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On Point In Nashville: Obamacare Rollout

On Point goes to Nashville — big medical center — to look at the rollout of the Affordable Care Act — Obamacare.

Tom and the panel (Photo by Molly Nicholas)

Tom and the panel (Photo by Molly Nicholas)

Six months from today, enrollment opens for Obamacare. October 1st, the Affordable Care Act begins to really roll out in earnest. No more hypotheticals. No more Supreme Court battle. A new day in American health care. Six months, and the rubber meets the road.

To see how the country’s preparing, we hit the road. Took On Point to Nashville – a major medical center where all the drama is playing out right now. We had a big crowd Friday night. A great panel. All live to tape for you.

This hour, On Point: rolling out Obamacare – the view from Nashville.

-Tom Ashbrook

Guests

Philip Bredesen, Democratic Governor of Tennessee from 2003 to 2011. Mayor of Nashville from 1991 to 1999. Author of “Fresh Medicine: How to Fix Reform and Build a Sustainable Health Care System.”

Dr. Wayne Riley, president, chief executive officer and professor of internal medicine at Meharry Medical College.

Lawrence Van Horn, leading expert and researcher on healthcare management and economics. Associate professor of management and executive director of health affairs at the Owen Graduate School of Management at Vanderbilt University.

From Tom’s Reading List

Businessweek “Many small business owners are asking questions about navigating the coming changes in health insurance under Obamacare. That’s not surprising, given that major reform provisions begin taking effect this year and next. There is also widespread confusion among small business owners about the law’s implementation and requirements.”

Bloomberg “President Barack Obama’s Patient Protection and Affordable Care Act celebrated its third birthday last weekend. This particular anniversary was a big deal, because it was often unclear whether the law would reach it. In the first place, it was imperiled by the Supreme Court; in the second, by Republicans’ promise to kill it if they won the White House in 2012. Over the past year, Obamacare survived both challenges, and next year it will begin its core mission of insuring tens of millions of Americans.”

WKRN Nashville “Tennessee Gov. Bill Haslam ended months of suspense Wednesday morning by saying he won’t expand the state’s Medicaid program as part of President Obama’s health care law. Haslam said he will pursue what he calls a “third way” to provide medical coverage for 175,000 uninsured low-income Tennessee.”

Gallery

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  • Shag_Wevera

    It’s the end of the world as we know it, and I feel fine.

  • Gregg Smith

    The cost is much higher than we were told, premiums are going up (way up) not down, the bureaucracy is daunting and unworkable, doctors are retiring early, businesses are cutting back hours to avoid compliance, it’s awful. 

    • brettearle

      Gregg–

      Short term analysis of a work-in-progress does nothing but expose the expedient need for instant gratification.

      When the Medicare Drug program was first implemented, under Bush II–a policy that was, by turns, a much, much less complicated one–it had all kinds of problems in adjustments, without a clear cut way, to this day, to finance the initiative.

      The Affordable Care Act (ACA) will not necessarily prove itself solvent, for years to come.

      That’s the problem.  The CBO sees eventual money savings well into the time, when the Baby boomers continue to retire.

      Now you may disagree with how slow the benefits are going to reach us.

      And you may believe that the benefits are, in fact, never going to BE benefits but are disasters, instead.

      But many medical economists disagree with you.

      They claim, instead, that without the ACA, the country would have eventually gone Bankrupt.

      As a priority, the President didn’t put this together simply because he wanted to save all people who couldn’t afford health care.

      His first priority was dire Economics.

      [All these statements, above, of course, are at the risk of being whisked down, off the pedestal that you have, recently, put me on. 

      Lord knows I still belong there.]

      • Gregg Smith

        There is nothing economically sound about Obamacare. I don’t accept the premise.

        • brettearle

          Neither of us can judge that, as yet.

          That’s the point.

          • deegeejay

            Have you followed TennCare at all? The feds keep having to bail it out – who do you think is going to bail out the feds? That’s right . . . our grandchildren. 

          • brettearle

            Neither you, nor I, are experts on the relative feasibility of ACA’s future projections.

            Many lawmakers believe in it.

            Many don’t.

            Same is true for the Economists.

          • William

             But we have Medicare/Medicaid as examples of unaffordable government  medical care plans.

          • brettearle

            Would you recommend paring down all entitlements?

            You’ll have older men and women, dropping like flies, in the streets.

            Is that what you want?

          • jefe68

            This is the problem.
            When we talk about this in the abstract, the reality of the consequences of doing nothing are sometimes lost.

            People are already dying from lack of health care coverage.

            Medicare does work better at controlling costs, but it still is operating in our dysfunctional fee for service system. 

            Until we deal with this not much is going to change.

          • William

             Yes. No choice. People won’t die in the street.

          • brettearle

            Your world experience must only make you privy to streets  that all mimic Sutton Place.

    • jefe68

      You’re right about the costs, not the idea of covering more people with care. 

      It’s the cost of health care that’s killing us. 
      We pay more, much more for health care than Canada, which coverers about 95% of their population. 

      Our system is broken. It’s clear that a market based system based on fee for service, is not only dysfunctional but is on the way to bankrupting us.

      Medical bills, even for those with insurance, is one of the largest causes for bankruptcy. 

    • Human898

      The provisions that place limitations of profit and where they spend insurance premium revenues for insurance companies have not fully gone into effect. Insurance companies, as they have before (just one of the basis’s for reasons for health care reform) are doing what was expected, trying to milk the current system for what it is worth before they are no longer allowed to.

    • hennorama

      Gregg Smith – please demonstrate the honesty of your statements.  Specifically, how these aspects of your claims are a) factual, and b) IF factual, that there is a causal/effect relationship to Obamacare:

      1.  “The cost is much higher than we were told”

      2.  “the bureaucracy is daunting and unworkable”

      3.  “doctors are retiring early”

      4.  “businesses are cutting back hours to avoid compliance”

      [EDIT/ADD] Assuming your post wasn’t simply an April Fool’s joke, of course.

      • Gregg Smith

        They are all factual and true. I wish it was a joke. Most of us have known it all along, no one’s laughing now.

        • hennorama

          Gregg Smith – you wrote “They are all factual and true.”

          This is in response to a request for you to “please demonstrate the honesty of your statements. Specifically, how these aspects of your claims are a) factual, and b) IF factual, that there is a causal/effect relationship to Obamacare:”

          “because I said so” is not a demonstration of fact.

          Nice try, completely true to form, unsurprising, and hilarious to boot.

          • Gregg Smith

            Thank you. If you question my facts do your own research. Please demonstrate how Obamacare saves money, creates jobs and is happy land for doctors. Please show how insurance premiums have gone down as promised.

          • hennorama

            Gregg Smith – Thank you for conceding the indefensibility of your statements, and your lack of personal honesty and integrity.

            You repeatedly say you are all for “open and honest debate” yet repeatedly lack the ability to demonstrate the veracity of your claims..

            “Because I said so” is not an argument.

            There is no need for me to demonstrate anything, as I made no claims. Your claims are in question, and remain so.

          • Gregg Smith

            You really ought to pull your head out of the sand. 

          • hennorama

            Gregg Smith – Paraphrasing you:

            “You really ought to pull your head out of” … well, let’s just say it rhymes with “morass”, and simply demonstrate the honesty of your claims.

          • Gregg Smith

            Really, it’s true. One has to try hard to deny it, everybody knows.

          • pete18

            Actually, the person that needs to prove the
            truth of his claims is Obama, not Greg. Our completely ineffectual and clueless president promised us that his health care plan would:

             –Lower health-care  
                costs.
            –Produce smaller     deficits.

            –Allow you to keep   your existing insurance if you wanted.

            –Would reduce unemployment and increase productivity.

            In almost every instance the exact opposite has happened and none of the current trends or estimates show that they will ever happen.http://online.wsj.com/article/SB10001424127887323374504578217720567917856.html 

            These were all easily predictable results based on the structure of his plan. It was a well intentioned but horrid idea that didn’t have public support, yet was forced through congress with backhanded tactics.We will suffer under the debilitating consequences of Obama care for a long time.

            That Obama supporters
            refuse to acknowledge the failure of ACA or hold him responsible for its poor results or the economy is unfathomable.

          • hennorama

            pete18 – TY for your response. I respect your views.

            If Pres. Obama was posting in this forum, you would have a point. Otherwise, the poster (Gregg Smith) whose claims have been questioned should be able to demonstrate the honesty of said claims.

            This is especially true in Smith’s case, as Smith repeatedly claims he is all for “open and honest debate”. When questioned, and when his contradictory statements are pointed out, Smith instead uses “because I said so” as an argument, and claims his statements were “cherry picked”.

            TY again for your response.

          • pete18

            See above.

          • pete18

             Hennorama:  If I were you I’d be much more concerned about Obama’s veracity than Greg’s. However, all four of Greg’s points are true and easily verified. Both #1 and #4 are addressed by the two articles I posted.

          • hennorama

            pete18 – TY for your response. I appreciate and respect your views.

            The opinions of two conservative and/or libertarian columnists are hardly proof of anything. Much of what they wrote is speculative, and none of it demonstrates the honesty of Gregg Smith’s claims. The two opinions you linked to are merely opinions, not facts.

            You also apparently missed the fact that Smith used the present tense throughout the four claims in question:

            1. “The cost is much higher than we were told”

            2. “the bureaucracy is daunting and unworkable”

            3. “doctors are retiring early”

            4. “businesses are cutting back hours to avoid compliance”,

            as if all four of his claims were current fact.

            They are not.

          • pete18

             See above.

          • Gregg Smith

            Yes they  are.

          • hennorama

            “Because I said so” is not an argument.

          • Gregg Smith

            Thanks Pete, but at this point anyone who is still denying what is happening is hopeless. It’s kinda’ sad.

          • pete18

             The articles give opinions supported by facts, which are documented. Do you have some facts that would support the opposite opinion?

  • Markus6

    There are almost no provisions in Obamacare to reduce medical costs. And we’re adding tens of millions of people who will have to be subsidized by the government. It is impossible for this not to increase the debt by tens of billions at least. And it will be a bureaucratic mess and ultimately lead to some form of rationing just like it has in other countries (though it’s never called that).

    The biggest advantage Obamacare has is that the existing system of health care is a probably a bigger mess than Obamacare and unsustainable over the long run.  

  • rvl1

    Amen!

    Read the eye opening special report by Time magazine – Why Medical Bills are Killing us  (March 4, 2013)

    It’s scandalous how rampant price gouging by hospitals, big phama, and almost everyone in the medical industry is allowed to continue unchecked.  The argument is always “who should pay?” never “why are prices so high to begin with?”

    Corrupt politics i.e. big money influence over lawmakers is one reason.

    • brettearle

      I don’t believe, for one minute, that what was revealed in the TIME article couldn’t be changed, within 12 months–if we had the political will, in this country, to do it.

  • creaker

    When we got Romneycare here in MA we  had a very percentage of people already insured. It will be interesting to see how this plays out in states with much higher numbers of uninsured.

  • ToyYoda

    Where’ the live streaming webcast?  I want watch as well.

  • glenn keefer-mcgee

    If you take the profit motive out of medicine you can find that balance.  Too bad the folks wanting a return to serfdom stopped that.  They would rather poor folks (including their kids) die.  After all, they’re just the underclass.  And probably non-white, so it’s cool.

  • http://www.facebook.com/peterboyle.4848 Peter Boyle

    While Obama Care does expand the number of people covered, it does nothing to reduce costs.  The Time article points out the reason for the ever increasing costs of health care, but no one wants to tackle those problems because Big Pharma contributes too much money to politicians.  There are few honest brokers for change, so things will get worse and cost will rise until we tackle the major contributors to rising costs – Big Pharma, Big Medicine, and Big Medical Equipment. 

    Shorten Patent coverage so Generics can produce sooner.  Allow collective bargaining by Gov for the costs of medications and treatment.  Strong jail sentences for those caught cheating – including Big CEOs.  Offer a Student Loan payback for General Practice doctors who will work for 7 years in low income areas with low income people.  Allow Physician Assistants and Nurse Practitioners  more leeway in treating and prescribing.

    In the end, reform of costs plus a single payer system (like Medicare) for all Americans would help everyone greatly.  Almost like catching up with the rest of the world.

  • Human898

    I’m wondering what happens to and what the costs were/are, of all the people that had no insurance before the PPACA?   They weren’t there?  Or were they more expensive because people used ER’s for their care instead of less expensive means?

    The provisions that place limitations of profit and where they spend insurance premium revenues for insurance companies have not fully gone into effect. Insurance companies, as they have before (just one of the basis’s for reasons for health care reform) are doing what was expected, trying to milk the current system for what it is worth before they are no longer allowed to.

  • Anita Paul

    The MA health plan has been basically pretty successful.  70% of MA citizens support it.

  • http://twitter.com/TN4th TN4th

    I’m wondering why the panelists are bemoaning the new burden on the system rather than celebrating that so many more people will have the care they need.

    • Kathy

      I was thinking the same thing. The “negative” of this is that more people will get getting health care? Really?

  • jefe68

    The ACA does not fix the huge dysfunctional aspect of our fee for service system that is broken. It’s written by the lobbyist from Big Pharma and the insurance corporations. 

    It does not address costs at all. It’s broken, and the only way to fix it is to rebuild it from the ground up. The market based fee for service health care system does not work. We, as Americans do not seem to be able, or willing to deal with this fact. 

    • Bruce94

      I agree with the premise of your argument.  A lot of concessions were made to get it passed (recall the public option was off the table before negotiations began) and perhaps the most egregious was the the cave to Big Pharma as one of the panelist pointed out.

      I’m hoping that perhaps the sellout to the drug industry can be addressed later in the implementation phase or with new legislation.  Your observation about the fee-for-service system is also on point.  If we’re not going to regulate providers to a much higher degree, then we need to introduce incentives for providers to offer more preventive care and to keep patients well (i.e. pay providers for value vs. volume of services). 

      I have always thought that if we could have a “do over” from scratch, a single-payer system like the British model that was developed following the devastation of WWII would make the most sense.  Even a public-private approach along the lines of Canada and many of the most advanced countries in the world would be preferable to the pre-ACA status quo.

      • Human898

        You’ve offered some very thoughtful reponses Bruce, thank you.  

        I agree with your thought that costs might be reduced by allowing incentives for cost reductions to be put in place,   I think it is interesting to hear the public response to CVS Pharmacy asking their employees to provide some basic vital signs and screening to CVS’s health insurance company as an incentive for consumers to lower their own insurance costs while at the same time allowing the insurer to perhaps get a better fix on their risk, especially with the new requirements in place for where they must provide care.   Interesting too that the private insurance aspect of the PPACA was the compromise to a single payer system where the “insurance pool” became the government or perhaps a not for profit trust.  

        This is all recognizing that one of the large costs in our health care system is sorting out who gets paid by whom and all the paperwork involved, not just for and by all those who get paid to paperpush, but health care workers themselves, taking time away from their care and adding another level of cost and work that would be reduced.   In addition, the government does not operate as a for-profit business.    

  • Bruce94

    Thanks On Point for this special edition and bringing together a balanced panel that seems capable of offering some real insights into this complex set of issues. 

    I’m wondering what they think about the incentives, defaults, penalties, etc. that are built into ACA to lower the trajectory of health care costs over time (e.g. emphasis on wellness and preventive care, changes in reimbursement policy, jettisoning of Medicare Advantage, expansion of electronic records, promotion of evidence-based medicine, standardization of ins. forms & procedures, others?).

  • http://www.facebook.com/people/James-Patrick-Dwyer-Jr/100002088204784 James Patrick Dwyer Jr.

    The developed countries deliver far better health care at half the cost than we do.  It looks like we could find out how they do it, and copy them.

    • jefe68

      Except we can’t get past the idea that any kind of socialized health care system will be shot down as 
      “socialism”, and “unAmerican”. 

      Here’s a reality, if you break your leg and end up in the ER the bills from this could reach up to $15000 to $30000 . The reality is our fee for service system does not work.
      Hospitals will still find ways to charge you 1500 times the cost for Tylenol and other charges. 

      Even if you have health insurance you might end up going bankrupt from the bills.  

      Bottom line our system is broken, period. And not one person on this panel is talking about it.

  • creaker

    The cost issues are where healthcare and capitalism butt heads. So, you’re dying, we can sell you something to fix that – what is it worth to you? Of course healthcare is expensive.

    • Human898

      Your health “care” is held for ransom.   You’ll be saved, only in some cases, to become bankrupted.   Some people don’t see that as a humane “market”, but a monopoly of sorts.   When unconscious on the ground, one cannot “shop” for their care, especially beyond or outside what has been and up to the current U.S. health “care” system.

      I remember a time before health care became an “industry”.

    • DeJay79

       and to the point of profit. there is no incentive “NO INCENTIVE” for a Pharma company to create a real cure for anything when so much more money can be made
      off of long term treatment.

      Aids, Cancer Diabetes, with as much money the bigs have made
      and the time they have had they can’t cure these things? BS!

  • Human898

    I’m still curious.  There is a lot of talk about how we’re going to pay for “this”.   Are there costs we’re not paying now?  Once again, are there no costs for and to society and the people that have not been covered?

    • creaker

      A big cost is people using ER as their primary healthcare, racking up bills they will never be able to pay for their own. Currently, the rest of us pick up the tab in higher hospital costs.

      • Markus6

        I think it was on Planet Money where an economist said she analyzed total costs associated with not having health care and using the ER, clinics, etc. vs. having it. They weren’t even close. It’s much more expensive to pay for insurance. Part of the reason is people go to the docs more and have more tests. This doesn’t speak to the quality of the care. I think it’s obvious that the care is better with insurance.

        So, I doubt that any form of government provided health insurance which includes adding tends of millions of new patients will be a money saver. But I am guessing that a single payer system could be made billions cheaper than Obamacare. Not that it’s his fault – it’s his and the Congress’ fault.

        • Human898

          I’m not sure many are remembering the health care insurance mandate and I would like to see the study and compare it to other studies.  I have seen studies and statements by physicians who could not be happier to see the reform and welcome it with open arms because of what it does.

          The argument that insurance makes people take advantage of services is not a good argument in favor of what insurance might also be doing to the overall cost of health care.   If patients are more likely to seek more care, (whether they actually need it or not) what might for-profit health care related workers and businesses also be doing because of insurance on the other side?   I also wonder if the study takes into account the reduction in the cost of care simply by nipping problems in the bud instead of people that didn’t want to be a burden to society, but who could not afford the pre-PPACA costs for insurance may have put off having an injury looked after and treated until it could no longer be ignored and they added cost of treating it at that stage versus much earlier.  

    • Bruce94

       You’re correct.  There are a lot of costs now–cost shifting and gross inefficiencies when the emergency room is used for primary care as well as huge human and social costs when an individual or family is wiped out financially by a single, unforeseen catastrophic event.

      The panel’s response seems to be that under ACA we can move on costs in three ways:  increasing out-of-pocket expenses particularly of the young and healthy, increasing taxes to pay for the universal coverage and expensive technology, improving the delivery system (didn’t hear as much on that as I would have liked), and (at least implicitly) rationing via govt. regulation, which is essentially what every other civilized, advanced country on earth does to guarantee access, maintain quality and control costs.  

      • Human898

        Thanks again for your thoughtful responses Bruce, I agree that there are costs, not just monetary, that society has had to deal with prior to any institution of health care reform.  A part of that cost may have been recognized by an icon of the political party that seems to represent the opposition to health care reform.   

        Ronald Reagan signed into law the mandate that ER’s could not turn anyone away.   Either he didn’t carry through the impact that would have on the cost of insurance for the insured or he may not have thought about the costs of ER care versus an office visit to a GP or clinic where at least some care could be administered that would prevent progression of an ailment or injury to the point it would require not just an ER, but much more extensive and expensive treatment.
        http://www.salon.com/2012/07/05/reagans_healthcare_mandate/

        I think you are correct that in many ways we are shifting costs more than necessarily adding a bunch of new ones, but for opponents of reform, because their profit margins are or might be squeezed, discussion about cost shifting, dilutes the notion that there is a huge ongoing cost added by the PPACA.   Without all parts of it implemented, especially those parts that direct where insurance premium revenue goes (putting more of it to care, rather than profit and marketing.) costs are doing as they did prior to the PPACA.

  • creaker

    I love how they talk about “consumption” of healthcare like it’s cake and cookies, something you can choose or choose to go without. For many folks it’s life and death – or being a functional citizen or permanently disabled.

  • hennorama

    Which American experiment do you prefer?:

    1.  A policy of unprecedented preemptive war, with estimated costs to date of about $1.7 Trillion (and total costs estimated up to $8 T), resulting in the deaths of and wounding of hundreds of thousands of people and the displacement of millions, and with questionable benefits to the U.S.  Among the dead:

    4,488 U.S. military

    up to 3,400 U.S. contractors

    nearly 11,000 Iraqi police

    318 allied military

    62 humanitarian workers

    - or -

    2.  A policy of providing increased health care access and cost coverage to tens of millions of Americans, with projected net costs of $1.33T from 2013 through 2023, and from which more than 100 million Americans have benefitted in some way thus far.

    Sources:
    http://costsofwar.org/sites/all/themes/costsofwar/images/Us_Costs_of_Wars.pdf
    http://mideast.foreignpolicy.com/posts/2013/03/20/the_iraq_war_ten_years_in_ten_numbers
    http://www.nationaljournal.com/daily/obamacare-at-age-3-still-too-young-for-prognosis-20130319
    http://www.cbo.gov/sites/default/files/cbofiles/attachments/43900_ACAInsuranceCoverageEffects.pdf

    • William

       But the Obama care is being sold by the same crowd (political elite government class) that sold us the Iraq/Afghanistan Wars. So why trust them?

      • hennorama

        William – TY for your response. I respect your views.

        Without comment as to the premise of your post – why trust the political elite government class – trust is not the issue.

        Both policies are past and present realities, and highly likely to continue on into the future. My question is which policy one prefers. It’s not that we HAVE choice in the matter, of course.

        Given that these policies are arguably the central policies of the current and most recent past Presidential administrations, and given that both policies were optional, with relative equality of economic costs to the US Treasury, I thought the contrast was interesting.

        • William

           We have been sold numerous “fixes” for social problems and few if any actually worked.

    • pete18

      This is you best defense of Obama care, comparing it to the Iraq War?

      The only similarity may be that the country will ultimately demand an exit strategy from the ACA because it’s failure to deliver on any of its promises: http://reason.com/archives/2013/04/02/obamacare-is-obamas-iraq

      • hennorama

        pete18 – TY for your response. I appreciate and respect your views.

        If I HAD been posting in “defense of Obama care” you might have an argument. Rather, I was asking a question, and listing some characteristics of two very different policies. I also included the source(s) for various items in my post, so the reader can decide for themselves if my post is factual, true, and honest.

        As I replied to another poster, “Given that these policies are arguably the central policies of the current and most recent past Presidential administrations, and given that both policies were optional, with relative equality of economic costs to the US Treasury, I thought the contrast was interesting.”

        If you define that as “defense of Obama care”, so be it.

        TY again for your response.

  • N. Chrystine Olson

    What a treat to be in the audience for the taping of the show. I’m the “Chrys from Cookeville” with the fluffy question about Nashville’s status as America’s cooest city. Would have asked something meatier about Obamacare and how it’ll work in Tennessee but the comma threw me off. Thought both hours would be taped here…first on Nashville,THEN on Obamacare. Thanks for using it ANYWAY. Always good to make an audience chuckle. My husband is kinda surprised at the gender shift though, didn’t realize we were in a same sex marriage ;)

  • Gordon Green

    Oh please.  The person complaining that the Affordable Care Acts was not passed with bipartisan support is making a preposterous point.  The act includes all kinds of compromises (remember all the things that were “off the table” – single payer, public option, medicare for all, etc., etc??), but the republicans were hell bent on obstruction from the get-go.  It was a republican plan for god’s sake!  There was nothing Obama could possibly have done to get republican support, and those who cite that as a weakness in the law are engaging in a particularly mendacious and partisan form of revisionist history.

    • Bruce94

      Yep, remember, if they could obstruct and delay healthcare reform long enough they could “break” Obama and it would become his “Waterloo” according to the Demented One–Sir James DeMint (R-SC) who is now marinating at the Heritage Foundation. 

    • StilllHere

      The majority of the compromises were to get Democrat votes.

  • Tyranipocrit

    Nothing about this plan improves health care–it is still a plan for the rich, that denies care to the poor–
    bronze care–wont cover surgeries, heart troubles, anything serious–
    silver and gold are for the upper classes

    and it illegally forces us all to put money into the coffers of private corporations to enrich them while denying health care to the same people who have traditionally been denied health care.

    It is not the “law of the land” our laws are made by a fascist corporate-aristocracy and thereby illegitimate.

    i will never pay into it. It is a fraud.  This show was a complete fraud and a joke.

    I am a progressive and despise tea baggers and Republican fascists –

    Wake up people–you live in the 4th reich.

  • Frank TheUnderemployedProfessi

    I love how the establishment commentators (including Tom) are completely oblivious to the real root cause of our healthcare problem.  I am tempted to say that they are unaware of the real problem, but I tend to think that they are more intellectually dishonest than completely ignorant.

    The problem is not that Americans have an irrational and mindless insatiable desire for healthcare that is metaphysically impossible to fulfill.  The problem is that, with or without Obamacare, our quasi-free market system is the world’s most expensive and inefficient system.

    Right now we are spending about 17% of our GDP on health care while tens of millions of people are uninsured or under-insured.  Meanwhile, each year we have hundreds of thousands of medical expense induced bankruptcies and a terrified populace.  Our businesses are also burdened by health insurance costs and concerns.

    In contrast, other first world industrialized nations spend much less than 17% of their GDP (and also in absolute dollars per capita) on health care while having 100% coverage, zero medical bankruptcies, a more contented populace, and businesses that don’t have to worry about benefits and health insurance issues.

    Is it possible…could it be possible that the basic economic framework of our healthcare system is fundamentally flawed?

    Could it be possible that in reality evil evil socialism (Run for your lives you brainwashed free market dogmatist sheeple!  Fear!) is a superior method of providing healthcare?  (Facts are facts, even if we don’t like them.)  Could it be possible that a large part of our healthcare problem is that an inordinately large percentage of the healthcare dollars are spent on people who do not actually provide health care such as highly compensated insurance company and hospital executives, company benefits plan managers, health insurance brokers, medical billings specialists, and billing department personnel, etc.?

    When you step back and think about it, you have to wonder how the hell our silly backwards nation ever put a man on the Moon.  In this case it isn’t even necessary to invent a new healthcare system.  Instead we need to merely study what numerous other nations are doing.

    In short, for this and numerous other reasons, the United States has become a Nation of Morons infested with “no-think” free market dogmatist Tea Party ‘Tards and Christian Taliban.

ONPOINT
TODAY
Jul 23, 2014
In this Saturday, July 12, 2014, photo, migrants walk along train tracks and boxcars after getting off a train during their journey toward the US-Mexico border, in Ixtepec, southern Mexico. (AP)

Crisis at the US border. What do Latinos on this side of the border have to say? We’ll ask our special roundtable.

Jul 23, 2014
Actor Wallace Shawn attends special screening of "Turks and Caicos" hosted by Vogue and The Cinema Society at the Crosby Street Hotel on Monday, April 7, 2014 in New York.  (AP)

From “The Princess Bride” to “My Dinner with Andre “and “A Master Builder,” actor and writer Wallace Shawn joins us.

RECENT
SHOWS
Jul 22, 2014
Lt. Col. James Howard Williams, aka "Elephant Bill," is the hero of Vicki Constantine Croke's new book, "Elephant Company." (Courtesy Random House)

We’ll travel to the jungles of Burma for the remarkable true story of Billy Williams—aka “the elephant whisperer”—and his World War II heroism.

 
Jul 22, 2014
Smoke rises after an Israeli shelling at the Shijaiyah neighborhood in Gaza City, Monday, July 21, 2014. The top Hamas leader in the Gaza Strip signaled Monday that the Islamic militant group will not agree to an unconditional cease-fire with Israel, while Israel's defense minister pledged to keep fighting "as long as necessary," raising new doubt about the highest-level mediation mission in two weeks. (AP)

The escalated Gaza offensive. We’ll get the views from both sides and the latest developments.

On Point Blog
On Point Blog
Our Week In The Web: July 11, 2014
Friday, Jul 11, 2014

As we prepare for a week of rebroadcasts, we reflect on Facebook posts, misplaced comments and the magic of @ mentions. Internet, ASSEMBLE!

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Two Former Senators, One Fix For US Democracy?
Thursday, Jul 10, 2014

Former US Senators Tom Daschle and Olympia Snowe joined us today with a few fixes for American political inaction.

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Future Radio Interns Of America: On Point Wants YOU!
Thursday, Jul 10, 2014

On Point needs interns for the fall. Could YOU be one of them?

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