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The 'Public Option' Debate
In this Aug. 15, 2009, President Barack Obama talks about health care during a town hall meeting in Grand Junction, Colo. Obama's weekend concession on a health care "government option" drew complaints from liberals and scarce interest from Republicans and other critics on Monday, Aug. 17, 2009, a fresh sign of the challenge the administration confronts in finding middle ground in an increasingly partisan political struggle. (AP)

President Barack Obama talks about health care during a town hall meeting in Grand Junction, Colo., on Aug. 15, 2009. (AP)

For months in the health care reform debate, the country heard Barack Obama describe a “public option” for government-run insurance as key to overhauling American health care.

On Saturday, in Colorado, the president said the public option was “just a sliver” of reform. On Sunday, his health chief Kathleen Sebelius said it was not essential. By Monday, headlines had it on the chopping block.

Conservatives rail against it. Progressives say it’s a must. This hour, we’ll talk with Democrat Howard Dean and more about the fate of health care reform and the public option.

You can join the conversation. Tell us what you think — here on this page, on Twitter, and on Facebook.


Joining us from Burlington, Vermont, is Howard Dean, former presidential contender, former governor of Vermont, and until January of this year chairman of the Democratic National Committee. He’s founder and senior advisor of Democracy for America, a progressive political action committee. He’s also a physician, a big voice in the health care debate, and a big supporter of the public option. His new book is “Howard Dean’s Prescription for Real Healthcare Reform.”

Joining us from Washington is Len Nichols, director of the Health Policy Program at the New America Foundation. He was senior advisor for health policy at the Office of Management and Budget during the Clinton administration’s health care reform efforts of 1993-94.

Also from Washington, we’re joined by Gail Wilensky, economist and senior fellow at Project HOPE, an international health education foundation, and recently served on the World Health Organization’s Commission on the Social Determinants of Health. She directed Medicare and Medicaid from 1990-1992.  She was an adviser to John McCain’s 2008 presidential campaign and a contributor to the McCain health care plan.

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  • Mike

    This is what 3k plus lobbyist per senator can do. As the pham, insurance, ama say there on board they send their lobbyist to push the opposite, still pushing for mandatory health care, non negotiable medicines, and letting the doctors still run wild. and the yapping far right republican(amazing many on medicare, watch some of the town halls when there asked to raise there hands, or when told medi-care is government run) yapping away about things that don’t exist in the bill because some far-right radio host, blogger told them so.

    On top of that obama is still trying to work with these republicans who in the end will not vote for the bill cause there fridge voters who are making up a bigger chunk of there party wont allow it. As these blue dogs are well aware but seems to keep watering down the bill to appease the fridge of our society. those people protesting government run health care and are on medi-care(who being healthy, and mid- 20th is paying for) should drop it and go for the private insurances and see how they fair with there pre-existing conditions i sure there many people in our country that would love to take there spot in a heart-beat.

    I cringe as what would have happen if obama was pushing for a real single payer system. But delight in the fact that something though small will get done, no matter the crying from the right and lies.

    I have faith that it will come about but the time frame will probably be push back even further to the future and will most likely occur when this fringe group loses there care and grandma is dieing or there kids cant get care cause the insurance company is only going to cover half a lung in expenses so a CEO and top management get a bonus at the end of the year for denying coverage.

  • Louise

    The reason why the left wants the “public option” so badly is because they know that private insurance companies cannot compete with the federal goverment and that over time the “public option” will become “single payer” Canadian style health care. No thank you.


    Everyone I talk with is in favor of a public option, the only true health care reform that would make a real difference as far as I am concerned. I am willing to do what I need to do to make it happen. Where are the organizers that want me out there working to make this happen. I want to help but how do I do it? I have contacted my legislators and am ready to organize. Now who do I talk to?

  • Lilya Lopheka

    Suggestion to Obama Administration

    First stop the Mortgage Bleeding and Transfer of Wealth from common citizen to the Wall Street and dishonest Mortgage Originators. With just one Executive Order, give broad authoritity to District Judges to postpone payments if the contract looked tidy biddy deceptive and Mortgage company is on the list of sleeze bags. By doing so, he will make 99.9% of the population happy and loyal.

    With that leverage, he can do anything in the healthcare field.

  • http://www.richardsnotes.org Richard

    I don’t want a public “option,” I want Medicare for everyone.

  • Ed Helmrich

    I’m not sure about the economics of the situation, but we need healthcare reform. But we can’t have healthcare that pays for abortion and that targets the elderly. We need reform, but not this one.

  • Mike

    hope this helps with anyone that wishes to learn more about the health care debate


    co ops


  • R.M.

    Either we get national health care like all the other democratic countries of the world or we sink completely to third world status …and…….I am sick of you hypocrite anti-abortion …..if you don’t want an abortion , don’t have one .”keep government out of our private lives ” and don’t dictate to us what to do with our bodies . I have had enough about your mythology that a fertilized egg is an human life . if you care so much about children there are plenty in this world that need your help … .

  • http://www.richardsnotes.org Richard

    Ed: In what way does the current healthcare debate target the elderly? Putting end of life counseling under Medicare is a good thing and the idea that this creates a “death panel” is stupid propaganda from Palin, Limbaugh which Chuck Grassley has decided to use to create misinformation about the bill. You don’t take them seriously, do you?

    I want Medicare for everyone for any medical procedure, period. If abortion ever became illegal in this country then it wouldn’t be covered but as long as it’s legal then it should be covered.

    I think a more interesting question is, how about voluntary plastic surgery? A lot of people are “sculpting” themselves these days. Not sure I want to be paying for that stuff with my tax money.

  • pw

    I agree with those who want “Medicare for everyone.” But I disagree with those who cringe over the possibility that Obama might have gone for a single payer system. The president started out unambitiously (after some big talk) and caved too quickly. Single payer should have been the declared goal and “public option” or Medicare expansion the fallback.

    As for the economics of reform, nothing could be as costly as the current system. It’s just that we have been reluctant to count the full costs, just as we have been bamboozled into not counting the full environmental costs of our way of life, of the Iraq war, or of any other legislative project which has the heavy support of health care or defense or energy lobbies. We’re encouraged to turn truth into an enemy, not an ally.

  • LinP

    Targeting the elderly? The elderly are already a target–a target for often unnecessary, painful, and torturous procedures that allows docs to make their next boat payment, but do nothing to prolong life, or the quality thereof. Are you blind? Have you never had an elderly person in your family at the mercy of the current health care gestapo. The elderly continue to be a target by remaining in the dark, uneducated about what their options are, and ignorant to what their rights are. That’s terrific health care, isn’t it. Actually, it’s health don’t care.

    Lest you think I don’t know, I watched both my mother and father linger in torture because of no living will, no power of attorney, and no DNR because they were ignorant of their options and their rights. Yeah, that sure was “care for the elderly.” A “death panel” could not have been worse.

  • gina

    Yay for Howard Dean! with Obama and`many other highly-placed Democrats compromising everything away to the Republicans who will STILL be opposed, he stands out. Re the public option: as he said, “You can’t really do health reform without it”. Granted, it’s weak compared to what this country needs, but if a public option isn’t part of the alleged reform, what’s the point? Delivering every citizen sheep to the insurance company wolves via mandate (as in the MA disgrace invented by uber-businessman-posing-as-governor Mitt Romney) is NOT the answer!


  • http://www.orient-lodge.com Aldon Hynes

    “The White House signals health care compromise, and could back away from a government-run “public option.””

    Is that really true? It contradicts what Linda Douglass, communications director for the White House Office of Health Reform is saying:

    “Nothing has changed,” she said. “The President has always said that what is essential that health insurance reform lower costs, ensure that there are affordable options for all Americans and increase choice and competition in the health insurance market. He believes that the public option is the best way to achieve these goals.”

    Is it that the media has gotten the story wrong? Are they stuck in black and white thinking that the choice is between either the public option or health co-ops? Is there not the possibility of both? Could there even be potential synergy between the public option and health co-ops?

    Personally, I want more choices for health insurance. The public option would be a great choice, and I don’t believe we can have meaningful reform without it. Health co-ops would be another good choice.

    However, too much of the debate has been about limiting our choices to the existing private insurances companies.

  • gina

    folks, best to ignore the trolls:

    Ed posts some variation on the same theme almost DAILY, no matter what the topic!

    Ditto for Joe B., in case he shows up …

  • Jan D.

    I have had friends tell me when the health care being proposed is exactly like what our senators, etc. get, then they will endorse it.

  • Alex

    “The reason why the left wants the “public option” so badly is because they know that private insurance companies cannot compete with the federal goverment and that over time the “public option” will become “single payer” Canadian style health care. No thank you.”

    If a government run program is capable of running private insurance companies out of business, that’s all the reason I need to hear in favor of the “public option.”

  • http://www.theeyeofthebeholder.net Eve Lyman

    We NEED healthcare reform. Public option though so important, is not essential. Bill is essential. People have been trashing the MA Commonwealth Care, but it is great. Not perfect, but perfecting itself every year. This anger in this debate has nothing to do with health care, it is thinly veiled racism. The media give this too much credence! You need to call it for what it is!

  • Steve

    Every Teacher, state worker and government worker has a public option and they love it. Why not US.

  • BHA

    The problem with co-op insurance groups is they will likely be too small to be effective. The reason single payer works is that EVERYONE is paying in all the time but only SOME use the service at any point in time. There is no duplication of administrative processes.

  • Hana

    If all the government employees would NOT be entitled to health insurance (like the rest of us) would that change the mind of those who oppose the public option?
    I think we need a much simpler, more streamlined, transparent, coherent public option offer that anyone could read and understand. Than we can discuss it more intelligently.

  • Brian

    The issue isn’t public vs. private. It’s “for profit vs. non-profit”. A non-profit cooperative, even if private, will create the desired ‘stiff competition’ for private insurance companies…correct?

    Thank you!

  • http://www.theeyeofthebeholder.net Eve Lyman

    OK – Dean has it just about right. Without the public option it is just insurance reform. Still worth doing, but not the same. Huge opportunity missed. And he is right about the right co opting the rage factor. But Obama has something more powerful behind him. You ain’t seen nothing yet!

  • Jackson

    Instead of the current 1000+ page bill being bandied about, I suggest two “simple” fixes to reduce costs VERY quickly. My bill idea would only take about 1-2 pages to write.

    1. Allow ALL insurance companies to sell their insurance plans NATIONWIDE. And while you’re at it, get rid of state insurance commissioners (who are mostly insurance lackeys anyway) since they will be irrelavent.

    2. NO insurance company in the USA, providing health insurance, should be allowed to be for-profit. All insurance companies need to be no-for-profit. As soon as you allow stockholders to become the main client, you lose quality and raise costs.

  • BHA

    Thank you governor for your comment that no public option means no health care reform.

    The public option is no replacement for single payer and I wonder if it wouldn’t have problems similar to co-ops in that those who have no insurance now may not be able to afford it but something has to happen to get EVERYONE covered regardless of where (or if) they have a job with paid health care.

  • Drew P.

    I think the turning point has been the focus brought on the British Healthcare system and the Wall St. Journal’s assertion that Prof. Stephen Hawkins would not be allowed to live under such a system.

    As Prof. Hawkins has himself corrected the record, the NHS has provided for his health for the past 30 years and provided healthcare that has provided a higher life expectancy for the British people than for Americans.

    Many people bring the example of people coming to the US for surgery. What is not mentioned is that these are by and large elective surgeries such as cosmetic breast augmentation.

  • BHA

    AAARRRRGGGG the internet feed went down!

  • librarymonkey27

    drug and insurance companies have not be forthright with their customers — they have had many years to change

    they have not

    a public option will force their hands

  • Don A.

    Dean says that Medicare costs less than private insurance. Isn’t this because Medicare doesn’t pay doctors and hospitals as much as their costs (which then have to be made up by private insurance)? Is this what we want: medical cost fixing? Is this really the back door way of reducing costs (after all, there aren’t any other ways of significantly reducing costs in the proposed plans)?

  • Beth

    Where has Howard Dean’s calm articulate voice been for the last few months, while the Whitehouse hasn’t been able to get a straight clear message out to the public? He should be put out there in front of the media to calmly combat the screamers. I sure hope he’s working behind the scenes. Thanks!

  • BHA

    PHEW- found the WBUR internet feed. VPR, where did you go? ;)

    Regarding the cost of health care and medicare reimbursement rates:
    PAY for doctors to get their MD as long as they become General Practitioners. They won’t need to be paid as much if they don’t have several hundred thousand dollars of cost and loan interest to recover.

  • Don A.

    Here in Western New York, the majority of people are insured by non-profit companies (Blue Cross, Independent Health, Univera). Why does everyone neglect the non-profits when talking about the great profits of insurance companies? And these non-profits are in very strong competition with each other and with for-profit companies.

  • Lynn Rhenisch

    Where is the voice of the 47+ million uninsured people in America? Not just the vocal attendees in the town meetings?

    It seems to me that our–I have been one of them!– opinions and positions on a public option–other options–is a critical issue in framing the current political debate, not just those who are afraid of losing “what they have.” Why isn’t this population covered in the polls and surveys?

    Would someone please poll those who have suffered tremendous life impacts, financially, physically and emotionally from loss through illness of health coverage. Who knows better the failures of our current system and what we need?

    I keep waiting for the poll that says, “The majority of the uninsured think….” NO ONE IS COVERING THIS and IT IS CRITICAL!!

    Please pose to Howard Dean.


  • Lilya Lopekha

    One suggestion for Obama Administration / perhaps Howard Dean can start a campaign for HHS

    When you go to almost any shopping mall in this country, there is an Information Desk staffed with one or two people who say: “How may I help you”.

    I went to HHS, VA and FDA buildings last week in Wash, DC. The only people I can interact with, as a taxpayer are poor African American (usually overweight) Security Guards, working for this Security Contract company at wages for which white people do not want to work for. For 9 years and 9 billion ID checks/scans in 900 government buildings, they haven’t caught a single thing.

    You cannot talk to a single civilian government person in my own government. If you insist on talking to somebody, you are treated with suspicion, looked at as a semi-terrorist and are told to leave.

    This is not the image of HHS we want to give to citizens and Taxpayers.

    Please Obama/Dean, let’s make HHS “for the People”.

  • Greg L

    What I’ve been able to gather from the argument so far:

    The insurance lobby has managed to paint a public option as being one that rations care and is bogged down in bureaucracy. However, this is exactly what the private insurance industry does.

    Single Payer / Public Option does not spell doom for insurance companies – but it means they’ll be smaller, leaner companies in the long run. People of means will still want to insure themselves privately; everyone else gets Medicare.

  • BHA

    Drew, good point. MY vision of Single Payer would be coverage for general health issues, including things like hip replacements. But if you think your nose is too big or your boobs too small, save up your money.

    We need to be sure EVERYONE can STAY healthy or get BACK to healthy regardless of their job status or position on the economic ladder.

  • Nolan

    Cooperatives will backfire. Instead of forcing for-profit insurers to compete, it gives them political cover to drop more and more patients that are expensive to their shareholders. This will force the most expensive patients into cooperatives which will drive up their costs doom them to failure. Only the strength of a national insurance program can manage to create enough true competition. Remember that your current employer sponsored seem is banking approximately 20 cents on every dollar we spend on health care. The strength of the nationalized Medicare program instead spends only 3 cents on the dollar.

  • Helen Barrett

    How does malpractice insurance play into the reform of health care? I thought that malpractice suites contributed to physicians excess of caution in ordering more tests, etc. than might be necessary if they weren’t concerned about being sued.

  • Elayne Cree

    I’d like to know what infrastrucure would be required for launch a public option vs. the so-called co-ops and how long each would take.

  • Tom

    Of course we need a public option.

    We need health care reform but first we need health care insurance and cost control reform. The current system under the medical-pharmaceutical-insurance complex allows no real competition, hides actual costs, and has become focused more on profit than services. To expand health care coverage to all under the current system with cost control will only expand this bloated system and be ultimately unsustainable.

    Since our government appears to be unwilling to deal directly with excessive cost issues, true competition from a major non-profit entity is essential. Medical coops make sense only if they can obtain critical mass by being authorized from the start to become a multi-state federations with the power to negotiate prices with pharamaceutical and service providers.

  • Beverly Lucey

    If we do not push for the public option, we are giving in to the loudest voices, and it appears those voices are ones of fear, hate and vitriol. This country needs a public option. That’s what real health care choice is. Obama promised. He must try harder. He must let this play out in Congress. He must NOT give in to alleged conservatives who vow to vote against a bill no matter what. In this case, efforts at bipartisan efforts will hurt more people than they help.
    I’m including part of a speech from The American President. We finally have a president who did not win the election that way. He won it for the people, by the people… not the corporations.

    “He is interested in two
    things and two things only: Making
    you afraid of it and telling you
    who’s to blame for it. That, ladies
    and gentlemen, is how you win

  • Dorothy Shackleton

    As an aside to the health care debate and a topic that presently seems to be missing in the discussion is the fact that most “government run programs” are not government run per se. There is public/private cooperation to run Medicaid in particular in many states. Private contractors such as EDS and Birch& Davis assist in the management of the federal/state program. Eligibility for Medicaid may be determined up front by “state” workers but the end product (payments) are generated via the tools developed and run by private contractors.

  • eric

    I think it is pointless to compromise health care reform any more at this point. The Republicans won’t vote for it anyway.
    If we find a bill with public option can’t pass without the Republicans later in September, that is the time to decide on a compromise. It is way too soon now.
    On the merits, Howard Dean’s argument wins hands down.

  • Candace Kearney

    I am so frightened that the public option will be dropped and that no meaningful health care reform will happen. I work for a small company that does not offer health insurance and my husband is self employed. We are hard working
    Americans, yet we have to pay $1000./mo for insurance with a $5000. per person deductible for insurance that covers almost nothing. In 2006, my husband had a heart attack, and the insurance co. that he had been paying faithfully, tried not to pay our hospital bills.
    People ask, do you want the government running your health insurance? My answer: YES! Anyone would do a better job than the private insurance companies are doing.
    I fear that the coop option can’t work. WE need a public option. WE as Americans need to think about the millions who can’t afford insurance.
    I say impeach the Republicans who are standing in the way of this.

  • Meredith McCulloch

    Just did the math. The six Finance Committee senators who own this decision represent a total of 7, 416,7 57 people of 2.5% of the US population.

    Why do they have so much power?

    Meredith McCulloch
    Bedford, MA

  • Tom PS

    Americans loves a winner. As much as it is a laudable goal for Obama to reach across the aisle, for some it is seen as weakness – and for most people will be respected more for winning by passing MEANINGFUL legislation to improve access to healthcare for ALL people living in America. The majority of Republicans figured this out a long time ago…it is a win/lose game for them.

  • Ernie Amsden

    Many listeners may not be aware that, as governor, Howard Dean presided over the elimination of health insurance competition in Vermont. Prior to his regime, there were about 11 companies offering health insurance in the state, upon his departure from office there were three.

    He will brag about instituting programs similar to the “public option” that allegedly made insurance affordable for all Vermonters. Take it from someone who has been a Vermonter for 52 years, Howard Dean is not being truthful!!! Dean’s brand of Socialism has not helped the People’s Republic of Vermont, and Obama’s brand of Socialism will not help the USA.

  • Nancy Wood

    However they can accomplish it, here are the end results I hope to see from health care and health insurance reform:

    For doctors
    Less paper work – one common insurance billing statement
    Incentives to choose primary care practice, reduced medical school expenses
    Fair compensation
    Limited liability
    Quality control

    For consumers
    Portability of insurance, not dependent on employment
    Universal preventive care for children including dental & vision
    Access to necessary quality care
    Choice of providers
    Affordable insurance and necessary care for all consumers including Rx drugs – community rating, no preexisting condition barriers

    Emphasis on good health and reducing need for health services especially for chronic illnesses
    Reduced administrative costs (providers, insurance companies, government)
    Increased quality and outcomes
    Reduced and controlled cost of the overall system in the US (as % of GDP)

    To get there we need to deal with some hard choices:
    Bare bones vs. comprehensive coverage
    Reduced use of extraordinary procedures including beginning & end of life
    Limited coverage of high cost prescription drugs

    And adopt broadbased funding options like:
    Mandatory insurance so overall system is supported by everyone
    VAT (value added tax)
    Sugar tax
    Payroll tax, to higher income levels than current Social Security or Medicare
    Surcharge on non-health care insurance premiums (such as auto insurance)

    And adopt serious cost reduction measures such as:
    No mandated coverage of voluntary procedures
    Rx drug negotiations & use of generics
    No coverage of Rx drugs that are advertised directly to the public
    Common forms for private and public insurance
    Community health centers, in-school clinics, public immunizations, health education
    Non profit or not-for-profit-only systems (hospitals, practices, insurance co’s, etc)

  • Greg Vitercik

    It seems to me that a logical first step would be for every protester resign from Medicaire.

    Second, all Republicans in the House, Senate, and government employment must resign from their government-funded health care.

    Let them live with that for 5 years and then report back.

  • Lilya Lopekha

    Howard Dean is 100000000% right.

    a) Insurance Companies are so corrupt, and the direction of their corruption is going to go only in one direction ….up, up, up.

    b) Not one single Republican is interested in Public Good and Healthcare. If I were a Republican Elected official, if I don’t want to commit suicide, at least I would have become Independent years ago. How can anybody associate him/herself with the Republican Party and also stands for public services. They are opposite of each other.

  • Kalai Mugilan

    As a society, we have deemed that water, highway transportation, perhaps our postal system, public education and others that benefits all and a disruption of this systems would hurt the public and the nation at large. Almost all nations have also concluded, in the list above, health is among them, and we as Americans have failed to do the same.

  • Ann Brock

    I am outraged that Obama is ready to abandon the public option,the key to true health care reform. For profit health insurance companies that focus more on bringing profits to their shareholders than caring for the health of their subscribers have put us in this desperate position we are now in. A strong national public option will offer the kind of competition to make the private insurance honest, bring costs down and make health care available to all.
    Of course, a single payer system would be least expensive and paid through our taxes based on our income, the fairest. Everyone contributes, everyone is covered and the insurance industry can roast in the hottest place in Hell.

  • Barbara Dumas

    Americans have no idea what it is like to have national health. To be able to start a small company, or work independently without worries about health care for the family. Americans will never have an idea, because there is no leader strong enough, brave enough, or eloquent enough to fight the corporations.
    The public option exists – and needs only to be carefully rolled out to the general population, but this will not happen until the collapse of the current system.

    Len Nichols closed with a desire that the president, and congress, cling to the goals of health care reform, but what are the goals:
    • The goal of the republican party is to stop Obama from succeeding at health care reform – or anything at all. Yes – the majority of those people who wrapped themselves in the flag eight years ago and bullied the nation into supporting our president at any cost now press for presidential failure at all costs.
    • The goal of the congress is to keep the lobbyists money rolling in so they can keep their jobs.
    • The goal of the insurance companies is to keep making money – more and more money every year. These are huge public companies that need to grow in order to live.
    • The goal of the democratic president is, apparently, to keep everyone a little bit happy. Nothing bold and nothing new.

  • Alex

    I would vote for Howard Dean in the next presidential election.

  • Stephen Conway

    I would take issue with Ms. Wilensky’s comments on Medicare. While the programs reimbursements might be below provider “cost” and be a negative margin for individuals and institutions, that is not necessarily bad. I live in a state (Iowa) where providers, especially hospitals have been whining about Medicaid and Medicare reimbursement for years but that doesn’t seem to restrict their ability to go on a building spree. Our 700 pound gorilla in insurance, Wellmark BC/BS with 70% of the market is building a huge new headquarters in downtown Des Moines and our two major hospitals Mercy and Iowa Health, are completing multi million dollar hospitals, speciality clinics, and wellness facilities in the suburbs. Logic would indicate that the margins for hospitals and the insurance companies are very lucrative if this type of expansion can occur at the same time 250,000 Iowa adults have no insurance.

    The real issue is the fee for service system. It is the medical equivalent of industrial piece work. Until we address this out of control reimbursement methodology, and get it under control, the health care all of us have is in grave danger.

  • Lilya Lopekha

    Here is a creative approach to level with American people that will benefit everybody.

    If a big company is already paying 75% of the health insurance premium, they should pay only for nine months with no deduction from the paychecks and 1 month out of three, they should have employees to write “paper checks” payable to the company.

    I know… it is clerical waste of time, etc. a few hours of adding checks, chasing people, depositing… but it is well worth the effort.

    Does anybody ever know, in large companies, how much the total 12 month health insurance premium is outside of the HR people?

  • Bonnie Nelson

    Howard Dean is correct and I appreciate his clear comments. This topic is very complicated and the public is (understandably) confused; most of the debates on this topic produce partisan heat but NO light. Frankly, we haven’t had good public education about the issues because the Republicans are more interested in obstructionism than in fixing the problem.

  • PW

    I think Howard Dean has been my president all along.

  • Don A.

    Dean never did answer Gail about the fact that the only way Medicare is able to reduce costs is by edict to the hospitals and doctors which is made up by increasing the costs of everyone else on private insurance. Is this what we want: medical price fixing by the government?

    If everyone has the public option and this includes price fixing, then the public option is guaranteed to cost less and everyone will switch to it. Then no one will have private insurance and there will be no one to make up the cost difference and hospitals and doctors will be paid less. Won’t the quality of care then decrease? Is this what we want?

  • Louise

    No matter what side of the health care debate you fall on, you have to admit that President Obama has not proven to be a leader you can put your trust or confidence in. I firmly believe he will prove to be our weakest and most inept president since the Jimmy Carter fiasco.

  • Lisa W.

    Thank you, Howard Dean, for speaking on behalf of those who desperately want to improve healthcare for all, but are shouted down by ignorant people who have bought the message conveyed by parasitic insurance companies and people with other crass motives, e.g., weakening Obama politically.

    Keep up the good fight!

  • Andrea Hitt

    Dr. Dean may respect Gail, but after 30 years working closely with a physician spouse, primary care provider, I suspect Gail is an Insurance Industry mis-information provider -1)the 3 or 4 Insurance giants form a monopoly and frequently offer rates BELOW MEDICARE to physicians who do not negotiate with large group/hospital backing 2)Insurance has consistently shifted all risk to patients and physicians – how else can they maintain the multimillion dollar CEO compensation ($205,000,000 at United HC for 1 yr, one man) 3)Earlier attempts that resulted in ‘regulation’ of the industry have failed because they find ways to shift risk -e.g. a private insurer enters Medicaid and might sign only one contracted primary care provider in a large area – state pays Insurer for all patients signed up, patients have no access to care 4) Capitation was the flavor of the decade in the late 80′s -90′s – Insurers often denied physician groups access to payment data, sometimes sued physicians for millions in costs incurred by patients the physicians had never seen, who were out of their states, but whom the Insurer had ‘assigned’ to the physician ‘risk pool’ – 5) HSA’s and Huge Deductibles shift even more risk to patients – how are people with no income going to fund their HSA’s? 6) as a small business owner I pay
    $23,268 annually for coverage of 3 persons – one of whom has Medicare as primary, commercial ins. as a sedoncary dependent/Medigap only coverage – and our deductible is huge – Thanks Dr. Dean for telling the truth – Private Insurance is afraid of losing the estimated $500 BILLION in overpayments arranged under the Bush Administration in the Medicare Advantage program in the next decade -the overpayments are not extra patient care/physician payments, just profit for the insurers – corporate jets, big salaries, and lavish payouts to campaigns of Blue Dogs, GOP, and ‘think tanks’ for folks like Gail – SINGLE PAYER would be my husband’s choice, I’d settle for a good Public Option – p.s. nearly every Insurance contract offered to a physician wishing to participate in an insurance network contains two clauses -a.One states that, if the insurance company becomes insolvent (after paying all those billionaire execs, maybe), the physician agrees to offer care, uncompensated, to all insureds/now not insureds, until the date upon which their insurance would have terminated and b. if the insurer is sued by a patient who suffers because a treatment / diagnostic was denied by the insurer, the physician agrees to indemnify – cover the costs of defending the insurance – and holds the insurer ‘harmless’ – TOTAL SHIFT OF RISK – PEOPLE PAY ATTENTION

  • Mike

    could it not be said that medi-care cost were high, because private insurance companies denied coverage and pushed the sick on the governement?

  • Jim T

    I can understand why some object to a Canadian style system for reasons of political philosophy. However, there are certain facts that ought not be ignored.

    Prior to the creation of the Canadian health system in the 1970s, the U.S. and Canada (which have comparable populations and life sytles) had nearly identical rates of infant mortality and life expectancy. What has happened since then?

    Today, infant mortality rates in Canada are roughly 40% less than those in the U.S. and Canadians live an extra two to three years on average. At the same time, Canadians spend about $3,000 per person per year for health care versus $6,000 in the U.S.

    What is the value of a philosophical opposition to government run health care if that opposition results in increased infant mortality, reduced life expectancy and more dollars spent? Is policial philosophy more important than lives and health? Not for me, it isn’t.

  • Mike

    also people from mass and the country Charile Baker, a
    health insurance CEO is puting his name in for governor.(one of the people racking in the douge for mantory health care with very few regulations)and gladly flauts that he was able to make his company millions and millions of dollars at the cost of people in mass.

    I wrote to the pres my congressmans and Mass Control about the failure of the mass health care, lack of cost controls, and if you find health care deemed to cheap for them you still get fined and is not deemed valid.

    though this mandated health care our cost in mass. exploded and so has profits for these insurance companies.

    I hope the mass. idea for the country does not get pushed as a good idea for the country.

    These people like romney and some dems in mass only care about making the image of everyone in mass. having health care, but in reality they cant use and in the same boat of not having it but paying for it.

  • Cindy Barnard

    Many of us believe in a single-payer plan. Health isn’t about shareholders… it is about taking care of the citizens. Just as we educate our citizens, we should also care for their health (putting aside all fiscal reasons to do so…).

    So yes, the public option is already a comprise for many of us. But finally we need affordable health insurance – the shareholders of the health insurance industry have come between the people and their care, and they have not met the needs of the people. We must have the public option.

    The angry voices get the attention at the town hall meetings because it is sensational news, not because they represent the majority, the ones contented with the leadership and the overall direction of his policies. The angry voices are more about lossing the election, about defeating President Obama, then about discussing the real issue of health care insurance reform

    If sensationalistic media and fear-mongering pundits throw this bill off its tracks, it will be a loss for the people of this country.

  • BHA

    Nancy – nice synopsis. I was all for it until:

    “And adopt broad based funding options like:
    Mandatory insurance so overall system is supported by everyone
    VAT (value added tax)
    Sugar tax
    Payroll tax, to higher income levels than current Social Security or Medicare
    Surcharge on non-health care insurance premiums (such as auto insurance)”

    - I DON’T want mandatory insurance, it means people have to buy coverage whether they can afford it or not and still may not get the coverage they actually need.
    .. I want a single payer system – EVERY legal resident is covered without having to do anything. As it is now, if I don’t properly guess every October what illnesses/accidents, etc my family will have during the next calendar year, I might pick a plan with too little coverage.
    .. There should be no deductibles, co-pays or lifetime maximums. Even with insurance, you look at the copay and deductible and think “well maybe this problem will go away by itself”.
    .. Anyone who wants and can afford supplemental insurance should be able to buy it. That is the business the private insurance companies can fight over.

    - I can not go for a surcharge on other insurance. People who don’t drive don’t contribute? People / companies that already pay for health care insurance should pay more? Those premiums are already higher than they should be because the hospitals charge the insured more to cover the cost of people who come in without insurance, frequently for something that would have been handled much more cheaply at a GP before it became serious.

    - I agree with “so overall system is supported by everyone”.
    .. We may not use much in the way of health care services some years but in our lifetimes, we ALL need health care.
    .. Just like public schools. You won’t have kids in the schools for all the years you pay property tax (either directly or as part of your rent). You may NEVER have kids in the public schools. We, as a society, decided decades ago that an educated population benefits all and education should not be limited to those with financial means.
    .. You may never need the fire department to come save your house but you DO pay for this coverage whether you own or rent. Do you want to shop for the ‘best’ fire department for your needs every year? Have them all come running and fight over who gets to put out your chimney fire?
    .. Health care should be the same. Pay and count yourself lucky if you don’t use all you put in over your lifetime.

    - I am OK with VAT and personal and business income tax without the income caps as long as they don’t cost more than I am already paying in insurance premiums. It isn’t a tax increase, it is an expense shift. If my employer and I don’t have to pay health insurance premiums in the current mode, that money can be channeled to the Single Payer system in part directly and in part through tax on things purchased with the money not spent on health insurance premiums.
    .. Make it VERY specific – the VAT would be used ONLY for Single Payer health care and the Health care funds can NOT be raided for ANY REASON. You would KNOW what you are paying for with the VAT. People are more willing to pay a tax if they know what they are getting for their money rather than putting it in a nebulous ‘general fund’.

    Every insured person is already paying TOO much to cover the administrative inefficiency inherent in our current system, especially as it affects the doctors and hospitals. If you aren’t covered by a large employer, you have no pull with the insurance companies and pay even more.

  • Rachel

    Lot of programs in this country are socialized – medicare, schools, etc… Why do I – as a single person with no children – have to pay for everyone else to send their kids to school, yet these same people want to deny me health care. It really makes me angry that when I was self employed I could not afford health care, but taxes were still taken out of my income to pay for schools.

    I have no problems paying for schools, but in return I want some health care!

  • Robert Studzinski

    The real savings in health care reform come with single-payer. The real freedom of choice and coverage for all comes with single-payer. The real savings for businesses and in foreign trade come with single-payer. This is what we really need. If the insurance companies want to save their behinds, not to mention all the lobbying dollars, get behind medicare for all.

  • Glenn Jilek

    Health care is not a commodity like cars, refrigerators, televisions, etc. Providing health care is a values issue. Health care should be a right without which you can’t have Life, Liberty, and the Pursuit of Happiness. We are supposedly the richest country in the world. Why can’t we afford to provide health care to all citizens like other countries? Why should any corporation make profits from the pain and suffering of people? Do we value the profits of insurance companies, pharmaceutical and hospital corportations, over the well being of our people? At this point in time it seems so.

  • Tiger

    Contrary to what one might think from reading the comment section, Americans tend to be cautious, skeptical, and conservative thinkers when it comes to a subject like tinkering with the healthcare system. If they aren’t comfortable with a single payer or public option, then that’s the best reason for excluding those elements from so-called health care reform. To do otherwise will put current officeholders in jeopardy come the next election, and they know it.

    I think it’s time Onpoint brought in someone from the private insurance industry to provide some diversity of thought for your listeners. Thank you.

  • Barb Adams

    I would like to point out to those who are against health care reform/public option because they don’t want government run health care that at this point their health (if they have any) is either government based OR their health care is decided by BIG CORPORATIONS who control what doctor they see, whether they can be admitted to the hospital and every important decision having to do with their care. You have NO VOICE with this care but the insurance companies, Republican bought off by lobbyist working for these companies. When will will the shrinking middle class and poor Republicans learn to vote their interests instead of what they hear on FOX and talk radio?

  • Alex

    “Americans tend to be cautious, skeptical, and conservative thinkers when it comes to a subject like tinkering with the healthcare system.”

    Some Americans, but not all and perhaps not even a majority.

  • Barb Adams

    I find it fascinating that all the Republicans that oppose government controlled health care HAVE government health care and in fact ARE THE GOVERNMENT! Are they saying in fact that they themselves aren’t capable of governing because they are so inept?

  • Putney Swope

    COOPS are a smoke screen and will not work. They are just a way for these rubes in Washington too say they have done their duty. Well it wont wash, it’s just a band-aid being put on serious open wound. It wont work.

    Obama has sold the people out and I guarantee he will sign some bill and say it’s great moment for America.

  • Anna

    I want a government option. I want Medicare for all.

  • Mike

    I guess bringing assault rifles to a protest outside the town hall where pres is speaking is the far-right way of debating.

    this trend is troublesome


  • Mike

    if you missed fridays week in the news, i suggest you listen to it jack nailed these protestors on the head with his intro speech. Of there fear, scare, rage tatics to stop any debate from these fringe groups now known as the republican party.

  • Putney Swope

    Mike that guy was African American, which is interesting. I agree that this is getting out of hand, but in Arizona people have the right too walk around like that.
    Scary if you ask me.

    I hate to say this but I think an attempt on Obama’s life is more likely now than ever.

    Sometimes I think we are a country of fools and then you just have too read a little history to understand that this kind of thing goes way back. FDR was demonized but he was also able to set his agenda and move on it despite the republican’s. Something Obama and the democrat’s should do.

    Howard Dean said it all, the republican’s only agenda is too go after Obama no matter what. They should be steam rolling over these obstructionist and not looking back.
    It’s what they would do.

  • Al

    When Gail talks about destabilization, I can’t help thinking she means there’s a threat to the insurance industry status quo.
    Eventually we will have to decide and articulate through legislation which matters more-the right to get (and stay)rich or the right to health care.

    Unfortunately a lot of people seem to believe that the free market or entrepeneurial ventures represent the highest form of expression available in our country.

    I love that at the end the Democrat was insisting on the people’s right to choose and the other voice was against that.

  • Louise

    You can hide, but you can’t hide from the truth. Americans do not want single-payer Canadian style health care, the polls prove it, and Americans have come out in the droves to let Obama know it. Most Americans like their health care and want no part of the “public option” which is nothing more than single payer in disguise. Leave my health care alone democrats!

  • LuxI

    HD is one of the few people I trust anymore. Why don’t we have public hearing re: corruption, costs, compensation in the private shell game? This alone would change public opinion. Why is our coward Prez not calling for these?

  • LuxI


    You have no idea what Americans want. Your post is simple mis-information. No polls say what you claim.

    Peace (war if you are Louise)out.

  • Putney Swope

    Louise, Obama and the democrat’s are in charge. They were voted in by a majority. This is or was a major part of Obama’s agenda. The republican’s are not in charge, period. The polls are reflecting more of the disinformation and the complete lack of leadership on this from Obama.

    Obama should start acting like the president we elected.

    This is from Eugene Robinson’s OPED:
    What the president hasn’t done is the obvious: Tell Congress and the American public, clearly and forcefully, what has to be done and why. Take control of the debate. Consult less and insist more. Remind the Blue Dogs who’s president and who’s not.

    Giving up on the public option might be expedient. But we didn’t elect Obama to be an expedient president. We elected him to be a great one.

    I could not agree more.


  • Sam

    To Louise:

    I’m more than willing to be on the current healthcare system provided:

    1. I dont have to worry about my cover if I have to switch jobs

    2. I’m covered all (I’m not talking about Cosmetic Surgery here)

    3. My premiums are affordable (presently mine+employer contribution = 2400USD per month)

    4. I dont have to worry about the Prescription Drugs

    5. I dont have to worry about any Dental/Optical coverage.

    What is your answer to that?

    Btw, Do you even know how much you and your company is paying for your healthinsurance per month??

    Do you know what ALL PROCEDURES are covered under your current Insurance (God Forbid) if you were to hit by a car on the way to park?

    Please reply back with your answers, and I promise if it answers any of my concerns I will join you to raise the awarness that we DONT need any change.

    Good Luck!!

  • Cheap Talker

    Dear Tiger,

    Your idea of including a voice from the private insurance industry in this debate is excellent. Wendell Potter would be an ideal candidate. http://www.pbs.org/moyers/journal/07102009/profile.html


  • Brett Greisen

    Dear Tom & Dr. Dean,

    Here’s how to fight the lies from the Right Wingnuts:

    Insurance lobbyists say #s 1 & 2 in their arguments against medicare for all, but leave out #3

    1. No government program is any good.

    2. No private insurer can compete against the government.

    1+2 = Therefore private insurers are worse than the government.

  • Richard

    The apparent savings achieved by government run programs are achieved by underpaying providers, who in turn must overcharge privately insured patients. What happens to these so-called savings when there is no one left to steal from?

    People must be willing to admit that the so-called public option will, for better or worse, end private health insurance. When one of the players defines the rules, that player is not a player but a referee. There can be no fair competition under those circumstances.

    The public option is opposed by a majority of voters in this country, for the simple reason that the quality of their health care will be degraded. That this degradation in part will enable broader coverage is small consolation to the large number of Americans who now enjoy unimpeded access to first rate medical care, and who know that both their care and their access to it are going to be reduced in scope and quality.

  • Alex

    “The apparent savings achieved by government run programs are achieved by underpaying providers”

    How do we know they are underpaying? What is the fair price? Established at what exchange? Maybe government run programs are being overbilled, but only pay what’s reasonable?

  • John Sarvey

    Richard, you must have missed the posting about how many of the private health insurance companies pay even less than medicare. I’ve had some doctors refuse to participate with certain insurance companies because the companies grind them down too hard. What this means is that I have to pay the doctor and then fight with my insurance company to get reimbursed.

    The biggest reasons that Medicare is so much more efficient than private health insurance is that Medicare does not have to spend money on marketing, multi-million dollar executive compensation, hordes of bureaucrats trying to figure out ways of denying claims, investigators trying to find reasons to disqualify you after you get sick, and of course, millions of dollars to distribute to shareholders.

  • Brett Greisen


    Ms. Wilensky mixes up healthcare reform & health insurance reform.

    If we really want to reform healthcare & go to a world class system instead our last World Health Organization ranking of # 37 – behind Cuba, we must go to Medicare For All.

    It’s 1 claim form (paper or electronic) instead of 200+ for private insurers and hopefully 1 electronic health record + advanced directives, living wills, DNR requests accessible @ any hospital in emergencies.

    It’s 4% administration cost instead of 15-20% @ private insurance firms.

    It’s freedom of MD choice and fewer bureaucrats than private insurance and with increase of primary care reimbursements will help the paradigm shift from pay-per-procedure to primary care health management. [See BBC World Service Radio, Business Daily of 15 May 09 – Myrna Brind Center of Integrative Medicine @ Thomas Jefferson Univ. Hosp. In Philly.]

    It’s lower co-pays for office visits & Rxs than private insurance.

    Most importantly, she simply fails the logic test. Her main points during the whole conversation = Statements 1 & 2 below which leads quite logically to # 3.


    1. No government program is any good. [Social Security, Medicare/Medicaid]

    2. No private insurer can compete against the government.

    1+2 = Therefore private insurers are worse than the government

    I used to work in a NY teaching hospital & the”efficient” private insurer couldn’t maintain the same benefits to the hospital staff from year to year. Out-of-pocket expenses for medical & support staff increased year to year & actual coverage of medical needs decreased every year I worked there.

    Private insurers are to healthcare as bicycles are to fish.

    Repeating 1/2/3 argument because the logic is

  • Kathryn Carpenter

    I was at the physical therapists office today when I overheard the accounts manager trying to explain to an older woman why her insurance wouldn’t pay. Yes, there is already a suit standing between us and our doctors and he is rationing care. We need a public option to get him out of the way!

  • Lety M

    One great incentive to improve costs and to improve the healthy future of America would to assist and encourage more individuals to become Primary Doctors….if I could get assistance to become a Primary Doctor, I would in a HeartBeat. I would do it not for monetary reasons but rather because I care for people and I want the future of our nation to be a healthy and productive population. Currently we don’t have the resources to become and sustain a healthy and productive nation. If this pattern continues we won’t have a future.

  • jeff

    The vast majority of Americans who have health insurance love it and don’t want Medicare-sytle rationing. (Rasmussen) A significant percentage of Americans with Medicare supplement it with private insurance to increase coverage. (Medicare Advantage/ Part B/ Medigap) Many doctors will not take Medicare patients (AAPS 20-25%).

    It is no wonder that sensible Americans who care are protesting another Obama administration power grab. Hands off!

  • http://www.amazon.com/Loved-One-Evelyn-Waugh/dp/0316926086 Sunshine

    Prey tell! What level of education have you reached?
    Check this out:

    And to save you the trouble of looking it up, infant mortality per 1,000 live births in the U.S. was 7.2 in 2007, just shy of bettering Cuba, those commie rats and behind just about everywhere else.

    It is a question of charity.
    Love thy neighbour Louise if you want to go to heaven.

  • DKH

    There are many people who do not have any health insurance, what do we tell them? I also believe that the major providers only answer to their stock holders and do not care what happens to their customers. Strip every politicians health plans and maybe a dose of reality will change there minds. The current system must go and everybody in this country deserves the same coverage! What’s the problem with this approach?

  • Louise

    Sunshine, if you are so enamored with Cuba, then you move there. At least there you would have a die-hard socialist running the country (Fidel Castro) and not some wannabe socialist like President Obama. As for me, no thank you!!

  • Daniel

    For those looking to organize in favor of healthcare reform, here is a website:


    I find it strange that the argument against healthcare seems to be a continuation of “government out of my X!” where X is healthcare. Why isn’t anyone crying out “government out of my food and drug inspection” or “government out of my mail delivery”? For all the supposed distrust of the government, we still seem to be perfectly happy with the government safeguarding our food supply and making sure that our medicines meet certain standards of safety.

    Even seniors seem to be perfectly happy with the government providing them healthcare. Unfortunately, per recent footage of the “town hall” meetings, too many of them don’t seem to understand that the government is actually behind Medicare.

  • Putney Swope

    I think everyone should read this piece in the NY Times.
    It’s from the perspective of an RN.


    If you still do not think we need reform after reading this, check too see if you have a heart.

  • Mike

    why dems should go in it alone


    even Sen Grassley who is working on this health-care is not going to be voting for it. I beat something real could get done instead dealing with people who wish it to fail no matter how much you give them.

    Along with his fear to debunk lies about the bill. (granny)

  • Mike
  • Louise

    My faith is renewed in this great country. As Americans learn more about liberal democrat health care proposals, the more they reject it.

  • Alex

    “My faith is renewed in this great country. As Americans learn more about liberal democrat health care proposals, the more they reject it.”

    Class, today we will have a competition. Come up with the best comeback to the above statement.

  • justanother

    *****I’m not sure about the economics of the situation, but we need healthcare reform. But we can’t have healthcare that pays for abortion and that targets the elderly. We need reform, but not this one.*****

    I hope you also respect the people that has the right to choose abortion if it need be.

    You have to remember this bill is not only written for YOU, it is for most people and people didn’t have a choice before. Don’t use your own moral standard to decide how other people should live. Have you protested every bill that’s passed by congress, which has something in there that you don’t agree with. And a lot of taxes we are paying right now, we don’t necessary agree or like them.

  • Frank the Underemployed Professional

    Gail Wilensky is a dogmatic free market moron.

    She completely failed to address the fact that the United States is spending almost 17% of its GDP on health insurance while leaving tens of millions of Americans uninsured or under-insured and with everyone else living in terror of losing their jobs and their health insurance while, in contrast, other nations’ systems cover 100% of their population for a much smaller percentage of GDP.

    I wouldn’t be at all surprised if she denies the existence of rationing and of death panels at the private insurance companies.

    You don’t have to be a rocket scientist to know that America’s system is terminally broken and needs to be completely restructured, but you do need to be a Town Hall Moron to support the current status quo.

  • US Citizen

    If President Obama does not fight for a public option in national heathcare, he is breaking yet another campaign promise that got him elected. The American people and especially working class families who supported him, many of whom are unemployed in increasing numbers now, will despise him as an ignoble liar, a disgraceful, arrogant fraud of the lowest order, and will surely not vote for him again..

  • Frank the Underemployed Professional

    Regarding government-funded abortion, abortion actually SAVES the government money?

    . B-b-b-but abortion is evil! God says so! How could that be?

    Abortion saves money because when unplanned pregnancies are ended, the government doesn’t need to spend money on welfare, health care, education, and later on criminal justice costs (poor people are more likely to commit crimes) for those unplanned and unwanted children who are often born into poverty. In other words, government-funded abortion would more than pay for itself.

    I can understand abortion opponents not wanting to pay for it, so I propose that on the tax returns everyone be given a check-box option. Those who don’t want to pay for government funded abortion shouldn’t be allowed to benefit from the costs savings the government would enjoy and thus should pay slightly higher taxes (what they’re paying now). This way their tax money won’t be going to pay for it. Alternatively, we could have all of the government expenditures that go to pay for the children from unplanned pregnancies billed to those who don’t want government funded and promoted abortion–let them pay for the costs of their backwards, primitive religious irrationality and insanity.

  • Linda

    “My faith is renewed in this great country. As Americans learn more about liberal democrat health care proposals, the more they reject it.” Louise

    “Class, today we will have a competition. Come up with the best comeback to the above statement.” by Alex

    my comeback:

    My faith in this great country was restored back in November when we elected a hard-working, intelligent, eloquent, and classy gentlemen with high morals. As I learn more about the democratIC health insurance reform proposal (especially the inclusion of a public option), the more I am for it.


    PS “I love that at the end the Democrat was insisting on the people’s right to choose and the other voice was against that.” Posted by Al

    me, too, Al!

  • Louise

    Sarah Palin is dead right on the death panels.

  • Frank the Underemployed Professional


    Could you please comment on the CEO-appointed Death Panels that already exist at the private insurance companies? I am referring to the ones that rescind people’s coverage after they are diagnosed with an ailment (the ailments that people purchase insurance to cover them against).

    If you oppose an overhaul to our system, then what are we to conclude other than that you support the existing death panels at the private insurance companies?

    What is your view on the fact that the U.S. spends almost 17% of its GDP on health care while leaving tens of millions of people uninsured or under-insured with the rest living in terror of losing their health insurance while businesses are burdened with insurance issues while other nations spend a much smaller percentage of their GDP on health insurance while covering 100% of their populace? In your view, are those well-documented numbers bogus? Were they made up by a conspiracy of wicked socialists?

  • Frank the Underemployed Professional

    Comic Relief. I thought that some On Point comments readers might enjoy these three animated political cartoons about the current debate. The first one provides an excellent overview of the situation. Enjoy.




  • Mike


    republicans love to use Europe for reasons to lower Corp taxes and how we should have the same markets Europe has yet cry’s socialist Europe when it suits them and rather Grannie die with no health care than admit that the free market doesn’t work with health care and only private providers in the game .

    That Michael Steele part was pretty funny i found this.

    republicans go urban.


  • Louise

    Frank, I never said the current health system is perfect. However, it is still far superior to anything being offered by President Obama or the Democrtats. The “public option” is nothing more than a slick ploy to force every American onto single payer health care. The federal goverment can’t even run the post office competently, do you really want the feds running our nations health care system?

  • Putney Swope

    Frank why are you bothering with the likes of Louise.
    Anyone who gives ant credence to Palin’s BS is not being truthful.

    Enough BS already, OK. Enough. The bottom line is if your not a millionaire and you get a serious illness such as Ovarian cancer or Leukemia your screwed. The stats are there, 60% of bankruptcies in this past year are from medical bills. Louise unless your extremely wealthy your not likely to be exempt from these statistics in your life time under the current way health care is payed for in the US. Palin is full of crap and is an idiot. If you like her well that’s your pejorative but it still does not change the facts.

    We are all going too die. Most of us will be passing away in a hospital bed with a lot of tubes coming out of our bodies.

    Why should we lose our houses and life savings for getting ill? Why?

  • Putney Swope

    Frank why are you bothering with the likes of Louise.
    Anyone who gives any credence to Palin’s BS is not being truthful.

  • Putney Swope

    Louise what’s your bright idea? How are you going to solve this problem. You and your conservatives who play political games with peoples lives like it’s a checkers have not offered one constructive alternative.

    You people are just obstructionist, period.
    You just scream at people and yell and confuse words such as nazi and socialist in one sentence. It’s embarrassing to watch someone approach a open forum on health care and use words such a nazi to a Jewish and gay congressman.

    Are you people serious? I mean it’s one thing to oppose what is being proposed with intelligent and rational arguments. To align one self to the ideology of a Sarah Palin is closing down the debate for me. I can’t take you seriously.

    Come up with an alternative other than no.

  • mikeVA

    Please listen and set aside ideology. The public option would require 4% overhead. Private insurance, even now, in negotiations, want to maintain 35% contribution margin – 35%!

  • Louise

    To the producers of On Point: Thank you for this forum. However, if individuals such as putney swope are incapable of having an intelligent debate with people they disagree with without hurling insults and profanities at them, then I believe it is not in the best interest of WBUR, On Point, or NPR not to post their blogs.

  • Putney Swope

    Really Louise? I ask you for your “bright ideas” on health care. That’s not an insult. It’s forceful, it’s putting you on the spot, but insulting I would say not.

    You know what I find insulting? People like you bringing up the Death panel nonsense. It’s not true, never was and I’m calling you on it. You seem too think that your having an intelligent debate. How can anyone debate a falsehood?

    What is there too debate? All your talking points are based on the conservative talking points and they are not giving anyone any answers or solutions. Instead you whine about me hurling insults at you. Well your making outrageous statements and I called you on them.

    Now you complain because you don’t like it.
    It’s a typical tactic that the right has been using.
    They make statements and when they are called on it they complain that people like me are not being fair. Or we are insulting them.

    Fox news used it after Barney Frank put a woman in her place for equating the Obama health plan with nazism.
    Afterward people complained that he was insulting her and that he was putting down people who had different views than him. Fox was all over this.

    You see instead of coming up with the real statistics to back up your comments you complain, try to make it out that your the victim here. I’m not buying it Louise.
    If you support Plains claims about death panels then prove it.

  • Putney Swope

    Louise what profanities are you talking about?
    I think the general consensus is the way health care is delivered in this country is not working.

    This is what I find offensive, the salaries of the CEO’s of insurance companies.

    From the Washington Post:

    Karen Ignagni, CEO America’s Health Insurance Plans (AHIP)
    Ignagni’s total compensation, according to AHIP’s most recent filing from 2007, was $1.58 million, which includes $700,000 in base salary, $370,000 in deferred compensation and a bonus. Ignagni won’t say how many hours a week she works. The number’s so high it’s embarrassing, she said.


    Ron Williams – Aetna

    Total Compensation: $24,300,112

    Details: Williams earned $24,300,112 in total compensation for 2008, with more than half of that ($13,537,365) coming from option awards. He also received an additional $6,456,630 in stock awards to go along with his base salary of $1,091,764.

    Personal use of a corporate aircraft and vehicle, as well as financial planning and 401(k) company matches added up to $101,487 for Williams.

    H. Edward Hanway – CIGNA

    Total Compensation: $12,236,740

    Details: Hanway took a significant pay cut from 2007 to 2008, due mainly to a drop off of more than $11 million in his non-equity incentive plan compensation. Still, his base salary of $1,142,885 surpasses that of Aetna’s Williams, and is supplemented by just over $3.6 million in option awards, and just over $820,000 in non-qualified deferred compensation earnings.

    Also, nearly $21,800 in “other compensation” included the use of a company car with a driver, in-office meals, and emergency assistance services relating to medical exams.

    Angela Braly – WellPoint

    Total Compensation: $9,844,212

    Details: Braly, like Williams, earned more money in 2008 ($9,844,212) than in 2007 (9,094,271), increasing her option rewards by nearly $1.5 million, and also receiving a $200,000-plus bump in base salary, from $922,269 to $1,135,538. Braly’s stock awards dropped from $2,160,159 to $1,750,015 because, according to the SEC, “performance-based restricted stock units awarded in 2008 were cancelled because our ROE target for 2008 was not met.”

    Braly’s “other compensation” comprised use of a private jet for her and her family on business trips, just under $10,000 for legal services relating to her employment agreement and cash credits.

    These are just a few of the CEO’s for more info go to the Daily Kos:


  • Jim T


    You say that, “The federal goverment can’t even run the post office competently, do you really want the feds running our nations health care system?”

    Right now the United States spends far more per person and far more of its GDP on health care than any other nation, Yet we are ranked 37th in the world by the WHO. Clearly, relying on the private insurance industry has us paying far more for health care and getting much less than we should. What’s the alternative if you are correct that our federal government can’t run a health care system?

    The answer seems pretty obvious. We need to turn our health care system over to a provider with an established track record of delivering high quality care at reasonable cost. We need to hire France!

  • Frank the Underemployed Professional

    I can definitely sympathize with Louise’s concern about the government’s ability to manage a health care system. I’m actually rather skeptical about it, too. However, I have more faith in the government to do it than I do in private insurance companies where our own system has already proven to be a complete disaster. In contrast, government-run systems in other nations have proven to be far, far more efficient and less expensive while delivering much better service for the majority of people.

    Government really isn’t necessarily the big evil monster that people make it out to be. At least it doesn’t have to be a big, evil, inefficient monster if we elect the right people. The Western Europeans seem to be doing relatively well and enjoying the world’s highest overall quality of life and standard of living.

  • Mike

    Funny some of these protestors are so against government and does not trust it with health-care yet fully heartly believe that the judical system, polices are the best,and little to none corruption exist.

    I think it not per say there against government but against government allowing the majority of people to benefit from say “education, health care” and many things that would help all americans instead of the few elite or corp elites and well to do and reasonig for this is “everyone should be lucky to have there scrapes”.

    If you notice when it is about power in a few hands,privilege, and religious control over others there all for it and government should be in charge, but when it comes to helping the whole of americans. they do the standard foxs news has help cement

    1. lie. distort, misinform as many people as possiable.
    2. dont reference facts but bloggers and opinions.
    3. Use anger and emotions over logic and understanding.
    4. present expert opinions in lue of facts even when the expert has no expertise on the subject or are paid lobbist.
    5. when called on it play the vitcim and cry its not fair.
    lastly , repeat, repeat, repeat

  • Putney Swope

    My beef with most people on the right is that they don’t have any talking points except that government is bad.
    Not one republican has come up with anything that is going to help with this crisis. If you don’t think we are not in a crisis this country with health care your not paying attention. We pay too much for to little. Sure some have great plans but most have plan like I do and it’s not very good bang for the buck.

    I’m not sure the plan the democrat’s are coming up with is going to work either. I also think Obama handled health care reform in a way that now makes me think he is not as capable as I thought. Right now it seems to me on the one hand I think the country is in a dire need for reforms in how health care is provided.

    It’s clear that the profit model is not working. In this model the companies answer to the share holders and the in case of health insurance the patient is viewed as a loss if they have to pay out. Where is the incentive to deliver health care in this model? There is none.

    I’m not sure I trust government as well as they seem so dysfunctional and this is bipartisan affliction.

    Is single payer the answer? I thought so a few months ago but now I’m not so sure. I do think regulations that force the for profits out of the health care picture are necessary. The way doctors are paid is an issue as is malpractice insurance which os out of control.

    What about dentistry? Not even mentioned.

    This is one hell of a mess that’s for sure. Coming on forums and talking about death panels is not constructive.

    Frank the Underemployed Professional mentions other countries such as France. Well they have a more centralized government and the French are not afraid to tell their government off if the need arises.
    I have lived for an extended period of time in Scotland and I like the NH system they have in GB. It works well. It does have problems, but what system doe not?

    Bottom line we don’t have a health care system. We have a health care market. This is problem in my view. The way we think about what our society should be and how it should grow and develop is the subtext. Do we want health care to be a right or is it just another commodity that one can afford or can not.

  • Sam

    To Louise

    “To the producers of On Point: Thank you for this forum. However, if individuals such as putney swope are incapable of having an intelligent debate with people they disagree with without hurling insults and profanities at them, then I believe it is not in the best interest of WBUR, On Point, or NPR not to post their blogs.”

    I did challange you my dear friend days ago on this aspect. However your complete silence and rather beating around the bush with your own not so bright statements make you a perfect candidate you are trying to complain about.

    Why cant you people ever think above the Party Lines??

    This is not about any Party but rather about me and you!!

    Come on Louise, you can do better than this!

  • Coby

    Disappointing show, in that I really didn’t learn anything. Also, wouldn’t it have been a good idea to have the “debate” between someone who supported the public option and someone who didn’t (as opposed to two people who would prefer a public option)?

    Also, Tom is getting on my nerves as a host. He used this mocking tone when discussing opposition to a public option, suggesting that the only reason to oppose or fear this “reform” was because of some misplaced, irrational view of “socialism.” That’s a real way to have an honest, reasoned debate, Tom.

  • Putney Swope

    I recommend reading this article by Marcia Angell, M.D.
    Physician, Author, Senior Lecturer, Harvard Medical School

    This is an excerpt:

    This year we will spend roughly $2.5 trillion on health care. Although about half that money comes from federal and state governments, most of the total is funneled to private insurers and entrepreneurial providers. Alone among advanced countries, we treat health care like a market commodity to be distributed according to the ability to pay, not like a social service to be distributed according to medical need.

    For nearly two-thirds of Americans, we rely on hundreds of private insurance companies to set prices and benefits and pay providers. They profit by refusing to cover the sickest patients and limiting services to others. In fact, we have the only health system in the world based on avoiding sick people. Insurers cream 15 to 25 percent off the top of the premium dollar for profits and overhead (mainly underwriting) before paying providers.


    I agree with Dr.Angell on every point she makes in this article. Health care in this country is in crisis, that’s the bottom line, not buzz words or deals made by legislators or the president. I hope they can get this right.

  • mr.progressive

    Borrowed from another forum:

    To all rightwingers trying to subvert The Nation via neurotic nonsensical diversions …

    You didn’t rage when the Supreme Court stopped a legal recount & appointed a President.

    You didn’t rage when Cheney allowed energy company officials to dictate energy policy.

    You didn’t rage when a covert CIA operative got outed.

    You didn’t rage when the Patriot Act took away so many of our rights.

    You didn’t rage when we illegally invaded a country that posed no threat to us.

    You didn’t rage when we spent over 600 billion(and counting) on said illegal war.

    You didn’t rage when over 10 billion dollars just disappeared in Iraq.

    You didn’t rage when you saw the Abu Grahib photos (except like Rumsfeld to fume that they were ever allowed to be taken).

    You didn’t rage when you learned we were torturing people.

    You didn’t rage when the government was illegally wiretapping Americans.

    You didn’t rage when we didn’t nab Bin Laden.

    You didn’t rage when you saw the horrible conditions at Walter Reed Army Hospital.

    You didn’t rage when we let a major US city drown.

    You didn’t rage when the deficit hit a trillion dollars.

    But you finally start raging when the government decides that people in America deserve the right to see a doctor when they’re ill.

  • Janet

    Mr. Progressive – You and your boy Teddy blew the money on the useless war on poverty the last 40 years so there is nothing left for universal healthcare insurance. Too bad..he should have cut the deal with President Nixon back in the 70′s when he had the chance…but alas, like a true liberal, he would not reach across the isle.

  • mr.progressive

    Janet let unpack your comment. What your saying is that the poor and underprivileged of our society don’t deserve any chances at all and they should just sit and rot.
    How humane of you. When you say blew money, what about the billions that have been wasted in Iraq? It’s OK to waste huge sums of tax payer money on unjust wars. That’s fine and dandy, but helping out fellow citizens with decent health care, living wages and decent housing that’s not OK.

    By the way did you go too public school?
    Do drive on PUBLIC highways?

    Why is it always the fault of politicians like Ted Kennedy, who incidentally did reach across the aisle more times than most republicans, than the right.
    Why do we have to come to you?

  • Putney Swope

    the useless war on poverty

    How profane and mean spirited.
    So fighting poverty is a useless ideal.

    Janet, I guess you and Mr.Ebeneezer Scrooge have a lot in common, that’s the Scrooge before he was visited by the Ghosts of Christmas’…

    So if you don’t support helping the poor then I guess you want to bring back work houses and debtors prisons.

Sep 3, 2014
This still image from an undated video released by Islamic State militants on Tuesday, Aug. 19, 2014, purports to show journalist Steven Sotloff being held by the militant group. The Islamic State group has threatened to kill Sotloff if the United States doesn't stop its strikes against them in Iraq. Video released Tuesday, Sept. 02, 2014, purports to show Sotloff's murder by the same rebel group. (AP)

Another beheading claim and ISIS’s use of social media in its grab for power.

Sep 3, 2014
In this Fall 2013 photo provided by the University of Idaho, students in the University of Idaho’s first Semester in the Wild program take a class in the Frank Church-River Of No Return Wilderness, Idaho. (AP)

MacArthur “genius” Ruth DeFries looks at humanity’s long, deep integration with nature – and what comes next. She’s hopeful.

Sep 2, 2014
Confederate spymaster Rose O'Neal Greenhow, pictured with her daughter "Little" Rose in Washington, D.C.'s Old Capitol Prison in 1862. (Wikimedia / Creative Commons)

True stories of daring women during the Civil War. Best-selling author Karen Abbott shares their exploits in a new book: “Liar, Temptress, Soldier, Spy.”

Sep 2, 2014
U.S. Sen. Mitch McConnell, R-Ky., talks with Mark Wilson, event political speaker chairperson, with his wife Elain Chao, former U.S. Secretary of Labor, at the annual Fancy Farm Picnic in Fancy Farm, Ky., Saturday, August 4, 2012. (AP)

Nine weeks counting now to the midterm elections. We’ll look at the key races and the stakes.

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