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What have the Olympics, oil and commodity prices, and supply and demand have to do with either pandemic preparedness or health reform? And what do either have to do with politics?

Pandemic preparedness is still an issue; pandemics are inevitable, and we are not yet prepared for one (follow the links for more, and go here to learn how to prepare). Health reform, which can mean either expanded access and coverage or cost control (it's both, actually along with rebuilding public health infrastructure and improving quality of care) is also obviously an issue. Yet, one problem seemingly separate from another problem quickly runs together to induce a major headache for the world, and one that is going to to be a major headache for the next President.

Here's an illustration of how that works: take the example of latex examining gloves. It's a staple of personal protective equipment (PPE) for health care workers for infection control, and a much needed barrier to protect against the spread of influenza (both seasonal and pandemic). One company, Medline, with 30% of the market share, is a big player. So this announcement raised eyebrows when it was released this week:

Hong Ray Enterprises of Shijiazhuang, China, the world's largest manufacturer of vinyl exam gloves and a major manufacturer of nitrile gloves, has notified Medline Industries, Inc., and other U.S. customers that they are facing "force majeure conditions" and that they will be unable to meet their normal agreements to customers. Hong Ray is Medline's largest exam glove supplier.

Force majeure means that large scale circumstances beyond control free the company for liability and obligation. In this case:

In its letter to Medline and its other U.S. customers, Hong Ray cited a long list of events and government actions that have led to its inability to fulfill its contracts. These include a fire at a major raw material manufacturer, dramatic changes in government policy impacting labor, taxes and credit and pollution-control measures associated with the Beijing Olympics.

According to Amdur, Hong Ray's situation is by no means unique.

"All of our suppliers are facing enormous and unexpected obstacles in fulfilling their contract obligations," said Amdur. "While Hong Ray is the first factory to formally declare 'force majeure,' other factories, including those that manufacture latex gloves, face similar circumstances. In Malaysia, for example, the government recently declared a change in pricing for natural gas, almost tripling the price overnight."

So, much needed medical supplies will either be absent or raise your medical bills just as surely as rising oil prices impact the airline industry.

"We are moving quickly to secure adequate supply for our customers through alternative factories, at ultimately a much higher cost. It is crucial that we act fast for exam gloves, however, because it's a high demand item that can spike in times of crisis situations such as SARS and the pandemic flu."

And with that background, look at the numbers from a previous post in March:

Those with insurance are satisfied with their own health care coverage (83% to 93% depending on the question), but fear paying more for care (41%) or losing coverage altogether (29%). That >80% satisfaction is a key finding, because people satisfied with what they have a) don't want to give it up and b) are less likely to push for change. And when asked to rank health care along with other important issues facing Americans, Democrats tend to rate health care as more important than either independents or Republicans, so the push for health reform is not unanimous by any means.

Another important difference is that Republicans are more worried about cost-containment and Democrats more interested in expanding coverage. This leads to the following caveat; while much of the public agrees with the goal of  increased coverage, there is no agreement about the best solution to get there.

The slides are from kaiser.edu, which is a great resource on health care information. In conjunction with the Roper Center at the University of Connecticut, a list of recent health care polling can be found and put to good use. For example, from a Feb 08 AP/Ipsos poll:

(People have suggested various ways that the government could act to try to fix the economy. How much do you think each of the following would help fix the country's economic programs: a great deal, some, only a little, or no help at all?)...Increasing spending on domestic programs like health care, education, and housing

43%  A great deal
27   Some
16   Only a little
14   No help at all

Does that mean that increasing dollars for increasing price of gloves, oil, etc is what people had in mind? Not likely, any more than donors to colleges want their dollars to pay for electricity and heating oil when what they wanted was increased scholarships or educational programs.

But the reality of rising commodity prices (including food), international supply chains and a just-in-time economy put us at risk for key shortages that will, if not a sexy headline-grabbing issue, nonetheless need to be dealt with both in enacting health reform and preparing for pandemics.

The only way to approach this is with a sober, reality-based approach, and it's going to require the next President to understand the science behind the politics. That's why the public prefers the next President to know something about science, and why the 14 Science Questions the Next President Should Answer include

  1. Pandemics and Biosecurity. Some estimates suggest that if H5N1 Avian Flu becomes a pandemic it could kill more than 300 million people. In an era of constant and rapid international travel, what steps should the United States take to protect our population from global pandemics or deliberate biological attacks?
  1. Health.  Americans are increasingly concerned with the cost, quality and availability of health care.  How do you see science, research and technology contributing to improved health and quality of life?

in addition to questions about innovation, energy, national security and research. There's no way this approach is going to to be simple or easy. But whether it's the all-at-once or sequential approach, there's no question that a science-based and evidence-based approach to health care policy and politics is the right way to go. And those kinds of approaches will recognize that cost is a factor in the direction health reform goes, and will need to account for it, even as universal care remains the goal. Start with children if you want consensus

As you may know, President (George W.) Bush vetoed a bill passed by Congress that would create a program to spend 35 billion dollars to provide health insurance to some children in middle-income families. Do you think Congress should vote to create that program by overriding Bush's veto, or do you think Congress should vote to block that program by sustaining Bush's veto?    

Congress should override veto 61
Congress should sustain veto 35
No opinion 4

and get everyone to where they need to be. But in this environment, cost and complexity and going to need to be accounted for, one way or another.

Originally posted to Daily Kos on Sun Jul 06, 2008 at 05:33 AM PDT.

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Comment Preferences

  •  things that happen there affect us here (3+ / 0-)
    Recommended by:
    marge, SecondComing, barbwires

    for example, Indonesia calling for the closure of a public health laboratory (NAMRU-2) run by the Navy is a big deal.

    That's part of our surveillance and early warniong system for emerging infectious diseases.

    "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

    by Greg Dworkin on Sun Jul 06, 2008 at 05:41:39 AM PDT

    •  Interesting diary, DemFromCT . . . (6+ / 0-)

      but I respectfully disagree, 1,000,000% that we cover children first.

      It seems if Obama wins, this will be our last chance and we must seize it with every shred of our being.

      I'll add that the Obama Plan, is very, very soft with hard facts. For example, he continues to say, that the American people should have exactly the same coverage he has, my question (and yes, I know the answer), will we pay, what he and his Senate colleagues pay?  (No.)

      He's proposing to lower insurance premiums for familes $2500.00. This doesn't even pass the laugh test.

      If we give the political class the cover they so covet and allow them to claim success by making healthcare available to children only, they'll all slap themselves on the back and declare "mission accomplished". There will be no going back for another generation.

      The rest of the civilized world can give their citizens healthcare, then so can the United States.

      Covering children first is a non-starter in my neck of the woods, even if this is the way toward consensus.

      •  I'm fine with covering everyone (0+ / 0-)

        "But whether it's the all-at-once or sequential approach" the end result is what matters.

        So, no disagreement with that.

        If you're talking pragmatism, well, the public and congress will have their say on that and there's no consensus. Single payer is looking stronger than ever, with the public, but the strongest support of all is children's coverage.

        NPR/Kaiser Family Foundation/Harvard School of Public Health survey. Feb. 14-24, 2008. N=1,704 adults nationwide. MoE ± 3 (for all adults). Fieldwork by ICR.

        "Next, I'm going to read you a description of a plan to make sure everyone has health insurance, and then I'm going to ask you if you support or oppose this plan. This proposal would require all Americans to have insurance. Most people would still get insurance through their work. People who don't get insurance from work would have to buy it themselves, or pay a fine if they don't. People with lower incomes would get help from the government paying the cost of health insurance. Would you support or oppose this kind of plan?"  

        Support Oppose Unsure  
         
        47 44 8  

        "Next, I'm going to read you a description of a plan to make sure everyone has health insurance, and then I'm going to ask you if you support or oppose this plan. This proposal would place requirements on individuals, employers, the government, and insurance companies so that everyone shares in the responsibility. Individuals who don't already have insurance would be required to buy it or pay a fine, with financial help from the government for people with lower incomes. Employers would be required to cover their workers, or pay money into a pool that helps people buy insurance. Government health insurance programs would be expanded. Insurance plans would be required to take anyone who applies, even if they have a prior illness. Would you support or oppose this kind of plan?" N=851 (Form B)

        Support Oppose Unsure  

        59 33 8  

        "A different proposal for increasing the number of people covered by health insurance would NOT require all adults to have insurance, but would require that parents get insurance for their children. Most children would still be covered by plans through their parents' employers. Parents who aren't covered through work would have to buy insurance for their children, or pay a fine if they don't. Parents with lower incomes would get help from the government paying the cost of health insurance or their children would be enrolled in public programs. Would you support or oppose this kind of plan?"

        Support Oppose  Unsure  
         
        65 31 4

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by Greg Dworkin on Sun Jul 06, 2008 at 06:07:01 AM PDT

        [ Parent ]

        •  I agree here 100% (3+ / 0-)
          Recommended by:
          DemFromCT, ArtfromMI, John2Luke

          I'm for single coverage, but I'll take what incremental steps we can get.

          Numbers are like people . . . Torture them enough and they'll tell you anything.

          by Actuary4Change on Sun Jul 06, 2008 at 06:18:55 AM PDT

          [ Parent ]

        •  We Need Leadership on Single Payer (1+ / 0-)
          Recommended by:
          nyceve

          To build consensus for single payer, we need politicians willing to propose single payer.

          Unfortunately, no "mainstream" politicians from either major party are willing to do so.  Our corporate media is certainly not going to push single-payer onto the table. And voters who claim to support single payer refuse to put their votes behind it (just ask Dennis Kucinich).  

          We can fantasize all we want about politicians who are opposed to single payer--or who simply claim it's unworkable (as Obama does)--bringing single payer about through baby steps. But it ain't gonna happen.

          The only way to get single payer is to elect politicians that support single payer. And that's certainly not going to happen when even the grassroots support that already exists for single payer doesn't vote that way.

          This nicely summarizes what's wrong with American political life today. (Source)

          by GreenSooner on Sun Jul 06, 2008 at 07:42:54 AM PDT

          [ Parent ]

        •  Looks to me (1+ / 0-)
          Recommended by:
          StrayCat

          People who don't get insurance from work would have to buy it themselves, or pay a fine if they don't.

          like it's a tax paid directly to a private company.  Way to go.  There will still be the standard for profit insurance company overhead taken out (IIRC 30%) and as people will be FORCED to buy their product, quality will suffer.  People and their doctors already have to jump through all sorts of hoops to get the insurance companies to pay from what I hear.  

          THIS WON"T CHANGE.

          I am an angry clown. Often pwnt, never owned. The world is a gradeschool playground with no teachers in sight.

          by obnoxiotheclown on Sun Jul 06, 2008 at 08:00:57 AM PDT

          [ Parent ]

      •  PS I have no idea why you think (1+ / 0-)
        Recommended by:
        nicolemm
        1. it's our last chance

        and

        1. why consensus is wrong when it comes to governance

        Sequential does not mean "stop when baby steps are achieved". But consensus maty be the only way to pass things. of course, universal care has a better chance with 60 senators from the D side and less chance with less than 60 (in which case, we'll hear a lot about Wyden's proposal).

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by Greg Dworkin on Sun Jul 06, 2008 at 06:10:42 AM PDT

        [ Parent ]

        •  You must still have good employer . . . (1+ / 0-)
          Recommended by:
          ArtfromMI

          paid for health coverage.

          The crisis even for insured middle class Americans is spiraling out of control. More and more are finding themselves simply unable to afford healthcare. Hence partial, interim or incremental solutions, does nothing for huge numbers of Americans.

          As the economic crisis worsens, more Americans will lose their jobs and their already paltry health benefits.

          So I don't see how you reconcile covering children with the terrible healthcare hardships facing Americans at every socioeconomic level.

          I didn't write "consensus is wrong when it comes to governance".

          •  you're describing black and white (0+ / 0-)

            when the world is colored in many different hues.

            "Insuring children" doesn't mean "not ensuring adults". And "insuring children" doesn't mean those pressures you describe disappear, which is why I asked why you think it's a 'last chance'. As you point out, increasing pressure does not make it a last chance, far from it. If anything, it drives reform even further for even longer.

            In any case, health reform is front and center on the table for discussion. There's no 'one best way', though I personally favor single payer. I don't favor things that can't pass.

            "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

            by Greg Dworkin on Sun Jul 06, 2008 at 07:08:56 AM PDT

            [ Parent ]

            •  This is true, DemFromCT . . . (0+ / 0-)

              I see very little nuance in this catastrophe. Note the word I use, 'catastrophe'.

              In addition, drSteveB made me realize that we must push hard for single-payer without compromise. Any compromise with the stakeholders will be  seen as the white flag of surrender.

              If we surrender in advance, agree to sequential, incremental--call it what you will--reform, we'll get exactly nothing. Or, as I said at the outset, the political class will congratulate themselves for covering all children, call it a day and that will be that for the next 25 or 50 years.

              •  my only concern about that (1+ / 0-)
                Recommended by:
                nyceve

                is treating people who might have nuanced approaches as 'the enemy'. Bad idea, that.

                Otherwise, go for it. Single payer has a lot to recommend it.

                "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

                by Greg Dworkin on Sun Jul 06, 2008 at 07:53:54 AM PDT

                [ Parent ]

                •  Illness doesn't handle nuance nicely. (0+ / 0-)

                  I don't handle nuance nicely either.

                  A quality system provides all needed and useful care to all.

                  A quality system does so at a globally competitive price for the nation and a reasonable price for each care item.

      •  BENEFITS AS GOOD AS Obama GETS (0+ / 0-)

        Guessing from Ted Kennedy's bill:

        BENEFITS AS GOOD AS YOUR CONGRESSMAN GETS- Benefits under such plans are similar to or no less than the health benefits coverage in any of the 4 largest health benefits plans (determined by enrollment) offered under FEHBP. Such plans may provide health benefits in addition to such required benefits and may impose a premium for the provision of benefits. Such plans may not provide for financial payments or rebates to enrollees.

        `(B) BENEFICIARY PROTECTIONS- Enrollees in such plans have beneficiary protections that are not less than the beneficiary protections applicable under this title to individuals not so enrolled and shall include beneficiary protections applicable under both FEHBP and part C of title XVIII.
        ....

        `(c) ANNUAL OPEN ENROLLMENT- The process under subsection (a)(2) shall provide for an annual open enrollment period in which individuals may enroll, and change or terminate enrollment, in private health plans in a manner similar to that provided under FEHBP as of January 1, 2007.
        ....

        `(e) REQUIREMENTS FOR FEHBP CARRIERS- Each contract entered into or renewed under section 8902 of title 5, United States Code, shall require the carrier to offer a separate plan under this section on similar terms and conditions to, but with a separate risk pool from, the plan offered by the carrier under FEHBP.

        Obama's plan will probably utilize that verbiage.

        Obama probably has a family plan that costs around $12,000 a year, of which Uncle Sam pays ~70% and Obama pays ~30% as Uncle Sam would do for federal employees.

        If self-employed, you will probably pay what a Federal plan costs in the NY area for a single person plus 10% more since you will probably be placed in a separate risk pool from Federal employees.

        You will probably get help to pay the cost only if your income is below about $50,000 a year. At about $20,000 a year, figure on Uncle Sam picking up half the cost. At about $10,000 a year, figure on Uncle Sam picking up about 85% of the cost.

        If you get a federal job, Uncle Sam will pay ~70% and you would pay ~30%.

        If you get a private sector job, you might pay the same percentages unless you work on Wall Street.

        Federal and private sector employees will get equal percentage help [say 50% at $20,000] as self-employed people for their ~30% share. Basically half-priced at $20,000 a year.

    •  "globalization" added as a tag? n/t (0+ / 0-)

      "We are what we repeatedly do. Excellence, then, is not an act, but a habit." -Aristotle

      by Aidos on Sun Jul 06, 2008 at 07:10:08 AM PDT

      [ Parent ]

      •  can't add too many tags (0+ / 0-)

        go right ahead

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by Greg Dworkin on Sun Jul 06, 2008 at 07:11:50 AM PDT

        [ Parent ]

        •  I once put out a TIP JAR for an excellent diary, (0+ / 0-)

          and got my head bitten off.  I don't know if it's kosher for a no-body [NEW COMER] like me, to do something.  There's rules in this here place ya know!  And ignorance of; the law, protocols, and egos that need to be massaged, IS NO EXCUSE!

          "We are what we repeatedly do. Excellence, then, is not an act, but a habit." -Aristotle

          by Aidos on Sun Jul 06, 2008 at 07:45:57 AM PDT

          [ Parent ]

    •  and locally, clinics face a 10% cut in Medicare (1+ / 0-)
      Recommended by:
      barbwires

      rates so pinched between rising costs of doing business with patients who are less able to pay and less likely to have insurance, Medicare and Medicaid are the main lifelines financially to these clinics.
      GWB's solution? He has suspended all payments for Medicare for two weeks and may extend the delay while the 10% cut is worked out.

      In the meantime, clinics in underserved areas already on the edge will have to fold.

      •  in the NY Times (0+ / 0-)
        Congress returns to work this week with Medicare high on the agenda and Senate Republicans under pressure after a barrage of radio and television advertisements blamed them for a 10.6 percent cut in payments to doctors who care for millions of older Americans.

        http://www.nytimes.com/...

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by Greg Dworkin on Mon Jul 07, 2008 at 04:53:07 AM PDT

        [ Parent ]

  •  Fear of losing coverage is the wedge. (7+ / 0-)

    I'm a family doc, and it simply boggles my mind that some patients who have already lost their health insurance and are being pulverized by health care costs still buy into the "scary socialized medicine" scam. But many of my blue collar patients are painfully aware that their health insurance (often with increasing co-pays and deductibles) already hangs by a thread, and may be lost with the next round of corporate downsizing or the next jump in fuel costs. They know that things are bad and getting worse; many of them have children who can't get (real) health insurance at any price.

    So this is the wedge, the lever, that progressives can use to start the conversation about a real national health care system. Sure, Obama's plan has lots of loopholes and ducks many of the real problems, but it's a start. And the "Medicare-like" program for people who can't easily get traditional insurance is the camel's nose under the tent. I suspect that if it's competently run and works reasonably well, countless employers will take the opportunity to shed the burden and push their workers into that system. And that's the doorway to single payer, "Medicare for all" that can finally get us out of this death spiral.

    •  none of the health care proposals (3+ / 0-)

      will pass 'as is', but Obama's is far superior to McCain's which doesn't even pretend to address universal care, or even expansion of care.

       

      McCain camp working out healthcare details
         Aides struggle to sort out his promises

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Jul 06, 2008 at 05:54:17 AM PDT

      [ Parent ]

    •  Another issue most don't need care "now". (4+ / 0-)
      Recommended by:
      barbwires, Ralphdog, ArtfromMI, Dichro Gal

      A lot of the problem is most people are generally healthy and only when they really need medical care do all the ramifications of under coverage and no coverage hit home.

      It's a shame none of the viable (aka not Kucinich) candidates stepped up and said they supported the "Medicare for All" option. It would have put it on the table for debate.

      Medicare for All has all the facts behind it, the most effective, efficient health care bang for the buck.

      Currently big fight in Congress with Democrats fighting Medicare cuts by Republicans who are trying to kill Medicare by cutting payments to docs and hospitals so they can't take Medicare patients and survive financially.

      We need a campaign to fully fund current Medicare as it is and roll back cuts over the last eight years.

      •  My Mexican dentist (0+ / 0-)

        operates without a staff.

        He practices with his wife, a pediatric dentist.

        Doctors in the US need to share/shed their high-cost staff.

        Doctors in the US also have to go to mainly electronic booking.

        Doctors in the US also have to go to bank/credit/insurance account debiting so they don't need people to chase down money.

        Medicare could pay 100% of the bill and debit the next (few) Social Security payment(s). Or it could withhold 5% a month of Social Security payments until a balance is built-up to pay possible doctor bills.

      •  To have only 40% (0+ / 0-)

        and in some alleged case 10% of government payments actually used to reward the provider is an absurdity.

    •  I think the real wedge (1+ / 0-)
      Recommended by:
      ArtfromMI
      has nothing to do with the pluses and minuses of McCain's plan. If it's true that the main issues here are that a. most people are happy with their current, emloyer-provided insurance but b. fear losing it or fear crushing cost increases, we need to slam McCain's plan because it contains the worst of all worlds and it alone could lose him the election.  He wants to virtually eliminate employer-based health insurance almost overnight, penalize those who still have it and turn everyone out to the mercies of the "free" market with a laughably inadequate amount of resources. I can't believe his plan, if anyone had the guts to poll it, wouldn't approach 90% disapproval (of course they won't poll it, because they know that and don't want to draw attention to it).

      I think an added plus (in addition to defeating McCain) is that it would scare people toward singer-payer when they realize just how vulnerable some people in government who are taken seriously want to make them, including a presidential candidate.

      We're retiring Steve LaTourette (R-Family Values for You But Not for Me) and sending Judge Bill O'Neill to Congress from Ohio-14: http://www.oneill08.com/

      by anastasia p on Sun Jul 06, 2008 at 06:56:15 AM PDT

      [ Parent ]

    •  Scariness assisted by the AMA (1+ / 0-)
      Recommended by:
      nicolemm

      The last time I looked the the AMA web site, they listed their first concerns as "physician salaries." This started decades ago, and most physicians bought into it. They convinced their friends and families, too. They helped convince patients by restricting explanations of disease to the patients themselves (I'm old enough to remember when telling the patient was a no-no, and you can still see that attitude on old TV shows), indirectly letting patients know that they're lucky to have access to such exclusive medical care - and that the high cost of care was necessary for the care. Socialized medicine would lower costs, went the opinion, and that would result in poorer care.

      I'm not against the AMA, but I must remember that they started the "scary socialized medicine" nonsense because of money.

      BTW - Are you aware that 70% of smokers who die are nagged to death?

      by SciMathGuy on Sun Jul 06, 2008 at 08:17:01 AM PDT

      [ Parent ]

      •  well, in 2008 (0+ / 0-)
        Poll Finds Americans Split by Political Party Over Whether Socialized Medicine Better or Worse Than Current System

         Seventy percent of Republicans think socialized medicine would make things worse and 70% of Democrats think it would make things better

        http://www.hsph.harvard.edu/...

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by Greg Dworkin on Sun Jul 06, 2008 at 08:20:45 AM PDT

        [ Parent ]

      •  actually look to the AHA for muscle (1+ / 0-)
        Recommended by:
        SciMathGuy

        AMA represents only 50% of physicians and their membership has been dropping steadily. In years when physicians had to take cuts or no increases in payments, AHA always manufactured hefty increases for hospitals.

        As more and more physicians become employees, expect the AHA to increase its clout and reach. The local hospital here has consumed all independent physicians groups except for two and one is on the verge of closing. 15 years ago there were 20 independent physician offices; some were bought out and others forced out by "disruptive physician" rules mandated by the BBA.

      •  Hey, I despise the AMA, and I'm a doctor. (4+ / 0-)
        Recommended by:
        DemFromCT, nicolemm, entlord1, SciMathGuy

        Within the medical world, the AMA has forged a well-deserved reputation for being a parochial, highly conservative Mid-Western club concerned solely with physician incomes to the exclusion of everything else. There is a long and dishonorable AMA history of fighting against universal health insurance, Medicare, even Blue Cross & Blue shield initially.

        The absolute lowest point from my perspective was when the AMA signed on to the Republican ban on partial dilation and extraction (AKA "partial birth abortion"), out of a misguided perception that it was a rarely used, even outdated procedure, and that throwing a bone to the anti-abortion loons would satisfy them. It was dead wrong on the science, dead wrong on principle, and dead wrong tactically.

        Things may be changing, though. A rising percentage of AMA officials are primary care physicians, and for us the importance of access to care is a lot more personal and obvious than it is for millionaire heart surgeons. It's also dawning on a lot of primary care docs as our incomes nosedive and costs explode, that we are labor, not management. The AMA is just starting to make a few tentative steps in the direction of embracing universal health care. It's a slow, grass-roots, ground-up process.

        •  views of voters (1+ / 0-)
          Recommended by:
          SciMathGuy

          http://content.nejm.org/...

          interesting background to any discussion, once again emphasizing the different attitudes and perceptions between Democrats and Republicans.

          Are surgeons Republicans and primary care people Democrats?

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by Greg Dworkin on Sun Jul 06, 2008 at 09:04:52 AM PDT

          [ Parent ]

          •  Interesting chart on that link! (1+ / 0-)
            Recommended by:
            DemFromCT

            To other readers: I have a dreadful time getting that link to come up. It was worth it, though. It's an interesting look at how Dems and Repubs look at some health care issues.

            Thanks, DemFromCT. Good 'un. And I also wonder if the NEJM would ever do a physician survey to examine physicians' politics. I had a wealthy cousin who was an ob/gyn, and he despised "socialized medicine." His kid, now a urologist, also despises "socialized medicine."

            But as for patients, and their views on "socialized medicine?" Well - have you ever known anyone eligible for Medicare who has turned it down?

            BTW - Are you aware that 70% of smokers who die are nagged to death?

            by SciMathGuy on Sun Jul 06, 2008 at 09:28:18 AM PDT

            [ Parent ]

          •  Absolutely correct. (1+ / 0-)
            Recommended by:
            SciMathGuy

            Thoracic surgeons (cough-Bill Frist-cough) are overwhelmingly Republicans, just like oil executives, and for the same reason. They derive immense financial benefits from a nexus of economic and policy decisions they have come to confuse with "the natural order of things". Sort of like the late, lamented Anne Richards said of George W. Bush: "born on third base, and thinks he hit a triple".

            Family doctors in the Mid-West still tend to be socially quite conservative, but elsewhere they lean Democratic, and Pediatricians are overwhelmingly Democrats. This follows directly from their recognition that their powerless patients are entirely at the mercy of greater economic forces, and that social justice is more than an abstract idea when you encounter lead-poisoned undernourished waifs on a daily basis.

    •  and therfore..... (0+ / 0-)

      out of the hands of for-profit insurance companies that are the driving force behind random and astronomical price increases for each and every service provided. Plus the practice of refusal of services to people (or their employers) that have been paying for decades.

  •  Preparedness link: "Three months food/water/fuel" (1+ / 0-)
    Recommended by:
    SecondComing

    The link for how to do this "Small Spaces,Small Budgets" is fascinating for all of us wannabe survivalists.

    Each two week supply for a family of four takes up a 66 quart cooler and costs $130.

    The "fuel" part refers to cooking fuel in case the gas or electric goes out and repairs are slow or non-existent.

  •  got to at least change (0+ / 0-)

    the way most people get coverage...through employment...get laid off or company folds.....no coverage!!! maybe incremental change would be the way to go

    A legacy of death, debt and deceit. He's a real hero.

    by billtmore on Sun Jul 06, 2008 at 05:57:17 AM PDT

  •  I'm one of the minority that (0+ / 0-)

    has insurance, but is unhappy with it.  Anything serious will cost me $4500 plus medicines out of pocket, which is about ten percent of my income.  Hard to budget for things like that when you're already living close to the bone.  I get $300 a year for radiological things, which gets more than consumed with a single MRI or CAT procedure.

    It's lame insurance, but it costs me little because I get it through work.  I don't know waht I would do if I lost my job.

    Je suis inondé de déesses

    by Marc in KS on Sun Jul 06, 2008 at 06:03:37 AM PDT

    •  maybe not such a minority (2+ / 0-)
      Recommended by:
      Marc in KS, echatwa

      some of these people have insurance.

      Gallup Poll. Nov. 11-14, 2007. N=1,014 adults nationwide. MoE ± 3 (for all adults).

      "Thinking again about health care in the country as a whole: Are you generally satisfied or dissatisfied with the total cost of health care in this country?"

      Satisfied Dissatisfied Unsure

      11/11-14/07 17 81 2
      11/9-12/06 19 79 2
      11/7-10/05 20 79 1

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Jul 06, 2008 at 06:12:24 AM PDT

      [ Parent ]

  •  My prescription-- (4+ / 0-)
    Recommended by:
    nyceve, echatwa, Aidos, SciMathGuy

    Socialize the funding; privatize the care.

    How do you tell a predator from a protector? The predator will eat you sooner rather than later.

    by hannah on Sun Jul 06, 2008 at 06:15:51 AM PDT

    •  Sounds simple, but . . . (1+ / 0-)
      Recommended by:
      Aidos

      We are currently spending 15.2% of GDP on Health Care in this country.  If we create universal health care without important cost controls, spending, and the taxes required to fund it, will increase to a point where people reject it.

      The solution is not going to be simple.

      Numbers are like people . . . Torture them enough and they'll tell you anything.

      by Actuary4Change on Sun Jul 06, 2008 at 06:23:13 AM PDT

      [ Parent ]

      •  thank you (0+ / 0-)

        it will require both cost control and expanded access to satisfy the public. Will taxes go up?

        http://www.pollingreport.com/...

        ABC News/Washington Post Poll. June 12-15, 2008. N=1,125 adults nationwide. MoE ± 3. Fieldwork by TNS.

        "Which of these do you think is more important: providing health care coverage for all Americans, even if it means raising taxes, OR, holding down taxes, even if it means some Americans do not have health care coverage?" Options rotated

        Coverage For All Holding Down Taxes Unsure

        6/12-15/08 66 31 3
        10/9-13/03 79 17 4
        12/99      71 26 3

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by Greg Dworkin on Sun Jul 06, 2008 at 06:27:39 AM PDT

        [ Parent ]

      •  Universal Access/Single Payer & Sliding Scale? (1+ / 0-)
        Recommended by:
        nicolemm

        We need a single payer, because the insurance co's will cherry-pick.  We need universally accessible and portable insurance, with a sliding-scale co-pay.  The individual insurance companies would simply stop owning the business and be corraled under the government umbrella to become ADMINISTRATORS and MANAGERS.  

        Nothing would really change except that insurance companies would probably not be traded on Wall Street because there would not be a profit to dole out to investors.

        Is this a good thing or a bad thing?

        "We are what we repeatedly do. Excellence, then, is not an act, but a habit." -Aristotle

        by Aidos on Sun Jul 06, 2008 at 07:41:41 AM PDT

        [ Parent ]

        •  geneally good (0+ / 0-)

          I think single payer is the best chance we've got.

          I do think there are potential problems in the form of

          1.  Fraud and abuse of the system (without the profit motive, how are you going to incent administrators to scrutinize claims carefully enough)
          1.  Making sure that medical research and training receives adequate funding (some of it is currently subsidized by hospital charges.

          Numbers are like people . . . Torture them enough and they'll tell you anything.

          by Actuary4Change on Mon Jul 07, 2008 at 10:15:57 AM PDT

          [ Parent ]

  •  Health Care is both an economic and a .... (3+ / 0-)
    Recommended by:
    DemFromCT, nicolemm, Aidos

    national security issue, even if you just throw away the idea that a country's government should have some stake in the common welfare of its people.

    Economically when businesses are asked to provide health care insurance they bear an unequal burden compared to companies in say the European Union, where government takes that responsibility.  In addition health care insurance is not at all static in cost (as we all know) and small businesses can go under or opt out of the insurance business altogether.  John McCain's solution to this is to dump it all on the individual, which will not necessarily help businesses as they do have a vested interest in the health of their employees.  The most viable way to deal with this without health care would be to reinstate slavery, an option some might find useful as they could discard slaves who became sick!  Admittedly immoral, but than immoral solutions are the stock and trade of the current crop of right-wing politicians.

    The national security problem comes with the obvious threat (well documented in this diary) from epidemic disease.  Even a dictator (we trend that way) needs a healthy army.  Napoleon suffered from his armies' bouts with typhus (Russia), plague (Palestine and Egypt) and yellow fever (Haiti).  In fact this pretty well crushed his army in Haiti.  Napoleon did not know what caused the diseases with which he had to deal, so he had no way to do anything about them.  However modern dictators aren't much better for the advances in medical knowledge (points to Castro and Ortega however as they oddly have actually taken health care seriously).  Of course we could always go to a Burmese or Zimbabwean form of government, where people are only useful if they line the pockets of the ruling class

    Thus even from the standpoint of the Imperium built by Bush health care should be an important policy issue, unless they don't value the country at all.

    Conclusion: A lack of effective health care is economically and strategically unwise, as well as being immoral. Only fools would pursue our current government policy, assuming that they are not moving toward absolute dictatorship.  Therefore our current government is composed of either fools or evil trolls (or perhaps both!)  Doh!

    •  There is no such thing as "effective health care" (1+ / 0-)
      Recommended by:
      nicolemm

      The only effective means are education, self care and the lessening of poverty.

      Our medicine is just another behavioral addiction with no real benefit. What people need to do is get out of the pharmacy.

      •  health care could be encouraging the first 2 (0+ / 0-)

        and I hope future science that health care relies on  will be real, objective science rather than corporate funded studies. We do use too much  technology and pharmaceuticals to fix what could be prevented or cured by healthier lifestyles

        -7.75, -6.05 The point of the war in Iraq is that there IS a war in Iraq- Keith Olbermann

        by nicolemm on Sun Jul 06, 2008 at 09:58:52 AM PDT

        [ Parent ]

        •  Objective science is not the issue either (0+ / 0-)

          The issue is long term care of chronic illness and end of life care.

          Unnecessary medicine and procedures swamp the system.

          It is not our health care, it is our behavior and our behavior is being worsened by health care and so called  "science."

          Health care cannot and will not encourage education and self care, because that doesn't keep the MRIs, surgical suites, and pharmacies filled up. We in health care are beat over the heads all the time for not being busy enough, spending too much time with patients, not enough high price procedures......

          Assuming the health care systems is trying to keep you healthy is like assuming Wal-mart is really trying to save you money.

          •  You can pay (0+ / 0-)

            less for "unnecessary medicine and procedures".

            If somebody wants an MRI and wants to jump the treatment protocol, then they can pay 2% of their annual income (max $600, min $200) which they will lose if it doesn't show anything undetectable otherwise, important, and treatable.

            You can have people pay a significant percentage of the costs for tests.

            Test X may cost one hour of pay (max $23, min $6) and Test Y may cost three hours of pay (max $90, min $18). This might be prorated down by age if the patient is a child since two year olds can't really help the doctor much.

    •  Funny story. (0+ / 0-)

      The most viable way to deal with this without health care would be to reinstate slavery, an option some might find useful as they could discard slaves who became sick!

      Many years ago, I went to New Orleans and read a historical marker or possibly some sort of pamphlet I forget which and it's not important.

      Anyway, the upshot of it was that when they were building the levees, the attrition rate of workers was quite high given the snake and alligator factor.  They most certainly did not use slaves for this work.  Slaves cost a significant amount of money up front in addition to what was spent on their upkeep.  Irish immigrants were flooding into the city owing to the potato famine and were desperate for work.  Irish immigrants could be paid wages barely enough to keep them alive and they would take it as they had no other options.  They died like flies.  Few cared.  

      Modern workers require training of some kind generally.  One can assign a dollar amount to the time and effort needed.  One can then compare this dollar amount to what one spends to keep an employee around and healthy.   In keeping with their responsibility to the stockholders, corporate officers can make decisions accordingly.  There is the side issue of employee morale which may enter into the equation.  

      You make an excellent point about infectious disease.  This is perhaps the single best argument for universal healthcare  I can think of that doesn't appeal to silly concepts like common human decency.  Perhaps you could expound upon this in a comment that wasn't quite so snark-laden.  Perhaps I could do the same.  Nah, I'm too lazy.  

      Time for breakfast.............

      I am an angry clown. Often pwnt, never owned. The world is a gradeschool playground with no teachers in sight.

      by obnoxiotheclown on Sun Jul 06, 2008 at 08:35:26 AM PDT

      [ Parent ]

      •  In essence the Irish were slaves - they .... (0+ / 0-)

        had no choice but to work in order to provide for themselves and their families.  There was enough of them so a few sick or dead paddies did not matter.  We could do the same with Mexican nationals (and probably already do!)  It is nice to be on top, except for when the revolution comes as it did to Imperial Russia!

        •  Worse than slaves (0+ / 0-)

          slaves weren't put in situations where their demise was a very strong possibility because of the aforementioned up front cost.  

          It was an example of a surplus of free market labor driving wages and working conditions down.  Six feet under, often enough.  Gee, why do we need OSHA again?  

          How does the widespread exposure to agricultural chemicals encountered by migrant farmworkers affect their health?  Would we tolerate it if it were primarily white people being affected?  How much would a head of lettuce really cost if the usual standards for pay and working conditions were applied to agriculture?

          I am an angry clown. Often pwnt, never owned. The world is a gradeschool playground with no teachers in sight.

          by obnoxiotheclown on Sun Jul 06, 2008 at 01:53:05 PM PDT

          [ Parent ]

  •  Is "Globalist" a swear-word yet? (1+ / 0-)
    Recommended by:
    ArtfromMI

    Along with "Sane," "healthy economy," and "appointment with a doctor?"

    There are no stupid questions, but stupid people are everywhere

    by SecondComing on Sun Jul 06, 2008 at 06:31:11 AM PDT

  •  Sooner or later, (2+ / 0-)
    Recommended by:
    nicolemm, ArtfromMI

    we're going to have to have local production of a lot of goods.

    Bush's presidency is now inextricably yoked to the policies of aggression and subjugation. Mike Whitney

    by dfarrah on Sun Jul 06, 2008 at 06:40:46 AM PDT

  •  DemfromCT, excellent discussion. In fact (2+ / 0-)
    Recommended by:
    Aidos, ArtfromMI

    given how the speculation in oil is increasing costs across the board: food, health care supplies, and social(educational) functions, does it reach the point where our government MUST regulate the private oil companies like they do regular electric/telephone companies?

    •  Congress to stop "video barrels of oil" (2+ / 0-)
      Recommended by:
      Silence is Complicity, ArtfromMI

      Analogy.   It's like ticket scalpers, buying out all the concert tickets [a limited resource] and forcing others to pay outrageous prices!  

      If you go to a gas station and ask to buy 200 gallons of gas, they won't sell it to you.  They will only fill up your tank. Congress is trying to get legislation to make speculators [oil-scalpers] TAKE DELIVERY of the product, not just own it in cyber-space for purposes of reselling it at an inflated price.  

      Speculators are buying things that only exist in cyberspace, never taking delivery and driving up the price of oil.    Oil-scalping Thugs.

      "We are what we repeatedly do. Excellence, then, is not an act, but a habit." -Aristotle

      by Aidos on Sun Jul 06, 2008 at 07:20:38 AM PDT

      [ Parent ]

    •  The government may ...... (1+ / 0-)
      Recommended by:
      Silence is Complicity

      then also have to regulate usage as a paradigm .

  •  Through " Collective Bargaining " ..... (1+ / 0-)
    Recommended by:
    DemFromCT

    Which is not an evil thing , employer paid health insurance has been the foundation and cornerstone of any success in health care in the U.S. Contrary to Republican propaganda this has been achieved over the years through "good faith" bargaining in lieu of wages in part . John McCain's plan opens the door for shifting insurance entirely to the consumer insurance making it easier for employers to shed this benefit to their employees . In the onset of such an variable implementation will be disastrous to many lower income working families . In my opinion employer paid health coverage should stand as the cost of doing business , and the right to bargain collectively should not be taken away , especially when companies can still operate with a profit margin .

    •  pfffft (0+ / 0-)

      By any measure, the American labor movement has been an utter abject failure, largely because it long ago forgot what it was supposed to be about, and has now climbed in bed with the employers to protect "American jobs" and American profits. They forgot the basic lesson that the IWW told us over 100 years ago:  "The working class and the employing class have nothing in common." "An injury to one is an injury to all".  "One big union of all the workers".

      Real wages have been in decline for decades.  The percentage of unionized workers in the US is less than 15%.  Work hours have not gone down since the 1920's.  Workplace safety has been gutted.  In all the areas that the AFL-CIO claimed as its priorities -- better pay, shorter hours, better conditions -- they have failed utterly.

      If we depend on "collective bargaining" to gain health care for Americans, we have no hope at all.

      Editor, Red and Black Publishers http://www.RedandBlackPublishers.com

      by Lenny Flank on Sun Jul 06, 2008 at 08:17:38 AM PDT

      [ Parent ]

    •  Just keep in mind, (0+ / 0-)

      especially when companies can still operate with a profit margin .

      no profit margin, no company, nobody has a job in the first place.    

      Everything comes from somewhere.

      I am an angry clown. Often pwnt, never owned. The world is a gradeschool playground with no teachers in sight.

      by obnoxiotheclown on Sun Jul 06, 2008 at 01:56:02 PM PDT

      [ Parent ]

      •  if I had a dime (0+ / 0-)

        for every time the business corporados cried that they were going broke, I'd be able to retire in the Bahamas by now.  Outlawing child labor would drive them out of business.  Raising the minimum wage would drive them out of business.  Environmental protection would drive them out of business.  Workplace safety regulations would drive them out of business.

        If I took the corporado's word at how broke they all are, I'd wonder how any business manages to stay in business, and why they didn't all shut down decades ago.  

        Quite apart from wondering how they pay for their big mansions and nice cars.

        Editor, Red and Black Publishers http://www.RedandBlackPublishers.com

        by Lenny Flank on Sun Jul 06, 2008 at 04:53:08 PM PDT

        [ Parent ]

        •  The majority of businesses fail (0+ / 0-)

          Even parts of cities can fail as in Detriot, Cleveland, and St. Louis.

          In the 19th Century the most beautiful street in America was considered Cleveland's Euclid Avenue.

          Its value was greater than Manhattan's Fifth Avenue.

          Only a few structures from that era remain.

          I read Detroit's Woodward Avenue has five mansions left. Detroit was once considered and was a beautiful city.

          Central St. Louis was solidly built with many mansions. They're almost all gone.

  •  6 (1+ / 0-)
    Recommended by:
    DemFromCT

    Pandemics and Biosecurity. Some estimates suggest that if H5N1 Avian Flu becomes a pandemic it could kill more than 300 million people. In an era of constant and rapid international travel, what steps should the United States take to protect our population from global pandemics or deliberate biological attacks?

    For those of us that keep up with the public health/security issues that are interwoven there can be no dispute that with regard to question 6 a failure by our society to adequately address these issues will cause us severe harm with the onset of the next bio-security emergency.

    •  hurricanes and pandemics are real (1+ / 0-)
      Recommended by:
      paul94611

      no one pays attention until they hit, but that does not make them any less devastating.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Jul 06, 2008 at 07:51:31 AM PDT

      [ Parent ]

  •  One Thing Wrong With This Diary (1+ / 0-)
    Recommended by:
    nicolemm

    This diary is very important, but it's missing one important dimension:  

    Other countries have done much more to solve these problems than we have. There's no need to reinvent the wheel. Our politicians may consider it taboo to raise the healthcare systems of other industrialized nations, but any serious discussion of a crisis with global dimensions must consider other, more successful solutions that other countries have adopted.

    This nicely summarizes what's wrong with American political life today. (Source)

    by GreenSooner on Sun Jul 06, 2008 at 07:52:16 AM PDT

  •  controling drug costs (0+ / 0-)

    i'm not sure what to suggest, but this is obviously a key issue.
    in order to have an informed populace people should at least know about drug innovation prizes. For example, Senator Sanders offered a bill last year about this.
    Right now, I'm reading an interesting book and here's a review of "Reasonable Rx: Solving the Drug Price Crisis".

    Personally, I think government plans should negotiate with companies for better prices. I am opposed to parallel importation from Canada (or another country) because I support the idea of tiered pricing of medicines, where the price of a drug in a country depends on people's ability to pay. I'd also like to see the government own some drug manufacturing plants in order to be able to reverse-engineer medicines so that we can prove how much it costs to make them b/c IMO this is an important piece of info in negotiations and the threat of compulsory licenses (to our drug plants or a third party) would provide a certain amount of leverage.

    •  Medicines are grossly overpriced (2+ / 0-)
      Recommended by:
      rickeagle, distraught

      and the drug companies are scalping us.  I have friends who pay over $1,000 per bottle of necessary medicine they must take.  The price is less than half in Canada and even less than that in Europe.  Guess what?  All of the medicine in Canada is manufactured here and shipped there, voluntarily, by the Drug Company....and they still make an overwhelming profit.  Much of the same medicine is shipped to Europe.

      The drug prices in this country are a scandal.  Something needs to change.

    •  The word "negotiation" stems from (0+ / 0-)

      a Latin word meaning deny.

      To deny a drug to a needy child would be immoral.

      Drug prices need to be set by law.

    •  Many Americans have (0+ / 0-)

      incomes below the Mexican average.

      Our incomes increasing depend on our line of work, not our national residence.

      Also if somebody makes $1,000 a month and has fixed costs of $800, then his true income is $200 a month. That's a Third World net income.

    •  Canada is a country of similar income (0+ / 0-)

      I am opposed to parallel importation from Canada (or another country) because I support the idea of tiered pricing of medicines

    •  Patents must describe (0+ / 0-)

      how the product is made so that a skilled person in the art can make it.

      No reverse-engineering should be necessary.

    •  One can simply (0+ / 0-)

      base maximum pricing on manufacturing process [recombinant] or structure of the nearest generic [chemical] and use a multiple of say three for patented drugs.

      Another way is to demand a rebate if sales on a per capita basis exceed those of Western Europe.

    •  TRIPS Article 31 (0+ / 0-)

      Other Use Without Authorization of the Right Holder

         Where the law of a Member allows for other use (7) of the subject matter of a patent without the authorization of the right holder, including use by the government or third parties authorized by the government, the following provisions shall be respected:

         (a) authorization of such use shall be considered on its individual merits;

         (b) such use may only be permitted if, prior to such use, the proposed user has made efforts to obtain authorization from the right holder on reasonable commercial terms and conditions and that such efforts have not been successful within a reasonable period of time. This requirement may be waived by a Member in the case of a national emergency or other circumstances of extreme urgency or in cases of public non-commercial use. In situations of national emergency or other circumstances of extreme urgency, the right holder shall, nevertheless, be notified as soon as reasonably practicable. In the case of public non-commercial use, where the government or contractor, without making a patent search, knows or has demonstrable grounds to know that a valid patent is or will be used by or for the government, the right holder shall be informed promptly;

         (c) the scope and duration of such use shall be limited to the purpose for which it was authorized, and in the case of semi-conductor technology shall only be for public non-commercial use or to remedy a practice determined after judicial or administrative process to be anti-competitive;

         (d) such use shall be non-exclusive;

         (e) such use shall be non-assignable, except with that part of the enterprise or goodwill which enjoys such use;

         (f) any such use shall be authorized predominantly for the supply of the domestic market of the Member authorizing such use;

         (g) authorization for such use shall be liable, subject to adequate protection of the legitimate interests of the persons so authorized, to be terminated if and when the circumstances which led to it cease to exist and are unlikely to recur. The competent authority shall have the authority to review, upon motivated request, the continued existence of these circumstances;

         (h) the right holder shall be paid adequate remuneration in the circumstances of each case, taking into account the economic value of the authorization;

      http://www.wto.org/...

      The US government has the power under TRIPS to allow charities to make drugs or medical devices under compulsory license.

      Sick people could collectively form a charity, a public non-commercial use, and ask for a license.

      The license would either be given or refused.

      Manufacturing could then begin unless the drug company simply agreed to sell at such a low price that independent manufacturing would be pointless.

      Non-profit hospitals could also form such a charity to provide for people that can't pay full price.

      royalty rates:
      http://www.who.int/...

  •  What - You mean it is not (0+ / 0-)

    A simple problem with a simple solution?  How dare you!!
    < snark >

  •  related : Spherion screws someone (1+ / 0-)
    Recommended by:
    barbwires

    Too short for a diary unforunately . . .. :

    "Dying of cancer, Thomas Amschwand did everything he was told to make sure his wife would collect on the life insurance policy he had through his employer."

    "Spherion Corp. [.......] told Amschwand-Bellinger she would not receive any of the $426,000 in benefits she believed she was due."

    http://biz.yahoo.com/...

    "Amschwand asked repeatedly whether there was anything else he needed to do and was told no. He asked that the new policy be sent to him. Spherion never did so."

    There should be an outcry about this. Seems it's not that unusual.

    I'm feeling more nervous about my benefits now.

  •  Enough of "The Children" (1+ / 0-)
    Recommended by:
    barbwires

    And those kinds of approaches will recognize that cost is a factor in the direction health reform goes, and will need to account for it, even as universal care remains the goal. Start with children if you want consensus

    I am a fifty-two year old cancer survivor; and I have been waiting a full generation for health care reform while feckless idiots have been proposing "incremental steps" and programs "for the children."

    At the rate this is going, I will be dead and gone long before any reform materializes  - assuming that it ever does.

    So read my lips.  I will actively oppose any "health care reform" measure that fails to include me - yes, me - up front, in full, and right now.

    Duncan Kinder http://www.billingsgatereport.net/

    by Duncan Kinder on Sun Jul 06, 2008 at 10:06:21 AM PDT

    •  so far the public disagrees with you (0+ / 0-)

      something like 65-35, but that's cool because that doesn't make you wrong - it odes make you outvoted, but don't shoot the messenger.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Jul 06, 2008 at 10:20:07 AM PDT

      [ Parent ]

  •  FORMATTING NOTE??? (0+ / 0-)

    For whatever reason, you are the only front-pager whose graphics obscures text when the post is on the front page for me. The graphics work fine if I open the diary.  Have no idea why ...

  •  I wonder.... (0+ / 0-)

    If the questions asked about health care were directed like this.....

    Would you like to see health care costs reduced for other Americans?

    Would you like to see health care available for other Americans?

    etc..

    what would the outcomes be as the questions are now directed outward rather than personal.

    You can support the troops at Votevets.org

    by rickeagle on Sun Jul 06, 2008 at 11:28:00 AM PDT

  •  I'd like to see another poll on (1+ / 0-)
    Recommended by:
    barbwires

    people's satisfaction with their health coverage or at least a breakdown of have they had a major, minor, or no illness in the last year they had coverage with their carrier.  It's difficult to gauge how responsive your insurance coverage is until you actually get sick and I'm afraid the vast majority of respondents have probably not had to deal with their carriers for any more than routine office visits and may be living in a Pollyanna world until they are struck with a serious minor or major illness.

    I have a major illness and I am happy with how my insurance has responded, but I know there are way too many insurance companies out there where this would not be the case.

    Also on the question of fear of losing coverage (which I worry about a bit every day) again if they have had a major illness or a serious minor illness as if they lose coverage it may be extremely difficult to get covered again.

    "...what Washington means by bipartisanship is mainly that everyone should come together to give conservatives what they want." --- Paul Krugman

    by puppet10 on Sun Jul 06, 2008 at 11:50:29 AM PDT

    •  latest poll (0+ / 0-)

      Kaiser Health Tracking Poll: Election 2008 [June, 2008]

      For each specific item I name, please tell me whether you are very satisfied with it, somewhat satisfied, somewhat dissatisfied, or very dissatisfied....The quality of the health care you receive    

      Very satisfied 51
      Somewhat satisfied 34
      Somewhat dissatisfied 7
      Very dissatisfied 7
      Don't know/Refused 1

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Jul 06, 2008 at 12:29:49 PM PDT

      [ Parent ]

      •  Are these for people who have actually (0+ / 0-)

        had to use their policies for a serious illness (heart attack, cancer, serious accident breaking numerous bones and damaging internal organs, dialysis, cirrhosis, etc)?  or are they people who mostly are getting routine care (office visits with primary care doctor for physical/cold-flu/maintenance medications (antacids, high blood pressure meds, statins)?

        People who have not pushed their insurer to pay up may not realize if their coverage is good or totally sucks.

        Obviously people with major health issues even serious less major ones (broken bone in an extremity, ulcer, difficult infection) would be a much smaller population than the general population so it would be much more difficult to conduct and would have to rely on people to decide if they've had a serious need of their health care - perhaps screen on have you had an illness in the last year that the total cost of treatment exceeded $15000 (or some other number).

        People for which it was a serious problem to pay for heath care and health insurance fit into the somewhat satisfied to very dissatisfied range easily.  

        Personally I give my insurer a very satisfied - but I know I have a quite good plan with certain limitations which have not applied to my care so far and don't appear that they will.

        I don't see that the poll screens along the lines I'm suggesting (I tried looking through the questions to see if it screened on health condition somewhere and then I would have to figure out how to get the results from just the people who answered that question in a certain way and look at their other answers using that as a screening question) - but perhaps it does somewhere I'm not at my peak cognitive ability at the moment so I'll totally admit I may totally be missing it.

        "...what Washington means by bipartisanship is mainly that everyone should come together to give conservatives what they want." --- Paul Krugman

        by puppet10 on Sun Jul 06, 2008 at 03:21:57 PM PDT

        [ Parent ]

        •  see question below (0+ / 0-)

          but the poll did not ask or separate the groups.

          http://www.dailykos.com/...

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by Greg Dworkin on Sun Jul 06, 2008 at 03:40:06 PM PDT

          [ Parent ]

          •  That's why my original post suggested that I (0+ / 0-)

            would like to see that separation of groups.

            I guess I just can't follow your responses to the original post which was all about how I'd like to see a poll with a breakdown of people who have had to use their insurance for a serious medical issue.

            The reason I'd like to see this poll (which probably won't happen just idle spouting of unreasonable wishes to see polls that haven't been done)  because I'm afraid many people who have not had to use their insurance for a major issue may be more satisfied with their coverage than they should be - or more satisfied than they will be if they are struck with a major medical problem requiring the significant use of their insurance.

            I'd like to see that poll to see if people don't really know if their insurance is adequate until they need it most.  

            The thesis being that people are satisfied overall at having insurance and haven't worried about the coverage quality sufficiently until they need it and find the coverage is wholly inadequate for their needs and become dissatisfied or very dissatisfied with their coverage at that point - when its too late to do much to fix it.

            If this were the case then I would expect to see the group of people who have had major medical issues to be much less satisfied with their coverage having seen it in action than people who have not had to use their coverage to any great extent.  

            On the other hand if the opposite were true that people with major medical issues were more satisfied overall or as satisfied than those without major issues would indicate that the coverage people are buying is meeting their needs when the 'shit hits the fan' and they need to use their coverage extensively.

            "...what Washington means by bipartisanship is mainly that everyone should come together to give conservatives what they want." --- Paul Krugman

            by puppet10 on Sun Jul 06, 2008 at 06:50:52 PM PDT

            [ Parent ]

            •  I appreciate your question (0+ / 0-)

              I'm just posting the data that we have, even though it's not the data we wish we had.

              "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

              by Greg Dworkin on Sun Jul 06, 2008 at 07:11:57 PM PDT

              [ Parent ]

    •  more.. (0+ / 0-)

      As a result of recent changes in the economy, have you or your family experienced any of the following problems, or not?...Problems paying for health care and health insurance...(If Yes, ask:) Was this a serious problem, or not?

      Subpopulation/Note: * = less than .5%.

      25%  Yes, serious problem
      12   Yes, not a serious problem
      63   Not a problem *    Don't know/Refused

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Jul 06, 2008 at 12:30:52 PM PDT

      [ Parent ]

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