The Health Care Bill: Where Is the Concept?
An open letter to President Obama regarding health care reform
Dear Mr. President,
I agree with your assertion that the health care crisis is an economic issue. We have the best doctors, the best hospitals, and the best drugs; however, they are out of reach for too many Americans. Costs have spun out of control. I commend your audacity in declaring this state of affairs as unsustainable, and your determination to reform it.
Three pages missing
I could not afford to read every line of the 1018-page document; nevertheless, I read the chapters deemed essential, and as many reviews as I could. I found three pages missing.
Of those three pages, I expected the first to summarize your diagnosis of the current crisis, with an itemized list of the key causes. On the second page, I anticipated an outline of the solution that you selected. On the third page, I sought an explanation of why your solution is better than others.
Instead, you threw at me 1018 pages of legal lingo, knowing that it would be physically impossible for me to comprehend all the provisions of this proposal before Congress will vote on it. I cannot speak on behalf of other taxpayers, but I found it disrespectful.
What is health insurance, and what should it be?
In my spare time, I conducted some personal research on the problem. In line with my engineering background, I tried to define the subject of my inquiry as a first step. To my surprise, I could not find a definition of the term "health insurance" in any U.S. government-issued document. I found definitions of "health insurance coverage," "health benefit plan,"and "health insurance issuer," but the definition of health insurance itself was nowhere to be found.
In other words, Mr. President, you are initiating one of the largest social reforms of our time, putting about $1 trillion of taxpayers' money at stake, on a venture that has an undefined subject. This puts you in the same camp as your predecessor, who in a similar manner, without defining the subject, started wars in Iraq and Afghanistan. In your defense, most of your opponents do not care to define health care either.
For the insurance industry, "health insurance" means covering claims within agreed limits for the term of one year. What is the value of this offer for a healthy individual who barely uses medical services? If after buying this insurance for twenty years, this individual will develop some chronic illness, this person will be priced out of the system due to preexisting conditions, unless he or she works for a large corporation or the government. What is the value of health insurance that will not cover a sickness when it becomes serious? It is no wonder that many people gave up on paying a premium for health insurance as it is now.
Thus the question is, what should "health insurance" be? The only health insurance that a reasonable person would like to have is lifetime health risk insurance. This insurance would include what we now call catastrophic coverage, would pay for expensive treatment of chronic diseases, and cover end-of-life care if needed.
Most presently sold health insurance plans include routine medical care. An average person sees a doctor once in a while due to a bad flu, skin rash, toothache, or cut finger. Those routine doctor visits are part of daily life, similar to our other unexpected expenses. Once a while, our refrigerator breaks and in short order we need to find some way to pay for the repair or replacement. Some of us buy extended warranty plans that pay for the repair in advance, and some pay for the repair when the refrigerator breaks. Similarly, some of us might prefer to buy health maintenance plans that pay in advance for those minor every day medical routines, some might prefer to pay out of pocket when the need arises.
One may notice that presently sold health insurance plans are a combination of one-year catastrophic coverage and a health maintenance plan for routine medical care priced accordingly to the health risk on the individual or a group. One of the ways of resolving our health care crisis is in separating these two products and treating them differently.
Why do some people not buy health insurance?
For people buying health insurance as individuals, the currently offered plans offer practically no insurance in case of serious sickness. About 18% of the uninsured make more than $75,000 per year; they can afford to buy health insurance, but did not do so since they gain little or no advantage from it. Regardless of whether they buy health insurance or not, in the case of a major chronic illness, they would be priced out of the insurance plan, and end up using government-sponsored programs anyway. Staying uninsured is a rational choice.
In your interview with Dr. LaPook, you stated that you would introduce an individual mandate, forcing those who could afford it into buying health insurance. You did not seem very concerned with the reasons why they did not buy health insurance in the first place. It took you only six months in the Office to acquire an attitude that our essential problems could be resolved by using the powers of the federal government to force Americans to do things that they do not want to do of their own will.
Freedom of choice or compulsion?
As a society, we decided that it would be inhumane to leave a sick person with no care. Out of compassion, we provide charitable care, which in the end increases the price of health insurance premiums (for those who buy health insurance), and the cost of government-run health care programs. Now, we have reached a point that where all agree that something needs to be done about it.
There are two schools of thought for obtaining social goals. One is in using the power of the government to mandate what is believed to be the right thing and then enforcing this under the compulsion of the government apparatus. You seem to be leaning toward this approach.
I prefer a different method, based on finding out what people want and then letting them do it by eliminating obstacles. I might be wrong, but it is my assumption that most uninsured Americans would like to have the comfort of carrying decent health insurance. Furthermore, the minimum they really want is health risk insurance, providing lifelong coverage in case of accidents, chronic illness, and end-of-life care. Jumping ahead of your possible answer, we do not need a government run insurance company. People would gladly buy this kind of insurance from existing insurers as long as the government could guarantee portability of these sorts of plans in the case of the insurer's bankruptcy. Therefore, there would be a role for the government, albeit very limited; this is rather as the Founding Fathers preferred.
This health risk insurance would form a legal framework for what we already do: subsidize health care for the poor, unfortunate, and socially misfit. With this understanding, Americans would accept so-called "community rating" for this very basic insurance, meaning that the wealthy would subsidize the poor, the health conscious would pay more to cover for the higher health risk of the obese, drunks, and smokers.
Statisticians can calculate the probability that I will live healthy until the age of a hundred and then one day not wake up, incurring no medical expenses. Similarly, there is some probability that tomorrow I may acquire some medical condition that would require expensive medical treatments for decades to come. Somewhere between those two extremes, there is a number of dollars per insured person, which the insurer would need to have on hand in order to stay solvent. Health risk insurance would build a cash-accumulating account associated with an insured individual, intended to cover the costs of expensive medical care. If the funds are not used during that person's lifetime, they become available for use by others in the pool, whose costs of medical care exceed the money accumulated in their accounts.
When providing someone with health risk insurance, the insurer would be interested in keeping the insured in good health, so it would offer health maintenance plans suitable to preexisting conditions of a person or a group. Furthermore, the insurer would be interested in invoking more health-conscious behavior in its reckless customers. If an insured person decides to switch his or her health risk plan to another provider, the cash associated with his or her account would go with that person. Before letting this cash go, insurers would make an extra effort to find a health insurance plan suited to the situation of that person.
By giving a tax credit matching the health care premium of a current decent health insurance plan, there would be no need to mandate the purchase of health risk insurance. In fact, not buying this rudimentary health risk insurance would mean a cash loss for most taxpayers. Those who are too poor to pay income tax would receive a voucher for health risk insurance.
This approach would leave room to downsize, and maybe even phase out completely, the current government-run health care programs, releasing some of the cash needed to underwrite the start-up of the health risk insurance plans.
Additionally, the health risk insurance plans, as outlined here, would create mechanisms pushing down the costs of health care. However, more factors cause costs increase.
Why have health insurance premiums become so high?
With many healthy people not buying health insurance, the premiums go up for those who buy. However, this is just one, but not the main, reason for the skyrocketing costs of health care.
Currently, whoever gets health insurance as a job benefit or government entitlement (Medicare, Medicaid, VA or TRICARE), milks it to its limits, as he or she does not feel a connection between the price and service obtained. Third parties pay 86% of the medical costs of people with health insurance. Neither those who receive nor those who deliver health care are concerned about the price. With the pool of people holding good health insurance shrinking, doctors and hospitals are inclined to get busy providing whatever profitable treatment they can justify when they seize a patient with a good health insurance. Skyrocketing health care costs are the obvious and logical consequence.
When criticizing the current system, some say that the mess we are in proves that, in the case of health care, the free market system does not work. Facts prove the opposite. The government, both on federal and state levels, is so over-concerned with the quality of health care that Americans receive that it heavily regulates the whole industry.
Heavy-handed licensing restricts access to medical practice, limiting consumers' choices. After all, in many urgent cases people go to the emergency room not because of the severity of their sickness, but because they cannot find a family physician who could see them. Mr. President, please help me understand how a government-run insurance plan would resolve this problem.
As you correctly pointed out in your speeches, in some states the costs of health care went up much more than in others. You indicated that, under your administration, the government would get busy finding the reasons for these differences and would create policies reflecting this. I have another suggestion. If I live in a state with high health care costs, and if insurance plans offered in another state are more suitable for me, I would like to be able to purchase my health insurance plan from this other state. Presently, state regulations do not allow me to do this. Mr. President, could you increase my freedoms by helping me in eliminating these restrictions? This would create competition between states, pressing down the price of health care, without any work from the federal government.
Excessive hospital care costs often make splashy points in debates on health care. However, if I could find a way of providing hospital care for the half the price that existing hospitals charge, I would not be allowed to do so. Before opening a new hospital, I need to obtain a "certificate of need" from my state. There, a few state bureaucrats, heavily lobbied by the owners of the existing hospitals, would deny my petition on the grounds that the beds in the existing hospitals are not fully utilized, hence no new hospital is needed. They would conveniently overlook the fact that the resources of existing hospitals are not fully used because many people who need their services cannot afford them. With the prices cut in half, my hospital would not only provide health care for some of those who cannot afford it now, but would also put out of business the expensive hospital, lowering health care costs for everybody. Mr. President, could you help me by getting rid of "certificate of need" regulations?
Critics of the current system often cite instances of hospitals charging hundreds of dollars for an item that one could buy for a few dollars at Walgreens. They forget that there are two parties in every transaction: a seller and a buyer. The seller might ask for the moon, but as long as the buyer does not accept the price, nothing happens. Instead of focusing on sellers asking excessive prices, I would shift attention to buyers accepting them. The U.S. government pays for 46% of all health care costs through its programs, and is the largest buyer of health care services. Therefore, it has the power to set prices. In plain language, greedy doctors, money-seeking hospitals, and profit-thirsty insurance companies do not set the prices of health care. The prices are set by what their largest customer, the U.S. government, agrees to pay. Mr. President, I have difficulties in comprehending how a public insurance plan run by the government can help us in resolving this problem.
In the previously mentioned interview with Dr. LaPook, you said that you want to create a public insurance plan in order to discredit the arguments of skeptics who claim that "government is widely inefficient and can never have anything done." Let me suggest to you that you can prove these skeptics wrong in a much simpler way, without creating a new government entity. For all practical purposes, the government is already in the health care business. Within the last ten years, the costs of both Medicare and Medicaid have roughly doubled. If within the next year you can reverse this cost escalation, one year from now I will look favorably at your idea of creating a public insurance plan.
What is the purpose of business?
Most Americans who have health insurance have it selected and in large part paid for by their employers. This appears to be the American way of handling it. Although, if personal freedom and the right of each individual to pursue happiness are core American values, then health insurance chosen and paid for by corporations is downright un-American. It means undignified patronizing. It is limiting someone's freedom of life through an essentially not business-related dependence attached to the employment contract.
This practice started during War World II when employers offered extra benefits to attract workers, circumventing government-imposed wage limitations. It is a relic of wartime government intervention into the economy. What is the rationale behind expecting an employer to select and pay for the health insurance of his or her workers, and their families? The purpose of business is making a profit by selling its product. The government takes its share of this profit, and in exchange provides the infrastructure for business to function. It pays for law enforcement, it monitors the education of youngsters, and guarantees technical infrastructure - water, sewers, roads, postal service, electricity, phone lines, etc. The government takes care of these essential services by administrating them itself or by regulating and closely monitoring businesses that provide these services.
Is it too much to ask that a business be able to select its workers from a pool of people healthy enough to do the job without having to take into account the cost of their insulin injections or the cost of healing the broken bones of their children? Should not the health of the public be a part of the infrastructure like water, sewer, education, and national security? And obtained in a similar manner?
Mr. President, please give me one good reason why my employer should buy me my health insurance. Should he select the plan suiting his personal preferences, or mine? Should he include abortion in the plan, and - indirectly - force me to pay for it, despite the fact that I consider it morally wrong?
Nevertheless, most small business owners work extended hours struggling to survive. You plan to drop one more administrative task on their shoulders. Forcing businesses to provide servitude in a kind of administrative work, which should be handled by the federal government, is an ungracious tax.
Lastly, forcing business to pay health insurance will affect their bottom line, especially in the current economic downturn; prices and unemployment will go up. With one hand you hand out money to stimulate economy, and with another you take it back.
Mr. President, I heard you say on several occasions that abandoning the routine of employers buying health insurance would create disruption that you are not ready to accept. Unfortunately, this is the essence of the current problem. If anything is worth changing, this is. Real change always causes disruption. If you cannot endure it, please call off your promise of change.
How urgent is it?
Americans are fed up with the current health care system and want speedy reform. On the other hand, the reform we need to make is at least a few decades past due. How much more damage will we suffer if the current system remains unchanged for another year? How much damage can we cause if we pass a reform that is not well thought out and contains provisions that many Americans disapprove of?
By creating obligations affecting every American, this reform touches the basic values of our political system. It is much more than who pays for health care and how. It is about what core American values, as defined by our Founding Fathers, mean to us today. I find it deeply disappointing that you put so much energy in pressing for a speedy legislation process, avoiding discussion on the concept behind your health care reform proposal.
This text can serve as an outline of an alternative concept of health care reform. Maybe it is worthless, as I do not have the wisdom and resources available to the federal government. However, before considering your proposal, I would like to see at least one, preferably two alternative proposals, equally detailed as yours is. Furthermore, I would like to have at least several weeks of public discussion of the pros and cons of the presented proposals. Out of this process, Americans will support one of them.
By following this regimen, you, as President, would be able to take credit for the best health care reform plan that American people were able to bring up. Unfortunately, as it is now, one can get the impression that it is less about fixing the health care system but more about implementing certain political concepts shared by some present leaders in Washington. This ideological leaning is prevalent in the report prepared by your Council of Economic Advisers. According to my unscientific observations, about 50% of Americans do not share ideological leanings of your advisers. In preparing your health care reform proposal, you dismissed their views and the American tradition behind them.
Its is your call Mr. President; in selecting the health reform plan you have to chose between political beliefs on one side, and a cold analysis of facts on the opposite side. It may take a little longer than we all would desire. However, it is worth some extra time and effort, because, in its very essence, the current debate is not about health care. It is about America defining itself at the beginning of the 21st century. What does it mean to be an American here and now? What do the fundamental concepts of individuals' freedom that led to the original rise of America mean to us today, and do we care?
Sincerely,
Henryk A. Kowalczyk
Bolingbrook, IL
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The one thing that I think will help frame this whole debate on Health Care and Universal Health Care is this: If I join the program that is run by the US governement and the insurer (of which is the US govt) does something wrong like not pay for something I need (that is backed up by statistics and other hard data as something that should be given), or a family member needs, and my family member or I loose a limb or pass on, can a lawsuit be created with the possibility of winning the same sums of money that the private insurers face?
In other words, if they make it so that I can not get the treatment I need when I need it by deniing payment, can I sue and win judgements much like the insurance industry does?
If rationng care happens (lets just be fair, whether you are for the proposal or not, it could happen) and I do not get treated, can I sue?
I think that will help people see what is at stake and if they want it or not by the answer our politicians give to that question (of which I still do not know the asnwer to).
P.S.
Most people do not know that it is dificult to sue the federal, state or local govermentsbecause they indemnify themselves in multiple ways including limiting any lawsuit to a specific amount.
Mr Kowalczyk - what do you think of this actual solution -
http://64.
There is a concept behind this solution, but it is not outlined there. One has to decipher it from the provisions recommended.
In this concept, I see many provisions akin to my suggestions. I guess that anyone analyzing the problem basing on facts and logic would arrive with similar conclusions.
In this proposal (at some points), it is not clear to me if suggested solutions reflect some ideological leaning, or knowledge that is not disclosed to the reader.
In my school, we first have to define the problem, then we have to phrase the desired outcome, and only after agreeing on the above, we can discuss potential solutions. Please notice that many politicians describe the problem (statistics about costs, and uninsured, and anecdotal data about people suffering) and call it the problem definition. Those are symptoms, no the diagnosis.
Nevertheless, this solution gave me a few good ideas. Thank you for pointing me to it.
BTW, you may like this video, http://www
You make some good points.
The House leaders reached a deal on Medicare payments: A "Pay for Value" reimbursement system that rewards doctors and hospitals that achieve the best outcomes at the lowest cost.
As a result, The House gained a lot of votes, a lot of people who were withholding support.
The federal Medicare program insures some 44 million elderly and disabled Americans at an annual cost of $450 billion, almost one-fifth of total U.S. health care spending.
Supporters of the agreement say it could save the Medicare System more than $100 billion a year and improve care, that means $1trillian over a decade. (Please visit http://www
The Times in a July 7 editorial argued “As much as 30 percent of all health-care spending in the U.S. -some $700 billion a year- may be wasted on tests and treatments that do not improve the health of the recipients,” Thus the remaining $239 billion over a decade does not matter.
No one can disagree with this best outcome / evidence-based system, and private insurance, too, will be greatly influenced by this change with the focus on value over volume.
“A Pay for Value” is just one more bureaucratic invention and will likely be as good as all the others before it, that lead to the almost financial collapse of government run medical programs.
Insurance companies are the same service businesses as car mechanics. Car mechanics do not fix cars for the love of automobiles. They are driven by greed. Some will take advantage of their customers. However, due to open competition most of them can make the best profit by eating with a teaspoon; by making a small profit everyday from the returning customers.
What I am trying to say is that real cost saving will take place not by government shuffling billions, but by every health care recipient and every health care provider, reasonably balancing dollars spent against potential benefits received.
While your numbers add up quite well, the key issue I have is rewarding "doctors and hospitals that achieve the best outcomes at the lowest cost"
What are these "best outcomes"? is it possible that as the plan grows and as doctors and hostpitals get used to how it work that maybe they will have many "best outcomes" even though they are not actually best outcomes?
In other words it sounds like an incentive to say the patient is ok AND that the hostpial used less money to help them while doing it.
So what are these treatmenst that are so unnessicary? And who is deciding that they are unnessicary?
Also another problem is that it would seem they about money they MIGHT save and costs that MAY becme lower. How come they don't talk about how if more people are covers that it may increase cost to cover them?
Medical treatment it is not arithmetic; whatever we do, it is our best guess, basic on the knowledge we have. Furthermore, we have to accept that sometimes there might be treatment good for us, but beyond our financial reach. Even the richest country on Earth cannot afford paying for the most expensive medical treatment for everybody all the times.
However, those are very exceptional instances. In most cases, and these decide on our costs of medical care, it is a choice between a cheaper, not necessary worse, and expensive ways of dealing with an illness. The first paragraph of this text gives you good idea what I am talking about: http://www
There is no government regulation that can impose personal integrity into the doctor-patient relationship. What it can only do, it can provide and alibi for questionable decisions, which basing on their conscience, doctors and insurance providers would never make.
"When criticizing the current system, some say that the mess we are in proves that, in the case of health care, the free market system does not work. Facts prove the opposite." How do the facts prove the opposite? We spend more than twice as much per capital on health care as any other country and yet the WHO ranks us only 37th. That seems inefficient to me. Almost all of the countries ranked ahead of us have some kind of single payer, national health care, or combination of those and private insurance.
In my text, the statement you cite is followed by several examples proving that we do not have free market in our current health care system. This is why our system is inefficient.
Health care systems in other countries reflect their traditions. In general, they are more socialistic than our American system. They face the same problems as we do: rising costs, overuse of medical services, and necessity of rationing health care.
My question is, what is inherently superior about the "traditional" American way of doing things? Frankly, perhaps it is time to consider that certain American "traditions" are in dire need of revision. I have never understood why American = Better, almost automatically in many people's minds.
The WHO highly values "universal coverage" in their criteria. Therefore ("Duh!"), the WHO ranks countries with national health care very highly.
Please define "milks it to its limits" and then provide evidence that that is what is actually happening. I have good company health care and I have no idea what you mean. I call the doctor when I am ill. I go to the specialists and take the medications and tests he tells me. As for the connection between cost and service. That's ridiculous. If my son gets cancer, I'm shopping around for the best doctors not the cheapest even if bankrupts me. I'm not James Tyrone Sr. from "Long Day's Journey Into Night" sending my son off to die in the cheapest hospital I can find. Most of us feel this way.That's why we need single payer.
“Milking the system” is well recognized, and agreed among experts, reason for rising costs. President Obama gave examples during his last press conference. I believe you that you are reasonable and prudent in using health care. Many people believe that the more expensive treatment the better it is for them. Almost one in every three births is by C-section. Most experts agree that it is at least twice as many as justified by medical conditions. C-section doubles the cost of child delivery, and increases risk of complications. This is an example of milking the system. We all pay for this.
Finally an engineering approach! I may be old but at one time, if you had a cut, you washed it; if you had a burn, you ran it under cold water; if you were sick, you maybe took some PeptoBismol. You didn't take an antibiotic, pay for a doctor or go to the emergency room. I have no statistics but I would guess a lot of the use of doctors and emergency rooms require neither. Either our mothers are no longer teaching us these things or we don't want to take responsibility for ourselves.
"we do not need a government run insurance company. People would gladly buy this kind of insurance from existing insurers as long as the government could guarantee portability of these sorts of plans in the case of the insurer's bankruptcy. Therefore, there would be a role for the government, albeit very limited; this is rather as the Founding Fathers preferred.
That would be fine as long as we are talking about non-profit insurance companies. Currently health insurance companies make profits by denying claims not by providing any services. Administrative costs are around 31%. Medicare's administrative costs are around 3%.
How do for-profit insurance companies decrease cost or improve health care when their profits go to share holders rather than hospitals or doctors?
Insurance companies make huge profits because they are so strictly regulated that for all practical reasons they are quasi monopolies protected by government regulations intended for public good. After all, they, not you and me, have an army of lobbyists making sure that whatever regulations might be, will be good for them. The fewer government regulations, the less lobbyists can buy.
Medicare has small administrative overhead but still if facing financial collapse. Why? Because government overpays for medical services. And, because people who have it,consider it free, so overuse and abuse it.
Lastly, I could not find solid data, but from what I know, I suspect that low administrative overhead for Medicare results from many administrative task being subcontracted to “inefficient” private insurance companies.
Insurance companies are the same service businesses as car mechanics. Car mechanics do not fix cars for the love of automobiles. They are driven by greed. Some will take advantage of their customers. However, due to open competition most of them can make the best profit by eating with a teaspoon; by making a small profit everyday from the returning customers.
Government is the largest customer of health care services, paying for 46% of all of them. Hence, setting the prices. When complaining about record profits by insurance companies, Obama omits conveniently that those profits are mostly due to payments from the government.
Poll Still Finds Public Support for Health-Care Reform: While a majority of Americans still think health-care reform is needed now, some of that support has wavered slightly as Congress wrestles with the details of producing a reform package, according to the July Kaiser Health Tracking Poll. Fifty-six percent of Americans continue to believe that health reform is more important than ever, despite the country's economic problems. And by a better than two-to-one margin (51 percent to 23 percent), Americans think the country would be better off if Congress and President Barack Obama enacted health reform, the poll found.
Aside from the savings created by the prevention and wellness program, medical IT, foreseeable potential stem cell effect, mental stress relief and massive job creation, ending subsidies for the private insurers and payment reform and so on could be enough to meet the goal of deficit-neutral.
Public school, public insurance policy, and public clean energy act are the natural parts of life in the free nations.
Thank You !
In surveys, Americans can only answer questions that are asked. It is unreasonable to expect that suddenly most Americans will become health care experts.
Our political leaders and media failed in giving Americans reliable diagnosis of our health care crisis. They produce thousands of pages of documents, but those three pages outlining the concept behind what they propose, are missing.
So the poll found that "Americans think the country would be better off if Congress and President Barack Obama enacted health reform"? Maybe that's because "reform" can mean anything. That's like asking people "Would you be in favor of The President fixing everything that's wrong with the health care system?"
How about asking "Would you favor structural reforms in the healthcare industry that increase competition and lower costs, or would you favor the Government taking over the industry?
I enjoyed the article. You appear to have given the topic much thought. I wish I could point to any of the public faces pushing the present reform and say the same. Unfortunately, I cannot.
jhNY: Perhaps Mr. Kowalczyk is out of his depth. With that said, if you've spent any time reading and watching the politicians and pundits from both sides speak about the present reform (good and ill), you will recognize immediately that he has given the issue more thought than most (all?) of them. I know it is not 1018 pages, but could you not even make it through Kowalczyk's article? Sometimes I am amazed at the drivel that shows up here.
If you like my way of reasoning, please tell it to your Congress Representative and your both senators.
This statement is COMPLETELY false.
"For people buying health insurance as individuals, the currently offered plans offer practically no insurance in case of serious sickness."
Most people prefer individual insurance plans to small group plans. Read the JD Power study:
http://www
At a time when we want to get people insured, why propogate lies about individual insurance policies? There are problems that occur there from time to time, but they're curiously similar to those that occur in group plans.
Imagine if Obama were to reduce the number of uninsured from 45 million to 25 million simply by getting people to enroll in what's already avaialble and what they can already afford? "I reduced the number of uninsured by 50%, whithout raising taxes or spending government money." Sounds like a good stump speech to me.
I know its easier to just be lazy, but when you're given a stage like this you should be responsible enough to do a little research before you open your mouth.
Incremental change is better than ideological gridlock.
If Obama would enforce immigration laws too, the ranks of the uninsured would drop even more.
Boy are you right. Like with most things in politics one problem exacerbates another. Unfortunately, Obama would rather deal with HealthCare Reform by raising taxes and lowering our benefits than handling the unpopular Immigration issue which would solve lower the cost of health care and probably save Medicaid.
I've read articles by economists which state that the impact of immigration is a net positive to the overall economy. Also since the economy has been bad, many of them have been returning home. They come for the money not the insurance.
I have to disappoint you. Without illegal immigrants paying taxes and barely using social services, our social programs would be in worse financial situation than they are now.
I wrote broadly on the subject, http://www
It should probably read "affordable insurance.
I have a problem with some of the people who can't "afford" insurance but can afford cell phones, cable TV, eating at McD's. etc.
I have difficulties in finding how your argument and the survey that you bring up contradict my statement that you quote.
For a guy that wants to be taken seriously, saying you 'could not afford' to read the proposal in full, and accusing its authors of knowing it would be "physically impossible" for you 'to comprehend all the provisions', which you find to be 'disrespectful' -- well, maybe you're just out of your depth.
And folks who presently have government or employer-provided health care coverage do not all 'milk it to its limit', and your statement to the contrary is insulting and comes with no proof.
Agreed. The author should define "milking it to its limits." Sounds like Bush when he blamed employees with "gold-plated insurance" for the high cost of health care rather than the for-profit insurance companies, for-profit pharms, for-profit hospitals, for-profit labs... Some people complain that others will go to the doctor with a cold "just to be sure." They should go "just to be sure." A doctors visit is cheap. Medical treatment for a serious isn't. The prevention of one $200,000 disease is worth a lot of $100 doctor visits that turn out to be benign.
Last year I had kidney disease. My doctor said I was the perfect example of why everyone needs health care. If I hadn't had insurance, I would have waited until I went to the emergency room and I would have needed dialysis and a kidney transplant and it would have cost about a 1000 time more than the tests and medications I took. And I might have died. Some of those tests came out negative. I didn't have kidney cancer. That doesn't mean the test was unnecessary.
Now I have a strange allergy. My throat and tongue swell up and I have to go the emergency room. I don't want to go but the doctors say I have to. It costs about 5K each time and I pay about $250. Boy I am really milking it.
Make that employees "choosing gold plated insurance.
Why you had to go to ER with a throat allergy? A family physician, at the cost of $100 visit could determine your problem, and – hopefully, as mostly this is a case – resolve your problem with a bottle of $20 pills from your pharmacy nearby.
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