The Ailing Health Insurance Markets

Oh no! Another economics post! And a long one! Don't fret. The next one will be as fluffy and short as I can make it. But today I want to play doctor and patient with the US health insurance markets.

How to fix the problems of health insurance is a hot topic, these days, honest, and I want to chip in before the elections are over and we forget all about its importance. While Barack Obama and Hillary Clinton are offering competing plans which would cover the forty-seven million uninsured in this country, John McCain has a proposal to cut health care costs by increasing competition in the markets. His idea is that competition would drive the price of insurance so low that most everybody could afford coverage! No need for the government to poke its nose where it is not wanted, and the conservatives surely don't want it meddling with the markets.

There's a sense of deja vu about McCain's proposal. Haven't we been injecting competition into the health insurance markets for a very long time? Even the establishment of the government Medicare and Medicaid programs in the 1960's had a pro-competitive edge, because it removed from the commercial markets the most expensive and the poorest paying cases, leaving them with the most lucrative consumers to insure. The Health Maintenance Organization movement of the 1970's was another injection of that competitive hormone into the insurance markets in the form of prepaid group plans which combined insurance with the provision of care. What additional forms of competition has McCain invented that health economists never dreamt about?

The truth is that not all competition is helpful to consumers. I know that this is not an idea free-market conservatives like, but it's possible for competition to actually hurt some consumers.

For instance, if a product is hard to judge in quality and contents, competition in the price of that product may be meaningless for consumers who don't know what they are getting for the price. Just ask yourself how many people clearly understand the concepts of deductibles and coinsurance (the parts the patient must pay despite having insurance) or how many people clearly understand that the insurance company may refuse to pay for some of those health expenses which you thought were covered by the policy. Then ask yourself what the actual insurance is that these consumers believe they are getting when a policy advertises itself for some attractive price.

Group health insurance policies get around some of these informational problems, sure. But those policies are not available to everyone. They are usually offered by employers. This means that the group to be covered is at least healthy enough to turn up for work. What about those who are not healthy enough for that or who work for themselves or for the many small firms which can't afford to offer health insurance as a benefit?

A recent boxing match between Elizabeth Edwards and John McCain's economic expert, Douglas Holtz-Eakin, highlights one particular problem in the health insurance markets: that of covering people with pre-existing conditions:

Edwards has read McCain's health care proposal (more competition) and asks whether either she or McCain could buy individual health insurance under that plan, given that they both have potentially expensive pre-existing conditions. Mostly people with such conditions have trouble getting affordable individual coverage, because the insurers know that they are not going to be low-cost customers, which means that they are not going to be an asset to the insurance company's profit (in the case of for-profit firms) or to its residual income (which is what profit is called in non-profit firms).

Holtz-Eakin's answer to Edwards is that more competition will make coverage more affordable, even for people with pre-existing conditions. (He also mumbles something about Elizabeth not understanding these difficult health care issues; better to leave them for experts.)

But ironically it is competition itself which may force firms to reject John McCain and Elizabeth Edwards as applicants. Think about it. The ideal candidate for an insurance company is one who always pays the premium and never makes any claims at all. People with pre-existing conditions don't qualify, and a firm which collects lots of them will not win the award for the Year's Most Profitable Insurer.

What insurers would really love to do is to skim the cream off the market by only insuring the young and healthy (hence the advertisements about maternity care and sports medicine by prepaid group plans). Well, not really, but a very cynical insurer might want to do just that, and it is not impossible to imagine a market outcome where all the high-risk customers are left without insurance altogether, except for the few, such as Elizabeth Edwards and John McCain, who can pay very large sums for the necessary insurance coverage.

So what ails the health insurance markets? The answer to that question will depend on how deep you wish to dig and also on whose interests you have in mind. On the deepest level the answer might be that "insurance" is the wrong model to apply to the way we cover the costs of health care. But if we insist on using that model then we should do it within a framework which regulates the kind of competition that firms are allowed to engage in.

Comments (194)

1. mccain was on letterman the other night, acting all chummy with dave and the audience. mccain likes to pretend his this sort of reasonable, straight talking, practical, humble, down to earth guy.

   he said something like, "the problem is we need to cut spending." no mention of iraq AT ALL. but he did mention, "we spent 3 million on studying the DNA of bears." everyone laughed in agreement. well that "study" was quite important, and led to the removal of wyoming grizzlies from the endangered species list. 3 million well spent, imho.

   but the crowd just laughs in agreement. "oh, that mccain, what a swell, funny guy!"

   Posted by darladoon at 04/02/2008 @ 3:22pm

2. universal health care NOW. for ALL.

   Posted by darladoon at 04/02/2008 @ 3:23pm

3. "But if we insist on using that model then we should do it within a framework which regulates the kind of competition that firms are allowed to engage in."

   Which would be a LOT better than trying to take over health insurance under single-payer. Regulate the companies...don't destroy them (which WOULD happen, even single-payer folks admit this).

   Posted by Mask at 04/02/2008 @ 4:13pm

4. "Oh no! Another economics post! And a long one!"

   It is telling that the author feels compelled to make this disclaimer. The fact is that liberals and progressives are gettiing pummeled, or as they say "pencil whipped" because of their lack of attention to the economics of issues.

   Follow the Money! It has never been more true, especially as the corporate media and the consevative think tanks trot out their bought and paid for economists. As Krugman complains the economists that get it right aren't covered by the press, the news or the TV pundits.

   One would hardly know that Krugman favors "Single Payer" because he has never been alllowed to make his case anywhere in the main stream media besides his column. And there are others such as Dean Baker who have excelllent predictive track records that are absent from the economic discussion of health care that is monopolized by the sychophants to the powerful.

   Wake Up Liberal America and follow the money !

   Posted by mmckinl at 04/02/2008 @ 4:26pm

5. Boy am I informed about health care. There use to be one of those sensitivity training modules where you had to go and spend Saturday night in the waiting room of a hospital. That should be required of every high school senior in the United States. Mrs. Edwards has the pulse of this one. "The role of insurance companies is to make money. They make money by refusing health care". Simple right? OK so if we remove the profit motive we will reduce quality and there will be rationing right? Let me give you a few personal anecdotes about rationing. a diabetic buddy of mine, went into diabetic shock because he couldn't afford fuel oil and insulin, we live in Northern Maine. By the time he arrived at the hospital he was dead. Another buddy of mine died of pneumonia for lack of health care. These were working poor. I have spent three months in the hospital with my son, who had brain trauma and have been up close and personal on this one. We fortunately had health insurance, Anthem. while we were waiting for our son to recover we saw people refused health services, because they were uninsured. Private health insurance only works for the few. Some things don't privatize and don't work well when they are subject to corporate greed. Some examples would be; police, fire, army, highways. I would mention government, but I think that has been purchased by corporations, there you go I rest my case.

   Posted by julien38 at 04/02/2008 @ 4:27pm

6. Let me guess one of our local conservatives will chime in with how, everyone should pay for their own insurance, socialism is the devil, and demoncrats are killing America.

   ....Wait for it....

   Posted by Cccomfo1 at 04/02/2008 @ 4:31pm

7. EH, BY THE WAY THANK YOU MS. GOODRICH. AND FORGIVE THE RANT. I WILL BE OK AS SOON AS I TAKE MY VALIUM.

   Posted by julien38 at 04/02/2008 @ 4:33pm

8. One would hardly know that Krugman favors "Single Payer" because he has never been alllowed to make his case anywhere in the main stream media besides his column.----Posted by MMCKINL 04/02/2008 @ 4:26pm

   Okay....so, Paul Krugman's column is NOT in the Main Stream Media?!?!?!??!

   So what's the NY Times....a local independent published in the back of some coffee house?!?!??

   Posted by Mask at 04/02/2008 @ 4:33pm

9. Let me guess one of our local conservatives will chime in with how, everyone should pay for their own insurance, socialism is the devil, and demoncrats are killing America.

   ....Wait for it....

   Posted by CCCOMFO1 04/02/2008 @ 4:31pm

   Don't forget the horror tales of long waits and Canadians mobbing the borders to get in to use our health care system. Besides Frosty, I know a few Canadians, and they find that assertion laughable.

   Also, watch for the false BC statistic I saw on FOX News about how OB/GYNs in British Columbia were sending patients to Washington to birth babies. They saw it as a failure in their health system when it was really a big baby boom that overstrained capacity. EVERY bed dedicated to birthing was full at the same time, so they made a contingency plan to insure safe deliveries.

   Posted by yutsano at 04/02/2008 @ 4:47pm

10. So what's the NY Times....a local independent published in the back of some coffee house?!?!??

    Posted by MASK 04/02/2008 @ 4:33pm

    If you ask our resident neocons it should be!

    Posted by yutsano at 04/02/2008 @ 4:48pm

11. Gov't paid Health Care for every citizen. Gov't paid Health Care for every "undocumented person". Gov't paid childcare services. Gov't paid education through PhD level. Gov't paid unemployment for as long as necessary to find new job at same or greater pay. Gov't paid housing subsidy for anyone wanting to live anywhere if they can't afford where they want to live. Gov't paid public transportation. Gov't paid insurance subsidy (house, renter, car, liability, etc). Gov't paid food subsidy. Gov't paid support for artists, musicians, writers, creatives. Vote for Lemminkäinen!

    Posted by sntauri at 04/02/2008 @ 5:02pm

12. MASK 04/02/2008 @ 4:33pm

    I presented the fact that Krugman was in the NYT. But you knew that.

    But there it ends. No real discussion in the NYT or WAPO or on TV about single payer.

    But you knew that ...

    Posted by mmckinl at 04/02/2008 @ 5:17pm

13. "she was told she had a 3 year waiting period. She ended up going to a private practice and paying for it out of pocket."

    Posted by LVLIBERTY1 04/02/2008 @ 5:57pm

    Thanks LL for pointing out that universal health care is still the best option for the country. All should pay in and should have the option of using the public care. If someone has the cash and would like to pay for a procedure that they feel the universal coverage is not paying for quick enough, more power to them. But they still have to pay into the universal health care. Sort of like with public education. You have to pay, but if you want to go to private school, you can.

    Going to universal health care doesn't mean the end of opting for procedures not covered by insurance. Besides, current health insurance doesn't pay for certain procedures either. Most, if not all private health insurance in this country do not pay for elective lasik eye surgery, many dental procedures deemed "nonessential" are not covered, hearing aids...not covered.

    Posted by BlueTexan at 04/02/2008 @ 6:18pm

14. All should pay in and should have the option of using the public care. If someone has the cash and would like to pay for a procedure that they feel the universal coverage is not paying for quick enough, more power to them.

    Oh, boy! So they get to pay twice for the same surgery! Isn't that wonderful?

    Better yet, I believe someone on this website wanted me to forfeit my government benefits because I was disagreeing with him/her about my taxes...so we should try the flip side of that and let all those who want socialized medicine pony up the money for it and let them take a number while they wait for the life or limb saving surgery that they need. But that would never work...mainly because they want everyone else to pay for their ludicrous ideas.

    Posted by usc1 at 04/02/2008 @ 6:59pm

15. Oh, boy! So they get to pay twice for the same surgery! Isn't that wonderful?

    Posted by USC1 04/02/2008 @ 6:59pm

    If you consider paying taxes for public school and then paying for private school for your kids paying twice? Then yes. But the greater good is being served because someone that couldn't afford private school is going to school for free. Having an educated population is a benefit.

    Having a healthy population is equally beneficial. So why not pay your part?

    Posted by BlueTexan at 04/02/2008 @ 7:05pm

16. Posted by LVLIBERTY1 04/02/2008 @ 5:57pm

    There we go I was right after all I just had to wait long enough.

    By the way LV there is no right for the government to prohibit gay marriage in the Constitution but you seem to be all for that.

    Posted by Cccomfo1 at 04/02/2008 @ 7:06pm

17. Posted by LVLIBERTY1 04/02/2008 @ 5:57pm

    How about people under the current system LV who die because insurance companies consider, what are thought of by doctors as routine surgery, to be experimental. For instance certain liver transplants. I would rather go blind than die because my insurance company doesn't actually want to do what I pay for it to do.

    Posted by Cccomfo1 at 04/02/2008 @ 7:08pm

18. Better yet, I believe someone on this website wanted me to forfeit my government benefits because I was disagreeing with him/her about my taxes...so we should try the flip side of that and let all those who want socialized medicine pony up the money for it and let them take a number while they wait for the life or limb saving surgery that they need. But that would never work...mainly because they want everyone else to pay for their ludicrous ideas. Note that all health care systems use some forms of rationing. The market based system gives the care to those who can afford to pay for it, even if someone else would need that "life or limb saving surgery" more. Systems which are based on government provision of care use other rationing devices, such as making people wait longer for elective care or deciding that cornea replacement surgery for an 85-year old one is not something that should be expedited.

    No system will offer us some kind of a health care paradise.

    But I should probably also note that my post is not about socialized medicine. It's unlikely that the U.S. would go that way, at least in the short run. Though it's interesting to note that the U.S. spends 16 cents out of each dollar on health care, while countries with more centralized systems spend about 10 cents out of each dollar. Yet the U.S. doesn't appear to get 60% more in output. Crude measures of reverse output (such as mortality rates) show this country lagging pretty much all other western countries.

    Posted by jgoodrich at 04/02/2008 @ 7:15pm

19. Both "to socialize" and "to ration" actually mean "to share."

    We'd all like to believe that sharing is never necessary and that "Get your own" is a realistic attitude toward health care. But this would be true only if there were unlimited resources. As the human population grows and the relative size of the planet shrinks, sharing will become increasingly necessary.

    What we need to discuss is how burdens and benefits ought to be distributed. A wise fellow once suggested that burdens should be distributed according to people's ability to bear them, and that benefits should be distributed according to people's needs.

    That wise fellow was either Jesus of Nazareth or Karl Marx - I forget which.

    Posted by JakobFabian at 04/02/2008 @ 7:28pm

20. "a diabetic buddy of mine, went into diabetic shock because he couldn't afford fuel oil and insulin, we live in Northern Maine. By the time he arrived at the hospital he was dead. Another buddy of mine died of pneumonia for lack of health care."

    Posted by JULIEN38 04/02/2008 @ 4:27pm

    JULIEN, I'm a ICU nurse. So forgive me on this one, but your friends didn't die from the "lack of healthcare coverage" they died as a result of their poor health. Your friends could have gone to any available free clinic to get their basic needs met. The fact that one of your friends died after going into diabetic shock tells me a couple of things: 1) he wasn't taking his insulin properly, 2) his blood sugar was hard to regulate, 3) he was eating the wrongs foods, causing his blood sugar to spike or 4) he neglected his health out right.

    As for your other friend who died from pneumonia, was he diagnosed with it before or after he died? I'm asking because a lot factors are involved.

    Posted by ACook at 04/02/2008 @ 7:36pm

21. Posted by LVLIBERTY1 04/02/2008 @ 7:26pm

    So you believe if there is a Protestant church who chooses to marry homosexuals that church should be left alone? I know some churches that would marry homosexuals.

    Posted by Cccomfo1 at 04/02/2008 @ 7:39pm

22. Posted by YUTSANO 04/02/2008 @ 4:47pm

    YUT, a lot of Canadians utilize the American healthcare system. I'm originally from Detroit and the folks from Windsor were always coming into Receiving Hospital. Most of the time it was for critical care. The fact that your friends laugh is because they know it to be true.

    Posted by ACook at 04/02/2008 @ 7:42pm

23. As I've stated repeatedly, the libs here won't be satisfied until they have a truly socialist nation

    in the shallow mind of this author, "truly socialist" means "single payer health care system"? despite the incredibly vast array of currently socialized services (roads, energy, military, schools, libraries, etc, etc), a transition into a single payer health care system would be the ultimate realization of a Socialist nation?

    there is little wonder why this country continues to downward spiral into a Dante-esque abyss when we have people in this country (like lvliberty) who continue to re-elect corrupt, shallow, incompetent and authoritarian politicians.

    Posted by darladoon at 04/02/2008 @ 7:49pm

24. o we should try the flip side of that and let all those who want socialized medicine pony up the money for it and let them take a number while they wait for the life or limb saving surgery that they need

    thankfully, it doesn't work like that, and luckily, we don't have minds like yours running institutions or schools. your job is to remain in your cubicle, and pretend like you're actually working.

    Posted by darladoon at 04/02/2008 @ 7:52pm

25. Posted by MMCKINL 04/02/2008 @ 5:17pm

    So...being in THE "newspaper of record" the NY Times, not enough...not to mention the couple dozen OTHER newspapers it's reprinted in.

    Or the 20 books?

    Or being on "This Week", "Hardball", "Countdown"...not enough?

    Now, what would you like? CNN to grant Krugman an hour, to himself and Candy Crowley interviewing.

    Probably...Krugman, like many other, have their cultists and think that like L. Ron Hubbard, if others aren't in it, it's because he's been "silenced by the MS Media"! Give me a break.

    Posted by Mask at 04/02/2008 @ 7:56pm

26. If you consider paying taxes for public school and then paying for private school for your kids paying twice? Then yes. But the greater good is being served because someone that couldn't afford private school is going to school for free. Having an educated population is a benefit.

    I'll give you three guesses on where I stand on school vouchers. BTW, where did I hear the phrase "greater good" before...hmmm...let me think......

    Having a healthy population is equally beneficial. So why not pay your part?

    Because I can see what people do to themselves on purpose and the consequences are not my responsibility. Why not let ME decide who I wish to help? Can't have that, can you?

    Posted by BLUETEXAN 04/02/2008 @ 7:05pm

    Posted by usc1 at 04/02/2008 @ 7:58pm

27. "How about people under the current system LV who die because insurance companies consider, what are thought of by doctors as routine surgery, to be experimental. For instance certain liver transplants. I would rather go blind than die because my insurance company doesn't actually want to do what I pay for it to do."

    Posted by CCCOMFO1 04/02/2008 @ 7:08pm

    You do realize that it's against federal law to turn anyone away from seeking medical treatment, regardless of their circumstances? Again, people don't die from lack of insurance, they die because they don't insist on being properly treated. If my insurance company told me today that it wouldn't pay for any serious medical conditions I develop, guess what? I'm still going to seek treatment and then I'm gonna sue their sorry asses in court.

    Geez, when are you people going to learn that you should never allow a company to dictate to you, instead you should be dictating to them? Afterall, you're the ones paying the premiums.

    Posted by ACook at 04/02/2008 @ 8:02pm

28. Back on-topic....

    I have always said...single-payer Universal Health Care is...inevitable....and going to be inevitably bad.

    Inevitable, due to the fact the system is so broken now, and the "reforms" merely drive us to worse situations, which will eventually facilitate a "Oh, well, what the heck? Let's let the Gov't run it, it can't be THAT bad!"

    And mind you, UHC proponents ...the Government WILL "run it". This lie that "No, they won't...they'll just pay for it!" is illogical and possibly duplicitious. To "pay for it", the Fed will need to keep track of where and HOW the money is being spent...and that means a BIG bureaucracy with lots of some-kind-of-agents to monitor the doctors, nurses, clinics, and hospitals.

    And we've got to consider the American psyche and American politics. The Congresspeople running and holding office will want to get re-elected...to do so, they will promise more and more and more benefits. Eventually there will be a collision.

    That collision will be where "benefits promised" collides with "taxes possible to be raised". People will be pissed about not getting free nose jobs....OR they'll be pissed that they're getting drained dry on taxes.

    It'll be an interesting moment, politically. Realist politicians will see they can't keep increasing the promises or raise the taxes anymore and the sheen will be off the "wonderful universal American health care system."

    Of course, by then, it'll be too late for any NEW reform...and we'll be stuck with the system.

    Oh, and by the way, that system WON'T include folks like Katrina vanden Heuvel or other rich liberals. The "private spa" system (called that to avoid Fed control) that will spring up will take care of them. Get all the good, RESTED doctors....well-paid nurses...and the state-of-the-art pharmaceuticals that work 99% of the time (while the rest of us get the generic that works 84% of the time).

    But...hey...it'll be "fair" and "everybody will be covered"...and that's the only thing that really matters, isn't it?

    Posted by Mask at 04/02/2008 @ 8:11pm

29. Geez, when are you people going to learn that you should never allow a company to dictate to you, instead you should be dictating to them? Afterall, you're the ones paying the premiums.

    Posted by ACOOK 04/02/2008 @ 8:02pm

    HAHAHAHAHA!!!

    Are you serious? Do you think the hospital just eats that cost? Where do you think it comes from? That's right, tax incentives and governmental grants to ameliorate that cost.

    Plus your insurance company has a whole team of lawyers who get paid very very well to prevent you from collecting a dime out of them if they choose not to pay it. And they have time on their side and will stall and stall until you're completely broke and can't continue your suit. So yeah, go ahead and sue. And when you're totally bankrupt and they still haven't paid you can go on Medicaid. And hey now you're on "socialized medicine!"

    Posted by yutsano at 04/02/2008 @ 8:19pm

30. Back on-topic....

    I have always said...single-payer Universal Health Care is...inevitable....and going to be inevitably bad.

    Inevitable, due to the fact the system is so broken now, and the "reforms" merely drive us to worse situations, which will eventually facilitate a "Oh, well, what the heck? Let's let the Gov't run it, it can't be THAT bad!"

    Actually, most real world examples of a single payer system are compromises, with one large single payer and additional small private insurance alternatives, and very few systems have governments provide most of the care. It is possible to have private providers and a centralized source of funding. Finland does that for primary care, for example.

    I'd warn people of getting over-emotional about the alternatives. There is no medical funding paradise but neither is there a medical funding hell. All systems have problems. To find the best of the bad lot is what we need to do.

    Posted by jgoodrich at 04/02/2008 @ 8:24pm

31. We desperately need a one-payer national health insurance system and not only for the patients' sake. It's also necessary for the sake of the doctors who spend endless hours dickering with the various insurers. A friend of mine is a psychologist and she tells me how frustrating it is to have to write justifications time after time for the same patient receiving the same therapy. An oncologist I know has a woman who does nothing but insurance. My internist and her partners also have a team of people doing the paperwork.

    I have switched carriers and found that a generic drug I take was Tier One in the first plan and Tier Two in the second. Same drug. same manufacturer. Two totally different prices. Different formularies. The patient and the doctor should not have to consider this.

    Putting everyone on a single-payment system would also allow the system to negotiate with the drug companies and would force the drug companies to work out a reasonable profit margin that didn't destroy either the patient or the company. Before I had to go off the drug, I was on a medication that cost $485 a month. That was almost entirely profit margin for Novartis. There are some chemotherapy drugs that cost much, much more -- into the tens of thousands. Am AIDS drug was once $12,000 a year, beyond the capacity of many HIV+ patients. It is now much lower, fortunately, but many infants died because their mothers couldn't afford it and they were born HIV+. This is much more rare now.

    We need some sanity in health care.

    Posted by midnight04 at 04/02/2008 @ 8:27pm

32. Posted by YUTSANO 04/02/2008 @ 8:19pm

    YUT, I work as a nurse in one of the Atlanta area hospitals and the only way an insurance company can get away with not paying is if you don't pursue your case or if you let them intimadate you. Many states, including Georgia, do go after negligent insurance carriers and make them pay up. Even my own hospital has sued BCBS twice and won.

    Posted by ACook at 04/02/2008 @ 8:45pm

33. Posted by MIDNIGHT04 04/02/2008 @ 8:27pm

    Single-payer would be disasterous. The systems needs to be overhauled.

    Posted by ACook at 04/02/2008 @ 8:52pm

34. Why not nationalize the Pharmaceutical Industry? Once the Gov't has tuned up the health care delivery system, imagine how much money could be saved if the gov't could get rid of marketing, sales, advertising, and profits!

    Posted by sntauri at 04/02/2008 @ 9:14pm

35. Windsor were always coming into Receiving Hospital. Most of the time it was for critical care. The fact that your friends laugh is because they know it to be true.

    Posted by ACOOK 04/02/2008 @ 7:42pm

    windsor has consistently elected mps and mpps from the party not in power.

    windsor is completely ignored by ottawa and toronto.

    Posted by frosty zoom at 04/02/2008 @ 9:54pm

36. Oh, and by the way, that system WON'T include folks like Katrina vanden Heuvel or other rich liberals. The "private spa" system (called that to avoid Fed control) that will spring up will take care of them. Get all the good, RESTED doctors....well-paid nurses...and the state-of-the-art pharmaceuticals that work 99% of the time (while the rest of us get the generic that works 84% of the time).

    Posted by MASK 04/02/2008 @ 8:11pm

    kinda like it is now..............

    Posted by frosty zoom at 04/02/2008 @ 9:55pm

37. Posted by ZERO 04/02/2008 @ 9:59pm

    but it's so dang cold in finland.

    Posted by frosty zoom at 04/02/2008 @ 10:20pm

38. Posted by JGOODRICH 04/02/2008 @ 8:24pm

    Ms Goodrich, the key element always forgotten is the American psyche. "everywhere else in the world"...is not the United States.

    Anybody here, yourself included, going to claim that the USA has achieved that noble aspiration of a fully-educated electorate led by clean, sober, and high-minded representatives who's only interest is the common good, logic, and cost/benefit responsibility?

    I'm patriotic and I won't try that.

    We are speaking of a massive benefit provided by the Government, a government that ultimately DOES respond to the people (we can debate the "corporatocracy" later...if true, we'd never had had the New Deal or labor laws and George Bush would have gotten Social Security privatization passed.)

    And given the attitude people have now about health insurance...when it's "free", things are going to get VERY political VERY fast. And in this case, political means "seeking to please everybody, inconvenience nobody, and end up screwing it up eventually".

    As for the private guys...sure, if you can pay a $3000 a month premium, they'll stay in business and you'll get a private room with a Harvard grad doc and drugs from the "A list".

    But the rest will get the "Federal Hospital".

    Again, yes, everybody will be covered....but not for more jam on the bread....the same amount of jam (maybe a bit less) just "spread more evenly".

    Posted by Mask at 04/02/2008 @ 10:20pm

39. As for the private guys...sure, if you can pay a $3000 a month premium, they'll stay in business and you'll get a private room with a Harvard grad doc and drugs from the "A list".

    Posted by MASK 04/02/2008 @ 10:20pm

    but isn't that the way it is now?

    wanna fix the health care crisis? -- cut the subsidies to monsanto, adm, etceteras.....

    Posted by frosty zoom at 04/02/2008 @ 10:25pm

40. Posted by MASK 04/02/2008 @ 10:20pm

    Mask, the moment the libs move the masses to a single payer system, I'm going straight into private duty.

    Posted by ACook at 04/02/2008 @ 10:44pm

41. Posted by FROSTY ZOOM 04/02/2008 @ 10:25pm

    FZ, you realize cutting subsidies won't cut down the spiraling cost of healthcare?

    Posted by ACook at 04/02/2008 @ 10:52pm

42. Posted by ACOOK 04/02/2008 @ 7:36pm

    As an ICU nurse, in what kind of institution and supporting what kind of practice? Unless you work somewhere like a state institution, I'd say you know next to nothing about the difficulties encountered by those your private institution "transfers" elsewhere because they are self-pay, have the wrong HMO or what not.

    If you are going to play the "expert" card - even if you work in a hospital the accepts the uninsured, the incarcerated and everyone else that gets left over after the private hospitals skim off all the so-called "good" patients - you should provide more details about your expertise and what exactly the reasons are for your position - beyond your politics.

    I know quite a few established, attending physicians that think single payer health care is exactly what this country needs. But then again, they work in public institutions with terrible pair mixes.

    Here's my guess. It's would be a disaster for you because it will mean a reduction of costs in the healthcare system and less funneled into private practice, the inability of private hospitals to farm off unprofitable patients to state hospitals, and ultimately, a worse pair mix that will not only hit the salaries of your attending physicians, but will also "trickle down" to ICU nurses.

    But I would love to hear if you have some other explanation beyond your self interest.

    Posted by srjenkins at 04/02/2008 @ 11:02pm

43. Posted by MASK 04/02/2008 @ 10:20pm

    As for the private guys...sure, if you can pay a $3000 a month premium, they'll stay in business and you'll get a private room with a Harvard grad doc and drugs from the "A list".

    A tip for you Mask, if you ever need medical care like surgery, the central question is not whether your doctor went to Harvard (there are many good schools in the U.S., residency programs and so forth) or the institution they are part of (such as Mayo). The central question is their experience, particularly how many cases they do, and how many they have done like yours. You also should consider the fine line between someone with a lot of experience but who hasn't updated their technique and someone with less experience but better technique. No good way to parse that unless you have an unusual circumstance but worth considering anyway.

    Now, question for you. Given the above to be true, who do you think are going to have volume on their side under single payer? Exception to that would be physicians that work for the state and then migrate to private practice after logging a lot of cases, but then, you have the technique issue that gets worse as they see fewer patients and as the medical technology evolves.

    Funny thing is, this is true now as well. You have to be careful which hospital you pick, but it is not unusual for state hospitals to have physicians with more experience with a wider range of problems. Again, it can very a lot by speciality too, but it is very much worth considering when choosing a primary care provider (generally speaking, they should be an Internist), and their associated hospital.

    Posted by srjenkins at 04/02/2008 @ 11:23pm

44. I skimmed the article so maybe I missed it, but what regulations do you propose we include in said framework?

    In the context of the example I was talking about I'm talking either about regulation which requires each insurer to accept the same fraction of high-risk cases (or as close to that as geographic circumstances allow) or the establishment of a fund for high-risk cases, to be paid by all the insurers or by taxpayers.

    Posted by jgoodrich at 04/02/2008 @ 11:53pm

45. Posted by ACOOK 04/02/2008 @ 8:02pm

    What about that young girl? Who needed a Liver transplant but her family couldn't afford to pay for it and their insurance company sat on their hands. Trying to decide if they wanted to pay for it. Just because the hospital can't refuse service doesn't mean you can pay for it. And once you have been raped of all your money for a surgery you couldn't afford you think you are going to have enough left to afford to sue?

    Posted by Cccomfo1 at 04/03/2008 @ 12:25am

46. the Government WILL "run it". This lie that "No, they won't...they'll just pay for it!" is illogical and possibly duplicitious. To "pay for it", the Fed will need to keep track of where and HOW the money is being spent...and that means a BIG bureaucracy with lots of some-kind-of-agents to monitor the doctors, nurses, clinics, and hospitals.

    this is an incredible exagerration, as our current system involves as much administrative coordination as it would under a "socialist" system. money moves the same anytime it changes hands. the government also has computers, offices, workers, printers, desks, cubicles, whatever.

    in canada, the doctors bill the government. wow. how complicated.

    tracking how the money is being spent? is this some sort of impossible feat of engineering of science of technology, what? mask, you are beginning to sound like john mccain.

    Posted by darladoon at 04/03/2008 @ 01:49am

47. the goal, the entire POINT of universal health care, is to provide for the common good. everyone deserves the opportunity to survive. we're not talking about excelling in life, but surviving in life. just to stay breathing, in some cases. there are people who just want to stay breathing. should people like this pay more to survive than the rest of us? why is that? is this humane? can any christian person here actually say that sick people should "pony up"? that seems pretty sick to me.

    those opposed to universal health care are, in my mind, cruel and inhuman.

    Posted by darladoon at 04/03/2008 @ 01:54am

48. doctors used to be integrated into the community. like a local breadmaker or milkman or chef. someone dedicated to the common good.

    what happened to us? where did we go wrong? why must someone put their life savings into surving a disease? why must even healthy people get billed, even when they already HAVE insurance? and pay hard earned dollars for it? is this fair?

    Posted by darladoon at 04/03/2008 @ 01:56am

49. srjenkins post at 11:02 pretty much hits the nail on the head.

    the pressure to keep health care 'market-based' is really coming from self-interests at the very top....

    Posted by darladoon at 04/03/2008 @ 02:06am

50. And given the attitude people have now about health insurance...when it's "free", things are going to get VERY political VERY fast. And in this case, political means "seeking to please everybody, inconvenience nobody, and end up screwing it up eventually"

    it will only get political if you have doubts about its effectiveness. i don't see any reason to doubt the effectiveness of a single payer system in this country.

    Posted by darladoon at 04/03/2008 @ 02:10am

51. Posted by ACOOK 04/02/2008 @ 8:02pm

    Also my best friends mother just went to the hospital. She has to get two non-cancerous tumors removed from her intestines. Her healthcare plan didn't cover it. They had to pay not only the check up fees but the fees to have them removed. So don't bother going on and on about how our system is great and others aren't you can get just as screwed under our system as you can under any other. For instance of the writers I work with HAS to work a certain amount of acting hours on a union show every year. Why you might ask? Because he had a cyst in his small intestine. If he loses his SAG insurance plan no other one will take him because it will be considered a pre-existing condition.

    Posted by Cccomfo1 at 04/03/2008 @ 02:45am

52. MASK 04/02/2008 @ 7:56pm

    The main stream media is much like you, consistent in being consistently wrong. Your diatribes about healthcare reveal either ignorance or propaganda ... I'm leaning to the former.

    Posted by mmckinl at 04/03/2008 @ 04:31am

53. As it is now, all of us are paying for healthcare for uninsured or those unable to pay, with a high overhead cost.

    Why not reduce the overhead? Why not look at what works for other countries and adopt those programs? Single payer does not equal gubmant hospitals. Why are you cons so stuck on the status quo, when it so clearly fails on many levels? where is your christianity?

    I guess when one thinks Finland is Cuba, one should be excused for being confused.

    Posted by crabwalk at 04/03/2008 @ 07:59am

54. Go ahed MASK, whip out the grandma quote, I know you are waiting behind the dumpster with it.

    Posted by crabwalk at 04/03/2008 @ 08:01am

55. For those that think a new bureaucracy will cause a downfall, I suggest that you have never dealt with an insurance company. In my experience there is no worse bureaucracy. None. Deny, deny, deny.

    over 50% of bankruptcies in the US are due to medical issues. Who pays? the same folks that paid for the S&L crisis, you and me.

    Posted by crabwalk at 04/03/2008 @ 08:04am

56. LUVVY, the constitution clearly states that slaves =3/5 of a person, and it is NOT a living document. So, I guess we are stuck.

    Posted by crabwalk at 04/03/2008 @ 08:05am

57. Why do liberals believe that people dying because they couldn't afford a life-saving procedure is any less humane or "Christian" than letting people die because they drew a high number in the surgery raffle that comes with socialized medicine?

    Posted by usc1 at 04/03/2008 @ 08:46am

58. Why do liberals believe that government will cover any and every surgery, medicine, and test that a doctor orders when it doesn't even do that now?

    Posted by usc1 at 04/03/2008 @ 08:47am

59. McCain IS wrong about competition helping to reduce the cost so everyone, or almost everyone can afford Health Care, but not because competition doesn't work. Fact is, competition hasn't been a part of the formula for 30 years, and is not the issue here: The issue is that those who are useing the product are no longer responsible for paying for it (nor could they at this point) Adhering to the principle in a free market that you charge as high a price as you can for your product, the Medical Industry has had a field day because they get their money from the deep pockets of business and state governments (and from us). What incentive do they have to lower their prices. If we had to pay for it ourselves, their price gouging would go away fairly quickly, as otherwise they would have no business. Which would lower the cost. Which would make it more affordable for more people, which is the issue.

    Posted by CHIP THORNTON at 04/03/2008 @ 08:58am

60. Posted by SRJENKINS 04/02/2008 @ 11:23pm

    SRJ, you're talking experience and that has nothing to do with the fact that once the Fed controls health care (Sorry, DARLA, they will NOT just "pay the doctor" with no oversight, investigations, mountains of paperwork, and an Asst. Deputy Regional Sub-Director For Region 65, Quadrant Epsilon on every street corner)....

    the "good doctors" will flee the system.

    Why would they work in crowded hospitals, where, due to no need for ANY restrictions or co-pays, the ERs flood with folks everytime "the kid" gets a sniffle...bruised elbow...or somebody has trouble sleeping and is willing to fill out the 30 Sub-Form Stroke J3 Pharma Sub-Release 874-XY forms for Lunesta (and of course wait 4 hours in the waiting room with six dozen people)?

    No...5-6 years into single-payer, the private hospitals will have waiting lists for doctors who want in. The "Federal Hospitals" will be slightly better than a MASH unit, but few "Hawkeyes"...mostly med school graduates trying to pay off their student loans with "community service" (another "reform" we'll see when the under-grads start to decide to switch to law school instead of med school (They'll NEVER nationalize legal aid...heheh) and the number of doctors starts to fall.

    But, hey, do the research yourself. Basically, what we're talking about with "single payer" is..."Medicare for all", right?

    Okay...go to your local GP, who takes a moderate (not large) amount of Medicare cases...and ask him how he'd like ALL his patients to be on it and have to do the same paperwork on ALL of them?

    I'll be happy to be proven wrong.

    Posted by Mask at 04/03/2008 @ 09:37am

61. I WILL NEVER DO THIS AGAIN, I HATE CHAT ROOMS, BUT SINCE MS. GOODRICH HAS POSTED HERE AND THIS IS A BURNING ISSUE WITH ME

    TO A COOK. MY SISTER IS A NURSE. I LIVE IN NORTHERN MAIN. FREE CLINICS ARE NONE EXISTENT. MOST OF THE PEOPLE IN THIS AREA GO TO CANADA FOR THEIR HEALTH SERVICES. MY FRIEND WITH PNEUMONIA WAS TOLD SHE JUST HAD A COLD AND THAT SHE WAS REALLY JUST TERRIBLY LAZY BY HER "RENT A DOCTOR" AFTER WAITING FOUR HOURS IN TRIAGE. SHE WAS NEVER GIVEN A FOLLOW UP GIMME A BREAK. DON'T PREACH TO ME ABOUT DIABETICS. MY WIFE IS A DIABETIC. IF YOUR GOING TO BE AN APOLOGIST FOR HEALTH CARE DO SOME RESEARCH. MY SISTER WOULD ALSO DEFEND THE MEDICAL PRO. WHEN SHE WAS PART OF THE CRISP WHITE LINE. BY THE WAY I SPENT THREE SOLID WEEKS IN ICU AND WITH MY SON. YOU GUYS DO OK BUT GO VISIT RECOVERY OR STEP DOWN ONCE IN A WHILE. THE TWELVE HOUR SHIFT FOR THIRTY SIX HOURS AND SOME OF YOU WORK SEVERAL HOSPITALS, WORKING 80 HOURS OR MORE A WEEK IS NOT VERY HEALTHY FOR YOUR PROFESSION. I LITERALLY WATCHED PEOPLE TURNED AWAY, FOR LACK OF INSURANCE. DON'T LIE ABOUT THAT AND PLEASE JOIN MY SISTER IN PRIVATE HEALTH CARE. SHE IS MUCH HAPPIER. BY THE WAY FIGHTING FOR INSURANCES TO PAY IS BULL. YOU HAVE TO FGHT AN ESTABLISHMENT THAT EMPLOYS FULL TIME LAWYERS TO FIGHT THESE CASES, WITNESS WALMARTS RECENT NATIONAL EXPOSURE. THEY ONLY PAID BECAUSE OF MEDIA ATTENTION

    Posted by julien38 at 04/03/2008 @ 09:48am

62. Posted by CHIP THORNTON 04/03/2008 @ 08:58am

    Adhering to the principle in a free market that you charge as high a price as you can for your product, the Medical Industry has had a field day because they get their money from the deep pockets of business and state governments (and from us). What incentive do they have to lower their prices. If we had to pay for it ourselves, their price gouging would go away fairly quickly, as otherwise they would have no business. Which would lower the cost. Which would make it more affordable for more people, which is the issue.

    Think about the definition of free market. Free markets generally have specific characteristics: low barriers to entry/exit, many suppliers/buyers, availability of substitutes, etc.

    Medicine isn't a "free market" nor will it ever be a "free market". Medical equipment and infrastructure is expensive (high barrier to entry), training doctors takes a long time - and many cases more than a decade - and they focus on specialities with higher margins so there are always gaps in supply that goes over years (few suppliers), there are no substitute for their services but death - although overseas healthcare is starting to provide an alternative at the expense of the local population.

    In short, the medical field has every incentive to jack up their prices, and your fundamentalist belief in market magic that would make "price gouging would go away fairly quickly, as otherwise they would have no business" shows that you don't understand the business of medicine or the fact that your standard economic model and beliefs do not apply to it.

    Posted by srjenkins at 04/03/2008 @ 09:51am

63. Posted by MASK 04/03/2008 @ 09:37am

    ...the "good doctors" will flee the system.

    The doctors that are in it solely for money, will look for other more profitable opportunities. While some of these are "good doctors", most of them are not. My example of state institutions, which is essentially a form of limited single payer under the current system, demonstrates the point.

    But, hey, do the research yourself. Basically, what we're talking about with "single payer" is..."Medicare for all", right?

    I've done the research. If you compare the amont spent on administrative costs for our system and single payer systems, single payer costs less. Of course, that doesn't mean that your Heritage Foundation talking points don't have some basis in reality and that the program couldn't be improved by simplifying regulation, electronic record keeping and the like. But, let's keep it firmly in mind that the problems of Medicare are not inherent to single payer.

    Posted by srjenkins at 04/03/2008 @ 10:04am

64. Posted by USC1 04/03/2008 @ 08:47am

    Why do liberals believe that government will cover any and every surgery, medicine, and test that a doctor orders when it doesn't even do that now?

    Why do conservatives believe that "liberals" want government to cover any and every surgery, medicine, and test that a doctor orders? Because it is easier to argue against an absurd position?

    Sounds like a great idea. Let me give it a go.

    Why do conservatives believe that people that don't have the disposable income to get standard check-ups such as physicals, blood work, immunizations and the like are better off dead?

    Posted by srjenkins at 04/03/2008 @ 10:10am

65. What I do understand, SR, is that BEFORE the medical industry found its "pot of gold" through business and govt,(which, admittedly, business themselves started in the '50's to draw quality workers with perqs) the prices, while expensive because its a specialty industry, wern't out of control like they are now. I'm seeing a connection there. The market principles still matter, perhaps not in the same way as they do when you buy a car, but they still matter. And obviously I'm not advocating letting terminally ill patients just die off cause they couldn't afford the care if we ever did do what I'm suggesting.

    BTW, you made the statement that "overseas health has an alternative to medical services regarding death? At the expense of the local population? What do you mean?

    Posted by CHIP THORNTON at 04/03/2008 @ 10:12am

66. Why do conservatives believe that people that don't have the disposable income to get standard check-ups such as physicals, blood work, immunizations and the like are better off dead?

    Posted by SRJENKINS 04/03/2008 @ 10:10am

    We don't...but apparently you don't realize that government doesn't cover a lot of this stuff now as my dad recently found out.

    Posted by usc1 at 04/03/2008 @ 10:26am

67. Posted by SRJENKINS 04/03/2008 @ 10:04am

    most musicians who are also good businessfolk,

    aren't good musicians....

    Posted by frosty zoom at 04/03/2008 @ 10:28am

68. hmmmm?

    let's see.

    get health coverage from one of a few companies that want to make a profit,

    or

    get health coverage from the non-profit insurance company which you and i own?

    Posted by frosty zoom at 04/03/2008 @ 10:32am

69. money is not the only thing that can inspire creativity and innovation.

    i doubt hippocrates was in it for the 342-inch plasma tvs and night golfing.

    and i doubt mr kanzius' [youtube.com] motivation is profit, either

    Posted by frosty zoom at 04/03/2008 @ 10:42am

70. Posted by SRJENKINS 04/03/2008 @ 10:04am

    First, didn't say it was "just about the money". It'll be about long hours, crowded waiting rooms, and lots of paperwork.

    Second, as above, I didn't say anything about "administrative costs". (A) because it's irrelevant to the paperwork that doctors and hospitals do. and (B) because Medicare is now only dealing with our senior population and Medicaid with the poor and disabled who are on it.

    But when "everybody" is on it, you're going to have to start "administering" a WHOLE LOT more...plus checking for waste, fraud, and abuse that doesn't come up now with Medicare. (Lotta old folks using it for "free nose jobs"?...nope, but when Missy wants one for her Sweet 16 and Dr. Hibbert can put it down to 'reconstrutive surgery' and charge the Fed....somebody will have to look into it!)

    Posted by Mask at 04/03/2008 @ 11:01am

71. Posted by CRABWALK 04/03/2008 @ 08:01am

    Oh, BTW, CRAB....I don't feel any need to resurrect your call to pull the plug on Grandma.

    Unless you're going to deny that under UHC, you WOULDN'T support rationing?

    Posted by Mask at 04/03/2008 @ 11:03am

72. Eh, by the way folks not to worry the super rich don't use the same medical facilities as the rest of us use. check out the top floors at any hospital if you can get there, sometime. there are entire wings for the super rich that look like plush hotel accommodations. John Edwards has it right, "THERE ARE TWO AMERICAS". Rich or poor if your hit by a bus you don't have time to go shopping. It seems to me that rich or poor you would want to improve delivery not your portfolio. Canada has a world class system, but it is true that elective surgeries do have a line. If you want a tummy tuck you need to go to Detroit, but if you get into a collision with a semi you'd better hope that you are in Windsor

    Posted by julien38 at 04/03/2008 @ 11:23am

73. I notice that Libs do have a tendency, if they don't like free market policies, to simply declare that "they don't apply" or "they won't work" in this case:"This is different", they say: I have to ask, how would they know? More to the point, what makes them think a socialized system WOULD work? It's certainly not going to bring the costs down (ie the overall costs) since with Govt footing a major part of the bill the pockets from which the medical industry can draw its payments just got bigger still. But wait, thats how it works in the free market!

    Posted by CHIP THORNTON at 04/03/2008 @ 11:30am

74. universal health care NOW. for ALL.

    Posted by DARLADOON 04/02/2008 @ 3:23pm

    I like the idea of universal health care, but am not too fired up on any of the candidates solutions. Mrs. Clinton would force people to purchase health insurance with the agreement that their would be some federal oversight, but this plays right into the hands of private health insurance companies.

    Obama would try to lower insurance rates, but stick with the system we have.

    Then we have McIdiot, who will do nothing with the exception of deregulate whatever regulations currently exist in health care now.

    Insurance companies are nothing more than a middle man making profits by investing peoples' premiums in the stock markets and cleaning up on the interest. Furthermore, they've positioned themselves to the point where they are dictating to doctors how to go about treating patients.

    As things stand now private insurance companies are milking the crap out of the system and provide nothing that the fed couldn't do for less, and there would be oversight with the fed involved. And you neocons can spare me the bullshit of the red tape argument because the insurance industry is nothing but red tape when it comes to actually paying out on a claim.

    Health care insurance should not be a profit business. Health care professionals should make a profit because they provide a service. Insurance companies don't provide a service other than weating their beaks similar to a damn extortionist.

    Posted by Wolfgang1 at 04/03/2008 @ 11:37am

75. I'm neither cruel nor inhuman. I'm just better informed than you.

    Posted by MARYBRETBRAD 04/03/2008 @ 11:48am

    No, you make your living from insurance premiums and wish to continue pulling down huge wages genrated by investments of your client's pemiums. Insurance is nothing but throwing money at statistics and probablity outcomes and stacking the deck in your favor. You guys are betting that a major catastophe won't hit and as long as you can hdege your bets, you win. Take when Katrina hit, the insuarnce aassholes out there drug their feet, wouldn't pay on claims, and also raised insurance rates on other customers in the process. So, the only service really rendered is lining your own pockets. It ain't rocket science.

    Posted by Wolfgang1 at 04/03/2008 @ 12:09pm

76. WOLFGANG, curious....you would put out of business, private health insurance?

    Posted by Mask at 04/03/2008 @ 12:24pm

77. Posted by CHIP THORNTON 04/03/2008 @ 10:12am

    We can agree that market principles matter and are instrumental in driving up costs, but those market principles aren't free market principles. They are oligopolistic principles.

    BTW, you made the statement that "overseas health has an alternative to medical services regarding death? At the expense of the local population? What do you mean?

    There is a growing trend toward health care tourism. If you can get bypass surgery in a place like India for a fraction of the price a similar procedure would cost in the U.S., you have a powerful incentive to consider the option.

    The problem with that though is that the standards are frequently different, such as they reuse and resterilize equipment that is thrown away in the U.S. I'd also rather not have to deal with a heart surgery complication in an Indian hospital because they don't have the same kind of medical infrastructure. It's a bit of a roll of the dice, but if you don't have a good alternative, what choice do you have?

    Also, since medical care is a scarse resource, healthcare tourists are in some way taking resources away from the local population. You could argue that they are helping to establish a medical center of excellence that also serves the local population, and there is something to that, I think in the main its a net loss - at least in terms of healthcare availability.

    Posted by USC1 04/03/2008 @ 10:26am

    Not only doesn't government cover it, many good insurance programs (PPO) don't either. Take an immunization for Hepatitis B. More than a million Americans are infected, 60,000 new people get infected every year, and the highest rate of infection happens between the ages of 20-49. Most insurance won't cover it unless you are over 65 years or But when "everybody" is on it, you're going to have to start "administering" a WHOLE LOT more...

    Which is why Wal-Mart makes so much money. Why people don't think economies of scale also apply to government is beyond me.

    Posted by CHIP THORNTON 04/03/2008 @ 11:30am

    I provided reasons why they don't apply. Feel free to address those arguments. The problem is your mental model.

    Posted by srjenkins at 04/03/2008 @ 12:34pm

78. WOLFGANG, curious....you would put out of business, private health insurance?

    Posted by MASK 04/03/2008 @ 12:24pm

    Yep

    Posted by Wolfgang1 at 04/03/2008 @ 12:47pm

79. So is healthcare more like transportation or education?

    neither. if one has cancer, or AIDS, or leukemia, how is this comparable to education or transpo?

    if one cannot pay for health care, then what should one do?

    why is profit/risk a factor in providing equal access?

    if one has cancer, is it ethical to charge them $100,000 to survive?

    i still have not read a convincing argument to these questions. mary has a very one-sided, self-interested perspective......usc1 et al are simply ideological....as always....

    srjenkins is the only critic to incorporate all sides.......the 'humane' side being the most important.

    Posted by darladoon at 04/03/2008 @ 12:49pm

80. when a conservative on this board can adequately address the human-side of the equation, i will listen.

    is it ethical to charge a higher premium on people with a higher potential to become ill?

    if so, explain.

    Posted by darladoon at 04/03/2008 @ 12:53pm

81. if one has a car accident (say, hits a patch of ice, spins off the road), hits her head, and falls into a coma for 6 months.

    is it ethical to bill her family into bankruptcy?

    did this young woman take a "risk" by driving? is it really a "risk" just to leave the house one day, to pick up some groceries?

    how can a family, with little $$, cope with the reality that they cannot afford life support?

    is this not cruel and inhuman to DENY this family a chance to see their daughter live?

    can any reasonable, humane, compassionate person answer this?

    Posted by darladoon at 04/03/2008 @ 12:56pm

82. wtf?

    what kind of society borrows trillions in order to kill

    and

    won't borrow trillions in order to heal?

    Posted by frosty zoom at 04/03/2008 @ 12:56pm

83. MBB-You are correct.We did not invade Iraq to improve on the lives of Iraqis or to bring them democracy.We invited AQ to come in and kill Iraqis while we are killing Iraqis.We're fighting them there so we don't have to fight them here even though none of you can say how they are going to get here in these numbers you people talk about.You don't invite terrorists to "bring it on" if you care about Iraqis.You do that because you don't care about Iraqis.

    Posted by i'm nobody at 04/03/2008 @ 1:08pm

84. Had nothing to do with an attemp to improve the lives of 25 million people by helping them establish democracy.

    Posted by MARYBRETBRAD 04/03/2008 @ 1:01pm

    many brutal dictators. much easier "targets" for "improvement".

    nope.

    Posted by frosty zoom at 04/03/2008 @ 1:10pm

85. Posted by MARYBRETBRAD 04/03/2008 @ 12:40pm

    MBB, I noticed you didn't argue my point about the probablity risk point. You wouldn't be in business if the risks weren't in your favor and it wasn't a profitable venture now would you be? The only reason you make the large profits is because you have a lot of policies and when you make money in the market off the premiums you clean up.

    So, why should you make money off other peoples' premiums is my question? Why shouldn't the people of this country have the option of a federal insurance program where they can take a portion of their paycheck and let that money grow in a federal health investment account overseen by the fed and SEC commission.

    If private insurers can make money off the interest, then the government should be able to run a system off those intersts as well and since it wouldn't be for profit, it should be cheaper which in turn would drive health care costs down, not up. I'd bet you'd see an exodus from a lot of the private health insurance plans if uncle sam ever started such a program.

    Posted by Wolfgang1 at 04/03/2008 @ 1:15pm

86. Had nothing to do with an attemp to improve the lives of 25 million people by helping them establish democracy

    this pretty much erases any credibility this person once had!

    Because if you don't you are forcing others to subsidize their risk (as opposed to pooling similar risks) when you do this, people will self select out of the pool leaving only the most expensive risks until they are paying a premium comensurate with their own risk

    "forcing" is not the right term, as a majority of americans actually WELCOME this type of subsidy, and not, say, corporate subsidies.

    mary, you are a cold-hearted, calculating person who has not adequately addressed the deep ethical problems of "market-based" solutions.

    Posted by darladoon at 04/03/2008 @ 1:15pm

87. Posted by DARLADOON 04/03/2008 @ 12:49pm

    Here's the funny thing. Conservatives on this board try to say they are more ethical than us. However they are fine with giving a person with cancer only two options, die or send yourself into poverty for the rest of your life. They like to deceive themselves by thinking private donations make everything better. However we still have millions of poor on the street. Habitat for humanity and church donations haven't helped them. We still have millions of starving. You guys are really good at ignoring the facts or scapegoating other things (government interference, the Constitution) in order to keep your pockets lined and then you try to paint yourself as morally superior to everyone else. If I know that my money whether it is forcibly taken from me by taxes or given charitably can be used to save someone's mother, father or grandmother from cancer I will gladly give. I will pay my taxes AND I will give to charity. There are many liberals who would do the same. Who do do the same. While conservatives by definition try to keep as much of their money in their pocket we want to give not only to taxes that help protect everyone but to charities that help protect the lowest of the low. That's the problem with your line of thinking. You think charity is the ultimate answer. However charity ignores the people who are ON the edge. The people who are over the edge are the ones charity helps. I want to help those on the edge so they don't get pushed over and I am fine with doing everything I can to help them and I think we should all have that mentality. After all we are all human. We all deserve to live and be happy and considering our only purpose in life is to live and procreate in order to propagate the species we should be trying to protect everyone including people in other countries. We all have the same DNA.

    Posted by Cccomfo1 at 04/03/2008 @ 1:17pm

88. mary, you are a cold-hearted, calculating person who has not adequately addressed the deep ethical problems of "market-based" solutions.

    Posted by DARLADOON 04/03/2008 @ 1:15pm

    Darla,

    MBB is in the insurance business, so it goes without saying that his reasoning would be some what skewed on this particular issue.

    As far as us going to war with Iraq to give 25 million people democracy....I have to laugh my ass off. How in the hell do you give someone democracy in the first place? That's not something you purchase, or give to a country, they have to decide that one for themselves.

    I thought we went into Iraq because Saddam had WMD, threatened to blow his nose on Bush Senior's shoulder, didn't play ball with the oil companies, and challenged W to a sword fight. Iraq was pretty much neutered after the first Persian Gulf War and Iraq's big defense at the time was setting oil rigs on fire as they retreated. Iraq was never a threat to anybody with the exception of Kuwait even then.

    Posted by Wolfgang1 at 04/03/2008 @ 1:32pm

89. The odds aren't in your favor, but you can't afford to lose your house so you take this gamble called home owner's insurance.

    Posted by MARYBRETBRAD 04/03/2008 @ 1:29pm

    I take the home insurance gamble because by law I have to take that gamble. Kind of like I have to have liability insurance by law because I drive. How do you suppose laws like that got pushed through? Concerned citizens or insurance lobby groups?

    Posted by Wolfgang1 at 04/03/2008 @ 1:34pm

90. My understanding has always been that all insurance companies make their real money by taking your monthly premium and investing it in the stock market. That obviously would not necessarily apply to not-for-profit companies.

    What kind of model is that? Some of the larger companies are making obscene profits on a scale similar to that of big oil. The more profit available to reinvest, ostensibly creates more opportunity for shareholder profit, which is the gist of where I'm going with this, albeit, not in a very straight line.

    The bottom line: Are shareholders ultimately determining who gets healthcare and who does not, and how much it will cost? If that's the case, then that in itself is a good reason to find an alternative approach. More competition will simply encourage the kind of gouging we have come to expect, and sadly, to accept.

    The cost of health insurance here in Florida, assuming you can actually get it, is completely unaffordable. I've been without it for two years and counting, even though I qualify for a small business plan under state law.

    Posted by jackwells at 04/03/2008 @ 1:37pm

91. Posted by MARYBRETBRAD 04/03/2008 @ 12:43pm

    You need to go back to your economics textbooks, MBB. If all inputs are increased in proportion, you have economies of scale. If you change a single input, such as the number of people putting tires on a car on an assembly line, there is a point on which you reach diminishing returns - such as four.

    Clearly, single payer is an example of changing all inputs, not a single one.

    Also I think your other argument is also bad. We can empirically see that there seems to be more corruption problems with large private enterprises (Enron and others too numerous to name) than in the U.S. government. Your arguments about somehow government is more succeptible to corruption warrants some kind of evidence because it is definitely counter-intuitive.

    Posted by MARYBRETBRAD 04/03/2008 @ 12:31pm

    Hopefully, you'll never be in a position to see what a diagnosis of malignant cancer does to your finances. Your savings? Gone. Your house? Gone. Not to mention households where the person striken with the disease is the primary earner, who may no longer be able to work, get the health benefits work provides and may even require care themselves to get to the doctor or administer medications.

    Catastrophic illness is something that can potentially effect every person in the United States, and it is something that warrants better protections than those provided by bankruptcy.

    Posted by srjenkins at 04/03/2008 @ 1:40pm

92. In response to MBB insurance gambling theories, I would propose that any insurance required by law should by run by the government. Since the fed has the power of each citizen's wallet and can provide the best investment portfolio in the market place, it would be far superior option compared to private investment agencies for a couple of reasons. 1) They would have a much much larger client base thus dropping premium rates. 2) They would have public oversight into their investment activities as well as how much interest was made off investments.

    Perhaps if this endeavor became profitable even with the reduced rates, either premiums could be reduced, or perhaps some of the money made by uncle sam could be used to improve some of the decaying medical facilities around this country such as closing trama centers as opposed to lining the pockets of folks like MBB.

    Posted by Wolfgang1 at 04/03/2008 @ 1:42pm

93. Darla

    I'll ask again...what is so humane about letting people die while waiting in line for life-saving surgery/treatments?

    Posted by usc1 at 04/03/2008 @ 2:02pm

94. Liv,

    Read the link below provided by the nation. Free market capitalism unchecked is just as bad as communism. Complete power corrupts and that includes church going folks like W and company. Also, our military is a government operation run in the form of a socialistic government. Do you think we should privatize that too? Let companies profit off wars and keep them going so the profits keep rolling in....oh wait, that's what we have now.

    http://www.thenation.com/doc/20080414/faux

    Posted by Wolfgang1 at 04/03/2008 @ 2:05pm

95. Oh, BTW, CRAB....I don't feel any need to resurrect your call to pull the plug on Grandma.

    Unless you're going to deny that under UHC, you WOULDN'T support rationing?

    Posted by MASK 04/03/2008 @ 11:03am

    for the N-th time, we have rationing now.

    Has anybody brought up the new thing in healthcare, medical trips to Thailand etc.?

    Posted by crabwalk at 04/03/2008 @ 2:06pm

96. Posted by SRJENKINS 04/03/2008 @ 12:34pm

    Check your sources. Hepatitis B shots are given to kids now and are covered by most if not all insurances...but still the joke is that liberals think that government will cover all these things to begin with.

    But if we all hold hands and sing "Cumbayah" it will magically happen.

    Posted by usc1 at 04/03/2008 @ 2:07pm

97. Hopefully, you'll never be in a position to see what a diagnosis of malignant cancer does to your finances.

    Posted by SRJENKINS 04/03/2008 @ 1:40pm

    So, by all means, let someone else pay for it.

    Posted by usc1 at 04/03/2008 @ 2:11pm

98. MBB, the worlds second most famous actuary, once tried to claim that obesity had no effect on the healthcare costs of others. go figure!

    Posted by crabwalk at 04/03/2008 @ 2:11pm

99. I wish I had more time for this, but in short, I second MBB.

    Posted by usc1 at 04/03/2008 @ 2:12pm

100. So, by all means, let someone else pay for it.

     Posted by USC1 04/03/2008 @ 2:11pm

     Again, WE ARE ALREADY PAYING FOR IT!!

     Posted by crabwalk at 04/03/2008 @ 2:12pm

101. Here are Q4 2007 profit figures for three of the nation's largest health insurers. Not exactly ExxonMobil but not chump change either. WSJ reported that profit for the industry as a whole was around $10B after write downs and all those other corporate accounting things that nobody actually understands.

     Wellpoint $859.1 million

     UnitedHealth $739 million

     AETNA $448.4 million

     Multiply by four for extra credit.

     Posted by jackwells at 04/03/2008 @ 2:42pm

102. Posted by MARYBRETBRAD 04/03/2008 @ 1:35pm

     I didn't say that die of starvation. I said starving. As in very hungry because they don't have enough food.

     Posted by Cccomfo1 at 04/03/2008 @ 2:53pm

103. Posted by LVLIBERTY1 04/03/2008 @ 1:54pm

     Don't even talk to me about unconstitutional legislation. You have taken away the right to habeus corpus, privacy and free speech.

     Posted by Cccomfo1 at 04/03/2008 @ 2:56pm

104. Still have not heard from the "right" why it is OK for the military to have lifelong socialized healthcare, but not the rest of the citizens.

     Posted by crabwalk at 04/03/2008 @ 3:08pm

105. 4. One needs look no further than Medicare to understand that our economic system and population in this county cannot support the kind of radical change many on this site desire. It has been stated repeatedly by the Comptroller General of the US that Medicare is bankrupting the country. Even a tripling of payroll witholding would not resolve this crisis. How then would putting the entire nation on a system that goes beyond Medicare be financially feasible

     Posted by LVLIBERTY1 04/03/2008 @ 2:15pm

     Funny you quote this. Yet the evil socialist economy you so stand up against manages to make all of these programs work and most european economies are doing a lot better than ours.

     Posted by Cccomfo1 at 04/03/2008 @ 3:11pm

106. Posted by LVLIBERTY1 04/03/2008 @ 3:08pm

     On November 1, the American Booksellers Foundation for Free Expression (ABFFE) sent a disturbing letter to its members.

     "Dear Bookseller," it begins. "Last week, President Bush signed into law an antiterrorism bill that gives the federal government expanded authority to search your business records, including the titles of the books purchased by your customers. . . . There is no opportunity for you or your lawyer to object in court. You cannot object publicly, either. The new law includes a gag order that prevents you from disclosing 'to any person' the fact that you have received an order to produce documents."

     Posted by crabwalk at 04/03/2008 @ 3:11pm

107. Hint: the answer is that all of you know that a constitutional change would not succeed. Therefore you attempt to bypass the constitution with unconstitutional legislation and trust in the power hungry nature of politicians.

     Posted by LVLIBERTY1 04/03/2008 @ 1:54pm

     hint: if The Supremes uphold it, it's constitutional. Like the income tax, Soc Security, Medicare.

     Posted by crabwalk at 04/03/2008 @ 3:13pm

108. It's really funny to read a "conservative" that is on one hand truly concerned about prospective job loss due to cost savings, and on the other desirous to keep beeyro-crats employed in private industry.

     Posted by crabwalk at 04/03/2008 @ 3:17pm

109. ...Lynne Cheney's group, the American Council of Trustees and Alumni, which she co-founded in 1995 with Senator Joseph Lieberman, Democrat of Connecticut.

     That group issued a report after September 11 called "Defending Civilization: How Our Universities Are Failing America, and What Can Be Done About It." It said, "When a nation's intellectuals are unwilling to defend its civilization, they give comfort to its adversaries." And it cited more than 100 examples of what it considers unpatriotic acts by specific academics.

     "What's analogous to McCarthyism is the self-appointed guardians who are engaging in private blacklisting," says Eric Foner, professor of history at Columbia University. "That's why the Lynne Cheney thing is so disturbing: Her group is trying to intimidate individuals who hold different points of view. There aren't loyalty oaths being demanded of teachers yet, but we seem to be at the beginning of a process that could get a lot worse and is already cause for considerable alarm."

     Posted by crabwalk at 04/03/2008 @ 3:21pm

110. No, insurance companies (life, health, property and casualty) make money by assessing risk accurately and charging a premiums that are commensurate with that risk. Specifically, the premium is equal to the present value of expected claims and expenses, plus a margin to compensate the shareholders for contributing risk capital to prevent insolvency in the event of adverse deviations from expected experience. That is how insurance companies make money.

     The benefits provide under a policy are listed in the policy. If an insurer refuses to reimburse covered benefits, it will be sued into oblivion. It must, however, deny benefits not specified in the policy as those costs were not included in the risk assessment / premium determination.

     This is certainly true, in the sense of how premia are calculated. But as I noted at the end of my post, the insurance model may not apply to health care very well. Moral hazard (of both ex ante and ex post types) is a major problem and so is adverse selection. And what an insurance policy is supposed to cover is almost always a vague enough question to leave room for some denying later on.

     And on the idea of suing the insurer: That requires energy, time and money, and the insurer can probably outdo the consumer in those. Most of us will not be able to sue, for those reasons.

     Posted by jgoodrich at 04/03/2008 @ 3:22pm

111. ahh, now military service is akin to slavery?

     One surrenders his right of movement for 2-4 years, perhaps pushing papers, perhaps dodging IEDs, then one gets free healthcare for life.

     Yes, just like slavery. Sorry I missed that too.

     Posted by crabwalk at 04/03/2008 @ 3:23pm

112. The Associated Press

     Thursday 03 April 2008

     Washington - For at least 16 months after the Sept. 11 terror attacks in 2001, the Bush administration believed that the Constitution's protection against unreasonable searches and seizures on U.S. soil didn't apply to its efforts to protect against terrorism.

     That view was expressed in a Justice Department legal memo dated Oct. 23, 2001. The administration on Wednesday stressed that it now disavows that view.

     More lefty hippy lies about lost rights

     Posted by crabwalk at 04/03/2008 @ 3:29pm

113. So, in 11 years when our costs have risen to more than 60% of the budget (given current percentages), how would Americans afford the level of taxation that would cover adding the other 80-90% of Americans not currently on Medicare?

     Posted by LVLIBERTY1 04/03/2008 @ 3:26pm

     1: gee, higher taxes, but, some of that money is already spent as premiums/out of pocket costs for the uninsured.

     2: reducing overhead from 28% to 2-4%. Again, money that is already coming out of the consumers pocket.

     3: (here you go MASK). Ranking procedure by cost effectiveness.

     4: recouping $10,000,000,000/yr in profits now eaten by insurance companies.

     5: Persons could still purchase their own healthcare where appropriate/needed.

     6: Medicare/aid now covers mostly the most ill. By broadening the pool, we spread the cost, just like a private insurer does.

     From my point of view, we need to do something. We need to look at what works in other places, and what does not, and modify our system. Too many people fall through the cracks, and we all pay for it now.

     Posted by crabwalk at 04/03/2008 @ 3:36pm

114. Slavery is not the same as indentured servitude . You picked the term, not me.

     Now, if we want to argue along the lines of indentured servitude you have a point. But, if offered the chance to enroll in either the armed forces, AmeriCorps, Peace Corp etc for 2-4 years, then get free healthcare for life, I think an awful lot of people would take that offer. Now there is one choice, Chimpies military.

     Posted by crabwalk at 04/03/2008 @ 3:39pm

115. Also, keep in mind that many that enter the medicare system have not had basic medical care for lengthy periods. By offering preventative care to all we reduce costs in the long term.

     Posted by crabwalk at 04/03/2008 @ 3:42pm

116. Posted by LVLIBERTY1 04/03/2008 @ 3:41pm

     Even if tied to income levels, I still think many would take that option.

     If we can give free care to a supply sergeant that serves for 20 years, why not a teacher, nurse, daycare provider?

     Ahh, we do for a unionized teacher you say, but with tremendous overhead caused by private insurers administrative costs and costs associated with the bureaucracy in dr's offices related to dealing with dozens of different insurance companies and their myriad assortment of plans.

     Posted by crabwalk at 04/03/2008 @ 3:47pm

117. Again, please remember that 50% of bankruptcies in the US are due to medical bills. To me that is a sign of a system that needs to be fixed.

     I KNOW we can do better, we are the greatest place on earth, ever, and God loves us. I learned that here.

     Posted by crabwalk at 04/03/2008 @ 3:50pm

118. What do we do with all of the insurance employees that will be out of a job?

     Teach them to be nurses, doctors, hospice workers, radiologists, mid-wives, counselors...

     Posted by crabwalk at 04/03/2008 @ 3:52pm

119. And if any insurance actuaries find themselves out of work, there are plenty of good paying jobs rebuilding Iraq.

     Posted by crabwalk at 04/03/2008 @ 4:02pm

120. Posted by LVLIBERTY1 04/03/2008 @ 2:15pm

     Most of that was complete horseshit. So, you would sacrifice 360 million people for roughly 3 million in the insurance industry? And if what you say is correct, and a good portion of those 3 million workers are salaried workers, that means they themselves can't afford their insurance either.

     The thing you conservative types don't see is that you are on the unconservative side of this issue. This system is wasting billion upon billions of dollars in profits going to shareholders instead of treating patients. For example, my doctor can't even prescribe a particular type of allergy mist because my insurance doesn't see fit to cover that. Now, who the hell gave insurance companies the right to tell pharmacies and doctors what to and not to prescribe? Evidently some suit probably making between 100k and 200k looked at a data sheet and thought, gee whiz, we can make more profit if we quit covering this particular product and go force our patients to use the lesser product. But hey, profits come first right LIV. So now, I run around sneezing in the springtime and falltime which inevitably leads to sinus infections because the insurance, WHICH I FRIGGIN PAY FOR WON"T COVER WHAT THEY SAID THEY WOULD COVER!!!!

     For someone who is so religious you are the most market driven, war driven, blood thirsty Jesus warrior I've ever heard...besides RIO of course, but you claim to be a minister which just blows me away. Just out of curiousity, how many guns and knives do you own?

     Posted by Wolfgang1 at 04/03/2008 @ 4:17pm

121. I think we are approaching the health care issue from the wrong direction. We have relied on the free market, the legislative branch, and the executive branch of the government to bring us affordable, quality, and available care for too long with decreasing success. We should realize that there is no more hope there. What they were willing to do, they have done. The situation grows more dire daily. I propose that we try a novel approach. Our Declaration of Independence states that the first right that our Creator has given us is the Right to Life, and the Bill of Rights says that we shall not be deprived of it without due process. It also says that governments are created to ensure that our rights are protected. When they are not, we have the right to change the government. It is encumbent upon our government to protect our right to life which in our current civilization means access to adequate and timely health care. The provision of health care should be one of our government's functions along with the provision of military defense as noted above. I suggest that we approach the judicial branch of our government in order to establish this new function as a logical function of the government. How? I propose that we start locally as all government really is local. I am not an attorney, but I suggest that those who are find cases of people who were denied care completely or in a timely manner which resulted in loss of life and bring suit against the local government as the initial point of contact. I believe that these cases will fail, but they should be pursued up the judicial chain until some case reaches the Supreme Court. I hope that there is a logical arguement to be made there so that they can spell out this function as a governmental one. The legislative and executive branches will have no choice but to figure out a way to enact a feasible system for delivery. As for the insurance companies and the HMO's, they have made themselves obsolete by their greed. When they began playing doctor with their decision-making, they ceased to be tolerable.

     Posted by Angeladtao at 04/03/2008 @ 4:20pm

122. Corp etc for 2-4 years, then get free healthcare for life, I think an awful lot of people would take that offer. Now there is one choice, Chimpies military.

     Posted by CRABWALK 04/03/2008 @ 3:39pm

     Crab, You know I would hate to side with Liv on anything becuase then I think I would be siding with Satan, but signing up for the military for one stint (4 or 6 years) will get you free medical care for only the 4 or 6 years you are on active duty. After that, you are on your own.

     Posted by Wolfgang1 at 04/03/2008 @ 4:28pm

123. Great post...and so fab to see you here!!

     Posted by veronicaeye at 04/03/2008 @ 4:30pm

124. What do we do with all of the insurance employees that will be out of a job?

     Teach them to be nurses, doctors, hospice workers, radiologists, mid-wives, counselors...

     Posted by CRABWALK 04/03/2008 @ 3:52pm

     Take MBB. He claims he has advanced math skills. If so, a guy like him could do something useful like engineering, possibly being a math teacher or go to Vegas and work for the gambling houses. They like to stack the deck against the players there as well. MBB would fit right in.

     Posted by Wolfgang1 at 04/03/2008 @ 4:32pm

125. This one is much longer (134 pages), but is a comprehensive examination of the 20 myths about Single Payer Health Insurance. It examines Single payer systems around the world in comparison to our US healthcare system.

     http://www.debate-central.org/topics/2002/book2.pdf

     Posted by LVLIBERTY1 04/03/2008 @ 4:22pm

     Liv,

     I haven't said anything about socialized medicine. All I"ve mentioned is removing private insurance coverage from the equation. Why do you worry so much if your insurance policy is brokered by the federal government versus some jack ass corporation trying to pocket as much money as they can? I wouldn't think that you would have a ton of stock in the insurance industry.

     I was suggesting removing the middle man (the insurance companies) from the equation. I didn't say anything about removing doctors and their private practices. I'll bet most doctors would love seeing the insurance industry get the hell out of medicine. Businessmen shouldn't be making life and death choices on people's health care. I don't want some greedy slick talking piece of crap deciding whether or not my daughters get care or not.

     Posted by Wolfgang1 at 04/03/2008 @ 4:42pm

126. I own no guns and the only knives I own are my kitchen knives and a pocket knife for camping or emergencies.

     Posted by LVLIBERTY1 04/03/2008 @ 4:25pm

     That's refreshing. At least you don't fit the stereotype of religious folk our where I live.

     Posted by Wolfgang1 at 04/03/2008 @ 4:44pm

127. have quite a few clients from the healthcare industry, especially nurses and doctors. Their comments are more like ACooks than the leftwing views I read here. And many of these people are liberal or moderates.

     Posted by LVLIBERTY1 04/03/2008 @ 4:32pm

     My doctors have told me the exact opposite. As a matter of fact, one group of doctors I had in Seattle completely moved their office, pulled their names from the insurance coverage lists and ran their own private office and billed patients directly and were able to make more money that way.

     Posted by Wolfgang1 at 04/03/2008 @ 4:46pm

128. You have done an excellent job of framing the logical conclusion of the womb-to-tomb government control that liberalism seeks to impose on Americans.

     Posted by LVLIBERTY1 04/03/2008 @ 4:36pm

     And your position is that the feudalistic. The lords versus the peasants. The wealthy get wealthier and the poor get poorer. Not so bad if you are rich, but it sucks like hell if you are poor.

     Posted by Wolfgang1 at 04/03/2008 @ 4:49pm

129. And your position is that the feudalistic.

     Sorry, meant to say your position if of the feudalistic system.

     Posted by Wolfgang1 at 04/03/2008 @ 4:50pm

130. I have read here that serving 20 years in the military will get you free medical care for life. That is a myth. As a military retiree, I can tell you the facts. A retiree under age 65 who is not eligible for Medicare must choose between several plans that all require payment out of retirement pay. My husband has Tricare Prime which means he pays a fee to be treated in the military facilities. I use Tricare Standard which means I see any doctor I choose who accepts Tricare and pay a 25% co-payment. If I select a preferred provider, the co-pay is only 20%. We have a Delta Dental plan that is subsidized by the government. If you are over 65 or younger and are eligible for Medicare, you pay the regular Medicare Part B cost, and Tricare For Life acts as a Medicare Supplement. Does that sound free? We also pay co-pays for our prescriptions if we aren't close to a military pharmacy or the drugs we need aren't available there. These co-pays are being raised constantly. Also, this administration and DoD are constantly trying to add on new fees. They are looking for money to fight the war by short-changing the retirees. Is this logical in a time of war and poor recruitment? I still think a single payer system would eliminate all of this kind of jockeying for dollars at the expense of one group for another.

     Posted by Angeladtao at 04/03/2008 @ 5:24pm

131. I am a self employed optometrist who hit the jackpot this year. I turned 55 and my rates went to $18,000 a year because I have had heart surgery and also have a few assorted health problems as many of us in our 50's and 60's have. With deductibles, co-insurance etc. I have paid $23,000 for healthcare this year. It will go up at at least $24,000 for my policy when I hit 60 not including the obligatory increases they hit me with each year. John McCain is so ignorant when it comes to healthcare. A market based system will ignore people like me to cherry pick the healthy. As J. Goodrich so eloquently mentioned: people like John McCain would be denied health insurance in 44 states if he applied for health insurance as an individual. That is what is so wrong with our Country. If you are 65 or over, or very poor or work for a big employer like the Federal Government, (do you hear this John) you have adequate health insurance. But, if you are self employed or have to buy a policy as an individual you are out of luck. The other day I had a 59 year old patient sitting in my chair who was legally blind because she had cataracts that needed surgery. She was in tears because she did not have health insurance and she couldn't afford to pay thousands out of pocket. The very next patient came in and had almost identical cataracts and was referred to a surgeon because she was seven years older and she was on Medicare. It is immoral! I will not even start on the topic of what it is like having an optometry practice and trying to deal with all these insurance companies. It is estimated that we as a Country spend 300 billion dollars a of year just on extra red tape, CEO salaries, advertising, marketing, stockholder dividends, underwriting etc. just to have all these health insurers under the guise that this is competition and a free market system. What a joke!

     Posted by wmeadow at 04/03/2008 @ 5:26pm

132. Posted by LVLIBERTY1 04/03/2008 @ 3:26pm

     Obviously you have a problem with logic. If Euros can make it work and still sustain their economy obviously we are doing something wrong however your argument that it is not possible to remedy is wrong because Europeans manage to do it. Was my point. Maybe before you insult people you should actually try to understand what they are saying.

     Posted by Cccomfo1 at 04/03/2008 @ 5:44pm

133. Posted by LVLIBERTY1 04/03/2008 @ 3:08pm

     HAHAHAHAH How about the right for the government to kick in my door and search my house without a warrant? Or to tap my phones without a warrant? How about the journalists that were arrested for submitting unfavorable articles? A friend of mine got his house searched by the government for no other reason than he was middle eastern in ancestry. He was born here which makes him an American citizen. They never presented a warrant. YOU are the one lying.

     Posted by Cccomfo1 at 04/03/2008 @ 5:47pm

134. Posted by LVLIBERTY1 04/03/2008 @ 3:10pm

     Also I don't seek to circumvent anything LV. There are plenty of laws initiated that are not straight out of the Constitution. So basically what you are saying is that any law that is put into place that does not come from the Constitution is Unconstitutional? Also I DO support putting in the Constitution, however I am not a politician so I can't. And can you please shut up with all the leftist rhetoric. Your bullshit is making my head spin. Can we have a conversation that doesn't involve you trying to type cast me as something and categorize. I could categorize you as a racist, bigot because most KKK members are more than likely Republican. However I don't because I'm intelligent.

     Posted by Cccomfo1 at 04/03/2008 @ 5:51pm

135. Posted by LVLIBERTY1 04/03/2008 @ 3:32pm

     Actually he is being perfectly honest. Does the military pay you? Therefore it is employment. With employment comes certain stipulations. The fact that you are given a paycheck means it's not slavery. It is employment.

     Posted by Cccomfo1 at 04/03/2008 @ 5:54pm

136. Posted by LVLIBERTY1 04/03/2008 @ 3:32pm

     What YOU are refering to is indentured servitude. Which is where you enter into a pact with someone. It was done a lot for passage to America. You get passage on a ship and in exchange you work for someone in America. Your only pay was a place to live and food.

     Posted by Cccomfo1 at 04/03/2008 @ 6:01pm

137. The best comment is by WMeadow the optometrist, he pretty much succinctly says it all. I am unemployed (last underemployed about 6 mths ago) & since over 40 yrs of age find it challenging to find a 'real' job. We live in FL & there are plenty of service econ $5 an hr jobs but my background is technical sales mgmt. bottom line companies want someone 30+ for the most part. Ageism is another very undiscussed issue in the country but that is another story... I was sick for over 2 weeks last yr & could not get over what I had finally I had to go to the Doctor & put it on my credit card. I have not been to a doctor for a physical or had health care insurance for 5+ years. Heard Hilary say something to the effect that many of the uninsured were chosing not to buy health care insurance. How dare she make that brazen statement! We are draining what retirement savings we had to attempt to survive until we find "real jobs". Americans don't realize we are treated like subjects & slaves - we are serfs & expendable & part of the Elite are the Senators and similar gov employee's. The healthcare crisis is not fixed because the controllers and powerful & their minions the Lobbyists don't want it to be!

     Posted by eecs at 04/03/2008 @ 6:15pm

138. here is the right wing argument against universal health care in a nutshell:

     "the united states is not ready for universal health care because the desire to exploit health services and products for profit exceeds the desire to make sure that every american is covered."

     can any reasonable person dispute the above claim? i dare them.

     the desire to exploit health services and products for profit is the raison d'etre of private insurance companies. if it wasn't, then they would pour their energies into a far less profitable venture (one which works against their own self-interests): public health care.

     so, my word for private insurance companies is: go to hell! you have made the lives of many americans i know HELL.......

     Posted by darladoon at 04/03/2008 @ 6:28pm

139. If you do, why would you think it is the government's responsibility to do all of this for you?

     there is a fundamentally deceitful aspect to your argument. either way, i'm paying. either way, i'm taking responsibility. how "responsible" is it to call blue shield and say, "i'd like you take take care of my health care" as opposed to having the government do it?

     where is the inherent responsibility in asking a private company to do the work of providing health services for you?

     what, do you think rich people do their own surgeries? you think some janitor can remove his own tonsils? would that be "responsible" enough for you?

     man, you guys are silly....

     Posted by darladoon at 04/03/2008 @ 6:54pm

140. If I had the attitude of most of the leftists here, I probably would have shot myself by now.

     Posted by LVLIBERTY1 04/03/2008 @ 6:51pm

     Great line from a pastor. Shows a real sensitive and loving personality.

     Posted by Cccomfo1 at 04/03/2008 @ 7:01pm

141. Posted by LVLIBERTY1 04/03/2008 @ 6:51pm

     LV have you ever stopped to think that maybe your generalization and narrow-minded ways of thinking aren't very intelligent? I like don't go to the doctor unless it's an emergency. I have been twice in the last 5 years. Once to check that a cyst was not cancerous and once for a broken leg. I like you practice responsibility for my own health. However I take compassion on those who aren't as long to be healthy. Some people are more prone to health problems than others. Some families who don't qualify for S-CHIP have children born with major problems and can't afford the hundreds of thousands of dollar that is required to be spent to make that child healthy. I want others to have the opportunity. I can get healthcare if I want. It's not for me, it's for everyone else. For someone who is so pro-religion you sure do practice a lot of Darwinism.

     Posted by Cccomfo1 at 04/03/2008 @ 7:11pm

142. Greata line showing a distinct lack of a sense of humor.

     Posted by FREIHEIT 04/03/2008 @ 7:04pm

     If you read enough of what he says you would know he's not joking. He like many other's call Democrats, Demoncrats and blame all the woes of America on liberals.

     Posted by Cccomfo1 at 04/03/2008 @ 7:12pm

143. Dear Ms. Goodrich: At the risk of sounding patronizing, or fawning, I have reread your article several times, as well as the several comments you have made to our rants. Every time we comment and then go back and read what you have written we tend to sound more and more idiotic. Thanks again for the article and I pray it has some impact on the powers that be.

     Posted by julien38 at 04/03/2008 @ 7:20pm

144. Hey Darladoon, is your dealer profit motivated?

     i am not profit-motivated. i am food-motivated, sex-motivated, herb-motivated, art-motivated, white sand beach-motivated......

     Posted by darladoon at 04/03/2008 @ 7:25pm

145. (Sorry, so late...hair cut for the boy and then supper)

     WOLFGANG, curious....you would put out of business, private health insurance?----Posted by MASK 04/03/2008 @ 12:24pm

     Yep-----Posted by WOLFGANG1 04/03/2008 @ 12:47pm

     Okay....how many people work in the private health insurance industry?

     Posted by Mask at 04/03/2008 @ 7:31pm

146. My being against nationalized health care is rooted in it's proven inability to provide universal results

     "its" inability? where is this? can you name a location where it hasn't provided "universal results"?

     this ought to be interesting.......it's like cheney claiming he's not part of the executive branch. even though.........he's part of.........the..........executive branch.

     Posted by darladoon at 04/03/2008 @ 7:33pm

147. still, no conservative has effectively disputed my claim that the interests of insurance companies run contrary to the interests of health service providers.

     Posted by darladoon at 04/03/2008 @ 7:38pm

148. The product we pay for is health care. Whether we pay Medicare taxes, or private insurance premiums, we give our money to someone else to pay our doctor bills. Who gives us the most bang for our buck?

     The insurance industry's "educational arm," The Council for Affordable Health insurance,"published a study in January, 2006, titled, "Medicare's Hidden Administrative Costs." They concluded you get 84 cents worth of health care for your insurance premium dollar, and 95 cents worth for your tax dollar.

     In other words, the insurance industry takes your money to pay your doctor bill, and charges you 16 cents of your dollar, while the government only charges a nickel. Who, with good sense, would pay 16 cents for a service they can buy for a nickel?

     The government doesn't pay sales commissions, it doesn't buy advertising, it doesn't pay multi-million dollar executive salaries, & it doesn't squeeze its clientele to provide a profit for investors. It just provides service, inexpensively & efficiently.

     None of these insurance industry costs contribute to paying your doctor bill, so for you they are unnecessary economic waste. The government provides the same service with less hassle for your doctor, and for you as well.

     Applying market forces to the insurance industry cannot bring down health care costs as long as 11 cents of each premium dollar is wasted on expenditures that do not pay your doctor bill. That 11 cents would go a long way to covering the uninsured if invested in a government program instead of corporate welfare.

     Posted by olroy70 at 04/03/2008 @ 7:59pm

149. And your motivations are characteristic of someone who has responsibility for no one except herself, and her own wants and needs

     nothing could be further from the truth, and you know this. do you need herbs? i'll give them to you in exchange for whatever you do for me.

     Posted by darladoon at 04/03/2008 @ 8:00pm

150. osted by FREIHEIT 04/03/2008 @ 7:27pm

     Just so you know I am not or or against Universal Healthcare. I play devil's advocate sometimes but I would like to see a solution that doesn't involve a full high jacking of the system. I don't trust insurance companies because their whole business revolves around the fact of them NOT paying out. The less money they have to give people the more profits they make which is inherently flawed. So your characterization is just as wrong as so many others have been of my points of view. I don't think anyone needs a hand out, I for one have never wanted a handout. I work for everything I get.

     Posted by Cccomfo1 at 04/03/2008 @ 8:03pm

151. Dardaloon Go look at this and pass it forward. You will LOVE it - especially the $$$ math http://www.universalhealthcareinfousa.com

     Posted by John Saarikko at 04/03/2008 @ 8:28pm

152. If you take your conclusions to their logical extension, then government must control what we eat, where we live, what we drive, where and what work we have, how many children we bear, whether we drink or smoke, and even what level of risks in life are acceptable (ie, sky-diving, body surfing, snow boarding or skiing, mountain climbing, etc).

     You have done an excellent job of framing the logical conclusion of the womb-to-tomb government control that liberalism seeks to impose on Americans.

     Posted by LVLIBERTY1 04/03/2008 @ 4:36pm

     what we eat -- well, cannibalism is illegal.

     where we live -- well, you can't live in yellowstone, can you?

     what we drive -- well, i can't drive a car that burns old tires, can i?

     where and what work we have -- well, selling crack is illegal.

     how many children we bear --

     whether we drink or smoke -- you can't open a beer or light up a camel on the white house tour, can you?

     level of risks -- isn't suicide illegal?

     Posted by frosty zoom at 04/03/2008 @ 9:49pm

153. For someone who is so pro-religion you sure do practice a lot of Darwinism.

     Posted by CCCOMFO1 04/03/2008 @ 7:11pm

     well put.

     Posted by frosty zoom at 04/03/2008 @ 9:52pm

154. It is the overall laziness, lack of ethics, lack of moral standards, failure of parents and grandparents to provide good parenting guidance and discipline, politicians in general from the right and the left, and a society that demands quick and easy solutions in the same way they are impatient if they can't cook something in the microwave, or buy it in a McDonald's drive through.

     Posted by LVLIBERTY1 04/03/2008 @ 7:32pm

     well put.

     Posted by frosty zoom at 04/03/2008 @ 9:53pm

155. Posted by FROSTY ZOOM 04/03/2008 @ 9:49pm

     One thing to always keep in mind with LVLIB is....(and yes, used this line already) he thinks everything done since Teddy Roosevelt "trust-busted" is un-Constitutional on the domestic front.

     Posted by Mask at 04/03/2008 @ 10:06pm

156. Posted by LVLIBERTY1 04/03/2008 @ 10:05pm

     if only you'd leave the violence behind.....

     Posted by frosty zoom at 04/03/2008 @ 10:06pm

157. The insurance industry's "educational arm," The Council for Affordable Health insurance,"published a study in January, 2006, titled, "Medicare's Hidden Administrative Costs." They concluded you get 84 cents worth of health care for your insurance premium dollar, and 95 cents worth for your tax dollar.

     In other words, the insurance industry takes your money to pay your doctor bill, and charges you 16 cents of your dollar, while the government only charges a nickel. Who, with good sense, would pay 16 cents for a service they can buy for a nickel?

     Posted by OLROY70 04/03/2008 @ 7:59pm

     It's obvious that you didn't actually read the report.

     Posted by usc1 at 04/03/2008 @ 11:22pm

158. do you need herbs? i'll give them to you in exchange for whatever you do for me.

     Posted by DARLADOON 04/03/2008 @ 8:00pm

     As I recall, you said once that you trade your herbs in exchange for many or most of your living expenses including rent. So out of curiosity, how much would you be paying in taxes to support the universal health care you lobby for?

     Posted by usc1 at 04/03/2008 @ 11:25pm

159. My states budget included free in-state college tuition up until 1937 (when SS started). Today, 40% of our state budget is consumed by Medicaid and Medicare.

     Insurance companies suck, but if you get rid of them, not only do you transfer the administrative aspect over to the government, but you also have to add the oversight (Insurance co's performed both of these functions). Based on economy of scale, we really can't afford to do it.

     The worst aspect of doing it would be that there would be no "un-doing" it. If it turns out to be too expensive/not as good, etc. Once the unionized bureaucracy is in place, not a chance in hell that someone will risk political suicide in cutting all those government workers loose.

     Since the majority of insurance is provided by corporations, how do you not see turning this over to the govt. as possibly the largest "corporate welfare" scheme imaginable?

     Posted by Sliver at 04/03/2008 @ 11:28pm

160. Oh Daaaaarla...

     You still haven't explained what exactly is so humane about letting people die just because they drew a high "lottery" number for that life-saving surgery.

     Posted by usc1 at 04/03/2008 @ 11:31pm

161. I will pay my taxes AND I will give to charity. There are many liberals who would do the same. Who do do the same. While conservatives by definition try to keep as much of their money in their pocket we want to give not only to taxes that help protect everyone but to charities that help protect the lowest of the low.

     Posted by CCCOMFO1 04/03/2008 @ 1:17pm

     Don't want to let this slide...this is another lie that gets propagated by the left.

     Conservatives actually give more to charity than liberals. Someone even wrote a book about it...you should check it out.

     Posted by usc1 at 04/03/2008 @ 11:46pm

162. Posted by USC1 04/03/2008 @ 11:46pm

     I didn't say the left gave more. I said that we are willing to give to charity and pay taxes. At least I am. I can't speak for everyone.

     Posted by Cccomfo1 at 04/04/2008 @ 12:09am

163. Can't wait for the free health care!

     Posted by FREIHEIT 04/03/2008 @ 7:42pm

     duh, it won't be free. Just like it's not free now. Some will get it at no cost, just like they do now. You will pay for that, just like you do now. Savings generated by universal administration and uniformity in billing procedures will run in the billions of dollars.

     Posted by crabwalk at 04/04/2008 @ 07:21am

164. Got insurance?

     Get really ill?

     Insurance co drops you.

     Go bankrupt.

     MBB and LUVVY pick up the tab.

     Thats the way it is.

     HAd dinner with a physician friend last night. His family practice has 1/2 dozen people dedicated solely to dealing with insurance companies. If we made one simple switch, universal billing procedures, 4 of those people could provide healthcare services instead of administrative services, at the same cost to the system.

     Multiply times every dr's office/hospital/clinic.

     Posted by crabwalk at 04/04/2008 @ 07:33am

165. most musicians who are also good businessfolk,

     aren't good musicians....

     Posted by FROSTY ZOOM 04/03/2008 @ 10:28am | ignore this person

     nonsense. I could just as well say that musicians who blog incessantly aren't good musicians.

     Posted by emile duBois at 04/04/2008 @ 08:20am

166. What's so special about health care? It's not even a primary need. Primary needs for humans are food, clothing, and shelter.

     you ever been sick? Mary

     absolute nonsense.

     you can be as rich as Croesus, when you're sick and don't have access to medical care, you are likely to die.food, clothing and shelter will no longer be necessary.

     Posted by emile duBois at 04/04/2008 @ 08:24am

167. It is the overall laziness, lack of ethics, lack of moral standards, failure of parents and grandparents to provide good parenting guidance and discipline, politicians in general from the right and the left, and a society that demands quick and easy solutions in the same way they are impatient if they can't cook something in the microwave, or buy it in a McDonald's drive through.

     Posted by LVLIBERTY1 04/03/2008 @ 7:32pm

     well put.

     Posted by FROSTY ZOOM 04/03/2008 @ 9:53pm | ignore this person

     NO IT ISN'T, it's a load of crap.

     Posted by emile duBois at 04/04/2008 @ 08:30am

168. How about the fact that he is friends with a communist agitator that is trying to bring down the government?

     Posted by MARYBRETBRAD 04/04/2008 @ 03:31am | ignore this person

     you have no idea what it is like to live in a free democratic society. free speech? free association? you are clueless.

     Posted by emile duBois at 04/04/2008 @ 08:34am

169. The free market delivers goods and services more efficiently than any centrally controlled governemtn program.

     it's just not true. there used to be private highways.

     Posted by emile duBois at 04/04/2008 @ 08:37am

170. as well as private bridges, private fire depts, etc

     Posted by emile duBois at 04/04/2008 @ 08:37am

171. nonsense. I could just as well say that musicians who blog incessantly aren't good musicians.

     Posted by EMILE DUBOIS 04/04/2008 @ 08:20am

     ah, but you've never heard me play. i've heard them play.

     Posted by frosty zoom at 04/04/2008 @ 09:25am

172. NO IT ISN'T, it's a load of crap.

     Posted by EMILE DUBOIS 04/04/2008 @ 08:30am

     i disagree. it's great to try to improve government.

     but the most important government is the one inside one's head.

     people dig their graves with their mouths.

     Posted by frosty zoom at 04/04/2008 @ 09:31am

173. Froz, you haven't heard most of them. your categorical statements are generally wrong. you just don't have enough information to make them.

     Posted by emile duBois at 04/04/2008 @ 09:39am

174. http://www.thenation.com/blogs/action/ignore.mhtml?who=frosty%20zoom

     cliche ridden tripe.

     Posted by emile duBois at 04/04/2008 @ 09:42am

175. Bottom line, a lot of folks here would just love to have the power of government force us to live the way THEY see fit. I see a bunch of rants here about "fat, lazy Americans". I believe the push for govn't provided and managed health care, a business ill-suited for government, is more about POWER, and far less about what's best for people.

     Posted by FREIHEIT 04/03/2008 @ 5:05pm

     You may be right, but one thing we do know is that the system we have now is failing miserably. Healthcare costs are so high it drives up costs for companies to pay for workers compensation. So, because the insurance companies are double dipping into the premiums, we are losing manufacturing jobs, engineering jobs, programming jobs and the list goees on and on to other countries.

     What do you propose? Keep going as we are and lose another 20 million jobs in the process so everyone can work without medical care and flip burgers making minimum wage? That's the direction we are heading in if our leaders don't pull their heads out of their asses.

     Posted by Wolfgang1 at 04/04/2008 @ 10:00am

176. Hi from OZ, i'd like to comment that Americans seem to be completely fooled by all things medical.You's seem to be typecast in this zombie type role concerning health.The health system and Government are yours -make it so.They have taken so much off you.You might be use to it but your country looks like a stress case to everyone else.So much ill and stress is brought on your society because of what is taken off you concerning health.It is not their right, it is something taken and conned and scammed off the people and controlled by spin and cunning press and fear.Free health does'nt mean your a communist, you've all been trained to accept that.We are suffering a major step towards a system like yours at the moment, the people have caught on and are putting their foot down and the govt claims to be backing off.But they are relentless.Stand up to the greedy control freaks, they are walking around with your lives in their wallets.Wake up good people and don't be conned, believe me they will, they'll do and say anything.No offence meant, my family use to look after your sons and fathers in the 2nd WW here in Nth Queensland.Take your lives back.

     Posted by P Casey at 04/04/2008 @ 10:02am

177. Posted by WMEADOW 04/03/2008 @ 5:26pm

     Thank you for the post. It's nice to hear medical professionals take on this issue. Like I said, every doctor I've talked to has said the exact opposite of what Livliberty claims.

     Posted by Wolfgang1 at 04/04/2008 @ 10:05am

178. dispute that claim Darladoon. There are millions of americans who make the choice not to pay for health insurance. Health care is not a right. It is an individual's responsibility to plan for the future. Do you pay for your health care Darladoon? Is is part of your job compensation? Do you have a 401k? Do you look soberly to the future and take care of your own future?

     Posted by FREIHEIT 04/03/2008 @ 7:56pm

     You made two errors with the planning for the future statement. Some people, for example, are born with type I diabetes. How the hell do you plan for that as an infant. Then there's the case of a completely healthy person getting injured in a car accident. And for the case of argument, let's say the accident is the other driver's fault. That person may never be able to work again or require medical treatments for the rest of their life. There's no way to take something like that into consideration.

     Also, you brought up the 401k savings plan. Many people, myself included, have watched there 401k shrink by half and change as the market fluctuates. Unless you put the bulk of your money into low risk markets or bonds, you really can't count on that money being there either as we saw after the dot com crash and are seeing now as well.

     Kind of like the depression, people can't forsee things like that happening unless they are the ones directly controlling the levers. The people pulling the levers don't have to worry about their 401k retirement plan or anything else. I just saw on one of the news websites where sales of multi million dollar yachts are skyrocketing? Why do you think that is? All of the money that is being siphoned away from your fellow countrymen is going somewhere, but it sure as hell ain't working people, it's wealthy, greedy folks who have so much money that they have money to burn.

     You wish to side with the haves and have mores, go ahead, but don't be surprised if the shit comes your way as well, because it does roll downhill and unless you have millions stashed somewhere, you can lose everything you have. Don't believe me, look back at what happened before and during the great depression.

     Posted by Wolfgang1 at 04/04/2008 @ 10:26am

179. So, even though I didn't say what you claimed I said, in a sense it is true. On average, obeses people have lower costs to the govenment than normal weight people.

     Posted by MARYBRETBRAD 04/04/2008 @ 02:39am

     That would be because they die of heart related disease on average sooner than your normal weight person.

     Posted by Wolfgang1 at 04/04/2008 @ 10:34am

180. I prefer to keep doing the useful things I do today, Like figuring out ways to lower life insurance premiums so that companies can offer more competitive products.

     Posted by MARYBRETBRAD 04/04/2008 @ 03:20am

     You and your ilk are failing miserably at your preference.

     Posted by Wolfgang1 at 04/04/2008 @ 10:36am

181. He makes money off of sick people? Why would you patronize such an evil individual?

     Posted by MARYBRETBRAD 04/04/2008 @ 03:23am

     Because this evil guy, who by the way is in the Seattle area as well, was actually the medical practitioner. He was directly charging me versus you getting your cut of the money which reduced the overall charge. Go figure.

     Posted by Wolfgang1 at 04/04/2008 @ 10:40am

182. So long as Congress gets free health care, no one else will. Elizabeth Edwards is correct to ask if she or McCain could even buy insurance. The billions spent on insurance company profit, overhead, and executive pay would be much better used to fund Medicare for all. We don't need health insurance. We need health care. We need health education. Too many chronic conditions that drain resources could be prevented through proper diet, exercise, and 8 hours of sleep per night. These behaviors need to be taught to 6 year olds and reinforced throughout their lives.

     Posted by Montemalone at 04/04/2008 @ 12:34pm

183. Posted by LVLIBERTY1 04/03/2008 @ 6:51pm

     Suppose you wake up tomorrow a little fuzzy thinking and go to the doctor and discover you have brain cancer. Are you turning the gun on yourself or having the taxpayer pick up the tab for your liberty and pay for the tumor resection, radiotherapy, chemotherapy and the doctor's visits?

     And even if you would pay the price for your bad choices, what do most people typically when this occurs?

     Posted by srjenkins at 04/04/2008 @ 1:43pm

184. Posted by LVLIBERTY1 04/04/2008 @ 2:18pm

     A Single PRayer System?

     Posted by crabwalk at 04/04/2008 @ 3:29pm

185. The Oregonian, USA Mar. 22, 2008 Jessica Bruder and Dana Tims

     The case of a 15-month-old Oregon City girl who died for lack of medical treatment could become the first test of a state law that disallows faith healing at the expense of a child's life.

     Ava Worthington died March 2 at home from bacterial bronchial pneumonia and infection, according to Dr. Christopher Young, a deputy state medical examiner. He said both conditions could have been prevented or treated with antibiotics.

     The child's breathing was further compromised by a benign cyst that had never been medically addressed and could have been removed from her neck, Young said.

     Child-abuse detectives recently referred investigative findings to prosecutors, who are evaluating the case in light of a law passed in 1999 after several faith-healing deaths of children.

     ...The Followers of Christ Church came to Oregon early in the 20th century. According to church tradition, when members become ill, fellow worshippers pray and anoint them with oil. Former members say those who seek modern medical remedies are ostracized by the group.

     ...The church still practices faith healing, he said, though members became even more secretive after the unwanted attention of the late 1990s and the Legislature's removal of faith-healing protections.

     "It certainly was our fervent hope that changing the laws in 1999 would change the behavior of the Followers of Christ," said Rita Swan, president of Iowa-based Children's Healthcare is a Legal Duty.

     She expressed dismay at the thought of parents who rely on prayer to heal children suffering from easily treatable medical conditions:

     "It means that they're very stubborn people who have decided it's more important to act out their religious beliefs than protect the life of their flesh and blood child."

     http://www.religionnewsblog.com/20949/ava-worthington-2

     Posted by crabwalk at 04/04/2008 @ 3:34pm

186. The mother of an 11-year-old rural Weston girl who died of untreated diabetes says she didn't know her daughter was terminally ill as she prayed for her to get better instead of taking her to the doctor.

     Madeline Neumann died Sunday from an undiagnosed and treatable form of diabetes.

     Her mother, Leilani Neumann, tells The Associated Press her daughter's condition worsened suddenly, and the parents stayed in prayer, believing she would recover...

     Posted by crabwalk at 04/04/2008 @ 3:40pm

187. Health care IS a right. It is one stolen off the people and the situation trained and educated,forced, maneuvered, conned by politics, media, psychology, fear, bluff and despair and self righteousness on the people.Those above benefitting don't want you to take that back.Here in OZ people have been killed, laws manipulated and Governments sacked to try to bring an American type system on.The people should be at the top of the food chain "cutting the public cake" not greedy,self indulgent murderers and control freaks.The blue bloods, elite and silver spoons, trades, investors,lackey's and benefittors will call you all sorts of names , manipulate ,lie, cheat, steal and kill to live above others and have them subservient to their system of govt that they set up with people,laws and systems to stop their stance being undone. THEY are the communists and thugs, NOT the people.True liberty and freedom is nothing to fear or the change to it and the people benefitting from their taxes and Governmental system is not a sin or a dream. These freedoms and rights were taken off you in other days by the rich and would be's and the powerful medical and legal trades.Don't ask for change, demand it.

     Posted by P Casey at 04/05/2008 @ 01:03am

188. Posted by LVLIBERTY1 04/04/2008 @ 4:15pm

     One point is that God does not listen to prayers for the lives of children, is he going to save you just because you ask?

     Posted by crabwalk at 04/05/2008 @ 01:32am

189. Canadian Comment I am a Canadian married to an American who was horrified to learn that some of my US relatives had to put a $40K mortgage on their house to help pay for neurosurgery as a result of co-insurance clauses in their "gold plated" medical insurance plan. Although single payer insurance has a number of drawbacks - I am on a 4 month wait list for an MRI - one of the best arguments in favour of single payer plans is that it gives Canadian companies a significant competitive advantage when bidding against American companies. I estimate that the difference in payroll costs to American firms is about 15 - 20% of total payroll OR depending on the industry at least 5 - 10% of revenue. We see it in the auto industry. That is "following the money" as one other commentator said. Two other comments in general: 1. When is the Nation going to issue a Canadian edition - big market up here - I used to subscribe but quit because of the lack of local content? "Y'all" might get some interesting perspectives on issues from us and we really should be combining forces to battle the common neo-conservative perspective - we have plenty of it here too. AND 2. Cut the nonsense about renegotiating NAFTA with Canada because of unfair labour practices and lack of green legislation here. Ontario and BC have tougher labour laws than most US states and BC is working with California to coordinate green legislation such as a new carbon tax on gas - not popular with a lot of people up here.

     Posted by WBA52 at 04/05/2008 @ 2:42pm

190. Canadian Comment I am a Canadian married to an American who was horrified to learn that some of my US relatives had to put a $40K mortgage on their house to help pay for neurosurgery as a result of co-insurance clauses in their "gold plated" medical insurance plan. Although single payer insurance has a number of drawbacks - I am on a 4 month wait list for an MRI - one of the best arguments in favour of single payer plans is that it gives Canadian companies a significant competitive advantage when bidding against American companies. I estimate that the difference in payroll costs to American firms is about 15 - 20% of total payroll OR depending on the industry at least 5 - 10% of revenue. We see it in the auto industry. That is "following the money" as one other commentator said. Two other comments in general: 1. When is the Nation going to issue a Canadian edition - big market up here - I used to subscribe but quit because of the lack of local content? "Y'all" might get some interesting perspectives on issues from us and we really should be combining forces to battle the common neo-conservative perspective - we have plenty of it here too. AND 2. Cut the nonsense about renegotiating NAFTA with Canada because of unfair labour practices and lack of green legislation here. Ontario and BC have tougher labour laws than most US states and BC is working with California to coordinate green legislation such as a new carbon tax on gas - not popular with a lot of people up here.

     Posted by WBA52 at 04/05/2008 @ 2:43pm

191. Mary that's true.The peoples wages are regulated, why not the top end? It's over 200 dollars here to get a needle and a tooth torn out of your head with a pair of pliers.About 10 minutes work.The public system was run down here on purpose so govt pays -with public money -for people to go private that can't afford insurance.Since this was arranged a few years ago the cost went from 70 to over 200.It costs $55 to walk in and out of a doctors room plus they stretch it to the 85 bracket by talking small talk especially to the elderly and pester everyone with indignance to come more often, you can't say nothing because it's too hard to get to see one.They pass everyone around to their friends who do the medical tests unnecessarily. That's public money.Many of the procedures are over rated and the skill needed.Nurses do more work in the hospitals.The stated average wage here is taken at middle ground including the richest but the true average wage here is 13 to $20 before tax.So who's working for who and arranging things legally over others? No matter who or what party has been in power here a doctor and dentist and medical speciallists shortage has been arranged by not raising training numbers for a few decades since our population was only about 12 million.They are sending us broke and killing people.It's a three month wait for emergencies and people have been going blind waiting for ops, one lady i know waited 3 years and her eyes are damaged now, plenty more have been waiting for 5 and 7 years living with a range of problems.Baby boomers are being fattened for the kill here (their houses and bank acc's) and the medical trades and insurance companies are arranging things for themselves.We've just had an arranged housing price boom here with public housing being sold off and no more being built and the country flooded with immigrants. Rent has gone from 120 to 350 average.No land is being released to keep prices up even though we only have a population of 20 million here in a country this size.Housing prices have gone through the roof.The cost of health is ridiculous. It's like the car insurance industry, corruption. Plastic hubcaps- up to $200 each, and all overcharged labour when insurance is concerned especially.The doctors should be paid more for their skill but this is criminal.We are slaves to them and they have all political parties stacked.Our governments have been held to ransom -they helped arrange all this though,so it's the people who are ransomed, and have been pumping hundreds of millions into the medical system to keep up services.The peoples money. Your country is no different, it's much worse.Our media is also controlled and we are bombarded with "spin" and lies to keep it up. They just take too much.People are dying from stress and suicides have gone through the roof and families are living in the bush everywhere. We've never had this before.I think it's called slavery, inequality and just basically marauding and criminal.

     Posted by P Casey at 04/05/2008 @ 2:44pm

192. http://www.thenation.com/blogs/action/ignore.mhtml?who=P%20Casey

     $200 for a tooth extracted? don't make me laugh.I just paid the oral surgeon $500 for that service. he did a fine job and I was glad to pay it.

     Posted by emile duBois at 04/05/2008 @ 3:12pm

193. It's actually $280 here Emil. I'm very happy for you.

     Posted by P Casey at 04/05/2008 @ 9:40pm

194. WBA52, those upstairs will also run the system down, like with what you are experiencing to make political change.Our medical trades worked in unison with the United States here in the 60's and 70's, contrary to what you hear, the Whitlam dissmissal was tied up with it.My Father was killed being used as a test case to break down the King's laws that were put in place here to protect the people, returned soldiers in particular, from doctors and lawyers preying on the people and govt systems.He did 2 years on the front lines in Korea. They were the onus of proof and benefit of the doubt clauses of the Australian repatriation act.The kings laws were quietly dropped after the dismissal and a fight over medicare ensured.We were forced to live in the bush as children and he still has no soldiers grave, his ashes are under someone elses marble grave and no one here will do anything about it, contrary to all Australian laws.Doctors and others who were responsible for his torturous death joined Federal parliament as Federal ministers straight after he died in Easter 75 and the Govt that was looking at Medicare was sacked a few months later.My family has been ignored and outcast since.No Government minister wants to know about it.You's need to keep your wits about you and stand up.

     Posted by P Casey at 04/07/2008 @ 8:36pm