Frankly I'm confused about Obama's health plan or what he stands for after I

[Cleita]

received this email yesterday. I've been writing to him about this at his White House email contact on a fairly regular basis and fairly regularly beating the single payer drum. So as of yesterday this is what he is saying:

Friend --

The chance to finally reform our nation's health care system is here. While Congress moves rapidly to produce a detailed plan, I have made it clear that real reform must uphold three core principles -- it must reduce costs, guarantee choice, and ensure quality care for every American.

As we know, challenging the status quo will not be easy. Its defenders will claim our goals are too big, that we should once again settle for half measures and empty talk. Left unanswered, these voices of doubt might yet again derail the comprehensive reform we so badly need. That's where you come in.

When our opponents spread fear and confusion about the changes we seek, your support for these core principles will show clarity and resolve. When the lobbyists for the status quo tell Congress to hold back, your personal story will give them the courage to press forward.

Join my call: Ask Congress to pass real health care reform in 2009.

After adding your name, please consider sharing your personal story about the importance of health care reform in your life and the lives of those you love.

I will be personally reviewing many of these signatures and stories. If you speak up now, your voice will make a difference.

http://my.barackobama.com/HealthCareOrganizing

American families are watching their premiums rise four times faster than their wages. Spiraling health care costs are shackling America's businesses, curtailing job growth and slowing the economy at the worst possible time. This has got to change.

I know personal stories can drive that change, because I know how my mother's experience continues to drive me. She passed away from ovarian cancer a little over a decade ago. And in the last weeks of her life, when she was coming to grips with her own mortality and showing extraordinary courage just to get through each day, she was spending too much time worrying about whether her health insurance would cover her bills. She deserved better. Every American deserves better. And that's why I will not rest until the dream of health care reform is finally achieved in the United States of America.

Please add your name to join my call. Then share your personal story about why you too will not rest until this job is done.

http://my.barackobama.com/HealthCareOrganizing

Last November, the American people sent Washington a clear mandate for change. But when the polls close, the true work of citizenship begins. That's what Organizing for America is all about. Now, in these crucial moments, your voice once again has extraordinary power. I'm counting on you to use it.

Thank you,

President Barack Obama

Donate

If I'm reading this right he's asking us to pressure Congress. I don't understand why he has appointed the people he has to oversee health care if what he has outlined in this letter is what he wants. Well, if we can't have single payer, at least what I think we the people want is the option to buy into a government plan like Medicare. I mean if it's true that he wants to guarantee choice then the lawmakers need to give us that choice and that includes him using whatever clout he has to influence Congress. I'll send my story and anything else he wants but I hope this isn't just a palliative to make us health care activists shut up.

[Oregone]

1. He stands for "reform"

Its a magic word meant to make your heart fuzzy. Fuzzy hearts burden the health care system less. The man is a genius.

[ThirdWorldJohn]

2. If you click on the link, it will end asking you for your donation. nt

[KakistocracyHater]

3. healthcare today is out to make money

healthcare tomorrow(& for as long as there's an America) should be about maintaining health.

[Oregone]

5. But that isn't what he claims to be for in his reform...

Rather....

"it must reduce costs, guarantee choice, and ensure quality care for every American"

So, it just has to be somewhat cheaper (still profit-based private), have choice (mysterious right-wing buzz word about socialized health care), and everyone must have some coverage (can be done with mandated private).

This ambiguous layout he is presenting in this email could mean the best if you grossly extrapolate, and also pretty much mean nothing. Its a sadly lacking email pointing to nothing firm, except trust and donations.

[tkmorris]

4. Ya know, I wanted to sign that

I figured it was pretty pointless but what could it hurt? Then I saw that signing it was declaring my support for Obama's "three principles" of Health Care reform. Here there are:

* Reduce Costs — Rising health care costs are crushing the budgets of governments, businesses, individuals and families and they must be brought under control
* Guarantee Choice — Americans must have the freedom to keep whatever doctor and health care plan they have, or to select a new doctor or health care plan if they choose
* Ensure Quality Care for All — All Americans must have quality and affordable health care

I can't do that. There is nothing in there that even attempts to reduce the influence that insurance companies have in our health care. Perhaps it isn't possible to get single-payer through Congress right now (though I'd still like to try), but without a public option of any kind there IS no health care reform, we are just playing games.

[Oregone]

6. Its a list of feel-goody crap points IMO

If he wants to come to the people for help and support, he needs to come to them with a firmly defined plan that is in their interests.

[sandnsea]

8. So call Congress

and demand that public option be one of the choices you have.

That's what he's asking you to do.

[Oregone]

9. I didn't get that from the email

And regardless, the "public option" (whatever form it actually manifests itself in, which is entirely unknown to the people at large) is quite a bit short from what Obama could and should deliver.

[sandnsea]

11. Everyone wants single payer - but -

nobody knows what a public plan option is. Is that what you're saying?

He is not a dictator. He is President of a lot of people with a lot of different ideas of what health care should be. I don't know why people think it's acceptable for Obama to cram laws down people's throats when they were horrified when Bush did it. We are not going to get single payer right now. The best we can hope for is a public option but that isn't going to happen either if people stand on the sidelines because they didn't get 100% of what they wanted.

[Oregone]

13. Im not saying everyone wants single payer now...

They do not because many have NO CLUE what it is, how it works, and how beneficial it is. That can be change QUICKLY with a little education and LEADERSHIP from, well, who else but the president!

But, politicans and policy wonks do know what it is in the meantime. Being that the democrats are in charge, they have no reasonable excuse for not implementing a system that is more beneficial for everyone.

It is entirely acceptable for the Democrats and Obama to cram through laws they *know* are more beneficial for the society at large (and sell them to the people while they are at it).

But why, why the hell, should anyone stand for some compromise "public option" when they don't even know what the fuck it will actually be when passed into law? I mean, come on now? Its like he is just saying, "follow me, because, well, I have a nice smile". Just take a look at Schumer's plan (who will have a much larger part in writing it than Obama) and tell me how its always a better option than nothing at all. You all might blow your load on a piece of shit.

[sandnsea]

18. I thought everybody wanted single payer

That's what the single payer advocates have been telling me for months. Now you're saying that isn't so?

But, people are supposed to believe whatever Obama tells them about single payer, but not supposed to believe information about a public plan option -- even though they would deliver health care exactly the same.

Bush thought all kinds of things were beneficial for the society at large. Or at least, that's what he sold the people who believed him when he said he wanted to bring democracy to Iraq and keep Americans safe. It's never okay to steamroll people just because you have the power to do it.

[Oregone]

19. No, not everyone wants it, as I said. If they understood it, they would want it.

"But, people are supposed to believe whatever Obama tells them about single payer, but not supposed to believe information about a public plan option"

Single-payer refers to a specific system of a single government funded insurance company to pay for care. The "public option" can be anything, depending on the writers of the legislation, and is currently being referred to in the most ambiguous terms (see the above email posted in the OP). Neither of them "deliver health care", as you state. They PAY for health care. But being that the "public option" may be unfunded, and refused by doctors, it would be absolutely hindered in its ability to pay for health care, in contrast to a single-payer system.

"Bush thought all kinds of things were beneficial for the society at large."

There is logic and empirical evidence here, aside from mere bible verses.

"It's never okay to steamroll people just because you have the power to do it."

And its never okay to allow people to be steamrolled just because they aren't marching in the streets against it. People are currently being fucked under a private system, and the "public option" isn't guaranteed to shape up any better. Should we let people wallow in their misery and stay down in their hole like some kidnapped woman with Stockholm Syndrome? That is NOT responsible government.

[sandnsea]

22. Our delivery system is too expensive

It would have to change to be functional under a single payer system. It would be just like public schools in the sense of constantly having to fight for funding and trying to figure out why one hospital can't function on the same amount of money another one gets, etc.

You keep saying the public option can mean anything. That's true, which is why we need to be fighting for it to be a full health delivery system just like single payer would be.

[Oregone]

23. You are ignoring the drastic effect of taking profit immediately out of the entire insurance problem

If everyone paid just 25% less than they currently pay in premiums, but without profit added into the insurance side, hell, their money may go just as far since it is actually put into the health care system (instead of the private coffers of the shareholders, but of course, this depends on how much profit each company rakes in). Hence, even though providers' services are expensive, there would be ample funds to cover it all.

And yes, the cost of the actual services could be changed with negotiation, but remember, these are still private providers (just being paid for by a public company), so you can not insanely micro-manage. But if all providers start dealing with a finite (in funding), lean, and powerful company, they may not perpetually increase funding each year, continually. The government can also set caps on charges for services (and now comes in the other single-payer problem, whereas if you restrict the profits of private providers too much, the demand for health care professionals drops and there is a shortage of doctors, contributing to wait times).

"which is why we need to be fighting for it to be a full health delivery system just like single payer would be."

If you honestly think you have the voice and power to get that, Im not sure why you do not think you could have the voice and power to accomplish single-payer.

[tavalon]

28. That isn't exactly what he's asking

Nonetheless, that is what we can and should do.

[sandnsea]

7. He said in NM he wants a public plan

If people don't pressure Congress for a public plan option, we won't get it either. He is asking people to get off single payer and help him at least get the public plan. According to Moveon, BC/BS is already planning a massive campaign against the public plan option. We've got to shit focus immediately.

[Oregone]

10. Ah, fuck that then...

He needs to get his ass of the mysterious, undefined, ever-changing "public option" and jump on a universal single-payer plan.

[sandnsea]

12. Yeah, fuck people seeing a doctor

Better to stomp your feet and hold your breath until you turn blue than to compromise so everybody can see a doctor.

[Oregone]

14. Everyone can see a doctor now

A magical and undefined "public plan" based on ambiguous premises destined to change will no more guarantee that happening in a better way than the current system. It may guarantee you will feel better about it n your fuzzy heart, but thats about all. This is like "Let's make a Deal" and you are picking the mystery curtain over a known piece of shit (pure private) and a known prize (single-payer). It may be in the middle, and it may just be a piece of shit. You may get the goat.

[sandnsea]

16. Just like a magican and undefined "single payer"

If the "public plan" is undefined, so is single payer because the public plan is to implement a single payer type plan alongside current insurance. The only ones getting all fuzzy hearted are the single payer people who think it's going to be some kind of dream panacea when there's clear evidence from other single payer countries that there are problems with it too.

And, no everybody cannot see a doctor now. If you have an emergency, yes. If you need treatment, no. I certainly hope single payer people don't start using that right wing line as propaganda to hold out for single payer.

[Oregone]

17. Look, single-payer...

Is a system where there is but 1 insurance company, owned 100% by the government, which operates at an acceptable loss and is funded by taxes monies if a deficit is reached. All people are covered, regardless of pre-existing conditions, and all treatment deemed necessary by a licensed physician will be covered 100%, no exceptions. Simple enough?

"there's clear evidence from other single payer countries that there are problems with it too"

The only problems with single-payer is when it is not adequately funded. Do you realized that the "public option" will probably not be funded AT ALL?!? You get that, right?

Single-payer implementation doesn't actually fundamentally change the health-care system immediately. It changes how it is paid for (for everyone). Thats it. Its just a streamlined, no bullshit, non profit insurance company that will not refuse residents care.

The "public option" can be anything from medicare (good) to an unfunded repository for private insurance companies to shed high-risk consumers, and thereby, increase their profit margins (bad). The bottom line is, you don't know what the fuck you are getting. Why get off your ass to make a call for that? You will likely get the goat with the people in charge of writing that crap.

[sandnsea]

20. All treatment covered?

No it won't be. It can't be. There will be a list and there will be treatments defined as experimental, etc.

If the problem with single payer in other countries is that it isn't adequately funded, then, uhm, that would mean an adequately funded system would cost more, maybe even as much as ours does. So maybe Obama's insistence on cutting costs in order to get health care to everybody isn't such a stupid idea.

[Oregone]

21. All required necessary treatment, yes, will be paid for.

My MSP states it like this:

"medically required services provided by a physician enrolled with MSP"

-------

"that would mean an adequately funded system would cost more, maybe even as much as ours does"

HUH? How the fuck do you figure? You realize the CEO wont get paid $24 million (maybe only half a million) and profits wont be required to be produced for the shareholders (since the shareholder is the government, who forgoes on potential dividends. Yes, single-payer systems may need more money to fund their services than they currently get, but as much as the current US system...you are beyond dreaming. Its an asinine assertion.

"So maybe Obama's insistence on cutting costs in order to get health care to everybody isn't such a stupid idea."

This ignores the capitalistic nature of the private companies. Are they going to cut costs AND profits (or just costs by denying claims, to maintain profits)? What if we could have all insurers (by just having 1) operate without profits at all?

[sandnsea]

24. beyond dreaming

if you truly believe there can be any health care system that doesn't have some kind of oversight of claims. There has to be and there will be.

"According to federal data, 60 percent of the nation’s 3,400 hospitals are 501(c)3 non-profit, 23 percent are for-profit hospitals and 17 percent are run by counties, state or federal government and account for 31 percent of total U.S. health care costs. Those costs are projected to increase to 39 percent by 2017."

I have no idea what this site is, I just grabbed the numbers out of it, which I've read before. Were you aware so many of our hospitals already are non-profit?
http://www.maurythinks.com/2008/04/17/how-many-advantages-do-non-profit-hospitals-need/

[Oregone]

25. Of course there is oversight to make sure the procedures required and provided by the physician...

But that is the end all, be all criteria of my single-payer health care system straight from their literature. It also goes so far as to cover non-required elective surgeries of certain sorts including sex changes, believe it or not. That is just the bottom line reality of it. Of course, there is a healthy public debate over what should and should not be covered. Its a debate Id prefer to see in the public forum, rather than the private. Fortunately, anything that isn't publicly covered, ba bing, is handled on the private market with supplemental plans (best of both worlds).

"Were you aware so many of our hospitals already are non-profit?"

That DOES NOT concern single-payer health insurance. Single-payer is about paying for services, NOT providing them. Private insurance companies create rates that pay excessive compensation AND produces profits for shareholders. Single-payer completely eliminates profits from the insurance side of the equation.

[sandnsea]

26. a healthy public debate

over what should and should not be covered. Exactly. And until we know, one might say single payer is "mysterious" and "undefined".

Much of health insurance is non-profit too. In Minnesota it was 80% just a few years ago, now it's 65% of insured people.

And CEOs of non-profits make a ton of money too.

http://www.consumerwatchdog.org/patients/articles/?storyId=25215

It would not be a quick fix and would still require cost cutting measures to make it functional. You can't separate the quality of health delivery from health payment. From medicine to advanced equipment to the people who are trained to use that equipment; health care is expensive.

I have to get some sleep.

[Oregone]

27. Well, as I said, services *required* are paid for, no exceptions

The debate is over what is "required" beyond what is reasonably required, if you catch my drift. No one is debating heart transplants, but rather, sex changes or vasectomies (both covered, but not required for life) or orthodontic braces (not covered except for severe congenital facial abnormalities). If you *need* something, rest assured, it is and will be paid for, no further debate needed. See the difference? Thats not really mysterious at all. The only mystery is the extras beyond the initial black and white language of *required*. Your knee is out, you get it fixed, period. You want laser treatment to remove hairs from your knee...write you health minister a letter and lobby.

The mystery of "public option" now is HUGE. It can be effective like medicare, and it can also be some unfunded piece of shit company that has no power to accomplish anything beyond collecting premiums for services from doctors who are allowed to refuse their payment. Don't you understand...that is real mystery. This thing you are asking people to lobby for can be a literal piece of shit.

"Much of health insurance is non-profit too."

Good, lets follow it up with making ALL health care non-profit, and further, all non-profit health care equal and complete (not lacking in any way).

"From medicine to advanced equipment to the people who are trained to use that equipment; health care is expensive."

Of course, and this is where you use the power of a single powerful insurance company to negotiate prices. You still must reasonably negotiate, as to not constrain an area.

Is it all expensive...yes. It takes tax dollars. Probably tax dollars that go towards war currently. You are already paying taxes, and costs for the failure of the private system. A fundamentals social change would be cheaper long-term, overall, and result in a bit more peace on the globe. But, if you think you are going to get a public option working without funding it (as Schumer suggests) you are wrong, and funding it still hits the same wall as the problem of funding single-payer. Its all going to cost some money. Dollar for dollar, looking at current comparisons of other countries, it will probably cost less than the current system per capita though.

[tavalon]

30. It sounds like you've already learned a lot about how the Canadian healthcare system works

I wonder how it works when there are multiple acceptable choices to handle a situation. I have a "for instance" using my own darling kidney. Last month, while being seen in the ER for severe abdominal pain, they accidently found out I have a tumor on my kidney. It's small and it may or may not be cancer. There are four different kinds of surgery that can be done or there is active surveillance which will require MRIs every three months and eventually, likely, one of those four options. In the system you're in, how would the decisions around treatment be made? Each option has its plusses, minuses and chances for a cure so.........

And now I return you to your regularly scheduled interesting discussion. And, BTW, I'll probably be joining you up there in beautiful Vancouver before too very long.

[Oregone]

32. I honestly do not know the answer to your question

Ive have only lived here a small period of time and have little experience beyond the fundamentals of how the system works. Initially, it would seem as if the treatment recommended by the physician (chosen out of what would best fit that required surgery) would be the one pursued. They have very detailed payment schedules for the amounts that doctors are allowed to charge for each procedure they do. Being that this is the case, I would *assume* that any billable procedure on that list that is required to be done is allowed. Hence, the decision would be between the two of you. But if anyone knows that this is wrong, feel free to correct me.

Hope you enjoy Vancouver!

[Cleita]

34. If your kidney condition is considered end stage where you will require

dialysis or a transplant, Medicare will cover your expenses because private insurance won't, nor will Medicare advantage plans.

[Oregone]

15. BTW, if doctor's aren't going to be forced to accept the public insurance plan for payment...

Its as good as fucking useless anyway.

"The government should not compel doctors and hospitals to participate in a public plan just because they participate in Medicare." - Schumer

Isn't it time to cut the bullshit and responsibly take care of people with Single-Payer health care already?

[Phoebe Loosinhouse]

29. In addition to that, Schumer wants the "public" plan to be funded solely with premiums

with no government subsidy, guaranteeing a quick death for the public plan, since there is NO WAY it will be able to remain solvent on premiums alone due to facts that should be GLARINGLY obvious to Mr. Schumer: The first enrollees of the public plan will be people who have been cherry-picked out of the existing system due to pre-exisitng conditions and chronic diseases or past histories of cancers, etc. Also part of the first wave will be some people who have not had access to healthcare for years due to lack of affordability. You do not have to be a genius to know that outflows will outpace income heavily, at least initially, if not forever. A public plan is not meant to be self-sustaining, it's meant to be financed BY THE PUBLIC. What doesn't Schumer get? Actually, he totally gets it, and that's why he wrote his "compromise".

[tavalon]

31. Yep, one of my partners has medicare and he has trouble finding doctors willing to see him.

[Cleita]

35. That's because Medicare reimbursement amounts were neglected or lowered

in the Bush years. It needs to be updated, that's for sure. Are you sure he has traditional Medicare or one of he Medicare advantage programs, (privatized Medicare), which I find practically no doctors in my area will accept?

[Cleita]

33. Well, if the public plan pays competitively they will accept it just like they

accept Medicare. One of my doctors has a sign in his office that he doesn't accept any Medicare advantage plan (privatized Medicare) and lists all the HMO and insurance plans he won't accept, but he does accept traditional Medicare. Why? Because he gets reimbursed better than the various plans out there and he doesn't have to risk denial of claims or being stiffed by the private, for profit companies, which happens too often.