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Real Canadians talking about Health Care

By Bea McManis

Howard B. Owens

Another take on health care, via Reason -- <a href="http://www.reason.com/blog/show/135906.html">health care in India</a>, where care is comparable, competition is high, care is much lower and health insurance nearly non-existent.

"An average surgeon's salary would be around $8,000 per month. The take-home pay to fix a hip fracture, for example, might run between $100 to $300, out of the $1,000 fee to the patient, says orthopedic surgeon M.S. Phaneesha. ... by comparison, a first-year resident might take home around $2,500 each month, and the average surgeon more than $20,000 per month. A hip fracture would cost a patient around $30,000, of which the surgeon's charge is $5,000."

The post does go on to list some of the issues with the Indian system, but it does show there are more than two options to what to do about health care in the US. Nationalizing health care isn't the only option to fix the current problems.

Sep 6, 2009, 5:42pm Permalink
Bea McManis

Obama, like the Clintons and like every president since Truman have tried to get health care to the forefront. The opposition says that they need more time. Fifty years, plus, isn't enough time?
I'm sure they will come to a compromise. I only hope it doesn't take another 50 years.

Sep 6, 2009, 10:05pm Permalink
Charlie Mallow

How true Bea. Just ask a Canadian what they think about their universal Health Care, it is not as if it is hard to find one.

The Canadians I have spoken to in passing about health care over the years thought that universal care was normal and would never think of changing. I also get the feeling they think we are all just a little bit inferior for not having the care they do as well.

You do not have to listen to the news or YouTube for this one. Go talk to one yourself.

Sep 6, 2009, 10:06pm Permalink
Mark Potwora

Fact is 80% of Americans have health insurance...Bottom line the ones that have it ,do not want to pay for the one that don't...I pay 20% towards my health care,plus alot of co pays..Most Americans feel that this is enough..There is nothing stopping any of those uninsured from buying health insurance..They pay for car insurance ,they don't ask the government to pay for that..They buy homeowner and renters insurance..I don't hear that the heads of these insurance company's make to much money and they we need to reign in their salary's,so that we can have lower car insurance cost...

What medical discovery's has the canadian health care system given us.You want the best you have to pay for the best..

People don't trust the government any more..
Obama even admitted that they can't even run the post office..Ups and Fedex can..

Its like the ambulance issue ..The city couldn't run it without losing money,so now its private and they will run it and make money...

The Canadians don't have a defense budget like we do.So they should have money for heath care ..If they were ever attacked who would have to bail them out...USA ..Everybody likes to bash USA,but when they are in a jamb who do they call..If its so great over there way don't more people from the USA move there....

Sep 6, 2009, 10:59pm Permalink
tom hunt

What was not brought up is where all the money to pay for this is being generated. Try 8% PST and 8% GST tax on all purchases. This is why you see Canadians streaming across the US border to shop the Malls.

Sep 6, 2009, 11:50pm Permalink
Lorie Longhany

My husbands cousins were just here visiting from England. From what they shared with us, their entire country is fed up with the American right wing's propaganda, lies and attacks against their system. So much so that they have twitter and facebook campaigns called "we love the NHS" in support of their system and to counter the lies of the American right wing http://www.facebook.com/group.php?gid=249360150703&ref=nf. Even the Conservatives in both England and Canada support national health care. From the Conservative leader, David Cameron in England -- "I support the NHS 100% and the Conservative Party supports the NHS 100%," he told the BBC. "We are the party that gives the biggest amount of support to the NHS. It is incredibly important to my family. It is incredibly important to this country."

Howard, I read the article that you posted on health care in India. My son's father in law is a medical doctor from India -- and most of his family members are doctors practicing either in Canada or India. He lives here in the US now and I can tell you he doesn't think very highly of our system. After graduating from medical school he moved to Trinidad where his specialty was wellness. Imagine a specialist that focuses only on keeping people well. That's a novel concept here. I'm going to call him, share this article, and get his take.
My son and his wife, like Brittany Baker, are among the uninsured. He works as an adjunct at two colleges -- no benefits for adjuncts. Thank God that his father in law is a doctor and can do at least a diagnosis when they fall ill.

Mark, I do find a 24 million dollar salary over the top and I do think that these enormous salaries should be questioned. This is where part of the 31 cents of every health care dollar goes.
Ron Williams - Aetna
   Total Compensation: $24,300,112
   H. Edward Hanway - CIGNA
   Total Compensation: $12,236,740
   Angela Braly - WellPoint
   Total Compensation: $9,844,212
   Dale Wolf - Coventry Health Care
   Total Compensation: $9,047,469
   Michael Neidorff - Centene
   Total Compensation: $8,774,483
   James Carlson - AMERIGROUP
   Total Compensation: $5,292,546
   Michael McCallister - Humana
   Total Compensation: $4,764,309
   Jay Gellert - Health Net
   Total Compensation: $4,425,355
   Richard Barasch - Universal American
   Total Compensation: $3,503,702
   Stephen Hemsley - UnitedHealth Group
   Total Compensation: $3,241,042
Not to exclude our local CEO’s -- David Klein of Excellus Blue Cross and Blue Shield at $2.73 million and Alphonso O'Neill-White, the CEO of Health Now (Blue Cross of Western NY, a division of Health Now), took home $2.24 million

If we do nothing to reform the current system by 2020 families like yours and mine will be paying $23,000 per year for health insurance. That is simply unsustainable for families or the businesses that will try and provide health care benefits.

So whether it's a public option or another plan -- it is imperative that we do something.

Sep 7, 2009, 8:44am Permalink
Bea McManis

After Rep. Roy Blunt, leader of the supposed House GOP Health Care Solutions Group, suggested Thursday that Republicans won't offer a health care plan of their own, Minority Leader John Boehner insisted one was still in the works.

Of course, the Republican plan as in 1993 is to stop health care reform at all costs to prevent an enduring Democratic majority. Bill Kristol, who told Republicans 16 years ago that there was "no crisis" justifying health care reform then, now simply calls on his party to "kill it." With spinmeisters Frank Luntz and Alex Castellanos supplying the talking points that a supposed "government takeover of health care" is "too much, too fast, too soon," obstructionists like Oklahoma Senator James Inhofe boasted his party would "stall" President Obama's health care initiative to ensure a "huge gain" in the 2010 election. In a nutshell, the GOP is proposing to extend the status quo for a nation gripped by a collapsing health care system.

Here, then, is the Republican 10-Point Plan for Health Care:

1.50 Million Uninsured in America
2.Another 25 Million Underinsured
3.Employer-Based Coverage Plummets Below 60%
4.Employer Health Costs to Jump by 9% in 2010
5.One in Five Americans Forced to Postpone Care
6.62% of U.S. Bankruptcies Involve Medical Bills
7.Current Health Care Costs Already Fueling Job Losses
8.94% of Health Insurance Markets in U.S Now "Highly Concentrated"
9.Dramatic Decline in Emergency Room Capacity
10.Perpetuating Red State Health Care Failure
For the details and data behind each, continue reading.

1. 50 Million Uninsured in America
Despite Senate Minority Leader Mitch McConnell's oft-repeated claim that Americans don't want health care reform that "reform that denies, delays, or rations health care," de facto rationing is precisely what defines the U.S. system today.

The latest U.S. Census Bureau in 2007 placed the number of uninsured* in America at 45.7 million, up from 37 million since the last time Republicans successfully blocked health care reform in 1993. But a February analysis by the Center for American Progress found that the recession added four million more to the rolls of the uninsured, a group which a study by Families USA in March found included 86.7 million Americans over a two-year span. And a Gallup poll released this week revealed the percentage of American adults without coverage catapulted to 16% from 14.8% since the start of the Bush recession in December 2007. All told, likely another five million people have pushed the ranks of the uninsured over 50 million.

2. Another 25 Million Underinsured
The crisis doesn't end there. In June 2007, a devastating assessment from the Commonwealth Fund showed fully 25 million more Americans were "underinsured," a staggering 60 percent jump since 2003. As the study showed, the number of "people who have health coverage that does not adequately protect them from high medical expenses" has skyrocketed:

As of 2007, there were an estimated 25 million underinsured adults in the United States, up 60 percent from 2003.

Much of this growth comes from the ranks of the middle class. While low-income people remain vulnerable, middle-income families have been hit hardest. For adults with incomes above 200 percent of the federal poverty level (about $40,000 per year for a family), the underinsured rates nearly tripled since 2003.

All in all, 75 million Americans - 42% of the people in the United States under age 65- have insufficient insurance or simply none at all.

3. Employer-Based Coverage Plummets Below 60%
Making matters much worse is the rapid deterioration of employer-provided health insurance coverage. A 2007 report from the Economic Policy Institute showed a dramatic decline in employer-provided health care. That drop-off from 64.2% of Americans covered through workplace insurance in 2000 to just 59.7% in 2006 alone added 2.3 million more people to those without coverage. Census data since showed workplace coverage dipped further in 2007, down to an alarming 59.3%. (A recent Thomson Reuters survey put the figure for 2009 at a stunning 54.6%.)

4. Employer Health Costs to Jump by 9% in 2010
To be sure, Americans' health care expenditures are spiraling out of control, expanding at triple the rate of wages. That annual tab now tops $12,000. Of that, a recent analysis by the Center for American Progress found that "8 percent of families' 2009 health care premiums--approximately $1,100 a year--is due to our broken system that fails to cover the uninsured."

And with successful Republican obstruction of Democratic health care initiatives, those jaw-dropping costs would only continue their steep climb. A new report from the consulting firm PricewaterhouseCoopers forecast employers will face a 9% increase in health insurance costs in 2010. 42% of those business surveyed will pass at least some the new burden on to their workers. As PWC's Michael Thompson concluded:

"If the underlying costs go up by 9%, employees' costs actually go up by double digits," he said, noting that will have a "major, major impact" when many employers also are freezing or cutting pay.

5. One in Five Americans Forced to Postpone Care
Of course, McConnell's dystopian future of health care delayed is already Americans' nightmare present. The Thomson Reuters survey released in April found that 1 in 5 Americans "have delayed or postponed medical care, mostly doctor visits, and many said cost was the main reason," a staggering jump from 15.9% in 2006. As study leader Gary Pickens summed up the grim findings:

"The results of this survey have serious implications for public health officials, hospital administrators, and healthcare consumers. We are seeing a positive correlation between Americans losing their access to employer-sponsored health insurance and deferral of healthcare."

6. 62% of U.S. Bankruptcies Involve Medical Bills
Given the deterioration of the employer-provided health coverage and the skyrocketing costs of out-of-pocket care, it's no wonder, as a June 2009 study funded by the Robert Wood Johnson Foundation determined, medical bills are involved in over 60% of U.S. personal bankruptcies:

More than 75 percent of these bankrupt families had health insurance but still were overwhelmed by their medical debts, the team at Harvard Law School, Harvard Medical School and Ohio University reported in the American Journal of Medicine.

"Using a conservative definition, 62.1 percent of all bankruptcies in 2007 were medical; 92 percent of these medical debtors had medical debts over $5,000, or 10 percent of pretax family income," the researchers wrote. "Most medical debtors were well-educated, owned homes and had middle-class occupations."

7. Current Health Care Costs Already Fueling Job Losses
While John Boehner trumpets his claim that Democratic health care initiatives "will kill American jobs," a new analysis from the RAND Corporation found that current excess U.S. health care expenses are already having a devastating effect on the economy. As BusinessWeek noted (via The Plum Line):

In a first-of-its-kind study, the non-profit Rand Corp linked the rapid growth in U.S. health care costs to job losses and lower output. The study, published online by the journal Health Services Research, gives weight to President Barack Obama's dire warnings about the impact of rising costs if Congress does not enact health care reform.

As it turns out, today's stratospheric growth in health care costs has the most crippling effects in precisely those industries where more workers have employer-sponsored insurance (ESI):

For example, the study estimated that a 10% increase in excess health care costs would reduce employment by about 0.24 percent in an industry such as motor vehicles, where about 80% of workers have ESI, compared with about 0.13% percent drop in the retail trade, where about one-third of workers have ESI. Economy-wide across all the 38 industries, a 10% increase in excess health care costs growth would result in about 120,800 fewer jobs, $28 billion in lost revenues, and about $14 billion in lost value added.

8. 94% of Health Insurance Markets in U.S Now "Highly Concentrated"
Republican critics of a public option tout regulatory reforms - still undefined - which would allow "insurance companies compete for your business and you can shop around for the best coverage and price."

But as the Commonwealth Fund revealed in a report titled, "Failure to Protect: Why the Individual Insurance Market Is Not a Viable Option for Most U.S. Families," that is a far cry from today's actual private insurance market, one in which Americans are simply priced out:

Over the last three years, nearly three-quarters of people who tried to buy coverage in this market never actually purchased a plan, either because they could not find one that fit their needs or that they could afford, or because they were turned down due to a preexisting condition.

Behind that market failure is the rapid emergence of health insurance monopolies in most areas of the United States. The past 13 years have seen over 400 corporate mergers involving health insurers. As the American Medical Association found, "94 percent of insurance markets in the United States are now highly concentrated, and insurers are thriving in the anti-competitive marketplace, raking in enormous profits and paying out huge CEO salaries." As I noted in 2006:

In most states, the AMA concludes, the idea of choice among competing insurance providers is a myth. The study showed that in each of 43 states, a small group of insurers exerts such market dominance as to merit the Justice Department "highly concentrated" market methodology for assessing potential anti-trust action. In 166 of 294 metropolitan areas surveyed, a single insurer controls over half the preferred provider network and HMO underwriting. In North Dakota, for example, Blue Shield owns 90% of the market. It's no wonder that Jim Rohack, an AMA trustee, concluded, "This problem is widespread across the country, and it needs to be looked at."

9. Dramatic Decline in Emergency Room Capacity
Last week, Mitch McConnell reassured NBC's David Gregory's regarding the 47 million uninsured by announcing, "Well, they don't go without health care." With that asinine statement, McConnell was only following in the footsteps of Tom Delay and George W. Bush, who in July 2007 declared:

"I mean, people have access to health care in America. After all, you just go to an emergency room."

As it turns out, the disturbing trends above are having a cascading effect on waiting times and treatment at American emergency rooms. While high-profile cases of the deaths of untreated ER patients in Los Angeles and New York put a face on the crisis, a 2006 report by the Institute of Medicine revealed that U.S. emergency rooms can barely cope with the volume of patients in the best of circumstances, let alone in the wake of crises such as a terrorist attack or flu epidemic:

The study cited three contributing problems to the rise in emergency room visits: the aging of the baby boomers, the growing number of uninsured and underinsured patients, and the lack of access to primary care physicians.

The report found that 114 million people, including 30 million children, visited emergency rooms in 2003, compared with 90 million visits a decade ago. In that same period, the number of U.S. hospitals decreased by 703, the number of emergency rooms decreased by 425, and the total number of hospital beds dropped by 198,000, mainly because of the trend toward cheaper outpatient care, according to the report.

10. Perpetuating Red State Health Care Failure
In May, the Washington Post rightly noted it would be blue state residents funding health care reform for their more conservative cousins in an article titled, "A Red State Booster Shot." (The same one-way flow of taxpayer dollars from Washington to red states, of course, is a permanent feature of federal spending in general.)

As I detailed in 2007, Americans' health is worst in precisely those states that voted for George W. Bush:

The Commonwealth Fund report, "Aiming Higher: Results from a State Scorecard on Health System Performance," examined states' performance across 32 indicators of health care access, quality, outcomes and hospital use. Topping the list were Hawaii, Iowa, New Hampshire, Vermont and Maine. Bringing up the rear were the Bush bastions of Kentucky, Louisiana, Nevada, Arkansas, Texas, with Mississippi and Oklahoma. The 10 worst performing states were all solidly Republican in 2004.

The extremes in health care performance are startling. For example, 30% of adults and 20% of children in Texas lacked health insurance, compared to 11% in Minnesota and 5% in Vermont, respectively. Premature death rates from preventable conditions were almost double (141.7 per 100,000 people) in Tennessee, Arkansas, Louisiana and Mississippi compared to the top performing states (74.1 per 100,000). Adults over 50 receiving preventative care topped 50% in Minnesota compared to only 33% in Idaho. Childhood immunizations reached 94% in Massachusetts, compared to just 75% in the bottom five states. As the report details, federal and state policies including insurance requirements and Medicaid incentives clearly impact health care outcomes.

For more on the performance of the American health care system, including international comparisons, see "U.S. Health Care by the Numbers." For a demolition of Republican talking points, see "Ten Myths About Health Care Reform" at ThinkProgress.
________

* It's worth noting, as the Kaiser Family Foundation did in its analysis, that "although legal and undocumented non-citizens accounted for 22% of the nonelderly uninsured in 2006, citizens still made up the bulk of the uninsured (78%). Further, the majority (76%-80%) of the growth in the number of uninsured from 2000 to 2006 occurred among citizens, not legal and undocumented non-citizens."

UPDATE 1: Over at Huffington Post, Sam Stein reports that an internal RNC poll found broad support for the public plan. Highlighting the need for Republican fear-mongering and obstructionism, the summary concludes that "If Obama Is Allowed To Sell This... He Wins."

UPDATE 2: Pointing to data from the actuaries at the Centers for Medicare and Medicaid Services, the Center for American Progress warns that per capita medical costs are forecast to rise by 71% over the next decade. That would catapult the cost of the average family's insurance policy from $13,000 a year to over $22,000 by 2019.
http://www.perrspectives.com/blog/archives/001574.htm

Sep 7, 2009, 3:19am Permalink
Charlie Mallow

Howard said," Charlie, nobody respects weakness, but neither does anybody respect wrong headedness."

Howard, the people who voted for Obama ( and there are a lot of us) did so, because he said he would fix health care. To most of us that means a single payer system. So, to his supporters, it would be "right headedness" for him to act. If he fails to act, he loses his MoJo and I start looking for someone who has the guts,I thought Obama did. Wilting to the lies on Fox News and Wing-Nuts is weakness I will not stand for.

Sep 7, 2009, 8:16am Permalink
Bea McManis

Mark,
Are you channeling Peter, or are you both getting your talking points from the same site? The language is identical (except for the ambulance issue).
Which is okay, you are echoing the right wing point of view.

In answer to your question about why people can't afford health insurance, Beth and I both explained that it isn't easy to afford the premiums when your income is almost nil. This isn't effecting only the working poor, but it is hitting the middle class as well. It isn't a myth. To keep repeating the talking point that everyone can afford health insurance is bogus. Perhaps one has to walk a mile in the shoes of someone who has tried to find a policy they can afford in order to understand that not having health insurance IS a choice, but not because they can afford it and choose not to get it.

The right wing legislatures have admitted that they really aren't interested in health care as an issue. They are more interested in bringing down Obama and the Democrats in November.

In a way, I respect them for being honest. I don't particularly like the way they are going about it, but at least they are up front about it.

Sep 7, 2009, 8:21am Permalink
John Roach

Most of my cousins live in Kingston, Ontario, just over from Watertown.

Sure they like "free", but they will tell you its not really free at all. They pay a lot in taxes to have this "free" care. And they also don't have as many not people who do not have to pay taxes as we do (around 40%). This is going to fall on the what's left of the middle class to pay for this and we all know it.

For normal things, they go to their local health care clinic or doctor.

But if they need it now, fast, they come to Watertown.

Sep 7, 2009, 8:52am Permalink
Lorie Longhany

Charlie is right. Elections have consequences. A 53% majority of Americans voted for Obama. Voters have an expectation that he will deliver on his promise for health care reform.

Sep 7, 2009, 8:58am Permalink
Charlie Mallow

John, those would be tree huggers, hippies and peacenics. You are also right, MSNBC is nothing more than Fox News for the good guys.

The fact is elections and your vote mean something. This country has shifted hard left and now it's leaders have to step up and do what they said they would do. Those of you who voted for the other guy have every right to complain and rally ( as long as you don't bring guns). Those of us on the winning side expect results for our vote. If we don't get it we need a change in our ranks.

Sep 7, 2009, 9:25am Permalink
John Roach

Charlie,
I don't think they voted "for" Obama, or health care. I think they wanted anyone but Bush/McCain. Clinton would have won also.

I also think they voted to end the two wars, neither of which Obama is doing.

Lorie is right, 52-53% voted for him, but that does not mean the rest have to lay down. Bush won (twice) and she had a different view then. You lose, but don't roll over.

Sep 7, 2009, 9:41am Permalink
Charlie Mallow

John, Obama never said he was leaving Afghanistan. He actually said the opposite. Obama said Bush didn’t finish the war in Afghanistan and he would, he was very hawk like about the subject. We are also pulling out of Iraq but, doing so slowly like the Conservatives said we should.

I also beg to differ about why people voted for Obama. We were told over and over again by the right that this man was a socialist and the most left wing leaning person in America. People are not stupid, they voted for the person they wanted.

Sep 7, 2009, 10:16am Permalink
Dave Olsen

My favorite part in the original post is" It would be helpful to the discussion if they knew what they were talking about". Amen. My fear is that if a compromise is reached in Congress, by the time they're all finished sticking their grubby little fingers in the pie and making sure their respective financial masters get their slices, we will wind up worse off. I don't think I can survive "worse off". I did not vote for Obama (or McCain either) because I did not believe that either could fix these massive problems, but he did promise, I support his effort and I hope he can get health care right.

Sep 7, 2009, 10:20am Permalink
Charlie Mallow

In the end, those on the right should complain and ready themselves for the next election. That is how our system works. Those of us who voted for Obama, really don’t care what those who lost the last election think. (might not be nice but, its the truth)

If you are paying real close attention, the fight is internal. This is about Democrats telling other Democrats to stick to their word and do what they said they were going to do. Democrats control the entire government. Some Democrats with weak conviction are waffling. The Republicans see this and are doing exactly what they should do, pounce. This all goes back to Howard’s point, those with yellow bellies and weak convictions should not run for office. Americans don’t need you or like you.

Sep 7, 2009, 10:29am Permalink
Howard B. Owens

Charlie, I don't remember health care being much part of the campaign. The economy and Iraq were the two big issues, and it was Obama's promise to get us out of Iraq that gave his campaign its initial mojo among Democrats.

Obama would be in much better shape if he'd taken care of Iraq and made sure the economy was healthy before tackling health care.

Also, why immediately launch into releasing legislation. Why not have public hearings first -- get all the information out, have a big national debate, that's the best way to defuse criticism. There wouldn't be a plan for the Republicans to arguing against. They could have their chance to be heard and legislation could be written that is a compromise among competitive ideas. The Obama approach stinks of just trying to shove more big government down our throats, and most Americans -- including many who voted for Obama -- recoil when it looks like the government is getting yet even more invasive. And Obama and the Democrats should have been able to anticipate that while many people might think they link the idea of government run health care, when they start thinking about the higher taxes, they get a little more uneasy.

The responses to the Obama plans are both predictable and anticipated. Given the utter 100 percent predictability of what the response would be, how can we be impressed with how the Obama Administration has handled this mess?

There was a time in this country when there was a need for major legislation to fix a problem, there would be Senate hearings and the legislature would work out a compromise and present a bill.

Now we're full into the era of the Imperial Presidency, where the president -- not the legislature -- proposes legislation and just expects to ram it through.

That's now how the system is supposed to work.

Bush did it (most disastrously with TARP with the full consent and assistance of Nancy Pelosi and the House Democrats) and Obama did it with stimulus with no clear indication that we're getting our money's worth from that deficit exploding plan.

You want the government to pay for health care? Start advocating the roll back of Empire. Bring all the troops home, shrink the size of the military. How many people could you insure with $600 billion in savings? My plan would start there and then create county level elected governing boards that would manage local health care using a mixture of locally managed and raised taxes and private sector contributions and ensure competition among health care providers.

(the Democrats would find common cause with a large number of conservatives, independents and libertarians if they took seriously the need to role back Empire)

I don't want some bureaucrat in Washington controlling my health care. I don't know much about Canada's national government, but I know our nationalist government is bloated, inefficient, self-serving, uncaring, expensive and prone to exponential growth in all of these negative characteristics.

And lest somebody think I'm getting talking points from Karl Rove, I don't watch TV news (we don't even have cable or satellite TV right now, but when we did have it, most of my TV news came from Jon Stewart and Steven Colbert), and my Internet news comes from a wide variety of sources. And when Obama was elected (even though I didn't vote for him), I was rooting for his success. I thought he had a chance to be a good president, but so far I'm not impressed.

Sep 7, 2009, 10:38am Permalink
Howard B. Owens

Charlie wrote, "Some Democrats with weak conviction are waffling."

Where Obama initially started having trouble among Democrats was with the rural Democrats in the House. They tend to be more conservative than urban Democrats. They were never really on board with the plan.

Which backs my thesis that Obama made a mistake by starting with a proposal and trying to win support for it, rather than making sure all voices were heard and then crafting a proposal out of those Senate hearings.

The Founding Fathers weren't stupid. They designed a system of checks and balances for a reason. When you try to subvert it, you're going to find yourself some trouble.

Sep 7, 2009, 10:43am Permalink
Lorie Longhany

I thank Bea for finding this interview. I think it's important to cut through all the misinformation concerning Canadian and British health care and actually hear from their citizens. I don't want to appear so slanted not to believe that any system has it's share of flaws, but to lie and distort and put up strawman arguments about other nations health care systems without actually listening to the citizens is a major distortion of the facts.

http://economix.blogs.nytimes.com/2009/07/20/should-canadas-health-syst…
This article from the NY Times, I believe is a fair assessment as it touches on the problems with the Canadian system too, but what is telling to me is the Harris poll found in the article -- The Harris/Decima survey found that 70 percent of the 1,000 Canadians that it interviewed thought their health care system was working well and that 82 percent believed it was superior to the system used in the United States.

And this from a British facebook message --

"The NHS was born out of my country's war with facism. It was based on the simple logic that if EVERYBODY in the country were equally prepared to give their lives for their country when attacked then the lives EVERYBODY should be equally cared for by the country.

The wartime government promised us the NHS and in 1948 they delivered it big time.

The vast majority of people in the U.K. would fight the Second World War all over again to protect it.

Any US citizen who wants to end their life, for whatever reason, should pop over here, walk into the nearest pub and diss the NHS."

Sep 7, 2009, 11:50am Permalink
John Roach

Lorie,
The other side can go out and find people in Canada or England that will tell you how bad their system is, so I do not put much faith in any of the interviews. Both sides will find somebody to side with them.

This week, another health care bill will be submitted in the Senate. So far the cost, according to them, for it is approx. 1 trillion dollars.

Sep 7, 2009, 12:28pm Permalink
Bea McManis

Lorie,
As much as I would like to take credit for finding the video, the credit goes to Mark Williams. Mark and I worked together for many years.

Sep 7, 2009, 12:29pm Permalink
Bea McManis

John,
Jesus Christ could come down and discuss health care and the Beaitudes from the Sermon on the Mount and the right wing would fault him for being a loose cannon. The right would not put faith in the very person many of them worship every Sunday.
I think of that sermon every time I read how people truly believe that they are righteous when they demonstrate no compassion for those less fortunate.

Sep 7, 2009, 12:38pm Permalink
Lorie Longhany

But, John the poll numbers in both countries are overwhelmingly in favor of their systems. That point is undeniable. You will always find problems and naysayers on everything, but just go over and visit the facebook and twitter page that the Brit's have set up. They're mad, and not because they want their systems overhauled. They're mad at the distortions.

I give your side points on presentation, though. With the help of 1.4 million dollars a day from your friends in the insurance lobby the "party of no" has done a great job of scaring the hell out of the American people and driving this debate.

Thank God my husband has a safety net with his single payer through the VA. After working hard our entire lives we have joined the ranks of the under insured with climbing deductibles and $40 co-pays. I've been self rationing for about a year and a half now.

Sep 7, 2009, 12:48pm Permalink
Howard B. Owens

Bea, having compassion for the less fortunate and expecting the government to give hand outs are not logically connected arguments. You could be as sanctified as Mother Teresa and still oppose using tax dollars for social services.

I'm neither defending anybody on the right nor trying to state any political position of Mother Teresa, just pointing out the illogical nature of the argument that people who oppose government-run health care somehow lack compassion. Maybe some of them do, maybe some of them don't, but there's very good reasons for opposing government run social services, many of them quite compassionate and arguably far more compassionate that those that would make poor people entirely dependent on government largess.

Sep 7, 2009, 12:54pm Permalink
Howard B. Owens

Lorie, let's stipulate that the citizens of other countries with NHS are overwhelmingly happy.

Now let's look at the chief differences, and chief of them is military budgets. Canada especially, but even England do not spend nearly as much as the U.S. on military.

U.S.: $986 per person
England: $530
Canada: $309

And Canada has a high tax burden, but England has a notoriously high tax burden.

Would Canadians and Englanders be so satisfied with they had to pay for health care AND $600 billion a year to support an overseas military?

What kind of tax burden are you willing to saddle us with in the U.S. when taxes are already to high to pay for our overseas misadventures?

Why don't the Democrats do something about that before coming to us with another hand reaching for our wallets?

I can't find the article now, but I read a story from the Washington Post yesterday: For all Obama wants to do, more than 200,000 new government jobs need to be created in Washington. Who's going to pay for that?

As I said to Bea -- opposing this plan doesn't equate to lack of compassion. It's about applying some common sense and recognizing most U.S. citizens, including most Democrats, don't want higher taxes. And nobody trusts that costs will be lower, or that individuals will be paying the same or less in taxes than they do now in insurance.

Again, Obama bungled this because he didn't follow the constitutionally prescribed way for getting legislation passed. He's probably set up the possibility of real reform another decade or more.

Sep 7, 2009, 1:07pm Permalink
Howard B. Owens

And shame on the Republicans for not taking matters into their own hands and setting into motion a constitutionally proper process for real reform. There's nothing stopping any Senator for calling for hearings, hearings the Democrats would be fools to oppose at this point.

It is true that the Republicans are purposely using this as a wedge issue rather than trying to do anything constructive.

And hence, why partisan politics sucks. Both sides want to push their own agendas as a way of consolidating their own power rather than just doing the right thing and getting something constructive done.

Sep 7, 2009, 1:11pm Permalink
Kelly Hansen

Thank you, Howard. I am tired of being labeled an uncaring heathen for opposing the current bill(s) before us. I voted most of my voting-life as a Democrat. I voted for Bill Clinton and was for the most part very happy with much of his presidency. I don't recall when, but at some point I felt that the Democrats had left me behind somewhere - I could no longer identify with much they spewed. I switched to Republican, yet I do not consider myself to be Republican. I am a concerned Christian: for those with no healthcare (which included myself most of my life), for the unborn and elderly, those who through no fault of their own find themselves in the gutter. I also worked for the Head Start program. I know the games, the rhetoric, the double-talk.

In a land where it is a federal offense to trample some sea turtle eggs, yet 50 million kids have been exterminated since 1973 I have more than a little concern.

No one has replied to my posts about the amendments that would have protected the elderly and unborn which were stripped from the bill in committee.

Not sure why I bother here - and judging by the amount of people who vote in the polls here compared with those who reply in comments, I find I am not alone.

Why this bill (HR 3200)? Why must it be signed yesterday? Why can't there be a few bills of smaller size which more people could agree upon (ie: healthcare competition across state lines, etc.)?

Why?

Sep 7, 2009, 1:25pm Permalink
Lorie Longhany

Howard, I'm with you on the military side. We haven't even begun to pay for the Iraq War, but how many on the right are screaming about that? You and I probably visited some of the same websites during the lead up to the war -- antiwar.com and lewrockwell. The only difference I have with your political beliefs is I see what all that war $ (920 billion+)could have been used for -- reforming a broken health care system.

I don't have all the numbers on the price tag of health care reform but I do know this much -- The US spends almost three times as much as the UK, and twice as much as Canada, per person, for health care -- and of the top 50 countries in life expectancy we come in 45th. Canada, the UK, Cuba and 40 other countries also have lower infant mortality rates than the US.

Here's one example of a place to find revenue to pay for it: Treating high cholesterol problems with drugs is cheaper than treating heart attacks. I say this because in the studies that I've read we can find approximately $700 billion by actually insuring those folks that have no coverage, getting them less costly preventative care, because as we know the uninsured use emergency rooms. When do they use them? When something catastrophic and expensive happens. Uninsured people who have heart attacks call an ambulance (expensive), are seen in an emergency room (expensive) and because of the Hippocratic oath and because we are still a compassionate people (I hope) are given very expensive life saving care, including bypass surgeries (very expensive). Boy those cholesterol drugs certainly are cheaper than that route. Who pays for the uninsured? I have read that you and I pay $1000 a year to cover the uninsured. The other place for revenue is repealing the Bush tax cuts to the Clinton administration rates.

Sep 7, 2009, 1:53pm Permalink
Howard B. Owens

Lorie, as a matter of full disclosure, I supported the invasion of Iraq. I've had a complete change of heart about the entire nature of U.S. foreign policy since then. I did read those sites, but with the goal of finding statements to criticize.

Also, I'm not arguing that there shouldn't be health care reform. I just don't believe nationalizing health care is the right way to do it. Since the government created the current crisis by meddling in the free market, it can undo it by unwinding the damage its done. Or if government intervention is now avoidable, through sound, reasoned and diplomatic consensus building through the legislative process, perhaps we can find a solution that most Americans agree on. Clearly, the present approach isn't working. It's almost as if it was designed not to work. It was merely bait for more partisan bickering.

Sep 7, 2009, 2:10pm Permalink
John Roach

Lorie,
You might be right about the right wing, but most of the left wing say their is no God, or if there is, what God said, God didn't really mean.

Left or right wing is not the point. It's do you want Obama or a Bush to control your health care?

How much more will you be willing to pay in txes, and don't give us the crap about only the rich paying. They always say that, and then they lower the amount rich is.

Sep 7, 2009, 2:12pm Permalink
Charlie Mallow

John, my employer and I spend roughly $10,000 for my health plan a year. Out of that my share is roughly half. So, if that money is turned over to the government to pay for a health plan instead of paying some CEO millions and in turn wasting a third of that money on administration, that in your book is an increase in taxes?

Why should I care who administers my plan? There are millions of people who worked for the state and they have great insurance administered by the government. I have never in my life heard any of these people complain about their health care. Why can’t I have the same policy they do? I pay a fortune in premiums; I work for a good company. Why can’t I have a choice? What if I lose my job and have a preexisting condition?

How does it go, Life, Liberty and the pursuit of Happiness? It isn’t Conservative to stand by and do nothing while people are without health care. Putting on blinders and pretending that we all don’t pay for the uninsured right now is not conservative either. Wasting up to 30% of our health care costs on administration isn’t conservative, its stupid.

Sep 7, 2009, 2:13pm Permalink
Howard B. Owens

Charlie, aren't you always the one singing the virtues of less government (to you that means consolidation, but that's another discussion) and the virtues of private enterprise over government run services?

Sep 7, 2009, 2:20pm Permalink
Lorie Longhany

Please, John, no broad brushing. I am a Christian. I am friends with pastors and took a trip with faith based groups to DC, spoke with a local Presbyterian minister in the seat in front of me the entire trip there and back. I made friends and prayed with a Catholic priest who I helped off his knees when the prayer was over. In my local organization we are represented by many faithful people, who are active in their churches and in the Party that I belong to. It's a big tent and you would be surprised at some of my other personal values.

In fairness maybe right wing and left wing should be kept out of the debate. I apologize to anyone that I may have offended with that terminology.

Sep 7, 2009, 2:31pm Permalink
Charlie Mallow

Health care is a basic necessity that the free market doesn’t do a very good job managing. The overhead costs are too high and not everyone is covered. I like the idea of free enterprise competing for business in the health care industry but, the costs of administration of health care should be managed by the government. If you have looked at conservatives in other countries, my viewpoints are not out of line. Conservatives in our country have taken on this issue as if they are fighting for liberty itself. Compassion is not a liberal value and don’t wave the flag on sick people.

Sep 7, 2009, 2:42pm Permalink
C. M. Barons

We talk about taxes in a generic sense. It's the jolt, I suppose, getting our tax bills in one fell-swoop (county, school and village/town/city). We see what is deducted from our pay checks, and we put up with filing in April. The truly painful part of paying taxes is the isolation- deprived of a say in how taxes are spent and an inability to connect with a benefit from what we pay out.

On a local level this is less evident- we see the crews repairing and plowing roads, the kids going to school and other applications of our tax dollars. The federal government is a massive organization with complex spending mechanisms and programs so invisible to the average person that it is impossible to grasp the output of one's investment.

The military budget (I will not call it defense) is a perfect example of a cash cow driven by political gain and corporate profit; the burden foisted on constituents with biblical admonitions of death and destruction. Our great enemy for most of my life was a paper tiger called the USSR that fell without a shot when its economy collapsed from over-investing in its own military machine.

Despite the riveting television as bomb bursts played on CNN, I see no compelling reason to be in Iraq, Afghanistan or any other foreign country. ...Other than the fact that we screwed them up so badly, there is now responsibility to fix them. The cynical subterfuge that got us there in the first place should earn the perpetrators a defendant's seat in an international court of war crimes. That's another matter.

A single-payer health program is one program that would be immediately apparent in its payback to every American. Instead of paying (or having your employer pay) private insurance premiums, tax dollars would replace that expense. The amount your employer pays into that benefit could now go in your wallet. Instead of paying the deductible or co-pay; there would be no deductible or co-pay. Health care wouldn't be free, but it would not require any additional billing or threat of interruption or approval or ... If nothing else, the convenience would be worth it.

I will never understand why some people feel that depriving insurance companies of profits is reason not to have universal health care. Is everyone out there an employee of an insurance company?

Sep 7, 2009, 2:48pm Permalink
nick driscoll

there are so many rumors, half truths and out of context statements out there, i have recently came across a website called politifact.com that is great for finding out what is true or false i would encourage everyone to at least give it a try and find out for yourself if you dont like the site i'm sorry for wasting your time but it has been a great tool for me. please let me and other people know what you think of it.
http://www.politifact.com/truth-o-meter/statements/

Sep 7, 2009, 2:52pm Permalink
Howard B. Owens

Charlie, health care hasn't been a true free market for decades. Since there's no real competition, both providers and insurance companies are able to constantly drive costs up.

Again, I argue against the false notion that there are only two choices: The current system or nationalization. That's a false choice argument.

A true free market solution would bring down costs and make some level of health care accessible to all.

Sep 7, 2009, 3:10pm Permalink
Bea McManis

Howard,
Your choice is to give the county the full responsibility for what we pay in taxes to the Federal and State government. Am I reading that right?
So, would it be correct in saying that since we wouldn't contribute to the state or federal coffers that we wouldn't receive anything monies from them?
Let's for the sake of argument make the smallest governing entity, Genesee County.
Could you take some time (no rush) to figure out what the tax burden would be on the citizens of Genesee County. Remember no Federal funds, since we are not contributing to the common good of the nation; no state funds since we aren't contributing to the common good of the state.
You mentioned that the citizens would vote on whether funds should go up the ladder. In this model, the citizens vote 'no' because they don't trust either the state or federal officials to spend their money wisely.
That also means no more social security checks for the elderly. So, how much will each person have to pay for self rule?

Sep 7, 2009, 3:31pm Permalink
Tony Ferrando

I fail to see how a true free market solution would bring down costs... it simply has no basis in reality - monopolies are not intrinsically evil. Are my cable prices going down because I can get DirecTV or Dish Network? AT&T was broken up into all the "Baby" Bells, most notably because long distance rates were so astronomical... So you trade lowering long distance rates for a much larger increase in local rates? Overall, did the price for phone services go down, or go up since AT&T was broken up in 1984? Phone prices are only now coming down, with free long distance and cheaper rates coming from an entirely different medium - the internet - and all those Baby Bells now exist within 3 large companies, AT&T, Verizon and Qwest. Unfortunately, health care isn't one where the same service can be provided thru an entirely different means. Maybe that isn't the best of examples, but there's plenty of examples of monopolies or virtual monopolies producing much better results than the free market alternative that existed post breakup throughout history. Standard Oil was broken up, oil prices went up. Perhaps the best example is Microsoft, which exists in a virtual monopoly, and just like AT&T, we were provided with a cheap universal product that follows us through our lives, for work, for play, for school. The competition exists at the end level, what PC manufacturer you buy from. Or in health care, what doctor you choose to see. In monopolizing the insurance, while leaving the doctors as private, the competition will exist between doctors, to be the best doctors, to build reputations and earn the money... as opposed to to being dictated that this is the list of doctors you can see, and you need to go through this doctor for referrals to specialists, who will have their own personal list of ones they prefer.

In these 3 examples, monopolies created a standard for service, and they did so at cheap prices. Where's our standard of service for health care? While the current solutions proposed do not create a monopoly, the national pools created would create a standard for access to the system, and the Public Option would create a standard for the basics that need to be covered in any plan.

Sep 7, 2009, 3:48pm Permalink
Howard B. Owens

Bea, so with the caveat this is just theory I'm playing around with (I'm not going to waste time of full study because it's an entirely unrealistic fantasy) ... just in theory ...

In my model, state and federal governments would be reduced to the barest essential services that can only be provided on a consolidated level (shared defense, for example, but I have friends who argue the "no standing army" and militia defense system of the founders is just fine and dandy)

If you do away with state and federal departments of education, for example, you greatly reduce the burden on tax payers. Education should be entirely a local matter.

Further, social services should be an entirely local matter. Without the large bureaucracies, where there are no checks and balances, involved in state and federal programs, the cost of providing for the needy would be greatly reduced.

It would take a great deal study needed to figure out what actual costs would be vs. the waste in the current system. And the plan is so far reaching, we would need to go through government program by government program and figure out which need to be completely eliminated vs. devolved to the smallest entity possible (some, maybe to the neighborhood level).

And the communities that ran their programs best would be the place that would thrive because people and businesses would vote with their feet and move to the most efficient communities.

I didn't say citizens would vote on sending funds up the ladder -- there would be a formula to ensure sufficient revenue was sent to state and federal levels to ensure the bare essential needs of these agencies were met. Citizens would vote on their own tax rates and methods based on local needs, desires and wishes while also ensuring some amount was pooled with the bigger government bodies.

To answer your last question -- since so much waste and inefficiency would be wrung out of the system, overall tax burdens would go down, productivity would increase and business opportunities would increase (more jobs) (all in theory, of course, a smarter person than me would need to do the actual math and gathering of empirical data).

And remember, in my system, there would be no social security, except as provided by the local community.

It takes a village to raise a child ... it takes a village to care for its elders.

Sep 7, 2009, 3:59pm Permalink
Trina O'Connor

As someone who makes very little money at my job but makes just over the maximum amount a month to qualify for medicaid... I can only see positive benefits from Universal Healthcare. I do have insurance offered to me through work, however, I cannot afford it. I have my own apartment to pay for. I'm not somebody who spends their money unwisely either. I have looked into plenty of insurance companies for a premium I can afford. I haven't had any luck yet. I don't think it is fair for others to judge those who do not have health insurance. It is not my choice to remain uncovered. You must walk a mile in the shoes of those who struggle on a daily basis to make ends meet before you can assume it's as simple as we don't want to pay for health coverage.

Sep 7, 2009, 4:10pm Permalink
Tony Ferrando

I understand that within the large two groups of American politics we'll likely never agree philosophically on one resolution. In fact if McCain had won and was proposing his plan we'd certainly have these exact conversations with the roles of the players flipped. But the call to wait is irresponsible. If not now, when? Another 15+ years down the road? When a growing issue finally hits crisis level? (if it hasn't already, the Detroit Big 3 have cited rising health care costs among their legacy plans for retirees as the biggest reason why they can't remain competitive) With anything you need a starting point, something to build off of. No plan will ever be perfect, but any plan implemented will provide accurate and very real things to improve upon, things done well that can still be done better, and so on.

If the President gives up his idea of putting it in on a bipartisan level and leads his party, he could pass this tomorrow. I think it's time for him to play that threat, then you really will see a bipartisan effort because the opposing side will look to play its role in its creation and have an effect on how it works. These things are still just in committee, where they are tinkered and changed. I'd expect actual change to occur on them if he plays that card.

Howard, you mentioned your local ideas in another story Bea or Chelsea posted where money would all be collected and spent locally, so it stays in the community. My question would be, what if I go on vacation? I drive to Buffalo every day for work... what if I get the worst papercut the world has ever seen and need medical attention (just a little joke about the perils of my work :-) )? Am I expected to return to Genesee County to be treated? I really feel that a national plan is needed, in the same vein that HIPAA was needed to ensure that smaller, local insurances and HMOs would be honored nationwide. Of course, maybe I don't fully understand exactly what you're proposing.

Sep 7, 2009, 4:28pm Permalink
Howard B. Owens

Tony, don't think I'm calling for delay. I think I said explicitly, the Republicans are culpable for the mess, too, since they're they're doing is engaging in partisan games and not putting forward any serious effort to find the best reform plan. I am saying that needs to be done now.

But if there is a delay, it will be because Obama blew it by not taking a more bi-partisan, statesmen-like approach -- putting it in the hands of the legislature before throwing out a proposal.

And such inter-community issues could be worked out. The least bureaucratic way would be for your health coverage to travel with you. You got a card, you got coverage. The kind of county-based idea I'm toying with would take state or national legislation to make a reality I imagine, anyway. I mean, we could all band together in some sort of community effort, but then you probably run into portability problems and you still have to work out mandates on employers to supply health insurance, and you would be doing nothing to drive down the actual costs of care.

Sep 7, 2009, 6:15pm Permalink

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