I don't think I am. You can move where there are FEWER children, but you will not escape paying for others. Presently, you ARE paying "for others" when you pay your taxes and with your health insurance. Them's the breaks.

Funny thing. I hear folks rail about states rights being abrogated, right up until they want to suckle at the Fed teat. Then they conveniently get over it. Funny, that there...

Everyone's talking about what's there. There are important things that are missing:

a) Tort reform and limits on punitive damage awards.

b) Enabling cost reductions by having the least expensive labor with the credentials able to offer the service. Example - in many countries pharmacists can precribe many medications. In some states, dental assistants can fill cavities. Allow certified nurse practioners (CNPs) and assistants (CNAs) to render routine medical services now delivered by doctors.

c) There is nothing regarding expanding the number of doctors and health care professionals from EMTs, to medics, to technicians, to nurses - we are facing severe shortages particularly in rural areas.

d) There is nothing which encourages market-driven competition of medical service providers other than having to compete unfairly with subsidized government plans.

e) There is no reduction in government required paperwork, oversight, reporting, bureaucracy and overhead.

What they're essentially doing is taking two ineffective and fiscally unsound public options (Medicare and Medicaid) and strengthening them at the cost of the financially viable private option - with the intent of making the private option wither on the vine and eventually die.

Funny, you call it hospice care the Editorial section of the Washington Post says you don't have to be a right wing wacko to question that approach. This article has so much missing in terms of actual coverage that it feels just as much as a shill piece for the Obama administration as does Obama articles on Fox does for the RNC. Government has had a long history of mismanagement. The mantra of this legislation is controlling costs. How do you control costs ultimately? You deny procedures and medication. You'll also need to shut down the ambulance chasers but there is no way the Lawyers lobby will allow this cash cow to die. Please consumerist standing up for consumers also means standing up to an parental authoritarian government.

Next, let's eliminate or severely limit patents on medicine. I went through chemotherapy a couple years back and it impacted my immune system. For 6 straight months I received a shot, one single shot, every 3 weeks that cost $14,000. The insurance company had negotiated a $12,000 rate, but, if I hadn't been insured I would have been on the hook for $100,000+ just for those shots. What could it possibly be made out of that cost that much? If the laws didn't allow companies to claim ownership on necessary medicine the costs would come down. I recognize that may have an impact on R&D spending, but maybe not...

We need to stop subsidizing the cost of medicine developed and produced in this country, yet sold in other countries. It's crazy that medicine produced in the US is often sold for pennies on the dollar in other countries.

Then, let's require all costs to be disclosed prior to services being rendered AND make any co-pays a percent of the bill. Let's let the Dr.'s and hospitals compete for business. All one needs to do is see what has happened to the cost of elective surgeries such as Lasik or Plastic surgery over the last 10 years to see what competition brings to the marketplace. I realize if you have bleeding artery you can't shop for the best rate and need immediate care. But if you are going in for a throat culture or any of thousands of other scheduled treatments, price should be part of your consideration.

The problem with most any program that is run by the government is that it becomes entangled in bureaucracy. Ask anyone that participated in cash for clunkers. Having to fill out pages and pages of forms is not my idea of efficiency at work. Many dealers are still trying to get reimbursements improved. It's not that the government wants to be inefficient, it just can't help it, not when 1/2 the population is trying to screw it, and all the while the government is trying to make sure that the lowest common denominator is met....

@SacraBos:

Even if you're moving from 10% to 20%, you're still keeping 80c out of every extra $ you earn. Granted, your _average_ rate goes up, but you're still taking home much more.

@SacraBos:

Yeah, it does. AGI deductions are phased, and AMT is an "either/or" system - you only pay AMT if it would be more than paying the regular rates, so your AMT could, in theory, be $1.

I understand marginal taxes are supposed to work that way: that the more money you make, the marginally less your work is worth to you.

Which still isn't really "fair", either. Say I make $49/hour and work 40 hr weeks (2000hrs/yr). I make $98,000 with 20% tax nets me $78,400 or actual of $39.20/hour. I want to make more, so I take another job at $49/hr part time 20 hours a week. That's an extra $49,000/year. So I gross $147,000/hr, and am taxed $34,100. So I work 50% more and now make $112,900 or $37.63/hr. The more hours I put in, the less my work is worth to me.

Of course, the marginal increase from 20% to 30% isn't as bad as the marginal rate jump from 10% to 20%, so for those making jump across that tax bracket, there is likely a larger margin in the dollar value of their work to them.

So don't talk to me about choice. You're just trying to say your choice has more value than mine.

Yes, I'm one of those idiots. Medicare only continues to exist as long as the government takes money from me by force. I don't want them to take my money, I was the one that worked for it. There's another word for a system where you believe another man's labor belongs to you, that they have no say or recourse when you take the fruits of their labor by force. It's called slavery.

If you can't (or won't) understand this, then there really isn't a debate here. You believe that people exist for the state. You belong to the state, and whatever the state wants, they should take from you, because they know better than you how to utilize the results of your labor. You believe that if enough people desire a government program, that's enough reason for them to take a little more away from the piece of your earnings they let you keep. And you seem to place little value on freedom or liberty, except for the freedoms or liberties that the state lets you have.

I reject that world, and hope others would too.

I think the burden of proof should be on those for the bill - since they are demanded that all of accept the ramifications of the bill (good and/or bad), not on those against it.

My concern is that rushing a bill this expansive without really vetting it and making sure it makes sense is reckless. When do we finally get the transparency promised and get a chance to really look at the bill that will be voted on?

1. Why does the health insurance industry deserve vilification and not the doctor? They both make profit off of the sick and suffering? Why is there a double standard? You really can't have it both ways here. Either the doctor is immoral for making money off suffering sick people, or the insurance industry is not immoral for doing the same thing.

2. Again, totally missed the point. A starving person that has no money doesn't have some additional source of cheaper foods. There is no market for them, because there's no cash to begin with. Why do those people deserve to starve while McDonalds makes a profit every quarter?

My point is not that a person has a choice between seeing a doctor and seeing a voodoo shaman. My point is that a person has a choice between one doctor or the next. A simple web search can tell me how much cheaper the TV I want is at various retailers. It can tell me how much I can expect to pay for a car, or to get mine repaired. But it can't tell me how much to pay for a checkup. If one doctor charges less, and another charges more, the insurance company pays both. They then spread the costs out to everyone else on the plan. Therefore there's no incentive for the doctor that charges less to do so, because he can charge the same price as the other doctors and pocket the profit (those damn evil profit taking doctors again!)

To restate: consider what it cost for your last checkup. Not your copay, but the actual cost. What was it? Did you shop around to find the best price?

3. It's really not immaterial. People are motivated by profit and incentives. It's basic economics, basic survival. Making the point that we give aid to foreign nations is really not helping a case with me, because that's a separate argument, and I don't believe we should be doing that either. But just because we are is not a justification for why we should do this. My point is, the doctors don't even do this job without profit motivation. They certainly don't just donate their time for free because "it's the right thing to do".

I don't want to pay for YOUR insurance at all! I

@Johnva
No. What's best suited for me might be no prescription plan, because I may not need one. Or a higher deductable and lower payments because I am healthy and have an emergency fund.

@thegirls: I stand corrected, when I said "fewer children" I meant with a smaller education infrastructure: one schoolhouse rather than thirty+.

@RandomHookup: You can object to military spending all you like but it's pretty much the only constitutionally mandated federal tax other than the government payroll.
I understand how property taxes work and know that ten miles down the road my taxes will be 33% of what they are now.

You wingnuts are absolutely adorable -- not only do you insist on reliving your delusions of grandeur, you manage to work them into every single discussion. Unless you can tell me how Dick Cheney reading your old MySpace messages directly implies that ObamaCare needs to be passed this year...

(And, for the record, practically every President and every candidate, from Obama and McCain to at least Reagan, has worked a stacked town hall. That's not exactly news.)

@sgtcody: Actually, fewer children might make your taxes go up as there are still fixed costs that have to be covered. It's really the total cost of the system that determines what your part of the pie will be.

Undoubtedly, if we go to national healthcare, then being self-insured won't be the best option, especially for catastrophic illnesses. Then your uncle would pay into the system and get his coverage that way. People who self-insure (assuming you aren't talking about a private insurance plan) generally are counting on not bankrupting themselves with a major illness. The system is assuming the risk at the high end.

Maybe I object to military spending or welfare, then I have the same conundrum...I still have to pay the taxes.

@TreyWaters: Outstanding , you seem to understand that all this about HOW health care is going to be paid for and NOT WHAT you are going to pay for it or control costs . In other words all this is about the source of income for the health care industry .

The whole problem with all the parties involved with health care and/or insurance is that the pricing is based on the premise somebody else is going to pay for it some way some how . But then this opens pandoras box with the eduction industry whoring the government for reimbursement .

One of my big things is I don't want the costs spread out or made up some where else . No more 1000$ Tylenols because you are trying to pay for another service . If it costs 999$ for an xray then charge 999$ and not 200$ then make up the rest some where else . This should help identify WHERE the costs actually are . That's why having the doctors and hospitals open to the costs is so critical .

One of the few areas where I have any empathy at all for the doctors is the price of medical school . If the government wants to pay perhaps this is what they should be looking at . If the doctors didn't have to worry about paying their loans perhaps their pricing would come down .

Another thing since it has become the poster child for the cost of health care/health insurance is the emergency room or use of . If they can man an emergency room 24/7 how come this can't be done in the form of a clinic . Heck if I knew going to a clinic at 3 in the morning would save a 6 week wait for an appointment I'd go .

The biggest problem is that the health care industry is hooked on insurance like an addict . And in many respects so have many of patients with insurance . All this dependancy has to be stopped .

And dont even get me started on your work environment. Any time you take help from others, you are stealing their work.

You sir, by your own theory, are a thief and and hypocrite.

@takes_so_little: Would you also like me to drop by your house and show you how to use the scroll bar? Go find my 3:08, 3:51 and 4:05 comments.

No thanks. This isn't Robin Hood. I make about ~60k a year I still feel that it would be a huge mistake to tax some to pay for others. It's stealing anyway you cut it.

In my mind, there is sooo much work to do before we talk about piling something as risky and complex as a public option on top of it all. If the dems push through some half-hazardly most-questions-than-answers plan just for the bragging rights, without fixing any of the actual problems first, things are going to be FAR WORSE in 10 years than they are now.

What needs to happen is requiring actual health CARE costs to become more reasonable. Why does it cost $500+ to go to the ER and get a Band-Aid? To me that seems ridiculous. And since those escalating costs are only passed on to insurance companies, insurance companies have no choice but to continue and increase their rates.

Not to mention the fact that it is almost impossible to call a hospital or doctor and get an estimate for medical procedures. If this information was available to patients, we could make informed decisions about our cost/care, which would lead to competition.

IMHO, these are changes I would like to see:

1. Make HCSAs and FSAs more like HSAs. I love the fact that with my HSA, the money I save doesn't disappear at the end of the year. Why do HCSAs and FSAs have to be use-it-or-lose-it? While we're at it, increase the meager $2500 annual savings limit. $2500 won't cover much of anything if something happens before you can bank a respectable amount.

2. On High Deductible Health Plans...I actually like this concept. It requires consumers to be more educated on the services they are asking for. And, for single coverage, I can eat the $5k annual out-of-pocket max, as you'd only hit that if something really bad happens. However, if I add, say, a wife or kid, the annual out-of-pocket max becomes almost $11k. That's quite a bit harder to swallow. Keep this down close to $5k, even for families.

3. Require doctors/hospitals to be more open on costs. I can get an estimate on most any other services I shop for, why not medical services??

4. If you're going to regulate something, regulate health care costs (NOT the same as health insurance costs). Go after the $500 ER Band-Aid, and other exorbitant billing practices.

@johnva: That's my biggest problem with national social programs. I know that most social programs are administered at the state level where we get to vote on changes to most programs. This is why California is insolvent and Texas is in pretty good shape. The unemployment rate is dramatically below the national average because our businesses get to use their money to hire people rather than to pay taxes on social programs. We're also a right to work state... no union-controlled Texas companies... The people in each state have the right to decide where their priorities lie and levy taxes accordingly. What does a congressman from Idaho know about the economy/health care/school system in Texas? Why should he have input on how we do things?

makes me wonder what they would have done had i been in a coma and not able to fill out each form, front and back, in black pen, write legibly.

so twice the shipping, add to the carbon cost of the item, and my supplies shipped today. they were ordered on july 21st. i will probably get them by thursday.
it should never ever ever take a a prescription an average of 22 days to get filled. especially not when it's something that could kill me if i don't have it.

their rules waste their money, not mine, and put me at risk of costing them more if i end up hospitalized from not having the means to administer my medication.

but no, i'm not stupid enough to let myself run out of supplies. my doctor knows the problem and over prescribes so i have several for backup all the time. which is good because i changed my infusion set today, hit a vein and lost the set and had to use another one within a few hours when they are supposed to last a few days.

insurers throw a lot of money away and then complain about not making enough profit. niiiice

I favor putting everyone on socialized insurance, personally, which is another way of solving the problem. I'm not sure that there is a better way, given that the Massachusetts experiment in individual mandates has basically failed. Maybe employer mandates will work better when combined with the public option (ie, the Obama plan). But I personally feel we will have to go to single-payer or some other sort of public/private hybrid system eventually.

I don't hide that I think that socialized INSURANCE is the superior solution to our healthcare problems. But I've looked at a lot of different proposals, including Republican ones. I'm clearly more informed than you are on this issue, since you don't appear to even be familiar with CDH (the biggest formal healthcare reform proposal on the right and in libertarian circles in the last few years).

I do not consider the New York Time an objective source by any definition. It seems to me that the healthcare reform will only succeed at making private insurance so expensive (because of increased regulations such as "bill would ban insurers from denying coverage or charging more for pre-existing conditions") that we will have no choice but to select the Obama plan ("would only crowd out private insurers if it offered superior benefits at a cheaper cost than the competition"). You see, the game is fixed. There will be no real competitive option because the government will make it impossible for the insurance companies to compete.competitive option beasue the government will make it imposible for the insurence companies to compeat.

@sgtcody: The Intersate Highway system is run by the state?

I assume you've also written your congressperson and told him to turn down all stimulus money and you will not engage in any activities that directly or indirectly uses stimulus money?

@thelushie: Sorry no. When Sarah Palin says Obama's health plan would kill her Child, when Hannity says that Obama's plan would kill the elderly, when you say "Your children will be indoctrinated and your grandchildren may be aborted!" means that I don't have to listen anymore. That's because you are intentionally lying and trying to muddy an already complex topic and prevent real debate. You're no better than the person, who screams, keep your government hands off our Medicare." Your goal is to prevent talking about the real issues. You represent anti-intellectual sentiment. Now if you had a legitimate concern about government's treatment of medical records, or something else, I'm happy to discuss that. But you're Limbaugh hyperbole allows me to ignore your (potentially) real concerns. Good Day Sir.

@sgtcody: I honestly look forward to the day when I get private insurance. Right now, I can not get it.

I believe that health care is an entitlement but with that comes responsibility. Very rarely is there a situation where someone can't contribute something to their own care. I pay for my perscriptions. The program I go through does not pay for $4 perscriptions. It helps with people being proactive about their health. And that is very important.

If I had a major misshap I would be in major trouble. As much as my idealistic mind dislikes big government, this is one area where I have changed my mind. I didn't know that no one would sell me insurance just because of problems I've had since I was born.

I hope this thing works out for people like me and you that have been deemed uninsurable.

Before Castro (and post independence from the U.S.) Cuba was a dreary parade of corruption and coups. Someone needed to overthrow Castro's asshole predecessor, Batista-the fucking country was basically run by the American mafia and a select group that owned the export industry. I believe that Castro and Guevara, while obviously having ulterior motives, were also trying to ensure some sort of social justice and self-determination for the island and alleviate the problem of poverty. Communism, socialism, whatever, I have no problem with what system he chooses-I have a problem that he turned Cuba into a totalitarian police state to solidify his grasp and maintain control. Repression is the problem, not the ideology. Repression is not built into the ideology. You can have repression with democracy, fascism, communism, etc. All peoples under all governments are susceptible

But I don't want to launch into a huge debate over whether I'm unAmerican or not.

If you're talking about paying for the public school system...that "STATE" you refer to is YOU--and me. Whether we have kids...or not. Whether you send your kids to private school...or not.

My question: do you believe that we as a society have a vested interest in producing nominally educated citizens? How much more important is health compared to education? You can survive in this world with a poor education, but with compromised health? Not so much.

@johnva: My mother almost died twice this summer and has some major health issues (but still leads a good life). Her private insurer paid for everything. Right now, we are getting lots of "bills" that state Patient Responsibility: $0.00

@EinhornIsAMan!: Maybe your dad reads it because he is interested in many different viewpoints before he makes up his mind about anything. That is why I read what I read.

@Kimaroo - 20% More Kitty Added!: With most of them that I have looked into, it is a permenent condition manifesting itself now. I have three. They hang up when they hear that!

But having said that, I do have two wonderful doctors, my appointments are taken care of (and meds paid for by me at my own request), and I am not sure that public healthcare is the answer.

Be honest: you've already decided -- or been instructed to believe -- that socialized healthcare is the superior option, so you're here to preach the gospel, not to engage in an open discussion. From your perspective, it doesn't matter what this "Republican proposal" is, or even if it exists, because it can't possibly be correct.

@ARP: But it is all hyperbole. Whatever side you are looking at/listening to stretches the truth, creatively interpets the facts, etc. All sides have their right to say what they want to say. The true sign of intellectualism is that you can listen to someone (or read something, or whatever), entertain the ideas for a bit, and not have to put them into your collective belief system (in fact, 90% of what you see, hear and read you should throw out). To cut off someone saying something because they are saying something that is unpopular (or you don't agree with it, or it is an unpopular side of the truth) is anti-intellectualism. When I hear something on Fox, CNN, etc. or read it in Newsweek, The Weekly Standard, etc. I take it with a grain of salt until I hear the other side. Only then do I think I am getting something resembling the truth.

My fear lies not in what this program is now, but in what it could become. Human beings (especially humans in government) are not that good at stopping at a good thing. They continue to tweak and mess until it is our worst nightmare. They need to cap how much of this can be changed overtime.

WOW! if that's what'll happen it's a good thing he didn't use common sense.

No one would suggest that you /have/ to use it - the UK for example has a tolerable NHS - it's worked well for me and mine over the years, but it also has a thriving private system, subscriptions to which are often offered as incentives by employers just as in the US. What would be so different?

You don't seem to be so bothered about private education - I don't see loads of people saying they won't ever pay for public schools and that everyone should pay for their own primary education and that it's immoral to educate people who wouldn't afford to pay at the point of delivery.

What's the problem?

@MaelstromRider: Medical Malpractice costs are about 5% of healthcare costs, net [Source: CBO]. Healthcare costs increased more than that in a single year.

@sgtcody: I've never called the fire department. Why should I pay for those that do? I don't drive, why are some of my taxes being used for roads? I don't have kids, why are my taxes being used to educate people?

@ZManGT: Lawsuits represent 1-2% [CBO] of healthcare costs. Unneeded tests are estimated at another 2-3% [CBO]. Guess how much healthcare went up last year? More than these percentages combined.

@thelushie: No, this is not even worth considering because you can see the hperbole. If he/she had more reasoned comments, it would be contributing to the debate. Instead its more Hannity, Limbaugh, Palin crap.

Here are the comments from a few of the listings above:

Your children will be indoctrinated and your grandchildren may be aborted! [ARP: This is talking about setting up a school clinic. Abortions nor education are mentioned]

They will tell us what to eat? [ARP: No, this is essentially an expanded view of the food pyramid that talks about healthy lifestyles. There is nothing that forces you to eat anything]

This Home Visitation Program includes the government coming into your house and teaching/telling you how to parent! [ARP: This is an optional program for new moms on how to change diapers, nutrition, basic first aid, etc. You don't want the poor to know how to treat their kids?]

@AkakmanH: OK- I don't have time to run through all of them. But here is a sampling:

1) Sect 122 Pg 29 4-16; Does limit care for "preventative care" not when something is actually wrong with you. to $5k per person or $10k per family). How much does your private insurance pay for preventative care? Almost none. Nice try to spin it.

2) Sec. 123, Pg. 30 - THERE WILL BE A GOVERNMENT COMMITTEE deciding what treatments and benefits you get. [ARP: Sounds scary, no? It's no different than the boards that private insurers have that determine levels of coverage for certain plans.]

3) Sec. 2511, Pg. 992 - Government will establish school-based "health" clinics. Your children will be indoctrinated and your grandchildren may be aborted! There is nothing in the bill about mandatory education or forced abortions. In fact its saying that schools should have clinics for poor kids.

4) Sec. 2251, Pg. 915 - Government MANDATES cultural and linguistic competency training for HC professionals. [ARP: You mean you don't want your doctor to speak English? You don't want your doctor to be aware if you don't eat pork? You don't want your doctor to understand if you prefer a male or female doctor for religious reasons]

5) Sec. 2201, Pg. 864 - The government will MANDATE the establishment of a National Health Service Corps. o Sec. 2201 - "Fulfillment of Obligated Service Requirement" [ARP Is a scholarship program. Basically, you agree to be a "public option" doctor and you get a scholarship.]

When the insurance company that you have is the only one offered by your employer, they sure as hell can.

@takes_so_little:
How many more taxes can my paycheck take for people that cannot provide for themselves. If its taxed anymore Ill be getting less than half of what I make after all the taxes and 401k. Taxes are out of control. The government is large enough and has its nose in the banking industry already and it should not have any controling interest in a free market. Do you really want elected officials to monitor and make decisions based on a budget and have much lower limits that the private sector currently offers. Health care seems to work for the people that pay their premiums. Its all the free riding scum bags that are able to work but since unemployment pays better than going back to work for a little less money why would they. I beleive that we should take care of our disabled and over 65 crowd free of charge. I dont offer a fix to the issue but I am sure that a goverment run medical plan would be disastrous to the country. OBAMA Cannot perform miracles. He has spent more money on problems that have not even come close to turning around even with Billions of dollars thrown at them. People need to wake up and stop listening to his broken promises and watch out for more taxes.

I'm sure you'll vehemently object, but in the end, that's all you have to go on -- personal invective, projection, and manufactured outrage.

Get a grip.

First off, I am one of the uninsured in this country. I am in graduate school and my GA position does not offer any sort of health insurance. I get healthcare through a nonprofit with my three preexisting coniditions. Both of the doctors I see allow me a pretty substantial say in my treatment. Even though the non profit will pay for my medication, I do my best to pay for it (only two meds, one is a little on the expensive side but I handle it as I budget for it and yes they appreciate this). I REALLY appreciate them paying for my doctors visits. So yes, healthcare for the uninsured does exist but you have to look for it!

My mother is 63 on Thursday. She has survived 5 heart attacks and 2 strokes. She works full time (pays a shitload of taxes being single) and is planning on going back to graduate school. She has excellent insurance that has paid for a myriad of health problems and alot of perscriptions. Her insurance just got better as it is now covering wellness things like gym memberships, no copays on medications if she is willing to talk to a pharmacist, etc. So, yes, she wants to keep her insurance.

I am not completely convinced that she would not lose that insurance and her quality of care would not go down. It may not be immediate, but at some point. And it scares the absolute hell out of me.

I also happen to get excellent healthcare so what would happen to mine. I don't want to be forced onto a government insurance plan. Trusting the government with my healthcare, yeah, ok. I am not so much worried about the short term, but the long term and what this plan would morph into.

@johnva: Insurance exchange - I'll have to look into that more. Maybe it's because I'm a federal employee, but I like to think that a lot of problems can be solved with stronger regulation. (That's only partly tongue in cheek...)

As a fed, I get spectacular health care, and it seems like all the different options (several HMOs, or some PPOs) I could choose for were really good. Excellent price, great coverage - I wish all people had this option. Every single plan I looked at last year had the basics I wanted, and around open season they are falling all over themselves to get fed employees to sign up or switch. Not out of the goodness of their hearts, obviously, but it goes to show how good the health care system can be when hundreds of thousands of people are in a good bargaining position.

@thelushie:

Yeah isn't it terrible. Having a vested financial interest in keeping your sorry ass alive so you can be a repeat customer works out just horribly for you doesn't it?

@trujunglist:

Well gee, this isn't hard, if you're only making a bit over what it takes to make the loan payments + malpractice insurance + any of the other million expenses it takes to run a practice, then its really not worth putting in 40+ hours a week now is it?

I'll make you a deal, you can go to work for 40+ hours a week, and I'll take 99% of what you make off the top and we'll see just how willing you are to work that much for what is left. Deal?

@thegirls: But it does provide another voice on the subject. The one thing I can't stand is internet GroupThink in that one view is written about and then most people agree with it. The few (or more) who disagree with it are quickly drowned out.

And I really don't take seriously anything qouted from Wikipedia. It isn't a real source.

@Trai_Dep: Yes, one data point, with no underlying analysis to determine all the potential why's certainly does completely disproves my hypothesis.

In related news I just through a ball up and it didn't come down, completely disproving the theory of gravity, nevermind the fact that the ball was covered in glue and simply stuck to the ceiling.

I know CYA is a big reason why those procedures are done. That rationale is coming to me from why wife's coworkers who are still in residency and thus not completely legally liable for malpractice and who get paid a flat salary so no conflicts of interest. In that case, if you don't lose out monetarily in the lawsuit, malpractice lawsuits stay with you both in your reputation and in future malpractice premiums.

I'm not in favor of outlawing anything like that however I am in favor of mandating transparency so that the patient knows about those situations as well as giving them the legal right to have whatever testing needs to be done at a procedure of their choosing.

@MostlyHarmless: Sorry but calling someone and their spouse an "idiot" does not translate well as a joke. Maybe you should try something that starts with "Knock Knock" instead next time....

@MostlyHarmless: Well let me ask, what do you do for a living? I'm sure whatever you do makes a lot of people's lives better or else there wouldn't be anybody willing to pay you to do it.

How much is your time doing that job worth? How much is combined time and effort you put into getting in that position worth?

Since we're now dictating what is "enough" for Drs. to make, I say we go with your job next and you shouldn't have any problem with that since its for the greater good right?

Speaking for my dear wife I can say that hers is worth a lot more than $100k/year, in fact you're just getting there at $200k a year. Thats because by the time she gets into private practice, she will have spent 5 years in undergrad, 4 years in med school (incuring $150k in student loans along the way) and 3+ years (depending on whether she does a fellowship) in a medical residency working 80+ hours a week with 30+ hour call blocks every 4th day all for a salary that works out to <$10/hour.

And thats a family doctor, the shortest medical residency there is. What of the specialities that spend nearly a decade in residency? When it takes people over a decade or in some cases multiple decades to be educated and trained to do these things, do you may be see why they might actually want to be compensated for their time?

But you know, screw those greedy SOBS. After all what is a decade+ of your life gone, never to return anyway?

I don't get it. How does restricting earning potential make it so she unable to pay back bills? Anyone can pay back bills, even McD's employees. Oh, you mean you won't get to have 5 cars AND pay off your loans, oh I see now aha, hmm, hohum

You're truly naive and quite dishonest if you think that Republicans were totally cool with dissenting opinions from the 2000 election until Obama was elected. You've got a whole lot of nerve to get all high and mighty about the reverse happening now and to a much lesser degree then it was then. I need proof? Where the fuck were you living for the past 8 years? Somewhere were everyone agreed with you and flew their American flags from the back of their pick-up trucks huh?

@nova3930: Nice to know that your wife is going into medicine for the money and not for that silly notion of helping people. Say it ain't so? But not to worry, I am sure she can find a specialty that will still allow her to rake in the big bucks.

Do you even know what astroturfing is?

@TheFlamingoKing: Food and shelter should not be exclusively for profit, no. Sometimes, both should be provided at affordable, and maybe (gasp) below-market prices. Perhaps even free.

The Constitution doesn't outline as clearly as you would like what the main purposes of the federal government are. It mentions national defense, but it also mentions a post office. It also goes on about coins for a while. So which is more important?

It does emphasize domestic tranquility and general welfare, so I'm going to hang my hat on that. The Constitution sets forth the principle that the U.S. should be a pleasant place to live, and in this day and age, to do that we need to have access to methods of curing diseases, preventing injuries, and guarantees of basic human rights.

Doctors will still make a profit under this plan. Should we vilify doctors because they treat people for profit?

(a) I didn't do any such thing, and (b), it's the HEALTH INSURANCE INDUSTRY that is the focus of "villification" here. And yes, I do in fact villify them for making a profit off of suffering.

People will still die of starvation, yet food is a for-profit industry in America. Is selling food to hungry people "the right thing to do for our nation?" Same with shelter - people will still die of exposure due to homelessness, yet housing is a for-profit industry in America. Is renting apartments, selling or leasing property the right thing to do?

Incredibly unfocused, apples and oranges argument. When the cost of foodstuffs increases 500% over a decade, non-stop, perhaps it would be arguable. Oh, but then there's this ability to eat other, cheaper foods to sustain one's life. Are you saying there are other, equally effective ways to cure disease other than medical treatment? If there are (waving dead chickens over people, incantations, calling the Enterprise to teleport diseased cells from a person), please point me to their existence, and I'll support your argument.

There are no "subsititutes" in the market for healthcare as there are for foodstuffs or housing. Please rethink this argument.

And finally, who are these noble souls that do things because it's the right thing to do for our nation? The right thing to do for our nation would be to give every dollar you have above your basic needs to someone else that doesn't have enough to meet theirs. Do you do this every month? Do all your friends?

Immaterial. We as a civilized nation do this. Hell, we're doing it now for people who hate us and wish us ill! Furthermore, individual charity pales in comparison to the economies of scale that large entities such as the government.

@solidbrassfasteners: Nice caveat there - pharma companies are not operating purely on taxpayer money, no. I'd argue that they operate to some extent on taxpayer money (via grants, sometimes not directly to the pharma companies themselves). They also take advantage of a publicly-funded health research & surveillance system, and - when they feel like it - don't hesitate to take government insurance (see 1976 swine flu aftermath). They're not in a completely private sphere, and regulations should clamp down on them a lot more.

@Ayarkay:

"Reality" only has a liberal bias in the minds of liberal nutjobs, the same way "reality" only has a conservative bias in the minds of right wing nutjobs....

This is why I don't think we need a "public option" at all. What we need is stringent guidelines about what is appropriate coverage, regulations requiring that plan costs be tiered corresponding to income, and an overseeing body with the power to enforce those laws. I believe there has to be a better way of implementing the change we need than turning the government into an insurer. I hope congress can find it, but I am not optimistic about their abilities.

@Trai_Dep:

A global financial apocalypse more than a little caused by gov't distortion of the markets through lending regulations, gov't pushing for "everyone to own a home regardless of if they can afford it" and such wonderful gov't sponsored "socialize the losses, privatize the profits" entities like Fanny Mae and Freddy Mac? Is that the one you're talking about?

@AkakmanH: Is this the Consumerist record for longest individual post?

@johnva: I see a 7th option - or maybe a variation on the second: STRONG regulatory reforms. Clear language on what an insurance company can and cannot offer, and for what cost. Every person in the U.S. can get the same basic coverage from any insurance company operating in their state. The requirements of that basic coverage would be spelled out in the law & regulations. You would not be able to offer insurance without offering this basic plan, which would be the same price for everyone.

How do you make money? By offering additional coverage for things people might be interested in. Do you want sports medicine? Orthodontics? Plastic surgery? Travel medicine? Nutritionist? Home visits?

Let the insurance companies be creative with the extras, and people can pick the plan that suits their lifestyle/needs while still making sure that everyone has the fundamentals taken care of.

@MostlyHarmless:

Wow ad hominem attacks in response to reasoned points. I wish I could say I'm surprised that's the track you're taking, but unfortunately I'm not. Personal attacks and demonization is the common "safe haven" that people with no real arguments retreat to...

@SonicMan: The previous administration was the primary cause of that. They decided they didn't need to add much more funding to the system even though there would be a huge influx of new patients from two wars. So, yes, if you are a complete idiot and don't give the system enough money, then it will do badly.

But don't worry, even if a public option gets passed, count on the Republicans to destroy it the same way they destroy every other government agency or plan. Its a fairly simple process:

1) Underfund it (most important)
2) give it more responsibilities but less enforcement or bargaining power
3) Give confusing or contrary rules
4) Amplify each mistake it makes as the "norm"
5) Argue that the private sector could do a better job and privatize.

@G.O.B.: Come on!: Don't eat squirrels

And don't go in the swimming hole.

And what about people who come from families that aren't responsible enough or don't have the resources to pay for insurance for them before they are even born? Are they just screwed because their parents didn't protect them? That seems to violate the whole premise of America to me, which is that everyone is supposed to have an equal shot in life.

As for fraud and Medicare, you're right, and Medicare certainly isn't perfect. But it's also questionable whether it's always worthwhile to track down all fraud. Sometimes that costs more than the fraud.

That being said, I would like to see that story reported in another source or two. I would've said the same thing about a HuffPo, liberal as I may be

@johnva: THAT'S what charitable organizations are for.

As for children (or unborn), families could purchase coverage for them as well that is transferable to them when they reach adulthood.

Regarding Medicare, I assume you mean it's efficient because of its lower administrative costs. This is true. But they also don't diligently investigate claims for fraud like private insurers do. For instance:

[www.washingtonpost.com]

Thanks for reading my post.

@SacraBos:

No, no it wouldn't have. Period. If he said that, God help us if he was teaching economics. Tax rates are marginal.

To use made-up numbers (for simplicity):

It's NOT that "if you make $100k/year, you pay 20% taxes (or $20k), and have $80k left over, but if you make $110k/year, you pay 30% taxes (or $33k) and have $77k left over, so you're better off just making $100k.

It IS the situation where "the tax rate on income BELOW $100k is 20%, and the tax rate on income ABOVE $100k is 30%." So, if you make $100k, you pay $20k in taxes, and have $80k left over. If you make $110k, you pay $20k on the first $100k in income, and then 30%, or $3k, on the next $10k in income, so you pay a total of $20+3=$23k, and have $87k left over. You're still better off making $110k.

And in #6, I'm just acknowledging reality. Think about it: if you're not a doctor, how are you going to be informed enough to know whether or not you truly need some medical test or treatment (a key part of evaluating whether the price for a service is worth paying)? Any doctor can tell you that patients do this sort of evaluation poorly, simply because they aren't trained to do so. It's not calling people "stupid"; it's just saying that most people aren't experts in the practice of medicine. Medicine is very complex, which is why the practitioners of it get paid a lot of money and go to school for many years (because not everyone can do it). And studies are on my side on this: patients weigh a lot of things incorrectly from a health standpoint when cost analysis becomes part of the equation for them. For example, people forgo clearly indicated medical treatments like vaccinations and recommended screening tests like Pap smears at a higher rate when they are on HSA plans, simply because they have to pay for them out of their HSA. People cut pills in half when they can't afford their prescriptions, sometimes making the medication entirely ineffective and wasting all the money spent on it, because they don't know enough to know that it won't work.

You're entitled to your belief, but I think it's more wishful thinking than empirical reality that it would reduce costs significantly. Moreover, most aggregate healthcare costs are for chronic illnesses, not frivolous use of medical care. So even if you could eliminate all overuse of healthcare magically, you still wouldn't fix the bulk of the problem.

@thegirls: What system? The one where you get only what you earn? What's to understand?
The United States is not a charitable organization nor should it be.

@Con Seannery:

On behalf of all Canadians, Suck It, Connery.

@thegirls:

I'm a gov't engineering contractor and work with a LOT of vets who are on tri-care. The funny thing is a very large portion of them have their own private plans that they use because Tri-care pays so little and is so restrictive in its payout, that they can't find Drs who will accept it...

As unbiased as the New York Times

@MaarekElets: One thing I forgot, my wife is on track to be a family doc. She'll probably already have as many patients as she can handle, like most family docs do. To add more patients will either require working more, or it will necessitate spending less time on each patient. Does either option of a constantly overworked doc making decisions affecting your life or one spending the minimum amount of time on you sound good?

) "Taxpayer subsidies, in most of the drafts being discussed, are only for people below a certain income level..." You highlight a big problem with this whole discussion, one I pointed out in my original comment. No one really knows anything that's going to be in the final bill. No one. This thing could change drastically by the time it gets voted on, and even then most of the people voting on it still won't have much of an idea exactly what they're voting for. So to draw assumptions about money this will supposedly save, about people it will cover, and to cite the government's virtually made-up claims is ludicrous and disingenuous.

Well, I agree with this to an extent. But you made it out like it's a fact that it would be subsidized in such a way that it would put private insurers out of business. I was just pointing out that that isn't necessarily true, and isn't true of any of the drafts I've seen. In other words, you're arguing with a point that isn't actually being proposed (just like the people who are arguing against "socialized medicine", which again, isn't being considered).

2) I've got absolutely no problem with competition, but when the only option left is the government option, how does that provide competition? And when one competitor is making the rules for everyone, that's not really competition.

I don't believe that the government will be the only option. That's not even the case in countries with true single-payer systems, like Canada. In Canada people buy private supplementary health insurance (which is much cheaper than health insurance here) to cover "extras" that the government plan doesn't offer, such as private hospital rooms and more extensive prescription drug coverage. There's no reason to think that a proposal that goes much less in a socialist direction than that would eliminate private insurance. It just might change the niche that they compete in (secondary vs. primary insurance, employer vs. individual, etc).

3) Why is my final point absurd? I say nothing about "cost per person." As private insurers go out of business and everyone enters the government plan, overall costs WILL skyrocket. And the only way to control this would be to cut services. I fail to see how this is an absurd point.

Well, what I thought was absurd was that you were trying to simultaneously argue that the government plan would put the private insurers out of business and that the government plan would be unaffordable, forcing cuts to services. If the cuts to services were deep enough, people would want to buy private insurance to cover the holes, just like in Canada, or to replace it entirely. Also, the more people are in the public plan, the more people would be paying premiums to the public plan. It would acquire new revenue at the same time it would acquire new costs. You didn't think they were proposing it would be free except for taxes, did you?

As to your point, yes, cost per person may drop, but I see absolutely no evidence for your assumption that expanding the size of a government bureacracy will somehow lower administrative costs.

My evidence is that Medicare has much lower overhead and administrative costs than private insurance, as do single-payer plans in other countries. Economies of scale, and standardization make it cheaper. Paradoxically, more competition makes healthcare more expensive.

And "if the plan started to suck, the private insurers would be able to compete with it again successfully"? Really? That's your Plan B for our national healthcare system? Do you think that the government, after fighting for control of the nation's healthcare, would just give it up if things weren't going smoothly?

It's absurd to think that they would ever get total control over the nation's healthcare in the first place, so this is a moot point. They aren't trying to, either.

As a Cuban, I find nothing inherently wrong with communism, just that every country that has ever adopted it has become a totalitarian police state to enforce it

@thegirls: We already have a program for disabled people: Medicaid.
Also, my son hit that max amount every single year and I never asked for a handout. My wife and I each got additional work to pay the difference. That's my point about sacrifice. It took me nine years to pay for my son's birth plus ten days in NICU, but I did it.
The current system restricts innovation? Seriously? It's just a fact of life that we all can't do what we're best at. Otherwise someone would pay me to drink.

Doctors will still make a profit under this plan. Should we vilify doctors because they treat people for profit?

People will still die of starvation, yet food is a for-profit industry in America. Is selling food to hungry people "the right thing to do for our nation?" Same with shelter - people will still die of exposure due to homelessness, yet housing is a for-profit industry in America. Is renting apartments, selling or leasing property the right thing to do?

And finally, who are these noble souls that do things because it's the right thing to do for our nation? The right thing to do for our nation would be to give every dollar you have above your basic needs to someone else that doesn't have enough to meet theirs. Do you do this every month? Do all your friends?

Of course, reality does have a liberal bias.

Secondly, it's your point #6 that we will eternally disagree on. You have a typical position - "People are too stupid to do this themselves, we need to do it for them. They're just not capable of making rational decisions about their own lives, or I personally might not agree with some of the decisions they make, so therefore privatized health care is bad."

Of course, this point is hard to argue either way. It's just a belief. I believe people are capable of so much more if our government spent its time educating rather than controlling. Others believe that the people can accomplish more and be more successful if the government controlled certain aspects of their lives. That's the crux to the health care issue, and it's hard to get people on either side to understand the opposing opinion.

@pax: I <3-ed you, btw. You're too helpful not to follow!

This is by far the most astute observation made regarding this post. I wonder why everyone screaming in the comments missed it...

I'm not sure we can adequately discuss health care reform without also discussing medical mistakes and malpractice lawsuits. Malpractice insurance is one of the major causes of high health care costs. Having better statistics on medical mistakes and holding hospitals/doctors accountable for them outside the courtroom in some fashion, combined with significnatly reducing punitive damages, would seem to be a no-brainer as far as reducing health care costs.

@vastrightwing:

Where in the hell have YOU been for like...ever?

The reason why this bill is being worked up is because THERE ALREADY IS A GREAT HEALTHCARE DIVIDE!

Shelter is clearly a life-and-death industry as well. Why should it be for-profit?

Also, your comment is a bit of a red herring. The Constitution clearly outlines that one of the main purposes of the government is to provide for the national defense, and in order to do so Congress is authorized to sign funding bills for a standing Army. The Constitution doesn't say anything about police or firefighters, but your State constitution or city/county Charter usually does. However, the Constitution doesn't say anything about healthcare being a right, or it being government's obligation to do it. It does say that if it's not explicitly stated that the federal government can do it in the Constitution, then it's a right reserved to the states or the people.

And if that's upsetting to you, there's a clear system for modifying the Constitution, through ratification of amendments. That means that things that are important enough for the people to want government to do require 2/3s of the states to approve a measure amending the Constitution to allow it.

In other words, the only thing saying that health care should be private (or only regulated at the state level) is the Constitution. It exists to limit the scope of government, because every additional piece of government is an assault on freedom and liberty. But it's also an open document that we can revise if we decide that something should be in the scope of government. Instead, we're just going to spit on the Constitution and pass whatever damn laws we feel like anyway. Thanks, forefathers, for all that revolution and stuff, but we care more about a paternal government than freedom...

Also, the public Medicare system is MORE efficient than private insurance, not less. Why would the public option be any different? (I know I'm probably wasting my time trying to convince someone who thinks "Reason" is...reasonable, but I'll give it a shot.)

@SacraBos:

I am sorry but that is not true, either you are lying or were lied to. It is not how the marginal tax system works, when you go up in income you only pay the higher tax rate on the portion above the line. So for example, all single people pay 10% on the first $8350 they make according to their AGI. Then from $8,351- $33,950 they pay 15%. That means that if your AGI was $8,351 (ow) your tax would be $835 for the first 8,350 and then $.15 for the extra dollar.... meaning you still made $.85 more for that dollar even though it put you in a higher tax bracket. It gets a bit more confusing when you start including Tax Credits (taken from amount of taxes owed as opposed to deducted from gross income) but this still will not result in making more meaning you make less after taxes. That's why it's called "marginal"

The current system also restricts innovation because many people are stuck at jobs that they aren't best suited for because they need the health insurance so bad.

@johnva: 1) "Taxpayer subsidies, in most of the drafts being discussed, are only for people below a certain income level..." You highlight a big problem with this whole discussion, one I pointed out in my original comment. No one really knows anything that's going to be in the final bill. No one. This thing could change drastically by the time it gets voted on, and even then most of the people voting on it still won't have much of an idea exactly what they're voting for. So to draw assumptions about money this will supposedly save, about people it will cover, and to cite the government's virtually made-up claims is ludicrous and disingenuous.

2) I've got absolutely no problem with competition, but when the only option left is the government option, how does that provide competition? And when one competitor is making the rules for everyone, that's not really competition.

3) Why is my final point absurd? I say nothing about "cost per person." As private insurers go out of business and everyone enters the government plan, overall costs WILL skyrocket. And the only way to control this would be to cut services. I fail to see how this is an absurd point.

As to your point, yes, cost per person may drop, but I see absolutely no evidence for your assumption that expanding the size of a government bureacracy will somehow lower administrative costs.

And "if the plan started to suck, the private insurers would be able to compete with it again successfully"? Really? That's your Plan B for our national healthcare system? Do you think that the government, after fighting for control of the nation's healthcare, would just give it up if things weren't going smoothly?

@BWoodle:

1. Student loan debt does not work like that. She incurred the debt before we were married and I did not sign the promissory note. Under the governing law of student loans, I and my income are not responsible for her debts. The only thing they could do would be to seize her portion of any tax refunds me might have or seize her estate should something happen to her.

2. You're right, it is a legally binding contract, one which has provisions for income contingent payment. If her income is zero, we'll pay the $5/month minimum payment and the remaining loan balance will be discharged after 25 years. All within the bounds of the contract and since they're federally guaranteed, Uncle Sam gets to fix the problem it created...

@BWoodle: You're right I can't grasp the wierd skewed "reality" that the left wingers in this country are pushing, the same way I couldn't grasp the Iraq WMD/Terra/name your Dubya BS "reality" that the right wingers were pushing the last 8 years. In that light I'll take it as a compliment...

@MostlyHarmless: Which I take to mean you've done no more than read what the NYT is telling you...

@MaarekElets: You're very funny. Yes lets get the US Congress (or any state legislature for that matter) who are all either lawyers themselves or bought and paid for by lawyers, to pass comprehensive Tort reform. Even the tort reforms that have passed in this country have largely been jokes.

IF this is all not to mention that this whole excercise is supposedly to make health care better and cheaper, then why is one big issue like malpractice liability not addressed at all?

I don't want 100% pay for play, but I do want a real reform of the system that could help, not more gov't interference.

I see 4 primary goals that everybody says they want:
1. Affordable coverage
2. Available coverage for all
3. Choice of Dr. remains with the individual
4. Treatment decisions stay with Dr and patient.

If you want all 4 of those, you have to get away from our current system employer based "cover absolutely everything" insurance. I have a pretty good idea how to do this...

1. Remove the gov't employer tax exemption for health benefits to encourage people to move to individual plans. Specifically high deductible catastrophic coverage plans. Higher deductible's will keep the coverage cost low and catastrophic plans give insurers less wiggle room to deny coverage.
2. Expand tax deductible HSAs in conjunction with #1. This will help cover the high deductible as well as routine Dr. visits and treatment. This way there is no one, either gov't or insurance, to tell you how to deal with your treatment since its your money in your account.
3. Scrap medicare and medicaid and replace it with a single means tested program to cover anyone who is unable to afford #1 and #2 regardless of age as well as any pre-existing conditions that would be cost prohibitive for individuals to cover.

I think this would cover all 4 criteria I listed above as well as reducing the role gov't has in health care

testing...?

Yes because people will gladly study for years and spend hundreds of thousands of dollars to become doctors out of the kindness of their hearts.

@kolacek: I resent damn near every word you said. This "whitey" has never been without healthcare because I was willing to work and make the nessesary sacrifices. I'm a high school dropout and have been living on my own since the age of 16.
You want healthcare? Better yourself so you can get a better job. Can't find a better job? Move where the jobs are. Hell, you can do what I did, bust your butt in the West Texas oil fields. Neither I nor any other "whitey" owe you a damn thing.

Also, again, they aren't proposing a single-payer system. They are proposing a public option. So if the "service" is terrible on the public option plan, you could always go buy private insurance to make it better. Even if it were a single-payer system, most single-payer systems allow people to buy supplementary private insurance to fill in perceived "holes" in the government plan. The purpose of the single-payer system would then be to ensure that everyone gets basic medical needs taken care of, not to ensure that everyone gets the best care available. If the government system got worse, the supplementary insurance could take up more of the slack.

I agree completely. But as the experiment in Mass. showed socialized medicine doesn't work, so now they want to throw the entire nation into the system.

It's easy to demand specificity of others, and then make no such demands on yourself.

I love how you look at a massive listed of direct references to the health care bill and then completely ignore them because you don't like the source that pointed them out. These originated with the Democratic legislature, how's that for a biased source.

@TomCoughlin:

"b) A private insurer has a very strong incentive to provide service - profit. As long as we have choices in insurance providers, it's in the best interest of a provider to at least provide some level of service."

Then please explain why this is not happening. People have become increasingly dissatisfied with service over the past few years and yet, profits go up. Also, what choices exactly? If you have even the smallest preexisting condition then you have one choice, who your employeer chooses. That isn't choice.

The point I was making about the Government bit is that the Government is made up of us.... it's not some superhuman race of people that run for office and it's not like you don't have a voice. It's one thing to be skeptical, but members of the party I used to call home (Republicans) have long since moved beyond skepticism to pure paranoia (except when we are killing people that is). It just seems unhealthy, and also a good way to find yourself controlled by someone else.

But it is a good analogy in how we APPROACH the two types of insurance. We don't buy car insurance that covers every little thing (oil change, door dig, tire rotation, etc) for the price of a $20 copay. We buy car insurance to cover major/catastrophic loss. We should buy health insurance the same way, and keep the insurance companies bloat out of the daily medical needs.

If Medicare and Medicaid is to great, why are the supplemental insurance policies available?

The government plan would make it impossible for private insurance to compete. That combined with attrition would effectively ban private insurance in the United States by driving them out of business.

Obviously we need some kind of reform to pay for those who currently cannot, but what the Democrats are currently tossing around is not what we need.

Never mind that comparative effectiveness doesn't apply across the board, and generics aren't held to the same standards of effectiveness that brand names are.

And you know what? I'm completely okay with that. Health care isn't some profit center to be squeezed for the last nickel of revenue--it is a public service that enables this country to be productive, defend itself, and succeed.

To be plain: screw profit from making sick people well. Do it because it's the right thing to do for our nation.

"About two thirds of people say they are "very" or "completely satisfied" with their current health insurance plan" ([ifawebnews.com])

1) First, instead of a national plan, how about we just let states make their own "public option"? If it is widely successful, other states will begin adopt it. This is what federalism is supposed to be about.

2) Level the playing field and tax employer provided insurance the same as income. Companies provide big health benefits because the benefits they provide are not taxed. It's much cheaper for them to provide health insurance than to simply pay workers more. This results in workers having more than they really need. Or they'll abuse it because "their company is paying for it". But then they have nothing if they lose their job. This is why health care in the US is so costly. Most people either rely on their employer or the government. In either case, they have little choice in their coverage.

3) In addition to #2 above, give tax credits for people to purchase their own health coverage. This way self-employed are given the same tax advantages as those with employer based coverage. This will create lots of competition and drive down costs. Plus people will be better able to find a plan that suits them.

4) Expand health savings accounts. Allow people to manage their own health savings accounts. People are much more discerning when it comes to their own money.

5) Allow people to purchase coverage across state lines.

6) Expand health-status insurance (by eliminating the tax preference of employer coverage).

[www.reason.com]

Health status insurance would basically cover the risk that your medical insurance premiums will rise if you develop a chronic condition. If an individual comes down with a deadly disease, they will be paid a large lump sum to cover the rise in medical insurance premiums. Plus, you're not tied to any insurer for your medical insurance, so you can shop around for what suits you the best.

These are all alternatives to a bloated, costly, and inefficient public option.

Basically, the idea from what I understand is that the government would fund comparative effectiveness research that would better determine where different drugs are warranted.

They already do this, BTW, with the existing large government-run healthcare plans.

As soon as I saw where the article came from, I didn't even bother to read the Consumerist summary.

I've been reading the Consumerist for a few months, now, and they seem to be left-leaning. Am I wrong?

@BWoodle: That's fine. All I'm asking for is the chance to do the same.

If you are so quick to challenge the version of the bill which will hurt, why isn't everyone allowed to challenge that any version of the bill will help?

@DollaValueLIFO: Huh?

@MaarekElets: a) "worthless scum" was lifted from johnva, I was throwing him a bone.

b) A private insurer has a very strong incentive to provide service - profit. As long as we have choices in insurance providers, it's in the best interest of a provider to at least provide some level of service.

On the other hand, with the government the only game in town, with zero competition and therefore zero recourse, the government has zero incentive to provide service. It's in their best interest to provide as little service as possible, and therefore to cut costs as much as possible, and to let you die as soon as possible.

And thanks so much for that last little bit there - I think you're a little confused about the role of the government in America. "We the people" are not one and the same as the government. The government is made up of our elected representitives, but despising government intrusion in my life is in no way akin to any sort of self-hatred, or whatever you're trying to assert.

Just because we can vote does not mean we ever get justice for the crimes committed against us by our government.

I'll never support a government health care system. There are too many examples of failed government programs and rulings left unaccounted for by any individual. We're talking about a government that sat silent for 56 years while Plessy v. Ferguson allowed racial segregation. We're talking about a government that took 110,000 Japanese citizens and falsely imprisoned them during WWII. We're talking about a government that falsified evidence of weapons of mass destruction to start a war against another nation. So I'm not exactly confident that this government has the people's best interests in mind when it does just about anything...

1. Read my post downthread. The current legislation does NOT allow for generalized subsidies of the public plan using taxpayer dollars. The subsidies it does contain are based on INCOME of the people in the plan, and aren't for the vast majority of people who currently have a high enough income to have private health insurance.

2. Adding younger people into Medicare would REDUCE Medicare's funding crisis, not increase it, since they would still have to pay premiums and would be less likely than current Medicare recipients to need expensive care.

3. This plan is not an expansion of Medicare, but a separate government insurance plan.

4. The plans being discussed contain plenty of provisions aimed at reducing the cost of care. A public health insurance option could reduce the cost TO THE PLAN immediately simply by having more negotiating power.

5. Corruption IS an issue, but the answer is not to just give in to ALL the demands of the corrupting industry.

6. Individuals are not really equipped to judge the cost effectiveness of healthcare treatments, and make their decisions emotionally and based on lack of information. That's why we have doctors to give them advice. Even if they were given complete pricing transparency, that wouldn't necessarily translate to them making better decisions. It might cause people to make WORSE decisions (such as avoiding preventative care) that would end up costing more down the line. There is some evidence this is the case already, based on studies of participants in HSA plans (where the individual has to bear more of the cost themselves).

1. When you're on an insurance plan, some drugs are covered under the formulary and others aren't. If the government creates a health insurance plan, would the government dictate that certain medications not be covered?

2. Given the government's love of generics, would a government plan create an (even more) unfair market slanted toward generics?

Really? There's a singular, published Republican proposal? That's news to me...

But hey, if you have more fun repeating talking points, who am I to judge?

Choice? What choice, you nice rich people over at "Conservatives for Patients' Rights?" I haven't so much as stepped in a dental office for 18 years. Do I work? Yes. Do I pay a shitload of taxes? YES. Can I afford getting ass-raped - again - by you and your lobbyist cronies? NO.

"Oh no...watch out! The Black President and his gang of godless Socialists are gonna tax poor, poor racially oppressed whitey and put old people to sleep. Don't forget mandatory abortions, death panels and eugenics. And NAZIS!"

Gimme a f*cking break. This is nothing but bullshit lies and dirty tricks and I'm starting to feel sick every time I turn on the 24 hour news.

I've since read the grandfather clause again - thanks. The problem is that I have read through a lot of the bill, but when he brings up some argument against it, I have no memory of it because I did not interpret it the same way, and I have no recollection of it.

The health industry is not a government subsidized industry. Pharma companies are not operating purely on taxpayer money; neither are doctors.

Unfortunately, it won't be because the government plan provides better insurance for cheaper. It will be because the government can undercut every single business because they're backed by taxpayers and the corporations are not. Corporations cannot charge an individual less than the actual cost of care and expect to stay in business. The government can charge below the cost of care because they subsidize that care with taxpayer dollars.

I'd make the point back that Medicare is seriously facing a funding crisis already. This is not new news either, there have been looming issues with Medicare funding for more than a decade now.

This bill will pass, and our taxes will go up, but there are no provisions in it that will actually lower the cost of health care. That's because this bill was heavily authored by the very insurance companies you hate so much thanks to corporate lobbyists. They definitely do not want to lose the profit racket they have in place, so they will do everything to keep that in power.

As long as people have no clue what individual health care really costs - not the insurance copay but the real costs - the health care cost issue will never be solved.

@darkwing: If only we could all be so blessed as to see through the veil of lies like you darkwing. Thank goodness we have true patriots willing to step up and spout a never ending stream of rhetoric. Our country is that much better for it.

@nova3930:

So then get your wife out there and push for a change in Malpractice lawsuits and stop trying to scuttle the reform for everyone else.

I am sorry but the analogy does stand. I understand the difference between liability and comprehensive, but that part of the concept doesn't carry over... however the part where your problem causes me loss and thus you should be required to insure it does. Unless you want to start arguing a 100% pay for play medical system then there is no way of escaping the fact that a large percentage of people are a risk to cost society a good deal of money when they get sick (this is compounded by the fact that they don't get preventitive treatment as much). When there is a car accident, someone eventually has to pay the bill for property and personal injury... because of liability insurance requirements this means that it's most often the insurance company of the at-fault party... if they have no insurance, then they are punished criminally and civilly. When someone gets sick, someone eventually has to pay the bill as well. Right now as it is, there are many cases where it ends up being the hospitals that are writing off the costs. Eventually through the movement through the system this is paid for by us in general through increased fees, higher premiums...etc... but despite us paying for it, it is poorly distributed, overly expensive (because we are bypassing preventive care), and a lower level of care for those without coverage. By having everyone covered by law, we put a control to these costs as well as increase the level of care being provided.

This also means your wife has a chance for more overall paitents because people who would be ER only, would suddenly be able to make office visits (assuming that she plans to be in private practice and isn't an ER physician).

That might just as well have been michelle bachmann.

Vague as vague can get. Thats a good trick to use when trying to disseminate misinformation. Take something thats untrue, fuzzy it up a bit, and then present it like it is an intellectually honest representation of the facts.

1) You are married supposedly, so you already own her debt. You can't tell the creditors to piss off and you can't bankruptcy out of student loan debt.

2) The government is allowed to change laws. Presumably that is their job. Your wife didn't take out Stafford loans on a condition that "I will only pay back of my career outlook remains great!" She entered into a legally binding contract indicating that she would pay then back. Regardless, the creditors she owes are not the same people who are responsible for the downturn in her career outlook that you are whining might happen.

How so? If multiple companies can deliver a package to your doorstep without a problem, what is it about putting a letter in your mailbox that would "destroy the system"?

"Yeah, somewhere in those 1000 or so pages, look it up yourself. Also, it said something that I interpreted as something possibly unrelated."

Try again.

Are you opposed to Medicare, also?

If so, why, and what alternative mechanism would you propose for taking care of the enormous healthcare costs of senior citizens that wouldn't result in many of them dying for lack of adequate health care/money?

If not, please explain how Medicare is somehow "different" from a public healthcare plan open to younger people, as well. How would you cover the people who are medically uninsurable or otherwise unable to afford or obtain health insurance in the absence of a public system?

You have a fundamental problem with basic Algebra. I don't know what fantasy land you are living in where your wife's salary will be stuck at some absurdly low value, but it isn't reality.

And you base this all on I don't remember the section but there were provisions for capitated payment schemes ie paying Drs a flat rate per year per patient. Please stop commenting. You really have no grasp of reality. You are a walking talking point.

Nearly half of TRICARE beneficiaries live in the South -- states where Congressional leadership has been most vocal in opposing public involvement in health care.

Go Figure!

@DollaValueLIFO: Agreed. There are more public programs for which your DH is qualified, even as a resident alien, than for which he is not.

Congressmen have dozens of staffers, most of them highly qualified, intelligent people, combing through the bills and reporting to them- like any busy executive. That comment you made is just fucking ignorance to the nth degree.

Yes, I know that's not what the administration is telling you, but that doesn't mean it's wrong.

And if everyone agrees that we need some sort of reform, why are there organized groups going and shouting, screaming, and weeping at the prospect of reform? Without even clearly stating what aspects of the proposed reforms they are upset by, or proposing an alternative plan? I was pretty fair in that I included the Republican proposal in my list. I just don't think it's a very good proposal.

@mizike:

Uhh, lets see, she started med school over 6 years ago now, when there was little to no talk of completly taking over the medical system. When there's nobody dictating how much you can make the equation works out a little better.

And the fact is we would just be making the decision to write off her student loan debt as a loss and a waste. We'd put all our assets in my name and tell the SL creditors to go pound sand. I have a certain moral problem doing that, but then again I have a bigger one forcing my wife to work for what amounts to negative wages.

@MaarekElets: The bill that I read was a House draft that appeared right before the recess. It was somewhere in the range of 1000 pages. I don't remember the section but there were provisions for capitated payment schemes ie paying Drs a flat rate per year per patient.

Under the right conditions I would have no problems with that. The issue is that under that scheme, Drs would still be on the hook for malpractice meaning they still have to provide ALL of the CYA treatment they provide now to try and prevent lawsuits, under a flat payment system. I hope people can see how that could quickly become an untenable position for a Dr. to be in.

Now as far as comparing car insurance to health insurance, that is a false analogy if there ever was one. State's require you to have LIABILITY insurance, not collision and comprehensive. I agree with that because a requirement for liability insurance is one way in which the gov't can protect individuals private property rights. Extend that to health insurance and the only reason me not having health insurance will be a burder on others, is gov't requirements to provide care. So basically you're arguing for a gov't solution to a gov't created problem.

And medicare and medicaid cause major problems as it is. Their reimbursement rates are so low, Drs end up either not taking them at all or they raise what they charge to private insurance or self pay to make up the difference they need to operate. So who exactly is unfairly shifting the burder again?

@HiPwr: The people who are organzing the interruption of meetings about healthcare are about as un-american as you could possibly get. Seriously drowning out people while they are speaking? When we lose the ability to have discussions or debate in this country we ALL lose.

Guess which one is 7 BILLION DOLLARS IN DEBT ? ...Of course the one that is run by government.

How about rather than asking for proof to dispute the claim you are making, you instead provide proof to support the claim you are making? The only proof someone could offer you is the full plan and saying "Look, IT ISN'T IN THERE!"

@SonicMan:

Key word: "Underfunded"

Who did that?

Oh yeah....the people who are fighting tooth and nail to maintain the status quo now.

Also...consider the source. Fox News is like Wikipedia, have something to coorberate, because it's likely that not all the facts are present.

An expansion of Medicare is NOT a bad thing, although that's not what this is.

And if you're happy with your current insurance, I congratulate you for having an employer that subsidizes your insurance and/or for having such good health that you can afford good coverage on your own and get treated well by the insurers. Not everyone is so lucky, which is the whole point of this problem.

@TomCoughlin:

Take your "whether they want it or not" comment to it's logical conclusion - that people who don't want to pay higher premiums shouldn't get the care being covered by those premiums. I thought part of the problem with all the "illegals" going to the ER was that they received care without paying for it. What's the difference?

@thegirls:

I think people forget that Veterans have nation-wide access to care and also have ridiculous amounts of low-cost drugs and services.

However, people are correct when they say that the medical care of non-traditional injuries incurred while active (PTSD, Depression, Alcoholism) is lacking. But then again, try getting BCBS to send you to a "Mental Health Specialist" for less than $120 an appt.

The bottom line is the only plan I will support right now would correct 2 things, the 2 money wasters in Health Care.

1. Tort Reform. Bottom line is we waste more money on unneeded tests then anything else because doctors are afraid of being sued.

2. Administrative costs. I work in IT, there has to be a way to simplify the healthcare paperwork. Make all hospitals and insurance companies use the same codes for everything.

I think if you do one and two the price of health insurance goes down. Those that doubt me... here is the source.

[money.cnn.com]

I feel all these issues should be handled at the state level as our founding fathers intended. I would always choose to live in a "sink or swim" state over one that robs me blind with social program taxes. Our federal government needs to stick to protecting our borders and stewarding the economy as the Constitution directs.

@BWoodle: If thats the case, she's not even going to bother working.

She's an idiot, then."

Kind of like people who say "I will just choose to not make as much" when marginal tax rates increase. It's a fundemental (and usually intentional) misunderstanding of the system.

Seriously, does anyone have a choice of doctors now? I get a list I have to choose from. If the doctor I like goes off the list, I've got to find another one. If the doctor I like isn't seeing new patients, I have to choose another one off the list. If I can't FIND another doctor in my area, I'm waitlisted. If I get sent to a specialist that my doctor wants me to see, I have to check and see if he/she is on the list. If he/she isn't on the list, I have to see someone else (even if that doctor isn't the best doctor for my needs). All of this with some very "high quality" insurance that YOU pay for (my husband is a government employee).

The way I see it is that we already have public health care, simply because there's never been a bill that hasn't been paid, somehow, by someone. You just paid for two friends of ours to have open heart surgery, and cancer treatment. They can't pay. You'll pay -- either with our taxes or through rising costs to cover the uninsured. You just paid for my husband's stepbrother's snake bite and hospital stay. He can't pay for it. You'll pay. My daughter will be uninsurable when she goes off our plan in two years. Given the fact that just out of college she will most likely not find a job that offers health benefits (most jobs do not these days), and she will be unable to find private insurance, if she gets sick and needs treatment -- You'll pay.

@Traveshamockery:

Compare the USPS to FedEx. One is a quasi-public arm of the government that doesn't turn a profit, but has to fund itself. FedEx has to turn a profit, lest it become valueless to its shareholders. Both are alive and well, though the USPS is struggling with reduced revenues, because FedEx has figured out how not to screw with peoples shipping.

Relate to healthcare, then relax.

This is why, even if I agreed with the party platform, I could never be a Democrat -- I just don't have that much hate in me.

@SonicMan: This was interesting too...
"But doctors there were sometimes implanting the seeds into the wrong organs, and in many cases gave significantly less radiation than was prescribed -- including during an entire year when their monitoring equipment was broken and they were essentially flying blind, the New York Times reported."

Lets let the Gov give us all such good Healthcare.

And for the record, I voted for Obama.

@MaarekElets: Really.

[www.foxnews.com]

From the article:

"Veterans groups and lawmakers say VA hospitals have permitted these violations because federal regulations allow doctors to work with little outside scrutiny. They say the VA health system, with its under-funded hospitals and overworked doctors, is showing signs of an "institutional breakdown," in the words of one congressman."

They're even afraid of Harry Potter:

From Wikipedia: Liberty Counsel has been criticized for intolerant and excessive tactics in pursuit of their causes[10], including threatening legal action against a public library for awarding certificates involving Harry Potter books, because "the certificate of witchcraft endorsed a particular religion".

@I Love New Jersey:

Destruction? How in the hell is this a destruction of the (broken) American medical system? I just knew there was something wrong with you (who in their right mind loves New Jersey?).

Seriously, the plan offered to Congress is not unlike the plans offered to employees at major companies interested in employee retention.

I have, however, met a great many people who can make a persuasive argument without having to fall back on the old "corporate greed" line.

1) Taxpayer subsidies, in most of the drafts being discussed, are only for people below a certain income level (in some of the proposed bills, as low as $30,000/year). Those people already can't afford good health insurance, and generally don't get it from their employers very often, so that's not really true that it could operate at a loss overall. It would only be able to lose money on a subset of the people it covers, mainly ones that don't have a real private insurance option anyway. So it wouldn't "unfairly" take many customers away from the private insurers except for people that they already don't want, at least as currently written. That's no accident: the insurance lobbyists have been at work.

2) On the other hand, the public option might draw people away from the private plans simply because it could compete better due to larger economies of scale, more negotiating leverage, lower administrative/profit costs, etc. I've got no problem with that, as that's just replacing private insurance plans with something better. They should adapt to become more efficient in order to compete with this, as it would be competition purely on the merits.

3) Your final step "which will cause costs to skyrocket and/or services to be cut" is absurd, and contradicts your earlier points. In reality, the larger the number of people in the public plan, the LOWER the cost per person would be, because it would consolidate administration more, and reduce the number of different insurance plans and individuals providers would have to deal with billing. And you would be spreading the risk out over a larger pool, increasing the predictability of costs/premiums. If the public plan started to suck, the private insurers would be able to compete with it again successfully (many richer people, the people who have access to good health insurance now, would pay more money to get private insurance if the insurance were truly better than the public plan). Remember that each new person joining the public option would also be bringing their premiums. That would be a further infusion of money.

There isn't anything wrong with questions whoever is in power, but when your tea parties are active recruiting places for Neo-Nazi and white supremacist groups, you should probably re-evaluate your message and think about a better way to present your thoughts than stirring up the insane fringes of your base.

@Kimaroo - 20% More Kitty Added!:

Don't - unless you absolutely know that you don't qualify. After trying so damned hard to get half of the hourly (under $10 an hour) staff to apply for the EITC when they did their taxes, I'm convinced people need to be more confident when searching for qualified programs and assistance.

@johnva: With MBA built in to private health coverage, I have better recourse with the Government. I can almost always sue the Government. The public plan also has no incentive to screw me over.

@katstermonster:

You're right, the media isn't doing it, its our own elected office holders doing it like Nancy Pelosi D-CA
...
[blogs.usatoday.com]

Along with comments calling dissenters nazis and the like...

She's an idiot, then.

• Sec. 113, Pg. 21-22 of the Health Care (HC) Bill MANDATES a government audit of the books of ALL EMPLOYERS that self-insure in order to "ensure that the law does not provide incentives for small and mid-size employers to self-insure"!

• Sec. 122, Pg. 29, Lines 4-16 - YOUR HEALTH CARE WILL BE RATIONED!

• Sec. 123, Pg. 30 - THERE WILL BE A GOVERNMENT COMMITTEE deciding what treatments and benefits you get.

• Sec. 142, Pg. 42 - The Health Choices Commissioner will choose your benefits for you. You have no choice!

• Sec. 152, Pg. 50-51 - HC will be provided to ALL NON-US citizens.

• Sec. 163, Pg. 58-59 beginning at line 5 - Government will have real-time access to individual's finances & a National ID health care card will be issued!

• Sec. 163, Pg. 59, Lines 21-24 - Government will have direct access to your bank accounts for electronic funds transfer.

• Sec. 164, Pg. 65 is a payoff subsidized plan for retirees and their families in unions & community organizations (ACORN).

• Sec. 201, Pg. 72, Lines 8-14 - Government is creating an HC Exchange to bring private plans under government control. • Sec. 203, Pg. 84 - Government mandates ALL benefit packages for private Health Care plans in the exchange.

• Sec. 203, Pg. 85, Line 7 - Specifications of benefit levels for plans means that the government will define your HC plan and has the ability to ration your health care!

• Sec. 205, Pg. 95, Lines 8-18 - The government will use groups (i.e., ACORN & AmeriCorps) to "inform and educate" (sign up) individuals for government plan.

• Sec. 205, Pg. 102, Lines 12-18 - Medicaid-eligible individuals will be automatically enrolled in Medicaid. No freedom to choose.

• Sec. 223, Pg. 124, Lines 24-25 - No company can sue the government for price-fixing. No "administrative of judicial review" against a government monopoly.

• Sec. 225, Pg. 127, Lines 1-16 - Doctors - the government will tell YOU what you can make. "The Secretary shall provide for the annual participation of physicians under the public health insurance option, for which payment may be made for services furnished during the year."

• Sec. 312, Pg. 145, Lines 15-17 - Employers MUST auto-enroll employees into public option plan.

• Sec. 313, Pg. 149, Lines 16-23 - ANY employer with payroll $400,000 and above who does not provide public option pays 8% tax on all payroll.

• Sec. 313, Pg. 150, Lines 9-13 - Businesses with payroll between $251,000 and $400,000 who do not • Sec. 401.59B, Pg. 167, Lines 18-23 - ANY individual who does not have acceptable care, according to government, will be taxed 2.5% of income.

• Sec. 59B, Pg. 170, Line 1 - Any NONRESIDENT alien is exempt from individual taxes. (Americans will pay for their health care.)

• Sec. 431, Pg. 195, Lines 1-3 - Officers and employees of HC Administration (government) will have access to ALL Americans' financial and personal records.

• Sec. 441, Pg. 203, Lines 14-15 - "The tax imposed under this section shall not be treated as tax." Yes, it says that.
• Sec. 1121, Pg. 239, Lines 14-24 - The government will limit and reduce physician services for Medicaid. Seniors, low income and poor are the ones affected.

• Sec. 1121, Pg. 241, Lines 6-8 - Doctors, it does not matter what specialty you have; you'll all be paid the same. "Service categories established under this paragraph shall apply without regard to the specialty of the physician furnishing the service."

• Sec. 1122, Pg. 253, Lines 10-23 - The government "validates work relative value units" (sets value of doctor's time), professional judgment, methods etc. (defining the value of humans).

• Sec. 1131, Pg. 265 - Government mandates and controls productivity for private HC industries. "Incorporating Productivity Improvements into Market Basket Updates that Do Not Already Incorporate Such Improvements."

• Sec. 1141, Pg. 268 - The government regulates rental and purchase of power-driven wheelchairs.

• Sec. 1145, Pg. 272 - Treatment of certain cancer hospitals: Cancer patients and their treatment are open to rationing!

• Sec. 1151, Pg. 280 - The government will penalize hospitals for what government deems preventable readmissions (incentives for hospital to not treat and release).

• Sec. 1151, Pg. 298, Lines 9-11 - Doctors, treat a patient during initial admission that results in a readmission and the government will penalize you for that action.

• Sec. 1156, Pg. 317, Lines 13-20 - "PROHIBITION on physician ownership or Investment." Government tells doctors what/how much they can own.

• Sec. 1156, Pg. 317-318, Lines 21-25, 1-3 - "PROHIBITION on Expansion of Facility Capacity." The government will mandate that hospitals cannot expand ("number of operating rooms or beds").

• Sec. 1156, Pg. 321, Lines 2-13 - Hospitals have opportunity to apply for exception BUT community input required.

• Sec. 1162, Pg. 335-339, Lines 16-25 - The government mandates establishment of outcome-based measures. Rationing.

• Sec. 1162, Pg. 341, Lines 3-9 - The government has authority to disqualify Medicare Advantage Plans (Part B), HMOs, etc. This will force people into a government plan.
"The Secretary may determine not to identify a Medicare Advantage plan if the Secretary has identified deficiencies in the plan's compliance with rules for such plans under this part."

• Sec. 1177, Pg. 354 - Government will RESTRICT enrollment of special needs people! "Extension of Authority of Special Needs Plans to Restrict Enrollment."

• Sec. 1191, Pg. 379 - Government creates more bureaucracy - "Telehealth Advisory Committee." HC by phone or the Internet - dial 1 for your health care advice?

• Sec. 1233, Pg. 425, Lines 4-12 - Government mandates Advance (Death) Care Planning consultation. Think Senior Citizens and end of life. END-OF-LIFE COUNSELING. SOME IN THE ADMINISTRATION HAVE ALREADY DISCUSSED RATIONING HEALTH CARE FOR THE ELDERLY.

• Sec. 1233, Pg. 425, Lines 17-19 - Government WILL instruct and consult regarding living wills and durable powers of attorney. Mandatory end-of-life planning!

• Sec. 1233, Pg. 425-426, Lines 22-25, 1-3 - Government provides approved list of end-of-life resources, guiding you in death.

• Sec. 1233, Pg. 427, Lines 15-24 - Government mandates program for orders for life-sustaining treatment (i.e. end of life). The government has a say in how your life ends.

• Sec. 1233, Pg. 429, Lines 1-9 - An "advanced care planning consult" will be used as patient's health deteriorates.

• Sec. 1233, Pg. 429, Lines 10-12 - "Advanced Care Consultation" may include an ORDER for end-of-life plans - from the government.

• Sec. 1233, Pg. 429, Lines 13-25 - The government will specify which Doctors (professional authority under state law includes Nurse Practitioners or Physician's Assistants) can write an end-of-life order.

• Sec. 1233, Pg. 430, Lines 11-15 - The government will decide what level of treatment you will have at end of life, according to preset methods (not individually decided).

• Sec. 1302, Pg. 468, Lines 16-21 - "Community-Based Home Medical Services means a nonprofit community-based or state-based organization."
• Sec. 1302, Pg. 472, Lines 14-17 - PAYMENT TO COMMUNITY-BASED ORGANIZATION: One monthly payment to a community-based organization. Like ACORN?

• Sec. 1308, Pg. 489 - The government will cover Marriage and Family therapy. This will involve government control of your marriage.

• Sec. 1308, Pg. 494-498 - The government will cover Mental Health Services including defining, creating and rationing those services.

• Sec. 1401, Pg. 502 - Center for Comparative Effectiveness Research Established. Big Brother is watching how your treatment works.

• Sec. 1401, Pg. 503, Lines 13-19 - The government will build registries and data networks from YOUR electronic medical records. "The Center may secure directly from any department or agency of the United States information necessary to enable it to carry out this section."

• Sec. 1401, Pg. 503, Lines 21-25 - The government may secure data directly from any department or agency of the US, including your data.

• Sec. 1401, Pg. 503, Lines 21-25 - The "Center" will collect data both "published and unpublished" (that means public & your private information).

• Sec. 1401, Pg. 506, Lines 19-21 - An "Appointed Clinical Perspective Advisory Panel" will advise The Center and recommend policies that would allow for public access of data.

• Sec. 1401, Pg. 518, Lines 21-25 - The Commission will have input from HC consumer representatives.

• Sec. 1411, Pg. 524, Lines 18-22 - Establishes the "Comparative Effectiveness Research Trust Fund." More taxes for ALL.

• Sec. 1441, Pg. 621, Lines 20-25 - The government will define "NEW Quality" measures in HC. Since when does government know about quality?

• Sec. 1442, Pg. 622, Lines 2-9 - To pay for the Quality Standards, government will transfer money from "qualified entities" (government Trust Funds) to other government Trust Funds. More Taxes.
• Sec. 1442, Pg. 624, Lines 19-23 - Qualified Entities: "The Secretary shall ensure that the entity is a public, nonprofit or academic institution with technical expertise in the area of health quality measurement."

• Sec. 1442, Pg. 623, Lines 5-10 - "Quality" measures shall be designed to assess outcomes and functional status of patients.

• Sec. 1442, Pg. 623, Lines 15-17 - "Quality" measures shall be designed to profile you, including race, age, gender, place of residence, etc.

• Sec. 1443, Pg. 628 - The government will give "Multi-Stake Holders" pre-rulemaking input into selection of "quality" measures.

• Sec. 1443, Pg. 630-31, Lines 9-24, 1-9 - Those Multi-Stake Holder groups include unions and groups like ACORN deciding what constitutes quality.

• Sec. 1444, Pg. 632, Lines 14-25 - The government may implement any "Quality measure" of HC services that bureaucrats see fit.

• Sec. 1444, Pg. 632-333, Lines 14-25, 1-9 - The Secretary may issue nonendorsed "Quality Measures" for physician and dialysis services.

• Sec. 1251 (beginning), Pg. 634 to 652 - "Physician Payments Sunshine Provision" - government wants to shine sunlight on Doctors but not government. "Reports on financial relationships between manufacturers and distributors . . . and between physicians and other health care entities."

• Sec. 1501 (beginning), Pg. 659-670 - Doctors in Residency - government will tell you where your residency will be, thus where you'll live.

• Sec. 1503 (beginning), Pg. 675-685 - Government will regulate hospitals in EVERY aspect of residency programs, including teaching hospitals.

• Sec. 1601 (beginning), Pg. 685-699 - Increased funding to fight waste, fraud, and abuse. (Like the government with an $18 million website?)

• Sec. 1619, Pg. 700-703 - If your part of HC plan isn't in the government's HC Exchange but you qualify for federal aid, you don't have to pay.

• Sec. 1128G, Pg. 704-708 - If the Secretary determines there is a "significant risk of fraudulent activity," on HC provider or supplier, the government can do a background check.

• Sec. 1632, Pg. 710, Lines 8-14 - The Secretary has broad powers to deny HC providers and suppliers admittance into HC Exchange. Your doctor could be thrown out of business.

• Sec. 1637, Pg. 718-719 - ANY Doctor who orders durable medical equipment or home medical services is REQUIRED to be enrolled in, or eligible for, Medicare.

• Sec. 1639, Pg. 721 - Government MANDATES that Doctors must have face-to-face with patient to certify patient for home health services.

• Sec. 1639, Pg. 723-24, Lines 23-25, 1-5 - The same government certifications will apply to Medicaid and CHIP (Children's health plan: Your kids).

• Sec. 1640, Pg. 723, Lines 16-22 - The government reserves right to apply face-to-face certification for patient to ANY other HC service.

• Sec. 1651, Pg. 734, Lines 16-25 - Proposes, for law enforcement sake, that the Secretary of HHS will give Attorney General access to ALL medical data.

• Sec. 1701 (beginning), Pg. 739-756 - The government sets guidelines for subsidizing the uninsured (and you have to pay for them).

• Sec. 1704, Pg. 756-761 - The government will shift burden of payments to Disproportionate Share Hospitals (DSH) to states (your taxes).

• Sec. 1711, Pg. 764 - The government will require preventative services - including vaccinations (no choice).

• Sec. 1713, Pg. 768 - Government-determined Nurse Home Visitation Services (Hello union paybacks).

• Sec. 1713, Pg. 768, Lines 3-5 - Nurse Home Visit Services - Service #1: "Improving maternal or child health and pregnancy outcomes or increasing birth intervals between pregnancies." Compulsory ABORTIONS?

• Sec. 1713, Pg. 768, Lines 11-14 - Nurse Home Visit Services include determinations of economic self-sufficiency, employment advancement and school-readiness.

• Sec. 1714, Pg. 769 - Federal government mandates eligibility for State Family Planning Services. Abortion and government control intertwined.
• Sec. 1733, Pg. 788-798 - Government will set and mandate drug prices, therefore controlling which drugs are brought to market. (Goodbye innovation and private research.)

• Sec. 1744, Pg. 796-799 - Establishes PAYMENTS for graduate medical education. The government will now control your doctor's education.

• Sec.1751, Pg. 800 - The government will decide which Health Care conditions will be paid. Say "RATION!"

• Sec. 1759, Pg. 809 - Billing Agents, clearinghouses, or other alternate payees are required to register. The government takes over private payment systems too.

• Sec. 1801, Pg. 819-823 - The Government will identify individuals "likely to be ineligible" for subsidies. Will access all personal financial information.

• Sec. 1802, Pg. 823-828 - Government sets up Comparative Effectiveness Research Trust Fund. Another bottomless tax pit.

• Sec. 4375, Pg. 828-832, Lines 12-16 - Government will impose a fee on ALL private health insurance plans, including self-insured, to pay for Trust Fund!

• Sec. 4377, Pg. 835, Lines 11-13 - Fees imposed by government for Trust Fund shall be treated as if they were taxes.

• Sec. 440, Pg. 837-839 - The government will design and implement Home Visitation Program for families with young kids and families that are expecting children.

• Sec. 1904, Pg. 843-844 - This Home Visitation Program includes the government coming into your house and teaching/telling you how to parent!

• Sec. 2002, Pg. 858 - The government will establish a Public Health Fund at a cost of $88,800,000,000 (That's Billions).

• Sec. 2201, Pg. 864 - The government will MANDATE the establishment of a National Health Service Corps. o Sec. 2201 - "Fulfillment of Obligated Service Requirement"
o Sec. 2201, Pg. 864-875 - The NHS Corps is a program where Doctors perform mandatory HC for 2 years for partial loan repayment.

• Sec. 2212, Pg. 875-891 - The government takes over the education of Medical students and Doctors through education and loans.
• Sec. 340L, Pg. 897 - The government will establish a Public Health Workforce Corps to ensure an adequate supply of public health professionals.

• Sec. 340L, Pg. 897 - The Public Health Workforce Corps shall consist of civilian employees of the United States as Secretary deems necessary.

• Sec. 340L, Pg. 897 - The Public Health Workforce Corps shall consist of officers of Regular and Reserve Corps of Service.

• Sec. 340M, Pg. 899 - The Public Health Workforce Corps includes veterinarians. Will animals have heath care too?

• Sec. 2233, Pg. 909 - The government will develop, build and run Public Health Training Centers.

• Sec. 2241, Pg. 912-913 - Government starts a HC affirmative action program under the guise of diversity scholarships.

• Sec. 2251, Pg. 915 - Government MANDATES cultural and linguistic competency training for HC professionals.

• Sec. 3111, Pg. 931 - The government will establish a Preventative and Wellness Trust fund, with initial cost of $30,800,000,000 (Billions more).

• Sec. 3121, Pg. 934, Lines 21-22 - Government will identify specific goals and objectives for prevention and wellness activities. More control of your life.

• Sec. 3121, Pg. 935, Lines 1-2 - The government will develop "Healthy People & National Public Health Performance Standards." They will tell us what to eat?

• Sec. 3131, Pg. 942, Lines 22-25 - "Task Force on Community Preventive Services." More government? Under the Offices of Surgeon General, Public Health Services, Minority Health and Women's Health.

• Sec. 3141, Pg. 949-979 - BIG GOVERNMENT core public health infrastructure includes workforce capacity, lab systems, health information systems, etc.

• Sec. 2511, Pg. 992 - Government will establish school-based "health" clinics. Your children will be indoctrinated and your grandchildren may be aborted!
• Sec. 399Z-1, Pg. 993 - School-Based Health Clinics will be integrated into the school environment. More government brainwashing in school.

• Sec. 2521, Pg. 1000 - The government will establish a National Medical Device Registry. Will you be tracked?

@pax: Yes.. we're waiting for that 3 years to be up.. I think it's coming up soon actually. If not this November, then the next.

My husband is Australian, even though they put that he was from French Polynesia on his green card the first time.

Boy, was that fun to correct.

@JGKojak:

Hey Kojak - it's the English language, we read left to right, top to bottom. Try it.

[en.wikipedia.org])

@TomCoughlin: So... you're saying you trust worthless scum (your words) who have the most to gain from providing you little to no service (while still collecting premiums from both you and your employeer) more than the worthless scum (by your rational they would at least have to be worthless scum) who have little to no incentive to deny your coverage?

Are you sure you are being rational, or did you fall into the "I hate the Government (and by association myself...we the people and all)" trap?

@HiPwr: What are those little quotey things in Un-American? During the Bush years, those weren't there. Why not? If you read the article, here is what's Un-American, "Drowning out opposing views is simply un-American." In fact, the intended goal of protesters is to prevent debate/discussion by shutting down the meetings. So is preventing debate Un-American? I wouldn't go that far, but it is pretty dickish.

No, this time around, the current administration is busy slandering its opposition, what with talk of swastikas and insurer astroturfers and so on.

@thegirls:

Exactly. I was just about to ask him how certain he is the version of the bill he might've read was going to pass through both bodies of Congress, the committe (cuz this mutha's getting marked up - believe) and then finally stamped by the Prez.

@Kimaroo - 20% More Kitty Added!: Also, it's not 10 years if your husband is planning on applying for citizenship--which he can do in 3 years if he got his permanent residence through his marriage to you. Once he is a citizen, he is a citizen as free to milk from the public teat as you and I! (Kidding, kidding...my husband is British and I wouldn't mind having an NHS.)

@SonicMan: Do you mean when the Government is run by people who hate Government and begin underfunding it? Well even then it ran pretty well, with some major slipups. Still much better than my private coverage.

My wife spent a while under medicaid. Apparently it was rainbows and kittens compared to the sludge that my employeer provides.

So... yeah I am pretty sure they will run it better than my current health coverage denier.

Early on (page 16? 18?), where the "exchange" is defined, it's made clear that only existing plans are grandfathered in. Since switching jobs requires you to give up your existing plan, you'd have to accept an exchange-approved (i.e. public-quality) plan.

I have what is considered great coverage, or at least that is what I keep hearing. Basically if the provider is in network it is 90% coverage up to an amount, then 100% or 60% coverage out of network. If that isn't a form of limiting my physician choices, what is?
If I find a network doctor and hospital, and require surgery, most hospitals have outsourced radiology and labs to independent groups of physicians. They may or may not be in the same networks as the hospital. So if I am in surgery and a biopsy sample goes to a out of network lab, there is no negotiated price, only full price covered at 60%.
That negotiated rate often reduces the "price" to 10-25% of the non-negotiated price. So if a $4000 procedure is negotiated to $400, I pay $40. If I don't get the negotiated rate, then I pay $2400 or 60% of $4000. These are not made up numbers. They are examples from bills I have received.
If you have any issues and have to consult the insurer, you may get to talk to an agent in India. Are my medical records protected in India? In any case you are dealing with a low paid call center worker who has no medical training and is monitored to the point they don't give a darn about anything. Also if you don't want your conversation recorded, you can either be refused, or hope that someone will call back.
And the insurance companies are not the only ones who are difficult. One medical center I recently approached will not treat you if you do not sign their consent agreement. That isn't unusual, but I thought the requirement that the form remain unaltered was a bit much. Especially the parts that stated the facility could make changes and would send a new copy for me to sign. I also had issues with the you will pay for whatever treatment the facility delivers. I have the right to refuse treatment, but not when I am under anesthesia. There I must depend on the doctor's judgment.
I have also learned from experience that the facility's administrators do not consider it medical information sharing if they release your name, your doctor's name, and the date of your appointment to a company that conducts surveys on important medical issues like "How long did it take you to make an appointment with the doctor?" They even do it with specialists like oncology, urology, psychiatry, and so on. Yet the facility insists that no confidences have been violated.
Hmmm, John Doe had an appointment with an oncologist on Tuesday. Think he has cancer?
There has also been talk of rationing and delays. After nearly 6 weeks, I have an appointment for a second opinion two weeks from now. Hopefully I can schedule surgery within a few weeks after that. And yes this is a serious illness and treatment is not optional.

So I ask, How much worse can a public plan be?

@nova3930:

Wait, did you really just say the following?

"There is a high probabily that this bill will restrict her earning potential to the point we won't even be able to pay back her $150k in student loans. If thats the case, she's not even going to bother working"?

Numbers, facts, and sources. Christ, you'd think for the husband of a woman going through med school he'd understand how the big brains make assertions.

I cry shenanigans on your statement.

@aphex242: Since many politicians fall into that age bracket, the firing squad option probably won't happen. I hope it does though, with the condition that it only applies to politicians.

1) Status quo: leaves millions involuntarily uninsured for either medical or financial reasons, bankrupts hospitals and small businesses, bankrupts families, fails to provide actual financial security should you get catastrophically sick, costs nearly twice what some other countries pay while getting worse results.

2) Status quo, with some regulatory reforms and subsidies. Might be better than what we currently have, but probably not since it doesn't remove the root of the problem (the corporate greed). Also, this has already been tried repeatedly with poor results. Doesn't solve the basic economic problem.

3) Public option/public private hybrid system for primary health insurance. Might work better and reduce costs, if the public option is not crippled to be inferior to the private plans and is open to everyone who wants to join it (rather than just the uninsured/uninsurable). Some other countries do something like this, with better results.

4) Single-payer (like Medicare or Canada): in theory, would reduce costs significantly (similar to how Medicare does). Could still provide a role for private insurers for supplementary insurance.

5) Fully socialized healthcare (e.g., like the VA or the NHS in Britain): in theory, might be even more efficient than single-payer, but would require a much larger government apparatus. Would be MUCH more difficult to get done politically.

6) "Consumer-directed health care" + high risk pools: (e.g., the Republican plan relying on eliminating employer-based coverage and using HSAs/tax breaks more heavily). Would probably screw anyone medically uninsurable, and might fail to control costs. Also, tax benefits would benefit the rich disproportionately to the poor.

@Elcheecho: It's funny how few people remember what it was like when hospitals were non-profit, typically church founded, businesses. Or what it was like before Clinton made it ok for Pharma to advertise products to people who can't buy them without a prescription. I was really young back then, but I can remember quite a bit of it. Hint: It wasn't worse.

@mizike: Also, during those 5 years you're on public healthcare, you just can't apply for welfare or disability.

@Kimaroo - 20% More Kitty Added!: 10 Years?? Wow, that's a long time. In Canada I'm pretty sure it's less than 5 for a spousal support application. I also find it completely insane that you're not only without health insurance, but are unable to purchase it at any price. How is the private sector completely refusing to cover someone not evidence that the system is completely broken? At a bare minimum there should be a public option to take care of the people who the private sector simply refuse to help.

@johnva: K, I'm just gonna go ahead and copy and paste from my original comment up there: "Does the writer really fail to see that a government-funded and controlled healthcare system that doesn't need to operate at a profit will inevitably "crowd out" any for-profit private insurance provider?"

Of course private insurance won't be able to compete with a government-run plan, that's my whole problem with this. But they won't be able to compete not because the government's "product" is better - private insurance won't be able to compete because the government plan is going to be heavily subsidized and will therefore be cheaper, and because private plans will be forced to provide a baseline level of coverage, whether their customers want it or not, driving up private costs. Private costs go up, customers switch to the "cheaper" (read paid for by taxes) government plan; private insurance dries up while the government plan swells exponentially; all that's left is a government-run monolith with the entire country on its client list - which will cause costs to skyrocket and/or services be cut. Which will put us right back where we started, but with nowhere to go for help.

I don't mind Consumerists' argument about health care reform, as long as they allow an open debate. Time will tell if they do for this post.

@pax: Yes, I remember that phrase from the papers we signed. This makes us shy away from applying for any kind of benefits for fear of getting the book thrown at us.

We're goodie-goodies that figure if anyone is gonna get caught, it's gonna be us.

@NeverLetMeDown: But it only sounds good when Sean Connery sings it, in his Scottish accent.

Your Doctor: The bill would allow you to maintain your current plan, but makes it illegal for you to switch between private insurers or get a new one if you lose the old one. It bans private insurance through attrition.

From HR 3200, page 16: ""Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day" of the year the legislation becomes law."

So let's say you lose your job, and thus your insurance. You're now stuck on socialized medicine, which brings me to the next part.

Socialized Medicine? A "public option" would be cheaper than private insurers could possibly be, and it's not about fair competition. Private insurers must be profitable, the government option would be deeply unprofitable, costing trillions of dollars. No private company can "compete" with that. Eventually most if not all employers would move to a much less expensive public option, again destroying your private choices. What's even worse is that whereas private insurers negotiate with doctors and hospitals to determine the price of care, the government DICTATES - as with medicare. If the government tries to force the price of health care below market levels it will become impossibles for some doctors and hospitals to continue to operate, as in Massachusetts when they tried socialized medicine.

Your Insurer: Any reform bill would ban insurers from denying coverage or charging more for pre-existing conditions. That part is true. And before you start thinking that this is a wonderful thing remember that insurance companies can't charge people with pre-existing condition any higher rates than those without them. So what's to stop people from never paying for insurance until they develop a condition? Absolutely nothing, and of course without healthy people in the pool to subsidize the chronically ill the system is further buried.

Cost: Remember how the President said health care reform would magically save us money? Well the CBO confirmed that it won't. And the House bill would cost $1.2 trillion, according to the CBO, not $200 billion ([www.washingtonpost.com]).

DEATH PANELS! Governor Palin was referring to the idea that care may be limited or denied to the elderly who the government simply believes cost too much, so they would require doctors to run cost-benefit analysis before providing care.

The Future Of Medicare: It's great that we'll be preventing the duplication of medical work under medicare. The problem is that by doing so we're admitting that this "reform" is really just a massive expansion of medicare - albeit under another name.

I think we need some health care reform - but most Americans have insurance and are happy with it, so let's not destroy the greatest medical care in the world. Let's take this slowly and make sure we do it right. And don't forget, this argument isn't really about "care" it's about insurance. Not being able to get care and not being able to pay for are two different things, especially when you can't be denied care on the basis of an inability to pay at a hospital.

@Kimaroo - 20% More Kitty Added!: Permanent residents and nonresident aliens are generally excluded from means-tested public benefits. If a "public option," if it ever happens, is open to everyone (i.e. freelancers and contract workers as well as the working poor and unemployed), then your husband will be able to take advantage of it with no problems with his immigration status, just as permanent residents are able to apply for, say, federal student aid with no problems.

We'll leave alone the question of whether or not an alien who applies for means-tested public benefits ever actually gets caught.

@nova3930:

"Hell, my wife is a Dr. (still in residency) and I've taken the time to personally read through the ungodly bill that most of the US Congress hasn't, just to see how it might affect us.

There is a high probabily that this bill will restrict her earning potential to the point we won't even be able to pay back her $150k in student loans. If thats the case, she's not even going to bother working. Now tell me how that would be good for health care in this country?"

Can you cite the which bill and what section of it you are deriving this conclusion from? Nothing I've read or seen has said anything trying to restrict what the practitioner can charge, rather it seems to be focused on insurance and pharma....two banes of the practitioner's existance (well except for those on the take from pharma).

As a libertarian, you of all people should realize that the right of everyone to persue their inalienable rights (which include life and managing the quality of it) exceed your (percieved) personal right to only have so much health coverage. Just like you don't have the right in most states to not have car insurance (because no matter how hard you try, accidents do happen and you owe it to society to attempt to not be a burden), the same should apply to health insurance. Unlike car insurance, you can't just choose not to live, which is why having a publicly funded insurance option is critical. The good news is, we already have an example in medicare/medicaid and have had it for years. The bad news is, they are not large enough to make sure everyone is covered. Also bad is that many people are so easily manipulated via fear (and the whole concept of identity politics where anything the other side says is automatically a plan to destroy the world) that the people who wish to continue to profit from the status quo can work them up into a frenzy with the now standard "Government is bad for freedom (unless of course we are killing people)" arguments. I think a lot also has to do with the general outlook on society.

You say "Individualistic", I say "Selfish"... let's call the whole thing off

@nova3930: It's going to restrict her earning potential to the extent that she won't be able to pay off $150k in loans over the next 35 years? I don't think the bill mandates that MD's get paid minimum wage. Also, if not working at all will allow her to pay back her loans more effeciently than working as an MD, why did she go to med school in the first place? If I could pull in enough money to not only pay for my cost of living but also pay off $150k in debt without having to bother working, I'd have just done that and skipped medical school altogether.

@MostlyHarmless: Well my husband isn't bound to an employer, but he's bound to me! lol.

It was a hard road to go down to get that green card.. We started in 2003 when they were still trying to figure out what to do after 9-11. I'm not sure if they've gotten things sorted out by now or not.. but the usually slow government red tape was brought to its knees back then. When he was finnally approved for his card, it took us almost a year to even recieve it. We kept going back to their office when his passport stamp wouldl expire and we finally got a guy that would admit, "They're just not printing cards right now." and he extended his stamp as long as was possible.

I'm glad to be mostly done with that mess. Next up: Citizenship!

I can hardly contain myself.

Your question also falsly implies that the current plans are "best suited to you", while a plan available through the insurance exchange would not be. Only true if by "best suited to you" you mean, "excludes anyone unhealthy or poor from getting healthcare coverage, so that you can pay less". And the current plans fail at even that, since they simply indirectly redistribute the cost of unreimbursed care that the providers have to eat onto you. So you're already paying for the uninsured, without them having actual coverage. With single-payer, you could pay LESS than you do now, while still covering them. The "public option" is more questionable on whether it would actually save people who currently have insurance money, primarily because it allows the insurers to keep skimming money out of the system.

@katstermonster: [blogs.usatoday.com]

@johnva: I care, obviously, as do a lot of other people.

In my mind, it comes down to this: Whom do I trust more when it comes to my healthcare coverage? My private insurer or the government? It's certainly a lesser of two evils, but for me, it's a no-brainer. I'll go with the worthless scum at my private insurer any day of the week.

@mebaman: A source on the above would rock. I only say this b/c this reads almost exactly how I envisioned reform here.

@Jage: You shouldn't try to use common sense on a forum filled with liberals. That will only cause a ruckus and get you reported to the "White House Re-education Corps".

If Rush Limbaugh tells me Obama wants to kill my Grandma, I'm gonna believe him! After all, he is right 98.2% of the time! I think the only solution to this is sending my Granny to live with Sean Hannity in the "un-disclosed bunker" of conservitism in exhile!

/Snickers

I am not even a resident yet ("non-resident alien"), and will probably still get to pay taxes for whatever bill gets passed. But I will still gladly do that, because since I intend to stay here full time, I have a vested interest in the well being of the country and its people.

You have got to love the H1-B program though. You are bound to an employer, and spend at least 6 years before you even get your green card. Meanwhile, enjoy paying all sorts of taxes. Not to mention getting the evil eye from people who hate H1B for various reasons.

That is one thing they should reform once they get done with the wars and stuff. Making it easier for productive people who WANT to live in this country to be able to do so, and reining in temporary imported labor (the ones that outsourced companies send back to work here for short terms).

And there would be an appeals process, etc built into the public plan. So I still don't see much of a practical difference, except that the public plan would be less of a scam.

Costs are high mainly because we are all on low deductible health insurance and because of issues plaguing the medical industry itself like malpractice. What does this bill do to actually reduce costs in healthcare? Nothing.

@squinko - Coming Soon: When DDoS Attack!: No shit?! They weren't allowed to question the government? I guess all of that media coverage of people questioning the government were figments of my imagination.

"the government already accounts for more than a third of total healthcare spending thanks to a little program called Medicare" Right this is a great point. If we're already spending this incredible amount of money on such a small minority of americans then you can imagine the cost of a full fledged healthcare system.

@I Love New Jersey:

We could give everyone the same coverage Congress has - would cost more than any of the plans being discussed, though.

@katstermonster:

But what if I want coverage from a plan that _doesn't_ include, say, anything but catastrophic coverage?

Clearly, the reason to set the minimum requirements is to maximize the size of the risk pool, and avoid a situation where some insurers create packages that appeal to the young and healthy, thereby leaving the older/sicker population for the gov't plan.

@aphex242:

While I'm not a fan of firing squads, the old Soviet anthem is actually a great song. Ever seen Hunt For Red October?

And they're screwing whoever they can, however they can, right now. It's not like we're going from a system that's all peaches and cream to some sort of tyrannical government system.

Finally, I'd make the point that we already have government health insurance (Medicare/Medicaid), and it works pretty well for the most part (though it's not perfect). Having more younger people in Medicare would make it work even better, because it would reduce the average cost per person in the pool. Even if the insurers were basically forced out of the primary insurance market, they would still be able to sell plans for secondary insurance to cover things the government plan wouldn't (such as private hospital rooms, or unproven treatments like alternative medicine).

That said, I'm still not sure the "public option" is a good idea. Nevertheless, it's simply not true that private insurers will not be able to compete with it. In fact, if you think about it, if all Americans are mandated to get insurance, this will EXPAND THE MARKET for health insurers, allowing them to garner more business than they already have. This can only be to their advantage.

The REAL problem with the reforms that have been proposed, is not anything the Right is complaining about. Rather, it's that none of the reforms will actually do anything to appreciably lower the cost of healthcare. All they will do is spread the risk. That could do a lot of things, but it won't make healthcare any cheaper.

With all the plans, we still end up with the basic problem of cost-passing due to the fact that providers will be reimbursed different amounts based on who pays the bills. Medicare and Medicaid already pay only pennies on the dollar, and will continue to do so. This leaves insurers ... as well as the "public option" plan ... to pick up what they don't pay. Rather than being fixed, the cost-passing will become even more deeply entrenched than it already is.

What would work, are changes to reimbursements ... namely, an end to the practice of charging different amounts for the same procedure, for different payers. If it costs, say, $50 to administer a flu shot, then that is what ought to be paid, every time a flu shot is administered. Not $2 for Medicare patients, $2.50 for Medicaid, $65 for a private insurance patient, or $80 for an uninsured one.

@SonicMan: My MIL (Army vet)can see the best doctors no matter where she is in the US for a reasonable rate. She has had lung cancer and heart disease and receives nothing but quality care with minimum hassles over bills. Her husband (Navy vet) was given every opportunity for quality care and received excellent end of life services.

Meanwhile, if I get sick out of network (even on my PPO plan), I have to fill out a stack of papers. When I had an HMO plan, getting an in network referral for specialist care was a nightmare.

In short, I've experienced both bureaucracies and I trust the one that doesn't make life or death decisions based on their P and L statement.

@JGKojak: That's LEGAL Immigrants Kimaroo asked about not illegal. And its a valid question.

I'm curious as to whether the proposed bills are including dental care. That's an area where my work premiums have absolutely skyrocketed over the last 10 years. Where my medical premiums and deductible has doubled, my dental premiums have gone up closer to 500% and the coverage has dropped from a mere $100 deductible once a year to only covering about 50% of the cost of any procedure other than a routine cleaning (meaning now I have to pay $700-$1,000 or so for a crown or root canal).

@skizsrodt: No, no! He's a nut! Only a nut would raise questions about expanding government.

Six months ago, he would be a good citizen, but things have changed. Now, he's just another kook.

You just have to change your perspective to the current thinking.

Sure, the bill states you can keep your existing coverage if you so choose. However, if your provider changes the plan in ANY WAY (which happens almost every year, with additional benefits, different copays, etc), the new plan must meet the 'minimum guidelines' set forth in the bill.

What does that mean? It means you will be forced to take a plan designed by this bill, not one that's best suited for you.

But the worst part is, it will be those of us already paying for heath care that will be paying MORE to cover the reform. I don't want to pay more.

@katstermonster:

Which is exactly Eboundings point. Their "minimum coverage" regulations will prevent me from making my own determination of what level of coverage I need and am willing to pay for.

As it stands, if I want a hugh deductible "catastrophic coverage" plan, I probably won't be able to get it because it won't fit the minimum requirements...

@thelushie: The last time I looked into insurance the guy told me that pre-existing conditions go all the way back to birth.. so.. I probably have.. uh.. well I don't know how many.. but I'm pretty sure it's a lot. lol.

The point is when it comes to insurance, I don't count.

I work with a far-rightie and have to put up with his worst case scenario doom and gloom scenarios all day long. This is one of the major ones.

See page 454 of the bill ([energycommerce.house.gov]). It mentions no legal recourse allowed.

I need help arguing against him. It is vague, but it also by no means translates as "death panel" to me.

I also want to know where he got the (mis?)information that if you switch jobs, then you will not have the option to stay w/ your employer's insurance and you'll have to accept the public option.

@JGKojak: I couldn't have possibly made it more clear.. He is a LEGAL immigrant. He has a Green Card and all the corrosponding papers.

As a libertarian, whats disturbing is that consumerist is fast becoming nothing but a shill for plans and politicians that will result in a reduction of my fundamental liberties...

to@Jage: Its more like there's no way for private companies to compete with a "public option" that basically has access to unlimited funding due to its access to the US Treasury.

@tmed:

Definition of fair: The system produces an outcome I like.
Definition of unfair: The system produces an outcome I don't like.

I don't like the fact that I can't get something without paying for it, therefore "the system" isn't fair. Does that about sum it up?

Hell, my wife is a Dr. (still in residency) and I've taken the time to personally read through the ungodly bill that most of the US Congress hasn't, just to see how it might affect us.

There is a high probabily that this bill will restrict her earning potential to the point we won't even be able to pay back her $150k in student loans. If thats the case, she's not even going to bother working. Now tell me how that would be good for health care in this country?

@JGKojak: But her husband is a LEGAL immigrant. He is going about being in this country the legitimate way. Personally, I think legal immigrants should be eligible but they don't want me in charge.

And I feel your pain about the preexisisting condition thing. I have three.

And another thing, what are they going to do to fix the "donut hole" for seniors who paid into the system their entire lives and for a period of time each year have to pay full price for their medication? That's not fair!

@HiPwr: Truely one of the top 10 dumbest comments made on here. Just because someone doesn't agree with you doesn't mean they don't have a right to express their own opinions. Did I type that slowly enough with small enough words so you can understand it?

And again I ask-- what's the difference between the govt (which you elect) and corporations making the rules on healthcare?

Ok, I'll take the bait.

"There are several draft reform bills flying around, and none of them are anywhere near final. The Senate Finance Committee still needs to weigh in, and the real fun won't happen until the competing bills turn down the lights and do the reconciliation dance in a conference committee."

So with your last paragraph you're saying that none of what you've just explained above actually matters, because everything that's in - or isn't in - the bill in its current state(s) can be changed.

"Socialized Medicine? Nope! All the current reform bills preserve the private sector's role in health care. A so-called "public option" would only crowd out private insurers if it offered superior benefits at a cheaper cost than the competition."

Does the writer really fail to see that a government-funded and controlled healthcare system that doesn't need to operate at a profit will inevitably "crowd out" any for-profit private insurance provider?

"The details wouldn't be known for some time, and the Congressional Budget Office predicts that only 11 million people would sign up for a public plan."

So we're being told that this healthcare reform will provide health coverage for all Americans. But only 11 million people will sign up for the public plan? So where does that leave the rest of the supposedly 46 million Americans without healthcare?

Think the Gov will run this well? Look at how then run healthcare for Vets.

For example, here's a point that's very misleading:

All the current reform bills preserve the private sector's role in health care. A so-called "public option" would only crowd out private insurers if it offered superior benefits at a cheaper cost than the competition.

A so-called "public option" would only crowd out private insurers if it offered superior benefits at a cheaper cost than the competition.

Ultimately, the unfair competition of the public plans would drive private insurers out of business...then what?

No, illegal immigrants will not be eligible, just like illegals immigrants are also not eligible for Medicare, etc.

@HiPwr: right wing zealot who should not be allowed to question our government? Who should be allowed to question our government? Oh yeah, everyone.

Health care in this country is not working right now. I'm for universal care, and I'll pay higher taxes to get it, until someone shows me an alternative that gets everyone basic medical care. I think covering the basic medical needs of all Americans is patriotic. And NO, I'm not calling those who oppose UHC UNpatriotic.

Healthcare reform will be subsidized by taxpayers thus allowing the government to offer artificially low premiums and extra benefits. Insurance companies don't have the ability to reach into everyone's pockets to fund their business. The government does.

Actually, it's the STATE governments who currently make the rules regarding health insurance. One could argue that federal regulation of an industry that is not involved in interstate commerce is unconstitutional.

Exactly. And first-class mail is more expensive than it needs to be because the US Government bans its competitors from that particular business. The biggest problem I have with the current proposals before Congress is that they will inevitably raise the cost of baseline health care. Federal regulation will make the health car exchange almost worthless because all of the plans will be required to have a certain base-line level of coverage.

While I despise the cries of "Socialism!" and "Death Panels!", there are certainly very big problems with the current legislation.

Primary problems with current health care:

(1) If you have a pre-existing condition and aren't self-insured or covered by an employer pool, you're in a lot of trouble (i.e., uninsurable).

(2) EXPENSIVE (due in part to third party billing, rampant fraud, and malpractice suits - whether such be frivolous or meritorious).

People looking for a universal healthcare system that is sustainable should look at the German system, which is one of the oldest and most successful in the world. It operates a bit differently than most socialized medicine programs, with annual conventions held between the government, regional insurers (private non-profits and public funds), and the medical industry to mutually hash out budgets and care provisions on a regional basis. It primarily uses the government as a referee (not as a player) to guarantee all citizens with a baseline level of insurance while leaving others with the option to purchase expanded services from a private company. Copays have been mandated to protect available services from overutilization, which, as countries like Canada have discovered, results in rationing.

Still, the German system seems reliant on tort reforms that simply don't exist in the United States, as it forces doctors to operate under a budget that doesn't allow for a lot of CYA testing (i.e., tests for conditions that have an extremely remote chance of existing, but that still need to be tested for on the off-chance that failure to test could be deemed an act of malpractice).

There's no perfect solution to this, but Congress needs to go back to the drawing board for a more comprehensive (and cheaper) plan if this is ever going to work.

Yes.

I could see you having a point if we were giving, say, Blue Cross Blue Shield the ability to regulate the health insurance industry, but that's not what's happening here. The government already makes the rules and provides health care through Medicare. It's the government's job to make the rules and to promote the welfare of its citizens.

Our current health care system is an economic and social drain on the country, forcing businesses to be less competitive than those overseas due to rising health costs for their workers, making people who's only "fault" is that they've gotten sick into deadbeats who don't pay their bills, and generally causing a lot of unnecessary problems for Americans.

Will any of the above plans fix these problems? Hopefully. It's hard to say, as they keep changing (and will keep changing.) But without making some changes, the country will not be able to handle the effects of rising health care costs and an aging population.

[www.satyamnayak.com]

Or the one that GitEmSteveDave created, which I cannot seem to find right now.

@tmed: The same rules do not apply to the every business equally. For profit insurers are readily watching people die, and Medicare is crippling the finances of the country while the people working for miserable wages get neither insurance nor Medicare.

I couldn't care less if it is fair, the current system isn't fair.

How about this- give everyone the same coverage Congress has? It isn't like they are going to subject themselves to this destruction of the American medical system.

@Jage: I actually see nothing wrong with your metaphor. What I see wrong with it is the metaphor.

This isn't a damned football game, this is healthcare.

I'm still waiting to see what happens with this. I don't qualify to purchase private health insurance because of pre-existing conditions.

I'm wondering if I will also not qualify for this new healthcare thing because my husband is a Perminant Resident Alien. We signed papers saying that he would not accept government help for 10 years or 40 working quarters.

I haven't seen anyone mention whether or not legal immigrants will be eligible. (They may not know yet.)

So it's not socialism. The government will just have the ability to tell you what coverage is and isn't appropriate.

@Jage: You may not be the only one, but you must be a right-wing zealot who should not be allowed to question our government.

Go to work, pay your taxes, and shut the hell up!

I don't see either of these issues being addressed, Consumerist.

and are we still Capitalism or are we going the way of Socialism and Communism?

That's like the referee having bets on a team they own, in a game they're refereeing!

Am I the only one who sees something wrong with this?