A Dose of Clarity
In a political battle marked by ignorance, spin and venality, it's my pleasure to present two paragraphs of common sense:
Heading into the health care debate, there was only ever one genuinely dangerous idea out there, and that was a single-payer system. Used by every single developed country outside the United States (with the partial exceptions of Holland and Switzerland, which offer limited and highly regulated private-insurance options), single-payer allows doctors and hospitals to bill and be reimbursed by a single government entity. In America, the system would eliminate private insurance, while allowing doctors to continue operating privately.In the real world, nothing except a single-payer system makes any sense. There are currently more than 1,300 private insurers in this country, forcing doctors to fill out different forms and follow different reimbursement procedures for each and every one. This drowns medical facilities in idiotic paperwork and jacks up prices: Nearly a third of all health care costs in America are associated with wasteful administration. Fully $350 billion a year could be saved on paperwork alone if the U.S. went to a single-payer system - more than enough to pay for the whole goddamned thing, if anyone had the balls to stand up and say so.
This is from the must-read article "Sick and Wrong" by Matt Taibbi in the Sept. 3 issue of Rolling Stone. Taibbi's language is raw, but his logic is undeniable.
If the health care debate seems like a hopeless morass, it's largely because moneyed interests want it to look that way - the better to convert principled people into weary, disengaged cynics. And the media have not helped - during President Obama's health care speech, why did an idiotic outburst by an obscure Republican functionary get more coverage than what the president actually said? At baseball games, when an unruly fan runs on the field, the cameras look away.
So here is Taibbi, to remind us that the most fundamental issue is simple: Who pays, and how?
His conclusion? Absent single-payer, a robust public option is absolutely essential because it would be a "miniversion of single-payer, a modest, government-run insurance plan that would serve as a test model for the real thing."
I could not agree more. I've said in this blog and my book that the content of medicine must be reformed or the costs will sink us. Part of that flawed content is insane administrative inefficiency. An incremental step toward halting the ruinously expensive avalanche of paperwork is far better than no step at all.
But now, Senate Finance Committee chairman Max Baucus, a Montana Democrat who has reportedly raked in more than $2.8 million from the health care sector during his career, has released his health care plan. It is still being tweaked by six committee senators, but you already know the centerpiece: so-called "exchanges" of nonprofit, member-owned co-ops that would compete with private insurance companies.
In other words, no government-run, low-cost public option. No "single payer lite" to test the system that the rest of the world knows already works. Senator Olympia Snowe, a Maine Republican working with Baucus, has said there is "no way" to pass a plan that includes a public option. And House Speaker Nancy Pelosi has said she has no "non-negotiable" demands.
The public option is in grave danger.
Matt Taibbi says, "We might look back on the summer someday and think of it as the moment when our government lost us for good. It was that bad."
I've been accused of being too demanding. I've been reminded that "the perfect is the enemy of the good." Perhaps that is true. But every other modern democracy on earth has managed to get to the proper endpoint of health care reform. Is it really too much to demand that we at least get to the proper beginning?
Andrew Weil, M.D., is the founder and director of the Arizona Center for Integrative Medicine and the editorial director of www.DrWeil.com. Become a fan on Facebook.
Follow Dr. Andrew Weil on Twitter: www.twitter.com/DrWeil
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My family has a no holds barred Government Health Plan because we were all in civil service and benefits are much more valuable than in private industry however pay, considering what our role was in protecting the community was laughable. I had to learn the investment field on my own, and for 43 years had a second job. Benefits do not pay the bills. Most Americans do not want to tear down the walls, a public option will come in under the table. I used to work for many years in the investigations field, two of the companies were international. My Dad was a prominent criminal lawyer and politician in my home town of New York City. The apple does not fall far from the tree, that is why those companies hired me and that is why I went around my small town yesterday and spoke to the high profile doctors asking"What is your take on the public option:? Retire, go to Nassau in the Bahamas, Teach, to wit I have had enough. Take money from a doctor you will regret it. Older gents like me will be playing harps as our PSA tests and colonoscopy procedures will result in perforated intestines and delayed retests. In many ways our present system is far from broke. If it ain't all broke do not fix it. You will be disheartened if they go nuclear should loved ones unnecessarily depart because of the potential chaos that we experience as history definitively verifies.
Don't forget a strong dose of Blue Dog greed:
http://www
Read it. It's disgusting. Here's an excerpt:
Arkansas Rep. Mike Ross — a Blue Dog Democrat playing a key role in the health care debate — sold a piece of commercial property in 2007 for substantially more than a county assessment and an independent appraisal say it was worth. The buyer: an Arkansas-based pharmacy chain with a keen interest in how the debate plays out.
Ross sold Holly’s Health Mart in Prescott, Ark., to USA Drug for $420,000 — an eye-popping price for real estate in a tiny train and lumber town about 100 miles southwest of Little Rock. “You can buy half the town for $420,000,” said Adam Guthrie, chairman of the county Board of Equalization and the only licensed real estate appraiser in Prescott.
NO STRONG PUBLIC OPTION = NO HEALTH CARE BILL = NOBAMA
Baucus = Travesty of Justice = Political Su!c!de for Democrats
HEALTH INSURANCE - -
If the health care debate seems like a hopeless morass, it's largely because
moneyed interests' LIES & PROPAGANDA CAMPAIGN makes it to look that way.
CHAOS + FEAR = PROFITEERING for health insurance industry
that DOESN'T WANT COMPETITION.
I've talked to quite a few Europeans about their health care. They'll tell you that it's OK, especially if you're healthy - but they'll tell you that funding it consumes about 50% of their wages. Then they pay VAT on top of that. The Dems are simply lying to us when they say that they can cover more people and save money. If that's the case, then why is Medicare already trillions in the hole with unfunded liabilities? Medicare is a single-payer system THAT WE ALREADY HAVE and it's broke.
Secondly, ScottontheSpot, I don't know of anyone who is travelling to Rwanda for health care. Why don't you move there if it is the socialist garden spot of your dreams?
Finally, the 10th Amendment forbids this kind of government power-grab. If you want national health care, do it the right way - get a Constitutional Amendment started and move it through Congress and the States. THAT is the only way this can be done lawfully.
There is no Europe-wide healthcare system; each country has its own.
There is no country in Europe that I know of that takes anything like 50% of wages plus VAT for healthcare from its citizens or residents.
You seem to be saying that Medicare is unconstitutional. I wonder why no-one else has noticed?
To those who would argue that Medicare is “bankrupt” I would ask:-
“How much better off would Medicare be with even a portion of the money we now pour into the gaping yaw of health insurance companies as premiums or to providers as deductable and co-pays?”
I believe that for a fraction of what people now pay directly to insurance companies and providers and through taxes for our awful “sickness insurance” system we could have instead world class healthcare, but this time for all Americans, not just the chosen few.
With the best features of Medicare and the VA system combined with American innovation we would be well on our way to moving up 37 places in the table that rates healthcare quality.
The opposition to health care reform is harping on that old cliche about bad government!
I have as yet to join with the Democrats, even though I agreed with most of their positions philosophically. In 2004 I was invited to attend a progressive workshop in Washington, largely sponsored by Move-on. During several discussions, I commented to several of the top Democratic strategists and campaign leaders that the party’s continuted slamming of the governement would come back to haunt them. Most all of them thought I was crazy. Recall, Jimmy Carter, who I like from many aspects, raised this to a new level when he ran for and became President (A major short sighted gain, in my estimation that lost him a second term and added to the government myth). How can you believe in Democracy where the people you elect are YOUR voters on issues and then use government as a whipping boy? We are the government. Everytime somebody says something referring to the government, there is a need to substitute the word we or us etc. Then it will have real meaning. Frankly I would rather have Us decide than the corporate executives and boards of Corporations, that have only one goal—make money. Which in many cases conflicts with a priority of Public Welfare! So Democrats, its time to profess the virtues of us/ we over Corporate execs and sapping profits in deciding what is good for us. Get it!
That is such a great comment and great observation. We've all forgotten that the government is "WE THE PEOPLE".
Of course, crooked politicians have made us cynical, but if even a quarter of the population would put down their Fantasy Football sheets and look at the pols in their districts, maybe we could reclaim what was originally ours and begin to put things back on the right track.
When a country starts to look at its government as "us against them", its days are surely numbered.
Under HR 3200 premiums for people with pre-existing conditions will not be capped in private plans. Insurance companies must take you, but can charge whatever they want. You can bet the premiums will be astronomically high, sending such people to the public plan.
Under the public plan, premiums will not be capped if you make above a certain income. According to the table on page 134, you don't have to have much income before your premiums WILL NOT BE CAPPED ... even under the so-called public option, whether you have a pre-existing condition or not.
1— $10,830 — $43,320
2 — 14,570 — $58,280
3 — 18,310 — $73,240
4 — 22,050 — $88,200
5 — 25,790 — $103,160
6 — 29,530 — $118,120
7 — 33,270 — $133,080
8 — 37,010 — $148,040
It’s a fair bet if you have a pre-existing condition, even under the so-called public option, your premiums will be high. You’re better off not making above the maximum in the chart if you have a pre-existing condition.
What many commentators never talk about is that it's to everyone's benefit to spead the risk.
The biggest reason that health insurance is out of control (well, one of the biggest reasons) is because many plans only have a few hundred lives in them. Where I work, we only have 200 or so "lives" in our plan, most of whom are quite old. Our policy is over $10,000 annually for ONE person. That is insane. It's been increasing at a minimum of 10% every year for each of the 7 years I've been here. Some years, it's jumped 20 % or more. Guess what? Our wages have been frozen for a very long time. What would be our wages is going to insurance companies instead.
So, even if you care about nothing else, realize that single payer would spread the risk and would very likely slow costs and reduce costs. Nothing is free, but I'm currently paying MORE THAN 1/5th of my income for insurance. Unreal.
So, the idea, and how Progressives ought to be selling the idea, is to spread the risk around. The more lives, the more spreading of risk. I'd gladly pay into the system at the federal level. I'd save thousands, no doubt.
I don't have a problem with taxes if I get something from it. Right now, some of my taxes and alot of my medical costs go to the people who don't have insurance. Oh, and they go to corporations and banks, too.
Paying $10,000 a year -- for care -- in a broken health care system is highway robbery.
$10,000 - I'm not surprised. I have excellent insurance through my employer, a wealthy and generous private University. The University pays 79% of my family's insurance. I pay about $350/mo for myself, my spouse and my daughter. So the total cost of our health insurance is approximately $20,000/yr and I'm just one employee!! My son recently aged off of my plan (they wanted $350/mo for him alone under COBRA) so I had to buy a separate policy for him. I found a policy for him through a large HMO carrier (he was 23 and very healthy) which I tried to tailor to his needs. I found one that fit pretty well and cost about $80/mo. The next policy year (about 5 months later) they raised his rates 20% even though he never used the insurance! Their explanation was "well, that's Illinois!". This year, he got a job with benefits and I could cancel the policy. Shortly before I canceled it, he received a letter saying his rate was going up another 20% and he still had never used it. I'm so sick of the greed and attitude that the wealthy are somehow more "worthy" than the less advantaged ("not everyone can afford a Cadillac"). All of our citizens deserve quality health care. What a sick nation we are!!!
Only two problems with this...65% of doctors HATE the gov't health programs http://www
Oh, very good. Quoting a poll conducted by IBD, the same intrepid "journalists" who fretted that poor Stephen Hawking would have been allowed to die had he been unfortunate enough to live in th UK, with their dreaded National Health Service. Of course, the crippled physicist Stephen Hawking,,,, DOES live in the UK.
Got any CREDIBLE sources?
Intellectual honesty is not their strong suit.
65% of doctors Hate the gov't health programs because they make less money on medicare patients and virtually no money on medicaid patients. Unfortunately most doctors entering the profession today go into it for the money and social prestige, not because they want to take care of patients. The only way to straighten out the system, which is breaking the back of American business and will bring the entire economy down in short order is to take the insurance companies and their obscene profits and inhumane practices out of the mix. Why are conservatives who claim to be pro-business supporting an industry so bent on ruining business?
And speaking of breaking the back of American business and obscene profits, don't even get me started on Worker's Compensation Insurance ( which could conceivably be eliminated by a 24/7 single payer system)!!
econ101lab
63% of MDs are in favor of health care reform.See New England Journal of Medicine Sept 15'09
That's a GOTCHA
Well done.
What evidence is there that there will be less paperwork under plans currently being proposed?
Death by Uninsurance
http://cor
A new Harvard study estimates that lack of health insurance kills about 45,000 Americans annually, which is 2.5 times as many as the previous best estimate commonly cited in the health care debate. This is a big difference (27,000 additional lives). But it still pales in comparison with the more than ONE MILLION AMERICANS WHO DIE ANNUALLY BY THEIR OWN HANDS -- which they use to light cigarettes, lift forks and convey too many alcoholic beverages to their lips.
What, in the current proposals, will adress the high death rate by lifestyle choice?
Given that everyone dies, what is an acceptable death as a goal under the new proposals?
What number of deaths per year is acceptable?
these are good questions and your fundamental one is the ciritcal piece - what in any legislation specifically remedies any of the quoted issues. Writers and politicans impute the correlation of a number or issue and the legislation and there simply isn;t. any. The harward study actually doesn;t say that lack of insurance kills 45k - when you actually read the methodology - its pretty bogus. Another red herring is a soup of misinformation.
I would argue it's virtually common sense that less variety in forms necessarily equals less money and time spent on completing paperwork.
I have family who work in billing departments. It takes a tremendous amount of time to enter codes for each different insurance company. The book of codes for each company is as thick as a NYCity phone book.
One code = less labor costs.
Moreover, insurance companies routinely reject claims the first time (at a rate of about 20%.) This means the hospital/clinc has to file at least TWICE for one in five claims.
It WOULD save billions. Sure, it's hard to be exact, but we do know, common-sensically, that it would save a lot of money.
Also, ask DOCTORS. You know, the people who provide the care? Some will offer HUGE cash discounts. Why? Because much of their costs are dealing with insurance companies. A short appointment really only costs a doctor 20 bucks, but get insurance involved and you'll get charged 90-100 dollars. Ask. Some doctors will accept cash payment at a much lower rate.
How are there going to be " less variety in forms" under current proposals?
You do know that doctors will still be working with insurance companies under current proposals. Various insurance companies are going to be providing the "public option" insurance ... as government contractors.
If the health care reform plan had a actual free market proposal in it; 90% of doctors and/or clinics, and hospitals would be unemployed; because, people would go to the best doctors, clinics, and hospitals for the best price.
And, people would be healthier; so that would be bad for big Pharma because less people would buy drugs.
Why has no one ever wrote a "Art of War" book for dummies?
Well, for one thing ... the paperwork could probably be cut in half (at least!) if people didn't have to fight endlessly when their claims are denied.
Secondly, if everyone were working off the same insurance system, i.e. paperwork, the entire system would be streamlined. Like the article says,
..."There are currently more than 1,300 private insurers in this country, forcing doctors to fill out different forms and follow different reimbursement procedures for each and every one. This drowns medical facilities in idiotic paperwork and jacks up prices: Nearly a third of all health care costs in America are associated with wasteful administra
People who oppose a public option like to say that COST-CUTTING is the solution ... not a government-run insurance plan. Here's a very simple way to cut a huge chunk of the costs from our health care system. Throw in the insane salaries of the HMO CEO's and you're starting to talk real money ...
Has anyone else brought an idea to the table that could reduce health care costs by a third?
Bottom line, HMO's profit from sickness and death. Not health and well-being. They are parasites that add nothing of value to the American public. They're no better than pimps.
Agreed. Well put.
Insurance companies are what labor unions of long ago would have called "parasites
Insurance companies are PARASITES. They thrive off others. They then make them even sicker and sicker, until they ultimately just dump them off when they're no longer able to make more money for the insurance company.
"Well, for one thing ... the paperwork could probably be cut in half (at least!) if people didn't have to fight endlessly when their claims are denied."
Who says claims won't be denied? They are all the time under Medicaid and Medicare.
Insurance = Gambling
I will bet the insurance company $800/month that my families health care needs exceed that amount every month. I will bet the insurance company $700/year that my home won't burn down. I will bet the insurance company $50 a month that I will die before the age of 65. I will bet the insurance company that I wont be in a car wreck this month.
I am not by nature a gambler. Why am I forced into this casino?
Single payer, taken from income taxes will diminish the stress level of untold millions of Americans. Don't we have enough to worry about without this?
whoever wants to join and pay through a single payer system
will do so.
whoever does NOT want to
can knock themselves out with their freedom to
buy and pay through a corporate insurancem and
get whatever procedure their profit-maximizing doctors order for them.
Single payer is not on the table.
However, if it were, you would not be able to 'opt out' of it.
The single payer is the taxpayer, all of them.
i'm just suggesting,
since the dummies and their greedy manipulators are kicking and screaming all the way.
one they see what the smart and humane ones are getting,
they might, just might wise up and join the majority,
and then there will be a real single payer.
in canada, alberta introduced a single payer first and
in no time, the rest of the country followed suite.
Which means health care reform isn't on the table.
Everything else we've talked about has just been one angle on corporate welfare or another.
I agree, but they should be able to join or quit whenever they want too.
I'ma have to check out of this debate because I've come to think the real reason we can't have "health-care reform" is too basic and depressing: we are a thousand times more afraid of death than we love our neighbors. How can there any good thing come out of that point of view?
Given that everyone dies and everyone knows that everyone dies, you're argument makes no logical sense.
No plan currently up for consideration is promising no death.
My endocrinologist has 2 full-time people on his staff who do nothing else but handle insurance paperwork. Think that's not included in the cost of my $225 office visit?
For that office visit, my insurance company will only reimburse me $30 (if and when I meet my $5000 deductible). Oh yeah, and my prescriptions aren't covered either. And for all this, I pay over $4000 a year in health insurance premiums as a self-employed person.
Somebody's getting rich and it's not me or even my doctor.
You are right on so many levels. Our costs with employer sponcered health care are $7000 a year. It's killing us. Our costs have quadrupled in the last few years. Our wages have not increased and thus there is no extra money to save, invest or spend in the economy. The worst part of this expense is that at least part of my payments go to funding conservative politicians that are fighting pubic option/single payer tooth and nail. This is criminal..
The costs are exhorbitant for what you get (it sounds like not much).
However, what makes you believe that costs will go down under plans currently under consideration?
Absolutely nothing. Max Baucus and his patrons in the insurance industry have made sure of that.
The proposed legislation currently under consideration has been gutted to the point where it's become completely meaningless.
Corporate America wins again.
I'm not trying to be mean, but the rest of us are arguing the merits of single payer, which is what the article is about, and you're responding about the "current" plans under consideration.
Most of the people posting here are not in favor of any of the current proposals either. We are arguing for a SINGLE PAYER system.
Argue against that.
I dont' support the Baucus plan either. I'd rather see that defeated than have any plan at all. The only thing the Baucus plan might do, as best I can understand it, is to give the insurance companies even more money and profit, while hosing the rest of us.
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