5 Steps to Major Health Care Reform

Barack Obama's poll numbers are falling as Congress heads into recess without passing a sweeping health care reform bill. Some voters may believe the criticisms from the Republicans that the Democrats are plotting a government takeover of health care, while other voters may be lamenting that such ambitious plans have now been taken off the table. The irony is that Obama's much maligned strategy of letting Congress hammer out the details of health care reform is just now starting to look quite sensible.

After several ideas have been floated only to sink from the weight of too large a price tag, there continue to be negotiations in both the Senate and the House where liberals and moderates are slogging through the messy details and making progress toward a set of incremental reforms that actually have a chance of passage and could make a real difference in improving the life and health of millions of Americans. Rather than criticizing incremental reform as half measures and sellouts, this is just the kind of progress progressives should be ready to embrace.

Let's Pass Health Reform I and Debate Health Reform II
One of the things that is increasing the temperature of the health care debate, making passage of reform more difficult and less likely, is the false view that whatever happens in 2009 will be the last word for a (political) generation. Republicans believe that if they can defeat health reform now, they can weaken Obama and defeat him in 2012. Liberals believe that anything left out of this year's deal is an opportunity lost forever.

There is room to negotiate a health care bill that achieves many, but not all of the current goals for reform, and continue to build support for broader measures. Rather than one giant leap, we can get where we need to be through a series of steps.

Step 1 -- Fund Evidence-Based Medical Records Keeping -- DONE: Although most people may not know it, the most important element in the whole package has already been passed into law. The illusive goal of extending coverage to more Americans and lowering the cost of health care is unattainable unless we can find ways to deliver more effective care at lower costs. If we fail to do this, whatever else we think we are passing this year will blow up the budget and become unaffordable over the long term. But the key element of long term cost containment -- evidence-based medical records keeping -- already received full funding in the American Recovery and Investment Act. In a few years, medical experts will be armed with a wealth of new data about what procedures and practices really work and are most cost effective in keeping people healthy.

Step 2 -- Health Insurance Reform: There is broad support for a package of reforms and regulations for the health insurance industry that would provide real protections for consumers and at the same time level the playing field for health insurance providers. It is quite possible that any deal that emerges from Congress would require health insurance portability eliminating the problem known as "job-lock" and also eliminate coverage exclusions for pre-existing conditions. These changes would go a long way toward addressing the health care anxieties for large numbers of people.

Step 3 -- Give Consumers More Choices: There are several ways to do this. Some are controversial and others are not. The least controversial idea, included in most reform proposals, is Health Insurance Exchanges. Health Insurance Exchanges are markets where employers and individuals can shop from a wide variety of competing plans to find plans that offer the benefits they want at a price they can afford. This system is already working in some states and for federal employees. If Health Reform I establishes strong regional exchanges or one national exchange, and people still believe more choice is necessary, then Health Reform II can look at the more controversial options like a public health plan or health cooperatives.

Step 4 -- Make Health Insurance More Affordable: Real health care savings may be possible in the longer term, but in the short term the only way to make health insurance more affordable to people is to lower the cost by spending government money. But the goal of making health insurance more affordable cannot come at a price that taxpayers find un-affordable. Public opinion polls continually show strong support for "health care reform" but little support for any of the new taxes needed to fund extended coverage. The politically viable price tag may not be zero, but it is substantially lower than current estimates of $1 trillion, or more, over the next 10 years. To get a deal that moderate Republicans and moderate Democrats will want to support, the number will have to go down. This means the goal of universal health coverage will not be achieved in Health Care Reform I. That is why we need Health Care Reform II.

Step 5 -- Add Government Mandates Only If They Do Not Mandate Bankruptcy: With all the attention on the revenue needed to pay for reform, too little attention is being given to the other legislative heavy lift, the possibility of government mandates. Whether the government requires all employers to provide insurance or pay into a government fund ("an employer mandate") or requires that all individuals have health insurance ("an individual mandate") or both, there will be a lot of details to work out and a lot of potential opposition.

Neither idea is unprecedented. Every employer is mandated to contribute to Social Security and Medicare. Every driver has an individual mandate to have automobile insurance. Still, however the lines are drawn and whatever exceptions are granted, in the current economy we can expect thousands of stories of struggling businesses that will not be able to keep their doors open if a new cost is added, or healthy individuals that will have to choose between the mortgage payment and the new cost of health insurance. If compromise legislation includes any mandates on businesses or individuals they are likely to include a lot of exceptions and opt-outs and still they will open up a whole new line of criticism for the plan. Getting this right will be another challenge for Health Care Reform II.

Progressives Should Embrace Progress. America voted for change last November, change away from winner-take-all politics toward a government that works to solve pressing problems. It would be nice if everyone agreed on what form health care reform should take, but that's not very realistic, and while it is easy to attack the motives of those whose do not share the same vision of reform, doing so does not represent a great deal of change from previous years' debates.

More than a be-all-and-end-all health care bill, what progressives really need right now is progress. Any bill that improves health care for a substantial number of Americans would be a clear signal that politicians can do something right and government can make things better. The more Americans that believe this, the greater the opportunities in the future to do what needs to be done.

Comments

[hsr0601]

-Some say we don't have faith in government, others say, we will be forced out.-
What kind of music does this reform dance to ?

I share the opinion that unlike the insurer-friendly, baseless senate plan by 'some' members, only a 'strong' public option will be capable of getting the premium inflation under control and saving the U.S in turbulence.
To my knowledge, a dual system tends to deliver better results than a pure single payer system. Supposedly, to be or not to be might be up to the innovations like a pay for value program, otherwise, the forthcoming start-ups may fill the void with competitive deals. The competition based on 'fair' market value would be a beauty of true capitalism, not monopoly, an objective for anti-trust.

[TSpoonttlb]

If you think that the insurance industry is rigged for huge profits, then how much of your portfolio have you committed to this industry. Guaranteed profits and dividens forever, so if you believe that then you should be heavily invested in that industry, right?

[Not Blind]

We'll probably end up with a bland and weak insurance restrictions, but not true health care reform as it appears. Even the modest proposals currently being put forth are being attacked as euthanasia for granny's and free abortions on-demand for all. These ads are disgusting as well as patently false, as there's no mention of either end-of-life or taxpayer-subsidized abortions in the bill.

ANY reform of the bloated insurance racket will help, but they've already found ways and means by which to continue reaping profits never the less. The government will force everyone to buy insurance (businesses and individuals), and will subsidize those who can't afford the premiums, while penalizing (taxing) those who can but won't. All of those sums will end up in the private insurance sector, yet we won't see better care for the subsidies (tax dollars and mandated private costs).

Our lawmakers have taken huge sums (contributions, junkets and perks) from the insurance industry, some of it coming from the TARP bail-out (which benefitted many insurers), to pander to their benefactors and sell their votes. This is what's criminal, and more akin to the world's oldest profession by any name.

[TSpoonttlb]

Maybe you should check into how single payer works in Britian. No Transplants past a certain age. Government decree's deciding who gets what kind of treatment not the now mostly foreign born docotor. Private Doctors and Hospitals for the Washington D.C. crowd. I'm not sure about abortion but the Irish lassies must go there for a reason. If not free then likely subsidized.

About 15 years ago a little girl in Milwaukee was denied an experimental surgical procedure by Medicaid. The press went nuts, eventually private donations saw the little girl recieve the treatment at a hospital in Pittsburgh. If I remember correctly it had to do with a small intestine transplantation. These are now routinely done with a 65% survival rate, but if Medicaid had its way the learning curve would have stayed at zero. Who runs Medicaid? Who will run a Single Payer system and tell you that every new technology is Experimental? Freedom from Choice is not a very good option.

[pfrogger]

thanks for the talking points.
I have no idea why you insurance shills use the same debunked points. you have to try something new.
and you lied about the UK system as well. big surprise. doctors decide what happens. in the US, the insurance rep with a college education reads from a piece of paper to decide what is or not covered. and they often override the doctor.
and of course the 50 million uninsured care about intestine replacement when they can't get basic medical care.
and millions of those insured go bankrupt every year. good job insurance. they are denied coverage, or dumped immediately so the insurance company doesn't pay.
and you're worried about transplants? these people don't get basic medical care, and you're worried about transplants?
useless and pathetic.

[middleoftheroad]

But not Tort reform right???

[Coinyer101]

no. that is like 1.6% of costs. It's insurance that needs to go out of business!

[Sheri and Allan Rivlin - Huffpost Blogger]

A balanced version of tort reform that is not slanted too heavily toward either plaintiffs or defendants could be part of a compromise deal. There is room to craft rules that do not punish doctors and hospitals that are doing what they should do while not taking away rights of patients to sue when there is real negligence. The two sides have been fighting so fiercely for so long it may be difficult to got to the sensible compromise position. Do you know of any good efforts to find the centered position on medical tort reform?

[Nutcase]

The proponents of this don't want tort reform. They want it eliminated. The right to sue for redress is something that has been developed for about 800 years and passed to us from English Common Law. They want to deny everyone the right to redress for harm.

They don't trust a jury of our peers. Why do they trust it for criminal cases? Why do they trust it for divorce and custody cases?

If one industry gets special dispensations or elimination from liability, how do you say no to other industries? Will Walmart not be liable if you break a hip tripping over something their highly-paid employees left lying around?

Read my post below on this same topic.

[TheHandyman]

Do you know of any good efforts to find the centered position on whether the Earth is round or whether it is flat? Or how about Global Climate change? Your continued mantra of centrism with regard to problems proves Malthus comments about everything tending toward mediocrity. I guess the two of you are the end results of that theory. As for tort reform, which is a code for, "we shouldn't have to pay for our stupid mistakes because it hurts our profits," there doesn't need to be any. How much is an missing arm, leg, or winding up a vegetable because some hospital or doctor screwed up worth? You believe that health care is a commodity except when that health care costs some one a body part or their life!

[johnashman]

In my MSRA idea that you so quickly dismiss, I describe a "Limited Liability Clinic" that allows doctors to form their own mini hospitals and have liability protection from lawyers. A panel would create a set of rules governing reimbursements of there is an accident based on the severity of the accident. Then a panel of judges would judge any disputes and award monies based on the outcome based on the guidelines. The patient will see these guidelines when going for service. By accepting the service, they accept the reimbursement policy. In return, they get lower costs. No lawyers needed. The doctors or nurses responsible would get 'reprimands' of some kind. At a certain point, careless doctors or nurses would lose their license or be forced into more training, depending on the severity. A little bit of bureaucracy, but it hopefully beats the out of control melee we have now in the courts. There should be no overwhelming rewards for suing unless you really have been harmed.

[TSpoonttlb]

Why would a bunch of lawyers pass laws that restrict their right to earn? The rest of us need to be controlled, don't pay attention to the man behind the curtain.

Oh and how come it always starts off with X number of million, including illegals, unisured and then suddently morphs into a discussion about care. Insurance is not Care. The cost of my insurance and the contract I agree to determine the level of my care.

Tort Reform first.

[johnashman]

I agree. Republicans need to demand tort reform. I haven't heard any demands for this. That would at least show a willingness to participate rather than simply torpedo. Even though I think this is one big cluster. I also haven't heard anything about HSAs or MRSAs even with Arthur Laffer's endorsement of them the other day. Democrats do have a point about obstructionism. They need to offer a solution to the American people, like they tried to 8 years ago.

[hasheville]

We should have reformed health insurance industry long ago - at this point the extent to which it can happen won't solve the problems. They will always be too powerful and lobby hard against any reform plans and chip away at anything that passes. Get them out of healthcare - their focus will always be to maximize profits. I don't want to "shop" for health insurance. Again, the industry will obscure and complicate the terms to such an extent we won't know what we are getting. Over half of all bankrupcies today are due to health costs and half of those are by people WITH INSURANCE!

[Coinyer101]

Sorry, but, I don't buy it. As one of those without coverage, I'm holding the President to his campaign pledge of no individual mandates. This was the only major difference between he and Hillary's plans. This is important to me, because, I don't earn enough to afford any insurance , and I refuse to be forced to buy anything from crooked insurance companies. THEY are the reason costs are so high. THEY are the ones who raked in all that $, for decades, providing absolutely nothing that would cure any illness or accident. THEY are the ones who picked and chose the people they would cover,and those they wouldn't. And now dems want to reward them with 40+ million new customers? I'm all for affordable healthcare, but, affordable insurance? NO. And don't tell me that the Gubment is gonna 'help' me pay for it, through a subsidy. They are not getting my life history, just so they can pay insurance companies for me, and I ain't standing in endless lines to give it to them. If the Gubment wants to pass something that benefits my health, and makes it fair for everyone ,without propping up the very industry that made our healthcare system 'sick', in the first place, then I'll get on board. Why support a bill that is destined to fail, because dems caved to the insurance and for-'profit' industry? No, I do not support any of the current proposals, except HR676. Nothing else will do.......,

[RealityThinks]

This comment is pending approval and won't be displayed until it is approved.

Good ideas - unfortunately , your audience isn't interested in compromise. Reforming healthcare and suppling care to the uninsured can be done a lot easier than creating a gigantic progam "public option" which would be OK in the beginning but would deteriorate as it's enrollment swelled.

Here's my suggestion (I have a public health Masters' degree and work in the industry).

an easy remedy is just to federalize Medicaid (not have states run) and cover
all individuals to 150% of poverty. Also extend S- chip to ages O - 22.

You need to include changes to private insurance too -

* Make them not for profit - non public /stock companies (Columbia did this not too long ago)
* They must accept preexisting conditions
* Detach the coverage from the employer (create purchasing pools in each state)
* Capitate medical malpractice awards

Pretty simple, unless your real objective is different than what you state " to cover those that are not covered now

[Nutcase]

Working in the field you should know a couple of things.

Blue Cross is normally limited to state-wide and all were nonprofit. Lately, a few have changed their status to for profit.

The issue of malpractice is not significant to the overall costs of healthcare. It is less than one percent. It is mainly a tool for the Republicans to attack trial lawyers.

Since at least 2000, both the number of suits and awards have declined substantially. Malpractice premiums have gone up. Why? Because the insurance companies invest (gamble) those premiums at the Wall Street casinos. I haven't found any identifiable group with a worse record on the street. Premiums are not tied to suits or awards.

[Sheri and Allan Rivlin - Huffpost Blogger]

Nutcase wrote: "The issue of malpractice is not significant to the overall costs of healthcare. It is less than one percent. It is mainly a tool for the Republicans to attack trial lawyers."
We can agree that most of the passion behind tort reform is as you say an attack by Republicans and insurance companies against trial lawyers -- trying to score political points and also trying to win cases by never letting a jury decide them.
But the one percent figure is incomplete. Doctors do spend a lot of money practicing defensive medicine (they admit it, statistics show it, and people know it when they go for care) and a lot of the paperwork burden is also driven by law suit defense.
The case was made forcefully by the Hilarycare team and it was not just a talking point..

[TheHandyman]

There are some things in Life, believe it or not, that should not be and do not need to be compromised on. The quality of my life and my right to good health care, like those people in the world who have single payer get, is not up for compromise!

[Sheri and Allan Rivlin - Huffpost Blogger]

Fine, take a principled stand! But unless you have 218 Representatives, 60 Senators, and one President who agree with you -- then "no compromise" is not really an option for you. At least not if you want anything to change.
By our count, currently, you have something like 20 representatives, perhaps 2 senators, and zero Presidents supporting single payer. You can wish it were otherwise, you can shout at everyone who disagrees with you that they are stupid, or corrupt, or cowards...
... or you can embrace the kind of change Barack Obama represents. Less ideology and "My side is right -- and the others can go to heck" -- more listening to other's concerns and looking for common ground. It is a new day in Washington. Progressives must learn to support progress.

[TSpoonttlb]

Live abroad, poor, and see how great you think that care really is. Single Payer is Freedom from Choice. DEVO told you that is what you want. Your quality of life and good health care are YOUR RESPONSIBILITY not mine Handy. I would tell you it is not a right, but you would confuse the right to pursue happiness with a right to have happiness.

When you create rights that infringe on my LIBERTY, via taxes, then I have a problem with your definitions. An arguement with no end, just a bunch of emotions on your part.

[RealityThinks]

Good ideas - unfortunately , you audience isn't interested in compromise. Rforming healthcare and suppling care to the uninsured can be done a lot easier than creating a giaganric progam "public option" which would be OK in the beginning and deteriorate as it's enroolment swelled.

Here's my suggestion (I have a public health Masters' degree and work in the industry).

an easy remedy is just to federalize Medicaid (not have states run) and cover
all individuals to 150% of poverty. Also extend S- chip to ages O - 22.

You need to include changes to private insurance too -

* Make them not for profit - non public /stock companies (Columbia did this not too long ago)
* They must accept preexisting conditions
* Detach the coverage from the employer (create purchasing pools in each state)
* Capitate medical malpractice awards

Pretty simple, unless your real objective is different than what you state – to cover those that are not covered now

[hasheville]

Jim Jaffe defends insurance industry and lobbyists! Well, Kumbaya on us!
Blue Cross insures 100 million Americans - lots of power and profit there.
The insurance industry running healthcare is absurd. Healthcare is personal, crucial, expensive and complex by nature. Since it's so expensive we should take as much profit out of it as possible so people can get the best care they can. DO WE HAVE TO ALLOW PROFIT OFF EVERYTHING?
Auto insurance - relatively cheap. The industry bets on your likely not having many accidents. If you have one they can raise your rates. Should your health insurance rates increase when you're sick? Currently you're definitely penalized for illness, probably even excluded from coverage. Do we want that in healthcare? Auto insurance policies generally pay out small amounts. Auto insurance is not used to make your car better, checkups or oil changes. Health insurance can be used for check ups, doctor visits and tests even when you're not seriously ill. Its used by consumers as healthCARE and the INSURANCE industry does not operate to CARE for you but to insure you. They want claims to be rare but people need the equivalent of oil changes. We should be strengthening the Medicare system in various ways including allowing people to buy into some form of it. Its a lie that this is complicated - its only complicated if we bend over and twist ourselves into knots to support profits by an industry that has been proven to have ripped

[blueken]

This is like three card montey. There is no ace, just a lot of shuffling. There is no peanut under the shell. Blah, blah, blah, you lose. The drug and health care industry is were all the money is. If they don't take a huge hit, there is no savings. End of story. We have been here before, FDR uses Blue Cross for all government employees, large pool to spread risk, keep costs down, doesnt' work. Insurance companies come into the market to compete with Blue Cross, keep costs down, doesn't work. HMO's get government loans, tax breaks, manage health care, keep costs down, doesn't work. There is no free market cure for this illness. It's just shuffling the deck.

[Liberalsrising]

I have two comments. First is about the goal of health care. Second is about rationing, the elephant in the room.

The goal should be sick care, rather than health care. Our goal should be that everyone who is ill receive the highest standard of care without regard to their individual income or wealth. If two people have similar cancers, which costs $10,000 a day for the highest quality care, both should get the same care. This eliminates insurance plans that offer low, medium and high options, with people shopping for the plan "which best suits their needs." Their need is to get the highest standard of medical care.

Everyone is dodging a discussion of rationing. Rationing is a necessity in any industry in which there is a scarcity of resources. There is a limit on how many cancer patients and heart or liver transplant patients or other exotic and expensive care that can be given for the available resources.

The reality is that we will need to ration care; maybe on the high end, the last three days of life which are very expensive, or the low end, which is preventive care. But ration we must. And first we should quick ducking the issue of rationing and discuss it openly.

[Nutcase]

The confluence of a president who wants reform with a majority in both houses and a public that was ready, until a lack of leadership and the resultant confusion sent the polls down, don't come that often. It is almost a certainty that the Regressives will gain some seats in the next election. The Blue Dogs have made Obama seem weak. That is shortsighted as it will put some of their seats in jeopardy.

It is either now or sometime in the distant future. The passing of a reformless reform will satisfy enough to make real reform that much more difficult in the future. The argument otherwise in this post almost certainly came from ones who have never won and held elective office.

Actually, the real problem is that the posters have bought into the opposition's premise. They are talking health insurance changes, not healthcare reform.

Bipartisanship won't work. Professional politicians know that you often can succeed only by being divisive. When it is us and them it becomes easier to marshal the troops. Being inclusive, there is no enemy to fight. You sap energy from the campaign.

The AHIP and PhARMA are real enemies. When was the last time an insurance company healed you? They contribute nothing to healthcare. They suck money away from helping the ill. They are the ones who created the mess we have. You want to make some changes to health insurance? Get real.

Single-payer is the only fiscally and politically viable real reform.

[jmpurser]

President Obama killed health care reform when he took single payer off the table. The rest of this is just a complex negotiation over what price he'll get for selling us down the river.

[Sheri and Allan Rivlin - Huffpost Blogger]

In these comments and all over the internet we keep hearing the suggestion that Obama's opposition to single-payer represents a sell-out. He campaigned against single payer in the nomination fight -- as did Hillary Clinton and most of the other candidates. Dennis Kucinich made a strong case for single payer but he did not get enough votes to win.
A very strong case can be made for single payer on the merits, but there are also strong arguments against it. The biggest problem with single payer in the current debate it that it has zero chance of passage in Congress. Too many people like their current health arangements, and they would have to change to a completely new plan.
Roughly 20% of the voting public strongly supports single payer as the only solution to our ills. The problem is this 20% believes falsely that they are in the majority. Single payer does get majority support in polls only when it is presented as a benefit without a cost. Tell people that they will not have the option to keep their current arrangements and support drops below a majority.

[DocTwain]

Why do enemies of single payer keep repeating that under single payer your coverage would change?

If we eliminated the private health insurance cartel, we would save $350 BILLION A YEAR--more than enough to comprehensively insure ALL of those who are currently uninsured and to IMPROVE coverage for all other Americans, without our economy spending a single penny more on health care than it does now.

http://www.pnhp.org

What makes coverage good is not that it comes from Blue Cross or Aetna, but that it's comprehensive.

Who cares who writes the check?

A national single payer program could provide the exact same coverage that every single privately insured person is receiving right now at between 15 and 35% lower cost to the economy per policy.

Who would that hurt? Not any patients. Only the corrupt private health insurance cartel, which adds zero value to the system, and which exists solely in order to collect dollars intended for health care and to spend as few of them as possible on providing actual care. The only thing the cartel does that is important to patients is to write checks, which a single payer program could do at a tiny fraction of the cost.

Any why are you bringing up Kucinich? I'm flagging you for non sequitur and red herring again. That line of argument is rhetorically invalid.

[Coinyer101]

The 'reality' is, if single-payer had gotten a 'seat at the table', instead of an 'escort out the door', we would probably now be debating which public option is best, instead of whether there will be one, at all. The President promised that these issues would be debated in an open forum, with all views represented. Of course, we all remember the single-payer protesters shouting for a seat, and promptly being removed. All the while the 'industry', the bluedogs, and the repubs, were all given a seat, but, single-payer wasn't , because, 'it would never pass congress'. So, in essence the President was willing to trade away, liberal support, once again, to try and placate the conservatives and centrists. I have said many times that we will never find real change, in the 'center', because it ain't there to find. We've endlessly searched there for decades, and here we are, all set to do it again.

[jmpurser]

First, it's a sell out because he not only didn't champion single payer, he has gone out of his way to kill it.

Second, he doesn't have a decent idea to replace single payer with.

Third, he has no problem chucking his campaign promises when it's convenient for him to do so. So using the excuse of keeping his sacred campaign promises when the cost is our lives and money just won't fly.

[memosyne]

As a family physician I had an automatic electronic patient record in my office. I did not share it because at that time there was no way to guarantee privacy. But I worked in hospitals that had excellent electronic medical record systems although not shared with other institutions at that time. The savings in time and wasted testing were significant. The savings in prevented medical errors were also significant. I could do a better, more thoughtful job because I didn't have to read through 100 pages of record to work on the current problem. Instead I could just look in my electronic patient record and see everything relevant from past patient history. And it was very easy to send a letter to a patient detailing results of tests and reinforcing information and advice given or asking the patient to make an appointment etc.
If you want to help yourself as a patient, prepare your own medical history and carry it with you. In an
ER, it will make everything work better.

[blueken]

Hey doc, how would you like a single uniform bill to present? Think insurance companies would go along with that? Who about uniform coverage, so that you wouldn't have to limit your prescritions to what your patients could afford. Think insurance companies would go along with that? How about a single rate for your procedures, wouldn't that be nice? Think insurance companies would go along with that? Maybe insurance companies aren't the answer. Inurance companies are not the soloution, the are the problem.

[RealityThinks]

All "bills" are already uniform (Part of HIPAA) - duh

[RealityThinks]

This comment is pending approval and won't be displayed until it is approved.

All "bills" are already uniform (Part of HIPAA) - you need to lean more about the process before commenting

[lwild]

I completely agree with you. Electronic medical records and personal health records will do much to help improve the quality of care and the speed with which care can be provided. It will be essential that these these systems be interoperative, so that patients can walk into any facility and be able to access their record or provide one that they have created themselves with MS HealthVault or Google Health. This is a valuable component of the overall healthcare reform program.

[noneIn2008]

Why not do it state by state? Governments have a poor batting average. Most things they do have unintended consequences and damage the people. Let each of the 50 states run their own health care program and we can learn from the good, bad and ugly. As is, we get one plan, devised by special interests, imposed upon all.

[Nutcase]

So, one government is bad but 50 is better? Several states, more likely most, are too small to support viable plans.

I'm also curious as to how an administrative overhear of 30-32% for private insurance companies is better than Medicare's 1.8%.

[Grunty1]

Looks like NoneIn whats more welfare for the red states.

[barriosbabe]

Tell the Americans the truth?

Are you aware that most struggling uninsured Americans won't even qualify for public ootion?

Tell the truth?

Are you aware that millions and millions of working Americans who do not overspend and are broke before the next paycheck will be forced to pay huge monthly premiums to insurance companies for little coverage?

Why not discuss that instead?

[pfrogger]

their entire article is filled with questionable issues.
and their responses are devoid of any facts or evidence.
they're essentially saying slow it down. good to know the GOP/insurance industry is hiring the "best".

[Biscuit]

Because it's a waste of time to discuss the lies in your post.