Because we wouldn't have places like the Cleveland Clinic or John Hopkins for you to go to.  Without free business practices in the US, the drive for innovation, high tech, and cutting edge solutions would be lost.  I respect your feelings about insurance companies, but I still pay my premiums in case.  You don't have to buy insurance but it is a very good idea to. 

The idea that this is some kind of emergency is ludicrous.  Americans need to sit back and breathe in a paper sack before going irrationally emotional. 

Mike,

Please see prior posting: http://healthcare.change.org/blog/view/health_care_is_the_anti-melting_pot

What's interesting about your position is that it ignores economic evidence to the contrary. Consider also that the Cleveland Clinic or Johns Hopkins are not options for most of our population. The market has not delivered this level of care to more than a few and, at best, they represent not our ability to proactively maintain a healthy populace but to react after the system has failed.

Free markets are the greatest economic engine in the world.. Nonetheless, anyone who would insist that every activity must be entirely or even principally economic in nature does so from an ideological rather than a pragmatic stance. Markets are not the answer to everything just as money is not the answer to everything.

That people can organize in an amongst themselves toward the attainment of goals on behalf of their communities to provide water, sewer, garbage, law enforcement, fire departments, schools, libraries, parks, roads, health departments, land management, etc., in no way threatens the significance of free markets. Similarly, having a national health insurance system in no way threatens advances in medicine as has been proved by other countries whose value for human life would apparently exceed ours.

Lastly, most the people "going irrationally emotional" are the ones who fear their free market ideology is at risk. Perhaps if they were more inclined to look at the empirical evidence in favor of health care reform, they might be able to "sit back" and take an objective view of what is a stake.

Mike, you're also uninformed. There are actually provisions in HR 3200 to enable places like Cleveland and Mayo Clinics to share what they're doing with other doctors, so we can learn how they provide better care and save money.  The Bill encourages innovation for better outcomes, it doesn't discourage it.  Drs. will be looking for ways to get better outcomes, rather than simply monitoring and medicating chronic diseases like they're doing now, because there will be payment incentives for success.  

I'm a health care professional who has worked in the field for 46 years.  i've worked for federal, state, and private agencies, and in private practice.  The best jobs I've had were federal jobs. They are typically well designed, cutting edge, provide excellent training, and have excellent outcomes because they are more realistic about expectations.  As one of my colleagues in one such job put it (after Reagan cut the funds).  "It a shame they're cutting it.  They actually let us do a good job."

The Bill shows a good understanding of where our problems are and what we need to do to  fix them.  THere are only a couple of things in it I disagree with, like allowing Med Advantage plans to continue.  They are not a good deal for anyone except the insurance companies.

personally, I'd prefer a single payer system.  What we go through to get paid is more than anybody should have to go through.  It's a nightmare.  But given that we aren't going to have a single payer, HR 3200 is a pretty good option.

Mike said "The idea that this is some kind of emergency is ludicrous.  Americans need to sit back and breathe in a paper sack before going irrationally emotional." Hm. I just got a notice from Blue Cross/Blue Shield that my rate is going up for the second time this year (to $19,000+ annually); the premiums for our family of 3 now equal our mortgage payment. Maybe the paper-sack-breathing will help allay the incipient panic that nothing is going to be done.

Regence Blue Shield of Idaho went up 23% this year, and they're non-profit.  They are one of the few companies that give providers a raise each year.  It is generally under 2%, so it ain't provider fees raising costs, at least not around here.  

Well, suffice to say, it looks a lot easier for them because they already have it... and it's wildly popular.

Robin,

Economists and politicians can overanalyze a situation. Many pols fear failure more than they crave success.

Sometimes, you just have to move in the right direction and "stay the course." Maybe this time we can do it for a good reason.

A loud outcry for single-payer needs to be sustained if only to balance out fear of substantial reform.

I have had a good read of everyone's comment. Okay so some of you have relations in Canada. WE are a very big country the second largest in the world. Waiting times have been difficult in some areas. WE have lost doctors to the USA and yes we need more specialists. However, while some people have fallen through the cracks, (HMO'S decides who lives and dies in the USA) we do have good care. Unless you have actually been here to see our wonderful hospitals like Toronto's sick kids and unlike the families Ted Kennedy met when his son had his leg amputated no one here would lose their home!  Our Sh'riner's hospitals are great too. I had to have both of my sons by C section and did not cost me a penny  in both 1977 & 1982. i am very tired of having our country lied about.

ummm, great - if you don't like the Canadian system - then keep the on you've got. See how far that takes you down... there are no redeeming qualities about insurance companies raking in Billions of dollars and preventing essential care to people. I say keep the current system in America for as Long as Possible... fight change tooth and nail ...then come back here in 10 years and let us all know how that worked out for your country.

Oh ya ...stop comparing Obama's HealthCare Plans to the Canadian healthcare system - oranges and apples.

Yes there are problems with the Canadian healthcare system - but it's a far better model than the current system in the US - so leave Canada out of your squabbles over healthcare - most of us are sick of hearing the left whine about it...

Patricia, I am glad you feel that way.  I have lots of family in Canada (Quebec) also.  However, many of them beg to differ on the performance of the Canadian system.

Did you know that the cancer survival rate is higher in the U.S.  Why--response time!

Women diagnosed in the United States have a 61% survival rate.  Canadian women have a 58% rate.

Men have a 57% rate of survival in the United States vs. 53% for Canadian men.

These stats are straight for the NCPA here in Washington.  Time is everything for cancer response. 

If you compare our numbers with the Europeans, US survival rate is even better, phenomenal!

I'd rather have a better chance of surviving cancer than change to the system you are happy with.

Amelioration of things in our system like stopping the dropping of policy holders and tort reform, are necessary but all-in-all I am happy with the system as are 80% of my countrymen who don't want government running more things in our country!

...and with our unhealthy care system and lifestyles, we'd better be good at cleaning up the mess!

If the incidence is lower, you don't get as much practice cleaning up. That what drives the US health care system, making money off of the crises. Nothing to be proud of.

The constant pounding about cancer mortality is focused on the flaws in our system, our inability to prevent disease and stay healthy. Beyond that, I think there's an old adage about hard cases making bad law.

How about diseases of the young with a future ahead? Let's look at infant mortality, the health of women of child-bearing age, incidence of heart disease, stroke, and cancer among working-age folk, the health of children and their parents. The amount and types of care these groups, a majority of the population, require, receive, or are turned away from drives our health as we age. Another old adage, garbage in-garbage out. We're reacting to extreeme cases as the population ages in part because we don't care for people when they're younger.

You think this is more sustainable than single-payer or other form of universal coverage? That's not morally or economically defensible.

Instead of throwing stones at Canada, let's just toss 'em around our own glass house. We're really good at fixing the broken windows!

Mike,

You might consider the fact that Medicare is principally responsible for seniors getting the cancer care they need here in the U.S. of A.

Mike:

I'll just accept at face value your claim that you have family in Canada. Not everyone in Canada likes the system there, I suppose your entire family could plausibly be in that very small minority group. Expecially if they're in Quebec, which is widely acknowledge to have the worst administered program of any of the prvinces.

That said, if you want to start talking comparative treatment outcomes be prepared to deal with more than a single study on the mortality rates for a few isolated cancers, and have those results not make the US look very good.

This:

http://www.openmedicine.ca/article/view/8/1

...is a systematic review of DOZENS of scientific studies of comparative outcomes of treatment of everything from cancer, to coronary artery disease, to chronic ilnesses, to surgical procedures in the US and Canada.

Canada produces superior results in the clear majority of them.

And this:

http://www.commonwealthfund.org/Content/Charts/Testimony/Insurance-Design-Matters-Underinsured-Trends-Health-and-Financial-Risks-and-Principles-for-Reform/Mortality-Amenable-to-Health-Care.aspx

...is statistics on how well industrialized nations health care systems prevent medically preventable deaths. That's the US down there on the end ranking dead last.

And all that while the system is absolutely gouging you on prices and bankrupting the nation. So frankly, if you're happy with it I can only conclude it's because you don't know any better.

Mike,

Your statistics are very biased. You neglected to mention that survival rates amongst American citizens are high for white Americans only. Once you start delving in to poverty stricken groups, survival rates go down dramatically. It is no small wonder why this is. White Americans typically have health insurance. The rest be damned. But who cares -- let them suffer without the care they need, no? 

A racial gap with regard to cancer survival is evident, with white patients more likely than blacks to survive, especially breast cancer. The comparison is confirmed right across the country. Survival rates also vary dramatically from state to state.

This... is what this healthcare debate is about. It is about the fundamental right for American citizens to attain affordable healthcare. Not a privilege, a right. If we can't begin to have empathy for our less fortunate citizens and agree to see them as people rather than an expense, then we are in big, big trouble. I'm glad you can sit back with your comfy insurance policy and not worry, but not everyone has it so good.

Quite frankly, I am SO tired of this debate. It should be a no brainer. Where has the empathy gone in this country? I'm willing to take a chance on this bill and try something different. What we have now is not working and something has to change.

I would also like to add that people who believe they have a sound insurance policy find out otherwise once they become ill. If the insurance companies have no competition, they can and WILL continue to offer sub-standard care to us. They treat the insurance business as just that -- a business. They don't care what happens to us, as long as they continue to make money off of us.

I'm more concerned that our courts have not excoriated our system for the rationing-by-market that is "permanently damaging people"  "Or killing them" through lack of care and underinsurance.

"And how does the fact that Canada has a little over 33 million people versus our over 307 million factor into this discussion?" Well, if you want to normalize the data for population density and figure out how thinner populations and resources are affected by both systems, then yes.If anything, it gives them fewer resources (taxpayers) to fund the system.

But if you want to focus on a market of comparable size which spends far less on health care, has a public and private mix, try the EU with 499 million people. That would seem to indicate that quality does not decline exponentially as population rises. That the challenge can be met.

The point here is not to keep questioning Canadians and the very American-like pride they have in their country and system, it's to find a way for us to get more and spend less.

Who said we have to do things just like Canada?  We can borrow what works and change what doesn't work.

No system is perfect.  Fact is, ours is imperfect for a whole lot more of the population.  I couldn't get insurance for six years because I had cancer. Now I'm on Medicare and thank God for it!  a public OPTION is a good thing for people who can't or don't want to support healthcare for profit.  

Right. It should be a no-brainer.  And if it weren't for the lies going around, it probably would be.

CHeck out:  http://healthcareviewpoints.com/

for a good review of the distortions and what HR 3200 is really about.

so if Canada has only 33 million, we are leaving uninsured more than their total population... how does that multiply? and does the person that dies of Cancer or some other disease that is undiagnosed because he never went to a doctor get counted into statistics?

Jeffrey,

Not really.  When you look closely at the number and exclude illegal aliens, people that have access but don't apply and their children, and those that can afford it but don't get it the number is somewhere around 12-15 million.  We could just buy them all insurance and it would cost a fraction of what is proposed.

We do have other issues, though, which we want to adress too.

James;

Most Canadians agree with you - our system is broken and needs repair, there is no debating that - what we are saying is that Obama's Healthcare plan is dissimilar to Canada's healthcare system - so stop running tv ad's and bashing a system that is very different than the proposed Obama healthcare plan. ...that's all. Canada's Healthcare system needs revamping - but it's still decades ahead of the american way of doing healthcare.

James;

Most Canadians agree with you - our system is broken and needs repair, there is no debating that - what we are saying is that Obama's Healthcare plan is dissimilar to Canada's healthcare system - so stop running tv ad's and bashing a system that is very different than the proposed Obama healthcare plan. ...that's all. Canada's Healthcare system needs revamping - but it's still decades ahead of the american way of doing healthcare.

Shane, got any studies that say Canada is "decades ahead?"  Please refer me to them for review.  Seems like from what I read and posted, many Canadians would disagree.

James;

Studies...  Actually I don’t need any – I’m not presenting a formal case – just an opinion.

I will give you one case study from this weekend – my wife tore her achilles tendon this past weekend – it took us about 1.5 hrs to be seen by the emergency room doctor – and they scheduled a ultrasound for the following day – which was a national holiday – and today her doctor booked an appointment to get it surgically repaired – which is only 2 weeks out.  So my experience this weekend sold me on the Canadian way of doing things …no paper work to fill out, no insurance adjusters to talk to… pretty simple eh?

no

I don't know what happened to my earlier reply, but here it goes again.

My queston was not about the insurance, but about the prevalance of disease and the difficulties in treating growing problems with a population 10 times that of another.

I believe the Court stated it was in fact happening, and there are many stories of individuals for whom this was true, or would have been if thay had not come to the States.

And who cares about which is more unsustainable?  Unsustainable is unsustainable.  Both need some reform for different reasons.

I'm unsure how you think prevalance of disease is dependant on the size of the population. Population *density* maybe, since close proximity would aid transmission... but as far as density is concerned Canada and the US are fairly equivalent since Canada's population is packed along the southern border where the climate is more livable.

The court stated there were a couple examples where wait times had, at some point, exceeded acceptable levels. It did not state that this was common, or endemic, or even unresolveable using the existing system and simply re-allocating resources.

And anyone who cares about doing something about unsustainability cares about degree of "unsustainability". If your system is currently "unsustainable" because your cost growth is like 1% too high to support over the long term that is rather different than if you are "unsustainable" because your cost growth is double what you can support. The former can be easily corrected with some minor tweaks and isn't cause for really significant alarm. The latter is going to require something radical.

I guess I'll have to let some more Canadians make my case for me. There is a thriving private industry dedicated to brokering health services because people are withering on the vine waiting for care. 

See http://www.timelymedical.ca/ for example.

Their site includes testimonials, and an impressive comparative chart of wait times.  It further states in part:

"While recognizing that many Canadians believe that we have one of the best health care systems in the world, the founders of Timely Medical Alternatives Inc. also recognize that there are some 875,000 Canadians currently on the waiting list for referrals to specialists or for medical procedures.

Our organization was formed in 2003 to help Canadians from coast to coast, to "Leave the queue" and take personal responsibility for their own private medical services.. Since then we have helped hundreds of Canadians obtain second medical opinions, MRI's / CT scans / PET scans (within days) and surgery (within weeks). We have helped our clients to regain their mobility, to get relief from chronic pain, to get diagnoses of illnesses and we have, in some cases, helped to save the lives of a number of our fellow Canadians."

Concerning the Quebec case, I will quote DIRECTLY FROM IT:

''Access to a waiting list is not access to health care,'' Chief Justice Beverley McLachlin
and Justices Jack Major and Michel Bastarache wrote in one of the two majority
opinions. 

''There is unchallenged evidence that in some serious cases patients die as a result of
waiting lists for public health care.''..."The evidence in this case shows that delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care.  The evidence also demonstrates that the prohibition against private health insurance and its consequence of denying people vital health care result in physical and psychological suffering that meets a threshold test of seriousness."

That is not saying "that wait times COULD do those things" (as you erronneously stated) but that it in fact HAPPENS, and is "widesptread."

So the Canadians, and the facts, are opposed to you.

Lastly, your continuing argument over comparative unsustainability misses the original point.  So I will not comment further to defend a point that you are not even opposing.

I am in favor of the Healthy Americans Act which is bi-partisan, provides universal care, includes pre-existing conditions, reduces costs and pays for itself.  I hope it gets a fair hearing.

James,

I'd like to add that access to insurance is not health care. Keep in mind that while people in Canada may be dying from the waits, no one has deemed any of them unworhty of receiving treatment.

In our nation, people are dying not because of being on a queue for services but for not having the means to merit services.

I take the flaws of a well-meaning and united effort over those of a judgmental and restricted system any day.

If Canada has long waiting lists for specialists, the obvious answer to that is to have more specialists.

In our country, the shortage is for primary care physicians, generalists and pediatricians.  This is because we pay them less and pay specialists more.  Most of our medical students are becoming specialists, for this reason.  HR 3200 addresses this by trying to even out the fees a bit, paying PCPs more, specialists a bit less (they'll get the same pay for the same services that PCPs give, like evaluating blood tests, etc. They will still get more for doing surgery.)  Otherwise, we're not going to have the generalists.  There is already a 30% shortage in some regions.

Like I said earlier, we don't have to clone any other system.  We can learn from them.

Another point, James.  People here don't die waiting for specialists.  They die waiting for their insurance company to approve treatment.  Or they die because they didn't have insurance and waited too long to go to the doctor. 

When I went in for my first Medicare checkup, I made it clear to the doc that I didn't have any money to pay for lab tests, and I wanted them to make sure they would be covered by Medicare.  I expected to hear back in a day or two.  I heard back in less than five minutes.  All they had to do is go into the computer and see if the service code was covered.

When I had ovarian cancer, the last words the doc said to me as they were rolling me into the operating room was "Your insurance company denied authorization, saying it's elective" (they didn't know yet what was causing those lumps in my abdomen because my blood tests were inconclusive).  I knew enough about insurance companies to know that it wasn't elective and that it would be straightened out.  What if I hadn't? What if I had waited?  i had a very advanced stage cancer.  Waiting for authorization could have killed me.

We've had more of this nonsense since Managed Care (which has benefitted no one but the managers) than ever in our history.  Reform is an effort to get some reason back into healthcare.

incidentally, if I had not been uninsured for years prior to getting cancer, I probably would have gotten to the doctor before it was so late in the game.  Fortunately, I had recently married and was covered for the first time in about 15 years when I was diagnosed.  

My husband's claims, on the other hand, for the first year of his cancer treatment (on that policy) was denied because it was pre-existing, leaving me with a $55,000 bill when he died.  

Pamela,

That's why I like the Healthy Americans Act best.  It reforms our current system without duplicating another system with issues of it's own.

Harold,

We don't need any more "well meaning" legislation that doesn't work in the real world; that is a liberal practice that has brought this mess upon us (in part).  People dying unnecessarily is people dying unnecessarily; let's not duplicate that.

We need legislation that is compassionate, yes, but actually works and doesn't surrender any of our liberties to bureaucrats.  I like the HHA best so far.

James, for your information, health insurance companies are run by bureaucrats!  

The CEO of Aetna makes $24,000,000 a YEAR! That's without bonuses and stock options.  (The head of Medicare makes $150,000 a year).  THey put us providers through MONTHS of hoops to join their "networks" so that they don't have to pay for care for months while we (licensed professionals) are "credentialed"  (so that they can pay us less when we do finally get into their networks). They have thought up more bureaucratic BS than any government worker ever dreamed up on their most imaginative day.

They are sending out a lot of smears about reform because they want to keep it this way.  Because they are making BILLIONS!  Just the CEOs are making BILLIONS!

There has NEVER in our history been more bureaucrats running healthcare than in the last 15 years.  I had a patient once who was clearing from a drug overdose in an attempt to commit suicide.  The SECOND day she was in the hospital, the BUREAUCRAT from one of our biggest insurance companies 3000 miles away wanted her on MEDICATION! when she was clearing from a drug overdose, so that they could get her out of the hospital ASAP.

It took us years to get the ability to sue these insurance companies so they would stop dictating health care from 3000 miles away!  Where have you been?

Reform is trying to reduce this nonsense so that people can get HEALTHCARE!

You dont' get it James!  THese people are in it to MAKE MONEY.  They are BUREAUCRATS!  Give me a federal bureaucrat any day.  I will welcome them with open arms! 

(I don't welcome the State bureaucrats, mostly because of their 5" thick policy and procedure manuals and insane paperwork.  But federal bureaucrats in health care, in my experience, are enlightened folks.)

James: You appear either unwilling or unable to listen to what I am telling you. You just decided to quote "DIRECTLY FROM" the court decision in order to prove to me that... it said exactly what I just finished telling you it said. That is SOME cases wait times HAD gotten too long and become serious problems.

So, umm... congratulations for showing my statement was accurate. I guess.

As for "access to wait lists are not access to health care". No kidding? Hurray for tautologies. Also, access to the line at the club is not accesss to the club... and access to the line at the fast food counter is not access to lunch. But the line at the club LEADS to the club. And the line at the counter LEADS to lunch. Did you think you were making some kind of profound point quoting that statement or something?

And I also find it endlessly entertaining to hear you telling me "the Canadians" oppose me. You happen to be speaking to one right now, although I currently live in California so have just a bit of familiarity with how the health care systems actually compare. But I prefer not to resort to personal anecdotes, there's too much of that in this debate already.

And it is extremely rare for Canadians to die waiting for treatment. It is considerably LESS rare for Americans to die due to lack of same. Which is why the United States, despite spending more on health care by a vast margin than any other country on earth, ranks DEAD LAST among industrialized nations on health care amenable mortality statistics.

Apparently you either have difficulty writing or understanding English, so I'll make is VERY simple for you.

YOU TYPED: "The *Quebec* supreme court ruled that wait times COULD do those things." and "The court stated there were a couple examples where wait times had, at some point, exceeded acceptable levels. It did not state that this was common, or endemic,...."

THE COURT SAID: ''There is unchallenged evidence that in some serious cases patients die as a result of waiting lists for public health care.''..."The evidence in this case shows that delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care."

If you read them to be saying the same thing, then we need to debate the merits of state-provided public education;and I will not waste any more time with you.

Thanks for the definition of a line.  I didn't find the concept nearly as profound as you apparently did, but I was quoting a Canadian Judge.  Go figure.

And Americans don't die in the streets in the USA for lack of care as I already stated.  But Canadians suffer for months waiting for stuff that we get in days.  But we are going to make our system even better as I said.

Also, I assumed you were French Canadian Mr. Comeau; it's called IRONY.  Look it up.

Lastly, here's some stats for you from a system that serves almost 10 times your population, eh?

"The United States had the highest survival rates for cancer of the colon, rectum, lung, breast, and prostate. U.S. survival rates were also among the highest for melanoma (fourth), uterine (second) and ovarian (fifth) cancer, cervical cancer (sixth), Hodgkins disease (third) and non-Hodgkins lymphoma (fourth). The United States was ninth in survival of stomach cancer."

There's more, of course.  BTW, Canada ranked DEAD LAST in a study of value received for money spent in one study.

Pamela,

No need to yell.  I think you are not getting it, so we will have to disagree there.  I think history clearly shows the government can't handle this so it is shear folly to prefer them over private industry that has far less power and and insulation from accountability (medicare, medicaid, post office, federal deficit.)

You say "They have thought up more bureaucratic BS than any government worker ever dreamed up on their most imaginative day."----I will challenge that statement any day, and twice on Sunday.  These politicians are practically out of control and rarely seem to be held accountable, even by the voters.

Then we agree to disagree.  I've been doing my own "administrative" work and my own billing and relating to various and sundry third parties for most of the last 30 years.  I know pretty well who is a pain in the neck to deal with and who is not.  

THere is one company here that I actually like dealing with.  THey treat providers like humans. THey actually try to help.  I looked them up to see what their profit margin was as compared to the other more difficult companies.

Guess what?  THey're still non-profit.

You know James, before breaking out the insults pertaining to other people's literacy, it's a good idea to make sure you're able to understand the words you're posting.

You just copied and pasted my statement, then the court's statement, but atill appeear to have difficulty comprehending their meanings since you're still failing to grasp that they say the SAME THING you moron. That "widesprad" you insist on highlighting like it's making your point does NOT refer to those cases. It just refers to "delays" in general. From anything to a "delay" that is problematic to a "delay" that is perfectly acceptable. Then the next part of the statement refers to the more serious SOME that have caused harm and ARE a problem.

And no, I'm not French Canadian. Just the plain old born and raised on the west coast english speaking variety.

And in case you missed it, while you're posting ONE study of mortality rates for a couple cancers were the US performs decently and pretending it's representative of overall system performance, higher up the thread a couple days ago yours truly posted a slightly more comprehensive data set. Feel free to go read it.

Oh, and that last study you mention? It only bothered looking at Canada compared to some other universal coverage systems in Europe to determine ways the system should be improved to catch up with THEM. There was no point looking at the US, everyone already knows where IT ranks there.

And before I stop dialoquing with you entirely, let me say as simply as I can (and assume I am speaking SLOWLY); You said that the delayed wait times COULD result in irreparable harm and injury.  The Court said it HAS.  Is that the same thing in Canada or California?

You also said, "The court stated there were a couple examples where wait times had, at some point, exceeded acceptable levels. It did not state that this was common, or endemic...."

The wait times exceeding "acceptable levels" were in fact found to be pervasive.  That why there is a thriving medical broker business.  Try looking at the web site.  The wait times and wait list is appauling.

Insofar as you cannot see or concede the obvious, I will not waste my time reading anything from you further.  G'day.

No, James, wait times "exceeding acceptable levels" were NOT founf to be pervasive. Just plain old "DELAYS" were found to be pervasive. Read for comprehension for crying out loud.

And you did just notice that in the first part of your post you accused me of ONLY saying wait times "could" be so bad as to cause a problem... then in your next sentence quoted me saying they HAD, right? Is your attention span like 3 seconds long or something?

One more time for James : Keep the system you have... and let us all know how that works for your country. James - do you work in the insurance industry ??

Personally - i think that america is becoming a fractured state... far too many "Far Left" and far too many "Far Right" with very few sensible people left in the middle. It seams the two sides are like siblings that just "can't" get along...

James - i think your missing the Gist of it all - it's about basic human rights - to have every man woman and child get the best care possible regardless of income of social status ...doesn't matter if your the crack-head on the corner or a million dollar CEO - everyone gets the same level of care - somehow this leaves a bad taste in the mouth of most reDUBlicans --- who all feel there a little bit better than everyone else...

Thanks Shane.  We'll follow the example of unity between the French Canadians and the non-French Canadians.  We are humbled by the impact of your great nation on the world.  We are the ones who are blessed to be free because we happen to be next to the great Canadian Superpower.

Try doing a little reading.  We are improving the system we have, which fundamentally is better and just needs some amendment; so talk to you again soon when we're done with the improvements wise guy.

I get the "gist" my friend; I just don't want to give equal access to an inferior system when we can do even better.  We're not going to lower quality just to improve statistical numbers by widening the door.  We are going to do better in both areas.

And we aren't going to be stuck having to go to the Supreme Court to legally get off the 875,000-strong waiting list like some poor guy had to do in 2005 in Canada to end his suffering.  By the way, that same Canadian court said medical care was not a basic human right.  Do some studying before you shoot off your mouth.

And by the way Shane, not everyone in Canada is getting "the same level of care."  And 80% of the 33 million Canadians have private healthcare--because they need it.

i still can't get past exec's of insurance companies paying themselves multi-million dollar salaries while denying care to those that need it - If i were American this would outrage me. I can't understand why there is not more supporters of a national heath-care plan. Unless you feel that insurance exec's deserve multi-millions for their "work" 

In the 50s, folks in the US thought it was a bit unAmerican to be super rich, but in the past few years, with deregulation, it seems to be tolerated and even admired.  It's amazing (and annoying).

The populace doesn't seem to get that if it isn't the providers who are doubling and tripling healthcare costs, then who is it?   Somehow, they overlook those outrageous salaries.

James: " just don't want to give equal access to an inferior system when we can do even better"

we finally agree ...you can do better, but you still need to take the first step - so turn off Rush Limbaugh and open your heart and your thinking.

Shane,

I don't listen to Rush.  Your stereotypical left-wing nonsense again shows your lack of research and knowledge.  Challenge yourself and listen to Fox News and then do some research on your own.  If you have an open mind, you'll be surprised at what you find.

james;

I’m not sure if your serious or joking ...I certainly hope that your joking - because everyone over the age of 12 knows that fox news is NOT news... manufactured lies - I have tried to listen to some of the garbage coming from fox news - and can only say that most of what comes from fox news is nothing but lies and miss-information. So if you do watch fox news, then we all know where you’re coming from - and the source of your information is tainted. I actually feel a little bit sorry for you know, knowing that you’re a Fox news watcher... but at least I completely understand your position now. Good Luck James. 

Whether I watch Fox or not, your response tells me all I need to know Shane.  Bruce Thornton described you well.  Adios, mi amigo.

Agreed.  The Healthy Americans Act would achieve this far better than anything offered to date and has bi-partisan support.

http://wyden.senate.gov/issues/Legislation/Healthy_Americans_Act.cfm

I've read through the bill. It isn't ready to go but it's a shame that it wasn't used as part of a foundation for the current bills. One thing it does well that the current bills do not is separate coverage from employment and it admits a need for mandatory universal coverage.

It lays the foundation for something similar to Germany's structure, could have had a public option grafted on, uses one of the federal plans, specifically, to define benefits.

It needs more concrete cost reduction measures (insurance is only one part and not the biggest part of the problem). Could be more generously subsidized and has some real antagonizers for the vocal anti-reformers (end of life discussions and abortion coverage). But it has some good ideas.

It received a cursory glance from the CBO but, like HR 676, is getting short shrift despite the sponsors.

So, I wouldn't support the current form but I'd like to see this bill and the whole employer-based coverage notion dragged out in the open. But it appears that scuttling employer-based coverage is about as popular with the Congressional leaders as a strong public option.

Maybe we should cut and paste a bill together and hand it to Congress?

This summary of the Bill sounds just about the same as HR 3200, without the public option.  I will go read the Bill itself and see what other differences there are.  Thanks for the link.

Personally, I believe that people who want to pay for private healthcare instead of a public OPTION should have that choice.  And I believe that people who do not want to pay for large CEO salaries, lobbying costs, campaign contributions, perks, and profits, should have a RIGHT to buy a public option.  If we are going to argue for freedom of choice, then lets include the folks who want a public option.  

I want something with bipartisan support.  The one size fits all mentality is so neanderthal.  Every one has good ideas.

Mike, it is obvious when reading HR 3200 that they have been listening to and trying to address all perspectives.  THey've identified an amazing number of issues and addressed them in a sensible way, in my opinion (having worked in the system for 46 years).  They HAVE listened to doctors, insurance companies, hospital people, etc.  They ARE, in my opinion, catering just a bit too much to the insurance companies (like allowing for the continuance of Med Advantage plans, but creating an agency to monitor them (because they've been costing Medicare BILLIONS that go to PROFITS), instead of providing good coverage.  It is uninformed or misinformed people who are screaming at town meetings, based upon the distortions of people with vested interests in keeping things the way they are.

If you want to learn more, go to my specially created website to deal with the distortions flying around.  Writing this, I learned more than I thought there was to learn about reform efforts (still editing, but the main section on reform is finished):

http://healthcareviewpoints.com/

dumping is illegal now. It is all in how THEY word it. Now they just don't admit you in and find something LEGAL to go off from. Wife had a severe TBI in Feb 2008. she was doing a bit better, but fell later in the the year hitting her head. She was back to laying there yelling help over and over. I took her to our local ER and they didn't take her. They told me the trick is to find a hospital that has both neuro and psyc facilities and get admitted through the ER. I picked her up and we went to Louisville, KY to the a hospital that had both in out area. We were there for 12 hours. I seen this guy in a suit that kept talking to the Doc every time he left our cubicle. she had a 2 inch gash on top of her head that was swollen.

The ER doc said that he could not admit her.I argued with him for at least 45 minutes. He was telling me it was because I was from Indiana. I argued that the guy two cubicles down could not speak English and I knew that he was not from Ky. I argued that I have insurance. He said that I have to go to my local Community services. The Doc even went as far as printing CS information on paper and saying "trust me I see this all the time and it is the only way that you will any get help for her".

The thing to do ( that they didn't come right out and say) is get a divorce and get medicaid. That is the only alternative that makes sense. "It is free", I have been told several times. Not really free though. It is very common for all of these Long-term disabilities to be pushed into medicaid. I pay for insurance and have access to one of the best hospitals in our area. Medicaid covers 100 %. It really comes to no surprise that 2 out of 5 homeless in this nation are disabled and medicaid is underfunded while insurance companies are making record profits.

Angela was back to not walking ( and seeing things that wasn't there) The hospital maintained that everything was legal. I was told that the real reason that they would not take her is the risk management issues that went along with her. Very common, I have been told.

 My only point is that just because it is legal does not make it right. This is pretty common as I hear it from other people. So is TBI ( Like every 23 seconds in the US on average)

Anyway that is my rant that comes to mind. Long term disability is being descriminated against now by the hospitals and insurance companies. And it is perfectly legal.

 I have always assumed insurance is there for me before now. I have great insurance that I pay for. They will pay for the cheap and fight the expensive. It turns into a big BS game where you hope that the case worker is a good liar to make the stipulations where the insurance will pay something. Then there is the thing where bills go into collection and 7 months later they pay. why is that? I think that hey are trying to starve you to get on medicaid sooner. I went to the doc previously for  the flu and they paid right away. They have no problems with the cheap stuff that I can pay out of pocket. When you really need the insurance ...look out. Legal isn't always right. Insurance laws don't always protect the American . You can bet your premiums that the million a day in lobby will go for laws that do not protect you at all and protect the business interests of insurance companies.

Right now if I get a bad cheesburger. I have a right as an American to take action as a consumer. There is also gov agencies to help regulate that we depend on. They make sure that it doesn't happen again to protect others that may get the same kind of cheeseburger. Nobody gripes about the billions that go to the private sectors for medical research. If you think that legal is fine just don't get a long term disability. As an American you are 4 times more likely to get a TBI, than you would to contract AIDS or HIV.

 Nothing Extreme about it. Just reality.

I am very sorry to here of your challenges Joe.  I can only say that we are headed for reform; the issue is the type and level of government involvement.  I don't know anyone (although there may be some) that do not support reform.

I wish you the best and sincerely hope (and expect) that the new reforms will remedy your medicalcare situation.

Brad, I just watched Bill Moyer's Journal. Apparently, Darmouth did do an interesting review of at least some aspects of the system and found, no surprise, that more doesn't produce better outcomes.  You can probably find it at pbs.org and go to his show.  

Also,  Elizabeth, I read an interesting article today about the drug company history.  It seems that most of their "research" is actually done by universities and NIH grants.  Then when they discover something, the drug companies develop it.  All this noise they make about research simply isn't true.  They produce more "me too" drugs with new patents than anything.  Here's the link:

http://www.nybooks.com/articles/17244

James,  today I've once again concluded that conservatives hold liberals to standards of perfection when looking at policies they've put into place, like Medicare and Social Security.  But when it comes to looking at the flaws in the system they've helped create (e.g., through de-regulation, etc.,) they are blind to those flaws. You folks live in a world of theory, untroubled by the facts.  Liberals look at the facts and try and develop ideas about how to address them.

That's my biased analysis! 

And with that I think I'll go think about something more fun.  This is way too depressing.  There is one bill for a single payer system I could probably feel a lot better about.  I wish I believed passing it were possible.  

I'm glad I'm retiring, and I'm glad I'm on Medicare.  Thank you to the liberals who fought to get it passed.  I'm just lucky my cancer didn't return for the six years I had no insurance.

Pamela,

You are entitled to your bias and opinion, but demonizing people with opposing viewpoints is why these politicians are having trouble getting the job done.  We need realism; The HAA is the best one out there so far per the CBO but it is barely even spoken of.  Everything the majority wants is a "public option" or they don't want reform per N Pelosi; frustrating when we can solve the problems without it.

James, i wasn't trying to demonize anybody.  I was just making an observation.  I noticed it during the campaign, and I notice it during this attempt at reform.  The articles I read by conservatives sound wonderful about how we could do this or that.  But they're theory.  They're theory like de-regulation was a theory.  They leave out the fact that people are greedy, among other things.

I have a very intelligent friend here who sends me all kinds of nonsense about reform.  The email smears, etc.  I've sent her a bunch of stuff back.  I get the same old drill.  "I don't want the government telling me what treatment I can get, what doctor I can go to," etc.  

She says she has always paid more for insurance to avoid that.  (I'm sure they still have networks--they all have networks).  I'm glad she can afford it.  She ignors the fact that other people can't.  She ignors the huge CEO salaries, the lobbying costs, the campaign contributions, etc.   SHe has no alternative to offer.  Since regulation isn't part of her world, then what?  Wish for change and never do anything?  I just don't get it.

Have a nice day everyone.

Thanks Pamela.  The House Bill is theory unless and until it is implemented as well as it is unlike other systems.  The best we can do is score the various offerings and make the best analysis possible.

The problem is that the House Bill as it currently stands does not deliver what the President has promised per the CBO and factcheck.org.  The one that has been scored and appears to meet all the criteria per the CBO is the Healthy Americans Act.

I really don't understand why it is not being discussed openly and frequently; except for the fact that it doesn't involve the government as much or a "public option."   The opposition to it would have to be ideological and partisan to me; or as you say based on theory not fact.  Yet it has on record bi-partisan support.  Very curious to me. 

I like all the inputs.  I want some kind of reform in the US and I don't want to add to the 11 trillion dollar debt.  Let's innovate in the US and not copy failing systems to fix our own.  We have brilliant minds right here.  We don't need Canada or Britain as models.  Americans can fix America's system.  Like it or not, none of the systems are without problems.  To copy Canada's system is pure laziness with no backbone or volition to do what is right. What a bunch of lazy politicians we have (or they are in a rush?).  Let's make a system everyone else wants to copy!

Actually, you're incorrect regarding JFK getting us in to Vietnam. And about Kennedy in general. Do some reading here: http://en.wikipedia.org/wiki/John_F._Kennedy

JFK, I didn't vote that year, was a fine president.  He did get us started in Vietnam and I've lost friends.  You should read up on your history.  Although not important to this subject, I do blame his vice (LBJ) for escalating the situation, but hey that's the way it goes.  This is just to let you know, we as democrats are just as guilty or worse off when it comes to bad war choices.  I'm still a patriot even though I don't always like what I see.

Except 80% who can afford in Canada get additional private insurance to cover what the state doesn't; the head of the Canadian Medical Association says the system is "imploding" and is unsustainable; and in 2005 the Canadian Supreme Court said that Canadians have been needlessly suffering (and some dying) as a result of rationing of healthcare/waiting lines which is "widespread."

According to a website (See http://www.timelymedical.ca/) of a medical brokering company in Canada, there are over 875,000 people on waiting lists for treatment.

Not so simple.

It's very strange that you keep quoting an advertising Web site selling services as though it were objective analysis.

What's next?  4 out of 5 dentists prefer the free market?

With all due respect, you published here an entire article defending the Administration's position with all support citing Moveon.org and the Administration's website.  I think my partial citation of fact from a Canadian business is a bit more objective than that.

Whatever happened to "promote the general welfare?"

The "General Welfare" Clause is alive and well. 

The "General Welfare" clause gives Congress the power "To lay and collect taxes, duties, imposts, and excises, to pay the debts and provide for the common defense and general welfare of the United States."  This clause is not a grant of power to Congress (as constitutional law professor Gary Lawson has shown). It is a limit to a power given to Congress. It limits the purpose for which Congress can lay and collect taxes.

During the founding, some Anti-Federalists were concerned that this clause "amounts to an unlimited commission to exercise every power which may be alleged to be necessary for the common defence or general welfare."

But James Madison, the "Father of the Constitution," explained very clearly that it granted no power to Congress.

In short, as Madison argued, Congress derives no power from the general welfare clause, which merely serves to limit Congress's power to lay and collect taxes.  Congress can only do so for purposes of common defense or general welfare, in the service of the powers granted to it elsewhere in Article I.

Pamela,

I agree with you. I believe it a positive human right and, therefore, can be advanced within Constitutional boundaries.

However, we must know the enemy. What you're dealing with is a negative rights interpretation of the Founders without regard to growth or progress. It stems from the Newtonian notion of laws which govern the universe. All government leads to despotism is, to them, a law of the universe.

From that perspective, the Constitution is a prescription to refrain from action wherever possible. Since the general welfare of the preamble is later brought up in Article 1, Section 8 - Powers of Congress with specific measures which they may take to achieve the promotion of general welfare, such rigid interpreters will not permit Congress to take a positive rights action outside those measures.

A tradition of conservative judicial and legal precedent supports their position. In fact, were it not for a conspicuously conservative judiciary during the Progressive Era of the late 19th and early 20th centuries would have influenced a much different view and we would be faced with broader spectrum of choices other than the simple white and red of Cold War ideology (Jon Wiebel's use in these blogs of "collectivist" as synonymous with progressive.) (I even get a kick out of the kind of economic and political Domino Theory being brought out by those farthest to the oppositional right.)

Couple these facts with the philanthropic and corporate endowments feeding an impressive network of think tanks and it is difficult to advance a rational, humanistic, or Christian view of general welfare. If you crawl the web, you will find conservative and libertarian originalist analyses using quotes from Madison, Hamilton, and Jefferson to disparage all government activism taken on behalf of the general welfare including Social Security, Medicare/ Medicaid, public education, public works, and national parks.

They purport to be neutral and objective, loaded with all the "facts". Here's one of their slippery slope sites: http://www.preserveournation.org/issues/generalwelfare.htm

There's a lot to confront - keep the faith!

"Freedom to-day is something more than being let alone. The program of a government of freedom must in these days be positive, not negative merely." Woodrow Wilson

The traditional interpretation of the Constution and original intent is rational, human and Christian. 

People seem to be missing the point.  It doesn't have to be a Constitutional right in order for there to be Universal Healthcare.  It isn't a Constitutional right in Canada either, but they have it.

The government can, if we desire, act to promote and even provide healthcare; it just cannot trample on individual rights in doing so. 

The debate is not whether it is a Constitutional right or not; it is the best way to go about reform.  The question is, can we do better than some of these other models and avoid the pitfalls of other single-payer systems; do somethinbg uniquely American.

The government being overly involved, and many may define that differently, is what makes a majority nervous.

I like the Healthy Americans Act if I have to choose between that and the House Bill.  And I am open to review others.

Me too!

Sorry to hear about your plight.

Just between you and me (LOL), I have wondered why we even need insurance companies for healthcare except for perhaps catastrophic injury.  They are just an unnecessary third party whose  mere existence significantly increases costs.

If Doctor Jones had to actually compete with other doctors in terms of quality of care, costs, availability and bedside manor the cost and experience would likely be significantly better.  And there would be no additional costs for processing insurance.

A guy can dream......

Gary, great that you're for a single payer.  THanks for the support!

I've heard tell (on PBS, which usually tells the truth) that every single cost-cutting measure Obama has proposed to congress has been nixed.   Except, now, possibly those airplanes he succeeded in cutting.   Congress wants cost-cutting like crazy.  Just not in their own districts or for their own constituents.  Which makes it a little difficult.

I am probably misquided, but my impression is that conservatives are going nuts at town halls, first, because many are paid by the insurance companies to be there, and secondly, because they've been fed distortions and lies by emails and Fix news. 

Pamela,

Tell me you don't really believe that!  I am crushed. :o(  That is so Party-line!  Really?  Say it ain't so.....

Pam, logging off and heading to bed, James is not all together off base, not every one attending the town hall meetings watches Glen Beck (funny he must be the new O'Reilly at least in my mind).

Check out my web site.  I'm actually a candidate on the ballot in the (cough) governors race in New Jersey.  Lost in all the mishegoss on the site is a link to the Bill Moyers Journal on Single Payer.

http://www.steinforgovernor.com/Black_Thursday__7_23_09.html

p.s. why that page? try to keep the web crawlers busy

Ok, James, I'm listening!  What cost cutters has he suggested that the Repubs have supported (or even a lot of the Dems)?  Name one!  Facts!  I'm all into facts!

Gary, I'll check out your website.  I just wrote the Newshour (after their interview tonight with a conservative about the public plan having an unfair advantage because they can negotiate lower fees!  Geesh!  Why don't the journalists know that the private companies are worse!  So I set them straight), and then I revamped a bit and sent it to Bill Moyers, who is so interesting and courageous.   I am not sure whether I saw his program on single payer.  I think I did.  

This is all so interesting, I forgot to eat dinner!  how could that happen?

Please tell me which "cost cutters" he has suggested?  He basically punted to Nancy Pelosi and Harry Reid.  But if I missed some that he championed beforehand, let me know and I will respond.

I know he wants a central database to remove unnecessary duplication of services. 

I do recall that he indicated that preventative medicine will will save money by avoiding the need for costlier treatment later.  The problem is that the CBO adressed that specifically and concluded that, in the aggregate, it would in fact result in a net loss of 90 cents per every dollar spent on preventative care. 

So in the individual case where something is actually prevented, it saves money (and quality of life), but across the board it results in NO savings and in fact the cost benefit ratio is dismal.

Actually, his handing this off to Congress is one of my disappointments with Obama's leadership. I don't think any of the plans has put forth what can be considered reliable cost reductions. There are items which may influence costs, but no targets.

I think that reform, if it's done right, should set some targets and time frames for a particular direction - try something aimed at reducing by some amount or percentage for some period of time and, if it doesn't work, find out why and take action. Isn't that how we do things at work, how we do the things needed to pay these medical bills?

The bills are all timid and fail to define success or failure. (What are we learning from our military actions? If you set out to achieve a non-specific something, you won't like what you get.) No matter what gets passed in this vein, a pol can spin it to be whatever he wants. That's what's driving all the think tank noise, now. Is that what we want?

The bipartisanship idea is dead. Dems, especially Obama, cannot let go of the public option. Repubs will not accept a public option and, as the minorty, bargaining means that they need to offer something the Dems want in order to get the Dems to give up the option. But what else do the Dems want? If the Dems want the Repubs to accept a public option, they could offer some token tort reform but damage caps don't work, what's nex? If they're given that, will Repubs reject the public option anyway? Sounds like it from both the Congress and voter end.

I make no bones about it, I support single-payer. But, if told there is no way in hell that I'll get it, I can't support HR 3200. It fails on too many levels. It's slow to implement changes, doesn't adequately define basic coverage (the HAA at least sets a baseline policy as a starting point - show the baseline product in HR 3200), leaves us with insurance tied to the employer, and, unless I'm reading wrong, doesn't demand that the employer offer the public option as an option for many years.

Obama doesn't think single-payer is currently possible, so he wants a gateway to ease it in. He also doesn't think that we're ready to have the employer-provded insurance model shattered, so he shelves the HAA. If you ask me, I'd have grafted some sort of public option onto the HAA instead of the HR 3200 monster we have. The American people are bolder than Obama or Congress and ready for substantial change.

Then there's the cost drivers. I hear almost no discussion outside of admin costs. There's even a conflation of profits with admin costs. I find it morally disturbing that there is profit off illness and injury but, looking at the numbers, profit pales beside CEO payroll (for insurers and provider organizations), the paperwork required to keep up with each person's insurance coverage. even then, we're still faced with a higher than desirable % of GDP to costs. What next?

Empty beds in hospitals carry huge overhead. It costs almost as much to have tham empty as full. Consolidation of hospitals and services creates diseconomies of scale. Which plan is going to fix that?

Worse, hospitals depend disproportionately on Medicare and Medicaid dollars. Most individuals, covered or not, need more primary care than they're getting and need relief from the huge bills that are coming from an aging population. Experts agree, primary care will yield cost savings in excess of what we invest into it. Which bill will do that? which one will balance the risk pooling? which one will make the needed hospital care cheaper? They have ideas on how to encourage lower costs but nothing that demands it.

http://business.theatlantic.com/2009/08/an_idiots_guide_to_health_care_reform.php

http://www.bluecrossmn.com/bc/wcs/groups/bcbsmn/@mbc_bluecrossmn/documents/public/mbc1_healthcare_cost_drivers.pdf

With all this spending, we still get less than adequate care and too many are left out in the cold. The inefficiencies just stack up. Which bill addresses the underlying inefficiencies? If Congress can't even get a bill that leaves the insurance game intact, how confident are we that, once something is passed,  they will ambitiously revisit the issue of underlying costs?

These costs do not follow basic supply/ demand rules. The prices do not follow business cycles. The inventories are often unallocated services, not hard goods. This isn't easy.

Very shocking headline covering up a story that is beyond mundane in context.

The Liverpool Care Pathway, as quoted in the article, "has been gradually adopted nationwide and more than 300 hospitals, 130 hospices and 560 care homes in England currently use the system."  That means it's in use by a mere 27% of hospitals in the UK.  Doesn't smack of a centrally-controlled program to me.

In contrast, we have about half our hospitals using some palliative care services along similar lines.  As you might suspect, our results are all over the map.

"In the new state-by-state ranking, only Vermont, Montana and New Hampshire get an A, while Oklahoma, Alabama and Mississippi get an F. The rest of the states are somewhere in between, although Southern states did not fare well in general."

http://health.usnews.com/articles/health/healthday/2008/10/02/national-scorecard-ranks-palliative-care-across.html

What does this additional quote prove?  The same thing James article does.  Some hospitals do palliative care well.  Some do it poorly.  Neither of our countries does it systmatically or with uniform quality.

We needed a link from James Dunham to tell us this?

Actually, I saw this with my father when he was dying.  He was away from family and friends, had moved away from his home town, and I only got over there every three or four weeks.  he had a toxic psychosis from his drug interactions, but the docs didn't know that.  They never blame themselves.  I called and pointed out to the doc that there is no mental illness in our family, dad had never been like this, I saw it happening after he took a particular medication, and then it would clear up....etc.  They just thought he was a crazy old man (he was only 73).   And did nothing about it, until I pointed out his history.  Actually, they still did nothing about it.  He was so paranoid, he wouldn't eat and starved himself to death.

I've also seen it when my mother and stepfather have been in the nursing home here.  For the first couple of weeks, if you're not there every single day, they don't get the care they should.  Their meds don't get straightened out, they don't get the right diet, etc.  You have to be there every day to let the caregivers know that someone is watching out for that person.  You have to advocate, and then check the next day to see that they follow through.  You have to help them understand the person's history (I took in a lot of pictures of Mom when she was young and beautiful).  You especially have to teach your parents how to speak up for themselves, when they can.  

When my stepdad (who is a POW and usually gets his care from the VA) was recently put into a nursing home for a while, I learned after a few weeks that the VA no longer contracts with that facility, so they were saying they wouldn't pay for it.  I said, but he is familiar with that facility, and the other one was full.  They said, well, we have beds in Sandpoint or St. Maries (both an hour away).  And I said, yeh, right, if family are not there every single day for a couple of weeks, until the caregivers know them, they don't get the care they should, and no way can I travel to Sandpoint or St. Maries every day.  The social worker admitted I was right and that studies actually show that.  so they ended up paying for it.

So, I guess I do agree with people that there are concerns about caring for the elderly.  I do see things in HR 3200 trying to address some of that.  But there simply is nothing like people having an advocate.  Nursing homes are FOR PROFIT!!!!!! There's that nasty word again!  And so they hire as few staff as possible, serve the cheapest food possible (it generally sucks--I'd die in a few weeks if I ate it) and they're too often overworked and undertrained.  Without government regulations, they'd be horrible. 

Although, I must say, my mother is now in an assisted living facility where the staff has worked together for ten years, and they do a great job (I've learned that low staff turnover is the best indicator of a good facility. If the staff are happy, the residents are happy). She's also getting better at speaking up for what she needs.  But one's first time in such a facility is such a shock, and they're so confused and upset, they just don't know how.  

I have no children, so I do worry about who will advocate for me if and when I get to that point.  I have thought about how I will find and become part of a community, so that I will have advocates (I don't plan to retire here).  (But I'm also a lot more assertive than my mother...)

I think the answer is to jump off a cliff when it gets to that.  Dad probably got it right.  He only lasted in the nursing home for three or four weeks.  He was done struggling.

"The study found that too often resources are limited and doctors have to make difficult decisions."

Whereas in the USA, insurance company and HMO bean counters make the decisions -- and their decision is always easy: not treating you is more profitable for us.

Pamela, we’re two chips of the old block, I also post long threads (over on immigration side, I’ll spare everybody the link).  If you kept it short I might not be writing this at all?  We shouldn’t apologize.

You mentioned the “Ugly American” and you haven’t been to my web site; now might be a good time http://www.steinforgovernor.com/News.html  The book title is a link.

If that interested you (I think my stuff might interest people?  Don’t we all!  It rarely does.) I have another web site where I’m actually pictured reading the book (The Ugly American) in Mexico.  So here’s where things stand so far- if anyone bothers to go to my link, we’ve established that the phrase “Ugly American” took on a life of it’s own after the book was published.  Originally it referred to one of the main characters in the book who had an unpleasant physiognomy.

In addition, on that same page in the Stein for Governor web site, you can easily find a link to Bill Moyer’s discussing Single Payer.

(Watch the thread grow)  Pamela, you mentioned that you e-mailed the “News Hour.”  Sort of been there, done that myself  http://www.dailykos.com/story/2009/6/1/737511/-Do-I-Have-to-Blow-My-Brains-Out  You’ll learn eventually.

Pamela, you mentioned about breaking out in song when your group returned to the US.  After my first trip visiting my friend, deep in the bowels (LOL) of Mexico, I was still quite a bit enamored with that cess pool of a country.  I remember the last day, flying out of Mexico City, and marveling how colorful the buildings and roof tops looked from the plane.  When our plane was landing in the Charlotte, NC hub in early December, I was thinking how drab everything looked, nevertheless I had the same feeling as you, I wanted to kiss the ground.

It’s all detailed on http://www.steinforgovernor.com/News.html including the last diary I published in the very intolerant left wing blog, the Daily Kos (using the name mightyquinntheeskimo):  health care nailed over coffee and a bagel.

p.s. Took a lot grief over on the Daily Kos, tried to return the favor; you can see it in the writing style, can’t you?  Was the writing that bad, never mind health care reform for a few minutes?

Screwed up, that’s my just deserts.  The first link should have brought you to http://www.steinforgovernor.com/TheGov_s_Journal.html  where the link is right there for the Ugly American.  Aaaah, the whole thing falls apart.  Let me make it up to you, this song is playing on the media player as I write this (an NPR station that plays rock commercial free)  http://www.youtube.com/watch?v=pBKx8PyE5qQ

Pamela,

I think I'm in love with a Liberal.  That was truly inspiring and patriotic.  It reminds me that we are ALL Americans and love this country.  I am so sick of hearing how ashamed we should be when the world has been so benefited by our existence and willingness to shed blood to defend freedoms.

Yes, we have done some damage but can we view her faults through the lense of our love for her rather than the lense of her shortcomings?

I wish I had your faith in the government's ability to handle this situation.  I have greater faith in their ability to impose restrictions on what can be excluded from policies like pre-existing conditions, and to punish wrong - doing and encourage good behavior (the carrot and stick, if you will.)

Quite frankly, I don't fear that we will NOTget some legislation labeled healthcare reform; I fear that we are going to get some disfigured bastard of the promised child that will displease us all in the end.

James, they have never imposed restrictions on taking care of people.  Their regulations have always been to assure that people get what they need, whether it be consumer protections, environmental stuff, nursing home regulations,  the good old days when they regulated monopolies, etc.  They had always been protections for the people.  If our government knows nothing else, it knows how to protect the people.   All of HR 3200, except the nonsense about keeping Med Advantage plans, is about people protections.  Including a lot of improvements to Medicare.  

I mean, afterall, THEY is US.  

Well, I could list quite a few things that either infuriate or leave me shaking my head; but I know you can too.  I think people are really choosing the lesser of two evils rather than a savior.

OK, I am sure everyone will scoff, but administrative costs for handling claims for benefits.  The study below explains it, so I will quote the below and provide the link.

http://www.heritage.org/research/healthcare/wm2505.cfm

Administrative Costs per Person

When administrative costs are compared on a per-person basis, the picture changes. In 2005, Medicare's administrative costs were $509 per primary beneficiary, compared to private-sector administrative costs of $453. In the years from 2000 to 2005, Medicare's administrative costs per beneficiary were consistently higher than that for private insurance, ranging from 5 to 48 percent higher, depending on the year (see Table 1). This is despite the fact that private-sector "administrative" costs include state health insurance premium taxes of up to 4 percent (averaging around 2 percent, depending on the state)--an expense from which Medicare is exempt--as well as the cost of non-claim health care expenses, such as disease management and on-call nurse consultation services.

From the other side of the perspective.  Full article likewise recommended:

http://krugman.blogs.nytimes.com/2009/07/06/administrative-costs/?pagemode=print

"However, the Congressional Budget Office (CBO) has found that administrative costs under the public Medicare plan are less than 2 percent of expenditures, compared with approximately 11 percent of spending by private plans under Medicare Advantage. This is a near perfect 'apples to apples' comparison of administrative costs, because the public Medicare plan and Medicare Advantage plans are operating under similar rules and treating the same population.

"(And even these numbers may unduly favor private plans: A recent General Accounting Office report found that in 2006 Medicare Advantage plans spent 83.3 percent of their revenue on medical expenses, with 10.1 percent going to non-medical expenses and 6.6 percent to profits-a 16.7 percent administrative share.)

"The CBO study suggests that even in the context of basic insurance reforms, such as guaranteed issue and renewability, private plans' administrative costs are higher than the administrative costs of public insurance. The experience of private plans within FEHBP carries the same conclusion. Under FEHBP, the administrative costs of Preferred Provider Organizations (PPOs) average 7 percent, not counting the costs of federal agencies to administer enrollment of employees. Health Maintenance Organizations (HMOs) participating in FEHBP have administrative costs of 10 to 12 percent."

Tim,

Could you please explain what the difference is between Medicare and Medicare Advantage or direct us to some source that lays out the specific differences?  Is there a source that does that and also includes the average private plan outside the system?

I will look myself, but if you know of anything other than the Medicare site itself I would appreciate it.

Thanks.

James, of course I would like to hear from Tim on this, but I also go into this pretty extensively on my site at:

http://healthcareviewpoints.com/

You won't find it readily, it's down a ways in the healthcare reform page, but hopefully, the reading will be interesting along the way.  You will understand HR 3200 pretty well by the time you finish. 

I couldn't figure out the difference for a long time when I was looking into Medicare Supplements.  Besides my site, the place I found that finally explained the difference to me was the Medicare advocacy site at:  

http://www.medicareadvocacy.org/

I don't know how the Med Advantage plans compare with the supplemental plans in terms of profits, but I suspect the supplemental plans aren't hugely profitable.    The Med Advantage plans are hugely profitable, making billions, draining the Medicare fund, and not providing very good bang for the buck.  That's why HR 3200 is creating a way to monitor them (more money being spent).  I'd just as soon they kill them, myself.  

Before I learned about Medicare, when I was trying to come up with the ideal way to create a private system, I thought to myself, "Why not have a cheat sheet with a limited number of plan options, each with a letter code, so that we could simply look at the cheat sheet to find out what someone's benefits are, instead of wasting time calling the company or looking online?"

I was ecstatic to find out that's how the Medicare supplements work.  Easy for consumer and provider to understand.  not so with most private plans, and WAY not so with Med Advantage plans.

Another place you can go is to the AARP med advantage plans, called Secure Horizons.  If you can't find them or can't get info, I think I haven't yet thrown out the document they sent me on the coverage of the plan we got for Mom (and then changed out minds), and I can send it to you.  Also, you can call various private companies and ask them to send you info on their med advantage plans.  Then you can compare them with the link on my site that outlines what the supplements offer and cost.  

You have to look beyond the surface, to imagining things like stroke, etc., that put people in hospitals and nursing homes for a couple of months.  That's when the Med Advantage plans do you in.

The "Medicare Advantage plans receive a capitated (per enrollee) rate from Medicare to provide Part A and B benefits to their enrollees."

http://www.kff.org/medicare/upload/2052-12.pdf

That amounts to a premium paid whether or not medical services in that amount are performed.

I think that's the central driver of excess costs to Medicare from these plans.

Tim, have you or anyone written anything comparing HR 676, HAA, and similar proposals? I have a Day Job, otherwise I'd spend hours and hours finding out about this stuff.

James, James, James...

Your Faux News-style disinformation is just soooo dishonest...

"When administrative costs are compared on a per-person basis, the picture changes. In 2005, Medicare's administrative costs were $509 per primary beneficiary, compared to private-sector administrative costs of $453. In the years from 2000 to 2005, Medicare's administrative costs per beneficiary were consistently higher than that for private insurance, ranging from 5 to 48 percent higher, depending on the year (see Table 1)."

Have you considered the fact that Medicare is for seniors, who require several times as much care as the average person on private health insurance?  OF COURSE the per-person administrative costs are higher for Medicare: the healthy people with private insurance aren't going to the doctor.

Duh.

The problem is, all your alleged evidence is of the same dishonest, superficial, cherry-picked, unscientific Faux News variety.  All of it.

Roy,

Critical thinking is not everyone's strength.  But I am sure you are good at other things.  Perhaps you can get a government job.

Good luck.

Pamela,

I actually don't own conservative books.  However, I would be willing to read your recommendation.

How about we make a pact:  We will not accept the representations of any politician or political activist until we have seen all the facts presented from multiple sources.  Then we will decide for ourselves.  I always seem to find that there are a lot of little facts (and some big ones) that are overlooked when trying to advocate for "the Party."  And some lies.

Ok, but I think I already do that.  I support healthcare reform because of my own experiences with the system, not because the democrats or Obama say it's cool or will get them re-elected.   And actually,  after reading HR 3200 and responding to that very distorted and downright dishonest email smear, I supported HR 3200, discovering that it's much more well thought through than I had previously believed.

 Then when i started researching to add links to my site, I got madder and madder.  And at this point, I'm all for getting rid of healthcare for profit completely (I mean, that would have been myfirst thought, anyway, but I didn't think it possible, so I just caved).  It was sort of salt in the wound when I had just learned the Aetna CEO makes $24,000,000 a year, and then I got a contract to sign lowering our fee $4 this year from last, taking it to within $2 of our fee 15 years ago (and then finding out my car repairs are going to cost $700).  Needless to say, I emailed them a response asking for a raise, not a decrease.  I haven't heard from them.

Pamela, don't forget me, check out the web site.  You know I'm on the ballot in a very important race with national implications.  I wish the folks would realize they have the real deal "Joe the Plumber" in the person of yours truly.  And an authentic Republican, albeit a poor one,  who is for Single Payer.  I'm spitting into the wind, no one cares.  I also had something unorthodox to say about immigration.  Don't let me down.

I looked at the one page, but it was the end of the day and I had to leave quickly.  I'll give it more time tomorrow.

I suspect in most races there are many people who would be more qualified than the people who actually pull it off.  Politics has become way too complicated.

you are so right (send me a friends request)

It's virtually impossible to get your message out- people are even busier now then when we where younger, take blogs for instance.  how about 2nd and 3rd jobs?

no wonder for the 30 second campaign commercial, and it's not surprising at all that demagogues get all the publicity.  Thinking specifically of S. Palin from Alaska (LOL)

p.s not criticising, I have no time, i glance at things if I'm lucky.  please get back, is web site- too whacky or o.k.?

So.......wanting Healthcare Reform but not wanting a single-payer system is anti-family values, anti-America, etc?  Scary.

Elizabeth,

Remember, if reform passes, we will lose seats in 2010.  If you further decide to vote for the opposition, we may be in a world of hurt.  Let's just hope for the best and hope lawmakers come up with some sort of compromise.

That won't work around here, Elizabeth.  Most people here are conservatives who are arguing against reform and a "government takeover."

I've written my representative and senators numerous times.  I've called my representative to try and sit down with him and tell him what it's really like out here as a provider.  I either get back the party line, or no response.  And amazingly, my representative is a democrat. He's been called the most Republican Democrat in the congress.   I called his office to share some things I've figured out about how to save Medicaid a ton of money in Idaho, without compromising quality of service at all.  no response.  no meeting, no call back, no interest.  They've made up their minds. 

I have never, ever gotten the feeling that they listen.  They lecture.  

Pamela,

It is not my impression that most folks here are conservatives; and it is DEFINITELY not the case that most are arguing AGAINST reform.  I think almost noone is against reform. 

Many are against the current House Bill with the government option, however, believing that there are other better solutions to be explored.

James, I am not speaking about people here.  I can see that most are for reform.  But I have never, ever encountered a liberal who is against the public option.  Liberals are not afraid of the government.  In fact, most liberals would be quite comfortable with a single payer government plan.

Conservatives are against the public option, as they were against Medicare, Social Security, consumer and environmental protections, voting rights for women and blacks, the end of slavery, etc.

It goes way back, dear.  conservatives don't like change, typically.  

Is there any liberal here against the public option?  Please stand up!  LOL!

I'm in the process of trying to find some documentation of the cost-cutters obama has suggested.  They mentioned them on Washington Week a couple of months ago.  I'll see what I can find.  

Hmmm...I believe Lincoln was a Republican and the only KKK member of the Congress (Byrd) was on the Dem side.  Nixon also proposed healthcare reform which was, ironically, shot down by Senator Kennedy as political strategy.  Voting rights?  I don't really know....I'd have to research that history to be honest.  And Healthcare with the public option is being opposed by some Democrats too.

I'm conservative and I want healthcare reform.

Pamela, are you going to cover the HAA on your web site? After seeing James' comments about it, I read the Wikipedia article, and it sounds good, despite comments by the Lewin Group (a front for the insurance industry.)

As a humble citizen, I feel cowed by the sheer amount of information, and discouraged by the conviction that nothing useful is going to happen any time soon. Meanwhile my insurance premiums go up 30% per year and the company could drop us any time they want if we get sick. The latest increase puts us over $19k per year for a family of 3.

oops...here's two:

http://www.manhattan-institute.org/html/mpr_05.htm

http://www.cahi.org/cahi_contents/resources/pdf/CAHIMedicareTechnicalPaper.pdf

Those against reform are the majority in Idaho. They are very ideological.  I have a friend who is a top realtor, smart lady.  She's smart enough to stop sending me all the email nonsense, because I invariably research them and get back to her with the truth!  LOL 

No amount of facts change her mind.  She has the money to buy premium insurance, and that's that.  It doesn't matter that other people can't.

Here, elections are about abortion and gay rights, period (except for the rich, and for them it's about staying rich).  Even when it's pointed out to them that the abortion rate is the same world wide whether it's illegal or not, that doesn't matter.  (the only place it is statistically lower is Western Europe, where it is legal and readily available, but birth control is taught!!!!!)

It doesnt' matter how many innocent people have died in the war (Iraqi's don't count, they only count Americans).  It doesn't matter how many people are starving worldwide (last I checked, it was about 875,000.  That's almost 1/6 of the world's population.  Tens of thousands are dying every day because their health is so compromised by poor nutrition--partly because fuel prices are so high, food prices have gone up beyond their ability to pay (partly because of our stupid energy policy).  That doesn't matter.  Climate change doesn't matter.  It simply is a natural phenomenon.  

My (Orthodox) priest's wife voted for Bush.  Twice, I think. But she voted for Obama.  She said, "I decided Bush is only pro-life from conception to birth. After that, he's not." 

But most don't see it that way.  And since they don't, they just buy the party line.  They are good, honest, decent people.  I like them.  "Some of my best friends are conservatives!"  LOL (and most of my extended family).  

But they just don't get that the party leaders and "think tanks" and Fix News, etc., lie to and manipulate them constantly.  All those people have to do is be against abortion and gay rights, and the people here will listen to anything else they say, no matter how nutty.  Sarah Palin's "death panels" are a perfect example.  How many people bought into that silly nonsense?  People here love her because "she's plucky."  

Nevermind that it takes a bit more than pluck to be president.  "She'll learn," they say.

I goofed.  It's not 875,000 that are starving.  It's 875,000,000!  So hard to comprehend, I keep writing it incorrectly.

Almost a billion.  My husband's best friend works for the same charity organization that Peter did before he died.  He said the main problem is not that there is not enough food, it's that the cost is so high because of fuel prices (getting it to market is expensive) people can't afford it.   If we would go to an alternative energy source.....or had long ago, things could be different.  

I know, this is a different topic....but I recall being taught in 4th grade (that's 55 years ago) that we would run out of coal and oil and would have to develop other energy sources.

We still haven't done it, not to the extent that it is affordable for everyone.  We won't do it until the public rises up and demands it.  

Sorry to be off topic, but this one takes the cake (about Obama speaking to our school children):  "I don't want my child to grow up to be a community organizer!"

I don't suppose he would want to think of Christ's disciples as community organizers!

Or anyone doing missionary work, for that matter.

Big difference between Christ's disciples and ACORN.  Sorry.

I surely don't know why people are against ACORN in any case.  But even so, it's the "over generalization" again, James.  Throwing out all community organization because one doesn't like ACORN.  That's what the guy on TV was doing. He didn't want his kids listening to our president, because gosh oh gee, they might grow up to be "community organizers."  

My husband was a community organizer.  He did terrible things like raise money (for nine years) to feed the hungry around the world (for the National Council of Churches), did post-war reconstruction in Bosnia after the war (for the same organization), took students to Russia to rebuild the churches and monasteries after the govt. finally gave them back to the people (during his vacations).  You know, all those subversive things we wouldn't want happening in our own community.  ;-)

The ACORN issue is a straw man created by the people who want to bring down Obama. just like death panels, birthers, etc. All they have to do is associate "Obama speaking to schoolchildren" with "socialism", and it sets off a knee-jerk reaction in those who are predisposed to it.

Pamela,

He sounds like the salt of the earth.  God bless him; but ACORN as an organization (being pursued and criticized by some of it's own former members) is quite different.  They wrote of themselves in 2003 that ACORN:

"is not shy about using the in-your-face tactics that Stern derides. A few years ago the Baltimore chapter attracted public attention when members piled garbage in front of City Hall to protest lack of services in poor neighborhoods, wielded huge inflated rubber sharks to disrupt a bankers' dinner and staged a protest in front of Mayor Martin O'Malley's home.

As Stern reports, Mayor O'Malley was upset. Even some of ACORN's sympathizers, such as Baltimore City Council member Lisa Joi Stancil are sometimes uncomfortable with the group's aggressive approach. Stern refers to a story in the Baltimore Sun that quoted Councilwoman Stancil as saying "There are boundaries, and they don't seem to have a problem crossing them."

ACORN is unapologetic about its tactics, in part because it not only helps draw public attention to neglected issues but also helps build membership. ACORN's success in Baltimore boosted donations and swelled its local membership to 2,200. Equally important, these tactics typically get results. Public officials who decry ACORN's tactics wind up agreeing with its agenda - or at least negotiating with its leaders to forge compromises."

And yet they decry the grass roots Town Hall protests as unAmerican.  They also were one of the driving forces of sub-prime loans, which was supported by both Dodd and Frank who actively opposed regulation, that lead directly to the economic crisis conveniently blamed on the former Administration. (ACORN used these practices to promote "policies that encourage banks to make mortgage loans to boost homeownership.")

http://www.nhi.org/online/issues/129/ACORN.html

Further, see the House Report at http://republicans.oversight.house.gov/media/pdfs/20090723ACORNReport.pdf

Table of Contents
I. EXECUTIVE SUMMARY....................................................................................................................... 3
II. FINDINGS .............................................................................................................................................. 6
III. THE ACORN HANGS FROM MANY BRANCHES......................................................................... 7
A. VOTER REGISTRATION FRAUD............................................................................................................... 7
B. EMBEZZLEMENT.................................................................................................................................... 8
C. ORGANIZATIONAL MISMANAGEMENT................................................................................................... 9
D. POLITICAL ACTIVITY ........................................................................................................................... 10
IV. ACORN USES ITS COMPLEX ORGANIZATIONAL STRUCTURE TO FACILITATE
FRAUDULENT AND ILLEGAL ACTS.................................................................................................. 11
A. ACORN FAILS TO FULFILL ITS CORPORATE DUTIES ............................................................................. 15
1. ACORN Breached Its Fiduciary Duties by Covering up Dale Rathke's Embezzlement ................. 16
a) ACORN Violated ERISA..................................................................................................... 22
b) ACORN Breached Its Duty of Care ..................................................................................... 29
c) The Embezzlement Is An "Excess Benefit" Transaction Prohibited By The IRS ................ 31
2. ACORN Breached Its Corporate Duties by Failing to Abide by its Bylaws.................................... 31
3. ACORN's Financial and Structural Mismanagement Has Led to Its Failure to Uphold Its
Corporate Duties ............................................................................................................................... 35
a) ACORN Lacks Quality Control in Hiring and Supervision of Employees ......................... 44
B. ACORN AND ITS AFFILIATES ARE NOT IN COMPLIANCE WITH THE IRS .............................................. 47
1. Congress, In Regulating Nonprofits Intended Nonprofits As Not-for-Politics................................ 48
2. ACORN and Its Affiliates Violated Their Restrictions As Nonprofits ............................................. 48
3. ACORN and Its Affiliates Engage In Substantial Lobbying Activities ............................................ 52
V. CONCLUSION..................................................................................................................................... 73
VI. APPENDIX 1: ACORN COUNCIL ................................................................................................... 74
VII. APPENDIX 2: RICO ANALYSIS..................................................................................................... 82

They are guilty of widespread voter registration fraud, to which at least on high ranking official plead guilty and is now cooperating in the ongoing federal investigation.  http://www.judicialwatch.org/blog/2009/aug/acorn-director-pleads-guilty

Yet they continue to be eligible to receive millions to billions of dollars of taxpayers money; and the Dems tried to put millions of dollars more into their coffers as a part of the STIMULUS bill!

If the concerns about ACORN are a "straw man" and they are not pure astroturf, then Al Capone's family got a raw deal.

So does this justify our man on the news disparaging every community organizer?

I'm not wild about "in your face" organizers, either. But overgeneralizing doesn't solve anything.  It's the same kind of mentality as racisim, sexism, or any other kind of prejudice.

I wish,  for a month, you  and other conservatives would watch PBS.  The Newshour, Washington Week in Review, Charlie Rose, Bill Moyers. Believe it or not, they all have conservatives on their programs.  But they do strive for accuracy and balance.  They are not propaganda.  Try it for a month, and you might feel differently about some things.

Pamela,

No it does not.  But how about these over generalizations: "the Republicans don't want reform, they just want to defeat Obama", or the opposition are all "racists", or all conservatives are duped by Fox News and Rush Limbaugh; or the Town Hall protestes were all "astroturf"; or the Tea Partiers were all conservative "racists" and "astroturf" financed and directed by Fox News; or that any facts that come from any conservative on or off Fox News is just "propaganda" but the MSM is not.

The lack of a truly open mind on the left is as hypocritical as anywhere on the Political spectrum.  The successful manipulation of Party Leaders is the reason they treat us all as dumb sheep.  They say "astroturf" and suddenly it's true; they say any of the above and the faithful say it's true. That's why they are elitists.

This is disgusting and the reason most good folks don't want to be politicians.

Well, perhaps you're right, I do tend to lump Republicans at this point.  But that's because everyone here I know who is a Republican listens to Fox News and thinks it's nothing but the truth. I can't even talk to them anymore.  Facts mean nothing.  For years I have been talking to them as if they will listen.  And not yet have I found one for whom facts make any difference at all.  

Pamela,

I have no doubt that that has been your experience.  But may I offer that folks on the other side have the same experience with folks who love Keith Obermann and MSNBC; that is as biased a channel as any.

The fact is that we have groups with tow opposite deeply held convictions about the government/insurance companies and the depth of their involvement in healthcare.  Even when we want to achieve the same goals, we are going to have some strong disagreements about how to achieve those ends.

That is why it is angering to me to see political leaders of BOTH camps say things, confident that the absolute die-hard constituents will just run with it.  To me, that is an insult.

Whether it's the use of sound-bite phrases like "death panels", or calling legitimate facts "lies and distortion", or honest protestors "astroturf" the dishonesty just further creates animosity between people that should be discussing how we can agree to get there.

WE shouldn't be hoping one side or the other wins; we should be hoping that something is done that actually remedies the situation well.  To me, anytime someone flat-out discounts a factual argument because of the source, it is a sign that we have fallen victim to that.

Whether it is Fox News or MSNBC, (or whatever) we should just be interested in the facts.  Honestly, while I am not advocating for one over the other, thinking that Fox News is "just propaganda" is respectfully just nonsense.

Now, the opinion shows are NOT the news but people keep lumping them together.  Glenn Beck and Hannity are not Fox NEWS although they are on the cable network.

I mean Mike Wallace's son, Chris Wallace, does a real good job hitting the facts.  And as an aside, Chris' interview of his father on the latter's retirement was a very heart-warming thing to see.  They even come from differing perspectives, but the love they openly expressed for each other was sincere and touching.

Too bad we can't have that in this debate.  It could really benefit from some love and respect.  All the more because this has become a very emotional issue for many.

Hi, fellow Westerner!  I love Wyoming!  I'm from Utah, originally (no, I'm not).

I don't know if I will review the HAA on my site for the simple reason that my webmaster has finked out on me.  It was a trade, and he's been too busy at work to even upload my links.  So I have a huge learning curve ahead of me to learn to do the site myself, and a lot of other things I have to do.   I'm pretty discouraged about the whole thing anyway.  The legislators aren't listening, as you've experienced.

Yes, they all try to whitewash their refusal to move forward and work with anybody.  One of the bloggers said it above:  if we win reform, the conservatives will lose the election in 2010 (and that's all they care about--down with Obama). Nevermind the costs to families or to our country as a whole.  I'm disgusted with politics.  I think we should just throw them all out.  Give them one or two terms, and then call it quits.  They get too in love with their jobs.

The one that has put me over the edge is the outrage about Obama speaking to school kids, to encourage them to stay in school. People are unbelievably racist and ignorant. They try so hard to hide it, but it just slaps us upside the head.  

Long live democracy and brotherly love.

I don't know if I mentioned that in my contract package I just received from Aetna (the company whose CEO makes $24,000,000 a year), they are trying to reduce our fee from $96 last year to $92 this year (Medicare pays $93).  I wonder how many people can live today on what they made 15 years ago.  What has there been since then, at least 30% inflation?  And we're supposed to keep on truckin', for some reason.  I just spent $631 on my car, so it would run.  Funny thing, the mechanics haven't had a fee reduction lately.  

wow, that cought my eye, i'm on the immigration side of the blog and got the e-mail, opened and see that you ran into Dick Cheney.  Tell us more!  I'm not joking.

and pamela, you forgot about me, Stein for Governor, send me $2 next year when i run again for congress.  the weasel we have will be on his 9th term, a term limit pledge guy from the 90's.

www.steinforgovernor.com

I am so sick and tired of the anti-Republican hypocrisy and bogus playing of the race card.  That is so friggin typical of the left when they don't ant to deal with facts that contradict their view.  Stop being hypocritical HATERS.

Was it racisit when the Democrats held hearings about the Constitutionality of Bush's speech to school children in the 90's even AFTER it was clear how benign it was?  Apparently watching Bill Moyers and PBS and the other supposedly more "fair and balanced" folks somehow is not resulting in more accurate knowledge and less partisanship.

http://www.washingtonexaminer.com/opinion/blogs/beltway-confidential/When-Bush-spoke-to-students-Democrats-investigated-held-hearings-57694347.html

When Bush spoke to students, Democrats investigated, held hearings

Really try hard for objectivity if you can

i don't live far from either.  if you check out web site, stein for governor, get back.  it's different, you might enjoy, as a matter of fact if you go along with what i'm doing there you might spend hours.

Yeah, see above.  I guess the dems were racist when they did the same thing and worse in the 90's.  Stop playing the bogus race card.  Every time it is used as a mere political hate tactic it does a disservice to the cause against true racism like the boy who "cried wolf."

I agree with all the principles he outlined.  I found the end particularly inspirational. 

The problem is the same that I have had all along---he keeps describing a Bill that as of this date does not accomplish everything he describes per the CBO. 

And he very cleverly this time said that there is nothing in the House Bill that "requires" anyone to give up their current insurance without acknowledging that, according to the CBO, 3 million will lose their insurance when employers do the math and drop coverage.  So calling others out for lies and distortion falls flat when he continues to offer his own.

The only thing different this time was his strong rhetoric that, while he supports it, the left needs to keep in mind that the public option was a means to a goal and implied it was not a "must have."  He also strongly called for contribution to make the bill "better" which I hope he means.  According to thehill.com:

Boehner: GOP leaders haven't met Obama for health talks since April By Molly K. Hooper - 09/09/09 11:09 AM ET The ball is in President Obama's court to reach out to Republicans if he wants a bipartisan bill on healthcare reform, House GOP Leader John Boehner (Ohio) said Monday morning.

Boehner told reporters that the president has not invited House GOP leaders to the White House for meetings on healthcare reform since the end of April.

Earlier this year, GOP leaders sent a letter to the president in May stating that they would like to work with the administration to find "common ground" on healthcare reform.

But the administration responded with a tersely worded letter indicating that they had healthcare reform under control.

To me he did a good job in campaign speech style, but was disappointingly lacking in honest detail and in drawing the promised lines in the sand about what he saw as "must haves" in the final version.   There was no real message to the die-hard left to compromise, and the tort reform "pilot  program" bone was just smoke.

When employers drop coverage, there will be many, many other plans people can buy into.  The price will be adjusted according to ability to pay.

To quote one of my heros, "We are the ones we have been waiting for."  Things aren't going to be cheaper unless we all do our best to stay healthy. Prevention is a huge key.  The CBO simply cannot predict what things will cost because they cannot predict people's ability or willingness to do more to stay healthy (and they cannot predict the cost of future tests and treatments).  They have to figure things on the basis of current conditions.  

Nothing is going to be handed to us.  When my blood pressure started creeping up and stayed up for several months, I finally started walking again and losing weight.  It's now back down to normal, two months later.  I have a goal for my old age: live to be 100, never grow old, and do not give the drug companies the satisfaction of buying their drugs.  I buy one, generically, occasionally,  if I have to.  When I can, I change my lifestyle.  We are not as powerless as we often think we are.

We all have to work to make this reform work. Personally, having done things my own way in a solo practice for many years, I don't look forward to changing the way I do things.  In some ways. I'm glad I'm 65 and might soon be able to retire.  On the other hand, if, in relation to demanding "evidence-based" treatments they give training for new approaches, I'm all for learning new ways of doing things.  

As for the door not being opened to Republicans, I'd have to read that letter to believe it.  I'm reminded a bit of our church, a Greek church where there are quite a few converts like me. The Greeks were angry for a long time that Fr. Stephen was spending so much time with the converts, in study groups, etc., and so little time with the old-timers.  We had a huge meeting about it when they tried to throw him out.  I pointed out to some of them, "You know, Fr. Stephen doesn't call us newcomers and invite us to participate in things.  We, as newcomers, don't have a pre-conceived idea of how he's supposed to do things, and we just participate in whatever is offered.  We don't get any more special invitations than the rest of you do.  Everyone is invited to the things we attend."  "Oh, I didn't know that," they said.  Because we were there more, they assumed we had a special invitation.

I sincerely doubt that one needs an engraved invitation to go talk to Obama about healthcare reform.  

But the point is he has lead everyone to believe repeatedly that "If you like what you have you can keep it."  So he changed his language this time without clarifying what his subtle change meant.

He also used a figure of "over 30 million uninsured"---what?  Is he now acknowledging for the first time what I have been saying (that the highly-touted 46-50 million number included illegal aliens?)

I agree about everyone taking responsibility for their own health.

I don't think you just get to drop yourself onto the President's Calendar. 

The speech still seemed to be in the spirit of "didn't hear a word you said in August -- take what Pelosi already drafted" which will likely make the hard left happy, but not very post-partisan.

Kind of schizphrenic--facially conciliatory and yet partisan and even threatening at one instance.

As an aside, I watched two different networks dissect the speech after the original then on rerun.

One major news network covered it like a horse race asking questions like:  "Did he do enough? Who was he really trying to persuade?  Who did he need to persuade?  Will a positive bump last?  How soon will we have our first poll results?  He of course can give a GREAT speech!"

The other network asked questions like: "Did he accomplish his goal? (same) Why did he say 30 million uninsured?  Can we find the savings by squeezing out waste in Medicare as he said?  Is it really possible to add 30 million folks and not increase costs or the deficit?  Why did he throw a couple of bones to the Republicans?  What does this mean for the Gang of Six? etc."

Now I ask you:  Which network was really doing it's job reporting the news?  Which would seem potentially biased or,in the very least, unhelpful to the watcher?

I think we can agree the latter was doing it's job.  Care to guess what the two networks were?  Here's a hint:  The one that did it's job consistently has a much higher viewership.

That was not my question.

And I can understand the frustrations involved in discussing and debating an issue, but intentionally misconstruing my position is uncalled for.  I can understand if you don't wish to continue our dialogue and will respect that, however.

I wish you well my friend.

Shane,

Pot meet kettle......

Shane,

By all means, please list the Republican ideas that you love.  I would love to hear them and discuss them with you.

Please be specific.

Shane,

By all means, please list the Republican ideas that you love.  I would love to hear them and discuss them with you.

Please be specific.

if you want to really know (which i doubt)... just head on over to Ron Paul's web site - a true conservative, and a model for what the republican should be based.

Pamela,

Thanks for the reply.  I am genuinely sorry that you are experiencing what you describe and hope you are doing better today.

I have seen that book you reference.  I certainly take the point to heart; but it makes me feel as though once something becomes political we might as will distrust the numbers on both sides.

Please understand, I am not asking questions just to build an argument.  I am afraid that we ask far too few questions of our representatives, and that has played a part in creating this mess.

And I wonder; if we the people cannot agree on the questions, how are we going to agree on the solutions?

So, my example was not so much about the questions themselves, but about the job the media is doing in asking the right questions.  I think it is generally dismal in the MSM.  They have a huge roll to play in society, and when they do it poorly we all suffer.  And then those that ask get attacked.

How was ACORN able to go for so long as corrupt as it is?  The media has not been doing their job.  Or pick whatever example pleases you.  Where are they?

So, if they don't do it we have to do it ourselves.  It is really that simple.

So in this case, I naturally ask myself when a politician says something; Is that true?  And when I read the CBO reports, for example, I find that what the President has been saying is in many instances untrue.

Many of the criticisms are also untrue, but my bigger concern is just the truth.  I can ferret out the lies OK.  If everything the President said was true, I would be very happy.

He says the Plan will not add to the deficit.  That doesn't seem possible, and the House Bill adds hundreds of billions of dollars to it per the CBO.

He said originally that everyone could keep their insurance if they wanted.  The CBO says not true.

He said we would find savings in preventative care.  The CBO said studies show that, in the aggregate, you lose 90 cents on the dollar spent.  For the individuals it helps, that is great though. 

He said abortion would not be covered.  Whether that is good or not, the website www.factcheck.org says actually not the case.

We were told unemployment would not go above 8%.  Not true.

He kept with the 40-plus million uninsured AMERICANS figure when I knew that wasn't true and now starts using a more realistic number presumavbly excluding illegal aliens.

So when they tell us how wonderful this complicated and expensive piece of legislation is, I am not encouraged because the track record on truth has been so bad. 

You may be the only opponent here that I truly respect other than Tim because of your honesty and integrity in our discussions.  So please believe me when I type:

I WANT reform.  I WANT to have faith in my President.  I WANT to believe that the House Bill is the answer or that what we end up with will be.  I WANT to believe that there will not be rationing of health-care that victimizes some.  I WANT to believe that every attempt has been made to make this bi-partisan.

So you are right.  Nothing is perfect.  But I think I would be far more confident if we were getting all the straight facts. 

I would feel better if the President had said that this is a moral imperative and it WILL have a significant cost.  But we are in it together; and that he really adopted some significant things like interstate health insurance competition in addition to the other things.

I would have felt even better if her had said that we can't do it all right away.  If the most important thing is Universal Healthcare, then there are some things we cannot afford to do right now to pay for it -- and laid them all out.  Then he would seem realistic and responsible, even if you disagreed with the cuts.

But a planned 9 Trillion dollar deficit and a stimulus bill with 9,000 earmarks is just "politics as usual" at BEST.

I WANT to trust my President.  But he has given me every reason not to.  So I must ask the questions that his supporters won't.  For myself and for them.

So, you think he was talking about the bills or one of the bills in Congress and not the bill he wants Congress to develop?

I thought he was addressing, quite deliberately, what was right and what he thought was wrong. I even entertain the notion that downplaying the public option was an effort to rally support for fear of losing it.

When he described the public option and the exchange, that was a direct reference to the House Bill, no?

He did list the things that he said both sides agree on.  That was not Bill-specific.

And then he threw out a couple of bones to the other side with a pilot program of the tort reform; and reminded the left that the public option was a  means to an end implying the means is not indispensable.  I don't recall the other Republican bone, I guess it was the risk pool idea of McCain's?

Oh, he definitely leaned toward the House bill but it wasn't totally the House bill, especially the deficit neutral stuff. I thought that was a play to get the Senate moving and say to us that there was a lot left to do.

The bones he threw out to Repubs were pretty meaningless. His tone said that.

One of the most telling signs of division was the lack of Republican response to his call for universal coverage. In my opinion, the mandate is going to be as big a barrier as the public option. Not because there aren't Republicans who support it but because they have formed a very tight opposition, closed ranks, and the Democrats don't have a real bone to throw over to them that will give them cover.

big hugs Pam... you're doing fantastic at stating your pov (much better than i could) ...congratz.

I feel you brought up a some very good points.

James - we'll just have to agree to disagree - but i really do have "best intentions" at heart - and i do sincerly apologize for any ill felt words... 

we are all part of the same system - and frankly we're all getting screwed - James you and i are just two sides of the same coin. I don't know if you have a family / kids... but that's my main concern - and i bet it's yours too ...providing the best life possible for our families. I'm not different than any parent - who wants a better life for thier children than they had. Healthcare is part of that, but it's only a part of the puzzle ...What we really should be doing is working together on a decent plan ...and stop listening to Both MSNBC & Fox... and the like - these stations and the information they serve up to us have little to do with the Quality of life. I think they have thier own agendas and it has little to do with "us". 

Very well Shane.  I accept the olive branch and apologize for my stern words.  Let's hope together that whatever comes from Congress helps all our families.

Thanks.