Health-Care Reform: You Can't Have It Both Ways

Here's a startling report: A PriceWaterhouseCoopers study says that the current health-care reform legislation would increase a family's insurance bill by $1,700 a year in 2013 compared with not enacting the legislation. By 2019, the increase could jump to $4,000 a year more than the current status quo.

Weren't we trying to lower health-care costs?
Admittedly, the study was commissioned by America's Health Insurance Plans, the trade group that lobbies for health insurers like UnitedHealth Group (NYSE: UNH  ) , CIGNA (NYSE: CI  ) , Aetna (NYSE: AET  ) , and Humana (NYSE: HUM  ) , so take the numbers for whatever they're worth. It is clear, however, that there's one provision in the bill that would most certainly increase the cost of insurance by itself: requiring health insurers to cover pre-existing conditions.

Despite the fact that insuring something that's already occurring is an oxymoron, I think the idea of mandated coverage for pre-existing conditions has a lot of merit. It essentially breaks the tie between health insurance and employer, because employees with high blood pressure or diabetes, for instance, would finally have the option of getting coverage on their own at a reasonable rate. They would be free to move to another company that might not offer immediate health insurance coverage or even start their own business. It would increase entrepreneurism, helping the next Google (Nasdaq: GOOG  ) , Intuitive Surgical (Nasdaq: ISRG  ) , or Dendreon (Nasdaq: DNDN  ) attract employees until the company was able to offer health insurance on its own.

But that freedom comes at a cost. Requiring health insurers to cover everyone will flood the insurance pool with people who are already sick, and those costs will have to be shared by everyone. The only way to lower the cost is to get healthy people into the system, too, by mandating health insurance.

A repulsive tax on the poor
The idea of requiring everyone to carry health insurance isn't that farfetched. States require motorists to carry auto insurance, for instance. But there's the question of how to make it a requirement. It's not like you need a license to live.

The easiest way to get everyone insured is to put a monetary penalty on those who don't have coverage. Essentially, give people a choice to pay for health insurance or pay a tax -- or lose a tax break, it's all the same.

The problem, of course, is that the people who are going to end up paying the tax are the ones who can't afford health insurance in the first place. That's not exactly "death-panel" material, but the counterintuitive nature of how to deal with getting the healthy covered doesn't sit well with many people.

To make it more palatable, lawmakers lowered the penalty originally proposed by Max Baucus, but that creates a whole new problem.

I'd gladly pay you Wednesday for a hamburger today
Without a high penalty for not having health insurance, the system is too easy to game. People could simply fail to carry insurance until they got sick, get coverage to pay for their illness, and drop the coverage later on. In Massachusetts, where the state requires citizens to have health insurance, there's some evidence that this is happening.

Using this strategy, people would still risk getting a life-threatening illness that needed immediate attention, but that's no different than the system we have now, where the uninsured are still taken care of in an emergency. And, when they can't pay their bills, the hospital eats the costs and passes them on to insured patients in the form of higher medical costs to the tune of about $1,000 a year, according to the president.

The Senate Finance Committee bill, in its current form, would extend coverage to 29 million people, but still leave about 25 million Americans without coverage. That's a good start, but far from a complete reform that many people were expecting, and it may come at a steep cost to those of us who already have insurance.

What do you think? Is this just a last-ditch effort by health insurers to keep the status quo, or are we setting up a system that's worse than the one we have now? Have an idea for getting us off the pathway of escalating health-care costs? Share in the comments below.

Google and Intuitive Surgical are Motley Fool Rule Breakers selections. UnitedHealth is both a Stock Advisor and an Inside Value recommendation. 

Fool contributor Brian Orelli, Ph.D., doesn't own shares of any company mentioned in this article. The Fool owns shares of UnitedHealth and has a healthy disclosure policy.


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  • Report this Comment On October 13, 2009, at 1:52 PM, ozzfan1317 wrote:

    There is no tax on the poor and the company that issued that reported is strongly backed by conservatives and insurance lobbyists. Why do I have a bad feeling this report reeks of bias?

  • Report this Comment On October 13, 2009, at 1:52 PM, ozzfan1317 wrote:

    There is no tax on the poor and the company that issued that reported is strongly backed by conservatives and insurance lobbyists. Why do I have a bad feeling this report reeks of bias?

  • Report this Comment On October 13, 2009, at 1:58 PM, thincaboutit wrote:

    Healthcare reform needs a “Parody Option.” Check out “Healthcare Fighting (King Fu Mix)” at http://www.youtube.com/watch?v=8nc1VwJOb9Y

  • Report this Comment On October 13, 2009, at 2:05 PM, theHedgehog wrote:

    <i>That's a good start, but far from a complete reform that many people were expecting, and it may come at a steep cost to those of us who already have insurance.</i>

    This is perhaps the key flaw in the public's thinking about work provided health insurance. You may think you have insurance, but what you actually have is health care coverage for the duration of your employment. For a very large percentage of Americans, those who live from paycheck to paycheck, it only takes the loss of a job and a major medical event to destroy everything they have built. This does not meet the meaning of "insurance" under any but the loosest definitions.

    Unfortunately, many major medical events creep up slowly, rather than happening suddenly like appendicitis. So, for some period you have increasing difficulties doing your job, you're fired, then you discover you need a surgery or other expensive procedures that you can't afford. You're left with the choice of dying painfullly and needlessly or going bankrupt.

    But, bankruptcy bills don't just disappear. The costs will be absorbed by the doctors, lawyers, hospitals, and state and local governments involved - not to mention the real costs to you, the patient.

    It's time we moved to a system that qualifies for the usage of the term "insurance". Universal single-payer healthcare is really the only alternative.

  • Report this Comment On October 13, 2009, at 2:32 PM, Chapter3 wrote:

    A couple things:

    1. PriceWaterhouseCoopers is already distancing itself from the report, saying that the insurance lobbying organization asked it to consider only 4 components of the bill that may add upward pressure on premiums, without looking at <i>any</i> of the components that would do the opposite.

    http://voices.washingtonpost.com/ezra-klein/2009/10/pricewat...

    2. An MIT researcher released a more complete analysis last night, reaching a completely different conclusion - that the legislation will reduce premiums significantly.

    http://voices.washingtonpost.com/ezra-klein/2009/10/mit_econ...

  • Report this Comment On October 13, 2009, at 2:52 PM, bob5270 wrote:

    This is a very Bias report. Why would anyone think that Wall Street is for the American person? Corp. America is their people!! MONEY MONEY MONEY

  • Report this Comment On October 13, 2009, at 3:32 PM, lpnews wrote:

    The bottom line is that private healthcare premiums will increase and taxes will increase. There is absolutely no doubt about it. You can't give assistance to millions of people and spend billions of dollars and not expect to pay more in taxes. Obviously when you start taking money from insurance companies whether it is a cadillac tax or wind fall tax it will be passed along. So whatever healthcare reform is passed expect to pay more in taxes as well as premiums. National healthcare would be a disaster no matter how you slice it. It does not work well in any country and won't work well in the USA. It will give doctors no incentive. Once implemented the government will start cutting costs since it will cost trillions. Which would leave us with a mess like all the other countries that have national healthcare. If you are willing to let the government take 70-80% of our income than national heatlthcare is possible, other than that forget it.

  • Report this Comment On October 13, 2009, at 3:50 PM, theHedgehog wrote:

    <i>National healthcare would be a disaster no matter how you slice it. It does not work well in any country and won't work well in the USA.</i>

    Actually, it does work well in other countries. The US is the only major Western country that still doesn't have universal health care.

    <i>It will give doctors no incentive. Once implemented the government will start cutting costs since it will cost trillions.</i>

    And how is this worse than so-called insurance companies cutting benefits, disallowing treatments, being slow to provide treatments such as hernia surgeries in the hope that the patient will go away, retroactively canceling coverage on technicalities, and all the rest of the ills associated with having a social issue under the thumb of a for-profit company?

    We're all very glad that you have the resources such that you can afford private healthcare and can assure yourself of health care regardless of what happens with your work or health situation. The rest of us need something a bit more reliable that fits *our* needs, thankyouverymuch.

  • Report this Comment On October 13, 2009, at 4:43 PM, Bamafan68 wrote:

    Hedgehog, I agree with you that the US is the only major Western country that doesn't have universal health care. Unfortunately, we are also the country with the worst medicolegal environment. As a result, an apples to apples comparison can't be made between Canada/England/France etc. and the U.S. One of the side effects of the defensive medicine that has been practiced in the US over the past 30 years is that patients expect and demand expensive tests and interventions although the "yield rate" is quite low. If patients are demanding certain tests and those tests aren't performed, heaven help the physician if there is a poor or unexpected outcome.

    BTW, I have been through health care reform before: I practiced in TN when Tenncare was instituted. See if this sounds familiar: the goal was to decrease the number of uninsured patients while not increasing costs by cutting out waste and fraud in the system. Tenncare was an utter fiasco. President Obama suggested pilot programs in some states to look at the effects of tort reform; after seeing the results of Tenncare, it seems to me that we'd be better off with pilot programs in select states to see what health care reforms actually work before rolling out a whole new entity on a national scale.

  • Report this Comment On October 13, 2009, at 4:44 PM, matthewbanis wrote:

    Why can't 50 million people afford health insurance in the richest country in the world???

    This should be the question, not, "why can't I have free health care in the richest country in the world".

    These poor people surely pay for their shoes, cars, and cable - maybe they need to reallocate their funds, and finally, if poor and or on welfare - go back to school there are plenty of grants and you probably have plenty of time.

    Respectively,

    Matt

  • Report this Comment On October 13, 2009, at 5:02 PM, Bonmotten wrote:

    Not only should we all be insured but we should all vote. If we did there would be none of this nonsense. It would soon be clear what the majority would want. We are in this together yet we do not participate, nor act according to our own very clearly, even elegantly, expressed principles of participatory democracy.

    It's time to pull together instead of engaging in fractious, divisive, so-called debates.

    Let's put United back in the name of our country...and mean it.

  • Report this Comment On October 13, 2009, at 5:02 PM, happypappy56 wrote:

    What on Earth is next!! Our Gov't has already bankrupted Social Security, Medicare, Medicaid, and every superfund they create. Now they are creating an additional superfund to raid and do not think for one minute that they won't! They have sucessfully demonstrated that they cannot efficiently run anything....what makes anyone think they are going to handle this any differently? Once again, we are screwed, and out children as well.

  • Report this Comment On October 13, 2009, at 5:10 PM, howboutme wrote:

    matthewbanis is on the right track.

    I am getting sick of all you slackers out there that want other people to take care of your a_ _ es without lifting a finger....preferably while your out enjoying your life and your toys with your careless, free living lifestyle. Those of us that balance our budgets, live in a modest house, have no toys, and save a few bucks for our retirement don't need to clean up after you people.

    Don't be surprised if one day you find us standing over your lying on the ground. If I have to take care of your butt, then I am going to have a say in it.

    Bonmotten,

    You think everyone should get to vote? Where do you think the world would end up if everyone wanted to do whatever they wanted......which is exactly what would happen because the media controls the voters outcome in this country. We let people do that once along time ago, then the earth was covered with water. The next time, it is going to be covered with fire.

  • Report this Comment On October 13, 2009, at 5:15 PM, glkolbe wrote:

    I'm still trying to understand "why" we all are supposed to insure at the same rate levels, those that abuse themselves and expect the majority of folks to pay more for their insurance to cover the abusers. Obese & all it's associated problems? Drug Problems? Gambling Addiction? Smoking Cessation? Why should I care about these folks that did it to themselves and now I should pay to fix it.

    We pay for it all. Then when the folks can't afford to pay the penalties, we will give them money to then purchase insurance. It all seems to be so counter productive. Why are we not sponsoring a string of government clinics for all those that want "free" basic health care and leave those of us alone that are willing to purchase our own policies that just might provide for increased benefits? NO! We want cadillac policies for everybody, even those that cannot afford to pay for them. Thought we had already seen this movie with the "everybody deserves a house" program that almost brought the U.S. to financial ruin.

  • Report this Comment On October 13, 2009, at 5:17 PM, SINGSANK wrote:

    I should be free to spend my money as I see fit. I have no desire to join an insurance pool and pay the same rate as those who smoke or are obese. Don't need the idiot government in my life anymore than it already is.

  • Report this Comment On October 13, 2009, at 5:18 PM, glkolbe wrote:

    Personally I believe that you should only have a "vote" if you have a job and actually pay taxes. This country will soon have as many folks not paying taxes as those of us who work and pay a significant amount of tax. All the folks who will not pay for the health inusreance are very willing to spend your tax dollars for their benefit.

  • Report this Comment On October 13, 2009, at 5:21 PM, mistre wrote:

    the fact is the cost of health care is going up with or without reform. the reform on the table adds a large number of currently uninsured individuals and families to the rolls but doesn't necessarily change the cost figures as much as all the proponents and opponenets alike say. The system already provides care (albiet not very effeciently) at a significant cost and in theory anyway, that cost would be shifted to the premiums paid for coverage. There is no question that a more effective and effecient delivery system would "insure" everyone probably at a lower cost overall than the current mish-mash does. And that includes illegals, since if they are not "insured" and paying where they have the income to do so, they will still be getting expensive treatment free.

    change is necessary but some of it is more simple than its made out to be: de-linking health insuraance from employment (the McCain plan) is a first step and one that makes the issue of preexisting conditions moot. Another is making coverage mandatory. As long as some folks can "opt out" the program will not work. If individuals truly can't afford the cost, assistance should close the gap. If some would rather spend their money on fun and games till they get sick, sorry! The shift i how providers work (the Cleveland Clinic example) is another direction that is overdue and absoutely necessary to the effecient delivery of health care.

    And last but not least, lets stop kidding ourselves...whether the government is the payor or insurance companies in a competitive market which make the most sense to me, some treatments will be denied and some people will feel like the system is not providing what it promised. If it did, it would be bankrupt faster than SS or Medicare will be.

  • Report this Comment On October 13, 2009, at 5:22 PM, lslobovia wrote:

    a singly payer, saving all the money now spent on insurance company and hmo profits and admin expenses, would save enough to pay for the currently uninsured especially since we are already indirectly paying for them when their problems get so bad that we have to.

  • Report this Comment On October 13, 2009, at 5:28 PM, laughingstk wrote:

    You know some of us don't want the government to take care of us. Do you really think Uncle Sam is going to bring more efficiency to Health Care! The only way to bring costs down is to let Coops, Hospitals and Insurers compete for our business.

  • Report this Comment On October 13, 2009, at 5:29 PM, njdo wrote:

    In his 2008 book, "Nudge: Improving Decisions about Health, Wealth and Happiness," Sunstein and co-author Richard Thaler discussed multiple legal scenarios regarding organ donation. One possibility presented in the book, termed by Sunstein as "routine removal," posits that "the state owns the rights to body parts of people who are dead or in certain hopeless conditions, and it can remove their organs without asking anyone's permission.."Though it may sound grotesque, routine removal is not impossible to defend," wrote Sunstein. "In theory, it would save lives, and it would do so without intruding on anyone who has any prospect for life"

    Does any sensible person think the government has the right to even speculate about such power over individual lives. We've seen how easily Wall Street in collaboration with the government manipulates statistics and the direction of financial markets for the benefit of corrupt individuals and to influence elections.

    Does anyone really think that this corrupt government is making decisions to benefit anyone but themselves? We are already living in a police state, willingly it seems and now the government wants us to sign over control of our own bodies, vaccinations, organ extractions. Americans are purposely and systematically reduced to peasants including sacrificing control over their own bodies, bank accounts and personal freedoms. Welcome to Jonestown.

  • Report this Comment On October 13, 2009, at 5:35 PM, Hansclin wrote:

    I thought that the following survey of physicians and group practice administrators was interesting. It certainly does not support the notion that the government is incapable of running something. As a matter of fact, Medicare beats every single health insurance company by 17% or better as the easiest entity to do business with.

    Medical groups ranked Medicare Part B higher than any other payer in a satisfaction survey released by the Medical Group Management Association at its annual conference in Denver.

    Members were asked to rate their satisfaction with payers on issues related to responsiveness, transparency, prompt payment, credentialing, overall satisfaction with administrative functions, and other metrics. More than 1,700 MGMA members participated in the poll.

    Medicare topped the list with an average ranking of 3.59 on a five-point scale. Aetna came in second at 3.14, and was followed by CIGNA, Coventry, Humana, Anthem, and UnitedHealthcare.

  • Report this Comment On October 13, 2009, at 5:35 PM, Texastee10 wrote:

    Gee, the healthcare industry commissions a study and comes out with the results they want. This just in, the tobacco CEO's have assured the world smoking does not cause cancer. Fire does not burn. Water will not flood anything. No one will ever die.

    All of western Europe has universal healthcare along with Japan, Australia and others. The U.S. spends more than twice the average and gets sub-standard care.

    In 1986 in Florence, Italy I broke my wrist. An hour in the hospital, with X-Rays and two doctors working on me and I was told healthcare in Italy was very expensive by an employee. I didn't know what to expect but was told I had to pay in CASH, no credit card. I was astounded at the bill, my out of pocket cost was $32.00 (Thirty two dollars. Not hundreds of thousands.) And I paid the "foreign's rate".

  • Report this Comment On October 13, 2009, at 5:36 PM, RichPletcher wrote:

    The amount of childish thinking I see on these forums never fails to amaze me. Insurance is a hedge against unforseen, possibly catastrophic occurrences. I am compelled to buy auto insurance for one of two reasons 1) if I cause an accident I can possibly injure another depriving them of their life, source of income, etc. 2) I am compelled to repay the loan I took to purchase the vehicle. I am covering the liability I may incur by damages to other individuals. It is simply fallacious thinking to equate a mandate for the purchase of health insurance with the requirement to carry auto liability insurance. With respect to pre-existing conditions ... if I try to purchase auto insurance and I've had 3 DWI's and wrecked two cars in the last year ... do you think any insurance company in their right mind is going to cover me .... NO!!! ... not unless I can pay $2000-$3000 a month .... what's the pre-existing condition? A HIGH RISK DRIVER ... Also, I resent being compelled to subsidize a plethora of what should be OPTIONAL "health care services" ... fertility treatments, sex change operations, just to name a couple. Finally the "dem-wits" in DC are not going to stop until they've turned this country into a collectivist cesspool. I assure you I and anyone I can enlist should shove back with every ounce of strength we have to prevent this (universal health care, cap and trade) RichPletcher@mail.com

  • Report this Comment On October 13, 2009, at 5:37 PM, shymel52 wrote:

    I manage a large entity w/ 900 employees and I saved $1.5 million this year by deserting our nationally known "carrier" that profited by more than $2 million at our expense each of the last several years w/ marginal service. We're now partially self-funded w/ re-insurance w/ great service and next year we'll save another million by opening our own clinic. My experience is that the big companies are running scared because they ARE the problem and more and more folks recognize it. So they fund this "study" to justify their greed at our expense!!!

  • Report this Comment On October 13, 2009, at 5:39 PM, steveelcpo wrote:

    I went to the townhall meeting with my congressman. He put a lot of numbers up on the screen, including the following: 900,000 constitutuents, 165,000 without health insurance, (he wouldn't answer how many were illegal aliens, a significant number in San Antonio) and he claimed that only 600 of his constitutuents would pay higher taxes. When a constituent asked "Explain to me how 600 are going to pay for 165,000?", he didn't have a solid answer. Now math isn't my strong suit, but common sense tells me that either those 600 are going to be bankrupted or sooner or later, everyone else is going to have to chip in at a much higher tax rate. The other issue is that nationalized health care hasn't worked in any nation where it currently exists, and tax rates are MUCH higher. The Democratic congress is completely ignoring the public outcry over this, and is literally shoving it down our throats. Is anyone running against Nancy Pelosi? Send me their address so I can contribute to the campaign!!

  • Report this Comment On October 13, 2009, at 5:40 PM, sk wrote:

    We don't need the government to fix anything for us. Americans need to be responsible for themselves. I was laid off in 2001 and didn't start working full-time again until 2005. I bought my own insurance coverage for myself and my family. I worked part-time and it wasn't easy, but it was the right thing to do. Not put my hand out and cry like a baby. It doesn't cost that much. We paid about $300 a month. Yea, we had a $3000 deductible. So what? That is how insurance works. You take care of the small stuff and have insurance for the big stuff. We still visited the doctor, dentist, eye doctor once or twice a year. We paid for our own prescriptions. We put out about $6000 a year in health care costs total, premiums and all. This is completely affordable to most Americans. Everyone needs to take responsibility for themselves and their families and not expect government to always provide help.

  • Report this Comment On October 13, 2009, at 5:43 PM, jshatchsr wrote:

    A major flaw in your reasoning is that by requiring health insurers to cover those with pre-exisiting conditions health care costs will rise.

    It seems to me that those with pre-exisiting conditions without insurance are probably not getting the health care they need. So what happens? They get sicker and ultimately they die, adding to our health care costs.

    Covering them makes them healthier and thus cheaper in the long run.

    The claim by private health insurers that health care reform (Backus edition) will cause costs to rise does not even deserve comment.

    Steve Hatch

    Steve Hatch

  • Report this Comment On October 13, 2009, at 5:45 PM, guiniepig wrote:

    As long as the insurance companys make a profit by not paying for your medical needs, how can you expect your medical needs to be a priority with them. There are only three countrys in the world that don't have a public system and the people proffiting from this want to keep it that way. Right now, that is the insurers and their employees in Congress. ( 100% of the Republicans and about 15% of the Democrats) and the morons that are persuaded by conservatives to cut their own throats. I give up on those people.

  • Report this Comment On October 13, 2009, at 5:49 PM, foolabomb wrote:

    Why do we keep talking about which insurance is better? I don't believe our government can run health care better than any other system they run (which is poorly). But that really isn't the point. The real point is health care costs are spiraling out of control. Nothing put on the table is going to prevent that.

    Health care costs are spiraling out of control because the costs are insulated from the public. I go to the doctor and it costs me $20. It doesn't matter which doctor I go to. It doesn't matter if they draw 10 vials of blood or just listen to my heart. It still only costs $20. If each doctor had a different charge, if I paid for all of those tests, don't you think I would pay more attention to my health care? Do you think I would do more preventative actions to stay healthy? Do you think there would be more competition between doctors and hospitals for your business, naturally driving costs down? We invented the MRI. Magnificent piece of equipment. But what are the drivers to make it more cost effective? There are none. Insurance companies mandate how much they will pay the hospital. I have already agreed to my maximum payment for my medical stay. So for me, after I reach the maximum, I could get an MRI every day and it wouldn't cost me more. Does that really sound like a way to keep costs in control?

    Earlier comments about tort reform were off base. Our doctors are foced to practice very defensive medicine to prevent getting sued for being wrong. Again, that happens because we don't really have to pay for anything. If I go to the hospital, I want them to run every test under the sun to see what is wrong. I want all those tests because my out of pocket expenses are essentially fixed. So if something goes wrong, I sue the doctors. However, if the free markets were controlling the costs instead of the insurance companies, the doctor would be presenting me with options. I would have the opportunity to provide my input about whether or not I should undergo any particular procedure. That alone would reduce lawsuits. How can I sue for declining a procedure? I could try, but I would lose. And once that happens a few times, people will stop suing for declining a procedure. Lawsuits go down, defensive medicine goes down, doctor's malpractice insurance goes down, therefor health costs go down. Free markets at work.

    But we insulate the health care industry from all of this by wrapping it in insurance. I will grant you that there is probably a place for health care insurance for long term/catastrophic issues (like cancer). But for most of the health care issues? The best way to fix the insurance problem is to find a way to fix the system where we don't need insurance.

  • Report this Comment On October 13, 2009, at 5:54 PM, maryjeanw wrote:

    But the bomb went off under the insurers. The only reason these costs can be passed on to consumers in the form of higher premiums is because there's not enough competition among private insurers to force them to absorb the costs by becoming more efficient. Get it? Health insurers have just made the best argument yet about why a public insurance option is necessary.

    Right now they run their markets and set their prices, and pass on any increased costs directly to consumers. That's what they're threatening to do if the legislation attempts to squeeze, even slightly, the colossal profits they plan to make off of 30 million new paying customers.

    They want every penny of those profits. They demand every cent. And if the government dares raise their costs a tad higher than they expected when they first signed on to support the bill, they'll pass those costs on to consumers in the form of higher premiums. They can carry out their threat only because they have unaccountable, untrammeled market power.

    But they've now hoisted themselves on their own insured petard. They've exposed themselves. If they had to compete with a public insurance plan, they couldn't get away with this threat. They couldn't pass on the extra costs. They'd have to compete with a public insurance option that forced them to give consumers the best deals possible.

  • Report this Comment On October 13, 2009, at 5:56 PM, toml2 wrote:

    The cost of the proposed legislation not covered through the proposed reductions in Medicare coverage will be covered through new taxes on health care insurance companies, medical equipment companies and other providers of medical services. It doesn’t take a rocket scientist to figure out that these additional costs will be added to the cost structure of these companies and passed on through to the American public, so those Americans who can afford to pay for health care will see their costs increase in order to cover medical services to those Americans receiving services at a discounted or no cost under the new legislation. If you are looking forward to benefit reductions in the Medicare program and/or cost increases in your health insurance you will love this program---unless you have no insurance coverage, then you will really love letting someone else pay for your health care.

  • Report this Comment On October 13, 2009, at 5:58 PM, youandmeforus wrote:

    Life, liberty, pursuit...- hey how about equal access to Heath care? When you are truely sick, the only thing you want is to get better.

    Insurance is only a way to finance the costs- so why the big slice taken away--should not be a for profit enterprise--hence the "public option". Is this where we should draw the line of obscene CEO's pay that is approaching 100 to 300 times the hourly employee.?

    Hey- how did they get it that there would be NO Negotiation on pricing? Isn't that a cornerstone of Capitalism.--Competition should be the name of the game.

  • Report this Comment On October 13, 2009, at 5:58 PM, matthewbanis wrote:

    For canusparadime - “JAG”

    You want to debate/talk/think okay, cool, you want to call people names in particular “ass”…well this just shows right off the bat you’re of inferior intelligence, probably a tool who voted for Obama and watches Michael Moore movies.

    And of course they want to increase there profits – that’s why they’re in business. And based on my experience with people who want to pay more in taxes, you probably make under thirty grand a year, and raising taxes won’t affect you, really.

    And the government as a “disinterested party” are you joking? Who’s writing these bills – not congress, that’s for sure, probably the same culprits who rewrote the bankruptcy and credit card laws back in 2004, MBIA – George Bush’s second largest campaign contributor, and so the cycle is going now.

    And really, the taxes don’t fall on everybody, they fall on the middle class – the rich people with real net worths – not based on their income – though, this helps too, have all sorts of ways of paying less in taxes…but what do I know…let me get back to being an “ass”.

    Matthew Tsombanis, CPA

  • Report this Comment On October 13, 2009, at 5:58 PM, afnariman wrote:

    Oct. 13, 2009

    It is clear that the PWC report is tainted, and skewed in favor of the Insurance Cos. who paid for it. However this does not mean there are not several flaws in Bills put forth by 4 Comte(s) in the House, and the Baucus Plan in the Senate. The Bills are convoluted, and we will not get the results we (USA citizens and Resident aliens) need.

    Frankly, if the end result is to get health care costs (premiums) down, and everyone covered, the Public Option is like "using one's left toe to scratch behind one's right ear", i.e. a convoluted way to get to the end result.

    The straightforward way to get to the end results we all want is:

    (1) Pass a Law to revert the HMOs to their prior (30 plus years prior) "NOT FOR PROFIT STATUS", AND THEN HEAVILY REGULATE THE INDUSTRY TO GET THE RESULTS WE WANT, i.e.,

    (2) require them to lower CEO (and top management pay) to a 40:1 ration of the average worker.

    (3) Require that there be 100% coverage of all U.S. Citizens and Resident aliens, with the poor being subsidized by the U.S. Government. Since, this would make Medicaid NULL and VOID, imagine the cost savings to the States and Federal Government. If you want to cover illegal aliens then there should be NO Government subsidy provided for them.

    (4) Medicare FICA taxes should then be used to purchase comprehensive health care for all eligible seniors from the Not for Profit HMOs. This will reduce the long term unlimited liabilities of Medicare of $39 Trillion. The Federal Government should be the group buyer of Insurance for the elderly (Medicare) and Poor (Medicaid), and not the HMO for these people. i.e, the Federal Government should not pay $80K for a hip replacement, instead they should buy comprehensive health insurance for the medicare recipient from the Not-for-profit HMOs- covering prescription drugs, eye, and dental care, including Drs. visits, and hospital care.

    This eliminates Medicare Part A, B, and D (prescription drug coverage). The FICA taxes are used to buy coverage. The people Age 65 and above are fully covered and do not lose any benefits.

    (5) Pre-existing conditions cannot be used to deny coverage, if the person was unaware of the underlying health condition. Also, coverage cannot be denied for an unrelated health condition, e.g. female has pre-existing psoriasis; and the HMO refuses coverage for Breast cancer treatment. However, if one has a preexisting condition and is required to buy health coverage then the Federal Government may have to pitch in for the first few years. Thereafter, everyone will have coverage before they have a pre-existing condition. The coverage will relate the the individual and has to be portable, as they go from one job to the next.

    HOWEVER, THIS CAN ONLY WORK, IF CONGRESS FIRST PASSES A LAW TO MAKE HMOS, NOT FOR PROFIT ENTITIES, AS THEY WERE 30 PLUS YEARS AGO, AND DID NOT HAVE THE PROFIT INCENTIVE TO PAY INVESTORS.

    COMPANIES SUCH AS UTILITIES, BANKS AND HMOs, WHICH PROVIDE BASIC SERVICES TO A COMMUNITY MUST RETURN TO THEIR NOT-FOR- PROFIT STATUS.

    Thank you.

    afnariman

  • Report this Comment On October 13, 2009, at 6:03 PM, laughingstk wrote:

    Steve, You should Insure Cars with pre-existing conditions. Sound profitable?

  • Report this Comment On October 13, 2009, at 6:08 PM, Susan68 wrote:

    You are correct, skingco, we should all be responsible for ourselves.

    Mistre makes a better point: a simpler answer than what has been presented can work. We have 50 states with 50 Medicaid programs. Why can't the Feds simply audit those programs, fix the problems, open the enrollment (sliding scale for premiums & copays) and FUND them? Why reinvent the wheel? The Feds only interest will be to prevent fraud: bean counters and investigators. States could be rewarded for a well-run,efficient program. No mandates on coverage. Keep what you have, buy what you want (or can afford), or go on the state program.

    If not - at least cover all the kids. If the Feds are gonna mandate something-then let them fund all the S-CHIP programs.

    Either way, the bills for these ideas could be printed on less than 1/3 of the pages of any (?) existing proposal and would be readable and understandable.

  • Report this Comment On October 13, 2009, at 6:14 PM, semieng wrote:

    One factor that seems to be missing here is that hospitals are currently required to treat those in immediate need of care, usually via the emergency room at high expense. Guess what...we already pay for that in higher insurance costs! Serving the currently uninsured in primary care settings will lower costs, not raise them.

    Medical loss ratios for insurance (MLR) companies in the US run about 80% meaning that insurance companies siphon off about 20% of the health care dollar for administrative costs and profits. Legislate the MLR down to 5% or 6% like that paid by other modern industrial countries and much of the 'cost problem' disappears. The MLR is even worse than this because of the high admin costs imposed on medical professionals. My family practice doctor tells me he spends an additional 7% on admin costs for insurance reimbursement over what it cost to do business with Medicare.

    Single payer may not be perfect, but it's a lot better than what we have now!

  • Report this Comment On October 13, 2009, at 6:15 PM, smokyfied wrote:

    Conservatives argue against reform by asserting that "the market" will always provide better results than "the government". Maybe a free market in "health" would, but you must be naive or wilfully ignorant to think that the current "healthcare" industry represents anything close to a free market in health. It is more like a black market in sickness. NOBODY in the current system has an incentive to make people healthier. Doctors, hospitals and drug companies sure as hell don't. And insurance companies spend most of their time and energy trying to delete the costs of sickness from the "system" by deleting sick people from being covered. How can people that claim to understand markets not see this? Because they have been bought and paid for.

  • Report this Comment On October 13, 2009, at 6:16 PM, bobbucy wrote:

    Just because the insurance group predicting higher costs is conservative doesn't mean that they are wrong. The proposed bill contains 7 new taxes as it stands right now, in addition to forcing insurance companies to accept all risks. And there is still no talk about tort reform because congress is made up of a bunch of crooked lawyers who want to keep suing the doctors. This is a typical government boondoggle and it's going to be a disaster.

  • Report this Comment On October 13, 2009, at 6:19 PM, opedbyme wrote:

    Not too many folks would ask a fox to guard the chicken coop. Please read the democratic rebuttal/responce.

    thanks,

    Dennis DiTullio

    Grafton, MA

    http://www.nytimes.com/2009/10/13/health/policy/13health.htm...

  • Report this Comment On October 13, 2009, at 6:20 PM, barrymac1945 wrote:

    Someone wrote that Medicare Plan B was considered very good by a high percentage of people. I don't know if it is true or not. It is my understanding that Medicare is almost bankrupt.

    It may be good, but it has to be funded. Let's all get on Medicare. Let those that want more coverage get the Supplemental that is available.

    But, really, it takes a great deal of intestinal fortitude to open this can of worms publicly and more guts to comment.

    I'll take a slimy exit without comment. Stirring it up is my only specialty.

    Dadaroo (the cameleon)

  • Report this Comment On October 13, 2009, at 6:24 PM, peters46 wrote:

    I agree with canusparadime, except I would add glkolbe in your first sentence. All those programs are free (tax-payer supported), except smoking cessation. That has been payed for many times over (to the tune of billions) by smokers, and is not a program as such, but merely a help-line where they tell you you are evil and stupid. The states promised to use those billions to help smoking cessation (along with smoking prevention), and this is what the states came up with. Kolbe and others actually believe the propaganda that the most effective life-style decision to prevent health problems is to stop smoking. False. Get on your feet. move. That is the most effective life-style decision to make. Why are tax-payers treating gamblers and druggies? To save them? or to prevent the resulting crimes? I dont' foresee any change in health care expenses (whether it is paid for thru taxes or premiums) without tort reform. Another way to lower expenses would be to modernize medicine. How? By coming up with intelligent software for medical diagnosis. A very large amount of money is spent each year on misdiagnosis. A person I know was given over ten (wrong) diagnoses over a 15 year period. Her next to last diagnosis almost killed her. Finally she was diagnosed with Graves disease and is now being treated. Over 15 years she was given numerous medications to treat conditions she did not have, and spent 15 years suffering. The practice of medicine should not be like the TV series 'House'. with forty different guesses as to what is wrong and twenty wrong treatments.

  • Report this Comment On October 13, 2009, at 6:29 PM, greenverde wrote:

    Just throw this report away. That it gets any attention is indicative of the problem with our media; bought and paid for like the congress. Not only was the report funded by the insurance industry., but Price Waterhouse even admitted that they were asked by their "masters" to look at only 1 small part of the bill. Unfortunately for all of us, the real solution is off the table; Medicare for all!

  • Report this Comment On October 13, 2009, at 6:33 PM, Rich9988 wrote:

    I'm a strong supporter of Health Insurance Reform, but I can see a point to the PW report. Everyone needs to be covered and minimal fines are hardly enough incentive.

    So the obvious conclusion is that this facet of the Senate bill needs to be fixed in conference.

    Given adequate subsidies, the costs for not buying a policy should exceed the costs of buying a reasonable one. You also then have to ensure that "reasonable" policies are being offered, and since there is no real free market in health care - one has to deal with that. (The whole issue goes away of course if you sweep all the dead wood out and simply go to a single payer system. I firmly believe that free markets work very well, where the conditions required exist: transparency, many suppliers, good information, elastic demand and supply. None of these apply to Health Insurance.)

    It is besides to point to note that the fines for not getting coverage were lowered to appease the Republicans, who are of course not really interested in doing anything but promoting an agenda of hate and divisiveness. One can only hope that the majority of Americans don't subscribe to that particular religion. I see evidence of moderate Republicans getting tired of getting tarred with that muck. Much luck to them, but they don't seem to exist in Congress.

  • Report this Comment On October 13, 2009, at 6:40 PM, matthewbanis wrote:

    funny, peters46, your second sentence doesn't even state to what it's referring too, and if you're referring to me, you obvisouly haven't begun to put down a answer to my question? Why? Is my statement "insensitve".

    If you're pro taxes and a propent of taking care of people who should and could avail themselves to what this country has to offer, perhaps you and canuspardime - w/e, should start a fund - call it the liberal fund, bail out brokers - w/e, and start contributing your own money to it - volunatarily - and until you do something like put your money where you mouth is, involuntarily - I will have to assume you're a liar.

    Now, I'm going back to work so I can move up the corporate ladder and make more money, and in turn pay for slakers, gangbangers, and baby mamas who should be having kids anyway, and can't pass a urine test but know how to milk the system - yeah, let me work to support them instead of my own family.

    Criminals.

  • Report this Comment On October 13, 2009, at 6:41 PM, flairplay wrote:

    Universal healthcare is the only way to go if you truly want to lower costs and cover everyone . There is nothing wrong with the Medicare model for everyone . There are people who will game any system and there are people who will get poor medical care in any system . The present system is not perfect and no system will be perfect . We just need to try and get a system that is fair and covers everyone . I just think the Medicare model is like that .

  • Report this Comment On October 13, 2009, at 6:42 PM, jaagu wrote:

    This report is about corporations being desparate to keep their corrupt and phoney capitalist programs alive. Everyone should read the Forbes editorial dated 10/12/2009 and realize how Wall Street screwed up our health care by changing it from a socialized program before 1970s to a for profit program.

  • Report this Comment On October 13, 2009, at 6:43 PM, dpbEsq wrote:

    Comparisons of the US Health care system to those of Canada and the United Kingdom are inherently flawed. Canada's population is 35mil, UK - 60mil, US-300mil. Canadian women are now crossing into the US to have children as there are no available beds in Canada. Britain puts a value on every human life to determine whether they are worth the cost of the health care they require.

    How did so many liberals infiltrate this normally capitalist-oriented website. Did Obama send out an e-mail to his minions to seek and destroy opposition again?

  • Report this Comment On October 13, 2009, at 6:43 PM, ShootNStarz wrote:

    Isn't it amazing that so many people are arguing that they and those they love will surely have to die sooner than than is necessary because they've never had a problem with an insurance company, yet! That the true death panels are insurance company bureaucrats whose job is to deny every claim they can so they can earn bonuses. I had "good" private insurance, before I qualified for Medicare ( and it's supplemental private policy). Several illnesses were not "totally" covered by that company and I had to pay large amounts out of pocket. All these people who argue against reform are revealing is either they or those they love haven't gotten sick enough to be denied. You'll change your tune when you go bankrupt under what you think is "insurance" that won't pay up.

  • Report this Comment On October 13, 2009, at 6:50 PM, GSmith42 wrote:

    Remember this. All other wealthy western nations cover all of their citizens with universal health care. This, in all instances, requires less of their GDP than Americans spend on health care now. Canada spends the next most at 10% of GDP while America spends 14% of GDP. This universal coverage is possible for less per person than American insurance companies currently charge. This universal coverage allows people in these nations to live longer on average than Americans. How could insurance costs actually go up if you followed the universal health care model? It makes no sense.

    Remember, a huge advantage of universal health care is that everyone qualifies and administration costs are lowered dramatically because you don't have to justify treatment - the doctor simply does what is necessary without the paperwork required by an insurance company. Doctors also have more time for patients.

    Now think. Who benefits from the staus quo of private health care insurance? Where did this study come from? Don't believe it will keep your health care costs lower - it's simply a strategy to make people afraid of what they don't know so they can keep the money in their pockets - and they have lots of it to advertise their point of view.

    Government programs don't always cost more - look at the world around you where every government does it cheaper than health insurance companies. And don't tell me waiting times are an issue - people live longer in nations with universal health care - obviously people are getting the treatment they need.

    Now act. Stand up and say to the politicians that they represent the people - not the companies that line their pockets - say no more corporate contributions to political parties and politicians - then maybe the people will get what is best for them.

    Or you can join me in Canada where I never have a sleepless night or a fear of losing my house to get medical treatment. I know how well our system works and hope you soon have the same peace of mind and guaranteed health care for life that I enjoy.

  • Report this Comment On October 13, 2009, at 6:52 PM, dalecinci wrote:

    1) no americans are flocking to 3rd world countries for health care....that idea is just bogus....canada, south america, saudi, mexico on and on run here for care..

    2) simple analogy...if we provide plumbing service for everyone then the cost of every plumbing job GOES UP!!!!!....don't need and MIT economist to figure this stuff.

  • Report this Comment On October 13, 2009, at 6:53 PM, matthewbanis wrote:

    ask now what your country can do for you but what can you do for your country.

    ask: if i can't afford health insurance in the richest country in the world - perhaps I'm doing something wrong?

  • Report this Comment On October 13, 2009, at 6:58 PM, matthewbanis wrote:

    ask now what your country can do for you but what can you do for your country.

    ask: if i can't afford health insurance in the richest country in the world - perhaps I'm doing something wrong.

  • Report this Comment On October 13, 2009, at 6:59 PM, JamisComp wrote:

    There are two options to fix health insurance:

    1. The government forces everyone to pay into the insurance system. This is the heavily regulated approach taken by most socialist-minded people.

    2. Capitalism. But there's only one problem - you have to turn people away if they can't pay for medical care in some way (either insurance or cash).

    We can try to reduce costs, but any system is going to fail if it doesn't adopt one of the above principles. You can't give everybody healthcare, and not have everybody pay for it. If you try that, eventually someone's gonna go bankrupt. So, either everybody pays, or only the payers participate. It's really that simple. I usually prefer the capitalism/competition approach. Give Americans the power to negotiate directly with the insurance companies for their coverage. I guarantee lower cost options will become available.

    I wonder how many corporate employees are aware of the massive lost income due to corporate healthcare costs?

  • Report this Comment On October 13, 2009, at 7:02 PM, PanGlobal wrote:

    Here in Canada is our much praised, much despised, socialized medicare system that, as in most other mandated countries, has pluses and minuses.

    Yes, there is full coverage for life for any virtually condition, pre-existing or otherwise, pharmaceuticals NOT covered except as used while in hospital.

    The trade-offs include long wait-times (3-months for a CT Scan, longer at times for an MRI), hospital emergency rooms that may require a wait of 12 hours before you are seen. With higher levels of diagnosis and treatment required, one may need to go to another country (usually the US) for treatment, only partially covered (minor portion) by Canadian medicare (my family has personal experience of this).

    I have come to believe the best system is a sensible, competitive private structure with government oversight only, with regulatory restrictions, etc. BUT, in the US example, the main cause of existing exorbitant premiums is the ability to sue for anything, with no cap on settlements, resulting in huge insurance costs for doctors and hospitals (it is virtually impossible to get a medical court settlement in Canada for anything over $400,000).

    Shakespeare had it right.......kill the lawyers.

  • Report this Comment On October 13, 2009, at 7:04 PM, jpsauvage wrote:

    My experience with United Healthcare (UHC) appears to be the rip, rape, and run pattern for the entire healthcare industry. Being self-employed, I have been forced to provide my own (single, male) insurance. From June 1996 through December 2008, my premiums went from $282/quarter to $2,461/quarter, a 773% increase in 12 ½ years, in spite of raising the deductible and converting to a PPO (losing a doctor in the process). A regression analysis of my premiums (paid quarterly as shown below) as a function of age yields a power curve: y = 3E-14x^9.3638 with a correlation coefficient of 0.95.

    % %

    Diff Diff

    Due Prem From From

    Date Age $/qrtr Prev. Initial

    06/01/96 52.0 282 0 0

    09/01/96 52.3 282 0 0

    12/01/96 52.5 282 0 0

    03/01/97 52.8 282 0 0

    06/01/97 53.0 345 22 22

    09/01/97 53.3 364 5 29

    12/01/97 53.5 364 0 29

    03/01/98 53.8 364 0 29

    06/01/98 54.0 489 34 73

    09/01/98 54.3 514 5 82

    12/01/98 54.5 514 0 82

    03/01/99 54.8 514 0 82

    06/01/99 55.0 585 14 107

    09/01/99 55.3 613 5 118

    12/01/99 55.5 613 0 118

    03/01/00 55.8 698 14 148

    06/01/00 56.0 698 0 148

    09/01/00 56.3 728 4 158

    12/01/00 56.5 865 19 207

    03/01/01 56.8 865 0 207

    06/01/01 57.0 865 0 207

    09/01/01 57.3 1,141 32 305

    12/01/01 57.5 1,141 0 305

    03/01/02 57.8 1,141 0 305

    06/01/02 58.0 1,141 0 305

    09/01/02 * 58.3 933 (18) 231

    12/01/02 58.5 933 0 231

    03/01/03 58.8 933 0 231

    06/01/03 59.0 1,045 12 270

    09/01/03 59.3 1,084 4 284

    12/01/03 59.5 1,084 0 284

    03/01/04 59.8 1,084 0 284

    06/01/04 60.0 1,213 12 330

    09/01/04 60.3 1,257 4 346

    12/01/04 60.5 1,257 0 346

    03/01/05 60.8 1,327 6 371

    06/01/05 61.0 1,327 0 371

    09/01/05 61.3 1,373 4 387

    12/01/05 61.5 1,551 13 450

    03/01/06 61.8 1.551 0 450

    06/01/06 62.0 1,551 0 450

    09/01/06 62.3 1,604 3 469

    12/01/06 62.5 1,779 11 531

    03/01/07 62.8 1,779 0 531

    06/01/07 63.0 1,779 0 531

    09/01/07 63.3 1,837 3 552

    12/01/07 63.5 2,057 12 630

    03/01/08 63.8 2,057 0 630

    06/01/08 64.0 2,057 0 630

    09/01/08 64.3 2,122 3 653

    12/01/08 64.5 2,461 16 773

    03/01/09 64.8 2,461 0 773

    06/01/09 65.0 Switched to Medicare

    * Converted to PPO and raised deductible

    Using that formula, my 91-year old father, in the absence of Medicare, would be paying $66,251 per quarter ($22,084 per MONTH) for insurance!!

    On 30 November 2007, my quarterly premium was $1,837. One year later (plus a day) on 01 December 2008, the premium went to $2,461 (a 34% increase). UHC has obviously already prepared a base from which to negotiate (demand) price increases for the proposed “universal coverage”.

    In 2006, Dr. William McGuire (UHC CEO) demanded and got a compensation package in excess of $1.5 BILLION. Part of this outrageous package included being able to illegally backdate stock options. The Feds stepped in, fined him several hundred thousand dollars, and made him resign his position. McGuire then got a $1.1 BILLION severance package (the largest golden parachute in the history of corporate America)!

    I have very little faith that my government can run an efficient healthcare system when the US Congress is bought and paid for by corporate interests, but at least I can vote against incumbents, regardless of political perversion. Corporate interests seem to have total immunity from any form of accountability because they get to make up the rules as they go along. The only choices seem to be:

    • Continued corporate gang-rape

    • Roll the dice with a government-run system

    • Let the vigilantes ride

  • Report this Comment On October 13, 2009, at 7:04 PM, peters46 wrote:

    Dalecinci

    People have been flocking to Mexico for dental care for at least 15 years. A neighbor is going there. The cost (not counting transport and hotel is $900. His local dentist said $4000.

  • Report this Comment On October 13, 2009, at 7:04 PM, mtracy9 wrote:

    The PriceWaterhouseCoopers study was bought and paid for by our current health insurance industry oligopoly. It is fatally flawed with incorrect assumptions and flies in the face of the most recent CBO study.

  • Report this Comment On October 13, 2009, at 7:06 PM, mtracy9 wrote:

    The PriceWaterhouseCoopers study was bought and paid for by our current health insurance industry oligopoly. It is fatally flawed with incorrect assumptions and flies in the face of the most recent CBO study.

  • Report this Comment On October 13, 2009, at 7:07 PM, lhollingsworth wrote:

    There are between 4 ½ and 6 million people in our country without health insurance. Many of these people head to the ER when they get sick because they can get care there and never pay for it. It both floods the ER’s keeping real emergency cases from being seen and drives up costs for everyone. If everyone had insurance, all could be treated in a more efficient manner - - i.e. family docs, etc. Of course, there is the compassionate side as well - - how do we allow people to go without needed care? There is certainly no perfect solution. I believe that everyone should be independent but they are not and there is currently $1,800 in hidden tax payments from each person in our country - - that is you and me - - and it goes toward medical solutions as I understand! Prescription drugs are available for less from foreign countries than here even with shipping added - - does that make sense? Many drug companies are draining the people just as are many insurance companies. By the year 2016 which is less than 7 years away, health care cost for the average family will be $24,000.00 a year if something is not changed.

    I realize that the health reform will not cure every issue, but something does need to be changed. Many people do not have time to stay abreast of the issues and are afraid of change, but change can be positive and is often necessary. Many countries that have government run medical systems rank far above the US in care and longevity and far below us in cost. If the health care reform takes place, it will be phased in over a period of of years and I am sure that there will be many areas that will need to be adjusted. To me, it hardly seems optional.

  • Report this Comment On October 13, 2009, at 7:08 PM, xetn wrote:

    And why does anyone believe the cost estimates of ObamaCare? There has never been an estimate of cost that is accurate. Every single cost estimate is ALWAYS low-balled and greatly increases.

    Too bad we cannot hold politicians' feet to fire and fire them for incompetence.

    All you have to look at is Social Security, Medicare, the wars in Iraq and Afghanistan, etc.

    Are you all just blind and stupid? Or maybe you just want to believe in the new lies.

    The only real way to cut the costs of health insurance and health care is to get government completely out of it. The high costs of health insurance is mainly due to the government mandate on pooling risks and the fact you cannot cross state lines.

    Once ObamaCare becomes law, you can bet that more coverage will be added, rationing will become common and people will start lining up for services, while others will just be refused services.

    I don't for a minute believe the cost estimates of the report referenced in this article, but I certainly do not believe the cost estimates for ObamaCare either.

    Carry on Socialist! You will get what you want, but I will bet you will not like what you get.

  • Report this Comment On October 13, 2009, at 7:15 PM, Ohrandom1 wrote:

    Interesting debate.

    So far the more incendiary comments above are missing the point. We need to become a more mature community than we are today. Stop whining about who will get something for nothing or welfare cheating. You can wave that flag all day long, but you will never grow up.

    Universal health care is the best path forward. As reported on NPR the other night Britain has an excellent universal health care plan. Let's all grow up and emulate Britain, France and Canada to start to be like them in health care, and then improve the system to provide the best health care service at the best cost.

  • Report this Comment On October 13, 2009, at 7:22 PM, YEN4PESOS wrote:

    Just a word to all the young voters that were all jazzed about the "Change and Hope" and couldn't see the smoke and mirrors that were all around you.... Welcome to the Ugly and Messy lies of politics.... The "change" is,.... your paycheck from Applebees will be somewhat smaller than you were counting on... As you will learn that there is no such thing as "Free Health care"... trust us on this one,... You are going to be taxed whether you want to particapate in the program or not.... Sooo just add a few more years onto paying off that school loan.. Or buying that new car, or getting your own place. Your take home pay will drop..... How's that "Hope and Change" sounding now? The "hope" is,... maybe you can find a second job to make ends meet. But Daaayum wasn't he cool... I don't know why everybody couldn't see his Cool like ya'll did..

    Well good luck... Next election,....? Please stay at home and play videos and let the electing process be handled by those that pay attention...... Oh ,.. I'm sorry ...maybe I just don't get it.......

  • Report this Comment On October 13, 2009, at 7:23 PM, KeitaiOtaku wrote:

    I noticed some of you were concerned about "Uncle Sam Taking Care Of Us". The fact is, these hospitals are getting rich at YOUR expense. My Mom went to investigate cost of a hospital stay for her hip surgery. Her personal costs with Medicare were marginal (2k). And they YELLED at her, when she tried to find out the real costs. They were MAD. You know why? Because when she got through all the BS, she found out it was $37,000, billed to Uncle Sam, to Medicare, for a 2 NIGHT STAY. This is just a few months old information guys.

    The fact is, the Hospital system is r*ping the public trust, and our pocketbooks. And we think that's efficiency? That's only efficiency of gathering money, not efficiency of service.

    The reason we need, MUST eventually have, a public option, is to put hospitals, doctors, insurance companies, big pharma, and medical supply companies in their rightful place: SECOND. YOU and YOUR health must be first. Not their profits.

  • Report this Comment On October 13, 2009, at 7:25 PM, otd365 wrote:

    I know what wrong with america, Dumb a--es like me waste our valuble time listening to the BOO HOO brigade complain about the governments inablity to run anything. Does there toilet not flush?, doesn't water come out of there tap?, Are there no paved highway in states? Doesn't there light go on when they flip the switch?. These are just a few of the state run monoplies or government natural monoplies we use every day and what I believe makes the US what is today.

    It's just to bad if they can make a profit out of someone elses pain and suffering !!!!

  • Report this Comment On October 13, 2009, at 7:26 PM, CentexDem wrote:

    Let's assume the private insurance industry funded report is correct. All the more reason why we need the public option, which would essentially give every one the option but not the obligation to purchase Medicare coverage at a premium charged to persons less than 65 years of age at an average rate 20 cents on the dollar less than that charged by private insurance. Such 20 cents savings would come from avoiding 6 cents of needless profit and at least 15 cents of needless administration costs for every dollar of private insurance premium. See U.S. Public Interest Research Group for supporting detail. Single payer universal Medicare would be even more cost effective but Republican Senators cling to private health insurance companies even harder than their often insurance poor constituents cling to guns and religion.

  • Report this Comment On October 13, 2009, at 7:32 PM, YEN4PESOS wrote:

    Wait a second here.... Too many people are assuming that alot of people care if your Big fat, cigarette smoking, alcohol drinking Soda pop suckin' unemployed, wellfare ridin' butt gets health care..... WE DON'T........... and we darn sure don't want to have to pay for you to have it...... We are over taxed as it is.... Move to Canada if you like the idea so much....... Your bleeding heart ideas are getting alittle much.......

    If you can make this hair brained idea work on a 15% flat tax,,,,,,(which you can't)... maybe some of us will talk..... Maybe

  • Report this Comment On October 13, 2009, at 7:37 PM, feadma wrote:

    i find it interesting that what i see in the propsoed legislation addresses how the health care cost are paid for, the payor system, not the underlying costs that drive health care. whether it is addressing a government plan, or insurance companies. these targets are both methods of paying the doctors and hospitals.

    i may be a lone voice in the wild, but doesn't controlling cost start at the point those cost originate. this would be with the hospitals, the doctors, the pharmacuetical co's, the tort system, the uninsured use of emergency rooms, the uninsured, and others that i haven't thought of.

    we have non profit hospitals that make so much money they have to keep building new hospitals. we have doctors that own their own imaging centers, and profit from their own referrals. we subsidize the rest of the worlds government controlled price structure for drugs, we have tort systems that drives malpractice insurance into the hundreds of thousands for specialist doctors. we have uninsured people using emergence rooms as the doctor of first resort. we have the uninsured that either choose not to purchase insurance due to excellent health or thry are not poor enough for medicaid and can't afford personal coverage.

    it seems disingenuious of our politicians to say they want to correct a problem, but only address part of the problem. are they united states congressmen representing the people of the united states, or are they in office to represent themselves and their own re-election.

    god bless america.

  • Report this Comment On October 13, 2009, at 7:44 PM, FJBuster wrote:

    Comparing health insurance to auto insurance is in it's self a joke.

    In the state I live in you need $30,000 in liability insurance to license and drive your vehicle. That amount will cover a lot LOL. But if you do not insure your car. You can still drive a company vehicle a state vehicle or any other auto that is not in your name. In fact you can still have a drivers license.

    In fact the plans that have been presented at this point are all false. Everyone wants cheap that is not going to happen. They want cheap have $50,000 deductible. They will have cheap. Obama is not a strategic thinker and there lies the problem. Vote every person in congress when their term is up.

    Then maybe we will get on the correct path.

  • Report this Comment On October 13, 2009, at 7:47 PM, holisticfool wrote:

    FWIW This is the meat of what I wrote to my congressman today.

    Our health-care system is expensive because it was designed to be. The players are stock-holder corporations, and their primary interest is in maximizing profit. The FDA is their tool.

    I organized and ran a number of businesses, beginning forty-three years ago. I consider myself a conservative capitalist. I hate what our corporate masters in the food and drug businesses are doing to us.

    If our food was nutritious we would have much less disease. Please look at Senate Document 264. The FDA could require that food meet minimum standards of nutrition. Of course the food companies would fight it. They can make tons of profit by selling this slop where chemicals replace vitamins and minerals.

    Will the Obamacare bill address the matter of invented diseases, and the sale of pills on TV to treat them? How about the constant reduction of what they call safe limits, for cholesterol and blood pressure?

    Most important of all:

    Aged garlic extract stops and reverses plaque deposition in arteries. How much money could we save if there were half as many bypass surgeries?

    Two hundred mcg of selenium per day cuts the incidence of most cancer by almost 50%. The FDA is lying when they say it doesn't work. The Chinese applied selenium to their soils and crops, and added it to fertilizers and table salt. The result was a huge reduction in heart disease, cancer and hepatitis. I was buying minerals and saw when the price of selenium increased six-fold as the result of Chinese purchases.

    Lutein delays development of cataracts and macular degeneration, the primary cause of blindness in the elderly.

    Reishi mushroom extract has cured asthma and the rash often associated with lupus, my son's asthma and a friend's lupus. It has an excellent record on cancer as well.

    I helped two friends with IBS to rid themselves of all symptoms through the use natural antibiotics and pro-biotics.

    I am one of the few who believe we need to use all the different disciplines; allopathic, homeopathic and herbal. Health-care should not be driven by greed.

    Our health care could be the best and least expensive in the world. We need the courage to step on some toes and make it so.

  • Report this Comment On October 13, 2009, at 7:58 PM, froshjazure wrote:

    Not to go off track, but...

    Who is buying healthcare stocks now? UNH, AET, etc...

    Where do you think they'll be in a year?

  • Report this Comment On October 13, 2009, at 7:59 PM, derfberger wrote:

    no americans are flocking to 3rd world countries for health care....that idea is just bogus....canada, south america, saudi, mexico on and on run here for care..

    Not true.

    a recent AARP article was devoted to people traveling to foreign countries for care.

    I lived in mexico. I had excellent attentive dental and medical care at a fraction of the cost in U S

  • Report this Comment On October 13, 2009, at 8:15 PM, DDHv wrote:

    I like the idea of test projects in different states. One of the advantages of having states is the ability to take care of problems at a lower level, and only involve the top layer when a workable system has been found. But the bureaucrats try to run things from the top down, and don't do a good job of it either.

    Medical savings accounts, and encouraging the rich to pay for better treatments (The rich make very good guinea pigs - once anything good is found, there will be work done on mass producing it.) should be part of the mix.

    Can anyone think of a good way to increase emphasis on prevention? After having my heart attack, I searched on "heart attack prevention" and found some useful methods I'd not known!!!

  • Report this Comment On October 13, 2009, at 8:19 PM, mtracy9 wrote:

    The Medicare program operates with just 3% overhead, compared to 15% to 25% overhead at a typical HMO.

    Provincial single-payer plans in Canada have an overhead of about 1%.

  • Report this Comment On October 13, 2009, at 8:24 PM, ozzfan1317 wrote:

    To those advocating Universal Healthcare even I do not want that. If you can afford to pay for better quality care you should be allowed to. I just feel that Coops or a public option for those who are too poor would not be out of the question. I'm not asking to pay other peoples bills but its not always your fault if your too poor to afford healthcare either fix the costs, fix the system or extend coverage somehow.

  • Report this Comment On October 13, 2009, at 8:25 PM, ozzfan1317 wrote:

    P.S. I am a veteran so that is my healthcare so this isnt even about me but If you had any idea the suffering I have witnessed growing up poor between people who were trapped you would understand where I am coming from.

  • Report this Comment On October 13, 2009, at 8:25 PM, ozzfan1317 wrote:

    To those advocating Universal Healthcare even I do not want that. If you can afford to pay for better quality care you should be allowed to. I just feel that Coops or a public option for those who are too poor would not be out of the question. I'm not asking to pay other peoples bills but its not always your fault if your too poor to afford healthcare either fix the costs, fix the system or extend coverage somehow.

  • Report this Comment On October 13, 2009, at 8:30 PM, theHedgehog wrote:

    <i>a recent AARP article was devoted to people traveling to foreign countries for care.</i>

    If memory serves, the article not only talked about Mexico, etc, but Southeast Asia as well as a destination for "medical tourism" or some such name.

  • Report this Comment On October 13, 2009, at 8:41 PM, lyndonevans wrote:

    I came here to seek investment information, not political bias. I am a retired person, having to use Medicare and facing a $500MM cut. I hear about obamacare daily, hourly, minute by minute and wonder how my wife and I will be able to live after we have worked so hard all our lives to make what we've saved and invested - partly due to Motley Fool.

    No matter how you package it, flavor it, or sell it, the obamacare government run health care mandate, if it's passed, is a signal that America is dead. Better sell all your stock, buy gold, and run for the hills with hoes and seed in hand. We will be bankrupt in short order, and no one will want to work, buy stock, or save anything.

  • Report this Comment On October 13, 2009, at 8:41 PM, ozzfan1317 wrote:

    Also we should improve the safety net or improve costs for the middle class. You should not have to go bankrupt just because of your health costs or a sudden illness.

  • Report this Comment On October 13, 2009, at 8:41 PM, ozzfan1317 wrote:

    Also we should improve the safety net or improve costs for the middle class. You should not have to go bankrupt just because of your health costs or a sudden illness.

  • Report this Comment On October 13, 2009, at 8:47 PM, akaplan7573 wrote:

    There are only two issues that truly need to be addressed in the healthcare reform bill. One is the public option. A free healthcare program should be available to all U.S. Citizens. Medicaide would be adequate. The second issue is tort reform. Doctors providing care under the public option should be treated as government employees largely immune to litigation. The rest is window dressing.

    Akaplan7573, M.D., F.A.C.S.

  • Report this Comment On October 13, 2009, at 8:55 PM, modeltim wrote:

    Pricewaterhouse Coopers report is a joke. Why do companies use management consultants? So that they'll tell them what the execs want to hear.

    We need a public single-payer healthcare system in this country. Profit has no place in healthcare just like profit has no place in running a police or fire department.

    Americans health insurers are predatory and immoral and the truth is that they can't compete with a publically administered system that's carefully designed to address human medical needs. If you want to call that socialism, so be it. That's the human bottom line.

  • Report this Comment On October 13, 2009, at 8:58 PM, gs8212 wrote:

    The real problem is not so much we need health care reform - everyone would be for better health care for all, assuming the government could actually pull that off. But put aside all the competing partisan ideas of personal freedom and responsibility versus Government social programs. Our country's finances cannot sustain the kind of program being proposed. It is impossible.

    Europe is cutting back on its social programs for the same reason - and its not just due to current problems - its been happening for many years. They cannot sustain the programs, and that is with the US paying for their defense. Let Europe pick up the tab for their own defense and you would see a quick re-evaluation of social programs.

    Which brings us back to the US. The proposals (there are I believe 2 in the Senate and 3 in the House) provide no significant details in them for how they would actually work. How will they be carried out? The devil is in the details. The Baucus plan voted out of the Finance Committee today has only very broad outlines of hoped-for reforms. And as of this afternoon only a summary of the bill was released. Would any of us in our private lives make such a monumental decision committing our future resources based upon so little information?

    One of the details that has been laid out is that over half the savings to pay for this is supposedly coming from $500 billion in "savings from fraud and waste" in the Medicare program. If there was that much waste and fraud (which I'm not necessarily disagreeing with) that is so evident and available for recouping, then why haven't we already done so and used those savings to pay down our country's debt to China? Are we to believe these savings from fraud and waste are going to suddenly materialize in the coming years? Is there not anyone in HHS or elsewhere in government that would have thought it was worthwhile to note and recover this money?

    Our country's debt is soaring to new heights as a percentage of GDP. And it isn't due to the wars in Iraq and Afghanistan. We've fought 2 wars for 8 years for about twice, I believe, the amount that was spent in one year on the "Recovery Act" - not the TARP and all the bailout money - but the almost $1 trillion appropriated in FY2009 for the "Recovery Act." That $1 trillion is in addition to the normal 2009 annual federal budget and the TARP and other bailouts. The TARP and other bailouts by the way amount to about $11 trillion authorized, and about $2 trillion spent.

    Social Security is now annually paying out more than it is taking in. Some say this is okay because we have the SS fund - that pool of assets available to pay benefits - right? Sorry. That pool of assets is simply receivables from Treasury. Our Congress spent those tax dollars (withheld from our paychecks each pay period) years ago. Know how the SS receivables will be redeemed? The Fed will sell more debt to China, and pay back the SS fund, which can then pay benefits to citizens. See where this is going? A program that is supposed to be paying for itself needs a bailout. Aside from SS being unsustainable, does anyone think this new government mandate for health care will somehow be different?

    Our country's finances have reached a level of unreality that it is hard to fathom. I work with Federal budgetary and financial information on a daily basis. It is frightening and paralyzing to see it. The information is out there in the public domain but if you don't work with it, its tough to know where to look for it, so I don't blame the public for not knowing more about it. But you can find much of it in the Treasury annual financial statements of the Federal government, especially the Notes to the statements. Come on fellow fools - we are supposed to know how to read statements and understand an investment, aren't we? GAO (independent investigative arm of Congress) reports on the sustainability of our governments programs. Go to GAO.gov and search on that term.

    Health care reform is the least of our problems - we should be reforming our current set of federal entitlements first. Get our house in order and then decide what other programs to add. We must first address the fundamental question about the sustainability of our Country's finances before making such a huge new commitment of our tax dollars.

  • Report this Comment On October 13, 2009, at 9:04 PM, ozzfan1317 wrote:

    Although I understand the frustrations with private insurers and I have no doubt about their blood or money lust I disagree with eliminating them completely nothing in our constitution says you are not allowed to make a profit and our country has too many needs to afford a single payer system. If you are wealthy enough to pay for healthcare you should not be forced into a public system.

  • Report this Comment On October 13, 2009, at 9:08 PM, theHedgehog wrote:

    Those of you who are against universal care because of the costs should be aware that the costs are already in the system. As a general rule, we don't let people die in a hospital due to lack of ability to pay. They may get shuttled off somewhere else and get a lower standard of care, but by and large they are getting care. And, it comes at a higher cost than maintenance healthcare.

    Emergency Room visits aren't cheap; either in dollar terms, or in the cost of the employees. The fact that so many ERs are used as primary care should give you pause. It's a waste of equipment and physicians. I'm not saying that the poor and indigent aren't worth the care, I'm saying that they shouldn't have to tie up emergency facilities for a sore throat or an ear infection.

    Providing a reasonable minimal care level to all, under a universal care system, would go a long way toward freeing up ER staff for gunshots, appendectomies, delivering babies, and other things we consider that should be dealt with at an ER. It would also pull a lot of the costs of operating a hospital, both in staff and equipment, out of the routine care equation.

  • Report this Comment On October 13, 2009, at 9:13 PM, theHedgehog wrote:

    <i>Although I understand the frustrations with private insurers and I have no doubt about their blood or money lust I disagree with eliminating them completely nothing in our constitution says you are not allowed to make a profit</i>

    There is nothing in the constitution about insurance companies one way or the other; so don't bother to pretend that there is some constitutional protection of profits for insurance companies. There is not.

    <i>and our country has too many needs to afford a single payer system.</i>

    That has not been established. In fact, given the profit part of the insurance business, it's not even a reasonable assertion.

    <i>If you are wealthy enough to pay for healthcare you should not be forced into a public system.</i>

    What would stop you from seeing an expensive boutique doctor under a universal system? If there's a need for such, it will be filled. But, let's face it, the average doctor provides average care. Math alone guarantees that. If you want to pay for care from the 5th percentile on the right, I can't see anyone stopping you. But, you still would need to be enrolled in the universal care system, for the same reason that you're still enrolled in social security and medicare.

  • Report this Comment On October 13, 2009, at 9:17 PM, gayledon wrote:

    the whole health care reform is based on the illusion of 'who is going to pay for my health care' or the insidious notion of entitlement.

    the current version approved in senate committee today is only going to cost 900 bil. that's if every star in the universe lines up correctly. the footnotes in the CBO report will make an average joe wonder if the cost might closer to 2-3 tril over the same period.

    dwk

  • Report this Comment On October 13, 2009, at 9:20 PM, ozzfan1317 wrote:

    YEN4PESOS

    I have no comment to assume every person my age is someone who just plays video games and works at Applebees. I don't know anything about you personally but God help us if you hold an important position anywhere.

    To the person from Canada this is why I dont want a single payer system people should have a choice. I only want a public option as a safety net for the poor or Middle class I don't believe we should eliminate private entities at all.

    With all due repect to anyone if you are on welfare you probably already have healthcare so most of the fat lazy people are already taken care sorry to correct those who thought differently.

  • Report this Comment On October 13, 2009, at 9:21 PM, ozzfan1317 wrote:

    YEN4PESOS

    I have no comment to assume every person my age is someone who just plays video games and works at Applebees. I don't know anything about you personally but God help us if you hold an important position anywhere.

    To the person from Canada this is why I dont want a single payer system people should have a choice. I only want a public option as a safety net for the poor or Middle class I don't believe we should eliminate private entities at all.

    With all due repect to anyone if you are on welfare you probably already have healthcare so most of the fat lazy people are already taken care sorry to correct those who thought differently.

    Also I agree Shakespeare was right lets kill some lawyers..lol

  • Report this Comment On October 13, 2009, at 9:28 PM, mtracy9 wrote:

    When the head of Medicare is making $150,000 a year and is providing better service than the

    private insurance industry CEO who is making $12 million a year, it's time to take another look.

  • Report this Comment On October 13, 2009, at 9:36 PM, sfun wrote:

    There seems to be no recognition that when politicians say that the plan is "paid for," it means we the taxpayers and consumers are paying for it!

    There is no free lunch and when the government is buying, it costs even more!

    The healthcare bills currently being considered have one major thing in common - government control. How much of your freedom are you willing to give up?

    I am very surprised that people who believe in the ability of individuals to control their own economic future are so willing to surrender that future to the tender mercies of the Federal Government!!!

  • Report this Comment On October 13, 2009, at 10:00 PM, wrkdiver wrote:

    First - Did all you blabbermouths MISS the Congressional Budget office's estimate of the COST of all this wonderfulness? Of course, they are obviously bought off by the insurance companies!

    Second - Did you also miss their estimate of how much would be SAVED by tort reform?

    Have the Democrats even MENTIONED tort reform? OF COURSE NOT! Are they owned by the tort lawyers? Well, one DID run for President on the Democratic ticket, didn't he?

    Third - Did you happen to read estimates of how much could be saved if insurance companies could operate across state lines?

    Fourth - The N.Y, Times Front Page Story?

    I'm not getting a raise in my Social Security - because it is BROKE! How long until Medicare?

    "Fool On"? No, Dream On, Fools!

  • Report this Comment On October 13, 2009, at 10:07 PM, stan8331 wrote:

    What really worries me about this whole mess is that so few people seem to grasp that we are going to go bankrupt if we don't find a way to drastically reduce our average lifetime per capita healthcare cost. Republicans like the staus quo, Democrats want to use any savings from reform to cover more people. NOBODY is looking for major cost reduction, because it will be painful and politically unpopular.

    Even with all its faults, Medicare works pretty well so long as the number of people paying in is in balance with the number collecting benefits. When that ratio gets seriously out of whack, as it already is and will soon become far moreso, the whole thing falls apart.

    I don't care whether you favor a single payer, government option or free-market system - unless you can find a way to actual major reductions in outlays - not mere limitiations of growth - you're employing an ostrich strategy.

  • Report this Comment On October 13, 2009, at 10:21 PM, RSHENKE wrote:

    I think we would be best served right now to first work on cost containment for services as they are now provided before venturing into a huge government run medical care option.

    Uninsured people are using emergency rooms as their primary care. Let's set up clinics that are open 24 hrs/day and direct them to these clinics which will be much less expensive to operate, We are already paying the bill. This just might help to reduce it significantly.

    Why do we pay such premium prices for prescription drugs. Lets open the market and allow people to buy from foreign pharmacies if our won't reduce the prices.

    Let's reform the legal system so that doctors can make decisions based on their best judgements without the threat of legal recourse if they don't get it exactly right. this could result in a lot fewer extra procedures to protect themselves.

    We should promote a minimum health insurance policy that could be offered on a national basis so insurance companies could compete in all markets and people would have the option of upgrading to get higher levels of coverage. State mandates in many states currently limit the choices for thei residents and thereby increase the costs.

    We should startr by doing some of these things and watch the results and then proceed on other cost saving measures. Cost is the big issue, not quality or accessibility. Let's get moving there.

  • Report this Comment On October 13, 2009, at 11:25 PM, rashworth wrote:

    thank you for a very helpful article. The problem is no one is reading the details. The media dominates us with political speech. Your conclusion is that the problem we have now with health care is better than the new laws they propose. Let's have some changes but not these bills. Let's get all insured by offering all an opportunity to buy cheap limited coverage. Then let's set up charity clinics and refuse to service people in emergency rooms. The ER is the state's place to take care of the poor. They set it up to service people there thru thier laws. The state should be required to provide clinics for the poor. Then charity can also step in and public and private non-profits can offer to run some of the clinics. Charity is better than gover. paid entitlements for the poor as well as the rest. Keep the gov. and politics out. Right now it is the gov. set up medicare system that is driving the health industry They have 30% of the market. They mismanage it. They fix prices. They do not fund or tax at the level needed to run the system they set up. They want to spread the poverty and mismanagement of that to everyone.

    The fact that healthcare needs repair does not entitle the gov. to step in. Let regulations and the industry itself run the fixes.

  • Report this Comment On October 13, 2009, at 11:34 PM, theHedgehog wrote:

    <i>Then let's set up charity clinics and refuse to service people in emergency rooms.</i>

    And refuse to give them abortions. Or birth control. The majority of charities in this country are faith-based. I'll pass on faith-based medicine, thank you.

  • Report this Comment On October 13, 2009, at 11:40 PM, JGPage wrote:

    I disagree with "Requiring health insurers to cover everyone will flood the insurance pool with people who are already sick, and those costs will have to be shared by everyone.".

    If a person begins treatment for a condition while covered by insurer A, resigns his job, goes to a new job, and is covered by insurer B, the cost for insurer A goes down, but for insurer B goes up for this one individual. However, the overall cost to both insurers as a group remains the same. Unless there is a higher flow of insureds to one or the other insurance companies, the general risk coverage for each company remains stable.

    I also think that there is another option for mandated coverage, that is mandated large and diverse risk pools. Insurance is about managing risk. Insurance companies have an incentive to minimize the risk of the pool which is lower payouts. The actual number of people who opt out of insurance because they are in good health is not significant, and as they get older, they will be insured - this means that while they may save a few bucks now, they will make up for it later.

    HR3200 is bad medicine. Federal micro-management of private money is not in anyone's best interest, no matter how well intentioned. Our economy is far too complex for that approach, even if our elected representatives could figure it out. This should be handled at the state level, which is where insurers are licensed.

  • Report this Comment On October 13, 2009, at 11:53 PM, sbxsentinel wrote:

    I didn't change the oil in my car for about a year. Turns out that it ran fine for quite some time without any problems... I saw the warning light on, so I unplugged it! That darn thing won’t annoy me anymore! Then one day it froze up solid. Now…, I think that I shouldn't have to pay for the overhaul of the motor; my neighbor should (the tax payer).

    This is today's health care. People do not on average take care of themselves. It's too easy to eat fast food, drink beer, and the like. It's not bad to do those things, but it is in excess! It's a well known fact that more and more Americans are obese. Fact is they don't take care of themselves. When someone gets a head ache, they unplug the warning light of the body by taking a drug for the pain. The first thing that the Chinese look at is the diet when there’s a problem. That’s a good first step; then maybe some exercise.

    I should not be forced to pay for the people neglecting their bodies. This bill takes away my freedom to choose what’s right for me. Why should I be penalized when I take care of myself? Penalize the person who’s sick, not the person who’s healthy!

    This is what I propose: Make it an option/ insurance plan to cover costs that exceed the normal checkups and visits and pay cash for the things you can afford. Like the dentist checkup, the physicals; any visit, say under half an hour. This will drive down costs because the insurance companies are not involved with half of the visits.

    Who’s stupid idea was it that said it’s a ‘right’ for everyone to have insurance? I don’t want it! That’s correct, it’s cheaper to pay cash! I went to the dentist and got a regular cleaning. It was a first visit to that dentist. They asked for my insurance ‘card’ I told them I didn’t have it on me. They assumed I didn’t have insurance. They gave me a bill for $50 and wanted the cash now. When I pulled out my wallet I remembered that I did have my card, so I gave it to them. There was a little scuttle, then they gave me a new bill for $60! I asked how much they were charging my insurance; they said $80! What kind of crap is that??? I told them that I was going to call my insurance company, they said, go ahead. When I did, my insurance company said they realize that goes on all the time, and they can do nothing about it. So I will be one of those cash payers to the end! Thanks you all for paying for the rest of the bill! Hahahaha!

  • Report this Comment On October 13, 2009, at 11:55 PM, maiday2000 wrote:

    Most people in America are stupid, and consequently, most people on this board are stupid. The unions and liberals control our schools, and kids learn less and less...and here is the result. Anyone that thinks providing more & better coverage while simultaneously costing less, is a complete and utter idiot. Insurance companies are an arm of the government at this point, we need to get all healthcare OUT of businesses and put it on individuals, and make people responsible for their own healthcare spending. Require publishing of procedure pricing. Competition will drive innovation and lower costs. The government has never fixed anything that it got heavily involved in, its a fact.

  • Report this Comment On October 13, 2009, at 11:56 PM, theHedgehog wrote:

    JGPage, much of your post simply gives good reason to abandon the private health care system we have. Do you realize that?

    I'd also like to address this: "I also think that there is another option for mandated coverage, that is mandated large and diverse risk pools. Insurance is about managing risk."

    You, like many others, are looking at this from the status quo - IOW, that health care is a private issue. One could say the same about any of the public utilities and services that we have. Police, Firemen, Water supply, sewage, electricity, natural gas, streets, are all, to some extent "nationalized" (for lack of a better word) for the good of the people. Sure, you have to pay for your electricity, but you don't have to write a check when the wind blows your power line down; nor do you have to write a check before the firemen put your house fire out.

    Healthcare is arguably a public issue, and not a private one. As such, it should be handled by a public trust, and not by a for-profit entity.

    There are those of you who will immediately attack this argument because they don't want the government to "stand between me and my health care". I have news for you, there is already a quasi-government entity making that stand, and it's called an insurance company.

    I was standing in line at the pharmacy recently. The lady in front of me was essentially refused a prescription because the insurance company would not pay for it until the next day. You say that she could have just paid for it? I tried that once, with an Rx painkiller, and the pharmacist on duty refused to sell it. The next day, I went over his head, and was assured that he would never pull that stunt again. But, still, it happens. And there's also the practical matter that the aforementioned lady's Rx was $150 without insurance.

    I assure you that your present insurance company is just as intrusive (if not more) as any government entity will be.

  • Report this Comment On October 14, 2009, at 12:02 AM, thomasblak wrote:

    To all of the following and anyone who thinks like them:

    Steveelcpo, glkolbe,singank,howboutme.....

    What the hell is wrong with you selfish, narcissistic people?

    1) National health plans in every other industrialized nation EXCEPT ours works very well thank you and all their citizens - conservative or liberal think we are nuts!

    Wake up! Quit listening to the paid shills for corporate domination like Druggy LImbaugh, Simpleton Hannity or that disgusting man-woman Coulter. And no, you are not going to have to pay for boob jobs or sex changes or abortions. Are you really that niave that you believe that crap?

    2) You healthy lifestylers who think you are so invincible - what happens when you get hit by a bus, or come down with MS. Should we stand over your body and blame you?

    3) Medicare is the most efficient billing service in the world 2-3% overhead - why do you want to pay the "middleman" 25% so he can deny your mom coverage and take home 700 million in pay?

    4) Believe it our not, we are ALL in this together. No matter how hard you try to hoard your own little stash, if society around you is one giant cesspool, you will eventually be sucked under. Your life will be much better if everyone else also has something worth living for too.

    5) A single Payer (not decider) system is by far the most efficient way to administer any all inclusive plan. Do you really want 100 different companies running the water systems that supply your house with clean fresh water each day?

    How bout the fire department? Privatize that? What happens when your neighbors house catches fire and he doesn't have "fire insurance?

    100's of road maintaining companies? Tolls at every intersection? Kinda puts a crimp on that whole freedom to move about thing you Libertarians like to extoll so often.

    What's next for you selfish forward thinkers? Private police forces. Private national parks, Private electrical grids,

    You don't own anything forever! Every new invention is built on something that someone else did before!

    You don't own the commons or what is for the common good. We all do!

    So like it or not, think of healthcare as the lottery - you pay your your premium and if you never get sick and have to use it - you win! But if you do, you may live to fight another day!

    Get with it and make a better world for everyone - you selfish pricks!

  • Report this Comment On October 14, 2009, at 12:03 AM, JGPage wrote:

    This is another red-herring: "The idea of requiring everyone to carry health insurance isn't that farfetched. States require motorists to carry auto insurance, for instance."

    The liability insurance we are required to carry does not cover the payor (insured), it covers the victim by protecting the victim from the insured's (otherwise) inability to pay for damages.

  • Report this Comment On October 14, 2009, at 12:09 AM, thomasblak wrote:

    Hip hip to the hedgehog and the few other actual sain people on this forum. The rest of you are selfish narcissists who deserver to be hit by a bus - and then stick us with the bill! LOL!

  • Report this Comment On October 14, 2009, at 12:16 AM, theHedgehog wrote:

    thomasblak,

    I haven't always been this enlightened. I'm one of the nouveau-poor you read about. You know, those slackers who had a good paying job and top of the line health insurance who lost his job a few years back, and then was diagnosed with a chronic illness. I'm what you call "uninsurable". I'm luckier than most, in that I did manage to put a small bit of money away, and I'm a proud veteran of the US Air Force, so my health issues are pretty much covered one way or the other. There are many in my position who had just a little worse luck than I did, and have lost home, family, everything.

  • Report this Comment On October 14, 2009, at 12:31 AM, GenChaos wrote:

    JGPage, I get what you're saying but the concept is still similar. Requiring people to carry minimum health coverage essentially protects the rest of us from having to indirectly foot the bill for someone who ends up in an emergency room without coverage. If hospitals weren't required to help people without coverage than we could argue for a person's right to take that risk.

  • Report this Comment On October 14, 2009, at 12:32 AM, TMFBiologyFool wrote:

    The auto insurance analogy isn't really a red-herring because they both cover other people. Many of the health costs incurred by the uninsured are paid for by the insured.

  • Report this Comment On October 14, 2009, at 12:34 AM, bs1934 wrote:

    Now hear and evaluate this one. Actual experience. My mother in law had a stroke and was admitted to a San Francisco hospital. My wife and sister in law concluded it best to allow her to pass on. After five days she was gone. THE BILL? Over 60,000 dollars. $30,000 billed for the room, the rest for those "necessary" tests. Pardon me, but even though we paid only $800, I was mortified. I guess they pad that bill so they can pass it on as "actual" costs not compensated for. Their spokesman told me that one insurance company would only pay $12,000. ONLY! Event that was exhorbitant considering that she was lying in bed with an IV for 5 days. And we don't need Health Care Reform? How stupid can one get!

  • Report this Comment On October 14, 2009, at 1:01 AM, CallyRose wrote:

    . I was previously for the public option, but have since changed my mind. After looking at the government's track record with Medicare and Medicaid I do not think that the government is very efficient at managing health care. People have died while waiting for the government bureaucracy to provide them with services. I worked in a county facility for 5 years, where the work ethic was pitiful. Employees tried to get out of work rather than provide services and did what they could to get paid for not working, or not even showing up. An ever increasing number of doctors are not accepting MediCare, MediCaid and even some private insurances, because they do not pay enough for them to cover their overhead, not withstanding that the government is often making cuts in MediCare and MediCaid.I think the only real solution is for insurance companies to be removed from the health care management system. They should be incorporated into the delivery rather than the denial of healthcare. Since the odds of this happening are slim to none, because no elected official is willing to stand up to the insurance companies, and refuse their bribes and offers of campaign financing, I think a better solution than a public option, which is so polarizing, would be to create a Coalition for Affordable Health Care (call it something other than a public option). It would be comprised of a group of insurance companies (or even change that term to something like healthcare coordinators or facilitators, to promote a new way of thinking) who are willing to coordinate healthcare while conforming to guidelines set and monitored by the government. They can receive subsidies, grants or tax incentives that will offset their costs. They can be administered by the companies but monitored by the government to ensure compliance. Maybe they should be non-profit if that will facilitate these efforts and put them in a different arena than the "for profit" insurers who think they will not be able to compete. Since they want to make a profit they may not compare themselves to the non-profit insurers. This could be a win win situation for all. Doctors and other healthcare providers must be involved in these negotiations because they know what it will take for doctors to be on board with this. This will appease those who disapprove of government managed healthcare and those who want to make healthcare more comprehensive and affordable. It is absolutely unfair for citizens to pay for the best of healthcare for elected public officials and not have it themselves. IO am very healthy but happen to have a pre-existing medical condition that was not self-induced. I am a physician and can only qualify for guaranteed health care coverage with premiums that are over $600.00 per month with a $1500 deductible and I am still paying hundreds of dollars for prescriptions. Yet, as an independent radiologist, I get paid $15.00 to read ultrasounds and mammograms, $7.00 for X-rays and $25 for CTs and MRIs. How ridiculous is that? The outpatient market has been driven down to this level because of undercutting by corporations who have taken over healthcare management. Yet I got a bill for $900.00 from a hospital for an MRI that only included the radiologist's fees that was not covered by insurance because they stopped being a preferred provider. My own doctor and the imaging center that I go to in Los Angeles, CA stopped accepting my previous health insurance. So what good is health insurance if it won't cover what you need to be covered. i recommend we go to a single payer system or do what I suggested above. Healthcare should not be for profit. People should not profit off of people's health. They can still make a good salary and if insurance companies were not siphoning off the money from the healthcare system, the healthcare providers could still be compensated well for providing quality care. Give people incentives to maintain their health by reducing premiums for non-smokers and non-drinkers. It doesn't mean everyone has to pay the same premium, but people should not be penalized for having medical conditions that they did not bring upon themselves.

  • Report this Comment On October 14, 2009, at 1:02 AM, MDexpat wrote:

    I am an American living abroad. I have lived in the US, Canada, Australia, Belgium and now China.

    I have to laugh when I read the dire descriptions of national health systems. I've lived under many systems in all the years that I have lived in countries with national healthcare systems, not once have I heard an individual who would trade their national system for ours.

    As for those private health insurance advocates on this blog. I would like you to tell me where you can buy private health insurance. There is no such thing, believe me I know, I have tried to buy private health insurance. It is not possible to buy adequate and affordable private insurance. No such plan exists. Why would it? It would be an absurd business model that would insure an individual. It is inevitable that we will all grow sick and die, an insurance company could only loose when betting on a single indivdual.

    I would like the people who take to position that a private system would be better at controlling costs to explain to me why healthcare is cheaper everywhere (especially the single payer countries) than in America. Perhaps those of you who believe that private healthcare is better at controlling costs should look up the word monopsony in the dictionary. A single payer has all the power, therefore that payer has a greater ability to control costs. That is an incotrovertable economic fact.

    As for those people who ask why they should pay for other people's bad decisions. I say to you, 1) you already do (hospitals cannot legally and or morally deny coverage to those who are sick), 2) two thirds of health costs ocur in the last two months of life (so your day of need will come), and then finally 3) shame on you - it is time you took a course in ethics and morality.

    I have lived a healthy lifestyle all my life but I have many friends and loved ones who are less diligent than I, yet I still care about those people and there well-being in spite of their faults. All of you who say; "why should I pay," should think about what you are saying. Are you willing to let granny die without healthcare merely because she smoked?

  • Report this Comment On October 14, 2009, at 1:19 AM, CallyRose wrote:

    I was previously for the public option, but have since changed my mind. After looking at the government's track record with Medicare and Medicaid I do not think that the government is very efficient at managing health care. People have died while waiting for the government bureaucracy to provide them with services. I worked in a county facility for 5 years, where the work ethic was pitiful. Employees tried to get out of work rather than provide services and did what they could to get paid for not working, or not even showing up. An ever increasing number of doctors are not accepting MediCare, MediCaid and even some private insurances, because they do not pay enough for them to cover their overhead, not withstanding that the government is often making cuts in MediCare and MediCaid.

    I think the real solution is for insurance companies to be removed from the health care management system. They should be incorporated into the delivery rather than the denial of healthcare. Since the odds of this happening are slim to none, because no elected official is willing to stand up to the insurance companies, and refuse their bribes and offers of campaign financing, I think a better solution than a public option, which is so polarizing, would be to create a Coalition for Affordable Health Care (call it something other than a public option).

    It would be comprised of a group of insurance companies (or even change that term to something like healthcare coordinators or facilitators, to promote a new way of thinking) who are willing to coordinate healthcare while conforming to guidelines set and monitored by the government. They can receive subsidies, grants or tax incentives that will offset their costs. They can be administered by the companies but monitored by the government to ensure compliance.

    Maybe they should be non-profit if that will facilitate these efforts and put them in a different arena than the for profit insurers who think they will not be able to compete. Since they want to make a profit they may not compare themselves to the non-profit insurers. This could be a win win situation for all. Doctors and other healthcare providers must be involved in these negotiations because they know what it will take for doctors to be on board with this. This will appease those who disapprove of government managed healthcare and those who want to make healthcare more comprehensive and affordable.

    It is absolutely unfair for citizens to pay for the best of healthcare for elected public officials and not have it themselves. My premiums are over $600.00 per month with a $1500 deductible and I am still paying hundreds of dollars a month for prescriptions. Yet, as a radiologist, I get paid $15.00 to read ultrasounds and mammograms, $7.00 for X-rays and have been paid $25 for CTs and MRIs. How ridiculous is that?

    The outpatient market has been driven down to this level because of undercutting by corporations who have taken over healthcare administration. Yet I got a bill for $900.00 from a hospital for an MRI that only included the radiologist's fees, which was not covered by insurance because they stopped being a preferred provider. My own doctor and the imaging center that I go to in Los Angeles, CA stopped accepting my previous health insurance, PacifiCare. So what good is health insurance if it won't cover what you need to be covered for. I recommend we go to a single payer system or do what I suggested above. Healthcare should not be for profit. People should not profit off of people's health. They can still make a good salary and if insurance companies were not siphoning off money from the healthcare system, the healthcare providers could still be compensated well for their quality of care. Give people incentives to maintain their health by reducing premiums for non-smokers and non-drinkers. It doesn't mean everyone has to pay the same premium, and their can be a tiered benefits, with people paying more for non-medically necessary services, but people should not be penalized for having medical conditions that they did not bring upon themselves.

  • Report this Comment On October 14, 2009, at 1:49 AM, Fryatt wrote:

    lyndonevans wrote:

    " No matter how you package it, flavor it, or sell it, the obamacare government run health care mandate, if it's passed, is a signal that America is dead. Better sell all your stock, buy gold, and run for the hills with hoes and seed in hand. We will be bankrupt in short order, and no one will want to work, buy stock, or save anything." ................ Comments like this make me wonder if I live on the same planet as this fellow, as it happens I do. America, finds itself alone among western democracies in regard to private health insurance. No politician in Canada would ever suggest dumping our health care system in favor of private health insurance , as he would never be elected again. Some things in life should not be privatized. Your local fire department comes to mind ............and possibly the health care of 300 million Americans

  • Report this Comment On October 14, 2009, at 2:18 AM, PALH wrote:

    I hope everyone knows by now that PriceWaterhouse came out today and essentially repudiated the right wing conservative health-insurance cartel flacks cherrypicking of the research they did.

  • Report this Comment On October 14, 2009, at 3:15 AM, tertertes wrote:

    Before President Obama was elected, I put together a 7 page letter of ideas for healthcare reform, and sent it to him via snail mail. Never even had the courtesy of an electronically generated response. What are my qualifications? An RN with an advanced degree, 15 hours toward an MBA, over 35 years of experience in both the private and the public sector, and licenses in 11 states. In 2005, I was hospitalized in France. Excellent care, better than the US. Total cost? $1300.00, including CT scans, MDs, IVs, everything.

    Two weeks ago, I was again hospitalized, this time in Budapest, Hungary. Again, excellent care, top of the line medical testing, saw my doctor at least 2 times a day, for more than a few minutes. Total cost: a little under $700 (currency exchange varies). What are some specific differences? I was given what I needed, nothing more, nothing less. For example, no menu choice except for special diets. No extraneous nurses aides (no I don't want to hear it, I've worked with too many of you, 60% should be fired, and 40% should be given huge raises). No bubble wrapped pills, no private bathrooms, etc. If you needed help, you got it. If not, you straightened your own bed, and gave your roommate a drink of water, rather than calling the nurse. OH MY GOD! What a concept. Helping someone else.

    In my letter, the things I proposed are basic, cost cutting measures allowing the money to go where it should.

    1. Drop the huge menu selection. If you don't want what they serve, have your family bring in your meals, or offer a catering service, paid for out of pocket, rather than out of insurance dollars.

    2. Issue 1 towel and washcloth on admission. Except for medical reasons, that's all you get. This nonsense of patients wanting 5-10 towels a day is ridiculous, Half of them walk out the door with visitors. Same with sheets, hospital PJs, and toilet paper. Each person issued 1 roll of toilet paper. Bring it with you to the toilet.

    4. Go back to the multidose bottles of basic medications such as aspirin, tylenol, and other inexpensive OTC drugs. Saves packaging, saves pharmacy time, saves bean counter time. Put a daily flat rate for OTC meds on every bill. It will be cheaper than the $5.00 aspirin you took.

    5. Stop using ERs for runny noses because you don't have insurance. ERs are only required to treat life threatening emergencies. ERs waste millions of dollars a year because it's cheaper than the law suits some greedy attorney wants to put together,

    6. Private insurances have put caps on substance abuse treatment, alternatives need to be developed for the indigent (socialist that I am). I recently worked in a county detox unit. Average scenario: SSDI check comes in, probably at a family member's house, but s/he can't live there, too disruptive. Three days later, money gone on substance of choice. Local ER: "I'm suicidal". Bam! Private room, 1:1 sitter for safety, give them cigarettes and take them to smoking area to keep them from getting out of control. Three or four days later, a facility like mine finally has a bed. Brought by ambulance because they're an 'involuntary' patient at a risk for self harm. Stay with us as long as possible, take meds, refuse group therapy, give the social worker the usual song and dance, blah, blah, blah. Try to stay as long as possible, If cannot - will be sent to another treatment facility that is open. Stay there till next SSDI check comes in, walk out the door, and it starts all over again. Multiply the costs nation wide. Talk about behavior modification, we've taught these people how to use and abuse.

    My solution? This is a mental illness. They are a danger to self because they said so. Develop locked community based shelters and pay for them with the client's SSDI. Let them earn spending money by doing chores in the shelter. If I have to shell out of my pocket for insurance and have to work for spending money, why can't they? Just because they're addicts/alcoholics, does not mean that they are incapable of pushing a broom, washing their clothes, or helping cook the food they eat,

    Doggone it, I'm a true anti-American. The idea of it all, good, basic healthcare that you need, with no bells and whistles. My problem is that I've seen so much abuse of the system, by all levels, that it makes me sick. Last year, I was offered a position in Atlanta for $17/hr. That same position in CA, with my degrees and experience, pays over $40/hr. At the same time, that particular hospital was on front page news; the administrator was collecting $600,000 year, with discussions about her abilities and the politics of her appointment.

    Does this solve all the problems? No. I have plenty of ideas beyond this, but suffice to say that there are many aspects of cost cutting that can be done immediately, and in this new fiscal era, people need to stop demanding orange juice if they got apple juice, people need to stop demanding unnecessary tests, hospital personnel need to do their jobs, administrators need to come out of their ivory towers, and collectively we could be #1 on the WHO (World Health Organization) list rather than #37. By the way, France is #1. so much for socialized medicine.

  • Report this Comment On October 14, 2009, at 3:21 AM, lhollingsworth wrote:

    We are currently funding health care for the poor and the wealthy can afford health care of their choice. Why not include the hard-working middle class? The projected cost of health insurance for an average family will be $24,000.00 in less than 7 years if it continues at the current rate (3 times the rate of inflation). How will a family be able to afford it? We already have hidden taxes that we pay each year in the amount of $1,800.00 per person to help fund health care. It does not make sense to leave out those who are paying for others.

  • Report this Comment On October 14, 2009, at 7:15 AM, phatfuzzel wrote:

    It's S O C I A L I S M. Which part of that word do you not understand? It's a political shell game reguardless of the shell you pick, socialism is still under it. The following is a list of places socialism has been successful:

  • Report this Comment On October 14, 2009, at 7:26 AM, lanoush wrote:

    The insurance industry decided to come forward with those numbers when it seemed that a reform plan was going to pass. But it only strengthens the arguments for a public option, which is not "socialism" unless you think highways are "socialism."

    Is the threat of a fine for not getting insurance regressive? Not with a public option, which could insure people by default who could not pay for private insurance. Is this more expensive, adding to the cost of reform? Not as expensive (nearly) as leaving people uninsured, and relieving the burden on another powerful lobby (besides insurance companies): hospitals, who end up picking up part of the tab for the uninsured.

  • Report this Comment On October 14, 2009, at 8:41 AM, lpnews wrote:

    Most countries that have universal healthcare have resource issues. Those countries that tax their citizens 60% plus may be the exception. If you have an issue in the middle of the night and go to the emergency room, unless you are near death you will be turned away and sent to a primary care type doctor in which you may also have to wait. This goes on because there are shortages of doctors and shortages of money to fund the system. The government will now dictate what doctors get paid, what hospitals get paid etc. Do you want the government dictating your healthcare? There is no question that health needs to be reformed. What needs to be done is to allow more competition among the 2000 plus insurance companies. Allow them to compete in all states for customers. Require them to insure those with pre-existing conditions. To make this work we would have to require all citizens to have insurance. If you cannot quarantee that no healthcare reform will work.

  • Report this Comment On October 14, 2009, at 8:49 AM, superratus wrote:

    There are a number of items that I feel are missing from the proposed legislation.

    1. Tort reform, everyone discusses the insurance industry lobbyists, but never mention the trial lawyers lobbyists. I have a number of doctor friends who consistently schedule their patients for more tests than they feel are necessary just to protect themselves from a malpractice claim.

    2. Incentives for young people to enter the medical field.

    Adding 25 million new members will definitely have an impact on the current medical providers.

  • Report this Comment On October 14, 2009, at 8:50 AM, donaldo15 wrote:

    Imagine if you could crash your car and then go get insurance at the same rate as before your crash to pay for it. Isnt that what this health care bill does?

    Millions of Americans would drop their coverage and pay a modest fine. Then when they are struck with cancer or another long term illness they would get insurance and pay the same rate as a healthy person who has had insurance all along. How the brains in Washington dont see the obvious implications here is just amazing to me.

    If health care reform is going to pass then it should be implemented in 2010, not 2013. Obama will be rewarded by many for passing this, so he should also be judged for it before the next election, not after it. Would any liberals disagree with this?

  • Report this Comment On October 14, 2009, at 8:57 AM, TheHappyHiker wrote:

    Isn't it naive of us to think an industry funded report won't show some bias? Just as it is naive to think politicians aren't motivated by ideology. My personal feeling is single payer, modeled on medicare, is the answer. Insurers could supplement what the plan didn't pay for. There could be vouchers for lower income users. Here is an interesting essay by an oncologist, giving his take on what our real problem is. http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_...

    Health care is the only system where we pay for whatever the provider orders, with no questions asked. And make no mistake, we pay for it, whether it is out of our own pocket, through taxes, or through added costs on the goods and services we buy.

  • Report this Comment On October 14, 2009, at 9:17 AM, mikan828 wrote:

    The only way to reduce costs is to spread the cost over everyone, both those who are sick and healthy. Mandating health insurance won't work. The poor cannot afford the premium and wait for a tax deduction or credit.

    The only way for the reform to work is for government to provide a medicare type insurance for everyone but allow anyone to opt out upon proof they have private insurance.

    This isn't nearly as complicated as the special interests and law makers would have you believe.

  • Report this Comment On October 14, 2009, at 9:46 AM, Celtics17 wrote:

    Sad to say DeTocqueville was right. This healthcare bill will be the silver bullet through America's heart. This country's going bankrupt. People better wake up before it's too late.

  • Report this Comment On October 14, 2009, at 9:59 AM, sbxsentinel wrote:

    YOU SAID IT, phatfuzzel! You are right on. This country started out a Republic. Where you cannot get your rights taken away, they were God given. Then it turned into a Democracy, where if there were more than 50% that agree they can vote away your rights. I say lets get back to the way things started and get rid of the Socialist/Communist infiltrators. Go to a country where you belong... like China! Quit destroying what little freedom we have left.

    My grandpa tells me that he only needed to work 3 days out of the week, the other 2 days were play money. He didn't make a lot, he was a construction worker. He says he saw the government chipping away at his check over the years and now look where we're at. I'm living pay check to pay check... and I'm a construction worker. Everyone calls me a tight wad because i don't like to spend money on frivolous things, yet i can't seem to get ahead. Social Security used to get 'paid up' and they stopped taking it out of your check. So the first 6 months you would pay the tax, then they stopped taking it. We let them have it and it's grown. This is what will happen if we let the government have yet another avenue to tax us.

  • Report this Comment On October 14, 2009, at 10:18 AM, eracer7347 wrote:

    Guys

    This string misses the point entirely. We don't need heatlh care reform.

    We need heatlh.

    Our medical infrastructure and insurance system should easily be able to cover all the births, deaths, traumas, and the terrible diseases that befall a relatively small percentage of the population.

    What we can;t aford and never will be able to afford is paying for folks who are fattened by a system that encourages huge ag combines and their minions to poison the entire population with fake food of low nutritional value that comes soaked in salt and high fructose corn syrup.

    We are a nation of pre-diabetic and diabetic whales. Smoking, dringking, drug abuse pales to insignificance against the basic crime fact that we are poisoning our own population

    Until we have safe food, whether by free market choice or by policy, no heath insurance system can handle what we are purposefully creating in the US.

  • Report this Comment On October 14, 2009, at 10:47 AM, goldbru wrote:

    It would be "foolish" to give this report much credit. Come on fool.com.

  • Report this Comment On October 14, 2009, at 10:55 AM, roseonkeys wrote:

    Lately the only health care coverage we could afford was catastrophic coverage, where the deductable was $10,000 a year per individual, $20, 000 a year per family. This was all that my husband's work (a major retailer) offered it's employees. This kind of coverage isn't even worth paying monthly premiums for. If this is the kind of coverage that will continue to be called health care and that we will be forced to pay for under the new guidelines then we are no better off than before. I think health care coverage means that you actually get coverage when you pay the premiums, not just catastrophic. I know many people that have only this type of insurance and the government labels them as covered under health insurance. The statistics about how many are covered with insurance should include the level of coverage they are receiving.

  • Report this Comment On October 14, 2009, at 11:00 AM, lumanchu wrote:

    ok, so a lot of reform is coming and with that some loopholes to exploit the system. but shouldn't the healthcare lobby be at least a little excited that the government is handing them 29 MILLION NEW CUSTOMERS! Last time I checked, that was 10% of the US population. The only other area you'd see that type of growth in is China.

  • Report this Comment On October 14, 2009, at 11:01 AM, LegalizeMe wrote:

    Obama promised no increase in taxes for what, 90% of Americans?

    He already broke that promise. We got a nice tax increase on cigarettes and soon we are going to be fined for NOT having health insurance? The insanity continues...

  • Report this Comment On October 14, 2009, at 11:07 AM, mvwon wrote:

    There are some truely bizare comments on this site. One person wrote "These poor people surely pay for their shoes, cars, and cable - maybe they need to reallocate their funds, and finally, if poor and or on welfare - go back to school there are plenty of grants and you probably have plenty of time." Is he saying people should go without shoes, clothing, housing, transportation etc. and simply give whatever small amount of money they have to the insurance companies? Another writes " am getting sick of all you slackers out there that want other people to take care of your a_ _ es without lifting a finger."

    This all smacks of Ronald Reagan when he said the homeless are homeless because they want to be! More people need to get out into the real country and visit with the many thousands who are hard working, honest people but for any number of reasons are struggling finacially.

    Access to good health and health care, like education, should not be reserved for only the wealthy.

  • Report this Comment On October 14, 2009, at 11:16 AM, fowlermike wrote:

    There is no doubt that the American way of insuring peopl"e is in need of change. Having worked in management positions and having played a major part in developing and maintaining an adequate health insurance program is a tough proposition. Our company has had a self-insured plan for the last 20 or more years. This does not mean that the company assumes all of the risks associated with employee illness, but that it insures individuals and the group in aggregate with stop-loss policies (catastrophic coverage). Most of us are willing to finance everything but our health - homes, cars, appliances, boats, appliances - you name it, we live in a time where the expectations are that we have been made to feel that "we are entitled" to so many things when in fact that is not what our founding fathers had in mind when they founded this great country. We have been hijacked by not only health insurance companies, predatory lawyers, our own entitlement mentality, unnecessary mandates, obtrusive laws and regulations, but primarily by those in Washington professing to want to help us when they are actually looking to please one constituency or another while increasing their own power and control of our lives.

    Our company has always maintained a plan with benefits far better than our competitors and the business community as a whole (as told to us by our insurance agent) because we know how important health care is to our employees and their families.

    Although we have tweaked our plan over the last five or so years in order to hold down costs, we have primarily adjusted our plan to cover tests and costs that are more preventive in nature and wellness related in order to save costs down the line. We made these changes not expected immediate cost savings or even rate changes, but because in order to reduce health care costs long-term we realize that all of us must start taking better care of ourselves through healthier habits - eating, exercising, early detection of disease, etc. All reform and more government control will do nothing to cut costs or save lives without a carrot and stick approach. As anyone with just a slight intellect would agree, the government will never take the steps necessary in the short term in order to reach a longer term solution. Their idea of "fixing" things is to throw more money at a problem that already spends too much money.

    If your look at all of the primary organizations supporting "government" health care reform it is definitely about money or power for one group or the other. AARP, which supposedly represents millions or retired or nearly-retired Americans, stands to gain hundreds of millions or perhaps billions of dollars in new "supplemental health insurance" business - AARP is nothing more than an insurance company with quasi-advocacy for the elderly. SEIU, which has more members in the health and wellness industry than any other union, stands to gains many more jobs and obviously much greater pay and political clout - something that scare the daylights out of me.

    The drug companings, who have been allowed to advertise way too much for my sensibilities, have jumped in bed with the White House and Congress knowing full well that their business will grow exponentially, and last but not least, our illustrious leaders who stand to gain more power and control of our lives in the name of "helping" Americans to secure health insurance and a better life.

    If you look at Social Security (a program meant to be a supplemental program to other retirement funds) Medicare and Medicaid, Fannie Maie and Freddie Mac, Cash for Clunkers and so many other earmark and pork-barrell programs that are ruining our country, a "National Health Insurance Program" is likely to be the straw that breaks the came's proverbial back.

    I would like to think that common sense would prevail, but from what our government has either done or allowed to be done to our country these last 20-30 years, I have little faith that they will do anything that will be meaningful in the mid to long term. There is enough blame to go around on both sides of the aisle, but far too many on either side willing to do the right thing.

    I cannot and will never support health reform unless everyone in Washington - The White House, Congress, and all federal, state, and local municipalities as well as all of the unions that have the supposed "cadillac - or should we now say Mercedes" plans, agree to be on the same plan that I and my family would be required to have - for some reason I do not think this will happen - do you not find something inherently wrong with that?

  • Report this Comment On October 14, 2009, at 11:31 AM, timeinthewind wrote:

    Even the insurance companies aren't against the pre-existing condition requirements .. as long as it comes with the requirement that everyone is insured. The pool gets much larger is everyone is insured and you can be sure the insurance companies have run the scenarios and seen that they make more money if everyone has to buy insurance even if they have to cover pre-existing conditions. Without the required coverage (or stiff penalties as noted in the article), it all falls apart.

    Having everyone insured also lowers the rise in care since hospitals don't have to spread the cost of the uninsured over the rest of us.

    Having an "assigned risk pool" for health coverage like there is in many states for auto coverage raises all kinds of ethical questions but doesn't it make sense that someone we know will have far greater expenses should pay more for their insurance? Otherwise, we're really not talking about insurance, we're talking about a massive shared cost for healthcare. If we do that, get rid of the insurance companies altogether and their need for profit and just run the whole thing as a government agency with all the good and bad that comes with that.

  • Report this Comment On October 14, 2009, at 11:50 AM, westslope wrote:

    If you believe this report,you really are a fool.

    Health"care"companies will raise rates on a whim.

    As I have said before,to provide the best care for the majority they must be run as non-profit organizations,regardless of whether they are run by government or private entities.

    Thanks.

  • Report this Comment On October 14, 2009, at 12:01 PM, newfoolishfool wrote:

    Startling???? Same old Lobbing and trumping misinformation by the very people that distroyed healthcare in this country....if you believe the insurance companies you are entitled to my name above without the 'new' in front of of it.

    Since Kaiser Meets Nixon healthcare went hell at an accelerating pace.

  • Report this Comment On October 14, 2009, at 12:08 PM, clydejazz wrote:

    thomasblak has it right.

  • Report this Comment On October 14, 2009, at 12:34 PM, retiredmexico06 wrote:

    Insurance premiums have risen 131% in the last 10 years (more than 13% per year), despite the fact that insurance companies have been denying coverage for pre-existing conditions, denying necessary medical care, placing arbitrary limits on policies or cancelling coverage altogether. That is why we need meaningful healthcare reform that includes a "public option".

  • Report this Comment On October 14, 2009, at 1:40 PM, matthewbanis wrote:

    thomasblak -

    Really???

    When's the last time you volunteered to pay someone's medical bill?

    Yeah, you didn't, and until you go to your local hospital and do so - keep your socialist, hypocritical big baby name calling, mouth shut.

    Thanks,

    Matt

  • Report this Comment On October 14, 2009, at 2:37 PM, ATrustingFool wrote:

    I have a question I am hoping to get an honest answer to... I know there are a lot of opinions out there about what is going to happen when our dollar folds or of it's going to fold, etc, etc. Just assume for the moment that our dollar does collapse and I mean pretty badly... how and/or where should your money be invested before this happens ? And for those who believe it will, what do you watch for as the indicators that it is going to happen in the next 3 months ??? or 6 months ??? What do I watch for and where should my money be ???

  • Report this Comment On October 14, 2009, at 2:58 PM, theHedgehog wrote:

    <i>Just assume for the moment that our dollar does collapse and I mean pretty badly</i>

    Why should we assume that? Why not assume the second coming happens next week, or a comet strike?

    There is plenty of bad news out there without going and searching for it. Your biggest concern should be whether your health insurance company will abandon you at the first real need.

  • Report this Comment On October 14, 2009, at 3:11 PM, matthewbanis wrote:

    atrusting fool - ignore thehedgehog.

    for the currency crash - if you believe it, i'd say agriculture, foreign currencies, and foreign stocks, you can buy these directly at etrade.com where i have an account, too.

    buying directly on foreign exchanges is expensive, though.

    buying other currencies is free.

    and some options, long puts and long calls, don't short though, a bit too risky - i think.

    just my opinion.

  • Report this Comment On October 14, 2009, at 3:25 PM, ATrustingFool wrote:

    My insurance company is in business to make money... of course they will abandon me if it means they can make more profit by doing so... this constant bad mouthing of companies because they do this or they don't do that... 99% of the time their decisions are driven to make more profit.

    Their decisions are not always based on good information but their motive is the same as anyone elses who is in business - to make money and that isn't an evil thing like the current adminstration wheels out to the state controlled media every time they start looking bad.

    It's "Look at those bad companies who are just in it for the buck" and "don't worry we'll protect you !" Anyone who says they are going to watch out for you or protect you... just know that you are going to get out your wallet and pay for that protection... and even after you have paid I doubt you will get much protection.

    So, back to my question, knowing the dollar is going to collapse badly, what do you invest in that is safe (insurance companies) and what do you watch for comets? The second coming ? This is the part where I was hoping for a real investor answer.

  • Report this Comment On October 14, 2009, at 3:27 PM, ATrustingFool wrote:

    Thanks MattewBanis

  • Report this Comment On October 14, 2009, at 3:46 PM, flossy23 wrote:

    I was watching a talk show the other night that made that statement.."The average person is spending nearly 20% of his household income on health insurance....that is way too much!"

    I asked myself: What is the right percentage? Do I feel I spend a considerable amount on my health? Absolutely. Is it worth more than my flat screen? my satellite TV? my cell phone.....you're damned right it is. If we could just even start with personal responsibility (1 in 4 is obese) and priorities we could begin to address the health care issue. The fact that we intend to make those DELIVERING the care a large part of the ones funding it is downright pathetic.

    Social Security, Medicare, Medicaid, U.S. Postal Service.........All bankrupt. I have a great idea. Let's add everyone's health care.

    You want scary and enraging. Picture this: your son or daughter with a terrible condition. You wait 4 hours in a waiting room for an exam and are told to come back in 2 months for "tests". After the wait and tests you are told to then come back 3 months later for more tests and further consultation with the doctor. Then treament doesn't commence for months later Sorry for the wait. He's busy. You and your child feel helpless. If you think this is far from the truth how sadly mistaken you are. This is a disaster in the making.

  • Report this Comment On October 14, 2009, at 4:05 PM, theHedgehog wrote:

    <i>This is the part where I was hoping for a real investor answer.</i>

    If you want an investment answer, then ask it in an appropriate forum. This is not the place. If you look way way way at the top, it's the response section to an article about health care reform - NOT THE DOLLAR.

  • Report this Comment On October 14, 2009, at 4:08 PM, theHedgehog wrote:

    <i>My insurance company is in business to make money... of course they will abandon me if it means they can make more profit by doing so... this constant bad mouthing of companies because they do this or they don't do that... 99% of the time their decisions are driven to make more profit.</i>

    So, I see you've somehow managed to find the point of this forum. The conclusion that many of us hoped you would come to is that private enterprise is not a good match for managing the public's health care needs. The needs of the two entities are too far apart to ever be a good match.

    As many of us have said on different forums, health care is a social issue with market implications, not the reverse.

  • Report this Comment On October 14, 2009, at 4:29 PM, enideckert wrote:

    Healthcare should be considered a public good. Like education it should be covered by taxes. Healthcare is not a commodity and should not belisted on the stock market where people other than the sick make money.

  • Report this Comment On October 14, 2009, at 5:13 PM, mizzensheet wrote:

    so many good arguments, for other countries that actually have good health care programs no one seems to want to include the national tax structure that makes the program possible. We already have a fairly good system, we mostly need less lawyers and less monoplies. However after reading the White House white paper on regulating banking money and the world I have to think that the whole health care debate is a wind mill to keep pepole busy while the administration give the world bank and fed all right to charge of our curency.

  • Report this Comment On October 14, 2009, at 6:22 PM, shartuga wrote:

    Government run healthcare is just one more step in the redistributive agenda. Nothing more and nothing less. They are not interested in the product or quality. These socialist democrat/progressives are more like the Taliban taking on a thousand year old carved Buddha with a T55. Progressives do not create, they level.

  • Report this Comment On October 14, 2009, at 7:15 PM, vegastar wrote:

    If I may add my two cents,

    The orgional post by MF has 'statements' that I have comments about which are denoted by '<<' and ending with '>>'.

    Despite the fact that insuring something that's already occurring is an oxymoron, I think the idea of mandated coverage for pre-existing conditions has a lot of merit. << I think if you replace "mandated" with the word "ensuring" the meaning would be more clear. The word 'mandated' carries with it negetive connotations.>>

    The post continues,

    But that freedom comes at a cost. Requiring health insurers to cover everyone will flood the insurance pool with people who are already sick, and those costs will have to be shared by everyone. << What data do you have that supports the idea that it will "flood the insurance pool with people who are already sick". I would be interested in knowing what the proportion is of the uninsured who are "already sick".>>

  • Report this Comment On October 15, 2009, at 2:10 AM, driller101 wrote:

    The report by the insurance companies is so biased it is barely worthy of comment except to show how far the insurance companies will go to save their profits.

    Will someone please explain how we have by far the highest per capita health care system in the world yet only a mediocre ranking in quality?

    Saying France, UK, Canada don't have similar health care environments is probably wrong. All those countries have large immigrant groups, France in particular has more old folks than we do, and I never met a Frenchman who didn't smoke and drink.

    The op should probably join Glenn Beck over at Fox News and be done with it.

  • Report this Comment On October 15, 2009, at 8:39 AM, carjjc wrote:

    The study is a great cry for coverage of everyone. The law that should be put in place should not be the one discussed above but ones with a public insurance option.

    My employer has an insurance exchange and the insurance companies in the exchange must take individuals and families with pre-existing conditions. Or rates are not higher than other employers who do not have an exchange and who do not accept pre-existing conditions.

    I think the argument may be incorect that rates will go up when we include pre-existing conditions in an insurance exchange.

  • Report this Comment On October 15, 2009, at 9:05 AM, crut100 wrote:

    There is one very fundamental flaw with Obama's healthcare plan as it now stands. The President states that we will save ~$230 billion by everyone having preventative healthcare. The problem is most people in America will not actually take care of themselves. My spouse is a physician in Indiana and takes all commers (insured or no). Those that are not insured get free healthcare and Wick/Medicade pays for drugs, etc... In fact, the hospital where my spouse works is so committed to helping the needy they will even send out a taxi to pick up patients at no charge to them. Consistently, those that have the free care fail/refuse to show up for their appointments - even those with dangerours conditions - - run away high blood pressure, extreme diabetes, etc... The don't come until they are carted in via ambulance and then spend days in the hospital. This happens on a routine basis and we live in a small town. Now scal this up to a national level and explain how we are going to save money. It IS going to cost everyone THOUSANDS per year more for insurance or we are going to get hit with a tax increase that will actually try to get blood from the provervial stone!!!

  • Report this Comment On October 15, 2009, at 9:37 AM, rakhir wrote:

    <i>But the bomb went off under the insurers. The only reason these costs can be passed on to consumers in the form of higher premiums is because there's not enough competition among private insurers to force them to absorb the costs by becoming more efficient. Get it? Health insurers have just made the best argument yet about why a public insurance option is necessary.</i>

    That is not how prices are derived. Only supply and demand affects prices. At any time a business charges as much as possible for their good or service. When you introduce another cost the price does not increase, but the marginal actor disappears.

    For example, assume you have two insurers, one that charges $100 a month but doesn't cover some sort of treatment and one that charges $110 a month and does cover that treatment. The government steps in and forces insurers to cover that treatment - the price rises, right? Wrong. The provider of the $100 service is no longer in business because they can no longer sell their product. They are called the marginal actor and they are now out of business in regards to that product. Now, the entity itself won't go away, but they will begin selling the new product - the $110 insurance. The guy who was already selling $110 insurance will continue doing so. His costs and price don't rise at all.

    So what you have then is everyone who could only afford or only wanted to spend $100 on health care now have no product available to them. They now must either go without or take money away from their other endeavors to pay for the extra $10.

    To repeat, adding to costs does not raise prices, it simply makes the marginal actor disappear. How that affects supply and demand (which then will affect prices) is a separate function entirely.

    <i>Right now they run their markets and set their prices, and pass on any increased costs directly to consumers. That's what they're threatening to do if the legislation attempts to squeeze, even slightly, the colossal profits they plan to make off of 30 million new paying customers.

    But they've now hoisted themselves on their own insured petard. They've exposed themselves. If they had to compete with a public insurance plan, they couldn't get away with this threat. They couldn't pass on the extra costs. They'd have to compete with a public insurance option that forced them to give consumers the best deals possible.</i>

    You can't compete with a public insurance option if the insurance is subsidized through taxes. The insurance industry profits aren't very high at all. There are already not-for-profit insurers and they compete with but do not dominate for-profit insurance companies. The only way a public option could win is to subsidize care, which it will do.

    Insurance is screwed up, but not because of this. Insurance is screwed up because we don't use it as insurance! The consumer is shielded from the payments of even routine care, so they don't even notice or care about what the insurance company is being charged. Nobody looks at the insurance statement after going to the doctor and gives a damn about the portion the insurance company had to pay. Nobody calls their doctor and complains that the covered portion of the fee was outrageous. It just doesn't happen.

    Health care costs are on the rise because we have no insurance competition on the part of the consumer. This is specifically because cheap insurance is tied to your employment. It is tied to employment because FDR insistuted wage controls. To differentiate themselves the employers had to come up with other things that weren't wages, so they started subsidizing insurance. Then the government tax-advantaged that behavior and now it is stuck that way. Make no mistake, the part your company pays for your insurance still comes out of your wages, but you just never see the money. Insurers' cost-sensitive customers are the employers, not the employees. If you got to choose from any insurer and the government stopped mandating insurance for routing care costs would go down.

    Until they tackle that "health reform" is a dog and pony show designed to drum up votes.

  • Report this Comment On October 15, 2009, at 10:08 AM, ozzfan1317 wrote:

    Ironically the more I read these comments the more I hope a legit reform bill happens. I have personally witnessed the struggles of medical costs with my grandparents. They pay 14,000 a year and that doesnt even include prescriptions or they would probably go bankrupt. As I have admitted the insurance companies are a business and they function soley for a profit. Nothing wrong with wanting a profitable business but is it really nessacary to raise premiums on a regular basis so you can make 15 million this year instead of 12?

  • Report this Comment On October 15, 2009, at 10:21 AM, msm3rd wrote:

    All I have to say is that since the insurance companies are already telling us that premiums will go up if any reform bill is passed, we definitely need a public option to keep them in check. they will expand coverage to millions of healthy individuals who do not currently have insurance, individuals who will not use much of the insurance at all, so why will premiums go up?

  • Report this Comment On October 15, 2009, at 11:33 AM, theHedgehog wrote:

    <i>For example, assume you have two insurers,</i>

    Well, there's your problem, right there. You make the assumption that there's actually competition in the insurance market. There's no more competition in insurance than there is in the airline industry. Everybody charges the same price for the same product.

  • Report this Comment On October 15, 2009, at 11:41 AM, mmandr wrote:

    I normally do not post on these type of discussions because I am just a simple man with simple thoughts. I have not read all the posts above so this may be something already out there.

    Instead of having a new health care system that even our (over) paid legislators cannot take the time to read and understand, let alone all of us lay Fools, why don't we just allow the government to pay/subsidise those who cannot pay for the health care we currently have? I don't have all the numbers but I suspect the cost could be covered by using the money currently spent on medicaid and the $1,000 per person increase (as indicated in the article) in health care costs added by the hospitals.

  • Report this Comment On October 15, 2009, at 12:28 PM, guiron wrote:

    "why don't we just allow the government to pay/subsidise those who cannot pay for the health care we currently have"

    That means taxpayers subsidize the insurance companies at great profit to them. Why? The actuarial work involved is not unknown. Medicare and the VA in particular handle this very well. Subsidizing uninsured people also will not bring costs down. The only way to do that in our system is to bring government in as competition on the actuarial level, which will force costs down through the chain. It's a first step.

  • Report this Comment On October 15, 2009, at 12:31 PM, theHedgehog wrote:

    <i>why don't we just allow the government to pay/subsidise those who cannot pay for the health care we currently have?</i>

    What do we "currently have"? Are you under the impression that everyone has health insurance coverage? And, are you suggesting that the government subsidise the health insurance industry? If so, I would disagree with you on both points.

    There has been a lot of noise about allowing the "free market" and "competition" to perform its magic. The problem with this idea is that the insurance industry doesn't provide a product - it provides a service. That service is well known. It has been studied and tweaked for decades, and there are no fundamental improvements left to be made to the process, other than lowering senior management costs; which isn't going to happen.

    IOW, insurance is a commodity service that cannot be improved. Given that it is in the public interest to improve it anyway, there is only one thing left to do, and that is to forcibly remove upper management and advertising costs by offering the same product as a government service. This gives the same resources without the burdensome costs, and allows the potential for universal coverage - which is the goal, anyway.

  • Report this Comment On October 15, 2009, at 12:39 PM, theHedgehog wrote:

    And as a byline to those who will shout that this will costs jobs. No, it won't. It takes X number of claims adjusters to handle Y number of claims. Since Y will effectively increase, the number of claims adjusters (X) will inevitably increase. As to the losses to advertising revenue and upper management jobs: meh.

  • Report this Comment On October 15, 2009, at 12:49 PM, mmandr wrote:

    "Are you under the impression that everyone has health insurance coverage?"

    No, if they did there would be no need for programs like medicaid. I am simply suggesting that instead of paying for medicaid for the poor that we pay their premium to include them in the current health care program

    ".And, are you suggesting that the government subsidise the health insurance industry"

    Heavens no!! I am sure they area already making enough money for themselves. And -- they probably need to be regulated as a monoply (but government regulation or the lack thereof has already gotten us where we are now hasn't it?) Again, I am simply suggesting that instead of paying billions in medicaid and more billions in additional charges by medical facilities due to their writing off $$$ for unpaid emergency room charges by uninsured poor that we use that money instead to include the poor in our current system.

  • Report this Comment On October 15, 2009, at 1:25 PM, theHedgehog wrote:

    <i>Again, I am simply suggesting that instead of paying billions in medicaid and more billions in additional charges by medical facilities due to their writing off $$$ for unpaid emergency room charges by uninsured poor that we use that money instead to include the poor in our current system.</i>

    Fair enough, except it's not exclusively a "poor" problem. The poor are well covered. The middle and upper classes are well covered. It's the lower middle class and those self-employed who work in a low margin business that need the help.

    What would really be the best thing is to just get rid of the health insurance industry in one swell foop (sic) and put everyone on medicare; with the working paying the same insurance coverage premiums and medicare deductions as they always have.

    This isn't going to happen because of the GOP's dedication to existing business. And I have to admit to some sympathy to their cause - change is disruptive; especially when you're talking about the death of an industry. What will hopefully happen is some abomination of procedures that grossly approximates what I stated, above, but in a way that the insurance industry will die of attrition and disuse. No-one is going to like the decade(s?) long process, but we will eventually wind up with single-payer universal care. Your insurance costs will be the same as always, but that last 10-15 percent(!) of the population will be able to have health coverage.

  • Report this Comment On October 15, 2009, at 1:39 PM, rakhir wrote:

    <i>Well, there's your problem, right there. You make the assumption that there's actually competition in the insurance market. There's no more competition in insurance than there is in the airline industry. Everybody charges the same price for the same product.</i>

    There are competition issues in the insurance market, but they aren't related to my example, which was illustrative only. We could have been talking about anything. Replace everything I said about insurance with blue jeans and you have the same result. The bottom line is that this is how economics works - businesses already charge as much as they can and increasing costs of production doesn't raise prices it removes marginal actors. Only supply and demand raise prices.

    The rest of your point is demonstrably false. What you are describing (everything the same product at the same price) is called a commodity. Like corn or a certain grade of oil or a certain breed of wheat. Within the bounds of the product description it's all pretty much the same.

    Airlines are not a commodity. They do not charge the same thing for the same product. I routinely fly to Dallas and I never take Southwest airlines because it's more expensive. I try to take American Airlines because they offer in-flight internet access on some flights. I try not to take US Airways because their baggage fees are too high. Etc, etc.

    Insurance is the same way. They all provide you with an insurance product of some sort, but the important details and the price vary - sometimes considerably. The lack of competition for the consumer exists, but not because there aren't insurance companies out there to choose from. It's because insurance is favorably slanted towards being provided by the employer. If you have a job you don't get to choose your insurance company. There goes your competition.

    Those who are left are in the individual market. They have plenty of competition for insurance, but that isn't their problem. Their problem is it's very expensive. The trouble there is that health "insurance" isn't insurance at all - it pays for almost all medical costs on things that routinely happen and therefore can't be insured against because they are foregone conclusions. It's more like a health savings account, really. The costs of each procedure coming out of your "account" are high because of a variety of reasons, not the least of which are the distortions to the market caused by the insulation of the consumer from the price of the product.

    If you purchased Car Buying "Insurance" that made you pay a $100 co-pay every time you bought a car, no matter what car or where you bought it, would people go out and buy Kias or BMWs? Would they buy the cars from used car shops with no service or would they buy it from a place with great (but expensive) service? Obviously the demand for BMWs goes way up, causing the price to go way up until supply can be created. That's where we're at with health "insurance".

  • Report this Comment On October 15, 2009, at 2:00 PM, theHedgehog wrote:

    <i>businesses already charge as much as they can and increasing costs of production doesn't raise prices it removes marginal actors. Only supply and demand raise prices.<i/>

    In the case of health insurance, there is no supply. There is nothing to supply. As I have already stated, it is a commodity service. The costs are more or less the same for every potential entrant to the insurance business. The only variables are the amount of profit to squeeze out of the insured, and the ability to limit whom you sell your commodity to.

    I chose the airline industry because that's what I'm familiar with. Perhaps it's different now, but here's the way airline costs used to be negotiated (colluded). An airline would publish a new far in the ATA (or is it IATA) fare schedule and then watch the competition. If the competition moved, then the fare would stay. If it didn't, the fare would be withdrawn. There's no competition in that, and in fact the industry was switching to the term "co-opetition" when I got out of it. Collusion would be a better choice of terms.

    Just like the airline industry, in the insurance industry the costs are well known. It costs so much, per geographic market, to fix a broken leg, treat a cold, whatever. There is no room for innovation in a situation where you have fixed costs. As such, there is no room for lowering premiums without providing less service.

    The insurance industry is allowed to be selective about what parts of the body it fill fix, whom it will fix them on, and what medical vendors (doctors) it will use. It is also allowed to package its products deceptively and cancel its product to specific customers with no notice. This is not in the public's best interest.

  • Report this Comment On October 15, 2009, at 2:07 PM, rakhir wrote:

    <i>The problem with this idea is that the insurance industry doesn't provide a product - it provides a service. That service is well known. It has been studied and tweaked for decades, and there are no fundamental improvements left to be made to the process, other than lowering senior management costs; which isn't going to happen.

    IOW, insurance is a commodity service that cannot be improved. Given that it is in the public interest to improve it anyway, there is only one thing left to do, and that is to forcibly remove upper management and advertising costs by offering the same product as a government service. This gives the same resources without the burdensome costs, and allows the potential for universal coverage - which is the goal, anyway.</i>

    First off, services are products. There is no economic destinction. People who value your service more than the money they already have (more specifically, more than what they can otherwise buy with that money) will purchase your service. Those who do not, won't. It's the same for toothbrushes as it is for insurance as it is for maid service.

    If what you say is true then we should nationalize all commodities. All oil, all food and drink, all metals and other natural resources. The 20th century did a pretty good job of showing where this is all wrong. You can't calculate the proper price of a centrally planned good because you can't say at what price each person values the good. Only a market can do that because prices are necessarily each individual's current desire for a good compared to their current desire for all other goods they could buy with their money.

    Trying to push down on insurance costs does nothing to health care costs and so must necessarily fail. In fact, it gets worse than it otherwise would be because "insurance" used to cover all expenses is not insurance at all, but it does insulate the consumer from the price mechanism. That makes demand go up.

    Compare heavily insured medical procedures to those that aren't insured. These elective surgeries are decreasing in price even in the face of rising demand precisely because the consumer has to make value judgements. When price is a factor more consumers value a product at a lower price. This leads producers to lower price and/or improve quality to compete.

  • Report this Comment On October 15, 2009, at 2:34 PM, rakhir wrote:

    <i>In the case of health insurance, there is no supply. There is nothing to supply. As I have already stated, it is a commodity service. The costs are more or less the same for every potential entrant to the insurance business. The only variables are the amount of profit to squeeze out of the insured, and the ability to limit whom you sell your commodity to.</i>

    In real insurance, the supply is the risk-sharing service. In health insurance today the supply is part risk-sharing service, part accountant, part negotiator, part lawyer. They provide so many services that aren't real insurance it's crazy. Many of these are value-add to draw customers, many are mandated. The only cost that is more or less the same is the estimated payout, and even that differs based on how good their models are (which are pretty good). In the face of competition (read: consumer not being tied to the employer's choice) you would see more differentiation in service levels, quality and price.

    <i>I chose the airline industry because that's what I'm familiar with. Perhaps it's different now, but here's the way airline costs used to be negotiated (colluded). An airline would publish a new far in the ATA (or is it IATA) fare schedule and then watch the competition. If the competition moved, then the fare would stay. If it didn't, the fare would be withdrawn. There's no competition in that, and in fact the industry was switching to the term "co-opetition" when I got out of it. Collusion would be a better choice of terms.</i>

    It's true that it used to be like that. But why? How did we get in a situation where airlines could charge above what the market would support without having to worry about an entrepreneur springing up and charging lower fees, thumbing their nose at the IATA?

    It's because the governments of the world forced participation in the IATA and in the US we put the CAB in charge of setting fares and routes. You couldn't operate an airline without their blessing. They went so far as to wave anti-trust laws specifically for them. Regulation of this sort is phenomenal for established businesses. They can do more or less what they'd like without having to worry about competitors springing up because the government has provided a barrier to entry into the market. They can get by with graft and bribery of some low-ranking departmental politico instead of pleasing the customer. This obviously harms consumers and would-be entrepreneurs.

    Sure enough, in the late 70s when the US scrapped the CAB fares began to decline. There are still massive governmental barriers to entry in the market but it's at least better than it used to be. The IATA still exists and still sets fares but nobody has to follow.

  • Report this Comment On October 15, 2009, at 3:49 PM, theHedgehog wrote:

    <i>If what you say is true then we should nationalize all commodities. All oil, all food and drink, all metals and other natural resources.</i>

    When I buy oil/gas for my car, I have many choices along the way, that *I* can make that will have a significant impact on my costs. I can buy a car with better efficiency, I can choose public transportation, rideshare, ride a motorcycle, whatever.

    Furthermore, I can choose what to drink, whether water from a bottle or from the tap. Food is similar - there are plenty of ways to lower my food costs.

    However, when it comes to having an appendectomy, there is one cost, and there's not much I can do about it. Not only that, I don't have much of a choice as to whether I have the surgery, or not. Using your method, I might have to make the decision to die or go bankrupt. But, the government doesn't like it too much when you decide to die rather than have a commonplace surgery. Nor can I make the decision to allow a child to die from a ruptured appendix.

    So, your thought process is faulty in this one particular case. As I have said many times before and in many ways: health care is a social issue with economic ramifications. It is not an economic issue with social ramifications. The sooner everyone understands and accept this, the sooner we join the rest of the Western world in providing health care to all of our citizens - not just the very poor and the middle and upper classes.

  • Report this Comment On October 15, 2009, at 4:02 PM, ewent0 wrote:

    I respectfully disagree. We can have it both ways. Isn't that what the HMO CEOs do? They have blue ribbon health care AND blue ribbon salaries. 16 years ago, Hillary Clinton tried to get health care reform on the agenda. Are things any better 16 years later? The only winners in any of this is HMOs who consistently make it to the 50 Wealthiest in the US list, if not the world. Sorry, but no CEO in the US is worth a billion dollars a year for pointing and delegating.

    Clean up the corruption in HMOs. All those administrative fees equal big fat CEO bonuses that have grown obscene. Face facts. 16 years from now, will there be ANY health care?

  • Report this Comment On October 15, 2009, at 4:05 PM, ewent0 wrote:

    Note to Matt Banis.....Would you want to have to choose between paying your rent and buying insulin for your diabetic child? The problem in this country is the ignorant HAVES who think they have all the answers and instead are the causes of the problems. For every tax loophole you get, some middle and lower class person is making up the difference.

  • Report this Comment On October 15, 2009, at 5:31 PM, TommyRob3 wrote:

    The real issue with the so called "health care reform" is not health care access but control of that segment of the economy. The current bill is extremely flawed and will ruin our current health care system, which contrary to many opinions is one of the best in the world. The appointment of a health care czar, the need to get approval on most health care issues, the extreme constraints on the private insurers, the mandated taxes for business owners, and the limits on who gets health care are all in the hideous health care reform bill being pushed through Congress. There has been several attempts by conservatives to offer real reform that would change the system without destroying it and all of them have been ignored by the liberals. The system can be improved by reform without destroying it, but that is not part of the current administrations plan or desires. By the way, if you do a little research, you will find that an entire industry has developed in Canada whose sole mission is to find and coordinate health care providers, treatments, and/or hospitals in the USA for Canadian citizens who can not get the public provided care in Canada. Looking at Great Britain, you will find people coming to the USA for treatment because they are either too old or have some chronic disease for which treatment has been denied. In the rare case where pulicly provided health care has even come close to working for all the people, the tax rate on the populace is astronomical!

    Health care reform - Yes. Socialized medicine - No! Let's work to improve it, not destroy it.

  • Report this Comment On October 15, 2009, at 5:35 PM, theHedgehog wrote:

    <i>By the way, if you do a little research, you will find that an entire industry has developed in Canada whose sole mission is to find and coordinate health care providers, treatments, and/or hospitals in the USA for Canadian citizens who can not get the public provided care in Canada. Looking at Great Britain, you will find people coming to the USA for treatment because they are either too old or have some chronic disease for which treatment has been denied.</i>

    Are you saying that we should continue our current flawed system so that we can absorb the runoff from Canada and Great Britain?

  • Report this Comment On October 15, 2009, at 6:07 PM, TommyRob3 wrote:

    Hum, Hedgehog, you didn't read my entire statement, did you. The research points out that socialized medicine does not work for everybody, it does not take care of everybody, it does not provide care for everybody, and so on. In some cases, there is far less care, or even the opportunity for care, than was available in those countries before health care came under the public domain. Our system can be improved without destroying it. By the way, if we do socialize the medicine here, where do the people of these other countries go to get health care that is supposed to be provided by their government?

  • Report this Comment On October 15, 2009, at 6:11 PM, texjammer wrote:

    You want true Healthcare reform, you have to get the LOBBYISTS OUT OF HEALTHCARE. Tort reform and allowing Insurance companies compete across ALL state lines will bring down healthcare and insurance costs.

    There can be no true "reform" in Healthcare until the trial lawyers are reformed. WE DID IT IN TEXAS! After passing Tort Reform, the number and cost of frivolous lawsuits against doctors and Insurance companies decreased and so did healthcare costs. The Federal government refuses to even consider Tort reform, since the Trial Lawyers reign supreme in the Congress (read LOBBYISTS).

    If the 1100+ insurance companies in the US can compete against each other in EVERY state, the costs of insurance would drop dramatically. Right now, the Federal and State Governments decide which select companies can compete in which states (read LOBBYISTS).

    There are LEGITIMATE REFORMS for Healthcare, however another Socialist/ Marxist program like Social Security, Medicare, MedicAid and Welfare is not the answer.

    They can't even run a railroad or package delivery service without losing money. Do you really think they could run an Insurance Plan?

  • Report this Comment On October 15, 2009, at 6:21 PM, theHedgehog wrote:

    <i>By the way, if we do socialize the medicine here, where do the people of these other countries go to get health care that is supposed to be provided by their government?</i>

    Why on earth would you think that that's a problem for the American health care system to solve?

  • Report this Comment On October 15, 2009, at 6:28 PM, TommyRob3 wrote:

    Okay, I see the point, Hedgehog. You're not really interested in discussing the problem and finding real solutions. You seem to have a bias for socialism and do not want to hear anything else. That's fine. I'll try talking with someone else who is genuinely interested in reforming our system and not destroying it. Have a good day.

  • Report this Comment On October 15, 2009, at 6:42 PM, theHedgehog wrote:

    <i>Okay, I see the point, Hedgehog. You're not really interested in discussing the problem and finding real solutions</i>

    Listen, YOU were the one who brought up the plight of the "poor" Canadians and Brits who have to come to the US to seek health care, not me. If you can't deal with an honest answer to your ideology based comments, then don't make them.

    Besides, from the news articles I read, the UK has a bigger problem with medical immigrants (i.e. people who come to the UK specifically to receive care that they can't afford) than medical emigrants (i.e. people who go somewhere else to receive care).

    But, back to the US health care system: can you honestly say that your doctor has never had to modify or refuse you treatment due to orders from your insurance company? I thought I had a very good HMO system while I was working, until I had to call them up and read them the riot act just to get approved for a hernia operation. I'm sure that you can find many thousands of people who have had similar cases; as well as their insurance flat out refusing some treatments or medications.

    The problem with US health care is mostly limited to that group of people who are just above the poverty line but below middle income status. As has been stated before, the poor get health care already, and they get it for free. The middle class and above are largely covered through their work-provided insurance plan. The problem is getting care for the working poor and some fairly large percentage of extremely small business owners who just make enough to scrape by. There is another group of neglected people, as well: those who are unable to work, but whose disability falls short of the SSA's guidelines. IOW, they can't work, or can only work very little, and they don't qualify for any sort of government aid.

    Does this sound like a system that you approve of? Where the indigent get priority over the working poor? I find it personally abhorrent, but refusing health care to the poor and indigent is not a solution.

  • Report this Comment On October 15, 2009, at 6:55 PM, NOTvuffett wrote:

    The lies on this makes me sick, listen to the words of Robert Reich:

    http://www.youtube.com/watch?v=IT7Y0TOBuG4

  • Report this Comment On October 15, 2009, at 7:26 PM, TommyRob3 wrote:

    Okay, I'll try to walk you through the thought process I use when I read statements that indicate or imply everyone will have the same opportunity for health care coverage and equal access to care. Such statements are grand and kind but not realistic. I'm sure those were thoughts and persuading points for the establishment of socialized health care in Great Britain and Canada, but the reality of the situation is that everybody does not have the same opportunity for coverage nor does everybody have equal access to care. That is the reality. Because the USA has not gone to such a socialized system, they can come here for care and treatment. Now, if the USA socializes its health care system, we will most assuredly have people who will not have the same opportunity nor equal access, AND those of these other countries will have no where else to go. That is not a system I want nor would ascribe to. Again, my point is that there are efforts to "reform" our system without destroying it, but the current liberal leadership is turning a deaf ear to those "reforms." Like I said before: Reform - Yes. Socialism - No. With great apprehension as to how you will take this aside, I ask this question, "If this health care reform is so great, why has Congress exempted itself from full participation?"

    One more thing, one of the President's top medical advisors is Dr. Ezekiel Emanuel. Take time to research some of his thoughts on health care and how "Comparative Effectiveness Research" should be applied in this country. If you do, it should scare you to death if you love your parents, grandparents, or have a child with an incurable or chronic disease. It certainly scared me.

  • Report this Comment On October 15, 2009, at 7:37 PM, TommyRob3 wrote:

    I do believe texjammer is moving in the right direction for "reforming" the system without destroying it (i.e. Socialism). His statements reflect some thought about real reform and not just another government mandated program.

  • Report this Comment On October 15, 2009, at 7:46 PM, TommyRob3 wrote:

    If you want to get a glimpse of the destruction the current health care reform will do our system, and this is just the tip of the iceberg, take a look at this footage from the floor of Congress

    http://www.youtube.com/watch_popup?v=G44NCvNDLfc

  • Report this Comment On October 15, 2009, at 7:54 PM, theHedgehog wrote:

    <i>With great apprehension as to how you will take this aside, I ask this question, "If this health care reform is so great, why has Congress exempted itself from full participation?"</i>

    I take this as what it is: a non sequitur - totally unrelated to the discussion at hand. I could equally ask why the CEO doesn't have the same benefit package as the mail clerk. It's called self-interest. We all have it. It's only when we are put outside the norm that we realise our self-interest comes at a price for the less fortunate.

    In passing, I will note that the legislators also vote themselves nice raises when the rest of the country is losing jobs and taking pay cuts. Do I trust them? No. Do I have a choice? No. They are the elected legislators - there is no higher authority to appeal to. But that's no excuse for simple obstructionism in the face of needed health care reform.

  • Report this Comment On October 15, 2009, at 8:00 PM, theHedgehog wrote:

    <i>Take time to research some of his thoughts on health care and how "Comparative Effectiveness Research" should be applied in this country. If you do, it should scare you to death if you love your parents, grandparents, or have a child with an incurable or chronic disease.</i>

    Why would I need to be concerned with a parent, grandparent, or child with a chronic disease, when I have one myself? Do you think my anger over this issue stems from simple idealism? I have the fibromyalgia complex.

  • Report this Comment On October 15, 2009, at 8:04 PM, prose976 wrote:

    I'll tell you what. Obama and the other nincompoops making all kinds of grandiose proposals to drive us all further into debt haven't got a shred of common sense among them.

    First step is to permit cross-state-border competition. If I have even 50X the choices I currently have, I guarantee health insurance prices will be affordable for everyone.

    Next step. The Federal Government covers insurance from a public fund ONLY when it is a life or limb emergency.

    Final step. Everyone requiring care receives care. But citizenship information is collected, and when an illegal has received care and is able to travel, he/she is escorted directly from the hospital to a holding facility where they stay until enough are gathered to fill a jumbo jet back to whence they came - to the farthest reaches of their country. They are put on an official NO ENTRY list and up returning will be jailed for their federal offense.

    Meanwhile, the border continues to go up, and we deploy more troops to defend our border than to defend ungrateful countries around the world.

    Let's try to enforce our present laws before we remake our whole country because we failed to enforce our laws.

  • Report this Comment On October 15, 2009, at 8:27 PM, TommyRob3 wrote:

    Well, if obstructionism means blocking the destruction of our health care system by socializing it, then I will be an obstructionist for as long I possibly can! Reform - Yes! Socialism - No! And if you will read what Dr. Emanuel says about people with conditions such as yours, you will see that you will be denied, that's right denied, treatment. So why are you such a strong supporter of this abysmal attempt at socializing our health care? Why not get behind those in Congress who are attempting to reform the program without socializing it?

  • Report this Comment On October 15, 2009, at 8:41 PM, prose976 wrote:

    TommyRob3, I believe you completely misread my post. To make myself clearer, I would prefer current laws to be enforced and fre market insurance competition to be allowed. We will then reduce the burden on our health care system by slowly eliminating those who are using our tax-subsidized health care services illegally (i.e. illegal immigrants). We will also drive the cost of insurance down by opening up cross-state border competition between companies.

    The only "reform" here is that we actually enforce immigration laws as they stand, and we actually allow the free market to stablize health care costs.

    I cannot be adamant enough that I do not believe we have a capable elected body and that their spending for proposed healthcare "reform," bailouts, etc. is beyond comprehension and they should all be sent to the corner with dunce caps because their brains have ceased functioning.

    Unless you were being sarcastic, then I hope this follow-up post answers your question about my view of this pathetic administration, congress, courts, etc.

    They are bent on redistributing money and it is exactly what will destroy the amazing system our Forefathers established for us.

  • Report this Comment On October 15, 2009, at 8:52 PM, theHedgehog wrote:

    <i>No! And if you will read what Dr. Emanuel says about people with conditions such as yours, you will see that you will be denied, that's right denied, treatment.</i>

    Silliness. Show me something concrete, and not just a referral to some nebulous Dr Emanuel. At this point, I give your post just as much credence as Palin and her "death panels".

  • Report this Comment On October 15, 2009, at 8:55 PM, TommyRob3 wrote:

    I am with you. My last post was in response to the remarks made by Hedgehog. Yes, you are on a track that is well worth pursing!

    Hope Hedgehog reads this.

  • Report this Comment On October 15, 2009, at 9:03 PM, TommyRob3 wrote:

    Dr. Emanuel, however, believes that "communitarianism" should guide decisions on who gets care. He says medical care should be reserved for the non-disabled, not given to those "who are irreversibly prevented from being or becoming participating citizens . . . An obvious example is not guaranteeing health services to patients with dementia" (Hastings Center Report, Nov.-Dec. '96).

    Translation: Don't give much care to a grandmother with Parkinson's or a child with cerebral palsy.

    He explicitly defends discrimination against older patients: "Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years" (Lancet, Jan. 31).

    Since Medicare was founded in 1965, seniors' lives have been transformed by new medical treatments such as angioplasty, bypass surgery and hip and knee replacements. These innovations allow the elderly to lead active lives. But Emanuel criticizes Americans for being too "enamored with technology" and is determined to reduce access to it.

    Translation: This is a direct attempt to limit the health care me and my wife have access to!

  • Report this Comment On October 15, 2009, at 9:06 PM, TommyRob3 wrote:

    Hedgehog, my previous post was primarily for you since you wanted some actual statements from Dr. Emmanuel. There are lots more, but those should give you the idea. He has made some very disturbing statements about how health care should be provided.

  • Report this Comment On October 15, 2009, at 9:44 PM, theHedgehog wrote:

    <i>Hedgehog, my previous post was primarily for you since you wanted some actual statements from Dr. Emmanuel. There are lots more, but those should give you the idea. He has made some very disturbing statements about how health care should be provided.</i>

    OK, I still classify this in the same manner as I do Palin's "death panels". Why? Because it appears that when you actually drill down to what he said, he didn't say it.

    From: http://www.time.com/time/nation/article/0,8599,1915835,00.ht...

    <quote>In her Post article, McCaughey paints the worst possible image of Emanuel, quoting him, for instance, endorsing age discrimination for health-care distribution, without mentioning that he was only addressing extreme cases like organ donation, where there is an absolute scarcity of resources. She quotes him discussing the denial of care for people with dementia without revealing that Emanuel only mentioned dementia in a discussion of theoretical approaches, not an endorsement of a particular policy. She notes that he has criticized medical culture for trying to do everything for a patient, "regardless of the cost or effects on others," without making clear that he was not speaking of lifesaving care but of treatments with little demonstrated value. "No one who has read what I have done for 25 years would come to the conclusions that have been put out there," says Emanuel. "My quotes were just being taken out of context."</quote>

    Time also has another article (came up first in search) that more or less gives the man's philosophy. I couldn't see how the man could possibly be saying these things unless his comments were being deliberately being taken out of context or just plain old misquoted. It appears that I was right, and the people responsible for trashing this man's good name should be ashamed.

  • Report this Comment On October 15, 2009, at 9:50 PM, mindflash wrote:

    Regardless of whether or not you are in favor of the proposed legislation, it is worthwhile to recognize that the Constitution does not give Congress the authority to force anyone to buy health insurance.

  • Report this Comment On October 15, 2009, at 9:55 PM, theHedgehog wrote:

    Oh dear, another "constitutionalist". Let's be clear about this one, shall we? The constitution, by definition, says whatever the Supreme Court says it does. States are allowed to mandate car insurance for the better good, so you had better believe that mandatory health coverage will pass constitutional muster; even if it has to be called a tax.

  • Report this Comment On October 15, 2009, at 11:22 PM, TommyRob3 wrote:

    Hedgehog,

    Well, I see the liberals are at it again. If you quote them and they have to answer for what they said, they backpedal and say things like "I was quoted out of context."

    Here are some exact quotes from his papers and nothing has been added or deleted. These are his words:

    Substantively, it suggests services that promote the continuation of the polity-those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations-are to be socially guaranteed as basic. Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia.

    The complete lives system discriminates against older

    people. Age-based allocation is ageism. Unlike allocation

    by sex or race, allocation by age is not invidious

    discrimination; every person lives through diff erent life

    stages rather than being a single age. Even if 25-year-olds

    receive priority over 65-year-olds, everyone who is

    65 years now was previously 25 years. Treating 65-year olds diff erently because of stereotypes or falsehoods would be ageist; treating them diff erently because they have already had more life-years is not.

    These are his words right out of the Lancet. Well, I am 65 and you can bet your bottom dollar I do not agree with that philosophy.

  • Report this Comment On October 15, 2009, at 11:46 PM, theHedgehog wrote:

    So, it essentially comes down to McCaughey says vs Emmanuel says, right? So, what dog does McCaughey have in the fight? IOW, what does he gain with his spin?

    A question for you. Have you ever said anything in a speech or conversation that, taken out of context, says something completely at odds with your personal beliefs? Now, considering your answer, and the fact that every word that Emmanuel says will now be parsed by the right for whatever good it can get them, what do you think of McCaughey's comments?

  • Report this Comment On October 15, 2009, at 11:56 PM, theHedgehog wrote:

    Tell me, TommyRob3, did you believe in Palin's "death panels", as well? Didn't it ever occur to you that you were being scammed when you read this about Emmanuel, or are you that eager to believe ill about others?

    There are no death panels. There is no secret conspiracy to kill old people or babies. Use your critical thinking skills on this, OK?

  • Report this Comment On October 16, 2009, at 12:43 AM, NotDefenseless wrote:

    Those who said national healthcare does not work in any country or a failure are totally ignorant and highly arrogant. Have you experience it? I am glad I have dual citizenship. In my country of origin, heathcare is free. If treatment is too expensive in the US, I can go "home" for free medical treatment. No hassle or long wait! My current insurance is just to cover my basic healthcare needs in US. It's been over 20 years and I will never relinquish my dual citizenship. Besides free government healthcare, private insurance coverage is also available. Since healthcare cost is cheap, all employers offer private health insurance to employee at ZERO cost to employees. We enjoyed both coverages. Doctors are trained from US, UK or Europe, India, China, Australia, N. Zealand and etc. So... don't be so arrogant to think our healthcare providers are inferior. And, there is no such thing as bankcruptcy from medical problems. In fact, there are also free community health clinics that offer beyond western healthcare like acupuncture and herbal treatments. Go figure why US has such a broken healthcare system and you think other countries have poor medical services. This is the 21st century and the age of technology. The internet has changed the world.

    Because private insurance ration heathcare (limit coverage) you actually don't have adequate coverage. Those who have coverage thru' employment, you WILL lose your coverage because you cannot work forever. Someday you will get sick/injured seriously as you aged. If are lucky, your private insurance will pay a portion or they will find a loophole to deny coverage. That's how profit-motive ins company works. So.... pray very hard you are filthy rich during retirement and can afford the best coverage money can buy. Your 401K, savings, hardwork cannot save you after that. Like one politician said, no coverage, don't get sick. If you do, then die quickly. Blunt and straight shooter but very true under the current broken system!

  • Report this Comment On October 16, 2009, at 12:51 PM, farrockgrad wrote:

    The "study" conducted on behalf of the AHIP was bogus as PWC was instructed on which elements to include and which to ignore by the AHIP. Even PWC admits this so to put any credence into the study is a mistake.

    Why not conduct an unbiased study to get the real facts rather than report on a biased study authorized by the insurance industry's watchdog group.

  • Report this Comment On October 16, 2009, at 12:54 PM, h2oencrusted wrote:

    It is very noticeable to me that those who oppose healthcare reform always use financial arguments because that's all they have.

    Basic healthcare is not a matter of money. It's a basic human right enshrined in the Universal Declaration of Human Rights.

    It is immoral for anybody to die an avoidable death for the lack of money; that happens to 22000 people every year in this country. It is immoral for anybody to be made bankrupt for the need of healthcare; 60% of personal bankruptcies in this country are caused by health bills (and 75% of those people HAVE insurance).

    This is not a question of money. It's a questions of morals. Where does this country stand on those?

  • Report this Comment On October 16, 2009, at 1:33 PM, Thumper1949 wrote:

    America is sorely in need of reform. But it may be far more appropriate to call it by a more meaningful name: "Insurance Reform" . The Insurance Industry has long been in the business of collecting premiums, has avoided the business of paying claims and is now venturing into the business of practicing and prescribing medicine by refusing to pay for a more costly procedure or medication in favor of the less exoensive option in spite of the fact that this activity is in direct conflict with the decisions of licensed medical practitioners. This practice must stop and stop now! I hear the complaaint that some consumers buy insurance when they have imminent need for coverage and then drop the insurance when the need has passed. In reality, how does that differ from the activity that the insurance industry has foisted on the American consumer for more years than I can recall. It's about time that someone played them on a level field. More stringent regulation and insurance "watchdogs" are the answer.

  • Report this Comment On October 16, 2009, at 1:59 PM, eaglett101 wrote:

    Health care reform can not take place until lobbying, and the cost of mal practice insurance and law suits are also addressed.

  • Report this Comment On October 16, 2009, at 3:27 PM, Shark52 wrote:

    It appears that many believe that high health care costs and high health care insurance premiums are one and the same. That is simply not true. High health care insurance premiums are a symptom of high health care costs, not a cause.

    We can make insurance more available to people generally (a good thing in the minds of most), but that comes with a cost (which nobody really wants to assume). That additional cost will be paid, for those that cannot afford it, from one of two sources – the government or higher insurance premiums. If the decision is the government, then it will require higher taxes. We can debate whether a fine is a tax or whether it is something else, but in the end, the money coming from the government will only be generated by people or entities paying money to the government – by most people’s definition, a tax.

    Given that 43.4% of Americans pay zero or a negative income tax, we are left with the reality that there will be either a significant increase in the national debt or 56.3% of Americans will pay more taxes. The statistics are per the Tax Policy Center, a joint project of the Urban Institute and Brookings Institution. Neither is a low-tax or conservative advocacy group; the Urban Institute was created under the Johnson administration during the Great Society era, and it receives most of its funding from the federal government. The Brookings Institute is a liberal think tank.

    But just as the health care debate, I have lost my way. The issue is (or at least in my judgment should be) the cost of health care. Notwithstanding all the talk, attacks, accusations and outright meanness on all sides of the issue, we have yet to have a meaningful discussion about that issue – the cost of health care. While I have no answers, I am pretty sure of a couple of things – if we want Cadillac care with a high level of technology that the United States currently has, it will cost more than other countries and the cost will increase as we cover more people in the current system. If we want to spend less, we will not have the level of care that 85% of the people in the United States currently enjoy (percentage of people currently covered by private health insurance or some form of government provided cost reimbursement). Do we need that level of care? Do we need Cadillac care? Is technology, with its substantial cost, adding value to our health care system? How long is too long to wait for non-emergent care? These are fair questions deserving of meaningful debate. The reality is that many people have different opinions on each of these topics.

    The other reality is under our Constitution, if the government is involved in providing health care, directly or through reimbursement of costs, it must provide the same to all to whom the service is offered. Said in another way, the government does not have the option of answering the questions differently depending on the person being addressed. Constitutionally, it must be a one size fits all. Before we pass legislation related to health care, please let us at least discuss the real issue – the cost of health care, not just manner in which it is paid.

  • Report this Comment On October 16, 2009, at 4:11 PM, ososad wrote:

    Our healthcare system needs reform. We spend a lot on it, and not everybody has it. However, the proposed reforms would ensure that we spend even more. I find it incredible that so few are asking how the legislation achieves its purported objective, lowering costs. Increasing demand is guaranteed to raise unit costs. That is not a Repulican opinion. There are many great ideas out there.

  • Report this Comment On October 16, 2009, at 4:46 PM, theHedgehog wrote:

    <i>I find it incredible that so few are asking how the legislation achieves its purported objective, lowering costs.</i>

    I'm not so sure that this is the ultimate objective. Approximately 15% of the US population has no health care insurance. Over 22,000 people die each year because they can't afford health care. Sixty percent of all bankruptcies are related to medical expenses. It is unconscionable that this is happening in the US.

  • Report this Comment On October 16, 2009, at 4:57 PM, FredBrown wrote:

    Does anyone know who is going to pay for health care going forward regardless of who is managing the industry? It is the same people that are paying now. It does not make any difference whether it is the gov. or private insurers. The biggest thing I see missing to control costs outside of tort reform is exempting the insurance industry from the Rob-Pat act. That eliminates competition thereby increasing costs in the entire health care system. If everyone would know up front how much a procedure would cost-then competition would prevail.

  • Report this Comment On October 16, 2009, at 6:48 PM, rgif102478 wrote:

    How in the world has health care companes now, have the power that they have, to bribe our house and senate and charge what ever they want?

    It seems that greed rules the day.

    And, why is so many Republicans agenst a public option? Is it they who are being payd off, O I know they have this excuse they don't want goverment to

    run it, but, arn't they the goverment? Are they saying

    thay don't trust them selvs? I really thank the kick back is what they won't and they don't mind turning

    their backs on 45 million people.

    For me I can't turn my back.

  • Report this Comment On October 16, 2009, at 10:49 PM, boat5705 wrote:

    How can one address the health care issue and it's cost without identifying how we are going to handle the illegal immigrants medical needs. They will still go to the emergency rooms and their cost will be paid for by everyone, even the ones who can't really afford the mandatory insurance. This shouldn't be!! Something like local clinics should be the first stop not the emergency room.

    Also -- today my daughter who has been fighting breast cancer for 13+yrs gets her PET scans when she needs them (timely) resulting in quick treatment. Because of that she is continuing to hang in there. I'm afraid of the bureaucracy that is inherent in government run programs that will result in authorization delays (because of $'s) and continuous challenges that will be needed to get the proper medical attention -- especially when the approvals will be made by people watching the $$'s (and stringent guidelines) not necessarily sympathetic to individual needs.

  • Report this Comment On October 16, 2009, at 11:30 PM, fool425 wrote:

    Another important goal of the Dem plan is to have a mandate for everyone to carry insurance or pay a fee balanced against coverage for pre-existing conditions. More patients in the system yields lowest possible cost for all. I, like others here, sense a bias against healthcare reform from the authors. That's really too bad, because the present system is unsustainable. The bottom line is that for-profit healthcare companies goals are diametrically opposed to the patients. As long as we ignore this fact, we will pay more for healthcare than any other Western nation on a per capita basis.

  • Report this Comment On October 16, 2009, at 11:40 PM, fool425 wrote:

    tommyrob3- you really need to check your so-called facts. Use FactCheck.org or Politifact.com. You keep repeating the nonsense one hears on the RightWing Echo Chamber; Rush, FOX News, O'Reilly, Beck, WSJ, Drudgereport.com, et. al. Like you, they continue to repeat things that have been thoroughly debunked as though the process makes them true. NOT!

  • Report this Comment On October 17, 2009, at 12:36 AM, singhash wrote:

    This is dreadfully simple: as long as companies make money by providing health insurance, somebody's going to get shafted.

    Roads, water, electricity... these are so essential that governments have either assumed control over the provision of the service, or they strictly regulate the service providers. If the American healthcare system is so great, why not apply it to things like drinkable water or breathable air?

    The provision of healthcare in the US is driven by profit -- a company will make money by _depriving_ you of care. It is patently absurd to imagine that such a system will deliver more health at cheaper rates. In forty years, three continents, and eight countries, I've found that the US has the worst healthcare in the developed world. Food poisoning in Vietnam was more pleasant and medically safer than dealing with an American health insurance company.

    I'll happily take my superbly-qualified, state-subsidized doctors who charge an expat rate of $25 for a quick checkup, an ER visit with meds will cost me all of $75 -- and a long wait for a non-critical procedure amounts to a few days.

    Sometimes, the death knell for an organism is a failure to evolve.

  • Report this Comment On October 17, 2009, at 12:59 AM, mfscheer wrote:

    As a surgeon, it has been very enlightening reading all the posts regarding health care reform. I think that there is near unanimous agreement that some form of health care reform is necessary and I agree. The current reform "bills" as proposed by the house and senate have multiple fatal flaws and are not sustainable. The two major goals for health care reform are coverage of uninsured and lowered cost. The proposed "bills" and I use that term loosely because the Baucus "bill" is a concept not even a draft of a bill, will only cover about half of the uninsured and they will not lower costs. So for proponents these results are poor. But if you want change for the sake of change, feel free to support it.

    I chuckle at the assertions that doctors do not care about getting or keeping people healthy. How misinformed. Do you really think a physician would be able to maintain a practice where his/her patients believed that the physician was not really trying to help. Not to mention the legal implications. That said, it is interesting that reform of the medicolegal system is not part of the legislation. There is no question that defensive medicine occurs. Most patients favor a physician who is thorough to the point of practicing defensive medicine. The current legal system forces us to practice in this fashion but reform in this area could lead to immense savings. So why isn't this a part of the reform? Remember lowering costs was a primary goal. The answer is because the laws in this country are made by the lawyers to favor the lawyers and they like their ability to easily bring a malpractice suit against a physician. The majority of malpractice cases are successfully defended because they weren't malpractice but the lawyers must think of them as a lottery and are looking for a big payout for which they collect 30-40%. Tell me that this makes any sense. To put it in perspective, I can perform a five hour surgery to remove a pancreatic cancer and spend untold hours caring for the patient afterwards and hopefully provide the patient many more years of quality time and what is my reward? I might receive $5000 depending on insurance.

    The comments about Medicare being better than commercial insurance are intriguing. In general, Medicare does not pay better than commercial insurance but there is less hassle with Medicare. I think that this is because there is less oversight with Medicare. The problem with Medicare however is that it is unsustainable at the current rate and will be bankrupt in the near future. That does very little for those approaching 65.

    Medicaid is a disaster! The majority of physicians refuse to see Medicaid patients so they end up receiving their care in the emergency rooms. I have an intense fear that a government plan would emulate Medicaid and would also be a disaster. If no doctor will see a patient with the government plan does it really matter if the person has insurance or not?

    One last comment, I had a patient just today tell me that a neighbor of hers went to India for a total joint replacement at a cost of $7000. To me this is just nuts. Now if you live in Tanzania (Africa) and need joint replacement or back surgery you HAVE to go to India or Europe for this and the medical care is a step up. However if you live here and have access to care it would be a step in the wrong direction in most cases. I deal with a lot of risk/benefit ratios and if the risk outweighs the benefits another option should be considered. The risks associated with having major surgery in a foreign country are higher and who is responsible for caring for the complications? For those of you who think the care is better in foreign countries, feel free to get your care there. If you don't mind rationed care, unavailability of care based upon age, and significant delays in care that should be right up your alley. America may not statistically have the best health care in the world but I would bet that Americans have the best access to health care in the world. I would like to keep it that way.

  • Report this Comment On October 17, 2009, at 1:33 AM, janis1023 wrote:

    matthewbanis, "those people" in your second paragraph are not the ones who need coverage now. It's taxpaying citizens that have been laid off. Maybe you will get to be one of them before too long and I'll bet you will change your tune. All this talk of costs and taxes does not address the fact that fellow human beings are suffering because they and their children cannot afford to go to the doctoer. Is this really what you want? Are you really that inhumane?

    I like the Cobra model, ergo we use what ever insurance company we want, and pay a % of the premium with the government paying the difference. The government doesn't need to get into the insurance business, and this may be a cheaper route.

  • Report this Comment On October 17, 2009, at 3:22 AM, tex41 wrote:

    I too would like the Cobra model, janis1023 referenced, if she will pay my premiums to the government componate for me.

    Folks nothing is free. For you or I to not pay for insurance from the government means someone has money stolen from their pocket.

    Reform is needed, what amazes me is that I find so few who subscribe to the tenets of the free market system actually understand therein lie the solutions to health

    care.

    If you find the reward of profit distasteful, you best invest in federal bonds for the high gain only government can provide you. Expecting the government to outperform the current health industry is shear ingnorance.

    As to being inhumane because someone cannot afford insurance, no, I am for helping the needy, and for continuing current assistance to those unable to buy insurance for a short time. I am not willing to have my money taken from me by force, which taxation is, for the benifit of someone sitting on their behinds.

    Those deserving of help should find in a reformed health system a solution to their needs. There are few who really meet the criteria, the rest chose to be victims.

    As a nation we can meet needs of the few. We have no need to bankrupt future generation to enable elitist to grab what is driving this issue, power. If you depend upon them for your very life in the health care they may or may not deem you deserving, the power is manifested in total control of you as an individual.

    Suggest you look up Walter Williams on the net, read and decide for yourself if what he has to say about this and other economic topics open your eyes and mind to another way of changing our health system.

    As for facts, check out IBD,com articles on stats. They are referenced and usually can be easily varified.

  • Report this Comment On October 17, 2009, at 7:35 AM, Huibregtsen wrote:

    From an outside Dutch perspective here are a few observations:

    1. It is a bloody shame that one of the richest countries of the world leaves so many without proper health care

    2. It is amazing that notwithstandig the above US's healthcare costs as a percentag of GDP are significantly above most other developed countries

    3. Thus there is an important obligation of the US people to this time around ensure a road to both a more universal and a more cost efficient health care system

    Obviously this is not an easy process and bickering about an invdividual tree will not make for a different forest. President Obama needs the broad support of all well intentioned citizens to get moving on this road. The world will look with disdain on a country that is not able - despite its many great achievements - to provide a proper health care system.

    There are many practical problems to overcome but much is to be learned from systems elsewhere.

    One item peculiar to the US system that will have to be addresses against undoubtedly overwhelming lobby forces is the legal system of outrageous malpractice penalties. This system contributes to:

    1. Unparallelled levels of insurance fees

    2. Delay in or refusal of treatment of potential risky cases

    3. Unnecessary extra medical investigations of a case in an attempt to avoid potential liabilities

  • Report this Comment On October 17, 2009, at 9:24 AM, santamema wrote:

    how about taking healthcare away from employers all together. then we buy health insurance like we buy car insurance; you have to have the minimum required by your state or federal? government, with the option of purchasing higher levels of insurance if desired. in this way, insurers will still compete for our business, and if you want to leave your job or get fired, you will still have your insurance. the regulated minimum can be subsidized by the government when and if a person is no longer able to pay.

  • Report this Comment On October 17, 2009, at 1:36 PM, theHedgehog wrote:

    <i>Those deserving of help should find in a reformed health system a solution to their needs. There are few who really meet the criteria, the rest chose to be victims.</i>

    It's a shame that this nonsense continues to be posted that it's the lazy who are the problem. You haven't listened to a word that's been said, have you? The poor and the indigent already have their healthcare covered under the current system, and it's free. Unfortunately, they are forced to tie up emergency rooms because of the way system works.

    In like manner, the middle-class and above have their health care covered through insurance at their place of employment.

    The problem is those in between. 1) The working poor who probably work more hours than you ever put in, but make minimum wage or below, and can't afford health insurance. 2) The marginally self-employed who effectively make minimum wage or less and don't qualify for state or federal aid (or won't apply for it). 3) Those in limbo due to medical problems who are either disabled but waiting for SSA to approve disability, or disabled but SSA refuses to accept them.

    In general, these three classes of people aren't lazy and unproductive. In many cases, they've worked their butts off their whole lives but due to lack of education or just plain old bad luck they're not able to improve their wages and so can't live the good life that you take for granted with pension, 401(k) and health insurance.

    There's also another issue that I and others have touched on: those who lose their jobs due to health issues and then lose everything because they have to choose between dying or having a surgery they simply don't have the money for. These people wind up in medical bankruptcy losing their homes, and often, their families.

    Shame on you for seeing lazy people everywhere you look. What a privileged soul you must be.

  • Report this Comment On October 17, 2009, at 4:44 PM, tex41 wrote:

    I will accept the rebuke, it was overstating to say the need for health reform was due to the lazy. It was lazy of me.

    My main thought, and poorly expressed as noted by the hedgehog, is the reasons underlying the need for reform the hedgehog outlined, will not be solved by government managing the system.

    The best solution will be found in the free market.

    A critical review of the stats for other nations systems

    do not support their superority to what we have. All still depend upon US innovation, althought this factor is decreasing due to over regulation by government.

    As to WHO saying our health system is substandard, the fact is adjusting for our life style, guns, and our attempts to extend care to life threatening conditions of the newborn, and elderly we maintain a higher standard of care and have better results.

    We have a system needing repair, not replacemnt.

    The deadly waits, lack of choice, and unavailabilty of technology are aspects of government health plans that will worsen, not improve our system.

    Most people under government plans are satisfied. I think satisfaction of what you know, does not rule out the superiority of what you do not know.

    Thus the argument endorsing and promoting the other side of the fence being green and where we all should be, includes the roughly 80% of Americans satisfied with their current plan.

    Assuming there is created from debate a new plan, the issue becomes freedom, will it be imposed, or will it be a choice.

    Finally, the debates provided by Tfhe Fools Discussion Boards allow all of us to expand our views on whatever the topic. They are a fantastic tool for seeking clarity of very complicated issues. They connect muddled minds with the orderly.

  • Report this Comment On October 17, 2009, at 5:41 PM, tex41 wrote:

    Hedghog, re"What a privileged soul you must be."

    You might stay your comments on the personal level, it could have been a fair question to ask if I see myselt as privileged. In fact I do, but I am not, as you infer superior.

    Having worked, since age 8 selling candy in a local grocery store before and after school. Working full time as a security guard nights, and at one point adding two evening part time gas station jobs, (back then your gas was pumped by an attendant), while carrying a full load in collage provides a modicum of ability to identify with the groups you list above.

    Now 68, I am privileged, privileged to have had the choice and opportunity to work toward a better life then my parents.

    Untill married I did it on my own.

    I grew up in poverty, knew hunger, lacked many of the ammenties common today, assumed by many today as rights to be provided by someone else.

    But I nor my sibilings were ever poor. We were nerver victims. We never ever were allowed to expect a handout and had one been offered would have refused.

    There was no lack of pride, nor were we destitute of privilege. We were rich with in the potential of the choices laid before us.

    There was no guarantee of result.

    The only retirement I have is self provided, and payout of a part of what i contributed to Social Security.

    Oh, and I am priviledged to be alive.

    You appear to have a big heart and a good mind, keep track of which is pertinate to a givin arguement.

    When 68 pomposity is allowed if one so chooses.

  • Report this Comment On October 17, 2009, at 6:11 PM, theHedgehog wrote:

    <i>When 68 pomposity is allowed if one so chooses.</i>

    Nothing else needs to be said.

  • Report this Comment On October 17, 2009, at 6:42 PM, theHedgehog wrote:

    Here's an interesting article that pretty much exemplifies the problem with for-pay insurance companies. It's an article about modern day cowboys in the American West.

    [quote]He had no front teeth. This was the result of what he described as a "horse wreck", when an animal he was in the process of breaking in, bolted and ran into a fence post. Neil's jaw was smashed and he lost most of his teeth.

    When the time came for treatment he said his insurance company agreed to pay for all his back teeth to be fixed because they are unarguably used primarily for chewing.

    Front teeth, he said he was told, are essentially cosmetic, at least in part, and were therefore not covered. [/quote]

    Note that the man is working and has health insurance. He isn't some lazy slacker sitting in a bar collecting welfare.

    From:

    http://news.bbc.co.uk/2/hi/programmes/from_our_own_correspon...

  • Report this Comment On October 17, 2009, at 6:55 PM, HOGridin wrote:

    "national health care coverage will give no incentive to doctors... "

    And 75% of working Americans that took either pay cuts or pay freezes are motivated to do their jobs how?

  • Report this Comment On October 18, 2009, at 5:21 AM, NotDefenseless wrote:

    It never cease to amaze me that some advocate competition in health insurance companies to bring down cost. Simple concept but naive. Since 1945, the health insurance companies enjoyed special privileges of federal antitrust exemption under McCarran-Fergusan Act. This means that they have monopolistic economic powers and get away with price fixing, price collusion and bid rigging. How could anyone think the health insurance permium can come down??! Yes, that's right since 1945. There won't be competition because they have lobbied and spent millions of dollars to defend this priviledge. Why would they want to compete among themselves???

    To make it difficult, health insurance companies ration care. And as everybody knows, discriminate against the old, sick and unhealthy; and come between the patient and the doctor to deny coverage using loopholes in the contract. Here's a simple verification. Review your healthcare coverage and you'll find that you can never have adequate coverage. Read all the restrictions, exclusions, disclosures, waivers and limitations. They are designed to provide maximum profits among a few major healthcare insurance companies. Repeal the antitrust exemption, level the playing field, then competition can be encouraged. Not just among insurance companies but other elements of competition like public options or national healthcare. What good is the claim to have the best healthcare in the world when only a few priviledged can access it and the majority is restricted by inadequate coverage. I call that faded glory. Nothing to be proud of. In fact, shameful. But basic healthcare for all Americans is more meaningful. That's more glorious.

  • Report this Comment On October 18, 2009, at 9:41 AM, ncadams wrote:

    I am surprised that more people are not commenting on prescription drug advertising and the overuse of prescription drugs in this country. The advertising adds directly to the cost of the drugs. The amount of money spent treating the side effects of prescription drugs is enormous and usually results in getting more drugs prescribed. Americans take a great deal more prescriptions than any other country - developed or non-developed. Until we are willing to address these problems, the costs for health care will not come down.

    One other note -- the health insurance industry is not operating under free market conditions. This industry is highly regulated by states and most states have dictated options that must be included in all policies. States also do not allow insurance companies to compete across state lines -- thus curbing competition. I heard a NC legislator bemoan the fact that insurance for state workers in Georgia was cheaper than it was in NC. He was not even considering what drives the cost, including the requirements to provide mental health and drug rehab in NC.

  • Report this Comment On October 18, 2009, at 12:41 PM, EyeT4Me wrote:

    NCADAMS makes a very valid point. A lot of money goes to prescription drugs and their advertising. Every time I see a doctor, they write a prescription...even if I tell them I don't want to take anything unless its absolutely necessary, I still leave with the prescription. I may or may not choose to fill it.

    This country has developed the vast majority of drugs used to treat major illness, which equates to a lot of money in research as well. I believe that money is justified and helps the whole world, but I don't believe that the cost of the advertising is.

    We can't fix everything at once without breaking what works, so why can't we focus on one thing at a time. Prescription drugs would be a great single target to begin with.

    Laslty, it is amazing to me the sense of entitlement that I have seen grown in the US over my lifetime. Everyone is not entitled to own a home. Everyone is not entitled to healthcare, either. You are, in the US, entitled to have liberty, which allows you to pursue those things if you choose to, but where along the way did that turn in to "I deserve this"??

  • Report this Comment On October 18, 2009, at 1:06 PM, theHedgehog wrote:

    <i>Everyone is not entitled to healthcare, either.</i>

    Why not? It's a simple question. Do you have a simple answer that doesn't involve "I don't see it in the constitution?".

  • Report this Comment On October 18, 2009, at 1:10 PM, dklawley wrote:

    Everyone needs to have access to health care. Everyone needs to pay into it. We also need to find a way to reduce costs without sacrificing lives. Health care reform is long overdue. Today we have too many people who can not afford to go to the doctor and if something major happened (illness or injury), then what? Would you let your adult child die because they don't have health insurance? Of course, the difficult thing is figuring out where to draw the line when someone has an illness that requires millions of dollars to treat. But we should at least cover basic health care to keep people as healthy as possible and catch any serious illnesses early when they are easier (and less expensive) to treat.

  • Report this Comment On October 18, 2009, at 2:07 PM, theHedgehog wrote:

    <i>Of course, the difficult thing is figuring out where to draw the line when someone has an illness that requires millions of dollars to treat.</i>

    Once you draw the line at where you're willing to throw people away like some old rag, you've drawn the line where your humanity ends and you're nothing more than an animal.

    It would be interesting to see which side of this argument YOU would be on if you lost your job, couldn't afford COBRA, and came down with some cancer that "requires millions of dollars to treat" with no assurance that you'd even be cured. Would YOU voluntarily end your life for the good of the insurance companies? I'm guessing not.

  • Report this Comment On October 18, 2009, at 4:42 PM, CosmicJustice wrote:

    This health care reform is a joke. No individual choice, get rid of the outdated system of tax breaks for employees and give them to individuals. I feel like im living on a different planet with these bills of a couple TRILLION dollars being thrown around while our deficit is unsustainable. I feel like i'm taking crazy pills

  • Report this Comment On October 18, 2009, at 4:43 PM, CosmicJustice wrote:

    employers*

  • Report this Comment On October 18, 2009, at 5:39 PM, MeHow5r wrote:

    National health care doesn't work anywhere. Just like social security. It's always like that when bureaucrats are spending other people's money to take care of other people's needs - the least effective way of allocating resources.

  • Report this Comment On October 18, 2009, at 7:35 PM, pickumnow wrote:

    The challenges are:

    1) People will always gravitate to what is in their best interest even if that means work the system. And we will work the system.

    2) Tex has mandatory auto insurance yet no matter how many times they change the law and impose fines 20-25% remain uninsured. The fine is less than auto ins premium especially if you have a bad driving record. MADD reports that "50 to 75 percent of drunk drivers whose licenses are suspended continue to drive" and that "on average someone is killed by a drunk driver every 45 min". Seems to say we lack the resolve and ability to require people to pay the price. Our politicians lack the courage to enforce the law and make people pay the acturial correct price for not buying insurance. Instead it is easier for the confiscate the price from the great majority who have jobs and get W2 earnings.

    3) Same applies to providing medical care to illegals or even enforcing the our citizenship laws. Why? Perhaps it is because it will cost votes? Perhaps they just don't like the law?

    4) Remember this is not about insurance. Health care is about a known event and provding a payment system for health exams and various maintenance type events that are neither catastrophic or unpredictable when dealing with certain lifestyle choices that raise the probability of needing expensive care.

    5) Ask a government worker if that are motivated or rewarded for doing a good job. In a recent conversation with a young lady who worked with parollees for the last 10 years, she related to me how there was no incentive to do a better job than the next person since they were all paid the same. Added to that is the frustration of the job where you see the same people all the time coming back through and seldom making changes.

    The truth is change happens within the heart when people, not the government, interacts with hurting people who need help. If individuals were doing what we should do, then the government doesn't get involved except with the exception. I predict that when the liberals pass their program, we fix it again, every 5 years after that.

  • Report this Comment On October 18, 2009, at 8:15 PM, theHedgehog wrote:

    <i>The truth is change happens within the heart when people, not the government, interacts with hurting people who need help.</i>

    The other truth is that in a legalistic society, such as the one we have, this is simply not going to happen. You talk about lack of motivation; well there is no motivation for the insurance companies to change, other than to find more ways to avoid payments, avoid treatment, and cancel costly policyholders.

    We have given the current system many many decades to get its act together. We have seen no improvement to the number of people who either have no access to healthcare or to the number of people filing medical bankruptcies. This is an unacceptable situation. And for what? So that some ideological code is followed. Shame on the bunch of you!

  • Report this Comment On October 19, 2009, at 12:43 AM, hsmom2004 wrote:

    Some things many of you may not be aware of:

    1) Medicare does not cover the actual material costs of products that are necessary in emergency transportation and care of a patient. This gets cost gets passed on to other patients or to communities through taxes that go toward for paying emergency medical services. (Strike against government insurance.)

    2) Medicare / Medicaid overseers are commonly known insurance companies that are selected to manage for given years. (hmmm)

    3) Each year Medicare / Medicaid submits new codes to doctors' offices nationwide with new codes they are required to use with very minimal changes, frequently, add a ".0" to this code or remove a ".0". Piddly changes. In order for the doctor to get reimbursed, they must ensure that they enter the right code (out of thousands). If a new code is missed, they don't get reimbursed in 3 months as they normally would, but get a letter stating that there is an error (no clues) and that they can resubmit and hopefuly get reimbursed 6 months after treating the patient. This means that doctors' offices and clinics must purchase new software updates each year (passed on to the clients) or pay someone to come in and update their software with the new codes (passed on to the clients). This changes all the more when a new insurance company is selected to take over the task of managing the government insurance.

    4) One doctor who accepted Medicaid (the only dentist in our county who does) had not received Medicaid payments for 3 months or more because they (Medicaid office) had received something back in the mail stating that it was not the right address. This dentist had been in business for 20 years at the same location. Something as simple as the postal clerk getting two letters stuck together and inadvertently putting something from Medicaid in someone else's box could have resulted in this. It took quite a bit of additional effort to convince the Medicaid office that they were still in the same place.

    5) Medicaid requires some treatments and care that are not always necessary and requires certain innoculations that may not be necessary. In Texas, we already had a battle regarding the governor mandating that girls receive the STD-related cancer vaccine. The public won out, but who wants the government mandating what one must receive.

    6) HB 3200 had provisions for allowing consultants to come into one's home to teach how to care for and raise children with reports from each state coming in to show the number of house visits each year. These were to be encouraged, presumably with incentives for increasing the percentage of home visits each year by each respective state. I don't want the government coming in my home telling me how to raise my children, but in some cases, individuals may feel compelled to allow this intrusion.

    There are a number of issues wrong with our current insurance methodology through private insurance, not the least of which is assuring a patient and doctor that a treatment will be covered only to decline to pay when the bill comes. Greater choice in providers can help here. The government has not shown me personally that they are good at managing things like this. I would prefer that they do their job - manage international trade and relations, facilitate interstate relations, and keep us safe. Leave the rest alone.

    Also, if one put back the money that would otherwise be paid to insurance companies for other than a catastrophic illness, one could more than pay for any illness or treatment needed. The dilemma is that those who cannot afford insurance cannot afford to put money back for the minor emergency cases, either. For those whose nose is stuck really high in the air about all this, realize that for those who make good money, there are a number of paycheck-to-paycheck employees who serve your needs and make enjoying your life possible: the convenience store clerk where you buy your gasoline, the grocery store workers, the attendants at the clothing store, the civil service workers providing water, sewage, trash removal, road repairs, and other such services. These people may themselves be insured, but ofttimes, their families are not because the insurance rates charged to add another family member (not even the whole family) can be 1/2 to 1/3 of their gross paycheck. While there are certainly cases of abuse that happen, most people who need assistance are workaday people who make our lives easier and better who just need a little help and since our society has moved away from local communities and congregations helping each other to dependence on the government this is what we are getting unless people are willing to look at those who serve us with appreciation and a willingness and concern to help when help is needed of our own accord (e.g. "love thy neighbor") rather than judgmentally heaping all people who need such help into groups of users, abusers, and aliens. A concerned attitude for our fellow person can make all the difference in helping to keep the government out of affairs it has no business in.

  • Report this Comment On October 19, 2009, at 12:57 AM, NotDefenseless wrote:

    I agree with theHedgehog writer. I noticed some writers lost it altogether Heathcare is not a behavioral science question or some abstract idea about constutional rights.Or about goverment involvement to control the lives of others. It's about basic human rights. Medical science has come a long way to improve the lives of human being in the 21st century. To be a doctor is a noble profession. It's a about saving lives and improving the quality of life. How can the richest nation in the world talk about democracy, helping other nations to improve their economic developments, donate food and medical aid to other nations to improve their lives but cannot solve a simple basic heathcare needs for its citizens. Instead it denied a select population size the abillity to access basic healthcare. This reform is past due and must be resolved now.

  • Report this Comment On October 19, 2009, at 1:18 PM, RadioFreePG wrote:

    Well, looks like we have plenty of commentary here, but these are likely being read by someone unlike the ones us fools send to the White House!

    My comment is we need to level the playing field FIRST. Number one, NOBODY pays taxes on their healthcare insurance premium. The system we have now still manages to have those of us who buy IHP's being pretty much taxed on every dollar of that. Number two, everybody uses the same form and gets charged the same, WHETHER OR NOT they are paying out-of-pocket or some insurance company is paying their tab -- that doesn't happen now...SS pays one rate, insurers another and the poor guy w/o coverage is charged THE HIGHEST RATE.

    Get this done and then we can think about extending coverage to everyone or mandating coverage for everyone. There will always be someone we can't cover and we need to accept that and plan for it as well. No matter what we do, we will always have people running around the country that don't belong here, are not on the gov's radar, have no money or coverage and end up getting sick or injured (or coming here seeking help in the first place.)

  • Report this Comment On October 19, 2009, at 2:37 PM, theHedgehog wrote:

    <i>Get this done and then we can think about extending coverage to everyone or mandating coverage for everyone.</i>

    You're looking at this backwards. First, make the decision that we're going to cover everyone. Then, look at the way it is now and find out why they aren't already covered.

    But your point about no-one paying taxes on employer health benefits is well founded. Whether there's the will to fix this or not is a different story. On the one hand, it will be a big hit to add $2500 (and up) to the tax burden on the middle-class. On the other hand, as you so rightly point out, the under-class is already paying that tax. Personally, I'd like to see the tax phased in over 5 years. It would still be a shock to the middle-class, but one that is manageable. Many of them will have their wages scaled-up to cover it, anyway - at least to some extend.

  • Report this Comment On October 19, 2009, at 3:45 PM, RPhFool wrote:

    The most basic flaw in all of health care 'reform' is the idea that government involvement will solve anything. To date govt involvement has only reduced care, increased beauracracy and skyrocketed the cost. More than 40 cents of every health care dollar now goes to goverment or insurance administration costs. How will more of the same improve the industry? How about returning to an actual free-market health care field...the costs will be lower and access to care improved.

  • Report this Comment On October 19, 2009, at 3:48 PM, theHedgehog wrote:

    <i>How about returning to an actual free-market health care field...the costs will be lower and access to care improved. </i>

    You haven't read a word, have you? And what is meant by free-market? Is that where the insurance companies continue to be free to rape and pillage and otherwise abuse their policyholders? Or do you propose something else entirely? Because, that's not a free-market, that's a captive-market - you know, like the one we have now.

  • Report this Comment On October 20, 2009, at 9:35 PM, Mungbork wrote:

    Well, there are lots of conceptual problems inherent in the "health care" debate. First, health care is not the same as health insurance. We keep mixing the two up when talking about them. Secondly, what we call "health insurance" really doesn't closely resemble insurance. The "health insurance" product that most people have isn't constructed for the consumer at all, but rather for their employers. Employers are the customers of health insurers, not individuals. That's why the risk rating and premium systems used in "health insurance" slice and dice the population so carefully by age, sex, and medical conditions...so employers can be given the best deal (meaning so they don't have to cover the bad risk). It has very little to do with individual concerns. Also, premiums are developed based on estimates of risk for one single year for an individual, not over the individual's lifetime. Thus the premium for a 20 year old who might have a terrible long-term medical prognosis due to being overweight or living an unhealthy lifestyle is far less than that for a healthy 60 year old. The insurance rating system only looks at projected risk for the next year. This is, of course short sighted, and has nothing to do with health care. Only with short-term risk. The problem is, that the costs ultimately come back on the system long-term. While there are "pockets" of good risk held by employers, the overall population, including the un-insured still incurs costs related to their disease states and health status. To fix the mess, we need set premiums for everyone at the same rate - total cost of health care for the entire population divided by the number of people in the population. Once the premiums are constructed this way - flatly - watch the insurers bail out of the business. The only way left for them to compete would be on service - no more buying an employer's business with an artificially low first year premium.

  • Report this Comment On October 20, 2009, at 9:37 PM, Mungbork wrote:

    One more thing. In case its not common knowledge, health insurance was created by health care providers as a means of stabilizing their cash flow...it was never intended to be a benefit to consumers. Reference the history of Blue Cross/Blue Shield for more details - created by the Voluntary Hospital Association membership...

  • Report this Comment On November 09, 2009, at 12:41 PM, Foolnobody wrote:

    It is obvious that we have a diverse set of opinions and thoughts on this issue probably based within our experiences and belief systems. Here's mine although not different from many of yours.

    1. I have traveled to many countries and am currently not living in the USA. When someone in my current country has a serious illness, they travel to the U.S. to get help. Why, because they know the care will be better. Having lost my wife to cancer, I can tell you the health care in the U.S. tried everything they could to help her. I worry that the Government will screw up what is an excellent system. France, Britain, and Italy, lived in those places, are going broke and are rationing care.

    2. Who pays for 'Universal' health care. Us, we, the working or at least those of us with money. What I have seen in the current house bill is a stiff rise in my costs for health care. I am happy with what I have. I earned it by getting up everyday for 47 years and busting it.

    3. There are some good ideas out there. Why not try some of those. Ex. Cross State insurance to increase competition. Texas has improved their situation by tort reform. We don't need to replace the fenders, engine and other parts because we have a flat tire. What the house is proposing is tyranny, not health care reform. It is a classic example of 'Animal Farm,' and will have far reaching consequences.

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