Why the U.S. needs a National Health Program

Discussions for Patients, Family, and Friends HD For Patients
1

Looks like that other thread is getting a little long in the tooth so I thought I would start this and hope nobody minds.

I’ve read what private insurance has done with Medicare Advantage and I don’t see them adding any value except as a middle man trying to keep as much as they can for themselves:
http://www.pnhp.org/news/2007/december/curbing_medicare_adv.php

The 1300 or 1500 insurance companies hold no real leverage and will never be able to hold down health care costs, it’s the VA and Medicare holding down costs in areas like dialysis and drugs:
http://seniorjournal.com/NEWS/Politics/2007/7-01-12-ConsumersUnion.htm

Anyway, when I start something like this I like to add a couple of my favorite organizations:

Physicians for a National Health Program (great FAQs and articles):
http://www.pnhp.org/

Health Care for all Colorado (member, might be one in your state!)

2

Plugger,

Thanks for the information. I feel that Universal Healthcare will be the downfal to Midicare and other Programs if the government takes control. Anything the government gets there hands on, they just make it 10 times worse. How on earth will the government pay for the extra costs of Universal Healthcare.

  1. It will eventually drive private Insurance Companies out of business.
    1a. This will drive the members of the private Insurance to switch over the the Universal Plan thus raising costs even more.
  2. The government will make the rules, and they will be able to change the rules if its not working out as they originally planned.
  3. The government will decide what treatments you can get, which ones you have to wait for, and which ones it feels you dont need.
    3a. Say your 85 years old, heck your almost dead anyway, so why waste treatment on you when we could give it to somone else younger.
  4. There will not be as many Docturs training in a specialized area due to the government telling them what they must charge, thus adding to the waiting perioud you must wait to see a Doctor or schedule testing.

If you like the government telling you what you can and cannot do, vote for Universal Healthcare. You better start making your appointments now, because its going to take a lot longer for you to schedule testing/appointments.

What they need to do is fix the current Medicare program of overspending and Insurance Fraud. Medicare wastes more money than any other federal program. Medicare pays up to 8 times of what other federal programs pay for drugs/supplies.
Medicare reform could save the taxpayers 20-30 Billion per year. How about fixing this before they put their hands on something else they will mess up.

I could g oon and on…

I was looking at a thread located here: http://www.nxstageusers.com/forum/showthread.php?t=300
Plugger, perhaps you could add to their forum for you have provided information for the other side. We all have opinions and both sides should be respected.

3

[b]Pluggger, thanks for posting this and am also a BIG supporter for this reform. Competition is good and thats one way to force competitors to start dropping their prices.

Universal HealthCare is a YES for me![/b]

[QUOTE=plugger_;18027]Looks like that other thread is getting a little long in the tooth so I thought I would start this and hope nobody minds.

I’ve read what private insurance has done with Medicare Advantage and I don’t see them adding any value except as a middle man trying to keep as much as they can for themselves:
http://www.pnhp.org/news/2007/december/curbing_medicare_adv.php

The 1300 or 1500 insurance companies hold no real leverage and will never be able to hold down health care costs, it’s the VA and Medicare holding down costs in areas like dialysis and drugs:
http://seniorjournal.com/NEWS/Politics/2007/7-01-12-ConsumersUnion.htm

Anyway, when I start something like this I like to add a couple of my favorite organizations:

Physicians for a National Health Program (great FAQs and articles):
http://www.pnhp.org/

Health Care for all Colorado (member, might be one in your state!)
http://www.healthcareforallcolorado.org/[/QUOTE]

4

So, you must like waiting in long lines? I had a very dear friend who went to the VA, for cancer. I would not take my dog to VA. If we would eliminate drug regulations and mandates, medication costs would be about 15 percent of the current value. If you have health insurance, have you ever looked at the bill that you have received from the hospital? I will bet any amount of money, if you have health insurance, you paid much less for your stay that you would, if you did not have insurance. If you enjoy drug regulations and mandates, would you like to pay $75.00 for a bottle of Epogen or $600 for a bottle of Epogen? I know some individuals on this board who think it is great, that we are paying $600 for a bottle of Epogen. They are making these statements because they are not paying the cost, they only see benefits, not costs.

If we are so concerned with safety, why not reduce the speed limit on the expressway to 10m.p.h.? We do not do this because the cost would outweigh the benefit.

Former UpJohn Research Scientist Mary Ruwart, Ph.D. (BioPhysics):

Over-reaching FDA regulations have caused the premature deaths of millions of Americans, according to research scientist Mary J. Ruwart, Ph.D., who also said federal regulations passed in 1962 are responsible for more than 80 percent of the cost of today’s prescription drugs.

Ruwart, who is senior instructor with Burnet, Texas-based Sci-Com and adjunct associate professor of biology at the University of North Carolina in Charlotte, presented her findings on November 8 before the 2004 annual meeting of the American Association of Pharmaceutical Sciences in Baltimore, Maryland.

Instead of protecting Americans from unsafe drugs, Ruwart said, “these particular regulations, the 1962 Kefauver-Harris Amendments, have proven to be more deadly than all of the drug toxicity that occurred before their passage.” She estimated that between 1963 and 1999, 4.7 million people died prematurely while the medicines that could have saved them languished in mandated testing.

“The amendments saved a few thousand lives, but the cost was [in] letting millions die [while] waiting for treatment. That’s why the amendments are ‘excess’ regulation,” Ruwart said.

http://www.heartland.org/policybot/results/16131/Drug_Regulations_Cause_Millions_of_Deaths_Each_Year_Study_Finds.html

5

Dr. Mary Ruwart, Ph.D.:

In the early 1900’s, Americans could decide for themselves which drugs to take. Before the FDA came into being, American drug manufacturers usually gave their customers the best drugs that the state-of-the-art would allow. After all, killing the customer is bad business. Deaths due to inadequate testing were much less frequent than the deaths produced by today’s “drug lag.”

 The FDA is a cure worse than the disease. If the FDA can't meet its own criteria of being safe and effective, we are better off without it.

Isn’t it time we stopped denying ourselves and our loved ones life-saving drugs?

http://www.isil.org/resources/lit/death-regulation.html

6

Yes, competition is outstanding, we could not agree more on this issue. Yet, how can the private companies compete with a entity that is not required to show a profit?

7

Here’s Robert Reich, from Salon.com:

[b]Why critics of a public option for healthcare are wrong

Those opposing a public option – Big Pharma, the AMA, the insurers – are doing so out of economic self-interest[/b]

By Robert Reich

June 24, 2009 | Without a public option, the other parties that comprise America’s non-system of healthcare – private insurers, doctors, hospitals, drug companies and medical suppliers – have little or no incentive to supply high-quality care at a lower cost than they do now.

Which is precisely why the public option has become such a lightning rod. The American Medical Association is dead set against it, Big Pharma rejects it out of hand, and the biggest insurance companies won’t consider it. No other issue in the current healthcare debate is as fiercely opposed by the medical establishment and their lobbies now swarming over Capitol Hill. Of course they don’t want it. A public option would squeeze their profits and force them to undertake major reforms. That’s the whole point.

Critics say the public option is really a Trojan Horse for a government takeover of all of health insurance. But nothing could be further from the truth. It’s an option. No one has to choose it. Individuals and families will merely be invited to compare costs and outcomes. Presumably they will choose the public plan only if it offers them and their families the best deal – more and better healthcare for less.

Private insurers say a public option would have an unfair advantage in achieving this goal. Being the one public plan, it will have large economies of scale that will enable it to negotiate more favorable terms with pharmaceutical companies and other providers. But why, exactly, is this unfair? Isn’t the whole point of cost containment to provide the public with healthcare on more favorable terms? If the public plan negotiates better terms – thereby demonstrating that drug companies and other providers can meet them – private plans could seek similar deals.

But, say the critics, the public plan starts off with an unfair advantage because it’s likely to have lower administrative costs. That may be true – Medicare’s administrative costs per enrollee are a small fraction of typical private insurance costs – but here again, why exactly is this unfair? Isn’t one of the goals of healthcare cost containment to lower administrative costs? If the public option pushes private plans to trim their bureaucracies and become more efficient, that’s fine.

Critics complain that a public plan has an inherent advantage over private plans because the public plan won’t have to show profits. But plenty of private plans are already not-for-profit. And if nonprofit plans can offer high-quality healthcare more cheaply than for-profit plans, why should for-profit plans be coddled? The public plan would merely force profit-making private plans to take whatever steps were necessary to become more competitive. Once again, that’s a plus.

Critics charge that the public plan will be subsidized by the government. Here they have their facts wrong. Under every plan that’s being discussed on Capitol Hill, subsidies go to individuals and families who need them in order to afford healthcare, not to a public plan. Individuals and families use the subsidies to shop for the best care they can find. They’re free to choose the public plan, but that’s only one option. They could take their subsidy and buy a private plan just as easily. Legislation should also make crystal clear that the public plan, for its part, may not dip into general revenues to cover its costs. It must pay for itself. And any government entity that oversees the health-insurance pool or acts as referee in setting ground rules for all plans must not favor the public plan.

Finally, critics say that because of its breadth and national reach, the public plan will be able to collect and analyze patient information on a large scale to discover the best ways to improve care. The public plan might even allow clinicians who form accountable-care organizations to keep a portion of the savings they generate. Those opposed to a public option ask how private plans can ever compete with all this. The answer is they can and should. It’s the only way we have a prayer of taming healthcare costs. But here’s some good news for the private plans. The information gleaned by the public plan about best practices will be made available to the private plans as they try to achieve the same or better outputs.

As a practical matter, the choice people make between private plans and a public one is likely to function as a check on both. Such competition will encourage private plans to do better – offering more value at less cost. At the same time, it will encourage the public plan to be as flexible as possible. In this way, private and public plans will offer one another benchmarks of what’s possible and desirable.

Mr. Obama says he wants a public plan. But the strength of the opposition to it, along with his own commitment to making the emerging bill “bipartisan,” is leading toward some oddball compromises. One would substitute nonprofit health insurance cooperatives for a public plan. But such cooperatives would lack the scale and authority to negotiate lower rates with drug companies and other providers, collect wide data on outcomes, or effect major change in the system.

Another emerging compromise is to hold off on a public option altogether unless or until private insurers fail to meet some targets for expanding coverage and lowering healthcare costs years from now. But without a public option from the start, private insurers won’t have the incentives or systemwide model they need to reach these targets. And in politics, years from now usually means never.

To get healthcare moving again in Congress, the president will have to be clear about how to deal with its costs and whether and how a public plan is to be included as an option. The two are intimately related. Enough talk. He should come out swinging for the public option.

8

[QUOTE=Dori Schatell;18038]Here’s Robert Reich, from Salon.com:

[b]Why critics of a public option for healthcare are wrong

Those opposing a public option – Big Pharma, the AMA, the insurers – are doing so out of economic self-interest[/b]

By Robert Reich

June 24, 2009 | Without a public option, the other parties that comprise America’s non-system of healthcare – private insurers, doctors, hospitals, drug companies and medical suppliers – have little or no incentive to supply high-quality care at a lower cost than they do now.

Which is precisely why the public option has become such a lightning rod. The American Medical Association is dead set against it, Big Pharma rejects it out of hand, and the biggest insurance companies won’t consider it. No other issue in the current healthcare debate is as fiercely opposed by the medical establishment and their lobbies now swarming over Capitol Hill. Of course they don’t want it. A public option would squeeze their profits and force them to undertake major reforms. That’s the whole point.

Critics say the public option is really a Trojan Horse for a government takeover of all of health insurance. But nothing could be further from the truth. It’s an option. No one has to choose it. Individuals and families will merely be invited to compare costs and outcomes. Presumably they will choose the public plan only if it offers them and their families the best deal – more and better healthcare for less.

Private insurers say a public option would have an unfair advantage in achieving this goal. Being the one public plan, it will have large economies of scale that will enable it to negotiate more favorable terms with pharmaceutical companies and other providers. But why, exactly, is this unfair? Isn’t the whole point of cost containment to provide the public with healthcare on more favorable terms? If the public plan negotiates better terms – thereby demonstrating that drug companies and other providers can meet them – private plans could seek similar deals.

But, say the critics, the public plan starts off with an unfair advantage because it’s likely to have lower administrative costs. That may be true – Medicare’s administrative costs per enrollee are a small fraction of typical private insurance costs – but here again, why exactly is this unfair? Isn’t one of the goals of healthcare cost containment to lower administrative costs? If the public option pushes private plans to trim their bureaucracies and become more efficient, that’s fine.

Critics complain that a public plan has an inherent advantage over private plans because the public plan won’t have to show profits. But plenty of private plans are already not-for-profit. And if nonprofit plans can offer high-quality healthcare more cheaply than for-profit plans, why should for-profit plans be coddled? The public plan would merely force profit-making private plans to take whatever steps were necessary to become more competitive. Once again, that’s a plus.

Critics charge that the public plan will be subsidized by the government. Here they have their facts wrong. Under every plan that’s being discussed on Capitol Hill, subsidies go to individuals and families who need them in order to afford healthcare, not to a public plan. Individuals and families use the subsidies to shop for the best care they can find. They’re free to choose the public plan, but that’s only one option. They could take their subsidy and buy a private plan just as easily. Legislation should also make crystal clear that the public plan, for its part, may not dip into general revenues to cover its costs. It must pay for itself. And any government entity that oversees the health-insurance pool or acts as referee in setting ground rules for all plans must not favor the public plan.

Finally, critics say that because of its breadth and national reach, the public plan will be able to collect and analyze patient information on a large scale to discover the best ways to improve care. The public plan might even allow clinicians who form accountable-care organizations to keep a portion of the savings they generate. Those opposed to a public option ask how private plans can ever compete with all this. The answer is they can and should. It’s the only way we have a prayer of taming healthcare costs. But here’s some good news for the private plans. The information gleaned by the public plan about best practices will be made available to the private plans as they try to achieve the same or better outputs.

As a practical matter, the choice people make between private plans and a public one is likely to function as a check on both. Such competition will encourage private plans to do better – offering more value at less cost. At the same time, it will encourage the public plan to be as flexible as possible. In this way, private and public plans will offer one another benchmarks of what’s possible and desirable.

Mr. Obama says he wants a public plan. But the strength of the opposition to it, along with his own commitment to making the emerging bill “bipartisan,” is leading toward some oddball compromises. One would substitute nonprofit health insurance cooperatives for a public plan. But such cooperatives would lack the scale and authority to negotiate lower rates with drug companies and other providers, collect wide data on outcomes, or effect major change in the system.

Another emerging compromise is to hold off on a public option altogether unless or until private insurers fail to meet some targets for expanding coverage and lowering healthcare costs years from now. But without a public option from the start, private insurers won’t have the incentives or systemwide model they need to reach these targets. And in politics, years from now usually means never.

To get healthcare moving again in Congress, the president will have to be clear about how to deal with its costs and whether and how a public plan is to be included as an option. The two are intimately related. Enough talk. He should come out swinging for the public option.[/QUOTE]

Dr. Thomas Sowell, Ph.D.(Economics)
Rose and Milton Friedman Senior Fellow
The Hoover Institution
Stanford University

Alice in Medical Care

Most political and media discussions of medical care have an air of unreality reminiscent of Alice in Wonderland. There is an abundance of catch-phrases but remarkably few coherent arguments.

Let’s start at square one. Why is there alarm about American medical care? The most usual reason given is because its cost is high and rising.

That is certainly true. We were not spending nearly as much on high-tech medical procedures in the past because there were not nearly as many of them, and we were not spending anything at all on some of the new pharmaceutical drugs because they didn’t exist.

This general pattern is not peculiar to medical care. Cars didn’t cost nearly as much in the past, when they didn’t have air-conditioning, power steering and high-tech safety features. Homes were cheaper when they were smaller, had fewer bathrooms and lacked such conveniences as built-in microwave ovens.

We would like to have all these things without the rising costs that come with them. But only with medical care is such wishful thinking taken seriously, with government regarded as a sort of fairy godmother who will give us the benefits without the costs.

A cynic is said to be someone who knows the price of everything and the value of nothing. If so, then it is political cynicism to point to other countries that spend less on medical care, including some countries where there is “universal health care” provided “free” by their governments.

Just as medical care, houses and cars were all cheaper when they lacked things that they have today, so medical care in other countries is cheaper when they lack many things that are more readily available in the United States.

There are more than four times as many Magnetic Resonance Imaging units (MRIs) per capita in the United States as in Britain or Canada, where there are government-run medical systems. There are more than twice as many CT scanners per capita in the United States as in Canada and more than four times as many per capita as in Britain.

Is it surprising that such things cost money?

The cost of developing a new pharmaceutical drug is now about a billion dollars. Neither political rhetoric nor government bureaucracies will make those costs go away.

We can, of course, refuse to pay these and other medical costs, just as we can refuse to buy air-conditioned homes with built-in microwave ovens. But that just means we pay attention only to prices and not to the value of what we get for those prices.

We can even refuse to pay for so many doctors. But that just means that we will have to wait longer to see a doctor-- as people do in countries with government-run medical systems.

In Canada, 27 percent of the people who have surgery wait four months or more. In Britain, 38 percent wait that long. But only 5 percent of Americans wait that long for surgery.

Surgery may well cost less in countries with government-run medical systems-- if you count only the money cost, and not the time the patients have to endure the ailments that require surgery, or the fact that some conditions become worse, or even fatal, while waiting.

A recent report from the Fraser Institute in Canada shows that patients there wait an average of ten weeks to get an MRI, just to find out what is wrong with them. A lot of bad things can happen in 10 weeks, ranging from suffering to death.

Politicians may talk about “bringing down the cost of medical care,” but they seldom even attempt to bring down the costs. What they bring down is the price-- which is to say, they refuse to pay the costs.

Anybody can refuse to pay any cost. But don’t be surprised if you get less when you pay less. None of this is rocket science. But it does require us to stop and think before jumping on a bandwagon.

The great haste with which the latest government expansion into medical care is being rushed through Congress suggests that the politicians don’t want us to stop and think. That makes sense, from their point of view, but not from ours.

9

Massachusetts Health Care: A Model Not to Copy
by Phyllis Schlafly

The Obama-Kennedy health plan is modeled after the Massachusetts plan, which, when adopted, many applauded as innovative and destined for success. In fact, the Massachusetts plan has been a massive failure and is a model for what not to do.

It has increased costs. It has wasted taxpayer dollars. It has limited patients’ choice. It has hurt small business. It has failed to achieve its goal of universal coverage. Most objectionable, it has created shortages and waiting lists.

Promoters predicted that the Massachusetts plan would lower health-care costs, but – so far – costs are moving in the opposite direction. State government spending on health-care programs in Massachusetts has increased by 42 percent since the plan was adopted in 2006 and currently is 33 percent above the national average.

The Obama-Kennedy health plan is modeled after the Massachusetts plan, which, when adopted, many applauded as innovative and destined for success. In fact, the Massachusetts plan has been a massive failure and is a model for what not to do.

It has increased costs. It has wasted taxpayer dollars. It has limited patients’ choice. It has hurt small business. It has failed to achieve its goal of universal coverage. Most objectionable, it has created shortages and waiting lists.

Promoters predicted that the Massachusetts plan would lower health-care costs, but – so far – costs are moving in the opposite direction. State government spending on health-care programs in Massachusetts has increased by 42 percent since the plan was adopted in 2006 and currently is 33 percent above the national average.

Advocates promised that the Massachusetts plan would make health insurance more affordable, but according to a Cato study, insurance premiums have been increasing at nearly double the national average: 7.4 percent in 2007, 8 percent to 12 percent in 2008, and an expected 9 percent increase this year. Health insurance in Massachusetts costs an average of $16,897 for a family of four, compared to a national average of $12,700.

The Massachusetts plan incorporates a system of middle-class subsidies called Commonwealth Care to help pay for insurance for families with incomes up to 300 percent of poverty level ($66,150 for a family of four) and also expanded eligibility for Medicaid.

The Massachusetts Connector, a new bureaucracy that was supposed to increase patient choice, has become an overbearing regulatory arm of government that has decreased competition by prescribing benefits insurance must offer. The Connector is evidently unpopular with patients, since only 18,000 people have used the Connector to buy insurance during the past three years.

The Connector has imposed regulations that add to the cost of insurance and limit consumer choice, such as requiring prescription-drug coverage and preventive-care services, restricting high-deductible policies and putting limits on annual or per-sickness policies. Complying with the Connector’s rules means changing from your current insurance that you like.

The costs to the taxpayers are rising, too, and one tax increase has not satisfied the appetite of the hungry plan. The prospect of huge deficits has elicited discussion of cuts in reimbursements to providers and the imposition of a “global budget,” which is a euphemism for rationing.

Even though Massachusetts has more doctors per capita than any other state, the Boston Globe reports that waiting periods to see physicians have grown. The average wait is now 63 days to see a family doctor, 50 days to see a specialist and the second trimester of pregnancy to see an obstetrician-gynecologist.

If you want to see the busiest, most popular physicians, the wait can be up to a year. The longer waits are the result of thousands of newly insured residents coming into the health-care system.

Massachusetts has reduced the number of uninsured, but there are no reliable figures on how many are still uninsured since some statistics are based on telephone surveys that don’t reach significant groups of people who lack landline telephones (such as young people and illegal aliens). Cato estimates that 200,000 are still uninsured.

If the number of uninsured had been measurably reduced, that should be reflected in the use of hospitals’ emergency care facilities for uncompensated care. But hospitals don’t confirm this effect.

Small business is hurting, too. The Small Business and Entrepreneurship Council ranks Massachusetts last of all the 50 states for business-friendly health-care policies.

A June 21 front-page article in The New York Times reported that one cancer unit in a Philadelphia Veterans Administration hospital bungled 92 of 116 prostate cancer treatments over six years (requiring these patients to undergo a second operation) before the errors were discovered. The real problem is that the government cannot run health care safely (or cheaper).

Canada is another model of what not to do. It’s fortunate that Canada is so close to the United States because Canadians rely on American medicine for serious surgery.

De facto rationing in Canada is practiced by waiting lists rather than by using its realistic name. The Globe and Mail in Toronto reports that the physician shortage is so acute that some towns hold lotteries to win a ticket granting access to the local doctor and that Ontario sent 160 patients to New York and Michigan for emergency neurosurgery between 2006 and 2008.

Although President Obama told the American Medical Association that single-payer (government-controlled) health care works “pretty well” in some other countries, no government has ever been able to run a health-care system as well as private enterprise. Less regulation of health care, not more government control, is the way to healthier Americans and lower costs.

10

[QUOTE=Dori Schatell;18038]Here’s Robert Reich, from Salon.com:

[b]Why critics of a public option for healthcare are wrong

Those opposing a public option – Big Pharma, the AMA, the insurers – are doing so out of economic self-interest[/b]

By Robert Reich

June 24, 2009 | Without a public option, the other parties that comprise America’s non-system of healthcare – private insurers, doctors, hospitals, drug companies and medical suppliers – have little or no incentive to supply high-quality care at a lower cost than they do now.

Which is precisely why the public option has become such a lightning rod. The American Medical Association is dead set against it, Big Pharma rejects it out of hand, and the biggest insurance companies won’t consider it. No other issue in the current healthcare debate is as fiercely opposed by the medical establishment and their lobbies now swarming over Capitol Hill. Of course they don’t want it. A public option would squeeze their profits and force them to undertake major reforms. That’s the whole point.

Critics say the public option is really a Trojan Horse for a government takeover of all of health insurance. But nothing could be further from the truth. It’s an option. No one has to choose it. Individuals and families will merely be invited to compare costs and outcomes. Presumably they will choose the public plan only if it offers them and their families the best deal – more and better healthcare for less.

Private insurers say a public option would have an unfair advantage in achieving this goal. Being the one public plan, it will have large economies of scale that will enable it to negotiate more favorable terms with pharmaceutical companies and other providers. But why, exactly, is this unfair? Isn’t the whole point of cost containment to provide the public with healthcare on more favorable terms? If the public plan negotiates better terms – thereby demonstrating that drug companies and other providers can meet them – private plans could seek similar deals.

But, say the critics, the public plan starts off with an unfair advantage because it’s likely to have lower administrative costs. That may be true – Medicare’s administrative costs per enrollee are a small fraction of typical private insurance costs – but here again, why exactly is this unfair? Isn’t one of the goals of healthcare cost containment to lower administrative costs? If the public option pushes private plans to trim their bureaucracies and become more efficient, that’s fine.

Critics complain that a public plan has an inherent advantage over private plans because the public plan won’t have to show profits. But plenty of private plans are already not-for-profit. And if nonprofit plans can offer high-quality healthcare more cheaply than for-profit plans, why should for-profit plans be coddled? The public plan would merely force profit-making private plans to take whatever steps were necessary to become more competitive. Once again, that’s a plus.

Critics charge that the public plan will be subsidized by the government. Here they have their facts wrong. Under every plan that’s being discussed on Capitol Hill, subsidies go to individuals and families who need them in order to afford healthcare, not to a public plan. Individuals and families use the subsidies to shop for the best care they can find. They’re free to choose the public plan, but that’s only one option. They could take their subsidy and buy a private plan just as easily. Legislation should also make crystal clear that the public plan, for its part, may not dip into general revenues to cover its costs. It must pay for itself. And any government entity that oversees the health-insurance pool or acts as referee in setting ground rules for all plans must not favor the public plan.

Finally, critics say that because of its breadth and national reach, the public plan will be able to collect and analyze patient information on a large scale to discover the best ways to improve care. The public plan might even allow clinicians who form accountable-care organizations to keep a portion of the savings they generate. Those opposed to a public option ask how private plans can ever compete with all this. The answer is they can and should. It’s the only way we have a prayer of taming healthcare costs. But here’s some good news for the private plans. The information gleaned by the public plan about best practices will be made available to the private plans as they try to achieve the same or better outputs.

As a practical matter, the choice people make between private plans and a public one is likely to function as a check on both. Such competition will encourage private plans to do better – offering more value at less cost. At the same time, it will encourage the public plan to be as flexible as possible. In this way, private and public plans will offer one another benchmarks of what’s possible and desirable.

Mr. Obama says he wants a public plan. But the strength of the opposition to it, along with his own commitment to making the emerging bill “bipartisan,” is leading toward some oddball compromises. One would substitute nonprofit health insurance cooperatives for a public plan. But such cooperatives would lack the scale and authority to negotiate lower rates with drug companies and other providers, collect wide data on outcomes, or effect major change in the system.

Another emerging compromise is to hold off on a public option altogether unless or until private insurers fail to meet some targets for expanding coverage and lowering healthcare costs years from now. But without a public option from the start, private insurers won’t have the incentives or systemwide model they need to reach these targets. And in politics, years from now usually means never.

To get healthcare moving again in Congress, the president will have to be clear about how to deal with its costs and whether and how a public plan is to be included as an option. The two are intimately related. Enough talk. He should come out swinging for the public option.[/QUOTE]

First, I have never worked for anyone in the medical profession, insurance companies, or Big Pharma, which I absolutely detest. Robert Reich worked for President Clinton. Reich has made claims in the past that have been false. In the Clinton administration, Reich complained about the wages of CEO’s to the average line worker. Yet, what Reich did not mention that the CEO’s wages were being compared to the wages of the part-time worker, a vast difference compared to CEO wages against that of a full-time worker.

Reich: Without a public option, the other parties that comprise America’s non-system of healthcare – private insurers, doctors, hospitals, drug companies and medical suppliers – have little or no incentive to supply high-quality care at a lower cost than they do now.[/b]

NDXUFan: We would have an incentive to lower costs with patient power, without government control and rationing. Patients will have control when they are spending their own money. With increased profits, the supply of physicians will greatly esclate, in all fields of medicine. If you dislike your physician or facility, with increased physician and facility supply, you would simply change physicians or facilities. When profits increase, supply of that commodity will also increase. For example, most people that are attending medical school have many options in other fields such as biology, chemistry, geology, and physics. Now, if you had those options, would you choose to be a primary care physician with low reimbursement rates, and 24/7 on-call schedules, as opposed to working in other fields, without low reimbursement or low income earings, along with not being obligated to a 24/7 calls? Think about it. The laws of economics do not change for Reich or any other government bureaucrat.

Reich: Critics say the public option is really a Trojan Horse for a government takeover of all of health insurance. But nothing could be further from the truth. It’s an option. No one has to choose it. Individuals and families will merely be invited to compare costs and outcomes. Presumably they will choose the public plan only if it offers them and their families the best deal – more and better healthcare for less.

NDXUFan: Yes, the public option is a attempted takeover of health care by the government. Mr. Reich, I have listened to people with your line of thinking at the University for years and years, they support a government takeover of healthcare and they have pronounced their support for this idea over the years, time and again. To prove my point, let us look at the non health care issue of interest rates. When you have excessive government borrowing, this crowds out private borrowing.

Professor John Taylor in the Financial Times:

"I believe the risk posed by this debt is systemic and could do more damage to the economy than the recent financial crisis. To understand the size of the risk, take a look at the numbers. The deficit in 2019 is expected by the CBO to be $1,200bn (€859bn, £754bn). Income tax revenues are expected to be about $2,000bn that year, so a permanent 60 per cent across-the-board tax increase would be required to balance the budget. Clearly this will not and should not happen. So how else can debt service payments be brought down as a share of GDP?

Inflation will do it. But how much? To bring the debt-to-GDP ratio down to the same level as at the end of 2008 would take a doubling of prices. That 100 per cent increase would make nominal GDP twice as high and thus cut the debt-to-GDP ratio in half, back to 41 from 82 per cent. A 100 per cent increase in the price level means about 10 per cent inflation for 10 years. But it would not be that smooth – probably more like the great inflation of the late 1960s and 1970s with boom followed by bust and recession every three or four years, and a successively higher inflation rate after each recession."

NDXUFan: In the real world, Mr. Reich, Government health care will crowd out private insurance. By the way, Mr. Reich, have you ever worked in the private sector?

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Reich: Private insurers say a public option would have an unfair advantage in achieving this goal. Being the one public plan, it will have large economies of scale that will enable it to negotiate more favorable terms with pharmaceutical companies and other providers. But why, exactly, is this unfair? Isn’t the whole point of cost containment to provide the public with healthcare on more favorable terms? If the public plan negotiates better terms – thereby demonstrating that drug companies and other providers can meet them – private plans could seek similar deals.

NDXUFan: The answer to this claim is simple, let health insurance policies sell their policies across state lines, creating massive economies of scale. Mr. Reich, the reason we do not have large health insurance economic scales is because of restrictions and mandates from your beloved government. For example, when I was in the hospital for a week, with a staph infection, the market price for that stay was $42,000.00 dollars. Yet, with the insurance company contracts, the total bill was $7,500.00 for my week of treatment. With allowing health insurance plans to sell policies across state lines, this will create an even greater economy of scale, benefiting patients and families. If I go to purchase a car from Honda and I think that the price for the car is too high, I walk across the street to buy from Toyota or Ford. What does a patient or family do, if the government insurance plan is the only game in town, they refuse to pay for my treatment, should I be left to die? Is your life more important because you are a government bureaucrat who thinks the public is just too stupid to understand health care?

An example of your wonderful health system:
http://www.civitas.org.uk/pdf/cw55.pdf

Roger Altman is an investment banker, private equity investor and former United States Deputy Treasury Secretary under Bill Clinton. http://online.wsj.com/article/SB124631646572370703.html

Only five months after Inauguration Day, the focus of Washington’s economic and domestic policy is already shifting. This reflects the emergence of much larger budget deficits than anyone expected. Indeed, federal deficits may average a stunning $1 trillion annually over the next 10 years. This worsened outlook is stirring unease on Main Street and beginning to reorder priorities for President Barack Obama and the Democratic congressional leadership. By 2010, reducing the deficit will become their primary focus.

Why has the deficit outlook changed? Two main reasons: The burst of spending in recent years and the growing likelihood of a weak economic recovery. The latter would mean considerably lower federal revenues, the compiling of more interest on our growing debt, and thus higher deficits. Yes, the President’s Council of Economic Advisors is still forecasting a traditional cyclical recovery – i.e., real growth of 3.2% next year and 4% in 2011. But the latest data suggests that we’re on a much slower path. Probably along the lines of the most recent Goldman Sachs and International Monetary Fund forecasts, whose growth rates average about 2% for 2010-2011.

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Reich:
But, say the critics, the public plan starts off with an unfair advantage because it’s likely to have lower administrative costs. That may be true – Medicare’s administrative costs per enrollee are a small fraction of typical private insurance costs – but here again, why exactly is this unfair? Isn’t one of the goals of healthcare cost containment to lower administrative costs? If the public option pushes private plans to trim their bureaucracies and become more efficient, that’s fine.

NDXUFan: I hate bureaucrats, pure and simple. However, Mr. Reich is stating that administrative costs are lower with the government than in the private sector. Really? Mr. Reich, what about the pension and benefit costs for government employees when they retire? Please take a look at California. The costs for government administration may be lower in the beginning, but, you are not looking at total costs for retirement pension and benefit costs. One of the reasons that the government may have lower costs is that they can say to an government employee or private health provider, “This is what we are going to pay, take it or leave it.” Again, Mr. Reich is just looking at premium costs and not total costs. Mr. Reich, what about the $.15 cents per dollar sales taxes that Canada pays for health care? What about the excessive income tax rates paid by taxpayers? Premiums, sales taxes, income taxes, and a possible VAT(Value Added Tax). The amount of taxes demand by this public plan are much higher than private health insurance administrative costs? What say you, Mr. Reich?

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Reich:

Critics complain that a public plan has an inherent advantage over private plans because the public plan won’t have to show profits. But plenty of private plans are already not-for-profit. And if nonprofit plans can offer high-quality healthcare more cheaply than for-profit plans, why should for-profit plans be coddled? The public plan would merely force profit-making private plans to take whatever steps were necessary to become more competitive. Once again, that’s a plus.

NDXUFan: I fail to see the benefit of borrowing trillions upon trillions of dollars to finance a public health care option. Mr. Reich, in case you have been unware, the individuals from foreign companies have said that they are thinking twice about buying United States Government bonds. What is going to happen when foreign investors fail to buy our debt, will you try to compel them to buy our debt, fat chance. Some have suggest that the Chinese will demand we pay all of our debt bonds at time, not going to happen, because then with so many bonds on the market, those bonds will be worthless. The Chinese and other investors are enabling us to live beyond our means. No one has said or claimed that for profit companies should be coddled, if they are incompetent, they will be driven out of business by the market. Incompetent companies who are wasting resources of our nation and should be forced to file bankruptcy.

If non-profit health care plans can push high quality and excellent access to health care, why are they not doing it? Competition across state lines would force for profit insurance companies to be competitive. We have competition in every other sector of our economy, why not health care? The main reason that private insurance is so expensive is because of your crowd pushing thousands of health care mandates, regulation equals cost.

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None other than BusinessWeek seems to refute that. Looks like another case of critics trying to use an isolated incident to put down the whole system. If it had happened at one of these hospital chains I would be willing to bet they would be trying to cover it up, and would be looking forward to charging patients for that second operation.

BEST MEDICAL CARE IN THE US

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Have had a hard time getting on the board, will comment on the rest of this article, later. How do you add millions of people on Medicare and cut costs?

Reich:
Critics charge that the public plan will be subsidized by the government. Here they have their facts wrong. Under every plan that’s being discussed on Capitol Hill, subsidies go to individuals and families who need them in order to afford healthcare, not to a public plan.

NDXUFan: If the Government is paying the bill for the subsidized insurance, how will the family afford private insurance when the government is not paying enough money for the family to afford private insurance? What other choice will they have other than the public plan? More later.

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Do have to agree with you on Massachusetts though NDXUfan12, problem looks to me to be they let the problem in the door - private health insurance.

Anyway, Frontline did a great program on countries delivering excellent health care at a whole lot less than we are (Taiwan was my favorite):
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/ (can watch whole program or in segments)

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Plugger:

Anytime that you add too many people thru government or private insurance without enough physicians to meet demand, you are going to have a waiting span. We do not have enough physicians because of low reimbursements. I will be happy to watch the program. :slight_smile:

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Look at the people from other countries who have national healthcare - what are they doing - Coming to the United States because of the long wait for basic medical care.

No the current system is not perferct. it needs fixed of all of the waste and fraud. fix this instead of adding to the confusion.
Let us shop around from state to state for healthcare. This will drive costs down due to competition.
We do not need the government to make the rules and change them when they feel ike it because it is not going as planned.
The US doesnt have the money to pay for all of the programs they sneek through in the middle of the nite as it is and they want to run, i mean ruin the healthcare system more than it is. What has the government ever done that has successed. You could probably count on one hand.

An example is Medicaid. The states over inflate the costs in order to obtain more funding. This is the problem. This is what they need to fix.
Instead of giving billions away from the taxpayers to banks and car companies, they should do something that will actually help individuals.
The government is not going to save the world, they should try saving America first…

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[QUOTE=Unregistered;18050]Look at the people from other countries who have national healthcare - what are they doing - Coming to the United States because of the long wait for basic medical care.

No the current system is not perferct. it needs fixed of all of the waste and fraud. fix this instead of adding to the confusion.
Let us shop around from state to state for healthcare. This will drive costs down due to competition.
We do not need the government to make the rules and change them when they feel ike it because it is not going as planned.
The US doesnt have the money to pay for all of the programs they sneek through in the middle of the nite as it is and they want to run, i mean ruin the healthcare system more than it is. What has the government ever done that has successed. You could probably count on one hand.

An example is Medicaid. The states over inflate the costs in order to obtain more funding. This is the problem. This is what they need to fix.
Instead of giving billions away from the taxpayers to banks and car companies, they should do something that will actually help individuals.
The government is not going to save the world, they should try saving America first…[/QUOTE]

Having worked for the government, I agree. Foreign aid is 1 percent of the Federal Budget.

Mark

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I’ve learned the to trust the government more with infrastructure: roads, fire protection, police, military, public utilities, and yes many times health care. Sometimes it makes more sense just to throw the money in a pot and take what is needed from there.

I would also add to that list drug research. It is expensive to do basic research and these drug companies won’t tell you how they let the government pull the heavy load when it comes to research and that 15 of 21 blockbuster drugs from '65 to '92 came from government research:
http://www.newamerica.net/publications/articles/2004/plunder_drugs

But getting back to waiting times, if we went to a national health program there might be some waiting while the medical system catches up with all the uninsured, might have to prioritize according to need rather than insurance and money - wouldn’t that be a pity.

Anyway, I understand Taiwan with it’s system similar to Canada’s is claiming NO waiting times. And this study by the Commonwealth Fund is showing Germany, not the US, with the shortest waiting times:

(click on smaller middle image beneath the main image)
http://www.commonwealthfund.org/Content/Performance-Snapshots/International-Comparisons/International-Comparison--Access---Timeliness.aspx