Posted by teri, a resident of another community, on Aug 1, 2009 at 7:59 am
Somebody needs to tell the Ragin' Grannies that socialists don't mind abortion for fetuses OR seniors! Seniors that have woken up are dearly protesting this health care control program. You have to be insane to let the government come between you and your doctor just because you want taxpayers to pay the bill. For example, under Obama's plan, you will have "coverage" that pays for routine care (if you can find a doctor in the next 6 months). If you have MS, it won't pay for any new treatments that come along because they will be too expensive and therefore deemed "experimental". Doctors fear there won't even be anybody LOOKING for new stuff- since it won't pay.
Posted by Rhonda, a resident of the Woodside: other neighborhood, on Aug 1, 2009 at 8:11 am
I am a health care provider. Should this plan get passed into law, I, like many of my colleagues will retire (or call it quits). Medicine will no longer be like it is today, will no longer attract the bright minds to this profession, and the pool of docs will dwindle. THEN try to find a new doc! If this plan is as odius to other providers as it is to me and my circle of doctor acquaintances, it's going to be a challenge to find a doc. At first, I will close my practice to new patients. When the office is no longer is able to provide the level of care needed, I'll be gone!
Posted by Libbie, a resident of another community, on Aug 1, 2009 at 2:49 pm
I support the Raging Grannies in their work for single payer health insurance. The state of California allows health insurance companies to not underwrite people with certain health problems, that they consider pre-existing conditions. How are these people supposed to get health care?
All people need to have health care! Not everyone is married or works in a large company.
Posted by sick and tired, a resident of the Menlo Park: Linfield Oaks neighborhood, on Aug 1, 2009 at 10:15 pm
Dear Rhonda, You will quit because medicine will be no longer what it is today? Well good riddance. I don't know what role you play as a "health care provider," but anyone who can bemoan possible changes in the obscene, corporate driven "health care" system we have today has zero credibility as someone who cares about people rather than profits.
Surveys of doctors show that in the main family doctors, those who have been known as "general practioners," and others who work with general health issues support universal health care and getting the profit motive out of the picture. MDs who support the status quo are in the main the specialists who milk the system, some of whom now have "boutique" practices for the wealthy.
The propaganda against single-payer health care reform that's being orchestrated right now by the right-wing corporatocracy is revolting, and all too predictable. The dishonest, scare-tactic dreck put forth by "teri" and others like her is despicable. Have you no conscience?
Posted by anonymous, a resident of another community, on Aug 7, 2009 at 9:35 am
For those who complain about the inadequacies of today's healthcare system, consider this.
Whether you have insurance or not, whether you are a citizen or not, get into a bad car accident and you'll find yourself at one of the world's finest medical centers (Stanford) getting the exact same treatment and care as a rich executive with a deluxe insurance plan. That happens dozens of times each day.
That said, I think our country is clearly capable of doing something for (a) citizens that (b) can't afford to buy their own insurance.
By nearly all estimates, that's about 15 million people (not the 45 million often cited which includes 10 million people who can easily afford to buy their own insurance but choose not to, about 8 million who already qualify for government assistance and about 12 million non-citizens). We can easily and inexpensively solve this problem for these 15 million people without changing the healthcare for the 250 million other people who have insurance and are relatively happy (80% by current polling!) with their current coverage.
Posted by stop the stupidity, a resident of the Menlo Park: Central Menlo Park neighborhood, on Aug 7, 2009 at 10:43 am
Anonymous from "another community," Your insurance plan obviously covers happy pills and rose-colored glasses. You're parroting the same dreck, on cue, as the industry-funded campaign to defeat meaningful reform of health care in this country, which is now an utter disgrace and is breaking the back of our economy.
So 80% are relatively happy with their coverage? Polls are funny, aren't they? It all depends on how questions are asked -- skilled propagandists can guarantee the outcomes of polls they design.
What about the polls that say well over 70% of Americans want a government funded option for health care? Are they happy with their health care? More than likely, they're frustrated and concerned about having ever more money taken from their paychecks for health insurance for themselves and their families every year, and worried about the increasing costs of their co-pays. They probably don't think much of having insurance industry bean counters dictating to their doctors what they can and can't offer to them to treat their illness, either.
As for the self-employed -- I REALLY don't think you even want them brought into the equation, given the unsustainable costs of their insurance and its double-digit cost increases every year.
Wake up, people. Tune out the propaganda. Don't jump on the stupidity bandwagon. Do your own research using credible sources. (The Menlo Park based, nonprofit, nonpartisan Kaiser Family Foundation would be a good place to start.) The propagandists are organized and determined to kill what could be the start of real health care reform. Don't let them!
Posted by Jerome, a resident of the Portola Valley: Woodside Highlands neighborhood, on Aug 7, 2009 at 12:35 pm
Every year, I pay more for my health insurance and get less for my money. Anyone who thinks health care reform isn't needed is either cashing in on the current situation, or being duped by Rush Limbaugh and Fox News.
Posted by anonymous, a resident of another community, on Aug 8, 2009 at 10:06 am
Anonymous here and thanks to "stop the stupidity" for your very courteous and thoughtful reply (and we thought it was the right wing protesters at town meetings that were rude!)
Thanks for the suggestion to check out the Kaiser Family Foundation web site. I was actually referencing a Kaiser poll when I noted that nearly 80% of today's insured were satisfied with their curent health care coverage. Perhaps even more revealing is the data from people in most need - 96% of those who RECENTLY experienced a "serious illness" were satisfied with their care. I know, go figure. Facts are stubborn things, aren't they?
As far as your comment that 70% of Americans want a government run health care plan, I would bring this link to your attention. it's from Politco.com (not exactly Fox News, is it) and it is fresh data. If anything, the support for a government plan is waning. Here's the link: Web Link
And you don't have to be rude, call people stupid, or ask your supporters to email you the names of dissenters at Town Hall meetings(as our White House did last week) just because they don't agree with you. (You have to admit that if George Bush had done that, it would have been the lead story on every single network and newspaper in America.)
Posted by Frances Griffin, a resident of the Menlo Park: University Heights neighborhood, on Aug 9, 2009 at 1:40 am
Everything opponents are saying about proposed reforms was said in the 60's about Medicare. But seniors overwhelmingly like their Medicare coverage. I thought I had good coverage when I had employer-based insurance, but Medicare is better in every way. Newsflash: it is a single payer plan. My only concern about the proposed reforms is that they are not enough like Medicare.
Posted by we need reform, a resident of the Menlo Park: Central Menlo Park neighborhood, on Aug 9, 2009 at 5:39 pm
Wall Street is in the middle of decisions made by physicians and other healthcare providers. I worry more about that than the government. But let's be honest, the proposal is not that the government take over but for there to be an option available so everyone gets healthcare insurance and care if it isn't available through their employment. I don't believe there is any place for for-profit insurance and healthcare companies in this industry but this proposal doesn't get rid of them, just requires them to stop denying coverage for pre-existing conditions and to provide standard level of coverage.
Posted by we need reform, a resident of the Menlo Park: Central Menlo Park neighborhood, on Aug 9, 2009 at 6:12 pm
Sorry 'Miss". The administration's proposal is not single payer. It's really about making sure that everyone will be able to get care. It keeps current payors in place, and adds an option.
We are probably regarded as very rich, but when COBRA ended, we couldn't find health insurance anywhere close to the comprehensive coverage when I was working - at any price - except through Kaiser. Despite paying premiums to the same insurance company for many years, all of a sudden we were considered "uninsurable" due to vague pre-existing conditions. I can tell you many horror stories about payment for care being denied. You must be lucky, and you don't appreciate that the system is really broken now.
Posted by anonymous, a resident of another community, on Aug 10, 2009 at 7:59 am
If this bill included getting rid of pre-existing conditions, tort reform, and allowing insurance companies to sell across state lines, I would probably favor it.
The promise that you can "keep your current insurance" if you want is truly hollow. The current House bill says that if you lose your current health insurance for any reason (including layoff, termination of your job or even switching jobs), you MUST switch to the government program. This means that eventually - probably in a pretty short time - the private system will collapse and everyone will be on the government system.
I'm very fearful of government making these decisions. In England, people now routinely refer to NICE (that's their National Institute for Health and Clinical Excellence) - the agency that chooses which therapies, drugs and patients will get care - as NASTY (Not Available Anymore So Treat Yourself!). And I used to work at a hospital that catered almost exclusively (better than 50% of our patients) to Canadiens who came across the border for health care that they couldn't receive in Canada. Please don't tell me it's so much better under a government run system. I'll take my Blue Shield and Palo Alto Medical Foundation anytime!
Posted by we need reform, a resident of the Menlo Park: Central Menlo Park neighborhood, on Aug 10, 2009 at 8:28 am
What is wrong with the kind of "government" program that our Senators and Representatives have? It is administered by private companies.
And what is wrong with the VA system? It is regarded as an outstanding care provider (certain benefits could be better, such as mental health, but that's an even bigger issue in private sector), and totally paid by government.
I have seen "rich" friends nearly bankrupted by family member health problems, and others' ailments worsen because of delays and denials of care prescribed by physicians. We cannot afford the current Wall Street-run health system.
People are also beginning to notice (as the CBOE has pointed out) that the proposed reform does little or nothing to reduce health care costs. It simply replaces the insurance company with the government.
It would be nice to see real reform where costs can go down!
Posted by Ethan, a resident of the Menlo Park: University Heights neighborhood, on Aug 10, 2009 at 1:47 pm
Here's how it goes all too often in the real world, folks:
Let's say you come in to the office one morning and a couple of HR people call you over to a meeting room and tell you that "there is no longer a business need for your position." Seems the company is laying off quite a few people, partly because having to pay for all those employee benefits is cutting too much into the bottom line.
Then the HR folks give you some papers to sign, one of which informs you that you can continue your present corporate healthcare insurance at the rate your employer pays. Not a bad deal, actually. That's COBRA, which is mandated by federal law.
But 18 months later the COBRA runs out, times are tough, and you still haven't found a permanent job. No health insurance. So you apply for an individual plan. But you're 49 years old, so the only affordable policy you can find has a deductible of over $5000 and a co-pay of 30%, and it's still going to cost you more than $500 a month. But the choice is no insurance at all, so you go for it.
Then you turn 50, and the premium goes up 22%. That's an automatic increase, based on your age. You check the policy to see what it's going to cost you when you're 60 and gulp. A few months later the premium goes up another 20%, this time due to "increased medical costs." The cover letter tells you how horrible it would be if you dropped your policy.
You can't afford it, so you ask about a lower-cost plan. Sure, there's a new one available for $100 less a month. But it doesn't cover your prescription drugs, which will now run you at least $50 apiece -- for generics. You look around, but you can't find a better deal from another insurance company. You start to realize none of them really want to insure somebody your age.
Better cancel that colonoscopy the doc wanted you to get and those other lab tests. And maybe even split the blood-pressure pills in half. But thank god you finally found a job. Problem is, the pay isn't that great. And. . .they don't offer medical coverage.
Worst-case scenario? Uh uh. Suppose you have a pre-existing condition and you can't get individual insurance at all, or they want you to pay $1500 a month for it. That's "rationing" with a vengeance. Or suppose you get sick and go for treatment, but the insurance company denies you coverage, after the fact. You forgot to disclose you had a vaguely similar problem when you were 13. You can submit your case to "neutral" arbitration, as required by your policy. But guess what? The insurance companies win those disputes almost 100% of the time. After all, they write the fine print.
But of course stuff like that only happens to deadbeats, losers, and illegal immigrants. You know, people who don't live in Woodside or Atherton.
Posted by A local MD, a resident of the Portola Valley: Central Portola Valley neighborhood, on Aug 10, 2009 at 2:30 pm
I think a single payer system would be the ideal. Any doctor who says they would retire in such a system is just giving doctors a bad name and appears to be greedy. I think that basic health care should be right. Do you folks really think that a for-profit insurance company cares about your well-being? Their goal is to keep as much as possible of your hard-earned premium dollars for profits for their stockholders and multi-million dollar bonuses for their CEO's. Medicare may not be perfect, but you don't see Seniors refusing to use it, do you? A better version of Medicare would cover everyone and permit free choice of doctors. And you don't see Medicare euthanizing people, do you? It's time to start being more critical of the demagogues who are trying to support huge profits for pharmaceutical companies and private health insurance companies. A single payer system is ideal for this country.
Posted by YAY, a resident of the Menlo Park: other neighborhood, on Aug 10, 2009 at 3:29 pm
I can't wait until the people who so professionally and competently run Social Security, IRS, Medicare, Cash for Clunkers, Indian Reservations, and the rest of our goverment are running health care...those will be great days. For anyone who has ever had to deal with the government for ANYTHING, this is a frightening prospect.
Posted by say no to demagogues, a resident of the Menlo Park: Allied Arts/Stanford Park neighborhood, on Aug 10, 2009 at 3:51 pm
YAY, On many occasions, I have had to deal with the government for Social Security, IRS, DMV, voter registration, unemployment insurance, etc.
I've also had to deal with AT&T (India), Chase Bank Cards (India), Kaiser (endless phone trees, dicey care), Macy's (India), private insurance companies (endless phone trees - in India?), PG&E (endless busy signals, hope the wind doesn't blow too hard), etc.
I would rather deal with a government agency any day of the week, any hour of the day, for anything, especially if my life might depend on it. Your "frightening prospect" is just plain silliness and/or demagoguery.
Posted by Ethan, a resident of the Menlo Park: University Heights neighborhood, on Aug 10, 2009 at 4:55 pm
Yeah, we wouldn't want a bunch of government bureaucrats running the healthcare system. Much better to run it with insurance bureaucrats whose corporate mandate is to keep 20 cents of every dollar spent in premiums. No DMV for us. We'd rather have Enron.
BTW YAY: People on reservations receive government-funded healthcare from the Indian Health Service. But I guess we all can't live out there in Indian Country.
Posted by YAY, a resident of the Menlo Park: other neighborhood, on Aug 11, 2009 at 6:22 am
Say no to demagogues...I disagree...and I cannot name one government department or buraucracy that is run well...not one. Ethan...go to Arizona and go on an Indian reservation...they make EPA look like paradise. The government is not our daddy and is trying to go way beyond the scope of their constitutional powers. How about we try some real tort reform and bring costs down before we go completely socialist. Don't believe the hype...READ THE BILL YOURSELF. I am sure you will be astounded.
Posted by anonymous, a resident of another community, on Aug 11, 2009 at 9:25 am
Some of the posters have charged that those against the current House bill are spreading propaganda and they counter by saying the vast majority of Americans support this. The link below is to a poll that was published TODAY. Sorry, most Americans DO NOT support this.
Being in the majority doesn't make anyone right or wrong... but I'd appreciate some intellectual honesty. Those who want a single payor system are a minority. Against the legislation include (a) those who recently experienced a serious illness, (b) seniors and (c) the vast majority (around 80% by a recent Kaiser survey) of those with existing private health care coverage - that's about 250 million of us. We should be able to provide healthcare to the 10 to 20 million Americans who don't have insurance without impacting the other 250 million who do.
Posted by Confused, a resident of another community, on Aug 11, 2009 at 2:16 pm
As someone who has private health care through my work and never had a major illness, and have actually had no problems with the cost/coverage of my health care, I still don't get why people are so against the reform. It's so easy to say No, and just move on, even when I think things are getting worse. The people I laugh at are the ones who say no government involvement in my health insurance, yet they're on medicare already! Also, the government already regulates the insurance companies to some extent. Paul Krugman of the NY Times I thought wrote a great piece about it recently. One of the points I think he made very well is that free market doesn't work for health care. Free market means maximum profits and efficiency right? In health care that means finding as many people to pay premiums without using service. They do this by denying as many "problem" people as possible, and fight as hard as possible not to pay for your procedures. One of the best ways to increase profits is to hire more underwriters to deny claims basically. You want this thinking to continue? These insurance companies aren't in it for the good of the people by any means.
I just don't get how anyone could say No in general to reform. Maybe to some parts of the plan that should/could be better, but thinking everything's fine is extremely ignorant I think.
Posted by Ethan, a resident of the Menlo Park: University Heights neighborhood, on Aug 11, 2009 at 3:21 pm
Here's what Wendell Potter, a former Cigna exec, had to say about health insurance companies on national TV (direct from the transcript):
"Well, there's a measure of profitability that investors look to, and it's called a medical loss ratio. And it's unique to the health insurance industry. And by medical loss ratio, I mean a measure that tells investors or anyone else how much of a premium dollar is used by the insurance company to actually pay medical claims. And that has been shrinking, over the years, since the industry's been dominated by, or become dominated by, for-profit insurance companies. Back in the early '90s, or back during the time that the Clinton plan was being debated, 95 cents out of every dollar was used by the insurance companies to pay claims. Last year, it was down to just slightly above 80 percent. So, investors want that to keep shrinking. And if they see that an insurance company has not done what they think meets their expectations with the medical loss ratio, they'll punish them."
Very simple, really. The more care the companies can deny or avoid paying for, the better Wall Street likes it--and the higher the executive bonuses. So essentially your access to healthcare is determined by the boys in the Brooks Brothers suits. They're the "single payers" in the current system, and they really don't like to pay because it comes right out of their pockets.
Posted by anonymous, a resident of another community, on Aug 11, 2009 at 4:01 pm
I'm not sure anyone is going to change anyone else's mind although the country is clearly moving away from supporting this "reform." I find it very telling that seniors and those who were recently sick - the two groups with the most experience and the most at stake - are overwhelmingly against change.
The reason most people like the current system is that they generally get good treatment for their illness or injury. No, that's not always true - but it won't be true for a government run system either. Even proponents admit that.
That said, I agree with the earlier posts about the profit motive in health care. It's an unusual "market" because the consumer (patient) doesn't pay the provider (doctor or hospital) for the delivered service. That's done by a third party (insurance company). Imagine if you told someone that they could get any food they wanted at Safeway and someone else will pay for it. There will be a lot of waste simply because they're not paying for it. Now if you had to pay for the first thousand dollars, you might have a different story.
My issue - and I don't think I'm stupid, ignorant or confused, thank you - is that there is very little reform in the current proposals to change that market paradigm. The House bill simply replaces the insurance company with the government. Until we shift more cost to the consumer (patient), they have little or no incentive to reduce spending at all.
Finally, I think it's deceptive for our elected officials to say that we can keep our private insurance if want to. Many employers - including all of the auto manufacturers and big industry - will opt for the proposed 8% payroll tax and shift employees to the government system instead of paying about 12% of payroll in insurance premiums today. So even if you like your current insurance coverage, you really won't get to keep it.
And, of course, with fewer insureds to share risk, private insurance companies will have to raise rates and eventually they will go out of business. But, of course, that's the true objective of "reform," isn't it? Proponents should just be honest enough to admit it.
I'm all for helping the 10 to 15 million uninsured Americans who cannot afford insurance. You don't have to impact the other 250 million Americans who don't need or want it.
One final question that no one has addressed. Social Security and Medicare are already going broke. How in the world are you going to pay for this - the largest single entitlement program ever devised?
Posted by Ethan, a resident of the Menlo Park: University Heights neighborhood, on Aug 11, 2009 at 10:38 pm
>>Now if you had to pay for the first thousand dollars, you might have a different story.<<
Try the first FIVE thousand dollars, Anonymous. With a 30% co-pay. For a premium of $700+ a month. Next year it'll be more. And more the year after that. That's your fate if you're self-employed and over 60. How many people in this country do you think can afford that?
The sad fact is, most of those who get healthcare insurance as a job benefit are simply living in a fool's paradise. They have no idea how much their employers are paying to insure them (still a lot less than what they could negotiate on their own), and they're just a pink slip or an HR "benefit reassessment" away from a very rude awakening.
Of course, if you're over 65 you're essentially home free. That's when that socialistic Medicare kicks in. One of the reason it's "broke" now is that it only covers old people, who obviously are the heaviest users of healthcare. Broaden the risk group to the rest of the population and you bring down costs considerably. Here's a thought: That notorious Bolshevik Dick Nixon once floated a national healthcare program.
Yeah, cost is still an issue. How about we skip the next oh-so-necessary trillion dollar war and invest the money in the health of our citizens instead? And maybe stop socializing risk and privatizing profits in the financial sphere while we're at it. That might free up a few bucks.
But whatever you do, don't quit your day job. Or annoy your boss.
Posted by hurting, a resident of the Menlo Park: University Heights neighborhood, on Aug 12, 2009 at 8:05 am
Well put, Ethan. But don't forget that not everyone who works is coveraged by their employers. I happen to be, but even so, the amount taken out of my paycheck to support my health care goes up every year (which always hurts but even more this year when the company slashed salaries), my co-pays continue to go up every year, and the cost of medical procedures and prescription drugs continue to increase.
Posted by anonymous, a resident of another community, on Aug 12, 2009 at 10:15 am
My reference to an individual paying "the first thousand dollars" did not refer to deductibles under today's private system. You may have missed it - it was in the same sentence - but it was under the proposed system where everything is essentially free. If everything is free from dollar one, then there is no incentive for patients (the real gatekeepers) to reduce costs. With no incentives to reduce cost, we are only substituting government for insurance companies... which you may prefer, but don't think you're getting reform.
But no one has yet to answer the question "who is going to pay for this?" No, you won't have to pay that horrible 20% or 30% of your employer's insurance premium payments or those nasty co-pays anymore... you'll just have to pay 8 or 10% more in income taxes.
Posted by Diana, a resident of the Menlo Park: Allied Arts/Stanford Park neighborhood, on Aug 12, 2009 at 10:36 am
Anonymous, Your condescension and obvious scorn for those with less money and less luck than you apparently have is disgusting.
You're conveniently ignoring several facts, including the way the current system is spiralling out of control. And how that affects those of us who are struggling with "those nasty co-pays," which are increasing all the time, and who have more and more money taken from our paychecks every year.
You're also conveniently ignoring the plight of people in Ethan's situation, who are self-employed, paying $700-plus a month for insurance (I know people who are paying well over $1,000 a month), and facing double-digit increases most if not every year.
Have you run the numbers? Some who have, whose credentials are more trustworthy than an anonymous poster from "another community," say the amount of increased taxes won't be any more onerous, and might even be lower, than what many working people are paying right now.
AND, everyone will be covered. The taxpayer is already footing the bill for the uninsured AND for seniors on Medicare.
AND, medical professionals will be making the decisions about what care we should have, rather than medical know-nothings in the insurance industry whose only concern is the bottom line and their resulting salary and bonuses.
If you really want to convince people that your position on this issue is the correct one, Anonymous from another community, you really ought to supress the ridicule and lack of concern you feel toward those less fortunate than yourself. It doesn't go down well with those of us who are barely surviving.
Posted by anonymous, a resident of another community, on Aug 12, 2009 at 11:07 am
I didn't mean to be condescending or scornful. But I'm still politely waiting for an answer about you propose to pay for this one trillion dollar entitlement program. No scorn. No condescension.
I'm all for helping the 10 to 15 million Americans who cannot afford insurance. It seems like you're not happy - but 80% of the 250 million Americans (see latest NY Times poll) who are insured are and their opinion counts as much as yours.
Posted by it's about time, a resident of the Menlo Park: other neighborhood, on Aug 12, 2009 at 11:40 am
Those 80% of satisfied customers are notably absent from this board. Too blissed out on prescription drugs to post? I don't know any consumer who is happy with the current system. Those with Kaiser coverage seem the least unhappy, but everyone except anonymous seems to agree the health care coverage system is flawed -- including those of us who have insurance. Similarly, I don't know any care provider who appreciates being told what to do by the insurance company customer service people, many of whom appear to be working in call centers in third world countries and need to have the names of procedures spelled out to them because they know nothing about medicine. Seems to me that the insurance companies are the only happy participants in this travesty, with boatloads of execs pulling in 7-figure compensation annually.
Sure, whatever new system is put into place will need some tweaks, but how can anyone look at the systems that are provided in Canada, France, England, dozens of other countries (without apparently impoverishing those nations!) and not feel shame that our great country is so far behind?
I expect anonymous works for one of the insurance conglomerates that is in danger of losing a chunk of profits if national health care goes through. Well, suck it up. Some of us have real jobs and we're tired of paying a fortune yet being reasonably certain that if, heaven forfend, we or our kids ever need care, our insurance company will jettison us as quickly as they can shred our policy.
Posted by anonymous, a resident of another community, on Aug 12, 2009 at 2:21 pm
Hmmm... who's being condescending now?
No, I don't work for an insurance company - never have, never will. But it's nice of you to make a totally false and unfounded allegation so easily. It says a lot about your thinking process (ie, anyone who disagrees with you must be one of those overpaid insurance executives). Not in this case.
As for the 80% of Americans that are happy with their current coverage, you only have to read the current Gallup and CNN polls. Or you can ignore them. Perhaps its simply a plot by overpaid insurance executives.
And if you think health care expenses in Canada, France and England haven't impoverished them, you need to read a bit more. All three of those countries are struggling to fund their current programs. The UK, in particular, has been rationing health care for many years.
But I'm concerned about our country. With Medicare and Social Security going broke - and no one denies that - I'm still waiting for an answer about how we're going to pay for this new one trillion dollar entitlement program.
Posted by Ms. Hippocrates, a resident of the Atherton: West Atherton neighborhood, on Aug 12, 2009 at 3:09 pm
The business model for health insurance is to charge as much as possible and pay for as few services as possible. Offer coverage to the young and healthy, and deny coverage to the old and sick. That's capitalism in action.
What other developed countries have realized is that a capitalistic model for health care has an enormous cost for society -- denial of insurance coverage to those in need, the population's loss of productivity, the need to create government programs to prevent people from dying on the streets of treatable illnesses. The cost of prevention is almost always lower than the cost of treating illness.
That's why many people support a single-payer system. Sadly, that's not what's being proposed in any of the bills currently wending their way through congress.
But instead of having a vigorous debate about health care reform, we have insurance company shills shouting in town hall meetings and Republic pundits making up ridiculous lies about the government trying to kill old people (and do what? Turn them into Soylent Green?).
If there is no health care reform, the only winners will be the insurance companies. And they are clearly willing to use any means, no matter how despicable, to make sure that that's exactly what happens.
Posted by Diana, a resident of the Menlo Park: Allied Arts/Stanford Park neighborhood, on Aug 12, 2009 at 4:14 pm
Anonymous, You seem to be fixated by this estimated trillion dollar cost of reforming the health care system, and you insist on using the inflammatory "entitlement" label (Gingrich would be proud). I won't try to interpret what that might mean, but I will try to address the "how will we pay for this" question.
From what I've heard (including from Obama) and read, the price tag of reform would be paid in part by higher taxes of those individuals who benefited from the outrageous tax cuts during the last eight years, those people in the top 5 percent of income who had their taxes slashed at the same time their boy in the White House was launching wars that will cost multiple trillions of dollars before they're over. (Where's the outcry at town hall meetings over that?)
There will also eventually be savings to the government as the new program gets medical care costs under control. Surely you wouldn't deny that they're out of control now, escalating at an unsustainable rate.
The spending that's needed to launch this reform is called "investment." Investment is not a foreign concept in a capitalistic economy. Look at the long-term spending plan for this reform. It makes solid sense financially. The government continuing to pay the costs of Medicare and other health care for the uninsured does NOT make financial sense if costs continue to escalate out of control. And they will.
Posted by Diana, a resident of the Menlo Park: Allied Arts/Stanford Park neighborhood, on Aug 12, 2009 at 4:21 pm
Oh yes. Since I'm addressing the cost issue, I may as well reiterate what I said in an earlier post: Taxes may also increase for some of the rest of us in the middle income brackets, but from what I've read, the cost of that increase should be no more onerous, and may be even lower, than what many working people are already paying for health care, through payroll deductions, co-pays and deductibles. And, our care will be in the hands of our doctors, not the insurance industry.
Posted by Ethan, a resident of the Menlo Park: University Heights neighborhood, on Aug 12, 2009 at 7:44 pm
Whether treatment will ultimately be "free" (and exactly who is proposing that?) for everyone, or whether patients will have some measure of co-pay responsibility (likely), is really quibbling over the mechanics. Are we really so incompetent as a society that we can't do a cost analysis and come up with a balanced plan that is fair to the average schmuck and also makes economic sense? Exactly how is NOT paying 20 cents of every dollar to insurance companies going to drive current costs UP? Even if your taxes do rise, at least you know your care isn't being handled by someone who has an incentive to limit or deny it.
If you're interested in a knowledgeable take on why medical costs are so high, and you haven't seen it already, check out this influential article that appeared in The New Yorker a while back:
Regarding the CCN poll that revealed how much the average American loves the healthcare system: Would that be the same CNN that has been running all the anti-reform ads sponsored by insurance and big pharma front groups? The same CNN that recently refused to run a Daily Kos ad critical of health insurance companies? As it happens, I just got a call from a Gallup pollster yesterday (really, 'tis true) that seemed to be sponsored by a national charity. The questions were obviously designed to yield data points that can be graphed and tabulated, not designed to find out in some reasonable detail what I think. Fact is, if I were asked if I'm satisfied with my healthcare, I'd say yes. I love those folks down at the Palo Alto Medical Clinic. But that's the CAREGIVERS, not the SYSTEM that they're forced to labor under.
BTW: Stephen Hawking says he gets excellent care in the UK and they didn't try to have him euthanized--not even once.
Posted by anonymous, a resident of another community, on Aug 13, 2009 at 8:40 am
Well, I'm not making any headway this this board, am I!
Fortunately, the rest of the country seems to understand the issues (or are confused or ill informed like me) because support for this legislation has now fallen to a new low. See this link: Web Link
Of course, this poll (like the CNN poll criticized above) was probably just paid for by overpaid insurance executives.
Diana - the trillion dollar bill came from the Congressional Budget Office. Sanity check: that's about 7% of the US economy (GDP = $14 trillion). Total healthcare expenditures are actually about 12%.
By the way, who's working against this reform, anyway? In exchange for leaving them out of any cost cutting (and real reform...), the pharma companies have signed on for it and, in fact, they've agreed to spend more than $150 million (that's about a week's sales of Lipitor...) in television ads to support it). The hospitals and AMA are both in. I even heard somewhere that the AARP was supporting it!
So is it really just insurance companies that are fomenting this rebellion? I didn't know they had that kind of influence. Seems like everyone else is actually on board.
Then again, maybe it's just average folks who, after watching both Republicans and Democrats, Bush and Obama so quickly and easily approving TARP, Omnibus, stimulus, auto bail-outs, bank bail-outs, AIG bail-outs, Ginny Mae and Freddie Mac bail-outs and cash for clunkers, simply think that their government is way out of control and that their Representatives need to watch the government wallet as carefully as they watch their own.
Then again, it could be a conspiracy and we're just not as informed as you.
Posted by Ethan, a resident of the Menlo Park: University Heights neighborhood, on Aug 13, 2009 at 10:52 pm
Ah, the polls. Admittedly this IS getting tedious. But just for amusement's sake, let's consider some recent examples of the vox populi as interpreted by pollsters:
CNN POLL, REPORTED MAY 29:
"Sixty-three percent of people questioned in a CNN/Opinion Research Corp. survey released Friday said they would favor an increase in the federal government's influence over their own health care plans in an attempt to lower costs and provide coverage to more Americans; 36 percent were opposed. The poll also suggests that slightly more than six out of 10 think the government should guarantee health care for all Americans, with 38 percent opposed."
FOX NEWS POLL, REPORTED THIS WEEK:
"And when asked about how the plans would affect their own family, by a much wider 15-point margin more Americans think they will be worse off than better off, while just over a third (37 percent) say the reforms would not make a difference to their family. Nearly half of Americans feel "frightened" (31 percent) or "angry" (17 percent) about the government being more involved in their health care, while about one in four feels "indifferent" (27 percent). Less than one in five Americans feels "reassured" (19 percent)."
USA TODAY POLL, REPORTED JULY 14
"Most Americans say it's important to overhaul health care this year, a USA TODAY/Gallup Poll finds, but they are less enthusiastic about some of the proposals to pay for it. By 56%-33%, those surveyed endorse the idea of enacting major health care changes this year. Just one in four say it's not important to them."
GALLOP POLL, REPORTED JUNE 17
While the public trusts the views of doctors the most, more than 6 in 10 Americans are also confident in university professors or researchers who study healthcare policy (62%) and in hospitals (61%). At 58%, Obama fares better than congressional leaders on both sides of the aisle; however, the Democratic leaders in Congress have more credibility on healthcare reform than do the Republican leaders: 42% vs. 34%.
USA TODAY/GALLUP POLL, REPORTED YESTERDAY
"A poll released later today about the [town hall] protests found that 57 percent of Americans believe genuine concerns were behind them, while 48 percent said organizing by activists was also a factor. While 51 percent said angry attacks represented 'democracy in action,' 59 percent said shouting down others attending the town halls was an 'abuse of democracy.' [Note: 51% + 59% = 110%. Could it possibly be that the questions on the poll don't yield, you know, conclusive results?]
The people have spoken! And they have said. . .uh, what exactly did they say?
BTW: Didn't we have a great big national poll back in November? And didn't we elected a guy who pledged to reform healthcare? "Give us back our country," indeed.
Posted by anonymous, a resident of another community, on Aug 14, 2009 at 8:54 am
Very good points about the polls but I'd less concerned about what May polls said than August polls.
Unfortunately, I don't know a single politician who isn't more concerned about their next "November" poll than their last one. It's pretty apparent that a lot of our elected officials are increasingly worried about their re-election prospects. No, we don't feel it here in Northern California where we re-elect our senators and representatives year after year after year. You don't have to look much further than what's happening today in PA, VA and NJ where Democrat incumbents are way behind. Politicians in other parts of the country, especially in swing districts, will be monitoring these races closely. Because their most important job is to be re-elected, they will vote accordingly.
Posted by Hoping for Real Reform, a resident of another community, on Aug 14, 2009 at 11:09 am
I for one am really happy that this topic is finally generating serious debate. Thanks are due to "Joe Friday" for the link to the Annenbuerg Public Policy Institute's FACTCHECK.Org, which debunked the seven falsehoods being propogated by the uninformed and the deliberate misinformers. Having been the recipient many years ago of the military's version of socialized medicine and now having parents who are pretty happy with Medicare, despite its shortcomings, I stand with everyone who realizes that any basic healthcare coverage is better than none.
I also encourage every one of you, no matter how old you are now, to sit down with your parents and family members and clearly communicate your own end-of-life wishes BEFORE the time comes. Those who are left to make those decisions really need to know what you do and do not want. If you don't want some bureaucrat at the insurance company OR a government agency to take matters into their own hands, DO IT YOURSELF and take them out of the decision-making process. There are plenty of very low-cost do-it-yourself software packages and free library books with the info and forms you need. NO EXCUSES. JUST DO IT!
Posted by hurting, a resident of the Menlo Park: University Heights neighborhood, on Aug 17, 2009 at 8:59 am
Well it look like our "leaders" in Washington may be ready to betray the public interest and cave on the public option. The insurance industry is spending hundreds of millions of dollars to defeat a plan that they know will give them too much competition, and now they're winning the battle between corporate self-interest and the public good.
The democratic process is just as broken as the health care system in this country.
Posted by hurting, a resident of the Menlo Park: University Heights neighborhood, on Aug 18, 2009 at 10:35 am
You're right, anonymous. The Dems can do "pretty much anything they want." And that's why I say our democracy is just as broken as the health care system. All the money the insurance industry and "big pharma" pour into the system is speaking loud and clear to our great "leaders" in Congress, and the public good be damned. To paraphrase the late Molly Ivins, both Republicans and Democrats are dancing with them what brung them.
Posted by anonymous, a resident of another community, on Aug 18, 2009 at 12:36 pm
I'm glad that we have finally found some agreement.
One point worth noting. Except for insurance companies, most other organized health care entities (pharma, managed care, doctors, hospitals) SUPPORT the proposed changes. Contrary to opposing it, pharma has pledged $150 million in TV advertising to support the administration's proposal. Don't blame them.
I still find it hard to believe that insurance companies have this much impact on public opinion. They're just not that influential, let alone loved.
I think what we're seeing is that most Americans are reasonably satisfied (except in Menlo Park, of course) and no one, including Congress or Mr. Obama, seems to know how to pay for this.
Posted by Concerned Parent, a resident of the Menlo Park: The Willows neighborhood, on Aug 19, 2009 at 5:12 pm
I find it interesting with all the posts and strong opinions, nobody has mentioned two things that could easily be done:
1) tort reform- malpractice and the threat of being sued has multiple insidious effects on the cost of health care. There are premiums which either get added to the charges or result in doctors leaving areas, then there are tests done "just in case" to avoid a suit. The sad reality is that many large awards occur not because of malpractice, but as a result of bad outcome (which can happen in medicine independent of best practices). I could imagine a system where there is a fund for compensating patients who are harmed by the medical system in parallel with a system for mandating transparency and investigations of such events. The result might be analagous to the flight systems where reporting of events and near misses (these don't get reported these days out of fear of lawsuits and liability creation) allow corrective action to be taken before something bad happens. Obviously for cases of medical incompetence, either re-education or alternative career counselling would be needed.
2- allow insurance companies to compete across state lines. Particularly in this age of virtual companies with locations everywhere, having medical insurance via states hurts competition. I would have top believe this would be more effective at generationg real competition as opposed to a monopolistic government plan.
On Medicare: of course people like medicare. They get much more from it then they put into it. As a business model, aside from the monopoly advantage it gets (the big government can set prices and let others pay for it), it is not revenue neutral. TO take that and expand it, will only increase the unfunded liability. If you have a business that loses movey on every transaction, you can't make up the difference on volume!
On the concept of insurance: If there is no stratification based on risk (pre-existing conditions), then it's not really insurance. In that case, why would anyone have insurance until they were sick. Take the case of a 60-year old man who needs coronary bypass (estimate the procedure at $100K for the sake of argument). He could pay insurance (whether through employer or individual) premiums at $10K/year for 40 years and will have put $400K into the system. Presumably he has used some resources for routine care and so on, but he will have paid $300K more than he consumed. If there is no rate differential for pre-existing condition, then why on earth would he (or anyone) get "insurance" until they are sick. Pay a bit as you go each year and if you have need for a big expense (major surgery, cancer treatment, heart surgery, etc.) then you pay your $10K. Now the equation is the individual has paid $10K and consumed $100K. The "insurance" company is out $90K. Now, if that's the proposal for a government plan, it's pretty clear it won't be anywhere near revenue neutral. It's fine if we want to do that as a society, but don't call it insurance.
Posted by Reform NOW, a resident of the Menlo Park: Fair Oaks neighborhood, on Aug 19, 2009 at 9:57 pm
"Concerned Parent," seems to me you're FAR more concerned with the health of the insurance industry than you are in the health of your kids, or anyone else's kids, or your fellow countrymen, for that matter.
No one has mentioned your "two things that could easily be done" because we know that continuing on the path of letting the insurance industry dictate what doctors can and cannot do to treat patients, and bleed us dry with ever-increasing premiums, will not solve the horrific healthcare problem we face in this country. We need to eliminate the profit motive from healthcare. Period.
Posted by anonymous, a resident of another community, on Aug 20, 2009 at 7:58 am
Bravo, Concerned Parent. Funny how no one talks about two very easy reforms at all, isn't it?
Baseless lawsuits - by the government's own numbers - cost us more than the 30% that proponents of "reform" claim the insurance companies keep in overhead (although that number is actually 20% for Blue Cross, Blue Shield, Wellpoint, Cigna and United - never mind those messy facts). We certainly don't want to limit the costs that are associated with trial lawyers, do we???
One other reform I would suggest - implementing a very low cost "basic medical insurance plan" sold be insurance companies that would have no exemption for pre-existing conditions. It could be a basic policy that would provide for doctor visits and hospital care (admittedly with a cap). Providing a universal tax credit for the price of this insurance would make it "free" to low income Americans and partially subsidize other Americans with their premiums. Wouldn't that be a far easier solution to a very difficult problem?
But the proponents continue to attack the people who dare disagree with them instead of facing the fact that 80% of the 250 million Americans who have insurance are satisfied with the current system. By the way, that satisfaction rate is almost identical to the satisfaction rates found in England and Canada.
I would love to solve this problem for the 10 million Americans who truly can't afford insurance without changing everyone else's world.
Posted by Reform NOW, a resident of the Menlo Park: Fair Oaks neighborhood, on Aug 20, 2009 at 9:29 am
Anonymous, Who's attacking whom? Look at the disruptions at town hall meetings across the country. Look at the name calling -- socialist, Nazi, communist, "death panel" supporters -- by opponents of a public option. And please tell us, who has "attacked" you as opposed to disagree with you on this thread?
No one is talking about the "two very easy reforms" you allude to because they're not reforms at all. They are more of the same: the insurance industry calling the shots, raising premiums until more and more people can no longer afford coverage at all, and telling doctors what medical care they can and cannot provide.
Stop blowing smoke. The profit motive must be removed from health care in this country.
Posted by Reform NOW, a resident of the Menlo Park: Fair Oaks neighborhood, on Aug 20, 2009 at 9:44 am
And while we're on the subject, stop with the phony numbers already. 10 million Americans who can't afford health insurance? As of late 2007, the number of people who were uninsured was around 46 million, 18 percent of people under 65. (Those 65 and older have "socialized medicine -- oh my!) And that was before the economic freefall that put so many people out of work and without their employer-based insurance. Are you really expecting us to believe that 36 million people don't have insurance because they just don't feel like being protected even though they can afford it? Oh please.
And your statement that 80 percent of Americans who are insured are "satisfied with the current system" is just an unconscionable distortion. The figure you cite is for insured people who think they're getting good care from their own doctors. The question they responded to wasn't whether they are satisfied with the current system overall. When that question is asked, the percentage drops significantly. And by the way, even the approximately 80 percent figure you cite drops significantly for people who have faced serious illness as opposed to those who rarely go to the doctor or who go in for minor problems or routine checkups.
Please, stop blowing smoke. Let's conduct an honest debate.
Posted by anonymous, a resident of another community, on Aug 20, 2009 at 10:53 am
I've been called stupid, ignorant, uninformed, on drugs, looking through rose colored glasses, rich, and an insurance executive - and that's just on this board in the posts above! Those are all personal attacks that have nothing to do with reform. I've tried my best to focus on policy and I don't think I've ever referred to people who disagree with me by those kinds of names. Certainly not those other deplorable names you noted above.
It was actually Nancy Pelosi that made the swastika reference. And Ms. Pelosi certainly supported vocal dissent and rankorous behavior against George Bush a few years back. And Hillary Clinton made similar comments when she disagreed with then candidate Obama during the campaign.
I always thought dissent was very American. I do, however, agree with you about the death panels - that is simply propaganda; but really not all that different than the propaganda used by proponents that "most Americans favor a single payor system." That isn't even close to being substantiated by a single poll, much less facts.
As far as removing the profit motive from health care, that would be a big change from America's capitalistic model that has been reasonably successful. Would you support removing the profit motive from food or real estate? Certainly food and shelter are more essential than health care.
And yes, of the "47 million" people you note that don't have insurance (and I don't disagree with that number), about 25% of them are referred to as "the invincables." They can afford to buy insurance, they just choose to have a second car or vacation instead. Just google it and you'll find it easily.
About 20% of that number already qualify for Medicaid or another program and choose not to (that's according to the White House). What makes you believe they'll sign up for a new program when they aren't taking advantage of a current one? About 5 to 10% of your number are "transiently" uninsured due to a change in their employment and (historically) most are insured under another plan within 12 months.
Finally, about 20% of that number are in this country illegally - and regardless of how you or I might feel about them, both Senate bills and the current House bill specifically exclude them coverage.
That leaves 25 to 30% who truly need help - that's less than 15 million people... even using the 47 million number. I won't argue whether my 10 million number is better than this 14 million number because no one knows for certain.
And, unlike your post, I do think that getting rid of pre-existing conditions would be a KEY reform that would benefit everyone. That one change would get more people on the rolls, lower premiums and prevent the truly deplorable stories about people being denied coverage. Judging from public opinion polls, there is overwhelming support for that change. I'd love to see it happen.
Finally, frivolous lawsuits that result in higher malpractice premiums and defensive medical practice (over using tests) represent a near identical cost as insurance company overhead and profits. You seem quick to go after insurance companies (and I'm no friend of them, either), but I don't understand why you aren't just as outraged at this waste.
That's my honest opinion and I hope I presented it respectfully.