Comments on: 4 Questions to Ask When Analyzing Any Health "Reform" Proposal

By: SJ Seeking Reform

SJ Seeking Reform — Mon, 21 Jul 2008 20:27:38 +0000

Dr.SteveB
I believe HR 676 is the best antidote to our ailing health care system and have spoken to many others who think there are different solutions. Thanks for leading me to think about four simple questions regarding the many proposals for “universal reform” to help people get through the maze of diversions on this important topic. The rhetoric is confusing and people need to consider the sources and motives.
1. How did I learn about it, is it described or promoted by an organization or media outlet that receives significant advertising revenue from the corporate system of big medicine or big insurance? People need to be skeptical consumers of information and carefully consider the origin of the info. There are too many questionable, potentially self-serving agendas from various organizations and individuals. AARP is now training an army of well-intentioned volunteers to go out and speak to groups of people. Their magazine is loaded with insurance and drug-company advertising but people still seem willing to trust them.
2. Is it elitist, or truly universal, comprehensive and humane with coverage that includes all U.S. residents for all conditions and necessary treatments while preventing providers and facilities with a preference for more lucrative payment plans to opt out? Enabling the healthy and wealthy to have availability and standards of care with reduced availability and standards for others is unjust, inhumane and (when subsidized) a waste of taxpayers money. There must be true choice of provider so sick people with low incomes are not pushed into a two-tiered system limited to a few overcrowded, overstressed medical providers.
3. Does it follow a successful model based on experience from this or another country with high quality health outcomes, and lower costs? Fragmented, incremental change is a diversion that wastes money, time and energy while sick people suffer because sweeping reform is what is needed. Our own experience with Medicare and successful plans from other countries can show us the way.
4. Follow the money, where does it go and who benefits? Patients and health care providers should be the beneficiaries. Financial resources must not be siphoned-off and diverted to non-medical systems. Taxpayer funds should not be diverted to obscene corporate profits and drug prices need to be negotiated and regulated. It’s sad to think of the many people who struggle to make ends meet, pay their taxes and insurance then fall into bankruptcy after an illness takes everything from them in order to support insurance, pharmaceutical and other executives who live like royalty.

By: EvaB.

EvaB. — Fri, 11 Jul 2008 18:06:42 +0000

Insurance which is tied to employment is not reliable, as people can lose jobs which come with benefits. Universal coverage needs to be funded with some % of everyone’s incomes, or government-provided, as is Medicaid, for people without income. Employers, like me, should pay a tax in lieu of providing insurance for employees.

By: Bob the Health and Health Care Advocate

Bob the Health and Health Care Advocate — Thu, 10 Jul 2008 00:21:20 +0000

What about “Mostly or exclusively non-profit?”

The 4 questions deal with cost and coverage
1. Everyone covered? 2. All care covered? 3. Individual cost? 4. Overall cost?

Focusing on #3 and #4 for a moment …

A bottom line question: will the complex “for-profit + government” bureaucracy involving 50 states be replaced with a simple “non-profit public agency” with the existing 10 Medicare regions … in order to achieve a high degree of efficiency that will provide the most positive initial impact on the costs for individuals and the country?

Since at least a 1991 U.S. Govt Accounting office report, it’s fairly well-known that non-profit single-payer efficiency and the associated elimination of bureaucracy will allow everyone to be covered with the same money or less. Thus, it seems like an associated question can be whether or not the health reform will be non-profit and will eliminate the bureaucracy of 1300+ health insurance companies and multiple programs that involve the federal government and 50 states.

Bob Haiducek Bob the Health and Health care Advocate
http://www.99oh9.org

By: ERdoc

ERdoc — Wed, 09 Jul 2008 21:08:20 +0000

One other element has to be present in any health care reform in the US…people must be given the option to obtain health care outside of the single payer system if they choose to…reform is not taking place in a vacuum – the current private, employer driven system insures nearly 90% of those citizens who actually vote, and unless we can come up with an unequivocally as good or better coverage for these people, focusing on the uninsured (or even underinsured) who disproportionately don’t vote is futile. The voting/employed public must be given the option to pursue other /extra care if they can afford it (a la Great Britain)…in order to get universal coverage under a single payer, by all means everyone must pay/play and be part of the large pool, but this is America and coercing the upper middle class to accept a new system that locks them into standard care/fee schedules will only produce very effective opposition. The analogy is in education, where everyone pays into the single (public) system but can pursue free choices. The tax deduction will probably have to disappear eventually as well in order for everyone to be in the same boat tax wise, if not care wise. We cant achieve a utopian “everyone gets the same care” notion and single payer . We can achieve single payer, and baseline care for all regardless of ability to pay/employment/age if we allow affluent Americans to pay extra, at least for amenities such as private rooms, etc. Single payer can prevail in the US, but not a la Canadian -physicians need to decide if they want to transform health care in this country or are simply make a political statement ?

By: JillSH

JillSH — Wed, 09 Jul 2008 19:13:54 +0000

About item #3:
I feel we need to talk about the cost of health insurance as a personal percentage of income.

In our society, if you go for a mortgage, get a divorce, apply for welfare, etc., there are standards of how much of your income should be spent on housing, transportation, food, etc. We need to assign a portion to health care. And it should be the TOTAL cost, premiums plus all out of pocket.

The most direct route to this is, of course, a progressive tax that would support the single payer system. If we pay that way, we would never lose coverage if our income goes down, or we’re unemployed, or if we only work part time. And put an end to medically induced bankruptcy.

And then all those wages currently being lost to increasing health insurance costs might end up back in our pockets (at least, if the corporations don’t call them profits instead).