Why a Public Health-Care Option Helps Capitalism

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If you happen to be living in a cave, on some deserted island, or deep at the center of the earth, I kinda envy you. Your remote digs mean you've most likely missed the increasingly angry and politicized rhetoric surrounding President Obama's efforts to reform our health-care system.

I'm here to assert that one of the most vilified planks of the Obama administration's platform -- the proposed public health care option -- may actually do the greatest good for our free-market economy.

But ... but that's socialism!
Before you start Photoshopping my head onto pictures of Josef Stalin, take a deep breath. I'm not arguing for a state-run, single-payer monopoly on health care. Neither is the president, for that matter.

Though Obama has spoken favorably of a single-payer system in the past, no part of the plan currently under discussion asserts that Uncle Sam should be your only choice for health care. Instead, the Obama plan proposes that anyone who wants to should have the option -- just the option -- to sign up for a government-run plan instead of a private insurer.

That's no different from the U.S. Postal Service, which must compete with UPS (NYSE: UPS  ) , or the government-subsidized Amtrak rail service, which vies with airlines such as Southwest Airlines (NYSE: LUV  ) , bus lines, and your very own automobile for your travel dollars. (Note that in both those cases, the private businesses are often doing better than their public rivals.)

And before you conjure nightmares of a public plan's endless lines and bureaucracy, remember that government-run Medicare has been doing a respectable job of treating our senior citizens for decades. I personally grew up receiving excellent health care from the government as the son of a U.S. Air Force officer.

The mere threat of having to compete against an organization that might be less expensive and more efficient has private health insurers absolutely terrified. That's the dirty little secret of capitalism: Some established, successful companies hate competition.

Doctor, doctor, gimme the news
A decade ago, the major record labels were fat and happy, making piles of cash off CD sales. They could use their massive marketing muscle to push manufactured bands onto the airwaves and into listeners' ears. If you had to buy a whole subpar album just to get the few songs you really wanted, well, too bad.

Then Internet file-sharing rolled into town. I'm not arguing that piracy's right, but digitally available tunes did become a real competitor to the established music business. Rather than adapt to consumers' changing tastes by going digital themselves -- which would have meant surrendering their fat margins, and some of their control over what people listened to -- the record labels panicked. They started suing file-sharers, driving their own customers away. In short, the record labels weren't meeting customers' demand; they were trying to dictate what they thought customers should demand, and actively ignoring what the free market really wanted. Does that sound like capitalism to you?

Industry outsider Apple (Nasdaq: AAPL  ) finally had to almost bully labels into offering digital tunes at a fair (or at least fairer) price. Now (Nasdaq: AMZN  ) and a host of others compete with Apple's iTunes, a rivalry that has lowered prices, eliminated restrictive copy protection, and generally given consumers better music options. In return, audiophiles bought more music in 2008 than ever before, according to a January USA TODAY article. Most of those sales came in the form of digital downloads and individual tracks.

In my opinion, private health insurers are no less slothful and stubborn than record labels were at the dawn of the digital era. Insurers' defenders say that a rival public option would "destroy their industry." WellPoint (NYSE: WLP  ) has set up a website to oppose it. But in my opinion, it's more likely that the increased competition would merely reduce their profits, loosen their control, and force them to work harder, smarter, and more efficiently. That may be bad news for health insurers' stockholders, but you can't deny that it's good news for folks who need health insurance.

To be fair ...
Private insurers like Aetna (NYSE: AET  ) and UnitedHealth Group (NYSE: UNH  ) have become scapegoats in the ongoing debate, as much for political reasons as anything else. By all accounts, they've given the Obama administration many concessions; in return, they get to, well, stay alive. Recently, though, they've been increasingly vilified by Obama and those who support his plan, simply because the politicians feel the need for a common bogeyman to help rally support.

Cry me a river.

Let's be brutally honest here. The way I see it, private health insurers' business model involves taking your money on the expectation that they'll pay the bills if and when you fall ill. But when you do get sick, insurers try to spend as little of your money as possible on health care, and pocket as much as they can in profits.

I'm not saying private insurers are solely responsible for rising health-care costs, nor that the promise of profit isn't a worthy incentive to drive innovation and industry. But I am saying that their near-monopoly on health insurance gives private insurers no incentive to be anything but complacent, inefficient, and profit-hungry. That's bad for customers, and in the long run, bad for the insurers themselves.

Sometimes, private industry needs a good hard slap from the ol' Invisible Hand. In this case, if it's efficiently and effectively run, I think a public health-care option would do that job quite well.

This is an important topic for both patients and investors. Are there better free-market solutions than a rival public option? Please take a moment and share your thoughts in the comment section below.

Apple, UnitedHealth Group, and Amazon are all Motley Fool Stock Advisor picks. UnitedHealth Group and WellPoint are Inside Value recommendations and the Fool owns shares of UnitedHealth. UPS is an Income Investor selection.

Fool online editor Nathan Alderman is not, and has never been, a Communist. He has no financial position in any of the companies mentioned above. See the stocks he holds. The Fool's disclosure policy eats an apple a day, just to be safe.

Read/Post Comments (118) | Recommend This Article (101)

Comments from our Foolish Readers

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  • Report this Comment On August 20, 2009, at 2:57 PM, DaretothREdux wrote:

    So GOV'T = Internet Piracy Revolution?

    And a gov't subsidized "option" is fair competition how?

    Ok. I got an idea. I want you to box Mike Tyson. Only I am going to put you in shackles and handcuffs with an iron ball to drag around, and Tyson doesn't have any of that.

    Let me know when you want me to set up the match...

    Of course, private insurance doesn't want to have to compete with a gov't "option" that is funded by taking money from the people via taxes or printing (inflation).

    You might be the greatest boxer in the world but Mike Tyson can still beat you when you're in shackles....

    The gov't "option" would beat private insurance companies not because it provides a better service more efficiently, but because like the US Post Office it would eventually have to make it illegal to compete, and like the VA it would be many people's only choice.


    P.S. Did I mention that we can't afford another trillion dollars a year? This argument shouldn't even be discussed until someone tells me how we are going to pay for this "reform."

  • Report this Comment On August 20, 2009, at 3:09 PM, Fool wrote:

    sorry... but as long as "everybody wants to go to heaven but nobody wants to die" still rules, the cost of the technology, drugs, doctors, hospitals, post operative care, rehabilitation, in vitro, in utero, incognito... will continue to drive up costs.

    the insurers are for profit. the doctors are for profit, the pharmacy is for profit, the hospitals are for profit...

    if the govt gets its way, the boondoggles that are social security, medicare, medicaid, cash for clunkers and bridges to nowhere will seem minuscule by comparison.

    look for ways to reduce costs....not bogeymen.

  • Report this Comment On August 20, 2009, at 3:09 PM, ByrneShill wrote:

    @Dare: Systems with single-payers end up costing roughly half what the US system costs (on a per-capita basis).

    If you don't have trilions to spend, here's a way to get a few, while helping sick people.

  • Report this Comment On August 20, 2009, at 3:14 PM, TRILLIBRO wrote:

    When the government sets the prices and terms there is no free market. Also, Medicare is going bankrupt. In the House Bill on three different pages it clearly states that if you at anytime go into the Gov't system you will not have the option to get out. I love The Motley Fool Service but, having worked in the medical industry to 20 years I have personally witnessed the complete failure of Governments involvement. Please, sticks to the stocks.

  • Report this Comment On August 20, 2009, at 3:21 PM, CMFStan8331 wrote:

    Very well-reasoned post.

    The situation we've gotten ourselves into with both healthcare and the financial industry is actually a distortion of a healthy free-market economy, because both are fundamentally non-productive. By allowing such a vast percentage of our economy to become devoted to those two industries, we drastically reduced the amount of resources available to produce tangible stuff we can sell to ourselves and the rest of the world.

    If America is going to effectively compete in the global economy, we HAVE to dramatically reduce the percentage of GDP devoted to healthcare and finance. We are no longer a 500 lb. gorilla walking amongst ants.

    To the left, I say we simply cannot afford to add coverage without finding dramatic cost savings. A goverment option is no guarantee of savings - pet projects and sacred cows will have to be slashed, whether or not a goverment option is part of the solution.

    To the right, I say that opposing a goverment option while offering no mechanism of your own by which we can find dramatic cost savings is a non-starter. You Rant and rave all you like about how evil the government supposedly is - I won't be listening.

  • Report this Comment On August 20, 2009, at 3:32 PM, levelplayinfield wrote:

    Nathan, you compare your experiences as a military dependent as favorable. What do the veterans think of their services in the VA. Lack of practioners, hospitals, pettitioning the goverment to acquire services from the private side. If the coops are mandated to be revenue neutral, thereby paying all their bills with the revenues received instead of being subsidized by taxpayers and if physicians have the right to decline services from the coop because reimbursements do not meet costs (as many physicians are now doing because Medicare reimbursements fail to cover their costs) then maybe we have a viable option. But as Fool wrote above everyone wants to go to heaven but no one wants to die.

  • Report this Comment On August 20, 2009, at 3:45 PM, cdubbies wrote:

    I find it interesting that you would invoke the term "invisible hand" in an article arguing for further government intervention into a marketplace. The term, originally coined by Adam Smith, was actually meant to distinguish the forces of a free market from those of a protectionist government, which acts with a very visible hand, sometimes even an iron fist.

    If we were going to rely on the free market's invisible hand to bring fair pricing to the health insurance marketplace, we would actually want to move in the other direction, by removing many of the distortionary public policies that exist today. The prime example is a tax incentive that encourages employees to receive health insurance through their employer. This not only limits the coverage and pricing options available to the end user, but also ties your health insurance to your job, such that if you lose or change your job, you will likely lose your health insurance, and be subject to a reevaluation. This situation exists in very few other insurance markets.

    Additionally, the government mandates that insurers provide coverage of various types of treatments, which inevitably drives up costs unnecessarily for those who would not like have those benefits covered. In a truly free market, an insurance company would be able to offer a broad spectrum of coverage options that would meet the individual benefit and price needs of each discriminating customer. But, alas, I am only offered three options by my employer, and they are all the same coverage with different deductible levels, clearly not the result of a free market system.

    Adam Smith believed that the baker, the butcher and the brewer did not put dinner on our table through their own benevolence, but by their own greedy pursuit of profits. I think it is important to bear in mind that profit pursuing health insurance companies, acting in a free market, have an incentive to not only keep you alive, but keep you healthy and out of the hospital, so that you can constantly pay your premiums without making a claim. One should always consider, if only momentarily, that another player, most likely the government, has changed the game in such a way that these are no longer the driving incentives of the industry. If this is indeed the situation, then it seems that the government should evaluate what part of problem it actually represents, rather than automatically assume that it is the solution.

  • Report this Comment On August 20, 2009, at 4:01 PM, ozzfan1317 wrote:

    I sincerely agree that a public option should be included just my two cents ut wy offer a cheaper option for thos that cant afford healthcare?

  • Report this Comment On August 20, 2009, at 4:08 PM, Amplifryer wrote:

    When Medicare was implemented in 1967 the budget for it was pegged at 1 billion, by 1970 its cost was already at projected 1990 levels based on 1967 analysis. Today its close to 50,000 percent higher, no exaggeration, in other words, its cost were grotesquely underestimated.

    That's what scares conservatives about successful things the government has done.

    The examples you cite as competition doesn't hold up relative to the complexity of health care...Amtrak vs Southwest? Please.

    All the EU examples of health care live in societies with tax rates at 40%+, plus most by supplemental insurance to make sure they "get the best". In France, you must use certain doctors.

    In the end, government can print money and make it impossible for privates to compete as they absorb losses like they do everything else. Most left wingers don't hide the fact the the ultimate goal is single payer.

  • Report this Comment On August 20, 2009, at 4:18 PM, Amplifryer wrote:

    The best soulutions I've heard so far include opening up interstate commerce to make it easier for the 1300 U.S. providers to compete. Currently the 50 States each have a different set of mandates, many regions are controlled by near monopolies. Monopolies can be busted up too, as Ma Bell was. Opening up private sector competition, enabling more of it will force prices down like competition always does. We have a third fewer doctors than most EU systems, yet were supposed to bring our per capita costs down with a government run plan? Insane.

    I dare government to legislate that the government run plan must run at a profit. They won't do it in a million years because that's not the real goal.

  • Report this Comment On August 20, 2009, at 4:21 PM, TMFNato wrote:

    The original version of this piece had a paragraph acknowledging the deficit, and expressing my concerns about the costs of a public option. It apparently got cut for space, and I really wish it hadn't -- I tried to keep my argument as fair as possible, and acknowledge as many sides of the debate as I could.

    In retrospect, Amtrak and the USPS were probably not the best examples I could have chosen -- but if they don't exactly bode well as models of what a public health-care program could be, they do seem to refute fears that a well-funded public option would instantly and automatically wipe private rivals off the map.

    Thanks for all the great, thoughtful, well-reasoned comments thus far. I highly recommend Brian Orelli's piece, "The Health Reform Witch Hunt," for a more in-depth and detailed view of the debate.

  • Report this Comment On August 20, 2009, at 4:39 PM, TMFMmbop wrote:

    <i>they do seem to refute fears that a well-funded public option would instantly and automatically wipe private rivals off the map.</i>

    They don't, however, refute fears that a public option would be horribly run. Further, the problem is that neither Amtrak nor the USPS look like they'll ever be allowed to fail, which means they chew up public resources in niches that could be ably filled by private capital. Fortunately, the costs of Amtrak can be somewhat constrained. The costs of a poorly run public health insurance scheme -- one that, for example, underprices risk in the name of universal coverage -- could be astronomical.


  • Report this Comment On August 20, 2009, at 5:04 PM, pmlang37 wrote:

    This entire debate is, in my view, about a second priority issue. If nothing is done about indefinitely continuing 8% annual cost increases of health care, no insurance however efficiently run can possibly be affordable, for either the patients or, if subsidized, by them and the government, in the longer run.

    Instead of addressing health INSURANCE reform, Congress and the Administration should be addressing health COST reform as the first priority.

  • Report this Comment On August 20, 2009, at 5:14 PM, foolraoul wrote:

    The Federal government is not the most efficient entity for health care or the post office or the passenger rail system.

    The private health insurance industry is not a "near monopoly" and many are non-profit.

    Look at the Texas model. It simply introduced tort reform in 2003 and insurance fees immediately dropped an average of 27% and the number of doctors applying to practice increased 57%.

    Only a Marxist/Leninist socialist would try to "fix" the problem by taking over 18% of the economy.

  • Report this Comment On August 20, 2009, at 5:17 PM, money4eds wrote:

    83 cents on average out of every dollar collected in premiums is spent on health care. 17 cents is left for the insurance companies to make a profit and pay all of their expenses beyond medical cost. Profit margin is regulated into the range of 4 to 8%. Scale and short term cash management is how they make money. The industry regulation on a state by state basis pretty much puts everyone in the same boat. On a profit basis the industry has more than 80 other industries that are more profitable. I have been in business for myself and I would never embrace this business model. 4% return on my investment, no thanks.

    Real reform could be had with two simple acts. Increase competition by eliminating the state by state regulation and allow insurance companies to serve any market.

    The larger insurance companies are already changing how they pay the providers. Results based compensation is slowly replacing procedure based compensation. The results are just starting to be published so members can decide where they will get the best service.

    No government entitlement program is anywhere near solvent. If they had to be cost neutral or profitable: Medicare, Post Office and Social Security would all be bankrupt.

    Read our founding documents, our government is responsible for National Defense. Our founding fathers did not want a big government, they left that system to create a more perfect union.

  • Report this Comment On August 20, 2009, at 5:21 PM, ldog51 wrote:


  • Report this Comment On August 20, 2009, at 5:23 PM, baybrowser wrote:

    Obama has made his position clear (unfortunately for him) in interviews videotaped several years ago. He said clearly that he thought a single payer system was best and that it might take ten or fifteen years to get there.

    He is as far left as his most rambunctious supporters; all of his former friends and contacts and his current positions on most anything demonstrate that. Further, he continues to denigrate his opponents, at least when he's not blaming Bush for something.

    We should have lots of competition in health insurance, but states have violated the commerce act by putting constraints on who and how many carriers are permitted to sell insurance to state residents. We have not been operating in a free market.

    A government competitor is impossible to deal with, and it ain't because they're less expensive. Many years ago when there was an actual program in place to bid against the government for some activities it was providing, we quickly found out that we (a very lean small firm at the time) weren't even close. Government labor didn't include such things as fringe benefit costs ! Ad hoc help from other groups or agencies was impossible to track, and you could be sure that government management and the unions were not going to be cooperative when their folks jobs were at stake.

    Finally, we're on Medicare right now because we're old folks. My wife and I pay $800 a month for coverage, and we're willing to drop it and self insure or purchase a large deductible policy. (It would be nice if we could use a deductible Health Savings Account with that) But this is all moot. We've been reading that the government won't even ALLOW us to drop Medicare!

    Also please take note that Social Security & Medicare have run up a debt that - depending on assumptions is between 50 and 100 TRILLION dollars. The governments annual revenue is currently less than 3 trillion dollars, and it invariably spends more than it takes in -- and in several years the excess in social security collected over what the government pays out will end. That means annual deficits will be much larger. Please tell me how you think the feds will ever pay off that Social Security and Medicare debt ??? (Incidently, that debt doesn't even include other significantly growing debts such as government pensions.)

    We may have no choice but to ration medical treatment in any event, because most of the health related incurred cost comes up in a person's last year of life. The politicians will continue to refuse to deal with it, hoping they can retire (and enjoy their much better health program) before they have to make a hard decision. We need problem solvers who temporarily go to congress and then go back to private life. Term limits is an absolute must.

    Incidently, do any of you realize that the so-called "47 million uninsured" is a bogus number? Between 12 and 20 million are illegal immigrants (which the democrats evidently claim won't be insured, but they're certainly in the 47 million count. There are millions more between jobs, so many in this group change every time the survey is taken. Millions more are actually qualified for Medicare or Medicaid and for some reason haven't even registered. Finally, there's millions more who earn enough to pay for health insurance but have decided to spend their money on other things.

  • Report this Comment On August 20, 2009, at 5:31 PM, taborek wrote:

    Hear about the way health insurers use their 20-40% overhead, and determine who gets care, in this interview with Cigna's former head of Public Relations, Wendell Potter:

  • Report this Comment On August 20, 2009, at 5:32 PM, modeltim wrote:

    Nathan Alderman is spot on. In my view, the main reason the U.S. economy has reached such a perilous state is that we have a capitalist system based more on monopoly than competition, and that is an understatement. If antitrust laws were still being enforced to the letter of the law most of the largest banks, pharmaceutical firms, insurance companies in this country would have been broken up a long time ago.

  • Report this Comment On August 20, 2009, at 5:35 PM, maguro01 wrote:

    The world is a laboratory of medical care systems. The CIA World Factbook (

    ) ranks the US as 50th in life expectancy. Germany, France, etc are higher. Even the UK is higher though it has an 'underclass' too as does France. Evidently these places aren't 'pulling the plug on Grandma'. The US is also 44th in infant mortality.

    The assumption that our choice is a market or government is not true. The cost of medical care is determined now in pay-to-play Washington and the state capitals. A market isn't that involved unless you call Congress a market. The government is funding almost all the basic medical research. Private companies spin off and develop the IP. Lobbying serves the industry in other ways - .

    The US has papered over its problems by just spending much more money. In a year or so medical care plus finance will eat 1/4 of the US GDP. 1/4. They are needlessly gobbling up the economy that pays for them. Our US life on the tab is drawing to a close as the foreign debt has skyrocketed in the last nine years. Finance appears to be using our bailout tax money to lobby too for killing reform.

    Does anyone else remember back when the AMA got medical schools to cut admissions to cut growth in US doctor numbers? They said it would save money! We couldn't imagine this stuff.

    The next few years will be a wrenching reality adjustment for most Americans. In medical care we can make that adjustment without much penalty. The rest of the developed world has for some time. Lifespan is not a zero sum game for us it seems.

  • Report this Comment On August 20, 2009, at 5:50 PM, MKArch wrote:

    You are out of your mind if you can't see that the "Public Option" is just a tool to get to fully nationalized health care. Force the public insurers to compete with a non profit company that is going to be run at continuous losses but backed up by the government. It's just a matter of time before the public companies fail and the government takes over the whole system by default. Which is the real Obama/ Democrat health care plan. Just what we need another health care entitlement that we can't and won't pay for.

    BTW check out WLP's profit margins they average ~5% for the last 8 years. Where are the big savings going to come from? This isn't about saving money it's about Obama and the democrats dream of creating a new super entitlement. Also all this posturing about having the plan break even is a ruse for Obama and the democrats to get a national health care fact on the ground that they can work on expanding later. Of course funding for this expansion won't come anywhere near keeping up with the costs of the expansion but that will be another president and congresses problem.

    Beside the fact that you avoided the government programs most closely comparable to the national health care Medicare & Medicaid which as I noted above are running at chronic losses, your examples of government programs that private companies can compete with are flawed. Amtrak doesn't compete with the airlines and USPS is the one government institution that is run like a private company in that it's customers pay directly for the service as they use them. It also doesn't hurt that it's a lot easier to jack the cost of a postage stamp up a couple of pennies every year than it is to charge tax payers the full cost of the highest standards of care that users of health insurance and their lawyers will demand and congress won't have the stomach to deny but also won't have the stomach to pay for.


    ps: I grew up in Southern New Jersey but went to college in Northern New Jersey in the 1980's. Back then it took a week or more to get mail sent from South to North Jersey and vice versa. I don't think it takes that long anymore and I'm guessing it had something to do with competition from the public companies. I think your example of public reforming private may be bassackwards.

  • Report this Comment On August 20, 2009, at 5:51 PM, phlox70 wrote:

    Thoughtful article Mr Alderman ! it really kills me,

    some of these seems the "Fools" that

    are the most vehement, know the least facts, and

    spout the most nonsense.......READ extensively, don't just drink KOOL-AID......Hmmmm, how long have we had this huge deficit ? You would think it just appeared a few months ago.....I rarely heard a complaint about deficits until this year.........Wake up

    America. Health Care Reform is a DONE deal.

  • Report this Comment On August 20, 2009, at 5:53 PM, HowthCastle wrote:

    So--it's illegal to compete with the Post Office? Then how do UPS and FedEx get away with it?

    Like the VA it would be many people's only choice? True enough--if they armong the milions who can't get private insurance.

  • Report this Comment On August 20, 2009, at 5:57 PM, Annie1139 wrote:

    "In a truly free market, an insurance company would be able to offer a broad spectrum of coverage options that would meet the individual benefit and price needs of each discriminating customer."

    One problem is that a health care purchaser, "discriminating" or not, really has no way of knowing what benefits he or a member of his family will actually need tomorrow or the day after. Many people who believe themselves to be perfectly healthy and who similarly believe that they are doing all the right things in taking care of their health can to their great shock discover they in fact have a health problem that will become quite costly. Or they may suffer an accident that can require multiple surgeries and on-going physical therapy. While the chances may be quite low, the are far from zero.

    "if the govt gets its way, the boondoggles that are social security, medicare, medicaid, cash for clunkers and bridges to nowhere will seem minuscule by comparison."

    Goodness, just recently there was a ton of outrage about the mythical "death panels" that would "pull the plug" on poor ol' gran-ma and that disabled baby. But apparently there are those who believe that "pulling the plug" on yet more of the poorer members of our society as well as the older ones by doing away with the assistance provided by Medicare and Medicaid programs is just fine and dandy.

    Hey, all you greedy, selfish people out there--haven't you been telling the entire world for years that the U. S. is the richest country in the world and positively reveling in America's superiority over all those other countries that just don't have the same degree of wealth that we do. But, now, oh, woe is us, we just can't afford to provide the kind of universal health care that every other industrialized country does. Moreover, we're too dumb to figure out how we could make it work. Do these other programs have problems? Yes, but the system of private health insurance we have here results in people who become non-productive citizens because they lack access to decent health care, bankruptcies, and unnecessary deaths. Why is this okay with so many people? Why have we turned from being a country that wants to be a model for the world in how we take care of our people into one that is by most measures at the bottom of the heap?

  • Report this Comment On August 20, 2009, at 6:04 PM, Celtics17 wrote:

    This is no "option" - that's just Obamanese for his ultimate plan to put everyone into a single payer system. The House Bill (page 15 or 16?) actually outlaws private insurance. Some "option". If they ask for our bank account info, is it still an "option". This country needs to wake up before it's too late.

  • Report this Comment On August 20, 2009, at 6:14 PM, lart80207 wrote:

    Anyway you cut it or dis-information about it, if a public corporation is making a profit from the misery of others, that corporation does NOT have the interests of the patient in mind, only the pocketbook of the investors. For profit corporations with investors taking profits, will always find the cheapest way to screw the patients and the medical staff.

  • Report this Comment On August 20, 2009, at 6:15 PM, clydejazz wrote:

    The current system is in a price-hike bubble similar to the recent housing market, so regardless of the system you prefer, the current system is unsustainable.

    Obama is not proposing to take over the health care system. He keeps repeating that if you like your present insurance, you can keep it, and keep paying more each year for it (costs are increasing 3 times as fast as wages).

    He is proposing some sorely needed reforms to control costs:

    1. emphasis on prevention and wellness

    2. new payment system for drs. and hospitals: paying for results instead of number of procedures. This is essential to control costs.

    3. faster implementation of electronic health records.

    Plus eliminating the most abusive current practices:

    1. no canceling insurance or jacking up rates when you get sick.

    2. no exclusion for pre-existing conditions.

    Several posters have provided links to factual information from various sources, so please listen to the various stakeholders explaining their positions directly, and don't listen to rumors or sensationalist distortions about the facts.

  • Report this Comment On August 20, 2009, at 6:21 PM, driller101 wrote:

    All big companies hate competition. In fact, everybody who wants to make money does. The only ones who really want competition are the ones on the outside trying to get on the inside.

    Meanwhile the ones on the inside hire politicians to make laws to make it more difficult for the ones on the outside.

    If your in business, you don't want to compete, you want to win. When Buffet invests, he looks for companies that have a franchise, a big advantage over their competition. It's only common sense.

    Depending on your philosophy or needs, you might hope that health care is a little different.

    I think if the public option goes away and the insurance get to insure all of those uninured people who will suddenly become insurable through government subsidies, it will be a big win for the insurance companies.

    But the rest of us will be losers.

  • Report this Comment On August 20, 2009, at 6:31 PM, dmerta wrote:

    Your being naive. Public option is just the first step to forcing most insureds into the gov't plan because there employers will drop the private plans because it will cost them less. Also, it will lead to reduced care of the elderly because Medicare will have to be cut. Lets fix what is broken now by allowing more competition of insurance across State lines, limit tort actions to reduce Doctors insurance, make all insurance portable so people can not lose coverage and provide tax incentives and more health savings accounts so more people can afford some insurance. Also make medical records electronic. These are good first steps to helping everyone.

  • Report this Comment On August 20, 2009, at 6:34 PM, branchre wrote:

    If the government plan is inexpensive enough that those not now covered will have an incentive to be covered, which is unlikely to matter much, it will have to be a lot less expensive than private plane. These plans make a net of only 2% to 5% tops, and they are probably managed a lot tighter than any government plan. Does anyone really think a 2%, or 5%, less premium is going to attract these uninsured? Let's face it, the government is going to have to subsidize the plan big time, make the premiums much less or no one will take it. And this will just be another taxpayer bailout. And if the premiums are so much less why would I want to keep my private policy?

  • Report this Comment On August 20, 2009, at 6:39 PM, richmacmf wrote:

    A public option is step one. It won't work. We the people of America will be worse off and it is one more large step down the road of socialism.

    Less goverment is better. We have had enough of the liberal control of this country. Congress has us moving down this path for the last 60 years.

    We became a great country due to our capitalism and freedom and independance and limits on government control. Why do we want to go down the path that Russia and Cuba and Germany and China and Iran and Iraq and Afghanistan and ??? have gone down. How did that work for those people.

    Capitalism and market solutions work. Give them a chance. We have been overregulated for the last 60 years and that is our problem not private enterprise. The profit motive has driven innovation and work ethic.

    The public cost of the public option is going to be HIGHER TAXES!

  • Report this Comment On August 20, 2009, at 6:43 PM, richmacmf wrote:

    My brother has spent his entire life on the outside of society, proudly avoiding paying taxes for 40 + years.

    A few years ago he has a massive heart attack and is taken to emergency room and they have to treat him and he ends up getting good care and survives and had no health insurance. He is doing fine and somehow he gets his meds and checkups regularly and is still kicking at 65 and smoking two packs a day.

    We already have a public option and we are paying for it.

    I am not sure what we are trying to "fix" here.

    Don't spread my wealth President Obama, spread my work ethic. That is what will help our country.

  • Report this Comment On August 20, 2009, at 7:02 PM, ccg39761 wrote:

    Seeing this type of article on Motley Fool really makes me not even want to look at the website anymore. It is simply amazing to me that a person who must at the very minimum have a quasi understanding of economics is arguing that the private market cannot deliver medical services because it has a "profit motive."

    At the end of the article the author asks if there are any "better free market solutions rather than the public option." The answer to that question is 'yes' and here is what needs to be done:

    1. Abolish all government licensing requirements for doctors, nurses, and everyone in the medical profession.

    Private, voluntary accreditation agencies would step up over night to certify doctors. The supply and variety of medical services would increase almost overnight and prices would fall dramatically.

    2. Abolish all mandates and subsidies put on employers that push people into insurance companies.

    Insurance is supposed to measure risk and not act as a prepaid service and corrosive racket that redistributes wealth and income.

    3. Abolish the FDA.

    This would increase the supply of drugs on the market and companies would compete over offering guarantees for their products and be directly open to lawsuits if their products injure anyone.

    3. Abolish medicare and medicaid.

    These subsidy programs breed illness and disease and are underfunded by more than $40 trillion.

    Until the above steps are taken the medical industry will continue to suffer and so will we, its consumers.

  • Report this Comment On August 20, 2009, at 7:03 PM, nedcall wrote:

    Some of the cost of healthcare is based on unnecessary procedures to protect the physician, but for the most part, increased costs occur because people want the best available. Isn't healthcare a part of our GDP? The US is a leader in pharmaceuticals and healthcare, why would we wish to hamstring these industries by cutting their profits? If the cost of healthcare goes up to 40% of GDP...... Do we have some more important use for that money?

    Why, if all hospitals are required by law to treat anyone who comes into the ER, and this is the most expensive type of care folks can have, will it cost more to move them from the ER to a physician's office where they can get the preventative care they need? Since everyone gets ER care under our current system, and we are all paying for it indirectly, there is no such thing as "the uninsured". So, lets mandate that those "uninsured" get health insurance. No exceptions. The poorest already get Medicaid. The elderly get Medicare. Most employed folks have health insurance. Make everyone carry insurance and let government subsidize a few in the just above poverty group.

    Stop the silly discussion of having the "public option". In the long run this will just cost us more with the bureaucratic inefficiencies, and political meddling that always accompany government projects.

  • Report this Comment On August 20, 2009, at 7:13 PM, stockmenot wrote:

    Thank you so much Motley fool for now interjecting yourself into politics. I was really wanting to learn more about the Stock market today, but now my time has been wasted. It's blatantly obvious to me that you have a stake in this, or it's your own personal view, stocks aside.

    The truth is, The government has never run anything right.

    The analogy about Mike Tyson was perfect!

    They will screw it up, they always do.

    Skyrocket the taxes on fast food and junk food, and put that towards the uninsured, since that is what's really driving costs up.

    And let me go across state lines.

    Now...tomorrow could we go back to the regular forum?

    This does NOT make me want to subscribe, and makes me very suspicious of your motives.

  • Report this Comment On August 20, 2009, at 7:21 PM, solderwave wrote:

    I love what you're saying, ccg39761, although I'm not so sure about simply abolishing medicare, etc.

    On another note, one thing I don't think has been mentioned is that no, Obama's plan is not required, but if you once sign up-you can never go back to private insurance (that is, if there are any private insurers left).

    Finally - if this plan is so good, why don't our senators and representatives and the president sign up for it?

  • Report this Comment On August 20, 2009, at 7:22 PM, peysia wrote:

    Has anyone asked why the American people can't have the same health insurance procedure as our Congressmen, Senators, President and all federal employees and retirees? The very Congressmen opposing the public option like their own version of it very much. There is only one (a doctor) who has refused this good coverage until the people he represents can have the same.

  • Report this Comment On August 20, 2009, at 7:23 PM, Ghostpepper wrote:

    You're killing me out here in Texas. This bunch of yahoos in the Whitehouse can't even get the Clunker Progam right and you want them to get into the health care business. I'm sorry I just can't follow the logic. Oh I'm sorry I forgot, logic left the billing last November.

  • Report this Comment On August 20, 2009, at 7:45 PM, jepepp wrote:



  • Report this Comment On August 20, 2009, at 8:00 PM, knucklelady wrote:

    Thank you. Thank you. Thank you.

  • Report this Comment On August 20, 2009, at 8:10 PM, TerryFreeman wrote:

    In the future please keep both politics and religon to yourself. I subscribed to this service for investing advice, not to hear your personal views on controversial topics. So stick to stocks, or quit and run for office. Not both.

  • Report this Comment On August 20, 2009, at 8:48 PM, GoOtto4Nic8 wrote:

    "Health Care Mythology" at makes a lot more sense than this article, and is a lot funnier, to boot. Read Myth #5, Nathan, and become a bit more enlightened.

    I don't think we need any more boondoggles on which to waste our grandchildren's money.

  • Report this Comment On August 20, 2009, at 9:04 PM, Nodack wrote:

    Very nice article. Like you said though, But ... but that's socialism!

    Too many people living in the stone age here are afraid of the word SOCIALISM! :) It even looks scary huh?

    I think they are right. We should dump all government run Socialism such as Social Security, Medicare, Medicade, Amtrak and all public transportation, Police, Fire, Military, Parks and Recreation, water, sewer, gas, trash pick up, highway construction and maintenance and some I can't think of right now off the top of my head. Those are all forms of SOCIALISM run by Federal/State and local governments.

    Since SOCIALISM is EVIL how many of you would be willing to give up those forms of SOCIALISM I just mentioned?....take your time....<crickets chirping sound>......

    That's what I thought, NONE of you. I've asked this question a million times and I have yet to have anybody respond with anything other than insults which pretty much proves my point IMO.

  • Report this Comment On August 20, 2009, at 9:13 PM, dhagan wrote:

    sorry nathan,

    name one thing the gov't does "effectively and efficiently"?

  • Report this Comment On August 20, 2009, at 9:41 PM, holisticfool wrote:

    Why is everybody missing the boat. We're comparing government to corporate and talking about relative efficiencies. The government is corporate. We're living in a corporate dictatorship. Greed has changed everything. The bottom line is the only thing that counts, whether you're in business or government.

    If there is a government supplier of health services, do you think the lobbyists will all go away? Why does the FDA ignore what's best for the people and only attend to the needs of the drug and food companies. Do you remember that when certain approved drugs were killing people, the companies recalled them even though FDA refused. We had the Aspartame neurotoxin sweetener approved, only because of political connections. Stevia, which has no side effects, other than positive ones, was not approved till Coke and Pepsi decided they wanted to follow the Japanese market that was using stevia. Now, what was bad is suddenly good. Stevia is now approved, but only in extract form, Extracts can be patented, you know.

    The New York Times published an article recently puzzling why research into potential breakthrough cancer treatments was not being funded. Government agencies and charities don't support research that might rock the boat. Chemo, radiation and surgery are big money-makers, so we don't want anything cheap and effective screwing things up. FDA is the "Republican Guard" maintaining the status quo.

    Grocery store shelves are loaded with nutrition-free foods that contribute mightily to our obesity problem. FDA could establish minimum nutrient standards that would make our people healthier and maybe a little thinner. To do so would surely annoy certain established interests so it's not likely to happen. It would have a very favorable impact on health and health -care costs though.

    The government is the problem, as Reagan used to say, but government thinking is led by the corporate lobbyists.

    The health-care problem could be solved if government stopped defending the corporate financial interests. If the FDA and NIH were removed from the corporate pockets wherein they now reside, we could develop therapies that are inexpensive and much more effective than what we have now.

    I have personal experience that caused a complete change in the way I see health-care. I was almost killed by a treatment regimen designed with profits in mind, rather than healing. I then went against the recommended treatment protocols and cured myself with herbs and supplements at a tiny fraction of the costs of approved treatments.

    We have been conditioned to think of anything not approved by the establishment as quakery. I am amazed at how effective that conditioning has been. The health-care system we have now was designed and is maintained to be extremely expensive. This is necessary in order to generate the payoffs that are required. Unless we deal with the underpinnings we'll never make it affordable.

  • Report this Comment On August 20, 2009, at 10:52 PM, dibo528 wrote:
  • Report this Comment On August 20, 2009, at 11:00 PM, 51dochudson wrote:

    It is a very odd fact that in all of the hand wringing over those who cannot afford health insurance or health care no one has noticed. that health care professionals receive no benefit (other than serving their fellow man) from donating free care to the truly needy. Either our leadership cares not at all for those who cannot afford basic health care or medications or they can only permit themselves to view the issue through the lens of more and bigger government. I propose that if the goal is to increase a certain behavior or outcome (more care for those in need), then rewarding that behavior (donating care) by giving well defined tax credits for donated care, would produce the greatest possible 'bang for the buck'. Has anyone heard of this option in the 1k plus page bills or the public discourse? As a health care professional I already donate a significant amount of my services free of charge. I much prefer to do this than subject myself to the ceaseless frustration of treating medicare and medicaid patients and dealing with the never-ending, multi-layered, ever-changing, abysmally reimbursing, bureaucraticly generated paperwork.

  • Report this Comment On August 20, 2009, at 11:04 PM, CaptainRadd wrote:

    If you took a lot of these gov't programs away, Social Security, Medicare, Medicaid, what have you, there would be blood in the streets.

    You folks need to stop drinking this Milton Freidman kool-aid and drop the supply side garbage. The Bush administration already tried to ram this down everyone's throat. Privatize everything, the market will always take care of everything.

    There's no grand scheme to nationalize healthcare into single payer. Nobody wants to do away with private enterprise. And no, the gov't can't and shouldn't solve everything.

    Obama is not Christ, and his health plan isn't perfect. But something needs to be done. When this blows over and a health care bill is passed and things change, it may not totally repair the system and it may add to the deficit. But we won't be flying red flags and reading Marx.

    You're not special and you're not a soothsayer. You're just an angry republican who's guy didn't get elected. When your diatribes never materialize in the future in a few years, you won't even remember saying them. But you'll dig them up again when the next liberal gets elected. And on and on.

    I remember when people could have reasonable discussions. That was before the internet, I guess.

  • Report this Comment On August 20, 2009, at 11:20 PM, savdawav wrote:

    "That's no different from the U.S. Postal Service, which must compete with UPS (NYSE: UPS), or the government-subsidized Amtrak rail service, which vies with airlines such as Southwest Airlines (NYSE: LUV), bus lines, and your very own automobile for your travel dollars. (Note that in both those cases, the private businesses are often doing better than their public rivals.)"

    Really- you believe that the USPS compete's with UPS? Not a chance-

    The USPS is an outdated government monopoly that is sustained through the txe revenues generated by companies like FedEx and UPS.

    This system- if allowed to evolve the way you illustrate with the music industry- the government entity should be down sizing and reducing its intrusion into the private sector- not growing into it.

    The same for Amtrak- to suggest that it creates a better airline is just unfounded!

  • Report this Comment On August 20, 2009, at 11:23 PM, 51dochudson wrote:

    For those who believe that health care is a morally mandated 'right' that only government can guarantee, please tell me when will all med-schools and nursing schools will become tuition-free? Furthermore, how will the medical profession continue to attract the 'best and brightest' when they will be facing a life time of working in a state-run bureaucracy? I shudder to think that to find sufficient physicians to provide governmentcare we will most certainly have to seek non-English speakers by the many thousands to just keep the door open in such facilities.

  • Report this Comment On August 21, 2009, at 12:10 AM, thomasblak wrote:

    At least one or two of you have any common sense!

    Holisticfool is right on when he says "We are living in a corporate dictatorship"!

    The "Gov't" seems to do a pretty good job running the military, utilities, infrastructure and the commons, which belongs to ALL OF US!

    Sure the gov't shouldn't be building cars or TV's, but acting as bill payer and paying doctors on time and fairly for their services while taking out the 25% overhead of FOR PROFIT health insurance Co and running it very efficiently, (3-5 % overhead for Medicare) can only reduce costs.

    There are NO employees working for the Gov't run Medicare system whose sole job is to deny coverage and drop your policy, like there is for United Healthcare.

    Fact: it takes 60,000 policy holders paying $1000/mo just to pay for the CEO's salary and stock options at United Healthcare!

    As for the Post Office arguement, get real! The Post Office HAS TO deliver every single letter to EVERY SINGLE MAILBOX in the country every day.

    If they lost 7 Billion doing that, I guarantee you Fed Ex and or UPS would lose twice that!

    That's the point - UPS would never deliver to every address for a flat rate, heck they charge hugh service fees for cities that are just 40 miles away from a major city already.

  • Report this Comment On August 21, 2009, at 12:24 AM, porchguy wrote:

    I can respect all the fools in the forum that have brought up about how this health care option will be paid for, but for the fools in the forum who think that Congress can just regulate the existing heath insurance companies should first check and see if their congresman or senator is taking campaign donations from the health industry.

    I think you will find out that there are so many doing it that you surely aren't going to see them bite the hand that feeds there war chest. which by the way they get to keep when they retire. A lot of people don't know that. So, if you have a congressman or senator with $5,000,000 in their war chest (campaign fund) that they use to get relected, but upon reitirement they have any amount they can either donate x amout to their respective national party, all of it, or none of it and keep it for themselves. That is why so many complain about not getting paid enough, but when they retire, they retire as millionares.

    If some kind of health care and it sure isn't co-ops isn't passed by the government, you will continue to see health care insurers raise their premiums on a yearly basis. It's all about profits at any cost to us civilians.

    They are no different than the oil companies. They know they have a monoply and they aren't willing to change. Why do you think they are against this. One fool above hit the nail on the head. They aren't willing to actually sit down and do away with all the waiste and inefficientcy in their business, because they are making so much money now, they really don't care and won't care until there is a government program that will make them be competitive.

    When have you seen any of them go out of business? If their has been any it is because of mismanagement, not because they weren't getting enough in premiums.

    I have insurance, but I sure would like to see people that don''t make alot of money have at least a chance at getting something affordable. It just might keep my premiums from raising faster than the cost of living.

    I'm one of those believers that we do need some competion with the health industry. Whether you believe it or not, they are all in bed together.

    Like I said above I respect all the comments left, but when the health care industry has so many of our politicians in their back pocket, you will "NEVER" see them pass a bill that will hurt the health care industies pockets.

    Just one man's opinion

  • Report this Comment On August 21, 2009, at 1:35 AM, Boomerchef wrote:

    I confess that I did not read all the posts before mine.

    The big issue seems to be the cost of the reform bill.

    If that's your focus, you need to look at two of the highest-rated hospitals in the USA - Cleveland Clinic and Mayo clinic - where the doctors are happily (gasp) salaried!! They give the world's best care at 80% less cost.

  • Report this Comment On August 21, 2009, at 7:16 AM, xetn wrote:

    Just how does the USPS compete with UPS? USPS has a "MONOPOLY" on 1st class mail, UPS cannot deliver it, nor can FEDX. What planet do you actually live on?

    The biggest reasons why "private" health care costs so much is government regulation of every area (FDA) regulations on private health insurers, high insurance cost for doctors, high costs of prescription drugs, etc.

    One free market advocate recommends the following:

  • Report this Comment On August 21, 2009, at 8:21 AM, KJTemplin wrote:

    Simply put, health care reform needs to be all about accountability (patents, doctors and insurance companies) and cost reduction. I would not be willing to fund a public option to achieve these goals. More fundamental changes (tort reform, testing, life style accountability, etc) need to be front and center for my money.

  • Report this Comment On August 21, 2009, at 8:43 AM, blades22191 wrote:

    These are interesting comments.

    first read the HR3200 there is no competiton. we will go on the government plan

    if the government plan is priced below market ie 15-20 the hospitals will lose money. They depend on commerical insurance for their margins. Since they are tooo big to fail they will be nationalized.

    how is this legislation reducing healthcare costs. taxes don't reduce costs.

    by the way medicare is 30 trillion in debt

    if the government would remove the limits on insurance being state specific we would have competition of insurance but the regulations are costing us about 175 billion per year.

    where is portability??

    do we need reform, yes but this bill is bad

  • Report this Comment On August 21, 2009, at 9:08 AM, donaldo15 wrote:

    WOW! Motley, stick to investing and stay out of politics. This is where the Fool must come from.

    You praise Medicare, yet its bankrupt. Just like the road Social Security is on. Inevitably it leads to higher taxes and more government.

    Other comments here show solutions that are obvious. Americans shouldnt pay for illegals health care nor should they pay for those with high enough incomes to get it but choose to not have it. Eliminate that group and you will find the problem is much smaller than advertised.

  • Report this Comment On August 21, 2009, at 9:38 AM, ishowuthemoney wrote:

    Well of course a government plan should cost less as they won't have to pay any federal or state income taxes.

    Let's just level the playing field and eliminate income taxes.

  • Report this Comment On August 21, 2009, at 10:36 AM, daji777 wrote:

    If YOU are for public run healthcare in any form, then my guess is that YOU expect to get something that YOU won't have to pay for. YOU believe YOU will be better off than YOU are today. My advice is that YOU stick to buying lottery tickets because your chances of winning that gamble are probably much better. If YOU are a "something for nothing" sucker then no logic will convince YOU. All of the comments posted have sound reasoning why this won't work but YOU still believe in fantasy come true and YOU will never listen because YOU can only see YOUR immediate benefits.

    That is what all those people thought who got loans they couldn't afford too. Some people can only learn the hard way. Unfortunately they drag everyone else down with them.

    Guess What? When YOU succeed in taking all the responsible hard working people down with YOU then there will be no one left to help YOU out any more. It isn't the government who is rich buying YOU all of these wonderful benefits. It is ME and all of the other folks who work hard and pay our taxes. So when YOU succeed in ruining us, YOU ruin yourself and your children's future and the government goes bankrupt and ultimately YOU will not be better off at all! YOU will be a lot worse off and your children and grandchildren will never have it as good as you do right now today.

    For once can YOU please not have to learn everything the hard way! If your mechanic always screwed up your car would you go back??? If your bank was going bankrupt would you continue to put your money in it? No, YOU wouldn't because that would be stupid now wouldn't it? YOU are only stupid when YOU think it is someone else's money. Well, there is a lot more here at risk than someone else's money. We are all interconnected and YOU don't see that YOU are eroding your own foundations. This will cost YOU everything.

    Only I won't get the last laugh. WE will all be crying together. Let's start thinking WE instead of ME. WE can go far. WE can be FREE. WE can fix it. WE can be united Americans against Corrupt Elitist Government. WE should be working together. WE will get a lot farther than YOU or I. Government is a lustful greedy sugar daddy that wants to screw US all and boy is he a sweet talker always. Wow is he seductive! Why don't YOU listen to your hard working fellow Americans instead of those pick pockets flying around in private jets. Let's get together! WE WE WE all the way HOME!

  • Report this Comment On August 21, 2009, at 10:39 AM, fingyres wrote:


    the problem with your anaysis, including the part regarding Medicare and Military health plans is that they are not efficient. Medicare is hemorrhaging and Military health care gets its "efficiency" from medical professionals who are in the Military. Translate, they work for military pay and are subject to military discipline and control.

    Additionally, the reason the health insurance industry has a "monopoly" is that government mandates allow them to. A person cannot "shop around" for insurance because each state can put in their own mandates and because of that all insurers that write in that state can pretty much charge what they want.

    The bottom line is if you add a national plan that can cross state lines, does not have to worry about the dirty word (profits), and can rely on the government to make it more favorable to enroll in its program you will have the 5000lb gorilla who will cause all plans to look the same or go out of business (which will likely happen since the private sector does not have the taxpayers to cover their losses).

    Please re-read Karl Marx and then reconsider your position.

    Additionally, while I don't like insurance companies making profits because of the way the government has allowed them to be a monopoly, the simple answer is take away the government controls that create this problem.

  • Report this Comment On August 21, 2009, at 10:42 AM, Padre3210 wrote:

    I am always amazed, given the bankrupt condition of Medicare, Medicaid, Bush's Pharmaceutical program for seniors, and Social security, that people will assume that any government program will be efficient or self sustaining.

    Eventually it would include anyone who is a voter, or could be, and of course it will be heavily subsidized.

    Government has never shown competence at anything.

    Let's concentrate on identifying cost drivers for health care, and get those costs lowered. Currently many dozens of good ideas are being ignored.

  • Report this Comment On August 21, 2009, at 10:56 AM, geeraf wrote:

    I am about to be eligble for Medicare. The leadership of the Democratic Party has done a horrible job of presenting their case for reform. Everyone knows the costs of health care are huge, but the proponents of reform have not laid out an understandable solution. There are many comments on bothsides that are simply false and proponents of change do not explain truthfully how the public option plan will cut costs. I get very concerned when I hear the public option will save millions of dollars inMedicare costs. Where are savings going to be generated? In some areas Medicare recipients care is already rationed with doctors limiting the number of patients they will accept covered by medicare. If the costs savings mean further reduction in fees paid to the providers of health care to those covered under Medicare, then I am opposed to the plan. Unfortunately, I can only assume this to be the case because no one will explain in everyday common language where the reductions will come. I would like for the supporters of the public option to present a clear and easy understood explanation of the savings---if it means the elimination of private helath care, state the facts and quit letting half truths dominate the discusssion.

  • Report this Comment On August 21, 2009, at 11:07 AM, danteps wrote:

    Get ready socialized medicine fans . . . should have plenty of time to wait for claims processing.

    This will be short and not-so-sweet.

    According to the Monday Morning Workload Report (MMWR) of the Veterans' Benefits Administration dated January 5, 2009, the backlog for veterans' benefits claims stood at 808,607. Report is here ...

    The same report for May 11, 2009 shows the backlog at 916,456. That report is here ...

    This is an increase of nearly 108,000 claims in the backlog in just a bit over four months ... an increase of 13.3%.

    As pointed out by Paul Sullivan of Veterans for Common Sense (VCS), at this rate the backlog will go past one million by September, 2009 and jump to more than 1.1 million when we hit 2010.

    VA Claim Backlog

    The U.S. Department of Veterans Affairs (VA) Regional Office in Los Angeles and a majority of other Regional Offices throughout the United States have a serious and unprecedented backlog of claims. As of April of this year, the Los Angeles Regional Office had a backlog of 12,800+ claims pending and 3,100+ pending appeals. Nationally, the VA had 512,700+ claims pending and 90,800+ pending appeals.

    Claim Processing

    The average new claim processing time appears to be 12 to 18 months while appeals may take several years. This backlog is frustrating and unacceptable to all concerned, especially to our veterans and their families.

    The reasons for this backlog are numerous, complex, and in all fairness to the VA, beyond their immediate control. The VA, however, is working hard to correct the problem.

    There are many claims related issues that the VA must resolve, such as documentation, evidence, and procedures, which must follow federal law and regulation, and must be determined before the VA can make a decision on your claim. These requirements vary depending on the nature of the claim.

  • Report this Comment On August 21, 2009, at 11:20 AM, alumni1 wrote:

    Hi all,

    Too much screaming here.

    The present system gives us lousy coverage and poor care (40 M not covered means they have terrible health and go to the emergency room where the rest of us pick up the cost; the US ranks 30th in care vs. cost).

    Continuing to do the same thing and expecting different results is a sign of insanity.

    Nathan's comments deserve better than screaming. He is right that the present 'system' favors the inefficient who want shelter from competition.

    The screamers are right that a sole source provider, especially government, will not be an improvement.

    Doing nothing however is not an option. Neither is more of the same.

  • Report this Comment On August 21, 2009, at 11:22 AM, miteycasey wrote:

    to sign up for a government-run plan instead of a private insurer

    It's called COBRA.

    "That's no different from the U.S. Postal Service, which must compete with UPS (NYSE: UPS), or the government-subsidized Amtrak rail service, which vies with airlines such as Southwest Airlines (NYSE: LUV), bus lines, and your very own automobile for your travel dollars. (Note that in both those cases, the private businesses are often doing better than their public rivals.)"

    Ummm....hello. Name one area the government competes with private industry and out performs.

    Except for where the government can write a blank check.

    This is the reason I'm against public health care. It will be bureaucratic and perform worse than private insurance.

  • Report this Comment On August 21, 2009, at 1:00 PM, dcstrade wrote:

    Here's an easy lesson in economics. High prices reflect high demand. Unaffordable prices are unsustainable, and reflect a distortion in demand, not actual demand (if it's unaffordable there's no demand because no one can buy it). That distortion is coming from government involvement. Remove government, see prices fall to meet true demand. End of story.

  • Report this Comment On August 21, 2009, at 1:18 PM, stew2724 wrote:

    So you want your readers to believe that the Government can run an efficient, profitable health care company without congress and K street continually trying to exert control? A government run health care option is not competition, it is government control of prices and health care outcomes. It is a wish by statist that will not work because there will be no profit motive, only social reform.

  • Report this Comment On August 21, 2009, at 1:23 PM, danthony wrote:

    I always thought the number of Health Insurer's provided plenty of competition. Why does the addition of a Government Option add competition better than other insurer's?

  • Report this Comment On August 21, 2009, at 1:24 PM, Mungbork wrote:

    Well, um, in Indiana, the private biz that is administering the public welfare system, none other than big blue - IBM - is performing worse than the government did, and costing the state more than before they took over. Its not the government per se that's inefficient, nor the private sector profit motive that guarantees efficiency.

    Just privatizing a public or quasi-public service is no guarantee of anything. In fact, in many cases, its a lazy-man's cure for what ails government. We have abandoned any belief in and hope for competency on the part of our elected/appointed officials, and perhaps what we really should do is demand accountability and integrity. Maybe that's too much to hope, but simply taking on the mantra that putting all things into the free market will cure any ills is foolish. We need to reshape our government so it does what it is supposed to do, rather than abandoning our civic responsibilities to the religion of business.

  • Report this Comment On August 21, 2009, at 1:28 PM, Mungbork wrote:

    Just a quick addition to the above. The "profit motive" isn't the only motive people have. If we act as if that's all there is to work with, and that's the only thing that will have an effect on our social, civic, and business enterprises, then we have given up our identity as Americans, and maybe as human beings. Its a cop out to assume that the profit motive will solve all social and economic problems.

  • Report this Comment On August 21, 2009, at 1:31 PM, Mungbork wrote:

    Sorry, one more addendum:

    It's interesting that the political right, which supports creationism, is so darwinistic when it comes to addressing civic and business problems. On the one hand, its the hand of the creator directly behind everything, and on the other, its "dog eat dog" and survival of the fittest.

  • Report this Comment On August 21, 2009, at 1:34 PM, LearnSomthing1st wrote:

    It is ALL ABOUT POWER! People against reform miss the point of what Insurance is for and the benefits it adds to our country, society, and individuals making them all prosper and more competitive in the world. The Status Quo on Health Care Insurance today, tilts over the balance of power/control to the establishment(Employers, Unions, Insurance) and I find it to do more harm to everyone than good. From a political point of view I think is hillarious when the typical Pro capitalist, Anti-Socialist, Conservative, Libertarian American argues that the current situation is the best in the world and for the country. Here is why they are wrong on this issue if they are true Capitalist and beleive in the Constitutional Rights of Life, Liberty and the pursuit of Happiness?

    #1) The Status Quo in Health Care is not in alignment with the American Constitution mainly because Amercans can only participate in this monopolistic system at a fair price thru some Employers. I never understood if this is America why Americans can not form or belong to a group and go to an Health Insurance Co. and set up a Group Policy. For Example members of a church, bowling club, etc.

    #2) Not all employers can provide Health Insurance to their employees at fair prices or at all. This creates another problem that hinders capitalism, by removing competition, and innovation giving more power to the current establishment because it sets a "high barrier to entry market" eliminating compettitors.

    #3) Have you ever thought what helds people back from their freedom and pursuit of happiness. It usually is lack of choice and it is enflicted by lack of access, ability, talent, education, opportunities, time or options. In the case of Health Insurance there is access limitation and options that are level the plainfield. Health Care today divide the country instead of unite us. Are options: work for and employer and maybe pay a fair price, willingly or unwillingly skip insurance risking financial ruin or pay unfair or hyperinflated premium.

    If America wanted the best for the nation it would be smart to increase competition and innovation by developing a nation of strong and healthy americans with efficient and effective health care for everyone. Education can also help we are still too underdevelop nation to understand the benefits yet.

    Today, I got health, employment, and health insurance. But I know my financial ruin is just around the corner. It is just a matter of time. Becasuse like every Amaerican one day I will be sick and unemployed and the Health Insurance Company will drop me, deny coverage or not pay for my care. What would you do when it happens to you? In case you do not realize it we already subsidized all the Uninsured Americas one way or another thru Insurance Premiums, Higher Medical Costs or thru Bankruptcy court. I rather be proactive and smart about it.

  • Report this Comment On August 21, 2009, at 1:46 PM, Alabare wrote:

    Out-of-control cost increases mandate the need for reform. And "good" reform needs to address:

    1 Cost shifting by goverment programs to the private sector (Medicare and Medicaid mandate lower payment to doc's and hospitals etc.) Result: the providers make it up on the rest of us.

    2. Out-of control malpractice awards -- result: out-of-control premium increases in the doc's liability insurance/overhead. Also forces the doc to practice "defensive medicne" = uneeded testing etc.

    BTW -- The "public option" you advocate is a pure and simple opening up of Medicare and Medicaid to everyone. Reimbursement to doc's and hospitals will be MANDATED not negotiated. That will put cost-shifting by governmental programs into outer space with the result that the private sector will cease to exist. Doc's will still need to pay the rent and hospitals will still need to meet their huge payrolls.

    Healthcare reform? By all means. But let's do it in a way that accomplishes what we need to accomplish.

  • Report this Comment On August 21, 2009, at 2:17 PM, JohnnyAngel33 wrote:

    I love the MF but this article scares me. It was clear absolutely no research was done before writing it and the lack of reason and common sense made in the comparisons is ridiculous.

    First of all, medicaid and medicare pay doctors and hospitals 20-30% below market price for their services. So how do they make up for that? They charge the private insurers more. You can thank government run medicare and medicaid for increasing private care costs.

    I'm still trying to figure out how someone can liken a competition between a rail service and an airline to the health care industry. Or pirated music for that matter.

    And what scares me most of all is the reasoning that starts the article. "Well Obama said the bill won't force out private insurers so it won't."

    Have you read the bills?! If you actually read them you will understand that in time this is exactly what will happen. As time goes by more and more private insurers will go under or drop out. Then the lack of private insurance and even less competition will cause prices higher and be a perfect precurser to the government taking over it all.

    Has anybody opened a history book recently? Where is this reasoning that you can trust governments to tell you the truth coming from?

  • Report this Comment On August 21, 2009, at 3:12 PM, beatnik11 wrote:

    This is a great article and am very glad it was posted in an effort to give some counter balance to many other bloggers posts on this site. The mere idea that that the government might be involved drives libertarian ideologues insane even though the current public option is more like a very watered down version of an european model yet to them this is stright up pure evil socialism that will lead to a Stalinist state. Never mind that there are dozens of examples of single payer and hybrid systems that are far more efficient and cost effective in the long run for their population. Yes, our system is a hybrid as well, but its a hybrid system that is far to slanted to private interests, it certainly has not reached a healthy balance. There are some things that are just fine and dandy to be not for profit and help our economy and society as a whole such as those terrible hard left ideas such as public education, public fire protection, and public police protection. Can you imagine if the fire department was run by for profit companies? It would be a disaster. Every other sector should be left to the private industry with mild regulation. Oh but then I forgot, we dont want anything to do with the health care plans of other developed countries, AM opinion talk radio keeps telling me that they are really Soviet states in disguise

  • Report this Comment On August 21, 2009, at 3:42 PM, allied35 wrote:

    Wow, most of you Americans obviously don't travel much. I lived in the US for 12 years and once got into a serious auto accident in which I suffered a compound tib/fib or in laymen's terms broken bones sticking out of my shin and a broken wrist. I was life-flighted and lost a lot of blood. While waiting to be wheeled the operating room I was asked if I had insurance and given a clipboard with a thick stack of papers on it and was asked to fill them in! I said I couldn't write because my wrist was broken and the guy had the nerve to ask me if I could perhaps use my left hand! I had my bones sticking out of my skin and they wanted me to fill in a stack of papers!!!

    Anyone who defends that healthcare system is ignorant and has not experienced the superb care available in Europe, to everybody, rich or poor.

    "But it'll be too expensive" the greedy Republicans will say. Well that is just not true. The US govt spends MORE per capita on healthcare than the UK, Germany, France, Italy, Sweden, Norway, Finland, Denmark, Spain, Holland..... yet the US has a LOWER life expectancy and far higher infant mortality rate than all these and many more countries. The US spends more per capita than any other country in the world on healthcare, yet the US ranks 44th worst in infant mortality!!!! Sweden spends less than half of what the US spends per capita on healthcare yet has less than half the infant mortality rate!!! US babies are twice as likely Swedish babies to die before their first birthday!!!

    Just admit your system sucks, change it and move on already. And I bet the most vocal opponents are the supposed "pro-lifers", if you really care about babies, reform your healcare system!

    In Europe, everybody has healthcare coverage, the quality of the care is obviously better(look at the longevity and infant mortality rates), and it all costs LESS per capita than the US system. More for less, the numbers prove this. Why are Republicans so afraid of "Socialized" medicine? You already have socialized police, fire brigade, national defense, post office etc and they all work very well so what's the problem?!?!?!

    Republicans would argue with a sign and take the wrong way home!

  • Report this Comment On August 21, 2009, at 4:12 PM, creekedge wrote:

    Fool's wake up-our forum is being highjacked!!!

  • Report this Comment On August 21, 2009, at 4:43 PM, WBRWBR wrote:

    If the government option is so great, let's demand that every member of congress and every government employee have to accept that option for their health care plan before any health-care reform bills are passed.


  • Report this Comment On August 21, 2009, at 5:24 PM, Repower wrote:

    My concern is that my health insurance provider is selected for me by my employer. I don't have any real choice as to who my health insurance provider will be. If I don't like my health insurance provider, I have to change jobs to get an alternative.

    If I like my insurance provider, I most likely get another insurance provider when I change jobs.

    I really don't have any choice and the insurance company knows it and treats me accordingly. They have a de-facto monopoly.

    If any other vendor put me through the same kind of hassles that are normal everyday business as usual in the health insurance industry, I'd switch immediately.

    Name me any other area of your life or your budget where you have so little control. I have very different health insurance needs from many of my co-workers. Why are we all forced to have the same policy?

    I don't hear this issue addressed in the health care debate.

  • Report this Comment On August 21, 2009, at 5:34 PM, tomcat65 wrote:

    I'm 65 and am a student of history.

    Point 1: The government is made up of politicians - NOT businessmen. All they know how to do is spend money and get elected. That's bad enough, but when you add the element of our present administration being a Socialist regime with the objective of "dismantling" our present freedoms, that's catastrophic. I KNOW what Socialism is - MOST people do not. Point 2: First comes Healthcare Reform, then Cap and Trade and then Illegal Immigration. It's not real easy to destroy this great country of ours, but systematically doing it without regard for our freedoms will probably happen. The younger people of this country will "reap the consequences" (though they think they "know it all"). Then the USA can truly become USSA - United Socialist States of America. I won't see its full effects because in 20 years I'll be old or dead. The best days of this great country ar truly behind us. Point 3: Just remember a phrase - to all of those who THINK that everything proposed by Washington is good for them: "Those who fail to learn the lessons of history are doomed to repeat them".

  • Report this Comment On August 21, 2009, at 6:11 PM, dancinglight wrote:

    Health care is a service not a right. It would be nice to see a free market response since what we have is predominantly socialist/collectivist influenced legislation. No government program has ever stayed on budget, fixed the problem it was intended to fix, it always causes corollary problems never envisioned by legislators, and is always unwieldy and far too complicated. They have no business touching health care-all they've done so far has run it into the ground. The best Federal policy is stand back, repeal the edicts, and let the market work. John Mackey's WSJ op-ed letter had several good suggestions. It is too much to hope Congress and the big O would take him seriously.

  • Report this Comment On August 21, 2009, at 6:40 PM, jszymanski wrote:

    The Post Office argument is the best reason NOT to do a government option. It consistently loses money, provides worse service than UPS and FedEx, and is basically obsolete, yet we continue to prop it up with taxpayer money.

    And the Post Office is way better than Amtrak or any other government entity that competes with private business.

  • Report this Comment On August 21, 2009, at 7:54 PM, Ladydidi wrote:

    To amplifryier :

    Living in France, after living in America, I think you are mistaking the French system with the British one.

    Here, to collect full rate refund, you choose, freely, one "médecin de référence" ( family doctor) and just have to inform the "Sécurité sociale" if and when you decide to change to someone else : There are 2 doctors in my village but choose another one, 7 miles away, because I know he is very dedicated and I feel better with him. The relationship with our family doctor is a direct one, no entity interferes. When we decide, together, on a specialist, I have more than my word to say as to which one we choose. If I get sick away from home, I can visit any local doctor and still collect full rate refund.

    Many people here are worried about our system going private because until now, money has never influenced treatment.

    My American relatives have to choose a doctor on a (very) limited list given by their insurance company and when my cousin suffered from lung cancer I had the feeling that, the insurance group owned the clinic and could easily have a say as to what treatment was used.

    One of my young relatives has psychological problems and she has very little choice as to the psychiatrist and therapist she can go to. And she has had quite a problem with that.

    Here, she could be the only one to choose, if she wanted, even if that means trying a few before finding the right one.

    Who is talking about having less freedom in Europe than in America ?

    I don't want to say that the French (or German or Suede... ) system is perfect. A perfect system is still to be invented.

    But disconnecting part of the health system from Wall Street is a good thing :

    In Europe a government deciding to save money by not giving proper treatment to the very old or the very sick would simply loose the next election. It's called political suicide : Nobody will ever take the risk.

    Now, if private insurances agree on doing that tomorrow and use the right lobbying techniques to make it acceptable, what will they loose ?

    Having lived in America, I think that here we do pay taxes for our health (... not much more and sometimes less than Americans when I compare inside my own family) but, we get good value for the money, even if the financing should be remodeled to compensate for now using less tax payers to generate the same gross product.

    The American system cost a lot more and gives a lot less. Look at the numbers, study health statistics and you will see : no doubt. Being forced to pay too much for too little service, wether it is in taxes or to a private company, is equally infringing on my freedom.

    Last note : I am amazed at so many people fearing to pay a lot for "the others". But I read somewhere something like 14 % Americans are convinced they belong to the wealthiest 3%. May be there's a link !

    ( What's more, and unless I am mistaken, part of GM problems - and GM employee's for that matter - was having to pays for too many former employees' health and retirement while their competitors, having less past workers had less to pay.

    In most of Europe, all being equally paid as taxes by both companies and their workers, Toyota and GM would have been fighting with the same weapons. Free enterprise, you said ? )

  • Report this Comment On August 21, 2009, at 7:55 PM, MedPeddler wrote:

    Please name for me one thing the government does better and cheaper than the private sector that isn't losing money in the process.

    These are the people that couldn't be trusted to run their own bank. Does anyone remember Dan Rostenkowski? They had to privatize their cafeteria. The press reported that the interstate highway system was a shambles during the Bush admin. All fixed now? I think not. They also reported about the deplorable conditions at Walter Reed and other military hospitals. They bemoaned how returning veterans weren't getting adequate care. I guess they're skipping out the hospital doors now.

    What it all comes down to is this: Obama wants us to trust government to handle 1/6 of our economy because he's in charge and not Bush. Congress is still largely the same except for the change of majority. The president wants us to believe in a system designed by people who know nothing about healthcare, overseen by an obese Surgeon General, and financed by a tax cheat treasury secretary. And the people that speak out against this are angry thugs??!! Reform may be needed, but not at the hands of people who have stated numerous times that they want the government to run it all.

  • Report this Comment On August 21, 2009, at 10:34 PM, StinsonFool wrote:

    Amen to the first comment in the list by DaretothREdux. My BIG concern is that the govt will set specific reimbursement rates for all medical procedures and deny the right of any provider to charge more than the existing formula allows, even though a patient might be willing to pay a higher rate for more timely treatment.

    There are many areas of medical insurance and payment procedures that can be improved, but that does not demand a complete overhaul of the medical system in the USA. Some form of Tort Reform must accompany any major change to the medical system.

    If reform is the major objective, it must be done in testable increments to determine real validity of the change. Landing a man on the Moon was not done in one major project. Use incremental steps by limiting the test to a couple of states with the Liberal plan and a couple of states with the Conservative plan. Find out what works and where are the pitfalls.

    Unfortunately, Obama seems to prfer making a decision (like Gitmo closing) without any real discussion or understanding of the potential problems of his decision. This is NOT leadership.

    What is the staus ot the health plans of Oregon and Hawaii that made a list of medical procedures that would be provided for all? Complex and expensive procedures were omiited. At least examine what data might already be available.

    It is time to study facts and limit emotions and political motivations from the decision making process. The majority (Democrats) may force their views into law, but that doesn't make them right.

  • Report this Comment On August 21, 2009, at 11:04 PM, crawlfish wrote:

    If our system is so good why do we pay at least two times more , don't cover everyone and statistically have worst care than every other industrial nation in the world? I believe free enterprise produces the cheapest and the best . Problem is as the author shows is that our system is not free enterprise but an Oligarchy . By having a public option finally insurance companies will have real competition on their hands and will be force to serve their customers not just stock holders and CEOs. This will drive innovation to produce better care at a cheaper cost as that is how you compete for customers and seek profit in a true free market.

  • Report this Comment On August 21, 2009, at 11:22 PM, crawlfish wrote:

    MedPeddler, I couldn't resist. I work for a municipal power and water company. We consistently year after year have the cheapest rates, the cleanest plants in the country, the best reliability and return solid profits every year to our owner a city.We beat the private own companies in those areas year after year. My doctor says that Medicare is more efficient than private insurance plans even though there is some fraud that needs to be rooted out. Actually private insurance has caps on what they will pay out for an individual and strict fees schedules for doctors. Doctors cannot just charge higher fees to them.Private insurance bureaucrats decide on how they will ration care. All plans do. I would rather have the person deciding not rewarded for denying me needed care to enhance profit for the company.

  • Report this Comment On August 21, 2009, at 11:38 PM, crawlfish wrote:

    Ladydidi , Good post and typical of what I have found on the internet of people who have experience our system of health care and other countries health care. I also work with British and Canadians and they say the same thing about their health care back home. Even know a person from Colombia who while has to purchase health care insurance back home it is far cheaper than any in this country and provides much better levels of care with less out of pocket expense. He keeps his policy current so if he has a major expensive he goes home and has it done there. It is cheaper to fly to Colombia and have it done there rather than in the US. What does that tell us?

  • Report this Comment On August 22, 2009, at 1:37 AM, georgesmithok wrote:

    It seems to me most people want a better system. We have different ideas on how to do it. We do not trust the government and we do not trust the greed of the private sector. Too many crooks in both places. We do not like the bail outs and the greed that caused the problem in the first place. Too much government meddling by forced loans and too much greed and dishonesty from bankers and the stock market. As a senior I find it hard to trust a government with my end of life decision that promotes killing unborn babies. Our government is supposed to allow us to pursue happiness, it does not guarantee we will achieve this happiness. It is to protect us from the greedy and unscrupulous so we can pursue happiness. it that case they would have to protect us from themselves as well. I say let us look a what is working in other countries that have health care for all their citizens and how much it cost and what level of care they have.

    Let us have some honest people examine this who will not gain financially from the choice made. We will not have heaven on earth, but we can be fair and just and compassionate. There are no free lunches. Let everyone pay a percent of their income. We are already socialized to a degree. Compassion is a reflection of love and concern. Be civil and guard your words. A person that controls his tongue (words) is able to control the rest of his life. The love of money will corrupt anyone. We need more people who understand the fact that we all will have to answer to God at some point. We need to live a life with the knowledge there is going to be a judgment day. The Pharisees of Jesus time were grinding the poor and needy under their feet. Jesus said he came to preach the good news Luke 4:18

    The Spirit of the Lord is upon me, because he hath anointed me to preach the gospel to the poor; he hath sent me to heal the brokenhearted, to preach deliverance to the captives, and recovering of sight to the blind, to set at liberty them that are bruised,

    To preach the acceptable year of the Lord.

    Shouldn't we have the same compassion and concern?

  • Report this Comment On August 22, 2009, at 4:37 AM, m0j0m0j0 wrote:

    this discussion shows how poor our schools have become

    #1 the post office has a monopoly on first class mail it is against the law for any company to delivery mail ups and fedex deliver packages at a profit the post office loses money and mail try to collect on the insurance they sell sometime you have to wait 3 months before filing a claim and must go to the post office it was sent from to bad if you where out of town when you sent it next day works the same way back to the sending office

    #2 i have yet to meet any vet who went to the va if they had any other choice my brother-in-law was in the navy and then work at a navy shipyard on regular and nuclear subs he had a cough for 1 year the va said he had asthma then 6 months bronchitis oh wait it's stage 4 lung cancer (he did not smoke

    #3 if you or i started a company offering a retirement plan the same as social security we would go to federal prison it is a giant ponzi scam

    #4 medicare is so efficient that over half of the costs are paid by tax payers not premiums

    #5 amtrack loses $65 or more on every passenger

    #6 why do i have to go to a doctor for simple prescription for a pain medicine or other simple medical problem

    #6 the government spends $9 for every $ it gives out in welfare that's a great example cost control has everyone forgotten that every time socialism or what ever you want to call it it fails usually killing 1,000's if not 1,000,000's of people remember stalin hitler mao castro the 1,000's of elderly people who died in paris when everyone else was on vacation during a heat wave a few years back my family came here to get away from serfdom i don't what it coming here we have already given up to much freedom let us get it back take the governments hands out of our pockets remember time is money and every dime in taxes is time stolen from your life

    #7 government healthcare means rationing long waits fatal delays in treatment do we pay more here i hope so because that means the profit motive makes it better the rest of the world sucks off our superior advances when a rich or foreign leader needs the best medicine where do they go to the usa this is not an argument about cost it's ideological between freedom and slavery who owns my body and work me or a dictator what ever the name is used for the government want to save money just go back to the healthcare we had in the 1930's oh wait we had no antibiotics mri's ct scans medical telemetry vaccines for polio smallpox the list is very long of course it costs more and if we can keep the power mad politicians away who knows our grandchildren could live full lives over 100 years or more

  • Report this Comment On August 22, 2009, at 10:00 AM, mlaursen wrote:

    Let's not forget that President Obama himself slipped up in a speech the other day, holding up the Post Office as an example of a government agency that isn't sustainable without subsidy.

  • Report this Comment On August 22, 2009, at 11:14 AM, loveitsomuch wrote:

    Wow, love the article. Thank you.

    What a wealth of responses and varieties of thoughts and emotions!

    The USA is really waking up around this topic.

  • Report this Comment On August 22, 2009, at 12:15 PM, holisticfool wrote:

    This may have been mentioned already, but WHO has stated that the US pays more for health care than any country in the world. They further state that we are 37th in the world in the quality of that care, below Peru and Morocco.

    Obama plans to make this care available to everyone while, at the same time, reducing the overall cost. Like putting a paint job on a clunker and putting it back on the road. Where will that put us, maybe at 137th?

    Most of the debate I've seen has been concerned with who drives the clunker. Why are so many of us so out of touch?

    Who needs health care? It seems to me that would be sick people. You find them getting chemo and MRI's. They're in doctor's offices and they're taking tons of prescription drugs. The alternative, it seems to me, is healthy people. They don't cost the program near as much.

    We have not even considered that possibility. It is not in the best interest of some with political power to see us get well. Most prescription drugs alleviate the symptoms without bringing a cure. Prescription drugs have side effects that often require more drugs to alleviate those.

    The FDA needs to be completely reoriented to begin programs and policies that would improve the health of the people, not just to produce and sell more and more expensive drugs. FDA is supposed to see that the food and drugs delivered to the public are the best they can be, safe and beneficial. They are not doing that now.

    There is one medicine that would solve the problem immediately, one that would cure greed. If everyone with both hands in the money pot would just take one of them out, what a great day that would be.

  • Report this Comment On August 22, 2009, at 1:32 PM, treasurehunter1 wrote:

    A government plan is fair only if it is self-funded by premiums from those who choose it and not by taxes on those who are not using it. This is why insurance companies are crying foul. They can't charge premiums to people who aren't subscribers.

  • Report this Comment On August 23, 2009, at 1:58 PM, KVoce2 wrote:

    If the free market model is all about competition, then why is the health insurance industry, supposed proponents of free market policies, so afraid of a public option? Because it can be truly comepetitive! Medicare's overhead costs are a mere fraction of those private industry incures. Back in the early '90's, insurance companies used about 95¢ of dollar of premiums on medical expenses, and they were still profitable. Now, they use only about 80¢, and they are much MORE profitable. But they've purged tens of millions of people from their rolls! This is America! What's wrong is wrong, morally and ethically, regardless of your attitude toward capitalism.

  • Report this Comment On August 23, 2009, at 2:26 PM, healthcare9 wrote:

    I'm sure this idea isn't new but what if....

    Employers were banned from offering healthcare. It would all be individual, couple or family orientated.

    That should accomplish 2 things:

    1) If you changed jobs you would still be insured.

    2) Drive down costs because there would be more competiton between insurance companies for subscribers.

    Then, the gov't could give a tax break to all who had insurance. (Another incentive to get health insurance besides the obvious) and could then tax employers who would be saving money from not providing it anyway, If the tax was higher that what they paid for the insurance they could pass that cost on to the consumer of whatever product/service they provided.

    We all-ready have insurance commissioners but if that may have to be nationalized so that people don't get ripped off.

    To help Doctors and hospitals with the billing and paperwork, there would need to be some sort of standardization to the billing process, and maybe even a clearinghouse.

    We do need change, and this isn't an easy thing to change, like the old adage goes... Keep It Simple Stupid!

  • Report this Comment On August 23, 2009, at 5:10 PM, Gratta wrote:

    I live in Europe. For us it is difficult to understand the issue about universal health insurance in the USA. We have been having since decades now and we believe it belongs to the rights of the population and the duties of every nation. About the cost, just consider that US has the most expensive health system in terms of % of BNP of all the developed countries and still is not able to offer coverage to the whole population, so maybe a little more intervention from the government in terms of controlling expenditures might not be a bad idea at all.

  • Report this Comment On August 23, 2009, at 10:57 PM, jocoroco wrote:

    We already have competition. BETWEEN INSURANCE COMPANIES. The author's premise seems to be that the health insurance industry is a quasi-criminal conspiracy with only illusory competition. Which is what typical anti-capitalist leftists also think.

    Anyone who thinks that the proposed government competitive insurance option is not intended to be just a temporary interval on the way to full-scale socialized medicine is being very naive. The strategy is to put the private insurance industry out of business. Once the government-run competitive insurance program is in place, Obama, Pelosi & Co. will make sure that the premiums charged are lower than those offered by the private sector, no matter how much additional borrowing and taxation it takes to subsidize the rates. Or does the author think the public health insurance rates will be lower because our federal government has a proven record of doing everything more efficiently?

  • Report this Comment On August 24, 2009, at 1:35 AM, worrab wrote:

    Here, here, Gratta. Couldn't have said it better. In France you can get a doctor to come to your home (yes, to your home) for 52 Euros (about $75). An in office visit is about 30 Euros ($45). You pay the doctor yourself (they are generally independent, not employed by the government), then submit a claim to the government health insurance. My private American healthcare insurance (UHC) pays at least $250 (negotiated rate not full rate) each time I visit my doctor, in his office, and it is essentially impossible to get a doctor to visit you at home even if you're too ill to travel. The problem in the US is that overall we are paying health-care providers at least twice too much. There are many reasons for that, including abusive lawsuits, and the enormous bureaucratic complexity of managing insurance claims. I am always shocked by the quantity of administrative staff that doctors are obliged to have here. You simply do not see that in Europe. I also find it very shocking (and bad for capitalism) that employers are obliged to be health providers.

    I agree with those on the right that we need tort reform and we need to get employers out of the healthcare business. But I don't agree that government run systems are necessarily less efficient. Based on per capita healthcare costs the government run health insurance systems in Canada and Europe are at least twice as cost-effective as the system here. Perhaps that explains why the insurance companies here are terrified of a government run system. Their profits are presumably a percentage of the overall cost, and if that goes down their profits go down.


    Thanks for having the courage to write your article.

  • Report this Comment On August 24, 2009, at 2:47 AM, worrab wrote:

    Two interesting reads:

    1. David Crum on a conservative plan for healthcase:

    2. Testimony of Wendell Potter, former head of corporate communications for one of the country's largest insurers:

  • Report this Comment On August 24, 2009, at 5:09 AM, stardusterboy wrote:

    I have a radical idea. Outlaw insurance companies!

    Before you stone me, think about how they skew the system of capitalism supply and demand.

    If I'm NOT paying the doctor with MY hard earned money, I want the best care money can buy, and I'll complain loudly if I don't get it. Consequently costs go up with every new expensive proceedure that comes along. I want the BEST when it comes to my health!

    If I'm paying the doctor with MY hard earned money, I'll take two asparine and only bother the doctor when I really need help, and then I'll chose a proceedure that passes MY cost/ benefit analysis.

    Unfortunately nobody wants to talk about the elephant in the room when it comes time for health care reform. We want everything except "supply and demand" capitalism to be considered to solve the problem. The end consumer no longer calls the shots in health care, and the double diget cost increases are a direct result of that FACT. THAT FACT NEEDS TO BE REFORMED or it will only delay solving the problem.

    The government take over does nothing to address this problem. Take medicare and medicaid, and the costs are spiraling out of control there just like the private sector.

    The government has a long history of being anything other than efficient. I'd be scared to let them take over my health care system.

    Until the consumer has the purse strings, nothing will be fixed. LET SUPPLY AND DEMAND WORK.

  • Report this Comment On August 24, 2009, at 5:14 AM, GoNuke wrote:

    Lots of speculation here about what will happen if....

    Why not look at the 20 or 30 existing models of state funded health care in the rest of the first world and see which elements seem to work. Every system has its shortcomings. For all those that are diametrically opposed to government run health insurance I ask you to take a reality check. The US pays twice as much for health care as any other first world country and still does not cover everyone.

    Americans are not as healthy, on average, as the people who live in countries where the state provides health insurance.

    There simply is no credible argument that could convince a sane person that the US system is cost effective or efficient.

  • Report this Comment On August 24, 2009, at 10:08 AM, eekthecat wrote:

    All you people who think the unfettered free-market with no government involvement or regulation will somehow lead to all our problems being solved in the best possible way, you are so absurdly naive, it is nauseating.

    We already HAD that. Remember all those previous centuries? All the death, and exploitation, and horrible standards of living that people suffered through in the US and Europe? THAT is what you get when there are no regulations. The reason life is tolerable now in modern countries is because the government finally decided to step up and protect people. Now it is no longer legal to sell poisonous food. It's no longer legal to work children to death.

    How are you people so stupid?

  • Report this Comment On August 24, 2009, at 10:11 AM, eekthecat wrote:

    Once upon a time, people were selling radioactive material as medicine. And you want to abolish the FDA?? SMH...

  • Report this Comment On August 24, 2009, at 8:45 PM, EdHira wrote:

    Capitalism? - not with the distorted supply-demand model that exists today.

    Both sides agree reform is needed. But reform needs to focus most on market participants that are at a disadvantage, due to the currently skewed system. It is impossible to address this entire issue in one note but I had a couple of points to add:


    When Congress gave employers providing health insurance related incentives (tax deductions) a few decades ago, they unwittingly crowded out all other market options. Employer based coverage won the day.

    As a result, the minority players (market participants that buy their own insurance or small business) are now at a big disadvantage. They do not have a market mechanism to band together and leverage their collective buying power effectively like a big employer. A consumer owned exchange/co-op (that plays the role equivalent to an employer) will help them enjoy the same privileges as those employed with big companies.

    Legislation should allow the private industry to set this up to operate across state lines and only open it up to the self employed/unemployed. The horror stories you hear about are generally folks that are in this marginlaized group. Employer based insurance does not face such challenges - do you think an insurance company will dare harass an IBM employee and risk losing the employer's large contract?

    Point 2:

    As for those that have employer provided insurance - leave them alone! They are content and do not need wrenching change right now. Market mechanisms will

    kick in, as the rising costs of healthcare delivery continue to escalate, to iron out the wrinkles. A critical mass of employers will start passing the costs on to their employees, who will in turn watch their healthcare dollars (out of pocket costs) more closely. They will start haggling with doctors and comparison shopping. If the majority starts doing this, providers will have no choice but to start competing on price, quality and efficiency. That will start a slow recovery to a market model. This will not be without pain but will be necessary.

  • Report this Comment On August 25, 2009, at 5:12 AM, Annie1139 wrote:

    "The Post Office argument is the best reason NOT to do a government option. It consistently loses money, provides worse service than UPS and FedEx, and is basically obsolete, yet we continue to prop it up with taxpayer money."

    Several people have made similar ill-informed statements: The fact is that the post office receives NO taxpayer money but is entirely supported by revenues from postage. Yes, it currently is running a deficit--but then FedEx suffered a first quarter loss and UPS had its profits fall 56%.

    Not everyone agrees that that the USPS provides poorer service than the other two entities. That is simply one of those unsupportable claims that anyone can throw out and pretend that they're really saying something. Come on, provide some real evidence that its service is worse than FedEx or UPS. Betcha can't do it.

    Thank goodness that I can send a letter across the country for $.44 with the USPS instead of having to pay the prices of an organization whose CEO has received more than $54 million in compensation over the last five years. How much would a first class stamp have to cost to pay Fred Smith of FedEx that $54 million?

  • Report this Comment On August 25, 2009, at 10:34 AM, rightisright wrote:

    Only a true communist would claim such an idiotic recommendation. Government run-health care, as touted by O'Commie, is MARXISM. MARXISM is diametrically opposed to capitalism. Read an economics 101 textbook moron!

    Socialized medicine will destroy 18% of our economy, cause shortages, rationing, and a decrease in the number of doctors. It will increase costs by triple, to say the least.

    The government NEVER has, and never will be more efficient than the private sector. It is NOT interested in determining what is best for the end user. It will set up bureaucracies and inefficient systems.

    I have suffered enough under government run medicine in the military for over 18 years. Some of the WORST medical care. Yes, there have been some good doctors (to be fair), but overall, it has been BAD. In addition, medicines are often generic, not the most advanced available, and are rationed. Here in Iraq, I can't even get some medicines I have needed, because they were NOT available!

    I have had doctors not even examine me before making a prescription!

    Government run health care will cause panels to ration medical care to elderly. Just look at the N.I.C.E. board in England! Just because someone is old, doesn't mean they're useless or have no value!

    Socialized medicine will also use taxpayer money to fund infanticide - yes, abortion. This is murder! I will not have my money used to pay to kill unborn children!

    You call the post office efficient? Are you smoking crack? Costs increase every year, yet service gets worse and cut!

    You want reform? How about TORT reform, Texas style! Wonder why doctors are flying to Texas to open up practice?

    And no- I am not a Texan.

    Get real man, stop opposing your country and it's founding principles of liberty and freedom.


  • Report this Comment On August 25, 2009, at 11:19 AM, FriarTuck100 wrote:

    Why don't they just top spending tax dollars and fix the abuses of medicare, medicaid, and social security. Private insurers and consumers can control cost via competition. The government will never control cost because they will continue to give more away to get re-elected. A good example is Dodd and Rangle who started out as reformist and ended up to be the biggest crooks in politics and no one does anything. All I want them to do is protect the country, give veterans decent health care and pensions and stay out of our way! We'll do the rest!

  • Report this Comment On August 25, 2009, at 2:41 PM, ValuBux wrote:

    Wow, this article is total crap. Here's the problem, this bill is the government setting prices, dictating terms, and levying regulations on all health insurance. If the US government got to set pricing, terms, and practices for the shipping industry you can bet the US Postal Service would begin to fare better against it's private counterparts UPS and FedEX. Within a couple years, the US Postal service would be the only entity standing.

    The idea of the government offering competition for private industry is so anti-American on it's face. It is not what this country was founded to be. Any goverment option, wether they call it a co-op or whatever else has one agenda. To be a transition to a single payer system. It is what the left wants, it is what they have always wanted. I want healthcare reform of the existing system, not this bill. This bill is nothing more than the government setting prices, and levying regulations to destroy private health care. Despite their campaign stating that there is a lot of misinformation being put out, they fail to provide any explanations of how this bill will improve care, or how it will further scientific advances, or lead to more access. They don't make these claims and explain because they can't. They just continue to say that the right wing and others are putting out misinformation. Stop this bill at all costs.

  • Report this Comment On August 25, 2009, at 6:42 PM, Melaschasm wrote:

    If you think government run health care is a good thing, that is fine. But do not lie to us, and claim it is not socialism, or that such socialism is good for capitalism.

  • Report this Comment On August 25, 2009, at 9:32 PM, shartuga wrote:

    Remember that crisis is opportunity for this kleptocracy. The crisis is not what we have now in spite of what the left would have you believe. The crisis is what will happen when the perfect healthcare storm hits with very predictable results. We know, even without any changes, that the aging boomer population is going to strain the existing system. We are now going to add more previously uninsured patients to that system. I don't know many docs that aren't already pretty busy. The government won't have to ration healthcare because the lack of providers will accomplish it for them. I haven't heard any mention in these bills of boosting the number of providers coming out. Attracting talent is likely to be an issue as well. The other side of the storm is the fact that providers will be squeezed from several sources. First, if they and spouse make over the prescribed "rich" line they get taxed more just like anyone else in that bracket. Second, they will now have to work harder to make less. Third, they will be forced to curb defensive medicine practices while knowing that with Obama's statement that "tort reform is not on the table" they have greater liability exposure. Lastly, it will become very apparent that an individuals best hope for a long life will not be taking the path of 60+ hour work weeks to early coronary land. Every doc over 50 (the most experienced providers along with the most burned out) will take a hard look at early retirement. So with a crushing burden of aging boomers and others how will we avoid this crisis that is coming and that the liberal kleptocracy wants so badly since it represents "opportunity" to them?

    Tort reform. Reasonable caps and consequences to attorneys who file nuisance suits. Providers will see their taxes go up and their incomes go down. Showing a little love might keep some of them from leaving the profession.

    Insurance reform. Open competition barriers and do not allow insurance products that don't meet basic requirements such as portability and coverage of pre-existing conditions to enter the marketplace. Stiff penalties for companies who drop patients without cause.

    Health Savings Accounts. People who have them like them. High deductable insurance for catastrophic care works for me.

    Providers should have a choice as to whether they accept a given insurance. Obama wants to pay providers based on results. Who takes care of the sick people then? Under that system providers will just fight over the healthy patients while the chronically ill patients who use the most resources will be avoided. No money there because you can't make them much better. Obamacare forces providers to take pennies-on-the-dollar assignments.

    Train enough docs and nurses for what is coming. If I'm wrong then the competition will help keep costs down. If I'm right we're going to need them very badly. Offer programs that allow tuition to be exchanged for x years of service in a medically underserved area. Hope that there are still enough good smart people who want to do the work.

  • Report this Comment On August 25, 2009, at 10:17 PM, Dforberger wrote:

    This author is naive. His opinion does not reflect the objective & facts of the House Bill. The Bill wants to eliminate competition, we need more competition. The Government cannot compete in anything. It can't run SS, Medicare, Cash-for-Clunkers or anything. I am sorry I waited my time reading this..

  • Report this Comment On August 26, 2009, at 2:35 AM, GuitarTeacher11 wrote:

    Bassackwards is the descriptor for this article. THE worst article I've personally EVER seen on The Motley Fool. Why? Because it's not only wrong and like an editorial, but it doesn't really educate, amuse, or enrich.

    Yes, the writer is naive if he actually believes Obama when Obama says the issue is not about the government doing healthcare, but rather whether that should be an option on the table. That's how politicians get the ball running on their agendas. They confuse the issue. It's a slippery slope. The government is a greedy hungry monster and that's why their vilifying the insurance companies - because the GOVERNMENT doesn't like competition and wants in. Not the other way around this.

    I'm discouraged that this article got so many recommendations.

    Please, for the sensible out there, and those who love your fellow man and want what is best for him, write your senators / congressmen and let them know that Obamacare is unacceptable and not what we want.

    Thank you, good people. And good night.

  • Report this Comment On August 26, 2009, at 3:05 PM, scorp1us wrote:

    Your article suffers from a catastrophic flaw. The USPS gets to set the minimum rates for UPS and FedEx. Yeap. its true. The only reason why USPS is not out of business is because the other services cannot use a mailbox and USPS keeps the other service's rates priced to the point that the fat sluggish USPS can keep themselves in business.

    And that is not what we need in a health care system.

  • Report this Comment On August 26, 2009, at 5:59 PM, JeremieP1 wrote:

    A few points on Healthcare

    Coming from a large family of various healthcare providers:

    1) The assertion that the current government run healthcare programs are shining examples is completely false.

    Among those of us who have worked in a VA, the truest yet saddest description is that it is a second chance for our veterans to die for their country. A bloated beuracractic system has made it very difficult to deliver timely, and appropriate medical care to our veterans. What the VA does do is provide a safety net for homeless vets who need a place to spend the night making it a very expensive homeless shelter.

    As other fools have commented Medicare is already broken. My wife limits her practice to 1-2 medicare patients per month, because at a reimbursement rate of less than $100/hr she is losing close to $200/hr on each pt. However, Medicare proudcly announces that she takes medicare. This is the lie that medicare has been propogating for some time. They have thousands of providers, those providers just limit their exposure to medicare losses by limiting the number of patients they see.

    Do you think a large government run health insurance plan will do better?

    2) A government run health insurance program WILL lead to a single payor system in five years or less.

    Medicare does not play by the same rules as health insurance companies. If a physician sees a medicare pt. and determines they need a particular treatment medicare sometimes won't give approval until after the procedure is done. Then when they deny care the physician is not allowed to balance bill the pt., because the pt. is a medicare pt. Insurance companies can't do this. End result - a medicare pt. had a procedure done and it cost medicare exactly $0. Please elaborate on how you can compete with an entity that makes its own rules.

    3) A single payor system will lead to poorer care for patients.

    Yes, care will be cheaper; and yes "everyone" will be entitled to care; and yes preventative care will probably improve (which is, I think, a very important thing); but when you are 62 yo and you break your hip after tripping on the ice the orthopedic surgeon who would have been willing to come in and fix your hip the next day will be 8 weeks booked out and have very little incentive to fix your hip, or take out your gallbladder, or MRI your knee, or inject your shoulder. Seriously fools, do YOU want to stay at the hospital until 9 o'clock at night if you won't make any more money for doing so? Not ME!

    4) Health Care is a Right, Right?

    Avoiding hi fat foods is a right. Excercising is a right. Not smoking is a right. Drinking reasonably is a right. Avoiding drugs is a right. Protecting yourself in the bedroom is a right. Wearing your seatbelt is a right. Driving safely is a right. In this sense your participation in your own health is a right.

    When you don't do the above it is everyone elses obligation to pay for your poor choices? I don't think so.

    There are more basic needs in peoples lives that we don't consider a right. We all pay for the water we use, the food we eat, the houses we live in. They aren't rights, they are expenses that we all expect and pay for.

    Providing consumers with a menu of health insurance options which could include a non-profit (but I suggest also non-government such as the co-ops) and mandating at least a high deductible coverage plan for unexpected catastrophic medical events (covering costs over 5k) and including basic preventative care is what we need. Beyond that people should be willing to pay for health care at least what they are willing to pay per annum for more important staples such as cable TV, McDonalds hamburgers, Marlboro cigarettes, and Coors Light.

    The cost of healthcare is a rising part of our nations GDP. This cost is NOT going to go away or be reduced by an increasing life expectancy; the notion that healthcare is our "right" and can be accessed without personal cost; an increase in obesity, the continued use of known carcinogens, or the failure to exercise at least a moderate degree of healthy lifestyle changes; and improved options for treating both life threating conditions as well as conditions that merely reduce the quality of life.

    Throughought history only one type of economy has improved quality of life in a sustained way. It isn't communism, socialism, dictatorship, or single payor system. It is a free market. Put some guidlines and consumer protection out there - put a non-profit competitor that plays by the same rules out there - but please, please don't have the audacity and hubris to think that one government run system will be the best solution...

  • Report this Comment On August 27, 2009, at 5:59 AM, expatriot08 wrote:

    Quite the hot topic! I don't know the answer but I do know that Cobra is not affordable for average people who have lost a job. Not to mention people who work for a small business that doesn't provide insurance. I have had to go without insurance for years at a time, just hoping for good luck. Why can't we have a safety net for those times when you don't have a job or for people who work for low wages and can't get ahead anyway. What about people who get denied coverage because of pre existing conditions.

    Free market isn't the only answer either don't you have the audacity to think that all of the good people in the USA and the kind man at the insurance company will just look out for each others best interests. If you want to live without a government go to Somalia.

  • Report this Comment On August 27, 2009, at 1:51 PM, CosmicJustice wrote:

    "In this case, if it's EFFICIENTLY and EFFECTIVELY run, I think a public health-care option would do that job quite well."

    Your argument has just lost all credibility with that one statement, there is no incentive for anything government to be efficiently and effectively run when someone else is paying for it.

    And whoever has sole control of the means must also determine which ends are to be served, which values are to be rates higher and which lower, in short, what men should believe and strive for.- F.A. Hayek

  • Report this Comment On December 07, 2009, at 6:14 PM, curiouscitizen wrote:

    My take is that government and corporate corruption are like can't escape them. Both entities abuse the people who empower them. In today's day and age corporations may unfairly influence the market in the abcence of competition, but they do not infringe on my personal decision making. The Government has proven through Social Security, Medicare, Medicade, Fannie & Freddie, swine-flu distribution and our current national debt that they can not effectively manage. What make's us believe that they can manage medical care.

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