The private market insurances have not shown themselves to be more efficient in the delivery of care than government programs. In fact, because of the deliberate administrative complexity they introduce in order to erect barriers to their medical losses (payment of claims) and thereby increase their profits, they are considerably less “efficient” in the delivery of care. It is in their fiduciary best interest to continue that practice.

If anyone here believes that the moneyed interests who are controlling and corrupting the current health care reform debate are powerful now, just wait until every American is required to have insurance and pay into their coffers even more. The currently proposed reforms in the Senate, other than the Sanders bill, would likely be a step backward in the cause of efficient, socially just and human health care in America. At worst, they will even further undermine public trust in government to administer coherent and economically sustainable programs.

One political consequence of fragmenting the entire US population into customer cohorts for market based insurance is that it further fragments political will into the “customer vs the company” on payment for services. Alternately, a public program such as Medicare provides a large, unified risk pool of people invested in maintaining quality of coverage. Going in the market based direction destroys political will, going toward a public plan enhances political will by providing a target that is mandated to be accountable to it's beneficiaries, not to profit seeking shareholders.

It is correct that here is no proven overall savings to preventive care. A few preventive measures in pediatric care (notably immunizations against infectious diseases) and a limited savings in ER costs have been shown, but most preventive care costs more on a systems level, not less. Doctors subscribe to it because of the benefit to the small number of individual patients who will benefit.

As Senator Chuck Schumer has privately said to single payer advocates, “You people will be the last left standing.” because only single payer will work in the long run. How many people will have to suffer and die in the interim? That's up to the vagaries of political will in the US.

I'm going to be very blunt…when you look at the population pyramid, the low projected growth rates over the next decade or two caused by the massive and still exploding debt, and increasing basic material problems, the world is going to have extreme challenges over the next 50 years that will lead to a decrease in standard of living by a ton. The question is how we respond to it.

I believe that we need to move away from a pro-growth economy to a pro-efficiency economy, but this would require massive political, monetary and social changes. One of the cornerstones of that is a single payer system (with private insurance as an add on if you want to buy it…I'm very against banning the private market entirely) simply because it has the ability to be far more efficient. However at present I think it'd be a disaster because it would contribute to some of the problems.

Thanks.

Since you accused me of non sequiturs, though, I noticed that you buried your support for a single payer plan at the end of this post.

A post where you laid out the case for a single payer system would be fantastic!

That said, I have a saying that it seems like the Republicans have policies specifically meant to help major corporations and the rich without regard to everyone else by design, while the Democrats have policies that try to help everyone by design, but only help the rich and major corporations because of unintended side effects and “compromises.”

This that an unfair generalization? Yeah…slightly, but not by much. In most cases.

My problem with the Democrats in general about nearly everything (the climate change bill and stimulus had this problem too) is that they are such cowards.

So many of their ideas start out trying to do something, but by the time they make changes to satisfy conservative Ds, to make it look bipartisan, and to reward all the backroom dealing, then the programs aren't ideologically consistent anymore. The end result is that they cost a lot of money, have lots of regulation and have gapping holes or hand outs that don't add up to much.

Then, even though the deals were made originally to “compromise” and have a more “centrist” bill, when the programs don't work they are attacked as showing that the government is incapable of doing anything. Well yeah it's incapable when it has policies that don't make sense. Which is what they post was trying to show.

Obviously I'm not defending the status quo, but according to the official analyses, few people are going to be added onto the rolls through this bill, so your point about the uninsured is a bit of a non sequitur. When I talk about the cowardly Democrats, I'm also not saying that it means that they have to be Leftists…I just am demanding logical consistency. My proposal at the end is the type of compromise that I feel is the “good” type because it seeks to address both the free market/competition viewpoint and the fact that the real hurdles for smaller and less profit seeking insurance comes from catastrophic cases. Of course the numbers would have to be run and maybe that too is unrealistic, but at least it could work in theory.

I presume you're referring to Myth #9. (Honestly, CStanley–would it freakin' kill you to specifically cite your source??? I have been complaining about this for FIVE years!!!)

Myth 9 ends by saying 85% of uncompensated care was paid for by a variety of sources, including federal and state dollars.

Eighty-five percent.

In an effort to make what I am saying plain, I'm going to italicize my next sentence here.

That means there's still 15% left to recover.

Right?

Anyone care to guess where it comes from?

I am sorry if this seems like shouting.

I too would like a perfect health care reform bill.

Anyway- I'm also not disputing that they debunked the idea that the expanded coverage for all would be a huge additional expense. I was just also pointing out that there's a counterpart to that myth on the other side of the debate, which is that covering all the additional people would save money instead of costing more.

It still remains true, even according to their figures, that the goal of covering everyone adds costs, not subtracts- so if we're going to pursue both goals of expanded coverage and bending the cost curve, we have to get much more serious about cost cutting than the currently debated plans do.

Myth 10: Expanding health insurance coverage to all, or even a large share of the uninsured, will cost far more than the country currently spends on health care.

FACT: Because both the uninsured and government subsidies pay for a good share of their health care costs already, the amount of additional health spending to cover all of the uninsured is relatively small.

It can't be that the 3% represents costs WITH admin expenses but the $48B does not, because the $48B is a slightly bigger number than the 3% one is.

Either they both represent costs with admin costs or they both represent the pure provider payment cost without admin- and from the wording it looks like it's the latter.

CStanley wrote: “If so, OK…but that's still a 3% increase, and they also mentioned that doesn't include the administrative costs of getting those additional people in the system.

No, the 3% increase is AFTER including administrative costs. The figure that does not include them is the $48 billion figure.

…the additional health care spending to cover ALL of the uninsured in 2004 has been estimated to be $48 billion. However, this does not include any administrative costs associated with reforming the system. These new dollars represent only a 3% increase in personal health care spending (which totaled $1.4 trillion in 2003).

CStanley wrote: “they're saying that covering the uninsured will cost more (a 3% increase estimated from what our current total health care costs are) but that degree of increase isn't as big of a deal as opponents make it out to be. Is that a correct interpretation?”

Yes, I think that is the correct interpretation and IMO this is just one of the ten myths exposed.

This study was not done by PR firm of a group with an agenda it was done by a respected and knowledgeable organization in the business of health care.

If you read the entire “Ten Myths about the Uninsured” article you saw anti-health care talking point after anti-health care talking point shown to be nothing short of dishonest, misguided misinformation.

I confess I look at Medicare Part D a little differently than you do. You see it as nothing more than a government boondoggle. I see it as a Republican boondoggle, passed through lies and evasions to satisfy short-term political goals without regard to long-term consequences.

Considering the costs, maybe the Democrats are trying to do the impossible in this bill. But the Democrats are, in fact, struggling to be responsible about the costs, reflected in the CBO numbers. That's why I dislike your analogy to Medicare Part D. In short, I see Medicare Part D as Republican business as usual:

Can there be anyone more two-faced than the Republican leaders who in one breath rail against the evils of government-run health care and in another propose a government-subsidized high-risk pool for people with chronic illness, government-subsidized community health centers for the uninsured, and opening up Medicare to people at age 55?

People who aren't covered by insurance go to the emergency room when they are sick. Many of them can't pay. People who aren't covered by insurance suffer catastrophic illnesses and accidents and go bankrupt, meaning they don't pay for everything. Hospitals still have to recover their expenses, so they increase their charges to people who can pay, which is you and me and everyone else covered by insurance.

I guess I could go into greater detail, but surely you see the gross inefficiencies in this (non-government) hodgepodge.

I'm sure you're not defending what we've got.

I appreciate your substantive response. But I hope my own point is clearer now.

If so, OK…but that's still a 3% increase, and they also mentioned that doesn't include the administrative costs of getting those additional people in the system.

I don't mind people setting the record straight in response to people who exaggerate- but from what I hear from a lot of people who support universal coverage, there's also been misinformation on the other side so that some people believe that covering everyone will actually REDUCE costs overall (they generally seem to think this is because preventative care is cheaper than going to the ER, which doesn't prove true in the aggregate.)

Part 1.

According to the scoring of CBO on the prevention & wellness program, all fitness centers around the world should close down immediately and all media have to end reporting health tips about prevention.

Immune System & Levee System :

All of the excellent health systems seem to have one thing in common, a expansive, systematic preventative program requiring immense investments. I think a prevention system works as a 'levee' built against flood by the government, similarly, it also needs non-profit investments from the government 'on a large scale'.

This might offer us the clue of why all of the free states have public insurance policy in place.

It won't be easy to draw some specific numbers on the economic effect of the 'levee' , but the flood measure lacking a stable 'levee' would be a house on sand, as the too high level of 'preventable' chronic diseases in America shows.

At present, about 75 percent of each health dollar goes to treating chronic conditions.
When tests reveal patients are at risk of a chronic disease, physicians have no benefit to help them make necessary changes to stay healthy. Rather, the system today is designed around treating patients once they become sick.

If current health care system could shift a small percentage of total spending into programs that help prevent people from getting sick in the first place, in combination with the KEY 'pay for OUTCOME' reimbursement reform based on IT SYSTEM, it would dramatically reduce the overall cost of care.

Thankfully, the health care reform bill currently before Congress makes several key investments in preventive care, and those pieces of the PUBLIC OPTION must be maintained.

“An ounce of prevention is worth a pound of cure.”, said Benjamin Franklin , and 'Early Detection' goes beyond monetary value as we see the recent case.

As far as I'm concerned, the congress affected by the special interests has impeded the budget request for prevention program in Medicare & Medicaid. Let's imagine the costs and invaluable lives following the levee breach.

Time is ripe for CHANGE !

To see the forest, get a big picture, massive job creation, promising stem cell research, several times more economic effects of 'from bed to work' , relief on the mental stress and keep-eating-habit caused by deep-seated financial anxiety, which are the epicenter of a number of different diseases, and beyond lie ahead, to be sure.

Part 2.

The 'innovative' idea of a 'pay for value / outcome' pack came after the CBO had previously pointed out this health care reform wouldn't work without 'fundamental' change in the out of date system. It is said that as much as 30 percent of all health-care spending in the U.S. -some $700 billion a year- may be wasted on tests and treatments that do not improve the health of the recipients, and this 700 billion dollars a year can cover a lot of uninsured people.

(Please visit http://www.kare11.com/news/news_article.aspx?st… for detailed infos).

The expected Benefits of this 'innovative idea' are as follows ;

1. Meet the objective of revenue-neutral.
Supporters of the agreement say it could save the Medicare System more than $100 billion a year and 'improve'
care, that means more than $1trillian over next decade, and virtually needs no other resources including tax on the
wealthiest. Supposedly even the 'conservative' number of such savings might be able to meet the objective of
revenue-neutral.

2. Quality and affordability.
If you are a physician, and your pay is dependant upon your patient's outcome, you will most likely strive to
prescribe the best medicine earlier in the process, let alone skipping the wasteful, unnecessary risk-carrying
procedures.

3. No intervention in decision-making.
The innovative idea of 'a pay for outcome' will more likely prompt team approach and decision, as at Myo clinic.
Under the 'pay for outcome' pack, for good reason, best practices as 'recommendations' would simply help them
make a better decision, and the government won't still have to meddle in the final, actual decision-making
process as a non-expert.

4. Speed up the introduction of IT SYSTEM.
The pay for 'Outcome' pack is most likely to expedite the introduction of Health Care IT SYSTEM.
The synergy effect of the combined Health Care IT & a pay for 'outcome' system may allow the clinicians to
'correctly' diagnose and effectively treat a patient earlier in the process so that it can measurably scale back the
crushing lawsuits and deter the excuse for unnecessary cares to make fortunes.

5. Accelerate the progress in medical science, in return, it saves more cash.

6. Settle the regional disparity.

7. Reduce the emergency room visits & save immense costs.
Public health insurance plans such as Medicare and Medicaid paid for more than 40 percent of U.S. emergency
room visits in 2006, according to government figures released recently. Many experts say reducing these hospital
visits would be an important way to lower the enormous, and growing, expense of U.S. health care.

I share the opinion that unlike the insurer-friendly senate plan by 'some' members, only a strong public option will be capable of getting the premium inflation under control and saving the U.S in turbulence.
To my knowledge, a dual system tends to deliver better results than a pure single payer system. Supposedly, to be or not to be might be up to the innovations like a pay for value program, otherwise, the forthcoming start-ups may fill the void with competitive deals. The competition based on 'fair' market value would be a beauty of true capitalism, not monopoly, an objective for anti-trust.

Part 3.

Science / Innovation Key To Recovery !

1. The pay for 'Outcome' pack is most likely to expedite the introduction of Health Care IT SYSTEM so that it can reduce the redundant work burden, focus physician's effort on patients, and store patients' informations to skip the repetitive and painful procedures.

2. The synergy effect of combined Health Care IT & a pay for 'Outcome' SYSTEM may help the clinicians correctly diagnose and effectively treat a patient earlier in the process so that it can measurably scale back the crushing lawsuits and deter the excuse for unnecessary procedures to make fortunes.

3. In modern society, 'medical institute' and 'energy sector' is the only arena that is not retrofitted with 'a must' . And what happens if the financial institutes get back to the PRE- IT SYSTEM ? , supposedly the crisis would be comparable to the present health care crunch. Unlike the numeric errors, medical mistakes, in most cases, is fatal to patients. It is believed that over the duration of two wars, computer IT has not expanded the progress to 'electronic medical records' & ' smart grid technology' . With them in place, people all around the globe might have avoided this tragic recession.

4. The Mayo Clinic medical practice has embarked on the first widely available e-health information service for patients on Microsoft's HealthVault service.

Through Mayo Clinic's network, users of its health-care services can keep up with their health information and information for family members, and receive health guidance and recommendations from Mayo that is optimized for each person.

The system also allows patients to upload information from home-health devices such as blood glucose monitors and digital scales. Patients can authorize whether they want to share their health information with doctors or other caregivers, and those caregivers can provide health-care and general wellness recommendations based on the information patients provide

Part 4.

-Scare tactics from verbal to physical-

1. 'Takeover and Rationing Cliche' lost ground, as this spoiled menu did the opposite for too long.

Like freedom of press, Public Well-being as a right, a nation took root in every free nation as a natural part of life.
The debate about it is most likely to puzzle people all around the free states. And with so many people uninsured
or underinsured, the humanitarian foreign aid ahead will confuse them, too.

2. Arbitrary Market Theory, Not Fair Market Theory, should not apply to a fundamental human right.

This last spring, due to the demand decrease, the peak fuel price came down below $40 per barrel, though, the
'Similar' insurance premiums keep on rising, accordingly the inaction could bankrupt family, business, and
government 'BEYOND this recession' , as all across the spectrum agree.

Basically, as demand diminish, the price tends to reflect it, nonetheless, the insurers that formed a cartel through
consolidation have replenished the loss by exercising inhumane malpractices involving denying, capping, rapid
premium increase and the like. And this runaway premium ended up in the collapse of middle
class ranging from finance to mental health, alongside the peak fuel price and fast-growing mortgage rate, as all of
us know.
They could be cited as an objective for anti-trust or anti-corruption.

3. The Deficit-sensitive groups have a distinctive common ground, they all have a Deficit-driven background out of
question. Therefore, I'd say they have nothing to say about deficit unless they come up with a legitimate plan.

4. These Deficit-sensitive and yet Deficit-driven allies struggle to ignore the positive effects involving massive job creation,
promising stem cell research, several times more economic effects of 'from bed to work' , relief on the mental
stress and keep-eating-habit caused by the deep-seated financial anxiety, which are the epicenter of a number of
different diseases, and beyond, as in the case of sustainable energy investments & the following savings.

5. To see the forest, get a big picture, it might be a way to go.
German firms on Monday 13 July launched a renewable energy project designed to provide European households
with electricity from the Sahara.
Utilities giants RWE and E.ON, electro-engineering group Siemens and Deutsche Bank are among the dozen
companies involved in the 400- billion-euro (552-billion US-Dollar) Desertec Industrial Initiative Dii.
Using high voltage direct current transmission lines, the energy could then be transferred to Europe where it could
supply 15 per cent of the continent's electricity needs.

Thank You !

Lack of health insurance coverage among millions of Americans remains one of this nation’s most pressing social challenges, but one that is often not well understood. Common knowledge about who the uninsured are, why they are uninsured, the difference health coverage makes, as well as the impact on all our lives of having a large uninsured population — is riddled with misconceptions and myths. Basic facts about the uninsured, outlined here under the most common myths, are essential to understanding how we might address the growing numbers of Americans without health insurance.

This report (a small 161kb .pdf file) should (but probably won't) point this debate in a more productive direction.

But I would agree that we simply can't ignore the uninsured as they are directly contributing to the increased. Not to be anectdotal and uncited (but I will anyway), but a hospital in Detroit swallowed $32 million last year in expenses covered the uninsured and underinsured. This year that number is expected to rise to $72 million. That cost falls on other patients, and reduces the ability ot invest in information technology and other crucial infrastructure needed to reduce the general costs of health care. By providing some form of coverage, we can decrease the general costs of those patients by getting them care earlier.

I do hope this is addressed through the development of non-profit co-op health groups, but that will probably be decided by the political winds. Sadly, no one is differentiating that in the public option description from “government-run health care” perceptions.