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Cross-posted at Liberal Street Fight

Unfortunately, that seems to be the choice in 2005. And the people are well aware of that fact. Two recent surveys, one of plain old people like us and another of actual health care experts, highlight where our health care system is really sick, and where the Administration and Republican-controlled Congress are missing the boat. Which of course makes it prime picking for our side.

While our lawmakers are blathering on about malpractice reform and protecting us from those scary Canadian drugs, people want them to focus on lowering the cost of health care and health insurance, ensure Medicare's long-term solvency, expand coverage to the uninsured, and improve the quality and safety of medical care.

More on the flip.

The first survey, by the Kaiser Family Foundation and Harvard School of Public Health, has some interesting tidbits. The first is that those polled ranked health care issues third when asked what was the single most important priority for the President and Congress to address (27% said war in Iraq, 17% economic issues, a tie at 10% for health care and national security).

When asked to rank what was most important in health care reform, a whopping 63% cited lowering the costs of health care and health insurance. Fifty-eight percent want to make sure that Medicare is solvent now and in the future, and 57% want to see health coverage expanded to the uninsured. Coming in at number 11 (of 12), with 26% of the vote is tort reform. But the breakdown within these areas is pretty interesting. An equal number of Democrats and Republicans want to see the cost of health care and insurance reduced. When the numbers on expanding coverage to the uninsured are broken down, some other details emerge. A sizeable portion (45%) would be willing to pay more in either taxes or higher insurance premiums to expand coverage to the uninsured. Not too surprising: 59% of Democrats would be willing to pay more, while only 36% of Republicans would. But I bet we could get to that 36%.

There are a few other things the loyal opposition should be paying attention to in this survey: seniors are much more likely to view the Medicare prescription drug "reform" law unfavorably (46%) than favorably (29%); only four percent of those polled had a health savings account, and 53% had never heard of them, and; 75% of the public still wants to get their health insurance through their employer. This says to me that we have a long way to go in trying to sell anything that looks remotely like a single-payer system.

The second survey The Commonwealth Fund Health Care Opinion Leaders Survey shows a remarkable consistency with the Kaiser results. Experts from four health care sectors (academia and research organizations; health care delivery; business, insurance, and other health industry; and government and advocacy groups) were asked to rank their priorities. An astounding 87% of respondents ranked expanding coverage to the uninsured as their top priority. Way down on this list of 12 priorities, coming in at number 8 with 30% of the vote, is malpractice reform.

Here's what Congressional Quarterly laid out as the health care issues the 109th Congress is poised to address (as reported by kaisernetwork.org in their daily health briefing: limiting medical malpractice liability for physicians; reforming the system used to calculate drug prices for Medicaid; address intergovernmental transfers between state and county entities, which critics say overstate the amount of state spending on Medicaid (huh?); and reducing Medicare payments to some health care providers to fund other legislative initiatives (that's going to go over well).

Clearly, the priorities of the Republicans are not the priorities of either the people or the experts. This tells me that it wouldn't hurt Democrats in Congress to be obstructionists when it comes to their health care agenda. By extension, we need to capitalize on the discontent in our senior population to derail Bush's hare-brained Social Security reform choo-choo train.

Originally posted to Joan McCarter on Fri Jan 14, 2005 at 06:42 PM PST.

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Comment Preferences

  •  Who's got health care insurance? (4.00)
    Anyone?

    All the snark that's fit to...er...pixelate? liberal street fight

    by Joan McCarter on Fri Jan 14, 2005 at 06:29:51 PM PST

    •  I have health insurance with an HMO (none)
      My employer pays 90 dollars, I pay about 200 a month.

      If I have a baby (and I want one):

      My employer pays 90 dollars, I pay about 600 a month.

      Re-goddam-diculous. Thats like another rent, or an expensive car payment. And I know there are plenty who have it worse.

      In the midst of life we are in debt, etc.

      by ablington on Fri Jan 14, 2005 at 06:59:37 PM PST

      [ Parent ]

      •  ouch (none)
        I'm so lucky to be employed by the state--phenomenal coverage that's cheap. I haven't been happy in this job for quite a while, but the thought of giving up those benefits is one of the things keeping me in it.

        All the snark that's fit to...er...pixelate? liberal street fight

        by Joan McCarter on Fri Jan 14, 2005 at 07:05:37 PM PST

        [ Parent ]

      •  asdf (none)
        Strange, here (Scandinavia) we get paid to have children, and in the US you have to pay to have them? And not just some insignificant amount, a whooping $400 difference, that's alot!

        I hope things go better, that capitalism stops interfering with health and education. Coke vending machines at schools, sugar industries trying to get your children to eat more and more sugar, blatantly counting on the "nag effect" where 40% of parents buy what their kids want as long as they nag. Flashy ads taking advantage of how children think, "getting them young, have them all life" is how commercial experts seem to think today.

        And at school the books are sponsored and misinforming.

        We should watch after our kids more, not cave in to the nag effect and most important of all, rid ourselves of the satan that is commercials directed towards children.

      •  My humble advice (none)
        if you want the baby, have the baby...you wont regret the "expensive car payment" one bit....
        •  Yes. Agreed. (none)
          So what if I never have new clothes or a haircut ever again? Maybe then someone could nominate me for 'What Not to Wear'! (my guilty pleasure TV show & secret fantasy) I can see it now...

          "This new mom needs some HELP!!!"

          In the midst of life we are in debt, etc.

          by ablington on Sat Jan 15, 2005 at 08:09:34 AM PST

          [ Parent ]

      •  Baby layaway (none)
        I am self-employed and in my child-bearing years. We have a two-year-old, and my husband and I would like to have one more child. Alas, he recently lost his job and, with it, our health insurance.

        We recently purchased a high-deductible policy for our family. Our big decision: Should we opt for a plan with a maternity rider? If you choose this, you pay about $150 month more for a policy. Sort of reasonable? After all, if you are choosing the maternity rider, you are pretty much declaring your intention to get pregnant.

        Of course, we all know that insurers are not in the business of giving something for nothing, so it is no real surprise that the so-called maternity benefit is actually more like getting your baby on a layaway plan.

        First, you have to wait 12 months before getting pregnant. Then there are the nine months of pregnancy. So, that's a guaranteed $3,150 in the insurer's pocket. And, better yet (for the insurer, that is), the fine print reveals that cost of your maternity care doesn't end there.

        The plan in question limits out-of-pocket-expenses to $2,000 per individual (and that's after the high deductible). But if said individual is a woman having a baby, that limit doesn't apply. Furthermore, instead covering 80% of costs (as it would for most other medical services), the plan only covers 60% of maternity costs--and that's after the $500 maternity deductible.

        With a C-section costing at least $12,000 and a natural hospital birth costing $6,000-$8,000, you'd be out thousands more dollars even after the deductible. Depending on your state's rules, you'd be better off looking into Medicaid. Or saving up for the baby with an interest-bearing account.

        I look down the road and wonder who on earth will insurance companies cover when their customer base shrinks after people like me stop having children?

        But, if things proceed as they have been, these individual insurers will have plenty of targets in years to come. Fewer and fewer businesses will offer group health plans and more and more people will be forced to purchase individual policies from insurers that that refuse to accept any risk--risk that a cancer will recur, risk that a woman will bear a child, risk that someone with allergies will wind up in the emergency room some night. You've got to admire an industry that is so good at taking risk out of the equation.

        I only wish that my family could eliminate risks so effectively---those pesky risks like losing jobs or watching our retirement assets evaporate. Instead, the cardsharps in Congress and corporate America are stacking the deck against us.

        Keep your fingers crossed for my family. Maybe one of us will land a job with good insurance again. Gone are the days when I could have given a cow or a lifetime supply of eggs to the doctor who would deliver my baby. And I certainly don't see Right-to-Lifers clamoring for a chance to pick up the tab for my maternity care.

        All I can say is, hooray for good-old, over-the-counter protection!

        Looking for investment opportunities? I want to say just one word to you--just one word. Rubbers. There's a great future in rubbers.

      •  Haven't seen this anywhere yet (none)
        Thought I'd post it as another option, though certainly not for everyone.  We just got insurance for the first time this past summer, I am 47.  I had my last of 4 babies nearly 5 years ago, and they were all homebirths.  It cost us about $1500.00 for the midwives in Va., but my midwife was driven out of business, so we didn't have one for the last birth.  

        I just saw a wonderful program on a midwifery practice in Seattle on the Discovery Health channel.  They have a birthing center and do homebirths.  In too many other areas of the country they are closing them down.  It's not for everyone, but some might want to check into it.

        Oddly enough, we now have excellent insurance, aobut $200.00 a month for a family of six.  They told my husband when he was hired that they had just had to raise what the employee pays and are not sure how long they can continue to provide what they do.  

        •  Seattle? Do you remember the name? (none)
          I would love to get more information on this midwifery practice in Seattle, especially if they deal with those of us who are high-risk. I live just across the Sound from Seattle and it's within a couple hours' reach at the most.

          They should all be judged soaking wet.

          by Kitsap River on Sat Jan 15, 2005 at 11:23:04 PM PST

          [ Parent ]

    •  Health insurance (4.00)
      I have an HMO health insurance. One employer paid premium covers almost all. But I have a nice union (CWA) and a progressive workplace (public radio station, KPFA)
      •  another reason (4.00)
        I'd like to see unions come back strong. I have no idea how to achieve that, but can you imagine how screwed we be without them?

        All the snark that's fit to...er...pixelate? liberal street fight

        by Joan McCarter on Fri Jan 14, 2005 at 07:29:38 PM PST

        [ Parent ]

        •  get Dems... (4.00)
          to talk more about labor rights and issues? i believe the word "union" barely came up in the three debates between Kerry and Bush. might help too if the activists were just as engaged/excised on labor issues as they are about abortion.
          •  don't see where abortion and unions (none)
            are mutually exclusive issues. But I do get your point on the unions. It's another "interest" group that the Dems take too much for granted, IMO.

            All the snark that's fit to...er...pixelate? liberal street fight

            by Joan McCarter on Fri Jan 14, 2005 at 09:20:24 PM PST

            [ Parent ]

            •  not mutually exclusive... (none)
              but one dominates the discussion and passions more than the other (i.e. see number of diaries here arguing on abortion vs. discussing labor--must be 10-20 to 1). labor rights are in way more of a crisis than abortion rights frankly, but no one (either among bloggers or the Dem party) cares enough to make as big a stink on them. to me, as a class-warfare populist, those are the issues i care about so when i see so much oxygen devoted to abortion, which is more of a symbolic issue, i find it disheartening, esp when labor rights are a politically winning issue.
        •  you are hitting at the crux (none)
          of Democrats problem. Unions are a victim of the shift to international financial markets and capitalism which have grown steadily more powerful thru global technological advances, like the internets. Unionized workers have become marginalized by (relatively) cheaper and well educated labor forces abroad, who see American wealth thru a different set of eyes than we do. They want it, too, and cannot afford to tak it for granted like we do.

          This creates a cognitive dissonance among many of us who support human rights, on the one hand, but who want to shut down the borders to stop the illegal immigration of desperately poor people into the US on the other hand.

          The Unions will not come back. The blue collar jobs will not come back.

          The traditional Democratic base is dwindling. Its not big enough anymore.

          You can mourn this development all you like, but it is fact and until we recognize ways to develop new bases of support the Democratic Party will be roiling around unhappy with itself, win or lose.

    •  no coverage here (4.00)
      I haven't had coverage since a bit after I got pregnant with my daughter in the early 90s. I was a VISTA volunteer at that time. VISTA was short on health $, as I recall they were covering the costs although it was officially through Blue Cross/Blue Shield. Every single claim I made was initially rejected (and they were very modest claims). I had to call people on the phone and complain to get coverage of each item. "That's not covered." "Yes it is, says here..(paragraph, page number)." "Oh, all right."

      Finally when I got pregnant, a person from up in the VISTA echelons of my state called me up and said they were going to fire me and instantly rehire me.

      "Let me guess," I said. "Then my pregnancy will be a pre-existing condition?"

      She said yes. I got so mad I quit. The dumb thing was my daughter's father and I were paying for a midwife, which the insurance plans don't cover anyway. Their entire tab, unless I had some kind of complications, was going to be $50 for one visit with the backup physician.

      I decided if anything was going to make me sick (or have complications giving birth) it was dealing with people like these. And I've barely been back to a doctor since. I can't believe the way allopathic medicine has completely taken over everything, supposedly everyone needs to be on drugs of some kind now, I hear 50% of the US population takes at least one prescription drug per day.

      I think our "health care" system is often making us sicker. Time to go back to chewing roots and leaves.

      i believe in the neo-cons-piracy theory

      by inclusive on Fri Jan 14, 2005 at 07:33:14 PM PST

      [ Parent ]

      •  This story is a good example (4.00)
        This is why we have to make the insurance industry the bad guys rather than the trial lawyers. So many more people have had experiences like yours than have been sued. So people hate the insurance industry more than anyone, even lawyers. We've got to look at where the problem really is, and that's in the insurance industry (and the millsions they spend on lobbying).

        All the snark that's fit to...er...pixelate? liberal street fight

        by Joan McCarter on Fri Jan 14, 2005 at 07:54:01 PM PST

        [ Parent ]

        •  I have heard .... (none)
          lots of 'socialist medicine' talk from the Bushies. He said that no American wants the government deciding their health care or telling people which doctors they can see.
          This is not what we have in Canada. We have our own GPs and can go to any general practitioner we choose. We know up front the things that are not covered (cosmetic surgery, for example - or private hospital rooms are extra) and everything else is covered without question. There is no governmental bureaucracy - because the doctors make all the decisions. We never see any paper-work, we never get a bill for services. Show your card and forget it.
          That is not to say that our system is perfect. The government decides how much money is put into the system (usually not quite enough) and our taxes are high to pay for it. There are long waiting lists for 'elective' surgery.
          But in general, the system works quite well. No Canadian has worried about paying medical bills.
          From talking to my American relatives, there are a lot of incorrect assumptions about 'socialized' medicine.
      •  Thanks to HIPAA (none)
        That couldn't happen now.  At least the 'fire me and instantly rehire me' part in order to create a pre-existing condition.
    •  On my mother's (none)
      But I lose it in June when I turn 23.

      After that, I better not get sick.

      But, hey, people chose death over gay marriage.  I'm trying really hard to censor myself from ignorant, mean comments about them.

      "We will fight them, sir, until hell freezes over. And then, sir, we will fight them on the ice."

      by Raybin on Fri Jan 14, 2005 at 08:47:11 PM PST

      [ Parent ]

    •  never had it... (none)
      ...as an adult, and I'll be 60 this spring.

      don't always believe what you think...

      by claude on Fri Jan 14, 2005 at 09:21:40 PM PST

      [ Parent ]

      •  what's your secret (none)
        for healthy living?

        Me, I have teeth that crack apart and a missing gallbladder. Without health insurance, I don't think I'd still be around. And I'm no where near 60! I've really screwed with natural selection, haven't I?

        All the snark that's fit to...er...pixelate? liberal street fight

        by Joan McCarter on Fri Jan 14, 2005 at 09:25:10 PM PST

        [ Parent ]

        •  mostly, it's luck... (none)
          My teeth are a mess, too, but, other than that, I'm in pretty good shape.  Probably the single largest factor, aside from good genes, is that I've spent most of my working life outdoors and on my feet.  I've eaten mostly organic for the last thirty years, don't drink much alcohol, but still smoke.  So does my Mom, and she's 79. Being small and wirey probably helps, too.

          don't always believe what you think...

          by claude on Sat Jan 15, 2005 at 07:56:53 AM PST

          [ Parent ]

    •  No health insurance here (4.00)
      Our coverage (my PPO via COBRA) got cancelled the day after I was discharged after giving birth to our daughter.  So, for the last 20 mos, we have not had coverage.  

      No one will cover us because at 5'7ish adn 215 lbs., I'm "morbidly obese" and my daughter had a hernia (as all babies do) when she was born.  My husband can get coverage though.  It will cost him almost $400/mo for med, dental and vision.  We're self-employed, so we get super-screwed for some reason.  

      "...Bush could kiss Osama bin Laden on national television and Karl Rove could spin it into a punch in the face." - Jim Hoover of Huntington Beach

      by fabooj on Fri Jan 14, 2005 at 09:38:06 PM PST

      [ Parent ]

      •  that's so scary (none)
        So many self-employed are in the same boat. One of the reasons I'm still at my job and not out free-lancing. I hope you all stay healthy!

        All the snark that's fit to...er...pixelate? liberal street fight

        by Joan McCarter on Fri Jan 14, 2005 at 09:43:48 PM PST

        [ Parent ]

        •  Meltdowns (4.00)
          I have these little meltdowns/panic attacks every 2 or 3 months about this.  I think it was in July 2003, the gov't changed the rules so that a group of self-employed people can no longer go in together and buy a group plan.  

          My biggest fear is that something horrible will happen to any of us and we don't have the money to fix it.  Even if I broke my leg tomorrow, I'm SOL.  When we could no longer afford to take my kid to her pediatrician, we started going to a women and children clinic on the other side of town.  They treat you and you pay what you can.  So we take advantage of that and when we have a few extra dollars, we donate it to them.  

          "...Bush could kiss Osama bin Laden on national television and Karl Rove could spin it into a punch in the face." - Jim Hoover of Huntington Beach

          by fabooj on Fri Jan 14, 2005 at 09:48:35 PM PST

          [ Parent ]

          •  of course you do (4.00)
            I'd be afraid to leave the house, I think. This is just so insane, so wrong. I feel like printing out this thread with all the stories of people without health insurance, or who are paying more for it than for rent, and sending it to all of Congress.

            All the snark that's fit to...er...pixelate? liberal street fight

            by Joan McCarter on Fri Jan 14, 2005 at 09:55:10 PM PST

            [ Parent ]

            •  That would be a good idea (none)
              Sending these stories to Congress.  They really don't seem to get it or care.  Companies need to see them too.  Maybe more than Congress.  I mean, if your benefits are getting cut and your company is laying off, are you really going to complain to them?  No, cause you need that job and those benefits.

              "...Bush could kiss Osama bin Laden on national television and Karl Rove could spin it into a punch in the face." - Jim Hoover of Huntington Beach

              by fabooj on Fri Jan 14, 2005 at 10:03:10 PM PST

              [ Parent ]

            •  No insurance here (none)
              Husband was covered under my insurance when he had an intracranial bleed.  Now he's covered by Medicaid and Medicare in nursing home. Younger son is covered by Medicaid. I got fired, so no health insurance, and my older son has none.

              I was so grateful for my little boy's medical card this summer because he had to have an emergency appendectomy.  We have a wonderful public health clinic in this town, so that's where I go, and I pay on a sliding scale according to what our family receives in SS funds.  

              I do worry.  I despair, sometimes.  

      •  Self-Employed (none)
        My mother had to drop her health insurance this year.  She is self-employed and was paying $800 a month with a deductible in the thousands.

        The problem is that my mother had a double mastectomy a few years ago and now has lymphoedema in both arms.  She needs insurance.

        Anyway, it is scary to be self-employed.  We really need a national health care system.

        At least in Massachusetts we have an excellent free and reduced care system in place.  My fiance has no insurance.  He suffers from severe allergies and asthma- serious enough that he usually ends up hospitalized once a year and gets asthma attacks after five minutes outside in the winter.  Through our system, he is able to get medicine for a very reasonable amount.  I don't know why we can't expand this system nationally.

    •  The health insurance mess (4.00)
      The crisis in our health service delivery system continues apace, and Bush is busy playing rhetorical games with an issue that as the reports you cite attest, is marginal.
      I see signs that the entire health insurance market is breaking down.  I co-own a small business with my sister. We need to provide health insurance to keep our core group of quality employees; as in most small businesses, Margaret and I are on the same plan as our employees.  And we've had four different health insurers in the past seven years. Companies have gotten taken over, gone bellyup, dropped our PCPs out of their plan, and pulled out of the region.  Even with the huge sums of money being vacuumed into health insurance, the entire industry seems unstable.

      And as to pricing?  Well, I have to laugh when I hear a lot of politicians talking about allowing small business pooling to make health insurance purchases, because I don't know how else we'd be able to afford it as it is.  There are dozens of so-called "small business associations" that are nothing but insurance-buying pools, we've been members of two of them.  The way they work is that the association negotiates deals with two or three different providers and members make choices among them.  To what degree these associations are "captives" of the insurers, I don't know.  But the differential between going through one of these associations and buying insurance privately for a company our size runs 25-40%.  Simply unaffordable to do it on our own.

      Insurance industry can make a good target.  I've been involved in a couple citizen action campaigns directed at insurers over auto rates, and those tended to be a pretty easy sell.  Health insurance is more complicated, I understand, as the mandatory nature of auto insurance generally brings with it a stricter regulatory structure.  But there must be ways to cut health insurance issues that can resonate with the public.  Once people get a handle on issues, their awareness of alternatives opens up, and the logic of single-payer is relentless.

      On the immediate political side, what does an opposition do?  First we figure this stuff out. The numbers indicate that only progressives can succeed on this issue, it's impossible for reaction to even accept the real issues.  So as with tort reform they'll go for cheap political posturing as a substitute for the real deal.  Well, these numbers indicate that people know tort reform is peripheral.  We need to be able to use his own agenda to make him look bad, Nero fiddling while our healthcare system burns.

      One of the wonderful things about being in opposition is that there is no risk of anything you propose immediately being adopted. So simultaneously while being dismissive and contemptuous of the tort reform stuff, the opposition should be laying out the central points of our dream reform.  They don't need to be highly detailed, don't even need to gain immediate public acceptance, but opposition means being busy planting the seeds that sprout with the growth of dissatisfaction with the governing party as well as fostering that dissatisfaction.  And no triangulating!

    •  HMO (none)
      myself, covered, but I pay for spousal coverage.  Good news, I got a 4% COLA.  Bad news, spouse's health insurance premiums ate it up and then some.  Worse news, the non-profit I work for can't afford insurance for my employees, so they're SOL entirely.  When will the small businessmen who are the alleged backbone of the GOP wake up and realize that universal, portable health insurance would be an immense boon for business?

      Social Security Piratization is Welfare for Wallstreet -
      CaliBlogger.com

      by CaliBlogger on Sat Jan 15, 2005 at 01:56:55 AM PST

      [ Parent ]

    •  No, and when I did (none)
      all my money went to paying for the coverage, so I couldn't afford to make use of it, or to get other treatements (like dental work) that were equally urgent or more so, because of being neglected due to the fact that I was paying almost $300 per month for my own "benefits."

      "Don't be a janitor on the Death Star!" - Grey Lady Bast (change @ for AT to email)

      by bellatrys on Sat Jan 15, 2005 at 03:16:38 AM PST

      [ Parent ]

    •  Not me. (none)
      Can't get it as an individual because I have a black mark under my name with Fascist Medical Information Bureau.

      My employer doesn't offer it.

    •  My Employer (4.00)
      A large network of hospitals, started a new policy this year.  There is a "tiered" cost structure on the part of the premium payed by the employees.  Here's the idea: those making more salary pay more (it's still a fair price, we're self-insured)than those in lower salary brackets.  It works so that folks working in Food Service and Housekeeping get their insurance nearly free while those in professional and administrative salary brackets pay a greater share.  Our CEO said, "It's the right thing to do."

      I don't mind the extra $30 bucks month it now costs me.  I can afford it.  What has really impressed me is that I have not heard one employee complain about the new policy.

      "It's been headed this way since the World began, when a vicious creature made the jump from Monkey to Man."--Elvis Costello

      by BigOkie on Sat Jan 15, 2005 at 08:06:02 AM PST

      [ Parent ]

    •  not me (none)
      I'm a "freelancer" working full time for too little money to buy my own.  And of course my full time "contract" employer won't provide it because I'm a "freelancer" and they aren't, technically, my employers, but an independent contracting party.  It's total bull.

      "Don't want to be an American idiot..." -- Green Day

      by Black Maned Pensator on Sat Jan 15, 2005 at 09:13:20 AM PST

      [ Parent ]

  •  This is great stuff (none)
    Recommended.

    To his virtues be very kind, to his vices, very blind. moralquestionsblog.com

    by Descrates on Fri Jan 14, 2005 at 06:34:23 PM PST

    •  thanks (4.00)
      This is kind of dull stuff, certainly not as much fun as the Zephyr fight, but what the hell. Maybe some folks will want to talk about health care tonight.

      All the snark that's fit to...er...pixelate? liberal street fight

      by Joan McCarter on Fri Jan 14, 2005 at 06:41:45 PM PST

      [ Parent ]

      •  But much more important than the Zephyr fight (4.00)
        Or, at least, much more important if you don't have health care.

        I fortunately have health care, but, like most Americans, will lose my health if I lose my job (at least will lose it after 18 months of COBRA.)

        Here's an easy reform -- how about doubling the length mandatory COBRA coverage from 18 to 36 months?  It won't solve everything, but it will help some people A LOT, and should be easy to do.

        Fight the American Taliban

        by pontificator on Fri Jan 14, 2005 at 06:57:03 PM PST

        [ Parent ]

        •  Yeah, with long term unemployment (none)
          Those COBRA benefits really should be extended. I like your idea.

          All the snark that's fit to...er...pixelate? liberal street fight

          by Joan McCarter on Fri Jan 14, 2005 at 07:01:53 PM PST

          [ Parent ]

          •  what good is COBRA if you're unemployed (none)
            and broke - and not subsidized by a spouse?

            I got deeper and deeper in the hole during my first time between jobs, paying to keep up my cobra to the tune of then) $200 per month - again not being able to actually afford to take care of any health issues like dental or when I came down with the flu, because of it.

            The second time, after I was laid off, I didn't even bother - I *couldn't, period, what with barely being able to pay the rent, and living on 12 oz of rice per day for a bit there.

            "Don't be a janitor on the Death Star!" - Grey Lady Bast (change @ for AT to email)

            by bellatrys on Sat Jan 15, 2005 at 03:25:19 AM PST

            [ Parent ]

            •  Agree (none)
              I paid $400 a month through COBRA.  Luckily, I found a job quickly because I could never have kept up payments like that.

              In fact, two and a half years after my daughter was born and I am just now finishing paying off the debt of my three months unpaid maternity leave and six weeks of unemployment after I was forced to resign from my then position due to the fact that my boss didn't approve of my decision to place my daughter for adoption.

              At my current job, I opted for disability insurance.  You never know what may happen.

        •  No company, No COBRA (none)
          If you lose your job because your company closes, there is no COBRA. Happened to my hubby 12 yrs. ago. Then, he couldn't get insurance on his own, because he had an inherited kidney disease (even though at the time his kidneys were working fine). I want single payer/universal healthcare!
          •  has he not had coverage (none)
            all these years? It's going to be a long time before we can bring people around to single payer. We've got to nibble around the edges of this, doing things like expanding the VA system for prescription drugs and other services to Medicare and Medicaid. Get people used to the idea that a government-run system can be efficient and effective.

            All the snark that's fit to...er...pixelate? liberal street fight

            by Joan McCarter on Fri Jan 14, 2005 at 08:49:49 PM PST

            [ Parent ]

        •  COBRA sucked for us (none)
          My former employer was paying half my coverage, I paid the other half (for me and my husband) which was about $275/mo.  When I got laid off, a week after I found out I was pregnant, I had no choice but to continue with COBRA, so I can have my well-baby checkups.  Well, our bill to cover me and my husband was $609/mo.  For a PPO?  And that was more than what my company was paying AND--to make matters worse--Cigna had cut a tons of their services and/or reduced payment on them.

          "...Bush could kiss Osama bin Laden on national television and Karl Rove could spin it into a punch in the face." - Jim Hoover of Huntington Beach

          by fabooj on Fri Jan 14, 2005 at 09:42:37 PM PST

          [ Parent ]

      •  personally, I find this much more interesting (none)
        than the Teachout thing.

        To his virtues be very kind, to his vices, very blind. moralquestionsblog.com

        by Descrates on Fri Jan 14, 2005 at 07:07:47 PM PST

        [ Parent ]

  •  Zogby (4.00)
    Asked me to participate in a survey tonight about starting a business. Throughout I was asked to rate my concern about: 1. getting Healthcare; 2. the cost of healthcare. Concerns on interest rates and economic confidence were tossed in, but I sure answered a lot of questions about healhcare concerns.
    Anyway, thanks for the diary mcjoan. Good information, as always.

    "Well, children, where there is so much racket there must be something out of kilter." Sojourner Truth

    by Lahdee on Fri Jan 14, 2005 at 06:58:16 PM PST

    •  I got a polling call last week (none)
      It was all about what health insurance reform we needed in Washington state--tort reform, prescription drug, expanding coverage. It was a really crappy poll--the questions were really poorly written and opaque, but it made me curious about what's coming up for us.

      All the snark that's fit to...er...pixelate? liberal street fight

      by Joan McCarter on Fri Jan 14, 2005 at 07:04:09 PM PST

      [ Parent ]

      •  KUOW (none)
        I'm glad we have a Democratic governor. It will be interesting to see her plans for healt care as discussed in her inaugural.

        "Well, children, where there is so much racket there must be something out of kilter." Sojourner Truth

        by Lahdee on Fri Jan 14, 2005 at 07:08:25 PM PST

        [ Parent ]

        •  Yup (none)
          and a Dem legislature. Sometimes I think we're a little island of reason in this country.

          All the snark that's fit to...er...pixelate? liberal street fight

          by Joan McCarter on Fri Jan 14, 2005 at 07:28:07 PM PST

          [ Parent ]

          •  We've got a Dem guv- (none)
            And a slightly Dem legislature (one side tied, one side Dem by 3 IIRC) and out healthcare system in Oregon SUCKS. The only reason the clinic I got to is still open is that the voters in Multnomah County (the bright blue island of hope in an otherwise fuschia state) passed a special surtax last year- my roommate grouses that her state refund turns around to pay the county, but she's glad the schools are limping along and the county clinic is open.

            Things are gruesome here. More downthread.

            "History repeats itself, first as tragedy, second as farce." -Karl Marx

            by Lainie on Sat Jan 15, 2005 at 03:42:51 AM PST

            [ Parent ]

    •  Very interesting....potential entrepreneurs (4.00)
      that I talk to at my local Women Entrepreneurs in Science and Technology group often ask me how I got health insurance, it is a really common fear.  And understandably--it is vague and mysterious how to--and expensive to get your own.  I pay $275 a month, no prescription coverage.

      And I have had conversations with friends that I would like to hire in my fledgling business, but they can't take the risk of not having health insurance for their families, which I can't afford to offer them yet.  They are stuck in jobs they don't like, I can't bring them in to build something new and exciting....

      So, I can't grow fast to the point where I could generate enough revenue....

      I am eager to hear how this survey comes out.

  •  Important stuff (4.00)
    and good diary.

    Our health statistics make me weep. When income is the #1 factor determining infant mortality, I want to scream. How much money you make should not determine if your baby lives or dies.

    In Hawaii, we have one of the most comprehensive employer-based health plans in the country. If you work 19.5 or more hours a week, you get health insurance. Period. Guess what--you'll get hired for 19 hours. In 2002, 9.8% had no coverage and about half were working but didn't make the required hours at one job. Want to guess the state with the highest percentage at 24.7%? Yup, Texas.

    I happened to be meeting with Chris Lee who is the executive producer for the next Superman movie. The first question out of any normal person's mouth would have been, "Who's playing Superman?" Me, I'm such a wonk, I ask "How do people like directors and writers and actors get health insurance?" He was very nice and answered me seriously:  Guilds.

    "I still think politics is about who's getting screwed and who's doing the screwing." -Molly Ivins

    by hono lulu on Fri Jan 14, 2005 at 07:17:02 PM PST

    •  that's so sad (none)
      I mean how employers can get around providing benefits. Not that it's limited to Hawaii. It's infuriating.

      So who's playing Superman?

      All the snark that's fit to...er...pixelate? liberal street fight

      by Joan McCarter on Fri Jan 14, 2005 at 07:27:06 PM PST

      [ Parent ]

      •  LOL (none)
        (which looks kind of funny coming after "that's so sad")

        I had to go look it up. From the Star-Bulletin

        The title character will be played by Brandon James Routh, 25, a relatively unknown actor. The Superman role brought fame to the late Christopher Reeve. Routh will appear in this year's film "Deadly" and the TV series "One Life to Live" and "Undressed."

         "He's a new guy, just like Chris Reeve was in the original," Lee said.

        My other inappropriate thought was, "ew, they waited until he (Reeves) died." That's sad, too.

        "I still think politics is about who's getting screwed and who's doing the screwing." -Molly Ivins

        by hono lulu on Fri Jan 14, 2005 at 07:36:43 PM PST

        [ Parent ]

  •  Give Me Health Insurance or Give Me Death! (4.00)
    Death it is then ! Becuae no one is gonna give you any health care for the next 4 years.

    How about some lovely "tort" reform, so when your paying top dollar for a procedure not covered by your absent insurance, and they fuck you up real good, you got to sit back and enjoy it, happy in the knowledge you helped saved the few who do have health insurance, oh, about 1% off their premiums.

    sound good ?

    Look on the bright side. At least you aint in vietraq.

    Of all the things American voters are most mentally deficient on, its universal health care. Hell even GM wants it. When you got big multinationals on your side, you KNOW things are bad.

    Thanks for this Diary, its a really important subject.

    I am a Reform Democrat

    by Pounder on Fri Jan 14, 2005 at 08:16:00 PM PST

    •  single payer (none)
      I sure wish we could swing public opinion that way. I think that's not going to happen any time soon, unfortunately.

      But I do think we've got some room to be obstructionistic on tort reform particularly, if we can demonize the insurance companies. Because that's where the problem is. And people hate insurance companies even more than they hate lawyers. Everyone has had a bad experience with an insurance company. How many have been sued?

      All the snark that's fit to...er...pixelate? liberal street fight

      by Joan McCarter on Fri Jan 14, 2005 at 08:29:07 PM PST

      [ Parent ]

      •  I agree (4.00)
        I think going after the insurance companies is a great idea.

        I think we also MUSt make it known that all malpractice suits, the good and the bad only amount to 1% of all healthcare spending, there simply isnt any savings to be had. Yet i hear people all the time talk about junk and frivolous lawsuits.

        I would push the john edwards idea to fix that problem, and point out that the extremist republicans just want to abolish all checks and balances so corporations can whatever they want and no one can stop them...that is the truth, and it should be heard.

        I am a Reform Democrat

        by Pounder on Fri Jan 14, 2005 at 08:36:00 PM PST

        [ Parent ]

      •  I'm not sure (none)
        your take on the poll results is really reflective of the prospects for a single payer system.
        I think we might find that 'gubmint healthcare' has been demonized, but that people would favor insurance through the employer, portability of insurance between employers, expanded post-employment protection, and expanded coverage (edging toward the universal).  Put those together and you have a mandate for something with alot of the essential characteristics of a single payer system, but disguised.  

        The clue for implementing this would be to mask the government role with less obvious subsidies, for example by:

        1. Giving tax breaks to employers that are generous and mandate a basic coverage level.

        2. Giving vouchers to cover cobra, or paying premiums directly along with unemployment benefits.

        3. Compelling insurers to pool the 'uninsurable', share the costs, and pass them on. Something like this is done with 'assumed risk' drivers in CA.

        That's the thin end of the wedge at least!
  •  Actually, They've Decided on "Death" (4.00)
    I'm a lawyer and have Oxford Health Plans coverage.  Ain't great, ain't terrible.

    The first eight years or so I was in practice as a law firm associate, it was customary even in small firms for the firm to cover all employees, attorneys and staff alike, and pay for family coverage.  Maybe you had to pay a really small part of it (there was some tax reason for that).  Some firms even had dental and eyecare insurance.

    I've changed firms a couple of times.  My present employer is fine in most respects, but -- as in nearly all but the very largest, top-dollar firms where new associates start out at $100,000 with $40,000 bonuses (I don't make that after 19 years in practice) today employees are covered, but only "equity partners" get family coverage paid for.  So my firm pays my insurance, and the cost for my wife and daughters is deducted from my salary.

    Don't weep for me, since thank God I have coverage (my wife and I are both over 50, with young kids ages 11 and 6) but yes, I feel the expense of it.  And dental and eyecare is 100% out-of-pocket, and we have had to postpone our daughter's orthodonty, although now grandma is giving us the money for it.

    Funny thing is, it ain't the doctors who are making out on this.  I have an old sweetheart, who married a pediatrician, and while they live well thank you she told me his gross has gone down six years running, the HMOs delay terribly in paying him, and the paperwork gets more burdensome, almost from month to month.  Our dentist is great, he's been in practice for quite a few years, and his wife is a podiatrist.  He told me private university for their kids was out of the question, and his kid is going to a state school (U. of Md. is by no means a terrible school, but dentist plus podiatrist in Queens would suggest that a private college would at least be a possibility).

    It's the frigging insurance companies, HMOs, and Big Pharma that are raking it in.  Oh, and Bill Fucking Frist (scumbag).

    And, if you can't afford to pay, well they don't mind at all if you die.  So go on and do it!

    •  it most definitely is the insurance co's (4.00)
      that are profitting. And it's a pretty dance they've been doing deflecting reform attention from themselves while they pour more money into lobbying.

      All the snark that's fit to...er...pixelate? liberal street fight

      by Joan McCarter on Fri Jan 14, 2005 at 08:32:21 PM PST

      [ Parent ]

    •  Exactly (none)
      Now you may not earn the megga bucks, but as a lawyer i am guessing it isnt chump change. I myself earn a reasonable living compared to most as an engineer, and even i cringe at the costs, so do my colleagues at work, many of whom are republican.

      People on both sides of the isle are really looking for somone to do something abuot this problem.

      I saw in a recent poll, which encouraged me, that most didnt feel tort reform was needed or was enough.

      when enough people feel enough pain, something will be done, and when fairly wealthy middle class are whinning as we are, well we cant be that far from the tipping point.

      I am a Reform Democrat

      by Pounder on Fri Jan 14, 2005 at 08:39:22 PM PST

      [ Parent ]

      •  there are plenty of people (none)
        feeling the pain.  I have no idea why Kerry didn't put his plan front and center. I know a dozen people who would be thrilled at some sort of single payer plan. And they don't want it to be free.  They want something that is somewhat reasonable to cover basic stuff. We ain't talking platinum standard care here.  We're talking about simple I break my leg/get a bad upper respiratory infection I can go to urgent care and get it taken care of with some basic copays with a basic deductible.  
        I have HMO coverage( I saw the 80/20 part of the PPO option and decided thanks but no thanks.) My premium is $180 - with huge copays - hospital stays are $500/day for 3 days. ER copay is $100. Specialist $40. For an acutely ill person they're okay but I wonder what a chronically ill person does - even with insurance your medical bills with pharm. and MD copays you could easily be paying out $300-400 a month and that's not including the premium.  
        You're so screwed if you get sick in this country. Oh,unless you're an upper 2 percent executive with a golden parachute a la Dick Cheney.
        For those red staters who bitch about the cost of medical care - I just have one thing to say - one of the big reasons you pay so much is that you subsidize those who don't pay at all. Go with a single payer so that everybody pays at least a little.

         

  •  Day 14... (4.00)
    without health insurance.

    I was covered under my parents insurance until I finished school. Now that I'm done with school, and have not found a job with health care yet, I'm bound to catch something that will kill me.

    So, while I'm still around, I'll be fighting for health care for everone, myself included.

    ::cough cough::

    "If the Bush Crime Family were the Corleone Crime Family, then Dumbya would be Fredo Corleone."
    Leoni's Blog

    by The 1n Only Leoni on Fri Jan 14, 2005 at 08:42:24 PM PST

  •  I knew I was a grown up (4.00)
    when I started worrying about health insurance. Right now I have really crappy coverage through school, which covers NOTHING, and I get to shell out 35 a month for birth control.

    Luckily, my fiance's really great union benefits kick in next month, then after we get married I'll get on his, but he had to go without it because it's so darn expensive. You just have to hold your breath and hope nothing happens.

    "The revolution starts now, when you rise above your fear"-Steve Earle

    by SairaLV on Fri Jan 14, 2005 at 08:43:37 PM PST

  •  Then You Might Want to Join a Party.... (none)
    ...that actually supports universal healthcare.

    The 2004 Democratic Party Platform carefully avoided any such explicit commitment.  Of course, the Dems support "expanding coverage."  But what we need is guaranteed, universal coverage of the sort that citizens of every other industrialized nation rightfully expect.

    Not prepared to leave the Dems? Then you have a choice:  accept the fact that your party isn't interested in universal healthcare, or work to move the party decisively to the left (and, no, Simon Rosenberg-style reform won't do this).

    Start doing the things you think should be done, and start being what you think society should become. -Adam Michnik.

    by GreenSooner on Fri Jan 14, 2005 at 09:53:15 PM PST

    •  Sorry (none)
      I just don't see the American public ready for single-payer yet. We're probably a couple of decades away from that, IMO.

      All the snark that's fit to...er...pixelate? liberal street fight

      by Joan McCarter on Fri Jan 14, 2005 at 09:58:24 PM PST

      [ Parent ]

      •  You Might Want to Retitle the Diary Then (4.00)
        Seriously. Something like "Give Me Health Insurance, or Pursue Just Slightly Less Damaging Policies than the GOP."

        For at least forty years the right has never made the mistake of assuming that its desires were too far out of the mainstream to be worth pursuing.

        The only way to make the public "ready" for any policy is lay the political groundwork for it. The GOP has been working for decades to poison the well of social security. On the other hand, they managed to manufacture an invasion of Iraq in just a little over a decade.

        So however long it will take to get the public to accept single payer, we need to start working toward it NOW (assuming that is we're serious about achieving it). Otherwise, it will simply never happen, and public acceptance of it will be an ever receeding horizon, which is, frankly, exactly what a lot of center-right Democrats would prefer.

        Start doing the things you think should be done, and start being what you think society should become. -Adam Michnik.

        by GreenSooner on Fri Jan 14, 2005 at 10:15:10 PM PST

        [ Parent ]

        •  outside of the title (none)
          Which of course you recognize as a rhetorical device written to get people's attention, we're in complete agreement. It's one of the reasons I wrote the diary. Public support right now is lukewarm on what the GOP is pushing and we should exploit that by shifting the debate to those issues that they do care about and see a role for government in.

          I do think that single-payer is ultimately the only logical system, and I do think we could get there eventually. Our leaving the Democratic party is of course going to do nothing to help achieve that. But pressuring our party leaders (such as they are) to agitate on these identified issues and to start the discussion--that's what I think we need to be doing.

          All the snark that's fit to...er...pixelate? liberal street fight

          by Joan McCarter on Sat Jan 15, 2005 at 09:43:01 AM PST

          [ Parent ]

      •  Serious question... (3.80)
        For God's sake, why?

        I mean, I'm reading all these horror stories. (And I'm currently working in New Jersey, so I have a story of my own. But I have the privilege that if I have to, I can always go home. The rest of you don't have that option -- you are at home.)

        So if things are bad and getting worse, why isn't the American public ready to think about single-payer, a system that actually works? What would make them ready?

        It's all those embedded misconceptions, right?

        So... and what exactly are Democrats doing to fix that? If nobody ever pushes hard for single-payer, explaining its advantages, how is the American public ever going to be ready for it?

        If nobody's pushing, it won't be just a couple of decades you'll have to wait for a solution. It'll be forever.

        Massacre is not a family value.

        by Canadian Reader on Sat Jan 15, 2005 at 05:44:06 AM PST

        [ Parent ]

        •  I don't know why not, for sure (none)
          There are a lot of misconceptions about single-payer. I was on the Hill for the Clinton health plan debacle, working for a Member who was on  Committee with jurisdiction over health issues (Energy and Commerce, Health and Environment Subcommittee). We saw a lot of constituent mail and got a lot of phone calls against single-payer. It buys into the assumption that government, really, can't do anything right. The rights says things like "Who would you trust more, your own doctor or the government?" and people believe that any control over their health care decisions will be resting with some bureaucrat in some building in Washington. What we have to make them realize is that it's a fucking insurance company actuary who's really making the decision about their health care. We can probably get there eventually, but I think it's going to have to be a gradual process. Expanding some existing programs like Medicare or the VA drug buying system to other groups would be a start. The VA has actually had some success in reducing cost and improving efficiency. It comes sometimes with a fairly long wait for service in non-life threatening instances, but saves a ton of money.

          All the snark that's fit to...er...pixelate? liberal street fight

          by Joan McCarter on Sat Jan 15, 2005 at 09:36:54 AM PST

          [ Parent ]

          •  In other words... (none)
            you have to get people to think the government would do a better job of health insurance than insurance companies do.

            Well, in Canada, the biggest reason our single-payer health care system is more untouchable than SS is in the US, is that health care is FREE. And a basic human right.

            Here's how to sell that in the US: In the list, "life, liberty, and the pursuit of happiness," life comes first. Nobody should ever have to worry about having to lose their home and life savings because a family member gets sick. Nobody should have to decide between health insurance and paying the rent. Losing your job is a big enough worry all by itself; you shouldn't have to worry at the same time that loved ones may die because you can't afford health care. Life is the most fundamental right of all, and it's the job of your government to do what it can to protect that right for every citizen.

            Isn't that better? So why is it such a hard sell?

            Okay, so Canada's income taxes are higher, because we pay the cost out of general government revenue. But that's not the only way to do it. Somehow you're going to have to bypass the drooling conditioned knee-jerk reaction, "Oooh, tax cut, go-o-od!"

            How's this? Don't call it a tax. Collect it separately, and call it a health insurance premium. But still make it a function of income tax paid, because that's really the only way poor people can be included in the system. Or get the money any other way you can, as long as you stick to the untouchable principle that everyone must be included in the benefits. (Because... it's a right.)

            It's important to stress the fact that single-pay is group insurance, just like employee group insurance, except the group is the whole country. Keep hammering the fact that the larger the group, the more cost-efficient insurance is. Point out that this group insurance, since it is a public service, will be non-profit by law, which cuts out a huge weight on the current system: the insurance companies' profits. Say, "Why should corporations be allowed to profiteer from your right to life?"

            Point out to doctors, hospitals, and other health providers how much they'll save, when they only have to submit a single monthly bill, which will be paid quickly with no chasing required. Another huge efficiency, which lowers everyone's costs.

            Businesses are already almost converted, I think. They don't want to be responsible for their employees' health insurance -- and they shouldn't have to be. They should be an easy sell; talk about salvaging America's competitiveness in the global marketplace. Talk about reducing unnecessary costs. Talk about how if they don't have to pay for basic health coverage, they can become more creative in the benefits packages they offer. (That last one is to convince the HR department, which might otherwise resist a reduction in their responsibilities.)

            Now. Insurance companies and HMOs... They are the ones directly threatened by the single-payer concept. You aren't going to be able to convince them; don't bother to try. (Though health insurance thrives quite nicely in Canada offering supplementary benefits packages... but insurance executives aren't going to consider that as an option until they are forced to.)

            Not convinceable... very well, then, demonize them. Shine the spotlight on how they are hurting people, and make "health insurance company executive" generate an automatic negative reaction in everyone who hears it. Make sure that whatever Harry and Louise tactics they adopt this time, they will be discounted: "Oh, that's just the insurance people, of course they're lying. Why listen to them? Everyone knows those bloodsuckers just want to profit from misfortune, and make us pay them for what should be ours by right."

            So... that's some of the stuff you need to be working on, if you ever want single-payer.

            Massacre is not a family value.

            by Canadian Reader on Sat Jan 15, 2005 at 12:36:35 PM PST

            [ Parent ]

        •  Simple answer (none)
          Propaganda
          Americans aren't ready for anything that hasn't been sold to them.  If it is statistically irrational to have non-universal coverage, then call us irrational!
          If it is stupid to pay over 30% in overhead for inferior service and high infant mortality, call us stupid.

          Why isn't infant mortality a pro-life issue anyway?

      •  then we need to reframe and educate (4.00)
        Let's add it up: 46 million or so of us have no coverage at all. I'm sure most people in that boat with me would take single payer in a heartbeat, at least if anyone made it clear to them what it is.

        Must be at least 50 million more whose payments eat up way too much of their disposable income.

        Must be vast numbers of people who have had really, really awful experiences with the insurance coverage they do have.

        Dennis Kucinich had this issue right when he added it up and said: we US citizens are already paying enough to provide complete coverage to everyone...if we weren't giving that huge cut of profit to the insurance companies, and if we didn't have that huge amount of paperwork that comes with having to deal with dozens of different companies.

        Seen on an optometrist's Yellow Pages ad: "Our rates are reasonable...because we do not accept insurance."

        i believe in the neo-cons-piracy theory

        by inclusive on Sat Jan 15, 2005 at 06:33:25 AM PST

        [ Parent ]

    •  The DNC should offer coverage to party members! (4.00)
      There was another thread recently where this idea was floated--I thought it was a great idea.  They must have some insurance, and it must work in 50 states, so....

      Imagine the boost to party membership if we can get the group insurance....I'm hoping we can talk Dr. Dean into this idea.

      Would generate some good press for the party, too.

      •  Great idea! Would get A LOT OF VOTES! (none)
        Would it be possible?  IT'S THE ANSWER TO EVERYONE'S PRAYERS (No offense to the non-religious people around here).

        I remember reading a while ago that a church was trying to offer coverage for its members, but was not allowed to do so.  Maybe the insurance companies refuse to cooperate?  What else is new.

        Why is coverage only available through COMPANIES?

        Sept. 11 + x = Shut-Up. (x=whatever you say) - The Daily Show

        by reform dem on Sat Jan 15, 2005 at 08:48:30 AM PST

        [ Parent ]

      •  Just what I was thinking (none)
        I saw the suggestion here a while ago.  Even if it were only catastophic coverage, it would help a lot of people, especially the self-employed.  I wonder whether it would be possible?  Professional organizations can obtain group policies for their members, I believe.
  •  MY HEALTH INSURANCE WENT DOWN (4.00)
    this year.

    My wife is retired with one of the state teachers' pension plans (she's employed full time elsewhere of course). Her pension is amusing but the health care covers us both and it actually costs less this year than last.

    It's amazing what people can accomplish when they can shove the private sector out of the way.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy....--ML King, "Beyond Vietnam"

    by Gooserock on Fri Jan 14, 2005 at 10:31:05 PM PST

  •  The Problem with Truth (4.00)
    I find these polls interesting and not at all surprising.

    What I really fear, however, is what starts happening when our health care system reaches a point where people start seriously and publicly dying because of our country's idiotic health care policy.

    What the conservatives are starting to learn now in Iraq is this: The truth has the irritating quality of being true.

    They may pull out their manhood and swing it around saying, "We create our own reality," but this is sadly, ironically, and comically False.

    If Bush's first term was about creating reality, his second term will be about getting kicked in the jimmy.

    We are about to see the price of hubris. Get out your Poetics, folks, the gods are angry.

    •  People probably already are dying. (none)
      Some people can only resort to emergency rooms for their care.  Emergency room care is not adequate, and one usually only goes there when it's already too late.  No preventive care whatsoever.

      Sept. 11 + x = Shut-Up. (x=whatever you say) - The Daily Show

      by reform dem on Sat Jan 15, 2005 at 08:52:17 AM PST

      [ Parent ]

  •  Thanks McJoan (none)
    Great diary on an important subject. Politicians should be made to live the life so many are forced to live for a couple months. I can't stomach too many of them at this point.  When Gonzales is confirmed, I believe I'll definately be through with at least 99% of the senators.

    What an excellent day for an Exorcism...

    by DianeL on Fri Jan 14, 2005 at 10:51:28 PM PST

    •  I joked last night (none)
      about printing this thread out and sending it to all members of congress. After waking up this morning and seeing so much more serious discussion on the issue--and seeing how many people are in serious financial and health situations because of their insurance or lack thereof, I'm not so sure it's a joke of an idea. Maybe I'll send out a few e-mails this morning with a link to the thread.

      All the snark that's fit to...er...pixelate? liberal street fight

      by Joan McCarter on Sat Jan 15, 2005 at 09:54:44 AM PST

      [ Parent ]

      •  Great Idea (none)
        I think one reason that people aren't aware of the magnitude of the problem, is that a majority of those falling through the cracks have no voice and are too busy just trying to keep a roof over their heads to have the time to write letters and get on blogs.  I think many would be surprised actually at the lack of home access to a computer; the voice of those people is truly drowned, especially when so many libraries are drastically cutting hours and being shut down.

        What an excellent day for an Exorcism...

        by DianeL on Sat Jan 15, 2005 at 11:52:52 AM PST

        [ Parent ]

  •  McJoan you are RECOMMENDED ma'am (4.00)
    I'm self employed and I went to get health care last month, cost me 1,200,000 lei. I know that sounds like a lot but its just about 35 bucks.  That's 35 dollars for an entire year.

    Of course I live in E. Europe so the prices here are different, but it illustrates a point.  Here I can choose from completely free healthcare, which involves a lot of waiting, or I can get private healthcare and pay 35 a year.  With that private insurance I can choose my own doctor, choose my own hospital and go get all the healthcare I wish, including "check-ups" and what's often called "preventative" medicine - going to the doctor when I first feel ill instead of limping in on death's door.

    Is the healthcare here the same "quality" as in America? No, not if I need complicated brain surgery.  But most people don't need complicated brain surgery. We need a doctor for when our back hurts, for when we have an ear ache, for when we have a fever, for when we accidentally cut ourselves slicing bread, for when we have an infection, that sort of thing...  and going to the doctor right away instead of letting something develop into an ER case is MUCH cheaper in the long run.  

    I don't have access to statistics but I for years I worked in a hospital and I can tell you that the ER visits were astronomically expensive.  And yet time after time people would come in, people often without healthcare, when they just couldn't stand the pain anymore and they were in serious risk of permanent injury or death.  I know because I was one of those people once - I had a small injury that got infected and I had no health insurance.  I let it fester and swell until the pain was so great I could barely walk.  I then was driven to the ER in the dead of night and my bill was for over 1000 dollars.... a thousand dollars you can be sure I didn't have.

    One of the things people outside America (and myself as well) can never understand is why such a wealthy nation would be unable to provide basic health services for its people.  A struggling nation like East Timor or Haiti could be understood, but America? The country with sparkling highways and shiny police cars and billion dollar missiles?  Surely isn't there enough money to pay for its own citizens to go to a doctor??

    And I have to tell them that it isn't a question of money but that the American people just do not care enough about the issue to pressure their government to make that one of their basic services.  That people will agitate to make sure their water is safe to drink (more or less), that their food is uncontaminated (more or less), their medicines are pure (more or less), that their criminals are quickly apprehended by the police (more or less), that their military is given the best equipment (more or less) but don't care if they or their neighbor gets sick and cannot afford to go to see a doctor.

    It's a horrible thing to say but it's true.  And I distinctly remember when the right-wing went absolutely bonkers at the merest hint that Clinton would suggest that every American get health care! Bonkers!  As if people never got sick or had an injury or twisted their ankle...

    I just read Upton Sinclair's The Jungle and I'm wondering if those in power now aren't a little nostalgic for those times... when the laborers and working class had nothing and capitalism was allowed to run rampant with no checks whatsoever...

    Pax

    Night and day, you can find me Flogging the Simian

    by Soj on Fri Jan 14, 2005 at 11:16:21 PM PST

    •  thanks, Soj (none)
      Wow. You go to bed and wake up to realize everyone wants to talk about health insurance. It's gratifying!

      American attitudes are a strange beast. And the health care system that arose from it is just bizarre. Because it's not a health care system, it's a sick care system. There's so little focus on healthy lifestyles, on prevention, on early intervention. It's all geared toward after-the-fact care when it's far more expensive and difficult to treat.

      And in terms of the market system, it's completely irrational. Why, for example, do three or four out of a half dozen hospitals in any given mid-sized city have to have the same ridiculously expensive diagnostic machine. An MRI for example. They not only have to have the equipment, but then have to provide expensive and highly specialized training to a number of staff to operate the thing. And maybe each hospital ends up using the thing a half dozen times a month. Wouldn't it make a lot more sense for a single hospital to make that investment, and to open it's doors to any patient from any hospital that needed those tests?

      Sorry, that rant didn't really answer your post. Just needed to get those ideas out there.

      All the snark that's fit to...er...pixelate? liberal street fight

      by Joan McCarter on Sat Jan 15, 2005 at 09:52:03 AM PST

      [ Parent ]

      •  See? (none)
        Health care issues ARE sexy!  </LSF reference>
      •  Exactly (none)
        I made the analogy of car maintenance and body (health) maintenance to some conservatives I know.
        If you let your car fall into disrepair, you have to pay a lotta $$ to fix it, if fixing is possible. And bodies are even trickier than cars, they really need good preventative care.  
        That's why every illness should not be a crisis.
        Now, every time my doctor doesn't have samples of a medicine I take, that's $160.  I DO despair. Dying is much cheaper.

        We can plan better than this. We can take care of our citizens better, for heaven's sake. This is an industrialized country.  

        Any Senator or Representative reading this must know that they have no worries about their health care. And they are our employees.  So HELP US ALREADY.

  •  $382 per month (none)
    $15 co-pay and tests. $10 generic drug perscriptions. 56 year old cancer survivor. Each visit (twice a year) with blood tests is $75.
    Self employed. Its a bitch paying that every month.

    "It is the duty of the patriot to protect his country from its government." --Thomas Paine

    by BOHICA on Fri Jan 14, 2005 at 11:22:03 PM PST

    •  my parents (none)
      They were paying something like $700 a month for prescriptions alone, because both have chronic conditions. And that was with generics and getting some prescriptions from Canada. Luckily, Dad finally got into the VA system, and their out-of-pocket costs were reduced drastically.

      All the snark that's fit to...er...pixelate? liberal street fight

      by Joan McCarter on Sat Jan 15, 2005 at 09:57:09 AM PST

      [ Parent ]

  •  dice (4.00)
    A lot of people had a big emotional stake in Kerry winning.  For me it was a bit more, and this is why.  Since I am now without health insurance, and given my age and other situations in my life, the next time I get seriously sick will probably be the last time.

    So it's not just rhetoric.  We all have to remember that the people who are most affected by what government does and doesn't do are mostly people we will never see make a comment here.  

    •  Dear Dashbro (4.00)
      Please remember the next time you're seriously ill to explain your situation on this blog.  Maybe some people around here will be able to help.  You are not alone.

      Sept. 11 + x = Shut-Up. (x=whatever you say) - The Daily Show

      by reform dem on Sat Jan 15, 2005 at 08:55:13 AM PST

      [ Parent ]

  •  I'm uninsured. (none)
    My husband has insurance, finally, through his work. I'm not yet eligible through mine. When I finally can get it, I'll pay a premium of close to $300 a month, a $500/year deductible, 80/20 on in-network care, and $20 per office visit for preventive care and "professional care" which doesn't apply to the deductible. Sixty dollars each for prescriptions, and I need at least two.

    I had had COBRA via my late husband, but when my former employer (who didn't provide coverage for anybody but the CEO) stopped paying me what they owed me in back pay, I lost it due to my inability to pay. I have been uninsured for almost a year.

    I'm diabetic (NIDDM), hypertensive, 45 (as of last month), and my new husband and I want to have a child; I'm childless. It's still quite possible; when I had insurance, I had my hormone levels tested, and they're good. But with my age and health conditions, even though they're treatable (with insurance!), I'd be a high-risk pregnancy, so I don't dare get pregnant until I have health insurance.

    And I'm not getting any younger. I don't know what we'll do if I have to go on bed rest, which is not that far out of the realm of possibility.

    They should all be judged soaking wet.

    by Kitsap River on Fri Jan 14, 2005 at 11:30:25 PM PST

    •  very tough decisions (none)
      It is so wrong that basic decisions about our lives end up being reduced to the equation of what we can afford because of our health insurance. I'd love nothing more than to become a freelance editor, but since I'm single and wouldn't be covered by someone else's insurance, I've hesitated to quit my job and give up the great benefits it provides.

      All the snark that's fit to...er...pixelate? liberal street fight

      by Joan McCarter on Sat Jan 15, 2005 at 10:00:33 AM PST

      [ Parent ]

  •  Good Topic McJoan (none)
    I carried my pretty good insurance with me from Fed employment when I retired.  Cost $98 a month.  Every year I get a booklet from Blue Cross telling what they are paying less on.

    Fortunately I am in good health and plan to stay that way.  One never knows though.  I take no meds and have found my way into alternative supplements for any such needs.  Who can possibly afford medications?If I did have to be hospitalized, I could not afford the deductable.  

    I want the same medical plan that congress and the Senate has at a low price that everyone can afford.  Actually, my experience with Canada makes me want us to copy the best of their plan.  Became ill while on vacation there.  Took me right in, less wait than to see my own Dr here, ran tests, gave me a prescrition and some advice and charged me $0.00. . .

    It works well for them, quality of care was as good as I get here and I think it's time we considered it.

  •  And how many will die this year for lack (4.00)
    of needed health care? Thousands?  Tens of thousands?  And Iraq costs $5.8 BILLION per month?????  

    Docter my eyes.....

    Social Security Piratization is Welfare for Wallstreet -
    CaliBlogger.com

    by CaliBlogger on Sat Jan 15, 2005 at 02:09:58 AM PST

  •  Eating up my savings (4.00)
    I am 58 and unemployed, so I'm paying about $700/month for an HMO with prescription coverage. I'm lucky that I can afford it, but it's eating up my savings. I feel that it's life and death for me to have the coverage because I had breast cancer 4 years ago, and I'm at the age where other things are likely to come up. Health care represents about 1/3 of my budget (I'm lucky to own my modest house, so have no mortgage or rent to pay.) Because I'm paying for insurance, I was able to go to my doctor for a complete physical last month. She sent me to a dermatologist to look at some moles on my back. The moles were fine, but the dermatologist noticed a suspicious spot on my cheek. Turns out it's superficial basal cell carcinoma, which is non-invasive and curable. But if I had not been checked, it would not have been found, and something like that could cause serious problems if left untreated, especially on the face. Earlier this year, I visited some relatives in Slovakia, which is a country that is struggled economically. But if they get sick, they get health care from the government. I told them that in the U.S., you only get health insurance if you're working or pay a lot of money. They were appalled. "What do you do when you get sick?" they wanted to know. If a poor country like Slovakia can provide a basic human need like health care, why can't we?
  •  I sort of have coverage... (4.00)
    My last full-time job was for a non-profit that had now insurance available. When they reorganized my job out of existence, I not only had no insurance, but no cash to pay out of pocket.

    That was four years ago. Back then, I had a couple of fairly serious, long-term medical problems, which unfortunately got worse with the long-term stress of job hunting in the toilet of Oregon's economy. My doctor eventually told me to quit looking- the stress was killing me and she doesn't think I should be working. I have an SSI claim pending, on the...3rd appeal, I think. It's agonizingly slow.

    In the meantime, I'm covered (if you can call it that) by the Oregon Health Plan. They've been doing everything they can to boot people off- getting draconian with premium enforecement and lowering the income limits to levels that might feed a frog if he wasn't very hungry. They've cut all but emergency dental. Mental health is hanging by a thread. Clinics close and reopen and providers move around alot. And there's talk of cutting hospital coverage to make sure there's enough money to cover prenatals and well-baby checks and little kids and old farts like me who shouldn't be alive.

    They aren't making any money on me, that's for sure. My medications are being paid for by the state to the tune of @$500/month. If I lost the OHP coverage, I'd be in deep trouble very quickly.

    Now, complicate the matter with this: my fiance and I have been wrangling with the marriage thing. We want to do it (we've been seeing each other for five years- I think it'll stick), but my health is one of the things in the way. He's going back to school soon to get teacher certification. Hopefully after he's out he can land a decent job with good health benefits. But the chances that I'm even insurable are pretty low, especially with the 'pre-existing condition' thing. And if we get married, I will lose my coverage on OHP. And there's no way we'd be able to pick up even my medication alone out-of-pocket.

    So I'm held hostage by my health. The one thing I want most in the world, to marry this man, is out of my reach because of my need for health care.

    This system is FUBAR No two ways about it.

    "History repeats itself, first as tragedy, second as farce." -Karl Marx

    by Lainie on Sat Jan 15, 2005 at 04:10:20 AM PST

  •  Congress doesn't play by the same rules (none)
    My husband has been unemployed for a year. I am an academic scientist (read:soft money) who was informed three months ago that my position would terminate Jan 12. When I called about COBRA benefits, I was told that family health insurance would cost me $900/month. I figure that that is more than I would get in unemployment insurance payout. Lucky for me, I found another position, with no pay cut (no increase, either).

    Has anyone else figured out that our responsive government doesn't even have the same health/retirement system as those of us who live in the US? How can we expect these people to really CARE about anything other than government costs (read:pass them on to states) when they have no vested interest in the system? This same scenario also works for SS, you know.

    And as far as Canadian healthcare: I love Canada, we own property and pay (minimal) taxes for a cottage there. My husband had a stroke while we were in Canada and spent 5 days in a hospital where the stroke was never diagnosed! One CT scan at hospital after the ER ruled out a hemmorhagic (sp?) stroke but no MRI, ever. US health insurance did pay the hospital stuff, we bought some prescriptions there and payed cash and it wasn't too terribly high. But upon fleeing back to the US when he could walk, and again NOT being diagnosed as a stroke victim by his PCP here, it took under 2 hours at the local hospital to locate  the blocked artery by MRI. By the way, the stroke was mild and the sequelae relatively benign. Jeers on both sides of the border.

    After that episode, we would be leery of Canadian hospitals if US hospitals could be accessed within  a reasonable time. I think that there was no MRI tech available on a Fri night. Costs and waiting times are issues.

  •  A nightmare (none)
    I'm self employed - have a MSA account through IEEE. This Jan premiums jumped from 400/month for the two of us to over 700/month. I predict they will stop offering coverage in the next few years and we're out on the street.

    It's a nightmare that I won't end in my lifetime

  •  $964 per month (none)
    Yes, you heard right - we pay $964 per month for BC/BS under COBRA for a PPO for me, spouse and child. This was the lowest priced option my former employer offered. After our mortgage, this is our biggest bill, and frankly, we can't afford to pay it for very much longer.

    After COBRA runs out, private health insurance will run us from $400 to $1000 per month, depending on the plan and they all are way more restrictive than the COBRA'd plan (high deductibles, lots of exclusions, no maternity coverage, etc.) We also have to be doctor-visit free for at least three months before anyone will touch us - and it doesn't help that my spouse is on medication for high blood pressure.

  •  I have insurance (none)
    thru my job.  Good.

    My daughter, 15 now, had a cancer when she was 1.  This means, I believe, that she will never, in her entire life, be able to get insurance on her own.  

    This scares the crap out of me.

  •  Limiting liability limits accountability (none)
    and that is incompatable with quality medicine!  I repeat this simple algorithm.  Putting an low absolute limit on liability puts a limit on accountability in our current system, and that is incompatable with improved quality of care.  Why should a provider bother to limit his/her/its income by following standards of care (where they even exist) if the cost to you is capped at a low amount.  Either let the courts and juries have their accountability effect, or go to a different system of standards and enforcement to make the medical care safer.  Remember, the IOM report of a few years ago (2000) puts medical system errors as the 7th or 8th leading cause of death in America!

    To Err is Human

    Political censorship is the root of all evil! It is the antithesis to a functional democracy!!

    by truthbetold on Sat Jan 15, 2005 at 07:02:14 AM PST

  •  An issue of fairness (4.00)
    The healthcare system in this country has those who pay their own health care bills subsidizing the discounts of the large preferred-provider plans.

    And of those who are responsible for paying, the ones who are able to pay subsidize those who do not.

    And those who self-pay and must pay a bill over several months are charged a 20% billing fee.

    As in so much in our society, it is socialism for the rich and free enterprise for the poor.

    The revolution starts now--in your own back yard, in your own home town

    by TarheelDem on Sat Jan 15, 2005 at 07:08:39 AM PST

  •  Self-Employed (none)
    $500/mo for me alone, had to drop spouse [she got hers through employer].  Stuck with Kaiser on their "conversion" plan after company belly'd up.  Thanks to COBRA they were required to offer continuing coverage.  [Kaiser turns out to have been the best choice].

    On the insurance companies:  In the early '80s, the Carpenters Union found that BC/BS was not monitoring claims.  Turned out that they cost the trust fund 3 million dollars in one year for claims that should have been charged to worker's comp.  Fired BC/BS and went to in-house admin.

    BC/BS has no medical staff, does not own any hospitals, or any other medical infrastructure.  They just administer the paper and collect in both directions:  raise the premiums, grind the doctors.  At least Kaiser is self-contained.

  •  And It's All So Needless! (4.00)
    Some of the problems, like manufacturing jobs going to well-qualified people overseas who will work for less, are thorny.  No easy solutions.

    But medical care IS soluble, for the time being at least we are still a prosperous nation, and we have the providers and the skills and technology.

    The problem is that we continue to interpose a large and insatiable level of profit-takers between people who need care and people who provide care.

    I am not a socialist; I'm just not a dogmatist.  Where the market works for pretty much everyone in providing some needed good or service, I'm happy to let it.

    But the so-called free market doesn't work with health care, and it's an essential.  So Democrats ought to be pursuing practical solutions, and put the needs of the many above the obscene profits of the few.

    I was uninsured for much of my life from 20 to 35 or so; when, intermittently, I had medical and dental coverage through employment, I would run and have all my cavities filled etc.  As noted, I am a lawyer, and while not making megabucks I'm OK.  For now.  But a few years ago, in my prior job, the managing partner's assistant embezzled more than $1 million from him, and I was laid off without warning.  My wife was employed at the time, and we had coverage.  She's not working now, and were I to lose my job again, two over 50 adults and two elementaryh-school age children would be without insurance.

    I'm sure the Canadian system, like anything run by mortal humans, is less than perfect, but from where I'm sitting it looks a hell of a lot better than what the non-rich have here.

    That we have to suffer sleepless nights over this makes me nuts.  Not long ago I was filling a prescription at the pharmacy, and a man in his 70s, wearing a jacket that identified him as a Korean War veteran, burst into tears when the pharmacist said that his insurance would not cover his and his wife's prescriptions, and he had to start choosing which ones he could pay for.

    Yes, there are many important issues.  This one, for me, ranks pretty high.

  •  Never mind insurance (none)
    What we need is health care.  Insurance isn't set up to cover fairly predictable events.  It's for the unexpected and the rates are based on the assumption that it won't be necessary to pay up.
    That's why every time it is, like after a hurricane, all the rates go up to cover the payments in retrospect.
    Where does the money go that's been paid in ahead of time?  Into the pockets of insurance industry executives and bad investments.
    We already spend more and get less than any other industrialized nation because of the many layers of bureaucracy.  You may think only governments employ bureaucrats.  Not so.  A bureaucrat is anyone who sorts information and stores it in files and drawers.
  •  Insurance companies are making less (none)
    because of lower interest rates.  They are earning less interest on the insurance deposits. They therefore have to raise premiums to make up for the shortfall.  Legal settlements don't have that much to do with it.

    Where legal settlements do come in, is with the health providers.  I don't think there are enough doctors.  It's hard to get a doctor's appointment these days.  Less kids are going to college to become a doctor because of the threat of legal suits.  It's also more expensive these days to pay for a doctor's education. Curbing legal suits would penalize victims of negligence.  The courts need to use common sense in their judgments.  Giving students more incentives to become a doctor may help.

    Sept. 11 + x = Shut-Up. (x=whatever you say) - The Daily Show

    by reform dem on Sat Jan 15, 2005 at 09:11:32 AM PST

  •  Health insurance is a train wreck (4.00)
    Two of my three sons are in the work force.  They do not have health insurance.  The decision is not even close.  They would have to choose between eating and health care.

    There is a huge transfer of risk occurring in this country, have you noticed?  The individual is forced to assume more and more responsibility for health care, retirement and employment/economic security.  The problem is that few individuals are in a position to shoulder this risk or control it. The health care crisis and the Social Security crisis contrivance by Bush are just two symptoms of the larger problem.  If we don't address it, we will end up like Argentina.

    •  Not sure that's true (none)
      I am on your side, but I believe that say 60 years ago, there wasn't anything that looked like health insurance and somehow people survived (or died) under that personal pay system. It is very diffent now.

      I see multiple movements, in varying directions, about healthcare. Doctors get paid less, payors pay more, more doctor visits, because we are all told that preventative care is best.

      We are being sold a system that has evolved in the last 30 years and told that we are responsible for seeing our doctors yearly to prevent our deaths. KOS family probably realizes that we will all die, maybe prematurely by acturalial standards, and at the end, the doctors can do nothing to extend your life.

      How did my grandmother live to be 86 with little healthcare til she had a heart attack and spent her last 6 years in a nursing home? I have no doubt that her quality of life was worse than my mother (who is 85, and suffers from some of the same family ailments). She is also sharp and cool.

      But what are we buying now? Our family spends many dollars per month on copays for Rx, and are living on 1/3 of the income of one year ago. I don't think that we are using non-useful prescriptions, but I am also not willing to "do the control". I was taking Vioxx for my problem and now I can't.

      I see normal people getting less and less connected with what has happpened to healthcare. I am not even sure what the field has become. With your pets, you do preventative care by getting vaccinations for rabies, etc. Oh, and you pay retail for that. But for oneself, you will pay $$ for a local body scan that might show a problem that might be something bad, or might be nothing, but will cost more money and might not even be covered by the health plan that you might have.

      We are here again being sold a bill of goods. Eat yur vegetables, and you won't die. Exercise 90 minutes a day and you won't die. See your doctor regularly and you will never die. And, by the way, pay your copay.

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