Your stand on universal healthcare
 

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Kind of an open ended question.

Becoming a new RN I have some insight that I never used to have.

I see people suffering all the time, either from the disease process itself or the mental anguish of finding out what this has done to their family's finances.

You'll get all sorts of opinions on this but I feel that there MUST be a better way. We live in a great country that is full of bright energetic people who can (and should IMO) figure something out that will provide quality preventive care along with top notch acute care.

I'm hopeful!

Russ

Not a good Idea. Tell me which universal health care system works as well as ours.

Yoda

Define "works"... By all standard benchmarks developed by industrialized countries to measure health, The USA is way down toward the bottom (despite the fact that we spend more per capita than ANY other country). I would recommend forum members go to www.pnhp.org to learn how damaged the current health care industry really is.

HMSA works
 

I have lived all over and had health insurance through my husbands employment for the last 32 years, But as a kid I didn’t, we never went to the doctor unless we where really at deaths door. In Hawaii I experienced HMSA. As I understand it(And I could be wrong) when insurance companies first wanted to write in HI. The state government said we are one people you will charge the same for all Hawaiians or not write here. Guess what they chose not to do business in HI. HMSA was developed by the doctors and hospitals to fill the gap. Everyone in Hawaii is covered either by their employer or by the state all at the same per person rate. People in Hawaii are very poor. The difference between the wages that regular working class people earn compared to the cost of living is huge, But all have health care. If it works for Hawaii why not the rest of us?

I know it's nit-picking, but it's "national" health care, not "universal."

Highly idyllic, but in the hands of "government control," it would drag all health care to its lowest common denominator and have more regulation than the current tax code.

Imagine having government administrators managing a "National HMO." What a concept!

Let's Start With Some Basics
 

Healthcare for Americans has been primarily the product of insurance plans negotiated by employers and offered by private insurance companies. For those of us that have coverage, it's become dramatically more expensive over the last decade or so. At the same time, payments to providers--with the exception of the pharmaceutical companies--have declined to the point where doctors and hospitals are being very selective on which insurance companies they will accept for assignment. Many big city doctors and hospitals won't accept Medicare anymore. And in Illinois, a large group of hospitals and doctors have opted not to accept the largest insurer in the state, Blue Cross-Blue Shield.

At the same time this is happening to those of us that are insured, there are 50 million Americans--almost 20% of our population--that have no health insurance at all. If they get sick or are injured, their only option is a hospital emergency room which, when they can't pay the bill, adds to the cost that must be shared by the rest of us.

THE PRIVATE SYSTEM OF HEALTHCARE INSURANCE THAT WE HAVE NOW ISN'T WORKING!

Clearly, something needs to be done to correct the problems I've cited. I'm sure there are all kinds of possibilities that will be discussed by Congress. The opponents of any form of government healthcare insurance will wail that the government will become our health care provider, they will pick our doctors and prescribe our treatment. That allegation will circulate, even on this forum, even though no one--NO ONE--has proposed that to be the case. The worst scenario I've heard is that the government will provide an insurance option, but that everyone will have the right to remain with their existing insurer if they so choose. But the plans being discussed will provide for healthcare coverage for the 50 million or so who don't currently hve coverage.

If in the process of legislating a plan, some of the abuses that have resulted from the lobbying of special interests--the effect of the pharma lobby on the Medicare prescription bill is a good example--so much the better.

I only hope that as a country we can afford to pay for a plan that private companies have failed horribly to provide.

A one payer system
 

someone suggests! Name ONE government system that is not rife with cost over runs, pork, and special interests. What else would you like the government to own/run? Cradle to grave care such as in Sweden? Subsided steel as in the UK.

At what cost are YOU willing to be taxed to provide health care to others?

The countries that provide government health care are some of the highest taxed in the world. You like their health care, see what they pay in taxes at:

http://en.wikipedia.org/wiki/Tax_rat...e_world#Graphs

Imagine non-gov't private CEO's running our largest financial institutions... Likewise, the insurance industry has recently had a number of embarassing blemishes related to fraud... one example right here in Florida.

:agree: This subject should not even be an issue until the country gets it's head well above water. And when it does..it should die a quick death.

Anything the government runs will be filled with pork and bureaucrats. It would be 10 times as bad as the education bureaucracy. Reagan should have eliminated that when he had the chance, too.

Whenever we want more than what we have, because what we have now is imperfect and we know there must be a better way, the easy way out is - let the government do it.

The problem is that government, specifically the politicians who realize money and regulation is their bread and butter, is all too ready to take more money and write more regulations. Unfortunately, more money and more regulation does not make something better, but it does make it more expensive.

"Free" health care is like a free lunch - it isn't. And the quality of free stuff never seems to be worth much either.

We abhor it when insurance number-crunchers determine if a procedure will be authorized or not. How will it be with government number-crunchers? What will be the job description and pay scale for the government employee who will decide - based on to-be-written regulations - what health care will be authorized and to whom and under what conditions? How will it be truly any different (or better) than what exists now?

Before we jump to wanting national health care, take a hard look at operations such as the Indian Health Service which provides health care to American Indians and Alaska Natives (see http://www.ihs.gov/index.cfm?module=About and http://64.38.12.138/News/2008/008277.asp and http://www.nysun.com/national/senate...th-care/71935/ ). Is this what we can expect - expansion of efforts like this?

Exactly. In Boston we call it the Big Hackerama. People that are connected get on the payrolls whether their qualified or not. It becomes a place for politicians to get their nephews and god-sons a hack-job.
In the dreaded private sector...payrolls don't get padded. Companies answer to boards and the stock-holders.
Who do the government employees answer to???? More agencies, departments, CZARS, etc. Government has been too top heavy for too long and we don't need to add to it. IMNSHO

I am not in favor. To supply all health care will mean a watering down of what most
 

of us have today to spread it to those who have nothing today. Then to make up the shortfall of what is not provided we will have to get a private supplement.
If you think you get to keep what you are provided today while they work in the have nots....you are mistaken.

Furthermore, it is a program that is destined to fail....will take forever to get passed....AND IS A DISTRACTION TO MR. OBAMA AND HIS CONGRESS TO FIX THE ECONOMY as promised to get elected.

The economy first before all the other fluff programs.

BTK

Single-payer health insurance
 

We already have a low-cost, single-payer system health insurance system. It is about health insurance, individuals have freedom of choice in selecting providers, administrative costs average 4% vs. 14% for private insurance carriers -- it's called Medicare!
Let's simply expand coverage to people under 65, DUH!
There are no waiting lines in Canada (I have spoken with Canadian consumers and not listened to the crapola from the lobbyists and their radio acolytes). Canadians love the system, the freedom of choice and the low insurance rates.
What are we waiting for?

Everytime when I am golfing and get paired up with Canadians I always ask them if they would trade their current health care system for ours. I know it's an unscientific poll but, to date, 100% emphatically say NO!

The above Medicare example is correct.

I would suspect that most who argue against universal coverage are all covered and quite comfortable.... and view the uninsured as a bunch of welfare losers looking for a free ride. Wrong--the majority of the uninsured are hard working Americans who make too much for medicaid, are too young for medicare and whose employer doesnt offer insurance. What do you recommend to provide health care for this group of people?????

Don't forget the VA, and TriCare for Life for military and vets.

Kahuna, why is it that you describe those who oppose the government's active role in national health care as "wailers" while you cloak your own support with a superior, aloof, pedantic Obamaesque attitude?

Like Obama, you state your case eloquently and intelligently but without the ever present teleprompter. However, do you really understand what is going on? Have you read Tom Daschle's book, "Critical: What We Can Do About the Health-Care Crisis"? The book is a boilerplate for the Obama Health Plan albeit an unoriginal ripoff of Britain's health care system. The significance of the book is that Daschle was selected to be Obama's Health Czar or Health and Human Services Secretary and sell the plan to Congress and the American people. Unfortunately or fortunately, depending on your perspective, he was derailed by a little $140,000 tax oversight for "consulting", (aka lobbying?), he was paid for. That and the chauffeured car he had at his disposal owned by whoever. I digress.

His proposal, largely lifted from the Brits, who by the way are largely not fond of it, calls for merging of employers' plans, Medicaid and Medicare with an expanded FEHBP (Federal Employee Health Benefits Program), no problem so far. However the system would be under the control of a Federal Health Board and you know what Federal implies as to control. Therein is the root of my opposition and "wailing". Do you think politics could enter the equation? Do you think politics could enter the life and death decision making? Let me explain further.

The essence of the plan is scary. It is built around and rooted in cost-effectiveness comparisons. Sounds like it could save money what with all that cost effectiveness overtone but I suspect it would be largely at the price of limiting patient access to certain medical treatments as determined by the Federal Board controlled by who?

In reality, medical treatment would be rationed according to "cost effectiveness as determined by the government. The British counterpart is called NICE for the National Institute for Health and Clinical Excellence. I talked to Brits just last week, who say most of their countrymen hate NICE. NICE apparently gets to decide who is going to get treatment and who is not, who is going to live, who is going to die. I understand the reality and economies of scale that could be realized and even heard a doctor support the concept. I am just not ready to abdicate to the government the right to decide who lives and dies in my family or any American family. Rank me with the "wailers" you mock if you wish, but I am not confident Obama and the government can distinguish and decide with political detachment such important considerations. If my recall of history hasn't left with my short term memory, didn't that little Austrian house painter in 1939 try to decide who was worthy of saving with medical treatment and who was not?

Further, the temptation to bait and switch in favor of power, is just to great for Washington to pass up. Who in the capitol is courageous enough to say what the Obama administration's true intention is......I believe it is to control health care in America at all costs. Banking, the automobile industry, health care, pharmaceutical vis-a-vis healthcare.........totalitarianism. Maybe that's just me "wailing".

Have a good evening in the Villages.

I'm all for it. Hopefully we that now can afford good health won't find ourselves being needy and w/o it. That's all I'm going to say.

P.S. I thought this was a poll and not another political platform. I'm sorry to say that so many posts are turning very political on TOTV.

From 1988-2003, I had health insurance from my employer, and it WORKED REAL WELL. I haven't had health insurance for 6 years. I am in good shape and work-out regularly. I know I can get sick and lose it all but I would rather not have any then to have a watered-down version of what I had before.
Hopefully, I'll find better employment that has good insurance.

Healthcare?

Let's see, Medicare and Social Security are both bankrupt as well as the entire Government in general. Hum...

Funny Thing About Sweden
 

Actually, there are some interesting facts about all of Scandanavia. A survey done last year, primarily among Swedes, Danes and Norwegians, showed that they were consistently happy with their way of life and their governments. A surprising section of the survey was a series of questions regarding where else in the world they would like to live and why. And where in the world they absolutely would not want to live.

On that last set of questions, the Scandanavians were almost unanimous in their opinion that they definitely would not want to live in the U.S. They felt that they enjoyed a better standard of living, better healthcare, better education, a more stable economy and were generally happier with their lives than any Americans that they knew. They had a uniformly high regard for the performance of their elected government. A high percentage of the survey respondents had visited the U.S. and had formed their opinions first-hand.

It was an eye-opener for those of us who think we have it pretty good here in the old homeland. Yes, the Swedes pay higher taxes than we do. But they believe they're getting their moneys worth, seemingly borne out by many of the country comparison statistics. It seems to beg the question of how satisfied we are with our elected officials and the governance they provide?

Let me see a poll is placed in the Political Forum...right?
 

And we should refrain from commentary because it is political?
And if this poll was placed in TV non general discussion, would it be OK to comment?
No struggle no progress. Stand and be counted. If ya don't like the heat stay outta da kitchen. The more the merrier.
Down with the SILENT majority:a20::beer3:

btk

Gee man...you make it sound so good....what are you waiting for?????????

We're A Long Way From Really Having Anything To Discuss
 

Here's an article from the most recent issue of the AARP Bulletin.

Basically, Congress and the special interests are still so early in the "discussion" stages of any kind of legislation, that there really is very little for us to argue about here.

Then, when all gets said and done, the question of whether we can afford whatever plan is put on the table will remain. All I can say is that it would be a shame--an indictment of our system, really--if the most developed country in the world can't come up with an affordable way to provide healthcare to almost 20% of it's population.

Here's the article explaining how early in the process we really are...

http://bulletin.aarp.org/yourhealth/...lthreform.html

Yea, we have developed a huge national debt
Yea, we have developed high unemployment
Yea, we have developed the fall of capitalism
Yea, we have developed panic in the business sector
Yea, were developing into the world's laughing stock...
I'll be back...I have some more developments......:confused:

Are you hangin' onto that stateroom on the Titanic?
 

That very best stateroom on the Titanic line is from this article from Business Week. It's a comment made by some think tank guy about those who cling to the status quo in this health care fight. It also can apply to those who have coverage and figure to heck with anybody who does not.

I am fiscally conservative. A moderate mostly about other things political. I have health care coverage. But I know something has to give. Somehow. Some way. And I think some kind of solution would be good for business. People could retire early and open jobs. And rising premium costs would not swallow small business whole. Oh and btw, I get the thing about the taxes. But there are CEO's who think the trade-off could be a good one. They want out of the business of health care.

The article is about CEO's who are secretly wishing for health care reform. They want out of having to provide health care coverage. The horrendous costs are making it more and more impossible for them to compete.

CEO's, the gods of capitalism. Some of them are pretty darn smart people. CEO's thinking that health care costs are killing their competitive edge. (Ya think?) A few are actually saying it out loud. But I'll just bet there is a silent majority.

So before some of you go all knee-jerk on me, maybe take a look at this article. You cannot get much more capitalistic than a CEO.

http://www.businessweek.com/magazine...1023543934.htm

Boomer

KayacerNC, I suggest you not praise the VA system until you have been in it. My personal experience is with the VA Hospital Gainesville and VA support for needed drugs. I was transfered to VA Gainesville, when I was diagnosed with double pneumonia here in the Villages. I was patient 5 in a 6 bed ward. While my temp spiked between 104 and 105, there was virtually no nursing care. As I got better, I realized that there were others in the ward that were in worse shape than I. The staff was upset that I was doing that which was needed and that which they were unwilling to do. As to drugs, I have taken Plavix for several years now to control a series of TIA's. It worked and both I and my civilian Neurologist felt it should be continued. The VA 'guidelines' require that Plavix be eliminated after two months wo further problems. My neurologist described this as malpractice and provided me with continuing prescriptions until such a time as I was able to go on Medicare. My brother, a highly decorated vet of WWII (Silver star and three purple hearts) and intense combat in Korea had similar problems when he became ill with brain cancer. His son, who had the actions to act took him to the Mayo Clinic in MN. They were able to extend both his life and the quality of it. His widow is now getting the same runaround.

In another thread, Steve Z pointed out that when health care is rationed, the elderly could expect to be awarded treatment on their potential future value to society. He's right. A single payer system will set us on the road to euthanasia by neglect.

We already have Natl. Health Care in practice.......it is call the Veterans Administration Hospitals......and haven't they just done a wonderful bang-up job for our veterans who come home armless, legless, missing many parts, just to be pushed into corners waiting for help. A disgrace to the uniform, the country, and our government. So how the heck would you expect them to run a natl. health care program? Easy......just like Canada. Stack the patients up, and watchem expire before any care is given.

The majority of bankruptcies in this country are caused by health care bills. So fixing our health care payment system may be a big piece of improving our economy. You're calling the health care system FLUFF?

And as someone mentioned, our companies are currently being strangled by health insurance budgets. Let's face it, the health care payment system needs to be changed or cost curbs (efficiencies) need to be enacted. I don't know which model would work best but the current one is broken.

And Keedy: I don't see what is wrong with loving the country you are in (USA in our case) yet still wanting to see improvements made as we progress. Yes we can learn things from other countries and formulate a plan that will work for us.

A couple of references: (2005) http://www.consumeraffairs.com/news0...tcy_study.html

(2009) http://voices.washingtonpost.com/hea...=moreheadlines

I'm for an affordable system that both private and some national program can compete against each other. I have health insurance as does my husband - premiums $9000 a year with a $1250 deductible. These are company subsidized programs from our retirement from insurance companies. The $9000 per year is what the 2 of us pay together. Our medications cost $1600. every quarter so we were glad to get it until we are old enough for medicare. I don't know what we would do if our granddaughters lost their coverage.

FYI... medical care is ALREADY rationed... spend some time learning about the "PRIOR AUTHORIZATION" process. Everyday in my office I need to smooch the behinds of dozens of insurance functionaries to allow pts to return for a certain # of visits, a certain type of medication, MRI scans etc. You need to spend a day in my shoes for an eye-opener.

Well said Doc! As a nurse I don't deal with the financials but I do deal with the worry and the concern the patients have over what their illness is going to cost them. Anxiety can worsen their already fragile state and it should be the last thing a patient is worrying about.

All the above are good points being made about the issue
 

of health care. However, as with so many programs proposed and discussed....what are some of the specifics? Just what does "fixing health care mean? Entail?

Does or will it include:

stopping pharmaceutical companies from hiding behind patents keeping drugs at extreme high prices?

stopping provider institutions and individuals from exploiting the system for maximum personl gain contributing to maximum costs?

grandfathering what coverage YOU have today from Medicare, when bringing all the have nots on board?

all....I mean ALL government employees including congress, senate, et al (:1rotfl:.....sorry I could not help myself!!!)?

understandable coverage that has no special coverages for vague differentiation?

drug coverage?

Just to name a few. Without the specifics, congress and Obama will pass another huge program with unspecified content that will benefit only providers and government officials and the usual medical provider special interest groups. There will be no accountability....no measurables.

The program will again get the Obama fast track label and be pushed through the partisan controlled system.

Skeptical? N egative? Absolutely!!!! Appropriately earned by previous actions/non actions by our incompetent lawmakers.

I have said it before and I will say it again....remember no matter what program is proposed for the masses will not be as good as what is available to us (retirees on Medicare) today. No matter what is proposed we will wind up having to offset the difference through private coverages just as we do with supplemental coverages today....except it will be more $$$$.

LAst of all how will it be paid for? And as stated above just how will it affect the economy?

Sorry for asking for specifics....I know it is an age old requirement not subscribed to by lawmakers and partisans!!:D

btk

My question would be along the same lines as BTK but not nearly as intelligent !!

The poll asked "What is your position on healthcare reform"....most of, if not all of the replies assume total government control and cost.

Is there not a middle ground for all of this so that it is not 100% government ?


Great discussion by the way !

Tort reform. Until you fix that any system will fail. Get the lawyers out, drop the cost of malpractice insurance for doctors and hospitals and drug componies, and ALL other health care becomes affordable.

Underwhelmed
 

The hosts of this very enjoyable and informative forum tout the fact that it "gets a million hits a month" which is quite impressive. So far there have been 42 responses to the survey. What's up with that? Seems kinda low.

Let me give you all an example of this health care problem. On Wed I saw a very nice young lady who was having a very unpleasant discontinuation reaction to a medication she was taking but had abruptly stopped. She was a single parent, had recently lost her job (economy) which WAS providing health care benes. She could not afford to continue the coverage under COBRA, she could not afford to refill her prescriptions and now comes to see me on an urgent basis because of the complications of abruptly stopping her meds. This isn't a "rare case".
I would estimate at least 25% of the meds, therapies or diagnostic studies I order are "denied" by insurance reviewers as "not medically necessary" or because there is a cheaper alternative. Folks, this is rationing. At least with a single payor system I'll know the rules and who I'm dealing with. It is impossible to know which insurers allow what, cover what etc. The pts are stuck in the middle..... they come in and say "my medication was denied.... YOU need to call 1-800-nooneeveranswers to get "prior authorization" This is why I have pleaded with my son to NEVER leave his position as a US Army physician. Our current system is insane.:shrug:

TO your point on the voting...great one. I have not voted as I am still reading and am not that bright in that I think there is need for healthcare reform, but not sure I want what is dubbed universal. Not sure if that makes sense but looking for maybe some alternative where we can reform the current system but not become dependent on the government !

I am sympathetic to your position as a nurse. I have some experience myself as a former combat medic and also working in a Mash type unit in a war zone. Anxiety is described as intense fear resulting from anticipation of a threatening event. No?
Well, I can tell you with certainty that millions have been affected with this syndrome since September 11, 2001. It further escalated after November of last year. People wake up every day to news that more and more of our fellow citizens have been laid-off from employment. People look at their financial statements and see that they have lost 40% of their wealth.
The world as they knew it is disappearing. One of the biggest companies in the world is bankrupt. (GM) The price of fuel is going up and inflation is rearing it's ugly head again.
All that being said, the USA has many reasons to have anxiety, and everybody wants everybody to be healthy. But we have to fix alot of things, especially the economy, before we tackle something as enormous as healthcare.

I think the answer is in the middle somewhere
 

It should not be an either/or.

Access at a reasonable cost is not out there for so many Americans. Throw in a pre-existing and there might be no access at all.

Why does everybody think it has to be either/or? We need middle ground. A solution that provides access to decent coverage at a reasonable cost. Something we could buy into. (both literally and figuratively)

We let the present system get away from us. Are we now at the point of no return?

Prescription cards for convenience. Yeah, that was great. A Trojan Horse that hid the real cost of the drugs as they skyrocketed.

I remember saving receipts in a shoebox and sending them in to my insurance company for reimbursement. I knew what the cost was. But then, somewhere in the early 90's, or maybe late 80's, suddenly everybody at work wanted that card with that co-pay. A few bucks at the pharmacy and we could be on our way. No pesky shoeboxes.

That drug card turned out to be a Trojan Horse.

For the sake of convenience, we as consumers of health care pulled that wooden horse inside the walls. The insane cost of prescription drugs has slaughtered us in our sleep. Just like in the story when those soldiers climbed down out of their hiding place inside that horse and slaughtered the Trojans. It was an easy slaughter. They were sleeping off the partying they had been doing because they thought they had won the war. They thought that wooden horse was a gift from the enemy. Just like people thought that prescription card was so wonderful.

So Big Phama could hide those cost hikes from the consumer. And hide them and hike them they did. We all know pipelines are not the whole picture.

And now, I really must state the obvious......Paper-pushers in cubicles at insurance companies spend their days trying real hard to prescribe drugs and limit procedures. And they often succeed. Gee. With all that experience, should a national plan arise, maybe they could transfer right on over to a government job.

And speaking of government jobs. And speaking of taxes. Isn't that our tax money that provides that health care for life that comes with a government job.

I know it is all a big mess. A huge ugly mess. But either/or is not the answer.

And I am glad to see some real experiences showing up in this thread.

Boomer

For one perspective go to www.pnhp.org Remember this is a physician organization. Their stats indicate over 60% of practicing docs support a single payor system.... why? Well, it certainly is NOT because there will be more $$$ in it for the docs. In fact, the opposite is more likely. I believe it is because the current "system" is so fragmented and chaotic that most docs simply can't stand dealing with it anymore.