considered "self-pay."

Ron Morgan writes; "I shudder to think how awful our health care system would be if health insurance were completely unregulated. What we have now is a travesty, what you propose would be a nightmare. Abolish licensing, abolish the ability to hold corporations accountable through the courts..."

Today somewhere between 50,000 and 100,000 people die annually because of medical errors. 12,000 die from unnecessary surgery and 100,000 from hospital acquired infections. If you are injured in a hospital by a doctor you have about a 1 in 16 chance of collecting anything.

Licensing laws were intended to limit competion for the medical profession and they did just that. Midwives were virtually driven from the marketplace with serious consequences for mother and infants. Mothers were denied a choice, maternal deaths increased as did infant mortality.

In some states today naturapaths cannot practice, denturist can only practice in something like eight states, nurse practioners are limited and physicains assistances are also limited as to what they can do because of various state's regulations. The market is closed! Low income suffer the most.

We need an open market supported with adequate liabilty laws to hold people accountable for their actions. That is what has been proposed. To my knowledge no one is suggesting that people be allowed to commit fraud, or harm to others without paying a penalty unlike today.

Kurt Chapman wrote:

"No pre-existing condition denials"

Good evidence that you probably don't understand the nature of insurance.

Should I be able to call the auto insurance company to enroll after I have a wreck and have it covered?

Blue collar Libertarian,

That healthcare licensing has had negative effects (I agree that marginalizing midwives, NPs, PAs, and naturopaths is poor policy) does not mean that licensing is a bad idea.

Any time the government regulates business, there is the danger that regulations and regulators may be captured by the industry regulated. There are ways of minimizing this danger without eliminating all regulation. We have ample evidence that the absence of regulation does not promote life, liberty, and the pursuit of happiness.

Good News !

A staff writer at The New Yorker and some experts have examined Medicare data from the successful hospitals of 10 regions, and they have found evidence that more effective, lower-cost care is possible.

Please be 'sure' to visit http://www.nytimes.com/2009/08/13/opinion/13gawande.html?hp for credible evidence !

Some have followed the Mayo model with salaried doctors employed, Other regions, too, have found ways to protect patients against the pursuit of revenues over patient. And a cardiac surgeon of them said they had adopted electronic systems, examined the data and found that a shocking portion of them were almost certainly unnecessary, possibly harmful.

According to analysis, their quality scores are well above average. Yet they spend more than $1,500 (16 percent) less per Medicare patient than the national average and have a slower real annual growth rate (3 percent versus 3.5 percent nationwide).

Surprisingly, 16 % of about $550 billion (the total of medicare cost per year) is around $88 billion per year, except for Medicaid (total cost of around $500 billion per year), medicare 'alone' can save $880 billion over the next decade.

In addition, under the reform package, along with the already allocated $583 billion, the wastes involving so called "doughnut hole" , the unnecessary subsidies for insurers, abuse, exorbitant costs by the tragic ER visits etc are weeded out, the concern over revenue might be a thing of the past.

(( Net Medicare and Medicaid savings of $465 billion + the $583 billion revenue package = $1048 billion - the previously estimated $1.042 trillion cost of reform = $6 billion surplus - $245 billion (the 10-year cost of adjusting Medicare reimbursement rates so physicians don’t face big annual pay cuts) = the estimated deficit of $239 billion ))

In modernized society, the business lacking IT system is unthinkable just like pre-electricity period, nevertheless, the last thing to expect is happening now in the sector requiring the best accuracy in respect to dealing with human lives. Apparently the errors by no e-medical records have spawned the crushing lawsuits (Medical malpractice lawsuits cost at least $150 billion per year), and these costs have led to the unnecessary tests, treatments, even more profits so far. And in different parts of the U.S., patients get two to three times as much care for the same disease, with the same result.

Thank You !

Joe Hill wrote:

" I would argue that the government is already obligated to provide universal health care under the 14th Amendment"

In your view, is the government legally obligated under the 14th Amendment to provide food to everyone, too?

So using Joe's logic, once you have a heart attack, stroke, or diabetes you should NEVER be able to have insurance or access to healthcare the rest of your life.

Or in Joe's little world, cars and human life are equal.

Explains alot about his character.

Scott,

Actually you can have insurance NOW in many or even most cases, but the pre-existing condition won't be covered.

Do you understand how insurance works?

Do you understand that if you bankrupt insurance companies by allowing people to sign up after the fact and still have the event covered that NO ONE will have insurance?

But that is actually the goal of the left, is it not to bankrupt the insurance companies?

Aren't they 'the devil'?

Do you know that most insurance companies simply shuffle the administrative paperwork for employers who act as the 'insuring company'?

It's called 'self insurance' and likely if you work for a company of mid or large size your boss is your 'insurance company'.

Do you understand how that works?

So forcing 'insurance companies' to cover major illnesses after the fact will actually cause employers (your 'insuror') to either drop coverage or go out of business or both.

So you've not only lost your insurance but your job as well.

You got it going on, don't you?

Yo Joe:

Do you know what "rescission" means?

Yeah, I didn't think so.

Thousands of Americans also lose health insurance each year through a practice called rescission. When a person is diagnosed with an expensive condition such as cancer, some insurance companies review his/her initial health status questionnaire. In most states’ individual insurance market, insurance companies can RETROACTIVELY cancel the ENTIRE policy if any condition was missed – even if the medical condition is unrelated, and even if the person was not aware of the condition at the time. Coverage can also be revoked for all members of a family, even if only one family member failed to disclose a medical condition.

A recent Congressional investigation into this practice found nearly 20,000 rescissions from three large insurers over five years, saving them $300 million in medical claims – $300 million that instead had to come out of the pockets of people who thought they were insured, or became bad debt for health care providers.

Several insurance companies have been found to evaluate employee performance based in part on the amount of money an employee saved the company through rescissions. Simply put, these insurance company employees are encouraged to revoke sick people’s health coverage for the sake of corporate profits.

Or let me put it to you in simplier terms - insurance companies make money by denying you coverage.

So I ask you - do you understand how insurance works?

And to answer your last question, yeah I got it going on. Unfortunately you don't.

Scott,

The activity you are describing is not legal. An insurance company cannot legally deny or rescind coverage for a condition that was not diagnosed at the time the insurance was obtained.

I am not in favor of looking the other way when a company breaks it's contract and acts in an illegal manner.

But tearing down the whole system to prevent an activity that is already illegal isn't a good solution.

Should we burn down the hospital because an employee stole supplies and resold them?

On the other hand, your defense of someone who 'failed to disclose' an illness left out an important phrase -- 'insurance fraud'.

And that's illegal too.

Why do you decry an insurance company acting illegally but wink at an individual who commits a crime?

William McGuire of UnitedHealth Group, the nation’s leading insurer, was the third-highest paid CEO on the Forbes list. His pay of $124.8 million could cover the average health insurance premiums of nearly 34,000 people.

William McGuire made $124.8 million denying people healthcare.

William McGuire is not in prison. William McGuire did not commit fraud. William McGuire made $124.8 million using standard accepted business practices.

And there lies the problem.

Joe Hill said, "So: Obama's lost the America that half-believed in him, that is the vast America that still hopes there is something more than craven Rove and Bush crapola to the Democratic party."

I wish that were so, Joe, since only a loss of faith in the newest false idol can save us. However, pollster.com (http://www.pollster.com/polls/us/jobapproval-obama-dems.php) recently found that an astounding 85% of Democrats have maintained their secular mystical addiction to the Dear Leader in spite of the fact that they have been betrayed on almost all issues that are important to progressives.

There is no "more than craven Rove and Bush crapola to the Democratic party", if there ever was (I lived under LBJ and remember well his militarist policies).

Speaking of Obama, oops, there goes my keyboard.

Scott,

I see that good old fashioned covetousness seems to be your real motivation.

You are simply jealous that someone made money.

You admit that they've broken no law, but they are somehow evil for making money.

Why should we trust your judgement when it is obviously tainted with your own greed for someone else's money?

You claim that he made money 'denying' health care. The fact is he made money providing health care.

If you have any evidence that he did so illegally you have a duty to go to the authorities.

On the other hand, if he simply abided by the terms of a contract that both parties entered into willingly and with full disclosure, then it is only your greed that makes this seem evil when it's not.

Do you understand how insurance works?

Joe, you're doing a great job explaining how broken our insurance-based system is. You are absolutely right that insurers who deny coverage for pre-existing conditions are simply trying to preserve their profitability, so they can continue providing insurance to everyone else. The problem is that health care is not like other insurable commodities.

Think about car insurance. Most car accidents are avoidable -- someone was driving too fast, or too drunk, or too recklessly. If you cause more than a couple of accidents, you are no longer insurable, denied for a "pre-existing condition" (i.e., bad driver). While that has a serious impact on that person, being a bad driver is an avoidable condition.

With health, that's often not the case. Yes, sometimes behavior like smoking or obesity lead to bad medical outcomes, but a lot of our health is based on our genes, or sheer luck. My daughter has a rare genetic condition, discovered when she was six months old. It won't impact her quality of life, but it requires continual monitoring and tests. You are arguing that it's totally fine for an insurance company to deny my daughter coverage for that condition in order to keep insurance rates down for everyone else. I think that view is totally immoral and shows a shocking lack of humanity.

Just because someone draws the short straw does not mean we can or should abandon them. I hope you rethink your views.

"You are simply jealous that someone made money"

Funny how conservatives have no problem with CEO's making $100,000 an hour but get their manpanties all in a bunch if anyone so much as suggests raising minimum wage another $0.15 and hour.

Hey Joe, care to guess how many lawsuits are pending against UH for denying care to policy holders?

Care to guess how many of those in past years have died waiting for the courts to hear their cases?

Yeah Joe, I'm really jealous.

Miles wrote:

"My daughter has a rare genetic condition, discovered when she was six months old. It won't impact her quality of life, but it requires continual monitoring and tests. You are arguing that it's totally fine for an insurance company to deny my daughter coverage for that condition in order to keep insurance rates down for everyone else. I think that view is totally immoral and shows a shocking lack of humanity. "

Most likely your daughter was insured when this was discovered.

In my view, as long as you pay the premiums, an insurance company should not be able to cancel her.

If you drop coverage, then it is you not the insurance company that has done your daughter a disservice.

If she wasn't insured at the time she was diagnosed, likely she can get insurance for other health conditions, just not the one that was known to exist prior to starting coverage. Tests and monitoring will have to be paid for out of pocket. And again, it is not the insurance company's fault that you did not purchase coverage soon enough.

If she wasn't insured, was it immoral for you to refuse to provide coverage for your daughter?

Scott wrote:

"Funny how conservatives have no problem with CEO's making $100,000 an hour but get their manpanties all in a bunch if anyone so much as suggests raising minimum wage another $0.15 and hour."

Perhaps that's because it's not the government's job to say how much anyone should make, whether they are at the low or the high end.

Should the government tell the company that employs you how much you should make?

Should it take an act of Congress to get a raise on your job?

Should it take an act of Congress to get a raise on your job?

Why not? Total control is their goal. What you drive. Whether you will drive with a RFID or GPS device attached to your vehicle. Who you employ. How much you should pay them. What you can and cannot fire them over. Who you must do business with. Whether you can have gender segregated bathrooms at your office. How many fire extinguishers you must have. Whether your lunch may contain transfats. Whether you should have to offer medical insurance. Whether you can answer a phone in your car. Whether you can own a gun. Whether you can keep any of your own money.

It's all on the line whenever a Democratic controlled legislative quorum is called.

Joe White:

So what you are saying is that some of us should be uninsurable, at least for any condition that existed before we obtained our current insurance plan.

And of course it is always our fault that we did not have insurance.....

And if we don't have the cash then we just go w/out needed medical care for said condition.

Is that what you are saying?

If you drop coverage, then it is you not the insurance company that has done your daughter a disservice.

And if I move jobs? Are you suggesting that I can never leave my current job given my daughter's medical condition, since that would mean I have to switch to a new employer and insurer who could deny a preexisting medical condition? Where's the free market efficiency in that?

And what if I lose my job? Does that indicate some moral failing in your view, the punishment of which is that my daughter loses medical coverage? And what happens when she grows up and can no longer be on my insurance?

Your view borders on moral depravity. I'm actually shocked you would admit to it. You have now said that those who have genetic conditions, or develop cancer, or any other of hundreds of medical conditions should have no expectation of medical coverage unless they're willing to pay out of pocket.

If only more Joe Hill's would speak up, health reform would pass in an instant.

Thanks for the kind word Miles.

The tenor of this conversation led me to consult FDR's 1944 State of the Union speech (what can I say, I'm a geek) to get a sense of how far we've fallen away from the ideals of the Democratic party.

In that speech FDR listed what he said were the fundamental rights of every American citizen. Among these rights, he said, are (quoting now):

'"The right to a useful and remunerative job in the industries or shops or farms or mines of the nation.

"The right to earn enough to provide adequate food and clothing and recreation.

"The right of every farmer to raise and sell his products at a return which will give him and his family a decent living.

"The right of every businessman, large and small, to trade in an atmosphere of freedom from unfair competition and domination by monopolies at home or abroad.

"The right of every family to a decent home.

"The right to adequate medical care and the opportunity to achieve and enjoy good health.

"The right to adequate protection from the economic fears of old age, sickness, accident and unemployment.

"The right to a good education."

It goes on.

Note that this is the President of the United States (probably the most accomplished president of the twentieth century) saying this, not some back bencher from a suburb of Cleveland or a senator from Vermont.

What would we give to hear those sentiments from behind the presidential podium again? Wouldn't it be great to hear Obama quote some of FDR's maledictions against the "malefactors of great wealth," and throw down against the sons of bitches that have stolen what once was good?

Miles wrote:

"And if I move jobs? Are you suggesting that I can never leave my current job given my daughter's medical condition, since that would mean I have to switch to a new employer and insurer who could deny a preexisting medical condition? Where's the free market efficiency in that?

And what if I lose my job? Does that indicate some moral failing in your view, the punishment of which is that my daughter loses medical coverage? And what happens when she grows up and can no longer be on my insurance?"

I believe that current law already allows you to change between group plans (like when you leave one job for another) and not lose coverage due to pre-existing conditions if you maintain coverage with a gap of no more than 60 days.

And I think the same applies when going from a group plan to an individual plan (and if it doesn't, it should).

As long as you pay the premium, you should be able to keep coverage. That's my view of it, and I think current law is mostly at that point already.

Mike wrote:

"So what you are saying is that some of us should be uninsurable, at least for any condition that existed before we obtained our current insurance plan."

You can't burn down the house and then call the insurance man to apply for a policy, can you?

Why not?

Joe Hill wrote:

"probably the most accomplished president of the twentieth century"

FDR's prescription of more and more government regulation, taxation and spending was an abject failure.

"FDR's prescription of more and more government regulation, taxation and spending was an abject failure.'

yeah that's why he was elected 4x and to date most of his legacy (social security, SEC, deposit insurance) remains broadly popular.

"You can't burn down the house and then call the insurance man to apply for a policy, can you?"

If you see that as the same as someone w/a pre existing condition being denied coverage when they go to buy a policy after being uninsured for a while well then.....

That says it all about you Joey boy.

I hope the state GOP elects you as their chairman and gets you prominent air time.

People wonder who is behind the town hall riots when anyone discusses health care reform, or Obamacare – the answer is Conservatives for Patients' Rights. Conservatives for Patients Rights, or the CPR, is headed by one Rick Scott – who isn't a doctor – but used to be the CEO of a hospital, and under his watch, his medical administration defrauded Medicare of $1.7 billion through a practice called upcoding, wherein a Medicare patient gets treated, but Medicare is billed for additional tests that never took place. (That's fraud.) Realistically, Conservatives for Patients Rights and Mr. Scott will never need short term loans, and the only reason why they oppose the bill is that they want the money from the program for themselves.

I believe that current law already allows you to change between group plans (like when you leave one job for another) and not lose coverage due to pre-existing conditions if you maintain coverage with a gap of no more than 60 days.

You're referring to the "P" in HIPAA, which stands for portability. You should do more research. Technically an insurer cannot deny you for a preexisting condition if you switch between group plans. So if you go from one large employer to another, and can get the job within 60 days, you MIGHT be okay. But there is no provision in HIPAA that prevents insurers from jacking your rates up to whatever they want to if you're unable to secure that next job with a large employer, or you decide to open a small business, or dozens of other scenarios. There are instances when insurers have increased premiums to thousands of dollars a month because they know the individual with the preexisting condition will be forced to drop the coverage, and they'll be off the hook.

I'm glad you've acknowledged government's needed regulatory role in health insurance. But frankly, once you've acknowledged that role for existing insurance policies, there is no rational reason to allow insurers to deny coverage for any preexisting condition. Your analogies about burning down your house don't make any sense. You do not control your genes, you do not have any say in whether you get cancer, and when. Since the only way to get good health care in America is to have insurance, you cannot in good moral conscience deny someone the right to buy insurance.

Miles wrote:

"I'm glad you've acknowledged government's needed regulatory role in health insurance."

Yes, I always have. The states have the responsibility to regulate insurance. The feds should butt out.

Miles wrote:

"But frankly, once you've acknowledged that role for existing insurance policies, there is no rational reason to allow insurers to deny coverage for any preexisting condition. Your analogies about burning down your house don't make any sense. You do not control your genes, you do not have any say in whether you get cancer, and when."

You can't understand the house analogy? Ok, let's talk life insurance.

You don't have control over when you die, but the widow can't call up the insurance company and enroll the dearly departed.

Mike wrote:

"social security"

is a Ponzi scheme. The only difference between Congress and Madoff is they were able to write themselves an exemption.

If seniors had been allowed to keep and invest their own money, they would have been far better off than scrimping by on SS.

SS has impoverished the elderly, and to defend it is an indication of disconnect with reality.

The program itself lurches from crisis to crisis because it is inherently poorly designed.

I say cut our losses and end it. It would have to be done over time, honoring current commitments, but there is no reason to subject all future generations of Americans to this monstrous failure.

Let's keep this simple. When the politicians and their families are on the same plan...sign me up. Until then, stop wasting our time talking about it. Its just a Power Grab by Government. Don't act surprised. Just wait until the militia start rounding up citizens for vaccine shots. Becareful what you wish for. That government that gives you everything, can take it away. JT

I don't want on the plan even if every politician's family is on it.

Just because they show bad judgement and are willing to sacrifice the country's future in order to make a political impression, doesn't mean I want any part of it.

Politicians are messing with health care in order to avoid the issues they are really supposed to be handling -- national defense, illegal immigration to name a few.

The framers of the constitution wisely gave a very limited scope of authority to the federal government.

They want to abdicate that responsibility and mess with schools, health care, libraries, police departments, economic stimulus, roads, retirement, banks, and numerous other things that are the responsibility of state and local governments or of the people. Read the 10th Amendment.

I don't want the feds 'stimulating the economy'. I want them to leave it alone. By giving one company money and not another, you are taking an improper role in the private sector. Stay out.

Likewise, the feds should have no say over local schools, colleges, insurance and a host of other items.

The federal government needs to be shrunken down to the size of it's task.

Those who worry about an 'imperial US' in foreign affairs do not seem to understand that it is they that gave the feds their God-complex in the first place.

Ron Morgan:

What we have now is a travesty, what you propose would be a nightmare. Abolish licensing, abolish the ability to hold corporations accountable through the courts

Bob T:

I don't know where people get the idea that in a free market there'd be no way to hold anyone accountable for the consequences of their actions. Individuals and people running businesses can be taken to court. The right to take someone to court is not a "regulation", or at least not what you consider a regulation (it regulates, that's for sure).

I get very tired of hearing progressives who say things like the second amendment is a right to murder, or regulations are needed in order to prevent someone from dumping trash in a neighbor's yard. Let me know when you understand what these terms mean.

Bob Tiernan Portland

Hey Joe White: tell some low-paid worker just laid off that they are undeserving morons for being unable to pay extortionate COBRA amounts. I dare ya! You may come back without a face - ire runs dire in these here trying times...

rw wrote:

"tell some low-paid worker just laid off that they are undeserving"

Wouldn't it be better to tell them something I've actually said, instead of something you made up that I didn't say?

Back slowly away from the strawmen, rw. You can do it. Willpower, girl, willpower. Put down the straw. That's it.

What happened to insuring the uninsured? Cover the uninsured with expanded Medicaid. Unless, that's not the point.

RW:

tell some low-paid worker just laid off that they are undeserving morons for being unable to pay extortionate COBRA amounts.

Bob T:

Do any government laws have anything to do with why such monthly payments are so high?

Do any sleazy lawyers like John Edwards have anything to do with high costs as well? (You know, the guy who just built a $2 Million dollar home in that "other America" with his lawsuit winnings).

Bob Tiernan Portland

Joe White:

They want to abdicate that responsibility and mess with schools, health care, libraries, police departments, economic stimulus, roads, retirement, banks, and numerous other things that are the responsibility of state and local governments or of the people. Read the 10th Amendment.

Bob T:

It's not that simple -- the Feds can protect citizens from abuses by state and local governments while the state and local governments should insulate us from central government abuses (which often means the Feds not being permitted to do X, Y and Z).

But those who think that the best level of government, the one automatically having our best interests in mind, need to explain why state legislators automatically become so "caring" simply be being elected to the US Congress. Or why it would not work to their satisfaction if a state like Mississippi became its own independent nation.

Bob Tiernan Portland

The founders of our nation recognized that it was much more likely that the federal government would overreach and grab power not assigned to it than that a state or local entity would do so.

And they were correct.

Joe White:

The founders of our nation recognized that it was much more likely that the federal government would overreach and grab power not assigned to it than that a state or local entity would do so.

And they were correct.

Bob T:

Any level can overreach. Even our state and local governments are far more abusive and intrusive than the Framers imagined.

Try to find a book titled Grassroots Tyranny: The Limits of Federalism., by Clint Bolick.

Bob Tiernan Portland

Good News !

A staff writer at The New Yorker and some experts have examined Medicare data from the successful hospitals of 10 regions, and they have found evidence that more effective, lower-cost care is possible. Thankfully, the provisions in the reform include more expansive policies than they have.

Please be 'sure' to visit http://www.nytimes.com/2009/08/13/opinion/13gawande.html?hp for credible evidences !

Some have followed the Mayo model with salaried doctors employed, Other regions, too, have found ways to protect patients against the pursuit of revenues over patient. And a cardiac surgeon of them said they had adopted electronic systems, examined the data and found that a shocking portion of tests were almost certainly unnecessary, possibly harmful.

According to analysis, their quality scores are well above average. Yet they spend more than $1,500 (16 percent) less per Medicare patient than the national average and have a slower real annual growth rate (3 percent versus 3.5 percent nationwide).

Surprisingly, 16 % of about $550 billion (the total of medicare cost per year) is around $88 billion per year, except for Medicaid (total cost of around $500 billion per year), medicare 'alone' can save $880 billion over the next decade.

In addition, under the reform package, along with the already allocated $583 billion, the wastes involving so called "doughnut hole" , the unnecessary subsidies for insurers, abuse, exorbitant costs by the tragic ER visits etc are weeded out, the concern over revenue (below) might be a thing of the past.

(( Net Medicare and Medicaid savings of $465 billion + the $583 billion revenue package = $1048 billion - the previously estimated $1.042 trillion cost of reform = $6 billion surplus - $245 billion (the 10-year cost of adjusting Medicare reimbursement rates so physicians don’t face big annual pay cuts) = the estimated deficit of $239 billion ))

In modernized society, the business lacking IT system is unthinkable just like pre-electricity period, nevertheless, the last thing to expect is happening now in the sector requiring the best accuracy in respect to dealing with human lives. Apparently the errors by no e-medical records have spawned the crushing lawsuits (Medical malpractice lawsuits cost at least $150 billion per year), and these costs have led to the unnecessary tests, treatments, even more profits so far. And in different parts of the U.S., patients get two to three times as much care for the same disease, with the same result.

Thank You !

Bob Tiernan wrote:

"Any level can overreach. Even our state and local governments are far more abusive and intrusive than the Framers imagined."

I don't disagree. But it's a lot easier to move your family or your business to a nearby town or suburb if the local corruption proves unfixable , than it is to leave the country.

Boikin wrote:

"What happened to insuring the uninsured? Cover the uninsured with expanded Medicaid. Unless, that's not the point."

Allowing the uninsured to cover themselves is the point.

Or at least it should be.

Why do we assume that the only solution is a government paid solution?

Allow individuals and small businesses (and their employees) to pool together to purchase group health insurance at favorable rates like large corporations do.

Cost to the taxpayer? Zero

Bob T:

Any level can overreach. Even our state and local governments are far more abusive and intrusive than the Framers imagined.

Joe White:

Many reformers recognized roughly 30 percent of all health-care spending in the U.S. -some $700 billion a year- might be wasted on unnecessary tests and treatments, and payment reform could solve this problem. Is this claim overstatement ? Please not to fear quitting drug !

Provided the American people pay around double the amount of efficient systems, the result is still well below them, the ratio of waste might be estimated to far more than 50% in the U.S.

Let's be conservative regarding the ratio. If 10% of savings apply to the combined Medicare and Medicaid cost of $923.5bn per year, as of July, the savings of $923.5bn over the next decade are possible.

And when these savings add to the already allocated $583 billion, the savings of wastes involving so called "doughnut hole" , the unnecessary subsidies for insurers, abuse, exorbitant costs by the tragic ER visits etc, the concern over revenue might be a thing of the past.

As a matter of fact, with the promising redesign in the pipeline, some patient-focused clinics in 10 regions have already achieved 16% of savings in Medicare while their quality scores are well above average.

Please be 'sure' to visit http://www.nytimes.com/2009/08/13/opinion/13gawande.html?hp for credible evidences !

Thankfully, the provisions in the reform include more expansive, systematic policies including 'a patient's outcome-based payment system' than they have. I for one firmly believe this American innovation, 'a patient's outcome-based payment system' , is capable of turning profit-oriented practices into patient-focused system / value.

Dr. Armadio at Mayo clinic says, "If we got rid of that stuff (waste), we save a third of all that we spend and that is 2.5 trillion dollars on health care. A third of that and that is 700 billion dollars a year. That covers a lot of uninsured people."

Please visit http://www.kare11.com/news/news_article.aspx?storyid=820455&catid=391 for detailed infos

Thank You !