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I just listened to this week's Bill Moyers. It was on health care, and it was excellent. The gist of the show was that the Obama health plan is too vague at present but the basic elements that are apparent are that individuals would be required to purchase health coverage if they don't already have it, the coverage would be subsidized, and they will buy either private insurance or (we hope) go for a public option.

The women who were interviewed on the show felt that this was keeping a bad system in place and just adding money to it. They noted how Obama said that the costliest option is the current system, and said that that's not true. It will be MORE costly if we keep the current system and then throw more money on it. They also feared that the drug companies would take the healthiest patients for themselves and dump the sick onto the government's public plan.

If that's the case, that's bull shit. I want Medicare.

To all of the people who talk about rationing care, it's rationed now. It's rationed, and I don't get any. I'm fortunate, for the moment. I had health insurance until recently, so now all I need are occasional prescription refills. I pay out of pocket and it costs about the same I might pay in insurance premiums if I had insurance (drugs are $150/mo, assuming I fill the bare minimum of my prescriptions, and I got free birth control from Planned Parenthood... if I had to pay it would be $60/mo).

I'm not alone. Lots of us don't get any care. If you have a certain type of job, you get care. Many have high deductible plans, which are virtually worthless unless you have a medical catastrophe and accrue costs so high that the insurance kicks in after you pay the deductible. That's rationed care too.

I've seen a lot, during the time when I worked in health care, and when I had health insurance myself. One patient was on a successful cholesterol drug and then her insurer changed the formulary and it was no longer covered. The drug would now cost an extra $100/mo, which the patient could not afford. She worked with her doctor to try other cholesterol meds, with little luck.

She accrued lots of costs as she visited her doctor more frequently and got frequent blood tests to check if any of the new meds were working. None of them did. When I spoke with the doctor, he was about at wits end over this. It looked like his patient was going to have to go back to the original drug that worked - and she'd have to pay.

Then there's the time that I needed to go to a hospital in Michigan for a nationally recognized migraine program. It was a unique program, in that they give patients interdisciplinary care - IV meds, education, mental health care, perhaps biofeedback, etc - to help them find a way to reduce their headaches so they can live with them. My insurance said no.

My neurologist called the insurance. The insurance said I could go to the hospital locally. No, I couldn't, said my doctor. The local hospital doesn't admit you for headaches unless it's an acute case. You can be admitted if you have a bad headache, and as soon as you're down to a 4 out of 10 on the pain scale, they send you home. They don't help you manage your headaches long term. Too bad, said the insurance, still insisting I could go to the hospital locally.

Medicare doesn't pull that kind of bullshit. So why would we set up a new program that does? The idea that any single payer or government run system would ration care is totally bogus.

How about choosing your doctor? Right now I can't choose my doctor.
Well, right now I can actually. They are all equally expensive because I'm uninsured. But when I had insurance, I couldn't choose my doctor at all. On my last insurance, a PPO, I couldn't find anyone who I was covered for.

They had an 800 number you could call and a website you could search to look for doctors. I tried using it and couldn't find just a regular, local, primary care doctor. Nor could I find a psychologist to see after my brother died. I found psychiatrists and social workers on the list, but not one psychologist.

Before that, I had an HMO. I picked an HMO that my doctor accepts, so in that case I was OK. For primary care, that is. But how about for my neurologist? I was referred (in network) to a neurologist, but I was unhappy with her. She was the only headache specialist in the network but she was not good, for reasons I don't need to elaborate on here.

Then I got another referral, in-network, to a general neurologist who wasn't a headache specialist but still saw headache patients. He was a jerk. He never even read my chart, barely paid attention to me, and then overbilled me. I paid my $20 copay and never complained about the bill because the insurance was going to charge me $20 as a copay no matter what the total bill was. But I didn't go see that doctor again.

Surely there must be a good headache specialist somewhere around here, but if one exists, they weren't "in network" and I never saw them. After those two visits to the two bad neurologists, I gave up and stopped looking. I'm done taking shots in the dark to find doctors based on who is in network. I found my psychologist (out of network) from a friend's recommendation and she's great. I'd prefer to do that for a neurologist - if and when I can afford it. If I had Medicare, pretty much all of the doctors would be "in network" because the entire freaking United States IS the network.

All of the other lies they tell about "government run" health care are equally flimsy. Ask anyone with Medicare if they hate it. Ask them if it's like getting their health care from the DMV. Ask them if they want Congress to repeal Medicare and make them buy insurance from a private insurer so they don't have to deal with having "government run" health care.

What about having your health care run by bureaucrats?
Guess what? You already do. IF you have health insurance, that is. Take that dipshit who didn't want me to go to the hospital even though my doctor argued with him on the phone for half an hour that it was medically necessary. He worked for a private insurance company, not the government, but he was a bureaucrat nonetheless.

Yes, there is some degree of bureaucracy in Medicare too. But nothing like the amount in the private insurance industry. After all, Medicare's primary goal is to provide care; private insurance's goal is to deny it. It seems to me that given a suffocatingly expensive private system that already puts a bureaucrat in between me and my doctor, and a government system, I'll take the government system.

Repealing Medicare would be a political non-starter, and for a good reason. People like it. It works. So if it works - why is anyone believing this nonsense that so-called "government run" health care is no good??? And why are any legislators scared to stick their neck out for a good single payor or public system, knowing now what a success Medicare is?

After listening to Bill Moyers, I'm pretty upset. I like the idea of the government spending whatever money is needed to insure all of us. That's good. But requiring us to all have insurance, and requiring us all to buy it? No thanks. It makes sense that you're required to have car insurance. If you can't afford it, don't buy a car. But you don't get a choice about health care. We can't say "don't have a body" if you can't afford health insurance. That's not an option.

As for the quality of the public option, it sounded from Moyers like the health insurance industry was out to make it as shitty as possible. They like the mandate for everyone to buy insurance because it broadens their customer base. They can take the patients they want and dump the ones they don't want on the government. That doesn't sound like a solution to me.

I'm all for reforming health care and doing it now. I think the speed Obama's been calling for is a good thing. Get it done, and then move on to debate other things, because quite frankly, health care is sucking all of the oxygen out of the room and while it may be the biggest problem it's not the only one. But if we're going to reform it, let's REALLY reform it.

We know Medicare works. So why can't we give everyone Medicare? I don't even mind if it's an option to buy into Medicare or have your employer buy into it for you in lieu of a private plan they supply now. It's a good system, it's in place, it's popular, and it works. So let's extend it to everyone.

Originally posted to Jill Richardson on Sun Jul 26, 2009 at 06:11 AM PDT.

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  •  Tip Jar (225+ / 0-)
    Recommended by:
    selise, paradox, Angie in WA State, vicki, tmo, tgs1952, eugene, ferg, ogre, SarahLee, irmaly, Geenius at Wrok, abarefootboy, Raybin, tiggers thotful spot, ScientistMom in NY, RunawayRose, rincewind, formernadervoter, Thomas C, Earwicker23, celdd, eeff, Mnemosyne, RFK Lives, object16, MarkInSanFran, givmeliberty, jancw, Doctor Who, opinionated, concernedamerican, 88kathy, CoolOnion, boilerman10, slatsg, Larry Bailey, itskevin, ctsteve, Cedwyn, antirove, sidnora, Eddie C, wader, SneakySnu, emmasnacker, Miss Jones, Sychotic1, lcrp, riverlover, forrest, dkmich, Donna in Rome, ralphbon, eco, Wife of Bath, The Gryffin, snowbird42, tea in the harbor, Julie Gulden, rapala, madaprn, Fabian, maybeeso in michigan, liberal atheist, el dorado gal, SherwoodB, Halcyon, Technowitch, Omir the Storyteller, panicbean, Simplify, drewfromct, Brooke In Seattle, farmerchuck, FrostyKotex, blue jersey mom, Sandino, alisonc, wiscmass, sodalis, the fan man, Spathiphyllum, CJnyc, debedb, Mother Mags, gwilson, BachFan, vigilant meerkat, sherlyle, cookseytalbott, koNko, ccmask, deha, cliffradz, kck, triv33, tecampbell, 4Freedom, FireCrow, myrealname, Unitary Moonbat, Andy30tx, doinaheckuvanutjob, SingerInTheChoir, CA Nana, profh, Lovo, kurt, airmarc, crystal eyes, Aaa T Tudeattack, NonnyO, Mishima, One Pissed Off Liberal, john07801, marykk, mochajava13, lobo charlie, possum, moosely2006, Wino, Jimdotz, LamontCranston, joyful, newpioneer, bnasley, Kentucky Kid, HCKAD, jgtidd, Moderation, gchaucer2, uciguy30, jgilhousen, Patricia Bruner, mconvente, flowerfarmer, TheFatLadySings, zerone, Involuntary Exile, elwior, minerva1157, beltane, happymisanthropy, pickandshovel, ShempLugosi, mofembot, Bluewoman, echatwa, BYw, allie123, dont think, Guadalupe59, wv voice of reason, maggiejean, cameoanne, Neon Vincent, ARS, BoiseBlue, banjolele, Stranded Wind, Pale Jenova, earicicle, delillo2000, Texas Revolutionary, allep10, kevinpdx, karma13612, Tommymac, Lazar, sulthernao, ppl can fly, political junquie, p gorden lippy, foolknot, LaughingPlanet, The Jester, UTvoter, Interceptor7, RJP9999, polar bear, Earth Ling, pateTX, debbieleft, addisnana, MsGrin, USHomeopath, TigerStar337, cany, DudleyMason, jeanma, theKgirls, brightwhitelight, penny8611, StateofEuphoria, msmacgyver, Cintimcmomma, We Want Change, sharistuff, BlueHead, Leftyy2k4, smallgal, not ready to make nice, theone718, eppa, tardis10, emf, Sark Svemes, borregopass, spider webs unite, lizzie blue, Cook for Good, wide eyed lib, KClandia, JayinPortland, Niphead, Vexed, Willa Rogers, RLMiller, StepLeftStepForward, Proleft, jaebone, Remarque, PrometheusUnbound, im hip

    I wrote a book! You should buy it!

    by Jill Richardson on Sun Jul 26, 2009 at 06:11:00 AM PDT

    •  employer already pays into your future medicare (6+ / 0-)

      they match it, just like the social security.

    •  I want to disagree in part.... The Netherlands (7+ / 0-)

      The Best healthcare in the world is insurance based.... It is regulated to all get-out but it is insurance based..... The funding side is the issue....Still the dutch model is new 06. It moved from a system in many ways like ours... It is rated the best in the world and EU....

      I am not against single payer but the end result is more important than the process or name...Still if we went with the dutch system we would eliminate medicare and medicaid.... Our budget would be transparent etc.... So we can get to the same place in other ways.... Just keep an open mind until the end....

      Not counting that Medicaid and Medicare have there own problems... Rates have not be changed since 89.... this is one reason that doctors are on board with reform.... 60 million boomers in the pipe and no adjustments for inflation and cost of living etc...
      The Netherlands has a dual-level system. All primary and curative care (i.e. the family doctor service and hospitals and clinics) is financed from private compulsory insurance. Long term care for the elderly, the dying, the long term mentally ill etc. is covered by social insurance funded from taxation. According to the WHO, the health care system in the Netherlands was 62% government funded and 38% privately funded as of 2004.[6]

      Insurance companies must offer a core universal insurance package for the universal primary, curative care which includes the cost of all prescription medicines. They must do this at a fixed price for all. The same premium is paid whether young or old, healthy or sick. It is illegal in The Netherlands for insurers to refuse an application for health insurance, to impose special conditions (e.g. exclusions, deductables, co-pays etc or refuse to fund treatments which a doctor has determined to be medically necessary). The system is 50% financed from payroll taxes paid by employers to a fund controlled by the Health regulator. The government contributes an additional 5% to the regulator's fund. The remaining 45% is collected as premiums paid by the insured directly to the insurance company. Some employers negotiate bulk deals with health insurers and some even pay the employees' premiums as an employment benefit).

      All insurance companies receive additional funding from the regulator's fund. The regulator has sight of the claims made by policyholders and therefore can redistribute the funds its holds on the basis of relative claims made by policy holders. Thus insurers with high payouts will receive more from the regulator than those with low payouts. Thus insurance companies have no incentive to deter high cost individuals from taking insurance and are compensated if they have to pay out more than might be expected. Insurance companies compete with each other on price for the 45% direct premium part of the funding and try to negotiate deals with hospitals to keep costs low and quality high.

      The competition regulator is charged with checking for abuse of dominant market positions and the creation of cartels that act against the consumer interests. An insurance regulator ensures that all basic policies have identical coverage rules so that no person is medicially disadvantaged by his or her choice of insurer.

      Hospitals in the Netherlands are also regulated and inspected but are mostly privately run and for profit, as are many of the insurance companies. Patients can choose where they want to be treated and have access to information on the internet about the performance and wait times at each hospital. Patients dissatisfied with their insurer and choice of hospital can cancel at any time but must make a new agreement with another insurer.

      Insurance companies can offer additional services at extra cost over and above the universal system laid down by the regulator, e.g. for dental care. The standard monthly premium for health care paid by individual adults is about €100 per month. Persons on low incomes can get assistance from the government if they cannot afford these payments. Children under 18 are insured by the system at no additional cost to them or their families because the insurance company receives the cost of this from the regulator's fund.

      •  Getting insurance companies (12+ / 0-)

        accustomed to basically running amok to accept the necessary level of regulation would be politically impossible. These guys own Congress. We'll be fortunate to get a functioning public option that isn't full of poison pills, IMHO.

        "All that serves labor serves the nation. All that harms labor is treason. -Abraham Lincoln

        by happy camper on Sun Jul 26, 2009 at 09:18:27 AM PDT

        [ Parent ]

        •  That might be true but my whole point is that (1+ / 0-)
          Recommended by:

          single payer is not better and we are much more likley to get a hybrid like the french or the dutch... WHO rates france #1 The dutch are rated #1 by healthpower house... which in part is based on how good the system treats the end user... I rates all EU plans and it rates the french 10th and the WTO rates the dutch 17th... Now one rates overall health the other on how the end users fare and cost...

          The big problem is finacing the system correctly and regulating care to control costs... Insurance will have to cover everyone like the dutch model. At that point we have little information to proceed... The dutch cover all old and young in one system of private insurance that has a regulator that issues money and looks at hard numbers of claims... If an insurer has alot of claims they get more money.. giving them little reason to thin their rolls etc...

          •  I understand what you are saying (5+ / 0-)

            and agree with your logic.  My fear is that in the United States we will never have the political will or the governmental transparency to make sure that the overlapping systems of governmental regulation and anti-trust provisions in the Dutch system are maintained here.  The Dutch political system is not as vulnerable to the influence of political contributions; in the US the trend has been to consider campaign funding by special interests to be protected speech unless one can meet a ridiculously high bar of proof of a quid-pro-quo.  

            Also let's face it... the Dutch are better-educated and more rational than we are, less ideological, and less likely to be stampeded into stupidity by AM talk radio or disingenuous health industry ads.  Our political system is so unhealthy and mercurial that I question whether it might not be better to get some sort of clear fairly simple public option than to try and fine tune a huge insurance lobby that is expert at political manipulation.  I worry that unless we have a simpler public option that automatically forces private insurers to compete with Medicare, we will always have to be on guard from the right wing attempting to erode the system or game it for electoral advantage.  

            "The red is going out. It's getting more bluer."

            by ivorybill on Sun Jul 26, 2009 at 10:05:56 AM PDT

            [ Parent ]

          •  I disagree (4+ / 0-)

            I think single payer IS better. obama even admitted it. And I've lived in the UK (briefly) and experienced single payer. It was a dream come true.

            I wrote a book! You should buy it!

            by Jill Richardson on Sun Jul 26, 2009 at 12:10:38 PM PDT

            [ Parent ]

            •  From the Moyers Journal (4+ / 0-)

              Bill Moyers Journal

              MARCIA ANGELL: Well, that goes to the cause of the problem. We are the only advanced country in the world that has chosen to leave health care to the tender mercies of a panoply of for-profit businesses, whose purpose is to maximize income and not to provide health. And that's exactly what they do.

              BILL MOYERS: The President, as you were saying a moment ago, is saying to everybody who's not covered, we're going to mandate that you exercise that right. We're going to mandate that you buy some form--

              MARCIA ANGELL
              : We're going to deliver the private insurance companies a captive market. That's right. And they love that.

              BILL MOYERS: Say that again.

              MARCIA ANGELL: They love that.

              BILL MOYERS: The-- his policy does what? His program?

              MARCIA ANGELL
              : Delivers to the private insurance industry a captive market.

              BILL MOYERS: By the mandate.

              MARCIA ANGELL: By the mandate.

              BILL MOYERS: It says "Marcia Angell, you've got to--"

              MARCIA ANGELL: For whatever price they want to charge. Right. And so, this will increase costs. And let me tell you what he's running into, and he'd like to be able to pull a rabbit out of the hat, but he won't be able to. If you leave this profit-oriented system in place, you can't both control costs and increase coverage. You inevitably, if you try to increase coverage, increase costs. The only answer, the only answer, and he said it at the beginning of his press conference, is a single payer system. In his first sentence, he said, that is the only way to cover everyone.

              BILL MOYERS: But he's also said, if we were starting the system from scratch, we could have single payer. But we're not starting this system from scratch.

              MARCIA ANGELL: You know, you don't pour more money into a failing system. You convert.

              Insurance, Oil, Banking, and Defense corporations all have a substantial equity positions in what's supposed to be our Congress.

              by Lefty Coaster on Sun Jul 26, 2009 at 01:40:09 PM PDT

              [ Parent ]

      •  some details (sorry about the formatting - PDF) (1+ / 0-)
        Recommended by:

        An insured person is entitled to care under the following

        The care insurer provides insured care needed by the
        insured person through its own care providers or through
        care providers that it has contracted. The care provider
        receives payment directly from the care insurer. This is
        called the in-kind model. An insured person is free to
        choose from any of the insurer’s own or contracted
        doctors or hospitals. If a person wishes to receive care
        from a different, uncontracted care provider despite
        his/her decision to take a policy with contracted care, the
        care insurer will decide the level of cost reimbursement
        that it will award. This allows the care insurer to oncharge
        the costs it has incurred by contracting care to
        insured persons who choose an uncontracted care
        provider. However, the insurer is not allowed to set the
        reimbursement so low that it would in effect make it
        impossible to obtain uncontracted care.

        Under the reimbursement model, a person receives care
        from a care provider with whom the care insurer has no
        contractual relationship. The insured person pays for the
        provided care and receives reimbursement of the costs
        from the care insurer. The care insurer is not allowed to
        set a maximum for the reimbursement, but has no
        obligation to reimburse a person more than is reasonable
        by prevailing market standards in Netherlands.

        Paramedical care includes physiotherapy, remedial therapy,
        speech therapy, occupational therapy and dietary advice. The
        entitlements of insured persons aged 18 and older to
        physiotherapy and remedial therapy are confined to
        treatment of chronic disorders. The entitlements exclude the
        first nine treatments for each disorder. Insured persons
        younger than 18 are entitled to nine treatments per year for
        each disorder. This entitlement may sometimes be increased
        by another nine treatments.
        Speech therapy must be provided for medical purpose with
        the likelihood of recovery or improvement of the speech
        function or speech capability. Occupational therapy must be
        provided with the aim of promoting and restoring the selfcare
        and self-help of the insured person and is confined to a
        maximum of ten treatment hours per year. For dietary advice
        there is an entitlement to reimbursement of up to four hours
        of treatment per year. The advice must be provided by

        The medicines covered by the
        insurance are divided in principle into groups of medicines
        that are therapeutically interchangeable. The maximum
        reimbursement for such a group is set on the basis of the
        average price of the medicines in the group. An insured
        person who chooses a medicine that is more expensive must
        pay the difference. There is no reimbursement limit for a
        medicine that is included in the cover but is not substitutable
        by other medicines. This system is called the "Medicines
        reimbursement system". With a view to the orchestration role
        that care insurers play, they are allowed to limit the
        reimbursable medicines to those they designate in each
        group. The definition of the care explicitly states that care
        insurers will designate medicines (subject to conditions). This
        was done to give extra emphasis to the role of care insurers.

        All insured persons aged 18 and older who have taken out health insurance pay their insurer a nominal premium. The premium is unrelated to the person’s income.

        Entitlement to the health care allowance depends on a
        person’s income. The allowance exists to help a person pay
        the costs of the nominal premium. The health care
        allowance is not determined through reference to the
        nominal premium a person actually pays, but by taking the
        average of premiums offered by insurers under care
        policies. This approach was adopted to promote competition
        between care insurers and to ensure that members of the public consider the size of the nominal premium when
        choosing an insurer.

        The right to a health care allowance is forfeited if
        a person’s partner has failed to meet the insurance

        Ex-ante risk equalisation
        Every care insurer that offers insurance in the Netherlands
        that satisfies the requirements of the Health Insurance Act
        receives a standard amount each year. The amount reflects
        the health risks of insured persons in its client base. This
        allowance is set at a level such that the sum of the
        allowance and the realistic estimate of the insurer’s nominal
        premium income is equal to the forecast cost of the care
        ("normative allowance").

        Ex-post aspects of risk equalisation
        The contributions received by care insurers must be
        corrected retrospectively for the differences between
        estimated and actual numbers of insured persons.

      •  Dutch-style deductions (1+ / 0-)
        Recommended by:

        A "threshold income" has been built into the health care allowance system to apply the principle that everybody should personally pay some of the costs of care. The threshold income has been defined in the Health Care Allowance Act. It is a mechanism for ensuring that nobody gets back all or nearly all of the costs of their health insurance premiums. The level of the threshold income has been set at a percentage of the statutory minimum wage for
        people aged 23. This amount is reduced by the employee’s contributions under the Unemployment Benefits Act and Sickness Benefits Act and increased by the allowance payable by an employer towards the income-related contributions owed by an employee who is legally bound to take out health insurance.

      •  If I'm not mistaken, (0+ / 0-)

        I think the most private or American-like system in Europe is Switzerland's, where everyone relies on regulated HMOs.

        I wanna quote another British poet.

        by Lazar on Sun Jul 26, 2009 at 11:57:14 AM PDT

        [ Parent ]

        •  All insurance companies and hospitals (1+ / 0-)
          Recommended by:

          in Switzerland that are accepted into the country's health system are non-profit, and the regulations and enforcement are more severe than anything our congress would ever enact.

          "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

          by SueDe on Sun Jul 26, 2009 at 03:10:19 PM PDT

          [ Parent ]

      •  doesn't the Netherlands (1+ / 0-)
        Recommended by:
        Brooke In Seattle

        regulate the amount of profits the insurance companies can make and set other rules to make sure their people won't get screwed? Cuz I won't be so opposed to privately insured health care so long as the rules are in place to make sure we actually GET health care.

        I wrote a book! You should buy it!

        by Jill Richardson on Sun Jul 26, 2009 at 12:09:53 PM PDT

        [ Parent ]

    •  Medicare for all would be okay... IF... (3+ / 0-)
      Recommended by:
      Happygirl, jgtidd, Jill Richardson

      ... they get the damned private insurance companies and pharmaceutical companies out of it so they don't muck up the system.

      And it needs to be simplified, too.

      Part A is paid for when we're young and in the working world, and I think it's the one that covers clinic and lab work and office calls.  However, medical costs have gone up so much there are now co-pays.

      Part B premium (don't know if it's public or private) for hospital costs is deducted from Social Security checks that the elderly and disabled receive.  The costs have soared so monstrously that many have to have costs subsidized by either their state/county Medicaid programs... or, if their assets are too much, they have to sell them off and/or buy very expensive medical insurance (often $2-500/month), which most people can't afford on their own if Social Security is their only income.  Some states have a program where the patient picks up the first XXXXX dollars, and Medicaid picks up what Medicare does not.

      Part D is actually a forced private insurance and it is for prescriptions and was passed during Georgie's reign. I was watching C-SPAN when they were having the debate in the Senate.  Literally no one could understand what the bill said, it was that jumbled.  Not the pharmaceutical corporations who wrote the POS, nor the senators.  One exasperated senator (can no longer remember who) got up and said [paraphrasing] 'We have to pass something tonight so we can go on break.  Let's pass this, and we've got notes that certain parts need to be fixed, then fix them when we get back from break.'  I no longer remember if they actually fixed those troublesome things or not.

      All I know is that I was so pissed off about a forced insurance that I never bothered to sign up for anything... until a few years later after I ended up in ER and was sent by ambulance to a different hospital.  High blood pressure and a newly-diagnosed heart condition (which only needs monitoring as is; there's nothing to be done for it) and I've ended up with a whole bunch of prescriptions.  There were literally hundreds of prescription insurance plans to choose from, and certain income guidelines and other things left me qualified for quite a few, and I had to go to a senior center where a worker input the answers to my questions in her computer and it spit out which plans for various insurance corporations I qualified for.  I selected the one that covered the high blood pressure meds (and later the osteopenia med that was additionally prescribed after a bone density scan a few months later).  Things like the at-home blood pressure equipment I got I had to pay for myself.  For some of those meds there is a co-pay or I have to pay the cost out-of-pocket if there is no generic equivalent in stock, but mostly the insurance covers the meds 100%... which makes me lucky - for now.  Rules and regs changed at the last open enrollment (and I still have no idea what that's all about), and the insurance went up by $4.07 per month and now that cost has to be covered by me.

      So, while it's a bit better, even with Medicare the financial outlay by the patient can be astronomical without county/state Medicaid (five figures for a three-day hospital stay to monitor the b/p and run tests for the newly-diagnosed heart condition I didn't know I had, not to mention trying to get my b/p under control which didn't happen until pill dosages were adjusted several times over some six or more months).  Or, perhaps a supplemental insurance plan paid for by a spouse - a single person receiving Social Security can't afford the $2-500/month insurance premiums.

      The ONLY way the US will be able to have reasonable health care is if our Congress Critters have the courage to kick ALL insurance, medical, and pharmaceutical corporations OUT of the whole process and set caps on fees so that the corporations (if they choose to participate) cannot make a profit off of the medical misfortune of people.  In the socialized medicine countries it's usually written into their medical care laws that it is illegal for companies to make a profit off of the medical system.


      by NonnyO on Sun Jul 26, 2009 at 09:06:51 AM PDT

      [ Parent ]

    •  We should be able to Opt-In to Medicare. (4+ / 0-)

      As it is, exclusive of certain categories of people, it violates the equal protection clause of the Constitution.

      Never mind that every wage earner is already paying into a fund from which he/she gets no benefit.

      Actually, signing up for the program is optional.  Paying the tax isn't.

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

      by hannah on Sun Jul 26, 2009 at 01:12:35 PM PDT

      [ Parent ]

  •  I actually met a Republican who agrees (70+ / 0-)

    At a rally at John Cornyn's office, which was crashed by teabaggers, there was a man next to me who kept talking about how he didn't want "socialism," or for "the government" to run healthcare.

    Turns out, he was a typical Joe Republican enjoying the benefits of medicare and social security.

    When I explained to him that putting everybody on medicare would spread the risk pool out, including healthy people as well as older people who need more care, he grudgingly agreed that it would probably work.

    Watching Pete Sessions and reporting from the Taliban-controlled 32nd Congressional District of Texas.

    by CoolOnion on Sun Jul 26, 2009 at 06:19:18 AM PDT

    •  I really think that we need to frame this (53+ / 0-)

      as medicare for all. It would also stabilize medicare. Right now, medicare covers the oldest and sickest members of the population. Adding some 20 and 30-somethings would help to make the plan more cost-effective.

      The other point about medicare is that, compared to private insurance, it is much less hassle. Even if you have good private insurance, invariably you have to fight the companies to make them play the claims. I am tired of that.

      •  The"Yes Men" should go to these teabag rallies... (32+ / 0-)

        ...and propose that senior citizens burn their medicare cards.

        A lot of these protesters are free to be there because they're retired and on Medicare and Social Security.  But they take these benefits for granted, and don't seem to think of their benefits as "socialism."

        Watching Pete Sessions and reporting from the Taliban-controlled 32nd Congressional District of Texas.

        by CoolOnion on Sun Jul 26, 2009 at 06:47:44 AM PDT

        [ Parent ]

      •  Medicare for all is all we can afford.... (30+ / 0-)

        Thanks to the banks, two wars, and the offshoring of most of our jobs, everyone is broke including the government.   We can't afford profits or middlemen in our health care.

        The fact that Americans want it and can't get it, despite the fact that Democrats are in charge of the WH, Congress and Senate, really pisses me off.  Give Republicans 10 seats, and they can pass or not pass anything.  

        "YES WE CAN" doesn't mean he is going to. ~~Daily Show

        by dkmich on Sun Jul 26, 2009 at 06:55:41 AM PDT

        [ Parent ]

        •  Today's NYT addresses the "bipartisan" angle (15+ / 0-)

          It's largely drivel, but it does come up w/ this gem:

          "I wouldn’t even have hesitated two, four years ago when the numbers were so close: It would have been absolutely yes on bipartisanship," said Senator Evan Bayh, Democrat of Indiana.

          He said he still believed it was important, but added, "The Republicans are reduced to a core, so there aren’t that many pragmatists left to work things out."

          When Evan Bayh, the essence of DINOdom, is downplaying the prospects for bipartisanship, I'm not sure what else can be said on the subject.  The idea that the party of Rush, Dick, Newt, and Sarah will play nice w/ the Dems now is about as realisitic as the idea that SH had vast quantities of WMD's was back in 2003.

          Has any Gooper in either house repudiated Jim DeMint's comments?  Does anyone here doubt for a moment that his views are widely shared w/i his party?

          We have fundamental differences w/ the GOP on this critical issue.  We have the votes, and they don't.  What's the question here?

          Some men see things as they are and ask why. I see things that never were and ask why not?

          by RFK Lives on Sun Jul 26, 2009 at 07:25:15 AM PDT

          [ Parent ]

        •  No, we need AMERICARE (4+ / 0-)

          An improved version of medicare, with premiums, but you can opt out if your insurance company (or employer, etc) certifies that they provide a plan at least as good. Like the current medicare D.  So
          you can keep what you have if you like it. If not, you must
          enroll in Americare.  I don't have time to put up the link to Rep. Pete Stark's proposal, which is in congress, but it has been diaried here (once I think), and ignored everywhere else.  Why,
          because it will save money, and it will work for everyone except the people who are really running the country.

          •  Pete Stark's AmeriCare Health Care Act H.R. 193 (6+ / 0-)

            Benefits: Adults receive Medicare Part A and B benefits; preventive services, substance abuse treatment, mental health parity; and prescription drug coverage equivalent to the BC/BS Standard Option in 2008. Children receive comprehensive benefits and Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) coverage with no cost-sharing.  

            Cost Sharing: There is a $350 deductible for individuals/ $500 for families (indexed over time), and 20% coinsurance. Total spending (premiums, deductibles, and co-insurance) is capped at out-of-pocket maximum of $2,500 individual/$4,000 family (indexed over time), or 5 percent of income for beneficiaries with income between 200 percent-300 percent FPL and 7.5 percent of income for beneficiaries with income between 300 percent-500 percent FPL. There is no cost sharing for children, pregnant women and low-income individuals (below 200 percent FPL). Sliding scale subsidies are in place for cost-sharing for individuals between 200 percent and 300 percent FPL.


            •  I'd be on board with this (1+ / 0-)
              Recommended by:

              if there is an option for the government to subsidize the deductibles and copayments of the poor.

            •  No to co-insurance. (2+ / 0-)
              Recommended by:
              CoolOnion, Kitsap River

              Who can afford to pay 20% of a $10,000 fee?

              Certainly not me or anyone I know.

              It sounds very reasonable until you have some high-dollar in-office procedure at a specialist's office.

              There have been stories told here on Daily Kos about people who have co-insurance and ended up owing thousands of dollars and not ever going to a hospital!

              No to co-insurance of 20 percent.

              "The difference between the right word and the almost-right word is like the difference between lightning and the lightning bug." -- Mark Twain

              by Brooke In Seattle on Sun Jul 26, 2009 at 01:46:18 PM PDT

              [ Parent ]

              •  read carefully (1+ / 0-)
                Recommended by:

                Cost Sharing: There is a $350 deductible for individuals/ $500 for families (indexed over time), and 20% coinsurance. Total spending (premiums, deductibles, and co-insurance) is capped at out-of-pocket maximum of $2,500 individual/$4,000 family (indexed over time), or 5 percent of income for beneficiaries with income between 200 percent-300 percent FPL and 7.5 percent of income for beneficiaries with income between 300 percent-500 percent FPL. There is no cost sharing for children, pregnant women and low-income individuals (below 200 percent FPL).

                0-200% - no premiums, deductible or co-pay
                200-300% of FPL - 5% of income
                300% to 500% of FPL - 7.5% of income

                So someone making $50,000/year would only pay an annual maximum of $3,750 for premiums, co-pays, and deductibles combined.

                So someone making $30,000/year would only pay an annual maximum of $1,500 for premiums, co-pays, and deductibles combined.

              •  You'd having to be making (1+ / 0-)
                Recommended by:

                over 500% of the FPL [about $51,000/year] to be fully exposed to that $2,000 co-pay.

            •  A good idea, except... (0+ / 0-)

              500% of the FPL for a family of 2 is $72,580. At $72,000, 7.5% of income is $5,400, so those beneficiaries with incomes equal to or over 367% FPL up to 500% FPL would pay more than the amount set as the maximum here. A family of two with an income of $43,709.86 would pay $2,185.49 while a family of two with an income of $43,710 would pay $3278.25, rather a large jump in costs ($1,092.76) for a difference of 14 cents in income, if you ask me.

              It seems that this is not as well thought out as it might be.

              Want to be a living kidney donor? I need one from someone with a bloodtype of B or O. Drop a note at

              by Kitsap River on Sun Jul 26, 2009 at 06:21:02 PM PDT

              [ Parent ]

          •  Dr SteveB's Diary on Stark's Americare HR193 (1+ / 0-)
            Recommended by:
      •  Another huge diff: Medicare's admin costs (20+ / 0-)

        are something like 2-3%, whereas private insurance skims around 30% to shuffle the damn paperwork.

        Looks like, for some reason, it costs the "non-government bureaucrat" a HELL of a lot more to DENY care than it does for Medicare to provide it.

        As someone who has been on Medicare for most of her adult life (b/c of disability), I think they can cut administrative costs even further. Each doctor's visit generates paperwork sent to me, showing how much was billed and how much Medicare paid. All of this could be done away with, and processed electronically.

        The savings from this unnecessary paperwork alone could probably fill much of Part D's ridiculous doughnut hole. Well, that, and...don't get me started on how Part D was a sweetheart deal for Big Pharma!

        Jill, I want you to have Medicare, too. It's worked pretty damn well for me all these years...especially since I got Working Disabled Medicaid to fill the gaps. Since I got full medical insurance, I've made HUGE progress towards getting well.

        What a shocker!

        "Sweet are the uses of adversity. Find tongues in the trees, books in the brooks, and good in everything." As You Like It, Shakespeare

        by earicicle on Sun Jul 26, 2009 at 07:10:48 AM PDT

        [ Parent ]

      •  And Medicare is enormously popular. (10+ / 0-)

        We should all celebrate the 44th anniversary this Thursday.  

        There's a rally in DC but people who can't get there are doing all kinds of local creative stuff as well.

        •  And that is why the opposition is attacking (5+ / 0-)

          Medicare. They are saying to the seniors if you adopt this Obama plan, Medicare as you know it will change. No longer will there be end of life care, when you reach a certian age and are deemed unproductive to society, you will not longer be given treatment and will be just left to die.
          This approach is targeted to Seniors who are at a stage in their lives where they are not longer working and therefore initially feel unproductive. Some are not well, but are hanging in there and are trying their best not to be a burden to their children, but the thought is there in their minds that perhaps they are. They already feel somewhat unproductive, so the opposition is using this to frighten them and mobilize them against any kind of health care reform.
          People talk all the time about the quality of life, but there is also something known as the quality of death. Physicians take an oath to end pain and suffering, if there is a method that will do that they are obligated to use it, even at the end of life.
          My Mom had incurable brain cancer, which was diagnosed the last three weeks of her life. Up until that time, there was no one I knew who had more of a zest for life, and enjoyed life more than she did. This joy of life extended to all that knew her. She was perhaps unable to work, or do what some would deem a productive life, but productive can not always be measured in concrete terms. Just by working and earning money, doesn't always make you productive, there are other ways a person can be productive. There is no way an objective panel can consider what is a productive life and what isn't.  
          Over and over again, the opposition uses half truth and scare tactics to make their case. They target the most vulnerable with these lies and scare tactics. How moral is that?
          What they are using now is how the left who wants to take away your health care is looking to kill two birds with two stones, not just taking away your healthcare but passing assisted suicide too.  They don't come right out and say it because they know it is an out and out lie, and you can call them on it, they do it by inference, and sometimes that is much worse.
          Our side needs to target Seniors with the truth, and show these people up for what they really are. They are not looking out for anyone but themselves, they are selfish, hypocritical, lying bastards, and they need to be shown as such.

          •  Divide and conquer. (4+ / 0-)

            Divide the old from the young, the young from the middle-aged, the poor from the middle class, and most of all, the selfish from the unselfish.

            That's how they win.  They turn us against each other.  They always have.  My Lord, how the poor whites took the slaveowners' side against the slaves!

            •  We all know this is what they are doing, (2+ / 0-)
              Recommended by:
              CoolOnion, StateofEuphoria

              Sounds to me like we need to do something about it. Didn't they try to do the same thing with Social Security reform, pit the old folks against the young. Fortunatly it didn't work, but they think they have an in here, so they will push it as much as they can. We need to mobilize and stop them, expose them do what ever we can.
              I see this as an all-sided attack, too much money, government making health care decisions, Obama has no real plan, it will cost too much to institute, and now drag the seniors into the opposition, they like what they have and left on their own, I am sure they would agree it should be extended to all. However, by telling them, if you support this, you will lose out big time, and you will lose out by losing your life, you will be forced to die befor your time.

      •  Buying into Medicare is the answer (14+ / 0-)

        to this health care debate. It is the easiest solution, perhaps not the best one for insurance companies but the best one for all of America.
        I cared for my Mom the last 15 years of her life, and she had Medicare all that time, she was also living on Social Security, so didn't have much disposable income. She went to her doctor regulary and didn't have to worry what was covered and what wasn't covered. She also bought a supplemental insurance plan through AARP. Initially her premiums for this supplemental plan were about $100.00 a month, but the same way our insurance rates went up so too did those rates, they rose along with the others, and also as she aged. By the time she died, she was paying an additional $162.00 a month for this coverage. This supplemental coverage paid the 20% that Medicare didn't cover, and if Medicare approved a procedure, there were no questions asked, they would also approve the supplemental cost of that procedure.
        Medicare deducted money directely from her S.S. check, and I am not sure how much that was, I am thinking about $100.00 per month. So for at the end of her life, it cost her $262 per month for the best medical care money could buy.
        I don't understand why this can not be extended to the rest of American, regardless of age. Actually, I do understand, because most younger folks would opt only for Medicare and forgo any supplemental insurance, so insurance companies would lose money, and that is why people are fighting so hard against this plan.
        I am going to be 64 this year, one year away from Medicare, and I see this as a blessing, as I am sure most Seniors on Medicare feel.
        Right now I consider myself healthy and still able to work, so if we were to adopt this option, I would probably pay for the initial coverage from Medicare, and take my chances on my health and not purchase supplemental insurance. However, as I age, and we start to live on a very fixed income, it sounds like it would make sense to carry this insurance so to avoid a medical emergency from wiping us out.
        I hear all this talk about Medicare being in trouble, financially, and how it is driving us deeper in debt. In my opinion it is because there are those who take advantage of the Medicare system, and there is absolutly no oversight. I have given the example over and over her on my Mom's wheelchair, which Medicare supplied to her for 15 years, they rented the damn thing at the cost of $115.00 per month and continued to lease it for the last 15 years of her life. My rough calculations tell me that wheelchair cost Medicare over $20,000. Hell for that price they could have bought a top of the line wheelchair every year for the rest of her life. My Mother was just one of millions of people on Medicare who needed the use of a wheelchair. This is an easy fix to stop this type of abuse and save money. When this is not recongnized and nothing is done about it, you wonder why.

        •  The "durable goods" suppliers have sweetheart (7+ / 0-)

          deals w/Medicare b/c they have lobbied Congress hard. Why else do you think they advertise so heavily on TV? This is definitely an area where Medicare needs reform, and where costs can be cut. OTOH, primary care docs should be paid more.

          "Sweet are the uses of adversity. Find tongues in the trees, books in the brooks, and good in everything." As You Like It, Shakespeare

          by earicicle on Sun Jul 26, 2009 at 08:10:52 AM PDT

          [ Parent ]

        •  No it's not the answer (2+ / 0-)
          Recommended by:
          Angie in WA State, SarahLee

          About half of the uninsured in this country are under 35, so you're telling them to wait around for another 25 years before they get health care?

          •  I don't think anyone is saying that, (6+ / 0-)

            I thought what was being said was to allow everyone to buy into Medicare, if they chose to do so. Younger people, who don't need as much health care, because they are young and healthy would bring the costs of Medicare down. There would be more young and healthy people in the system, rather than just the elderly and sick. The contributions they make each month would hardly be used by them, but it is there if needed. Still there would be an additional 20% that would be paid on all services.
            Perhaps I misundestood the diary, but that is my opinion, allow everyone to buy into Medicare.

        •  Medicare must be trying to fix this problem (1+ / 0-)
          Recommended by:

          because my mother had a stroke 4 years ago and received a wheelchair through Medicare. The company who supplied the wheelchair would call and ask me if she was still using it and I told them yes each time.
          As of 1 year ago the company said that Medicare bought the wheelchair so the wheelchair belongs to my mother. I would have to go back and view the statements that come in to find out for sure what happened. I get so tired of looking at all of the statements coming in along with all the other medical paperwork sometimes so I might have missed what exactly took place.

        •  Medicare finances (1+ / 0-)
          Recommended by:

          Medicare deducted money directely from her S.S. check, and I am not sure how much that was, I am thinking about $100.00 per month.

          It's been $96 per month since 1/1/08, before that it was a little less.  So you're pretty close.  The trouble is, Medicare Part B is subsidised out of "general revenues" (mainly income tax) and the real cost of that coverage is roughly four times as much.  Medicare Part A is paid from the Medicare tax that's taken out of employees' pay.  In order to have Part A coverage at no charge, a person has to have a work history, or have been married long enough to a person with a work history, or be the disabled child of a person with a work history.  Those very few who don't meet the work history requirement can buy Medicare A from the government, but that costs around $400 per month.  In other words, the total cost for Medicare Parts A and B is about $800.  Of course, that's for a population that's generally in poor health and high cost.  If Medicare covered the whole nation, including healthy younger people would bring the average cost down.

          I have given the example over and over her on my Mom's wheelchair, which Medicare supplied to her for 15 years, they rented the damn thing at the cost of $115.00 per month and continued to lease it for the last 15 years of her life.

          I don't understand this, Medicare does pay for buying durable medical equipment like wheelchairs.  Did you ever ask about it?  Did her doctor order the wheelchair for her long-term or short-term?  If the doctor told Medicare that your mother would need the wheelchair for just a short time, of course Medicare would just pay to rent it.  If the doctor told Medicare that your mother would need it long-term, Medicare would pay to rent or buy it at your mother's option.  Medicare couldn't force your mother to buy the wheelchair because she might not have enough money for the 20% copay on the purchase price.  

          Renewable energy brings national security.

          by Calamity Jean on Sun Jul 26, 2009 at 01:46:48 PM PDT

          [ Parent ]

        •  Being healthy & able to work (3+ / 0-)

          is no guarantee of an income these days.

          That's part of the problem.

          We have an increasingly larger pool of workers over 50 who are too old to get a job -- especially a decent one with benefits -- and too young for Social Security or Medicare. And every time the discussion turns to either, a bunch of young and employed people want to raise the retirement age to 67 or 70!

          Who the hell is going to hire all of us old farts?

          No one, that's who.

          So we are unemployed, uninsured, and in the worst shape of our lives when we hit Medicare.

          "The difference between the right word and the almost-right word is like the difference between lightning and the lightning bug." -- Mark Twain

          by Brooke In Seattle on Sun Jul 26, 2009 at 01:56:49 PM PDT

          [ Parent ]

          •  If you are over 50 and under 65 (1+ / 0-)
            Recommended by:
            Angie in WA State

            you probably want Rockefeller's S.960 Medicare Early Access Act of 2009:

            A bill to amend title XVIII of the Social Security Act and the Employee Retirement Income Security Act of 1974 to provide access to Medicare benefits for individuals ages 55 to 65, to amend the Internal Revenue Code of 1986 to allow a refundable and advanceable credit against income tax for payment of such premiums, and for other purposes.

            Annual Premium-

            `(1) NATIONAL, PER CAPITA AVERAGE- The Secretary shall estimate the average, annual per capita amount that would be payable under this title with respect to individuals residing in the United States who meet the requirement of section 1860E-1(b)(1)(A) as if all such individuals were eligible for (and enrolled) under this title during the entire year (and assuming that section 1862(b)(2)(A)(i) did not apply).

            `(2) ANNUAL PREMIUM- The annual premium under this subsection for months in a year is equal to the average, annual per capita amount estimated under paragraph (1) for the year

            Subsidies of up to $300/individual and $600/couple would be available.

      •  Ah yes, the hassle. (8+ / 0-)

        This isn't an insurance-nightmare story, God knows, we have enough of those, too. It's just an insurance-hassle anecdote, and we have millions of those. I bet that every single person reading this thread could tell the story below. Or at least the ones lucky enough to have insurance could.

        The LH and I got home from vacation yesterday to the usual pile of dead-tree mail, including what should have been a reimbursement check from my insurance company for recently-done routine tests: a mammogram, a breast sonogram (physician-prescribed because I'm high-risk for breast cancer) and a bone-density test.

        Instead of a check, the envelope contained an EOB with the following notation for all three tests:"The diagnosis is inconsistent with the patient's age".

        I am a 61 year old woman. I have breasts (still, thank God) and bones. I have a longstanding family history of breast cancer, fibrous breasts, and a decade-old diagnosis of borderline osteoporosis/osteopenia. What part of that is inconsistent with my age?

        So tomorrow morning, when I should still be enjoying my post-vacation glow, I'll be destroying it on the phone with my insurance company. I'm banking that someone made a typo and listed my age as 6 instead of 61, but I've been through so many of these absurdities in the past that I've come to believe that they constitute intentional harassment.

        If they deny enough claims, even because of dumb errors, some subscribers will forgo what is rightfully theirs. Though I'm not one of them, there have been times that I felt fighting with the insurance company was more detrimental to my health than the condition they were trying not to pay for the treatment of(I don't handle conflict well).

        For the insurer, the end of the story is always the same: any unpaid reimbursement ends up in the insurance company's bottom line, so why shouldn't they try anything?

        The only thing we have to fear is fear itself.

        by sidnora on Sun Jul 26, 2009 at 09:49:30 AM PDT

        [ Parent ]

      •  Yes--"Medicare for all" is the answer (1+ / 0-)
        Recommended by:

        Most people can't figure out what the heck "single payer" means.

        When my group petitions in the street we ask people if they would like to sign in support of a "Medicare for All" type of program--95% say yes.

        Good diary.

    •  Did he explain why he didn't think Medicare was (4+ / 0-)

      "socialized medicine"?

    •  Good for you, onion! That's how we'll win this-- (1+ / 0-)
      Recommended by:

      you must be super tactful.  :O)

    •  Wow. 70 recs for this comment. (0+ / 0-)

      Twice as many recs as I got for the diary I wrote about that guy I met at Cornyn's rally.

      I'm noting the day and time: Sunday, 8:19 am CDT.  Next time I get it into my head to write a diary, I'll try posting on Sunday morning!

      Watching Pete Sessions and reporting from the Taliban-controlled 32nd Congressional District of Texas.

      by CoolOnion on Sun Jul 26, 2009 at 05:08:47 PM PDT

      [ Parent ]

      •  And it made the "top ten" comments (0+ / 0-)

        Top ten comments (not including tip jars).

        No complaints, really, just funny how this place works.  I spent an hour or so putting the diary together and got 35 recs.

        The comment referencing the diary took about 2 minutes to write, and got 70 recs.

        Guess it's all in the timing.

        Watching Pete Sessions and reporting from the Taliban-controlled 32nd Congressional District of Texas.

        by CoolOnion on Mon Jul 27, 2009 at 05:59:54 AM PDT

        [ Parent ]

  •  My Sunday Newspaper Opinion Piece (2+ / 0-)
  •  Ah, yet another "progressive" broadside (5+ / 0-)
    Recommended by:
    Davinci, smartdemmg, lookit, JoanMar, zenox

    against the most progressive President in U.S. history.

    Why is "Obama" in the diary's title when it is Obama who wants a strong public option? Why is this diary not addressed to the Blue Dogs & the Republicans trying to kill health care reform?

    Wouldn't be to get readers, eh?

    You are becoming predictably boring & boringly predictable.

    "Someone who does not see a pane of glass does not know that he does not see it." --Simone Weil

    by AgnesBee on Sun Jul 26, 2009 at 06:39:31 AM PDT

    •  You don't seem to have read the diary (39+ / 0-)

      She isn't asking for a public option, she wants out-and-out Medicare.

      Further, Obama appears ready to embrace the mandate to buy insurance, which is an unusually bad policy that will cause financial distress for millions of Americans and blow up in the face of Democratic reelection chances.

      Just because you have a different view of what constitutes desirable health care reform doesn't warrant this personal attack.

      I'm not part of a redneck agenda - Green Day

      by eugene on Sun Jul 26, 2009 at 06:41:36 AM PDT

      [ Parent ]

      •  I read the diary, thanks. (4+ / 0-)
        Recommended by:
        Davinci, murrayewv, elwior, lookit

        You seem to know very little about health care reform. In every single country with universal coverage, there is a mandate to buy insurance. Without mandates, no health care reform is possible.

        Single-payer systems mandate payroll deductions.

        Non-single-payer systems (France, Germany, the Netherlands, et al) mandate that everyone purchase insurance. Otherwise, the risks are not spread out & costs are not controlled.

        I did not make a "personal attack." I reacted to the diarist's predictably boring & boringly predictable (Sirota-like) sensationalist "broadsides" on Obama.

        "Someone who does not see a pane of glass does not know that he does not see it." --Simone Weil

        by AgnesBee on Sun Jul 26, 2009 at 06:48:04 AM PDT

        [ Parent ]

        •  Stop misleading readers (25+ / 0-)

          There is a fundamental, qualitative difference between a mandate to buy private insurance on a market, where the insurer sets the price, where there is NO guarantee that the purchase will provide care, and taxation to fund public health care. You are using misleading language to label taxes as a "mandate". You cannot draw an equivalence between the two.

          Further, you are leaving out the fact that in France, there IS indeed a government-provided health care program that does not require purchase of insurance. It comes through their version of Social Security. Its benefits are basic and many other French buy additional insurance, but it is not a mandate system.

          Finally, there is a massive difference between those European models and what the Congress proposes. Private companies, including insurers, are regulated to within an inch of their life in those countries. There are much higher taxes and therefore much less incentive for insurers to generate huge profits (in fact, many of the insurers are non-profits).

          Your comment is full of misleading statements, false equivalencies, and yes, personal attacks.

          I'm not part of a redneck agenda - Green Day

          by eugene on Sun Jul 26, 2009 at 06:53:18 AM PDT

          [ Parent ]

          •  Right. (0+ / 0-)

            And if the health care reform bill that Obama signs does not set governmental controls on the minimum criteria that private insurance policies must have, your point is valid.

            Do you have evidence that the bill will not contain such requirements? If so, please respond with the relevant links.

            If the bill Obama signs does not contain such minimum requirements, I will stand corrected, and join you in condemning Obama.

            Until then, I find these Sirota-like attacks on the most progressive President in U.S. history boringly predictable and predictably boring.

            "Someone who does not see a pane of glass does not know that he does not see it." --Simone Weil

            by AgnesBee on Sun Jul 26, 2009 at 06:56:50 AM PDT

            [ Parent ]

            •  Minimum requirements (13+ / 0-)

              Are meaningless, since insurance companies will simply ignore them. They already ignore other rules and laws regarding their practices. Blue Cross here in California was slapped with a multi-million dollar fine for their refusal to pay for covered procedures. They paid the fine and have continued the practices.

              You're so focused on whether someone is "condemning Obama" or not that you're totally missing the point about the policy aspects of health care reform.

              And in turn that actually jeopardizes Obama's future. If he and the Congress get health care reform wrong, he will have an extremely difficult time getting reelected in 2012, and none of us want that.

              I'm not part of a redneck agenda - Green Day

              by eugene on Sun Jul 26, 2009 at 06:59:23 AM PDT

              [ Parent ]

              •  Huh? (2+ / 0-)
                Recommended by:
                Davinci, slinkerwink

                So if the French government regulates the private insurance industry in France, it's good. But if the U.S. government regulates the private insurance industry in the U.S., it's not good, because the private insurers will "ignore" the regulations?


                "Someone who does not see a pane of glass does not know that he does not see it." --Simone Weil

                by AgnesBee on Sun Jul 26, 2009 at 07:05:52 AM PDT

                [ Parent ]

                •  American Companies Ignore Regulation (3+ / 0-)
                  Recommended by:
                  SarahLee, Sychotic1, mochajava13

                  Even as we speak, someone is being told by a health insurance company that their coverage is being denied, even though their policy does provide for coverage for that treatment.  

                  This happens all the time.  These companies engage in fraud, hoping that a certain percentage of these people who are wrongly being denied coverage will just give up and pay for their own treatment.  This is not investigated, but it happens all the time.  

                  How can we trust the very companies that have engaged only in the practice of denial of coverage as they take the insurance premiums?

                  In the US it is becoming clear that the free market cannot be trusted.  

                  Unfortunately, under Bush, and now under Obama, it is clear that the government cannot be trusted either.  

                  Sadly, the public option is our only hope, but it will be monitored by the same government that gave us Iraq, Abu Ghraib, Guantanamo, and now the TARP program which Obama doesn't really want to monitor, notwithstanding that the Republican congress wanted such oversight to protect our tax dollars.  

                  Transparency, anyone?

                  •  I see you prefer painting with one of these. (0+ / 0-)


                    "Someone who does not see a pane of glass does not know that he does not see it." --Simone Weil

                    by AgnesBee on Sun Jul 26, 2009 at 08:12:27 AM PDT

                    [ Parent ]

                  •  It is the whole squeaky wheel (2+ / 0-)
                    Recommended by:
                    Kentucky DeanDemocrat, Sychotic1

                    theory. Unless you raise hell you will be denied many things you are entitled to have. This is why lawyers play such a valuable role in our society. They are the only defense we have available to us to level the playing field, and this is why corporations want to dismantle them, and pass "tort reform".
                    Perhaps Michael Jackson is not the best example, but he might be alive today, if he had doctors who were true to the oath they took to get their medical licesnses, and not just in it for the money. Doctors are not God, nor are they God-like, some are really good people, and have choosen that profession to save lifes and do good, but there are others, and more than you would beleive who are in it for the bucks, and they will do all they can to make those bucks.
                    People are afraid to go up against thier doctor, because they have put their life in that person's hands and fear they will be angry at them and have to power to end their life if they chose. It shouldn't be that way, but it is.

            •  I read your comments and had to respond. (14+ / 0-)

              Where is YOUR evidence that Obama is the most progressive president in US history?

              I find that a sweeping overgeneralization and contrary to evidence and actions that supports a contention he is a Hamilton Project Democrat and far from progressive, but a centrist, as is oft repeated by many of his supporters and Obama himself.

              March, 2009:

              President Barack Obama firmly resists ideological labels, but at the end of a private meeting with a group of moderate Democrats on Tuesday afternoon, he offered a statement of solidarity.

              "I am a New Democrat," he told the New Democrat Coalition, according to two sources at the White House session.

              The group is comprised of centrist Democratic members of the House, who support free trade and a muscular foreign policy but are more moderate than the conservative Blue Dog Coalition.

              Obama made his comment in discussing his budget priorities and broader goals, also calling himself a "pro-growth Democrat" during the course of conversation.

              The self-descriptions are striking given Obama’s usual caution in being identified with any wing of his often-fractious party. He largely avoided the Democratic Leadership Council — the centrist group that Bill Clinton once led — and, with an eye on his national political standing, has always shied away from the liberal label, too.

              •  good call: Obama not progressive (6+ / 0-)

                Still in Iraq
                Using guys who crashed economy to "revive" it
                Trillions in hand outs to banks---no accountability
                No accountability on torture.  Zero.  Nada.
                Housing crisis continues unabated
                Foreclosure help non existent
                EFCA is fucked
                Illegally bombing Pakistan
                Illegally arming Israel
                Illegally allowing aid to continue to flow to Honduras
                Arne Duncan
                Escalation in Afghanistan
                Free trade for Africa
                Cover up WH visitors
                Still torturing at Gitmo
                More government secrecy


                "I happen to be a proponent of a single payer health care program." Pres. Goldman Sachs Obama, 6/30/03

                by formernadervoter on Sun Jul 26, 2009 at 07:11:25 AM PDT

                [ Parent ]

              •  Show me a more progressive President. (1+ / 0-)
                Recommended by:


                Obama's stimulus plan is exponentially larger (in real dollars) than FDR's. In real dollars, FDR's "New Deal" amounted to about $85 billion (figuring interest) over ten years. Obama bested that by 10 times.

                Let's hope Obama doesn't need a World War to finalize his stimulus, as FDR did.

                LBJ? Carter? I'll put Obama's short record of progressive accomplishments up against them all.

                "Someone who does not see a pane of glass does not know that he does not see it." --Simone Weil

                by AgnesBee on Sun Jul 26, 2009 at 07:15:02 AM PDT

                [ Parent ]

                •  If that is how you judge progressivism... (7+ / 0-)

                  by basically giving huge sums of money to the bankers and insurers who precipitated the mess, then I cannot argue with you.

                  I, however, have a different standard.

                  You have not even addressed Obama's own words that contradict your claim.

                  •  If there's any source not worthy of a response (0+ / 0-)

                    it's Politico's Jonathan Martin. The story you cite is fueled by "two [unnamed] sources." The quote itself is meaningless. What does "New Democrat" mean, one way or the other?

                    No, Obama will never get a place on the hallowed walls of Amy Goodman's Progressive Hall of Fame. But six months into his Administration, I like what I see, and I'll stack it up against the first six months of any "progressive" President in history.

                    Just my opinion, as small & putrid as it is.

                    "Someone who does not see a pane of glass does not know that he does not see it." --Simone Weil

                    by AgnesBee on Sun Jul 26, 2009 at 07:57:16 AM PDT

                    [ Parent ]

                    •  Do you have any evidence... (2+ / 0-)
                      Recommended by:
                      SarahLee, greeseyparrot

                      that Obama did not say this?  

                      Your statements seem way overbroad and dismissive to me.

                      •  No, I believe he said it. (0+ / 0-)

                        I don't believe what he said has any inherent meaning.

                        He is certainly not a Pacifica radio, Green Party, Kucinichian Democrat. He never campaigned as one.

                        Many of us who followed Obama's campaign from its infancy and who took him at his word are not surprised that he is governing from the center-left -- much further left than Clinton's center-left.

                        Many of us would define "progressive" as center-left. Many of us wouldn't.

                        "I am a New Democrat." Jonathan Martin saw evil in them there hills! Of course, Jonathan Martin doesn't give a rat's ass about progressive causes.

                        Hmmmmm...that would make him a...


                        "Someone who does not see a pane of glass does not know that he does not see it." --Simone Weil

                        by AgnesBee on Sun Jul 26, 2009 at 08:25:11 AM PDT

                        [ Parent ]

                        •  As I said...we have much different views... (5+ / 0-)

                          of what a progressive is.  A centrist can sometimes be progressive, but just as often may not be.

                          Martin did not see evil, he just seems to have reported what Obama himself said.  Politico can be a rag, unless it goes after someone one does not like.  And then it is great!  Once more, your characterization seems overbroad.

                          Most progressives I know would not consider a New Democrat as a progressive, but a centrist.  That is why the broad brush graphic you smartly used to criticize someone who claimed that insurance companies violate the spirit if not the letter of law is equally if not more applicable to your statement that Obama is the most progressive president in US history.

                          As I indicated, look at Truman's record on assuming office, which is at least as progressive as anything Obama has done, considering the times involved.  To desegregate the armed forces, he bucked much of his own party.

                          I know Obama's record, too, from his stealth campaign fundraising to his more Bush like positions on unitary executive.  I don't find much progressivism in many of his actions.  Unlike Truman, where has Obama fought for much of anything?  because I think much of his progressive rhetoric has fallen by the wayside on a number of issues, I spoke up about your exaggerated comment.

                          •  You've got me there -- my rhetoric was bloated. (1+ / 0-)
                            Recommended by:

                            So let me end my part in this thread by thanking you for your candor & your vigor. We can agree to disagree on our varying takes on the political spectrum. (I am partly color-blind; perhaps that explains it.)

                            I see Martin's article as a typical right-wing attempt to stoke the flames of dissent in the already fractured Democratic Party. I stand by that reading.

                            Truman? Truman?? Ha. I'd love to see what DKos would look like during a Truman Administration. Hiroshima & Nagasaki? His military support for Israel? The Korean War?

                            Ah, you might say, but his domestic policy:

                            In the spring of 1946, a national railway strike, unprecedented in the nation's history, brought virtually all passenger and freight lines to a standstill for over a month. When the railway workers turned down a proposed settlement, Truman seized control of the railways and threatened to draft striking workers into the armed forces.

                            Truman deserves credit for desegregating the Armed Forces. But let's not do to Truman what George W. Bush hopes the American people do to him -- namely, forget.

                            "Someone who does not see a pane of glass does not know that he does not see it." --Simone Weil

                            by AgnesBee on Sun Jul 26, 2009 at 09:13:40 AM PDT

                            [ Parent ]

                          •  Again...different times are involved. (4+ / 0-)

                            Truman was fighting a world war against true fascism.  We did not start the Korean War against adversaries that were brutal regimes, and the Cold War actually existed at that time.  Remember the Berlin blockade and communist expansion into Eastern Europe.  Obama's war in Afghanistan and incursions into Pakistan may prove in time to be problematical in the context we have discussed, just as this partnership with bankers and insurance companies.

                            Can you come up with some examples of Obama fighting for progressive causes at risk to himself?

                            I am no great Truman fan, partially for the examples you cited, but used him as an example of a president who promoted truly progressive ideas.  In addition to integration of the military and proposing national health care, helping in the formation of the UN and Israel were progressive in my view.  Yes, he seized control of the railways, but look at Obama and FISA.  At least Truman did not do about faces from his rhetoric, unlike our current president who created impressions he would not act as he has in a variety of matters.

                          •  Here's my problem with this view... It is looking (0+ / 0-)

                            at politics as something it is not... First many judgements on obama were off for many progressives.. Compared to Bush he is way progressive on many issues.. That he has chosen not to fight on his opponents field of battle is not reason enough to judge... We are on track to leave Iraq... We are attempting to reduce the threat level of the southern afganistan/pakistan area of the world... (I remain skeptically optimistic)...

                            Gates says Gitmo will close by years end... (Lets hope)... Still if you can score a few points in the first quarter you do not get retribution from last season.. That is fourth quarter stuff when you are ahead... So impatience is my big issue with this view of Obama.. We need reform until we have it on many issues the status quo is the default.... We might need to wire tap people for security..(Not something I like but the real issues is penalties for abuse.. I hope the president can go to sprint and say we need this info now without them having to go to court etc... I just want peoples rights upheld etc... Regulatory frame works are needed in many areas but they need to be modern and flexible with real teeth..

                          •  Using Bush as comparison? (0+ / 0-)

                            That seems off the wall to me.

                            I am basing my view of Obama on facts, not to mention actual decisions he has made.  Too many voted for him because he represented a change from Bush.  That, alone, does not make him progressive.  I think he presented more of a progressive aura to the general public in the form of hope and change than is the reality, and I believe it will become more evident with time's passage that he is just like other politicians, despite his campaign claims to the contrary.

                          •  Hey I remember when Gore was not considered (0+ / 0-)

                            Progressive enough... Look were that lead.

                            I am under no illusion that obama is in the Dennis K mold of left or progressive..
                            Obama is a center left realist with a progressive streak that is done on his timing.. In fact I Imagine that he is more progressive than his policy show ...
                            The art of the possible...
                            Still would be nice if he started using some of his talent to bend the Overton window on some issues...

                •  Richard Nixon N/T (1+ / 0-)
                  Recommended by:
                •  Although he will be forever tainted for (12+ / 0-)

                  escalating the war in Vietnam, I will give LBJ great credit for Medicare, Medicaid,the Voting Rights Act, and the Civil Rights Act. He became president in November of 1963, and all these were passed by 1965.

                  •  I too give LBJ credit for all you site. (0+ / 0-)

                    The Kennedy brothers should get a mite bit of credit for the Civil Rights Act, though it's debatable whether anyone other than LBJ could've pushed it through Congress.

                    As for LBJ's Great Society: he passed so many unfunded mandates (further depleted, as you suggest, by Vietnam) that his form of progressivism was short-lived.

                    My prediction is that Obama's accomplishments will be longer-lived.

                    "Someone who does not see a pane of glass does not know that he does not see it." --Simone Weil

                    by AgnesBee on Sun Jul 26, 2009 at 07:52:49 AM PDT

                    [ Parent ]

                  •  There's also Truman, the other Roosevelt... (6+ / 0-)

                    and Wilson.

                    Truman, for example, desegregated the military (no small feat), helped create the UN, initiated the Marshall Plan, and advocated a national health care program in 1945.

                    No president is perfect, but each of these left a progressive mark in the country.

                    That is why claiming Obama to be the MOST progressive, particularly based on his far from complete record to date, is ludicrous to me.

            •  OK, you're just trolling now. (2+ / 0-)
              Recommended by:
              sidnora, JoanMar

              "The great lie of democracy, its essential paradox, is that democracy is first to be sacrificed when its security is at risk." --Ian McDonald

              by Geenius at Wrok on Sun Jul 26, 2009 at 09:22:04 AM PDT

              [ Parent ]

              •  I don't think Citizen's trolling by (2+ / 0-)
                Recommended by:
                Sychotic1, polar bear

                comparing Obama to other Progressive presidents. I mean, Citizen and I may not see eye to eye on all things, but Truman for example fearlessly desegregated the Military, while Obama hems and haws and futzes around with the absurd DADT policy.
                  Also, Truman fired MacArthur when he insisted on making policy decisions, while Obama seems to be very willing to take policy direction from "commanders on the ground."
                  Don't get me wrong, I'm thrilled that Obama is our president. I don't regret throwing myself into his campaign one iota. And I will reserve judgment on his presidency with only about 6% of it on the books thus far, particularly because he's got a job with a steep learning curve.
                   But like so many other Progressives, I'm somewhat disappointed at Obama's timidity thus far in a number of areas. Is this tendency part of a larger strategy? Some argue it is, others that it's not. Me, I don't know.
                   Thus far though, he's far from being the most Progressive president we've ever had.
                   But we shall see what we shall see.

                "We the People of the United States...." -U.S. Constitution

                by elwior on Sun Jul 26, 2009 at 11:00:48 AM PDT

                [ Parent ]

          •  Oh, and you are quite wrong about France. (11+ / 0-)

            France is not a single-payer system, unless you stretch the definition of "single-payer" to the point that it bears no resemblance to actual single-payer systems (a la Canada & Britain).

            According to the stridently pro-single-payer PNHP, France is considered a multi-payer system, regulated but not run by the government:

            Health care insurance is not directly managed by the government but by an autonomous authority made up of representatives of employers, unions and the government.


            The French health care system is primarily funded by Sickness Insurance Funds (SIF’s), which are autonomous, not-for-profit, government-regulated bodies with national headquarters and regional networks. They are financed by compulsory payroll contributions (13% of wage), of employers (70% of contributions) and employees (30% of contributions). SIF’s cover 99% of the population and account for 75% of health expenditures.

            I'm all for single-payer, but since there is less than zero chance of a single-payer system being adopted in this country, it's important to know that there are several roads to universal coverage. One of those roads, France's multi-payer system, has led to the highest ranked health care system in the world.

            "Someone who does not see a pane of glass does not know that he does not see it." --Simone Weil

            by AgnesBee on Sun Jul 26, 2009 at 07:04:10 AM PDT

            [ Parent ]

            •  thank you for reminding others of that (6+ / 0-)

              I'm on Twitter. I'm also a part of the FDL team on health reform.

              by slinkerwink on Sun Jul 26, 2009 at 07:05:37 AM PDT

              [ Parent ]

            •  Go back to my comment (1+ / 0-)
              Recommended by:

              And find where I called France "single-payer."

              I'll wait for you to find the quote.

              I'm not part of a redneck agenda - Green Day

              by eugene on Sun Jul 26, 2009 at 07:05:51 AM PDT

              [ Parent ]

              •  You wrote (misleadingly) that (4+ / 0-)

                there IS indeed a government-provided health care program that does not require purchase of insurance.

                It is not "government-provided." They are private insurers. And the citizens are, in fact, "required" to purchase these privately-run insurance policies.

                You were right about the government tightly regulating them, but then you say that government regulation will do no good because the private insurers here will "ignore" them.

                Hope that clarifies things.

                "Someone who does not see a pane of glass does not know that he does not see it." --Simone Weil

                by AgnesBee on Sun Jul 26, 2009 at 07:08:14 AM PDT

                [ Parent ]

                •  The French system (3+ / 0-)
                  Recommended by:
                  eugene, SarahLee, greeseyparrot

                  La protection sociale contre les risques financiers liés à la maladie est assurée principalement par l'assurance maladie, branche de la Sécurité sociale, dispositif de type légal sous tutelle de l'Etat. Les organismes mutualistes ou les assurances privées offrent, par ailleurs, une protection complémentaire.

                  Du fait des règles de la prise en charge financière des soins, l'assurance maladie joue un rôle prédominant dans le financement des soins médicaux. Elle prend en charge 75,5 % des dépenses de santé. Un nombre croissant de personnes (87 %) ont recours à des assurances complémentaires.

                  Actuellement, la totalité de la population est protégée par l'assurance maladie, le plus souvent sur une base professionnelle ou familiale (actifs et retraités ainsi que leurs ayant-droits). Les chômeurs ont également accès à la protection sociale en matière de maladie. La couverture maladie universelle permet aux plus démunis de bénéficier d’une prise en charge financière de leurs soins.

                  Différents régimes gèrent l’assurance maladie. Ces régimes sont placés sous la tutelle de la Direction de la Sécurité sociale du Ministère chargé des Affaires sociales.

                  - Le Régime général de la Sécurité sociale est le plus important.

                  Il assure les salariés du commerce et de l'industrie ainsi que leurs familles, soit environ 80 % de la population. Il est géré au plan national par la Caisse nationale de l'assurance maladie des travailleurs salariés (CNAMTS) et au plan local, par des caisses régionales (CRAM) et des caisses primaires (CPAM).

                  - La Mutualité sociale agricole (MSA) couvre les exploitants et les salariés agricoles, ainsi que leurs familles, soit au total environ 9 % de la population.

                  - La Caisse nationale d'assurance maladie des professions indépendantes (CANAM) couvre les artisans, les commerçants et les membres des professions libérales, soit 6 % de la population.

                  - D'autres régimes numériquement moins importants couvrent sur une base professionnelle certaines catégories professionnelles (mines, SNCF, marins....).

                  Le Régime général, de loin le plus important du point de vue du nombre de ses affiliés. La Caisse Nationale de l'Assurance Maladie des travailleurs salariés (CNAMTS), qui le gère au plan national, est responsable de l'équilibre financier général et assume certaines missions en matière de prévention et d'action sanitaire et sociale. Elle organise en outre le contrôle médical sur l'activité des professions et établissements de santé. Elle donne son avis sur les propositions de loi et de règlement portant sur son domaine de compétence.

                  Les caisses régionales d'assurance maladie (CRAM) assument des tâches d'intérêt commun aux caisses primaires de leurs circonscriptions. Elles développent par ailleurs la prévention des accidents du travail et des maladies professionnelles ainsi que des programmes d'action sanitaire et social approuvés par le ministre chargé de la Sécurité sociale.

                  Les Caisses primaires d'assurance maladie ont un domaine de compétence locale; il en existe une ou plusieurs par département. Elles sont responsables de l'affiliation des assurés, du service des prestations, de l'action sanitaire et sociale de leur circonscription et de diverses actions de prévention.

                  Dans le cas du régime général, les ressources sont constituées par des cotisations patronales et une contribution sociale généralisée assise sur les différents revenus. Les cotisations salariales n'interviennent plus que marginalement.

                  L'organisation des autres régimes, simplifiée par rapport au schéma du Régime général, est basée essentiellement sur une caisse nationale et des caisses locales.

                  Des Unions régionales des caisses d'assurance maladie doivent, dans le respect des conventions d'objectifs, définir en ce qui concerne leur ressort territorial, une politique de gestion du risque dans le domaine des dépenses et soins de ville et veiller à sa mise en oeuvre. Elles déterminent, en outre les actions prioritaires à mener et émettent des avis sur les plans d'action des caisses des différents régimes. Elles coordonnent l'activité des services du contrôle médical aux plans régional et local de l'ensemble des régimes. Enfin, elles contribuent à la mise en oeuvre par chacune des caisses des actions de prévention et d'éducation sanitaire nécessaires au respect des priorités de santé publique arrêtées au niveau régional.

                  Pour remédier aux inégalités des recettes et charges entre régimes, liées à la structure démographique de leurs personnes protégées, il existe une procédure de compensation relatives aux charges de l'assurance maladie et maternité basé sur le ratio ayant-droit / assuré.

                  Le bénéfice des prestations de l'Assurance Maladie est accordé en principe après constatation d'un emploi salarié pendant 120 heures au cours du mois précédant la demande ou encore 600 heures au cours du semestre écoulé.

                  Une récente réforme de la protection sociale a instauré une couverture maladie universelle. Elle garantit à toute personne, quelle que soit sa situation, une protection contre le risque maladie par rattachement à un régime obligatoire d'assurance maladie. Tout résidant en France ou dans les départements d'outre- mer qui ne bénéficie pas de droits à un régime obligatoire sur la base des critères traditionnels (activité professionnelle ou critère assimilé, statut familial) sera affilié au régime général du fait de sa seule résidence sous réserve qu'elle soit stable ou régulière. Les personnes dont les revenus sont les plus faibles ont droit à une couverture complémentaire gratuite et sont dispensées de l'avance des frais. Les bénéficiaires du Revenu minimum d'insertion sont admis automatiquement.. L'affiliation à un régime d'assurance maladie est obligatoire. Le régime de l'assurance personnelle est supprimé. Les jeunes de seize ans peuvent obtenir à leur demande le statut d' ayant-droit autonome.

                  L'assurance complémentaire

                  Trois types d'organismes de protection complémentaire coexistent : les mutuelles, les compagnies d'assurance privées et les institutions de prévoyance. La protection complémentaire peut résulter d'une démarche individuelle, mais le plus souvent, elle est proposée aux assurés à titre collectif dans le cadre de leur activité professionnelle.

                  Au nombre de 6500 environ, les groupements mutualistes jouent le rôle le plus important dans le domaine de la protection complémentaire maladie. Ils assurent plus de 30 millions de personnes, soit 60 % des titulaires d'une assurance complémentaire et prennent en charge 7,1 % des dépenses de consommation de soins et biens médicaux.

                  Les compagnies d'assurance, estimées à 80, sont des entreprises privées gérées par le code des assurances. Elles financent 3,0 % des dépenses de soins et biens médicaux.

                  Les institutions de prévoyance, environ une vingtaine, sont gérées paritairement par les syndicats et les employeurs. Elles participent à 2,0 % des dépenses.


                  The main insurers aren't insurers like Aetna, UHC, or Cigna.

                  One insurer, Le Régime général de la Sécurité sociale, covers 80% of the French.

                  •  No, they are not Aetna, UHC, Cigna--or Blue Cross (1+ / 0-)
                    Recommended by:

                    but neither is the French health care system a "single-payer" "government-run" system on the Canadian or British model. That is, and has been, my only point.

                    The French healthcare system is funded by the working population. French employees pay about 20 per cent of their gross salary – the self-employed pay even more - deducted at source, to fund the social security system, known as Sécurité sociale.

                    I wonder how far a 20% payroll tax proposal would make it in Congress? One-term presidency, anyone?

                    And it is hardly single-payer:

                    Unlike in the UK in France treatment, whether private or public, is not free at the point of delivery. Even if you subscribe to the Sécurité sociale, on seeing a doctor or specialist (specialiste) you first pay the full bill (tarif) and are then reimbursed at a later date (about 10 days). Generally speaking, Sécurité sociale refunds 70 per cent of the cost of a visit to a médecin traitant (a GP or family doctor) and most specialistes.

                    70%?? What about the other 30%??? Who pays for that?

                    You guessed it. The sick person. Which is why a majority of French citizens have to buy an additional insurance policy, above & beyond the 20% payroll tax they are paying for the government-regulated insurance:

                    Even when you are affiliated to the French system a fundamental principle of healthcare funding in France is the element of personal contribution. To make up the difference between what the state pays and the cost of treatment, most French residents take out an insurance policy to cover the difference (complement). This is called a police complémentaire or mutuelle.

                    Let's not deify the system. It's 1000 times better than ours. It's nowhere near as comprehensive as Canada's or Britain's. And Obama doesn't have a snowball's chance in Fresno of getting 1/4th what the French have.

                    "Someone who does not see a pane of glass does not know that he does not see it." --Simone Weil

                    by AgnesBee on Sun Jul 26, 2009 at 08:48:28 AM PDT

                    [ Parent ]

                •  The organization is clearer in this quote (1+ / 0-)
                  Recommended by:

                  En France, il existe :

                  Trois grands régimes :

                  Régime général : salariés et travailleurs assimilés à des salariés soit environ 80 % de la population.

                  Régime des travailleurs non salariés non agricoles (appelé Régime social des indépendants ou RSI): artisans, commerçants et professions libérales. À compter du 1er juillet 2006, les régimes de retraite des commerçants (ex Organic), de retraite des artisans (ex - Cancava), Maladie des non salariés non agricoles (ex Canam) sont fusionnés au sein du

                  Régime social des indépendants (RSI). À compter du 1er janvier 2008, les Non - non auront un Interlocuteur social unique (ISU)

                  Régime agricole (au sein de la MSA)

                  Divers régimes spéciaux, antérieurs au régime général et qui ont refusé de s'y fondre lors de sa création : cadres, sénateurs, Assemblée nationale, SNCF, RATP, EDF-GDF, Banque de France, clercs et employés de notaires, port autonome de Bordeaux, Caisse des français de l'étranger, régime local d'Alsace et de Moselle...

                  One organization for most employed people, one for the self-employed, one for the agricultural sector, and important governmental agencies (the national railroad, power company, bank, the French versions of the Senate and House of Representatives, etc.)  are allowed to each have their own coverage organization.

                  I'm not sure if cadres just means executives in the public sector.

                  •  more (0+ / 0-)

                    Le régime général est géré par l'Assurance Maladie. Elle assure à près de 56 millions de bénéficiaires une protection au regard de cinq risques : maladie, maternité, invalidité, décès, accidents du travail/maladies professionnelles.

                    L’Assurance Maladie mène une politique de gestion du risque qui vise à améliorer la santé de la population, en renforçant l’efficacité du système de soins et en maîtrisant l’évolution des dépenses de santé. L’Assurance Maladie finance près de 75 % des dépenses de santé. En moyenne, en 2006, chaque assuré du Régime général a perçu près de 1890 euros de remboursement de soins[6].

                    Les organismes d’Assurance Maladie forment un réseau de structures départementales et régionales : Un siège social (CNAMTS), 128 Caisses Primaires (CPAM), 16 Caisses Régionales (CRAM), 22 Unions Régionales (URCAM)...


                    La réforme de l’Assurance Maladie d’août 2004 a renforcé et complété les responsabilités de la CNAMTS, notamment dans l’optimisation du fonctionnement du système de soins. Aujourd’hui, les principales missions de la CNAMTS sont :

                    - Définir les orientations, les principes et les objectifs qui guident son action et celle de l'Assurance Maladie en général, et en assurer la mise en œuvre.

                    - Assurer la mise en œuvre des accords « conventionnels » passés entre l'Union nationale des caisses d'assurance maladie (U.N.C.A.M.) et les syndicats représentatifs des différentes professions de santé, notamment pour la mise en place du parcours de soins coordonnés

                    - Développer la maîtrise médicalisée des dépenses de santé

                    - Définir et promouvoir la prévention de la maladie, des accidents du travail et des maladies professionnelles

                    - Organiser et diriger le Service médical de l'Assurance Maladie

                    - Déterminer et coordonner l'activité des organismes des branches maladie et accidents du travail - maladies professionnelles (Caisse primaire d'Assurance Maladie, Caisses régionales d'assurance maladie (CRAM)), négocier et attribuer les budgets aux caisses locales dans le cadre de Contrats pluriannuels de gestion (CPG), et assurer des services de conseil et d'appui au réseau dans le cadre de son activité

                    - Gérer la politique des risques de l'ensemble du système de soins, via les Agences régionales d'hospitalisation (ARH) et la politique médico-sociale, via les CRAM

                    Les missions de la CNAMTS sont encadrées par une Convention d’Objectifs et de Gestion (COG) conclue avec l’Etat pour une durée de quatre ans et par L'Objectif national des dépenses de l'Assurance Maladie (ONDAM) qui dresse l’objectif de prévision des dépenses de soins de ville et à l’hôpital, voté chaque année par le Parlement.


          •  Your assuming that price would be set by (1+ / 0-)
            Recommended by:

            the companies....If you take the dutch model as above the insurance profit turns into long term safe low yield investments... I posted the dutch model above since they have the best health system in the world that covers their whole population... Our problem is that reform with true cost savings regardless of system will have a big impact on GDP and Jobs.... Healthcare is a large employer and provides many millions their lively hood... Their will be a cost regardless of system of coverage...

    •  Get a thick skin... (5+ / 0-)

      Yes to single payer and just say no to watered down public option. Go read here for more progressive "broadsides" from the likes of Bill Moyers:

      The big drug companies are already so pleased with what they've been promised that they've brought back Harry and Louise -- the make-believe couple who starred in TV ads that helped torpedo the Clinton health care plan -- but this time they're in favor of reform...

      ...This is part of the reason, as Alicia Mundy and Laura Meckler recently wrote in The Wall Street Journal, that "the pharmaceuticals industry, which President Barack Obama promised to 'take on' during his campaign, is winning most of what it wants in the health-care overhaul."

      Their story describes "a string of victories" plucked from the Senate Finance Committee by drug company lobbyists, including no cost-cutting steps, no cheaper drugs to be allowed across the border from Canada, and no direct Federal government negotiations with the pharmaceutical companies to lower Medicare drug prices.

      And that's not all. The Senate Health Committee is giving the biotech industry monopoly protection against competition from generic drugs for 12 years after they go on the market.

    •  Obama doesn't want a strong public option (0+ / 0-)

      The one is the bill is weak and even Hacker's strong option cannot work in theory or practice.

      "I happen to be a proponent of a single payer health care program." Pres. Goldman Sachs Obama, 6/30/03

      by formernadervoter on Sun Jul 26, 2009 at 07:06:53 AM PDT

      [ Parent ]

    •  Agnes (11+ / 0-)

      I see people taking care of the substantive arguments below.

      There is another point: Obama and other progressive leaders have asked us to stand up and push him on issues. This is what is required of us by the leader you are defending.

      This diarist has not taken any swipes at Obama in the diary. She is addressing him and asking for what she thinks is the best solution, while supporting that with information.

      This is quite different from a "progressive broadside". She is addressing Obama, as far as I can see, because this position pushes him further than he currently stands and he is the one she wants to take up the call.

      We can do more than one thing here. There are many people working to push Blue Dogs and others to support the currently described plan.

      Again, it is entirely appropriate for us to stand up and address our leaders with our facts and opinions on what should be done.

      •  Well said. I agree with every word. (4+ / 0-)


        The diarist's titles are (too often for my taste) provocative, screedish attacks -- a very effective marketing tool, to be sure, but not (for my taste) admirable.

        **Obama Is Packaging Screwing The World's Hungry as "Aid"**

        **Food Safety & Failing Up in the Obama Admin**

        [and today's...]

        **Obama, Don't Feed Me to the Insurance Companies. I Want Medicare**

        The diaries themselves often contain more nuanced arguments. But the headlines? Is Obama "screwing the world's hungry"? Can he just snap his fingers and voila restructure the entire world food aid system? Does one Obama appointment spell DOOOOOOOM for the food safety system? And is Obama "feeding us" to the monstrous jaws of the insurance companies?

        I find such rhetoric misleading (at best) and inflammatory (at worst). Just my opinion, which doesn't mean much.

        But as you say...

        it is entirely appropriate for us to stand up and address our leaders with our facts and opinions on what should be done.

        "Someone who does not see a pane of glass does not know that he does not see it." --Simone Weil

        by AgnesBee on Sun Jul 26, 2009 at 07:43:50 AM PDT

        [ Parent ]

        •  your critique on titles (1+ / 0-)
          Recommended by:

          is well noted.

          And I would argue some of the internal arguments could also be more nuanced.

          I did not observe this title in a continuum as you did, so did not see it as particularly inflammatory. Now that I see your perspective, I understand that point of view.

          Thank you for your thoughtful reply.

        •  Jill's among the best diarists on this site (4+ / 0-)

          Especially on the subject of food, Jill's one of the few diarists here that opened my eyes to things I didn't even know I should be thinking about.

          This isn't directed at anyone in particular. The thing about titles just made me want to point out what a valuable contribution Jill makes.

          •  Yes, she shouldn't cheapen her valuable work (0+ / 0-)

            by resorting to rhetorical excess.

            But this is the way of political discourse. Always has been, always will be.

            "Someone who does not see a pane of glass does not know that he does not see it." --Simone Weil

            by AgnesBee on Sun Jul 26, 2009 at 08:28:21 AM PDT

            [ Parent ]

    •  This diarist ALWAYS does this. She uses Obama's (0+ / 0-)

      name in her titles in a sensationalistic attempt to get people to click on. It is becoming rather tiring but she is getting on the rec list - which is what she wants. This is a somewhat decent diary but I refuse to reward her for not only exploiting Obama's name but also adding to the body of negativity surrounding his name.

      Max Ehrmann (author of Desiderata): Whatever else you do or forbear, impose upon yourself the task of happiness; and now and then abandon yourself to laughter.

      by JoanMar on Sun Jul 26, 2009 at 11:18:39 AM PDT

      [ Parent ]

  •  I get the impression that those of us who (16+ / 0-)

    can 'afford' health insurance (income too high for the public option subsidy), will be forced to purchase private health insurance at an astronomical price, and still be denied coverage for treatments our doctors prescribe. In other words, except for about 9M of the poorer people (yay for them) who will be able to get the public option (if it survives August), the rest of the 47M uninsured will be extorted to donate money to the health insurance industry, with no promise of healthcare.

    •  How would that work? (1+ / 0-)
      Recommended by:

      I am under the impression my healthcare will remain with the plan that my spouse's employer (the federal government) currently subsidizes and we make payments toward.  

      Your impression should address who the federal employees will get healthcare from- they are a big group.  How will states insure their employees under the new plan?  They are a big group.  My state plan insures all the teachers as well as all the other state employees.

      You shall know the truth, and the truth shall make you mad. Aldous Huxley

      by murrayewv on Sun Jul 26, 2009 at 06:59:58 AM PDT

      [ Parent ]

    •  Punish the well-insured (4+ / 0-)

      Axelrod explained today that a potential source of funding for healthcare will be by taxing the beneifts the people who have expensive coverage "like the president of Goldman".

      Translation: fuck those of us in the middle who are fortunate enough to still have real coverage, rather than tax high income. The president of Goldman dosn't care if his health insurance is taxed, but he sure as hell cares if all his income (read: from any source) is taxed.

      What Goldman wants, Goldman gets.

      •  It is the union coverage (2+ / 0-)
        Recommended by:
        greeseyparrot, lgcap

        that they want to tax hard.

        Health care cost coverage is the main cause of labor-management strife in modern America.

        They want to undermine and eliminate the union demand for more coverage by taxing the majority of union members that are healthy.

        The fatcats at Goldman just will be collateral casualties that can easily brush off financial wounds of a few thousand bucks yearly apiece.

  •  A fantastic diary (12+ / 0-)

    One of the main problems we face is that the corporate media will not allow these stories and these perspectives to be told. A socialized fire department works just fine, and virtually nobody wants to return to the bad old days of fire insurance (where your home would only be saved from the flames if you'd paid up). Yet the media refuses to tell these stories, with the exception of heroes like Bill Moyers.

    It would help if Obama had embraced these kinds of frames. Instead he embraced frames that enable the right, such as cost control. (Of course, there IS no cost control possible with private health insurance, but Obama refuses to accept this either.)

    I'm not part of a redneck agenda - Green Day

    by eugene on Sun Jul 26, 2009 at 06:44:27 AM PDT

  •  Sorry Obama doesnt write legislation (3+ / 0-)
    Recommended by:
    Kickemout, JoanMar, AgnesBee

    Direct your ire at congress, they are the ones writing the legislation. Obama is not a dictator and there is even a chance that healthcare reform will not see the light of day

    •  Does Obama have any role? (1+ / 0-)
      Recommended by:

      Or is it all up to congress?

      •  He misread the Clinton failure (4+ / 1-)
        Recommended by:
        SarahLee, irmaly, lgcap, StateofEuphoria
        Hidden by:

        It wasn't because Bill tried to ram it through it was because he didn't engage the single payer movement and by extension the majority of the public that wants it.

        Instead he went corporate and so is Obama and that is why both failed.   (yeah, Obama's already failed.)

        "I happen to be a proponent of a single payer health care program." Pres. Goldman Sachs Obama, 6/30/03

        by formernadervoter on Sun Jul 26, 2009 at 07:14:06 AM PDT

        [ Parent ]

        •  Obliterate preexisting condition clauses (2+ / 0-)
          Recommended by:
          irmaly, marina

          Obviously not a panacea, but we all know they aren't going to fix anything. So take a baby step to reform the existing system? Regulate the insurers so that if they promise coverage, they have to deliver.

          There is a reason even the most ridiculously simple steps aren't taken. Any guesses?

        •  Did the majority want single-payer in 1994? (0+ / 0-)

          When a statewide single-payer initiative was on the ballot in California in 1994, it failed by a vote of 30% to 70%.

          •  Only sold with bad tax news (0+ / 0-)

            and not the premium savings.

            The ballot summary was:

            Establishes health services system with defined medical, prescription drug, long-term, mental health, dental, emergency, other benefits; available to California residents, replacing existing health insurance, premiums, programs.
            Services funded by tax upon employers, individuals, with stated exemptions, cigarette/tobacco products surtax, existing federal, state, county health care funds, if authorized; proceeds deposited into Health Security Fund. Health benefit providers, authorized costs, paid from fund.
            Elected Health Commissioner administers fund/system, coordinates with federal law.
            Provides cost controls; annual expenditure limits based on prior year expenditures, unless adjusted.
            Creates advisory Policy Board, Consumer Council.
            The fiscal estimate provided by the California Legislative Analyst's Office said:

            Total funds for a state-administered health system potentially exceeding $75 billion annually, including $40 billion to $50 billion from new state taxes. Costs could be less or greater than funds.
            Potential state and local government savings in the hundreds of millions of dollars annually over time if these governments limit their contributions to the new health care system.
            Potential state revenue losses initially as much as a few hundred million dollars annually. Long-term effect on state revenues is uncertain, but probably not major in context of the total state economy.


            Repeat Offenders (Three Strikes).
            The ballot summary was:

            Increases sentences for defendants convicted of any felony who have prior convictions for violent or serious felonies such as rape, robbery or burglary.
            Convicted felons with one such prior conviction would receive twice the normal sentence for the new offense. Convicted felons with two or more such prior convictions would receive a life sentence with a minimum term three times the normal sentence or 25 years, whichever is greater.
            Includes as prior convictions certain felonies committed by juveniles 16 years of age, or older.
            Reduces sentence reduction credit which may be earned by these convicted felons.

            The fiscal estimate provided by the California Legislative Analyst's Office said:

            Provisions of this measure are identical to a law that was enacted in March 1994. That law will (1) increase state prison operating costs by hundreds of millions of dollars annually, reaching about $3 billion in 2003 and about $6 billion annually by 2026; (2) increase state prison construction costs by about $20 billion....


            $20 billion for prisons!

            Imagine what enough lunatic asylums would cost.

        •  Bill Clinton himself disagrees with you. (0+ / 0-)

          He says the problem WAS that the WH dictated the health care plan down to the details, so the Congressional Dems didn't fight for it since they felt no sense of ownership, and thus they made competing proposals and ended up in a situation where none of the proposals had a majority of support.  And no single payer, which a faction of Dem Congressmen were pushing, didn't have majority support either.

    •  Don't feed this troll folks. Read his history. nt (2+ / 0-)
      Recommended by:
      greeseyparrot, JoanMar

      Learn more about second-class U.S. citizenship at

      by Larry Bailey on Sun Jul 26, 2009 at 08:38:50 AM PDT

      [ Parent ]

  •  I think you miss the point (0+ / 0-)

    It is not should everyone have access to helthcare because everyone has access today via local chip programs, medicare, medicade, and the simple fact no hospital can deny access.

    The question is who is going to pay for your access to health care.  Is it an individual responsibility or is it the respnsibility of others to pay for your health care?

  •  You'd make the perfect the enemy of the (14+ / 0-)

    good? Single-payer isn't going to happen unless we get the public option in place. You really should read about what a major fight it was in Canada to get to their current health care system now. People fought to get the infrastructure in place, and then worked to expand it further, and they had to fight private insurance companies every single step of the way.

    It's what we're doing now. Advocating for single-payer as the only course now isn't going to work. It actually damages your chances of getting to single-payer because you're not working to get the infrastructure in place now.

    I'm on Twitter. I'm also a part of the FDL team on health reform.

    by slinkerwink on Sun Jul 26, 2009 at 06:52:20 AM PDT

    •  I totally disagree (14+ / 0-)

      I am active in the fight for a public option, as you know, but I simply do not agree that a public option will lead to single-payer.

      In fact, there is a very real risk that a public option will actually blow up in our face and lead to a public unwilling to give the government more of a role in providing health care.

      The Canadian fight, which was spread out over about 40 years, was always about government providing something much more robust than the "public option" - it was more of a battle for a kind of health care Social Security.

      I disagree that advocacy for single-payer damages anything, as long as that advocacy is focused on undermining Blue Dog opposition to government involvement in the provision of health care.

      I'm not part of a redneck agenda - Green Day

      by eugene on Sun Jul 26, 2009 at 06:56:27 AM PDT

      [ Parent ]

    •  You're right. (6+ / 0-)

      Has there been a diary about the history of Canada's approach to health care?  It would be interesting to know what they started with and how they got to their present state of things.
      And thank you, slink, for all your hard work on this issue.  Even if you don't hear it often enough, it's deeply appreciated.  :)

      •  thank you. Actually, Canada (6+ / 0-)

        took about twenty years or so from 1946 to get to their near-universal health care system today.

        I'm on Twitter. I'm also a part of the FDL team on health reform.

        by slinkerwink on Sun Jul 26, 2009 at 07:02:00 AM PDT

        [ Parent ]

        •  If you look at that article (7+ / 0-)

          It explains that in Saskatchewan, where Canada's universal health care began, they went straight to a single-payer model. It was implemented in stages, beginning with hospitals. But they didn't mess with this intermediate step of a "public option."

          I'm not part of a redneck agenda - Green Day

          by eugene on Sun Jul 26, 2009 at 07:03:35 AM PDT

          [ Parent ]

          •  yes, and they had to fight (9+ / 0-)

            private insurers, hospitals, and doctors every single step of the way.

            We won't be able to go straight to a single-payer model here in the US, not by a long shot, but we can work with getting the public option in place, and then working to expand it over time.

            Stuff like this isn't easy.

            I'm on Twitter. I'm also a part of the FDL team on health reform.

            by slinkerwink on Sun Jul 26, 2009 at 07:06:58 AM PDT

            [ Parent ]

            •  well, we certainly can't do it (7+ / 0-)

              with everybody telling us it's impossible every step.  

              advocating for the best plan in no way hurts other plans in consideration.  that's absurd.  there is absolutely no harm in keeping up the calls for single payer and demanding it's included in congress' debate.  you and bag of health and politics are just totally baffling on this point.

              does the single payer contingent come into every diary of yours and excoriate you for ruining health reform by settling for the public option?  no.  we all jump in and fight for the public option.  it'd just be nice if the public option set would return the courtesy, instead of telling us we're ruining all the good work of "serious" people who "know" what can and can't be done.


              Quit posting non-sequitur "replies" just so your comment will be high up in the thread. It's effin' douchey. ♥

              by Cedwyn on Sun Jul 26, 2009 at 07:21:06 AM PDT

              [ Parent ]

              •  I'm happy that single-payers jump in (4+ / 0-)

                to fight for the public option, but there are certain people that you see in diaries crying about the failure of the public option in legislation that hasn't even been passed yet. They're working against the public option by urging that no one work to pass it, and only work to pass single-payer instead.

                I'm on Twitter. I'm also a part of the FDL team on health reform.

                by slinkerwink on Sun Jul 26, 2009 at 07:25:17 AM PDT

                [ Parent ]

                •  and there are certain people that you see (6+ / 0-)

                  in diaries crying about the failure of a single payer plan ever being in legislation, when it hasn't even been discussed yet.

                  if congress would get off their self-absorbed asses and have CBO run the numbers on single payer, the benefits of the system would be absolutely undeniable.  it'd be well nigh impossible to pretend it's not the best plan.

                  imagine, if you will, where we might be if all of the calls to congress over the past month exhorted them to enact single payer reform?

                  i mean, look:  either our calls make a difference or they don't.  if one believes they do, that must hold true for whatever message the calls are sending.  if making phone calls works, then why not demand what you truly want?

                  message matters.  period.  otherwise, the maxim needs to be "your calls make a difference, as long as it jives with what congress wants to do anyway."  

                  and one should never, EVER start negotiations from one's compromise point, anyway.

                  i happen to agree with the opinion that passing nothing is preferable to a fucked-up public option that is a mere sop to the public.  i don't expect you to agree with me on that.  but it is yet another example of how keeping single payer in the debate strengthens the public option, not the least of which is that people MUST understand that single payer != public option.

                  so seriously...let the single payer contingent be, please.  they are only helping the cause.  

                  Quit posting non-sequitur "replies" just so your comment will be high up in the thread. It's effin' douchey. ♥

                  by Cedwyn on Sun Jul 26, 2009 at 07:46:57 AM PDT

                  [ Parent ]

                  •  the CBO numbers on single-payer would (0+ / 0-)

                    be huge. It doesn't measure savings to the system, only the federal spending in the system. So the numbers you'd see for single-payer would be huger than what's in the estimate for the House and Senate bills.

                    I'm on Twitter. I'm also a part of the FDL team on health reform.

                    by slinkerwink on Sun Jul 26, 2009 at 07:52:59 AM PDT

                    [ Parent ]

                    •  on what are you basing this? (3+ / 0-)

                      CBO only scores real proposals, none of which have been put up for single payer. the CBO can't know costs without knowing the proposed funding.  since no one would be paying premiums, co-pays and deductibles anymore, they're not going to notice paying a little more in taxes every year.  they might even see higher wages, since their work is no longer burdened with insurance costs.  which means more funding revenue.

                      take the insurance sector profit and administrative costs out of the equation entirely and the savings would immediately be HUGE.  doctors wouldn't mind medicare payment rates if 1/3 of their office resources weren't devoted to insurance claims. etc.  these are efficiency considerations that are imperative for any responsible financial analysis.  

                      better value isn't always in the least spending.  sure, the government outlay would increase, i mean, duh!  any time enrollment in a program increases, its costs go up. but a system in which 20% more of each health care dollar spent goes towards actual health care represents savings.  period.

                      since we don't have a congressional single payer plan for the CBO to score, we are left to rely on what we do have, all of which supports the cost savings of single payer.  if the plans coming out of congress can fund an exchange, the review board, the public option. blahblahblah, we can afford single payer.

                      Quit posting non-sequitur "replies" just so your comment will be high up in the thread. It's effin' douchey. ♥

                      by Cedwyn on Sun Jul 26, 2009 at 08:09:55 AM PDT

                      [ Parent ]

                  •  i mean hell, let congress take their vacation (3+ / 0-)

                    if the purpose of waiting is to get it right, great!  let's start discussing single payer so that we really get it right.

                    Quit posting non-sequitur "replies" just so your comment will be high up in the thread. It's effin' douchey. ♥

                    by Cedwyn on Sun Jul 26, 2009 at 07:56:26 AM PDT

                    [ Parent ]

                    •  If you think for one second that the Senate would (1+ / 0-)
                      Recommended by:

                      ... vote for Single Payer, or that the current President would sign it, you are completely delusional.

                      WTF ?  Why do you keep wasting everybody's time and effort with this ?

                      The Majority Leader in the Senate, along with a fracking  Senator from a podunk western state that is nothing but a cattle pasture and a ski area for rich people with condos,   almost killed off reform this past week.

                      They will do nothing that endangers the private insurance system, which bought them out a long time ago.

                      One of the above would have to go against his church hierarchy because they truly believe it is God's will to vote Republican and free market.

                      He gave them the month of August off so the Republicans can go work against us all month. Do you know what they are planning for September 12 th ?  
                      A great big Tea Party Protest to fight against Health Insurance Reform. In Washington, DC. The day after 9/11.

                      How obscene is that ? The day after 9/11 a bunch of whiners with delusions that the Founding Fathers created this country as a right wing profiteering "christian" nation and that they are the equivalent of the revolutionary war forces are going to DC to "save the Constitution."  

                      Reid and Baucus, they just gave the President a big finger in the air and waved him on to his vacation in Martha's Vineyard-  to a house he's renting from Republicans.

                      They do not represent America. They represent Corporate Business America, and there's no way they care in the least bit if people are suffering and dying. They think they have the President and Rahm pretty much in the pocket.  

                      One term President.

                      Our only leverage power is in the House, where they are much easier to throw out of office.

                      MAYBE we can get something with a Public Option thru there, and have them force the Senate and the President to deal with it.

                      "Toads of Glory, slugs of joy... as he trotted down the path before a dragon ate him"-Alex Hall/ Stop McClintock

                      by AmericanRiverCanyon on Sun Jul 26, 2009 at 09:40:00 AM PDT

                      [ Parent ]

                      •  where did i insist congress would nut up, (1+ / 0-)
                        Recommended by:

                        do the right thing and vote for single payer?  

                        what i said was that keeping single payer in the debate only strengthens the public option.  if congress hears nothing but demands for single payer all day long, they'll feel more pressure to support the public option.

                        people can't cry "socialist medicine!" in opposition to the public option with single payer staring them in the face.

                        et cetera

                        and fuck you for telling me i'm wasting mine and everybody's time.  who the hell are you?

                        Quit posting non-sequitur "replies" just so your comment will be high up in the thread. It's effin' douchey. ♥

                        by Cedwyn on Sun Jul 26, 2009 at 09:44:26 AM PDT

                        [ Parent ]

                  •  Thank you, Cedwyn (3+ / 0-)

                    Well said.

                    While I am a strong single payer advocate, I have helped with calls and petitions for the Public Option - I wonder how many public option folks have returned the favor and called for single payer.

                    I wonder what would happen if for one week - this next one - all of the health reform advocates joined in calls for single payer - if they told their reps that the public options under discussion were too complicated and were not, per the CBO, demonstrating savings needed to be sustainable, so we need to go back and just get an Expanded and Improved Medicare for All Single Payer plan.

                    What would the reactions in DC be if they suddenly felt that change in patience from everyone?  I imagine that work on a better, simpler,  public option would commence quickly.

          •  That's because the public option is not an (2+ / 0-)
            Recommended by:
            SarahLee, greeseyparrot

            intermediate step.

            It firmly keeps in place two things:

            1. Insurance tied to an employer
            1. Private market.

            These are permanently locked in this legislation and it isn't going to lead to single payer, ever.

            When people see that the PO doesn't work to control costs---and it will not---the momentum for government interference in the market will be lost, maybe for decades.

            "I happen to be a proponent of a single payer health care program." Pres. Goldman Sachs Obama, 6/30/03

            by formernadervoter on Sun Jul 26, 2009 at 07:18:22 AM PDT

            [ Parent ]

            •  where in the bills being considered (2+ / 0-)
              Recommended by:
              SarahLee, greeseyparrot

              is insurance still tethered to unemployment?  iirc, portability is one of the bigger issues.

              also, where is the part about mandating insurance purchases, someone please?


              Quit posting non-sequitur "replies" just so your comment will be high up in the thread. It's effin' douchey. ♥

              by Cedwyn on Sun Jul 26, 2009 at 07:22:20 AM PDT

              [ Parent ]

            •  How will employer provided healthcare survive? (1+ / 0-)
              Recommended by:
              Calamity Jean

              We are told that 80 percent of US workers are employed by small businesses.  

              Small businesses can no longer afford to provide even a meaningful portion of their employees' health insurance costs.  Two years ago I left a job at a small business (15 employees/ 10 of whom received insurance from the company).  At that time, premiums for a family plan ran $1050 a month - and that's with "group" coverage.  (The employer had to limit its share of the premium to $750 a month.)  I can't imagine what the premium is today.  

              Once there is a public option, there will be a tsunami of people moving to the public option, mostly from small businesses.  

              Then private health care "insurance" will be dead.  Finally.  And not a day too soon.

          •  Saskatchewan's population (4+ / 0-)

            was, and is, quite small. A fundamentally different sized fight than we are facing here. Saskatchewan has - right now - just over a million people. Implementing universal health care in saskatchewan is equivalent to implementing universal health care in San Jose, California, and nowhere else.

            There seems to be a lack of awareness here  of the enormity of the United States - we are the 3rd most populous country on earth. There are only two countries with more people than us - India and China. Think about that.

            No country this size has implemented a fully first-world universal health care plan before. the closest is Japan, which has less than half our population and a less geographically and culturally diverse society.  It's never been done. Obama isn't some sort of Bush clone, as is implied in numerous comments here, simply because he can't wave his magic wand and psychically get the exact system that a particular commenter on Daily Kos thinks is best by August.

            The public option is a rather nice "camel's nose under the tent" in my view. This is what has to happen in the short term. If it is actually accomplished, it will be, on its own, a miracle.

    •  I am familiar with the Canadians' fight (9+ / 0-)

      for single-payer.  But Jill is right, in that we fought the Medicare fight years ago, and now we have the infrastructure in place.  We don't have to fight that battle.  All we would have to do is expand the infrastructure we have now.

      One more thing the Bill Moyers program made clear is that there is plenty of money in the health care "system" we have now to completely cover the cost of health care for everyone in the U.S.  The money is just being spent unwisely, mainly to keep afloat private insurance companies and hospitals that have shareholders who demand profits - not to mention the money spent on pharmaceuticals because there is no negotiations required on drug prices.  Between what employers pay, what individuals pay and what the government pays (or doesn't collect taxes on), there is plenty of money.

      This is not making "perfect" the enemy of "the good."  There is no guarantee that a public option, once the insurance companies get through with it, will even be "the good," and there is certainly no guarantee that it will lead to a single-payer system.

      "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

      by SueDe on Sun Jul 26, 2009 at 07:14:15 AM PDT

      [ Parent ]

    •  Incorrect: PO does not lead to SP (2+ / 0-)
      Recommended by:
      SarahLee, greeseyparrot

      In fact it's set up to be the ineffective mouse that it is.

      These people in Congress are protecting the drug companies and the insurance companies with this legislation.

      The Democrats who crafted this horrible legislation are blocking real reform.

      "I happen to be a proponent of a single payer health care program." Pres. Goldman Sachs Obama, 6/30/03

      by formernadervoter on Sun Jul 26, 2009 at 07:15:55 AM PDT

      [ Parent ]

    •  From what I have read of the public option... (2+ / 0-)
      Recommended by:
      SarahLee, greeseyparrot

      as it currently exists, it has virtually no chance to materialize into anything like single payer, and is far from the Medicare Plus proposals previously put forth that had that potentiality.

      •  Actually, it has a chance of materializing into (4+ / 0-)

        anything like single-payer. The House Tri-Committee bill is our best chance at it, and if people aren't working at getting it passed out of committee, then we WILL not have a public option that works towards single-payer.

        I'm on Twitter. I'm also a part of the FDL team on health reform.

        by slinkerwink on Sun Jul 26, 2009 at 07:19:35 AM PDT

        [ Parent ]

        •  I disagree for many of the reasons... (3+ / 0-)
          Recommended by:
          SarahLee, greeseyparrot, Willa Rogers

          put forth in the Moyers program and others who argue, among other things, that the public option may become a dumping ground that will discredit more government involvement in the area.

          Even the CBO projects that the proposals now considered will fall far short of what the public is led to believe.

          Until I see otherwise, I prefer nothing to what I see as a sham of a reform.  Americans want national health insurance and the politicians have aligned with those who are addicted to dysfunction to create an illusion of doing something for the public good.

          •  That's not true about it becoming (1+ / 0-)
            Recommended by:

            a dumping ground because of the insurance regulations in the bill and community rating.

            I'm on Twitter. I'm also a part of the FDL team on health reform.

            by slinkerwink on Sun Jul 26, 2009 at 07:36:03 AM PDT

            [ Parent ]

            •  The truth is we don't know the truth... (3+ / 0-)
              Recommended by:
              SarahLee, greeseyparrot, fernan47

              and there are plenty of voices saying it has that potential.

              Personally, knowing how things work in Washington and seeing Obama's record to date, I think the fix is in.

            •  v serious request... (2+ / 0-)
              Recommended by:
              SarahLee, slinkerwink

              That's not true about it becoming a dumping ground because of the insurance regulations in the bill and community rating.

              skinkerwink, would you give me a link to an analysis of the proposed legislation to back that up? i'm serious. although i don't see it, i want to be persuaded to change my mind. so i'm looking for geeky weedy details if there are any to be found.


              •  here you go (1+ / 0-)
                Recommended by:

                I'm on Twitter. I'm also a part of the FDL team on health reform.

                by slinkerwink on Sun Jul 26, 2009 at 08:40:47 AM PDT

                [ Parent ]

                •  thank you v much for the reply... (2+ / 0-)
                  Recommended by:
                  slinkerwink, fernan47

                  but i don't see anything at that link on the details of the regulations that would prevent the public option from becoming a dumping ground. am i missing something? quite possible and if so, could you (or someone) point me to it?

                  i've done some background reading on this issue previously. then read some of the tri-committee bill (to see what it said) and when i didn't find any details called my rep's leg health aide who told me the plan was to leave the details up to hhs. but the details matter -- i don't see how any conclusions can be drawn without them.

                  i'm really, really not trying to be a pain in the ass (so sorry, apparently it comes naturally, no matter what i do!). it's just that i want to understand for myself and be convinced -- if that's possible.  taking it on faith is not where i'm at right now (esp having lived through the 2006 MA reform).

                  adverse selection, etc in health insurance are not easy problems to regulate away (all the attempts in the usa i know of have failed). which is why i think, to have a chance to survive and succeed, the public plan would have to be v big at the outset. but again, really really want to be persuaded otherwise.

                  •  the ban on pre-existing conditions (1+ / 0-)
                    Recommended by:

                    and recission policies are big huge "gets" in preventing the public option from becoming a dumping ground.

                    I'm on Twitter. I'm also a part of the FDL team on health reform.

                    by slinkerwink on Sun Jul 26, 2009 at 09:35:44 AM PDT

                    [ Parent ]

                    •  Rescission is important, no doubt,... (1+ / 0-)
                      Recommended by:

                      and it seems would be part of any new law, but what stops companies from charging huge premiums or lower premiums with huge deductibles for those with pre-existing conditions?

                      The question of underinsurance is neglected and I heard yesterday that 50 million are affected.

                      •  I think you have to take market pressure into (0+ / 0-)

                        account I also think that by def: pricing out people would in fact be viewed as recission by default... Now we have to see what the law states or the power given to HHS... IMHO.. it needs to be in the law... That way another administration can't do like they did to California with spot market pricing..... IMHO...

                        •  Recission by default is a non-sequitur... (1+ / 0-)
                          Recommended by:

                          to me.  It occurs AFTER one has a valid policy.  It is a way to avoid a contract based on a material misrepresentation or perhaps a matter that completely frustrates the purpose of a contract.

                          Underinsurance or excessive premiums due to pre-existing conditions is a different animal.  I don't think that underinsurance, which already exists for many, is even addressed, and I am not confident in any market driven solution.

                          •  Well I have not seen the bills language and so (0+ / 0-)

                            have little Idea at this point what is missing... I agree for it to work to lower costs etc... we need a minimum bottom level of care set in law or a public option along with a minimum level of care... along with rules governing who is covered etc...
                            If I was a congressman I would have studied this system.. It is the most like our system before change and the closest to what we get in the end... IMHO...

                            Doing nothing will cost more... IMHO

                            The dutch system does it this way... By law, insurers are required to provide medical care, including care by general practitioners (GPs), hospitalization; dental care; all citizens are additionally covered by the statutory Exceptional Medical Expenses Act (AWBZ) scheme for a variety of chronic and mental health care services, including home care and care in nursing homes.
                            The insured pay a flat-rate premium (set by insurers) to their private health insurer. Those insured in 2006 were eligible for a refund of €255 ($367) if they made it through the year without requiring any medical attention. If they incurred costs of less than €255, residents were eligible for the difference at the end of the year
                            The insured are required to pay the first €150 ($216) of any health care costs in a given year (with some services excluded from this general rule).
                            In addition, the government provides health care allowances for low income citizens if the average flat-rate premium exceeds five percent of their household income.

                      •  The House bill (1+ / 0-)
                        Recommended by:
                        Willa Rogers

                        basically protects against rescission, pre-exclusion, and provides affordability for non-indebted people not living in expensive places like NY and LA.

                        The coverage minimum will be defined by government bureaucrats and it will not be minimal.

                        Payouts in cases of sickness will be bearable unless your household is teetering on the edge now.

                        It has flaws.

                        Premiums on the affluent and medical costs are not controlled.

                        It doesn't allow the removal of most costs (office and hospital staffing) and most barriers (specific drug not covered, specific doctor not in plan)that a single payer plan could and normally would.

                        It allows a couple earning $800,000 to pay only about 3% of their income for all medical care and coverage while a self-employed couple making $50,000 a year might pay about 18% of their income for all medical care and coverage.

                      •  see sections 111 and 113a (0+ / 0-)

                        what stops companies from charging huge premiums or lower premiums with huge deductibles for those with pre-existing conditions?

                        i hope i'm quoting the correct text here. someone please correct me if i have it wrong!


                        4A qualified health benefits plan may not impose any pre-existing condition exclusion (as defined in section 2701(b)(1)(A) of the Public Health Service Act) or otherwise impose any limit or condition on the coverage under the plan with respect to an individual or dependent based on any health status-related factors (as defined in section 2791(d)(9) of the Public Health Service Act) in relation to the individual or dependent

                        SEC. 113. INSURANCE RATING RULES.

                        (a) In General- The premium rate charged for an insured qualified health benefits plan may not vary except as follows:

                        1(1) LIMITED AGE VARIATION PERMITTED- By age (within such age categories as the Commissioner shall specify) so long as the ratio of the highest such premium to the lowest such premium does not exceed the ratio of 2 to 1.

                        (2) BY AREA- By premium rating area (as permitted by State insurance regulators or, in the case of Exchange-participating health benefits plans, as specified by the Commissioner in consultation with such regulators).

                        (3) BY FAMILY ENROLLMENT- By family enrollment (such as variations within categories and compositions of families) so long as the ratio of the premium for family enrollment (or enrollments) to the premium for individual enrollment is uniform, as specified under State law and consistent with rules of the Commissioner.

                    •  agree v important no doubt. but..... (0+ / 0-)

                      regardless of the mandate and public option those are v important regulations (we had them in MA prior to the 2006 reform). but they are NOWHERE close to being sufficient to preventing adverse selection, etc.

                      here are a couple of simple examples of what i'm talking about.

                      1. competition by denial of care. for example, what happened to the sarkisyan family (denial for needed liver transplant). health insurance companies compete by denying care. the administrative cost involved in that "saves" money - for executive salaries, etc and also so that premiums can be less. that means that they can offer a cheaper (but with poorer coverage) policy. a polcy that health young people would be more likely to choose while the older, sicker people will be more likely to choose the more expensive policy that doesn't deny expensive care.
                      1. competition by targeted advertising. health insurance companies compete by targeting relatively healthier customers for advertising.

                      these are the kinds of things that are expected to lead to the public plan option being where the more expensive people end up. especially if it starts out small.

                      there may be things that could be done via risk adjustment regulation and enforcement but i don't see anything like that in the bill (could have missed it though).

        •  Is this the same Tri-Comm bill version... (2+ / 0-)
          Recommended by:
          StateofEuphoria, Willa Rogers

          ...that comes into effect in 2013?

          Because if so, slinkerwink, that means the House failed to sell hc and capitulated to teh Republicans.

          Can't you just hear President Obama running for re-election on  health care reform AGAIN...? Because by then the Republicans will have the public pleading to stop the bad-old-bill that bad-old-Congress passed.

          HR 676 - Health care reform we can believe in - national single-payer NOW.

          by kck on Sun Jul 26, 2009 at 09:40:31 AM PDT

          [ Parent ]

    •  Sorry - but my feeling is that those of you (3+ / 0-)

      who compromised so early on a public option over single payer are the reason we are winding up with proposed bills that are so complicated and provide so little savings as to be unsustainable, even if passed.

      If we don't get a good working, sustainable Medicare like public option, it will be because so many decided to start negotiations at the "line in the sand" public option instead of pushing for single payer.

    •  Precisely what I was about to say (0+ / 0-)

      I simply don't get the arguments that the two ladies from the Moyers interview were putting forward.  How is added competition merely "throwing money" on a currently existing pile?  Isn't that assuming that the public option would operate exactly as the private insurers do?  It's not a captive market if the public option is significantly different from the private plan.  And do they really expect us to believe that Obama is taking a hands-off approach because he doesn't want his fingerprints on a failed plan?  If that's the case, then why is he all over my TV?  Obama's so blatantly taking ownership of this issue that I have to wonder if these two women own the cable.

      I think the interview is instructive in terms of what problems could happen in a worst case scenario, but then they hopped from "worst-case scenario" to "Medicare or don't bother".  And I don't think they really made particularly convincing arguments as to why we should expect this worst case scenario to happen.

  •  but (4+ / 0-)

    I was just in Mexico on vacation and was able to purchase perscription drugs off the shelf at 10% of the cost here.

    So there are serious issues we must deal with.

    •  only beacuse..... (2+ / 0-)
      Recommended by:
      SnowCountry, Justanothernyer

      high prices for prescription drugs in the USA pay for most drug development.  Most new drugs are invented (not really "discovered") in the USA.  This is a costly process.  This issue is very important because is affects ultimately better treatments for disease.

      You shall know the truth, and the truth shall make you mad. Aldous Huxley

      by murrayewv on Sun Jul 26, 2009 at 07:12:11 AM PDT

      [ Parent ]

    •  I also live in Mexico (2+ / 0-)
      Recommended by:
      SarahLee, StepLeftStepForward

      and some days, I get so pissed at our healthcare mess, I want to become a drug smuggler.

      No, nothing that the black market would be interested in but I know the U.S. government would treat me no differently than if I was trafficking in cocaine.

      Hey, maybe we should organize all international travelers to bring the maximum allowable amount of drugs to which they're prescribed and donate them to a collective...

      (-7.75, -7.69) No matter how cynical I get, I just can't keep up - Lily Tomlin

      by john07801 on Sun Jul 26, 2009 at 07:18:03 AM PDT

      [ Parent ]

    •  Beware of buying drugs in Mexico (0+ / 0-)

      If you can't tell they are working or if they are critical to maintain life, don't buy them.

      Also 10% of the US price is suspiciously low.

      I think maybe 60% of the US price is more typical.

  •  So afraid of health care (3+ / 0-)
    Recommended by:
    SarahLee, panicbean, sherlyle

    It's so odd that people are afraid of universal health care when its the best option for those without health insurance as well as those with it.  

  •  Ah, the common sense approach (12+ / 0-)

    If only our "leaders" worked that way.

    We're going to keep spitting on a fire for the rest of our lives, convinced that we're putting out the flames while it rages on beyond our reach.

    I have great insurance. I have a fantastic doctor. I have a deductible that will bankrupt me should I ever become ill, and that is, as noted, with one of the better plans available today.

    God bless America.

    I know theft is illegal, but look at all the cool stuff I got!

    by BoiseBlue on Sun Jul 26, 2009 at 06:56:01 AM PDT

  •  It's possible to have a good system (12+ / 0-)

    that includes private insurance, but not private insurance as it now exists, that is, for-profit insurance companies.  Many other countries' heath care systems utilize private insurance companies and private hospitals, but both are required to be non-profit or they're not certified by the government.  For-profit companies only exist to offer supplemental policies, if they exist at all in these other countries' systems.

    But of course that's the sticking point in the U.S. system - congress is determined to keep for-profit insurance companies and hospitals in business as for-profit entities.  Until this changes, both citizens and the government will continue to shovel money into these for-profit entities, and by extension to their shareholders and executives.

    I've said for twenty years now, "Medicare for all!" while I waited to grow old enough to get into Medicare.  Now I'm almost old enough, and my biggest fear with this boondoggle being fashioned by congress is that Medicare will be swept up in the "reform" and I'll be forced to underwrite the profits of for-profit insurance companies anyway.

    "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

    by SueDe on Sun Jul 26, 2009 at 06:56:59 AM PDT

    •  I'm hoping Medicare will be there, too (3+ / 0-)
      Recommended by:
      SarahLee, sherlyle, StateofEuphoria

      Two more years to go for me, and it's a nightmare to think that Medicare will be "reformed" before I get there.

      I fear our government is run by business interests now and we have no chance of getting anything sensible. I've been reading the stories about how much money the corporations are donating to Blue Dog Democrats to block anything that will help the people and hurt their profits.

      "I was actually born on Krypton and sent here by my father Jor-El to save the Planet Earth."

      by lesliet on Sun Jul 26, 2009 at 07:23:42 AM PDT

      [ Parent ]

    •  Exactement. (0+ / 0-)

      "Someone who does not see a pane of glass does not know that he does not see it." --Simone Weil

      by AgnesBee on Sun Jul 26, 2009 at 07:26:34 AM PDT

      [ Parent ]

  •  Nathguy's Universal Health Care Plan (6+ / 0-)
    1. Everyone get's medicare,  just sign in using your SSN at the doctor.
    1. to help pay for this, lift the cap on medicare tax, it's capped at 87K,

    let it be collected on all w-2 and 1099 income. tax as income private medical benefits valued in excess of medicare.  increase taxes on capital gains.

    1. give any facility that already earns over 50% of it's income from Medicare/medicaid the VA Patient electronic record system software and a free conversion.  
    1. Any facility that earns over 75% of it's revenue from medicare/medicaid may be forcibly converted into medicare salary. Providers will be paid a generous


    1.  medicare only pays for generic drugs and competitively sourced proprietary drugs.
    1. medicare only supports 30 days hospitalization per year, after that you have to go to a nursing home, homecare or hospice.
    1. all pharmacies accepting medicare must install electronic dispensing

    systems.  medicare will lease the hardware for $1/year.

    what that does is gets us moved away from fee for service to  a migration path for salaried care.  It moves insurance companies out of primary care and into selling supplementals.It makes medicare taxes progressive

    George Bush is Living proof of the axiom "Never send a boy to do a man's job" E -2.25 S -4.10

    by nathguy on Sun Jul 26, 2009 at 06:58:20 AM PDT

  •  All we have to do is elect Democrats (7+ / 0-)

    The mantra of this site.


    Look at the bad plan they have crafted.  It is unacceptable as reform.

    Top Ten Reasons the Public Plan is a Bait and Switch

    1. It leaves in place the deficient employer based model.    As the National Organization for Women noted in their single payer endorsement  (July 7, 2009) of the only viable reform model, single payer, many Americans are tied to jobs they don’t like because of the antiquated employer based insurance model.  For those switching from one job to another, those wanting to go on strike, those wanting to quit a job, etc. it prevents the ability to move freely as a laborer.
    1. It leaves private insurance, a major contributor to administrative inefficiency and bloated bureaucracy, in charge of health care decisions.
    1. It only results in about 10% of the savings that would accrue were single payer to be enacted.  That’s assuming 50% of Americans can enroll---an optimistic figure (Jacob Hacker’s assumption that Congress has drastically scaled back to a tiny plan).   Since hospitals and doctors will still have to deal with 1300 insurance companies little savings will result by adding a public option, reports Dr. Don McCanne of the Physicians for a National Health Plan, March 26, 2009,   24% of hospital budgets go to billings (only 12% in Canada) and this wouldn’t change under any version of the public option.   As Drs. Steffie Woolhander and David Himmelstein note, the bureaucratic savings of the public plan option "would be miniscule". (The New York Times, Room For Debate, June 18, 2009).,,
    1. It does not pay for itself, unlike single payer, requiring a huge tax increase.   As the State Legislators for Single Payer Healthcare (including initiating sponsor WI State Sen. Mark Miller) note there is "no increase in total health care spending" with single payer.   Instead of everybody in, nobody out, an inclusive approach based on solidarity, public option pits the wealthy against poor, taxing the rich to provide subsidies to help poor people buy overpriced, insufficient private health insurance.   In the mainstream media this is being framed as the liberals taxing the rich for their liberal plan to force everyone into big government care, when In reality, the tax proposal would be used to shore up the private insurance system, giving them more customers and higher profits.    In her June 24 Congressional testimony, Dr. Woolhander estimated that it will cost 200 billion annually to pay for health insurance costs for those who cannot afford it.   That’s a much larger tax increase on the wealthy.
    1. It becomes part of the same failed private model: co pays, deductibles, denials of some necessary procedures, services and medications.   Coverage and benefits will be similar to the private plans due to inability to control costs.  (see no. 3)   "The ‘Public Plan Option’: Myths and Facts available at and see the excellent analysis , "Health Care Reform 2009: A Train Wreck in Slow Motion by Dr. John Geyman, July 21, 2009 available at
    1. It leaves millions uninsured.     Mandates have already failed in states where it has been tried, mostly recently in Massachusetts.    And, the model for a health insurance exchange, the Federal Employee Health Benefit Program leaves hundreds of thousands of federal workers uninsured, and does not control costs (Nicholas Skala, Congressional Progressive Caucus testimony, June 4, 2009).
    1. It Segregates patients into two groups: health patients who will be aggressively pursued by insurance companies and sicker/older patients who will end up in the public plan.   The public plan will not make private insurers honest.   Private insurers compete by denying (necessary coverage).  The public plan will either emulate this model, or quickly go under as it becomes overburdened by the sicker, older patients, reports Dr. Woolhander (June 24 House Subcommittee on House Energy and Commerce).
    1. Projected savings claimed by Wisconsin Citizen Action (based on a Lewin group study of Hacker’s original PO proposal) are not based on historical trends with public option plans that have already failed in every state where they have been tried.   (see Wisconsin Cost Savings under National Health Care Reform by Dr. Robert Kraig available at The HMO-Medicare history shows that public plans do not keep private insurers "honest".   "A quarter century of experience with public/private competition in the Medicare program demonstrates that the private plans will not allow a level playing field."   The Public Option Con,
    1. Private insurers will still continue to deny claims and as a result, a major issue, bankruptcy due to health costs will remain unaddressed.   In their June 2008 endorsement of single payer, the U.S. Conference of Mayors noted that "millions with insurance have coverage so inadequate that a major illness would lead to financial ruin."
    1. The public option will not provide choice of provider unlike single payer since the public option will need to appeal to providers to obtain services.   "Patients will still have a limited choice of provider restricted by networks" as a Physicians for a National Health Program fact sheet states.

    "The ‘Public Plan Option’: Myths and Facts available at

    "I happen to be a proponent of a single payer health care program." Pres. Goldman Sachs Obama, 6/30/03

    by formernadervoter on Sun Jul 26, 2009 at 07:05:10 AM PDT

    •  My Only Disagreement (0+ / 0-)

      Is whether the public option would not lead to a massive move by small business employers from the private insurers to the public plan.  

      If 80 percent of all US workers work for small businesses who can no longer afford to provide insurance for their employees, will there not be a massive migration to the public plan?

    •  Let's take the arguments one-by-one (0+ / 0-)
      1. Portability of the public plan solves that problem.
      1. If someone belongs to the public plan, then how is private insurance in charge of his/her health decisions?
      1. This is a bit of a problem, but keep in mind that any public plan will have FAR lower administrative costs than private insurance companies (3% versus 33%). The administrative savings alone will be HUGE. Furthermore, the greater the membership of the public option becomes, the more bargaining power it will have with health care providers and drug companies, allowing lower service costs.
      1. When it comes to taxing the wealthy to pay for the public plan, I say: full speed ahead! Who the hell cares what the right-wing media thinks?
      1. Again, with higher taxes, greater bargaining power, and massive in-built administrative savings, this will not be a problem.
      1. This problem can be solved by automatically enrolling the uninsured in the public option.
      1. This issue is multi-pronged. First, if the public plan were almost 100% tax-subsidized, then the premium would almost be free and there would be no adverse selection problem, since everyone (healthy and sick) would want to flock to the public option. Barring that, the way to solve the adverse selection issue is through strict regulation of insurance companies banning discrimination on pre-existing conditions, banning rate discrimination, and banning denial of services. I believe that the House bill does the first two of these.
      1. I need more elaboration on this. Could you explain which states have tried a public option? Were those public plans open to all residents? Did they have full bargaining power with health care providers? Did they receive at least startup tax funding?
      1. Easy: those who have this problem can switch to the public plan. That is the purpose of the public plan.
      1. This is the biggest problem with the public option, IMO. But it too can be solved by requiring provider participation.
  •  I saw the program last week, and was (3+ / 0-)
    Recommended by:
    SarahLee, greeseyparrot, Eryk

    pretty depressed -- sounds like same-old, same-old in reformist garb (although I'd address this more to Congress than Obama). I'd like to ask Mitch McConnell and others: if a public option or single payer means "government will get between you and your doctor," or if it means "some bureaucrat will ration your care," then why don't you drop the "socialist" plan you and your pals in Congress have and venture into the free market with me?

    stay together / learn the flowers / go light - Gary Snyder

    by Mother Mags on Sun Jul 26, 2009 at 07:12:59 AM PDT

  •  All these people (6+ / 0-)

    that are afraid of universal healthcare don't know the facts. Our health system has failed but they cling to it because they think it could be worse. The MSM is a huge cause why people are so misinformed. They get large sums of advertising revenue from the medical industry so they are not about to let the real facts get out. Plus, they do a good job of letting the conservatives lie about universal healthcare without any questions asked.

    •  Most Americans of a certain age (0+ / 0-)

      know that our government has never been known for focus and efficiency compared to the private sector.  This is the primary reason behind the conservatives' "small government/no new taxes" mantra.  Of course, the private sector's energy comes from its desire to maximize its take regardless of the impact on its customers.

      But government is only as good as the leaders that are elected and with healthcare representing such a timebomb to our nation's future, it's critical that we centralize the need, expense, administration, research, etc., for the public good.  

      The question is: will the great minds of the industry help the country create a governmental entity that deprives them of their own cash cow?

      (-7.75, -7.69) No matter how cynical I get, I just can't keep up - Lily Tomlin

      by john07801 on Sun Jul 26, 2009 at 07:47:43 AM PDT

      [ Parent ]

  •  We're not going to get single payer. Get over it! (0+ / 0-)

    Conservatives are not necessarily stupid, but most stupid people are conservatives. John Stuart Mill

    by Micheline on Sun Jul 26, 2009 at 07:26:12 AM PDT

  •  they are saying we lose 5 freedoms (2+ / 0-)
    Recommended by:
    SarahLee, bwren
    1. Freedom to choose what's in your plan
    1. Freedom to be rewarded for healthy living, or pay your real costs
    1. Freedom to choose high-deductible coverage
    1. Freedom to keep your existing plan
    1. Freedom to choose your doctors

    Fortune Magazine

    We need to say something as simple.  But true.  Like are you free?  Pre existing conditions?  etc.  Come on people.  Get creative.

    Republicans are walking the socio Path.

    by 88kathy on Sun Jul 26, 2009 at 07:40:18 AM PDT

  •  Obama is shilling for Big Health Care, but this (4+ / 0-)

    is NOT what he said over and over again during the campaign.  He said to thunderous applause during the campaign that 'we should get the same health care that Congress gets.'  

    Obama has climbed down on this position, and we could have seen it would happen: he got more campaign money from Big Health Care than McCain did.

    We have to face facts:  Obama is all about corporate and banking power and could care less about the Americans who work for a living.   He's as dishonest as they come, but very slick at it.  And we're fools to continue to 'hope.'  

    And it's not just Obama, it's the Democratic Party too.  We've been scammed by the party and by Obama, time to face it.

    •  If anyone was "scammed" they weren't paying (1+ / 0-)
      Recommended by:
      Steppin Razor

      attention. Obama used vague language so that the naive could paint all of their hopes on him and believe that their beliefs were his beliefs. He is the same now as he was then. He was always a centrist. Anyone who thought he wasn't just didn't pay attention and it's their fault if they feel scammed.

      I know theft is illegal, but look at all the cool stuff I got!

      by BoiseBlue on Sun Jul 26, 2009 at 07:51:53 AM PDT

      [ Parent ]

      •  Correct (0+ / 0-)

        During the campaign, the best reality check was to follow along in the position papers on the candidates' web sites, using them as a guide to interpret what they were saying in their speeches.

        The speeches simplified and dramatized their positions, but the web sites filled in the gaps and supplied (some of the) fine print.

        In the earlier campaign, this was more true of HRC than Obama, but by the end, Obama's web site had surpassed hers in both artistry and in its contents.

        McCain's never stopped being filled with vagueness and clichés.

        Greg Shenaut

      •  Disagree...because he used manipulative... (2+ / 0-)
        Recommended by:
        greeseyparrot, StateofEuphoria

        marketing tactics, paid for with all that cash, to create an illusion of hope and change for many people who do not follow politics closely.

        How much did he outspend McCain by?  With the money he raised, a dog could have won presenting itself as a human.  That is how I see it.  He did not win marketer of the year in 2008 for nothing.

        I voted for him with eyes open, and have always seen the style over substance, sometimes deceptively so.  But he kept it vague for the politically illiterate because that is what his high paid consultants advised.  So many times I asked average Obama supporters about him, as compared to many here, and all they could say was hope and change, hardly a word about substance on important issues of the day.

        Gotta love that money.  farewell to campaign finance reform.

  •  obAMA doesn't seem to be listening. (1+ / 0-)
    Recommended by:

    If he hasn't figured this out by now, forget it.  Why continue to expect any leadership from him on this issue? What a pathetic effort and it just gets weaker and weaker as industry lobbyists get more and more threatening. He promised the AMA no government-run insurance and that's what we're going to get. No government-run insurance. At least if he has anything to do with it. Sellout.

    "At least the war on the environment is going well."

    by spider webs unite on Sun Jul 26, 2009 at 07:51:59 AM PDT

  •  HMO's and PPO's (2+ / 0-)
    Recommended by:
    SarahLee, notrouble

    Plans already DICTATE who you can and can't get healthcare through.

    So, any CongressCritter who says otherwise or that the Government would decide for you is full of it.

    I have Medicare and Love IT.  Ask your parents who are on it if they are willing to give it up?  No takers?  Not surprised - they all have a pre-existing condition called "old age" and the insurance industry doesn't want them.

    Even Medicare now offers these HMO's and PPO plans.  I refuse because they really do limit who I can go to just like why I never went with an HMO in the first place (PPO's have a broader range of choices).

    The last time Republicans killed healthcare reform (15 years ago, see:  Clinton, Hillary), they F'ed it up even more (as seen by today's situation).  

    So, trust the healthcare industry or the government?  Right now, I don't feel like either one is on anybody's side.

    -6.13 -4.4 Where are you? Take the Test!!!

    by MarciaJ720 on Sun Jul 26, 2009 at 08:05:30 AM PDT

  •  I empathize OC (7+ / 0-)

    I'm Uninsured, Unemployable, and very soon, an Unperson.

    I was once a treehouse, I lived in a cake, but I never saw the way the orange slayed the rake... The Llama Song.

    by farmerchuck on Sun Jul 26, 2009 at 08:09:15 AM PDT

  •  "all the doctors would be in network" if... (1+ / 0-)
    Recommended by:

    Most doctors, at least in the large city I live in, do not accept medicare. Most primary care do not accept new medicare patients. One endocrinologist accepts new medicare patients, and she is an idiot. Not a single psychiatrist accepts new medicare patients.

    So, having medicare is not some magic answer. Doctors have to accept medicare. I hope that if medicare-type public option becomes available, all doctors will HAVE to be willing to accept new patients with said insurance. Either because it will somehow be mandated, or because such a large share of the market will have the new insurance plan.  Because now they simply refuse new patients on medicare and or medicaid.

  •  Moyers' program was disappointing (5+ / 0-)

    It didn't cover the fact that the insurance exchange and public option in the House bill do a lot to regulate insurers and limit their profits. Frankly, it was a show full of ill-informed single payer or bust talking points like "we don't know what it'll look like" (only if you haven't read the House bill), and the public option will be a "dumping ground for the sick." I don't know where they're getting that one. The House bill requires all insurers to abide by the rules of the public option starting 1-1-13. It is true that initially the public option is limited to the uninsured and those who work at small businesses, but after 2 years of the exchange's operation, the House bill would let anyone join (at the discretion of the Commissioner).

    Frankly, the journalists he had on are better than the talking points they were spewing. I read them, and generally find them informed on many issues. But on this one they just didn't bother to pick up the bill.

  •  I totally agree (4+ / 0-)

    Great post.  I couldn't agree more.  Just remove the age requirement and let us all buy into Medicare.  It's such a no-brainer.   My current solution is to look for a Canadian to marry me.

  •  Medicare is no cure-all (1+ / 0-)
    Recommended by:
    Kentucky DeanDemocrat

    A couple years ago, for example, my disabled brother, who is on medicare, needed several root canals in his front teeth. Medicare would pay to have the teeth pulled, but not for root canals. He basically begged me to "lend" him the money so that he wouldn't lose his teeth. It was over $3000, which I'm glad I was able to provide (and so is he). But I think there are frequent trade-offs like that with medicare, and I assume they will still be there with the public option or even with full-bore single-payer.

    The reason is logical: from a health standpoint, getting rid of the teeth would allow the underlying infection to be cured, and would remove the health risk. But there are other considerations, like how it looks, how one feels about oneself, and in this case, there are health advantages to having a full set of teeth.

    On the other hand, it is absolutely true that even if I hadn't been there, medicare would have paid for having the teeth pulled, which would have dealt with most of the health risk. In that regard, it would still have been much better than nothing.

    Greg Shenaut

  •  I am not sure if I get you, Jill Richardson (2+ / 0-)
    Recommended by:
    slinkerwink, notrouble

    They also feared that the drug companies would take the healthiest patients for themselves and dump the sick onto the government's public plan.

    If that's the case, that's bull shit. I want Medicare.

    Drug companies are already taking the healthiest patients for themselves. Remember the difficulty of finding a good insurance with a preexisting condition? Dump the sick onto government's public plan? Hey, it is hell of a better fate to at least have "a government's health care option" available then having no option at all. Do you know what it means to be a poor twenty some year old with juvenile diabetes? Or is it that you don't give a damn because you yourself is not a poor twenty something with juvenile diabetes?

    Plus, you say you want medicare... Have have it. And what do you think medicare is? Private insurance?

  •  And the worst part of Medicare aside from (2+ / 0-)
    Recommended by:
    SarahLee, notrouble

    advantage (part C) is really the only part that has been privatized, the prescription drug benefit (part D).  Part D plans are an absolute nightmare still for people to navigate through and unless they are a dual-eligible still have problems with a gap in coverage unless they pay an exorbitant premium to a private company.

    Thanks the GOP for not giving Medicare the ability to negotiate Rx prices which would have allowed the gap in coverage not to be imposed.  

    I'm a Leftist Radical and I am going to Netroots 2009!

    by HGM MA on Sun Jul 26, 2009 at 08:29:28 AM PDT

  •  Moyers show missed point about REDUCING COST. (4+ / 0-)
    Recommended by:
    SarahLee, missLotus, Kickemout, fernan47

    Also there is no Obama plan.  For good or bad (bad as it is turning out) Obama did not propose a health care reform plan and left it up to insurance and drug lobbyists to write health care "reform".

    There are three main Congressional plans but they all raise the cost of health care in the US from 17% of GDP to 20% of GDP. Health care costs are unsustainable economically at 17% of GDP much less 20%.  Every other developed nation has national health plans that cost 10% of GDP and do a better job of providing health care.

    The Congressional plans have very weak public option and it is not even available to most people. If you have company provided insurance, you must stay with it and pay the insurance company. If you work for small business, you get nothing, they are completely exempt. If you are poor and/or sick, you can get the "public option" but it doesn't pay health care provider costs and providers are not required to take patients on the "public option".

    All in all an expensive, pointless exercise that benefits insurance companies the most who, of course, provide no health care services.

  •  I'm getting confused with this (1+ / 0-)
    Recommended by:

    Obama has said that Americans 'get to keep their current plan' if they like it, but is there also the option to get rid of it and go for the public plan if they don't like it?

    I get that the public option is designed for people and business who can't afford private plans, but is it ONLY for them?

  •  Single payer - NOW! (4+ / 0-)

    The term "Free Market Healthcare" contradicts the reality of wellness for all.  Saving money by exclusion does not cure, but creates more costs.  Very simple, but do you think the greedy politicians and lobbyists get it?  They do, and that's why they are fighting with everything that they can throw at it.

    I fear that Obama will sign us a watered down bill and then claim success:  Not in my book is that success.  The citizens of this country will, this time, be more cognizant of that fact and will vote accordingly.  We are doomed to have do nothing government for the rest of our natural lives.  

    Shame:  Politics are more important then leading, and governing.  

    "Try not to become a man of success, but rather to become a man of value." ~ Albert Einstein

    by LamontCranston on Sun Jul 26, 2009 at 08:44:43 AM PDT

  •  Lowering costs (2+ / 0-)

    is equally important. A recent office visit to my GYN (15 minutes) was $387.00. Family physician is ~$147.00 (15-20 minutes). An ultrasound (again ~15-20 minutes) $559.00. Fortunately, I'm covered by the same plan that congress has and I paid $50 out-of-pocket. The question remains, how is anyone without insurance, especially those making minimum wage (~$1100 a month) supposed to be able to afford any medical care at all?

    "I have never missed Hunter S. Thompson, George Carlin and Abbie Hoffman more than I do today."

    by wv voice of reason on Sun Jul 26, 2009 at 08:49:31 AM PDT

  •  The only meaningful chance for a solution (5+ / 0-)

    at this point seems to be the chance that the Kucinich amendment to remove federal barriers to state by state adoption of single payer "experiments" will survive into the final bill.

    Dr. Aaron Roland is a family physician in Burlingame, CA. Follow him on Twitter @doctoraaron

    by doctoraaron on Sun Jul 26, 2009 at 08:51:21 AM PDT

  •  Healtcare Insurance Should Be Mandatory (0+ / 0-)

    First of all everyone should have healthcare, and not just at the emergency room.  Once you make it mandatory everyone will have to have health insurance.  To those who can't afford healthcare insurance we need a public option.  Also, we need to have it where nobody can be turned down for health insurance for any reason.  If I have cancer and no insurance but need it I should be able to go out and get it, and not be charged extra for having cancer.  If the insurance company will take you but hikes the price because congress didn't put cost controls in the reform plan than there should be a public option with price controls for that person.  Without cost control, insurance companies and pharmaceutical companies will not put brakes on prices.  I believe price control should be a very big part of any health care reform.

  •  Outstanding Commentary - very well-written - (3+ / 0-)

    I am mailing a copy of this to my Rep, Senators AND Obama.

    Thanks for taking the time to share your thoughts.

    "I have sworn upon the altar of God, eternal hostility against every form of tyranny over the mind of man." -Thomas Jefferson

    by delillo2000 on Sun Jul 26, 2009 at 09:06:31 AM PDT

  •  Medicare Works! (3+ / 0-)

    Lower the eligibility so more people can use it. Taking something that works, making it better, and expanding it to serve more people is simple and easy to grasp.

  •  That has become the bottom line, eh, Jill? (4+ / 0-)

    Thank you for crystalizing m thoughts just this morning. I am a health care reform advocate and retired form a career in HMO and insurance. I know what I am talking about technically, economically, and personally. As of last night, I have changed my my mantra...  

    We want Medicare and I'll have to say Medicare+.

    Let's eve save those poor people on Medicaid who have no Providers and few Hospitals that take Medicaid.

    Give all Americans Medicare+ and let whoever wants to, opt out into their employer plan, or their own plan.

    All Americans deserve the choice to join Medicare+ NOW.

    HR 676 - Health care reform we can believe in - national single-payer NOW.

    by kck on Sun Jul 26, 2009 at 09:31:15 AM PDT

  •  I posted this link (0+ / 0-)

    in another diary-but it's a great article on the state of our healthcare-

    "The all-white American Media-where the REAL questions of guilt or innocence are decided."

    by lyvwyr101 on Sun Jul 26, 2009 at 09:36:32 AM PDT

  •  "Medicare doesn't pull that kind of bullshit." (0+ / 0-)


    Wanna bet? Be careful what you wish for.

    You are not a beautiful and unique snowflake.

    by MnplsLiberal on Sun Jul 26, 2009 at 10:23:14 AM PDT

  •  Putting the entire country Medicare.... (0+ / 0-)

    ....would change the system as we know it.  It would no longer be the system you are describing.   It's not like taking a recipe made for 4 and multiplying the ingredients to making to for  4 doesn't work that way.  

    Putting that many people in medicare would fundamentally change the system as we know it...and not necessarily for the better.

    It's not what Obama is proposing, and it's not going to happen.

    "In every revolution, there's one man with a vision." -James T. Kirk

    by The Navigator on Sun Jul 26, 2009 at 10:23:58 AM PDT

    •  More like adding 250 million SSNs (0+ / 0-)

      [it would take ~15 minutes] and 50% more claim processing work.

    •  three days ago (2+ / 0-)
      Recommended by:
      4Freedom, StateofEuphoria

      PRESIDENT OBAMA: I want to cover everybody. Now, the truth is that unless you have a -- what's called a single-payer system, in which everybody's automatically covered, then you're probably not going to reach every single individual....

      We know that we're spending, on average -- we here in the United States -- are spending about $6,000 more than other advanced countries where they're just as healthy. And I've -- I've said this before. If you found out that your neighbor had gotten the same car for $6,000 less, you'd want to figure out how to get that deal. And that's what reform's all about, how can we make sure that we are getting the best bang for our health-care dollar.

      Our neighbor is Canada.

      They use provincial single-payer systems.

      The $6,000 is their per family savings.

  •  Why? Because it limits profitability (2+ / 0-)
    Recommended by:
    polar bear, StateofEuphoria

    of the private sector which in turn limits the amount of contributions lobbyist can make, for access to key legislators.

    The current system enriches campaign chests, private enterprise, and ensures the current aristocracy a few more years of social inequality.

  •  Be careful what you wish for (0+ / 0-)

    I became disabled and unable to work some years ago.  I still am part of the insurance group with my former employer an urban school district.  I pay the premiums myself to have this coverage, pretty much like COBRA that doesn't have an end date.  I could have medicare as I qualified for SSDI.  Here's the thing about medicare.  Part A (hospitalization) doesn't have an cost beyond what I paid in while I was working.  Part B costs about $100 a month and then there's Part D (drug coverage) and the famous donut hole.  To buy a tie in plan for Medicare from private insurance, it costs at least as much as what my premium is for private insurance through the school district.  Then there are all the doctors who don't want to treat people on Medicare.  So, be careful what you wish for in that Medicare will still cost you money by making you have to purchase a gap insurance and you still may not be able to see a doctor you want.  It's the whole bloody system that needs fixing.  I watched Moyers' as well and I think the guests were spot on in their analysis.  What we are being offered now is a boon to private insurers and their shareholders.  

    Winning without Delay.

    by ljm on Sun Jul 26, 2009 at 11:53:23 AM PDT

  •  A quick quiz (0+ / 0-)

    The way to get Medicare for All or to end the wars in Afghanistan and Iraq, or to pass the Employee Free Choice Act (complete with majority recognition), or anything else of real significance that we want is:

    a) Persuade office-holders that these policies are in the best interests of the country;
    b) Persuade office-holders that opposing these policies might threaten their re-election;
    c) Persuade office-holders that opposing these policies could threaten social stability and the continued existence of institutions of power that they serve/belong to in DC.

    I'd contend that (c) is the only real answer.  It's how we won the New Deal and Civil Rights.  Electeds don't really care very much about the good of the country, or can always rationalize their parochial interests as central to our interests.  And politicians are rarely worried about re-election in a genuine way (with good reason, incumbents have huge advantages); and, in any case, particular office-holders are just temporary place-holders as far as institutional power in DC is concerned.

    If they think the entire ship is about to sink, however, they'll start throwing valuables overboard.

    "Run, comrade, the old world is behind you!" -- Situationist graffito, 1968

    by Pesto on Sun Jul 26, 2009 at 11:57:03 AM PDT

  •  no care here, either (0+ / 0-)

    I'm coming to the end of four months of antibiotics for Lyme and I've paid for the treatment out of pocket. I saw the bankruptcy attorney last week, I'll probably declare the first week of August, health issues are what's behind it, and thanks to an (as yet trouble free) kidney condition I can't get insurance at all. Period.

    If we don't have a public option and I get something treatable it can still make me destitute and homeless again in short order.

    Thanks a lot, Congressional Republicans, I'll be keeping you in mind come 2010.

    "Not dead ... yet. Still have ... things to do." -Liet Kynes

    by Stranded Wind on Sun Jul 26, 2009 at 12:04:47 PM PDT

  •  migraine (0+ / 0-)

    I don't know that medicare would help, here.  I've been reading up because my sister in law has been seeking, with gold-plated insurance and a good income, for migraine relief for decades.  Medicine doesn't know what causes migraine or how to relieve it.  People try different therapies until they give up or it goes into remission.   Every so often a new "cure" is announced and then fades when enough people have tried it for its failure to become noticeable.

  •  Ok, but you actually don't want Medicare. (1+ / 0-)
    Recommended by:

    I've written several diaries about this. Medicare does not cover dental, vision, or prescription drugs. Medicare does not cover preventive services - except on a very limited scale.

    You don't want Medicare. Not at all.

  •  My Wife Has Medicare, I Have It (0+ / 0-)

    next year.  The nameless, faceless bureaucrats in Medicare (I assume they exist) just pay bills, they do not deny anything.  All medical decisions are made by your doctor.

  •  We need a hero. We thought Obama was it. Wrong. (0+ / 0-)

    Obama is a politician who belongs to the Democratic club and doesn't want to give up his membership, his status or his power.  Nothing unusual, he's a good politician.  But he's a politician.

    We need someone willing to NOT be a good politician.  Someone who doesn't care if he/she loses their membership in the club.  Someone willing to go out on a limb and take a risk.  There are no heroes in America when it comes to health care, because the enemy is too powerful, too frightening.

    We need a David.  

    "I'm going to need ordinary Americans to stand up and say, now is the time." Barack Obama, July 1, 2009

    by keeplaughing on Sun Jul 26, 2009 at 12:53:34 PM PDT

  •  Added benefit to Medicare (1+ / 0-)
    Recommended by:

    If you can no longer work because of a catastrophic illness (such as some of the treatable cancers), you won't get dropped from your insurance or expected to pay several hundred dollars a month for COBRA insurance while you've got zero income.

  •  I want it too. (1+ / 0-)
    Recommended by:

    This is the most direct way to a single payer system that can compete nicely with insurers.

    I've got a value added spin on this too, in my complimentary diary here!

    Speak or be spoken for. This is the lesson learned over the last 8 years.

    by potatohead on Sun Jul 26, 2009 at 01:14:34 PM PDT

  •  Mandated coverage with a public option can be (0+ / 0-)

    done poorly, or it could be done pretty well. In general, pretty well means (this is by no means a complete list):

     --The govt-run plan has a fair sliding-scale schedule of premiums and is FREE to those who live below, say, 200% of the poverty line;
     --Doctors, pharmacies, hospitals and other providers will be mandated to accept public option patients as a condition of their licensure;
     --Private plans are legally prohibited from this murderous and utterly twisted practice of denying coverage for pre-existing conditions, with HARSH civil and CRIMINAL penalties;
     --The plan administrators can legally use the sheer size of the public option pool to beat down prices from providers, drug manufacturers, equipment leasing agencies and so on.
     --The plan will need to be subsidized; premiums won't cover all of it. The funding mechanism should be progressive. Yes, soak the rich, but everyone else should kick in too, again on a sliding scale.

    It should be noted that a number of the other industrial democracies have a mix of public and private health insurance, and it works well enough, certainly a damn sight better than what we got right now.

    My story: Between me and my employer, we are currently paying about 400 bucks a month for my health plan. Screw Medicare. With a good public option in place, pushing costs down, that kind of money could pay for a real Cadillac private plan, or I could enroll in the public plan, have my basics covered and save me some scrylla every month, and my employer would be able to give me my next raise sooner, 'cause her bill went down too. Suits me.

    "Democracy is like chicken soup. You have to stir it up often or a scummy oily film forms at the top."

    by StratCat on Sun Jul 26, 2009 at 02:53:28 PM PDT

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