Reply #160: you raise an important point- we do NOT have a health care system

[BREMPRO]

this bill creates one that has some fundamental structures that can be implemented and adjusted over time. Right now we essentially have NO system. The randomness and lack of a system creates runaway costs.

There was a great segment on 60 minutes tonight about end of life care- did you see it? It chronicled the high costs driven by this idea that we have to do everything to keep people alive in the last few months of life, even if they should be sent home to die in peace with family instead of on hooked up to a respiratory. it's inhumane and it's VERY expensive. Partly this is driven by pressures for doctors and hospitals to make their budget-as well as to cover their costs for uncompensated care. Partly by our cultures fear and avoidance of death. This bill has structures to deal with end of life counseling, comparative effectiveness/best practices research. The bill gives HHS methods to change us from a "Fee for service" model, to an outcomes focused system. The fact that 30-40 million more will be insured should reduce emergency room costs and uncomensated care that will save money. All this is build into this legislation and is something to be celebrated. I think these provisions are much more important than the insurance part that has gotten a disproportionate attention in the media and blogs. I'm frustrated to see all the corporate conspiracy hype here about insurance and not enough real examination of the bill and its positive aspects.