Having watched a good number of the GOP debates, I have been struck by the general unwillingness of the candidates to acknowledge that there is a healthcare problem in this country. All of the candidates talked about shopping for private insurance and getting coverage through lean, efficient private services. I have news for the candidate-that doesn't exist! Just like Bush #41 didn't know they had scanners in supermarkets, these guys have no clue what the costs are, let alone what a challenge it would be to find good coverage. Let's see if you can help them out.

Scenario: You are a worker with four dependents.

Your income: 30,000 a year, or $2,500.00 a month

Costs: $450 a month for rent, $200 a month for a car payment, $200.00 for food. $150.00 for gas

You have $1,50.00 after these costs.

State plan: You pay $226.00 a month and the state throws in $700.00, you have a $20.00 co-pay.

After that cost, you have $1,274 in expendable income.

The challenge:

Find a private plan of equal or less cost with a smilar co-pay and show the numbers that would beat the state plan.

Questions for debate:

1.)Can private providers realistically provide health insurance at a reasonable cost to families? Why or why not and provide numbers.

2.)Would you choose a public plan or a private one if given the choice? Which one would be most cost efficient for you and provide better service? Put hte proof where the pudding is and throw up some numbers.

Can private providers realistically provide health insurance at a reasonable cost to families? Why or why not and provide numbers.

Yes I think with more government involvement in the form of mandates, a stronger focus on universal coverage, subsidization, price controls, tax credits and incentives that private would be more affordable and many Americans could rely solely on private Ins. for their health needs. Of course all that I have listed and used to support this idea also indicates the need for government to further expand their own health coverage too. I don't see it as a one or the other scenario.

Although I do not believe private insurance alone can realistically provide health insurance for all, obviously this is not even the case now as many Americans only have access to health insurance and coverage because the state provides it to them.

Would you choose a public plan or a private one if given the choice? Which one would be most cost efficient for you and provide better service? Put hte proof where the pudding is and throw up some numbers.
Why all these requests for numbers? I am not an Insurance agent so I don't have any quotes on costs. But I have had each, state and private and I had access to what I would consider comparable care. I have read many accounts of where it is difficult for those with state coverage to find a doctor willing to take them but that is no different with private plans, many doctors refuse HMO's and many private insurers refuse to cover those they consider to be high risk. Again I don't see many of the issues we face with our health care as being issues that are exclusive or one or the other scenario.

They can provide health insurance at the best prices that will get coverage and they can do it efficiently.



I would NEVER ever, ever chose a public plan. IMO they would be doomed to fail and the bigger that are the worse the failure. Fraud and inefficiency would eat them alive and many doctors would not even take them unless forced to do so.

Ted, have you ever priced off-the-shelf health insurance? It's insanely expensive, and way out of the reach of lower income earners. Call around, and see what kind of prices the free market can offer you. I'll bet you'll be shocked.

The challenge:

Find a private plan of equal or less cost with a smilar co-pay and show the numbers that would beat the state plan.


There's a problem in your scenario. Let's take a look at your scenario:

State plan: You pay $226.00 a month and the state throws in $700.00, you have a $20.00 co-pay.

But where does the state get the money? From us. This is what is constantly forgotten when advocating government programs. Without factoring that in, why not just provide health care (and heck, everything else, too!) to everyone, for free with no copay? There would be no reason not to if you ignore the fact that 'the state' has to get that money from us to begin with, which is what your scenario does. The reason private health plans are stated to have less cost is not that those receiving the handout spend less, it's that the system does.

Given that,

2.)Would you choose a public plan or a private one if given the choice? Which one would be most cost efficient for you and provide better service? Put hte proof where the pudding is and throw up some numbers.

I would choose private insurance. Providing that to the family in question saves me (the taxpayer) $700. We struggle enough paying for our own health care costs and other costs---we don't have any money left over to pay for other people's health coverage. Therefore, the onus of such proposals is not on me, it is on those advocating something else. Show me how providing this insurance saves me money. Put the proof where the pudding is and show me numbers. Until then, these debates are non-starters.

However, in your scenario, the family has $926 to spend on health care ($226 they play plus the $700 the state pays). Although health insurance is indeed expensive, you can find private plans for that amount or less, providing the same coverage. An HMO would probably be the best choice for that family..it would provide the most coverage at the lowest cost with the lowest copay.

Not really true either as the costs of private health insurance are more because well the costs are more. If you compare what the net expenditures are for medicare to what the costs are to private you see that there is a difference of total costs.
Medicare Outperforms Private Insurance at Containing Health Care Spending, 30-Year Trend Shows

Besides the idea we avoid costs by refusing to cover those who can not afford health insurance is not factoring in the many realities of health needs in the US either. Just because people do not have or can not afford health insurance does not mean they then forgo or relinquish any health needs. And so the costs still exist and are just deferred to us all in another form or avenue.

Here's the real challenge:

Link us to private health insurance coverage that is cheap.

Link us to private heath insurance coverage that is not a scam.

Link us to something other than laying out personal prejudiced subjective yammering.

You'd be doing a public service to show that the free marketplace actually works when it comes to health care insurance.

Trouble is, I don't expect any links like this. However, I do expect some sort of linkage, and then we can all take a good, close look at how it actually works in the good old US of A.

$200 a month to feed a family of six (four dependents, mommy and daddy)? Sure, if no teens are in the house And you're raising chickens and goats And you can stretch two eggs into six omlets

Really. Some people do live in a bubble of surreality.

Okay, so what does it cost to have a baby in the US of A today? Assume a normal birth with the usual prenatal care. I googled it and came up with what looks like marketing come-ons and no real information, at least without giving up my information. So forget it, the cost is so high that nobody is talking about it. Also the free market is taking advantage of people terrorized by health care costs.

Prove me wrong.

Actually, I think it has been thoroughly discussed and the conclusion is that you are the one that is responsible to prove anything. As it has been explained many times over, you don't go into a debate, make broad unfounded claims and then tell everyone to prove you wrong. Right now without looking anything up I can say you are wrong because you have zero facts provided to support your claims. Prove yourself right, and then someone will prove you wrong.

$30,000 a year for a family of four means that the children fall under the SCHIP guidelines (usually 200% of the federal poverty level and are eligible for free health care.

So you need to cover the two adults. There are programs in Nebraska starting at about $141 a month according to ehealthinsurance.com. Of course they have co-pays, deductibles, etc. the same as any private plan. Most adults don't need extensive coverage, only catastophic coverage so depending upon an individual or family's needs there are plans available.

Of course, the plan originally offered for comparison costs $900 a month or $10800 a year. The individual may not pay it, but somebody does. And that is the entire basis for disagreement. Some people want others to pay for their needs and wants and others expect those who are able to pay to do so. Medicaid and SCHIP and other programs offer help to those that need assistance, but they do not subsidize those able to pay their way, expecting individuals and employers to pay for those needs.

Many of today's societal problems stem from the "gimme gimme gimme" "I need, I need, I need" attitude that people have. It may sound harsh, but the real solution here is probably a second job. $30,000 a year is simply not enough to raise a family of five in the US. Choices in individuals lives are often based on what they want to have, not what they need to have. Cable TV, cell phones and internet access are all luxuries that a large part of the country has but doesn't need. Life is about choices. It's time that Americans realize that they can't have everything.

Wonderful. Since you are so sure that these savings will outweigh the cost of providing the insurance, then I'm sure you will gladly put them on such a program and pay for it yourself then, right? After all, doing so would save you money. Why involve the government at all...that just dilutes the savings. This could be completely paid for out of private money. Have all those who want to participate in the savings provide the funding, and there should be more than enough to pay for the program. Those who don't can continue with their current program. Both camps are happy then, right?

Here's a perspective that may shed light on some positions. If we determine that everyone in this country should have socialized health insurance because the government is already paying for those that are either under insured or not insured, should we also then as a nation also provide home-owners insurance? Look at the Gulf Coast after Katrina, for example. Many people were under-insured, chose not to insure, or were unable to pay for home owners insurance, and what did they get in return? Tax dollars. I mean, we are already covering those that don't have home owners insurance, why have a private sector when the government is already footing the bill, right? It is the same argument, but just as absurd.

Is this seriously your counter argument to the needs to reform and work towards universal coverage? Privately how do you propose me and all the do-gooders out there actually meaningfully reform health coverage in this nation as I have highlighted earlier with mandates, tax credits and incentives, price controls and subsidization etc.? How can I and my band of privateers do all this? The goal is not solely handouts but to make a better system where health care is more affordable and available.
Do you not acknowledge that health care cost have risen dramatically over the past 10 yrs with no relationship to inflation, and that it has a negative effect on the nation as a whole not just the poor? Health care costs are now %15 of our nations GDP, and are projected to only rise, we rank above all other developed nations. Don't you think this places us at a disadvantage for growth and competitiveness in the world market?



You shouldn't toss out your accusations of absurdity until you are sure you fully understand the argument being made. I certainly am not advocating a single payer plan, I never have. The private sector is one component of the whole. Government involvement is necessary even in the home insurance sector in order to ensure we have the best system possible.

Yes. It is exactly this which makes me skeptical that having to pay for all this coverage for tens of millions of others isn't going to cost me any extra money--money I don't have, and if I did I would rather spend on my own family's health care needs. I'm not against reform at all. Reform and universal coverage are not mutually inclusive however. In fact, if reform does indeed address the dramatically rising costs you mention, then it will also simultaneously make things cheaper for those who don't have insurance as well (and make it easier for other companies to provide it for them). Although I am open to reform, I am in a position where I am not willing to risk the status quo on something that might be better, especially when I have extreme skepticism to our governments ability to actually deliver on any of the promises those promoting universal care make. So, on this issue, I'm from Missouri--I'll have to see it before I'll believe it.

Excuse me, did I direct anything at your post specifically? Just curious. Maybe you should fully understand the argument I made. If I had made a response to your post, your post would have been quoted in my post, so climb on down off that defense wall and calm down a little.

The comparison is accurate. Since we have people in America that own a home and don't have insurance, or sufficient insurance, we as tax payers pick up the difference now. If anyone disagrees, explain the involvement of FEMA in any catastrophe. Just like the health insurance proposal in the opening post, if you agree with it, we should have government sponsored home owners insurance because of the same reasoning.

I think either idea is absurd. Not a statement of fact, but an opinion. I can toss accusations of absurdity anywhere I feel they are appropriate.

What happened with Katrina is actually a good illustration of the shortcomings of private insurance (health or homeowners). Normal homeowners insurance does not cover flooding, which comes as a big, unpleasant surprise to many homeowners. If you live in a floodplain, you have to get flood insurance from the government. Note also the court battles that insurance companies are waging with their insured, fighting them about whether the damage is due to floods or the wind & rain. It was so bad that it even spurred Trent Lott into action (he also got the shaft from his insurance company). So there you are, dutifully paying insurance premiums for years, and along comes Katrina. Everything you own is washed away, and what do you have to look forward to? Your insurance company denying your claim. Hopefully, you had the government flood insurance.

Same story with private health insurance. Hit your ceiling? (see the other thread on that) Have a pre-existing condition? No soup for you, my friend. You are not profitable to insure. Hopefully, you will be eligible for some sort of government insurance.

Is that what everybody means when they say that private insurance is "efficient"? That they are good at making a profit for themselves?



________________________________

Scubatim, to address your suggestion that the government pay for everyone's homeowner's insurance - I know what you are driving at. Why are we footing the bill for flood insurance and disaster relief? Didn't those people realize that sooner or later, a hurricane was going to come along? Well, think of New Orleans as a national asset. America needs that port, so we accept the cost of rebuilding after the occasional disaster. If, on the other hand, you wait for market forces to repopulate the area, you are in for a good long wait.

You can apply the same argument to health care. It is in America's interests to have a healthy populace. Some people are going to be more expensive to insure, but in total, many people believe that it will be worth the price to get everyone covered (which the market will never do).

So in turn, we put the rest of America into a system that is running Medicare/Medicaid and the VA hospitals? Is that the quality of care, efficiency and low cost you are referring to?

Yes, it is. I don't like excluding people because they are unlucky. Don't forget that the government now insures the hardest to insure. Old people, poor people, and veterans. Maybe we should dump them, because they are too expensive. Republicans are constantly trying to chip away at funds for all of those so they can increase the defense budget. Let the free market take care of them!

There is a link floating around, probably early in this thread, that points out that the government is actually pretty efficient when compared to private insurance. I know it's just instinct for conservatives to think that the government is inefficient at everything it does, but that is not always the case.

If you look at the rising cost for Medicare/Medicaid, all of the stories about poor conditions at VA Hospitals, and the people that get denied Social Security benefits that need them, I think there could be a good argument that our government isn't ready to insure 300 million people and that our government would not do as great a job as many want to claim. Don't turn this into a conservative vs. liberal debate. We are debating an issue that effects each and every one of us. This isn't about which side of the isle you are representing, it is about whether or not the government can provide health care for 300 million people and still provide quality and timely care, efficient care, at a lower cost. With the programs that are currently run by the federal government, I would have to say no.

Exactly, government picks up for the cost of lower income and middle class citizens who can't afford $800 a month insurance. My brother in law is self-employed, makes some decent money, but he can't afford insurance. He constantly has to pay out of his own pocket. Why not go to a government systen? We have a de facto version of that anyway.

Isn't it also telling that not ONE of the republican candidates who opined about the wisdom of private insurance has yet to take it over their government plan!

Once again, it is simply unrealistic to expect that a family could gain private coverage that is affordable. If they did, it would probably feature high co-payments and more "pre-existing conditions" than you could shake a stick at.

But one of the methods of lowering costs is requiring universal coverage, not exclusively but it is said to be an important piece of reform. I don't really get your argument, it seems to me that the conservatives here believe that the democrats are proposing nationalizing health care. The government, our government currently insures tens of millions of people already, and yet their costs are in fact lower and have not risen as much as private insurance's have:
Second time posting this link

I also don't really get how we can make the reforms needed and not see more government involvement and find ourselves relying more heavily on the government's ability to find a solution. What do you propose as an alternative to government involvement? Or perhaps you could explain why you feel the private sector is more honest or capable in addressing American health reform.




Well you surely are not addressing the topic as it has been presented, by me or any other. No one has proposed nationalizing health care, well no one except you.

Does everyone need to own a home, it is in kind with the car ins. example, not everyone drives (or is a home owner) and costs most often are the determining factor. Yet I think everyone has health care needs, unless you can prove otherwise?

Also I have to wonder how much you are aware of the going ons in the relationships of private home insurers and the Federal and State governments. For example were you aware states like Florida have reinsurance programs that help private insurance companies pay claims from major storms? Don't see many here complaining about the corporate handouts to insurance companies.

Also there are Federal government insurance plans available to those who live in high risk areas.

Government involvement and the policies set forth by the two leading democratic candidates are two different things. First, Obama wants to offer government healthcare to anyone that wants it. That means that even if you don't want it, you still have to pay the additional taxes created to pay for all of those that do. Under Clinton's plan, if you don't have health insurance, you get penalized. You have to pay a fine. These are not solutions.


I proposed nationalizing healthcare? If this is not what you are proposing, what exactly are you proposing?


You either own or rent or are homeless. If you want me to be more specific, do you propose home owners/renters insurance to be provided by the government? I think everyone has housing needs, don't you?


And I don't agree with either of them. Now what is your point?

I just want to know when we can, instead of having privatized auto insurance, have the government supply it for us.

Using the logic I've seen so far in advocating for "more accessible" healthcare, it would be cheaper and everyone wins.

And even if you take the bus, this would greatly reduce the fare. And yes, everyone has transportation needs.

The bottom line is that you always get top dollar when you have no competition. When the government pays, there's no competition.

Fantastic. Name three things the government does that the private sector can't do better, cheaper and more efficiently.

I think of things people complain a lot about. Such as the Post Office. Are you seriously suggesting that it couldn't be more efficient? In fact, two private companies emerged with great success - Fed-Ex and UPS. I didn't realize so many people were happy with the level of service and professionalism at the DMV.

Could that not be equally applicable to Democrats, Independents, Greens....

But I agree. Make them dump their government benefits and live like us. Then they'll pass some laws that the private healthcare industries must do, such as proof of billing. Make them call the people we have to call. Make them run through the billing process, fax documents, get letters of approval from their PCP's...

I truly believe that people think that if they need a double-bypass or a colon-surgery like some of our prominent leaders, they'll pay a $25.00 copay and the government will pick up the tab for a $50,000 surgery, plus hospital stay, plus rehab. Sorry kiddies, those are reserved for those allowed to vote for their benefits. They'll turn to you with their noses up and say, No you can't have a surgery. NOT YOURS.

I'm no fan of Republicans raising taxes. But you bring up a point.

Let's take the Veterans, all 200,000 of them, and run a test pilot program and see what that does to the economy. I'm ALL for that, DESPITE what it does to the economy. But let's run it and see what happens before we try it with an entire country. When 1 out of 3 homeless people have worn a soldier's uniform, there is something horribly, horribly wrong.

Here's the problem I see.

Private Insurance will make a profit if they run it. Theres no doubt there. But that money goes into research and development, new technology and breakthrough research and development, and new medicine, ALL from the private sector.
The Government will make a profit if they run it. What is their incentive to try new things before running it by Congress first? Good luck!! Goodbye innovation!

Then there's the issue of "well, that insurance says I'm not covered for _______ surgery". Which makes a headline here and there.
Let me guess how long it will take cries of "America says I have to die" when the near-death 92 year old man with dementia, cataracts, and bone-cancer is denied a heart transplant. "Our country is killing people and nobody cares" cries will be deafening. "America hates old people!!!"

I know some of you guys won't believe it, but there are quite a plenty of downsides of National Healthcare that Michael Moore didn't show you in Sicko.

Like 84.2% of America is covered by some sort of health insurance plan. Oh, but apparently this system "doesn't work". What? 82% say it works.

If you think it's too expensive now, just wait until it's "free".

But I guarantee you, if a private insurance company had the opportunity to insure 11 million people tomorrow, they'd do it more cost efficiently, and with a serious advantage. Of course, nobody is proposing incorporating people who can't afford it, and offering it as a group discount to a public insurance company to bid on. Woah, people would have to choose between cable TV and medical insurance. And Oprah has this awesome special guest on tomorrow!

No, we're waiting for Hillary to fix it all for us, along with the fame and glory of ruining an entire industry. There's a bigger picture than just 11 million people. It's how it affects the rest of us who already pay into a working system. That silent 82% that we never talk about.

You know, there are disadvantages to any system. I have a reputedly good insurance, and it has covered a lot of things, especially since I had cancer. However, when I was admitted to Intensive Care through the emergency room at our local public hospital and an internal medicine specialist was assigned to treat me for septic shock, we didn't take the time to check and see if that physician was part of the accepted physician group for our insurance company. I was personally too sick to think about it with my blood pressure plummeting and my kidneys failing, and my husband had to make arrangements to care for our daughter and then came back to the hospital, because they didn't know if I was going to live.

So it turned out that the physician was not paid for the work he did. I mentioned that to the nursing "case manager" of the insurance company, who said that we should have checked to see if this doctor was a "plan" physician. I said, "For crying out loud, I was dying!" She sympathized, but they certainly did not cover it.

I am thankful to be alive, but my husband and I, who are both on Social Security disability, have no way to pay for the shortfalls incurred when the health insurance company decided not to pay those who cared for me but weren't part of the "plan." We are routinely contacted with dunning letters and phone calls, but there are only so many people we can pay, and we certainly cannot cough up the whole amount anybody is asking for.

We don't like living this way. But what is our alternative? The types of jobs available to people who are older and less physically able are limited and certainly do not pay enough for us to pay off the debt. Further, we have a teenage daughter to raise until she's able to be on her own.

A governmental health care system would be one that would not exclude people. There would be standardized procedures, and standardized reimbursement. The specter of "socialized" medicine is less frightening to me than the concept of people simply going without the care they need because they have a "pre-existing condition" or not being covered because they had the "wrong doctor" assigned to them when hospitalized.

Both my husband and I paid in to Social Security. We did not know that illness would put us into the condition that we are in. I am so glad that we have Social Security benefits so that we can actually buy our medicines, pay for phone/electric/gas, and have transportation. Our payments come like clockwork every month. Government may be inefficient, but we have been able to depend on the assistance we didn't dream we would have to receive so soon in our lives.

Hardly the extent of their plans, but you do not seem to be all that bothered with details.



Yes you did with wild claims that: "our government isn't ready to insure 300 million people" and "it is about whether or not the government can provide health care for 300 million people" The basis of your argument centers around an ideal that no one here but you has suggested, I have pointed this out to you now three times. The debate questions themselves reflect the idea that there will still be consumer choice and an open market approach by asking which policy you would best prefer. So you , sir, can still have your preferred private health care plan.

I propose real reform and universal care. Universal just means to ensure all are covered, currently we have what 46 million uninsured? So really the idea of universal health care in the US means to further include another 46 million into the system, not this (to use your own word) absurd 300 million figure. And if you have data that proves or even indicates that all 46 million currently uninsured people in America would require the government to pay for and supply their health insurance 100% (not even the current state of medicare now) then I would love to see it.



You are a hoot, you seem to have no awareness of our nation's complexities.

In my city the Federal Housing Authority rules, we have more people per capita in public or subsidized housing than anywhere else in the nation. So no, you do not either rent or own, there are other alternatives to housing in the US. Not to mention some people live their entire lives institutionalized , under the roof and care of the state. Do you believe these people, some murderers and rapists deserve their health needs attended to? How do you justify the fact that someone who is a citizen, pays taxes and labors in our nation's economy has less access to health care then prisoners?


The point was to show how you were misrepresenting the relationship of our state and private insurance and how even those who claim to be "private" are still feeding from the public hand.

It's interesting you bring that up. I can sympathize.

I went to an Urgent Care last week for a back spasm, because the Clinic is covered under my insurance. I had the girl check my insurance, which took a half hour while I sat there hunched over a chair. However, they have an internal (what they call) "mobile unit" which is apparently a separate section of the clinic that holds the medicine chest. My covered doctor left the room, and in came a nurse. You'd figure - they checked my insurance, and overcharged my co-pay - we can settle that later. But they said that the muscle relaxer I needed was going to cost 40 bucks, cash, please. Because of my back, I guess you could say I was bent over twice. Again, I figured we could deal with the insurance later, and I've been VERY happy with my private insurance. So the nurse (apparently also seperate) gives the injection, and then leaves. The doctor comes back in and suggests that I see my PCP first thing on Monday (Saturday Night). Well DUH.

So the overcharge on the co-pay, no problem. That gets reversed.

But the injection was not covered because the "medicine section" of the Urgent Care wasn't a participating plan provider, nor was the nurse who administered it. She was really nice and gave a painless shot. But it should have been covered.

So I'm miffed and confused over a $40.00 charge. I can certainly appreciate what you're going through, Paladin and I fully agree. It's not right.

Actually, I have no idea what it's like to be in over my head in medical debt. I have no clue, and it shouldn't be that way.

Can the government decide what is Medicare covered vs. Medicaid covered vs. HillaryCare covered? What happens when there is a conflict between you and the government? I know how the IRS is when it comes to demanding money they believe is due. And this is assuming that there are no deadbeats, even on the co-pays - which leads to admin costs, mailing costs, collection costs, lawyer recovery fees... There are simply too many questions without answers.

This leads me to believe that there are a lot of supporters who are uneducated at best, and apathetic until they have to deal with it at worst - and then it's too late. For everybody. Show me someone with a plan. Hell, show me a plan at all. I hear promises, but I don't see how it could possibly work. Would you pay to build a house without a blueprint? Yet some people demand that this happen. Okay, great. Let's hear the details. Let's hear what we get. Hangnails clipped? Open heart surgery? What do we get?

So far, all I hear is: If "A" doesn't work, then "B" would be so much better. We think. Maybe. Well... "A" really sucks for some, so "B" can't be that bad, therefore, "B" is the answer.

As for me, if possible, I'd still keep my private insurance. I may get my own network of private doctors who will see me quicker. I think a lot of people would. And we'll still go back and forth with the "haves" and "have nots".

I noticed that nobody cited why rising healthcare costs are increasing the way they are, never mind why hospitals are going bankrupt. That the elephant in the room that nobody wants to talk about - hospitals that are being used as doctors offices for illegals. Repeal the Emergency Medical Treatment and Active Labor Act (EMTALA), and THEN I would be open to discussion and support of a National Healthcare system. At least OUR tax dollars will go to each other. It's time to say "enough", considering our contribution to the U.N. At least allow us to take care of our own if we launch this kind of system.

It's sad that someone like Paladin would have bills she can never pay. But then to let an illegal go scott free after receiving the best care in the world? That's unacceptable.

Illegals make up at least 25% of the uninsured in America, quite possibly higher. They cause hospitals to close because they get treated and don't pay. We already pay for that. You take away free insurance for illegal aliens and all Non-Americans - citizens only - and you may quite possibly have my 100% support.

But that will never happen. The Jackhole Republicans voted for amnesty-loving McCain to run against amnesty-loving Obama and amnesty-loving Hillary. This is your year, liberals. Our party shafted us for you. But for goodness sake, don't let Hillary do to healthcare what Bush did to foreign affairs - jumping in too far before knowing the facts.

To answer the original posters question: I proved it by explaining that there's not enough information to make an educated decision.
Prove to me that a National Healthcare system is all the things everyone in this forum is assuming it is.

Telling myself to take three deep breaths before responding.....

Correct me if I am wrong, please. I am asking you to provide these "details".


Yes, let's look at how great Medicare is. I think putting the rest of America on a simlar plan is ludicrous. Why is it that so many seniors have to purchase Medicare supplement insurance if the government is so great at providing health coverage?

So, after your 46 million people get covered, how many Americans would have coverage? A different number than 300 million? Since it is estimated that there are 300 million people in America, I would be interested in finding out really what you are talking about. And how do you "ensure all are covered" without forcing people from being on some sort of socialized health care? By fining them if they choose not to have health insurance?


Oh goodie! You pulled out the prisoner point! That is productive, really it is. And yes, since we are forcing them to live behind bars and not allowing them to work, we should provide them with health care. But back to the actual debate, your position on health care also says that we should have homeowner/renters insurance. You made my point exactly with your point about your city. Since some people are getting covered by the state already, we should just extend that to everyone. At least that is your argument for health care. Why would it be different for any other form of insurance?


I am feeding the public hand through taxes, but when you expand this to your 46 million people, how is this not going to increase my taxes? I think there have to be ways that won't increase my tax liability that will improve the availability of health care. Forcing people into insurance (Clinton) is not the way to go.

I have provided details. And I am sure each candidates' web pages has a wealth of information on each of their proposed policies. This is not central to the debate and certainly not anything I have based my arguments on.

I don't know what more I can say to explain this and why you are having such trouble with the idea of what universal health care is and what nationalization is. I really don't wish to engage in a debate where I have to keep explaining the central theme and definitions of the words commonly used to discuss it. No one here has advocated a nationalized program. I have lived in a country where health coverage was universal by the means of mandates, price controls, subsidies, along with public and private insurance plans and facilities. It was not purely socialized and private health insurance was still very much an integral part of the system, I in fact had private insurance as did everyone I knew.



How is this absent of the actual debate, it is an example of the necessity and role of state supplied health care. So your argument here is that we owe it to them? But somehow you only extend this sense of responsibility to our citizens incarcerated. Also people in jail and prison work...another example of your refusal to see the whole picture of what we as a nation are and do.



I already adressed this and in fact pointedly stated that my position was the opposite. My argument here, as it was previously, is that I feel health care is more of a necessity and an unavoidable consequence when you have a bunch of people, you know a society. People don't have to own a home to have shelter and I am honestly not that concerned about property damage (in the context of renter's ins.), altho I know property rights is a big deal to you conservative guys. I think someone's health is more important then their TV and underwear.


Well then let me bring your attention to the debate question you have yet to address....
Private health insurance is better?-Prove it!

edited to clarify

Build roads.
Cover victims of disasters like Katrina.
Provide health care for the elderly and poor.
How do I know the private sector can't do these things better? Because they don't do them at all. The private sector runs away from anything unprofitable, even if it needs to be done.


Give FedEx or UPS $0.41 and see how far your letter gets.


Private insurance pays for research and development??? I thought they simply distributed their considerable profits to their stockholders.

It is delusional to think that the free market will solve all of our problems. The free market does one thing well - it maximizes profits. It also leaves about 48 million Americans without health insurance.

Sorry about the quotes thing. I really suck at those.

Okay, building roads. You got me there. The joys of CalTrans aside (when a freeway would take 3 years for 2 miles), for what we pay in taxes for those roads at the pump (not to mention any applicable toll roads), they ought to be paved in gold. However, noone else does roads like the government. You definitely win there.

Katrina? Really? The Red Cross is a Government job? The churches that went in and fed people? Wal-Mart allowed people to clean off the shelves of necessities for free beforehand, and Wal-Mart even trucked in goods immediately after it was safe for trucks to do so. Free of charge. I don't want to threadjack this into Katrina, but the government did very little. Bush and Clinton lead a nationwide fundraising effort to help the victims of Hurricane Katrina, and Wal-Mart donated $15 million to jump start it. I wouldn't use Katrina as an effort to appeal people to rely on the government. Private businesses (read: Private Sector) did the donating. You get a half a point for the government (military) pumping out the water, but you lose that half a point because the rest of the country had to endure Ray Nagin and his mind numbing press conferences. The government then blamed the government for not doing the job! To which that government said the other government should have listened better. That's not helping your position.

Provide health care for elderly and poor? That's a federal law, and on top of that, the private sector is forced to NOT deny that. So your crack about it being "all about profits" is completely wrong, unless you can explain to me why over 50 hospitals closed in California in the last several years. I can. Nobody is going to touch the illegal issue, I already know that. But it's silently observed that they deserve medical treatment for the mere reason they ended up here, and for that, we already pay for them. The government reimburses 50% of the hospitals loss. If it goes on long enough, that other 50% that doesn't get paid ends up closing the hospital.

So much for profit. And to hell with actual Americans. That's a lose lose. If the government reimbursed the entire 100% of even JUST THE KNOWN ILLEGALS, my argument would be trumped. And you think the government will do better when they're in control and have to eat the losses at 100% of at least 11 million people, PLUS the actual honest people who simply can't pay the bill? You think the government can write that off easier than the private sector?

Sorry, the private sector loses because the government makes them do charity work, and then offers a paltry "reimbursement" as a result of a federal policy, and expects businesses to thrive. When they don't, healthcare costs go up. Yet "the private sector is teh suxorz" because medical costs go up? For that response, (video) I award you no points, and may God have mercy on your soul.

1 of 3. You got me with roads. Not bad. (and I'm just giving you a friendly rib with that clip)


Have the Post Office stop by and pick up grandma-who-can't-drive's packages for her grandchildren at Christmas. Oh wait. You can't.
After 5pm. You can't.
Toll Free Number? You can't.
Bonus: Customer Service? Not yours!

Three things the free market does to one thing the government does. Are you going to make a case?

However, this thread delivers!

Right, so rich people can get richer off sick people. Is that your argument?

People AND Insurance companies will pay top dollar for a $5.00 pill that defeats a $20,000 surgery. You betcha, it's about profits AND breakthrough in science.

Show me revolutionary medicines that come from a government sponsored research facility, and you'd have an argument.

You also avoided the fact that government will be making the "profits" that private corporations, citizens, investors and others could invest in. And still, people are convinced that the government is going to give that back to you. Uh huh. By what? Buy a government bond?


Right, because all those other countries with socialized medicine programs... what... have a free market? They do it out of charity?

They're given what the government thinks they should have. It's not their choice, and it's incredibly limited with long lines. And that makes them better? C'mon! Can you wait two weeks for a toothache? Some guy in England made a self extracting tooth kit for HOME USE. He sold 600 the first day they were available. That doesn't tell you something? Brits have a shortage of dentists because they won't take the National Health Care. Why? IT DOESN'T PAY ENOUGH. There's your social medicine. Welcome back to PROFITS. Chew carefully. Many dentists abandoned Britain’s publicly funded health care system after reforms in 2006 backfired, leaving a growing number of Britons without access to affordable care. (read that part again.) 45% of dentists surveyed said they no longer accept National Health Service patients. And that's just TEETH.

Was that factoid featured in Sicko? No, but CNN got it right. So wait.... even with healthcare, you're not guaranteed a doctor will take you, much less one that is close to where you live. That's a HUGE world of suck! And you Democrats are BEGGING for this!

The free market DOES maximize profits. Do you work for nothing? You say that like capitalism and a free market are a bad thing. You think the government is going to pay full price for a private company's work? I don't think so. Somebody has to.

It ALSO stimulates the economy, creates jobs, creates medical solutions, which allows people to live longer and healthier. The US dumps more money into medical research... WHY? Because it's profitable to have a WINNING medication. It's FANTASTIC to have a machine like dialaysis. Or a machine that you can hook your arm to to make plasma.

And for pete's sake, if nothing else, it makes up for the abuses when illegals leach off a system designed for "x" amount of people. It's hard to help everybody when you can't afford to help anybody. Of course, our government doesn't know how to live within a budget, which is obvious. That fact that people think otherwise is both astounding and awe-inspiring to me. And further, one who thinks the federal government will save Americans money with their massive plan and budget by insuring 43 million more people? Are you kidding me? Like I said. If you think it's expensive now, wait until it's "free".

I require a machine that sends electric pulses to strained muscles. It's $700.00 on the free market, and I made the case to my insurance company that it was either this, or more hospital visits in the middle of the night. Guess what hoops the government would make me jump through? Tell me, because I don't know. The private sector took one look at profits and decided that giving me a stupid machine was an investment worth taking. That decision was made in less than an hour. I'm not even going to entertain what the FEDERAL GOVERNMENT would require.

And what happened overnight here? Suddenly the government is wealthy, and generous. Is nobody else suspicious of this strange turn of events after years of IRS abuses?

And nobody is answering the questions. (Cept you and your roads, JFC!)

JFC, you're okay, man.

So you are saying that it would be ok for everyone that lost their home in New Orleans to remain homeless if they didn't have insurance, or they were underinsured? Shelter is not very important?



So this debate was opened with a demand to prove an opposite? I don't think that makes any sense. Why don't you prove that governmental control is better? I don't think opening a debate with a question demanding someone prove something makes any sense. Although, I can point towards the VA Hospitals and Medicare and Social Security as three programs that are representative of how the government runs things, and I don't think we need to subject everyone to that. I may be wrong. But you should attempt to prove that governmental control would be better.

No, it isn't telling, at least not of that. The program that Congressmen have is more akin to a corporatate health insurance package than it is of a government program. You think if the government had to provide insurance to everyone, that that is the package they would get? Hardly--the government (ie, us) couldn't afford it.

As for your brother-in-law, when you say go to a government system you are in essence saying why shouldn't the rest of us pay for his health insurance as well. I would turn the question around--why should we? He could have chosen a job that provided health insurance, but he didn't. He also could have chosen to get health insurance ahead of any number of other items he has purchases (you say he makes decent money), but he didn't. Why then should I, the taxpayer, be expected to pay for his insurance in addition to my own? Also, as a self-employed person, he has access to health savings programs (HSA's) that those of us who have corporate insurance don't have, which both cover catastrophic health care costs and also accumulate contributions in a savings account...win, win.

As for hi co-pay, in truth, that is what most people should get. Health insurance is just that...insurance against catastrophic health care issues. The normal stuff that most of us go to the doctor for shouldn't be covered by insurance--that is what makes most health insurance packages so expensive. People use them to pay for what amounts to routine maintenance. This would be akin to have our car insurance pay for oil changes, new tires, etc. Imagine how expensive car insurance would be then.

First, health insurance should only be for catastrophic health issues, as it was originally intended. No health insurance should pay the way we want it today, with some tiny deductible and with even routine visits covered. No premium most people can afford really pays for all of that. We should have 25,000 annual deductibles and health insurance should only be there to cover cancer treatment, heart attacks, etc.





I would choose exactly the coverage I discussed above, if I could find it. Right now, high deductible policies are not that much cheaper than better coverage because insurers subsidize low deduc insurance with the costs of the high deductible plans. I still use a more traditional PPO plan I pay for through my firm.

I also want to elaborate generally, as follows:

The health care problem is deceptively simple. We
> will never have enough
> doctors, staff and hospitals to go around at prices we can afford; we have
> to ration. We can
> ration by ability to pay, or by govt'l
> mandate--poverty, age, overall
> health, etc; but ration we must.
>
> We already get this to a great degree with
> Medicare/Medicaid, which
> opens the system to people who cannot afford to pay,
> pays below market
> to the providers, and skews the system so the system overcharges those
> who are not on MM. Private insurers in response
> created managed care,
> which also pays below market after using group
> negotiation with
> providers to artificially lower some prices. Managed
> care insurers also
> meddle in our medical protocols to save themselves
> money.
>
> Now, we have way too many people in the system,
> paying too little, and
> our health care system is not very satisfactory
> anymore. Doctors must
> see twice as many people to make the same actual
> money as they did 25
> years ago, and our care isn't as good as it once
> was. Additional govt
> regs, plaintiff lawsuits, and nursing shortages
> (smart, liberated women
> often go to med school now) all play their part,
> too.
>
> Any system that opens up access to those who cannot
> afford to pay will
> always do 2 things--drive up the cost to those who
> can pay; overtax our
> medical resources by permitting more people access
> than the system can
> handle. Anyone who tells you otherwise is simply
> uninformed or lying.
>
> The system, if being paid below market, will never
> expand to meet demand
> that does not pay the freight, even if it could. No
> business would. (If
> you recall, the last Clinton admin tried to increase resources by
> aggressively pursuing foreign educated doctors to
> come here and ramp up
> the supply. You can argue that the AMA keeps too
> tight a rein on supply,
> and that's fair, but it will never be easy to snap
> one's fingers and
> magically create tens of thousands of new,
> well-trained, competent
> doctors. Heck, who would want to be a doctor if
> being a doctor means
> making regular-guy dollars and working all the
> time?)
>
> If we do the Nurse Ratchett, I mean Hillary, and force employers to pay the
> tab, well--that
> great sucking sound from India and China will grow
> and take as many
> white collar jobs as it can find to go with the blue
> collar jobs they
> already have. Indeed, many white collar jobs are
> already gone, for this
> and a number of other reasons....
>
> The US citizenry may want a new system, and if so, fine, but even we cannot escape market forces. MM created lots of the problems we have now, and creating even more below market customers can only make the situation worse. There is no way to give everyone all the health care they need all the time.

Finally, it is still debatable whether using the power of government to steal from those who have to give to those who have not is right and proper. There is no guarantee of health insurance in the Constitution.

That said, one possible practical approach is to create a network of health clinics nationwide for the impoverished and staff them with interns and other health professionals in training. Service there would be part of one's educational process. Legal recourse against such clinics would be limited, much like a worker's comp. model (which we may need for all doctors as a way to cut costs). This may get the overloaded emergency rooms out of the daily care business.

Care in such clinics likely would not be as good as you can get by paying for it at the Mayo Clinic, but then that is why people work so hard to get big dollars--you get better stuff of all kinds when you can pay for them, which is as is should be....

I have friends who pay it – one is a psychologist. And I do think the states should come up with ways to offer affordable private insurance even if this means everyone has to buy insurance – al la Mass. plan
What I will never favor or buy is anything that Is government run or “single payer:.

Ted, I think you made a great point without intending to, but you said that the states should come up with a plan. This is a states issue, not the federal government's issue. I think this along with all other social programs should be handled by the state and not the federal government.

Here is the explanation of why Medicare costs aren't rising at the same rate of private insurance: the government caps rates that providers can charge. Since these rates are not as high as the cost of the services, they increase the cost of services to those that pay the going rate: insurance customers. Medicare costs are held artificially low by inflating the cost to those covered by private insurance. Bucket's article says that the average growth rate of Medicare from 1970 to 2000 was 9.6%. Yet the government cut payment rates in 2002 and was slated to do so again in 2003 (Congress intervened).

Providers do not like dealing with Medicare recipients. My mother-in-law, who did billing for years in a nursing home explained it to me this way: First off, they can't charge the same amount as private insurance billing. Second, there is a lot of bureaucratic red tape. Third, they must carefully record everything a Medicare patient uses: toothbrush, pillow, all the sunderies. Medicare only pays for certain services and not for others. All of this usually does not impact the actual care the patient receives, but the provider has to eat the headaches because it can't charge more. The nursing home then determined whether or not to bill the patient directly for services Medicare did not pay for. It was a huge hassle.

From the patient side, Medicare is no bed of roses. Although Medicare is subsidized (via payroll deductions), enrollees pay a monthly premium of $96.40 (currently), which is usually deducted straight from their Social Security check. In addition, there are out of pocket deductibles such as over $1000 before Medicare starts paying for hospital stays (Medicare Part A). Although the deductable for Part B is low compared to private insurance ($135), the individual pays 20% of all services covered under Part B. They also charge extra for services performed by non-participating providers (same as a PPO).

Most seniors can't pay these out of pocket expenses and they get gap coverage for the things Medicare won't pay for or the individual is responsible for. I'm sure we've all seen the commercials for these plans. If Medicare by itself is so great, why the need for a second insurance?

Medicare Part D pays for prescription drugs, but it has a huge doughnut hole where the seniors has to pay out of pocket for a big chunk of prescription drugs. Of course, there is supplemental insurance for that, too.

Then let's analyze the costs to the government. Okay, the government doesn't have any money, let's look at the costs to the people. The GAO ranks Medicare as a "high risk" of fraud and estimates that billions are lost every year to fraud. It spends over $1 billion annually to combat fraud.

Medicare covers about 40 million Americans, using about $440 billion in the process. In 2003, it accounted for 13% of the federal budget. Keep in mind that the cost to care for seniors is higher (at least 20%) than what the government pays out.

Let's assume that we are simply going to cover the 47 million uninsured. Seniors cost more to care for than average folks. We can safely assume people 65 and older cost about three times more than people in other age brackets. Still the cost to insure these people would be high. It is difficult to quantify the costs needed, but we are talking a hundred billion dollars or more. Some of this cost might come off of private insurance costs which (similar to Medicare) absorb the real cost of treating those that can't pay. Somehow I doubt it. Costs rarely go down without serious competition.

Excellent post, Amlord.

I've gone over this in other posts, but I'll do it again: nobody said universal coverage would be cheap, but I still think that it's worth the cost. And I'm talking flat-out, single-payer, full-coverage government-style insurance that everyone is afraid of. I think it can work, and I know it would solve a lot of problems in other areas.

Here are the biggest negatives that I see with the system as it is:

1. Cost of medical care is way too high (of course).

2. 48 million uninsured (at least, that's the number I've seen bouncing around here)

3. Lots more underinsured. If a patient is going to end up paying 20% of an outrageous bill, they are still going to end up over their heads financially. I've had a lot of clients get pulled under by normal procedures - having babies, back problems, cancer treatments, etc. They get behind, they get buried, they struggle for a while, then they finally declare bankruptcy. There are a lot of hidden costs in going that route.

4. Businesses are expected to pay. Why? Why not pass that on to their employees, who can then buy insurance? (I have not forgotten that they get better rates on insurance.)

5. Hospitals have to pick up the tab for treating the uninsured. Another circuitous route to the government paying for insurance, and another factor driving up the costs of treatment.

6. Inequality. Wouldn't it be nice if, instead of the poor going to the ER for a sinus infection and disregarding the bill, they had the same little insurance card as everybody else, and could visit a family doctor? Pony up a reasonable $25 or $50 copay to see a regular doctor, and walk out of there with a prescription and their dignity intact. Then, when you need the ER for a real emergency, you don't have to sit there forever, looking at your broken leg.

The common thread here is that there are a lot of hidden costs in the present system that are not easily quantified, so they are seldom included in any discussion of costs. Scrape together all of those costs - the drag on business, the drag on hospitals, the loss of productivity due to avoidable health problems, the costs of bankruptcy - and you have a pretty good start on paying for universal coverage.

I don't know if it should be administered by private insurers or not, which is the flavor of the month, or if the government should just take care of it. But I don't trust insurance companies as far as I can throw them, so my preference is to take them right out of the equation. But I would accept pretty much any plan that sufficiently covers everyone in the country.

I will name three things the goverment does FAR better than private sector:

1) Prisons- hands down winner on the goverment side
2) Postal service- no private system even comes close to the size, scope, efficiency of the post office. I would personally assasinate UPS and Fedex as corporations if I could. And that is speaking as a businessman that has to deal with those tools at Fedex and UPS. I will take USPS, any day, anytime
3) Education. Sure, like with UPS and Fed ex, they can do a good job in certain niches if you are willing to pay the raping price- but overall, the goverment does a much better job than the private sector- several studies have shown this- and have been posted here before. Overall, 99% of our institutions of higher learning are goverment funded and can't live without thier funding- many of them state universities as well.


There is this myth that business does everything better- and in many cases, that is true- one field that it is ABSOLUTELY not true is the medical field- to make a profit- you have to deny care- period. You can't run a profitable institution and focus on good care- can't do it- you have to determine cost effectiveness each time- and that usually means- someone has to be denied the best care available.

AS it stands- only the super rich can afford the best care. Only the middle class with companies that have an insurance plan or union that has negotiated a plan can expect even MEDIOCORE care.

47+ million can expect no care at all, until it is usually too late to get any care at all- just watch them die or suffer in the ER at that point.

Europe, and indeed, any country that has a health care system and is not third world, has far better care than we do.

here is the deal- I am a capitalist, and I truly believe that the capitalist system is the best path to ultimate freedom for all.

That being said- It is not the case in every aspect- a realist must understand that there are some areas that the profit motive is detrimental to the mission statement.

You simply can't give good care and and manage the bottom line at the same time in the medical field.

The insurance industry MUST deny claims to stay in business- they simply can't afford to pay all legitimate claims. T