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Your Thoughts on Health Care

President Barack Obama, flanked by health care professionals Barbara Crane, left, and Stephen Hanson, speaks about health care reform on March 3, 2010, in the East Room of the White House. (AP)

Health care reform is about as big as it gets when it comes to systemic change in this country. Now the White House is throwing everything it’s got at passage.

But Republicans and Democrats are making sharply different claims about what the American people want. The President says the people want action, now. Republicans say the people want this reform killed.

You can read the polls a lot of ways. So today, we’re putting it straight to you. Open phone lines. Your questions. And ours, the big one: yea or nay on this reform?

This hour, On Point: open lines and your views on health care.

Tell us what you think — call 1-800-423-8255, or comment here on this page, on Twitter, or on Facebook.

Guests:

We have two deeply knowledgeable guests this hour to help answer your questions and add their perspective.

Joining us from New York is Laura Meckler, staff writer for The Wall Street Journal, where she’s covered health and health policy for many years.

And from Chapel Hill, N.C., we’re joined by Jonathan Oberlander, associate professor of social medicine and health policy and management at the University of North Carolina at Chapel Hill.

During the show, Jonathan mentioned the Kaiser Foundation’s interactive online subsidy calculator.  You can check it out here.

Please follow our community rules when engaging in comment discussion on this site.
  • Tony Casey

    Capitalism has failed us here. The United States is the only industrialized nation that does not have a universal health care system because pharmaceutical companies and health insurance companies have too large of a grip around our economy. It’s a crying shame!

  • http://www.workerscenter.org/healthcare James Haslam

    Real change federally has been hijacked not by a political party, but by the corrupting influence of an industry making millions off our health and who have bought off Congress. We believe change must happen on a state level. The Healthcare Is a Human Right Campaign, a project of the Vermont Workers’ Center (VWC), aims to change what is “politically possible” in the healthcare debate through grassroots organizing and our long-term goal is a universal system in which health care is recognized as a public good and provided collectively, rather than as a commodity sold in a marketplace, and where the human right to health of all residents. Financing must be based on principles of universality, equity, and social solidarity, such as a single-payer system.

    Our Principles

    1. Every person is entitled to comprehensive, quality healthcare.
    2. Systemic barriers must not prevent people from accessing necessary healthcare.
    3. The cost of financing the healthcare system must be shared equitably.
    4. The healthcare system must be transparent in design, efficient in operation and accountable to the people its serves.
    5. As a human right, the healthcare system that satisfies these principles is the responsibility of the government to ensure.

  • Jared

    What I want? Single Payer Health Care!! I’d settle with a real public option….

  • cory

    Here are some questions regarding healthcare in America.

    1. Many Americans say we have “the best healthcare in the world”. What does this mean? For whom is it the best? What about the study that ranks us behind Cuba? Is this based on outcomes or expenditures?

    2. Do we really believe we are right and the rest of the civilized world is wrong about universal healthcare? Is this American Exceptionalism or raw stupidity (if there is a difference)?

    3. When will spiraling costs intersect with the cultural maturity necessary to recognize that medical care is a basic human right? 10 years? 50 years?

    4. When will the bottom 75% of Americans realize that in a Democracy they have the power to force the wealthy and entrenched interests to behave morally? Tax the rich until they squeal like stuck pigs (where else are they going to go, Europe?), and hammer corporations and big business. Never forget that the wealthiest 5% of Americans control 75% of the wealth and assets in America. It doesn’t need to stay this way. Maybe they’ll have to make due with 45%. Is this class warfare? Sure, why not!

    Thanks! Love the show as always!

  • Ed H.

    The health care bill still funds abortion with taxpayer money. This is a large chance and represents a large funding of abortion. It might cause the bill to be defeated.

  • peter nelson

    What I want is from the _PRESS_ -

    John and Jane Conservative are not necessarily rich. Many of them are unemployed or work in low wage jobs like gas stations or beauty parlors and have no insurance. When they or their children need care for something like cancer or heart disease or serious injury, costing hundreds of thousands of dollars, how do THEY think it should be payed for?

    The Republicans and liberals both condescend to these people, thinking either that they don’t care or that they’ve been brainwashed into not thinking about it. Why won’t the press go out and interview these people and ASK them exactly how they would like to see health care payed for?

  • http://wbur.org Kathyah

    I do not trust that Obama’s current plan is fully funded. I need to see hard cold figures & facts.

    My feeling is that corporations will drop all existing plans in favor of the ‘non provider fee’ option which is cheaper for THEM overall. And, I believe it is the senate plan that permits the IMMEDIATE raise of 25% on individual health care premiums. Immediate.

    Has anyone seen the tax rates of the countries who provide single payer? My feeling is that MOST Americans are not aware of the tax rates in those countries and still do not realize the impact to them personally. And I don’t think it matters what your salary is (meaning, above/below $250k)

    I would really like to know how this across state lines thing will work. Everyone talks about the ‘race to the lowest cost’ – find the state with the cheapest cost & operate out of there. My imagination pictured the HIGH RANGE of current minimum requirements of ‘what HAS to be offered in any plan’ across all states. So, even if it is a ‘race to the lowest’, the cost state by state would still be uneven, purely based on the individual state’s bare bones requirement of any plan offered in that state. If anyone has insight, I’d very much appreciate.

    I do agree there needs to be change. I need concrete figures on funding source. I would like to see the ‘don’t provide insurance?’ fee raised – was this truly the tipping point figure to pass it? How was it reached? What ARE the tax rates in countries of single payer gvt provided health care? I would like to understand how interstate insurance options would work, how the fraud will be eliminated/significantly reduced (and kept that way) and how will undocumented immigrants be removed from the gravy train (and sent to their birth country, so as not to run up emergency room bills)

    Two really good things about the obama plan – portability & no dropping/not covering pre-existing conditions. (even at that, I wonder ‘at what cost?’, meaning the premiums will be sky high)

    I think in the macro picture, we can’t look at healthcare with blinders on to the rest of ‘what this country spends $$$ on’. If/when more than 50% is INTEREST on the debt (i.e. NOTHING), that’s a huge issue. In looking solely at healthcare, my issues are laid out.

  • Ed H.

    The problem is that we’re missing 50 million people who would be young and paying into healthcare, it’s a demographic problem. Now we face either rationed care or care limited to certain groups.

  • Brett

    Ed H., you are not being factual when you claim the healthcare bills fund abortion with tax payer money. The language is based on current law. The language clearly says: “No government funding for abortions. (Except in the case of rape, incest, or a threat to the mother’s life—the same exceptions granted under current law.)”

    You may not like Roe v. Wade, and you may wish to see this healthcare bill undermine or even ban Roe v. Wade altogether, but it is a current Federal law. Don’t make up “facts” in an attempt to support your desires. There is not language in either bill that changes current law.

  • j brunson

    Core of the problem: credibility – the public does not trust any party or individual to act in their best interest.

  • http://healthblawg.typepad.com David Harlow – HealthBlawg

    The current proposal on the table is characterized by the President as “health insurance reform” — scaled waaay back from the more sweeping “health reform” we heard about during the presidential election campaign. Health insurance reform, imperfect and incomplete as it may be, is a good first step. Without it, more and more of the domestic economy will be consumed by health care expenses. We must also turn to quality controls and cost containment — two other inextricably linked parts of the puzzle — but we have to start somewhere, and if the political realities require starting with a push towards universal coverage, then that’s a reasonable place to start.

    David Harlow
    The Harlow Group LLC
    http://HealthBlawg.com
    Newton, MA

  • LinP

    “If you think it’s a socialist plot, then please drop out of the federal employees health program.” — Sen.Richard Durbin (D-IL), to Republican lawmakers at the health care reform summit.

    Can I get an Amen on that?

    I want health care for all–rich, poor, black, white, gay, straight, young, old, legislator, garbage man–the same system for everyone. Single payer. Period. End of my story.

  • Dave

    In our system of government, it always comes down to exactly two options: vote for a bill or vote for keeping the status quo. We have to realize that legislators who vote against this bill PREFER the current system, and it has to be articulated in EXACTLY those terms.

    We also have to understand that we are choosing to keep the current system while we are in the process of discussing reform. It’s a defacto reality. Reform has been “on the drawing board” now since 1975. Everytime this issue gets sent back to the drawing board, champaigne corks pop in the executive offices of health insurance companies all around the country. At this point, “back to the drawing board” and “let’s start over” is the same thing as doing nothing, as keeping the status-quo.

  • Gregor Clark

    Tom,

    Please have your guests address the possibility of reviving the public option now that we’re only talking about 51 votes to pass this bill. More than half the country, myself included, wants some kind of public option. I personally have asked my Senators to vote against any bill without a public option, because then the proposed mandates really just become a big payoff to the insurance industry at taxpayer expense. I think the Democrats would find a huge groundswell of new support if they revived their fight for a public option in the final bill. Without it, I think we’ll see a repeat of the Scott Brown phenomenon, where voters on the left will abandon the Democrats, seeing them as incapable of representing the people’s true will.

    Of course what we really need is single-payer health care. But I am willing to compromise on a public option as a first step.

  • http://www.lit.org/author/fritzwilliam F. William Bracy

    @Cory

    “Many Americans say we have “the best healthcare in the world.”

    Of course we have the best health care system in the world … for those who can afford it!

  • Sean

    enough is enough we need health care NOW!! The conservatives are turning us into a third world country

  • BHA

    Can someone give us bullet points on just WHAT we are giving the thumbs up or down? The ‘bill’ is not understood by most if any of the people answering these polls.

    The Democrats say we want it. The Republicans say we don’t. The Democrats say we like all the pieces when mentioned individually. The Republicans say “yes but they don’t want to pay for it”.

    I KNOW what *I* want. Universal Health Care. Cover the basics and cover dental. NO ONE should have their teeth rot out because they can’t afford to go to the dentist. NO ONE should end up in the ER because they couldn’t afford to go to the doctor before something got serious. If you don’t agree with this, I suspect you have the “as long as I get mine” mindset.

  • Joe

    Tom — It may not be practical politically, but could we break the insurance system in two, creating a universal/single payer/public option primary care system first? The care and costs in primary care are pretty knowable and pretty fixed.

    It seems that care for chronic illnesses and catastrophic injuries is what drives up cost — so, we would still have to tackle that. But, not having primary care creates an ED-first care system for some people and if we could cut that, it might trim overall cost.

    Then, people could shop for their chosen level of catastrophic coverage on the private market, and we could roll preexisting conditions into existing public programs as if those patients were elderly.

  • Todd

    NO! to any health care reform that has the gov’t controlling any part of it!

  • Michelle Rich

    We need healthcare reform NOW!

  • Benjamin

    There is a lot of “the next generation” rhetoric thrown around by both sides. As someone who is just getting out of school. What I need is affordable health care as I am trying to land a job.

  • Naomi Bindman

    The Republicans do not speak for “The People.” Perhaps if they were in the majority they could make this claim with some legitimacy, but since the voters have given the Democrats a majority in Congress and elected President Obama, these elected officials have a responsibility to follow through on what they stood for in their campaigns: namely health care for all.

  • Steve Provizer

    Doctors are in the middle of this. they know the system is broken and universal coverage is imperative. Why aren’t they speaking out?

  • Judith Juliano

    I have a great insurance policy and I do not want it messed with. I have a daughter who doesn’t have health care insurance but she does not want it as she cannot afford it at this time in her life. She takes sole responsibility for that fact and does not want to be coerced into buying something she cannot afford at this time.

  • Bob Larson

    There is no question there is a need for change. There will be no perfect answer. There are as many opinions as there are Americans. UNFORTUNATELY, our Congress is about as disfunctional as the Iraqi Parliment when it relates to being able to act on this issue. They are afraid. Republicans and Democrats need to get a back bone (no need to go to the doctor), stand up and create results on this issue.

  • Emma Jane Reed

    We have to pass something. Single payer would have been better, but I will take what we can get at this point.

  • http://www.libertarianplace.com/heresourhealthplan.aspx John Howell

    The President says everything has been said that can be said, but nothing has been said about this: the biggest single cause of inflated health care is abuse of the emergency room. 40-50% of those seen in the typical ER would be appropriate for a minor care clinic or a primary care office. The difference between the cost of a minor care clinic staffed by nurse practitioners and physician assistants is 3000%! Why has no one addressed this. It has a simple fix. Congress could pass legislation requiring ER’s to screen patients for medical necessity and turn away those who are not true emergency patients. The same legislation could include liability protections for ER’s when good faith errors are made in triage. See this web address for a comprehensive alternative plan.
    http://www.libertarianplace.com/heresourhealthplan.aspx

  • Peter Sargent

    I am a small-city lawyer. I pay about 1/4 of my net income for health insurance for my small family. I tell my kids not to get sick because the co-payments are killing me. The insurance lobbyists are running this show. They have blank check to create a huge complex system that is very expensive to administer and accounts for a lot of the cost of healthcare. If we had healthcare like Canada or England I would be enjoying middle age, not living paycheck to paycheck. It would allow me to hire another employee. It would allow me to contribute to my children’s college education.

  • Eric

    the only reform this country needs is to remove the criminal organizations called republicans & democrats, all else will fix itself once the influence peddlers are gone.

  • Ellen Dibble

    I live in Massachusetts.
    1) About 1990 I switched from Blue Cross (COBRA) to Arbella insurance and then back to Blue Cross when Mass. law began to allow (insist?) state insurers offer plans to self-employed people. My insurance advisor (a business, advising mostly bigger institions) told me that if I KEPT UNINTERRUPTED INSURANCE I would be protected against something — presumably being dumped in case I got sick. So about 1992 insurance gurus knew there was a way to AVOID THE PREEXISTING CONDITION problem. Or so I see it.
    Are people getting dumped because of gaps in coverage?
    2) I’ll get to that.

  • Nancy Garrison

    I supported Obama in large part because he promised to work for health care. I prefer a single payer system but I think this healthcare bill is an important first step. My husband and I have healthcare insuarance. However, we have two children with serious conditions. As they become independent and we reach retirement and then the end of our lives, healthcare for them becomes a big question. One is severly disabled and will only be able to get Medicaid when the assests he inherits are depleted. The other pays $25,000 a year for insurance that he would not even be able to get if he was not working where he works. He would like to be self-employed, but that is not going to happen until he can get affordable insurance.

  • http://z15.invisionfree.com/Augusta_Alternative/index.php?act=idx JohnRandolphHardisonCain

    Americans cannot have guns and butter. End all U.S. wars, bring all U.S. troops home, and cut the Pentagon’s budget by 50%. That will save upwards of $500 billion annually. Then and only then can we responsibly talk about universal health insurance for all Americans which must contain a public option. Americans neither deserve nor can afford life saving health care while our country is killing and killing and killing. In the meantime put a freeze on health insurance premiums. When we have peace check out the New Zealand model of universal health care.

  • Joyce Cummings

    Please talk about how Medicare would be affected by this plan.
    Thanks,
    Joyce Cummings Ames IA

  • http://yes David

    Do your sponsors permit you to say the words

    “single” & “payer” next to each other?

    The simple truth about the Republicans is
    that they want to see the Obama administration
    fail, even if that failure should
    bring down the rest of our entire civilization.

    They’re all a bunch of thieves.

    LET’S HAVE THE SINGLE-PAYER HEALTH CARE THAT MOST OF THE WORLD (INCLUDING OUR OWN CONGRESSPEOPLE & SENATORS!)
    ALREADY ENJOYS.

    WHOEVER SAYS THERE’S NOT ENOUGH $, BALONEY!

    WE HAVE ENOUGH $ FOR 2 WARS @ THE SAME TIME
    WE HAVE ENOUGH $ FOR OBAMA TO HAND OUT $8,000,000,000.00
    TO GREEDY BANKERS.

    SO WE HAVE ENOUGH $

    SAY IT WITH ME, TOM: SINGLE PAYER!

  • Joe
  • Sarah Laux

    Health care reform is a complex issue. We have all had a chance to elect representatives to inform themselves and choose policies that they believe are in our best interests. For a politician to say, “the american people don’t want this” is for me an invalid argument. The politicians are privy to the details of the legislation being considered, the consequences and costs and should be way more informed than the rest of us. They need to govern!

  • Sandy

    being required to purchase health insurance is crazy. I have a good job, my employer pays almost $10,000 per year in premiums for my insurance and what exactly does “being able to afford it” mean? I certainly would not appreciate being dumped by my employer because they acknowledge that I am now required to provide my own; I fear that’s exactly what would happen. A new $10,000 per year payment to cover, wham.

  • Sean

    judith juliano , why don’t you and your daughter drop off from this planet . YOu are not the only ones on this earth…

  • Ellen Dibble

    In Massachusetts we started mandated coverage and an “exchange” (The Connector or something like that), and for people making an average income (about $40,000), you’re pretty much on your own nonetheless.
    What I discover is that I’m still shopping just the way I did before the exchanges. The offerings on the exchange are another basket of options, but I have found the better offerings come direct from the insurer. The difference is — in the case of direct comparison, in one case, for an additional $30 per month, the same insurer, the same plan, OUTSIDE OF THE EXCHANGE, I get far better coverage in case I needed an operation. If you’re self-employed and need an operation, therefore not bringing in money, the last thing you want is a steep bill from the surgeon. Just the anxiety of thinking of say $3,000 out of pocket on the spot is enough to bring on an attack of blues. So I fork out the $30 and get the additional coverage.

  • Deb

    Yes, we need healthcare reform now and I support the proposal — although I would like to see a public option. I listened to the entire 6+ hours of the healthcare summit and think that Pres. Obama has tried to address legitimate concerns.

    *** I would like to have some assurance that vigorous measurements will be used in future years to monitor health outcomes and savings/costs.

  • D Keith

    The one thing that is unequivocally true: My family and almost every one in the country is one job loss and one disease away from complete financial ruin. Not just financial stress, but bankruptcy.

    The astonishing thing to me is that I keep hearing arguments against a “government takeover of 16% of the economy”
    (1) it is *not* a government takeover;
    (2) if it *were* a government takeover, that might be a good thing, since medicaid is the most highly-rated plan, and is among the most efficient; and finally…
    (3) **WHY** is medicine 16% of the economy? That is massively out of alignment with the cost to deliver care, especially at the below-par outcomes that our system delivers

  • http://terristerling.com Terri Sterling

    We need health care reform now. Those who say Wait often are those with employer-provided health insurance and thus are insulated from the very alarming problems. But that will change as employers push more of the cost and responsibility onto employees due to higher and higher costs. I want to call out Tennessee Senator Lamar Alexander who was a key voice at the long discussion about 2 weeks ago with the President. He keeps saying wait and piecemeal. Health care reform that is meaningful has to happen in a comprehensive way—do the research and you will see. We need guaranteed coverage, mandated universal coverage and premium subsidies. I am a 53 year old divorced small business owner on COBRA. I am halfway through my COBRA coverage (18 months). What am I going to do when it’s up? Can I purchase coverage at all? How much will it cost? We need reform YESTERDAY, even if it isn’t perfect. I have a brother who is unemployed with no coverage—what happens if he’s injured in a major car accident—will he go bankrupt? I have a college age nephew who isn’t in school this semester—he has no coverage. We must fix this very broken system.

  • http://www.cloudbyte.com Terry Sneller

    As an expat living in Canada for five years now, it’s terribly sad to see how the badly the Republicans have blatantly scrambled this vital issue.

    I think how the issue is framed is critical! If it is simply presented as a “Health Reform” bill WITH a strong Public Option — the voters are wildly in favor of it.

    However, present it as “Insurance Reform” without a Public Option and the voters become negative.

  • William St. Laurent

    Municipal, state, and federal employees for the most part enjoy rich health care coverage, even in retirement. This is essentially a public option funded by my property and sales taxes. And the percentage of my taxes for this expense keeps going up. Yet I cannot afford the inadequate coverage available to me. I’m self-employed.

  • paul singley

    I’d like to have the public option, but yes, pass what we’ve got so far.

  • Joan

    Topm –

    This is the type of radio program that is going to drive me nuts!! You MUST ask where the callers get their information. Also, such as with the first caller..ask them if their question has been answered.

    BTW — I agree w/ the caller from Iowa — and love Dick Durbin’s comment.

  • Lisa

    I want action and I want it now. I believe the nature of healthcare and health insurance reform is a process that has been hijacked by large corporate interests with the deepest of pockets for too long.

    I want this healthcare bill to pass. Not because it is exactly the right bill, but because I think reform is a process that needs to begin again and continue until we get it right. It has to start now (one of the problems with the bill is the delay in putting provisions into effect).

    Americans do want ‘healthcare’ and we don’t want to be frightened away from it through the misinformation permeating the debates.

    I have had employer-based health insurance for 25 years and I hardly use it for myself. It provides a basic sense of security – that I can receive care when I need it. My brother & his wife are self-employed & under-employed and worry all the time because one health issue years ago brought them to the brink of bankruptcy and next time it could cost someone’s life.

  • yar

    Healthcare is as divisive today as slavery was in 1860. Economic slavery can be as brutal any other form of slavery. We have no idea what we pay for our own healthcare much less what we are paying for the health care of others. Unless we work together and attack this problem with honesty, I fear our union will fail. I believe is crucial to put the real expenses on our pay-stubs and the percent of cost shifting on our medical bills. We currently pay 17 percent of GDP for healthcare, to expect more is unrealistic. The real barrier to reform is that current slave owners don’t want to pay their share. They are fighting reform by telling us slaves that it will raise our taxes. Taxes or tariffs, it is the total amount we pay as individuals that matters to most Americans. Our nation’s health funding system is the most regressive payment system ever devised.

  • c. eich

    pls don’t use my name
    my main concern is the ‘mandatory’ portion of the bill. I am unemployed more than a year, but not qualifying for unemployment help. only charity from friends and family provide enough for my food and rent. mandatory insurance would push me over into homelessness. tell me how THAT can possibly benefit my health!

  • KadeKo

    NO! to any health care reform that has the gov’t controlling any part of it!

    I’ve got your Medalert bracelet:

    No emergency treatment, no Medicare, no Medicaid, EVER
    .

    And make sure your entire family have them too.

  • Bernadine Schwartzentruber

    I voted for Obama and strongly believe we should have health care reform. But to do this by way of for profit health insurance companies is completely wrong. Their goal is for maximum profits for stockholders, not to pay out for sick people. Go to PBS Bill Moyer’s Journal interview with Dr. Angell on March 5. She tells it like it is.

  • http://none marilyn bentov

    Why do I, living in boston, lose my excellent Medicare Advantage plan under this bill, while 800,000 seniors in florida get to keep theirs? My plan gives me the electronic medical connections, central PCP care, wellness approach etc, that Mr. obaama said he wants! Under straight Medicare, the cheapest supplementary insurance will cost more and give me far fewer benefits.

    Secondly, the bill will be funded by cuts to Medicare under the guise of bringing down costs. Does that mean lowering the obscene fees of MD’s and hospitals OR does it mean cutting benefits to seniors? I have an ophthamologist who sees me for a procedure 5 minutes a month and charges my plan, i.e., Medicare, $500!

  • Douglas C. Dodge, Esq.

    Blatantly Unconstitutional! No longer taught in the public schools, ours is designed as a government of limited and specific powers. For years I have challenged many of the full-time, professional politicians in Washington, the poorly-informed “journalist” and several self-styled “constitutional law experts” to point out the language in the Constitution that empowers Congress to get involved with health insurance, health care, etc. No response to date.
    Art I, sec. 8 makes no mention of anything resembling it; the Tenth Amendment reserves the subject to the States or the people. Hence NOTHING the Congress does about the subject is the least bit binding on any of us!

  • Rosemary Schmid

    I want a public option for starters, but as a beneficiary of a decision made by a 17-year-old to make the Army his career, I have benefited from government-backed health care (minus dental – a real oversight), as have members of my family. IT WORKS. IT’S STAFFED BY REASONABLE PEOPLE, like you and me.

    I do think we need a few bullet points with no political blah blah to clarify. I dare the Republicans to give out the questions that elicited the claim that “everyone” wants to start over. Get real!

  • Paul

    Mandated coverage without cost controls is totally irresponsible. Insurance rates are growing far faster than inflation and GDP and citizens cannot afford to spend an ever-increasing proportion of their income on tribute to the healthcare industry.

  • Andrew Johnston

    This is NOT about health insurance; it is about health CARE. How is it that noone understands that? The US is, 28th, 37th or 92nd.

    Why has the President not said “It costs $7,000 per head per year in the US for this bad health care. We must give the American people at least as good health care for care as good as the rest of the advanced world. Get on with it, Congress! Oh, by the way, Congress, that’s health care at least as what you have given yourselves.” There would, of course, be no “pre-existing conditions”.

  • Expat Bob in Nassau, Bahamas

    I think that the proponents have made a huge mistake in calling it “health care reform” rather than “health insurance reform.”

  • Troll Doll

    Do we really think that insurance companies are going to be easier to deal with once everyone is paying into it? First we handed over the treasury to wall streetand now we’re paying out the insurance industry? We are going to pay our taxes into a for profit industry run by corporations?

  • Chris Hoagland

    The Government is simply in buisness to make its self work. Once people in America realise that one in washignton cares about them. That is anything ever happens in washington to help americans it is only because someone got more money than the competition. That’s it. Other than that everyone in washington, just like everyone else in the world, is simply out for themselves. The only way things will work in Washignton is to start all over again. To have another 1776 revolution and toss out the people that are there and start with real people. Blue & White collar workers that know how things get done with out all the BS.

  • Jen Amos

    Do NOT scrap the bill. A procedure that my insurance company paid over $10K for costs $500.00 for non-insured people. People with insurance are subsidizing people who don’t have insurance. I would rather have a single payer, and not be put through so many unnecessary doctors visits, tests, and procedures which are in effect being used to pad medical facilities bottom line in order to cover non-payers.

  • http://WBUR Melissa Forbes-Nicoll

    YES – PASS IT This bill is not everything that I would like it to be (no public option is included) but, it is better than nothing. This is one reason that we elected Obama President. We need to stick together and go for it. Hopefully we can make changes to improve it later. Don’t let the naysayers with their negative whining win.

  • Bobbie Paxton

    Dear Tom,
    I’ve been working since summer of ’08 for OFA for Obama’s agenda. Health care has been a huge part of conversations that I have had with hundreds of people, either in person or via phone banks. People want health care reform. They are sick of for-profit insurance companies making billions, handing our huge increases at will, paying their execs millions, and the consumer is paying for it. With increasing preniums or getting knocked off their plan for whatever reason their insurer decides. People who say they don’t want health care are often of the Medicare generation, or they mistakingly think that because they now have health care coverage from their workplace, it will always be there, because the employer has promised it. I can attest to the fact that that is not so. We lost our coverage, even tho it had always been promised as part of our retirement benefits. The day my husband retired, his company cancelled our coverage. Boehner and McConnell have no crediblity with me! Bobbie

  • Liz

    The politicians who worked on this never considered REAL reform. All key elements of the current system are preserved. Apparently they wanted to get all the ¨players¨ on board — but do we need all these players? The only truly essential components of healthcare are the patient, the doctor/clinician, and perhaps a facility (hospital, clinic).

    So which element is the dead weight, siphoning off money and getting in between doctors & patients? Which is the hardest to understand? What do medical offices spend most of their time dealing with?
    What promises much but delivers little? INSURANCE.

    So-called health insurance is a bad concept. Third-party reimbursement distorts the market and obscures the basic goals of prevention, and diagnosing & treating illness. It creates cost-shifting, defensive medicine, and the whole problem of uninsured people.

    Health is not a commodity that can be valued, and therefore it cannot be insured. In the end, no amount of money can restore our health. The insurance model should be pitched out the window.

    What about the workers who will lose their jobs, you say? Re-train them to work in healthcare itself!

  • Bonnie Pomfret

    Here in Massachusetts we are required to have health insurance and have a number of individual plans to choose from, much as what the federal legislation will mandate. The options are not great.

    Working part time at 3 employers who do not offer me insurance and self-employment as well, I must go it alone as an individual, and cannot afford an adequate plan. Though I am techinically “insured” I am not able to schedule some tests and procedures at this time, and they will have to wait. Even items which would seem to have been covered are turned down for no good reason, and my rate went up 30% in December.

    The subsidy in Massachusetts tops out at $150 per month for an individual, which given today’s insurance costs isn’t very much help.

    We who are “individuals” in this market need a “group” to have some bargaining power, and that is why a public option was and is necessary.

  • Susan

    I’d also like to see a public option but in the interim let’s pass something. I’m a farmer buying my own insurance and my premium just went up 22% and now i’m faced with deciding whether i can afford to continue having insurance. Many of the people I know who are opposed to this bill have good health insurance via public employers. People change their tune when they have to pay for it themselves.

  • Ron DeMattio

    The Republicans need health care to help them with their chronic lying syndrome. The media has fallen down on the job by not challenging their game. They hold up a bag and tell their voters ‘you don’t want what’s in this bag.” over and over. They can make any claims as to what’s in the bag “govt takeover- death panels-destroying the economy” or whatever gets people agitated until they agree’ we dont want what’s in that bag.” They then turn to their microphones to say “see? They don’t want it.” It’s the mirror of bait and switch and it makes me angry. Yes! I want health reform now because the opposition will crow over a loss and kill it for years.

  • Mark Hoeger

    Waterloo had two sides. Wellington became Prime Minister and a national hero. If Obama wins this battle will he reap the rewards and credit for pulling off what so many have failed to do?

  • Paul Ploof

    Tom,
    I had my salary cut 10% last year, my company provided health insurance premium set at $10,000 and the deduction increased to $10,000 for the family. I have never been so poor. America needs to make a change quickly.

  • Debra Simes

    Premiums for our family of 4 in exurban Boston — for an HMO plan, mind you, not a “Cadillac Plan” — have risen steadily, but are now 60% higher than in 2008! I got our premium increase in the mail last week. We’re both self-employed and pay through a small business group for this HMO coverage. What will our current HMO coverage cost us for 2010? $28,560!!! That is more than the median U.S. income! There should be no profit motive in healthcare.

    What I want is universal, single-payer healthcare coverage. What I know is that cost containment will not happen without universal coverage and either intense government regulation or a government-run program such as Medicare.

  • Dave T.

    Politicians reference the public opinion polls all the time. I wonder how many people have even read this bill. How many even know what’s in it? I suspect the answer is, very few. I wish the backers of this legislation had done a better job explaining it instead of letting their opponents define it. If they had, we the public might be better informed and better able to respond to pollsters with meaningful opinions.

  • http://None Eric

    Yes, pass the bill that Obama is putting forward. As I see it, this is the smallest step in incremental health insurance reform that we can make at this time. As a physician, I can’t stand it any more, everyone deserves the right to healthcare! I would prefer a public option or single payer but I will take what is one the table.

  • brooke

    I really want to see this pass. I am disappointed that the public option is dead. As a self-employed parent, I struggle to pay our health premiums (which is more than our mortgage). We are healthy and active. Thankfully our visits are for preventive care and vaccines, but that could change at any second. I am concerned the next emergency or illness will push us over the edge financially. I feel people receiving health care from their employer and don’t see the necessity of the bill are being shortsighted and selfish. Once they loose they job and see how expensive it is to purchase health care on their own they will be crying foul.

  • http://emredden@snet.net Eileen Redden

    Is this about class warfare – Republicans always block legislation that supports the working, middle class and poor in this country – they obfuscate the real issue and pitch simple, fear based opposition and will continue to do so throughout Barak Obama’s administration. Democrats need to marginalize their message, as the Republicans did throughout Bush’s era.

  • Elizabeth Lyon

    I wanted to see a much stronger health care reform with single payer or at least a strong public option. Now I want to see the current bill passed with some improvements (including public option) through reconciliation.

    Too many Congressmen and Senators have sold out to Insurance Companies. Too many people have fallen for the scare tactics that have been used. The President is at last fighting for this and I hope he will be able to get through to the frightened.

  • Ellen Dibble

    Health care premiums, to my mind, ARE ALREADY TAXES, in Massachusetts, insofar as it is our responsibility to be covered and we accept that the State has an obligation to insure health care for all.
    If we are obligated to pay, on behalf of the common good, THIS IS A TAX. I would be happier to have the payments go straight to something NONPROFIT, and where I know that what my neighbor gets is what I get –
    I can therefore know is money being wasted on this care.
    And I would pay for additional insurance if I could afford it, thus keeping private insurers in business.

  • EllenP

    YES to health insurance reform NOW. The Republicans lie and manipulate. The Democrats are cowards. I am tired of politics getting in the way of policy matters. We elected Barack Obama overwhelmingly. We should support him in enacting his policies. The program is not perfect and the way the Democrats presented and worked it through the system stinks. But it’s a vast improvement over the status quo. I want our elected leaders to step up NOW and make this happen. Anything short of that is simply unacceptable.

  • Marc

    The insurance companies aren’t the demons that some like to portray them as. With reference to record profits, health insurers are in lowest third, in terms of profitability. Please stop making them the Big Tobacco of today. They’re no more angels or devils than other industries. Ok, that’s not a great defense, but it doesn’t help to simplify the problem by making them the bad guy.

    I’m disappointed that single payer was dropped as well as tort reform. And the attempted give-aways to unions and states makes me very nervous about what other back room deals have been done or will be done. I wonder what they’ve done for trail lawyers.

    The nonsense that adding 30million people will not greatly increase costs says I can’t believe any of these talking heads. It defies all logic. Finally, given the interest by democrats and many republicans to enact “comprehensive immigration reform”, I predict we’ll see an additional 12 million relatively poor people will be brought on. And those will shortly be followed by millions of additional immigrants who see the reward for sneaking in to this country.

    The current state of health care is such a mess, that it should be changed. It’s just really hard to trust the people currently in power to do what makes sense.

  • Ellen Dibble

    Back there, woops, if all have ONE CARE, then we can know there is NOT waste — one hopes.

  • Catherine Back

    I DO NOT want this scrapped! I really want Single Payer Healthcare..I have health inusrance which I pay over 1/4 of my take home pay to have! When I lived in Spain in 2002-2003 my son got very sick and we brought him to a local clinic and the doctors were incredibly thorough Billing wasn’t even discussed! And they prescribed
    can you imagine!
    Lets move forward!

  • Randy Potvin

    It is far beyond time that an industrial nation as great as ours have some sort of health care reform. It may not be perfect out the shoot but it will be better than not doing anything at all.

  • petercohen

    AI agree with the attorney/small business owner who was just on. As a physician and consumer of healthcare insurance, I don’t understand why Obama took single payer off the table–it would lower administrative overhead from ~30% to about 3% (the current overhead in Medicare). His current proposal will increase access (a good thing) but has no clear mechanism for controlling costs otyher than expanding the risk pool and trying to extract some savings from Medicare Advantage (which has been a give-away to private insurance– an avaricious profit driven system that does not exist anywhere else in the industrialized world where access to healthcare is seen as a moral right.

  • Shona

    Yes, I want a health reform bill to pass and I would love to see the bill contain a public option, though single-payer seems to make even more sense.
    I buy my individual health insurance through Commonwealth Choice (the health insurance exchange in Massachusetts) . If we didn’t have health insurance reform in our state, I wouldn’t be able to get any insurance at all. When I applied for my health insurance, the only variables they were allowed to consider were age and city. I now have great coverage for pro-active medical care; check-ups and pro-active tests (blood work, etc.). I have high deductible for emergencies ($5000), but there is a good chance an emergency would cost me much more if I didn’t have health insurance at all.

  • beach

    are you kidding!!!!!!!!!!!! warren buffet has it right, this bill has nothing in it to control cost’s.

  • Katharine Layton

    If you ask individuals what they think about each component of the president’s health care reform proposal they are overwhelmingly for each reform. Those who will benefit from scrapping reform have been very successful in scaring people into opposing the bill even though they are for what is in it. Too many people have been sold a bill of goods. As for myself, I am fortunate to be covered by an excellent CIGNA insurance plan …as long as I remain married to my husband whom I have been separated from for 3 years with no hope for reconciliation. In the mid 90′s I left my benefitted job with local government to raise my children, something I will never regret, but I have not been able to find a permanent benefitted position in my rural area where I own my home and my child goes to school so I can move on with my life. I will therefore be heading to Dupont Circle early tomorrow morning to join others in staging a citizen’s arrest of the insurance companies for their crimes against the people: 1) thousands of deaths incurred in the process of pursuing insurance industry profit 2) breach of contract and fraud–denial of promised coverage paid for by working Americans 3) money laundering–clandestine transfers of $10 – 20 million to fund attacks designed to deny health coverage 4) bribery of public officials. I cannot stand to watch my friends sick and dying from lack of health care coverage. Are we the greatest or the greediest country in the world?

  • Bill Walz

    I strongly favor a single payer approach to health care, but if what’s on the table now is what’s possible, I support its passage. Much more will need to be done in terms of cost control, however.

    Politically, the Republicans are scared to death that a program they have opposed, demagogued and lied about from the outset will be enacted. When McConnell and Boehner are out warning Democrats about the congressional seats they’ll lose if reconciliation is used, their motives are more than transparent.

  • kastle brill

    This is to every person who fears their health coverage may be a little worse if other people get health coverage. I would have them imagine what it’s like to have none. To be one of the 45,000 who will die for lack of health care; imagine it is they or their child who will be one of the dead or dieing or suffering. If they are still comfortable with keeping exactly what they have in order to abate their fear of the unknown then they are truly evil.

  • Rosemary Schmid

    When Americans say – not in the Constitution – they need to start with

    We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.

    Seems like health care / health insurance reform falls under the promote the general welfare phrase, along with the blessings of liberty!

  • pamela drexler-lopez

    Why does malpractice/tort reform come down to “Republicans want it, Democrats dont’t”? This seems like a logical area for the two sides to come together. As a healthcare provider (certified nurse-midwife) I’ve seen the astronomical rise in malpractice insurance over the years, and am well-aware of how much “standards of care” are dictated by fear of being sued (fetal monitoring inlabor being a case in point: no evidence that it improves outcomes, but try to forego it and you could never justify yourself in court). The Democrats, with whom I share the majority of views, seem to balk at any substantial changes in the current, very damaged, system.

  • Diane

    Health care is a basic human right to to own a gun isn’t.

  • Martha Schwope

    It’s frustrating to hear this issue attacked or supported by such relatively weak reasons.

    The health care issue is about staying healthy, minimizing sickness, and dealing with injuries. When we’re healthy, we go to work, and our children go to school. When we’re unhealthy, we stay home from work, which in some cases could add up to losing our jobs, and in many other cases, cuts into our two-week vacations. If our children stay home from school, we either leave them alone or take more days off from work. Expecting individuals to be able to avoid sicknesses and injuries and cure themselves is a fairy tale. We need an educated population; that’s why we have public schools. We need a healthy population; that’s why we want a public health system.

  • Larry Oden

    Employers should not have any voice in the plans offered to employees. They look at their bottom line to determine what they pay and most often the worst plans are chosen by them. I have personally seen fewer benefits and higher copays from employer plans.

    All employers and employees should pay into a group plan that includes a maximum number of participants.

    I am retired with adopted children and health issues that make private insurance unafforable for them.

    Republicans have no idea what the real problems are for people that must depend on the market price for insurance. They are not offering solutions. Their tort reform is a minor factor in the cost.

    Doing nothing is not an option.

  • Sue Lewandowski

    Tom,
    I have insurance through my employer and I contribute to the premium. At last open enrollment, I chose a high deductible plan – a trade off for cheaper premium. I believe this legislation should go through. I don’t hear the Republicans coming up with any cost savings – just more negative rhetoric about how it’s going to cost so much more and blah blah blah. (And where was all this frugality when Bush & company were spending like drunken sailors?) We already have “socialized medicine” – Medicare – and it seems to work well for seniors. My family is thankful there’s Medicare for our parents. I think expansion of Medicare to provide for everyone makes sense; the infrastructure is in place, it would create more jobs to handle new enrollments and everyone would be eligible.

  • Nancy Scott

    I believe that most people are in favor of having access to health care. I believe that the Republicans are totally wrong to claim the lie that Americans do not want to have access to health care.

    What we want and need is Universal Health Care not Universal Insurance. Access to health care should be a right not an option only for the wealthy and those who have the luck to have a job that provides health insurance or an opportunity to buy insurance.

    If we care about our people, then we should believe that no only should children have an opportunity to go to school, but all people should have access to health care.

    As far as the cost, that is easy. We have no business wasting money and lowering our morals by attacking other countries such as we are doing in Afghanistan and parts of Pakistan and in Iraq or thinking about attacking Iran. Although we must spend a lot of money to fix what we destroyed with our wars, we should be willing to spend money to provide health care for the people living in the United States.

    I am very much disturbed that the bill being discussed is all about rewarding the insurance companies. I am against punishing women with problem pregnancies and not a word about doing something about the males who caused the pregnancies. Abortion should not even be mentioned in a health care bill as that should only be a private decision between the woman and her doctor as all other health decisions should be.

    Americans need Universal Health Care. Pass the current bill so that there is a start to access to health care, then we must work to get Universal Health Care.

  • jake

    call me a socialist, but for me an essential service like heath care being for profit is disgusting. and this includes health care insurance.

    yes, it’s a national issue. yes, it should be regulated national. and, yes, the bill should be stronger.

    but, this is a start.

  • Dawn Landsiedel

    Not having a national health care has influenced my life immensly. I have never had the luxery of a family to fall back on. Though healthy I have always known that I was one accident or disease away from poverty with out health care. Thus I have gotton jobs with large companys with health care. We need health care for everyone, so that we don’t have family’s losing everything because of something that we can’t help. Also I know people who can not get health care becasue of the risks of thier jobs. I like horses, my trainer, blacksmith, or others can not get coverage.

  • Susa

    A second comment here. I just heard one of your callers who supported reform say we need health care reform for the poor. I have heard this comment repeatedly from your guests and callers. I am not poor, i am a health responsible 57 year old citizen who wants to pay a reasonable premium so i will be able to pay for preventive care testing and health care in case of an accident or serious illness. There are many of us out here old and young who want to be responsible and pay for our own health care via reasonable premiums.

  • Nancy Sullivan

    Yikes – I was on hold and got cut off. since then its been busy.

    I just wanted to say that my family has individual health care for the most part as we are all doing our own business. Carpenters, builders, artist, etc. Our health care costs have gone up by 30%(ours), 60%(my son’s, and we estimate my daughter’s will rise. We need to control those insurance companies’ profits.

    Also, why doesn’t the president get on TV and explain the bill, so that the Republicans can’t tell lies about what is in it? Up here all the people I know are for the public option.

  • Lorie

    I want single-payer universal health care for all U.S. citizens and all visitors to the U.S. I feel this is crucial (I don’t use that word lightly) for several reasons: moral – if possible, health care should be provided to every human, and I believe this is possible in the U.S., that we have the resources and organizational skill to do this. Pragmatic – so that we have a healthy population that can do what needs to be done in this country and so we can control disease more effectively. Competitive – so that our corporations don’t need to compete internationally with companies that don’t have health insurance charges on their books.

    The health care reform bill before Congress is far from perfect but I support it because it’s a huge step in the direction of universal health care.

    I don’t think Obama has handled this well but that doesn’t affect how I feel about universal health care or health care reform or him; I passionately support all three.

  • Michelle Waddell

    I support the President’s bill, as a step in the right direction. My husband and I have a great idea for energy reclamation and would like to start a business doing this, but I had skin cancer at one time and have been refused health insurance. So, my husband had to take a job that provides insurance.

  • Heidi Sikina

    What we are referring to as health care reform is actually insurance reform. Health care is as much a right as education is, which is mandated through age 16. Education has public and private options. Health care should have those same options. Health insurance (the public option) should be paid for through taxes. Employers could hire many more people if they didn’t have the extra burden of insuring them. Cap malpractice, and allow healthcare professionals, not lawyers and insurance companies, to give care.

  • John

    The problem is that we’re missing 50 million people who would be young and paying into healthcare, it’s a demographic problem. Now we face either rationed care or care limited to certain groups. – Posted by Ed H., — The unemployment rates for young people are extremely high and thus the additional hypothetical people would not all be paying into health care as we already have more workers than jobs. Also, how many of the alleged 50 million would have been severely disabled or retarded and thus adding to the costs of the health care system?

  • Robin Couture

    I live in Tennessee, where we have a program called TN Care. It is essentially medicaid administered by the state and it is the biggest mess in the country. You can’t get coverage unless you are a pregnant female. My best friend died last year because she had been unemployed & without health care coverage. I definitely think the states CAN’T handle this issue themselves! Please pass this bill!

  • Carolann Najarian

    Dear Tom:

    Does it go far enough? NO! I am a physician — an internist and left practice 10 years ago because health insurance was such a mess. I was required to hire two or three people just to figure out how to bill these companies. If nothing is done, the BANDITS —the insurance companies win. They may win any way!

    Carolann

  • Margaret

    We just had a huge referendum on national health care! It was called the 2008 election. The opposition needs to be a loyal opposition and help craft a good plan.

  • http://carolpetersen@ymail.com Carol Petersen

    Yes, we need a healthcare bill.

    No pollster contacted me or any of the people I know. To whom are they directing their questions?

  • Roger Johanson

    Quick points on today’s program.
    1) Polls are only as good as the public’s knowledge – which is poor because so many special interest and the whole conservative establishment are invested in confusing the public.
    2) The Republican party, the party of NO, has nothing going for it except the politics of fear. They can only find their way back to power by thwarting the President and Democratic initiatives. So they have devoted themselves to scaring the public about health care.
    3) Health care was an important motivation that drove Obama to his victory. That desire for improvement will not go away.
    4) A vitally important part of our jobs problem is the fact that health care costs are an enormous burden on companies who provide insurance. We must nationalize this cost to allow our American corporations to be competitive. The long term improvements to the deficit that would result from getting health care costs under control would be a huge benefit.
    5) It is utterly baffling that (conservative) Christians oppose expanding health care coverage to all citizens. Millions in this country are suffering because they don’t have access to health care – or have greedy insurance companies denying coverage.
    6) The inefficiencies and profit component of our current health care are not going to be substantially improved without a public option at a minimum and a single payer system as the ultimate goal for cost containment.
    7) We have to pass the current bill because the political climate will not allow anything better. This is an essential first step.
    8) KUNI, Iowa Public Radio – thanks for carrying this program.

  • http://www.heliosadvertising.com Bill Womack

    I’d prefer a national single-payer system as most efficient (like getting a Sam’s Club membership, I don’t see it as socialist!). If that’s not possible, I still support the plan being proposed by Obama.

    I lived in Japan and used their excellent (NOT PERFECT) but generally excellent national health care system for 11 years. No premiums, and it included dental and pharmaceuticals as necessary.

    The Republicans are blowing smoke. Why can America not join the rest of the first world with affordable national health care?

  • Monica S

    The proposed reform is not enough, but it is a start.

    We need to move NOW to help our citizens. I have endured the unpleasantness of having 2 collapsed lungs and being in ICU, uninsured. I got that sick because 1) working in a sick building 2) being uninsured I didn’t get adequate medical care. I laid there in my bed imagining all the debt ticking up, knowing I made too much to qualify for medicaid, but I barely made enough to cover my rent. I was in such pain and so sick and I imagined the years of debt that lay ahead of me and just… no one should have to endure that.

    For a robust America and economy, everyone needs the assurance of basic healthcare that won’t bankrupt them.

    What entrepreneurial, scholastic and national feats could we all acheive if we had the assurance of care.

    Americans who are against the public option have not seen the NHS in action. Have not seen the Canadian system in action.

    YOU HAVE A MANDATE. BE BOLD – FINALLY! PLEASE.

  • Barbara Hankin

    The healthcare should be passed and then every member of Congress has to life with the same healthcare they passed – no less and no more!

  • Terry

    Unless you have a national health system the only real way to control costs in a market system is use the forces of bulk buying and risk spreading. There needs to be a requirement for everyone to participate to spread the risks. That’s how insurance is supposed to work. Then the participants need to be organized into as largw a group and as few groups as possible. This is why a company with 100,000 employees can get better rates than one with 10.

  • Ellen Dibble

    I hear “We have employer-based coverage,” and yet I hear over and over and over that THAT IS THE PROBLEM. Of course people worry. But HEALTH INSURANCE AS A JOB BENEFIT is TOAST.

  • Paul

    Not support for public health care? BS. Everybody loves Medicare and public option polling is very favorable. The “no support” trope is BS.

  • Jonas

    We need healthcare now. I support it!

  • peter cohen, md

    Just listened to Harry and agree with him completely– The private health insurance industry is morally bankrupt–30 % of private insurance costs go to administrative cost compared with the 3-4% cost of Medicare.

    We need Medicare for All.

    Dr. Katherine is naive. We need improved access but there has to be a systematic mechanism in place to lower costs–we need to expand coverage to expand the risk pool. We need to do away with an employer-based healthc insurance system–an anomaly dating from price controls imposed during WW II. This country is the only industrialzed society that does not guarantee universal access to healthcare–this is a moral outrage !

  • Jean Gerber

    I just don’t understand why we can’t have a system like Canada’s. It’s frustrating listening to these reform arguments when right north of us is an excellent system. I lived in Montreal for 3 years as an American citizen yet even my family and I were taken care of by their system. My daughter was born with a life threatening condition and received the care she needed to save her life immediately and the follow up in intensive care and beyond was superb. In all of her and our family’s medical needs we never waited in line, never had to schedule an appointment 2 months in advance, which is what we have to do here, and we had doctor choice. It’s mandated in Canadian Supreme Court that their citizens must have doctor choice. What went wrong? Why are we being so ignorant and blind to the single payer system?

  • Malcolm

    Why do the media continue to let the Rebublicans cite opposition to the bill as if it all came from the right, when much of it, perhaps half, comes from progressives who want a public option?

  • Bob Roberts

    Why do big US corporations self-insure?

    Because it is more efficient to eliminate the middle-man insurance companies.

    The government should do the same for all citizens.

  • Pam Murphy

    As director of a Free Clinic in Virginia that serves low-income underinsured families, I am anxious to see some sort of health care reform passed. It is estimated that over 500 people in Virginia die each year from a lack of health insurance coverage, even while 58 Virginia Free Clinics like mine struggle valiantly to meet as many needs as we can. We need a more permanent solution. Seeing people die who could have been helped had they gotten all the care they needed — it is heart breaking.

  • Chris Green

    My vote would be yes, not because the bill is perfect but because it would begin the process of change, which is essential.

    Coverage (rather than cost cutting) seems to be the priority right now. But, because this process has begun a much deeper national conversation, I think that doctors, hospitals, insurance companies, and the insured will hold all more accountable.

    I believe that a nationally organized plan will ensure more even-handed coverage than 50 state plans.

    Chris Green

  • Peter Sargent

    Take away the healthcare from members of congress and let them find their own. That would change a lot of minds immediately. They live in a world of their own and don’t know what it is like for the majority of us.

  • Rebecca Shao

    Now it is the time that government shows to the American people and the world that they can finally make something happen after all the debates. Endless debate and indecisiveness delays our progress while other countries are relentlessly going forward. No one, if he truly cares about this country’s future, should be saying ‘no’ simply for his political agenda. Debate is essential for democratic system, but compromise and collaborate are also the keys to success of a democratic system.
    I believe the public option is the way to go. But even without it, the current bill is a good start.

  • Catherine

    The physician who called in earlier has it exactly right. What we need is insurance reform. Many clinics and physicians refuse some insurers because it is either not fiscally reasonable or the administration of the insurance is too cumbersome. I think all of the policitians are off the mark and I am concerned they will make it worse. I adamantly disagree with the statement we have to do something.

  • Lisa Bastille

    Health Care is a human right. As I see it the insurance companies have done nothing if not to drive up the costs of health care to such a level that no-one without their product can pay for service. This is a disgrace and is why we do need a public product for everyone no just people who can afford health coverage.

  • David

    Opposition to reform is coming largely from the right whose leaders are resorting to distortion, deception & falsehoods. Where are the lies on the side of those who support reform?

  • Marilyn Neuerburg

    I’m in favor of this package promoted by President Obama. We desperately need to start somewhere with health insurance reform. My husband is a chiropractor and I work in his office. The patients we have who are happiest with their insurance are the patients who have Medicare! I’m in my mid-fifties and can’t wait to have Medicare. The only health insurance we’ve been able to afford is a HSA with a $5400 deductible. Please, politicians, start promoting good policy and quit pushing your own political agenda. If you pass good policy, your political future will take care of itself.

  • Randy

    I live in Alabama and a shareholder in a small business. I am pleased with my health insurance as it is and have no complaints. I certainly believe that the Obama plan will increase taxes and I pay enough of those already. So, I am a resounding NO to the plan. I don’t believe that passing what we have and then work to make it better is a good idea. It would most likely just cost the country more money in the long term.

    I think the elections in Massachusetts and other venues show the public is trying to tell Washington they don’t like the Democratic ideas. Further, if Congress crams this through, the mid term elections will be very interesting to watch.

  • Debby

    I have not heard the issue addressed that the lack of healthcare is directly contributing to our federal deficit. I would like to have this aspect of healthcare brought out

  • Scott Taylor

    I do not support this heatlh care reform. I see the section of the health car bill (501 I think) requiring all people to participate or pay a tax on income as a way of handing the American People’s pockets to the Insurance companies. Forcing 47 million people to buy insurance is not “providing” health insurance. There is no way that requiring people to buy health insurance will will foster a competitive market. We can not allow goverment to keeping chiseling away citizens’ independence. NPR did an article on MA, program and found that people gave and just paid the fines instead of buying health care because they could not find coverage they needed or the price was just too much for too little. I have a good plan right now throught my employer, but what if I want to strike out and do my own business? I don’t want a mandatory plan adding to ny expenses. I want the abiltity to chose my own plan. That’s what keeps the insurance industry from doing what ever they want,the peoples’ ability to choose.
    I also do not support this because the one good option, the public option was deleted from the bill.
    If one doesn’t think this is windwall for insurance just do the simple math- 47 million required to pay times mothly premiums.

  • David Nocella

    If most of the healthcare costs are spent in the later years of life and Medicare covers those cost,don’t we really have socialized medicine now and by-in-large private insurers do not share the risk with the tax payers who fund Medicare?

  • Eric Olson

    If you’re opposed, be honest about your reasons – open hatred of poor people. Period.

  • Ann Marie

    Re included/excluded (not pre-ex) coverage:

    At what point did we all abdicate to others the right to choose what legal care we get? I am a taxpayer, and it is also my money we’re talking about which would provide coverage. Why are we even considering excluding certain coverage to satisfy particular groups? What happens if a particular group starts to loudly complain that people should have to pay extra for cancer coverage if it’s due to smoking? What about their position on coverage for HIV/AIDS? To even consider this category of exclusion is inexcusable.

  • Ronald

    I have watched the debate and discussion surrounding this issue closely during the last year and it is clear to me that President Obama has given careful thoughtful consideration to all points of view. The reform bills currently before the Congress being proposed for reconciliation have the best ideas from both parties. The bills are bi-partisan even if they do not enjoy bi-partisan support.

    I am disheartened by democrats who do not support President Obama and the health insurance reform program he has worked so hard to develop. As a physician, I cannot tell you how much of my day is devoted to working around byzantine and bizzare insurance policies designed only to reap massive profits for insurance companies at the expense of patient’s well being. The bottom line is, no one should have to die because they cannot afford healthcare. No one should be sick because they do not have insurance. Healthcare is different. The free-market private practice small business model of healthcare in America, as it now stands, is broken. It is hurting people, particularly those who have lost their jobs and as a result have lost their health insurance. I would hope we would have the courage to fix it.

  • Rob G.

    I’m stunned that no one is discussing the mandate. This legislation will enslave us. The Federal Government will become the enforcement arm of the insurance companies. How is this acceptable to anyone?
    Anyone who has looked at this issue knows that a single payer, Canadian-like, system is the correct solution. If we pass the current bill, we will never, never be able to correct the choke hold the insurance companies will gain over every aspect of our lives.
    We need to defeat the current bill and start over with a true reform of health care, NOT health insurance. Give us a single payer system. Nothing else is acceptable.

  • Kathryn

    If the Dems would take the risk, translate: grow a spine, the bill should be pushed through WITH the original public option. I believe the resulting voter turnout would be one that shows that we the people appreciated having us thought of instead of the next campaign contribution.

    Why should a lawmaker fear that some opponent would say “He voted for something that will help many American people?”

  • Paula

    We definitely need this bill, as a small baby step in the right direction.

    I have a minor health problem that I manage well, and that costs very little to take care of. But it’s been enough to cause me massive problems with getting insurance. (Never mind “affordable,” sometimes I haven’t been able to get any at any price!)

    Carolann, I was one of your patients, and hope you’ll return to the profession some day — we need great doctors like you!

  • Alice

    With $600 a month going to premiums (and that’s with our employer paying half), $150-200 a month in copays, I wonder if my taxes would be higher than that if we had a national option. I doubt it. I know that the money saved would be put back into the economy; I would spend it on things I’ve been doing without since being held hostage by healthcare premiums and perhaps a meager retirement plan, something that is on hold while I take care of here and now.

  • Donna Mooney

    I have a hard time listening to Republicans say that Americans don’t want this. They don’t speak for me, and I don’t think they speak for all of America. If they did, wouldn’t they have won by a landslide in the last election? The election of Scott Brown in Mass. doesn’t not mean “ALL Americans” are now against health care reform. When people like John Boehner makes this statement again and again, I just want to cringe! I am an independent, and I voted for Obama because I wanted change, and I thought he might have a chance of doing it. I still want change! I wish politicians would just lie a little less. Couldn’t John Boehner just say ” The Americans that I represent don’t want this, and there are a lot of them” It kills me when they flat out lie, and nobody call them out on it.

  • Todd

    “‘NO! to any health care reform that has the gov’t controlling any part of it!’

    I’ve got your Medalert bracelet:
    No emergency treatment, no Medicare, no Medicaid, EVER.
    And make sure your entire family have them too.”
    Posted by KadeKo

    And I don’t want any of those services, EVER! I have no family; but, if your eligible for adoption, then order two bracelets, and I’ll show you how to live w/o gov’t welfare.

  • Joe Woycie

    I agree with the caller who condemns the Republican party. I’m also a disenchanted 45-year registerd Republican. The GOP leadership stance that the bill should be abandoned without debate is a pathetic insult to intelligent, patriotic America. Where were our Republcan leaders when health care reform was first debated and legislation drafted? Where are they now? Doing nothing, waiting for the next elections? Do what you had been elected to do now. We’re going to the poorhouse waiting for you to do something, anything. John McCain, where are you?

  • Ellen Dibble

    I saw a question above in this thread: Does it cost this nation insofar as there are the 40 million without health care.
    Obama is saying the current situation is making the COSTS spike, essentially driven by the prices insurers are willing to pay for the health care for their insureds. So it is those WHO ARE CARED FOR that is attacking our national well-being, charging up the national debt, looking especially at those over 65 and the baby boomers.
    The COST of those WITHOUT HEALTH CARE is the cost of having working-age people die, family-raising-age people hamstrung as to changing jobs and thus insurance, entrepreneur-type people unable to strike out.
    The cost of someone disintegrating physically is nil. It’s free to the Republic. NO HEALTH CARE is NO COST. But of course, we invest steeply in education in order to get those people able and willing. Then we let them die.
    If they can keep things together to 65, they can get a fresh start.
    I know that leaves out Medicare, but someone else can figure that in.

  • Ellen Dibble

    I mean, leaves out Medicaid.

  • Tom Clark

    I am against the current bill in its present form. Yes, some provisions are valuable, but not as a package deal. Here are my desires in a health-care bill:
    1. Convert the health insurance business to be as the auto-insurance business–free for all to all. There would be no restrictions to purchasing from any insurer the coverage the user chooses.
    2. Remove all employer-paid health benefits from all businesses, and pay each worker additionally the amount of their current coverage as regular salary.
    3. Make it mandatory to have health-care insurance, chosen by each citizen with the features he/she can afford or desires. They will receive from hospitals/ clinics only what they have purchased.
    4. If one does not have health insurance, remove all responsibility for hospitals to care for non-insured clients, including emergency care. We don’t require an auto-body shop to fix the cars of the uninsured.
    5. Remove all benefits to illegal aliens to provide coverage for any services they have not paid for.
    6. Remove from Social Security all but those over 65 and those whose parent has died. It might be self-sustaining if the leaches were removed.
    7. Require all members of the government to purchase the same health-care plans as available to every other citizen. The Congress does not get free car insurance, and their health-care should rest on the same premises.
    8. Ensure Medicare and Medicaid are paid for by those using it, pay as you go–no subsidies to pump up its survival.
    9. Remove the ability of patients to sue doctors/ hospitals over minor errors, capping all settlements at $1M, regardless of injury or death.
    10. Remove the ability of insurers to change rates for anything but a cost-of-living rise.
    11. Require the insurance companies to charge the same for all customers on a given plan.
    12. Restrict the insurance companies from charging different rates for pre-existing or post-existing health conditions.

    These twelve elements, without a plethora of new government agencies or rules, would completely overhaul the health-care business and provide all Americans with superior care and availability of services.

    Thanks,
    Tom

  • Kay

    “State by State” as endorsed by Mitt Romney and others is a terrible idea. We had a healthcare program in Tennessee called Tenn Care. It was so successful that sick, uninsured people from other states flocked here to receive coverage. Along with the lack of oversight and resulting corruption, our system ultimately failed.

    Using states as laboratories will inevitably doom the most successful states in a mobil society.

  • Thomas

    I’m a US citizen who has lived in Canada for the past 15 years — and despite what previous callers have said the Canadian healthcare system doesn’t work. In theory, we all have equal access to services here — however, you may not get the services when you need or want them. Here in Quebec, there are doctor shortages, long waits, and the quality of care is substandard compared to that in the US. Ironically, in Quebec there is a move to private care. Many private, for-pay clinics outside the public system are opening up, and these provide a better quality of service, but you pay out-of-pocket. Plus, the taxes here to support the healthcare system are onerous. We have a 15% sales tax on everything, except most groceries. But you can add 15% to the cost of everything else, whether it’s a car, a suit, a newspaper, and even — unbelievably — stamps at the post office. Gas here today is about C$1.10 a liter (~US$4.00 a gallon); it’s been as high as C$1.40 a liter ( ~US$5.00 a gallon). We’ve also got a higher personal income tax that is applied at lower income levels. So, if you guys want ObamaCare, fine — but don’t think that it will come cheap, or that you will continue to have the range of choices you currently have. While things may work for 10, 20, or 30 years, the rules of economics will eventually catch up to you…

  • Ellen Dibble

    I don’t see why the USA can’t have both private insurance as well as some baseline national health care. As is, if you show up at a hospital, you don’t get turned away, so there is some baseline that we accept as responsibility. But the cost of that care is made up by those who mainly make the hospitals tick, that is, private insurers (that is, the premiums of their insureds).
    So why not accept reality: We provide a baseline care, but make that a national responsibility, not spread it among those who pay insurers but those who pay taxes.
    Above whatever baseline we decide, then insurers can offer a cornucopia of options. Long-term at-home support is something I would pay for (do pay for actually). Dental care I would pass, don’t need that. So that could preserve a lot of what we like about the current system, and we could MOVE THE LINE according to circumstances.
    I think it is partly BECAUSE WE HAVE COSTLY INSURANCE that we have medical advances, COSTLY ADVANCES, and maybe lead the world in available medical care.
    AVAILABLE CARE — not AFFORDABLE CARE. But the insurers have little motivation to offer LAST YEAR’s BEST CARE. For that, you can go to Canada — maybe.

  • Melissa Mueller

    The idea that whether or not this bill is passed may come down to the abortion debate has me incensed.

    Recently I lost my job while pregnant. Unsure I could afford to stay on COBRA, I found that I was eligible for Medicaid. This made me aware for the first time of the issue of access to abortion for women on publicly-funded health plans. Currently, Medicaid is only required to cover abortion in cases of rape, incest, or life endangerment. However, some states, such as my home state of New York, do cover abortion as part of their Medicaid policies. Women who need publicly funded health care coverage and live in states that follow the federal policy are routinely denied access to what the Supreme Court has determined is a constitutional right, unless they can afford to purchase their own separate abortion coverage. The House version of the health care bill goes further: it would deny women who choose a federally subsidized health care plan the ability to buy their own, separate abortion coverage. This is supported by many Republicans.

    I have ethical questions and problems with several medical procedures, technologies, and practices, but I am not going to make those decisions for another person. The idea that someone else’s morality and ethics would determine my right to a medical procedure is abhorrent. Even requiring me to pay extra for the coverage is unethical. This is one of the many reasons I don’t think Obama’s health care reform goes far enough, but at least the compromise preserves more of the status quo on abortion than the House bill or the GOP, who would drag us backward and deny many more women their reproductive rights.

    Can anyone imagine a health care bill passing if, say, coverage for penile enhancement medication, prostate cancer screening, or any other male-specific treatment or procedure required special, costly coverage or if coverage were denied altogether?

  • Julian Garmil

    It’s clear that Congressman Boehner is not listening to a wide spectrum of Americans. Since I can’t afford a lobbyist to get his attention, I hope that On Point will pass along this comment the next time the health care issue is covered.

    Dear Congressman Boehner:
    I have good news and bad news.
    THE GOOD NEWS: Many Americans will not be paying any inheritance tax!
    THE BAD NEWS: Without affordable health care these constituents will be penniless when they pay the ultimate price!!!

  • http://carrollann.com carroll ann bottino

    Re: Health Care
    I have sent and resent my opinions to:
    Our president, and my house & senate representatives
    Dem Nat Committee
    AARP
    And others whose appeals to me I have been able respond too, hope to influence and/or support
    & * &

    I am in favour of a SINGLE PAYER health plan for all.

    If this is not possible, any health care legislation should have a PUBLIC OPTION.

    At this time point in time, GET A BILL PASSED, and move forward amending this bill as needed to meet the needs of the citizens of the United States of America.
    I too want health care coverage like our Federal Representatives, Senators, Justices, V. President, President, and federal employees have!
    ~ * ~
    Now, with their feet held to the fire by pending federal legislation, the health care ins.. industry has offered to make changes in the delivery of service they provide to the citizens whose ins.urance payments provide for their professional and personal life style.

    Where was their moral responsibility to the citizens whose ins.urance payments provide for their professional and personal life style prior to having their feet held to the fire?

    Moving forward WITH a health care bill, where will their moral responsibility be without having their feet held to the fire by our legislators moving to change the health care ins.. industry practices through legislation?

    With the health care ins. industries ability to lobby and financially support our legisllatore ability to be in office, our legislatore have a challenging moral responsibility to their citizens to govern, through legislation, the morally responsible delivery of health care ins. to our citizaen.

    BUT, they are in office as a result of our vote. We can vote them out. We can search for, support, and vote for someone who represents the needs of the citizens who pay for their responsibility to legislate and govern responsibly.

    Democracy is a costly, time-consuming, citizen involving form of government at best.
    It is NOT a spectator sport.
    But, it pales in comparison to other options.

    Respectively submitted,

    Carroll Ann Bottino
    62 Sherburne Road South
    Lexington, Ma 02421

    Tel: 781-862-3337
    Cell: 781-354-8419
    email: carrollann@mac.com
    http://www.carrollann.com

  • fay

    I vote yes and let’s move on it. Even though the bill will be imperfect, it is a start, and I think, vital. I am personally for the public option and single payer,and hope it will eventually happen. We need to get costs down and somehow get rid of the outrageous influence of the pharmacutical corporations on Congress.

  • http://wbur.org Kathyah

    judith juliano – for the past few decades, younger people have been ‘paying it forward’ so that elders living on fixed incomes would not have to bear the burden of their own health care costs. It is my fundamental belief that each of us must also pay it forward. Otherwise, we need a beaurocracy that states ‘if you did NOT pay in for X # of years, you only get THIS much coverage in retirement’. Also, individuals w/o insurance are frequently denied treatment from drs and are not eligible for organ transplants.

    The government has already been controlling healthcare for YEARS. This, via the insurance companies who ‘determine’ what the doctors will provide in coverage. The same insurance companies in the back pockets of our legislators. There is a REASON why you need to wait for ‘approval’ for tests, procedures and several services.

    I swear on a holy stack of bibles (from my distrust of govt, no documentation what so ever) the corporations will DROP corp provided healthcare & pay the ‘don’t provide’ fee. It allows them to be globally competitive. We then have to buy individual insurance which I believe the senate plan allows for an immediate 25% increase in premiums. With the insurance companies getting all these new subscribers, where do you think the premiums are being spread out to? Legislators, big pharma & themselves. I don’t know about drs.

    Terry – it IS Health INSURANCE reform, NOT Health CARE reform.

    Marylin – my understanding is the 500 million cut from medicure *insurance* payments are restored under a separate 300 million bill to restore these payments to doctors. Would love to know if this is accurate.

    Jen Amos – absolutely agreed.

    Debra Simes – that is a crime.

    Katharine Layton – Thank you.

    pamela dexler – re: tort reform. In the summit, this was deemed to be 1/5th of 1% of the total cost. I’ve heard 1.5%. Interestingly, they did not say how ‘cost’ was defined. Is it what is paid out in legal settlements (more likely) or the premiums the drs pay as a result of fea of being sued. It would be interesting to know the true, actual cost.

    Lorie – how do you pay for it?

    Bill Womack – Japan’s tax rate is either 42 or 48%. Just so you know what it costs.

    Randy – 10:56 – your insurance will be gone if obama’s plan passes. You’ll need individual coverage and awaken to a new cost reality.

    David Nicolla – you do realize medicare is going banckrupt?

    Ann Marie – for me, abortion rights have to be excluded if this bill has any chance of passing. Do I like it? No. Pragmatically, it’s the only way it’ll get through.

    Alice – if there are savings, only obama would give it back to us, in the form of education. Which is good. This requires bills to make it through the house & senate first to get to him. Do you trust them? Any other administration will find another way to waste it.

    For the record, I do believe we need change. I’ve said before, any tax increases necessary to fund it need to be signed in AT THE SAME TIME. Else, they’ll NEVER get signed in.

  • Karen Williams

    The reform thus far has focused on DEMAND- whether you wish to call it healthcare or insurance coverage doesn’t matter much. Americans wish to be seen by health care providers ( the SUPPLY ). My concern is that adding 30-50 million persons to the list of potential patients does nothing to add to the suppliers of that care.
    There is nothing in the bill that expands the numbers of MDs ( 12 years prep time) nor the other providers (PAs and Nurse Practitioners). More loans for MDs will take at the earliest 12 years to see even the first graduate- and Nurse Practitioners are not offered any incentives to be primary acre providers either. Many nurses who hold BSN degrees could attend grad school and be ready to give primary care in about two years. That’s a great plan- rather than 12.
    My fear is that we will have passed a bill that will entitle Americans to coverage at some level- but no openings/providers in clinics or hospitals to provide what we all feel is a right. Just imagine how incensed they’ll be then.
    I offer that an incremental bill be thought of, just as you wouldn’t ask 20 people to dine on two pieces of bread- you should not be entertaining caring for people you do not have the resources for. Beef up the resources, encourage people to enter health care ( more secure jobs) and then match the need with the supply incrementally- gear up- otherwise it’s a house of cards.
    It makes no sense otherwise.

  • Richard Clements

    I keep hearing from Republicans that universal health insurance would be a burden to small business and would make the USA uncompetitive in the global marketplace. Absolute nonsense! If universal health care were really a “job killer”, how is it that after 50 years, the Canadian economy is doing quite well and our jobs have been getting killed off at an alarming rate?

    It was interesting that a few years ago, when NAFTA was being negotiated, the US took the position that the Canadian universal, single-payer health insurance was an “unfair advantage” for Canadian businesses. So what is it, a “job killer” or an “unfair advantage”?

    For more than 50 years, Congress through US tax system has kicked this issue down the road, making health insurance benefits tax deductable to employers and tax free to employees. Great idea if you’re under wage controls in WWII and generally acceptable in the booming 50′s and 60′s when we had no serious global competition and most Americans had reasonable job security. Health insurance benefits were a way to retain employees.

    Now, as small businesses are being slammed with spiking health insurance costs, cutting or even eliminating benefits to stay competitive, this makes no sense. Why should small businesses be penalized with escalating costs and employees be pushed into the individual insurance market or left uninsured? Why do we ask employers to solve this social problem?
    I happen to have run businesses in the USA and in Canada and can tell you that with their universal, single payer system, an employer probably spends less than 15 minutes a year on health insurance benefits, perhaps offering a dental plan or some wellness program at minor expense to employees. In the USA, we are continually having to research ways to control benefit costs, and retain key employees, (quite apart from the ethical question of cutting insurance from those with pre-existing conditions who would be uninsurable in the individual market). Tying health insurance to employment makes no economic, ethical or practical sense.

    Let’s get real and put a single payer system in place! Instead of 30% or more of premiums going for administrative costs, with a universal system built into our infrastucture (like almos every other developed economy), we already have administration in place, that would automatically adjust premiums by income level – the IRS. Underwriting the risk pool would be easy compared to the millions insurance companies have been paying to exclude high risk applicants. We also eliminate that ridiculous burden that American businesses have been carrying. Why did GM and Chrysler go into bankruptcy? It wasn’t lack of production efficiency, but “legacy costs” of providing health insurance for employees and the growing pool of retirees – costs NOT loaded onto our global competitors. Why is it so impossible for us to make basic health care for our citizens part of the infrastructure, like police protection, fire departments, roads, water, sewage, etc.? It’s not socialism. It’s pragmatism and practicality.

    BTW, I am an independent who has voted for both of the major parties in the past, based on issues. From my pragmatic viewpoint, neither party has it right, but the Democrats at least are moving this towards a more practical solution than the Republican non solution. We can no longer live with the status quo!

  • Diane Huffman

    It is time to pass health care reform. I voted for Barack Obama for change and I would like Congress to get to work and make this change possible.

  • Ellen Dibble

    Gearing up, pay-go for one, and care providers/newly insureds for the other.
    I think the Congressional Budget Office has vetted the bills, Senate and House, with a conservative eye, not counting lots of savings that reasonable people might foresee. The Obama plan should help, not harm the national debt.
    For care providers, I see this in Massachusetts, where I can be told the next chance for a check-up would be in eight months. Retired physicians can be called in as back-ups, I believe. Anyway, it seems a way of dealing with too many patients per primary care doctor is to send the patients to specialists ASAP, which of course costs the insurers a lot more, but it get the patient some care.
    It is my impression that the people Obama wants under the new umbrella are mostly people who CHOOSE now to forgo insurance. They consider themselves plenty healthy. I don’t know the exact breakdown. Medicaid, they say, will extend over more.
    So possibly a lot of those new insureds won’t actually need many doctor visits, if any.

  • Gina

    I really don’t understand how a supposedly intelligent, rational adult can comment on HCR by saying “people who don’t have health insurance should not be treated” as a some kind of panacea for reform. Because Tom’s comment above isn’t the first I’ve read today in regards to the mandate.

    “We don’t require an auto-body shop to fix the cars of the uninsured.”

    Do you really understand what you are saying? You can buy a new car. You can’t buy a new body. This is the fundemental premise as to why Health Care should not be subject to free-market rules.

    So an ambulance is supposed to leave someone at the scene of an accident if they have no proof of insurance? An ER or medical clinic is supopsed to send someone home with a communicable illness untreated, to spread it because they can’t pay for it? You are basically advocating letting human beings—you fellow Americans die on the street because you don’t want your taxes to go up.

    People complaining about a mandate need to then understand that the risk pool needs to be expanded and leveled somehow. Single payer would be a much fairer and efficient way that clinging to some misguided attempt to preserve our blessed Free-market economy.

  • Harvey Weinberg

    We need to pass healthcare reform now. My wife and I could not get health insurance in California on our own because of pre-existing conditions. The Insurance industry only cares about profit and not the public. We should just go to single payer.

  • Liz

    Brooke, youŕe right on target about those with employer-sponsored coverage. The often-heard talking point is

    ¨Most Americans are happy with their health care¨

    but you could just as easily rephrase it as:

    ¨Americans who receive health insurance at work are just happy that they have it at all!¨

  • Gina

    Kathyah, and others who use the strawman argument about how high the taxes are in places with universal single payer, these countries also educate their population, the citizens or Japan, Sweeden, etc recive many benefits and services from their taxes. It’s not a fair comparison to suggest that the population of the US will suddenly see their tax rates go up to such rates just by adding a public option health care plan.

    To the commentor above who suggested that any added tax burden she’s face probably wouldn’t be more than the premiums and co-pays she carries now: Hear! Hear! Plus it would be adding money to the economy more directly and efficiently.

  • peter nelson

    Judith Juliano writes:
    I have a daughter who doesn’t have health care insurance but she does not want it as she cannot afford it at this time in her life. She takes sole responsibility for that fact

    I DARE you to tell us exactly what this means!

    So if your daughter is in a serious car accident or has a serious illness costing hundreds of thousands of dollars to treat, does she expect to be left out on the sidewalk to die?

    Who DOES she think is going to pay for her care if that happens? Does she even have a clue what the cost of a major illness or injury is?

  • Ellen Dibble

    I certainly heard the man who called in, stated his position for reform, and then became quite emotional speaking of having had to watch his father die, an uninsured father.
    So it’s not just the individual put in straits by medical difficulties. Someone mentioned in this thread that they hope the kid under 26 is on good terms with his/her parents, so as to be allowed (under the new plan) to continue on the parents’ insurance.
    But if your father or son, or maybe an ex-spouse who has custody — someone important to you — if they get sick or injured while uninsured, WHAT DO THOSE NEAR AND DEAR DO? Karen Tumulty has been a major voice on TV and here on OnPoint, speaking to this issue, with a brother who, underinsured, fell ill.
    One person uninsured or underinsured can be a MORAL AND ETHICAL AND FINANCIAL TRAGEDY for an entire FLOCK OF PEOPLE, insured and otherwise.

  • Velvet Rowe

    I want a single payer/Medicare for all health care plan.
    Keep insurance out of the health care system. I voted for President Obama to get it. What happened? We pay over $400 dollars every three month for each of us. The insurance company fights to keep every penny even for deductables. They will fight paying us anything until we die or run out of money. Canada has what we should have. Our right to get single payer health care is blocked by a congress that gets theirs paid for by our taxes and takes bribes from the insurance companies to keep us paying insurance.
    Sincerely,
    Velvet Rowe

  • Ellen Dibble

    If the Senate health care bill and Reconciliation passage depend on the Stupak stubbornness, the vote that depends on making abortion unavailable by separate private insurance, though Constitutionally a right — I say okay, we have to have the abortion debate all over again. The Supreme Court WAS NOT THE LAST WORD. STUPAK HAS THE LAST WORD.
    Here goes: What happens to a Fallopian tube pregnancy? What happens to the something like 80 percent of fertilized eggs that fail to implant? Actually, what happens to an unwanted child? Not everyone sees it as an option to put each implanted possibility of life into the arms of an unknown family. “I wouldn’t curse my child, however unwanted, with THAT kind of possibility.” So you make do. You welcome motherhood, and it is a means of surviving, a morally legitimate way of surviving, for those without skills. You can provide New Blood for yourself (warm, dependent little creatures), New Blood for your congratulatory family, New Blood for the military/industrial complex — that will pay for their education and health care for decades.
    We need to make room for all possible children. Of course.

  • Ellen Dibble

    Somewhere on Sunday talk — possibly local, where there is less, um, “oversight” — I heard non-national candidates talking about how you go about running for office, and how you have to sign off on certain agreements, accords, or something, in order to get the kind of financial backing that lets you run.
    It sounded like this was common knowledge, or I would have got more of a jolt than I did: You sign off to the big corporate interests (health insurance, banks, housing contractors…), and then you can run.
    When Obama ran, it looked like he was getting all the money he needed from the internet, by $25 grabs from the likes of me. The media was full of it: Obama runs on Small Donors.
    Now we learn that was a lie. Likely those with Very Deep Pockets who got him to sign off on those “agreementns” in order to give him funding the likes of me could never provide, those lobbyists also made sure that the Media did NOT broadcast in whose pockets he really was.
    But I don’t think the Congress either is really free to come up with Single Payer. They all have these campaign “accords” which mean they CAN’T help us.

  • http://wbur.org Kathyah

    My issue is I want to know precisely how it is funded. I want the word I’ve grown to hate – transparency – on this. In very simplest of terms, I want two lists. One that I identifies ‘source of funding’. One that identifies ‘this needs to be funded’. Then, I want a line, item by item, from the funding source to the needs to be funded.

    Provide abortion riders in the free market. And, before we go to ‘what about those who can’t afford a rider’, I think we’ve all said this is a first step. I don’t have all the answers. I do know something needs to be done.

  • http://sramundt@gmail.com Sandra Ramundt

    I am a registered nurse. I am also a brain tumor patient.

    I was a healthcare executive with “great” private insurance when I was diagnosed at age 49. I have watched the deterioration of the US healthcare system over the last 38 years, beginning with DRG’s. I have experienced financial ruin while fighting brain tumors for 9 years. My reward for my struggle to overcome this disease is that I now can no longer afford to live. My medications cost more than my disability income.

    We have become a country of have and have nots. I did everything right. I put myself through college, never relying on another person for support. I was brought up to be self sufficient. I worked 2 jobs most of my life and saved my money.

    Brain tumors didn’t kill me but the US healthcare system has brought me to the brink of suicide. My story is not unique.

    This is what I see; People that still have jobs and healthcare insurance are mostly satisfied with things staying the same. They secretly pray they don’t end up needing to use their insurance and fear the outcome. It’s like going to Las Vegas, it’s all a big gamble. Roll the dice and hope you don’t get cancer, hope you’re never in a bad accident or wow, hope you don’t wake up with a head chock full of brain tumors.

    Then there are the rest of us.

    My solution is to permanently leave the US. I am moving to France. In my opinion they have the best healthcare in the world. And they seem to care about each other a bit more than here.

    This can happen to anyone.

  • j peters

    Who wants it scraped? Only the Republicans, the healthcare industry and the drug companies. Everyone I know wants reform. The people need help. Healthcare is increasingly being priced out of reach for most Americans.

  • Ellen Dibble

    Kathyah, the Senate bill is some 2,711 pages, I believe, and it sets out quite a bit. The Reconciliation bill to bring that bill in line with House interests will take on board a whole different way of funding, a whole different approach to costs. So the sausage factory isn’t done smooshing things. You’d have to ask each of the 435 Congressmen, or however many will be voting. Each will have a different take, and Nancy Pelosi will have to find what can be agreed upon.
    Over here, I want my insurance premiums to go straight to the government and worry about their corruption under another bill. I want the 30 percent that goes to insurance administration and profits, or to the insurance “department” needed at present for every health care provider, that money to go to help make single payer a reality. In other words, my premiums go toward single payer, not a for-profit market, with or without “exchanges.” There has always been exchanges. It’s called the free market. And we can always buy supplemental insurance. Providers of supplemental services will make sure of that.
    Meanwhile, I don’t think the “transparency” can be set forth. Each representative in Washington, D.C., is getting his say-so, and you can call yours and have your say-so as well.
    Corruption in campaign or in governance is another issue, but fear of it should not make it impossible to move ahead at all.

  • Michael S. Cullen

    Must protest that Boehner and McConnell profess to speak for all Americans. I was born and raised in New York and have no other than my American citizenship and neither Boehner nor McConnell speak for me. Or: would they deny that I’m American.
    The President has to call both of them out on this: They speak for themselves and their donors, but they don’t speak for millions of Americans.
    Michael S. Cullen, Berlin, Germany

  • Mary Pelham White

    Health Care in America must be reformed now.
    I want the best system that can be designed, without regard to political interests, be they congressional or pharmaceutical. Fair acquisition of Health insurance should not be linked to employment.
    Pre-existing conditions must be covered.
    Emphasis must be shifted over time to prevention and to holistic health rather than sickness.
    A single-payer system or a viable public option is necessary.
    Health issues must be treated between the physician and patient and restrictions must not be allowed by political entities.
    The public must realize that the health system is inextricably tied to our economy. We are focused on sickness and survival rather than creativity and production because individuals and families are often one illness away from job loss and homelessness.
    Insurance requirements re. tests, etc. are inefficient and do not reward good medicine/science.

  • David

    I say NO Government Health Care Plan. When was anything
    cheaper or ran better when the government got involved.

    What’s wrong with our health system? Nothing, we have the best Doctors, Hospitals, care givers and the latest technologies in the world. Why is the cost so high and how could we cut Health Care cost in half and make it affordable for everyone? Through Education and Protection…People need to be educated about what causes poor health, ie Tabacco,Alcohol,Illegal Drug use,
    Poor Diet and Pollution. These are probably 50% or higher the reasons people need health care.
    Why should I pay for others bad habits and why does the President think I should? I feel like I’m being dictated, force againest my will to except his plan. Whatever happened to government by the people for the people?
    If the President wants to help with health care, how about giving up SMOKING. Take the first step set an example for the rest of the country

  • Jeff

    We need health care reform, too many people are without health insurance and they get their care through emergency rooms. My only question is how are we going to pay for this? One listener pointed out that medicare did not bankrupt this country it may not have bankrupted the country but it added to the deficit. As it stands now my taxes will increase due to my wife’s insurance plan being taxed as a “Cadillac” health plan.

    My vote is nay until a better plan is proposed. The House and Senate seem to have a great plan why not expand that program.

  • Jeff

    I agree with David anytime the government gets involved costs increase and service goes down. Why should I pay others who cannot take care of themselves. The President should give up smoking.

  • Michelle

    Hello,
    I am a 26 year old liberal who is on her way to graduate school. I’ve worked for 10 years and only one job has ever offered me health coverage. I have been paying out of pocket, or doing without since I was 18. An employer based health care system doesn’t help those of us who are outside of the business world or working seasonal jobs- as for the past 4 years I have.

    The conversation on health care seems to focus on helping older people to get health care, but there has also been talk- as in MA- of requiring health coverage for individuals. Health care for all ages needs to be available but to set the precedent that the govornment can force ust o buy something is a terrifying thought.

  • Vick

    The Government should enact anti-trust actions against the Medical Insurance Industry. There is no need for Health Care Reform. There is a need for TRUST BUSTING! This President is all talk. He’s not only as bad as Bush, he’s worse because he’s as smart liar instead of a stupid one. This Healthcare system worked in 1980. There is your goal, roll everything back. We must go backwards this time in order to move forward. NO on this illegal legislation. Insist that your leaders grow a pair instead! DOWN WITH THE HMO’s! Ban them in their current form, and split them up into tiny pieces!!!

  • Ellen Dibble

    Michelle, I don’t know tax law, but being self-employed I pay every year for Medicare and Social Security out of my taxes. There’s a page where you compute it — 15.3 percent, I believe — right off the top after you tote up everything you earn. It’s called FICA, I think. And AFTER you calculate the tax you owe the IRS, THEN YOU ADD the tax for Medicare and Social Security. It is a whopping amount.
    So that is forcing me to buy something. I won’t have the benefit of that till I’m 65 or older, and won’t have the benefit of that at all if the economy and the national budget can’t get itself straightened out.
    But I have no choice. BUY SOCIAL SECURITY. BUY MEDICARE. NO CHOICE.
    Maybe we should go back to choice, and tell people they don’t have to provide this way for their old age. They can have the option of relying totally on their children or local charity.
    On the other hand, if someone young, with dependent family, trying to launch productive careers, if THEY have trouble, OF COURSE THERE SHOULD BE NO CHOICE. IF they have not provided for themselves, they can go rot.
    We only demand participation when it comes to the very old or the very poor. Everyone in between, our almighty middle class, we bleed them with premiums that spike in order to help care for the old and lame.

  • Liz B.

    Those who say that the American health care system is the best in the world has a myopic vision.

    The American system is a highly defective health insurance system where great service is provided to those who can afford expensive insurance plans or who work for the federal gov’t.

    The current ‘debate’ on health care is a farce because it does not provide any improvements; if it passes all will be mandated to contribute to the insurance companies revenue stream and the specifics of the services provided to us are unknown. Knowing the insurance companies’ tactics, they will find ways to continue denying or restricting services to those who pay for insurance. The vary fact that we would be forced to ‘shop around’ for insurance plans foreshadows this practice!! Essentially, the burden will be on the individuals to find an insurance plan which may not fill their future needs which is impossible to know in the present.

    PUBLIC OPTION must be included in the health care bill at the least, otherwise it is useless to those without insurance or to those with inadequate insurance.

    A SINGLE PAYER SYSTEM would be the best because every resident would be provided with health services.

    I find it dumb that so many Americans are against a single payer system. It shows the stupidity and vulgarity of the American masses.

  • Ellen Dibble

    It’s one thing if someone has a brain tumor that recurs and spreads — she is well-prepared and has saved, but the way the system works, THE SICKER YOU ARE, THE MORE YOU PAY. You work like a rat, a maniacal rat, in order to meet your premiums, falling apart at the seams as you go — Pray, I Mean PRAY — for divine intervention. Most doctors would not prescribe overwork as a cure for what ails you. But that is what the insurance companies prescribe.
    Most families could not extend themselves to help someone with a catastrophe like that. But what about the case where a $5,000 intervention would have pulled someone off the skids, stopped a steep mental/physical decline or blocked an infection that took their life?
    A family finding out later that the grown child did not get in touch for financial assistance, asserting their self-reliance and pride, that family would be crushed. Utterly crushed. Couldn’t this have been prevented???
    Well, yes, it could.

  • Brett

    The Senate bill does not include Stupak’s language, with respect to private insurance. So, what does that mean? In the Senate bill (the bill conservatives/pro-life people are objecting to): 1) NO government funding for abortion unless in cases of rape, incest, or threat to the mother’s life. AND, 2) for private insurance, the money women pay (to private insurers) who have those policies that offer abortion coverage is to be kept separate from any funding those insurers may receive from government subsidies. So, it is kept separate…I repeat: SEPARATE in those private insurance companies’ accounting so as to prevent any government subsidies from “commingling” with private money. In the House bill, Stupak’s Amendment language IS included for the #2 part, and what this means is that for the #2 part abortion services are banned from being covered even if the insurer gets no government subsidies/even if the insurer (getting government subsidies) keeps the money distinctly separate from government subsidy monies in every aspect of their accounting structures.

    Conservatives/pro-lifers don’t like that #2 part of the Senate (which doesn’t include the all-out ban that is written in the House bill for the #2 part). Why? because they want to seize this as an opportunity to weaken Roe v. Wade and chip away at banning abortion services altogether. So, even though they try to use false arguments and say abortion is funded in the healthcare bills, in both bills there is explicit language that prohibits government funding of abortions (consistent with current Federal law); in the House bill, the language even bands abortion from being funded by private insurers not receiving government subsidies (which tightens restrictions on the current Federal law, effectively changing/dismantling it).

    The crux of the matter–as much as conservatives/pro-lifers wish to say otherwise–is NOT that either bill will “expand” abortion rights/services or “loosen” any Federal legislation on abortion, it’s that the House bill will further restrict Roe v. Wade, making it even more difficult for a woman who has chosen to get an abortion. And, it is not simply a matter of a woman having to pay out-of-pocket, it is a matter of access to care. What will effectively happen, if the “Stupak language” remains in the House bill and the Senate bill language is reconciled to conform to the Stupak Amendment in the House bill, is that a woman seeking abortion services will have more difficulty finding facilities that offer those services. Why? Because most medical facilities get some kind of government subsidies; so, if they want to stay in business, they won’t offer abortion services at all, even if they keep their government subsidies from commingling with their private funds.

    The average pro-lifer wouldn’t have even batted an eye, if not for Stupak. He has politicized this issue and played opportunist by distorting the language and intent of the bills without his amendment. Why? Because he is a devout Catholic and saw his opportunity to kill the bill unless Roe v. Wade is further restricted. His maneuvers are exactly such: he wants abortion banned, and he won’t vote for a healthcare bill unless he sees language in a bill that further restricts abortion services than is current law.

    For those who think, so what? Who say let Stupak and his supporters have their way! I say, why should Congress be ruled by an individual Congressman’s/woman’s personal beliefs/morality when it comes to passing legislation? If a member of Congress wants a personal/constituent benefit added to a bill in order to vote for a bill, we call that dirty politics.

  • Sam Wilson

    @ Peter Nelson:

    I guess Judith J, is under some influence of “kool-aid” and she is so far lucky that she or her kid hasn’t had a Type-1 Diabetes, any cancer or not being injured in any major accident.

    Ms Juliano, please dont be so insensitive about the people who get diagnosed with any of such diseases or get into major accidents without being in fault, because no one knows when he or she will end up being in that situation.

    Btw, Peter Nelson has echoed my very thoughts, I just thought it will be too rude to speak to you that way!

    God Bless

  • Denise

    So many people are against single payer insurance or government involvement in their health care, but everybody loves their Medicare coverage. I would love to see the qualifying age for Medicare lowered over a period of time to say 60 or 62 years of age.

  • peter nelson

    Why should I pay for others bad habits and why does the President think I should?

    But this, like most conservatives, ducks the question.

    When someone who is poor and uninsured DOES get sick or injured (let’s say they’ve been a model healthy living up to that point) how should their care be paid for? Or would you just leave them on the sidewalk to die?

    The conservatives keep ducking and dodging – they don’t like the Dem’s plan (I don’t either) but they won’t say what they DO this is the right approach.

  • peter nelson

    I guess Judith J, is under some influence of “kool-aid” and she is so far lucky that she or her kid hasn’t had a Type-1 Diabetes, any cancer or not being injured in any major accident.

    . . .

    Btw, Peter Nelson has echoed my very thoughts, I just thought it will be too rude to speak to you that way!

    I couldn’t think of any NON-insensitive way to make my point.

    And you’ll notice she never responded. The conservatives only know what they don’t like but, they have have no solution to the current problem.

    BTW several people here have repeated the old canard that if the government gets involved health care costs will go up. How do those people explain the fact that most other advanced industrial nations which have universal coverage – plus MORE government involvement than here – are around 8-10% of GDP and the US spends 16% of GDP?

  • Ellen Dibble

    It seems to me that for-profit insurance in some nontransparent way have pushed the cost of medical care up — WAY up — to fatten up their 16% share of the national economy or whatever. Who stands in their way? I see in the paper today that in Massachusetts, it is state government who would block increases in premiums — in this mandated coverage state.
    I quote the AP out of Boston: “Massachusetts health insurance companies have asked the state to approve significant rate hikes, weeks after Gov. Deval Patrick waned his administrtion might turn down increases it deemed excessive. // The insurers have asked for increases of 8 to 32 percent starting April 1. // Last month, Patrick said the state Division of Insurance would review rate increases higher than 4.8 percent as part of a broader effort to control health care expenses. // The Boston Globe reports that if the state rejects the increases, it would be the first time Massachusetts has capped health insurance rates. // Insurers say the increases are mostly the result of a rise in medical spending. They say if the state caps the rates, it would cause confusion because contracts have already been negotiated under the higher rates.”
    By the way, there has been no rise in my rate of pay since the early 1990s; actually a decrease. All I can do is increase efficiency and hours.
    But I believe the state is high on requiring insurers to require rebuilding breasts after mastectomies. Right, and that drives me right into paying the penalty for non-coverage and having no insurance.
    Sorry, insurers. The healthier we are, the more likely we are to bow out of the grand plans that flow. Massachusetts was SUCH a nice model for the nation.

  • Richard Clements

    Isn’t it clear that single payer is the overwhelming preference in these oomments?

    As for comments like this Republican talking point, I’m tempted to ask for examples.

    “… anytime the government gets involved costs increase and service goes down. Why should I pay others who cannot take care of themselves.”

    By this logic, why should I have to pay for your police protection? Why should I have to pay for your use of the interstate highway system? Why don’t you hire your own air traffic controllers? Who picks up your trash? There are many other services we take for granted as government responsblities. Why not healthcare?

    We live in a mixed economy and not the free market. There are plenty of examples of rational, necessary, and effective government programs providing services that wouldn’t be provided by the private sector or would simply be available to a handful of exceptionally wealthy. In other countries those who can hire their own police are called “warlords” and those aren’t the kind of contryies I want to live in.

  • Vick

    NO NEW LAWS! NO REFORMS! USE THE LAWS ALREADY ON THE BOOKS! TRUST BUST! There is no reason the American People should have to endure anymore of this burden and nonsense. Take this issue to the Anti-Capitalist Medical Trusts that have destroyed our Health Care System! Do not put one more burden on average people’s backs! FIGHT BACK AGAINST THE ANTI-CAPITALIST MEDICAL TRUSTS! Bust them up! The tools are already there! Stop lying to the American People Obama, and get to work for us! Take on the bullies! Don’t ask the bullied to “do more!”

  • Maureen Jenner

    Vote for this healthcare bill! We keep hearing people (sorry but mostly Republicans) say that “the public is not for this bill. That is not true. One of the reasons we voted for Obama is to pass a healthcare bill. This seems to be the best we can come up with now. The anti-abortion piece is ridiculous that some Democrats are trying to sneak in. Another reason we voted for Obama, because he is pro-choice. Don’t waste time on those senators. I also agree with some comments that Senators should get whatever the public gets and rescind the lifetime benefit unless it’s for everyone. Maureen Jenner, Sun Valley, Idaho

  • Sam Wilson

    “Why should I pay others who cannot take care of themselves.”

    Isnt ANY insurance the same thing? I pay for my auto insurance so that anyone who wrecks someone else car or property can get reimbursed from MY PREMIUMs?

    By the same logic, the very people MUST not buy insurance at all.. NEVER!!, after all if you wreck your mercedes or BMW or any vehicle you must have the money to pay for its repair from your own pocket and if your are more than 50% at fault, then the other person’s property as well, or else dont drive!!

    No penny given, None Expected!

    Isnt it the way its supposed to be?

  • Vick

    Requiring a human being to do business with a Private Company, just because they were born with a body is UNCONSTITUTIONAL! It is an ILLEGAL idea! If this is passed…DO NOT COMPLY WITH IT! You as Americans are under no obligation to obey an ILLEGAL LEGISLATION! You body is not the same as a driving privilege! No GOVERNMENT can FORCE you to do business with private companies over this! Your body BELONGS TO YOU!

  • jeffe

    I urge people to watch this interview with Single-payer advocate Dr. Marcia Angel. It sums it up for me very well.
    The bill stinks and is a give away to the insurance companies. It does not deal with them at all or with the issues of these companies raising premiums and denying care. The bill does not deal with what is fundamentally wrong with health care in this country

    http://www.pbs.org/moyers/journal/03052010/watch3.html

  • Rick Evans

    Both pacaderms and donkeys choose to ignore the real crisis in the American sick care system. The problem is not lack of insurance. Plenty of folks with insurance who are “happy” with their insurance go bankrupt when they really have to use it and find out that their contentment wasn’t happiness afterall.

    The real problem is spending. Compared to other industrial nations we spend like drunk sailors. American per capita spending is $7300 or about double annual per capital spending of our OECD industrial partners.

    Obama would rather paper over the problem, as has been done by Massachusetts, by offering people who can’t afford insurance free or subsidized insurance cards and bullying those barely in the middle class ($33000 per year) into buying this private product or being fined. With insurance cards we just create more drunk sailors.

    All the talk of long term savings is folly. Does anyone think the Medical Industrial Complex and its army of lawmaker renting lobbyists will go away after this giant piece of corporate welfare is passed.

    The president’s use of “health insurance reform” is telling in that it reveals that it does NOTHING to deal with the underlying reality rising health insurance premiums reflect the profligacy of the underlying profit driven health care industry.

    Universal coverage is a worthy goal. Doing it without strong costs controls little more than a reward to the people who got us here. Then again, the first lady is a former hospital executive.

  • Rick Evans

    jeffe, I caught Dr. Angell’s interview this weekend. I’m a big fan. However, single payer without cost containment does nothing to deal with the underlying problem; excessive spending, waste and corruption. Medicare is single payer and is rife with excessive spending, waste and fraud. 60 Minutes did a segment on the fraud capital of the U.S. Miami.

  • Vick

    This kind of draconian, neigh fascist, forcing of Free Men and Women of the United States of America to do business with Private Medical Corporations, simply because they are alive and have a body, is tantamount to Slavery at worst and a Debtors Prison System at best!

    This is far from unpopular, this is an impeachable, and treasonous offence on the part of any Politician who passes it! YOU CAN NOT PUT PEOPLE IN JAIL BECAUSE THEY WON’T PAY MONEY TO A PRIVATE COMPANY FOR THEIR SERVICES! DO NOT COMPLY! RESIST! THIS IS UNCONSTITUTIONAL, AND TREASONOUS!

  • jeffe

    Rick I thought about that. Dr. Angel had some great things to say but I do not remember her dealing with this problem.

    How does Canada, Germany or the Netherlands deal with this?

    I personally like the German and Dutch models as they have both public and private insurance. The bottom line is, all of these countries I mention above offer health care to all and at half or less of GDP than we do. Something is not right here. Non-profits such as Kaiser Permanent seem to be a better bet for the us. The absurd thing is from what I have read of this bill it hurts companies like Kaiser.

    Doing nothing is only going to make it worse. Letting the market deal with it does nothing except guarantee that costs will go up in the double digits for premiums.

    The bottom line is that insurance companies are in business for their shareholders and denying care is part of the profit model. It’s the model that’s a huge problem here. People are still going to get sick and lose jobs and so on. Doing nothing will be disastrous.

  • Sandy Allen

    The proposal that is currently under discussion as proposed by the President is not “health care” reform. It is a re-structuring of “health insurance” and does little to address the health care needs of the people.

    Like the rest of the 80% of the people who are against this legislation, I don’t like the proposal for several reasons:

    1. The bill is over 2,000 pages long. My Bible isn’t that long. There is no need to overanalyze the situation through legislation. Whenever government wants to simplify something, they make it more complicated. As a prime example, look at the tax code, which was “simplified” a few years ago. It doubled in size and complication.

    2. It is loaded with political earmarks that have absolutely nothing to do with healthcare. Like the economic stimulus package, this is costing us, the taxpayers, a lot of wasted money.

    3. If I can’t afford to buy the policy, the government is going to fine me? When did the U.S. become a gestapo state that they can order me to buy something I can’t afford? This is not freedom. This is a dictatorship. If I can’t afford to pay the premiums, how am I going to pay the fine? If I don’t pay the fine, what are they going to do? Put me in jail? Nice government we have, eh?

    4. This bill was constructed by the wealthy insurance companies in order to ensure the survival of the insurance industry. Once it’s in place, we will have to pay premiums that will be set by the insurance companies and the medical profession based on what the medical pros want to charge.

    If the government wants to give us real health care reform, why not address the real issue: HEALTH CARE.

    “Educate. Don’t legislate.”

    This program should be administered by a private company set up by the Dept. of Health and Human Services and overseen by a group of private citizens who have no connection with the insurance industry and the medical profession. Insured people will be categorized by their current status, medically and economically.

    a. All participants will be required to participate in health management educational programs and other training, through DVDs, TV programs, on-site classroom participation and/or other means of such training.

    b. People whose earnings are below the poverty level will pay nothing. That includes the unemployed, welfare recipients, retired and others who are in good health but cannot afford to pay.

    c. People who are obese and morbidly obese will be evaluated as to what is causing their condition. If it is judged that it is because of poor eating habits and/or overeating, they should be required to participate in health management training classes. Until then, they will pay higher rates than healthy people. If they can afford to eat junk food and other unhealthy habits, they can afford to pay high premiums.

    d. People who smoke, drink excessively and/or misuse illegal narcotics or prescription drugs will also pay higher premiums and be required to take classes in quitting. If they can afford to practice these bad habits, they can afford to pay high premiums.

    e. Once people successfully complete training in reducing their health risks and can demonstrate that they have lost weight, given up their bad habits, etc., then they can be reevaluated for lower premiums.

    f. Pre-existing conditions will be treatable at a cost consistent with their condition. Depending on the extent of their condition, people will be evaluated as to their eligibility for subsidized health management.

    g. No one will be discriminated against because of having a medical condition for which treatment is available, no matter the cost involved or what caused it.

    h. This proposed, government subsidized insurance company will be competing with private insurance companies. This is in order to keep costs down. The existing private companies will have to keep their premiums in line with the new company, which will be subsidized by federal funds set aside through tax-exempt donations from the wealthy, who will have an income tax surcharge to pay for this program.

    This is just a suggestion from a person who tries to keep my body and mind as healthy as possible by not having any bad habits, eating healthy food, exercising and getting enough rest. I don’t think that I should be penalized by subsidizing the bad habits of others and the poor system management by the government, the insurance industry and the medical profession.

    “A hospital is no place for sick people.”

  • Sam Wilson

    @ Vick

    “this is far from unpopular, this is an impeachable, and treasonous offence on the part of any Politician who passes it! YOU CAN NOT PUT PEOPLE IN JAIL BECAUSE THEY WON’T PAY MONEY TO A PRIVATE COMPANY FOR THEIR SERVICES! DO NOT COMPLY! RESIST! THIS IS UNCONSTITUTIONAL, AND TREASONOUS!”

    Yes, I agree with you, lets prosecute and sentence Mitt Romney first, for his health care reform in MA. Because in MA its MANDATORY to have health insurance…

    Sorry, you seem to be an alien from Mars!

  • Rick Evans

    @ jeffe, Ray Suarez had a nice story on the Dutch system on PBS Newshour a few months ago. The Dutch require everyone carry a basic policy which according to the story is quite a high quality product. And, unlike false choice of thousands of shell game plans typical of the U.S. insurance market the basic Netherlands policy has one goal, to protect your health.

    Insurers can only compete on service. A policy costs a consumer less than $200 per month and the Dutch don’t discriminate on the basis of age or gender. You can buy extra coverage for optional, expensive, non life threatening issues. The simplicity of the Dutch system appears to obviate the cost of hoards of hospital bureaucrats and insurance bureaucrats in a constant profit driven tug of war. It was not clear from the report but I imagine taxation plays a part in funding.

    That said, the Netherlands provides excellent health care for about half what we spend per capita.

    Of course to make this work the Dutch impose budget contraints on the entire system. One need only look at the medicare part D corporate welfare gift to big PharMa or how willing Obama was willing to roll over for health care groups in exchange for *voluntary* savings over a decade to know Congress and the White House have no stomach for real reform; which is why I oppose this pseudo reform.

  • peter nelson

    I noticed that no conservative has addressed any of my points. Duck and dodge; duck and dodge.

    There is no way to do the math so that you can create an insurance policy that can cover what a major illness or injury costs, and still have that affordable to a poor, low income, or unemployed person, especially if they have any pre-existing medical conditions.

    This puts the conservatives between a rock and a hard place because they either have to publicly admit that they don’t care and would be perfectly happy to leave the poor person out on the sidewalk _or_ they have to endorse some sort of subsidized scheme, which would be “wealth distribution”. This is why they never propose anything – there is nothing they CAN propose.

  • peter nelson

    Requiring a human being to do business with a Private Company, just because they were born with a body is UNCONSTITUTIONAL! It is an ILLEGAL idea!

    So you don’t live in a state that requires that drivers have insurance?

    I don’t like the insurance companies either, but then again, I support a public option.

  • Orlando

    I also would love to have a public option and resent when senators claim that we don’t want to have what they have. Right now I am interested in opening a small business but Im afraid of losing my employer-supported health insurance. Feel like a prisioner without options of leaving a job only because of tha fear of being uninsured. Insurance companies need a little competition to losen the grip they have on most of the American public.

  • George Butler

    Want to solve the health care issue? Strip congress/senate of their existing health care plans and whatever plan they come up with-will be the one that they (and all government employees) get.

  • Ellen Dibble

    Peter, I gave up my car (and insuring it) partly in order to continue to have health insurance. Giving up the car limited the accessibility of certain health care options, but where I live, if you’re over 62, there is a sort of limousine service that takes people for $2 to $5 anywhere within about 30 miles for appointments. So one can manage without a car, but not without a body.
    I think some of the Massachusetts representatives in the US Congress “support a public option,” but not with much spine. That is a fence-sitting measure that will cave. I remember hearing the Congressman who ran for Ted Kennedy’s seat saying that he voted for the House bill but everyone knows that Stupak’s stand on abortion would get eradicated in negotiations between the Senate bill and the House version.
    I’m wondering if “everyone” in the House knew that the public option would get eradicated in negotiations, and their standing in the good graces of the insurers with their campaign funding could remain intact.
    Watch the “public option” that our representatives say they stand for melt in the heat of the moment.

  • Jerry O’Brien

    I’m in favor of this bill because I’m hopeful it will end an unfair practice going on here in Wisconsin and probably all over the country. We have many large, prosperous agricultural employers here that employ many Mexican workers. Over the 20 years I’ve lived in this area, the Mexican migrant communities have grown. I welcome these new neighbors; they don’t cause any trouble and they work hard. However, my friend is a pharmacy technician and tells me this community is using Wisconsin medical assistance and they do not have health coverage from their employers. Those of us who do pay for our own insurance, either out of pocket or in liew of higher wages, are also paying for coverage for the Mexican workers to the benefit of the Christmas tree and cranberry barons.

  • Cynthia O’Hair

    I have been a teacher in a public school in the fourth largest school district in the country for the last 30 years. I am well-educated and concerned. For the last 10 years, any substantial raise we have gotten has been eaten by rising health care costs and the quality of the district-provided insurance has gone down.

    Health care costs are eating all of us alive and what so many don’t take into consideration is that we are already paying for medical care for the uninsured. Our hospital emergency rooms are overrun by those who cannot afford to go to the doctor and turn to the emergency room for more-or-less routine health care. EXTREMELY expensive for all of us.!!

    The insurance companies have continued to raise premiums, all the while making huge profits – no competition and little regulation. A recipe for disaster to the common middle class worker.

    The members of congress sit there with the best health care that money can buy, paid for by the US tax payers -for life! All the while, they are denying any health care to others. What hypocrits!

    I am for a single-payer option – if some worry that the government is going to make decisions for you in regard to health care – what do you think that the insurances companies have been doing for years!! Talk to someone who has been denied necessary, perhaps even life-saving care by an insurance company. They are the masters of the run-around. Talk to someone on medicare – a government-run program. Have you ever heard of a person on medicare turning it down, even if they could afford regular medical insurance. Makes you say “hmmmmm.”

  • peter nelson

    I also would love to have a public option and resent when senators claim that we don’t want to have what they have

    This point has been raised a lot here today and elsewhere but I don’t think it’s valid. They have health insurance as an employment benefit like lots of other people. You can’t really claim that they’re getting a “public option” anymore than any other government employee or military personnel. They get a salary and other benefits, too, just like people in the private sector.

    A more valid point would be to call attention to the fact that Senators and Congressmen cannot conceive of what life would be like with health insurance.

  • Ellen Dibble

    I think Peter means Congressmen can’t conceive of life without funding from health insurers.
    No, he means they can’t imagine being uninsured.
    or…

  • Vick

    @Sam Wilson:

    I’m from Mar’s huh? That goes to show how little some in this nation understand the the other. Well, pal, if you think your body can be mandated by the Federal Government, then I think YOUR from Mars.

    Thank God the Founding Fathers armed us with a vote and failing that…come try “us from Mars”; I beg of you.

  • http://none Ellen Wakefield

    We must have health care reform now. I want single payer, but a public option would certainly be a huge step toward making health care available to all. We must have that to force the health insurance industry to become more responsible, stop raising rates in order to pay executives higher salaries, and stop making decisions based on what it costs rather than what benefit the patient would receive. The arrogance of the health insurance executive (from the company raising rates 39 percent in California) implying the executives deserve million-dollar-plus salaries and taking no blame for the higher health care costs was exasperating. It’s a crime to pay such salaries when the guy next door can’t afford the cost of the cheapest health insurance policy at $300 a month. So yes, I want the health care bill passed, and I want the Republicans to stop playing obstructive politics with such a vital issue.

  • Vick

    Rahm Emanuel, and his Chicago Gangsters haven’t met us from the Midwest yet. I cherish the opportunity for that piss-ant little nothing to get up in my face/our faces! Bring it on Skell’s!

    http://www.foxnews.com/politics/2010/03/08/massa-accuses-democrats-pushing-pass-health-care/

    Come on Rahm, you and your “crew” come “break bad” to us, and see what happens! It’s ON!

  • Susan Harrison

    Democrats are correct, Americans want Health Care Reform.

    But then the Republicans are right too, we do not want what is proposed.

    This is a gift to the insurance companies. What is being offered is not reform, and the American people know it.

    Maybe it is time that we stop funding a separate health plan and retirement plan for public employees. They seem to be able to get it right for themselves, but can’t get it right for the rest of us.

  • peter nelson

    I wrote: A more valid point would be to call attention to the fact that Senators and Congressmen cannot conceive of what life would be like with health insurance

    Obviously I meant “withOUT health insurance”

  • Terry Henkel

    I am a retired cardiologist. I agree that the estimated savings through tort reform seem small when measured against the projected 10 year cost of the Obama plan, if believable tort reform had been in place during my years of practice I would have saved Medicare, etc. a tremendous amount of money by limiting testing and procedures. I made money by ordering tests and procedures and could always justify my practice pattern by invoking “defensive medicine” as a reason. Costs are unlikely to come down until physicians feel protected against frivolous law suits and change current practice patters by ordering tests based on best practices.

  • Andrew Simons

    I would take single payer in a moment. It would be so much better that the current situation!

    However, if we can’t get single payer we need to empower consumers and this bill doesn’t begin to do this.

    I am devastated that the current bills seem to be the worst of both worlds.

    We need to reduce the % of GDP spent on health and provide coverage to those of us (?20%) who don’t have good insurance through their employers >>> me included!

    I buy independent insurance and I have six employees that we compensate pre-tax to pay their individual policies. We can’t get a reasonable group plan and if we could they could cancel, at their will, leaving us uninsurable.

    At this moment my small business won’t survive an expensive employer mandated insurance.

    My major issue for many years has been health care reform! Health care is a right not a privilege. But what is on offer now is not the solution because it doesn’t begin to control costs. My uncle and other friends say pass it now and then make it better. This seems bazaar to me. I don’t believe we can overcome the special interests later if we can’t do it now?

    These bills can’t protect the Insurance Industry and Big Pharma and control costs. I want the politicians to get real. The current bill is B.S. we can do better.

    Power to the People not insurance company functionaries, government bureaucrats or employers.

    Let’s get it right!

  • peter nelson

    Want to solve the health care issue? Strip congress/senate of their existing health care plans and whatever plan they come up with-will be the one that they (and all government employees) get.

    In theory this sounds great, but the flaw is that Congress is a millionaire’s club. Worse comes to worse and they can afford to pay out-of-pocket for all their health care expenses.

    In fact the average Republican will probably brag about it – “See? We don’t need health insurance reform. I paid for my heart transplant out of the money my wife and I had set aside to renovate our yacht! If I can do this on a Senator’s salary then all those Americans without health care must just be lazy!”

    If you think I’m joking check out Tom Delay’s comments yesterday that we only have an unemployment problem because unemployed people could get a job if they wanted to but would rather collect unemployment! I’m am not making that up! They live in a different reality – some bizarro parallel universe.

  • Vick

    Can you hear that? Can you hear it?

    WAR’s coming.

    NO to new legislation! NO to not TRUST BUSTING and TRIALS! Here is the moment. Here it is. If you think working Americans are going to lay down for this…well…”you’ve got another thing coming! PAL! We’ve got nothing left to lose; BRING IT!

  • Terry

    Like the majority of Americans, I am in favor of single payer health care. When that sensible approach was overwhelmed by insurance company propaganda, I was hopeful that the public option would pass. Now I am doubtful about the remnant of a health care bill that is left. This is what I fear: poor people will buy the lowest priced policies. What makes the price low is a high deductible. Many people will be paying for insurance, but the high deductible will mean that their policy will not pay their medical bills unless they have extraordinary expenses.

    I fear that this will end up like so called welfare reform, where welfare recipients were supposed to receive training and support so that they could become productive wage earners. They lost their welfare support, but never got the training and support they were promised. Health care reform is beginning to sound alot like welfare reform. The insurance companies will benefit,since they will have many new paying customers, but what will become of sick people?

    I am a 71 year old woman who has medicare. I was recently quite ill and because of medicare, I received the treatment I required: medication, hospitalization, surgery. I am now well. This is what I want for everyone. I have this security, members of Congress have it. All Americans should have it.

  • twenty-niner

    I’m not against government-run health care in principle; I’m just against our government running it.

    If we could outsource our government to Canada for example, I would be all for a government option or single payer.

  • Alex

    My bother lives in Germany. He works for a major consulting company. He has severe back problems. His employer provides several options including a public option, which is what my bother has picked for his family. When his back got so bad as to require surgery last month he found an excellent private surgeon to do the operation. The surgery was done in a matter of weeks. He is now recovering. Admittedly, I don’t know how much my brother had to pay the private surgeon. But I think his example illustrates that a system like that works perfectly well in that public and private health care systems co-exist, private doctors were not wiped out by the public option, and there was no need to wait for months to get this surgen to do the operation, contrary to what we keep hearing here.

  • Vick

    AMERICA is not any other nation! It is unique! Stop looking to those we’ve vanquished for ideas! Start looking to your grandfathers and Founding Fathers! We’ve let too many in without convicing them. The folly of the valiant and generous. This is our reward for being “nice!” Stop being nice, and defend your liberty! Millions have died for it! Be worthy of the sacrafice! NO to Obama!

  • peter nelson

    A cardiologist writes -
    I made money by ordering tests and procedures and could always justify my practice pattern by invoking “defensive medicine” as a reason. Costs are unlikely to come down until physicians feel protected against frivolous law suits and change current practice patters by ordering tests based on best practices.\

    But just to be fair, my wife is being treated for cancer and she’s had a TON of tests, as you can imagine – C-T scans, MRI’s, PET scans, bloodwork, etc, and I’m a pretty serious science geek – my idea of a fun way to spend a rainy afternoon is to curl up with an issue of Science, Nature, or NEJM – and I haven’t seen any sign of any extraneous testing on her.

    Also, specifically WRT cardiology – since I have friends who are cardiologists – I’ve heard stories of cardiologists hearing heart sounds that suggested valvular defects and ordering ultrasounds, which the insurance company subsequently refused to pay for because the regurgitant jet that was found was not of sufficient intensity to warrant intervention! I.e., if the doctor is not 100% sure of his diagnosis based on his stethoscope, they won’t pay for the U/S!

  • Dr. Denise Long

    As long as this country mandates that care be provided to any sick person who shows up to an emergency room, and as long as there are lawyers to sue if care is not provided in the most humane and efficacious and correct manner for any person who arrives at any doctor office or emergency room for care, then we HAVE TO HAVE some kind of way to cover ALL the people. We are running the most expensive, least responsible healthcare system in the world in that we reimburse most for providing the most expensive care. We just have to stop. Our care is so expensive because of how we do it.

    For all those people who believe that their health care plan is forever, they need to wake up. Starbucks pays more for healthcare than it does for coffee. This way of doing things is OVER.

    As long as CEOs can make millions of dollars while people pay for a plan that decides to drop them AFTER they’ve paid in, we are headed for revolution and chaos.

    This system cannot sustain itself. We have to move on the healthcare plan NOW. It is NOT perfect. However, the alternative is disastrous.

  • twenty-niner

    “So you don’t live in a state that requires that drivers have insurance?”

    Driving is considered a privelege not a right. Therefore, the state can mandate insurance coverage.

    In fact, the states could mandate that drivers have health coverage using the argument that an accident on the road has a strong possibility of necessitating medical care for those involved.

  • Ellen Dibble

    As Terry pointed out, forcing people to buy health insurance will inevitably lead people to buy the cheapest available, and that is high deductible and high co-pay, which in effect is not all that different from the uninsured go-direct-to-the-emergency-room model, except that there are fewer bankruptcies along the way.
    You deal with say your leg pain, your phlebitis or whatever, something that can be treated so as to avoid catastrophe — I’m sure you can think of many others — and the first thing your doctor sees of you or your family is when it is too late for easy interventions. So you go to the hospital, costing your insurer many thousands of dollars.
    Under the old system, if you didn’t have insurance and you went to the hospital, you ended up bankrupt. Under the new system, you will go to the hospital, and the costs to The System will be shocking. And the premiums will continue to rise. The percent of GDP will rise.
    If it costs $25 to see a doctor, co-pay, a lot of us “choose” not to go. If we have a $5,000 deductible, we become incredibly savvy health consumers. We are no-shows unless there is an emergency. We are do-it-yourselfers. I think this will continue under Obama’s bill. Fewer bankruptcies (the banks will like that), but lots of people with suboptimal care.
    Courses in elementary and high school given by public health nurses in preventive care and health management would be a good step, for sure.

  • Vick

    Grow some balls America! Stop letting down those brave men and women who gave your freedom! Stop letting the bad guys dictate the discussion. NO to Obama! Take a stand for once in your life, or suffer the same fate as the Jews.

  • Joseph Schachner

    My younger daughter is about to finish college. For both my daughters, ANY time they went to a doctor, for ANYTHING, the insurance company used by my employer denied coverage until I sent in a letter from the registrar of their school, on school letterhead, affirming that they were still enrolled as full time students. And every time, the registrar wrote in the letter that there was a web site that the schools all submit data to, and the insurance company could check it – they didn’t have to make me get a letter. Conclusion: they made me jump through an unnecessary hoop! If I don’t, they don’t pay. And, no penalty to them for doing that.
    Recently my employer changed insurance companies. My younger daughter subsequently went for a blood test. We got a letter requesting that we supply “confirmation of insurability” certified by the previous insurer; the new insurer was checking if whatever she was being tested for could possibly be a pre-existing condition and then they wouldn’t pay … their letter spelled that out. One problem, insurance through an employer is a GROUP policy and they cannot rule out members of the group for a pre-existing condition. I took their letter to HR, they called the insurance company, and the problem was resolved. But: the insurance company surely KNOWS it’s a group policy. Why would they send me such an outrageous letter? Because, again, if I do nothing, they don’t pay. Another hoop to jump through, to get what I’m actually entitled to.
    I can’t actually imagine having to buy insurance privately and deal with this on my own. Private insurance is out of control and reform is badly needed.
    Is this the ideal plan that I’d prefer. No. But I completely support it.

  • Fan

    Lowering health care cost is the most important thing for any reform, Obama’s plan does NOT address any serious issue.

    Please vote :No. Otherwise he is going to bankrupt this country.

    I am so regret supported him, we were desperate for change, but forgot change can be worse and we elected this stupid and no experience President, what a nightmare!

  • twenty-niner

    “Costs are unlikely to come down until physicians feel protected against frivolous law suits and change current practice patters by ordering tests based on best practices.”

    Agree 100%. I’m not sure why there is so much opposition to tort reform, other than the trial lawyers being a very powerful lobby.

    I served on active duty in the military for five years, and the medical care I received was quite excellent. Under the Feres doctrine, military medical personnel and hospitals are completely immune from malpractice claims; and I never felt that the military personnel were any less conscientious than those on the civilian side.

  • peter nelson

    As Terry pointed out, forcing people to buy health insurance will inevitably lead people to buy the cheapest available, and that is high deductible and high co-pay

    1. The “cheapest available” will be whatever the designers of the system say it will be. As someone else here pointed out, in the Netherlands the cheapest plan is still pretty good.

    2. Whether a “high deductible” plan is appropriate depends on each person’s circumstances. My wife and I did the math for us – she has cancer and very expensive treatment and I have some pretty expensive stuff, too, and we decided that a high deductible plan combined with our HSA gave us the best $$. But different people’s MMV.

  • Ellen Dibble

    AARP has a newsletter in which they outlined a few months ago statistics about denials by insurers. Apparently it is extremely high, pretty much predictable, insofar as there is quite a bit of hassle involved in sorting through the red tape, as Joseph detailed. AARP gave out some phone numbers and web sites to assist people, but it doesn’t solve the problem.
    Personally, I have a Blue Cross plan for a self-employed person, and have never been turned down. In my opinion, if someone shops around for the cheapest insurance, they are likely to get insurers who save money by making people jump through these hoops.
    I don’t know if the Senate bill addresses this. If they’re talking about exchanges and letting people “shop,” they are going to be offering insurance that plays this same game. I suppose they say they are trying to keep premiums down.
    I think this is what state and national regulatory boards are supposed to be set up to do on our behalf, keep premiums down. If that is not in the bill, nothing will help. Insurers will “keep premiums down” in this tried and true way: denying coverage.

  • Alex

    “I served on active duty in the military for five years, and the medical care I received was quite excellent.”

    Wasn’t that medical care run by the government?

  • Eddie Brown

    This bill is meant to give fully subsidized health care to the, poor and stick it to every one making forty grand and up. “One for all, and all for one” plain and simple. Count Me out, I make forty one grand a year and would rather not get thumped for the sake of a slackers ability to collect yet another social service bone throw.

  • peter nelson

    “Costs are unlikely to come down until physicians feel protected against frivolous law suits and change current practice patters by ordering tests based on best practices.”

    Agree 100%. I’m not sure why there is so much opposition to tort reform, other than the trial lawyers being a very powerful lobby.

    I’m totally in favor of tort reform as long as it doesn’t prevent legitimate malpractice claims from being compensated, but let’s do a realty check here – the most optimistic projections of cost savings from tort reform have been about 1.5 percentage points and most have been less than that. So MAYBE that would reduce our 16% of GDP to 14.5% of GDP – vs about 10% for other advanced industrial nations. Not nothing, but not a panacea.

  • Anna Elizabeth

    We shouldn’t underestimate the state of medical inflation in the US. I’m a US citizen living in Argentina without local insurance. Here I have always received great care, at a reasonable price- the equivalent of around $10 – $20 for a visit with a specialist, for example. I also know that if anything catastrophic happened I could go to a public hospital and be cared for for free. Next month, I’ll be returning to the US, where I will be without health insurance for two months before my next contract starts. I’m scared about not having insurance: if anything happens, my plan is to just fly back to Argentina.

  • Icabod

    http://www.youtube.com/watch?v=lTurfn7vvCk

    Obama is the Prom Queen. Show him and his evil schmoozing the door! This is not freedom! This is slavery by another name.

  • peter nelson

    Alex says,
    “I served on active duty in the military for five years, and the medical care I received was quite excellent.”

    Wasn’t that medical care run by the government?

    Sssshhh! They don’t want to hear that. The government can’t do anything right, haven’t you heard?

  • http://www.enjoy-life.com Phyllis Parun

    Reducing health care costs involves educating people about living healthy lives, eating a grain and plant-based diet. Without self-reliance and education people will expect more financing of medicine, not knowing that medicine cannot treat chronic disease. Health care costs are increasing because insurance companies are profitable regardless of want people do in their personal health practices. We need a system of healthy food choices, financial rewards for people who improve their health, and interest bearing group employee accounts so people can see and feel the results of their healthy food choices. Employers need to be rewarded with lower costs when employees respond to effortless exercise breaks on the job, and improve their health by better choices. We need on the job healthy lifestyles educational seminars.

    Anything short of this approach will result i more cost, more failed medical treatment, and continued escalating chronic disease. Anything short of this approach is a waste of money.

  • Ellen Dibble

    Eddie, the bill will also make it extremely unappetizing for anyone making under forty-grand to gun their engines and climb into the middle class. It will effectively add an additional tax for every thousand bucks everyone under forty-grand makes. If you get to that magic number 40,000 (whatever the number ends up being), you can then keep your health insurance costs in a steady state. The government will not diminish your subsidy any further, that is.

    However, there is no guarantee that the cost of insurance will not rise independently (as we have been complaining about).
    The bill creates a glass ceiling keeping those scratching by at the bottom right in place, highly malleable.

  • Alex

    “However, there is no guarantee that the cost of insurance will not rise independently”

    It is guaranteed that it will.

  • peter nelson

    Do you notice how all the more-or-less liberals here, even if we don’t agree completely, are able to have a basically rational, fact-based conversation where we contribute information and context and details?

    And meanwhile the conservatives like vick and icabod and eddie brown have nothing to add except emotional rants and bizarro slogans?

  • Maud

    If only there had been real discussion about the different systems in all the other developed countries, I think we might have had some kind of universal system.

    Allowing universal care to be labelled “socialist” was one of the first bad moves. If Americans knew that in the UK and elsewhere Right-wing governments accept universal care as the best option. Even Margaret Thatcher, the arch-capitalist, didn’t try to end it.

    In former Soviet Bloc countries they have kept their government-run system, even the most anti-communist among them don’t want to abolish it.

    We could have had an imaginative wide-ranging debate, instead we’ll just be tinkering with the unethical, inhuman system of “care” we somehow can’t break away from. Look at tiny Cuba, they’ve figured out a system which takes care of everyone at a fraction of our costs (we spend 26 times what they do per capita) and they’re much healthier, and have lower infant mortality.

    We are pathetic.

  • Alex

    Well, if somebody could explain how exactly this bill implicates (1) the fate of Jews, and (2) slavery, that would be helpful.

  • Ellen Dibble

    Peter, I certainly notice. I tend to ignore them, since they don’t back up their positions. They are like chess pieces, not people. I don’t know what their situations are, why they are angry, that sort of thing. They rant about war and the Founding Fathers, and I hear that. I call it rant. It doesn’t help solve this problem.

  • Icabod

    You cast us off at your own peril Peter. We VOTE! Have fun with that. We’ll see you when we see you. The sleeping Giant has awoken, and it’s not in China. It’s here! The PEOPLE RULE! Not you. Obama is a sell-out! It’s over for him! Yes, we are emotional about being told how to live. It’s only right that we should be. We are a force larger. We are unstoppable.

  • peter nelson

    Employers need to be rewarded with lower costs when employees respond to effortless exercise breaks on the job, and improve their health by better choices. We need on the job healthy lifestyles educational seminars.

    This sounds great, and as a runner, organic food gardener, and non-smoker, I think everyone should be more health conscious.

    BUT look at the Feb 15th issue of Business Week. Companies are spending $BILLIONS on this stuff and it doesn’t work! Our health insurance company along with my wife’s employer has seminars and yoga and hotlines and they give away free pedometers to get everyone to walk 10,000 steps a day, and gym memberships and weightloss and stop-smoking clinics, etc, etc – the list ALONE would give you good exercise just reading it – and it doesn’t help. It’s hard to change people’s habits and we have an epidemic of obesity in the US.

    Read the Business Week article.

  • George

    The Canadian system is cheaper and provides better health care than the US system. But this reform is better than nothing. Yea!

  • George

    Sarah Palin went to Canada to obtain health care.

  • http://gbp-studio-acoustics.com Glenn Brown

    I feel its time for our government to make a much larger change to our health care system. as a self employed small business owner, I can not believe how much of my income is going out to insurance these days.
    I fully support President Obama, but I think the healcare system needs a major overhaul. Any objection from the Republicans is just trying to make more trouble for our President and his desire to help hard working Americans like myself.

    Glenn Brown
    Music Producer.

  • Vick

    Explain how Obama and the Democrats can tell free people that they MUST do business with private industry only because they were born? EXPLAIN IT! DO IT!!! YOU CAN’T! It’s not just.

  • Vick

    Pay this company I say you must or go to jail! That’s not freedom! That’s what this nation fought against!

  • Ellen Dibble

    It is interesting that companies spend billions on healthy lifestyle training to reduce health care costs (if that is what Peter means — I haven’t read the article), and it doesn’t work.
    I take it that investments by employers in yoga and gym memberships and so on do not reduce the cost of healthcare for those employees. They still get sick.
    I turned down a plan with a health care savings account because it gave steep discounts of some sort for gym and things like that. I think they gave out movie tickets. In my situation, I go around by bike, which would get me no movie tickets. And I haven’t had time for a movie since the 1980s. So they struck out doubly. Blue Cross offers gym memberships, and again, I think, if you had work like mine, you would never get a chance for gym. You have to do your exercises during breaks. If you want to stay fit, you teach yourself a sort of yoga, when to stop, when to start. For me, I have to be in motion almost nonstop. Nerves I guess. Or else I get stiff.
    Anyway, I am very dismissive about MONEY being spent on trainings and gym and so on. Running is free; ditto long walks. Get a little carpet and stretch till you’re tired. It should be automatic, just like a cat will stretch and jump, as if wired to do so.

  • Daniel

    I’m thinking that weather you insure people that do not have insureance or are under insured. the tax payer and the insured pay for the unpaid medical bills.

    I want change now!

    I just think insureance companies are dirty and premimums are out of line along with RX drug companies.

    As your guest said I am fett up!
    I want everyone to be insured and insureance companies to pay the bills they are taking money to cover.

  • twenty-niner

    “I’m totally in favor of tort reform as long as it doesn’t prevent legitimate malpractice claims from being compensated, but let’s do a realty check here – the most optimistic projections of cost savings from tort reform have been about 1.5 percentage points and most have been less than that.”

    That’s a critical question. When you factor the amount of defensive medicine that would no longer be needed, would the cost savings really be 1.5 percent? I seem to remember a physician strike in Pennsylvania not too long ago over this issue. Would these physicians really walk away from their posts over a measly 1.5%?

    http://www.informaworld.com/smpp/content~content=a713608096&db=all

    As the retired cardiologist noted above, he would’ve
    “saved Medicare, etc. a tremendous amount of money by limiting testing and procedures.”

    That 1.5% estimate may be what we would save next year if we enacted tort reform now, leaving the bulk of the defense medicine being practiced still intact. But what if we had enacted such reforms 20 years ago? Would literally millions of unnecessary tests and procedures not have been performed?

    We really need to hear from more physicians on this issue.

  • Eddie Brown

    Um, I’m a liberal Democrat in N.Y.C…
    But I must say, Love the “bizarro slogans” quip.
    Think I’ll use it for My bands name.

  • Ed

    The core of most of our problems with health insurance seem to revolve around the fact that we rely on employers to provide it.

    Employers have no core interest interest in providing health care, and small employers cannot afford it at all.

    Individuals who wish to be self-employed or start new businesses are horribly punished for not being associated with a big group; as are employees of small businesses.

    For those who do rely on employers to provide us with health plans, they find they have no choice in what plan we can have. Often our only option is to get another job, which simply is not practical much of the time.

    Meanwhile, insurance companies have no interest in appealing to us, the users, since we are not the buyers.

    However, the government is NOT the only alternative payer.

    Why does no one mention the option of simply banning employers from providing health insurance? Of course, they would then presumably provide more in terms of salary, and consumers could actually SHOP for health insurance.

    We would see real competition in the market. And if insurance companies insist that there have to be groups, we could still have groups other than by the company we work for. Certainly we belong to more communities than our job…?

    I am truly discouraged that this option is never even mentioned in the public debate.

  • Julie Jackson

    I vote yes on the health care bill. I live in Michigan. Most people do not have insurance through their employers. Benefits are on the block with both public and private employers.
    The Republicans are disingenous on the issue. There is no health care bill that they will vote for, anytime, in any form. Health care for all will not costs jobs, or economic or social desolation. Just do it! Congress must buck the insurance industry lobbies and the mean spirited politicians.

  • Ellen Dibble

    Vick, you wouldn’t be going to jail. Your taxes would reflect a fee for the coverage that the country is providing to you and all of us because you are alive.
    I do agree with you that mandating we pay A PRIVATE FOR-PROFIT INSURER as a responsibility to our fellow citizens, that is going too far. I will agree to be required to pay additional taxes for NON-PRIVATE, NON-PROFIT-DRIVEN insurance, akin to that of the military or senior citizens or the disabled. It’s the profit-driven part that’s ripping us all off that I object to.
    I don’t think you could get a majority to “give up” their health insurance because it involves profit-driven companies.
    How would that happen? A moratorium on going to the doctor? A big sit-in at all the hospitals to say we don’t want you to be open for business until you get all the insurance coverage out of the way? Only non-insured money comes in? Straight from my pocketbook into their coffers?
    What exactly is the method? What exactly is the goal?

  • Kirk in Michigan

    What I find fascinating are the polls that report that half of America is “against the current reform bill,” but when they delve into each of the major provisions of the bill, people overwhelmingly approve of each of them. What does that tell you?

    We need leadership. And just maybe one day more people would be open to the possibility that America just isn’t #1 in everything (traitor!) and has something to learn from all the other wealthy nations who have already figured this out better than we have.

  • Alex

    “I do agree with you that mandating we pay A PRIVATE FOR-PROFIT INSURER as a responsibility to our fellow citizens, that is going too far.”

    Every employer I have worked for has told me to pay one specific private for-profit insurance company (sometimes there is a choice of two) or take a hike. I suppose that’s not mandating, but then again, what else am I going to do? Is this the freedom that our Founding Fathers were fighting for?

  • Vick

    The polls or the guns Ellen. Either way…”No to this bill.” Simple as that. I won’t live as a slave. Neither will most. “By any means necessary!” Peaceful if possible, by any other if not. NO MAN, President or not, tells me who I must do business with over my own body. The Politicians get payed, they must figure out the way. Our jobs as Americans is to remind them death awaits if they do not do the people’s bidding.

  • Ellen Dibble

    Ed, I think that if big corporations (emphasis on big) were forbidden to provide health insurance as a benefit, they would rebel against having to pay the equivalent in salaries. The employees would be paying more for insurance, and the company would have to pay more in salary increment to compensate for that. Why would employees have to pay more? You say they could be in larger groups with greater bargaining power. This is being done in Massachusetts, where everyone has been pooled, and the Exchange (Connector) is set up so people can Shop, and the result is disastrous.
    The insurers seem to play Divide and Conquer. I think if everyone knew the next guy, the next shop, had the same plan, it would be easier to sleuth out if there was Something Rotten About This Plan. Word would get around.
    When we don’t know what price the next individual pays and what sort of plan he/she thinks he/she has, it’s hard to compare notes. It’s hard to police the whole market for fairness. Impossible, maybe.
    So I don’t think forbidding employer-based insurance would enhance competition in and of itself.

  • George

    Trying to understand the American health care system is like trying to understand organized crime, where most of the key activities occur in the shadows. No wonder everyone seems baffled.

  • Ellen Dibble

    Vick, you are paying for Social Security and have been since you were born, unless you are very old. You pay for veterans’ care and disabled and poor and care for those 65 and over. You pay for lots of things that benefit all of us, and if you don’t agree with all of it, please do vote, but if you think it is your duty to kill somebody in the government (somebody a lot of us voted for), that is not your job as a citizen. Far from it. Use your power of persuasion. Use your experience and your networks. That is what the Founding Fathers did.

  • twenty-niner

    Me:

    “I served on active duty in the military for five years, and the medical care I received was quite excellent.”

    Alex:

    “Wasn’t that medical care run by the government?”

    Yes it was. In my experience, the military (“the government”) does quite a few things very well, especially the primary mission, but I can’t say that the military does them efficiently (in terms of resources) or economically. Far from it. The amount of waste and fraud that I witnessed firsthand was shocking and permanently etched my political views.

    In my humble view, there is a military-industrial (and now let’s tack on) insurance company-bank complex that threatens to bankrupt this country.

  • Ellen Dibble

    Twenty-niner, I hear you. Maybe we need campaign reform before anything else happens.
    But didn’t the Supreme Court just make a decision that sort of preempts that? OMG

  • Ellen Dibble

    Alex, oh, the employer telling you to pay the for-profit insurer or take a hike! Good point. Maybe employers can be mandated to offer the same public option as an alternative that ought to be offered to self-employed individuals.
    Actually, I think I heard that the public option would not be offered to self-employed individuals who ALREADY HAVE INSURANCE. OH GOOD GRIEF.
    I should cancel my insurance right away, so as to be uninsured when the public option I want gets offered.
    Oh, my head.

  • Ed

    Ellen, if employers are banned from providing health insurance and large corporations do not compensate salaries, I think there would be massive rebellion among the employees/unions of those corporations.

    But more to the point, regardless: small companies and individual entrepreneurs would be free to flourish as they would no longer be punished by not having competitive health plans. Small businesses could attract better employees and individuals could quit their jobs and start new companies without fearing loss of health insurance.

    I agree that banning employer-provided insurance is not a solution in itself, but it certainly should be on the table. It opens so many doors, and the doors it closes maybe should be closed anyway. Do we want a country where everyone is driven toward working for massive corporations as if their life (literally!) depended on it? That’s what we have now, and even so, small business provides more than half the jobs in the nation. Imagine what it would be like if small businesses were on a slightly more level playing field with the impersonal, multinational behemoths.

  • Ellen Dibble

    Ed, I agree. Pax vobiscum. A plan! Let’s take this thread to the White House and tell them we’ve figured everything out.

  • Gina

    Vick you sound an awful lot like the guy who clamied to be goading everyone in the Tea Party show discussion for some sociological point.

  • Gina

    Well, that’s timing.

  • peter nelson

    Why does no one mention the option of simply banning employers from providing health insurance? Of course, they would then presumably provide more in terms of salary, and consumers could actually SHOP for health insurance.

    And the insurers could SHOP for the consumers!

    That’s the problem with your plan. Insurers would cherry-pick the lowest cost, lowest risk consumers.

    The bottom line is simple math. Medical care is expensive – VERY expensive. Shaving a few percentage points off the costs with tort reform or single payer isn’t going to make a big enough dent to change this. Taking what is today a $350,000 medical bill – not unusual for cancer, major trauma or major cardiovascular disease – and reducing it $300,000 isn’t going to make it affordable to a non-rich person.

    Insuring someone against that risk is expensive, especially if that person is middle aged or has pre-existing conditions, so it is a myth that the magic of the marketplace can bring the cost of that risk to the insurance company down to the point where a poor, unemployed, or low-income working person can afford a policy!

    As I said above – this is where conservatives are stuck – they don’t want to admit that they just don’t care about those people and would be just as happy to see them left out on the sidewalk to die in agony, but they also don’t want to admit that the only alternative is to subsidize policies for those people. This is why they desperately hope that no one makes then propose a comprehensive plan – because they simply can’t.

  • peter nelson

    I wrote and reducing it $300,000 isn’t going to make it affordable to a non-rich person.

    I meant “and reducing it TO $300,000 isn’t going to make it affordable to a non-rich person.”

    The US is the only country in the civilized world lacking a modern health insurance scheme, and OnPoint/WBUR in the only discussion site in the civilized web lacking a modern EDITABLE discussion forum!

  • Ellen Dibble

    I think that the sums of money involved make for an increasingly difficult debate. Twenty years ago when I had cancer that had gone into the lymph nodes and needed surgery, chemotherapy, and radiation, I could afford to pay out of pocket but was happy to have insurance. The extra financial flexibility allowed me to start my own business rather than become essentially a ward of the state. Nowadays the costs of the same care would be multiples, as are the premiums.
    Twenty years ago there was no Viagra, there were not costly reproductive options, not methods of adapting DNA to overcome genetic mal-dispositions. Twenty years ago, people didn’t expect to be working into their 70s. Now, a couple of stock market crashes later, a lot of us take it for granted we will be working into our 70s. We also see by the statistics that we can live pretty much as long as we can afford to.
    So how many crises do I want to live through? How long do I want to live? How long do I want “public option” type (Medicare?) insurance to sustain me for? Do I want to put a dollar value on it?
    Yes. I think these are the decisions that do confront us. The fallout is that we end up with people who can be “treated” preventively or cured for reasonable cost are just as uninsured (when they lose coverage) as those whose care would cost $350,000. If you can’t afford $3,000, then you can’t afford to live, if that is the price of care. So someone has to decide who lives and who dies.
    Personally, I have no trouble with that. I will know when. I am advised the best way is to starve yourself. To which I say I have already tried that, and I gained weight anyway. :-)
    But sometimes someone else makes the decision for you. Your children decide for you. They decide you live till there is no more inheritance. Something like that. Or they all fight about it.

  • Ed

    Peter, like I said: 1. Banning employer-provided health insurance is not a complete solution in itself, but it makes no sense to have employers be involved in insurance at all: it is not their business. 2. Removing employer-related groups does not preclude (and in fact opens up) the possibility of creating other kinds of groups. What possible rationale is there to group people by their employment group? It is as arbitrary as anything else, so… choose something else.

  • Ellen Dibble

    Vick, you have said you are a fraud, or something like it, a composite. You are certainly not a mental midget. But who exactly could be shot as relates to your health care, um, “issues”? Everyone in the health insurance industry? Everyone in the health care profession? Everyone who pays for health insurance? I take it you vote, so probably not the people we vote for.
    Oh. I’ve got it. The scientists. Those who do the research and devise the new cures that are driving up costs. Be forewarned, Vick they are spread far and wide. They are not all in one place.

  • Richard Clements

    Ed is absolutely right when he says:
    “The core of most of our problems with health insurance seem to revolve around the fact that we rely on employers to provide it.

    Employers have no core interest interest in providing health care, and small employers cannot afford it at all.”

    This nonsense of tying the health insurance issue to employment is strangling our industry and still leaving millions uninsured. On the economic side, it’s health insurance costs that largely put GM into bankruptcy. American industries with huge health insurance costs are up against global competition from nations where health care is simply part of the infrastructure. Even if we ignore the economic burden on business, look at the social costs. Lose your job and lose your health insurance and potentially your home and life savings. Peolple can’t leave to take another opportunity or can’t afford to start their own business because of the difficulty of having to find individual health insurance with the pre-exising condition of one of your family members, (as was my situation several years ago).

    We need universal health insurance, personal, portable and a single payer system makes the most sense to keep costs controlled with a risk pool that would include all Americans. Millions of expenses for insurance underwriting, administration and profts would be saved, while lifting the burden from American companies to boost our competitiveness. It works in other countries for far less than what our average cost is. Despite the fearmongering and propoganda, the Canadian economy is doing quite well in comparison after nearly 50 years of single payer health insurance.

    The Democratic plan is so watered down it is next to impotent, but it is at least a step forward from the unsustainable status quo. I hold my nose and support it as the least of two evils.

  • Liz B.

    After reading the posts here, I haven’t seen that many comments with a satisfactory comment about insurance companies. hmmm… Doesn’t that imply something?

    Again, I’m for a single-payer system, where this stupid fighting about people’s health care and life is not a political issue. It should not be in the 21st century.

    We live in a country with one of the largest economies in the world; and we bicker about who pays for somebody’s MRI or a doctor’s visit? Don’t we pay enough taxes already to put this behind us? Come on!

  • peter nelson

    That 1.5% estimate may be what we would save next year if we enacted tort reform now, leaving the bulk of the defense medicine being practiced still intact. But what if we had enacted such reforms 20 years ago? Would literally millions of unnecessary tests and procedures not have been performed?

    The studies I’ve seen take that into account.

    Look at it this way – tests are only one part of the cost of healthcare. There is the actual treatment – surgery, drugs, physical therapy, etc. There is the consulting/exam time in the doctor’s office, there is the the care of the patient in the hospital, including all the expensive stuff in the ICU; There is the cost of the hospital itself, there is all the home care – wheelchairs, colostomy bags, dialysis, home nursing, etc; there is all the bureaucratic and paperwork stuff – billing and recordkeeping, etc. The list is huge.

    What part of this is diagnostic tests? And what percentage of those diagnostic tests were only done for CYA reasons? In my personal experience not many, but maybe a few. And then you have to ask how many of THOSE would be prevented by tort reform? It’s not like under tort reform doctors can’t get sued or can’t lose their license, so they will still want to protect themselves (and their patient!) by ordering longshot tests. And then add in the fact that many times tests are NOT run that should be run!

    I worked for many years in scientific and medical imaging as an engineer and I can tell you that the question of WHICH tests to run based on a particular set of exam findings, history, patient complaints, and other factors is very difficult. It’s a judgement call and you always want to err on the side of minimizing patient risk, NOT saving the insurance company money.

    If the patient has a set of symptoms suggesting a 90% chance of having X, which is mild and treatable, but a 10% chance of Y which is fatal if not caught early, you really have to test for both. Even though 90% of the time the test for Y will be negative. Armchair bureaucrats don’t get this and complain about the 90% “wasted” tests.

  • Ellen Dibble

    A decade ago, somebody told me that a “primary care physician,” the one selected and reported to the health insurer, got a big bonus just for having been named your primary care physician. This seemed a bit of a stretch to me, given my PCP didn’t see me for whole years. Now it seems apparently the PCP does get paid for the tests — which have hitherto been free under my insurance, free to me, a bonanza to him. I don’t jump for these tests because I can tell from my own body what the results will be, and I figure the extra cost will drive up premiums if “we” don’t watch out. What insurance is apparently NOT interested in paying for is appointments long enough to actually let my doctor know what is going on. So I type it up and present it for my file.
    And Vick, I think you’ve now drunk the Kool-Aid. Elysium, now or later, right, and I’ll pick my time, death squad or no. Free forever, like a cloud, yeah.

  • peter nelson

    2. Removing employer-related groups does not preclude (and in fact opens up) the possibility of creating other kinds of groups. What possible rationale is there to group people by their employment group? It is as arbitrary as anything else, so… choose something else.

    I totally agree that there is no rationale for basing health insurance on employment but in the absence of an alternative it’s all we have (in the US). Your post made it seem like you were proposing using banning employers from offering health insurance as a forcing function. This seemed cruel and barbaric in the absence of an alternative.

    A better approach would be to HAVE an alternative so that employers would be freed from the pressure of having to offer healthcare.

  • Curtis Jasa

    The insurance companies of America can’t make money on The exact people who need it the most.

    1. The sick
    2. The poor
    3. The elderly

  • Ellen Dibble

    3%? So we go and turn Iraq into a democracy. We go and turn Afghanistan into a democracy. Carefully making sure that 3% do not make it into a home for insurgents, a nest for criminals.
    Now, we settle down to minding our own business, and what ho? We have morphed into a terrorist state ourselves.
    Vick, you didn’t have to tell us this is a possibility. Even 9/11 was hatched right here, depending on which lenses you use. I think we got the message.

  • Chris

    Ellen, why even try to have a conversation with Vick? He obviously gets hd jollys by making totally outrageous comment and adds absolutely nothing meaningful to the conversation. He is like an annoying fly that needs to be swatted (hello moderator???). In addition, he posts under multiple names in order to make people think there is more than ONE person making such duffus remarks.

    Public Option or Single Payer is the way to go and I like the idea that Congress must give up their cushy health insurance plans & spend a year with no insurance at all-it would be quite a learning experience for them.

  • Ellen Dibble

    If a bunch of paranoid mental midgets took over the good old US of A, I think the Chinese would have no difficulty coming in and bringing some rationality to governance. I will start learning Mandarin ASAP.
    But paranoia has as one attribute that the self doesn’t consider oneself paranoid. One considers one’s beliefs and suspicions entirely valid. So someone who announces he/she is paranoid is by definition a fraud. I mean, I give you the benefit of a doubt, but I don’t know anything at all about you except that you lie. Have you tried mental health care to disillusion you about your sense of self? If you know you are paranoid, maybe you should relax about the possibility of uprising. The chance of global warming swamping our shores is about equally imminent.
    Mental health insurance gets its own separate experts and discussion groups, in my humble opinion.

  • twenty-niner

    “There is the cost of the hospital itself, there is all the home care – wheelchairs, colostomy bags, dialysis, home nursing, etc; there is all the bureaucratic and paperwork stuff – billing and recordkeeping, etc. The list is huge.”

    No doubt. It seems that, strategically, Congress should’ve divided its effort into two parts, with the first part focusing on cost-cutting measures and the second being the mandate for the uninsured. A bill that focused purely on wringing inefficiencies out of the system (via mandatory electronic records based on a common standard, tort reform, portability, elimination of anti-trust protection, etc.) would’ve surely passed; and the prospect of significantly lowering costs would’ve had wide public support. If people actually saw their premiums drop, a mandate to expand coverage would be more tenable.

  • Ellen Dibble

    OnPoint posted a link to a program that shows the subsidies for the Senate bill, the House bill, and the Obama proposal, from a computer program set up by Kaiser. It’s at the top of the thread. I put in age 63, single, for the three choices and saw what I saw. They point out that the co-pays and deductibles aren’t figured in. They point out that the bill will make for a different set of standards. But for me, if I made $44,000, under Obama, I would pay $7,911 a year, a limit of 18% of income, with me paying full freight. Ditto for the Senate bill, same $7,911 a year, payable by me.
    However, if I made $43,000, the premium remaining at $7,911, but I would only have to pay 9.5% of income, or $4,085, with a government subsidy of $3,826. The same 9.5% applies under the Obama proposal if I were making 35,000. The House bill shows an insurance cost of something like $6,000 a year, with some subsidy, but I don’t think the House bill is the one on the chopping block.
    The program shows Medicaid available to those up to $133% of poverty.
    I would save $3,826 (if I’m reading my handwriting right) a year by making sure not to earn over $43,000. I’ll make a note of that, restrain myself.

  • joshua

    It is a scam to make us buy health insurance from private companies. I will never buy it. NEVER. SIngle-payer universal health care is the ONLY right and correct and ethical way to reform. Everything else is a gift to big corporations that have no place in a moral ethical human society.

    So what–now low-income people make even less, maybe not enough to put food on the table–oh, unless its McDonald’s and Walmart. But that’s exactly what they want. Obama is giving the big corporations exactly what they want. it will standardize our lives even more than they all ready are and the grip that factory farming ad fascist walmart has on the the world will get even tighter. You have no choice. never again.

  • Brett

    “I served on active duty in the military for five years, and the medical care I received was quite excellent.
    Wasn’t that medical care run by the government?” -Alex

    “Sssshhh! They don’t want to hear that. The government can’t do anything right, haven’t you heard?” -peter nelson

    My parents have TriCare “for life” and have had several health problems in recent years (they’re in their 80′s). Most recently, my father (84) broke his hip and had hip replacement surgery about 6 months ago. My mom (82) is dealing with stage 3 uterine cancer right now (she’s had surgery and is finishing up radiation treatments and looks as though she won’t undergo chemo–which I agree with, but I don’t think the decisions have been made with any finality).

    Mom is doing fairly well at this point (Dad is doing better), although for her type of cancer–for women her age and considering her stage–the future doesn’t point to a prognosis of more than a 4-5 year survival rate after treatment.

    I guess what I am going through is what most of us have to go through at some point in our lives, if we are fortunate enough to have our parents live into their 80′s. I, of course, am worried for them, worried about my mother’s illness directly; and, although I’m worried less with my father’s continued recovery from hip replacement, I do worry about my dad should anything happen to my mother.
    One thing I don’t have to worry about is my parents’ care and coverage. From what I have seen in their various health concerns in the last four years or so, is that their care has been in the vanguard of what is considered state-of-the-art. Also, their coverage has been great.

    I can’t say much beyond what I see with my parents’ experiences with “government run” healthcare, as well as having some friends who are happy with their healthcare with the VA, but it does seem to indicate the government CAN do a pretty good job with running healthcare.

  • Janet

    I think if we just expanded the Public Health Service and the network of clinics that they already have in place would be a better way to go.

  • Ellen Dibble

    I had mentioned Public Health Service as a possible teaching source for the schools. My experieince with them was having TB treated — a year-long process — about 1978. The “clinic” was one room, one woman.
    I think “government-run” usually in our lingo means “single-payer,” which is to say, take the middle-men out of base-line insurance, let us pay the government, but let us use the same providers we always have used. There wouldn’t be any miraculous new army of physicians and hospitals, just a single claim/bill form for physicians/hospitals to use.
    As I understand it, the VA health care system has its own hospitals and its own physicians, and I haven’t heard about herding physicians into something similar for the rest of us.
    Under some new system, it would be a good idea to have more Urgent Care center, with 24/7 nurse practitioners to help with non-life threatening situations, and we have heard that synchronized groups of doctors with various specialties, as well as with primary doctors backing each other up, that makes an awful lot of sense and has proven effective and cost-effective. So that should evolve.
    But if government-run means we get across-state-borders care, that would be good, because I might be able to travel someday. Right now my insurance policy specifies the group of providers I can go see, and they’re all in my immediate area. I think I could petition for an exception, but I somehow don’t trust that. I think it opens me up for room for denials.

  • Ellen Dibble

    All Things Considered ran a story on Monday about Obama’s efforts to increase international tourism to the US, which has gone way down since 9/11. Our share of tourism has dropped as compared to the rest of the world.
    Therefore there is being instituted a $10 fee to help pay for promotion of US tourism. This, they say, is minimal compared to a fee of over $100 for visiting the UK, which is an invisible fee since it is part of an airline ticket.
    But the Argentine woman in this thread who said she worries about lack of health coverage if she were to travel here reminds me of this. I thought one purchased “travel” insurance to cover health needs overseas. I guess that’s a waste of money if you are already paying $100-plus just to get through customs in London. But then they have super care for visitors.

  • David

    A new public entitlement program as big as this one should also require that we do away with some programs just a big. Eliminate Earned Income Credit, WIC, Head Start, Student Loans, some gov. agencies inorder to fully fund this new program.

  • Rachel

    Junk the special interest gift bill and incorporate medical care services within the military.

  • Ellen Dibble

    I believe it is fully funded, and if you take a look at the profits and overhead and waste and inefficiency that are being addresssed, that is not surprising. Right now we reward excess, not conservativism, in care, just for starters.
    But other waste should definitely be on the table. How do you propose making sure poor children are fed well and get optimal education, preschool through college?

  • Ramon

    From: sansrx@bellsouth.net
    Subject: The Real Threat to America’s Health Care
    Date: Saturday, February 20, 2010 4:29:30 PM

    ————– Forwarded Message: ————–
    From: sansrx@bellsouth.net
    To: “Secretary Kathleen Sebelius, Department of Health and Human Services”
    Subject: Re: The Real Threat to America’s Health Care
    Date: Sat, 20 Feb 2010 21:16:21 +0000
    You all have yet to get it right!!!!
    Hippocratic oath has yet to be practiced instead Hypocritical oath is.
    The biggest threat is the incompetent medical system.
    Surgeons leaving you in worst shape after the surgery.
    “There are no guarantees!” That’s how they protect themselves.
    Make as much money from the insurance companies with no concern to the patient’s well being.
    Drugs with dire side effects.
    Hospitals, ER showing no concern for the patient.
    Good people have died because of the medical system’s inadequacy adamant-apathetic behaviour.
    Sincerely
    Ramón
    P.S Will be favorably impressed if I get one honest-sincere response instead of a boiler plated rhetoric.

    ————– Original message from “Secretary Kathleen Sebelius, Department of Health and Human Services” :

  • Ramon

    Was left waiting 3 hrs in the ER with chronic urine retention. Could have had kidney-liver shutdown.Total apathetic behavior.
    And Don Shula gets paid for endorsing this medical institution who employs incompetent non caring staff.
    And how about Disease Prevention vs Disease Treatment?
    There’s no money in Disease Prevention.
    The medical system is not designed to make you well, but to extract maximum profit.
    We need to clean house without playing favorites.

  • peter nelson

    No doubt. It seems that, strategically, Congress should’ve divided its effort into two parts, with the first part focusing on cost-cutting measures and the second being the mandate for the uninsured. A bill that focused purely on wringing inefficiencies out of the system (via mandatory electronic records based on a common standard, tort reform, portability, elimination of anti-trust protection, etc.) would’ve surely passed; and the prospect of significantly lowering costs would’ve had wide public support. If people actually saw their premiums drop, a mandate to expand coverage would be more tenable.

    But what’s your evidence for this? The whole problem with this whole discussion, here on OnPoint, and in the country, is that people make these broad statements without being able to cite hard data.

    Take medical records, for instance. As a software engineer with a background in medical products I am a HUGE fan of electronic medical records! But even I have to admit that the best data to date has not shown strongly that they save much money or prevent many mistakes when they’re deployed in the real world. (advocates say it’s too soon to tell)

    Of course there are some inefficiencies in the system – all large, complex systems have inefficiencies – but that doesn’t mean there’s any way to reduce them much without ADDING to the cost. Keep in mind that the insurance companies have been trying for years to do this by demanding that doctors get separate levels of approval for every test and procedure in the name of not wasting money. This takes a lot of time and effort by clinicians, which wastes money and other valuable resources. My wife’s insurer used to offer a 50% REWARD for any mistakes a patient found! (that is, if the patient noticed a $100 bill for something that wasn’t actually performed they’d get a check for $50!) But they stopped this program because it had no impact.

    So if it costs a $billion in bureaucratic oversight, restrictive rules and clinicians’ time to SAVE a $billion then you haven’t saved anything.

    One of the biggest inefficiencies is the HUGE cost overhead by doctors’ offices dealing with dozens of insurance companies with hundreds of separate plans. Each employer negotiates their own deal, so two different patients with CIGNA might have entirely different drugs and procedures and co-pays. And the doctor has to spend her day arguing with with insurance bureaucrats to justify some test or procedure. Single payer would fix this but it’s off the table.

    Another source of ineffiency is insurance company profits – none of that money goes to pay for actual care.

    And also healthcare costs are going up so fast (close to double digit) that even if you DID manage to cut costs, premiums wouldn’t go down – they’d just go up more slowly.

    Keep in mind that HMO’s were invented to improve efficiency.

    And finally note that lack of health insurance is a crisis NOW. People are losing their homes, their retirement savings, and going into bankruptcy NOW because of this problem. And studies in Lancet and NEJM (and other journals) have shown beyond doubt that the uninsured have much poorer survival and outcomes. In other words, in the US people are dying for lack of health insurance.

  • Brett

    Ellen Dibble,
    WRT Urgent Care facilities in one’s neighborhood, I believe they would be effective if one could develop a rapport with a particular clinician or group of clinicians. If they would just be that you see whomever without regard for rapport, I believe this would undermine good, consistent care and efficiency.

    I believe rapport helps the physician/nurse practitioner understand how one as an individual responds to treatment and it helps him/her listen better to the patient as an individual; it minimizes return visits (at least this is my experience in treating my chronic conditions). I also believe electronic filing of medical history in a universal data bank would have to be a part of this kind of system.

    In my parents state they Have Urgent Care facilities. They work well in many respects, although I don’t know how effective they are with chronic conditions/being able to establish rapport, etc.

    The other issue with “clinics” is how they are to be staffed, in terms of how many doctors and nurses and their hours. The ones in my parents’ state don’t operate around the clock, so without a regular person one can contact after hours or one “gate keeper,” etc., I believe some people would be back to “going to the ER” for non ER conditions, and I also see that this way of providing care would be inefficient on many levels. I see that many people do not take charge of their health, don’t care to learn about how their bodies work how medication/medical procedures work, and so on. Seeing whatever clinician at whatever facility means in many cases return visits, trying different procedures, etc. This is not a very efficient sounding way to do business.

    What you are proposing sounds like around the clock facilities with well staffed clinicians all the time in each neighborhood…I don’t know that we could expect such a thing happening, nor should we even necessarily want to.

  • jeffe

    The polls or the guns Ellen. Either way…”No to this bill.” Simple as that. I won’t live as a slave. Neither will most. “By any means necessary!” Peaceful if possible, by any other if not. NO MAN, President or not, tells me who I must do business with over my own body. The Politicians get payed, they must figure out the way. Our jobs as Americans is to remind them death awaits if they do not do the people’s bidding.
    Posted by Vick,

    Are the producers of On Point reading this? This is the second or third posting by this person with direct threats of violence towards politicians.

    I’m not sure if this guy is for real or not but statements like this in light of recent events in Texas make me shudder to think what this person is about if these are the rantings of someone who believes what they are saying.

    To use a threat of violence in the political discourse in my opinion is the sign of a thug.

  • peter nelson

    Plenty of countries have systems that are MUCH cheaper than ours and produce outcomes that are at least as good as ours – and in and many cases better. If we were really serious about fixing our system we could adopt one of those systems wholesale. Of course we won’t because Americans would rather spend 50% more money and get poorer outcomes out of a sense of patriotic pride.

    Also, if you look at the systems in Europe – Germany, the Netherlands, UK, France, Sweden, for instance, they’re all different. Some are single payer; some have private insurance companies, employers’ roles vary, they’re all funded differently, etc – to lump them all together is ignorant.

    One factor that contributes to lower costs is that in most of those systems doctors are paid less. Does this mean that the doctors aren’t as good there? No. One difference is that in the US doctors graduate from medical school with a MOUNTAIN of debt to pay off! In Europe medical school is usually state-funded. Also in the US doctors have high malpractice insurance premiums. So while US doctors are paid more, their expenses are higher.

    Also increasing numbers of US doctors are leaving the system because they are fed up with all the insurance company shenanigans and having to spend their day arguing with bureaucrats doing paperwork instead of helping patients.

  • peter nelson

    Are the producers of On Point reading this? This is the second or third posting by this person with direct threats of violence towards politicians.

    I totally agree. I hope the moderators/producers here are taking note of this.

    In several recent cases – the Ft Hood shootings, the guy who flew his plane into the IRS office, and the guy who attacked the Pentagon last week, the perp left a trail of warnings on the web with comments that were violent and threatening.

  • jeffe

    What I did not hear in the program yesterday was the obvious. The Republicans are fighting this because they do not want Obama and the Democrats to have a win. This is more political than anything else.

    When you look at the mess our health care system/market is in you have wonder why the Democrats, (who well know what the Republicans are playing) are not pushing for a better bill. It seems to me that the answer to this is they are not interested in creating a good health care system in.
    They are also looking for a win and they made the deals they did with big pharma and the insurance corporations.
    This was a huge miscalculation on their part in my view. They also seem to be kicking the can down the road.
    They were lobbied to make provisions to favor both industries. From my perspective Obama lost a real chance here, one to make some real changes in controlling how lobbyist effect legislation and coming up with good reform package that would have been good for the country.

    What I see here seems to have some good things but they seem to be out weighed by the overall status quo that bill leaves in place. Obama just did not have the political will or so it seems to get this done.

    It does not matter, if the bill passes it will be thrown out in the fall when the Republicans gain seats in both houses. What both of these parties fail to realize is that while they play politics, real people are dieing and going broke from getting sick in this country by the tens of thousands every year. Shame on them.

  • Ellen Dibble

    Brett, where I live there are two new Urgent Care facilities, actually established by an emergency room doctor, a physician affiliated in a leadership role with Physicians for Social Responsibility or maybe Medecins sans Frontieres, I forget. Anyway, he saw a need, and no wonder. Here, if I have a splinter that seems to be getting infected and I can’t pull it out, there are so few primary care physicians that they have a lot of trouble making way for me. And the emergency room is really not the place for this sort of thing. Or if I twisted my ankle and it starts to cause trouble about midnight, trouble I can’t figure out of palliate on my own. The Urgent Care facility here is right across the street from the hospital, and it is open 24/7, and they can and do send people across the street for x-rays or whatever they can’t provide. I think they rely more on nurse practitioners than some practices, though probably have a physician present at all times. It frees up primary care doctors to deal with the wider picture, and do follow-up the way ER’s do. They can make a referral to the Urgent Care place, and have agreements with insurers to cover this.
    It seems to me their value is clear, but their success may depend on how the bills now in Congress shake out.
    I hear you, Brett, about how uninsured people might use an urgent care facility INSTEAD of a primary care doctor. I don’t know about that. I don’t know if it’s allowed. I think there are clinics sponsored by CVS pharmacy and by the city public health service to provide flu shots and certain other screenings, tests — I think even an indigent person can get 150 pounds of flesh stripped off oneself one month when one makes oneself scarce, for appearance’s sake, and be thus stripped by a VERY minimally trained practitioner at say a certain spa, and for a very low cost, you might say “for favors,” and then you can try to pretend you had been on a very stringent diet.
    I don’t consider that responsible self-care. No.

  • Ellen Dibble

    To clarify, the ER’s and Urgent Care facilities refer patients back to the primary physicians (yes, with electronic transmissions, in a perfect world), and the primary care physicians take responsibility for oversight and coordination.

  • Ellen Dibble

    ABC Nightline did a piece about the “truthers,” focusing on a conference of those who believe the US Government was behind the 9/11 attacks. I believe they also did a report on a woman who died of liposuction in Florida, done at a spa by an individual who had only three days training in that, which is what Florida requires.
    The truthers — they were not threatening violence. Among those interviewed (briefly) for the piece was the woman FBI whistleblower from Minnesota who had tried to warn about the people training to fly but not land a plane.
    ABC said that they (the ABC crew) were filmed every step they took (serves ‘em right) and were not at all welcome in their probing questions. They showed people being quite defensive, not really able to back things up, whilst proclaiming they are scientists and so on. Well, I’d be defensive if Nightline was cross-examining me too, I suppose, but I think you can go view those segments at their website — maybe. Cynthia McFadden was hosting.

  • jeffe

    Ellen what does a Nightline show about the “truthers” have to do with the health care crisis?

    By the way Nightline is not a news program as it would like you to believe, it is more of a hybrid new/entertainment and I would take what they do and say with a grain of salt.

  • Ellen Dibble

    Jeffe, I was struck that Nightline latched onto two issues from this thread: One, conspiracy theorists, government-distrusters, who think government can’t do anything right, ssssht, and as you say, why do I even bother to take notice. Nightline was noticing.
    And the second thing, the danger that totally irresponsible health care is being resorted to for lack of reasonable insurance options. Something along those lines.

  • jeffe

    Ellen cosmetic surgery is not covered by any health insurance policies that I know off.

    The woman went to a clinic and was willing to get liposuction done by someone who was not a doctor.
    I am sorry but one needs to be careful when dealing with anything that involves cutting into your flesh. Liposuction to my knowledge is a minor surgery and should be done by a doctor who is trained in this field.

    As for the conspiracy theorists well that is another topic and I am sure a whole show could be done on the why’s and hows of this phenomena.

  • Bob N

    On the healthcare debate since congress can’t decide or give us the facts it is time to bypass congress. In Novembers election the House bill and the Senate bill could be put on the ballot along with neither and let the people of the country decide what they feel is best and what ever wins has to be signed by the President.

  • twenty-niner

    “Take medical records, for instance. As a software engineer with a background in medical products I am a HUGE fan of electronic medical records! But even I have to admit that the best data to date has not shown strongly that they save much money or prevent many mistakes when they’re deployed in the real world. (advocates say it’s too soon to tell)”

    I’ve logged many hours as a software engineer myself. I’m talking about a Federally-mandated standard interface that ALL practitioners and ALL insurance companies would have to adhere to. It wouldn’t cost that much money to commission a panel to design this interface, and Congress could write it into an easy-to-pass law that would have almost no opposition.

    The point is that simple (or simpler steps) that concentrate on lowering costs by wringing efficiencies out of would be EASIER to get through Congress and could be done in piece meal versus trying to solve every problem at once. Right now, there’s a better than 50% chance that nothing is going to get done as a result of trying to fix the whole mess at once. Using software-development speak, it would be the political equivalent of the “agile” method.

    I’ve been to the doctor’s office enough times to witness the vast amount of paperwork (with actual paper and pen) that get generated with every visit, which could be eliminated with a computerized standards-based system, which in turn would bring down costs.

    I’ve checked the history books. This country actually put a man on the moon, so I’m pretty sure we could figure out how to eliminate reams of paperwork and actually lower NET costs using computers that we invented to help put a man on the moon. And by the way, we went to the moon by building progressively bigger and more complex rockets, seeing what worked and what didn’t along the way.

  • http://www.beccar.wordpress.com Eugenia Renskoff

    I am getting more and more frustrated over the Health Care Debate. I feel that there is no hope for unemployed people like myself. I have one or two pre existing conditions and I would have a very hard time getting insured. Going to a public hospital is not an option. I ask: What else is there? Eugenia Renskoff

  • Ellen Dibble

    Jeffe, I worry “conspiracy theorists” who think the government can do nothing right (with A LOT OF GOOD REASON) will vote in some idiot in November. Some host of idiots.
    Also for liposuction, I refer to more than Florida and cosmetic surgery. There has been plenty on this thread about the cost of care for America’s obese. If someone does the equivalent of a back-alley abortion and instead of having a costly specialist switch her from to obese to scrawny, makes cheap choices, well, it saves the cost of the gym, the cost of the nutritionist — it’s a factor to consider. I didn’t know people do it. Then I come across it in New England, then see the Florida piece.

  • Flick

    You must make a specific, target threat in a public place for free speech to fall under the legal precedent laid out in Schenck v. United States. And Politicians are considered Public Figures and therefore can not be protected under slander laws the same way a Private Citizen can be, so long at whatever choice words directed their way are tied to their Public Office.

    You make the intentional mistake of blurring those lines in regards to my words, most likely because you simply don’t like what I have to say. Besides, every debate I engage in on this site drives up the post and hit count of it’s corresponding story. Think of me as an artist, and you’re going to really have to buckle down to back me into a corner. I look forward to your next tactic to explain to me how I am not allowed to say what I say.

    The main factor in this particular debate is the mandate to do business with private enterprise under penalty of Government Action; first financial, and then incarceration. That is simply unconstitutional, and the reason why this set of laws are so very, very dangerous. If they are indeed passed, then it does legally open up any Public Figure Politician who willingly voted for it to Treason proceedings as it can and should be seen as a form of tyranny, and in direct conflict with the whole notion of Freedom that this nation is founded upon.

  • Brett

    With TriCare my parents pick their own doctors, etc., procedurally very much the same way as if they had private insurance. My friends who use the VA, as Ellen says, have to go to VA doctors, VA hospitals, etc. Either way, I’ve not heard any complaints/problems from those folks I know.

  • Greg

    Wow, 330+ comments!

    Here’s my problem (actually a couple of problems).

    1. Health Care and Health Insurance are fundamentally different things. What we have not is not insurance as it wold be properly understood in any context other than health care i.e. a pooling of risk to provide insurance against “catastrophic” events. Instead we have health care reimbursement plans which defray the cost of what would be considered “Maintenance” in other contexts. If Jiffy Lube billed auto insurance providers for oil changes, auto insurance premiums would be astronomical. It is absurd, in my opinion, to adopt an insurance model to provide “universal” health care to everyone regardless of risk, pre-existing conditions, etc.

    2. I know people who could easily afford the cost of the health care they receive, yet they continue to let Medicare foot the bill. It is not at all clear to me why anyone over 65 should receive health care reimbursement regardless of ability to pay while tens of millions of others go without health care because they cannot afford it.

    Very little about the current debate makes sense to me.

  • Greg

    “The main factor in this particular debate is the mandate to do business with private enterprise under penalty of Government Action; first financial, and then incarceration. That is simply unconstitutional”

    I learned long ago that statements such as “that is simply unconstitutional” made without reams of supporting evidence are “simply” hyperbole.

    If you had said, “I believe this is unconstitutional” we would have no quarrel. It may seem like a small point to many but to me, it speaks volumes. Guardianship of “The Truth” is the stock in trade of demagogues and tyrants.

  • Ellen Dibble

    I challenge you to prove the hit count goes up when you post, Flick. All I can go by is the speed of refresh, and that has been much worse when we talk about terrorism, regardless of how many posts by the sort unperson you say you are — unless some site-meisters have tinkered with things in Boston.
    But I believe I’ve answered your points so I won’t go over it again. It seems your issues fall in the purview of laws, the lawyers, all that, which is not my realm, except to the extent we are all born with a sense of justice, and you have issues that have been ripe, as they say, many times before, so it’s not without precedent.

  • Stephen Hughes

    The only efficient way to lower the cost of health insurance is to remove for-profit healthcare insurance corporations from the healthcare system. Private corporations are driven by profits. Stock analyst rate stocks as Strong Buys, Buys, Holds, Sells and Strong Sells based on a company’s earnings per share. Earnings per share goes up, the stock price goes up.

    As an example, at last week’s house hearing, Waxman, chairman of the Energy and Commerce Committee, one of three in the House with jurisdiction over health care made the point when he said, “Corporate executives in WellPoint are thriving, but its customers are paying the price.” WellPoint paid compensation of at least $1 million apiece to 39 executives in 2008 and spent $27 million over two years on executive getaways, citing documents obtained by his committee. When Rep. Jan Schakowsky asked WellPoint CEO Angela Braly “how much money do you make?” CEO Angela Braly replied, “My salary is 1.1 million dollars. I receive stock compensation with a value of 8.5 million dollars and last year an annual incentive payment of 73 thousand dollars.

    No company executive who was given stock compensation wants to see their company stock go down in price. Consequently, these companies will always be creative in finding/inventing ways to increase premiums. They are not bad people, that is the way corporations operate.

    Now tell me, was the $73,000 incentive to lower premiums? Not likely. This is just one company. What are the rest doing? Just how much of our premium dollars are reaching our health care providers? I say first choice, a national healthcare plan, second, Public Option.

  • peter nelson

    I’ve logged many hours as a software engineer myself. I’m talking about a Federally-mandated standard interface that ALL practitioners and ALL insurance companies would have to adhere to. It wouldn’t cost that much money to commission a panel to design this interface, and Congress could write it into an easy-to-pass law that would have almost no opposition.

    . . .

    I’ve been to the doctor’s office enough times to witness the vast amount of paperwork (with actual paper and pen) that get generated with every visit, which could be eliminated with a computerized standards-based system, which in turn would bring down costs.

    In principle I totally agree. I go to a doctor’s office and have to fill out by hand a form where 95% is the same as a year ago. Why can’t they just print out the filled-in form an ask me to note the differences? It would save time and data-entry costs.

    I go to 3 different specialty practices. One switched to electronic records and loves it. One switched and has had lots of problems but they’re sticking with it and trying to get past them. And one switched to electronic records and had such a bad experience that they switched BACK to paper!

    So just as I believe in evidence-based medicine, I also believe in evidence-based cost projections. Even though it seems like common sense to you and me that electronic records should reduce costs and errors, large-scale widespread studies have yet to confirm this. So I don’t want to count on this as a money saver yet until more data comes in.

  • peter nelson

    It is absurd, in my opinion, to adopt an insurance model to provide “universal” health care to everyone regardless of risk, pre-existing conditions, etc.

    1. What’s the alternative?

    2. Other countries manage to do this and still maintain high quality of care and dramatically lower costs. So it’s not like it can’t be done.

  • twenty-niner

    “The only efficient way to lower the cost of health insurance is to remove for-profit healthcare insurance corporations from the healthcare system.”

    I’m not sure if for-profit insurance automatically translates to higher rates. I have for-profit auto insurance and my rates (in both inflated and absolute dollars) have actually gone down over the last ten years. My guess is that the state mandate (that most drivers be insured) coupled with stiff competition has driven this trend.

    It seems like when I watch commercial television, which is rare, half of what I see are auto-insurance ads:
    The State Farm ad with the guy from “Heat”.
    The Progressive ad with the girl wearing clown makeup.
    The endless dumb Geico ads with lizards and cave dorks.
    I’m sure Allstate and Travelers are in there as well.

    I imagine that the auto-insurance companies could actually argue for higher rates with increasing congestion on the roads, drivers becoming ever more distracted with texting and such, cars becoming increasingly complex, and crumple zones turning what used to be fender-benders into crumpled balls aluminum foil; but yet auto-insurance rates seem to be stable.

    Also, other countries such as Switzerland have private health insurance, and yet don’t have runaway inflation.

  • jeffe

    So slick now you call yourself Flick…
    Or is it Vick, or Ick… or Ack!.

    If you said the things below they are a bit over the top.
    But hey that’s just me. When someone says “bring it on” or, “come “break bad” to us, and see what happens! It’s ON” it means you are intending to do them violence, at least it seems that way. I’m not talking about slander, I’m talking about the subtext of your diatribes which seems to be steeped in anger.

    Rahm Emanuel, and his Chicago Gangsters haven’t met us from the Midwest yet. I cherish the opportunity for that piss-ant little nothing to get up in my face/our faces! Bring it on Skell’s!

    Peaceful if possible, by any other if not. NO MAN, President or not, tells me who I must do business with over my own body. The Politicians get payed, they must figure out the way. Our jobs as Americans is to remind them death awaits if they do not do the people’s bidding.
    Posted by Vick

    Come on Rahm, you and your “crew” come “break bad” to us, and see what happens! It’s ON

    These are threats, period.

  • peter nelson

    I’m not sure if for-profit insurance automatically translates to higher rates. I have for-profit auto insurance and my rates (in both inflated and absolute dollars) have actually gone down over the last ten years. My guess is that the state mandate (that most drivers be insured) coupled with stiff competition has driven this trend.

    It’s also because highway fatalities have been going down dramatically over the years. In 1957 there were 5.98 fatalities per 100 million vehicle miles. By 1970 it was 4.82; by 1980 it was 3.85; by 1990 it was 2.07; by 2000 it was 1.55, and by 2008 it was 1.27. (Source: NHTSA). Much of this is due to “socialized” mandates by the government for improved safety standards for autos as well as better road design, antilock breaks, better tires, cars that accelerate and maneuver better, and a lot of other factors. Other accidents have also been declining.

    But WRT to medical insurance there’s no declining trend in sight. And every dollar of profits is a dollar that’s NOT going for patient care. Furthermore it’s hard to get around the fact that European countries, including single-payer ones, have dramatically lower costs.

  • peter nelson

    Also, other countries such as Switzerland have private health insurance, and yet don’t have runaway inflation.

    That’s because the Swiss, like the Dutch, have mandated coverage and mandated standard policies, plus they enforce a uniform fee schedule.

    All of these are things that the conservatives in the US oppose.

    Really, there are LOTS of different and good ways of addressing the problem of health insurance that are in existence and working today! It’s maddening to listen to people here and elsewhere say, “gee, what if we did this / what if we did that?” as though they are required to think of some novel solution, when we have so many existing, working examples to choose from!

    But the conservatives think of it as a flag-waving act of patriotism to reject any idea that the Europeans come up with regardless of how messed up our own system is.

  • Gina

    That is simply unconstitutional, and the reason why this set of laws are so very, very dangerous. If they are indeed passed, then it does legally open up any Public Figure Politician who willingly voted for it to Treason proceedings as it can and should be seen as a form of tyranny, and in direct conflict with the whole notion of Freedom that this nation is founded upon.

    That’s for the Supreme Court to decide. Not some faux “Patriots” with guns.

    You my friend, and all your ilk at Freeperville and World Nut Daily need a dose of reality.

    It isn’t 1950. Get used to the fact the majority of this country’s population isn’t “white” and “male” anymore.

  • jeffe

    The Swiss also control cost by not allowing the insurance companies competing in the health market to make a profit.
    Which is another reason they can control costs.

    It isn’t 1950. Get used to the fact the majority of this country’s population isn’t “white” and “male” anymore. So right, and in twenty years or so the Latino population will equal or surpass the white Anglo population.

  • david

    Would you buy into this???
    You go to buy a car. The dealer states the terms as follows: You will pay $500.00 a month for the car for 4 years. We will store the car in a facility until you pay the loan off, at that time you can come and get the car. How many of you would sign your name on the dotted line for this deal??? None I expect!
    The same is true about this healthcare bill. You will start to pay immediately once it is enacted and not receive benefits till 2014.
    If the rush for this was because of dying people without insurance, why will people be made to pay for 4 years and not receive benefits till 2014?
    In other words, sign on the dotted line, pay thousands for 4 years and Uncle Sam will keep your insurance benefits in storage till 2014.
    Sounds like a great deal to me!

  • Bush’s fault

    We started out trying to figure out how to pay for medicare and wound up confiscating peoples’ wealth to cover illegal immigrants, aliens, or whatever you want to call them…this is no solution the the heart of the issue: how to establish a reasonable cost for medical care…which is a service, not a right.

    Junk the special interest driven bill and get to work.

  • Bush’s fault

    Get over it…the President and Congress have rejected European medical care models; after all, we’re not Europeans.

  • Bush’s fault

    “My solution is to permanently leave the US. I am moving to France. In my opinion they have the best healthcare in the world. And they seem to care about each other a bit more than here.” – Sandra

    Mais oui! A bientot!

  • Dick

    Gina, I’m well aware o that. The nation is broke, fractured, and headed toward 3rd World status too! Yeah! It’s not the 50′s anymore, with all it’s power, money, security, stability, and beauty!

  • LynnSwann

    3rd World People make 3rd World Nations. Multiculturalism only leads to Balkanization. There may be many family traditions, but there can only be one culture, otherwise, it all falls apart. See Exhibit A: The state of the nation, for proof.

  • peter nelson

    The Swiss also control cost by not allowing the insurance companies competing in the health market to make a profit.
    Which is another reason they can control costs.

    Well, close but not exactly. They aren’t allowed to make a profit on the basic policy but they are allowed to make a profit on the higher tier ones.

    (I’d love to see what sort of accounting rules the Swiss use to enforce that!)

  • peter nelson

    There may be many family traditions, but there can only be one culture, otherwise, it all falls apart

    You mean, like Switzerland? How much time have you actually spent in Europe or among Europeans? What on earth makes you think that Italian culture, French culture, and German culture are “the same”?

  • Lewis Harvey

    I am 58 yo I have no health care my wife has no health care. I think the insurance want a slow death for health care. Pass what we they have and work on improving. we have get the ins co out of health care business

  • ThomasB

    I do want healthcare reform but I don’t see any feasible way of accomplishing it. Expanding access in a financially responsible way is nigh impossible. I work at a blood bank and often ask people to donate blood, at times in front of a grocery in Small Town, America. These people give excuses such as diabetes then come out of the store with donuts. People with hepatitis walking out with beer. Unhealthy people shopping for unhealthy food.
    I believe Americans do want healthcare reform but we don’t want to pay for our neighbors’ bad habits.

  • Kilgore

    Maybe they just don’t want to give you any blood. It’s their right to keep their blood. They don’t have to give it to you.

    As far as what they eat, well, that’s none of your business. You just irritated me and raised my blood pressure. You’ve just contributed to deteriorating my health. I don’t think you should be allowed to irritate me. It’s affecting my health.

    ThomasB, mind your own business. There is a limit to what others do affecting you. You get no guarantees in this life. The training wheels are off. If you want to try and tell people what to eat, you open the door for me to say that you can’t say what you want to say. You really want to go down that path?

    P.S. Nobody owes you anything, and nobody has to give you any blood. Stop annoying people a little more, and maybe they won’t lie to your face just to get you to go away.

  • ThomasB

    Kilgore,

    Of course it’s every American’s right to donate or not donate blood. My point is this healthcare reform would make an individual’s health, and what they eat consequently, every American’s business because your hard earned tax dollars would be supporting and enabling Americans to lead sedentary lives. Obesity, diabetes, high blood pressure, high cholesterol, the majority of these are caused by lifestyle. Lifestyle choices on which I do not want to spend tax dollars.

    People tout other countries’ healthcare systems without considering the lifestyle and eating habits of their citizens. France on the whole has a much healthier diet than the US. The obesity rates are lower and people are more conscious of their health. Their healthcare system doesn’t have a glut of gluttons that we would here.

    The training wheels ARE off Kilgore. Individual responsibility and freedom has reigned and look what this freedom has wrought for the ‘unhealthy by choice’ American. I don not want to pay taxes to enable unhealthy habits. We do need healthcare reform in this country but more than that, we need a change in food culture.

  • jeffe

    Kilgore are sure you know what you’re saying? Maybe you do and this is your philosophy on life. Live as a selfish senseless human being.

    The man was doing a blood drive for pete’s sake.

  • Sam Wilson

    @ Kilgore

    My friend, if you cant take the heat, get out of the kitchen, i.e. if you are not open to others views and points, do not read their comments!

    Be civil, be respectful dude..

    We all talk about our “rights” so much, I guess we also need to talk about our responsibilities as well!

    God Bless America!!

  • memememe

    But Kilgore don’t you want to give your blood? Spill it for that tree of liberty? It will help your health.

    Maybe the government should play reverse psychology with you freaks and get you to shoot each other and spare us your BS.

  • http://www.onpointradio.org/2010/03/your-thoughts-on-health-care#comments Kali Blount, RN

    As a nurse working multiple units in a large Magnet hospital, I see the failures of our insurance-profit-driven Health Care System (HCS) every week. Over and over, patients are discharged according to insurance “guidelines” and re-admitted within days after nearly dying at home. Typically, patient and family were begging to stay longer on the front end; this re-admission cycle is fantastically profitable, with a bolus of big charges at re-entry.
    And I see it every day in the short-staffing that administration calls minimum adequate coverage — a far cry from what direct care professionals know to be safe and functional. Nurses lack time to catch errors in medical orders, deliver the most thorough care (that prevents nosocomial infections and new complications), and communicate laterally and forward. This drives nurses away from bedside care — the side of the nurse shortage that hospital administrators won’t talk about.
    And in the community HCS, I see people declining and dying because medical judgement simply wasn’t engaged. Doctors can only secure their own economic survival (and get ahead of the huge debt they graduate with) by seeing the most patients possible in the briefest possible time per person — they’re getting paid to show up rather than to think about best outcomes for patients. And the doctors’ training, in medical curriculums dominated by Big Pharma, is tech and symptom oriented; they overlook the whole person, prevention, and healthier lifestyle (i.e. PATIENT-CENTERED WELLNESS) in favor of high-profit practitioner-centered business.
    Health Care is as vital to the health of this society as free, compulsory public education. And health insurance companies and big pharma ARE THE PROBLEMS with our HCS. Health Care should be in the Bill of Rights. Didn’t the President, with the voice of Ted Kennedy’s letter, speak about the CHARACTER of the nation? That’s the Constitution, not any single Bill — repealable by the next Congress!
    Now they’re talking about Tort Reform as the solution to Malpractice impacts on the cost of our HCS. Again, the lack of patient-centered thinking is solving the problem for the sake of business. Limiting damage awards, which injured patients deserve (and often need to cope with their remaining lifetime with their injury), is a LICENSE TO HARM. REDUCING ERRORS should be the focus; don’t hurt people more cheaply but hurt fewer people!! DUH!! What’s makes this so hard to grasp!?!? Better communication (doctor’s handwriting, electronic records), expanded training for clerks/transcriptionists, adequate nurse coverage (referred to in first paragraph) and other ways to reduce errors is the humane way to address malpractice costs. But capitalism without controls in NOT HUMANE; nothing matters above the flow of money and there is no concept of ENOUGH!
    The current Bill (both versions) is wheedling pablum kissing the golden toes of health insurance companies and big pharma. We should be working to pass HR 676, but the simple political (and politics is packed with plenty of simpletons or they think all of us in the public are too simple to see who’s bought) fact is that if this crap Bill fails, our crippled Congress won’t pick up anything for the HCS for another 14 years!! We usually get change in creeping increments. How sad!
    Kali Blount, RN tanacabana@yahoo.com 352.278.8510

  • peter nelson

    People tout other countries’ healthcare systems without considering the lifestyle and eating habits of their citizens. France on the whole has a much healthier diet than the US. The obesity rates are lower and people are more conscious of their health. Their healthcare system doesn’t have a glut of gluttons that we would here.

    No that’s too simplistic – the French and Japanese smoke like chimneys; the French think our fascination with gyms and exercise is a peculiar American affectation; the Japanese have a diet high in nitrosamines so they have an incredibly high rate of stomach cancer; the Germans have a very unhealthy diet. I flew to a cardiology convention (the AHA convention) awhile back with a huge FAT German cardiologist jammed in the seat next to me!

    Yes, Americans have unhealthy habits but this is endemic to advanced industrial nations; we’re not unique and ALL countries could lower their risks by better habits. Every advanced country is seeing their rates of Type II diabetes soar because of overweight and too many sweets. Ditto with other disease. So you haven’t explained anything.

    As I’ve said repeatedly in this thread – we don’t have to speculate! All the data you could possibly need to about why our costs are so high and how we could do things differently is readily available.

  • peter nelson

    As a nurse working multiple units in a large Magnet hospital,

    . . .
    . . .

    Great comments!! My sister and my niece are nurses, and for some reason my social circle has a lot of doctors and other health professionals in it. And I’ve heard all the same reports from them.

    Surviving our healthcare system is really hard. Medical staff are incredibly overworked – my wife’s oncologist has called us at 10PM or on weekends because it’s the only free time he has! Nursing staff work insane hours – which is not good for their health, nevermind that of their patients! And everything is a constant battle. I’m an unusual patient (and advocate for my wife) because I have a science background; I speak medical lingo, I’m comfortable reading peer-reviewed scientific and medical research, plus ( as others have noticed here 8-) ) I have a feisty don’t-take-any-crap-from-anybody personality.

    That’s what you need to survive the US healthcare system. Everytime I hear a conservative complain about “government bureaucrats” interfering in our healthcare system, or taking away your freedom of choice I laugh until coffee comes out of my nose!! Those idiots have never dealt with an insurance company.

  • http://npr.org jmtx47

    This would have been a great discussion had you had opposing opinions. Both guests support the idea which does not appeal to the general public.

    NO!!…DO NOT pass this bill and hope for changes. It DOES NOT work like that for the government and anyone who thinks it does is comatose.

    The thing most of us do not like about this whole thing is that it feels like we’re in a car dealership and a “deal” is being forced on us. Maybe backing up a little, looking at more options would move us closer to a resolution. Do we NEED healthcare reform…yes. Do we need THIS…I don’t think so…NOR do the majority of Americans…and NO, we are not stupid like some would have us believe.

  • peter nelson

    This would have been a great discussion had you had opposing opinions

    WHAT opposing opinions?? Where do you suggest we seek an opposing opinion? The conservatives just say “no”. That’s not an opinion, it’s a muscle spasm.

    The reason why we’re stuck with an unsatisfactory plan is because the conservatives have been AWOL. No significant conservative group, think-tank, or GOP committee or caucus has proposed ANY comprehensive alternative designed to ensure that all Americans can afford basic healthcare !!

    People are going into bankruptcy, losing their homes and losing their life savings because of lack of health insurance. And worst of all they are dying due to lack of health insurance. Studies in Lancet (on cancer) and NEJM (on cardiovascular disease) and other prominent medical journals have clearly shown poorer outcomes and higher death rates for Americans without health insurance.

    I don’t like the Obama plan either because I prefer a European-style system, but we are way past the point where we can continue to do nothing.

  • Debbie

    Yes, we should have national health care in this country. Obama wanted reform and that’s what we need. He’s backed off on that (temporarily, I hope), but at least he is trying for positive change. How the Republicans can hijack this and make it sound like this is bad socialism, a waste of money or an abuse of taxes, is absurd. How people can fall for this crap and be so selfish is beyond me. Let’s support Obama! We elected him for hope and change!m And, by the way, as a federal employee I have decent insurance; but I am not selfish and recognize the problems of other working people in this country.

  • http://www.beccar.wordpress.com Eugenia Renskoff

    What do I say? I say I need health insurance and it cannot come too soon. Eugenia Renskoff

  • justanother

    I have to say I’m not very savvy about getting the information how this heathcare bill work, too many information flying around here and there.

    Why doesn’t Obama administration create a website where people can just go there to do the math by putting in rough numbers in the formula to see how much people will pay more or save more with this health reform?

  • John Simpson

    Hello

    I am not sure if you have done a program on the stories of the underinsured. Having health insurance is not enough, when it doesn’t kick in after thousands in personal expenses have been met. And, then there is the way insurance companies calculate their payment to you that insures you owe more than you ever imagined. At least with my auto insurance, once the $500.00 has been paid, they step up to the plate.

    Thanks,
    JS

  • http://abelwren@yahoo.com Robert Tinel

    My name is Robert Tinel. I am 64 years old. I am “RETIRED”. I am “DISABLED” I had to save and save and save in order to purchase the computer that I am writing on today.
    When I was 19 years old, a young man with an open can of beer in his hand ran me over. The “ACCIDENT” broke seemingly most of the bones in my body. Eleven years later, I managed, while working, to slip and fall down about twelve feet. I worked very successfully for nineteen more years; at which time obvious “pain related behaviors’ caused me to be “RETIRED”. I could neither walk nor stand upright without assistance. Thirty one times a well schooled person told me that their company, or any company that they knew of could (or would?) not offer me health insurance. “PRE-EXISTING CONDITION!’. All of these messengers did not want the COMPANY that they worked for to loose their paycheck by paying for my care.
    I once had a doctor who charged me $300 for a prescription I did that many times. I never saw the doctor. I presented myself at a concierge’s desk, handed over an envelope containing a check for $300 to the man at the desk, picked up his envelope for me, left the building, paid $20 for parking: I started a thirty day period, at the end of which I would do it AGAIN! I really had to.

  • http://best-max.com/ Jake

    Thank you for sharing this. Well done!

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