OP-ED

Health Care Reform: What do People Really Want?

Humphrey Taylor is Chairman of The Harris Poll.  Prior to joining Harris, Taylor worked in Britain where he conducted all of the private political polling for the Conservative Party and was a close adviser to Prime Minister Edward Heath in the 1970 campaign and subsequently to Margaret Thatcher.

What do people really think about health care reform?  When political issues are difficult and complicated, published polls sometimes confuse rather than enlighten the debate.   And health care reform is fiendishly complicated, with many different issues and many different proposals for addressing them.  No wonder that the debate is generating more heat than light.  This is surely one of the times when political leaders should lead rather than follow public opinion.  As Winston Churchill once said, “The problem with politicians who keep their ear too close to the ground is that it is difficult to look up to them in that ungainly posture.”

While policy makers have to address the details of the proposed policies, most people do not.  They know what they want, or don’t want, but have only a very limited understanding of which policies will actually achieve their aims.  They are often strongly influenced by political rhetoric that varies from the accurate to the simplistic to the completely false. Many different words and phrases are used to describe different policies.  It is unreasonable to expect the public to understand the details of the proposed reforms or how they work in practice.

However, if you study all the polls, as opposed to cherry picking them as many politicians do, a  clear picture of public opinion emerges:

  1. Most people are unhappy with the current health care system and favor reform.  They want to have a system that gives them affordable access to quality care for the rest of their lives.  International surveys show that Americans are more dissatisfied with the U.S. health care system than are people in all, or almost all, other developed countries.
  2. Most people think that some kind of government intervention is needed to fix the system, to expand coverage, and to contain costs.  However, support for government intervention does not, in most case, translate into support for a “government-run” system.  (Though what people understand by that phrase is far from clear.)
  3. While most people believe that fundamental changes are needed in our health care system, only a minority wants to completely rebuild it.  Most people favor building on the present system and the bits of it that seem to work well.
  4. There is substantial support for health care reform not only among the public but from large majorities of almost all major interest groups.  Only small minorities of doctors, employers or insurers think that the system works pretty well now.  However, they also have different interests and tend to see very different problems and support or oppose different proposals.
  5. Most people are at least reasonably satisfied with their own health insurance (if they have it) and with the quality of care that they receive.  However, that does not mean that they like the system.  Most people believe that the costs are too high and that everyone should be covered.
  6. More people think that both the total cost and the out-of-pocket costs of care are too high, but their perceptions of why this is so are different from those of most health economists.  They often blame greedy insurers and pharmaceutical companies and think there is a lot of fraud and abuse.  But they are less likely to focus on over-utilization, the impact of fee-for-service incentives and the relatively (compared to other countries) high price of medical services.
  7. Few people seem to worry much about the unfunded liability for Medicare that economists tell us is a huge problem.
  8. Proposals that people believe will take away the health insurance they have now, or force them to change doctors, that “ration” care, or prevent them from getting the treatments they think they need are deeply unpopular.
  9. There is no consensus on the appropriate roles of the government, employers and individuals.  Half of the population thinks that health insurance and health care should be “an entitlement paid for by taxes,” while a third believes that it should be like other products and services, where you get what you can pay for.
  10. Republicans and Democrats are highly polarized on many aspects of reform.  Most Democrats think that this is a very important issue and focus on expanding coverage and limiting out-of-pocket costs.  They tend to favor an expanded role for government.  Most Republicans focus on cost containment and oppose a bigger role for government.  Democrats are much more likely than Republicans to think that health care is a “right.”
  11. There are many things that many people do not want.  They do not want to pay much higher taxes and out-of-pocket costs.  They don’t want to damage the economy or increase unemployment.  They dislike the idea of rationing and oppose anything that they think might reduce the quality of their care or limit their choices.
  12. Most people do not think or talk about the issues that are the focus of much debate among policy wonks, think-tanks, and legislators.  They rarely mention health information technology, comparative effectiveness reviews, a health information exchange, reimbursement reform, pay-for-performance, quality measures, or outcomes research.  When asked about these issues, the public’s replies vary dramatically, depending on whether the language used is that of the proponents or opponents of proposals.  For example, a new agency to provide information on which treatments work better or worse sounds pretty good – but not if it is used to deny care that a doctor or patient wants.
  13. Most people do not seem to see a conflict between giving patients every test and treatment they and their doctors  want, however expensive, and containing costs.

As a pollster, I believe that it is unreasonable to expect the public to understand health care reform policies because the issues are so tough and so complicated.  As H.L. Menken wrote, “For every complex and difficult issue, there is a simple solution – and it is wrong.”  The enormous complexity of the issues and the emotional public response to misleading political rhetoric, make one think fondly of Bismarck’s famous maxim that the public should not be allowed to watch the making or sausages or laws.  We should also remember that almost all health care systems in all countries seem to be almost permanently “in crisis” and that no matter what reforms are implemented, the demand for more reform – like death and taxes – will always be with us.  Democracy may be better than all alternatives but it sure is messy.

Humphrey Taylor is Chairman of The Harris Poll, Harris Interactive.  Prior to working at Harris Interactive, Taylor worked in Britain where he conducted all of the private political polling for the Conservative Party and was a close adviser to Prime Minister Edward Heath in the 1970 campaign and subsequently to Margaret Thatcher. In 1970, Taylor’s firm was acquired by Louis Harris and Associates, and Taylor took responsibility for building the Harris organization’s international business. In 1976, he moved to New York. He was appointed president of Harris in 1981, chief executive officer in 1992 and chairman in 1994.

Taylor has testified to congressional committees and subcommittees on Social Security, health care cost containment, Medicare, aging, policies affecting the disabled, drug exports, taxation of employee benefits and privacy. He has presented on these subjects in the White House and on Capitol Hill. He has published many articles and papers on survey research and public policy, he has also written editorial page articles for the New York Times, Wall Street Journal and the London Times. Taylor has been a guest lecturer at the University of California at San Francisco, the Kennedy School and the School of Public Health at Harvard, Oxford, New York University. He writes a weekly column that is syndicated in over 100 newspapers, and he broadcasts frequently on radio and television. He is the author of chapters on opinion polls in two leading textbooks on marketing research in both the United States and Europe (published by AMA and ESOMAR).

A few Harris polls on health care (PDFs):

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101 replies »

  1. All members of Congress have a conflict of interest in the health care debate- They all have fantastic health care. They should all recuse themselves or give up their government sponsored, tax payer funded health care. Let them get it on the open market. The premiums have become too expensive for the taxpayers.

  2. Wouldn’t it be great if at least a few of OUR representatives and senators decided ‘to hell with re-election’, I’m going to vote for what is REALLY best for the American people and what THEY want to see happen?
    I’m afraid the news media would have a field day – but then they’d probably like it because it would be BIG news. If it was my senator or representative, I would certainly re-elect them. But then I’m not one of those ‘American people’ who get counted in polls or by politicians.

  3. It seems that no matter what, people expect the government OR some large corporation to solve the problem or pick up the pieces when we are all broken, but it really falls into our own laps every time, STAY HEALTHY BECAUSE ITS IN YOUR HANDS NOT OBAMA AND NOT THE HEALTH COMPANIES. http://www.vitaminalmanac.com

  4. CF Mother. Thank you for telling your story. Millions can relate. What really got me was how you mentioned that what kept you up at night was not the disease, but the thought of losing insurance.
    I’m a 20 something year old with Reumatoid Arthritis. I worked for a national theme park company the past 5 years and was laid off in December. Even with Cobra, my medication costs me $400 a month (there is no generic brand). I was also was forced to discontinue my physical therapy because of the co-pays.
    I say this not so people will feel bad for me, but because it is the story of so many. Arthritis is the leading cause of disability and cost’s the U.S. economy nearly $128 billion per year in medical care and indirect expenses, including lost wages and productivity. 50% of people diagnosed with RA will nolonger be able to work after 10 years. Indivicuals who can’t afford proper medication, doctors, or therapy, are likely to end up not only disfigured, but also living off the government and YOUR tax dollar’s. I don’t have the answer’s. Yet I do know that we deserve a change. Not only for those going through medical challanges, but also for the rest of you who will have to help “pay the price” in the long run.

  5. I believe that the Federal government is the only entitiy trying to help the people of the United States.
    If the insurance companies want to help they would have already done so. I dont understand why people dont get it that that the health care system is broke. I have some examples;
    11 years ago I went to the hospital emergency room and withing 1/2 hour I was out cold due to loss of blood.
    I dont need to tell the whole story, but this was a very tramatic experience for my body and it took a long time to recouperate. 2 days after I got home from the hospital the someone from the insurance company called me and said they may not cover this because I did not call them to tel them I was in the emergency room! I went bazerk and asked them if there were trying to kill me, I told them that for some strang reason when I went to the emergency room I was not thinking about them. They are cold and calculating and have no compassion at all for what I just went through. I almost died and they probabily would have preferred that i did.
    Another time I was denied a proceedure because they said it was experimental. A Dr had recommended this proceedure as an attempt to prevent cancer. (So where is the rationing, rite here with the insurance companies). Next time I had a problem was when I moved and tried to get individual insurance and was denied due to pre-existing condition. Same thing happened for my wife. Has everyone heard about the girl that died because she was denied a kdney transplant and due to public outrage the insurance finally agreed and then the girl died before she could get the transplant. I am sure the CEO of that insurance company was happy that they didnt have to pay for that transplant. Also the people at the insuance companies that talk to you when you call are arogant and disrespectfull. They may not seem that way on the surface, but try to get a real answer sometime! Insurance companies are only out to make a profit and for healthcare insurance this must change. They will never change without being forced to.
    What happened to preventive care? They dont care, what they want is for every one to give them money and they never want to pay out for the reason we give them the money. One insurance company said they were going broke and needed to have a large increase and then gave a bonis. Somehow I dont see how a bonis can be given when they are going broke? I understand that there are people out there that have good health care and dont care if anyone else ever has the same and also wish the older people would just die off. But I wonder how they would think if things changed for them!! And they will also be old some day. So lets get real people and get behind the govt and get this health care bill passed.

  6. reforms need to change health care as important for a better quality of life of people in countries with low economic resources, according findrxonline this reform should be based on obtaining prices and lower costs, improve medical centers and keep people better served, because these are basic concepts for a better performance in the health system.

  7. Questions for those who do not support health care reform:
    Twenty years ago our cheery toddler was diagnosed with cystic fibrosis. Afraid, we dug into the medical research to understand the disease that threatened his future. We healed through optimism, roused by the news eight days after his diagnosis that the gene that causes CF had been found, opening the door toward a cure. We knew that our heroes, the researchers and his doctors, would continue to find ways to protect his future. We were no longer afraid of CF.
    The fear that woke me in the night was of losing our health insurance because our son was on every insurer’s no-fly list. While my husband’s profession was periodically roiled by layoffs, he decided against the security of opening his own firm because the cost of carrying coverage for our eldest son was too high, the thread on which his health care dangled too slight.
    With luck, we made it through our son’s childhood without a gap in coverage. Now 22, he’s kept his health thanks to his medical care and his own glorious determination not to allow CF to cramp his style. He earned his black belt, went to college, joined a fraternity, and drives a 1961 Buick LeSabre. He spent a year in China, learned Mandarin, and discovered that even the drug that enables CF patients to digest food couldn’t help him digest raw sea cucumber. He backpacked through Thailand, had his wallet and passport stolen, but managed to hang on to his meds. This spring he will graduate with a degree in chemical engineering with a concentration in biochemistry. His resume includes summers researching the transmembrane conductance regulator, the protein channel in our cells that, when malformed, causes cystic fibrosis.
    We can’t wait to see what this kid is going to do next. Next, however, has filled me with that old middle-of-the night fear. Our son will age off our family policy in April. He must shape his future not according to his dreams and ability, but in ways that will ensure that he keeps his health insurance. He must find an employer with health benefits that will hire a new college graduate in a poor economy. Or he must extend his full-time student status until he’s 25, putting off career plans and his desire to support himself. Despite his wanderlust and world-wide opportunities, he must remain a resident of Massachusetts, an isolated island where CF patients are not pariahs to health insurance companies.
    I tell our story not because it is unique. Other families have been harmed, rather than merely threatened, by the ruthlessness of American health insurance. I tell it to ask a question. It is for you, the person reading this who does not wish the current effort to reform health care to succeed, who calls it “Obamacare” and “socialized medicine”. Help me understand your position, because I am mystified.
    Are you a parent? Do you know that the bill under debate will prevent insurers from dumping people with pre-existing conditions, like my son or, perhaps, someone in your family? Do you believe that anyone who needs health care can get it somehow, or that illness happens only to other families?
    Are you a fiscal conservative concerned about cost? Do you realize that the current system discourages small business development and blocks young adults’ opportunities to succeed, the foundations of a growing economy? Do you believe access to health care is not as essential as access to education in preparing our next generation of skilled workers?
    Are you are an insurance executive? Do you devise new ways to make it difficult for my son to obtain prescriptions and services as cost-saving measures? Would you prefer to cover the cost of his lung transplant, because he has not been able to get the treatments he needs to stay healthy? Or have you decided that the ultimate cost-saving measure is to let CF patients and other chronic burdens to your bottom line die young?
    Help me understand why, rather than reforming the American health insurance system, we should turn our backs on my son and the promise he and other young Americans like him offer all of us.

  8. I do not understand how the government is giving free health care to people who are ilegal in this country. If someone is ilegal, that means they have broken laws and entered this country. Now, to reward them we will offer free health care? Something does not sound right!! I am an American citizen and can not really afford health care. How can I get free health care. Do I have to break a certain law. Maybe the answer would be having double citizenship, will that help to get free medical coverage. Illegal aliens get free food stamps, medicaid, and the American citizens get “shafted”. As my little girl says, “AWW, COME-ON”
    • Page 29: Admission: your health care will be rationed!
    • Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)
    • Page 42: The “Health Choices Commissioner” will decide health benefits for you. You will have no choice. none
    • Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.
    • Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.
    • Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens
    • Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter.
    • Page 124: No company can sue the government for price-fixing. No “judicial review” is permitted against the government monopoly. Put simply, private insurers will be crushed.
    • Page 127: The AMA sold doctors out: the government will set wages.
    If this stays intact would it be better to be an illegal alien. If they recieve all the benefits for entering this country illegally, what motivation do they have for following the laws. Hey, did’nt President Obama say that the health care plan “Would not benefit Illegal aliens”, I remember someone screaming “YOU LIE”
    hhhhmmmmm…..AAAWWWWW COME-ON
    visit http://homegoldrush.110mb.com

  9. What I look forward to having real choice and real Competition free from the strings of employer Grounded insurance. Our Lopside, Corrupt governmental agencies have created a partnership with corporate America that is detrimental to the publics good.
    As much as I hear the distain for socialism. It is Facism that has prevented Health Insurance from being reformed. The Corporate profit Makers dictate the terms of this circus performance that some call Congress. Americans are not stupid as some repeatedly mention. They know that this push for additional members come with a price. While the partners of fascist ideaolgy have decided on eliminating the cracks in the floor of Pre-Exsisting:the Sky has no limits in out of pocket and Premium control.
    If Health Insurance was actually part of this Free Market Society and was held accountable by the Members. We would see the Changes that some dread and older people look forward too.
    Expecting anything from Congress is like expecting a bum to get a job.However, Social Security and Medicare have keep your parents off the Streets in their twilight years. Profiting off the misery of others is so priceless that the term Fascist is synomious with profits first and foremost.

  10. Dear Friends and Relations,
    I hope I won’t offend any of you by writing to express my anger about reports we read in UK papers about the distortions and downright lies concerning the British National Health Service (NHS), propagated by the enemies of your President. I hope you will feel able to copy this e-mail to any friends who are against Obama’s proposals for health reform.
    It is particularly galling to hear that the utterances of an idiot UK Member of the European Parliament are being quoted as gospel. The man concerned (whose name I can’t recall and of whom we had never heard until this episode) is clearly far to the right wing of the Conservative party and his views have been disowned by the leader of that party.
    No health service is perfect because it depends on people to run it, and to err is human. When it runs well, it is not “news”, but the occasional failures and problems hit the headlines in the right-wing press.
    There are also issues about how to handle leading edge and expensive technology. New technology has to tried and tested, but when it is both new and expensive, choices have to be made about the initial use of it in designated centres of research. This always gets into the papers because patients who just might possibly have their lives prolonged by a new treatment, understandably want it NOW. I know this would be my own gut reaction. But if logic suggests that the money (which is not infinite in any system) could be more cost-effectively used for other more proven treatments for many more people, then I have to agree that it would not be sensible to for me to get the experimental treatment. I used to draw the comparison between kidney and heart transplants. It is probably cheaper now, but a few years ago one could save the lives of many people in kidney failure for the cost of one heart transplant. The experimental technology eventually becomes cheaper and routine, a fact that I am heartily glad about.
    It seems that the anti-brigade have latched onto this concept to say that the NHS rations care and dictates who shall live and who shall die. That is a crude nonsensical interpretation of the facts and must be contrasted with cases in the US where people don’t take the drugs that would save them, because they cannot afford them.
    May I also point out that the USA spends twice as much as the UK per head of population on health care, and yet you have a worse life expectancy and perinatal mortality rate than us. I read recently that your perinatal mortality rate was far worse than the much-vilified Cuba. How ironic that the bete-noir of the US right wing should actually give its infants a better life chance, in spite of years of economic isolation. In fact, Cuba trains so many doctors and para-medics that many work in other third-world countries.
    How much of the money spent on health care in the US goes into the profits of the insurance companies and the profits of the private health facilities? And yet I read that 50 million Americans are without health insurance and rely on a dodgy and inadequate back-up system. How many more have insurance limited because they have a pre-existing health problem? How many more have health insurance through their job and so dare not change jobs?
    What would my recent experience of the NHS have cost in the USA?
    For those who don’t know, one day back in March this year, I fainted at our Local History “club”. The emergency number was dialled and our local stand-by para-medic in a fast car was there within minutes, shortly followed by an ambulance which took me to the local hospital. No questions about insurance, because we are all looked after by the NHS. All sorts of tests and scan were done and the doctors discussed the findings with doctors at the main teaching hospital in Leeds. It was decided that I should be transferred to Leeds, about 10 miles away.
    The transfer to Leeds under flashing lights and siren was about the only thing about the following two weeks that I can still remember. I think the ambulance men were anxious that I didn’t die on them, hence the flashing lights etc.!
    At the Leeds General Infirmary, they did more tests, and told Helen that they were reluctant to operate because it was potentially so difficult and hazardous. I am told that I was quite chatty that weekend, but on the Monday I collapsed again and they decided that surgery was urgently necessary. Helen was visiting and talked with the surgeon before he started 13 hours work on me. They replace my aortic valve and a section of the ascending aorta. I was then unconscious for 5 days in Intensive Care before gradually being brought round. There was a setback 4 days later, when they had to take me back to theatre to remove some clotting round the heart; but that went well and three days later I was moved to the ordinary ward from where I went home 10 days later.
    I like to joke that, if the new parts last half as long as the originals, I will live to 105!
    A few days after I got home, the cardiac rehabilitation nurse came to visit me (all part of the service), and I was advised to take graduated gentle exercise and invited to attend the Tai Chi classes at the local hospital. I am about to graduate to a more strenuous exercise class at the hospital (all available free), but as some of you know I can already do modest 2 or 3 mile walks.
    I am on Warfarin (I call it rat poison) to prevent clotting, and my blood has to be tested regularly to get the dosage right. It now seems to have stabilised so that is now being done at 4 week intervals whereas earlier it was weekly. I am also on two blood pressure reducing drugs, making 7 pills a day, all free of course. I would have to pay something for medication if I was aged under 60 and over 18 and had an income.
    Contrary to what is being put about by President Obama’s enemies, the treatment I had was exemplary. Every single member of staff at the hospitals was superb. Even the orderlies who dished out the food did their best to cheer me up and get me eating. Something, either the anaesthetic or being on the by-pass machine, had spoilt my sense of taste, so most food either didn’t taste of anything or was slightly revolting. Fortunately that has passed and food is nearly back to normal. But the whole atmosphere on the wards was cheerful and encouraged one to push oneself to get better. So it annoys me intensely when people opposed to your proposed health care reform claim that the NHS is failing. It is a lie.
    The NHS is superb. I hope you get something like it soon.
    In the UK, we are not forbidden from take out supplementary health insurance. We ourselves actually have it, mainly so that we can get privacy when we need it for minor procedures, and so that Helen as an ex doctor is not in the embarrassing position of potentially being treated by staff she worked with. But it is really rather a waste of cash, because, when the chips are down in a serious emergency, the NHS gives us everything we need.

  11. As a smoker, I am SO for a tax on soda. I hope you holier-than-thou assholes get a taste of what we’ve had to deal with for years now. While they’re at it, I hope they tax the fuck out of all sugary and fatty foods. And then, instead of using that money to help people with junk-food addictions, they just lump all that money in with the rest of their tax revenue. Maybe then the rest of you would realize what a bunch of snooty shits you’ve been to us smokers.

  12. Several Congressional committees controlled by the Democratic Party recently passed bills representing their vision for healthcare reform before the August recess. Their goal was to achieve President Obama’s ambition to reform the American healthcare system and to insure all Americans. During the recess, many Congressional representatives encountered strong opposition from their constituents when they went back to their home districts. Many people, with some encouraged by right wing Republicans, were very vocal and confrontational during the town hall meetings. After August recession, a senate committee unveiled another bill which made some compromise and reduced some cost, but still a very ambitious plan.
    This display of angry shouting is certainly not constructive if we are to have a serious discussion of such an important social policy. Many of the arguments by the opposition are based on misinformation. One such argument against the Democratic reform bills, which has been blown out of proportion by the media, is that they would create so-called “death panels”. I, in fact, think this is a good idea. It lets patients, especially elderly patients, receive consultation from doctors about possible end of life treatment. They can then decide in advance whether in certain circumstances they would choose to either continue or end life support, so that their family would not be burdened with the decision. This would avoid what happened a few years ago to Terri Schiavo. In her case, her husband and her parents could not agree whether to keep her in a vegetative state or to end life support, and thus they went to court, resulting in a long and costly litigation process. Using the term “death panels” to describe this reasonable proposal is outright ridiculous.
    Likewise, pretending to be on the moral high ground by using “politically correct” language, such as “it is everyone’s right to have the same quality of healthcare as a Congressman” does not help solve the problem either. Blaming the rapid increasing of healthcare costs mainly only on the health insurance companies is also baseless.
    Undoubtedly, healthcare in the US has a lot of problems. Healthcare spending in the US is much higher than in other developed nations. In fact, the cost of healthcare is increasing faster than inflation. There are also several millions Americans without health insurance. However, there is still a silver lining. Our high quality health professionals and new advanced medical treatments attract patients from all around the world. The emergency care system in the US is well established and top rated and hospitals accept patients for treatment regardless of their ability to pay. The US is the leader in developing new drugs and new medical advances. More than half of the Nobel Prize winners in medicine are from the US. Recent statistics also show that life expectancy is now almost at 78 years and the death rate from most diseases is decreasing.
    No one thinks that reform is unnecessary. The question is how.
    My two main concerns and doubts on the reform bills presented by the Congressional committees are as follows.
    First, in order to provide health insurance for everyone including those with low incomes, the government needs to spend a lot of money. No matter how it is paid, it is taxpayers’ money. Do tax payers want to pay for it? If the government forces those employers who do not provide health insurance for their employees pay a penalty tax, eventually either the employees will be paid less or it will be passed on to the consumers. If the government forces the wealthy to pay more in taxes, it means to raise the percentage of the tax paid by rich people. If most people think it is reasonable, this money can be used in other areas, for example, to reduce the huge deficit or to let those with lower and middle-class incomes pay less in taxes. If it is paid by increasing the deficit, not only will our children need to eventually pay it off, it will also adversely affect the economy and everyone will suffer.
    These bills contain very little cost cutting measures. The amount they claim to save from Medicare by cutting waster may not be very much and waster can and should be cut already without a huge program. Watering money is government’s crime. The final cost of all governments run programs is almost always far higher than originally projected, whether it is a huge program, such as Social Security or Medicare and Medicaid, or a small program, such as Cash for Clunkers. For the latter case, our recent memory will hopefully still remind us that Congress later injected two times the amount of money than originally projected for the Cash for Clunkers program. Current plans in the bills largely use the Massachusetts health plan as a model. The Massachusetts health plan has been around for three years and it has already impacted its state budget. We must also remind ourselves that Massachusetts is the third richest state in the US. Its per capita income is 30% higher than the per capita income for the entire country. If the same standard is used, a much higher percentage of the population in the nation will need government subsidized insurance then that in Massachusetts.
    Secondly, both President Obama and his supporters promise that there will be no single-payer system. Those who are satisfied with their current insurance and doctors can keep what they have and nothing will change. However, if there exists a government subsidized insurance plan, some private insurance companies may disappear and many employers may drop their health care benefits. It will be cheaper for them to pay the penalty tax than to provide health care benefits for all of their employees. Eventually the government plan will become the only plan.
    President Obama recent address on healthcare reform tried to attract more people to support his ambitious goal. To count the opposition, one thing he said that I found very striking but also encouraging is that he will not sign a bill which will add a dime to the federal deficit now or in the future. Additionally, he mentioned that spending and benefit will be cut if the promised savings are not realized. I will be very appreciative if he really means what he said and if there will be a concrete measures to do so. None of the current bills has such an automatic cut mechanism.
    If you’re someone who currently has no interest in highly involvement by the government in healthcare, does not like a Canadian or European style healthcare system, but at the same time wish to give some help to those who cannot afford health insurance and reduce the speed at which healthcare costs are increasing, then what I propose next may be something worthwhile to consider. Of course, there is no free lunch, but what I propose is to spend much less than what President Obama proposes, and to walk in small steps instead of huge ones.
    Design a very basic health insurance plan. The government helps those with low incomes buy such a plan or other similar plans. It provides free basic health checkups every two years instead of every year, as most current plans provide. It has a higher co-pay for other medical services than most of current plans. It does not cover certain drugs such as Viagra nor organ transplants. In essence, it does not cover health services which do not mainly cure a disease or which are very expensive. It covers only generic drugs with a co-pay. Brand name drugs will only be covered if they are life-saving or if there are no similar generic drugs which can be substituted. Ambulances are only covered only for life-saving cases and physical therapy is covered only for severe cases. I am personally acquainted with a Medicaid patient who often used an ambulance to take him to a hospital which was four blocks away from his home when he could definitely have used a taxi. Hospitals should provide economy rooms, where each room would accommodate four patients without the use of a TV and where the patients would pay for their own meals. If there are similar medical tests, choose cheaper ones. For example, the cost of a Pap smear with or without using computer assistance is about two to one, but the difference in the effectiveness of detecting cervical cancer is minimal.
    Such a plan still requires additional taxpayers’ money, but it is much less than what is currently proposed by Congress. In the future, as the economy grows, the deficit is down, and voters want to provide more assistance to low income persons, coverage can be expanded. Compare this to President Obama’s plan. He wants to start off with a huge plan and cut out parts of it if it ends up costing too much. I would rather start with a small plan and expand it when we are willing to spend more.
    Every worker is given a tax-free healthcare expenditure account, and a minimum of three to five percent of their income would go to this account. Like a 401k retirement account, one can contribute more pre-taxed income to it if one wishes. The money in this account can only be used to pay medical expenses. When the person reaches 65, it will be converted into a retirement account, if there is any money left. If the person dies, his or her spouse and children can inherit. Do not require everyone to buy a health insurance, but if you do not, you need contribute five (or more?) percents more of your income into your health account.
    The government should not set a price cap for any drug or medical treatment, but any healthcare provider, hospital, drug company, and pharmacy must charge the same price for the same treatment or the same drug. Currently a bill sent to an uninsured patient by a hospital is much larger than what would be received by an insurance company. A drug store now charges much more to a person who buys a drug without insurance than it would receive from an insurance company. Pharmaceutical companies sell the same drug to many foreign countries cheaper than to the US. This means that Americans are subsidizing foreigners.
    Likewise, health insurance companies shall sell the same plan at the same price. Currently they give large companies big discounts. A heath insurance company cannot reject any child because of a precondition. It also cannot reject anyone who had insurance but discontinued it due to situations, such as being laid off, switching jobs, or bankruptcy of an insurance company to buy a similar plan. For those adults who do not have health insurance and want to buy an insurance because of a pre-existing illness, an insurance company can not reject, but can charge an extra fee, for example 5 or more years insurance premium. Insurance companies may give a discount for those who do not smoke nor are not overweight, and may charge extra for those caught using illegal drugs.
    Encourage patients to check their bills. Previously, I’ve discovered that my insurance company once paid a hospital twice, that a hospital charged it did not perform, and that a doctor charged for a procedure different from the one that was performed. Insurance companies, including Medicare, and Medicaid should give some reward patients who find such errors.
    Set a cap for medical malpractice judgments, but increase the deduction. It can not only reduce the insurance premiums doctors buy and hence reduce the cost of healthcare, but more importantly it can reduce the waste of unnecessary procedures when doctors order a test mainly for preventing future law suit. High premiums only increase the healthcare cost, while high deduction will help decrease malpractice due to carelessness.
    Since there is a shortage of donated organs for transplantation, the law needs to be changed so that if one does not opt out, the person will automatically be an organ donor. Also it is reasonable that, with all other considerations being equal, an organ donor should come before a non-donor when determining who shall receive the transplantation.
    Some of the good ideas in the current bills, such as the requirement of digitizing medical records, can be implemented independently, without attaching it to a huge reform plan.
    Personally, I am not against using tax payers’ money to cover legal abortions. Since this is a very emotional issue and many are strongly against it, it is wise not to cover it. Let private organizations raise money to help pay for abortions.
    When Medicare and Medicaid is facing bankruptcy because it is taking in less money than it is paying out, the federal deficit is increasing by leaps and bounds, and the economic recession is yet to recover, it is not wise for the government to start a huge costly program. We should reform Medicare and Medicaid first to make them solvent. Doing so will also allow us to gain experience for future healthcare reform. If we still want to do something, then the above suggestions can be considered a compromise, even though some of them may be politically incorrect. I hope more people will raise concrete suggestions instead of shouting and saying big words.

  13. It has been interesting listening to the news, US congress, and public outrage about a government run health plan. Knowing most people have known a family member who has been out of work for an extended period of time, denied a needed surgery’s , or just needed comfort care to finish living their last day’s only to be denied. Medical plans help people who have them, and they are not perfect, what is even worse is hearing how people who don’t have medical shouldn’t be covered; everyone could go into a story of how someone they know can’t get treatment. It is also public knowledge on how much Emergency rooms are costing the average tax payer in America because they are being used as doctor’s offices due to the fact they are not allowed to turn anyone away. Yet healthcare is become such a political issue, it is almost as if everyone is scared they are not going to get credit for coming up with the solution; however, they also don’t want to take credit for backing one that isn’t 100% perfect. If congressmen and women would stop putting out false claims on what could happen and trying to scare people into thinking how evil this plan is, a solution could be reached.
    It is despicable that anyone on Capitol Hill was voted for; hearing that a public option would ruin private health care was almost laughable if it wasn’t such a dangerous claim. Workers have been told that if there is a public option companies would not get the same discounts and healthcare would go up for both the company and the workers. Here’s a fact if a public option was available and it was so good that the majority a company’s employees switched over, it could save major companies millions, offering a higher net income and possibly higher wages to its employees. Now look at the fact of all the people that get an injury that with proper medical treatment they could go back to work, instead they spend month’s applying for disability, they appealing the initial denial, before finally losing almost everything they own running up countless emergency room visits, and living on welfare before finally getting the treatment they needed to return to work. Of course that doesn’t hurt other American’s right, or is that even more costly than if someone was off work for 6mths got the medical coverage they needed and then became a productive member agian. This also has to make you wonder would it also help social security if so many young Americans did not need to be on disability because they were able to get the medical help, or if people would not need to lose or quit their jobs because they were able to take the time off for medical coverage.
    The next point all the fear messages that are being sent out by the media, first the companies are not going to lose money if insurance rates have to go down to compete. Less people will be on disability if they have the medical coverage that will get them treated before they qualify, remember under the current rules you have to be off work for one year before you can even qualify of disability. Also the dreaded public option again if it is cheaper than what you are paying now or the coverage is better, would that really be a bad idea. Many people have lost their own retirement funding because of the 80/20 plans. People would abuse the system, yes in the beginning many people would probably go to the doctor frequently to take care of several issues they have neglected for years, due to not having any coverage. The same is happening at companies that are offering insurance to its employees, those that have had it for a long time don’t need it as often and tend to be healthier because they have used when they needed to, although the ones who have not had it run to the doctors several times a month for the first couple years taking care of everything while it last. That is an all too common factor for people who care about medical, if you have it and it is good coverage eventually you don’t think about it and just use it when you have too. If you have not had it and are grateful for having it you may use it in excess for a while, that does calm down, unless you are a hypochondriac. They are going to be exceptions to every rule that does not mean that the exceptions are the rules and that is what Americans are being told, by employers, and others that thrive on people fears.
    In conclusion, while a government run anything may not be the best possible solution, having no solution is even worse, at least with a government run health care system it would open the door for private run insurance companies to relieve some of its burdens and come up with some new innovated ways of doing business. It is often when you see something else done that a new idea may come up, and possibly much better solutions. I have found stats both ways supporting universal health care and against universal health care, I guess it just depends on which opinion I want to have that day. What is pathetic is how American’s continue to die or be out of work because people in the Media and Government can’t come together on what needs to be done and that is getting more people healthcare. I will leave you with one thought, I have an Aunt who has worked for the same place for the last 37 years and does not get health coverage, if she ever retires she will lose her home, not to mention she has now developed a lump on her throat, question is it cancerous or isn’t it? Does it even matter she will worry herself to death wondering because of the lack of treatment and if it is cancerous it will spread too far to be treatable by the time she does get coverage. So she will lose her home, and everything she has spent her life working for all because she can’t afford insurance. Who is going to have to pay for all the medical bills she leaves behind and the foreclosed home, you are that’s who. Makes you wonder if getting people in her situation medical coverage should be a concern, of course she will probably one of them that has to get on disability early and take an even bigger chunk from social security and still we argue and put fear into people just because you have the power to do so. The fact is when this next election happens the public will speak again and let everyone know if health care was an important issue, that is unless of course it gets pushed through now and then the tied can be turned onto a different subject, but make no mistake those that listen to the media and didn’t listen to their own states will not be there for the next health care debate.

  14. Thanks for the information. This whole thing is very frustrating. I am a single mother of 5 and struggling to make ends meet. I do have a full time job. The state does not help me in any way, ( I would rather do it myself anyway). Any other info on this new reform they trying to pass would be helpful.

  15. We are wanting to reform health care because of the ever rising cost and massive inflation.
    There are a couple of things that congress could do that would help.
    TORT reform. Stop the insane lawsuits.
    Fix the government run health care entitlement programs we have now in Medicare, Medicade, and VA.

  16. I think it’s time to quit “playing politics” and get down to business. If this country is serious about healthcare reform then it needs to happen. I think an excellent starting point is to nationalize healthcare and get EVERYONE on the SAME plan. Once the playing field is leveled we’re going to see a far more honest approach and a lot less political posing. It serves no purpose to have some of the people on the “elite” plan and the rest of the country on a “basic” plan. As for mandatory health insurance, get real. People on minimum wage haven’t got money for monthly premiums. If they are forced to pay for those, then they’ll need to decide which is most important. Health care or a roof over their heads. A lot of people are going to fall into brackets where they might be able to afford a monthly premium but won’t be able to use the plan because the copays and deductables are too high. Everytime I read new information, the total earnings for a family of four keeps dropping. Right now it’s sitting at 22K. With a few school loans, a mortgage and a family, how in the heck do you afford mandatory healthcare? Go figure…
    I think we need for our government officials to get down to some real planning and quit with the posing.

  17. To everyone who wants the government to control their healthcare:
    I was hit by a drunk driver. I recieved a severe brain injury and a broken neck, while he broke a few ribs and hurt his shoulder. He was out of the hospital in about 2 weeks. I was in a coma, in the hospital for two months and I have lots of brain injury related issues. He got SS Disability quickly while I have been turned down 2 times and am on my 3rd and final try. I cannot work! By the way, he had disability while in jail. How does that make sense. One of the times I was turned down, I was examined at a chiropractic office by a SS doc. I DONT HAVE BODY DISIBILTY, I HAVE A BRAIN INJURY. They didn’t test me for what was wrong. Instead they tested me for something totally different. The government will choose who and what they will cover and they will get it wrong the majority of the time. I dont trust them with healthcare. I speak from experience.

  18. What’s really in Obama’s health care reform bill? Almost no one knows, and here’s why: It’s 1,017 pages long and written in an alien form of bureaucratic English that can barely be decoded by earthlings.

  19. I want to suggest a key component that I think is missing in the debate: a Health Credit. This is how it would work.
    If I have good health (as quantified by not spending as much on healthcare), I get a health credit. This works very well within a public option system. Say each person in the program pays (say) $1000 per year to buy a public option that covers $2000 of healthcare bills for basic/preventive care including dental, vision, and generic (but not branded) drugs. The person and the government would split the cost 50/50. If that person has a balance of any portion of their $1000 at the end of the year, they roll it over to the next year or can withdraw it tax free. This should incentivize people to not spend, and the best way not to spend is to keep yourself healthy. If they want to save up for say Lasic – then they can earn earn it by staying healthy over several years.
    Like all other plans, the public option would be negotiating price discounts for mass purchase power.
    Of course in this system, people are free to buy more advanced health insurance or fee for service products. Thus the for profit insurance companies will still make plenty of money. Analogous to riding the subway for $1.25 or taking your private car for $20 on a federally funded interstate – people should have choice based on what they can afford. If you want better plan – then you need to go get a better job so improve yourself and think long term. The government shouldn’t subsidize anything above the minimum required to keep the overall health of the population high enough to be competitive in a globally connected economy. Remember our constitution says “life, liberty, and the persuit of happiness” – but not free healthcare – are rights. This must be balanced against the long term sustainability of our economy which means we as a people have a vested interest in keeping the population healthy.
    To go along with this, we need a large government funded training program to train physicians and other healthcare workers who promise to spend the first 5 (or so) years of their practice within the public option system (likely at a lower salary level but good benefits) in exchange for free or lowered tuition. This way even if there are more patients who enroll, they can be covered by the physicians or residents in training in these public option programs. The programs could be hosted by existing hospitals & clinics – who will be happy since they won’t have to pay as much and get more low cost labor. As part of this plan, the government would block or severely curtail medical malpractice claims in the public option.
    Then once physicians are done with their service, they could decide to go into private practice or not based on the best choice for them, but you’d have a significant percentage of physicians over time who belong to this fraternity and in the future would know how to reduce overall healthcare cost and provide higher value in ways we do not today.
    I also would make all healthcare records conform to basic healthcare IT data model so that as a consumer or any other person in the healthcare economy I could pay for a third party review that could spot ineffciencies and allow for clawbacks or fines on overcharges. A whole new industry analogous to the credit card credit score monitoring services would open up. Development of this data model should be facilitated by the government (just like the internet was).
    Everyone wins:
    1. People have choice and can get a good low cost plan, or any other plan they can afford.
    2. Insurance companies are free to compete for more profitable patients and win through innovative products and keeping their overhead low.
    3. Doctors don’t graduate with crushing debt that forces them to make career choices based on profitability.
    4. Hospitals get sufficient labor and more efficient business processes because of standardized IT
    5. Government saves money, builds infrastruture for long term returns, and creates jobs.
    6. New industries are created
    7. The workforce is competitive globally because we’re healthier

  20. Why doesn’t the USA step out of their bubble and look at other countries’ Health Care Systems.
    Australia – Medicare tax of 1.5% of gross income, no upper limit (if you earn a million you pay $15,000 per year) – lower income earners, pensioners etc do not pay. The average full time worker earns $60,000 per year and pays just $900 per year for medicare! Nobody complains about the medicare tax, the middle man (insurance companies) are cut out of the picture. Insurance companies now offer extras cover for elective surgery, dental cover, prescription lenses, chiropracty or naturopaths, or to have your own doctor in a private hospital (eg for childbirth you get your own gyno)
    Medical services such as hospitalisation are essentially FREE for ALL. NOBODY is ever refused hospital treatment. Yes the system is not perfect, you may have to wait a few months for non urgent surgery such as cataract removal, but let’s face it we are a much healthier nation, as there is a strong emphasis on PREVENTATIVE medicine (free mammograms, pap smears, eye tests, hearing tests etc) which saves everyone money in the long run.
    A friend of mine from USA told me she had such a sore knee which clicked because she fell down the steps a couple of months ago, but could not afford to go to the doctor… I could not believe her, she could have a chipped patella or anything and she is walking around in pain!
    My daughter got sick at the age of 12, at that time I had left my husband and was struggling trying to set up a new business, diagnosis (Stills Disease) and hospital treatment was free, and because of the excellent treatment she got she is now a healthy 18 year old, with no treatment she could have easily suffered irreversible damage and pain throughout her life… how many US children have to live in pain because their parents can’t afford insurance or treatment?
    Obama… take a good look at the systems in Australia & England. I would say the USA health system is beyond repair…scrap it and start afresh!

  21. On Tuesday, 9/29/09 at Noon P.D.T. we are asking all Americans who support a Public Option as the only remaining viable choice for health reform, to shout out “Strong Public Option” wherever they are. It would be preferable if this were done outside or in a group. Let’s put voices behind all of those emails, in the manner shown in the film “Network”. Pass it on…

  22. Dear President Obama,
    Please do not accept a bill that excludes a public option for health care. It is essential that we have a public option to keep the private insurance companies honest and competitive.
    Melodie Miller
    Voter

  23. Our health care system does have its problems but has anyone considered what the root cause is to our crumbling health care system? Could it be that our relentless pursuit of wealth is contributing to the sky rocketing cost of healthcare? Pharmaceutical prices increase routinely, but are the drugs more effective? Insurance companies never deny care they just deny payment, how do they define success, is it ethical to reward executives for not paying claims? I serve in our armed forces and receive excellent healthcare; however, I must admit our hospitals are not the most efficient; for various reasons, but the care I receive is great. I agree we need to reform our system, but I suggest our leaders in the health care system evaluate their motives. We are not simply in the business selling dealing with cars, computers or other items; we are dealing with people’s lives, who are moms, dads, sons and daughters. I’m confident that our private sector and government together can accomplish this task, if we focus on quality of care for people instead of what rights you are giving up by joining a public option plan. There were similar thoughts with Medicare, but it was the right thing to do.

  24. Interesting piece – want to hear what people want and need, check out MyamericanHealthcarestory.org for a some stories of average American’s dealing with the healthcare situation as it is now.
    Just because you have insurance doesn’t mean that you get coverage – John and Sara couldn’t get insurance to cover their child’s swine flu test. (see link below). Nellie is afraid every month she won’t be able to pay her insurance plan bill. Is this how Americans should live? We can do better.
    Nellie’s American Healthcare Story
    http://myamericanhealthcarestory.org/nellies-american-healthcare-story/
    John and Sara’s American Healthcare Story
    http://myamericanhealthcarestory.org/john-saras-american-healthcare-story/
    Ben’s American Healthcare Story
    http://myamericanhealthcarestory.org/bens-american-healthcare-story/

  25. My healthCare Finance Reform Plan:
    1. Federalize all medical staff. Pay them by the hour or by salary, not by procedure. This would stop the nickle and dime billing currently happening. The doctors most in demand would be the highest paid. Therefore, Family Practitioners would be the highest paid doctors. This would encourage new doctors to go into the fields where they are most needed.
    2. Have the doctors send bills to the govt for salary and to replenish stock & medicine. They’d still be responsible for utilities, keeping them energy conscious. Perhaps energy companies could discount medical offices, or they could go into an energy co-op. This will prevent wasteful energy spending.
    3. Pay for these salaries with a Federal Sales Tax. This way, even illegals, homeless, and visitors pay their fair share into the healthcare system. People will no longer need insurance, or need to pay those premiums, thereby encouraging more consumer spending.
    Now you can just walk in, get treated, and walk out. No bills, no claims, no fuss!
    This is the bare bones plan. More needs to be added. For example, we need ideas on bringing down costs for drug development and sales. Ideas?

  26. Until we quit allowing our political differences affect a crucial issue like healthcare reform, there will always be a problem. When you ask an average American age 55 and up about healthcare reform, the response is ‘keep government out of my business’. Did people really understand the issue on the table? Everybody seem confused. I remember before the campaign, we are all complaining about the skyrocketting price of healthcare, malpractice insurance, the almighty powerful health insurance companies and the high cost of drugs. Are we now loosing our focus?. The problem plaguing American Health system is enormous. Its time to let go our differnces and come to a common ground in finding solutions to this problem. Portability of health isurance is very important. With the state of the economy, we are afraid to loose our jobs. The slogan is ‘No job, no health insurance’. Why is health insurance tied to our job? It’s time to reform healthcare.

  27. Most people do not seem to see a conflict between giving patients every test and treatment they and their doctors want, however expensive, and containing costs.

  28. The only way to reform health care is to reward people for being healthy. We are a sick nation, obese, addicted, the list goes on. If you want health care costs to go down, give people breaks on their health insurance for being at the right weight, not smoking, having clear check ups. We can’t afford our health care because we don’t take care of ourselves.
    Don’t make it easier for people to be unhealthy by subsidiizing their health care…it’s counter productive.

  29. All of you who extol this writer’s claims should be embarrassed. This man gives no warrants for any of his claims about these health care polls.
    Humphrey Taylor is correct in saying that the majority of people do not understand the way our health care system works; however, many do- especially republicans since we understand the devastating impacts that government health care can potentially cause.
    Regardless about whether most people understand or not, most people DO NOT want government health care, and the president has shown no respect for that at all.

  30. Healthcare should be our number one priority in this world. Next to education, I believe this should be attract most of the government’s budget.

  31. It is health care and life care we need to change. I walk around the dollar store and I see un-healthy food cheap. We all should be able to eat healthy and afford it.
    We need to rebuild our sense of community and our sense that we need not be afraid of change. Exercise and active lifestyles should be normal. The FDA needs an overhaul as well as the insurance structure. If we took care of ourselves and did not consume so much bad food, we would need the doctors less. As it is, the insurance structure puts such financial burden on medical care providers, a loss of quality ends up being the final result. Doctors charge too much and patients who need it are left without a solution.

  32. DISCLAIMER: For those of you who post replies to this comment and mention 10 year old type 1 diabetics, I believe that some kind of Medicaid-like government insurance program for incurably ill people makes sense. My comment is generally aimed at the 95% of us who occasionally break something, get infections, and really just need to be financially protected from something like a heart attack or cancer.
    Think about what your world would be like if you thought about food the way you think about healthcare. You would expect your employer to pay for your homeowner’s insurance, you would delude yourself into thinking that the employer wasn’t taking the premiums out of your salary, and you would expect homeowner’s insurance to pay for your groceries. A claim would be filed every time you bought food. Your employer would lower your salary to pay for sky rocketing premiums (that in turn paid for an army of grocery adjusters and “non-profit” grocery companies). Grocers wouldn’t give you a straight answer about how much a loaf of bread costs. And bread would cost $20/loaf because no one would compare prices before buying it.
    That’s the state of healthcare. No hospital can tell you how much a procedure will cost. And you’d rather your employer pay tens of thousands of dollars for your healthcare services than take the money as salary and shop around for medical services yourself. Healthcare is not a right. Thank God. The Soviet Union made food a right. They kicked out all the “evil” profit seekers in the food industry, and that’s why the Soviets stood in bread lines for hours as they suffered from malnutrition.
    You want coverage for everybody? Don’t take my money and entrust an army of unaccountable “non-profit” bureaucrats to dispense it. Instead, fight to reduce costs so that people can afford healthcare services. Demand price transparency from hospitals. Look at health insurance the way you look at other insurance — as catastrophic protection. Demand tort reform so that OBs don’t have to worry about paying $500k in legal fees every time they deliver a retarded baby. Insurance companies make a nice scapegoat, but they aren’t the problem. Hospitals are the problem. Lawyers are the problem. And you are the problem.

  33. Thank you for this article! It all makes sense. I am listening to Janet Parshals America, and I certainly don’t trust what she is telling me–that Americans don’t want health care reform. I searched Google and found this article that helped me understand the issue much better. Thanks!

  34. I am Happy that Americans are suffering and there s no one to help. Why? Because Hilary Clinton( though I totally despise her) was Pushing for health care reform for every American that was in need in the 1980s and instead of standing by her side and supporting her ,y’all brush her aside like a bad Idea, Saying that she was promoting COMMUNIST AMERICA. instead y’all put the reigns of health reforms smack in the hands of the Large pharmaceutical and Insurance companies(the very same people who were making millions of dollars from keeping you in misery and suffering) now you are wondering what has America come to. please dont for get that this was your own doing. Karma 101

  35. I and most of you will be very pleased with the health care plan developed by our Senators and Congressmen if they will be willing to obtain their medical services under the idintical plan. I realize they will need to change the current law but that is very doable.

  36. RE: “Where are the doctors who are willing to say they are willing to give up a chunk of their personal gain from our broken system to make it better.”
    Right here: http://www.pnhp.org/
    “Wouldn’t it be pretty to think so?” You were hoping THESE doctors would provide you with your free care? After all, someone has to actually DO the WORK.
    These PNHP doctors have already removed themselves from primary care (with the partial exception of the Harvard professor), and do not have a dog in this fight.
    Look up the officers: Academics, researchers, policy wonks. If they are truly volunteering to give up their teaching jobs to work for free at a government clinic, I commend them.
    But that isn’t what they’re doing. These individuals have left the arena, and yet proclaim to represent actual doctors who see patients for a living. I find it detestable.

  37. NewsFlash! American Poor: Fattest People on Planet – Now Also Dumbest?
    -I wish this was a joke-
    LiveScience.com – Tue Aug 25, 10:35 am ET
    A new study finds obese people have 8 percent less brain tissue than normal-weight individuals. Their brains look 16 years older than the brains of lean individuals, researchers said today.
    Those classified as overweight have 4 percent less brain tissue and their brains appear to have aged prematurely by 8 years.
    The results, based on brain scans of 94 people in their 70s, represent “severe brain degeneration,” said Paul Thompson, senior author of the study and a UCLA professor of neurology.
    “That’s a big loss of tissue and it depletes your cognitive reserves, putting you at much greater risk of Alzheimer’s and other diseases that attack the brain,” said Thompson. “But you can greatly reduce your risk for Alzheimer’s, if you can eat healthily and keep your weight under control.”
    The findings are detailed in the online edition of the journal Human Brain Mapping.
    Obesity packs many negative health effects, including increased risk of heart disease, Type 2 diabetes, hypertension and some cancers. It’s also been shown to reduce sexual activity.
    More than 300 million worldwide are now classified as obese, according to the World Health Organization. Another billion are overweight. The main cause, experts say: bad diet, including an increased reliance on highly processed foods.
    Obese people had lost brain tissue in the frontal and temporal lobes, areas of the brain critical for planning and memory, and in the anterior cingulate gyrus (attention and executive functions), hippocampus (long-term memory) and basal ganglia (movement), the researchers said in a statement today. Overweight people showed brain loss in the basal ganglia, the corona radiata, white matter comprised of axons, and the parietal lobe (sensory lobe).
    “The brains of obese people looked 16 years older than the brains of those who were lean, and in overweight people looked 8 years older,” Thompson said.

  38. PEOPLE…..this health care reform will happen, I hate it, but there is a whole world out there with solutions, I know i would’ve never thought about leaving home just medical care but I did. the government is only good at collecting taxes and expending more than they collect, so they don’t care they are too busy playing golf.
    friend of mine took actions.
    http://www.truthaboutmedellin.com/medical.html

  39. We CAN DO IT if we use a common sense approach.
    FACTS/PROBLEMS:
    1. Patients are unhappy and fearful of loosing coverage
    2. 50+ million uninsured. Many more under-insured. Even these numbers are conservative.
    3. Only 14% of our doctors are GPs (includes internists, Family physicians, pedriatician). 50% in other countries.
    4. Doctors esp. GPs are unhappy. They are underpaid unappreciated and earn much less. They are overworked.
    5. Only 2 % of doctors are trained to be family physicians(FP)
    6. Patients want the latest and greatest, but
    unwilling to pay for them.
    7. Escalating healthcare cost
    8. Destruction of our healthcare system by the
    current campaign financing methods. Elected officials
    are more concerned about their re-election .
    9. Little or no regulation of health insurance companies, HMOs, for profit hospitals.
    10. Americans pay more for the same drug than patients
    in developed countries.
    11. System too complex.
    12. Health insurance companies cherry pick patients –
    they play games.
    13. Our current system is only effective in treating
    and suppressing symptoms of disease. There is no
    focus on prevention.
    14. American lifestyle is not good for health –
    obesity, inactivity.
    15. No incentive for being healthy.
    16. Food companies , pharmacies make more $$$ if more Americans are SICKER and SICKER.
    17. Development of unnecessary drugs – eg. to prevent
    menstruation, to prevent urination. Combination of drugs. Once a month/week pill instead of a daily
    pill. Not much research into drug resistant TB, malaria,
    aids, etc.
    18. Development of dangerous drugs with more risks, side effects than benefits. Invasive procedures.
    19. Fraud and abuse
    20. TV ads for pharm drugs.
    21. Practice of defensive medicine. Only lawyers not
    patients are winners here.
    22. 1/3 of medicare cost is going towards heroic attempts to keep the very sick and old alive.
    No focus on quality of life for the patient. This money should be directed towards preventing chronic illnesses.
    I do not advocate killing anyone by denying treatment
    that can restore quality of life. We need to use
    common sense.
    23. Emergency room is flooded with people who have
    no health insurance.
    24. We are not able to control illegal immigration.
    25. We have no guest worker program – hard working people need basic coverage.
    26. We are allowing legal immigration of older people
    who could place more load on our inadequate healthcare infrastructure.

  40. The problem with the current Health Care reform is that it is centered on the 50 million who do not have insurance instead of lowering costs for all. I have a number of pet peeves. The first is doctors who charge more for cash patients that for those with insurance. This could be easily reformed, but doctors hands are tied most of the time. They have to change the medicare list price or the insurance company will consider the lower price as list and want their contracted discount. Now that is bull. Second malpractice liability should be taken over by the government. Local review boards made up of citizens should determine awards and should have the right to pull a doctors license. And all records should be public. I want to know who I am seeing before he does something bad to me. In 2006 insurance companies spent 30 billion to fight and pay medical liability claims while taking in 190 billion in revenue. There is a problem here that can be fixed. I don’t think we need tort reform to fix the problem just a better way to finance it.
    Third we need to control costs and this can be done by making sure that new technology reduces costs. Most of the over spending in the American medical system is in the fact that medical technology has no incentive to reduce costs for things they bring to market. Every study I have read bares this out. The real over spend in the American system is in out patient costs where the most profit is as well. Hospitals make 280% profit on these types of services and is the cash cow for both doctors and hospitals. We need to know what things costs in the system. If I have a $20 co-pay then to me the doctor visit cost $20 not the $220 the doctor is charging. Or the MRI that I pay nothing for but costs $800 or a $1000. We need to know what things costs so that we can ask the right question.
    The health care debate that is going on in Washington is all lies from both sides and I have not seen anything that is going to help the average American worker. we want real reform

  41. I don’t understand the details of the problem. I’m neither an economist nor a politician. I don’t have an agenda. I do have health insurance.
    I believe that capitolism, as a system, mimics natural selection and leads to a better market through survival of the fitest. I believe that a government exists by the people for the people. I believe that when capitalism is applied to a government we no longer benifit from either. I know I don’t have the capability to reconcile the two systems. A separation of wealth and state that I liken, in my mind, the separation of church and state being a difficult problem we face.
    I believe the health care reform is a symptom of that broader problem of market(consumer and provider) influence on our political governance. I’m calling it like I see it.
    I know that our society is above our government. It is founded by good neighboors forming communities that succeed in every way because they care to. I live in an amazing and wonderful American Society. In my “-‘hood” we work together. We find each other houses, cook for one another, scout for jobs with each other, and build our lives with each other. One where The People treat each other with dignity, respect, and understanding. At times agreeing to disagree, but always sharing the table. The government isn’t needed when people work hard, it gains power when people are too lazy to do the job themselves. I’ll do it. I’ve done it. I can’t watch my neighboors get sick and die. Yet I wont quit.
    I’m a health care professional.
    I support health insurance reform.

  42. Thank you Dan,
    I too am a college student, now transitioning into the working world through massage therapy. As an uninsured American citizen I find myself in debt for a hospitalization that, while brief, cost me thousands of dollars. While I try to understand people’s resistance to change as a result of deeply held beliefs about what makes our country strong, I am saddened that amidst historic wealth (present–hopefully- briefer- than- expected recession/depression aside) we as a people do not consider healthful and disease free living a right worth striving for in everybody’s life in the coming decade. Simultaneously, I am so gladdened to see the tradition of protest carried on, where’s the music and dancing? Apart from the difficulty I have in truly understanding the capacity of policy to initiate healing, I see a beautiful light forming in the democratization of the healing arts through greater acceptance of simpler, more traditional, preventative healing techniques that are relatively less expensive than after-the-fact toxicity directed at pathological conditions. Modern miracles through science and technology seem to occur with increasing regularity and remind we of our progress towards the possible and preferable. At the same time, this rising up of traditional and inexpensive preventative medicines, including intelligent and available exercise points firmly towards our shared benefit. There is so much to agree on once our hearts realize the progress of the recently passed century and the coming together of healing traditions from around the world, and strongly from within our own history. Optimistically, I believe that the truth is we have all been given some capacity to heal both ourselves and the world around us, should we find our will and love strong enough to face the challenge of our limitations and powers.
    (I ramble amidst the relaxing pleasure of an anniversary ale- excuse the collegiate mind and take what you will from this message)
    thank you for your attention and thank you for the path of healing 🙂
    humbly yours

  43. As a self employed person for 17 years, I have watched my own personal premium start at $325 for my family and go to nearly $2,000 when I was forced to drop it due to the sheer weight of its expense. Now, uninsured, I have been turned down repeatedly because of my Type 2 diabetes. My republican friends (who all have high tech jobs and insurance coverage) tell me to quit my whining and get a real job as if all I have to do is walk out the door and walk into a full time position at Intel or Microsoft. My family is no longer covered and all these conservatives simply argue that we should not reform health care because it will mess THEIR existing plans up. So far that seems to sum up the arguments that I have been hearing coming from the right wing. No health care reform because it will mess up or disrupt what we already have in place for ourselves. For those that don’t have health insurance, just wait a little longer and the law of supply and demand will cause more competition and prices will fall. In the 17 years I have been self employed and paying for my own plan, I have NEVER once seen prices fall. They have gone up for me $100-$200 each and every month without fail. I figure, in 17 years, if the law of supply and demand and good ole capitalism will drive down health care affordability, it would have materialized by now.
    I am now enrolled in college to study for a degree in nursing. I figure, if you can’t beat the beast, you can join them. You can follow more about my career transition from self employed to college student to nurse on my blog at http://www.mycareerdoover.com

  44. Tyronne, I am not at all behind the Obama poster with the Hitler mustache–one bit. (Yes, I am white.) I do not like it one bit. However–the message is not anti-black. It is anti-socialism–right or wrong. I think you are short changing ppl like me who celebrated Obama’s win. Hubby and I actually made a holdiay this past election. We voted–went out to eat (a very rare thing for us)– in celebration–and returned home glued to the TV for the results. We love our president.
    Health care does need reform. There are many who are questioning if they have it right. I have questions. The GBO is saying that the amount wasted in fraud is not that significant. I just cannot believe that–at all. All these years and little has been done to find it and stop it. 20/20, Dateline and 60 Minutes can find it–but the GBO says it’s not there. Mmp!
    The 47 million–that can be brought down to about 8 million who are actually falling through the cracks. Many of the 47 million figure are illegals. Others just chose not to buy insurance–like my 30 year old neighbor–he would rather a steep BMW payment than a policy payment. (I drive a ’94 Jeep and buy my own.) He’s 30 and feels invincible. I am 61 and don’t.
    The illegals–our President says they will not be included. How can that be? Part of the discussion for the last many years is that they are over burdening the health care via emergency rooms, etc. So–if this passes–they will stop doing that? The hospitals will give it to them for free? They will all go home?
    I have posted before–obesity is a huge expense to health care. Our food stamp program buys all the junk food a convenience store carries. I do not see any change to that proposed. Keep the amount they receive–but cut out the junk.
    No tort reform included in this. Why not? Again it is argued that it would not make much of a difference–bull-pucky. I just cannot support this without some sort of tort included. I’m sick and tired of making lawyers rich–especially those well connected.
    End of life–this has ppl up in arms. Obama is not out in front of this. The bill is still in it’s formation and the town halls have congress members that are addressing a bill that is not finished, yet. It has ppl riled up. Much of the mis-information is not because Obama is black–the color is green-as in money. The various groups that are behind much of this–it is money driven. Not race driven.
    There is a sense of fairness issue, too. Right now Medicaid will cover hearing aids. My policy does not. My husband suffered a sudden hearing loss from a virus. Poof–deaf in one ear. I now yell to him–because the hearing aid needed is over 2 grand. This is just one example. It is getting ppl riled, and rightfully so–that they pay for others what they cannot afford.
    This bill–so far–is not addressing this.
    But, back to your post, Tyronne. I watch the TV news all the time–Fox, MSNBC, CNN equally. All 3 showed that poster being carried–and I saw some black folks carrying it, too, at those town halls. I attended Bernie Sanders’ town hall–and he was depicted with a mustache on one of them in the crowd.

  45. OK–Illegals are not covered. We just give them the emergency room care–just like we do now–so is that a difference without a distinction? The big hoopla in the beginning was all about the costs of illegals to our health care system–the strain on it–blah, blah, blah. So–now this is free–without a cost?

  46. This healthcare situation is just amazingly stupid! President Obama is trying to do the right by Americans. And you got these stupid white so-called American. Mad about no body knows what. They are just yelling! Then you got the white stupid racist media that repeat the same talking point. ” President Obama should have started off better explaining his healthcare program! If President Obama fails to get his plan past then he is a failure as a President. Which is just not true. Sane people know that JOBS and geting the country back from the stupid situation President Bush put the country in is not easy task. Shamefully republicans that voted for the Iraq War that took to date 4,339 American troop FOR NOTHING! Where quick to vote for a war that was a lie. President Bush didn’t have to do much explaining. The 911 report stated that President Bush and the idiot that sent American troops to Iraq. Forgot armor that could have saved 750 troops from death. The healthcare bill will help 47 million un-insured Americans. And sick white Americans call President Obama Hitler?

  47. It wouldn’t remove the patient’s civil rights to file a suit. But, putting caps on claims that are granted by juries, in my opinion, is needed. It is estimated that at least 40% of suits are lost–but with the system the way it is–frivolous–it’s like — what the hell–let’s try–I got nothing to lose
    If you are ever on the other end of one of these suits–you would know what I mean. Being in business, we have faced four–so far. It would not cover just medical–but the suit system in general. Like the over weight man who came into our parking lot in the middle of an ice storm in moccasins and fell on his ass. He lost–but we were out over 5 grand facing it. Under tort, he would have paid my defense. He suffered no injuries–except black and blue on his butt. We also own a laundry-mat. Had to defend against a suit where a lady washed her daughters prom dress in hot water–ruined it–and filed suit. I defended us in that–but it took a great deal of my time. The third one–this is the God’s honest truth–a child was pecked by a chicken. A person brought a live chicken into the laundry mat–and it pecked another customer’s kid. We lost that one–and had to pay the medical costs for the kid. We did not have adequate supervision to stop “pets” from entering a non-pet zone. I swear–this is true. The person with the chicken was not sued–they were broke. They sought punitive–but lost on that.
    My father sued and won–he woke up during major surgery in 1964. He had a heart attack and a mild stroke. He felt everything being done–unable to speak. His compensation was within normal limits–it was years ago. Tort would not stop a patient from suing for things like this–but would bring to all a sense of fairness. Not all are stupid suits–but tort would put a stop to those that are.
    OB/GYN average mal-practice premiums are over a hundred grand per year, now. And climbing. If we are going to do an entire health care reform–with more ppl coming into the system–we have to do a bit more to encourage ppl to go into medicine. Right now–in my estimation–without tort we will face a huge shortage of professionals.
    My insurance was paid by a school district–I am a retired school nurse teacher. Today–that school doesn’t have a nurse. Not enough SNT graduating. The secretary will check children for the H1N1.
    No, Peter–good tort reform — in my opinion–is crucial in a proper health care reform. So that is is fair to all parties.

  48. Glenda, if you were injured by a doctor/hosptial/nurse what would you say about tort reform then?

  49. ICan anyone explain why Tort reform is not included in this new proposal?
    For years and years, I volunteered in free clinics. The last one, over 8 years ago, I had to sign a form that I was aware that no immunity or exemptions were being granted to me regarding law suits. I walked out and never returned.
    I am hearing estimates of costs lowering from 10%-30% with proper reforms, caps and loser pays.
    I just cannot get behind this bill with NOTHING being done about this. I know Congress is full of lawyers–but this is just too important of an issue to not include.

  50. it’s disheartening that so many who should be the “opinion leaders” on this issue nowhere to be found–or are not interesting enough for the media. No one trusts the insurance companies, or hospital CEO’s, and certainly not the politicians, so where are the doctors?
    Where are the doctors who are willing to say they are willing to give up a chunk of their personal gain from our broken system to make it better.

  51. Peter, being 61, I have seen our society change so much. Both my and my hubby’s Mom never worked out of the house. Nobody’s Mom on either of our blocks did back then. These ladies were domestic engineers. I mean–it was a matter of honor that she put on a good dinner each night. We were at 6PM sharp–hubby was at 5PM. Back then the Dad’s salary went much farther. Why? Gov’ts were smaller–all levels. My Gram moved in with us–today she would be boarded in a nursing home with several gov’t agencies tending her needs. Mom tended them back then. I am not saying today is better or worse–it is just different–and it costs a lot. We played outside all evening–teasing not to come in. We exercised the fat off. Today–I cannot allow my grand kids out–there are 42 registered sex offenders in my 2 mile radius.
    My son has a good job with a power company. Last year he paid over 36,000 in income taxes. His property tax is now over 6 grand a year. The house cost the prior owner 769.00 in 1988. My daughter-in-law, also a RN works 12 hour shifts. My grand kids are fed by me. I am an excellent cook and big on nuritition. I send over their dinners. My daughter-in-law HAS to work. A life style option that my mother had is no longer feasible. If it weren’t for me–they would use take outs way too often–high fat, high calorie take outs. LOL–I’d like to know the number being sold tonight. My daughter-in-law comes home exhausted. I see her get out of the car–and I remember my Mom in pearls and high heels. Oh, Peter–things are so different.
    The blame? Governments–all levels. Too big. Too expensive. We are doing too much for too many. Right now–pick up your phone book–look up a particular gov’t agency. It takes forever–there are so many. They did not exist when I was a kid. Any time a tax is passed–it is permanent. No–I cannot agree with the fat soda tax. It will be just as mis-used as the social security tax. It makes no sense for taxpayers to pay for the cause and the cure. Now that paper food stamps are not being used–it is difficult to discern the food stamp customer. The EBT card is accepted just like a credit card. You can be behind a user in a line and not know it.
    Yes–not all over weight ppl are on SNAP. If I had the power to turn the clock back to 1955–you would not see the number of fat ppl that we do now. It was different–just different.

  52. Glenda, I agree that items on the food stamp list are as much about politics as they about hunger:
    http://www.fns.usda.gov/FSP/retailers/pdfs/eligible_list.pdf
    but not all fat/overweight people are on the SNAP food program. I agree with the fat tax but not so much as it will change peoples habits but that it will collect needed money for healthcare as these fat people with no medical insurance start getting sick – that is as long as the tax is dedicated to healthcare and not rolled into the general (slush) fund. I agree it should be a visable, up front, at the counter tax and not hidden – but that’s how state/local politics works – find another taxpayer to collect from, not your own. I have said before that it is a myth that Americans don’t like taxes, they just like other people’s taxes.

  53. Just a quick post about this “Soda Fat Tax” being proposed by so many states, including mine–New York–and how it affects food stamp recipients.
    Retailers are not allowed to charge sales tax on food stamp benefit items. It makes sense inthat taxpayers should not have to pay 8% (or so) more on these taxable items.
    However–if a fat tax is added–it will not be done at the retailer’s register. It will be done as a pre-paid tax. Otherwise known as a hidden tax. The wholesaler will collect it upon sale to me, a retailer, and then in turn they pay it to the government. I will not be required to get that tax out of that item at the time of sale.
    It is a devious way for the states to get the federal taxpayers that pay for the benefits to actually pay that tax now.
    If the purpose of this fat tax is to discourage purchases and consumption of soda–because states have to pay all the health care results from this crap–why are we allowing that purchase in the first place? It’s the dog chasing it’s own tail. It’s just so pathetically dumb.

  54. Peter–If I had a dime for every kid I have diet advised since 1978 I could retire on a private island. The system works against ppl like me. Quick story — to get the kids to eat a good healthy snack– I fixed carrot sticks, celery sticks, cheese cubes–put a little low fat dressing in a dunking cup. Cubed melons and even got my dairy company to do a deal on half pints of low fat chocolate milk. Offered it up at MY cost. The food stamp program notified me if I did that any more my authorization would be removed. We are not allowed to sell “prepared” food items.
    It is the system. Peter–I see mothers buying Mt. Dew by the 2 liters–I KNOW they are putting it in their toddlers bottles.
    I am no political science graduate–but the lobbyists for Pepsi-Frito, Coke, etc. have more power than small shop owners like me. It is up to us all to write our reps and demand change in the food stamp programs. Let me say this–if they DID do the change–I would lose sales. I am saying–it IS that bad–that change needs to be done. I have never seen kids so over weight. The poor dears waddle up to my register. It is heart breaking.

  55. “Why are we talking about increasing costs, when there is no much waste to be trimmed.”
    Jeff, one man’s waste is another man’s income, or at least a politician’s campaign donation or future lobby job.

  56. “I run a small store and see this all day long. Kids waddling up with arm loads of this crap. It’s legal. It is allowed.”
    Glenda, why don’t you take a moral stand then and refuse to sell “this crap” to them?

  57. Just want to give a shout out (wink, wink) to all the enthusiastic shills who have done such a great job at the townhall meetings these past few weeks learning your lines, ratcheting up the drama, shouting at the tops of your blessed little lungs to help our blessed health insurance industry. But, hey, do me a favor? Don’t tell anyone how much we paid you, mkay?

  58. The insurance companies did agree to stop rescission and pre-existing condtion clauses in exchange for everyone being required to have insurance.
    Their explanation for that stance was solid.
    That in itself would improve the situation drastically.
    Rather then providing a free ride for so many the bill could restructure costs to expect the vast majority to pay some of their heatlh care costs, even if minimal. The way it is written now the costs of much of the population falls squarely upon the middle class, and they cannot afford the costs. As well it falls on those that employ the middle class and provides a free ride for those that employ at lower wages. That encourages those that hire at better wages to cut their wages or get rid of employees, while the rest are expecting them to pay for their health care.
    Beyond that, read the CBO reports, if the bill isn’t going add to the deficit long term, and not help overall premiums or health care costs, what is the point of it? There are easier and cheaper way to get coverage for the 47 million. 27 million of who are small businesses or their employees, 9 million who are foreigners, nonresident aliens and illegal aliens are not covered anyhow, some of who make more then 70,000. And others who are eligible for current programs, just have’t enrolled, since they apparently haven’t felt they needed health care.

  59. Equal (substanderd and inadequate) oportunies.
    Up to date, 1977?
    Got will laugh at our futile clinging to a false god, healthcare.
    If you depend on a health system to stay alive, you are about to drop off the evolutonary cliff.
    Only if you control your own health care dollars will you get value for your own health.

  60. >>We need to show the world that we won’t stand for this.<<
    The world? The world is still dumbfounded we haven't figured this out yet.
    To quote Uwe Rienhardt, "Go and explain to God why you cannot do this. He will laugh at you."
    And we should be deeply ashamed if we don't at least move a bit more in the right direction this time.

  61. I’m trying to start o twitter movement.
    I’d appreciate it if all those who oppose the Health Care Bill could tweet #NoHCBill
    We need to show the world that we won’t stand for this. If other Trending Topics can make it on the news so can this one.
    TWEET: #NoHCBill
    (I am not trying to offend ANYBODY …… we’re all entitled to our own opinions)

  62. No one is to blame but Mr&Mrs America Fool. First there’s the doctor who finds that he gets paid less for every hour of patient contact than a plumber and then figures that at least he’ll get paid in egomania remuneration. So he tries to enjoy having gone from the high school geek to the God in White Coat as his reward for a life of hard work having no life. He likes to dispense good health care, doesn’t give a damn about the payment– his wife runs that part of the office if single practitioner or an office manager does if in a group. All he worries about is doing the right things and saying the right things to make you feel better as if he were the Burning Bush doing miracles. But in fact he knows little and is only groping in the dark. The HMO capitations dump so many patients on him that he barely has time to think– never mind time to learn the new genomics revolution at the cutting edge of medicine. It’s all foreign language to him for the medicine he learned less than a decade ago is based on physiology, not molecular biology; his chemistry and physics he forgot and counts on the miniskirted drug rep with a college degree in jazz ballet to tell him what drugs to use and why. What with legal and “best practice” blah, blah, blah thrown at him by journals that are 80% drug ads, he works most of the time off of a Chinese menu: ColA: signs&symptoms; ColB: diagnoses, ColC: treatment– all in algorithms that protect him from the lawyers….so he thinks. He is forced the give the patient 5 min. If the patient can’t articulate the problem in the first minute, it doesn’t matter, we’ll catch on the next 5 min. visit…..and so it goes until the cancer is caught too late to really be killed. Secondly there’s the patient who deems his disease as a big bag; once it fills with symptoms and is too cumbersome to carry around he goes to doctor, drops it on MD’s lap and says: “my insurance pays you to take care of this…I don’t want it anymore…I just want to get back to my regular life.” Thirdly there are for-profit corporate insurers. They know they didn’t sell insurance, just a rigged roulette table. The chances that your house goes on fire are minute, but you get fire insurance anyway, just in case. But you getting sick is inevitable– especially as you reach 45 to 65… you are at highest risk then of serious, chronic, irreversible and thus expensive diseases like cancer. That’s why a lot of people lose their jobs at around 45 and have to wait 20 years until Medicare kicks in to pick up their diseases, unable to find an “insurer” who covers “pre-existing conditions (whatever that means since many can be said to have been “pre-existing in your genes at birth). By then serious chronic illness is so sure that insurance wants to leave it to Gov because they don’t sell insurance, they play actuarial statistics for big profits and dump you as soon as these are at risk. The same Wall Street that killed your economy managing it for profits is now managing your health for profit. But since you join the work-force at 20, it takes your bosses money for health “insurance” premiums to play the spread instead of the odds. By the time you reach a streak of bad health luck (~ 45), they find excuse to dump you or raise your premiums to unbearable. But stupid Americans don’t care. 80% haven’t reached that inevitable point so they think they are fine. After all, American education consists of learning how NOT to think ahead and enjoy your freedom to watch TV while someone else is in charge of your life. Our schools teach you to sell your freedom so you don’t have to suffer the responsibilities that go with them. HMOs know that you don’t care what your “insurance” is like so long as you have it because, hey, at 20 who gets sick? From medical education to funeral, America is a rip off– overpriced for the little it gives. Someone always makes much more than a good living from your devastation….HEY! THAT’S THE AMERICAN WAY OF DOING THINGS. HMOs are like jungle predators. They hit the very young, the debilitated and the old whenever they can and devour them in their utter ignorance. They are cannibals eating their own species for profit. They are Bush-it “entrepreneurs”– French for THE TAKER IN BETWEEN– who does nothing but set up a toll at which he charges for things to go through. That’s whose keeping Gucci going; they can afford it at your expense. They like the taste of blood– your blood– because their gut can convert it into wealth for manure-eating entrepreneurs. For OUTRAGEOUS profit corporations stack up like saprophytes between you and your doctor making out like bandits (why does a tongue depressor cost 10x the price of a Popsicle stick like the $50 hammer and $100 toilet seat for the Defense Dept.?). BUT HERE’S THE REAL ISSUE. YOU ARE AN IDIOT BECAUSE YOU DON ‘T WANT TO TAKE TIME AND INVESTIGATE THE CURRENT HEALTH CARE SYSTEM YOU DEPEND ON TO STAY ALIVE. Like drinking, smoking and sweets&fats eating you do, you are an irresponsible hedonist who doesn’t want to be bothered and doesn’t understand that FREEDOM IS A RESPONSIBILITY. So you go on and on, pissing in your doctor’s face because you waste his time babbling rather than coming in ready to answer his probing questions and then you never see yourself as HIS/HER PARTNER IN YOUR CARE — shared responsibility– once you dropped off your bag of illness and paid your co-pay.
    IT IS YOUR FAULT…NOT THE HMOs, BECAUSE THEY DON ‘T HIDE THEIR PREDATORY NATURE IF YOU WOULD ONLY BOTHER TO LOOK BEHIND THE STUPID TV ADS……NOT THE DOCTOR, HE TRIES TO HOLD OUT AGAINST HIS INEVITABLE DEFEAT AT THE HANDS OF DEATH, PROLONGING YOUR LIFE AS LONG AS HE CAN….NOT ALL THE “ENTREPRENEURS THAT GET BETWEEN YOU AND YOUR DOCTOR AND COLLECT PROFITS LIKE MAD BECAUSE THEY ONLY GET TO YOU THROUGH THEIR DRUG ADS…..IT IS YOU DEMANDING THAT YOUR DOCTOR PRESCRIBE WHAT YOU SAW IN TV COMMERCIALS.
    Yes, in the end it is always smug you– Mr&Mrs Ignorance is Bliss. You are like the dog at the vet…you don’t know whether he’s trying to repair you or hurt you, so you bite him as soon as it hurts. Dr. Obama is trying to fix YOUR healthcare system before your employer dumps you and so, like the dog, you bite him. You like your “coverage,” so why bother? Employer paid healthcare was a gimmick started in the 1950s to attract employees. Now nobody needs employees so why pay the ever rising premiums? But you are too short-sighted to wonder what will my plan be like for you when you’re 40, or 50, or anytime you reeeeaaaalllllyyyy get sick? You take no responsibility…. you want to learn nothing…. after all, you’re a happy follower, not an exposed leader and master of your own fate. You are caught by HMO lobbyists like squirrels trapped with peanuts. So you go to Town halls to show how big Viagra made you, not to show that you think and learn….You pretend you read the whooole plan when all you have is the page number of the sentence or two the lobbyist gave you to site in your attack. Just as you didn’t study in school you don’t study now. You think you are Constitutionally entitled to express your opinion…. but you never heard of a responsibility to study the issue on which your opinion is based.
    That “dumb n–ger Obama who is anti-American and foreign born,” as so many of you call him– a total series of lies to cover-up your view of him as a “n–ger” trying to impose “socialism” on your healthcare….even though all he tried was to give you a choice so you can choose which better serves you– for-profit predation or Federal social-conscience. But what you don’t know– BECAUSE YOIU DON ‘T WANT TO KNOW– is that US medicine AS PRACTICED TODAY is for average people– as opposed to millionaires– below that of most Western CAPITALIST countries that provide single-payer healthcare because it is technologically backward contingent of big profits for HMOs and PHARMA so everything is overpriced except for your primary physician (who is UNDERPAID), and everyone but your boss who pays is making out like bandits by making your care SUB -OPTIMUM so it doesn’t cut into the massive profits. It will take a lot of money up-front to fix this current for-profit mess so you can get better and scientifically up to date medical care. The HMOs don’t want to lay out the money, they just want to get rich on the POOR CARE you now get. You are only a dumb squirrel trying to cross a busy highway if you don’t bother to look and investigate. Are you thinking: Hell, I’m covered…I can smoke…I can drink….I can eat crap…I’m covered and they have to take care of me because I’M COVERED”?
    WELL YOU’RE NOT COVERED BECAUSE YOUR HEALTH IS DANGEROUS TO AMERICA ‘S CORPORATE PROFIT HEALTH– and hey baby, better you than them! So you take their handout, read your lines at the town hall and bully the speaker figuratively spitting at that “N–er Obama” trying to socialize your healthcare. The for profit corps and HMOs and PHARMA can count on you because you are a total lazy ass who never really wanted to educate himself on how to use the advances of medical research for a better life for you and your family: “ain’t my job…I pay the doc to take care of that and I’m not interested in all that readin’ and thinkin’!” But if you don’t, you are a fool who has a damned good chance to die for profits. It will be YOUR fault because you are the one so smug who just verbally spit into the face of your Congressman!

  63. It’s more like–what do I NOT want? I do not want to blow my tax dollars out of both ends. Why does the Food Stamp program (now re-named SNAP) allow the purchase of sodas, candies, ice creams, confections, chips, dips? Hell–I run a small store and see this all day long. Kids waddling up with arm loads of this crap. It’s legal. It is allowed.
    Let’s save money–and have the insulin injections available at the cash-out? Mmm? Do it all in one trip. Now–that would save tons of money.

  64. It’s wonderful to talk about prioritizing health care spending in favor of value-based benefit design and taking back resources from treatments which do not justify their cost in terms of quality-adjusted life-years. Try telling that to a family member whose parent is admitted to the hospital with a terminal diagnosis and has to make medical decisions on their behalf. Even a 10% chance of success seems worth trying, particularly if you’re spending health plan or government money and not your own resources.

  65. According to a Price Waterhouse Coopers study, half of our health care spending (about $1.2 trillion per year) is wasteful. You can read the Wall Street Journal article about it at http://blogs.wsj.com/health/2008/04/10/report-us-wastes-more-than-half-of-health-spending/?mod=WSJBlog .
    There was also a recent ABC news report showing cases of Medicare fraud. They showed case after case of businesses that didn’t do anything other than bill Medicare while providing no services. I beliieve that they estimated the impact to be about $600 million per year.
    If we could get rid of just over 10% of this waste, it would pay for the current estimated costs. If we could eliminate all of this waste, our insurance bills could drop in half.
    Why are we talking about increasing costs, when there is no much waste to be trimmed. If you “follow the money trail”, I’m sure it’ll lead back to our politicians.

  66. A pop quiz: What famous “communist” said this:
    “The discoveries of healing science must be the inheritance of all. That is clear. Disease must be attacked, whether it occurs in the poorest or the richest man or woman simply on the ground that it is the enemy; and it must be attacked just in the same way as the fire brigade will give its full assistance to the humblest cottage as readily as to the most important mansion… Our policy is to create a national health service in order to ensure that everybody in the country, irrespective of means, age, sex, or occupation, shall have equal opportunities to benefit from the best and most up-to-date medical and allied services available.”
    Winston Churchill, 1944.
    It will come as quite a surprise to all of our allies in Europe, Japan, and elsewhere that they are living a communist nightmare. Better go warn them!

  67. >>Anyone who thinks they are “ours” is a communist. Go find another country.<<
    Too funny!
    Since you've elevated the discussion:
    My friends and I (you know, the majority) are thinking you all ought to move to Texahoma or somewhere with the prarie dogs and secede and live the Ayn Rndian dream. Go Galt, baby!

  68. How true. That is what I have been arguing with people that public outburst by few is not an indication of lack of public support. Leaders need to lead.
    We all are responsible to make the reform happen…may be not reform but transformation. I just wrote an article “The villain of Healthcare Reform” on my blog.
    rgds
    ravi
    blogs.biproinc.com/healthcare
    http://www.biproinc.com

  69. Regrettably this very articulate summary points to health reform by fiat from “elightened” politicians who reportedly know more than their own electorate. These comments that suggest politicians should take matters into their own hands is not exactly what a democratic society is about. The reform debate and proposals to date are about budgets, not health. Why would we discuss paying for something when we do not know what we are buying?
    Please read my Blog for suggestions on health reform that might actually work. http://tiny.cc/0QWIT

  70. President Obama, we are tired of the Whitehouse trying to sell us health care reform. You know, I know and the American people know this is really about more government power and control. Our biggest problem has become our government! Stop! Just stop all this nonsense! Do not treat U.S. like we are stupid, ignorant morons! Join U.S.!
    Do Not Sell Out “We the People” of the U.S.A.! We Trusted You!
    President Obama, great Presidents do Great things! They have great Honor and Integrity! We know you can do it! “We the People” know the truth! We want to hear it from you! Please join U.S.! Tell the American people the Truth! Confess! Americans are forgiving! We feel if this took place, a renewed Spirit of Patriotism could spread through our government! The American people have never lost our Spirit of Patriotism! We never will! Join U.S.!
    “Few men have virtue to withstand the highest bidder.” –George Washington
    President Obama, You owe nothing to the manipulators who bought your way into office. Those people only used you! Americans do not want to use you. People have been using you and lying to you all your life.
    You Have to Betray Them or Betray the U.S.A.! What’s Your Choice?
    Look at the people of the United States. We are real! We are good people! We are intelligent and can think! The elitist mind is really small and weak! The elitist people are selfish and twisted. We just want a President with Honor and Integrity. This is your big chance to become the Greatest President of all time! You need to lead our government by example, with Honor and Integrity! President Obama just do the right thing!
    Join “We the People” of the U.S.A.!
    “Experience has shown that even under the best forms of government those entrusted with power have, in time, and by slow operations, perverted it into tyranny.” -Thomas Jefferson
    President Obama:
    Can you stand on your own?
    Can you make your own decisions?
    Can you be a man of Honor and Integrity?
    If we have any other elected or appointed “public servant” leaders in our government who have any Honor or Integrity left inside them, they should come totally clean with “We the People”! If most of our leaders have any intestinal fortitude, then we should have a long line of them holding resignation papers in their hands or begging to ask our forgiveness! Do they no longer think they are accountable to U.S. and believe they can do whatever they please? They have developed a “spirit of insubordination” that has gotten way out of control! We no longer need employees working for us that practice malfeasance in office.
    We need laws stating that any Representative, Senator or President that has the audacity to sign any bill without reading it and fully understanding it should go immediately to jail without any bond? We must raise the bar of Integrity and Honor for our employees! Elected or appointed “public servants” need to achieve a much higher standard. How did it get so low? If they are found guilty, a 30 year minimum sentences would not be out of line! This complete lack of responsibility is a very serious issue! It’s totally scandalous, outrages and just plain wrong! It’s Criminal!
    We Must Never Again Allow Our Leaders to Have Unaccountable Trust! EVER!!!
    People are corruptible! We must always question and watch very closely everything they do! Our Freedom, Our beloved Constitution, Our National Sovereignty, “We the People” and the fact that we are a Constitutional Republic is why the United States of America is the Greatest Nation in the World! Any bad truths about our Country are the slow results of the corruptible human nature of a few individuals! Power and wealth can corrupt a person if not kept in check! After we fix our current problems, and we will, we must put in play many more “checks and balances”. We must figure out a way to completely take away the opportunity of corruption! Nothing personal – but “We the People” must always come first and be protected!
    http://www.tomdavidd.com/blog/
    “We can all commiserate forever about how bad things have been, are, and will continue to be. But I don’t think that we can afford to wait for elections in order to have our say about putting a stop to this madness. Enough, already! Let’s start talking treason, prison, and death penalties for all malefactors in government who subvert, ignore, skirt and otherwise trash the Constitution of these United States of America. Those who have sworn to uphold the Constitution and have then ignored their oaths of office are guilty of perjury and malfeasance in office.” -Stephen A. Langford (personal communication to this author)

  71. Hi,
    Thanks so much for the information and it was really helpful and I hope the article on health care will help you a lot.
    Regards.

  72. Polls for the last couple of years have shown consistent support for a government run plan, only recently has this changed with the media campaign and the government’s. Why don’t you mention that?

  73. The finite resource are not “ours”. They are mine and yours. Co-mingling them is a function of thieves and government.
    Anyone who thinks they are “ours” is a communist. Go find another country.
    There are two public options right nnow that are totally under the control of government, Medicare and Medicaid. The government does not have the intestinal fortitude to cut costs in programs that they alone control. If you think the government can control costs, you are blind.
    Preventive care is overrated and will not cut costs. The feds could create a pool of funds for people with catastrophic illness that could be tapped to pay for care. But the reason for runaway costs in the first place is insurance itself.
    With good old real insurance the consumer still paid 20% and discretionary elective care was paid for out of pocket. We must return to such a structure to end the addiction to medical attention on demand, with no cost consequences for the demanding.
    Seniors would of course defer futile care if their family had to pay a chunk of it instead of Uncle Sugar paying for it. The family would have a different value set compared to now.
    As for the unfunded Medicare liability, Congress can fall on this time bomb all by themselves. They have been the political benificiary of runaway spending for decades and the tab has come due. Congress hosted the party and they can pay the band.

  74. No. 13 is really interesting.
    I think it is partially true and here’s why I know many know it’s not true: Much of the venom coming from the elderly has to do with the idea that if we cover the uninsured, necessarily we will ask something of them.
    This is sad, morally. Would any 90 year old not forego a $200K terminal (or even just pre-terminal)ICU stay if the money went to treat her uninsured granddaughters breast cancer? Or to provide a thousand kids several years worth of primary care?
    Yet, they just want to make sure they get theirs, goddammit. I get it, a little. You don’t want to give it up for nothing. I think that is why the Social health insurance model and ethic is so essential to communicate to the public. We are all in this together. We must, as a society, decide where to spend our necessarily finite resources.

  75. I appreciate your insights on the controversy surrounding healthcare reform. Unfortunately, the myths keep on multiplying and there is a concentrated effort to hide and manuipulate the facts. As a Palliative Care nurse, the lies about end-of-life care(EOL) have been so twisted the public thinks the government will cut off care at a certain age. It is imperative that we discuss EOL concerns as dying is a normal process of living. Our advanced medical technology has allowed us to live much longer with many chronic illnesses which does not mean that technology will improve a patient’s quality of life. We should be asking:”Is a medical treatment benefiting a patient or is it causing harm and promoting suffering?” Mechanical ventilators and dialysis machines were never intended to keep dying patients alive and was originally meant for younger healthier individuals to use temporarily. We must discuss costs as 20% of our patient population uses 80% of our healthcare dollars. Over-utilization and medical futility are taking funds from preventive care, healthcare for children, and pregnancy. This country should be ashamed that women in other developed countries can get better healthcare and have healthier babies than the USA. I have not heard about any discussions regarding shifting more money to skilled nursing facilities, home health, hospice, or assisted living facilities. These institutions need enough funding to hire educated staff and offer competitive salaries as they provide care for the majority of our aging population which is growing by an unprecedented rate. I believe our healthcare providers should be posting the actual costs of healthcare services so the public can see how much it costs to provide care. America must have a realistic and flexible healthcare budget that places more emphasis on preventive care, support services to promote healthier lifestlyes, and facilitate transitions to caring supportive care instead of continuing aggressive medical treatment when it is futile, non-curative, and decreases a patient’s quality of life.
    Thank you for allowing me to share my comments on this website.

  76. The “Healthsteria” that has gripped America is so very disheartening. With the millions of Americans loosing their homes, or finding themselves underwater with a devalued property, as big banks and mortgage brokerage companies walk away with profits and bonuses. More millions have lost their jobs, as Corporate America lops off large vestiges of their workforce, just to pad the bottom-line, and deliver dividends to the share holders. With this economic nightmare that has sent shockwaves through Wall Street, and continues to unleash a drowning tidal wave on Main Street, just the thought of a Healthcare system that puts the care back into Healthcare, offered a tiny glimmer of hope. Then the nay-Sayers began to chant the Public Option was about to throw Mama from the train in her twilight hours. As I watched the Bill Moyer show featuring Mr. Wendell Potter, the former chief corporate spokesman for Cigna, I wondered how many Americans got the opportunity to view this broadcast. I wanted it to be mandatory viewing at all public forum discussions on Healthcare Reform. I wanted it to be broadcast day and night like one of those less than blockbuster movies that cable TV puts into a continuous loop of air time.
    I tried to reassure myself and say that the American people are not as ignorant as the Big Insurance industry would believe them to be, that they would see clear the smoke and mirrors, that they would indeed pay attention to the man behind the curtain. I tried to convince myself that they would see, as Mr. Potter’s presentation so clearly showed, who was pulling the purse strings, and speaking through these ventriloquist dummies, more commonly known as conservative politicians, and those who now have let the Blue Dogs out. But as the weeks have passed, and the heckling calls failed to die down, what saddened me so, is that there are many poor Americans who have been duped by all the fear mongering and have brandished the Anti Health Reform regalia, to the chant of the party line!
    How I know with all my heart, that so many of the well intended Anti-Health Reformists could benefit personally, if not have a dear loved one benefit, from caring health system. Yet, I am reminded that not so many generations ago hysteria swept many as Orson Wells read the War of the World, over the air waves. Should I be surprised by the waves of panic that now sweep many over this modern day War of the Words.
    How I just wish there could be a young child, who would yell it out, to all of the highly intellectual conservative thinkers and their adherents, that the cloth of the argument that now cloaks the Insurance Empire as being the best healthcare delivery system in the world, that shrouds all those who rally to this rant, is in reality devoid of any substance at all, and will leave all of America naked and openly exposed to the status quo that keeps rewarding big business, as they continue to give the small guy (or the little boy) if you will, the business!!!

  77. “Most people do not seem to see a conflict between giving patients every test and treatment they and their doctors want, however expensive, and containing costs.”
    That is because most people don’t pay the bill themselves. As an economist friend of mine wryly noted, Americans will happily consume all of the health care that someone else will pay for.
    Indeed, the incentive is to consume, as otherwise you face paying in and not getting any out.
    I also note that the rhetoric of the “public option” supporters seems to border on religious faith. It will WORK because it will WORK, you see. Costs will GO DOWN because they will GO DOWN. They just WILL!
    Oh, and anyone who questions these statements of faith is a tool of the insurance industry, just like anyone who questions religious dogma must have Satan whispering in their ear. Evidence, please!

  78. The American way of life embraces the idea that anyone, regardless of the circumstances of birth, can increase their standard of living through hard work and natural ability. This concept is expressed in the firm belief of honest and fair competitive market place, free and open democracy where productive expansion has no bounds. There is a disturbing and detrimental effect on the American way of life brought on in recent years by the outlandish ideology of the conservative right-wing of the Republican Party who have teamed-up with the very elite and rich corporations, organizations and individuals that are attempting to erode and set back the gains made since the 1700’s in the lives of ordinary Americans. Thus far there has not been a significant amount of public out cry to help bring these conservative right-wingers under the rule of law where justice can be served. These problems cannot be solved without the American people standing up to these conservative right-wing selfish individuals and corrupt businesses, corporations and organizations that are mounting a huge campaign attempting to shut the door on Americans liberties, justice, freedom and their pursuit of happiness.

  79. The compelling evidence and discontent of workers in America that still plaques the workforce after years of Republican propagandizing and attacks have created devastating defeats for labor, not only in the difficult working conditions, but also to the persuasive fear the workers feel if they try to organize or complain publicly. One just about has to be nameless or lose her or his job. The workingmen and women in America cannot live on these low wages and feed their families. It is worse than criminal for such conditions that brings pain, misery and suffering to the unfortunate poor. This sort of conditions and situation forces peopl contrive to survive which is not very good for the country. When the workers do rebel against the unfair and un-American condition, these Republicans authorities who pronounce good hard working Americans as “reds, Communist, Socialist and other such defamatory remarks in my opinion will themselves be held accountable and could feel the wrath of the American people come election time.

  80. August 16, 2009
    America is debating health care reform and the future of health care in America. It seems the news media gives most of its attention to the loudest voices. But, what is really needed is to hear the voices of the million and million people who are suffering and struggling every day with a health system that often works better for the health insurance companies than it does for the American people. There are many horror stories how the insurance companies are exploiting and denying health coverage to the very people who need it the most. I hope the American people do not forget the way the insurance companies treated the American people on the gulf coast after hurricane Katrina that is shameful because there is not a dimes worth of difference between all these corrupt insurance companies. If anyone doubts the integrity of these insurance companies all one has to do is ask Wendell Potter the former Vice-President of corporate Communications of insurance giant Cigna who says the health insurance industry is playing “dirty tricks” in an effort to manipulate public opinion. If President Obama’s health care proposal is passed you will have a choice of high quality, affordable coverage for yourself and family.
    This will be coverage that will stay with you whether you move, changes your job are lose your job. It will also bring down cost that will be a real savings for families, businesses and government. By cutting waste and inefficiency in federal health programs and the unwarranted subsidies to insurance companies that do nothing to improve health care and everything to do with the insurance companies profits. By making Medicare more efficient, more tax dollars will go to caring for seniors instead of filling the insurance companies’ coffers. The President’s health reform if enacted will protect the individual and hold the insurance companies accountable. It will also require the insurance companies to cover routine check ups, testing, screening etc. If the American people want quality, affordable health insurance then they should help our President pass his health care proposal. There should not be anything in this reform that puts the government or insurance companies between patients and their doctor, or any type of rationing of health care. The health care debate has been going on now for over 50 years its time now to act. Congress must act as it promised PASS HEALTH CARE REFORM NOW if you want to return to your seat after the next election.

  81. There is a snake in the grass when it comes to the American health care system and its the employer based health insurance idea that the employer picks an insurance plan for the worker that is causing the health care crisis now going on in America. The employment based health insurance program was brought into being based upon evading wage controls during World War Two.
    The employment based insurance program has many serious and complex problems. Not every American who needs and want health insurance has a job and/or cannot work due to circumstances out of their control. The contributions employers make toward the fringe benefits of their employees comes out of the employees’ take home pay. This is nothing but simply stealing in that the employer takes a portion of the employee’s total compensation to purchase whatever fringe benefits they “give” their employees. This process is very hazardous and detrimental to the employees and their families because when a worker loses his or her job so to goes their health insurance. For small business when one or a group of serious illness affects the business it can greatly drive up the premium for every employee. The current health care reform effort now in Congress should abolish this asinine employment based system and replace it with a system that is solely owned, controlled and bought by the worker or individual which every the case may be. The health care market place should be highly competitive, affordable, transparent and portable. The new health care system should be well regulated with public assistance when deemed necessary.
    The unsubstantiated statistics that 80% of insured individuals in the employer based health insurance program are satisfied with their employer based health insurance is nonsense and is use as a propaganda tool by the captains of industry to exploit the American people. Employer based health insurance is a burdensome, exploitive and ill suited for the American work force. Some ill informed individuals believe employer based insurance keeps people in jobs with companies that they are not passionate about but fail to recognize that it is harmful to their health as well as instrumental in the exploitation of the American work force. The employer- based insurance is a kin to the old days of shopping at the company store for all one needs that gives business an unfair advantage over the work force and also drives down wages because they have a captive work force. The employer based insurance program is nothing more than another tool of the “captains of industry” to enslave, exploit and rob the American people and it should die a quick and sudden death and be replace with a more fair and just system where all Americans can have affordable access to quality health care

  82. The passage of health care reform must have a real public health insurance option. It is critical for containing skyrocketing cost and guaranteeing security for all Americans. Our health care system is broken, cost is skyrocketing and too many people can’t afford coverage. The public health plan insurance option is the key to fixing these problems. The cost of inaction is too high. Every day that we delay, 14,000 Americans lose their health insurance and nearly 2500 file for bankruptcy because of medical cost. And costs continue to spiral out of control. In the not so distance future the average family premiums will hit $22,000 a year. With the real public option, costs will start to go down and millions of individuals, families and small businesses will have access to high quality, affordable health insurance. And no matter what happens to our jobs or our health, a public option will always be there for us. A prescription for the public option should be filled

  83. Jane C, maybe you can give us more information. Keep in mind that my wife worked in the Alaska Native Medical Center where natives got exceptional care at no cost.

  84. I admire the civility of the posted comments. Since all the press about the townhall meetings, I have been trying to get a better handle on the various proposals in an attempt to understand people’s fears and concerns. Whether I was looking at blogs or comments on an article in the Wall Street Journal, inevitably some portion of the dialog has become a name calling contest. Debate can be healthy; what I’ve been reading from conservative and liberal viewpoints, is anything but. Thank you for helping me keep the faith.

  85. Seems like a level-headed assessment. It reminded me of a health care conference I attended maybe 20 years ago, back when managed care was touted as the solution. Leonard Schaeffer, then the CEO of Blue Cross as I recall, was on an expert discussion panel. He said that he was often asked what people want. He said the answer was pretty simple: “They want to feel good, to look good, and to live forever.”
    Schaeffer was only half kidding. There has been for a long time a big discrepancy between public perceptions of what medicine is capable of and the realities of delivering it on a mass scale. Mr. Taylor’s point 13 captures the situation succinctly. And now the discussion is so intertwined with an ideological grudge match that it seems we cannot have a rational, thorough dialogue about what the alternatives and facts are. Taylor is right again when he suggests the health care dispute is likely interminable.

  86. If you want to see an example of government run health care then check out how well indian reservations have fared under it. Enough said.

  87. I have come to believe we have created a beast far too big to kill – it will have to die a natural self consuming death before we can have concensus, or at least exhausted acceptance, of what needs to be done. It’ll be ugly before it will get better. I think Dave Folz above has hit the crux of the problem. Reality is a scary thing.

  88. Thank you for this rational approach to the healthcare reform discussion. Tomorrow, August 20th, many lay people, mostly those over 55, are planning a massive blog on health care reform on their individual blogs to attempt to clear up misinformation and also, to show that the dialogue is NOT all about naysayers.

  89. Great discussion – about both health care and our leaders (both executive and congress). Too bad we (and “they”) can’t see more of this in the public media.

  90. I am of those who don’t begin to understand the complexities of the problem, but my intuition is that health care must be rationed – it is economically impossible to provide all services to all people. But publically stating this is about as politically suicidal as discussing euthanasia. So inevitably any reform will be clouded in rhetoric and result in unpopularity.

  91. What’s the public’s perception of medical malpractice reform and it’s impact on healthcare reform?

  92. Wonderful piece.
    If you have watched/read the news, listed to the rhetoric, or examined some blogs, you intuitively know that everything Mr. Taylor states above is true.
    The decline of this country began when we lost our status as the most literate nation on the planet. In a democracy, an uneducated voter is too easy to manipulate and too illogical to convince with data. I fear that our decline will continue because of this.
    The health care policy controversy is simply a symptom.

  93. Like all Americans, I have all kinds of personal bias when it comes to health care. But what drives me especially loopy is how impossible it is to have a real debate over the issues because there is more misinformation than real information available. Most debates on the subject seem like separate discussions with consensus virtually impossible to build. George Halvorson, the CEO of Kaiser Permamente has created a pretty good book that surprises me in its push for universal care as the only system that is affordable. He stands in a position where he could be an apologist for the healthcare industry and he certainly has enough facts and figures to back up any argument he chooses. But in “Health Care Will Not Reform Itself” he steps out on a thin limb much to the ire of his fellow CEOs to present a striking rationale that is cogent and simple enough to understand. I work for the copublisher that is handling the book but am not invovled with its marketing. I just wanted to bring it to people’s attention (profits for the book go to charity) because it gives them the kind of infomraion they need to take part in the debate with intelligence….

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