one payer health care

[iomegaman]

I think one of the most telling signs that what is being advertised is quite different than what is being proposed behind closed doors is the "urgency" to pass legislation without even knowing what it is.

The President has almost demanded immediate change, and yet has admitted that he himself has not read the legislation.

So whats the big rush?

I know we've suggested these changes before, and on previous tracks the change has been defeated and rightly so, but there is a significant danger in rushing into legislation where there is no longer any semblance of balance (the dem's have their 60) and the lack of pertinent available transparency and information suggest to me that what is being proposed is not really what we will get.

Look how well the TARP and bail-out have done for us (the real number of unemployed is beyond what we were told it would be if WE DID NOT PASS THESE TROJAN PAYOFF HORSES)...

I am absolutely reluctant to hand over another vast portion of our economy to a team that was failing even before they got in office, (Geithner was one of the architects of the tarp and could not even file his own taxes correctly), we need to see significant improvement on the economy before we hand over any more of our life.

There is no real danger in waiting a bit and accurately coming up with better solutions, the race to pass this legislation borders on down right falsehood.

...and one more thing...we were promised an open and transparent government like there had never been before, and at this stage in the game it is actually quite a bit less than the Bush & Co we had before.

I say live up to some of the campaign promises before you start any new projects.

 

[sodderboy]

I'll restate what I think is the most important thing - a majority of the citizens of this country have decided that they are fed up with how health care has ended up under the free market approach, and they'd like the government to step in.  I can't think of any better example of elitism, "nanny state-ism", etc. than to have a few naysayers claiming that the people don't know anything, that we're better off not getting the federal government involved, etc.

But the problem is already too much government involvement.  There is no free market approach now with states protecting the corporate fiefdoms of managed care companies.  The fact that a HR department chooses a group of health plans for employees is a crazy notion going back to legislation from the 40's.

The current legislation in congress will only pretend to accomplish what "the majority of the citizens" wish.  And "majority"?  What about the tens of millions who are happy with their "health care", the millions who think that the current state of "healthcare" or "insurance"- even the politicians do not know what to address with their hundreds of un-read pages, is already the government's fault, and the other millions who could give a sot?  THEY are the majority.

The real majority is currently speaking, and that is why there will be NO legislation "no later than August 7th".  Now 44 is saying "by the end of the year".  He will have to push that ahead even more when he starts reading ALL of the "letters I get from people". 

There is a "donut hole" of coverage for those neither poor nor rich enough, and those who require constant care.  We still have the best medical system in the world, and to fill the hole will require more effort by the people rather that legislators- especially the bunch in power now.
Mike

 

[JohnRoberts]

I am glad to see some thoughtful discussion.

I need to clarify one point. I don't believe that our healthcare now is an unfettered free market. There are only a few niches that are vibrant and they seem to be outside the reach of the dreaded insurance cabal.  One example that comes to mind is cosmetic or optional procedures like corrective eye surgery. Thanks to this not being influenced by insurance, the market forces have driven the availability up and costs down. Would this happen under government control, I think not.

If the new crew want to offer the "public option" to increase competition between all insurance providers, let's level the playing field. The government program must make a profit and be self sustaining like any other business. I'll even allow them an initial (taxpayer) capitalization to get started, but no power to change the rules that everybody else must follow, and no infinitely deep pockets, to price others out of the market.

If they truly have better way that will cost less money... prove it. If they really are better and cheaper, show us, and I'll be glad to sign up (watch what they do, not what they say).

JR

 

[sodderboy]

I sent this to my congressman Steve "dirty oil" Israel to answer his recent email, where he also claims that congress needs to do something as an "reform alternative to the free-market healthcare situation we have today".
 
There is no free market when we cannot buy catastrophic insurance outside of a government dictated tax-free account.
There is no free market when employees have but a few managed care choices for their insurance dictated by their employer.
There is no free market when a sole proprietor has but four choices for insurance, three of them "managed care".
There is no free market when a hospital's goal is not to heal but to "sustain" the sick to get extra government insurance payments.
There is no free market when Medicaid cost estimates include and justify a 20-25% fraud overhead.
There is no free market when someone can only visit the local medical clinic.
There is no free market when single passengers are carted around in large Medicare welfare-wagon ambulettes.

So many people here sit for hours matching components, analyzing and listening to different circuits, different transformers, etc.  and yet choose to outsource important health decisions to federal politicians.  These same politicians legislate to pay more than twice the regular store price for spiral ham and processed cheese food products.
AND these same politicians will NOT PARTICIPATE PERSONALLY in their proposed "healthcare reforms"!  Hello!?!
Oi! Now I'm sick with a conniption-fit. . .
Mike

 

[sodderboy]

Aahhh.  Some train rides in NH helped me ease my fit, and I get this email from my Congressman Steve "dirty oil" Israel.
You see, he chooses only to answer to phony cliche scare-tactic rumors, rather than read the actual bill and the emails from his constituents. 

Interesting that there is NO "Obama White House" health care bill, but only what congress is supposedly drafting.  What a lazy load!  Has his special interests write it, and then lets congress make it even more vague, while they try to appease any poll-tested dissent.  Lies, lies, and yet more un-funded mandated lies.

"Dirty oil's" offices have yet to offer me a schedule of his town hall meetings for the month. 
Mike

A Closer Look at Key Issues in Health Care Reform
August 10, 2009 by NOAM N. LEVEY

WASHINGTON
WITH lawmakers home for their August recess until next month, a fierce battle has broken out over what precisely is in the health care bills being pushed by congressional Democrats. There has been no shortage of misinformation, much of it advanced by critics of President Barack Obama's overhaul effort, who have made sometimes outlandish claims. Here is a look at some of the most contentious parts of the legislation.

Does the legislation include provisions to encourage senior citizens to commit suicide?

No. This has become one of the most misleading, inflammatory claims made in the debate, advanced repeatedly by conservative commentators such as Rush Limbaugh and Sean Hannity and Republican lawmakers working to stoke fears among seniors.

The House bill would give seniors on Medicare the option to sit down with a doctor for an "advance care planning consultation" every five years to discuss options should they become unable to make medical decisions. Topics could include the development of a living will and directives for care.

"These are important discussions everyone should have so they are fully informed and can make their wishes known," said Dr. J. James Rohack, president of the American Medical Association. The provision is endorsed by the AARP.

Will the government start paying for abortions?

That's unclear. Neither House nor Senate versions of the health care legislation contains any requirement that federal funding be made available for abortions. Claims that tax dollars will be used for abortions, as a television ad from the Family Research Council contends, are premature and somewhat misleading.

But the legislation is short on many details. Depending on how future regulations are written, it is possible that some women who receive federally subsidized insurance could buy plans that cover abortions.

Under the most popular Democratic proposals, millions of Americans would buy insurance in a new, highly regulated marketplace in which private insurers and the government would offer a choice of health plans. It appears unlikely that the government would require the plans to cover abortions. But some private insurers in the exchange may cover abortion services.

Will the government ration care?

This is almost impossible to say, although if the legislation passes there may be less "rationing" than there is now.

Under the nation's current system, private insurers and the federal government put a variety of limits on what kinds of medical procedures, imaging and drugs they will pay for. Millions of people with pre-existing conditions are turned away by private insurers.

Both House and Senate bills would prohibit insurers from denying coverage to anyone with a pre-existing condition, thus eliminating one form of rationing in the current system.

The legislation also would give the government the authority to set minimum benefit levels that insurers would have to offer in order to sell policies in the new exchanges. That could mean more coverage for millions of individuals and many small businesses.

Most controversially, the bills would fund more research into the comparative effectiveness of various drugs and medical procedures. Some critics say the law someday could allow the government to use this research to limit what Medicare or other government insurance programs would cover.

Will illegal immigrants receive free health care benefits?

Provisions in the House and Senate bills explicitly prohibit people who are "not lawfully present in the United States" from receiving federal aid to help them buy health insurance in the new exchanges.

No matter what happens with the legislation, undocumented immigrants will almost certainly still be able to obtain care in emergency rooms, a major burden in parts of the country.

 

[JohnRoberts]

Typical political mumbo jumbo.. There is an apparent strategy to spin honest concerns as a disinformation campaign a subtle form of ad hominum that takes attention off the arguments and discredits the questioner.

Interesting developments recently..  white house is now calling it "health insurance reform" instead of healthcare reform. The other day in Mexico President Obama dismissed the Canadian model as inappropriate for here. Today in that town meeting in NH he suggested that the deal cut with big Pharma for cost reductions may get renegotiated for deeper cuts..  We'll see if they're still singing in the choir after hearing that their done deal is not done.

Another tidbit about illegal immigrants, They are talking about including them in the 2010 census to count for house of representatives apportionment. Reading between the lines, I don't think they're going home. But the last administration punted on this issue too...  Now if they get representatives in congress what else do they get?

Interesting times...

JR

 

[PRR]

I don't think either side of this axe needs more grinding, here; and yet I came across this painting which is just too strange to accept -or- ignore:

http://twitpic.com/dea73

 

[Mbira]

Is that Chuck Norris?

 

[JohnRoberts]

Who,, the one on the "right" ?

JR

PS: I really tried to ignore this...

 

[CroatianSensation]

Looks like "House."

 

[sodderboy]

Looks like a copy of an eastern european style.  They love their iconic style depictions, and always put a bottle in there somewhere.
Tacky, amateurish, and not to the point at all.
Mike
PS: I think it is Rahm Emanuael.  Speaking of him, I am SO glad we are rid of that dark, manipulative, conniving, presidential chief of staff Karl Rove! :kumbaya:

 

[okgb]

No Prayer health care ?
Goonbya

even here you want to avoid having to go to the
Hospital , may be free but you may come out dead

 

[sodderboy]

We have an older Canadian friend who pays extra for some sort of higher tier "care".  She was psyched to only have to wait a month to get a MRI- scheduled for 2 o'clock in the morning.
That painting is beau coup offensive as well.
Mike

 

[ethervalve]

I used to work for a medical newspaper and I had to read a few comparative studies on international health care systems (particularly the German, Italian, Swiss, French, Australian, Swedish, Dutch, Canadian and American systems). There are some good summaries of foreign health care systems available here: http://www.euro.who.int/observatory/hits/TopPage
here's my rant:
The US has a woefully inefficient, money-gorging, byzantine, bureaucratic nightmare of a system. Frankly, it's weakening the nation (and not just the uninsured).
Outcomes in the american system are considerably worse than in other any comparably developed country--and the US pays FAR more for its oft-shitty care. For example, the US does badly on life expectancy and especially infant mortality (worse than CUBA).
Beyond the bureaucratic insanity, a less obvious problem with US-style retail/market-driven health care is that the 'lucky' people with good insurance get too much care. If you search Pubmed, there's a growing body of evidence that excessive intervention is bad for health. Which brings me back to Cuba, the US obviously has the finest teaching hospitals in the world and the latest, greatest technology--the american system itself is so lousy that even an impoverished, isolated communist dictatorship can do a better job at keeping its babies alive.
On the other hand, America is the place to be if you've got money to burn and and you want a positron emission tomography scan of your hangnail--like now!

 

[JohnRoberts]

We agree that change is needed, we disagree over how...

my humble suggestions:

* remove legal obstacles to expanding high deductible catastrophic event insurance, and expand HSA program.

* make tax treatment the same for employer provided and self paid health insurance.

* Remove prohibitions against insurance competition across state lines.

* Reduce government mandates over what insurance must and doesn't cover.

* tort reform

* make costs transparent to consumer so they can make informed choices.

* Normalization of worldwide drug prices (we would pay less than now, others probably more, sorry folks).

* properly fund Medicare that is running out of money.

* safety net support for the poor, perhaps something like food stamps that can only be spent for medical care from clinics instead of using emergency room for everything.

* Government guidance in setting standards for electronic patient records and confidentiality protections for same. Perhaps some research into applying expert systems to practice of medicine.

=======
The political hot button about rationing is being pressed by both sides. Rationing of health care occurs in all systems. The difference is whether that rationing is occurring in the free market, or by fiat of government bureaucrats. I'll take my chance with the free market, but concede we need to chase out the lawyers and thieves, including politicians, currently making our healthcare more expensive than it should be. .

The "how" is the hard part.. I don't believe we will get change for the better from bills, politicians admit they haven't read. Even their own budget office is predicting huge cost increases from their best laid plans...  This legislation needs to go back to the shop and get reworked. The dems are already talking about using a parliamentary gimmick to pass with a simple majority in the senate. We need a housecleaning in 2010 and then again in 2012. Throw all the bums out. 

JR

 

[sodderboy]

Those studies listed use data that is more than tainted.  Criteria for death especially.  At the least, each country submits different criteria for classification.  How can a study then compile any proper comparison?  Certainly not an un-biased one.  And any study from an NGO is a biased tome to please the teats they suck. 
Any reference to Cuba is a total joke!  The citizens of Cuba are crap in the eyes of their totalitarian rulers.  Yeah, I really believe any stats from the friggin' Healthcare Statistics Czar of Cuba.
Great list, John!  Why are our rulers considering NONE of those points?
MIke
PS: And all european countries don't have to thank me for their fantastic health care, but they really should thank a Yank in uniform.  They are all over there, saving those countries billion dollar defense expenditures.  Think about that when you turn your head an cough during a free exam.
 

 

[JohnRoberts]

I find the comparisons questionable too. Prisoners get free healthcare but I don't want to be in prison.

The defense expenditure doesn't quite compute since they are typically paying less than we do as a percentage of GDP for healthcare. I really don't expect many to appreciate our military, I am just thankful that our soldiers get decent treatment from their fellow citizens at home, unlike my generation.

There is no question that our delivery of healthcare is inefficient but for reasons not being directly addressed or perhaps intentionally ignored. I don't expect tort reform from the side of the aisle in power now. Threat of litigation causes over testing. I've seen estimates published and the cost was many times the cost related to obesity.

The government is working on computerizing health records, but the government is probably batting less than 50-50 when it comes to big computer systems. There are already probably several private company solutions out there that may get tangled up by government "help".

JR

PS: We get to thank several European countries for their support in our early days, and we are still a relatively young nation, so this is still early days. I hope we don't break a system that has given us so much economic growth and prosperity in the past.   

 

[ethervalve]

PS: And all european countries don't have to thank me for their fantastic health care, but they really should thank a Yank in uniform.  They are all over there, saving those countries billion dollar defense expenditures.  Think about that when you turn your head an cough during a free exam.

i humbly suggest that you guys stop poisoning the well and it least consider the possibility that other countries have superior health care systems.
have you read anything about the health care systems in these countries? no two are the same. they each reflect national cultural/political peculiarities (some are even based on regulated private insurance) and none are perfect. but ALL of the systems in advanced economies get more bang for the buck than the american system. So their higher standards of care have less to do with their higher tax rates than you might think--and absolutely nothing to do with their sane military budgets.
And the US is already a mixed economy and it already has some aspect of universality in its health care (people going to the emerg when they're already really sick). so what's up with all this slippery slope fallacy stuff?
JR's suggestions like Tort reform are valid in and of themselves but simple reform is inadequate.
But if you want total freedom from the state i suggest you consider what would happen if the military was privatized and blackwater won the bid to become america's privateer army.

edit: oops i didn't see JR's latest post which addressed a few of the things i wanted to say.

 

[lofi]

PS: And all european countries don't have to thank me for their fantastic health care, but they really should thank a Yank in uniform.  They are all over there, saving those countries billion dollar defense expenditures.  Think about that when you turn your head an cough during a free exam.

So theres no Brit solders being killed daily in Afghanistan then? And defense of what? the all American way of life....

Man with nephews in uniform in Afghanistan

 

[JohnRoberts]

Superior depends on how we measure. I am afraid I have become more educated than I care to about other country's health care systems (France one classic example of universal coverage, has been running at a deficit for years and is currently cutting back services to trim costs).  

I try to avoid fallacious arguments, but nobody is perfect.

There is no debate, our system is clearly in need of improvement. The inefficiencies that are systemic, added to the demographic shift and weak economy are bringing this to a head. I believe this is too important for a single party solution to be forced on us.

The problem with socialism is you eventually run out of other peoples money to spend. I believe we need to address the inefficiencies in our system by restoring free market forces that are not working correctly now, not socialize it further.

Not to throw stones at other systems but there was an amusing report about pet healthcare in Canada. You could get an appointment to MRI scan your dog or cat in about a day. To get a MRI scan for yourself is weeks or months depending on how  "elective" your condition. Apparently even most cancer treatments are classified as elective. While in another recent comment from a guy in GB, he reported he was able to walk into a clinic and get seen in 45 minutes. I can't even do that at the local, paid cash on the barrel head clinic, but individual anecdotes may not be representative of the broader picture.

JR

ps: Coalition deaths, of which US deaths out number other nations, are higher this year as fighting ramps up in an effort to stabilize the nation to allow the imminent election to occur without undue Taliban interference. If this election wasn't held now the fledgling Afghanistan government would be in violation of their original constitution. 

I feel we all owe a debt to these soldiers for "defending the american way of life", if that's all you think is going on there. If trying to provide enough security to hold a free election is the American way of life, so be it.

Australia 11
Canada 127
Czech 3
Denmark 24
Estonia 4
Finland 1
France 29
Germany 33
Hungary 2
Italy 15
Latvia 3
Lithuania 1
Netherlands 19
Norway 4
Poland 10
Portugal 2
Romania 11
South Korea 1
Spain 25
Sweden 2
Turkey 2
UK 199
US 781