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President Obama has made an overhaul of the healthcare system a central part of his domestic agenda. It has certainly became the topic of choice for town hall forums, and talk shows (like this one!) throughout the summer. But for all the talk, the President has so far been stymied much the way Bill Clinton was before him.
Now Congress is back from its August recess, so the President is taking the opportunity to make an unusual address to a joint session of Congress to try to push legislation forward. Speculation abounds about whether he'll be able to pull it off. But at the very least, it's another chance for him to communicate to the majority of the Amercian people what they would gain by an overhaul of the system.
Did you listen to the President's speech? What did you think of it? Do you have insurance through your workplace? Through a private plan? Can you afford your co-pays or deductibles? Are you uninsured or self-insured? Do you work for an insurance company? Or are you a healthcare professional? What did you hear in President Obama's speech and how would his proposed overhaul affect you?
GUESTS:
- Paul Goreman: Physician practicing in Portland who teaches at Oregon Health and Science University and Providence and works at the Wallace Concern. He is also part of the group Mad as Hell Doctors.
- John McConnell: Health economist with Oregon Health and Science University
- Jenifer Hood: Event Coordinator for the Oregon Office of Rural Health
- Kerry Barnett: Executive vice president of corportate services for Regence Blue Cross/Blue Shield and Oregon's insurance commissioner from 1993 to 1998
Photo credit: Official White House Photo by Pete Souza
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Obama let down all of us when he didn't endorse single payer healthcare last night.
Years ago my family (we have 3 kids) was on the oregon health plan. My husband had a debilitating medical problem. Luckily we were able to get by during his recovery period. He had surgery and we used food stamps and TANF (temporary assistance for needy families).
Now he is working for a local portland company, they provide insurance, and he makes over the average income for the portland area. However we pay more than 12,000 dollars in medical bills a year. His employer requires that he pays for each dependent and our health insurance only pays a certain amount of each doctor's bill. All of this adds up with 3 kids.
When we had OHP we had to go to the clinic that was assigned to us, it was out of the way and we had to wait to see a doctor. However when my daughter broke her leg, it didn't break the bank! We could go to the specialist and get the tests with out having to think twice.
I would love to be inconvenienced now and then, if it meant universal health care!
Single Payer should be a human right in America, like good drinkable water, it is good for the whole if we are all healthy!
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Please do your homework on single-payer systems. Without exception they are a disaster both in quality and quantity of care. Study both Great Britain and Canada.
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SanityCheck,
Half my family lives in England and they love the health-care! I actually had to use it on vacation and I was more then impressed. Of course just anecdotal.
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"Please do your homework on single-payer systems. Without exception they are a disaster both in quality and quantity of care. Study both Great Britain and Canada.
SanityCheck — Thu Sept. 10th 10:04a.m. "
That is just a right wing lie, please stop spreading it.
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Dude, sanitycheck, check YOUR facts, Britian doesn't have a single payer system, they have socialized medicine where the state owns the hospitals and just about all aspects of healthcare. Canadians love their system 89%, say so, it is single payer. Their government pays $300 per capita on healthcare whereas the US pays ~$1000. Single payer would actually lower the cost of what we pay now, and it will pay for everyone, even you.
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Dear SanityCheck,
This is taken from Wikipedia:
Single-payer health care insurance is a public service financing the delivery of near-universal or universal health care to a given population as defined by age, citizenship, residency, or any other demographic.
Single-payer health insurance collects all medical fees and then pays for all services through a single government (or government-related) source. In wealthy nations, this kind of publicly-managed health insurance is typically extended to all citizens or legal residents.
The fund can be managed by the government directly or as a publicly owned and regulated agency.[2] Australia's Medicare, Canada's Medicare, and healthcare in Taiwan are examples of single-payer universal health care systems.
The term 'single payer' refers to funding and does not imply a socialized medicine system. A socialized medical system is one "in which all health personnel and health facilities, including doctors and hospitals, work for the government and draw salaries from the government," an example being the U.S. Veterans Administration, while U.S. Medicare is a single payer system which is not socialized medicine.[3]
In Canadian Medicare, which is a single-payer insurance available to all citizens, doctors may work in private practices or for public or private hospitals, each of which is in turn paid by government health insurance. Under the United Kingdom's National Health Service, which also uses a universal single-payer fund, the public owns the health systems and facilities. The term single-payer thus only describes the funding mechanism—referring to health care being paid for by a single public body—and does not specify the type of delivery, or who doctors work for.
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Err, forgot to say that we can all be wrong at times :)
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Kind of late to reply, but for a longer look at what other countries are doing, read T.R. Reid's 2009 book, "The Healing of America," where he describes the systems (pros and cons): France, Germany, Japan, U.K, Canada, South Korea, Switzerland, and the U.S.
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Last night the president drew snickers from members of Congress when he said that many details are yet to be worked out. That's an understatement.
Here's a detail that has yet to be addressed: What about employers who pay for the insurance of employees but not their families? How are family members to become insured in such situations or are employers going to be required to pay full family coverage? That's very expensive.
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I listened to the speech and I like what Obama was saying. I have healthcare coverage and pay quite a bit to support my family on a bi-weekly basis. I hear the stories from friends who are currently unemployed and need healthcare coverage but the only option out there is Cobra. For a single man, unemployed who is in transition of careers he is paying $900/month for health insurance without any preconditions. That is a rent payment. This is ridiculous. I get frustrated listening to the Republicans negativaty to this healthcare plan. Why is it OK that Congress and the President and Senators can enjoy basically free healthcare (government run) and we can't? Wouldn't this healthcare plan be an extension of the great care they are gettings now?
Some things that I don't agree with are the exclusion of people from the plan. If you are going to insure people with pre-existing conditions then you should be able to insure everyone, us citizen or not. As the greatest nation on earth we should be leading by example in this healthcare industry and paving the way showing the world how we take care of each other and anyone that visits. Unfortunately that is not the case.
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I also don't see how it will be possible to exclude illegals in many situations.
If a person is seriously injured in a car accident and comes into the emergency room, are they going to ask for proof of legality and if it isn't available then turn them out to die in the parking lot? Or more mundanely, if there really is a swine flu epidemic, are we only going to treat the legal citizens and/or visitors? If we are only vaccinating/treating legal people in any epidemic then we are, by definition, maintaining a pool of potential carriers and risking everyone. (I assume we won't deny medical treatment to legal immigrants or tourists.)
So we can deny them the cheap and useful basic/preventive care, but not the expensive emergency care? How does that help?
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Plus, it is expensive to figure out who is who, and the cost to us can come later in the emergency room if something goes untreated. I think illegals should be covered by a portion of a government fund that is allocated for tourists who run into trouble here. We can always manage these things later if they become too much of a cost.
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As a self-employed business owner, I've been living without health insurance for over 3 years. While I realize this is a gamble, I can't yet afford standard monthly premiums - and couldn't qualify for a plan even if I could. I pay cash on the rare occasions I see my doctor.
No plan will be perfect, but I was relieved at the considerations for small business Mr. Obama mentioned in his speech last night. I'm enthusiastic about his vision for health coverage in the U.S., but am dreading the "democratic" process that will get us there.
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Jenh,
How do you feel about the president's plan that everyone — including you! — will have to buy health insurance? How much could you afford for monthly premiums?
Dave
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David,
In theory, if everyone pays into the system, the cost is spread out and premiums should go down. But that's the question: without regulation or competition, would insurance companies just pocket the extra premiums?
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I have been listening and participating in the on-going debate about health care reform for the past several months. The more I hear, from those who oppose meaningful health care reform, the more I am convinced that these folks are afraid of the unknown and buy into the cable and talk shows myths and made up lies.
Last night President Obama made it very clear to all of us, what is it to be an American. If we were afriad of the unknown, and listened to cable and talk shows, we would have never advanced our country from the Atlantic to the Pacific. Neither would we have have explored the space or gone to the moon.
I believe that it is a special privilege to be an American. Yesterday the President explained why. Now we have to shed our fears aside and tackle this issue of our time and make sure that health care for all Americans is a right and not a privelege for a few.
No given plan can be 100% right the first time. However, if we can agree on 80% as the President said, the 20% should not keep us from acting American and acting boldly. We have to first learn to crawl before we can walk. If we are afriad to crawl, we will never walk.
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I support what the president is trying to do, but I must admit I am a bit worried about what mandated coverage for individuals will mean. I don't think I could afford another bill right now. I understand that expemptions would be made for people who are low income but the details are all pretty fuzzy. How will they decide what low income is and does that mean the poorest of us will still be without insurance? How much will those who need to get their own policies have to pay? As much as I believe in healthcare reform it's a bit scary to dive in without having any idea how it will affect me financially.
I remember when I had insurance. I actually paid much more for routine doctor visits than what I paid at sliding scale county health clinics without insurance. I'm hoping that if we have a public option it too would be more affordable.
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I really want to see health care reform. I work in health care -- dentistry, to be exact. I earn about $50,000 a year with a family of four. I pay 20% of my gross income for health insurance and a modest IRS section 125 cafeteria plan that pays for copays. My insurance has $3000 deductible per year. it would be financially ruinous to go to the hospital.
We're healthy. We're trying to eat right and exercise. Here are some of my questions:
1. Will it cost me more than 20% of my income to reform healthcare (e.g., more taxes, etc.)? After the mortgage this is the biggest payment I make all month.
2. Can't we incentivize people for living healthy lifestyles?
3. What would be the actuarial effect of changing our national junk food lifestyle?
4. Who are the people who arguing against healthcare reform? I have trouble believing that the people saying, "Don't mess with my healthcare" are paying their own premiums.
Thank you public broadcasting for reigniting the debate.
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I agree and have the same questions!
I had 80/20 coverage thru my employer. That 20% for me to pay is still so high that I still question my ability to go to the doctor. Now we have switched to a 70/30 plan which has a broader range of coverage but that 30% is huge. I know I am not alone on this.
We need to start thinking of the greater good for everyone instead of "what is it going to mean to me"
Single payer system is a fantastic option!
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I wish we would quit calling this the American Health Care System when in reality what we have are many business making a profit from illness. The hallmark of an organizational system is the systems primacy to the interrelationships, not to the elements of the system. These dynamic interrelationships flourish through communication. That is not my experience with health care.
As a breast cancer survivor of 10 years, I feel fortunate to have employer group insurance that won't allow me to be dropped because of a pre-existing condition. I want all Americans to have this protection. In the past 10 years, my insurance has covered less and cost more. I liked President's Obama's assurance that I can keep my insurance but with more protection.
My brother who is a self-employed filmmaker pays exorbitant premiums with a huge deductible which means he pays for insurance that pays for nothing. He only keeps it as a hedge against catastrophic illness or accident. Having affordable group options would be a godsend to him.
As a college counselor, I witnessed many students who were unable to seek medical assistance because they had no insurance and ended up the Emergency Room. The Oregon Health Plan was a boon to them when it was adequately funded. Prevention and early treatment saves us all money.
In short, I am encouraged by the main points of President Obama's plan. My doubts lie in the ability of our congress to agree on a plan that will actually benefit the American people.
Ann Clark
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Health insurance is NOT analgous to auto insurance. You can live without driving. The chances of a long and healthy life without healthcare are slim to none.
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Why is health care for everyone so controversial? No one who has private insurance will lose it. We are afraid of a public option because we are afraid of socialism. Why not let the scary monster out of the bag. It might turn out to be our best friend.
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I think people have no idea what 'socialism' is and just equate the word with all things "bad and anti-American"
But yes, I agree with you.
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And let's not forget many countries all over the world do provide Public Insurance and everyone loves it there.
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I lost my health insurance when I lost my old job. I have a "pre existing condition" and it is now impossible for me to get any kind of coverage, including the Oregon Health Plan. Obama's Health Reform to me means I can start saving instead of living pay check to pay check. It means I don't have to make the choice between medication and grocery shopping, I could stop borrowing money from my family and be independent. I am 23 years old - why does the world seem to think those in their 20's just 'choose not to have health insurance?' I want those people to look at my medical bills and then try to say that to my face.
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I am self employed. I have insurance but will be unable to afford it within two years if rates continue to increase at the pace they have for the past 7 years. In that time my rates have nearly quadrupled. That's with two non-routine doctor visits in 8 years.
If there is no true non-profit public option, what is to stop the insurance companies from price fixing amongst themselves to gouge a now-captive customer base?
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I so agree with you. Why are the insurance companies so afraid of being run out of business by a public option? And if they are that inefficient (and greedy), maybe they need the competition.
I am also self-employed, and my husband is avoiding starting his own business in large part because of the cost of health insurance and its rapidly increasing rates. So now we get insurance from his employer and it costs our family over $1000/month! We're lucky to have it and be able to afford it, but surely we can do better in this country.
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President Obama has made sincere efforts to reach out to Republicans and achieve bipartisanship. The utterly uncouth outburst by Senator Wilson during the speech was again demonstrative of the utter lack of good faith on the part of Repbulicans, who remain more interested in trying to score political points, than in resolving what is tantamount to a national emergency.
I, for one, applaud Obama's overall approach, and hope that the Republicans' zeal results in their falling on their collective swords.
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Why is everyone focusing on the uncouth-y-ness of Wilson's outburst rather than the fact that he, himself, was the liar.
His outburst is just another in a long string of blatant lies from opposition. The bill contains a very simple, one-sentence clause that denies coverage to illegal aliens.
Wether you agree with the denial of coverage or not is immaterial. The fact is, the bill denies coverage and Wilson was lying.
99% of the arguments from the opposition are flat out, unapologetic lies and no one is calling them on it.
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In asking how the Obama plan affects each of us, I think you are asking the wrong question. The question should be, "How does being OK with millions of Americans not having access to health care affect us as a nation that pays lip service to "liberty and justice for all?" Another question we need to ask ourselves is this: "Why is the United States the only advanced industrial country that does not routinely provide universal health care?" Health care has been widely recognized as a universal human right, while we continue to treat it as an economic commodity to be bought and sold.
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WE WANT A PUBLIC OPTION!
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On the 11th of September, in the year 2001, Americans became infected with fear and fanaticism. Faith turned planes into bombs, and the conductor of our collective response, our fighting back, Mr. Bush, turned to fanaticism and the same type of irrationality that fueled the terrorists, and he used it to fight the terrorists. Fight fire with fire. Fight fanaticism with fanaticism. This infection spread and public displays of extreme stupidity have taken over, have become commonplace. People are speaking in tongues and I can't understand them.
Fanaticism is mainstream, heckling the president is mainstream, irrationality is mainstream. If there is a sound-bite: use it! If there is an exaggeration, a lie: find it, and spread it like the H1N1. Fear and anger are powerful emotions, once they burn inside us, once they infect the culture, it is hard to turn back, it is hard to get the witch out. Last night we saw the witches respond. It is hard to remember the speech, because the commentators told us before and after what it meant, they claimed they had the correct take, they filtered the words, they decoded the code. The mealy mouths have taken over and we can't tell up from down, inside from out. Is there a suture big enough to stitch the mouths closed? These broken records are torturing us all. We are delirious because the bombs did not bring us together.
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scottmil, you really should rearrange that into a poetic meter. I see such a brilliantly dark poem there.
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Thanks!
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Right, however our own ignorance is what kills us. It takes two to tengo, but we seem to be stuck in an eye for an eye. How does H1N1 spread? In circles or in squares? Does it dance or does it sit still? Or does it do all those things? I really can get lost at times when time and language are all a blurr. I suppose I have a fan in my attic that has blown the right words right out of my mouth right in time. I've always been a big fan of that fan, it leaves me with a good expression. One that knows what to say.
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The thing is that most people DO want socialized medicine. They prove it all the time by what the expect --- adequate, even exceptional, health care that they do not have to pay for personally out of pocket.
The dirty little secret is that they DON'T want available to everyone and they want to limit who could get what. What people don't want to admit is that they only want socialized medicine for the "worthy." We just can't agree who qualifies as worthy and what they are worthy of --- everyone? only Americans? only the employed? only the wealthy? only my social/regional/ethnic group? only people "like" me? only "mine"? only ME? And what do they get --- preventive care? chronic care? emergency treatment? surgery? transplants? experimental care? alternative care? drugs? the works?
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The dirty little secret is that they DON'T want available to everyone and they want to limit who could get what.
Yes, bravo! It really angers me when opponents talk about public health care limiting care, letting people die, etc. That is exactly the system they want. That is exactly what a capitalistic, get-what-you-pay-for health insurance system does: if you cannot afford insurance, oh well, good luck.
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The "dirty little secret" may be bigger: If everyone is busy trying to stay alive, then everyone won't have time to participate in government (like voting, campaigning, contributing, etc.). That way, the powers that be (both public and private), remain in power.
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This most important statement in the speech: that the cost of healthcare reform will be less than the amount of the tax cuts on the wealthy. What is wrong with this country? - provide basic healthcare to all or provide more benefits to rich people? Should be a no-brainer.
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Yes DonnaL, but regardless of who gets taxed, the CBO estimates that it will cost us $1,042 billion dollars over the 2010-2019 fiscal years. What guarantee do we have that tax law will not change during that time and the rich hand us the bill? None, and we really shouldn't have that guarantee so we can change tax law when we feel we need to during that time. Generally we should pay for things by changing tax law, get them done, and move on, but in the case of healthcare, we should build a system that will guarantee our well being. Single payer is a system that does that (Not so keen on the English system though, would shake things up too much if the government took over the hospitals). Thus, I find a single payer system the only option right now that that will pay for itself without factoring in who has to pay, but I am open to other suggestions that are proven to work. Multipayer systems for instance. We need not to be too greedy. Rich people are people too, and while payment should be based on a percentage of annual income, so we can afford subsidize those who can't afford healthcare, the rich should not have to pay unfair share.
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I believe the health care system needs fixing, but what concerns me is establishing a system (ala social security) that taxes all for those who don't take care of themselves. This isn't even easy to write because I'd like to think that *everyone* should have healthcare, but not being an "expert" I have to ask is it realistic, especially in light of all the studies and media coverage around the fact that obesity at an all time high and most significantly contributes to poor health. We need to fix this epidemic in tandem or I'm afraid any system that is put in place will fail and be over-costly, no matter how well architected.
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You are already paying for them now. Every time someone has to go to the emergency room to get care and cannot pay, regardless of how well or how poorly they took care of themselves, their costs are passed along to either other consumers or to the taxpayers. And emergency room care is the most expensive care there is.
I understand the reluctance to pay for those who can't or don't take care of themselves, but in this case, ideology makes no difference. We will all pay for everyone one way or another. It would be a LOT better to pay for them in a preventative, non-emergency context than to do it in the emergency room.
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Universal health care will help people who don't take care of themselves to take care of themselves. It is very depressing to know you can't help yourself because you can't afford it. It makes you feel sick in fact.
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I think it so disturbing that the GOP seems so completely invested in their political agenda which has focused on outright opposition and defiance in the hopes they can undermine President Obama's success in office. In defeating healthcare reform through staunch and steadfast opposition, they hope to be able to catastrophize the Democratic Parties ability to pass meaningful legislation. They'll turn to America in the next election cycle and say "Look! You got your man in office, and he failed to produce anything but a larger deficit!".
It is deplorable, destructive and adolescent to take on political warfare rather than national success in the face of such dire need for reform, not only with healthcare but also financial regulation, foreign policy, and equal rights.
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I think the speech was very good. Heath care-It is a moral issue in addition to the needed right for American people. As a Swedish lady once told me, "Your country does not care about its people." She was referring to our health care system OR lack of it.
If only 4 countries in the world do not have health care for all its people and we are one of them and the other three countries are third world countries. That is really a bad image to show of the respect given to the American citizens.
Single pay system is the only really system that makes sense.
Please do not use my name.
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What is wrong with America that we are the last advanced country on the planet to have a single payer plan and we are still fighting about it? The answer is insurance company profits. America cares more about profits than it does about its people. It's that simple. Let's just be honest about that and go from there.
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Here is a list of expenses, hassles and stresses that will no longer accost us when we finally choose single payer. The "public option" does not remove these:
Insurance marketing costs
Insurance CEO salaries
Insurance stock market dividends
Huge clerical staffs to determine eligibility
denial management
appeals
law suits
judgements and appealshuge donations to fund political campaigns
Medical mistakes due to duplication, miscommunication between specialists, confusion of conflicting billing codes, and 'mistaken' insurance denials which result in fatalities.
Pharmacological marketing costs
Big Pharma CEO salaries
Stock market dividends
huge marketing staffs
advertising costs for designer drugs
tax write offs for millions of samples
huge donations to help fund political campaigns
Interminable defensive measures that hospitals force their staffs to take including nurses inoculating hospitals against law suits with mounds of extra paperwork
Doctors making many extra tests either for defensive reasons or because of income incentives
huge clerical staffs to sort out the intentionally different billing codes of competing insurance companies
The systemic pathology of fee for service incentives which creates a doctor corps that is composed of 90%+ high charging specialists
and less than 10% family practitioners whose job it is to keep people OUT of high charging hospitals.
(This last ratio is telling, for all other countries have very different ratios between family docs and specialists, their goal being to keep people healthy, rather than make generous incomes buy treating the ill.)The cost of health care does not only oppress families, it makes US products uncompetitive in the world. Businessmen understand cutting overhead, why don't we see more of them lobbying for single payer?
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You missed one: cost of insurance company "Resision Groups" (spelling?). Congress questioned 3 insurance execs a couple months ago about this. These groups look for ways of RETROACTIVLEY cancelling insurance coverage of customers making large claims (that means claiming that they shouldn't have given you insurance in the first place) .
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mikejb:
Just to be clear, the recision you speak of is where the insurance company issues you a policy, but on later review, if they find a small error of any kind in your original application they will kick you off the policy and deny you coverage. (And once you are denied coverage, no other company will cover you either if you are applying as an individual - they check.) This doesn't happen because you made large claims. They can do it on a regular review of any policy, any time, for the smallest of reasons. If you didn't perfectly understand all the questions on the application form, if you don't have a perfect knowledge of all your medical history and reveal it on that application, if you just messed something up, or your doctor's office messed something up, you are outta here. And they keep the premiums that you paid in over those years. They call it "reducing costs."
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There are two things that drive me nuts regarding this matter -
1. Our do nothing government.
2. The OVER inflated cost of our health care in this country. I am currently wearing a Holter heart monitor that I received yesterday. I was warned when I picked up the monitor to be careful with it - due to the cost of the unit !!$4200 DOLLARS!! It looks like a vintage 1980's beeper. Now I realize that this is a sophisticated piece of equipment but is it really worth $4200?!? I seriously doubt it.
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Like most things (particularly electronic things) it probably costs just a few dollars to make, but the price is set by what the market will bear. Since you can't comparison shop for medical things, there's no competition and nothing to keep the price from rising.
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Single payer makes economic sense to remove the huge overhead expenses. Remove the profit motive and we might get higher quality care.
But, insurance companies are very profittable and have much political power. Why would they want anything to change?
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If our government is unwilling to create a public option: can we? Can we the public do it? Can we create a national non-profit insurance company, with an advisory board made up of experts in economics, ethics and health-care? Or am I terribly naive.
This may be silly but: if there is no public option and everyone is forced to be insured, doesn't this just give the insurance companies more business? If there is no public option to compete with these companies, then what is the point?
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I agree scottmil. You can build a public option on a local level through your city government if you get a number of people on board, but it needs to pass certain avenues to become a federal program. You're right, this will give insurance companies more business. The idea is, however, that premiums will go down with a larger pool of funds invested into insurance companies. I personally, don't think it will help the uninsurered unless the fed heavily subsidize the poor, which is expensive. It doesn't curb costs, it just provides more investment.
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My best friend of 46 years, a staunch Republican conservative worked all of his adult life, earning praise and appreciation from his employers. He was laid off, five years ago and, while looking for work, he began feeling mild abdominal pains. Being broke, with a partner to support and barely enough money to buy food, he decided, as millions of other Americans have to, that a visit to a doctor would have to wait until he had the money to pay for it. He finally got a part-time job as a log truck driver but was not covered by health care until after a 6-month probationary period. Knowing that if he went to a doctor before he was covered that he would be denied coverage because of a pre-existing condition, he tried to tough it out.
When he was finally rushed to an emergency room, it was found that he had acute diverticulitis which had perforated and infected the organs in his peritoneal cavity. They removed all of his large intestine, 30 feet of his small intestine and gave him a colostomy.
His condition was advanced, though, and they couldn't stop the infection. He underwent TEN more difficult surgeries over the next 40 months and spent all but six weeks or so in the hospital during that time. Of course, he wasn't covered for any of this, so the hospitals and, ultimately, taxpayers that will now ultimately have to foot a medical bill that will, in all likelihood, exceed a million dollars.
And all because he couldn't get the few hundred or few thousand dollars or so in health care up front that would have saved his life, given him another 20 years of productive, tax-paying working years and prevented heartache and misery for his lover, his family and his friends. He passed away, of multiple organ failure, three weeks ago.We have complicated problems that require complicated, thoughtful and courageous solutions. The single-payer option is not on the tables because 'conservatives' like Steve (unfortunately) do not understand that government allows us to band TOGETHER to do, together, the things that we cannot do singly. Government is NOT the answer to everything but it IS the answer to some things.
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We spend 50% more on health care than any other country on the face of the Earth. However we rank between 28th and 50th in the world in terms of quality and delivery of health care (depending upon which study you read). Not surprisingly, every other developed country delivers better health care for 2/3 of what we pay by regulating profits, eliminating waste, fraud and inefficiency and ensuring that everyone is covered.
A Harvard Medical School study in 2003 identified over $390 Billion PER YEAR in waste, fraud and inefficiency. Medical costs have risen substantially since then. WE are paying for all of that, as well as multi-million dollar salaries for executives, etc. A lot has been made of the $10 Trillion price tag of Obama's health care reform.It would take less than three years of the waste, fraud and inefficiency to pay for ALL of the reform plan.
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I've a member of a labour union and I've been involved in choosing our group medical insurance. The gentleman from Blue Cross says that there is a great deal of competition for medical insurance in Oregon. That's true in the sense that there may be several companies with prices that may vary by as much as $ 100 a month. That is competition - but if it costs the empoloyer $ 1500 to $ 2000 a month for coverage, they cannot afford to purchase the insurance.
The hope is that a government sponsored health plan will bring down the basic cost of insurance by a significant amount - not just 10 or 20 dollars. -
The problem is that in our capitalist society "health care" has become synonymus with "insurance." They need to be disentagled so one does not benefit directly by the other.
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I find it difficult to believe in the sincerity of the Blue Cross representative since deciding to change my Medicare secondary provider earlier this year.
The Blue Cross application form asked extremely detailed questions for several years' history. The questions seemed designed to eliminate anyone who actually gets medical attention OR, more importantly, to put Blue Cross in the position to cancel an insured person for so-called lying because they failed to mention a doctor appointment 5 years ago.
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As I understand it, several European nations (Germany, Switzerland, maybe others?) retain the private insurance system. Yet they manage to deliver high quality care and insure virtually everyone at manageable cost. How does this square with the position of the "mad as hell" doctor that single payer is the only option?
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It is a multipayer system. Works, but has more paperwork.
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Conservative Republicans are against what Jesus taught about when he said “even as you treat the least of these”, which makes them anti-Jesus.
Democrats try to be “our brothers keepers” just as Jesus taught, but Conservative Republicans are offended by Jesus’ teachings and work to prevent them from being brought to life.
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Self-employed, earning about $30,000/yr. Medical premiums - for my NON-profit insurer - $5,000/yr. Co-pays, prescriptions, dental, glasses - my insurer does not cover these - about $4,000 last yr.
1/3rd of my income goes to medical expenses. I'm healthy.
This isn't right! Shame on a country that let's this happen. Every citizen has a right to basic healthcare at an affordable cost. We need to work backward from that principle.
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There is no reason why in this rich country we cannot afford to make sure that everyone who needs medical care receives it.
However, to think that a single payer or public option will reduce overhead costs is silly. That payer, the taxpayers through our government, will certainly not treat anyone only provide the bureaucratic mechanisms to insure payment at some government determined level. Just as medicare does now. Anyone who has dealt with social security administration or with medicare is certainly aware of the bureaucratic cost of administration.
As one simple example, my wife needed physical therapy. The clinic posed two choices ... pay us $70 or we will bill medicare $150. What medical benefit did that additional cost provide? none all of it was the cost of administration on the part of the provider then add to that the cost of the government administration!
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Taken from Wiki about Canada's single payer system, their sources aren't sited, but I believe this to be accurate:
Fees for doctors, hospitals and other providers are set by negotiations among doctors' associations, provincial or regional governments, and the national government.[citation needed] Global budgets eliminate the high potential costs (as is the case in the U.S.) of billing individually for huge numbers of products and services.[citation needed]
Check out this link that has a summary of reports about the projected savings from single payer systems to the federal, and various state governments:
http://www.unbossed.com/index.php?itemid=2669
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Somehow we have to standardize what it means to have health insurance. Right now, there are so many different plans, all with different coverages, different copays, different exclusions, different deductibles. It is impossible to negotiate the maze, and if you're employer is providing an insurance option, you may have no choice as to your plan. This complicated system surely adds to the cost and inefficiency of the system, and out-of-pocket costs may still make obtaining medical care prohibitively expensive for many people. It seems to me that one way to standardize it is to provide a public option....
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Hi, Is blue cross going to keep their claims processors. the people who validate the claims as worthy to pay?
thanks
Scott
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It concerns me that the importance of health care reform will be drown out by the partisan debate. It appears that the Republican party thinks that this is their opportunity to thwart President Obama, and in doing so, weaken his presidency and improve their chances in the 2010 and 2012 elections. So an improtant issue that almost everyone agrees needs to be addressed is left to fester because of partisan politics.
Rick Wopat
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Two weeks ago I had a minor accident in which I sustained two somewhat deep cuts from falling glass in my arm. It was evening and the nearby clinics were closed, so I went to the OHSU emergency room to get teh cuts stiched up. After the customery wait out front, I finally got into a room where a nurse practicioner performed the necessary work, which took about 20 minutes. This week, I received a statement of charges. The total was around $1500!! I was appalled! I called to verify if this was accurate, and the person that answered the phone assurred me it was, but couldn't understand why I was upset about this because I have insurance and they will cover it (or at least most of it). But that is not the point. I feel that this is exhorbitant for so little work, regardless of who ultimately pays for it! No wonder our healthcare is in such dire straits!
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Emergency room care is the most expensive there is, because the costs associated with maintaining a 24/7 facility that can handle the most dire of emergencies just plain costs more. And the costs have to be spread across all the people who walk into E.R.
It is regrettable that this is the case but ... this is the case.
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The insurance company will use some of that $1,500 to cover the cost of people they treat who are uninsured. That is called "cost shifting" and is one of the reasons everyone needs to be covered. The insured - especially small businesses and individuals, who do not have clout - pay vastly more than others because we are paying for more than just our treatment.
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It's upsetting that some of those who DO have healthcare (I, myself, am covered under my employer) don't want to pay for "those who don't take care of themselves". Isn't having health care an integral part of taking care of oneself?
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Excellent point.
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I just heard Kerry Barnett, corporate servant, say that blaming the insurance industry for the bulk of the problems that this country experiences with health care are unfounded. Obviously he represents his employers and obviously he has never watched a loved one die an excruciating death due to the fact that he could not get access to the health care he had payed for his entire work life. My father died from an asbestos induced lung cancer last year, I watched him wither up in front of me while spending his last days fighting with insurance companies to pay for the treatments he needed, the chemotherapy and medications to ease his pain. Today, my wife is pregnant and can not afford the insurance offered thru her employer, she works for doctors. I lost my job due to this poor recession and we're having to figure out how in the hell we're going to have a child and not see a doctor, maybe thru a midwife, hopefully we don't have any complications. My wife deals with insurance companies and the patients supposedly served by them on a daily basis, she finds that even covered people, like my father can not get the coverage needed to deal with their medical conditions. Insurance companies are constantly limiting patient options, raising costs, dictating who they can see and who they can't, not paying for treatments, etc. I find your guest, Kerry Barnetts' ignorant comments insulting to our intelligence has well as personally offensive. Why can other countries deal with this heath care challenge constructively while the U.S. flounders, are we stupid or just having the quality of our lives dictated to us by corporations who have an obvious economic stake in making us a commodity to be traded. Obviously there is a huge problem with heath care in this country in it's current form, I'm tired of a minority of loud mouthed morons insinuating that those of us who are uninsured are just belly aching and making things up. Wake up America! Get rid of for profit, corporate medicine! Yes we're a capitalist country but capitalism has no place in health care on the care level. How can we call ourselves civilized yet at the same time let insurance companies make millions of dollar from other peoples suffering?
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We don't need insurance, we need health care.
We need to get the insurance industry out of the health care business.
We need to have modestly paid government employees rubber stamping "Paid" on medical bills.
Universal, Single Payer, government run health care is the only thing that makes sense.
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Obama didn't say anything new, and he never addressed the real problem: Cost. The medical programs currently run by the government are bankrupting the country according to his own admission. He claims he won't sign any solution that isn't self-supporting--NICE TRY! Look at the facts. Anyone who believes this hasn't been paying attention to what happens whenever the government does anything.
Cost can be controlled through changes that involve the government in one way: Get rid of government mandates altogether.
No one who has been paying attention would fail to notice that there is no problem bad enough that the government can't make it worse.
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What government mandates are you referring to that increase the cost of health care? And I think the millions of people covered by medicare would disagree with you that the government has made their access to healthcare worse.
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"SanityCheck"
Check returned, stamped "Insufficient Funds!"
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SanityCheck is right here. President Bush enacted Medicade Part D that will last through the 2015 fiscal year. It was estimated in the Congressional Budget Office's report from February 9, 2005, that it will cost American's $558 billion dollars more between the 2004-2013 fiscal years than the cost would have been had it never been enacted. Merely a patch poised to suck in more votes from seniors by Bush. All too common among politians in my opinion. Cost us a bunch and encourages a great deal of growth in cost between those years that we as users of the medical health care system have to deal with, aka our per capita cost. Under the single payer system, not only the federal government, but also state governments would have lower per capita costs to tax payers. That means you and I both pay lower taxes. That is a good thing, then we can spend our money elsewhere and generate jobs for people. That is also a good thing. Single payer will also reduce the cost to schools for my mother's medical insurance. Then they can pay her more, or hire someone in addition to her to get more done. With more getting done in our schools, we can give more people opportunities that will help carry them through life. Madates aren't necessarily a bad thing by the way, they help us keep the things we have, but what we have costs us too much and we feel the pressure.
Check out this link for CBO, state, and various other sourced reports on single payer cost:
http://www.unbossed.com/index.php?itemid=2669
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The President, who was hooted last night by a republican (in small letters), has the right general plan to finally bring the great United States into the universe of advanced nations who recognize that quality affordable health care is a right. Like freedom of speech.
From my first paid employment at age 12 to my current status as having lived long enough to be eligible for Medicare coverage, I have held jobs in the public, small business, and non-profit sectors. For 50 years I've had coverage due to employment with the State of Washington, State of Oregon, State of Arizona, City of Portland and Multnomah County.
But these positions have not been smooth transitions from one to another. There have been stretches, due to my family responsibilities or national economic circumstances when I could not get coverage. COBRA in my most recent situation was unaffordable because I was "sent home" due to a medical condition. How could I then pay for COBRA with out a salary?????
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With a single payer system, we will be more competitive in the global marketplace with Canada, Australia, and Taiwan who also have single payer systems. With the addition of German, Belgium, and the Netherlands who have Universal healthcare with multiple payers, but have some single payer features, and Japan, England, and France, who have other Universal healthcare systems that are of substantially lower cost to employers than the United States, we would be more competitive in the marketplace with most of our largest trade partners.
Single payer is the only system that I have seen that will lower costs, seems to be the only system that will help grow our economy, and provide healthcare based on need and not by ability to pay, which as it turns out is not only a financial burden to the US, but also a social burden as well. My father once told me that a healthy employee is a happy and more productive employee. Let's make America more productive.
Please join my facebook page about single payer (the not-for-profit option). I'm no doctor, and maybe a bit too passionate in my comments, but there are good links to read the things I have that made me so passionate about the single payer system.
http://www.facebook.com/home.php?#/group.php?gid=109758312985&ref=mf
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Recently it was revealed that DNA testing is getting more accurate and is able to predict illness that you may contract in your later life. There are now home DNA test that inform you of these. One big question that is ask is who is allow to see these results. In the current system the insurance companies would refuse you coverage if they found out you had a possible illness in the future. On the other hand if a person knew they wouldn't get sick they would be more likely to not get health insurance and safe money and those that were to get sick would want to get lots of insurance. The current insurance companies gamble on everyone staying healthy and this new information will drive them out of business. If only those that were to get sick got insurance the insurance companies would lose and go out of business paying claims.
It seems with the ability to predict illness becoming more accurate, (they will only get better) that in the end a government run health insurance will be the only system to survive. Rather you call it single payer or medicare for all.
This is just one more reason why that our old model is going to fail.
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Have you looked at Switzerland lately? They are struggling with ever higher health care costs and now have introduced copays. their premiums are ever increasing and the man in charge of the Dept of Health has resigned becasue he was unable to restructure the health care system.
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Nothing is perfect, and every country is having economic difficulties and struggling in some way with costs. However, on a comparative level, the U.S. still comes out far less capable of providing healthcare to its citizens than other developed countries. [See stats at www.oecd.org click statistics, then by topic, then health].
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Switzerland does not have a single payer system and is more similar to what the US wants to do with a mixture of private insurance and a public option. Single payer is different and may not have the same problems. Also, Germany, as a different example of things not working, has a multipayer system that is in a bit of a crisis, not because of the system itself, but because of population growth. Germany's population is projected to shrink in the future, which means there will be fewer people paying into the system to cover the elderly who generally have more health problems. The US population is growing, so we shouldn't have that problem for years to come under a single payer system (or multipayer for that matter).
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To @AlexanderBuxton's comment, "The US population is growing, so we shouldn't have that problem for years to come...."
Let's see, if we banned abortion in general, in about 20 years we'd have a LOT more people in the workforce to keep paying for the elderly, and we'd have solved the problem more-or-less permanently rather than only "for years to come." Why even risk the shinking of our population? Let it flourish! Of course we'll have to all learn to be less consumeristic and greedy along the way, and change our disposable society to a steady state economy (http://www.steadystate.org/) in order for the planet to sustain us....but that's another issue, isn't it? And just as important too I think.
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Dear Datico,
Hmmm . . . there is always a point at which a population consumes more resources than a given area can sustain, so no, I don't think banning abortion will cause human population to keep growing. Yes, we will run into problems in the future, especially if our coasts dissapear due to rising sea levels.
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I had to laugh when Kerry Barnett said that the insurance companies make a mere 1% in profit.. Because healthcare is responsible for 6% of national costs, the 1% starts to look pretty big!
Paul Goreman made the most sense here and has actually convinced me of his argument. I have been for single payer, but have felt that some of the other options would be an improvement and better than no action. After listening to his argument I dont think the compromises on the table will take us any closer to our final goal. I totally agree with this thought he expressed, that Health Care should be a right for all just like fire and police protection and should be treated as such, tho he said it so much better than I have.
I am looking up his organization and plan to support it!
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I agree. Profit is exponential in that sense. I also agree that the other plans being preposed are wasteful and don't take us any closer to the goal of universal coverage. They merely distract us and create a ton of work. Think about a carpenter who works all the time to cover his son's healthcare costs, he would like some time off too.
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I find the comments that people make about being taxed for other peoples unhealthy lifestyles ridiculous. I'm fit, active, I eat a healthy diet, so does my wife yet I have to see a doctor several times a year for an injury I received from an auto accident. The cost to me out of pocket is upwards of over $3,000 a year. Last year I payed over $5,000 to deal with my injury plus a dental problem that arose from breaking my front teeth off as a kid, I'm 34. I figure I've paid almost $20,000 since 2003 out of pocket, how can paying for the occasional slob to see a doctor be any worse then that? A lot of times people have to deal with health care issues that stem from things other then poor lifestyle choices, that's reality, from the young to the old. Yes, their are a lot of others who let themselves go but it would still be an improvement to get health care coverage for all then limp along with this broken, corrupt system we have now. The system we have now taxes those who still have coverage by raising costs on them as more and more americans loose their coverage and can't contribute anymore, it's just going to get worse as this economy continues to stink. I often wonder since the Right seems to consider ourselves a christian nation, why we refuse to make health care available to all americans? Is this what Jesus preached? Is it christian to profit from the suffering of others? Is it christian to be a self absorbed narcissist not concerned for their neighbors?
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Health insurance is analogous to auto repairs though... if a brake job cost $3,000 dollars we would all have to have some kind of automobile repair insurance.
Big Pharma and the health insurance industry are making vast fortunes off of easily cured or managed illnesses.
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A nice message about single payer from Canada:
http://therealnews.com/t/index.php?option=com_content&task=view&id=31&Itemid=74&jumival=4158&updaterx=2009-08-27%2004:08:11
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Dear Think Out Loud,
I have to say that, as an ex-Regence employee, you missed one critical point. Kerry stated that Regence was a "not-for-profit" but the commentator repeated "non-profit". There is a big difference.
Regence is hiding behind the "not-for-profit" shield because they reap huge tax benefits by doing so. (Note that their web site is regence.com, not regence.org, for example.) I watched our "free" benefits become "competitive in the marketplace". Translation: The people making the stuff started charging those responsible for making it and the price keeps going up while coverage erodes.
Regence pays huge salaries and huge "golden parachute" severances to the 6-figure upper echelon. Regence pays huge bonuses to "the board" every year, win, lose or draw. The party line that Kerry spouted about being in business to care for people is nothing short of horse feathers. I couldn't stand by with a clear conscience and watch the egregious spending hand-over-fist on failed technology projects and other monumental wastes of money such as their "REMAC" project, to name but one.
I, for one, was glad to take a huge pay cut and move into a job making over 1/4 less money and am now happily, truly helping patients by working in a health clinic. I may be poor but at least I earn an honest days living.
Sincerely
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The representative from BCBS made a comment about forcing people to have health insurance like they do for car insurance. The funny thing is, driving a car is a privileage. I don't look at being alive as a privileage that just happens to be chance that we are all here. Being able to seek affordable health care is a basic human right not a privileage. Those who think otherwise should really take a hard look at that.
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@lynsky:
"I don't look at being alive as a privileage that just happens to be chance that we are all here."
Your comment doesn't make any sense. I don't believe we're here by chance either...but I certainly do believe that life is a privilege. How can it not be? Anyone born nowadays has been privileged to live and not get aborted. Life is not a right, which we can expect or demand...it is a gift from God and your parents, and every breath is a gift and therefore a privilege not a right. Do you demand that Nature overlook itself and require us all to live to be 120? Or longer? Do we have a right to expect doctors to keep us alive as absolutely long as possible, regardless of the cost? Everyone dies.....if Life was a right then we would all be living forever already.
Now lets be clear...we do have a right to *live* the life we are given....and to that point health care should be available for all to help us *live well*. In that case, wellness programs, lifestyle reform and an overhaul of the American diet/food system is probably the most important part of health care; these factors can simultaneously help people live better lives and prevent them from visiting the doctor so often, driving health care costs down. THIS is the real reform that BCBS is after...just check out myregence.com and see.
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datico,
Life is not a 'privilege.' It is a matter-of-fact thing, that is neither here nor there, it simply 'is.' A privilege requires something of comparison, there is no comparison to life. Death is not a comparison it is an opposite.
The term 'right' does not have an inherent clause that indicates infinity. If you have a right to take a vacation it doesn't mean the vacation should never end...
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Dear Datico,
"Anyone born nowadays has been privileged to live and not get aborted." You are idealising the past. There is not a general decision that happens today with parents of whether to abort their child or not. Sometimes it happens do to personal/medical choices, but that has been happening since the dawn of man as far as we know. This is God's world if that is what you believe, but it isn't a world that has slipped away from God and was once closer to God. You're right that fitness programs would help, but there are many other health problems besides obesity, but I tend to lean towards altruism, not predjudice and have a general wish that those around me should do the same. I think we do, but I also think there are a lot of misunderstandings, especially if I were to tell you you are wrong.
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This is what Kerry Barnett from BCBS was driving at, when he said that we should not force people to have health insurance. The point about car vs health insurance is that car insurance is almost invariably to protect yourself from others and protect others from yourself, because a car can be a dangerous hazard. But your personal health does not impact others quite the same, except for perhaps communicable diseases (which are easily controlled). If you have a heart attack, that is not going to cause someone else to have one. So forcing people to have coverage for their bodies does not serve any real purpose except to keep their own medical costs down at the expense of everyone else. It would be better to force people to eat right and exercise more, perhaps by banning High Fructose Corn Syrup and preservatives, and giving tax credits for walking more than 2 miles to work, etc. These are things that would drive health care cost down by improvements to the general health of society, thereby making healthcare affordable for everyone. The point is clear: like cars and TVs, pretty much everyone will buy something once it becomes affordable.
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Again, I find myself disagreeing with you. Communicable diseases are not nessecarily easily controlled. Heart attacks or other life threatening diseases can effect families, friends, work, or you. I feel that universal health care will help protect me and those around me, just like car insurance. I do agree with you that we should eat better and excersise more, but I believe that the money should be spent in our schools to teach people how as it will be far more preventitive than trying to convince people to get out and excersise. I also agree that people will purchase health insurance if it is affordable, but our healthcare costs are estimated to grow in the future and not to decline. There are solutions that reduce all cost, standardizing forms for instance reduces administration costs for everyone.
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World leaders need to revive bogged-down climate talks at a one-day summit on September 22, unless they want to risk failure in Copenhagen. Is 350.org going to try to effect the Spetember 22 meeting?
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Comments are now closed.
Universal single payer is the only thing that makes sense.