Universal health care is the only humane system for a nation of such great wealth, and the only logical discussion is how to get there. Except, why has this Congress not taken a baby step? Why has it not authorized Medicare to negotiate drug prices?

Other first world nations have found their own way to provide government sponsored universal health care to their people. Japan does it yet is able to provide nearly instant services at extremely low cost to the residents (yes, it is not restricted to citizens).

Britain provides care at very low cost but has delivery delays that trouble some. Germany provides both excellent care in a timely fashion, but is more not as inexpensive.

Taiwan studied these and other universal systems as well as the American model. As they put it, our system is “what happens when you don’t do anything.” They found it to be worse than the other models because we pay the most for the least benefits.

But while politicians pronounce, announce, promise, debate and dither about their way to get there, there is at least one single step that could be taken now and it would result in enormous savings to Americans.
We need to authorize Medicare to negotiate drug prices for its beneficiaries.

Medicare carries enormous clout in setting prices – ask hospitals and doctors. Yet they are prohibited by law from negotiating drug prices, an insane policy that was wrong when adopted and even more glaringly now.

There are many things that can be said about health care and what changes are needed to bring the entire system into balance and to provide excellent health care. But as usual, Congress is in love with the charade we call democracy, they would rather talk about something than doing it.

Maybe none of the ideas now out there are the entire answer. Maybe each has some merit and eventually the system we will get be a synthesis of current and future plans. But wouldn’t it be better to just get started, test out one change at a time until we are able to agree on the next one.

Congress, just do it.


  1. Sandra,
    It is not a partisan issue, rather an ideological one.
    I believe we can and should protect the health of our citizens and it’s well within the boundaries of the Constitution if we pass legislation to do so.
    You think accident only coverage is enough but it’s not if you get sick.
    How about preventative care?
    From what I’ve read of your postings you lean Liberetarian and your posts are well thought out and articulated, I just happen to disagree.
    Listen to Thom Hartmann talk about “The Commons” and you will see where I’m coming from on this one.
    The “Don’t Get Sick” healthcare plan is not where I want to go on this issue and poll after poll suggest the American people overwhelmingly agree.
    Vote early, vote often, vote Democratic (Now that’s partisan).
    P.S. I carry a pocket sized Constitution in my pocket every day.
    Got it from Senator Byrd.

  2. I believe that any further exchange with you on this topic is wasted effort. As Mr. Remington notes, you are not going to recognize as fact anything that undercuts your opinion; however, you will offer no support for your claims and simply insist that they be accepted without question. Further, it appears that you now attempting to change the topic from health care options to the matter of states rights versus federal power.

    Perhaps others may wish to continue the pursuit of a will-o’-the-wisp with you.

    Most sincerely,

    T. J. Flapsaddle

  3. Sandra, we’re all pretty smart people here and understand what would result if health care was turned over to the government. I, too, would like to see someone propose a plan that would provide national health care for all americans. One that would not be controlled by the government. I have tried for years and have not been able to do it.

    I have never in my life had to pay one penny for my health care. 32 years of it was covered by being in the Navy. When I retired they gave me a health card and all I had to do was hand it to any doctor’s office, pharmacy, or hospital and that was the last heard about payment. When I turned 65 I was switched to medicare like everyone else with my government card being the secondary. But nothing changed. I still pay nothing.

    I get print outs once a month with a break down of who is paying what and how much. I give it a quick read out of curiosity and am always surprised at the amounts. My drug cost alone is over 20 grand each month. Cancer is expensive.

    I know a lot of people are jealous of me but I don’t care. I earned my health care. And somewhere along the way of crawing around in all the jungles and deserts and garbage and so forth I picked up the bug that caused the cancer that is, now, killing me.

    Anyway, my point is, that if the government can run my health care so efficiently, why couldn’t they do it for everyone? Whatever system they were using for me before I turned 65 must have been a good one. I know it paid on time because I saw copies of the bills. Both medicare and my government insurance paid less than the asking price but that was accepted by the doctors and hospitals and pharmacies.

    If they have the power to reduce my bills, just think what they could if they were the only health care provider. Let’s face it – doctors charge too much for what they do. $100 for the privilidge (office visit) of sitting in their office for an hour looking at 6 month old magazines and 10 minutes talking to the doctor.

    Hospitals charging huge fees, such as the 42 thousand they billed us for my 10 year olds broken leg when he was hit by a car, to make up for all those uninsureds they are forced to take in. But again, my government insurance knocked that down to 24 grand and the hospital accepted it. That was what it was worth.

    That is what a single universal provider would do. Elminate uninsured and set fees for doctors, hospitals, and pharmacies at what they are worth.

    Of course, the case for the government single payer system is based on the riculous assumption that everyone is going to play fair. We all know there will always be a few that will find a way to beat the system. That’s why we have oversite and investigators.

    Thus far I haven’t been able to come up with a better national health care plan. Maybe some one here can?

  4. Sandra:

    This is going to be the last time I comment on anything you say. You do not appear to assimilate anything that disagrees with your point of view, and I will in the future not spend my time trying to make you understand what you patently refuse to even think about.

    But you said this:

    For example, the Supreme Court is debating the death penalty. That is a State’s Right not a federal right.

    You could not be more wrong. The Constitution forbids cruel and unusual punishment. Period. States have no right to institute anything repeat ANYTHING that is contrary to our Constitution. This is not the Confederate States of America, this is the United States of America. States are not free to do any darned thing they want to.

    In addition, we have Federal death penalties. We have used them. Timothy McVeigh comes to mind. He may have been executed in a state prison, but he was convicted and sentenced under FEDERAL LAW!!! You can look it up.

    I will read no more of your posts, so please don’t think you have to respond to this one. Life is too short.


  5. Individual states have the legal authority to take us all by the hand and make us equal in anyone’s standards. We have the ability to leave states that are too involved in our decision making. The difference Keith, it that the states are run by the voters and we have the ability to make our own laws. For example, the Supreme Court is debating the death penalty. That is a State’s Right not a federal right.

    I’m sorry but I do not consider Wikipedia to be a link to anything. We need to discuss with actual numbers how many Americans cannot afford health insurance. This can be done by asking the IRS who is living in poverty. People taking outrageous loans on their house and claiming to be living in poverty is ridiculous. I realize there is a level of Americans who cannot afford any coverage and they should be looked at as a special needs for coverage. The biggest problem are the illegals who also want into the free health care offered by the candidates. It gains them votes. Our Congress can take a solid week,if not more time to worry about illegal drugs given to our athletes. Who sets the priorities with these bozos?

    Just saying one cannot afford insurance is not enough. It would be better to turn this over to the individual states who can investigate these poverty claims.

    Keith, what if the plan fails and there is not enough money in the till to pay for anyone’s medical bills? Do we ask China to pick up the tab? It is a problem solved by the Bush Administration who cleaned our our budget for the war. We will never have the money after the rest of the soldiers bring their broken bodies and minds into the system. We throw away our futures when we elect men like Bush and now McCain. They are notorious for scamming the citizens on false premises.

    We all knew this election would be based on health care, all the candidates promised to bring it up but not one of them has plan to keep the system away from the government because there is no system that can do it. It is on the bottom of the priority list and nobody realizes what a government program like this would cost; a loss of care and medical help with another budget debit added to our kids.

    If we fall into this terrible plan, we will never be able to get out if it.

    There comes a time when all of us elderly seniors know we have worn out our welcome. The cost of keeping us pain free is way too expensive. I have thousands in my groups all over America who would rather simply die as soon as possible. You will all get there and wonder if another day of pain is worth breathing. Many get into alcohol and even illegal drugs.

    I remember in the late 60s when Reagan suggested making Social Security an option. But it was mandated and a lot of our money was taken out of our paychecks and put into the federal budget. We knew it and we tried like hell to get it out of there. The LP jumped in in the 70s to work with us. We were all told that Americans were too stupid to set aside their retirement funds and D.C. treated us like idiots. We have been screwed for years and when anyone dares to speak of it, we are considered dangerously demented.

    Apparently there is nobody here who would take a stab at trying to fix this health care system and also to keep it out of the government. Once the system is in place it will be set in cement and I feel sorry that most here cannot see it.

  6. SP: America has the longest living citizens and has kept up on innoculations and we are a lot stronger than any other nation on this planet.


    There are 19 countries that have a lower infant mortality rate per 1000 live births. The U.S. rate is 6.4 per 1000. The 19 countries range from 2.8 per 1000 in Sweden, to 5.7 per 1000 in Italy and New Zealand. 10 of those nations have rates of 4.5/1000 or better. A handful have between 4.5 and 5.7 per 1000.

    People in the United States live an average of 78 years. Fourteen other countries fare better, ranging from 81.4 in Japan to 79.2 in Austria. Three countries average 80.6, Most average above 79.0 years.

    Documentation: http://www.infoplease.com/ipa/A0004393.html

    Questions: Can we use the above statistics as a general indicator of the general level of medical care in these countries? Note that some of them, Germany for example, have national health care systems. Are those systems providing a higher level of care than the United States?

    SP: We must remove this health care mess out of the government and assign the states to work out something that they can afford. Where are the entrepreneurs that made America great? Dumbed down or outsourced???? We must fix the academics and stop this silly outsourcing of our products.

    KS: I agree wholeheartedly, assuming you meant to say “…out of the FEDERAL government and assign to the STATE governments…”. Another uncomfortable question: Is “socialized medicine” okay in the states but not in the federal domain? If so, why? Of course those with means will be able to move to a state that does NOT provide socialized medicine, and they will purchase health insurance in their new homes. Others without means may be stuck where they are, regardless whether they live in a “socialized medicine state” or a “free enterprise medicine” state. Obviously we would still have uninsured people in those states.

    SP: There is not a single political party or candidate who can fix a damn thing. Every time we come up with a candidate who can fix the problems, they are forced out of the campaign.

    KS: Totally agree.

    — Kent Shaw

  7. SP: The American people want health care without paying for it. They do not believe that their taxes will be increased to cover the expenses they are so eager to give away.

    KS: All opinion, not fact.

    SP: Anyone who smokes, takes drugs, drinks too much and being over weight by so many pounds will be excluded.

    KS: Fear and opinion.

    SP: The medicare system is going into bankruptcy in less than 10 years…

    KS: Not if we stop spending a couple trillions of dollars on useless and illegal wars. (Speaking of SOCIALISM, a huge bloated military is a perfect example.)

    SP: I happen to have an HMO which will cover me for emergencies.

    KS: Because you can afford coverage. Many cannot. You have been harping on people supposedly spending extravagantly on material goods and neglecting to purchase health insurance, and I suppose there are a few people like this. But please tell me how a single mother with a child or two making $20K a year covers all of the family living expenses and can still afford $300-$1000 a month for health insurance. I doubt that her waitressing job provides health insurance. Life throws a lot of curves at people. Maybe that woman had to quit school to support ailing parents without health insurance. In that case she might not have had opportunities to pull herself up by her bootstraps the way you did. What if you had suffered a crippling injury in your younger years and could no longer work? How would you have provided health care for your family? You have previously described your life and how you have conducted it. And I have nothing but respect for what you accopmlished. But, I submit to you that you have been extremely lucky. God forbid that one of your children came down with one of those life long life threatening illnesses that quickly drain a bank account. You would have had two choices. Let your child die or accept public assistance. Which would you have chosen? I guess you “wouldn’t have taken a damn dime” from me “or anyone else.”

    SP: I cannot help it if you need the government to cover your bad habits.

    KS: Needless, assumptive and arrogant ad hominem attack.

    There is one earth. None of us own it. Is it to be every man for himself at all times, or are we sometimes all in this thing together. Am I my brother’s keeper? Am I responsible to no other human being, only myself?

    — kent shaw

  8. No. This is not correct: America has the longest living citizens and…

    According to this article in Wikipedia on longevity, we trail well behind a number of other countries. With a mean life-span of 77.7 years, Americans lag behind the UK (78.4), Germany (78.7), France (79.6), Italy (79.7), Australia (80.4) and Spain (82.3) and some others as well.

    As Mr. Remington stated above, you need to buttress your claims or else clearly indicate that they are merely your opinions and subject to verification.

    Most sincerely,

    T. J. Flapsaddle

  9. A lack of documentation is often a problem on the internet, and all of us have to deal with the misinformation, misconceptions and resultant pointless exchanges predicated on the same. Many people do not seem to grasp the significant difference between a fact – which is objectively determined – and their opinion.

    I find that one of the most common logical fallacies indulged in by the unprepared is the ad populum – the notion that the fact of a matter is dependent upon the number of people agreeing with it; this seems to be a common fall-back used to transfigure one’s opinions into matters of fact in the absence of objective information. Other frequent ly-used fallacious arguments are some form of the ad ignorantum or of the “appeal to authority” – especially the anonymous authority.

    I do not mind someone stating their opinion as to a matter – we all do that, don’t we? – but it that’s quite a distance to leap from and say that it’s a fact because many agree with it, or because of a long history of seeking out such opinions. If I state my opinion on something, I believe that I should couch it in such terms that it is clear that it is not necessarily factual or else I should be prepared to support the claim with something objective.

    Suffice it to say that I agree with your position that someone making a statement and either asserting or insinuating that it is a matter of fact should be prepared to document – cite – at least one objective source for the claim.

    Most sincerely,

    T. J. Flapsaddle

  10. We in America have gone through many problems starting with slavery that has put the whole mess into the hands of the government. Those in government drool at the concept of ruling over the masses.

    We also have the opportunity of looking at the other nations and how they tried to solve things such as prisons, birth control, health care and how to manage the horrendous racism and anti-Semitism that still prevail in America. We have two choices on these problems: We can hand it to the government or we can design our own solutions. The problem is that we are not equipped to think for ourselves and tend to look to Shakespeare or the bible and bring up a Jesus quote. That only diverts the situation and bores the reader.

    America has the longest living citizens and has kept up on innoculations and we are a lot stronger than any other nation on this planet. The problem is that for 40 plus years, we forgot to educate academically the broad base of the American culture. We trained people how to fill out forms for handouts. We trained teachers how to train to the tests.

    We must remove this health care mess out of the government and assign the states to work out something that they can afford. Where are the entrepreneurs that made America great? Dumbed down or outsourced???? We must fix the academics and stop this silly outsourcing of our products.

    There is not a single political party or candidate who can fix a damn thing. Every time we come up with a candidate who can fix the problems, they are forced out of the campaign.

    Here we are just 7 months from the most important election in our history and not a damn thing has been fixed for 20 years.

  11. Costs are out of control even with the system we have now.

    Consider the medical contract for a typical company and it is often paying double digit medical increases. How would this be constrained by government intervention? Only by some limitation. That must be happening in the European and Canadian plans, which means that the government is deciding what to pay for, what to cover. If you want to control your medical coverage then you have to pay for it, directly.

    Loose control systems are poor and inaccurate.


    Peace without freedom is still slavery.

  12. On the horns of a dilemma: How do we provide access to reasonable health care for everyone without bankrupting us or without creating another massive government bureaucracy. Unfortunately, it is probably impossible without one or the other. Because of the existing system(s) – perhaps it might better be said that because of the lack of a system – the normal market-forces cannot correct the distortions without wreaking considerable havoc among the extremely vulnerable.

    Part of the problem has to do with expectations and attitudes on the part of our citizenry. Americans expect the best medical care in the world . After all, we are the richest nation on the planet, the most inventive and the most technology-oriented, the most hard-working, etc.; therefore, why should we not have instant access to the best in health care? Many expect it to be at low or no cost, because part of the American reality is that most of what we want and need is available at a reasonable cost to all of us. At the same time as we hold these high expectations, we operate from a general attitude of self-reliance and the notion that we should generally earn this ourselves and not expect others to hand it to us.

    The reality has collided with the expectations, and now we as a nation find ourselves in the situation of having health care services becoming more and more expensive for everyone and less and less available to an increasing fraction of us. For many, especially the older and retired and for the poorer, the cruel choice often has to be made between eating or health care services. The collision has generated two opposed schools of thought: The government-must-do-something notion and the get-off-your-butt-and-fix-it notion.

    Both sides tend to gloss over the hard realities of their respective nostrums and to indulge in a certain amount of double-talk and sleight-of-hand as to how the respective cures will work. Both sides are convinced that they can indeed square the circle and trisect an angle despite the evidence to the contrary.

    The proponents of the government-based solution tend to deny that their solution is other than a nationalized/socialized system of medical care; thus, they come up with alternate labels – “universal access” or “single-payer” – in order to try and say otherwise. Further, they pretend that their system does not involve the continued rationing of health care; they simply ignore the reality that the government will replace the insurance-carriers as the gate-keeper. They also would have us believe that it will be free or low-cost, and that the major burden will be borne by “the rich” or by “big business”, in effect ignoring the economic reality that businesses always pass on costs to the final consumer of the product. Finally, they expect that the system will not be excessively bureaucratic, that it will be accomplished by existing agencies with little distention – unlike Falstaff’s embroidering, there will not be “eleven rogues in buckram from two”.

    Those advocating the self-reliance and market-forces solution also evade some harsh facts. Just as Jesus told his disciples, the poor will always be with us – as well as some totally lazy and worthless – and these must be considered as well. They also seem to think that all of us have some assets that we can easily liquidate to cover the costs and still continue life as usual. They also tend to insinuate that someone seeking help may be,well, just bit lazy and in need of a kick in the butt to set them aright. And some tend to think that the single parent who is working a low-wage job with no insurance benefits is just being a bit hysterical and overreacting when they are trying to comfort a fever-wracked child at two in the morning.

    Yes, it is a dilemma, and the solution is probably not going to be a particularly good one either.

    Most sincerely,

    T. J. Flapsaddle

  13. My point of view is shared by many Americans. I spent many hours a day discussing politics on line and in person. The American people want health care without paying for it. They do not believe that their taxes will be increased to cover the expenses they are so eager to give away.

    The medicare system is going into bankruptcy in less than 10 years…Is this the system you want extended? Do you realize that we all pay close to $100 a month for this coverage?

    Ted, I make sweeping statements because I have been involved in all this government fraud and corruption since the end of WW2. It is like watching a cancer take over our Constitution. I want it to stop eating away at our values, freedoms for the comfort of people too damn lazy to earn a living and pay for their own health care. At this time nobody is turned away from any hospital. If the federal government gets their greedy and corrupt hands on this system, it will collapse and nobody will get help.

    Can you even imagine the restrictions put on people if the government take over the health care? Anyone who smokes, takes drugs, drinks too much and being over weight by so many pounds will be excluded. I guess it is a good way to weed out the under achievers.

    There is nothing better than to have individual freedoms for all Americans and let them choose their insurance plans. I happen to have an HMO which will cover me for emergencies. I have been a health nut since birth and have paid my own way including my children without taking a damn dime from you or anyone else. I do not want federal government corruption to be involved in anyone’s medical care.

    Look Ted, I was raised and trained to be independent and the U.S. Constitution gives me this right to live outside the jurisdiction of any Socialistic federal program. It is a point of view that comes from being an American. I cannot help it if you need the government to cover your bad habits. You cannot make an argument for Socialism as it means a reduction in personal care. Go live in Canada and wait your turn when one of your kids is bleeding. I guarantee you will be back to America and you had better work for any system other than the Federal government.

    Any system that is mandated is evil.

  14. Sandra:

    You have apparently not understood what I am saying;

    I am proposing that a tried, tested, and working well nation-wide system be expanded to include other people not included in the original scope of the program.

    The FEHBP does not set criteria for length of stay in hospitals; never has. The insurance companies which operate under that umbrella set guidelines, but they do not refuse to pay if an individual patient exceeds their guidelines due to medical necessity.

    The very best doctor I have ever met participates in the HMO which I chose as my insurer when I was in Colorado. He is NOT an employee of the HMO. He is in private practice. He also takes other kinds of insurance, but he contracts with Pacificare of Colorado to participate as a preferred provider. He would not have it any other way. He likes doing business this way. He is not going to run screaming from the practice of medicine because of the existence of HMOs, PPOs, and the like.

    I am not saying that the Federal Government can or should be a provider of health services; what I am saying is that they have a vehicle that we can, if we choose, make larger to carry more people, thus achieving more competition while spreading the costs over a wider client base.

    You say that I am nitpicking your statements; not true. I am asking you to support them. You make sweeping statements and provide as basis such things as “The documentation for this information comes from listening to the American people day and night through television and radio talk shows.” That certainly is not documentation, but only your personal view.


  15. staunch. You have made this discussion of health insurance into a political partisan issue. We have many Canadians who come to America for the more sophisticated surgeries. If you would pick up a copy of the U.S. Constitution, you will see that our federal government is limited in their authority over the American citizens.

    To protect the American people, means having a military defense. The States have the authority to build police and fire departments. There is no mention of medical coverage in any part of the U.S. Constitution. It is up to the states to handle their own residents.

    This is not a partisan argument but a Constitutional problem.

  16. Ted. The federal government will set the standards for surgeries including the length of stay in any hospital. This would remove the resonsibility from the medical community. It would also rate each doctor on their charges and control the hospital rates and services. At this time our patients’ insurance coverage is based on the amount of coverage we buy. When medicine is controlled the patient will have to face the same treatment that our vets face. We will be allocated to a specific hospital and a doctor who caters only to the government.

    The only reason the government is involved in our medical insurance at this time, is that Americans feel it is their right to have medical insurance because they are Americans. The documentation for this information comes from listening to the American people day and night through television and radio talk shows.

    The American people believe this right for coverage is their right and yet many have the luxuries of fancy homes, new cars, and all the trimmings of the wealthy, including having cable TV so they can call into CSPAN.

    My political opinion comes from personal responsibility not handouts and welfare. My points are very clear that if we go into federal insurance, we will lose the best doctors, hospitals and our general health will suffer.

    Ted, we know how to eat, exercise and that every body needs proper nutrition, plenty of exercise and sleep. If the parents took more care of their growing children our health care would not be necessary for the government to get involved.

    You are nitpicking on my statements because you obviously believe the government has resonsibility over our health. You miss the factor that we have developed brains done through years of evolution and self development. For documentation of this, read Richard Dawkins.

  17. I live near Canada and, despite what the propoganda machine says the vast majority of Canadians I talk to love their health care system and think we are nuts.
    The only exception is elective procedures, which do involve a long wait.
    The Medical system has not been destroyed, rather they rate higher in most categories than we do.
    What is different is that people like Bill Frists father haven’t become billionaires by sucking 20-30% off the top.
    Socialism is when the government owns the buildings and pays the workers salaries.
    If you have a problem with socialism you must eliminate the military, the police, the fire department, the courts, all federal, state and local governments which is a Conservative wet dream.
    The only problem is the Cons have never produced anything but massive debt and poverty.
    We can and should provide for our citizenry and it’s time to stop talking about it and do something about it.

  18. There may be people in this country who can afford health insurance but choose not to carry a health insurance policy. There are for sure working people in this country who cannot afford health care insurance. These people do not drive new cars and have cable television. They are lucky to know where the next meal is coming from and often have to decide whether to pay the rent or buy medicine for the kids. And there are jobless and homeless people. How are they going to afford Hillary Clinton’s mandatory health care insurance? And what happens to them when they do not purchase health care insurance? Do we jail them? Refuse them food stamps? What?

    — Kent Shaw

  19. Sandra:

    You said: If we go on a mandated government coverage it will destroy our medical system.

    Can you explain why this would result?

    You also made the statement:

    Americas (sic) do not want to pay for their health insurance and too many feel it is the function of the government to do it.

    Can you provide documentation for that viewpoint?

    Lastly, you said:

    If you can afford cable television and a new car you can afford to pay your own way.

    Do you mean that such people can afford to pay for your own health insurance or do you mean that they can afford to go bare, i.e. self-insure?


  20. I would prefer a choice of either having emergency coverage only in the private sector or government control of their procedures. If we go on a mandated government coverage it will destroy our medical system.

    Americas do not want to pay for their health insurance and too many feel it is the function of the government to do it. I wish you could show me where this function and authority comes from.

    If you can afford cable television and a new car you can afford to pay your own way. Don’t expect me to pay your bills if you drink and smoke too much and eat like a pig. This is America not Cuba where everything is free except the citizens.

  21. If medicare is so great, why do all our parents have “supplimental insurance”?

    Many of the doctors of 30 years ago are glad they do not practice today. They recognized then that HMOs and government regulation would stop them from practicing medicine as they wanted to.


    Peace without freedom is still slavery.

  22. I have a couple paragraphs for sale, but will not give away my work for free.


    Peace without freedom is still slavery.

  23. Thank you stauchdem for helping to make my point. If you establish universal health care, you have no need for insurance companies. They are only expensive overhead dedicated to denying as many claims as possible. That’s why the insurance and drug companies have poured so much money into the campaign funds of certain candidates.

    Who do think it was that derailed Hillary’s plans for a “universal” system back in ’92? She learned a lesson from that and, now, she proposes a system that would leave the insurance and drug companies in control. Not only that, she has made it mandatory, forcing all those insurance ‘deadbeats’ that fill the ERs every day for free medical treatment to become cutomers. That’s more than a million new premium payers.

    Ted: you are correct that what I describe is socialized medicine wherein the agency would establish standard fees and co-pays that the doctor or pharmacy could follow or not. But the patient would know what the standard fee was and decide whether to use them or go next door.

    The massive burocracy you fear already exists – Medicare. It would simply be expanded. And no matter what kind of system you create, some will figure out a way to enrich themselves from it. That’s why we must have oversite and investigators for it just like any other program.

    Insurance companies have no place in a true medical care program that serves the needs of all americans. As long as they are involved we will be told which doctors ond hospitals we can use and there will be higher premiums and exclusions that cause needless sufering.

    True, that it would be mandatory, but based upon a percetage of income I believe we would find the cost affordable for all. And all the money would go towards medical care instead of large expensive homes and Hummers for insurance executives.

    I don’t like socialism either. In fact I hate it. But this is the only way possible to truly provide affordable, efficient, universal health care for all. We must remove the profit motive, ie., the insurance company.

  24. I think the term Universal Healthcare is misunderstood.
    The proposal that makes the most sense is a Single Payer system much like Medicare.
    Medicare has about 3% administrative costs while our current private plans shell out between 25-30% overhead enriching a very few.
    Meanwhile we are not even in the top ten in categories like infant mortality, and many others.
    Plain and simple we are the only industrialized nation that hasn’t figured out how to get this done.
    I believe we owe it to our citizens to get this done one way or another.
    It won’t be a walk in the park but we need to do it.

  25. SEAL:

    You said: “The plain fact is that if you are going to create universal health care for all americans (sic), you automatically eliminate insurance companies.”

    Why is this a plain fact? Everyone is down on insurance companies, but I have yet to see anyone provide specifics about what the companies do that is so antithetical to the interests of the world.

    You said in part: “All fee schedules would be mandated and any required co-pays should be established the same for all, however, any doctor or pharmacy could charge a higher or lower co-pay fee.”

    Who would establish these fee schedules? Under what authority? Yet another massive bureaucracy?

    They you say that co-pays would be established the same for all but any doctor or pharmacy could charge a higher or lower co-pay fee. In the first part of your sentence you say the co-pay fees would be the same for all, but then you say doctors didn’t have to accept the co-pay schedule. This reminds me of the cartoon of Charles Dickens sitting across from his editor, who sneers, “Well, Mr. Dickens, was it the best of times or the worst of times? You can scarcely have it both ways.”

    What happens when the doctors emulate John Galt, shrug the world’s shoulders, and tell you they are not going to work for slave wages?

    What you are proposing is a strict socialized medicine setup which is completely antithetical to the way Americans do business in the real world. Instead of having the marketplace decide priorities you would have bureaucrats doing it. That way lies chaos.

    Back in the 1970s I worked in an agency which tried to collect the overpayments made to nursing home service providers under the Medicare program. The setup of was extremely complex, but boiled down to a situation where the Medicare program bore a portion of the overhead costs of the facility that were proportionate to the number and type of Medicare patients in the facility. The case files on these debts were as big as the debts: HUGE. Almost impossible to comprehend.

    But one day I was leafing through a file and a name caught my eye. Annie Something. I thought to myself, I remember seeing that name. She was listed as the head nurse of a nursing home, and her salary was included in the overhead. And over here, in a seemingly unrelated case file, Annie Something appeared again, with her head nurse salary as part of the overhead of another facility.

    So I and the other adjudicators put together a card file with the names of the employees. Lo and behold, Annie Something was being paid a head nurse salary in some 50 or 55 facilities, all at the same time! Even more interesting, Something was her maiden name, and she was married one of the owners of the facilities.

    This is the sort of stuff that happens when you put a bureaucracy in charge of big money like this. Crooks come out of the woodwork and steal us blind. We succeeded eventually in putting several of these people in jail, but we couldn’t begin to collect the money because these people had spent it or gotten it to a place where the Justice Department couldn’t get to it.

    The lesson: Let HMOs and PPOs and Blue Cross/Blue Shield all compete and let the market determine where payment goes. Once you inject a bureaucracy into the equation you end up with massive theft and other inefficiencies.

    We have an existing medical marketplace which, while not broken, is admittedly pretty bent up at the moment, but which could work well with some tweaking to get rid of some of the inequities. Don’t throw the baby out. Help him grow up.


  26. Let me remind you that seniors are covered by medicare. When an office procedure or hospital procedure is sent to the government (Medicare) they take up to 4 years to pay the hospital and doctors.

    I’m watching CSPAN at this time and the lack of doctors is increasing drastically. The cost of medical coverage for them is so high and the delay in being paid by Medicare is sending them into a private practice and many will not take a Medicare patient.

    I have had a couple of procedures done without the use of my insurance or medicare and this is becoming more popular with my seniors here in the development. Some of the best doctors will not take medicare and who can blame them?

    If the federal government takes over universal health care, every single one of us will regret it. Will our doctors who refuse to accept Medicare have to leave the country to practice?

  27. I think it still reduces to a matter of regulation both by the insurance industry and by government.

    The insurance company, the “customer”, decided what it wants to pay, and it also decides who can/cannot be insured and for what. Hospitals really cannot opt out of the problem due to federal regulations – they essentially have to treat, or at least evaluate, everyone who shows up; doctors must try and treat or at least evaluate everyone that shows up. If they, doctors and hospitals, do not, they look a malpractice charge in the eye.

    There are some really strange, illogical things here, though, in that a person who presents with chest pains can get admitted to cardiac ICU – at about $5,000/day – and be there 3-4 days, but cannot get coverage that would get him a couple of annual doctor’s visits and BP and blood thinner meds that could cost as little as $5/day.

    Unfortunately, the resolution is probably going to be a government-administered system that will still ration health care and still pass the costs on to the public at large.

    Most sincerely,

    T. J. Flapsaddle

  28. The plain fact is that if you are going to create universal health care for all americans, you automatically eliminate insurance companies. If everyone is automatically provided healthcare there is no need for a middle man to take a cut off the top inflating the cost of the care. Universal health care is paid directly into a health care fund through automatic payroll deduction based on a percentage of income.

    Universal health care would be non-profit. Universal health care would create an autonomous agency to oversee and control it. It would no longer be called ‘insurance.’ There would be no such thing as exclusons for any reason.

    As the only provider it would have the power to regulate the cost of prescription drugs, hospital costs, lab and specialized diagnostic fees (such as MRIs). I have no way of knowing but I suspect the cost to the individual taxpayer would be less than they are currently paying for medicare. Lobbyists would be eliminated. There would be nothing to lobby for.

    Under universal health care the individual could choose any doctor or hospital they wanted. All fee schedules would be mandated and any required co-pays should be established the same for all, however, any doctor or pharmacy could charge a higher or lower co-pay fee. Essentially it would be very much like the medicare for seniors we presently have. There would be no middle man (insurance company) being paid to do little more than punch up our file on a dumbputer and tell us what is covered and what is not.

    Such a system would dramatically reduce the cost of health care in this country. No middleman raking a cut off the top – preventive medicine would reduce major medical conditions [like a +baby’s cold becoming pneumonia] – reduced staffing of Emergency Rooms that would handle only true emergencies. There are many other minor cost saving features that would add up to a great deal of savings.

    I see universal health care as being so simple to establish, efficient to operate, and such an obvious cost saving program I can’t understand why Ron Paul or Kucunich or some other “radical” candidate hasn’t proposed it. Surely I’m not the only one who has thought of this.

  29. Roncorvus: Unless you post in paragraph format with some white space I will not read your posts. Also, like Ted said, if you make allegations you must supply facts or reasonable, logical argument to support them.

    It was a very good posting, just very difficult to read.

  30. T.J. wrote:

    We have no idea what medical care really costs because the system has been distorted through regulation. For example, why should the “courtesy kit” – barf pan, insulated drinking cup, toothpaste, toothbrush, shampoo, body wash, mouthwash, comb, razor, etc. – issued a hospital patient be billed to the insurance carrier for $45.00 when the indinvidual (sic) components can be bought at a “dollar” store for about $7.50?

    At least part of the answer is that this is how the health care provider recovers the costs associated with giving those items to people who cannot (or will not) pay for their care in our country.

    It also reflects the failure of health care providers to fully recover the true costs of providing care to those people who do happen to have insurance, but whose insurance companies refuse to fully reimburse those costs.

    So, in that sense, it isn’t just “regulation” that has “distorted” these costs, T.J., it’s ALSO the result of insurance providers not fully reimbursing health care providers for the true costs of the services they provide, as well as covering the costs of the tens of millions of people using the health care system in our country who aren’t (for various and sundry reasons) paying for it.

    It’s just like a food merchant who must cover the costs of theft, breakage and/or spoilage of a portion of the items they offer for sale by passing those costs along to those who actually buy their wares with real money.

    And, I’ll also bet the actual reimbursement the medical provider got from the insurance company for those items you mention was a lot closer to $7.50 than it was to $45.00.

  31. All that a universal coverage system will do is change who rations medical care. Currently, the insurance carriers are the gate-keepers – and that is the “customer” that the hospitals and doctors have to satisfy. If you replace the insurance companies with a government agency, then it becomes the gate-keeper to whom the medical service providers are beholden. Under either system, the patient is not the customer who must be satisfied.

    We have no idea what medical care really costs because the system has been distorted through regulation. For example, why should the “courtesy kit” – barf pan, insulated drinking cup, toothpaste, toothbrush, shampoo, body wash, mouthwash, comb, razor, etc. – issued a hospital patient be billed to the insurance carrier for $45.00 when the indinvidual components can be bought at a “dollar” store for about $7.50?

    Most sincerely,

    T. J. Flapsaddle

  32. I’ve seen so-called “Unviersal health care” at work up close and personal-like in Canada. And it’s an absolute mess!

    It’s so much of a mess that fully one quarter of my USA doctor’s patients are now Canadians coming across the border and paying confiscatory CASH rates his far more timely and responsive services.

    For the REAL story of how NOT to implement such so-called “universal” care (and rather than repeating it here), I invite you all to have another look at my previous Blue Blog postings on the subject (Some Thoughts On Universal Health Care) here on Capitol Hill Blue, along with the resulting discussions.

    I believe all of it will, once again, prove enlightening:


  33. Ron:

    Please try to put your thoughts into paragraph format. Makes it more likely that people will read it.

    I have one question and one question only. You say up towards the top of your post that 2/3ds of the money spent on health care in the US is “sucked down” by for-profit corporations. That is, at best, a specious argument unless you are saying that the money is not going to health care. If so, it is your duty to provide support for that statement.

    What percentage of your food dollars go to for-profit corporations? Do you complain that every dollar goes into the hands of a for-profit corporation? Didn’t think so.

    I point out to you that pretty much every dollar you pay directly to a doctor or dentist goes directly to a for-profit corporation, since almost all such medical care providers have incorporated themselves for various tax and legal liability purposes. If they were non-profit do you think they would continue to provide you with medical treatment?

    What I suggested in my post above was providing medical care at the most competitive rates by creating an environment where health care providers were encouraged to compete with one another. Certainly if you want to put together a non-profit organization and compete with for-profit corporations there would be nothing to stop you, but non-profits are normally incapable of competing for one single reason: they cannot sell shares of stock, so they have no way of putting together the kind of money needed for doing such things as building a hospital. And hospitals tend to be on the extensive side.

    Look at http://en.wikipedia.org/wiki/Category:Non-profit_organizations and the sources cited therein for further enlightenment on this subject.


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