Private Muscle and the Public Option in Health Care

We're headed into the end game for health care reform. The president has put himself in the arena. The insurance lobby is unleashing the scare campaign. A strong bill will pass the House. But at this point, too many Senators are still standing in the way.

The reform includes a broad range of measures to extend and improve care and help curb rising costs, but the epicenter of the debate is over what is called the "public option." Health care reform will mandate businesses provide insurance or pay into a general fund. Individuals will be responsible to get health insurance, with subsidies for those that can't afford it. We'll able to retain the insurance we have, or have the choice of a range of plans, including a public option, modeled after Medicare. A strong public option, competing with private insurance, is key to helping to get costs under control.

And costs must be brought under control. We now spend nearly 50% more on health care per capita than any other country, with mediocre results. We ration care by price, with some 47 million Americans uninsured. It costs the rest of us about $1000 a year to pay for the price of their care when they are forced finally to check themselves into emergency rooms.

Tell stories, not statistics, the pollsters tell us. But after adjusting for inflation, health care costs have soared by 58% since 2000; while wages for most Americans were stagnant or lost ground. As the auto companies showed, businesses increasingly can't afford health care. Families find it unaffordable. Virtually the entire long term debt challenge facing the US government is from the projected rise of health care costs. Get health care costs under control, the US has no long term fiscal problem. Fail to get them under control, the costs will bankrupt the federal government, state governments, businesses that offer health care (and increasing numbers won't) and families. Reform that gets costs under control is imperative. There is no choice.

A key to getting costs under control is the public plan. It can take advantage of its purchasing power to gain cost reductions. It can model best care practices. Private insurance -- which in most localities translates into a couple of dominant providers that don't compete on price -- will be forced to measure up with greater efficiency, innovation, and cost savings techniques.

Yet the debate in the Senate has been fixated on how to weaken or abandon the public plan rather than strengthen it. Republicans, for the most part, have taken themselves out of the adult conversation. Like first generation robots, they endlessly repeat the exact same words crafted by Frank Luntz - "government takeover," "no choice of doctor," "bureaucrats not doctors prescribing medicine." It's frankly pathetic. We have no choice as a society but to figure out how to fix this - and Republican leaders have chosen simply to peddle lies and scare stories and absent themselves from any serious discussion.

A gaggle of Democratic Senators -- led by Senator Baucus and the so-called "moderate" Senators -- have publicly thrashed around for ways to weaken or gut the public option. Outside groups like the Third Way have provided guidelines for disemboweling it. Some have suggested putting it off until private insurance competition proves it can't get costs under control -- as if that hasn't been proven over the last decades. Baucus suggested decentralized local "co-ops" would serve as the public option -- an idea notable for being both unmanageable and ineffective. Even if a network of coops somehow arose to insure that people had an option, they wouldn't have the clout to hold costs down and force private insurance to compete.

Others, remarkably, have detailed ways to deprive the public option of the power to lower costs. They call for a "level playing field" with private insurance. The public plan can't be subsidized, can't use its buying power to lower costs, can't take advantage of lower administrative overhead.

This sounds silly. We face soaring health care costs that will literally cripple our future. Surely, no Senator concerned about the country would work to undermine the key idea that would help get a lid on costs. They wouldn't, as Barack Obama warned, just "create a system where the insurance companies have more customers on Uncle Sam's dime, but still fail to meet their responsibilities." If you assume that, you would be wrong. They've done it repeatedly in the past.

For example, early in Bush's first term, Republicans decided that passing a prescription drug benefit for seniors would help cement Karl Rove's permanent majority. The benefit would help 41 million Americans with a soaring cost of care not yet covered by Medicare. It would also create massive new market for the drug companies. And, of course, Medicare could do what governments across the world do -- use its buying power to lower the cost of the drugs.

Only, when Republicans passed the law -- in the dead of night, twisting arms to get it done -- it actually prohibited Medicare from negotiating a lower price for drugs. Don't worry, they argued, competition would lower drug costs (even as they banned the import of cheaper drugs from Canada or Mexico).

Why? Well, using government muscle violated "free market" sensibilities. More importantly, the drug companies have one of the most powerful lobbies on Capitol Hill. Billy Tauzin, the chair of the key House committee ushering the bill through, left soon after to get a two million dollar a year job as a head of Big PhRMA, the drug company lobby. Tom Scully, the administration's point person who helped secret the actual cost of the bill, was already negotiating his million dollar job as the debate was going on. In all, 15 congressional representatives, aides and administration officials involved in the debate left shortly thereafter to take jobs with the drug lobby. With a $9 billion increase in annual profits at stake, the drug industry got an amazing return on its investment.

Today, seniors pay 60% more for the same drugs than the price charged veterans becuse the Veteran's Administration does negotiate lower prices.

Extreme? Not really. The health insurance companies decided they should be allowed to compete with Medicare in providing health insurance options to seniors. Seniors would get more choice; Medicare, the bureaucratic behemoth, would get agile competition. Win, win, they argued, calling the program "Medicare Advantage."

Only the insurance companies couldn't compete with Medicare straight up. So they demanded subsidies from the government to enable them to vie with the Medicare program they described as horrendously inefficient, unpopular and bureaucratic.

And they stand to pocket an estimated $177 billion in excess payments over 10 years to compete with Medicare - subsidies that Obama would sensibly cut to help pay for health care reform.

Money talks. Nine Republican Senators on the key Senate Finance Committee wrote President Obama to say they would oppose any reform with a public plan. The Center for Responsive Politics reports that the nine had had pocketed $17.7 million in contributions from insurance and health care interests over the course of their careers.. http://www.bio-medicine.org/medicine-news-1/Senators-Who-Signed-Letter-Opposing-Public-Health-Plan-Took--2417-7-Million-in-Campaign-Donations-from-Health-Care-and-Insurance-Industries-48233-1/

Not surprisingly, the 20 largest insurance and drug companies and their trade associations have pumped up their lobbying by 41% over last year -- with reported spending over $75 million in the first quarter alone.

This is the corruption of crony capitalism; a compromised congress using taxpayer's money to enrich entrenched interests. Only now, the cost of this in health care is not sustainable. Dramatic reform is vital or we all follow the auto companies and go belly up.

So if your Senator says he or she is opposed to a public option, or wants a weaker public option, or a non-profit co-op that isn't big government, or prates about the "government takeover of health care," about losing your choice of doctor, about bureaucrats not doctors prescribing medicine, don't fall for it. Either he or she is either utterly clueless or more likely is representing the interests of the industry, not the voters.

This business as usual is no longer affordable or acceptable. We shouldn't let cynicism lower our expectations. Soaring health care costs and the human tragedy of those without insurance can no longer be ignored. Reform can't be postponed. It is a stunning disservice that Republicans have taken themselves out of serious discussion. And it is an open scandal that Senators are catering to the private insurance industry that has profited from the problem rather than helping to solve it. We must expect more and demand more from those given the privilege to represent us.

Comments

[expired]

Health Care: The Public Plan Option

These Democratic Senators have NOT agreed to support it:
Senator Blanche Lincoln (D-AR)

Senator Tom Carper (D-DE)

Senator Maria Cantwell (D-WA)

Senator Ron Wyden (D-OR)

Senator Bill Nelson (D-FL)

Senator Ben Nelson (D-NE)

Senator Mary Landrieu (D-LA)

Senator Kent Conrad (D-ND)

Senator Max Baucus (D-MT)

Senator Dianne Feinstein (D-CA)

Senator Evan Bayh (D-IN)

Senator Mark Pryor (D-AR)

Senator Joe Lieberman (I-CT)

These names are reported by The Hill here and here

Update: Senator Kay Hagan (D-NC) says she supports a public option.
Update: Senator Jeff Binghaman (D-NM) says he supports a public option.

You can also contact the White House and voice your opinion
Comments: 202-456-1111
Switchboard: 202-456-1414

----------­----------­----------­----------­----------­----------­----------­----------
On The Show
Coming up Friday, July 10, 2009
•Senator Tom Harkin (D-IA) joins the show to talk about health care reform
•ABC News This Week host George Stephanopoulos joins the show
Thursday, July 9, 2009

[socalgal38]

congress pay
Rank-and-File Members:
The current salary (2009) for rank-and-file members of the House and Senate is $174,000 per year.
Congress: Leadership Members' Salary (2009)
Leaders of the House and Senate are paid a higher salary than rank-and-file members.

Senate Leadership
Majority Party Leader - $193,400
Minority Party Leader - $193,400

House Leadership
Speaker of the House - $223,500
Majority Leader - $193,400
Minority Leader - $193,400

A cost-of-li­ving-adjus­tment (COLA) increase takes effect annually unless Congress votes to not accept it.
Want a raise? Don't beg to your boss. Just vote yourself one. That's what the United States Congress just did. For the fifth year in a row, lawmakers voted not to reject their automatic "cost of living" raise that will increase the annual salary of members by $3,400 to a total of $158,103 per year.

[FaceReality2]

Do they sell us out to the insurance industry and other special interests just for campaign contributions, or does special interest money end up in their offshore accounts?

I can't believe they sell us out just for campaign contributions.

[Silent1NoMore1]

Admirable as the passion is from all those for single-payer or public option, none of the comments here, none of the articles, none of horror stories will make a bit of a difference. You can safely bet that there will be a lot of show, a lot of talk about bi-partisanship; and nothing will change. It really doesn't matter how fair or unfair either position is. Bottom line - nothing will change! Unless.....

At the risk of stating the obvious, let me posit that there are two major factors:

1. Money talks, BS walks
2. The President and the Congress do NOT represent the people

We all know this. Yet we persist in indulging in impassioned arguments, as if it would make any difference.

The real solution to this problem lies in how we address the two factors.

The first one is not difficult. Are we willing to put our money where our mouths are? Remember the number of small donations that got Obama elected. It is quite possible to raise a large sum of money. What we do with the money is another discussion.

The second one is trickier to counter. Lets put out collective heads together to find an effective way to remind Washington that hey serve us.

[BiffThiele]

We can't raise the money to offset this freight train, at this late date. Who is going to collect it?

This is the time for action. They will vote soon. A huge stand by the people in the streets of Washington is what will get attention. Just look at the situation in Iran. Sitting on our computers is not enough. The people must take collective action, to counter the money that the powers that be are exchanging. We are not pissed enough, so they are not paying attention.

Where is the organization?

Everyone is talking and nobody is walking!!!!!

[Silent1NoMore1]

Agreed....we need action. But I disagree that its too late to collect money - its never too late to show them the money. You'll see how quickly people can change positions once they see green.

[vanmungo]

There are plenty of dedicated organizations and activists working to inject single payer into the national debate and to win, and they are making headway.

Here's a partial list:

www.singlepayeraction.org
http://www.healthcare-now.org
www.pnhp.org
http://www­.1payer.ne­t/
http://www.guaranteedhealthcare.org/

Among the organizations represented on this list are Physicians for a National Health Plan (membership 16,000 and representing the pro-single-payer views of the majority of American doctors) and the California Nurses Association, the nation's largest state nurses union. Moreover, a majority of the American people favor single payer--see the following:

http://www.healthcare-now.org/wp-content/uploads/pdf/polling.pdf

http://www.reuters.com/article/latestCrisis/idUSN31432035

In brief--don't mourn and carp, organize!

Do

[FaceReality2]

Bribe the bastards the way the insurance companies do? Not a bad idea.

I wonder if they all have offshore accounts. I have always found it hard to believe that they work against the public interest just for campaign contributions. They must be packing money away for themselves somewhere.

[Silent1NoMore1]

Exactly!

There's also more than one way to skin this cat....just think John Ensign, Larry Craig, Eliot Spitzer.....see a common thread?

[billw8017]

60% of bankruptcies are due to the medical costs of people who had insurance on the onset of the disease/problem. The tragedy of those without medical insurance is sad, but they would be without insurance because they did not afford insurance. 20 000 people died in 2008 for not be able to get medical care. Many merely uninsured get their inferior emergency room care and stiff the doctors. Those to pay have something to lose -- and, they can lose it all.

[mbaty]

No matter the details that will be worked out, we need to remember that we have a decision to make, ethically, about the ability of everyone to recieve medical treatment when they need it. A populace that is sick makes a sick, unproductive nation. Financially we spend more than many many other countries and we get much less for our money, with some people getting none. And then when you need an emergency treatment, do you bargain for how much it will cost? No, most of the time you don't even know how much you will pay for it until later, when it's too late to say no. This is how they scam us, and this is very much a scam. Medical costs force people into backruptcy a lot, and how can we say that is acceptable? What is it really worth to have a population that is cared for and taken care of when it gets sick? Because I think we've spent quite enough on this joke of a system. It's time we pool our resources into sustainable programs that allow all of us to thrive. There are many countries who have done it well, and we can improve on their ideas. Isn't America supposed to be innovative?

[langej]

What no one is telling us is how much the Democrat representatives are getting from the drug and health insurance companies.
Okay, we know the Republicans got a lot when they were in power and will get more to ensure they do not waver in their opposition to real reform.
But the Democrats are finally back at the trough again, after 8 years of foraging in the wilderness. We need to target these people hard, so they stay with us just to prove that they haven't been bought.

So who is getting what? Anybody know?

[Pearlswan]

Senator Baucas gets the most, I know that much off the top of my head. Check democracynow.org because they did a show on Wednesday listing all the contributions the lawmakers get and from what companies in the industry.

[vanmungo]

See the following:

http://www.opensecrets.org/news/2009/03/health-insurers-owe-policyhold.html

http://www.washingtonpost.com/wp-dyn/content/article/2009/03/07/AR2009030701748.html

[socalgal38]

according to an analysis by Consumer Watchdog, insurance companies contributed over $35.7 million to members of Congress during the last two election cycles. Top recipients:
Senate House
McCain, John (R-AZ) $2,287,345
Kanjorski, Paul E (D-PA)* $491,545
Dodd, Chris (D-CT)* $1,102,056
Rangel, Charles B (D-NY) $480,290
Baucus, Max (D-MT) $449,125
Pomeroy, Earl (D-ND) $474,769
McConnell, Mitch (R-KY) $448,633
Boehner, John (R-OH) $383,175
Lieberman, Joe (I-CT) $403,644
Bean, Melissa (D-IL) $358,
Nelson, Ben (D-NE) $363,636
Frank, Barney (D-MA) $342,796
Cornyn, John (R-TX) $324,194
Tiberi, Patrick J (R-OH) $332,609
Chambliss, Saxby (R-GA) $308,386
Crowley, Joseph (D-NY) $325.18
From 2007-2008, add the fact so far in 2009 the contributions increased 45% or more

[BiffThiele]

Obama can't do this alone. Where is the story I want to see? The story that says 5 million angry Americans converge on Washington, demanding "single payer" health care, NOW!!! This is a government of the people. But out representatives have forgotten who is in charge and it looks like we have forgotten, as well.

I am ready to go.

So, that's 1. But, I am not leaving Chicago, until I see some action. Are there 4,999,999 more of you out there?

Where is Common Cause? Where is Public Citizen? Where is PIRG? Where is MoveOn.org? Where are the Unions? AARP? ACLU? American Council on Science and Health? Congress Watch? Where is the media coverage of the People's voice?

[vanmungo]

Obama wouldn't even try to do it alone--he made it clear in his remarks to the AMA that he is opposed to single payer.

Let's tune into reality--Obama is as much a hireling of the HMOs and drug companies as Baucus/Pelosi and the Republicans. His campaign bulged with some $15 million from the health sectors, twice as much as McCain received.

It's critical to be able to distinguish your allies from your foes. Obama is not among your allies in the struggle for single payer.

[BiffThiele]

And that was my point. In his heart, he does support single payer. In his campaign, he said as much. If the public rose up and demanded it, he and the rest of Washington would have to take notice and I believe a stand would be made for the People. There are supporters in Congress who remain silent, because they don't see the public outcry they need to see to motivate them to speak up and speak loud.

There is no call to arms. Everyone is sitting on their butts, complaining. I am more frustrated with the lack of activism than I am with Congress. This is an outrage and people are giving in to the rhetoric. What happen to YES WE CAN???

[socalgal38]

Remember the forrest gump movie, can you imagine getting that many people to start walking their way to washington?

[Chip W]

This health care "debate" is an extremely good example of people refusing to look beyond their own self-interest.

[herbprof]

It is a dog chasing its tail. Modern medicine has lost the fight with disease is the root cause of the problem that everyone overlooks. Lets just look at a few of the problems, there are 140 autoimmune diseases and they are at epidemic numbers (of every 4 people in the USA 1 will have an autoimmune disease), arthritis has 100 different forms alone. Cancer is epidemic 1 in 3 women and 1 in 2 men, they say less people die from it but what good does that do when more people get it. Obesity is also epidemic (34% of the population and growing) and every one of them will have multiple diseases and medications for the rest of their lives. If it wasn't such a tragedy for so many people it would be a colossal joke! They ask for donations and government money (it must add up to 100’s of Billions of dollars) to find a cure but they have not found a cure for a single disease in 60 years, something is very wrong here. Think about this, if every time you took your car to the mechanic and he told you "I can't cure the problem but it's treatable at a cost of $80 to $150 dollars a month for the life of your car." How long would it be before you would be bankrupt? Paul

[billw8017]

Modern medicine is pretty good, but it has natural limits, and everybody dies. The problem is to not die unnecessarily soon or live in unnecessary misery. There are things that can be treated, things that can be done. Some vigor and mental acuity can be sustained to the greater advantage of society. This is so significant that it is worth some effort.

Fox sponsored its tea parties for people who want to eliminate taxes during a time of great national deficits that will further weaken the dollar, undermining both the economy and our system of government. Who will sponsor parties to truly enhance our lives, the purpose of government?

[neckozihp]

Fox did NOT sponsor any Tea Parties. This was a grassroots movement. Fox was the only major network willing to provide media coverage. Yes, Beck, Hannity and others were invited to attend and MC some of them.

[billw8017]

We can spend a large share of tne national budget on military supplies. We can plan a human trip to Mars. We can build highways to travel 65 miles per hour. We cannot afford to assure our people a minimum program of health care.

If this were not so serious, it would be an amusing example of twisted priorities.

Bankruptcy is not an issue. Either we support essential things or there is no reason to gather money.

[FaceReality2]

Exactly. Don't forget the 700 military bases we maintain in 130 foreign countries, or the 1 to 3 trillion dollars we will have wasted in Iraq. There's always money for the military and military contractors even if we have to borrow it, but no money to take care of our own citizens.

[textynn]

The current system is not only killing poor people it is killing the wealthy alike. The for-profit system covers up and outlaws alternative therapies. Anything that cuts into their bottom line is covered up and gotten rid of one way or another. Drug companies are taking out patents on diseases and not allowing anyone else to even research the disease because they own it. This kind of control of research will costs millions of people their lives and the suffering that might be avoided will be infinite. The stifling of progress in disease control will be unprecedented.

Further big pharma will obstruct anyone finding cures for diseases. They don't want cures they want as many people on pharmaceutical maintenance as possible. When they themselves find the cure to something, if the ingredients are common place, they cover up these findings. For example if the cure for AIDS was found in a pineapple they would make sure no one knew about these findings because there is no money it, They are fixing this problem by having laws passed that have enabled them to take out copyrights on plants that have been around since the dawn of time. For example University at Waco owns a copyright on Turmeric a healing herb that has been around since before man.

[vanmungo]

This public-option proposal is inherently unworkable; in fact,it is not even a half-step toward single payer: it is it is at best a step sideways, and perhaps a step into the abyss. Here's why:

The advantage of single-payer is in risk pooling--everyone is in the same pool: well, sick, young, old, sick, and poor, thus averaging out the risks and costs of guaranteeing cost-efficient coverage to everyone. In the "public-option plan," everyone is NOT in the same risk pool, as they would be in single payer. In a "pub-op" plan, the oldest, sickest, and poorest would end up in the public plan; the youngest and healthiest--and hence most profitable--would be aggressively marketed by the private HMOs.
Hence the whole advantage of single-payer risk pooling would be lost: combining EVERYONE's resources (through a modest tax rather than bloated private premiums) so that the currently healthy 80 percent subsidize the unhealthy 20 percent and thus achieve cost efficiencies not obtainable if these two groups are in separate pools.

Moreover, because of these untenable costs, the public plan will have to charge premiums and impose deductibles, just like the private plans--more of the same, notwithstanding the "public" branding.

We need to say, "Single payer Medicare for all . . . or NO DEAL! We stay in the streets until we win REAL REFORM, not another corporate liberal sham/flim-flam."

[Randian]

Honesty at last.

The single payer plan is about combining everyone's resources and pooling risk. And the 80%
subsidize the 20% who through either bad luck or much more commonly poor choices are unhealthy.

A kind of welfare for health care.

Another entitlement program because the last four have worked so very well at changing the status quo.

Tell me what is going to make government run healthcare work so much better than Sosial Security?

Anyone reading this blog going to rely on SSN for you retirement?
Welcome in a new era of reinsurance.

[vanmungo]

This is not about government administering or running health care. In the single payer system--as in Canada or Medicare--the system is publicly financed by privately administered--all the hospitals, labs, and medical practices remain private.

The point is about cost containment--the private health-care system in this country is bleeding the economy white with its enormous 30 percent overhead, caused by (1) the redundant billing bureaucracies needed by the insurers, hospitals, and doctors to keep track of billing from 1,300 different payers; (2) profiteering that siphons off hundreds of billions each hear to stockholders and overpaid CEOs (last year the average HMO CEO made $14 million). Not ONE PENNY of this hundreds of billions wasted on billing and profiteering goes to providing health care.

Contrast this to the nonprofit, single-payer variants in all the other industrialized countries of the world: their overhead averages about 3 to 5 percent, their per capita health-care costs are HALF those of the United States while covering all their citizens, and they have better life expectancy and lower infant-mortality rates.

As Senator Tom Harkin said, "I used to sell insurance. The basic rule is the larger the pool the less expensive the health care. Today we have 1,300 separate pools - separate health care plans - and that is why health care is so expensive; 700 pools would be more efficient and less expensive and one pool would be the least expensive. That's why single payer is the answer."

[Octoberluna]

The very definition of welfare is wellbeing of person - why is that so dirty for some people - if you guys just give it a chance it might just be the best thing for your country - heal thyselves and be productive contributors to global society but if you don't start in your own house you are doomed. The mentality of the all mighty dollar is a twisted vision that is very hard for may to see past the buck. You have a certain way of thinking in terms of the money but I really thik it can work for the better if you really take a good hard look at how the Canadian system works (yeah yeah not perfect but given the alternative...100% better).

[ProgressiveVoice]

The public option proposal is a feint. The Republicans can't argue against it without sounding ridiculous - "The public option plan will be a mass of bureaucracy, long waits for treatment, no one will want it. Everyone will choose the public option because of costs and private insurance won't be able to compete." The majority of Americans want single-payer and accept the public option as an admittedly weak first step.

Unfortunately, although the majority of Americans want single-payer, the majority of VOTERS are still buying into the decades-old "socialized" medicine scare tactic. Ironic when you think about how many of them are on Medicare. Reformers don't want to give the industry and it's usual stooges the opportunity to repeat past success at turning people against reform.

From an administrative standpoint, expanding the existing Medicare bureaucracy to encompass the public option is the most efficient and cost effective method best managed via slow, steady growth. Even if Congress passed single-payer, implementation would have to be in phases or it would be a nightmare.

Republicans are correct in one aspect. The public option will be 20% to 25% less expensive immediately because it will be non-profit. Those insured through the public plan will experience the switch the same way they do any time their employer changes providers. Private health insurance will go out of business because they cannot compete. Voila! America has a single-payer plan by default.

[vanmungo]

I do not share your confidence that the public option will reduce costs.

First of all, there is no completely specified version of what this public option will be--it could end up being the farce floated by Chuck Schumer: self-sustaining (no public funds), would have to charge premiums and impose deductibles, would have to offer higher rates of compensation than Medicare. How is that going to cut costs?

Moreover, any public option plan will be denied the cost efficiences of single-payer risk pooling.

Public options have been tried in five states, and in none of those cases did they reduce costs or increase coverage.

You were right when you called the public option a feint--but that's all it is. It's a nonstarter, from all angles.

[Wake-up]

70% of all Americans have some sort of healthcare coverage today, and easily half (likely more) could have coverage but choose not too... I / we shouldn't have to pay for them!

"bureaucrats not doctors prescribing medicine" - is exactly what Obama's plan will result in... they will price-out free market solutions that work well now.

Want to reform this all? DEAL with the ridiculous Law Suits and the price goes down for all of us...

[ruralwannabe]

And who pays for your health insurance? Anyone who has had to pay for their own wants reform. Anyone who already has health insurance can't IMAGINE the prices paid by those who don't have insurance. Insurance companies don't just pay for health care, they negotiate the cost of it way down so they pay a fraction of what an individual pays. I see this first hand. I have very limited insurance, but just because I have ANY insurance at all, the cost of a procedure is automatically cut by 40%. This is not fair. Match the car insurance policy - make it illegal not to have insurance, the price will drop for everyone!

[Wake-up]

You can get catastrophic coverage for about $1,600 a year, that's about $4.50 a day.

Make it illegal = forcing people into the Gov. policy!

[Michael Gerety]

You ever try to get insurance if you have a preexisting problem? Have you ever counted the number of preexisting conditions that eliminate you from coverage? When car insurance was made mandatory, they had to provide for the provision that everyone could get it. it is called the state option.

It would help if you listened to both sides of the argument, learned them and then made up your own mind based on reality that you can see for yourself. Stop listening to people who prove themselves wrong time and time again.

You ever try to get the new insurance (after being laid off) to pay for the condition the old insurance was paying for? Nope, preexisting condition. Sorry, you are or might get sick.
Wonderful "system we have." Don't want to help your neighbors when their kid gets hit by a car and pop has been laid off? Fine. Just stand up and say it.

The system we HAVE has been designed and built on the "private model." over 40 some years. It is nuts and it makes Americans look stupid. It is time for some public input. Insist on a bill that we can all read and understand. I want a real discussion with my representatives. I want him to indicate that he completely understands what he is voting on!

[neckozihp]

Are you familiar with the VA hospitals. While training for my profession I had to spend time in several of them. The staff in these VA hospitals are a joke. They show up, get paid and provide some of the worst care I have seen. No incentive to do a good job. And the new grads (nursing) leave after a few weeks out of frustration.
Plus the medical equipment is not maintain or serviced. Doctors have difficulty ordering needed tests and procedures because for example, the X-ray machine is out of order.

I'm afraid this will be what ObamaCare will be like. Keep government out of healthcare!

[vanmungo]

None of your assertions are true.

In the current system, you have private HMO bean counters making medical decisions-­-dictating what doctors can and cannot do based on their bottom lines.

Under a single-payer system, the funding is public but the administration remains private. ALL medical decisions would be in the hands of doctors, never insurance-company penny-pinchers.

[Wake-up]

You think HMO's are bad, wait till you see Washington's Service!

Wake-up - What's the Gov. record of service??

This is being rushed (why rush it = fear that the details will be rejected), like the stupid stimulus bill which has done NOTHING!

"There is no free lunch!"

[textynn]

Poor people all over this country subsidize the upper classes every day. We subsidize it by doing jobs that are underpaid. We subsidize it by having wage theft forced on us. We submit or we don't eat. We work for companies that steal from us on a regular basis. I worked for the state of WA and they played unbelievable games with our pay checks.

One game they played was to take all the community college teachers health care across the whole state away every summer. How did they do this you ask. Well they came up with some formula where since the summer quarter was shorter we all fell behind hours and we all lost our health care every summer. They kept the subsidy from the government for our health care over the summer however. They were sued after several decades of doing this, but hung on an additional 8 years using the appeal process. I was hurt very badly the first summer I worked for them. I didn't realize I had no health care.

This is the kind of crap that poor people, esp women, have to deal with everyday.There's more formulas for separating people from their health care than there are birds in the trees. It's a game where the rules change without warning and you are screwed if you get sick and can't work. The poor pay higher prices for everything and they usually pay with a pound of flesh.

[Wake-up]

"Poor people all over this country subsidize the upper classes every day." - Completely false.

The top 1% of income earners pay about 32% of all income taxes. The top 5% pays 51.4%. The top 10% of high income earners, pay 63.5%. The top 20% of income earners pays 78% of all federal income taxes. –Congressional Budget Office, feel free to look it up.
Page 5 Figure 1 - http://www.taxfoundation.org/files/sr151.pdf

Most of all, estimates are that this heath care thing will cost about $1.56 TRILLION (actual numbers will likely be times 2 this) and BO has already spent that on the stimulus bill that has done NOTHING... we can't pay for ANY of this!!

[MJinCanada]

"Am I my brother's keeper?" asked Cain.

The American resentment against pooling resources so that everyone has a better life is very strange, and pretty much unique in the western world.

And by the way, in Canada, bureaucrats have far less to say about treatment than your health insurance pencil pusher. We also have far fewer medical lawsuits because, well, most people get treatment in time.

[textynn]

I know!! This lie being spread that the government will get in between you and your doctor is beyond contempt since the Medical Insurance Industry goes over every single treatment prescribed with a fine tooth comb and decides if you get it or not. And the reasons for denial are not that you don't need it but rather your policy doesn't cover it.

Bureaucrats don't pretend to know about treatments but the Medical Insurance Industry pretends to know everything about what you deserve and what you don't. And mostly you don't deserve.

[Wake-up]

"Pooling Resources" - Hahaha!!

Let me ask you, what this wasteful entitlement program cost? We're hearing $1.6 TRILLION, on top of $1.8 TRILLION that we can't pay back...

WAKE-UP PEOPLE!!

[Randian]

Canadian health care decisions are made by bureaucrats. Teh thing is, in Canada you just don't get offered what is not on the menu.

Case in point, Bone marrow transplantation, a life saving procedure commonly used in the US. Whiel employed in Canada, the eligibility requirements are significantly more severe.

[PigLipstick]

"bureaucrats not doctors prescribing medicine"

I'll take Bureaucrats over insurance company clerks with a treatment denial quota. At least the Bureaucrats are paid by the people requiring the medical treatment and they get no bonuses for denying services !

[Wake-up]

WHO said insurance companies? I'll take the Insurance Company... I'm successfully negotiating with Aetna right now.. Gov. = Minimum wage loser!!!

[DonJeff]

If Congress (espcially the Senate) fails us on true health care reform by eliminating or watering down a public option, and fails us again by watering down re-regulation of the financial services industry, will you finally see that we need to elect legislators who choose to run campaigns and solicit campaign funds as did our president during his campaign? It does no good to have a 'Democratic majority' if they fail us now, just as they have failed us by voting for financial de-regulation, the wars and the Patriot Acts. It will be up to us to elect a Congress that has vision and truly wants to solve problems, rather than represent only organized constituencies.

[vanmungo]

Notice how many people advocate a "public option" without having any idea about what it might entail. Hence "public option" becomes a vague, amorphous signifier of good intentions, so championing it is pretty much like advocating "peace and love."

We need to know the details of what you're supporting--would it charge premiums? Would it impose deductibles? Would it have to be self-sustaining, or could it accept government funding? Would it base its fees on Medicare, or would it have to offer higher fees?

If you can explain the details of what YOU mean by public option, which variant of it you support and which variants you oppose, and how it would give citizens an advantage over private plans, please do so--in your own words.

If you can't, that means you have no idea what you're supporting, other than a vaguely good intention that means nothing.

Public-option plans have been tried in five states, and in every case they have failed to reduce costs or increase coverage. The only PROVEN way of accomplishing both of those goals--based on a half-century of experience in the rest of the industrialized world--is a nonprofit, single-payer approach.

For a detailed analysis of the pitfalls of the public options, please see the following:

http://www.commondreams.org/print/43440

http://www.pnhp.org/facts/singlepayer_faq.php#public-option

[PigLipstick]

Good point, it's hard to tell what's what without a program. As usual, the for-profit group are injecting a lot of the old Razzle Dazzle into this version of Three Card Monty.

Oh, by the way, you don't have to be a doctor to join PNHP, I told them I wasn't a doctor when I signed up so I wouldn't be arrested for practicing Healthcare activism without a license !

[DonJeff]

Very clearly! If you wish to keep private health insurance and have a 'public option'.
1. Remove health insurance from employment
2. Offer public health insurance with coverage choices where consumers pay monthly premiums and co-pays, as they do with private health insurance. This will mean that employees who now have subsidized premiums may have to pay more, so that the uninsured and those independents paying many times more with far less coverage pay the same as others. The reduction in costs to state and local governments would be huge. (if you really got creative you could give public employees an across the board wage increase to make up for part of the subsidy that they lose) Rates, etc. can be worked out. You could also contract to the private sector the administration of claims.
3. Allow private health insurance as well. Unlike the present system where they offer 'sweetheart deals' to govt agencies and large corps. based on volume, they can market to indiviudals and families as with other types of insurance.
You obviously have decent coverage or you would realize no system could be worse than the present system, unless you have a good job with good coverage.

[DonJeff]

A second comment since your reply to me was patronizing and insulting.
1.How can you compare single-payer systems in countries, such as Canada or Western European countries, with populations at most 15% of our own? Where is the analysis to show that such a program administered by the government in a nation of 300 million would not be both a fiscal and bureaucratic catastrophe?
2. Where is your analysis on the results of eliminating the private health insurance industry with job losses totaling close to 1 million and the investment money of hundreds of thousands (or more) providing the capital for those companies?
3. In any case the present system of having employers subsidize medical insurance is based on outmoded employment patterns in the private sector, where a majority of workers had a measure of stability and even smaller companies could afford the premiums, and where the public sector did not come anywhere near the 30% total of the workforce that it is today. Do you comprehend how much taxpayers actually spend on health care right now with the full coverage of public employees at all levels of government plus Medicare and other govt programs.
We need 21st century solutions that will work for our situation, not Canada.

[Wake-up]

Lobbyist...

[writerroz]

Another case of half of the truth. What you aren't talking about is the fact that the states who tried public options still had private insurance companies, so this only proves that the two don't work together, nor does private insurance alone work. It hasn't for many years. People who come here to spew Limbaugh, Republicans & insurance companies' LIES make me furious. We were told it would be a tough battle, and you naive who spout off Republican lies are part of it.

[Wake-up]

How are you going to pay for this? $1.6 Trillion or so... in DC that means x2.

Honestly, I'd like to know? Bush left with a half a Trillion or so in debit, Obama has x3rd that and for what? "0"!

Now you're jumping on this? THERE IS NO MONEY!

[vanmungo]

Health care is now 16 percent of the American GDP thanks to the cost-bloating and profiteering of the HMOs--it's less than 10 percent in Canada and Europe. In the current U.S. system, that figure is projected to rise to 34 percent in the next ten years. In other words, we can't afford NOT to have the cost savings of single payer.

[racetoinfinity]

Can it be any more obvious? Big corporate interests and Big Wall St. (the plutocracy) HAS BOUGHT The Congress (with some notable exceptions like Dorgan, Kucinich, Sanders, Brown, Webb, and a few others).

Campaign Reform, i.e. public financing of campaigns is the ONLY solution along with radical reform in lobbying restrictions.

Until then, we will have a government bought and paid for by the rich greedy selfish interests.

I hope that horrible ruling by the Supreme Court that money equals speech (!) will not block any true reform, desperately needed. Go to Common Cause or Public Citizen to get involved!

[Sabrina1]

Totally agree with you. Our representatives are bought and paid for by the big businesses (banks too big to fail, insurance companies, pharmaceutal companies). This is the root cause of the economic crisis and how it is being handled right now, and with our health care reform. Until we make changes to rid the corruption in our government, and I mean out right corruption, nothing will change. The problem now is that the American people don' t have any money (inflation and high healht care costs), jobs or health insurance Where do the big businesses think they will get the money now? I suppose they think we will just print more, to keep them in business, because they are too big to fail. Why would we ever allow a business to be too big to fail? Weren't there laws passed to prevent this?

[ProgressiveVoice]

Ditto!

Lately I have been wondering if the laws against bribery have been repealed. Has any one arrested for bribery attempted a "free speech" defense?

Lobbying, bribery, influence peddling - it's all the same thing. How can just one be protected free speech?

Let's all get / stay involved in the political process - starting at the primary level. We've gotten our government away from the wing-nuts. Now we have to clean out Congress, get rid of legislators that put corporate interests before the people's interests. They won't be hard to spot.

[wiig]

It seems that when listening to the media on this, there is a focus on the public option destroying private insurance. Though, if that is the best argument against the public option, then that makes a viable public option a requirement. If the public option wasn't a viable alternative, it would not be a threat and it would be included without question.

It is funny to say this; however, include a viable public option and let the market decide and we will over time transform our healthcare system to a single payor system. If the nay-sayers are right that public programs like Canada's and those in our countries are no good, then of course this won't happen. This is why the public option is so scary to some people and why their arguments against a public option are actually one of the best arguments for a viable public option.

P. S. We can't go straight to a single payor system anyway as it would cause a massive economic restructuring that would be untenable in today's economic climate. That is why it must be included as an option to allow a migration to the public option over time.