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Thursday evening, I attended a screening of The Healthcare Movie, a new documentary exploring the divergence of the Canadian and American healthcare systems over the past half century. Documentaries like Sicko do rightly point out America's inferior system- both in financial sustainability and quality of care. The important aspect missing from Sicko is history. Why does the United States not have the same healthcare setup as its economic equals? Why have so many politicians, from Ted Kennedy to Teddy Roosevelt, failed?

There has been historical opposition from the American Medical Association  and in the last fifty years, private insurance companies. The famous Ronald Reagan Speaks Out Against Socialized Medicine (video) was part of an AMA campaign. Since the second Red Scare, connecting universal health insurance with the Soviet Union (or more recently, just saying "socialism" a couple dozen times) has been an effective method of stopping both universal coverage, as well as the initial, much stronger drafts of Medicare, Medicaid, and the Affordable Care Act.

In the last gladiatorial contest charitably called a 'debate', the insurance lobby spent $102.4 million. This helped not only kill the public option (thus not really changing all that much in the long run), but also attacked things like the Medical Loss Ratio, which cut into profit margins. Non-profit healthcare companies have been hustled out of the debate because they can't practice price discrimination- price discrimination of course being how any sort of private insurance operates. Thus their market share has been engulfed. The ACA's effect on private health insurance companies is to be seen, but it seems unrealistic that the MLR and other measures will drive them all out of business.

The story in Canada in 1962 was not much different. When Tommy Douglas, premier of Saskatchewan, proposed the measure it caused a huge firestorm. When it actually was implemented there was a 23 day strike of the province's doctors- in which doctor 'scabs' were brought in from Great Britain and other countries, while the population at large began setting up community health clinics for them. Eventually the doctors broke.

In the end, there was not a massive salary cut for doctors. In fact, nothing changed in the way doctors practiced- they could have their own practice, work with other doctors, work at a hospital- whatever they wished. And the big thing sold them (and brought me new perspective) was a simple fact:

Under a single-payer system, doctors do not have to spend time and effort getting their money.

In American medical practice, there is a huge billing component for every doctor. Someone needs to work through a multitude of insurance companies, each with a multitude of plans. Not every client can pay, or pay on time.

Now turn all those clients (500-2,000 for a private practice doctor) into one client, who is really good at paying on time. Suddenly, compensation is much easier. Doctor pay has been increasing and keeping ahead of inflation, so this is the cherry on top.

Douglas and the democratic socialists in Saskatchewan didn't achieve their goals easily. It took two major things to succeed:

1. A true bully pulpit, not just by the executive, but by thousands of people who educate themselves, turn their knowledge into terms that are not only understandable, but arouse a sense of social justice.

2. A complete disregard for your political future. Private health insurance will not go away quietly. Nor will you be able to convince everyone when the system does not exist yet. If you're looking to keep your elected office, or use this as a stepping stone, you may not be right for the fight.

It is exciting to be getting involved in the fight for single-payer in my home state of California.  Healthcare for All, along with other organizations, including the state chapter of Physicians for a National Health Program. Single-payer has been on the precipice of reality for decade now- twice being vetoed by Governor Schwarzenegger, and more recently dying in the Senate due to Democratic abstentions and two votes against the bill.

Tommy Douglas and his allies didn't ever achieve a federal health insurance program- rather their model became adopted by all the other provinces, with strong assistance from federal Parliament. Single-payer on the federal level is, unfortunately, a distant prospect. But Vermont has led the way with a bold, if incomplete, single-payer system. Once waivers to the ACA become available in 2014, much of the federal money sent to Vermont (or hopefully, California) can be used to form a truly unified and world-class system.

It's time for a second healthcare battle. It's time to go all the way. It's time for single-payer.

Originally posted to Neutral Politics on Fri Aug 31, 2012 at 06:17 PM PDT.

Also republished by Community Spotlight and Single Payer California.

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Comment Preferences

  •  Tip Jar (140+ / 0-)
    Recommended by:
    SYWTSAR, bluedust, Bob Love, Preston S, cassandracarolina, Quicklund, Chi, RockyLabor, corvaire, Glen The Plumber, Just Bob, ActivistGuy, Dewstino, Zack from the SFV, 207wickedgood, TBug, mumtaznepal, Lensy, artr2, atana, qofdisks, maybeeso in michigan, ovals49, magicsister, caul, irate, Egalitare, Calamity Jean, Habitat Vic, jcrit, Shelley99, DamselleFly, Lily O Lady, aseth, Mike08, Homer177, Justus, bostonjay, buckstop, historys mysteries, BB10, Pat K California, ZedMont, hester, karmsy, NJpeach, hazey, Pinto Pony, GayHillbilly, dalfireplug, tbirchard, jnhobbs, Its a New Day, pioneer111, lcrp, politik, scott5js, joe shikspack, mimi, EquityRoy, Nick Lento, tripodisblack, Isara, StrayCat, molecularlevel, LNK, ferg, Debs2, skyounkin, ChemBob, hideinplainsight, orlbucfan, muddy boots, antirove, mkor7, bnasley, ColoradAnne, Shockwave, demdoc, Getreal1246, science nerd, leonard145b, DixieDishrag, Robynhood too, Cronesense, ZhenRen, Assaf, JD SoOR, hyperstation, ringer, Smoh, salmo, jasan, HeyMikey, CoolOnion, kurt, erratic, whaddaya, susakinovember, salsaMan, ladybug53, livingthedream, WheninRome, radarlady, wuod kwatch, INMINYMA, spacecadet1, willyr, fhcec, tofumagoo, puakev, Oaktown Girl, mrsgoo, Publius2008, Jujuree, Mr Robert, Kentucky DeanDemocrat, 1Nic Ven, akmk, mooshter, NWTerriD, Simplify, Aaa T Tudeattack, means are the ends, jhb90277, ridemybike, MsGrin, Illinois IRV, oxon, RebeccaG, James Kroeger, WisePiper, QDMacaw, jbob, blueoasis, Mayfly, yellow cosmic seed, splashoil, artisan, brook

    "I know not with what weapons World War III will be fought, but World War IV will be fought with sticks and stones." -Albert Einstein

    by Kazmarov on Fri Aug 31, 2012 at 06:17:28 PM PDT

  •  The Race Card gets played a lot (26+ / 0-)

    in blocking health care reform.  The tactic is, if you are white, not only will you have to wait in line, but a person of color may get ahead of you.

  •  Why America is last (21+ / 0-)

    because when it comes to health care, this guy is waaay too much of a damn left-wing commie for proper American tastes:


    Ever get the feeling you've been cheated?

    by ActivistGuy on Fri Aug 31, 2012 at 10:04:25 PM PDT

    •  My feeling is that once ACA is implemented . . . (6+ / 0-)

      People will see it actually working. I know parts are implemented now but it is not the full package yet.

      The opposition has vilified the ACA so much that when it is actually fully operational, people will wonder what why some thought it was so bad.

      This will open the door for further reforms.

      •  Like Social Security (3+ / 0-)

        It will be like Social Security and Medicare - a third rail, hated by the right.  Seventy years from now, some new version of Paul Ryan will have a tricky scheme to voucherize it.  These fights never end.

        •  I don't believe it (0+ / 0-)

          Remember, the vouchers are already in it. And they're only for 'poor people'.

          This means that there's no real penalty for the Republicans if they 'slow the growth' of the vouchers, because poor people vote a lot less, and their base really likes it when they hurt poor people, because some of them are brown.

          Without the subsidies, the whole thing more or less goes off the tracks all by itself. The Republicans can say, 'Well, clearly it was an experiment by the Democrats that didn't work!' And the Democrats will be left trying to explain something that takes more than about eight seconds to explain, which means that the American public won't be listening.

      •  Actual Waiver Date is 2017 (0+ / 0-)

        That mendacious delay is in the ACA.  Of course, like many things there are those who say they support an earlier (2014) date when they know there is no chance.

  •  I have been told.... (8+ / 0-)

    ....that during the Saskatchewan battle, the Canadian medical establishment used some sort of racist scare tactics to drum up support. Haven't ever been able to pin down the details, but it doesn't surprise me a bit.

    "They smash your face in, and say you were always ugly." (Solzhenitsyn)

    by sagesource on Fri Aug 31, 2012 at 10:33:41 PM PDT

    •  It wasn't mentioned in the movie (6+ / 0-)
      Recommended by:
      caul, Justus, hazey, antirove, bnasley, salmo

      But I did see in on the Wikipedia page.

      It was an ugly battle. Social programs are not like the Agora, where you prove their merit through debate and then everyone accepts it. Doctors hated it when it was enacted. A decade later there was not significant opposition among physicians.

      "I know not with what weapons World War III will be fought, but World War IV will be fought with sticks and stones." -Albert Einstein

      by Kazmarov on Fri Aug 31, 2012 at 11:47:05 PM PDT

      [ Parent ]

      •  I seem to recall scare stories about (0+ / 0-)

        "drafting doctors into the army" to keep them practicing under the "socialist" Canadian programs. Anyone know if there was any more to this than the recent "Amero" or "FEMA internment camp" conspiracy legends?

        Paul Ryan's guru-ess did a lot to spread that one around, as I recall.

        If it's
        Not your body,
        Then it's
        Not your choice
        And it's
        None of your damn business!

        by TheOtherMaven on Sat Sep 01, 2012 at 07:42:42 AM PDT

        [ Parent ]

  •  As you point out (26+ / 0-)

    Insurance companies suck the life out of our health care system in many ways.  It's not simply the higher overhead costs and profit margin of the insurance companies that burden the current system.  

    My primary care physician's office, in order to manage the complexities of billing numerous insurance companies, each having their own coding and diagnostic protocols, spends approximately 35% of their gross revenue in their efforts to bill and collect for their services.  Additionally, many hours are spent each week on the phone with practitioners arguing with insurance company minions about what is medically necessary for proper diagnosis and treatment of their patients.  

    Stipulating a minimum "medical loss ratio" is a help, but it does noting to address escalating costs of procedures and medications or the enormous waste of time and energy practitioners have to suffer to get paid for their work or to argue what's in the best interests of their patients with insurance company lackeys.

    It has always seemed strange to me...The things we admire in men, kindness and generosity, openness, honesty, understanding and feeling, are the concomitants of failure in our system. - John Steinbeck, Cannery Row

    by ovals49 on Sat Sep 01, 2012 at 01:41:42 AM PDT

    •  There are some promising signs (14+ / 0-)

      from state-level plans. The issues with pharmaceuticals (which the ACA basically ignored) are being dealt with in the Vermont and California plans. Mass bulk purchases of drugs and durable medical equipment drive down costs, and basically attempt to deflate the pharmaceutical bubble built on the borders of the Untied States.

      Medical spending is a case where you can truly identify waste in all its forms. It is amazing that in the United States, so much has produced so little. Healthcare is unaffordable for a very good reason- no serious effort has been undertaken to negotiate drug rates and buy in bulk. No effort has been taken to deal with insurance using Medicare as a checking account. No effort has been taken to even produce a competitive private market, if we're still going with bad ideas.

      "I know not with what weapons World War III will be fought, but World War IV will be fought with sticks and stones." -Albert Einstein

      by Kazmarov on Sat Sep 01, 2012 at 02:03:01 AM PDT

      [ Parent ]

      •  That last can't be done (5+ / 0-)

        What kind of economic basics does a "free market" require?  Things like elasticity of demand, low barriers to entry, the ability to comparison shop for price.  So what's the "elasticity of demand" for medical care when you're having a heart attack?  How do you comparison shop for prices when you've been hit by a truck?  Can anyone just hang out a shingle and start practicing medicine, or are there high costs--high barriers to entry--to participating in the field?  

        Those are the ground level fundamentals that a "free market" requires, and as I have just shown, exactly none of them can be made to apply to medical care.

        Ever get the feeling you've been cheated?

        by ActivistGuy on Sat Sep 01, 2012 at 10:25:52 AM PDT

        [ Parent ]

        •  The other basic failure (1+ / 0-)
          Recommended by:

          is lack of expertise.  Almost by definition you are looking for an expert in a field you don't understand.

          Start with the fact you are a poor judge of the expert's ability, and add to that the institutional barriers to getting data about the physicians.   What public quality measures can you get, even when you have time to choose?  

          We have some proof of this fact.  The justification for increasing copayments and sharing premium costs is that it makes the patient a more careful consumer of healthcare.  This would, by the magic hand of the free market, lower utilization and reduce overall costs.  This particular drum was being pounded pretty hard as far back as 1985, when I worked in health data analysis.  

          So far, implementing cost sharing for the last thirty years has accomplished... cost sharing.

  •  I concede that restrictions on MLR... (3+ / 0-)
    Recommended by:
    Justus, historys mysteries, ladybug53

    ...alone are not going to "force" true Universal Health Care into being. But the one thing that Financial Elites "value" is a theoretical high ceiling on potential future profitability, and MLR regulations lower that ceiling. Certainly not rapidly enough or dramatically enough more my taste, but enough so that we can place more focus on those other roadblocks to true Universal Health Care delivery.

    When you are right you cannot be too radical; when you are wrong, you cannot be too conservative. --Martin Luther King Jr.

    by Egalitare on Sat Sep 01, 2012 at 04:42:04 AM PDT

  •  In Texas doctors are still complaining about (5+ / 0-)
    Recommended by:
    antirove, bnasley, mimi, salmo, ladybug53

    Medicare - it's low reimbursement rates and what they claim is a horrendous nightmare of bureaucratic red tape they must navigate.

    There are doctors on this blog.  I'd like to hear from them on this.  

    I'll have to be honest, I just this year got on Medicare, and was shocked by how low the reimbursement rates are.

    I was also surprised that doctors are complaining about Medicare red tape, because it was my understanding that Medicare was no more - and maybe less - onerous to deal with than managed care private insurance.  Is that wrong?

    My primary insurance before this year was FEHB. Until I looked into Medicare, I did not realize that once a FEHB member reaches age 65, FEHB will pay no more than the Medicare rate.

    I wondered if that was the case with non-FEHB private insurance was well.  I sort of doubt it, because that would be a disincentive for the health-care heavy 65+ to opt for Medicare, thus ridding private insurance their costliest burden.

    Would appreciate more info. from doctors on these issues, and from insurance professionals for that matter.

    Because stupid people are so sure they're smart, they often act smart, and sometimes even smart people are too stupid to recognize that the stupid people acting smart really ARE stupid.

    by ZedMont on Sat Sep 01, 2012 at 06:13:44 AM PDT

    •  Problems with Medicare (13+ / 0-)

      As a doctor whose practice has a high percentage of younger women having babies, Medicare payments do not affect me as much as some. I personally know one excellent geriatrics specialist who closed down his practice and became a hospitalist (not his best field, he was wonderful with providing care for seniors in the office) because he could not afford to keep up. It was not just the low reimbursement rates but the changing rules and the constant threat of draconian cuts in reimbursement rates which, even though they do not happen, make it hard for an individual doctor to make financial plans for a practice.

      He once did not get paid for several months because there was a rule change that was not well explained and a solo practice doctor whose wife works as his nurse needs to have rule changes spelled out clearly.

      Another good doctor dropped his office and does part time medicine with home visits to his patients.

      Many doctors have dropped membership in the AMA in part because we felt they did not represent us well and seemed to make us look greedy and not people who put the patient first. I personally never belonged except for a brief period when my employer paid my dues for me by his choice.

      The word in the privacy of the doctor's lounge at the small community hospital where I worked during the healthcare debates was that there were many physician supporters of single payer health care.  It was definitely a more bipartisan group than many would expect.

      •  Another Anecdotal Confirmation (3+ / 0-)
        Recommended by:
        ladybug53, tbirchard, ZedMont

        I have a brother practicing in Upstate NY, who doesn't bother to bill for many services where patients have Medicare coverage.  As he explained over Thanksgiving turkey, Medicare pays $23 for ___ (I don't remember what it was), and it costs me $28 to send them the bill.  Of course, that means that the number of Medicare patients he sees must be limited.  I should also note he says that Medicare pays a very low rate in the rural area in which he practices, and substantially more in a place like NY City.  

        •  also the report in CA - big differential (3+ / 0-)
          Recommended by:
          Mr Robert, salmo, ZedMont

          in urban/rural payments. And a "rural" designation is sticky - it can continue long after an area becomes urbanized.

          Medicare Advantage was instituted, IIRC, to provide payments that were more in line with costs.

          But would Docs have to pay so much for billing (e.g., employing a full time dedicated billing team) under a single payer system? Many Docs had to deal with as many as 25 different insurance plans on a regular basis. They longed for single payer.

          I surveyed a random sample of CA Docs at one point about their reasons for/against participating in a government funded special program for women's cancer care. Some were reluctant to take patients who are not like their regular patients - clean, well to do, long covered by health insurance.  Apparently some of their long term patients were also uncomfortable in the waiting room when other patients were from a "different" demographic.

          The most common reason for not participating in the cancer care program, tho', were  persistent delays in reimbursements. Many Docs intended to close their practices because of delays in payments and the demographics of their new patients.

          "There's nothing serious about a plan that claims to reduce the deficit by spending a trillion dollars on tax cuts for millionaires and billionaires." - President Obama

          by fhcec on Sat Sep 01, 2012 at 02:04:43 PM PDT

          [ Parent ]

    •  Highmark BCBS denied cancer therapy (4+ / 0-)
      Recommended by:
      ladybug53, Mr Robert, NWTerriD, ZedMont

      I have prostrate cancer, i got a appointment at MD Anderson in Houston Tx.on 5/25/12 first doctor consult, got a call that it was all approved Ms H. had called BCBS for authorization was told if Medicare paid BCBS would. treatment started on June 18. half way through Proton Beam Therapy PBT they sent to my home address that claims had been denied. I called BCBS I was told to file a appeal. I had Insurance with this employer since 1972 first time I've really had a claim if this is what they call a cadillac insurance plans it's turned in to a Yugo.  Medicare has paid about 10%

      •  These are the kind of stories (2+ / 0-)
        Recommended by:
        ZedMont, vet

        that need to be heard by all those who claim that the private insurance system in this country is just hunky-dory without Obamacare.

        "These are not candidates. These are the empty stand-ins for lobbyists' policies to be legislated later." - Chimpy, 9/24/10

        by NWTerriD on Sat Sep 01, 2012 at 06:19:07 PM PDT

        [ Parent ]

      •  Thanks for all the candid responses. This is not (0+ / 0-)

        what I wanted to hear, and frankly, I don't think it bodes well for Medicare, but the problems won't be fixed unless they are understood and acknowledged.

        I suspect that this will become an issue after the election, if the president is reelected.  

        If Romney is elected, it will be moot because Medicare will gradually cease to exist, and private insurance will continue to erode into garbage - except for the well-to-do.

        And of course if the president is reelected, Congress can strangle Medicare with even worse reimbursement rates.

        Because stupid people are so sure they're smart, they often act smart, and sometimes even smart people are too stupid to recognize that the stupid people acting smart really ARE stupid.

        by ZedMont on Sat Sep 01, 2012 at 08:53:03 PM PDT

        [ Parent ]

        •  NOT if we keep ousting the Goopers and Blue Dogs (0+ / 0-)

          and replacing them with people who give a damn about anybody less well-off than themselves.

          So let's get on it.

          If it's
          Not your body,
          Then it's
          Not your choice
          And it's
          None of your damn business!

          by TheOtherMaven on Sat Sep 01, 2012 at 10:13:53 PM PDT

          [ Parent ]

  •  I wholeheartedly disagree with you here that (6+ / 0-)

    "it wouldn't have changed much."

    This helped not only kill the public option (thus not really changing all that much in the long run)
    Affording some people, even if a small amount, the opportunity to obtain health insurance from not a health insurance company, that would have been the foot in the door to get single payer started and to be built upon.

    The ACA regulated insurance companies and pretty much made sure that we would be dependent upon them for decades to come.

    Brarack Obama:  "And I still believe that that’s what the American people are looking for: solving problems. What I’ve tried to do is to take ideas from everyone — Democrats and Republicans — that I thought would make a difference in the lives of working families. That’s why the Recovery Act — a third of it was tax cuts, traditionally an idea Republicans supported. That’s why our health care bill relies on private insurance and why it looks so much like Governor Romney’s health care bill."

    I did not think then nor do I think now that the reason a public option didn't pass was because of tons of money utilized to lobby against it.

  •  Thanks for the diary. (10+ / 0-)

    We need to keep this topic in the spotlight, for sure. Keep it on the table, under discussion, a talking point.

    Yes, eventually, we DO need to end up with single-payer healthcare.

    But you evidently believe, where HCR is concerned, there is no such thing as a partial legislative victory:

    This helped not only kill the public option (thus not really changing all that much in the long run),
    I beg to differ.

    The loss of the public option was a big disappointment to me, too, and to many people. But, for the very first time in my memory, we saw the administration in Washington articulate the need for "universal affordable healthcare," injecting this as a talking point into the political discourse. We saw big business forced to make concessions that were heretofore unthinkable. This year, we saw the SCOTUS uphold the ACA, giving us that much more time for its effects to be felt. Very much, we've seen the door opened to ever-more drastic reforms of healthcare funding and delivery in this country.

    Rome wasn't built in a day, but built, it was. Where for-profit health insurance is concerned, the hits have already started, and they are just going to keep coming. It will become politically fashionable to regulate their excesses. Sometime in the future, insurers will see that it's really not profitable to be in business, at all.

    Mark my words.

    No, we don't have decades to wait. People are dying, I know that. That's why I always tip and rec these HCR diaries, if they're decently written, and stop by the sad personal HCR diaries to mourn and to pay my respects. They're urgent. This cause is urgent.

    We haven't lost until we've lost the will to fight.

    We won't inaugurate single-payer healthcare fast enough. But get it, we will.

    It's here they got the range/ and the machinery for change/ and it's here they got the spiritual thirst. --Leonard Cohen

    by karmsy on Sat Sep 01, 2012 at 06:37:39 AM PDT

  •  But why say last battle? (6+ / 0-)
    Recommended by:
    Nick Lento, ferg, vet, ladybug53, fhcec, ridemybike

    I do believe in this idea, but it will take much persistence to pass. Several election cycles.
    Rep. John Conyers has re-filed HR 676, with the same bill number as in the last Congress. It has at least 70 co-sponsors, including my own Rep. Sheila Jackson Lee (D-Houston).
    A single-payer resolution easily passed last April 21 in Houston's 15th Senate district convention. A more muted plank made its way into this year's Texas Democratic platform.

    Censorship is rogue government.

    by scott5js on Sat Sep 01, 2012 at 06:48:30 AM PDT

  •  Republicans May Lead the Way to Single Payer (2+ / 0-)
    Recommended by:
    fhcec, Mr Robert

    Should Republicans gain control this year, I see their policies possibly leading to a single-payer system.  The proposed Medicaid cuts will leave millions uninsured. Romney has said he will make all health insurance premiums tax deductible.  This sounds innocuous but could result in employers getting out of the insurance business. Instead of acquiring health insurance for its employees, a company may turn what they pay in premiums over to employees as extra salary.  The employees could then go out and purchase tax-deductible insurance on their own.  Employers would then index this yearly payment to regular inflation, dumping rising medical costs onto their employees.  Finally, the Republican Medicare plan is designed to last, at best, for only 9 years (i.e., when people find out what it means, they will recoil).

    The result is likely to create a health care crisis. Hospitals will close while people remain sick or even die for lack of health care.  Which way will we turn then?

    •  We are already headed for crisis (2+ / 0-)
      Recommended by:
      ladybug53, Mr Robert

      with rising insurance costs hitting both employers and consumers hard. We should not wish for it to get worse faster. That is no guarantee we will quickly go to a better system, since no Republican is going to vote for single payer. It goes against their whole ideology, the idea that government can do something that works and is more efficient than the private sector (Despite the example of Canada showing that this is so).

      •  At some point, (0+ / 0-)

        when there are riots in the streets, even Rs will have to reconsider their stance on some issues.

        "These are not candidates. These are the empty stand-ins for lobbyists' policies to be legislated later." - Chimpy, 9/24/10

        by NWTerriD on Sat Sep 01, 2012 at 06:22:02 PM PDT

        [ Parent ]

    •  BCBS Sucks ! Health care insurance LOL (0+ / 0-)

      Google BCBS Sucks page after page where people have been denied claims they will pocket the money some how with creative book keeping

  •  Medicare for all is the best way (7+ / 0-)

    to go and I am in the health care field.  By allowing those priced out of the health care insurance market to buy into medicare would allow Medicare to be sustained for the long run.

    The reimbursements are lower however and if the reimbursements were a little higher, the doctors would like it a whole lot better.  

    What is a shocker is the price of medical equipment.  $22000 to 40,000 for a cautery machine that could be easily reproduced at Costco prices.  

    We are getting ripped off by those companies.

    There has to be a Costco way of providing this specialized medical machinery which could be duplicated in someone's basement by someone with an bio-engineering degree.

    •  Dems could have done this with ACA (4+ / 0-)
      Recommended by:
      ladybug53, WheninRome, brook, dfarrah

      or at least could have 'tried'. Instead, they compromised with Repubs and we got a few 'nice to have' rules bolted onto the same old unsustainable, most expensive HC system in the world.

      Which is why the Dems are desperately scraping the barrel to find votes for Obama.

      If Dems lived up to Dem principles, this election would be a land slide already.

      "It is the world that has been pulled over your eyes to blind you from the truth." - Morpheus

      by CitizenOfEarth on Sat Sep 01, 2012 at 09:36:01 AM PDT

      [ Parent ]

      •  Any Dem that's at the bottom of the barrel (2+ / 0-)
        Recommended by:
        mooshter, vet

        and needs to be scraped up is a Dem that hasn't thought about a Supreme Court staffed by Justices vetted by Robert Bork and  his ilk!

        "There's nothing serious about a plan that claims to reduce the deficit by spending a trillion dollars on tax cuts for millionaires and billionaires." - President Obama

        by fhcec on Sat Sep 01, 2012 at 02:13:04 PM PDT

        [ Parent ]

        •  The Party of Austerity (1+ / 0-)
          Recommended by:

          Party of Austerity explains why things are as they are.  It's worth a close read to help understand the "big picture" as ugly as it is.

          Similarly, the health care bill was sold on “bending the cost curve” and constrained by statutory paygo, which made it impossible to bring forward a new program with any deficit spending. Obama turned to austerity rhetorically in 2010 when there were large majorities in Congress, and by the middle of that year fiscal policy had turned negative at the federal level. We have the lowest number of federal employees as a share of the population since the 1960s, and the lowest amount of public investment in terms of discretionary spending as a share of GDP since the Eisenhower Administration. I know this because Obama touts it, over and over.
          We are losing our base and without honestly looking at this stuff we deserve to lose it.
    •  I have a friend who has a friend who is (2+ / 0-)
      Recommended by:
      tbirchard, cassandracarolina

      a dentist and quite knowledgeable about medical equipment. He made his own gear out of superior materials with greater efficacy for one tenth the cost........medical insurance didn't like it. Has to be the bloated corporate network schlock or they don't play.

  •  No thanks. The government can't even run the (0+ / 0-)

    Post Office properly.  

    He only employs his passion who can make no use of his reason. - Cicero

    by SpamNunn on Sat Sep 01, 2012 at 08:36:47 AM PDT

  •  Cant wait to get into the health (1+ / 0-)
    Recommended by:

    care field

    I will pack up and go to Cali!

  •  Thank you so much for posting this. (3+ / 0-)

    The history you tell of how this came about in Canada is new to me.

    I can't tell you how much I hate the medical insurance death zombies in this country and their evil supporters. I hate them so badly I think to even call them that is an insult to zombies.

    If "elitist" just means "not the dumbest motherfucker in the room", I'll be an elitist! - David Rees from "Get Your War On".

    by Oaktown Girl on Sat Sep 01, 2012 at 02:26:13 PM PDT

  •  I think it will happen. (2+ / 0-)
    Recommended by:
    Kentucky DeanDemocrat, vet

    I just can't see a system that mandates people to deal with lying cheats like Blue Cross and Blue Shield lasting that long.

    "To recognize error, to cut losses, to alter course, is the most repugnant option in government." Historian Barbara Tuchman

    by Publius2008 on Sat Sep 01, 2012 at 03:23:05 PM PDT

  •  The Greatest Canadian (3+ / 0-)

         Thanks for this article and the many thoughtful comments....

         Tommy Douglas, the man most responsible for bringing us single-payer universal health care, was voted Greatest Canadian in a television reality show a few years ago... Yes, greater then Glenn Gould, Marshall McLuhan, Leonard Cohen, Wayne Gretzky or  Sir John A. MacDonald....

         Tommy had actually moved on to be national leader of the NDP by the time the fight was won, but he was Premier of Saskatchewan when the fight began.... The success of medicare in that province convinced other provinces and eventually a Liberal federal government to extend the program nation-wide.  He is still loved here for his fiery speeches and fearless fight for the underprivileged...  Ironically, the province he governed for so many years is now a right-wing fiefdom, after achieving prosperity due to record commodity prices (potash, oil and gas, uranium, wheat, etc.    

        Tommy's daughter Shirley, a long-time activist herself, was married to  Donald Sutherland,  so Kiefer Sutherland is Tommy's grandson.....

  •  Thank you, Rescue Rangers! (0+ / 0-)

    I don't know how I missed this the first time around, but I'm really glad you gave me a second chance to read it.

    "These are not candidates. These are the empty stand-ins for lobbyists' policies to be legislated later." - Chimpy, 9/24/10

    by NWTerriD on Sat Sep 01, 2012 at 06:13:37 PM PDT

  •  False. (1+ / 0-)
    Recommended by:
    This helped not only kill the public option (thus not really changing all that much in the long run)
    Tell that to my friends with diabetes as a preexisting condition. Tell that to seniors who were in the donut hole. Tell that to everyone who got a rebate check because of the expenditure ratio requirement. Tell that to 22-year-olds who got sick but are still on their parents' policies.

    Tell it to the people of Vermont, who, under the ACA, are TRYING a single payer program, because the bill gives them the flexibility to do that.

    I am sick of whining about single payer. Obama would have signed a single payer bill if it had reached his desk, but there was never a moment--not a single moment--when that was the remotest possibility. Five Senators we had to have to beat a filibuster were adamant that under no circumstances would they support single payer, so it was DOA. There was nothing Obama could do about it: four of those Senators came from states that went for McCain (so he had no leverage over them: it HELPS them politically to defy the President), and the other was...wait for it...

    Joe Lieberman

    If there comes a time when we can get a single payer system, I'm all for it. But complaining about the ACA just because you didn't get your impossible dream is unwarranted, factually baseless, and strategically hapless. Please stop doing it.

    Have a flagon and discuss the news of the day at the sign of the Green Dragon, or hear me roar on Twitter @MarkGreenFuture

    by Dracowyrm on Sat Sep 01, 2012 at 07:04:44 PM PDT

  •  Red state, Blue state divide? (1+ / 0-)
    Recommended by:

    One aspect of Canadian politics of the 1960's and 70's was that this sharp divide did not exist. ALL 10 provinces adopted some form of universal health care, with 10 different ways of paying for it.

    A second point is that while there is no federal program, there is a federal Health Care Act, setting a standard to which the provincial programs must adhere if they wish to have federal funding, the formula for which is also set out under that Act.

    If a province tries to shift their medical plan to a two-tier or to a private system, violating principles set out in the Act, they find themselves in danger of losing that funding.

    A state driven system in the US would, I fear, quickly result in Blue States having a universal system, while Red States did not, the later electing to live in medically impoverished righteousness. In the event of a national pandemic, that division could undo the good the Blue States have sought to do.

    Often left out of the discussion of the "Canadian System" are two facts. 1) Hospitals are separate entities. If your local hospital is struggling, the quality of the care you receive may be compromised. This needs to be rectified.

    2) The big cost factor remains pharmaceuticals, and an industry focused on maintenance (continued revenue stream) medicines, rather than on cures. This can, in my opinion, only be resolved by some form of public consolidation of the Pharmaceutical Industry. It doesn't take much of a residual capitalism to sabotage a progressive program.

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