Obamacare

[SaadBell 0]

Independent.co.uk

Sicko? The truth about the US healthcare system

Michael Moore's new film is a damning indictment of the way the world's richest country looks after those who fall ill. Andrew Gumbel finds out whether his accusations are justified

Monday, 4 June 2007

Cynthia Kline knew exactly what was happening to her when she suffered a heart attack at her home in Cambridge, Massachusetts. She took the time to call an ambulance, popped some nitroglycerin tablets she had been prescribed in anticipation of just such an emergency, and waited for help to arrive.

On paper, everything should have gone fine. Unlike tens of millions of Americans, she had health insurance coverage. The ambulance team arrived promptly. The hospital where she had been receiving treatment for her cardiac problems, a private teaching facility affiliated with the Harvard Medical School, was just a few minutes away.

The problem was, the casualty department at the hospital, Mount Auburn, was full to overflowing. And it turned her away. The ambulance took her to another nearby hospital but the treatment she needed, an emergency catheterisation, was not available there. A flurry of phone calls to other medical facilities in the Boston area came up empty. With a few hours, Cynthia Kline was dead.

She died in an American city with one of the highest concentration of top-flight medical specialists in the world. And it happened largely because of America's broken health care system - one where 50 million people are entirely without insurance coverage and tens of millions more struggle to have the treatment they need approved. As a result, medical problems go unattended until they reach crisis point. Patients then rush to hospital casualty departments, where by law they cannot be turned away, overwhelming the system entirely. Everyone - doctors and patients, politicians on both the left and the right - agrees this is an insane way to run a health system.

When Elizabeth Hilsabeck gave birth to premature twins in Austin, Texas, she encountered another kind of insanity. Again, she was insured -- through her husband, who had a good job in banking. But the twins were born when she was barely six months pregnant, and the boy, Parker, developed cerebral palsy. The doctors recommended physical therapy to build up muscle strength and give the boy a fighting chance of learning to walk, but her managed health provider refused to cover it.

The crazy bureaucratic logic was that the policy covered only "rehabilitative" therapy - in other words, teaching a patient a physical skill that has been lost. Since Parker had never walked, the therapy was in essence teaching him a new skill and therefore did not qualify. The Hilsabecks railed, protested, won some small reprieves, but ended up selling their home and moving into a trailer to cover their costs. Elizabeth's husband, Steven, considered taking a new, better-paying job, but chose not to after making careful inquiries about the health insurance coverage. "When is he getting over the cerebral palsy?" a prospective new insurance company representative breezily asked the Hilsabecks. When Elizabeth explained he would never get over it, she was told she was on her own.

Everyone in America has a health-care horror story or knows someone who does. Mostly they are stories of grinding bureaucratic frustration, of phone calls and officials letters and problems with their credit rating, or of people ignoring a slowly deteriorating medical condition because they are afraid that an expensive battery of tests will lead to a course of treatment that could quickly become unaffordable.

Even when things don't go horribly wrong, it is a matter of surviving by the skin of one's teeth.

In Montana, Melissa Anderson can't find affordable insurance because she is self-employed - an increasingly common affliction. When her son Kasey came down with epilepsy two years ago, she was saved only by a recently introduced child health insurance programme specifically tailored to people who aren't poor but can't afford to pay monster medical bills. She herself remains uninsured for anything short of major care needs.

Over the past 15 years, the stories have become less about poor people without the economic means to access the system - although that remains a vast, unsolved problem - and more about the kind of people who have every expectation they will be taken care of. Middle-class people, people with jobs that carry health benefits or - as the problem worsens - people with the sorts of jobs that used to carry robust health benefits which are now more rudimentary and risk their being cut off for a variety of reasons.

This is the morass that Michael Moore has chosen to explore in his latest documentary, Sicko, which goes on release later this month. Moore spends much of the film demonstrating that there is nothing inevitable or necessary about a system that enriches insurance companies and drug manufacturers but shortchanges absolutely everyone else. His searching documentary looks at health care in France, Britain, Canada, and even Cuba - still regarded as a model system for the Third World.

Moore has his share of ghoulishly awful stories. The film kicks off with an uninsured carpenter who has to decide whether to spend $12,000 (£6,000) reattaching his severed ring finger or $60,000 to reattach his severed middle finger. Later on, Moore focuses on a hospital worker whose husband needed a bone marrow transplant to save him from a rare disease. The couple's insurance company refused to cover the transplant because it regarded the treatment as "experimental". The husband died.

Many more stories are collected in a newly published book called Sick: The Untold Story of America's Health Care Crisis, by Jonathan Cohn. A woman in California called Nelene Fox died of breast cancer after she, too, was turned down for a bone marrow transplant by her insurance company. In Georgia, a family whose infant son went into cardiac arrest were forced to take him to a hospital 45 miles away on their insurance carrier's orders. He survived, but suffered permanent disabilities that more prompt treatment might have averted. In New York, an infant called Bryan Jones - whose case was trumpeted all over the local media at the time - died of a heart defect that went undetected because his insurance company kicked him and his mother out of hospital 24 hours after his birth, too soon to carry out the tests that might have spotted the problem.

America's health system offers a tremendous paradox. In medical technology and in the scientific understanding of disease, it is second-to-none. Since doctors are better paid than anywhere else in the world, the country attracts the best of the best. And yet many, if not most, Americans are unable to reap the advantages of this. In fact, as The New York Times columnist Paul Krugman has argued, the very proliferation of research and high-tech equipment is part of the reason for the imbalance in coverage between the privileged few and the increasingly underserved masses. "[The system] compensates for higher spending on insiders, in party, by consigning more people to outsider status --robbing Peter of basic care in order to pay for Paul's state-of-the-art treatment," Krugman wrote recently. "Thus we have the cruel paradox that medical progress is bad for many Americans' health."

Having the system run by for-profit insurance companies turns out to be inefficient and expensive as well as dehumanising. America spends more than twice as much per capita on health care as France, and almost two and a half times as much as Britain. And yet it falls down in almost every key indicator of public health, starting, perhaps, most shockingly, with infant mortality, which is 36 per cent higher than in Britain.

A recent survey by the management consulting company McKinsey estimated the excess bureaucratic costs of managing private insurance policies - scouting for business, processing claims, and hiring "denial management specialists" to tell people why their ailment is not covered by their policy - at about $98bn a year. That, on its own, is significantly more than the $77bn McKinsey calculates it would cost to cover every uninsured American. If the government negotiated bulk purchasing rates for drugs, rather than allowing the pharmaceutical companies to set their own extortionate rates, that would save another $66bn.

Astonishingly, there hasn't been a serious debate about health care in the United States since Bill Clinton, with considerable input from his wife Hillary, tried and failed to overhaul the system in 1994. That, though, may be about to change as the 2008 presidential race heats up. Everyone acknowledges the system is broken. Everyone recognises that 50 million uninsured - including almost 10 million children - is unacceptable in a civilised society.

Even the old, classically American free-market argument - that "socialised" medicine is somehow the first step on a slippery slope towards godless communism - doesn't hold water, because in the absence of a functioning private insurance regime the government ends up picking up about 50 per cent of the overall costs for treatment anyway. The indigent rely on a government programme called Medicaid. The elderly have a government programme called Medicare. And perhaps the most efficient part of the whole system is the Veterans' Administration, a sort of NHS for former servicemen.

Rather like London and Paris in the 19th century, where the authorities belatedly paid attention to outbreaks of cholera once the disease started affecting the rich and middle classes, so the American health crisis may be coming to a head because of the kinds of people who are suffering from its injustices.

Corporate chief executives, for a start, are gagging under the ever-increasing costs of providing coverage to their employees. Starbucks now spends more on health care than it does on coffee beans. Company health costs, as a whole, are at about the same level as corporate profits. In a globalised world where US businesses are competing with low-wage countries such as India and China, that is rapidly becoming unacceptable.

That explains, perhaps, why the chief executive of Wal-Mart, Lee Scott, has made common cause with America's leading service sector union - more commonly a bitter critic of Wal-Mart's labour practices - in calling for a government-run universal health care system by 2012. It's going to be a tough battle. The insurance and pharmaceutical industries bankroll the campaigns of dozens of congressmen and have so far been brutally efficient in protecting their own interests. The Clintons were defeated in 1994 in part because of the power of the industry lobbies. Doing better this time will take singular political courage.

In the meantime, we will hear ever more crazy stories like the one told by Marijon Binder, a former nun in Chicago who ended up being sued by a Catholic hospital for $11,000 because her two-night stay for a heart scare was not considered a worthy charity case. Binder, who works as a live-in companion to a disabled old woman, wrote on all her admission forms that she had no insurance and, in her telling at least, was reassured the hospital would take care of her anyway.

After a year and a monstrous bureaucratic fight that went nowhere, a civil judge promptly absolved her of responsibility for her bill - a lucky outcome, for sure. Binder said: "The whole experience was very demeaning. It made me feel very guilty; it made me feel like a criminal." She is, though, alive and solvent. Not everyone in this system catches the same break.

http://www.independent.co.uk/news/world/am...tem-451651.html

[GaryC 7]

The government wouldn't be providing the healthcare, just getting rid of the insurance providers, so there's very little red tape. If you're sick, you go to the doctor and your insurance pays for it. The responsibility of managing healthcare would be up to the doctors and hospitals, not the insurance company...as it should be.

Again, what you want isn't what you will get. When the government acts as the insurance company they will decide who gets what and how much of it they get. They will also decide how much the doctors get paid and how much the medicine costs. Do you really want the government to have that kind of power over you? It also means that the government has all your medical records. I thought that kind of intrusion into your privacy was something you didn't want? Sorry man, it all sounds good on paper but in practice it will be much worse than what we have now.

The only incentive for the government acting as insurer, to step in and limit service, is if medical costs are exceeding the amount of insurance that is coming in which currently is not happening to private insurance companies. In fact, most of them are profitable. Insurance works on the premise that not everyone who pays into, is ever going to 'cash out' or use all that is paid into it. I would support a national healthcare where that money could not be re-appropriated for anything else - that is when government gets into trouble.

Steven, please think about this. Ask yourself this question. Has the government had ANY social program that stayed in budget? Has the government had ANY social program that didn't have costs escelate year after year? Has the government had ANY social program that isn't in danger of going bankrupt at some point without massive tax increases? Come on now. The government is batting 000 on this kind of thing. What makes you think the biggest government take over of a private sector industry in history wouldn't be just as bad only on a more massive scale?

Break it up and break it down. The Federal Government could act as the central insurer, then appropriate funds to each state, according to need. Each state could manage their own budgets for healthcare, much like they do for public schools.

I am all in favor of it being a state by state thing. But my premise still needs to be answered. Is there any government program (state or federal) that isn't running huge cost overruns year after year? Or in the case of state run health care, is there one that does not ration services worse than insurance companies do? I have done some checking. There are just as many horror stories about state run health care as there are private insurance.

But back to the OP. What you are wanting isn't what Obama is proposing. If he is elected and he gets his way what you will get is what is in the OP, not what you are asking for.

[GaryC 7]

Independent.co.uk

Sicko? The truth about the US healthcare system

Michael Moore's new film is a damning indictment of the way the world's richest country looks after those who fall ill. Andrew Gumbel finds out whether his accusations are justified

Monday, 4 June 2007

....

http://www.independent.co.uk/news/world/am...tem-451651.html

Yes Gaja, we all know about the evil US health care situation. It's a wonder we are living at all. But the government isn't the answer. All they will do is transfer the evil from insurance companies to the government. Try and answer the questions I posed to Steven. Try and do it honestly. The government will be worse than what we have now. Oh, and using Michael Moore isn't the best idea. He has the credibility of a slug.

Edited June 18, 2008 by GaryC

[one...two...tree 2,762]

The government wouldn't be providing the healthcare, just getting rid of the insurance providers, so there's very little red tape. If you're sick, you go to the doctor and your insurance pays for it. The responsibility of managing healthcare would be up to the doctors and hospitals, not the insurance company...as it should be.

Again, what you want isn't what you will get. When the government acts as the insurance company they will decide who gets what and how much of it they get. They will also decide how much the doctors get paid and how much the medicine costs. Do you really want the government to have that kind of power over you? It also means that the government has all your medical records. I thought that kind of intrusion into your privacy was something you didn't want? Sorry man, it all sounds good on paper but in practice it will be much worse than what we have now.

The only incentive for the government acting as insurer, to step in and limit service, is if medical costs are exceeding the amount of insurance that is coming in which currently is not happening to private insurance companies. In fact, most of them are profitable. Insurance works on the premise that not everyone who pays into, is ever going to 'cash out' or use all that is paid into it. I would support a national healthcare where that money could not be re-appropriated for anything else - that is when government gets into trouble.

Steven, please think about this. Ask yourself this question. Has the government had ANY social program that stayed in budget? Has the government had ANY social program that didn't have costs escelate year after year? Has the government had ANY social program that isn't in danger of going bankrupt at some point without massive tax increases? Come on now. The government is batting 000 on this kind of thing. What makes you think the biggest government take over of a private sector industry in history wouldn't be just as bad only on a more massive scale?

Break it up and break it down. The Federal Government could act as the central insurer, then appropriate funds to each state, according to need. Each state could manage their own budgets for healthcare, much like they do for public schools.

I am all in favor of it being a state by state thing. But my premise still needs to be answered. Is there any government program (state or federal) that isn't running huge cost overruns year after year? Or in the case of state run health care, is there one that does not ration services worse than insurance companies do? I have done some checking. There are just as many horror stories about state run health care as there are private insurance.

But back to the OP. What you are wanting isn't what Obama is proposing. If he is elected and he gets his way what you will get is what is in the OP, not what you are asking for.

Accountability and transparency - there are problems with any type of health care system...it's a question of what system is most efficient and the statistics are pretty clear that national healthcare is the most efficient. It's why Japan, Canada, Europe - most of all industrialized nations have health care.

Obama won't strong arm his ideas to become legislation for healthcare... he'll be reasonably minded about forging together with Congress a healthcare bill that has been rigorously scrutinized and widely endorsed and accepted. That's the kind of leader he'll be.

[GaryC 7]

The government wouldn't be providing the healthcare, just getting rid of the insurance providers, so there's very little red tape. If you're sick, you go to the doctor and your insurance pays for it. The responsibility of managing healthcare would be up to the doctors and hospitals, not the insurance company...as it should be.

Again, what you want isn't what you will get. When the government acts as the insurance company they will decide who gets what and how much of it they get. They will also decide how much the doctors get paid and how much the medicine costs. Do you really want the government to have that kind of power over you? It also means that the government has all your medical records. I thought that kind of intrusion into your privacy was something you didn't want? Sorry man, it all sounds good on paper but in practice it will be much worse than what we have now.

The only incentive for the government acting as insurer, to step in and limit service, is if medical costs are exceeding the amount of insurance that is coming in which currently is not happening to private insurance companies. In fact, most of them are profitable. Insurance works on the premise that not everyone who pays into, is ever going to 'cash out' or use all that is paid into it. I would support a national healthcare where that money could not be re-appropriated for anything else - that is when government gets into trouble.

Steven, please think about this. Ask yourself this question. Has the government had ANY social program that stayed in budget? Has the government had ANY social program that didn't have costs escelate year after year? Has the government had ANY social program that isn't in danger of going bankrupt at some point without massive tax increases? Come on now. The government is batting 000 on this kind of thing. What makes you think the biggest government take over of a private sector industry in history wouldn't be just as bad only on a more massive scale?

Break it up and break it down. The Federal Government could act as the central insurer, then appropriate funds to each state, according to need. Each state could manage their own budgets for healthcare, much like they do for public schools.

I am all in favor of it being a state by state thing. But my premise still needs to be answered. Is there any government program (state or federal) that isn't running huge cost overruns year after year? Or in the case of state run health care, is there one that does not ration services worse than insurance companies do? I have done some checking. There are just as many horror stories about state run health care as there are private insurance.

But back to the OP. What you are wanting isn't what Obama is proposing. If he is elected and he gets his way what you will get is what is in the OP, not what you are asking for.

Accountability and transparency - there are problems with any type of health care system...it's a question of what system is most efficient and the statistics are pretty clear that national healthcare is the most efficient. It's why Japan, Canada, Europe - most of all industrialized nations have health care.

Obama won't strong arm his ideas to become legislation for healthcare... he'll be reasonably minded about forging together with Congress a healthcare bill that has been rigorously scrutinized and widely endorsed and accepted. That's the kind of leader he'll be.

Obama won't strong arm? How do you know this? He will be reasonable? How do you know this? The congress will rigorously scutinize the bill?? Sorry, that goes so far I can't hold it in. You accuse me of swallowing what Bush says and turning a blind eye to what he does. Isn't this what you are doing now? What makes you think that Obama and this congress will do anything like what your implying? You get mad when I say Obama is a messiah but then you turn around and say these things. What else can I think?

[one...two...tree 2,762]

Accountability and transparency - there are problems with any type of health care system...it's a question of what system is most efficient and the statistics are pretty clear that national healthcare is the most efficient. It's why Japan, Canada, Europe - most of all industrialized nations have health care.

Obama won't strong arm his ideas to become legislation for healthcare... he'll be reasonably minded about forging together with Congress a healthcare bill that has been rigorously scrutinized and widely endorsed and accepted. That's the kind of leader he'll be.

Obama won't strong arm? How do you know this? He will be reasonable? How do you know this? The congress will rigorously scutinize the bill??

Because if he wants to broad support and succeed with national healthcare, he has to bring everyone to the table. That's how our government works or should work. We can get bipartisanship to work on issue that has broad support among Americans.

Edited June 18, 2008 by Jabberwocky

[Empress of Groovy 373]

This article doesn't even acknowledge that obtaining and keeping insurance is the major issue in this entire debate. All the writer says is that the people mentioned lost their coverage and then provides a few anecdotes about the superior care they received when they had private insurance. (They were lucky they got Medicaid at all!) In fact, all the complaints about Medicaid's relatively low reimbursement and less than generous prescription plan for certain conditions could be applied to private insurance as well. And there's no mention of what may have happened if they didn't have insurance at all.

In terms of the privacy concerns, do they not apply to Medicare? I wonder how many people who firmly believe that a universal scheme in the U.S. would be disastrous are prepared to forgo Medicare when they become eligible and instead try their luck in the private market.

[GaryC 7]

Accountability and transparency - there are problems with any type of health care system...it's a question of what system is most efficient and the statistics are pretty clear that national healthcare is the most efficient. It's why Japan, Canada, Europe - most of all industrialized nations have health care.

Obama won't strong arm his ideas to become legislation for healthcare... he'll be reasonably minded about forging together with Congress a healthcare bill that has been rigorously scrutinized and widely endorsed and accepted. That's the kind of leader he'll be.

Obama won't strong arm? How do you know this? He will be reasonable? How do you know this? The congress will rigorously scutinize the bill??

Because if he wants to broad support and succeed with national healthcare, he has to bring everyone to the table. That's how our government works or should work. We can and do get bipartisanship working on issue that has broad support among Americans.

Hehe, sorry Steven. Your living in Never Never Land with that attitude. This is the US congress we are talking about. Just because Obama is the president it will not magicly change to something it has never been. Please Steven, your an adult. You know this isn't going to happen like you wish it would. Obama isn't some sort of a Messiah that will bring the congress and the country together. He is just a man and a politician like any other. Please wake up or your going to be in for a real let down later.

[GaryC 7]

This article doesn't even acknowledge that obtaining and keeping insurance is the major issue in this entire debate. All the writer says is that the people mentioned lost their coverage and then provides a few anecdotes about the superior care they received when they had private insurance. (They were lucky they got Medicaid at all!) In fact, all the complaints about Medicaid's relatively low reimbursement and less than generous prescription plan for certain conditions could be applied to private insurance as well. And there's no mention of what may have happened if they didn't have insurance at all.

In terms of the privacy concerns, do they not apply to Medicare? I wonder how many people who firmly believe that a universal scheme in the U.S. would be disastrous are prepared to forgo Medicare when they become eligible and instead try their luck in the private market.

The point is that Medicare does not work very well. We all have older friends and relatives that are on Medicare right now. Most have to have supplemental private insurance to take up the slack.

The way we do things now isn't perfect. Not by a long shot. But the government done way isn't any better. The trouble with the government run way is that it is a one way street. Once don't it can't be undone.

I am in favor of reforming the private insurance companies. If it can be made portable, eleminate the exsisting condition clauses, regulate the costs and supplement the poor so they can get it we wouldn't need a government take over.

[one...two...tree 2,762]

Accountability and transparency - there are problems with any type of health care system...it's a question of what system is most efficient and the statistics are pretty clear that national healthcare is the most efficient. It's why Japan, Canada, Europe - most of all industrialized nations have health care.

Obama won't strong arm his ideas to become legislation for healthcare... he'll be reasonably minded about forging together with Congress a healthcare bill that has been rigorously scrutinized and widely endorsed and accepted. That's the kind of leader he'll be.

Obama won't strong arm? How do you know this? He will be reasonable? How do you know this? The congress will rigorously scutinize the bill??

Because if he wants to broad support and succeed with national healthcare, he has to bring everyone to the table. That's how our government works or should work. We can and do get bipartisanship working on issue that has broad support among Americans.

Hehe, sorry Steven. Your living in Never Never Land with that attitude. This is the US congress we are talking about. Just because Obama is the president it will not magicly change to something it has never been. Please Steven, your an adult. You know this isn't going to happen like you wish it would. Obama isn't some sort of a Messiah that will bring the congress and the country together. He is just a man and a politician like any other. Please wake up or your going to be in for a real let down later.

Gary, the Democratic Party is united on the issue of wanting national healthcare - the devil is in the details. Unless you have an example of Obama not getting along with fellow Democrats in Congress over certain legislation, then you're argument is baseless. Americans want national healthcare and with a Democrat in the White House and a majority in Congress, we will have a national healthcare system that has broad support.

[Sheriff Uling 3]

Accountability and transparency - there are problems with any type of health care system...it's a question of what system is most efficient and the statistics are pretty clear that national healthcare is the most efficient. It's why Japan, Canada, Europe - most of all industrialized nations have health care.

Obama won't strong arm his ideas to become legislation for healthcare... he'll be reasonably minded about forging together with Congress a healthcare bill that has been rigorously scrutinized and widely endorsed and accepted. That's the kind of leader he'll be.

Obama won't strong arm? How do you know this? He will be reasonable? How do you know this? The congress will rigorously scutinize the bill??

Because if he wants to broad support and succeed with national healthcare, he has to bring everyone to the table. That's how our government works or should work. We can and do get bipartisanship working on issue that has broad support among Americans.

Hehe, sorry Steven. Your living in Never Never Land with that attitude. This is the US congress we are talking about. Just because Obama is the president it will not magicly change to something it has never been. Please Steven, your an adult. You know this isn't going to happen like you wish it would. Obama isn't some sort of a Messiah that will bring the congress and the country together. He is just a man and a politician like any other. Please wake up or your going to be in for a real let down later.

Kuya Gary... You say that he's not a Messiah, but you are the one who had the Obama "appearing to walk on water" cartoon in your signature recently. So as far as I’m concerned, you have perpetuated this phenomenon and then turned around to complain about it. Hehehehe...

[SaadBell 0]

When it comes to reforming health care, McCain would rely more on individual efforts and market forces to drive down costs. Obama would rely more on government and establish health insurance mandates for companies and individuals to make coverage more affordable.

But, of course, we need to have a further breakdown. So here it is.

John McCain and health care

John McCain is all about individual efforts. No insurance will be required, but individuals would be able to get a tax credit. But here's the catch, now, individuals would be taxed on the subsidy they receive from their employers' plans (they aren't taxed on it now). SO, individual income tax is increased, and then offset by a credit. McCain wants to encourage people to look for lower priced health plans with this idea, trusting that "free market" forces will then take over to lower health care costs. (I'm skeptical of this, since allowing "free market competition" hasn't done anything to keep health care costs down so far.)

The people that would probably benefit most from this arrangement are those that already buy individual insurance (like me). Since I don't get a subsidy for my insurance premium, a tax credit (beyond the deduction i get for the self-employed health insurance) would be helpful. But for those already working and getting insurance through their employer, this just means that the costs are offset, but nothing really significant is changed.

I do like that McCain would abolish the idea that you can only buy insurance within a state -- insurance could be bought across state lines, allowing increased competition for lower prices. It is also nice that McCain would allow federal funding for state insurance plans that provide subsidies for the uninsured and underinsured.

Barack Obama and health care

Barack Obama has a different idea. He isn't for making health care completely universal. He does want coverage mandatory for all children, though. He would boost aid to programs that provide health care for children. What a great idea. Help children.

For adults, there is help as well. Obama recognizes that there is a growing number of people in the Middle Class who are unable to afford health care costs, but do not qualify for government aid through programs like Medicaid. He would add a subsidy for those in this position to the subsidy for those covered at work. A National Health Insurance Exchange would also be used, so that people could choose between public (he wants "regular folks" to have access to the same plan our Congressional folks get) and private plans. This would benefit the Middle Class, small business and others who are struggling to pay health care costs.

Obama offers employers a choice: offer a health care plan to employees or contribute to health care costs. Or give some money to support the health exchange.

Obama's plan would be a big help to many in the Middle Class. I like that it still allows for competition, but injects the government in to make for the obvious (and gaping) hole that is present in a health care system that is so focused on the private sector. Heck, Obama's plan makes the government a competitor in the health care game. Obviously, this would need to be paid for somehow, and would most likely be done through Obama's tax policy.

McCain's plan, though it has some elements that are beneficial to the individual, mostly helps insurance companies. It gets rid of some of the regulations, and it encourages people to buy more insurance from the private sector, without really providing a significant reduction in costs for the Middle Class. Unless, of course, health care providers and insurance companies lower prices in response to market forces. Good luck with that.

[SaadBell 0]

In terms of the privacy concerns, do they not apply to Medicare? I wonder how many people who firmly believe that a universal scheme in the U.S. would be disastrous are prepared to forgo Medicare when they become eligible and instead try their luck in the private market.

Thank you so much for pointing that out, usually the people that complain the most of government health care are at the front of the line for their medicare

[GaryC 7]

Accountability and transparency - there are problems with any type of health care system...it's a question of what system is most efficient and the statistics are pretty clear that national healthcare is the most efficient. It's why Japan, Canada, Europe - most of all industrialized nations have health care.

Obama won't strong arm his ideas to become legislation for healthcare... he'll be reasonably minded about forging together with Congress a healthcare bill that has been rigorously scrutinized and widely endorsed and accepted. That's the kind of leader he'll be.

Obama won't strong arm? How do you know this? He will be reasonable? How do you know this? The congress will rigorously scutinize the bill??

Because if he wants to broad support and succeed with national healthcare, he has to bring everyone to the table. That's how our government works or should work. We can and do get bipartisanship working on issue that has broad support among Americans.

Hehe, sorry Steven. Your living in Never Never Land with that attitude. This is the US congress we are talking about. Just because Obama is the president it will not magicly change to something it has never been. Please Steven, your an adult. You know this isn't going to happen like you wish it would. Obama isn't some sort of a Messiah that will bring the congress and the country together. He is just a man and a politician like any other. Please wake up or your going to be in for a real let down later.

Gary, the Democratic Party is united on the issue of wanting national healthcare - the devil is in the details. Unless you have an example of Obama not getting along with fellow Democrats in Congress over certain legislation, then you're argument is baseless. Americans want national healthcare and with a Democrat in the White House and a majority in Congress, we will have a national healthcare system that has broad support.

Oh jeez, Steven! We are talking about the US government here! How can you distrust Bush and the reps and then turn around and trust Obama and the dems by an equal measure? I am at least honest enough with myself to understand that neither of them can be trusted. You have this fantacy that it will all be rainbows and kittens if Obama and the dems are in power. I hate to break it to you but it isn't going to happen that way. Each member of congress will be asking for his own piece of the pie. By the time they get done with it your utopia will be a dragon. People are people and that applies to dem members of congress just as much as it does to insurance company CEO's.

[HAL 9000 96]

The Case For Single Payer, Universal Health Care For The United States

Outline of Talk Given To The Association of State Green Parties, Moodus, Connecticut on June 4, 1999

By John R. Battista, M.D. and Justine McCabe, Ph.D.

1. Why doesn’t the United States have universal health care as a right of citizenship? The United States is the only industrialized nation that does not guarantee access to health care as a right of citizenship. 28 industrialized nations have single payer universal health care systems, while 1 (Germany) has a multipayer universal health care system like President Clinton proposed for the United States.

2. Myth One: The United States has the best health care system in the world.

* Fact One: The United States ranks 23rd in infant mortality, down from 12th in 1960 and 21st in 1990

* Fact Two: The United States ranks 20th in life expectancy for women down from 1st in 1945 and 13th in 1960

* Fact Three: The United States ranks 21st in life expectancy for men down from 1st in 1945 and 17th in 1960.

* Fact Four: The United States ranks between 50th and 100th in immunizations depending on the immunization. Overall US is 67th, right behind Botswana

* Fact Five: Outcome studies on a variety of diseases, such as coronary artery disease, and renal failure show the United States to rank below Canada and a wide variety of industrialized nations.

* Conclusion: The United States ranks poorly relative to other industrialized nations in health care despite having the best trained health care providers and the best medical infrastructure of any industrialized nation

3. Myth Two: Universal Health Care Would Be Too Expensive

* Fact One: The United States spends at least 40% more per capita on health care than any other industrialized country with universal health care

* Fact Two: Federal studies by the Congressional Budget Office and the General Accounting office show that single payer universal health care would save 100 to 200 Billion dollars per year despite covering all the uninsured and increasing health care benefits.

* Fact Three: State studies by Massachusetts and Connecticut have shown that single payer universal health care would save 1 to 2 Billion dollars per year from the total medical expenses in those states despite covering all the uninsured and increasing health care benefits

* Fact Four: The costs of health care in Canada as a % of GNP, which were identical to the United States when Canada changed to a single payer, universal health care system in 1971, have increased at a rate much lower than the United States, despite the US economy being much stronger than Canada’s.

* Conclusion: Single payer universal health care costs would be lower than the current US system due to lower administrative costs. The United States spends 50 to 100% more on administration than single payer systems. By lowering these administrative costs the United States would have the ability to provide universal health care, without managed care, increase benefits and still save money

4. Myth Three: Universal Health Care Would Deprive Citizens of Needed Services

* Fact One: Studies reveal that citizens in universal health care systems have more doctor visits and more hospital days than in the US

* Fact Two: Around 30% of Americans have problem accessing health care due to payment problems or access to care, far more than any other industrialized country. About 17% of our population is without health insurance. About 75% of ill uninsured people have trouble accessing/paying for health care.

* Fact Three: Comparisons of Difficulties Accessing Care Are Shown To Be Greater In The US Than Canada (see graph)

* Fact Four: Access to health care is directly related to income and race in the United States. As a result the poor and minorities have poorer health than the wealthy and the whites.

* Fact Five: There would be no lines under a universal health care system in the United States because we have about a 30% oversupply of medical equipment and surgeons, whereas demand would increase about 15%

* Conclusion: The US denies access to health care based on the ability to pay. Under a universal health care system all would access care. There would be no lines as in other industrialized countries due to the oversupply in our providers and infrastructure, and the willingness/ability of the United States to spend more on health care than other industrialized nations.

5. Myth Four: Universal Health Care Would Result In Government Control And Intrusion Into Health Care Resulting In Loss Of Freedom Of Choice

* Fact One: There would be free choice of health care providers under a single payer universal health care system, unlike our current managed care system in which people are forced to see providers on the insurer’s panel to obtain medical benefits

* Fact Two: There would be no management of care under a single payer, universal health care system unlike the current managed care system which mandates insurer preapproval for services thus undercutting patient confidentiality and taking health care decisions away from the health care provider and consumer

* Fact Three: Although health care providers fees would be set as they are currently in 90% of cases, providers would have a means of negotiating fees unlike the current managed care system in which they are set in corporate board rooms with profits, not patient care, in mind

* Fact Four: Taxes, fees and benefits would be decided by the insurer which would be under the control of a diverse board representing consumers, providers, business and government. It would not be a government controlled system, although the government would have to approve the taxes. The system would be run by a public trust, not the government.

* Conclusion: Single payer, universal health care administered by a state public health system would be much more democratic and much less intrusive than our current system. Consumers and providers would have a voice in determining benefits, rates and taxes. Problems with free choice, confidentiality and medical decision making would be resolved

6. Myth Five: Universal Health Care Is Socialized Medicine And Would Be Unacceptable To The Public

* Fact One: Single payer universal health care is not socialized medicine. It is health care payment system, not a health care delivery system. Health care providers would be in fee for service practice, and would not be employees of the government, which would be socialized medicine. Single payer health care is not socialized medicine, any more than the public funding of education is socialized education, or the public funding of the defense industry is socialized defense.

* Fact Two: Repeated national and state polls have shown that between 60 and 75% of Americans would like a universal health care system (see The Harris Poll #78, October 20, 2005)

* Conclusion: Single payer, universal health care is not socialized medicine and would be preferred by the majority of the citizens of this country

7. Myth Six: The Problems With The US Health Care System Are Being Solved and Are Best Solved By Private Corporate Managed Care Medicine because they are the most efficient

* Fact One: Private for profit corporation are the lease efficient deliverer of health care. They spend between 20 and 30% of premiums on administration and profits. The public sector is the most efficient. Medicare spends 3% on administration.

* Fact Two: The same procedure in the same hospital the year after conversion from not-for profit to for-profit costs in between 20 to 35% more

* Fact Three: Health care costs in the United States grew more in the United States under managed care in 1990 to 1996 than any other industrialized nation with single payer universal health care

* Fact Four: The quality of health care in the US has deteriorated under managed care. Access problems have increased. The number of uninsured has dramatically increased (increase of 10 million to 43.4 million from 1989 to 1996, increase of 2.4% from 1989 to 1996- 16% in 1996 and increasing each year).

* Fact Five: The level of satisfaction with the US health care system is the lowest of any industrialized nation.

* Fact Six: 80% of citizens and 71% of doctors believe that managed care has caused quality of care to be compromised

* Conclusion: For profit, managed care can not solve the US health care problems because health care is not a commodity that people shop for, and quality of care must always be compromised when the motivating factor for corporations is to save money through denial of care and decreasing provider costs. In addition managed care has introduced problems of patient confidentiality and disrupted the continuity of care through having limited provider networks.

8. Overall Answer to the questions Why doesn’t the US have single payer universal health care when single payer universal health care is the most efficient, most democratic and most equitable means to deliver health care? Why does the United States remain wedded to an inefficient, autocratic and immoral system that makes health care accessible to the wealthy and not the poor when a vast majority of citizens want it to be a right of citizenship?

Conclusion: Corporations are able to buy politicians through our campaign finance system and control the media to convince people that corporate health care is democratic, represents freedom, and is the most efficient system for delivering health care

9. What you can do about this through your state Green Party

* Work to pass a single payer, universal health care bill or referendum in your state. State level bills and referenda will be most effective because a federal health care system might in fact be too bureaucratic, and because it is not politically realistic at this time.

* Bills or referendum must be written by and supported by health care providers for the legislature to take them seriously. It is thus imperative to form an alliance with provider groups. The most effective provider group to go through is Physicians For A National Health Program which has chapters in every state (see hand out for partial listing of contact people). A number of states already have organized single payer efforts: Massachusetts, California, Washington, Oregon, New Mexico, and Maryland. Join with them.

* A first step is to contact state representatives from PNHP and offer to join with them to write and support a bill bringing single payer, universal health care to your state if this has not already been done. The Connecticut and Massachusetts Bills can be used as models to make this task easier (email us at riverbnd@javanet.com and we will send you copies of the bills). A referendum is another way to go, in which case the California referendum can be used as a model.

* A second step is to contact state legislators and find a group who are willing to sponsor such a bill.

* A third step is to create a coalition of groups to work together to support and publicize this work, or to try to bring together existing groups to work together on this project. Labor unions, progressive democratic groups, Medicare/Senior Advocacy groups, the Labor Party, the Reform Party, UHCAN, existing health care advocacy groups, and state health care provider groups are all imporatnt to work with and get to join such a coalition. The state medical society and state hospital association are critical to work with in order to get any legislation passed. Try to get them to work with you to design a new model for health care delivery. They will be particularly concerned about who will control the system, and be very mistrustful of government. A public trust model with participation by providers, hospitals, business, the public and government is like to be much more acceptable to them than a pure government system. Emphasize doing away with managed care, and get them to try and work with you to find other ways to control costs (necessary to convince politicians) such as quality assurance standards, which will also protect them from malpractice

* A fourth step is to give talks in support of your bill or referendum where ever possible. Senior groups, medical staffs, church groups, high school assemblies, and labor unions are particularly good sources. Excellent materials including slides, a chart book and videos are available through PNHP.

* A fifth step is to raise money through fund raisers, contributions and benefits held by entertainers. Benefits are particularly useful in bringing out people who you can inform about single payer, universal health care and your efforts.

* A sixth step is to develop media access. The creation of videos that can be shown on local cable access TV stations is very effective. Newspaper articles, letters to the editor, and articles by the press are critical. Radio interviews and radio talk shows are important.

* Getting the public to write and call their state representatives in support of a proposed bill is critical, as is coordinating testimony at a public hearing.

* Because the data about single payer universal health care are so revealing of the problems with corporate America, and because the US citizenry is so concerned and dissatisfied with our health care system these efforts may yield surprisingly positive results and be helpful in establishing the Green Party in the US as a party of the people, by the people and for the people.

We would be happy to help you. Contact us by email at riverbnd@javanet.com, by phone at 860-354-1822, or by mail at 88 Cherniske Road, New Milford, CT 06776

http://cthealth.server101.com/the_case_for...ited_states.htm

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