Let's have a conversation about values.

[LWolf]

Specifically, health care.

I believe health care is a right. Not a product. I believe every person has a right to the same level of care, regardless of ability to pay. I support universal, single-payer health care. I support taking the profit out of the equation. Here's just one reason why.

My 26 year-old son is getting ready for another surgery in about 6 weeks. We've been working on this for years.

For 3 years he had Kaiser, through work. His gp diagnosed 2 hernias. He was in constant pain. Kaiser's specialist kept sending back a contradictory diagnosis, saying he didn't have any hernias. The pain continued. He fought for 2 1/2 years before they would "approve" surgery to repair, then they only approved surgery for one of the 2 hernias. He had that surgery last summer. Disgusted and frustrated with Kaiser, because they were refusing to treat the 2nd hernia at all, he "switched" insurance carriers to one with a copay. And a big deductible. It was the other choice offered by his employer. The coverage transfer was lost in his employer's system, and it took 6 months for them to reconcile the switch.

So, he goes to the new doctor. Who doesn't argue. Who diagnoses hernia, gives him a lot of information the Kaiser doctors didn't, and schedules surgery. By the time he gets done with his deductible and copay, this surgery will cost him about $2000. Which he will have to go in debt to pay. But he's decided the $2000 debt is worth it to be pain free and be able to operate physically. For 3 years, he hasn't been able to lift anything more than one book without sweating, turning pale, and nearly fainting.

Three years of pain and diminished capacity, and $2000. And he has health insurance.

I don't want a candidate who will tinker with the current system. I don't want a candidate who will keep the insurance companies deciding who gets care, when, and how much care we have to do without to keep their profits rolling.

Universal, single-payer, not-for-profit health care for all. Let the doctors treat people. Value people. Let them get care.

[corporatewhore]

1. not having universal health care is barbaric imho

oh yeah we have the treatment that will ease your pain or save your life, but wait your poor ,sorry!

[LWolf]

8. You're damned right.

It's barbaric. And I'd like my nation to be more civilized with this issue!

[mrgorth]

2. Agreed.

[HFishbine]

3. I'm with you

But I don't see how it's gonna happen. Edwards' plan relies on insurance companies -- even making purchase of private insurance mandatory. So, the gatekeepers to care will still be there (and you'll be required to fund them.)

I'm less familiar with Kerry's plan. Maybe a Kerry supporter can tell those of us who favor single-payer health care what promise Kerry's proposals offer.

[LWolf]

9. This is one big reason

why we need to send the votes and delegates to Dennis. I'd like to see this part of the discussion at the convention.

[nedlogg]

4. Saddam Hussein . . .

is getting free healthcare.

The prisoners in Guantanomo get free hrealthcare as do our domestic prisoners.

So one can only sumise that crime is the ticket to free healtcare.

Nice system, ay?


:puke:

[LWolf]

10. What a sick, perverse

society that provides health care to 100% of criminals, but not 100% of the rest of the population.

Health care for 100%, no matter what subgroup you belong to. A fundamental right. (JMO)

[Ysabel]

45. the idea that health care is provided to criminals...

is false...

[quispquake]

5. Just went thru the "Double Hernia" hell last month...

My 'health insurance' covered 80% of it (that with a $500 monthly charge for my son & myself). I went in, they cut me up, and sent me home 3 hours later...they had shot me up full of morphine, so I thought I could deal with the pain (all they gave me were some percocets).

Then, the morphine wore off...the pain was so intense I could not get out of my bed...I had no phone, and I had noone to help me until my sister showed up in the morning & helped me to a chair, where I remained for 2 days without even going to the bathroom.

When I called my doctor to complain, he told me that the insurance company demanded that this be day surgery only, or they don't cover it. So, I'm paying $500 a month, I now am in debt $2000 to cover my co-pay to the hospital, and this is what I get???

I keep on hearing how this nation has the world's best health care...well, not if you're not in the top 1% it doesn't...this experience really opened my eyes.

I COMPLETELY agree about single payer health care (one of my main reasons for supporting Kucinich in the Maine caucus). Our health care system is sytematically raping the poor & middle class in this country, and is giving half-assed care in return.

So, I understand and feel the pain your son is going through...hopefully, one day, the powers that be will realize that money is not the only thing. (But I doubt it).

pp23

[LWolf]

11. Same story all around.

I'll be picking him up; for the 2nd time in a year, since we've had to do this twice. I'll be administering the home care until he is up and moving again. At his request; I guess when you know what's coming, mom is the best antidote, outside of an actual hospital bed, nurse, etc.

I hope you are recovering well!

[Armstead]

6. I totally agree that healthcare should be a basic right

IMO universal access to affordable healthcare should be considered a basic right, along with public education, the use of roads, sewer and other infrastructure.

There are many ways possible to accomplish this. But the bottom line should be direct move towards at the very least guaranteeing basic coverage that is based on a percentage of income as a sliding scale.

Tinkering around the edges, or trying to placate insurers and corporate providers, is counterproductive.

[LWolf]

12. That's right.

Tinkering around the edges, or trying to placate insurers and corporate providers, is counterproductive.

It's like tinkering around the edge of a tumor instead of removing it.

[democratreformed]

7. I have lived in healthcare debt my entire married life.

I guess I have just come to accept it as a given that I will always owe one doctor or hospital or another. I complain about it and it is highly aggravating, but it is always there. When my died unexpectedly, I missed a couple of payments so my debts were turned over to collection. My credit is ruined primarily b/c of medical bills. AND, I, too, have spent very little time w/out some type of insurance. My largest bill (@$8000) came as result of insurance that refused to pay. It's a long story but the short one is that the agent filled out the papers wrong. The lawyer said I could sue but that he knew the person and I would not get anything.

At the same time, I have come to completely distrust doctors in general. When my son was 9 months old, after four visits to the doctor, I had to tell him "we" thought he should be in the hospital. He said "okay". He had double pneumonia.

My mother went to the doctor 13 times in the last year of her life. More times than the rest of her life put together. Still, they called her pain "shoulder strain" and "ulcers" instead of the heart condition or whatever it was that killed her.

[LWolf]

13. Exactly.

This is exactly why I keep saying that giving people insurance isn't enough.

Insurance doesn't guarantee care, damnit!

[democratreformed]

15. It sure don't!! n/t

[JasonBerry]

14. Right not a privilege

The state of a person's health should NEVER depend on the size of their wealth.

[snoochie]

16. Nobody gives a s...

Values? Passe.

Winning is all that matters. What you win is irrelevant.

It tears me up that people don't even want to try to stand up for their own values.

[LWolf]

29. Some of us are still here doing just that, snoochie.

:hug:

Those of us who make our choices based on issues and our values have a place at the primary table, too. And we will be heard.

Those who are wavering between voting for issues and/or values and voting for "whoever everybody votes for" can strengthen our voice.

[muffin_man]

17. It does sound great

healthcare for all. If it is right then I assume housing,clothing,food,should all be rights too simply because we need them to survive. I mean it is a very altruistic idea but don't see it as a reality. What good is healthcare if you don't have a house or food or clothes?

[democratreformed]

18. Maybe I am altruistic or dreamin' or whatever, but I think those things

should be rights as well. Well, darn! Now ya made me go and start thinkin'. What about those people who could provide themselves with those things but choose not to? I don't know. I'll have to think some more.

[muffin_man]

19. Good question

Now your really getting iffy. How do you decide who can provide for themselves? How do you decide what "provide" is? And as we all know this is America and people would horribly cheat the system.

[democratreformed]

22. I suspect you are entirely right about the cheating.

After all, I see some of it every single day. Like I said, I'll have to think some more. I haven't really ever considered health care a right, but I do think the current system is terrible. On the other hand, there is something inherently wrong with letting a person die b/c of lack of money. They could live w/out shelter. Not w/out food. I forgot what your other one was.

Hmmm..... I need to think some more.

[muffin_man]

24. I just doubt the government

could handle it. I mean I know SS is a success wait no sorry I mean medicare...no not that one I meant welfare..Darn it! I'm gonna get it right its education that is the success of government!.......Sorry for the extreme sarcasm (I know there is an abundance on DU) I just have become very apathetic to government/politics that offer a lot of hype with no real solutions and took it out on you. Boy anarchy is lookin good!

[democratreformed]

26. Hey, no offense taken

I sincerely enjoyed the conversation. And, I definitely understand sarcasm.

Oh, and I'm still thinkin'. I ALWAYS enjoy that. I am one of those people who could definitely be a lifetime student - I enjoy learning and thinking.

On edit, I guess I really am a lifetime student - of life.

[LWolf]

34. I wish we were all life-long students.

That's been my goal since I became a teacher. To help children become life-long learners. Not test takers.

I applaud your efforts. :hi:

As far as this discussion goes, it looks like a 2-pronged concern:

1. Cheating

2. Inept bureacracy

Cheating--I think people have a right to food, shelter, and clothing as well as health care. And I believe that health care includes mental health care. If our society has raised up a bunch of people who want to "take advantage," we can address that with education. Give me a chance. Back off with the damned testing gestapo, build more schools, give me a smaller group of kids to work with, and let me spend my days developing whole people. Let universal concepts like honesty, integrity, cooperation, etc. be given as much play time in my room as the 3rs. Include some funding for family education. And give me a generation to make the shift.

I don't believe people are going to make up mysterious illnesses just so they can get some office time with the doctor.

2. Inept bureacracy. Absolutely. Things done on a large top-down scale tend that way. But guess what...that's how corporations are run, too. I can tell you that, since the "business/corporate" mindset entered public ed, we are more bureacratic and less efficient than we were when we were just free education provided by the government. Then our focus was kids; now our focus is test scores.

My friends in Canada tell me that they get their care just as quickly and easily as we do here in the US.

Dennis Kucinich wants privately delivered, publicly financed health care. "Privately delivered" leaves the care up to the doctors, not the government. I think that helps the efficiency.

[democratreformed]

40. LWolf, you have hit on the most important issue

Education. I used to be a teacher until I got disillusioned with the system. It is so different today than it was when I was in high school.

I think education can help solve many problems, though. If we could only fix the system so that it focuses on the children and what is best for them, I think we could do more to advance this country than we ever imagined.

I know that may seem simplistic. But, can you only imagine a place where children are allowed to learn on their own terms? One in which the enthusiasm that they begin with in kindergarted is allowed to grow and is fostered instead of being quashed? One in which each child is valued for his or unique characteristics instead of being constantly pushed to become "like everyone else"?

I am a firm believer in the phrase "Children are our future." Right now, our children are in many ways the most neglected group of people in our nation. We have lost the "be all you can be" idea. It's now more like this: "Be like everyone else or something is wrong with you."

Well, now that my rant about education is over, I have gone back and read your post. You have said pretty much the same things I did - just in a different way.

[LWolf]

69. Hey, democratreformed:

But, can you only imagine a place where children are allowed to learn on their own terms? One in which the enthusiasm that they begin with in kindergarted is allowed to grow and is fostered instead of being quashed? One in which each child is valued for his or unique characteristics instead of being constantly pushed to become "like everyone else"?

The answer is yes; the answer is that, prior to the big standards and accountability takeover of public education, I worked at a public school that did just that. We weren't perfect, by any means. We had plenty of room to grow and improve. But you just defined our philosophy. And guess what? We had the smallest student turnover in our large district. We had parents at school with us, all day every day, involved in every aspect of keeping a school functioning and kids learning. And kids I taught, and their parents, still stay in touch years later. We were partners on a team whose goal was to nurture individual children, and we loved it.

Then came the standards and accountability one-size-fits-all everybody better fit the system or else legislation. And that dream died. We were forced into the "mainstream." Some of us, though, keep those goals locked in our minds and hearts, and are ready to put them back into play at the first sign of a political seachange. Keep the faith. And vote for politicians who don't support one-size-fits-all top-down politically motivated school reform.

[democratreformed]

78. It must have been great to have been there.

In my teaching experience, i never had that pleasure. I only taught six years and several things led to my decision to leave. Sometimes I think about going back but can never bring myself to do it.

What's even worse is that my own son is one of those who doesn't fit in the system. I sent him to public school for one year and three whole days of the next year. Now he goes to a little tiny private school (11 students). He's been there for three years (this is his third). Constantly, I am wondering what to do if the school no longer exists, or if I can't afford it, or if something else happens.

If I were rich, I would think about sending him to one of those ADD and ADHD schools that I see in ADDitude mag. Or, I might start my own around here.

[muffin_man]

46. Not worried about made up

illness just to see the doc but I have for reasons lied about illness to gain narcotics. Say what you will I did so love my pills! But I did have insurance and it did cost me for the visit and prescription.It was not hard at all to do even with the suspicions of the insurance company.Now I can imagine how easy it would be if the government were managing 300 million doctor/prescription bills for me to slip through. Not to mention the major insurance fraud that goes on now w/docs and patients working together.How much easier would it be to defraud the government than an insurance company trying to make a profit who has to protect itself from fraud or crash. The government could just raise taxes to make up for it. If I'm wrong on this fine I just don't see government hands making this any better only worse.

[iverglas]

63. d'ya think?

Now I can imagine how easy it would be if the government were managing 300 million doctor/prescription bills for me to slip through.

Sorry, but *I* speak from experience -- being a Canadian who, some years ago, had closer contact with a number of substance abusers than I had ever wanted.

One of 'em was up in court fairly regularly on "double doctoring" charges: getting narcotics prescriptions from different doctors he would manage to con. For a very, very short time, each time. Nobody said the drug-addled are actually smart. And few doctors are really stupid. And now pharmacists have the computerized access to records that they need to spot criminal prescription-getting.

Several of 'em had found a doctor willing to write them for dilaudid -- he seemed to be a genuine do-gooder, trying to help addicts, with no concept of the depths of dishonesty his clients might dive to. One of them stole one of his prescription pads, and had a ball writing all his friends for whatever they wanted. That, too, lasted a very, very short time. The doctor switched to goldenrod-coloured prescription pads (bad for photocopying) with a rubber stamp for his name -- and also had his authority to write narcotics prescriptions unsupervised taken away.

Not to mention the major insurance fraud that goes on now w/docs and patients working together.

Yes indeed -- every once in a very blue moon, a doctor in Ontario, say, is charged with heftily defrauding OHIP, the provincial public health plan. Payment caps for payments out of the plan to individual doctors tend to deter the billing of six patients for one time slot, for instance. And the central clearing-house for billing -- the government department that administers the plan -- would be a lot harder to double- or sextuple-bill that way than a collection of different insurance companies, I'd think.

The amazing thing is that in our public health plans, doctors have virtually total discretion about the treatment they give their patients and the specialists and tests they refer them for. The plan covers "medically necessary services", and as long as the service is on the schedule, it's up to the doctor whether someone needs it. And I just haven't heard of many medically unnecessary gall bladder removals or kidney transplants being done by dishonest docs.

How much easier would it be to defraud the government than an insurance company trying to make a profit who has to protect itself from fraud or crash. The government could just raise taxes to make up for it.

And yet ... it isn't easy at all, and it happens so seldom that no one is very concerned about it.

If I'm wrong on this fine I just don't see government hands making this any better only worse.

And yes, you're wrong. As to why you "don't see" (or would say you don't see) an efficient, effective public plan being better than one in which huge fractions of health care funds are skimmed off and stuffed into the pockets of companies providing no service to the patient at all (i.e. private insurance companies and HMOs) -- a much huger fraction than could ever be taken out of the public system by fraud -- ... why, I could only guess at the reason. I think my guess would be pretty accurate though.

.

[diamondsoul]

65. Why it's not easy to defraud

either and why I do NOT comprehend the scam artist-

One, Insurance Companies, HMOs etc. have to answer to stock-holders and others expecting profit for investment. The Fed has to answer to the taxpayer. Either way they're held accountable, except with private insurers they can manufacture fraud to solicit pity and sympathy from the public. Sort of like the mythical "welfare queens" once touted by the US politicians. The thing is it's a bit harder when the records are open to public inspection as they would be with Kucinich's system.

[iverglas]

77. heh

I read this after writing the two posts I just made.

1. Cheating ... I don't believe people are going to make up mysterious illnesses just so they can get some office time with the doctor.

Yeah, eh? And those who do, obviously need to see a doctor. ;)

2. Inept bureacracy. Absolutely. Things done on a large top-down scale tend that way.

Except that, as you and I have both pointed out --

"Privately delivered" leaves the care up to the doctors, not the government. I think that helps the efficiency.

-- a single-payer system is *not* run from the top down. The choices and decisions are actually made at the bottom -- it operates by allowing consumers to seek their own health care and health care providers, and empowering the providers to provide the health care that, in their professional opinion, is needed.

The "system" doesn't decide what health care individual consumers will receive, within the parameters of the care that is covered by it. It simply pays for it, while maintaining the general oversight of providers that is needed in order to ensure that they are doing the work they bill for, and not engaged in some pattern of providing unnecessary services.

.

[Lydia Leftcoast]

67. A liberal would rather

feed nine cheats that let one honest person starve.

A conservative would rather starve nine honest people than feed one cheat.

Frankly, the world's great relgions all support the liberal point of view on this.

[LWolf]

70. Great description.

I guess that makes me a liberal, because I'd rather deal with the cheats than let the honest person suffer.

And, of course, that just gives our society another opportunity to evolve and grow. The more social and economic justice, IMO, the fewer people will find themselves needing or just wanting to cheat.

[iverglas]

75. and when you really think about it

How much can the consumer of health care services "cheat" anyway?

How many tonsillectomies does one person need? How much time does one person really want to spend sitting in a doctor's waiting room to make sure s/he gets more than his/her fair share of health care services??

The "cheating" is far more likely to come from the providers of those services, specifically by billing for services not performed. It's conceivable that such cheating could be in collusion with a consumer (e.g. by billing the payer for services not performed, and splitting the payment with the consumer). But in either case, a centralized billing/payment system (the "single payer") that tracks all the providers' billings to the system, and all the services provided to each consumer, is far more likely to deter that kind of cheating, and to identify instances of it when it does occur, and be able to deal effectively with them.

And, of course, that just gives our society another opportunity to evolve and grow. The more social and economic justice, IMO, the fewer people will find themselves needing or just wanting to cheat.

Indeed. Making things just nicer all round.

.

[Mairead]

79. If you want to be accurate, you'll dial down your sarcasm

Because SS and Medicare are both extremely cost-effective. On the order of 3% overhead, and they save any number of lives every year. Any failings are due to the GOP trying to gut them.

[eridani]

21. What about people who could put out their own house fires--

--but choose not to? Let's just abolish property taxes that support the fire department, and let only people who have fires split the entire tab among themselves.

[democratreformed]

25. Hmm....

This is what I have to get around. I have a former employee who was also a friend. He stayed in my camper for about a year. I was hoping he would get his life together and do well. A couple of weeks ago, he went AWOL. He's now on meth and lord knows how he lives, eats, etc. He's no longer here, by the way. We haven't seen him - just heard about him. He took off with my quilts and a cell phone that we promptly had shut off but still have to pay the bill on until the contract is up.

I guess you could still say he has a right to food, clothing, and shelter. He needs treatment. Fact is, he has already been to prison (well, actually "boot camp") once and has gone back to the same old thing. I have an ex sister-in-law whose story is similar. Only she just got back from RPF (residential placement facility complete with drug rehab programs) in October. My brother has their 6 yr old daughter. Where is she? Running with her drug buddies again. Their daughter is in counseling - she throws up all the time from the stress of wondering where her mother is. My brother tried to help her when she got out. Let her come and live with him - good for mommy, bad for daughter when mom ran off again.

Then, there's my very own in-laws. My father-in-law is classified disabled. But, he manages to work for cash every single day in order to supplement his "disabled" check. My brother-in-law managed to get himself disabled too. He doesn't need any extra so he spends his days doing whatever he enjoys - fishing, watching satellite tv, whatever.

[Mairead]

80. Some people will do their best to game the system, no question

But it doesn't matter what the system is. So do we want a system that makes it hard on everyone, or easy on everyone? Which kind will cost us more in toto?

It's been proven over and over again; a whole school of psychology is based on it: when people feel they have power, they engage. If they feel powerless and exploited, they disengage. People watch the Really Big Chunks game the system all the time, in ways that those doing the watching can't even hope to match. But if they get alienated enough, they'll do their tiny best to 'get theirs'. Who can blame them?

People gaming the system is a symptom, not a problem, and problems are never solved by attacking symptoms.

[democratreformed]

85. You're right, of course.

Thanks. Sometimes, it is easier to be bitter than sympathetic? You know what I mean? Most of the time, I do pretty good. Sometimes I slip.

[Kanary]

20. "Infastructure"

During one of the many health care discussions, one DUer (sorry, don't know screenname) said health care should be considered part of the infacstructure of the nation. That sounds right to me... it's certainly as important as education, and more important, even, than transportation.

I'm very sorry to hear what your son is going through. There is NO reason for this country to treat it's citizens so shabbily/

If we could get over this "unelectable" garbage, and just support Dennis, we'd have good healthcare!

Kanary

[eridani]

23. eridani

The following archived thread

http://www.democraticunderground.com/discuss/duboard.php?az=show_topic&forum=104&topic_id=1046027#1047536

[LWolf]

35. Awesome post, eridani.

Thanks for linking me to it.

And I agree. Health care is infrastructure.

[nothingshocksmeanymore]

27. I'd favor more regulations rather than taking the profit out entirely

While I believe everyone should have healthcare, I believe everyone can have healthcare and still have reasonable profits in the system.
The healthcare field would no longer represent gainful employment if the profit were taken out.

I'd rather see insurance reforms and tighter regulation of big pharma than to see profits removed given what it takes to work in healthcare.

One can have both and still make healthcare affordable.

On a side note, I am assuming your son is covered by Kaiser So Cal which does not offer as good a care based on my personal experiences as Kaiser No Cal.

Removing profit does not remove the risk of inaccurate diagnosis and incompetence.

[eridani]

28. Non-profit INSURANCE---

does not mean non-profit health care. As Kucinich says, "Publicly financed, privately delivered."

[LWolf]

31. That's right.

Everybody doing the work is still making money. The insurance companies are not taking profits from those $$, which is what makes it possible to include everyone. And they aren't deciding who gets approved for what care, so doctors and patients can be the decision makers when it comes to treatment and care.

[LWolf]

30. Kaiser so cal. Correct.

Or he was. He's getting better care, for a bigger personal expense, without Kaiser. That's part of the point. The quality of care should not depend on which company you are covered by or how much you can afford to spend.

[HFishbine]

32. I believe

you may be confusing profit for insurance companies with profit for providers. Having a single-payer system cuts out the insurance companies, but the hosptitals and care facilities could still be run for-profit.

[LWolf]

36. "health care delivered privately, funded publicly."

Yes they could. And of course, doctors and all health care workers would still be making money.

Hospitals don't have the same force driving them; they don't make more money by providing less care, like the insurance companies. And if they know care will be funded for all, they don't need to deny care for budgetary reasons.

[HFishbine]

37. Exactly

Any time the government does business with a private provider (from road-building to medicare), it's an example of a single-payer contracting with a for-profit entity. All we're talking about is taking the for-profit money-handlers out of the health care equation.

[iverglas]

64. and exactly how it's done in Canada

Most hospitals are publicly-owned and operated -- but physicians, x-ray labs, physiotherapists, pharmacists, etc. etc., are all private entrepreneurs.

The provincial governments establish fee schedules and the lists of services that are covered by the public plans, and pay the healthcare service providers according to those schedules for the services provided.

And there is virtually no prior oversight of physicians' practices -- if the physician believes that a service is necessary, and the service is covered for the patient's condition, the physician provides it or refers the patient to the appropriate provider. There's nobody second-guessing the doctor. And of course doctors are involved in determining what services are "medically necessary" and thus covered, and the medical associations bargain their fees collectively with the government.

It's so simple, and it works so much better.

.

[LWolf]

68. Simple but effective.

Is that the problem? Is it just that simplicity isn't the "American Way?"

Taking the for-profit money-handlers out of the health care equation; a simple adjustment to the equation by HFishbine.

I can't think of a single valid excuse for not doing so.

[Mairead]

81. Why? What do the profit-takers contribute to healthcare?

I think you'll find it impossible to demonstrate that they contribute anything necessary or even worthwhile. They're gatekeepers and maklers. Like a restriction in a hosepipe, their entire 'contribution' is to create turbulence and restrict the flow. But they're not restricting the flow for our benefit, they're restricting it for theirs. And where's the good in that?

[GreenPartyVoter]

33. Yep. It's insane that it is not a right. A libertarian

posted on another board something to the effect of "why should we give everyone mediocre health care when that will prevent folks who can afford it from getting great healthcare"?

It was so moronic and made me so mad I haven't been able to reply to that one yet. *ick*

[TheDonkey]

38. I think health care is a right BUT

we can't expect to jump right into single-payer immedietly. The rethugs are at the door already for less costly measures. We must take this one step at a time, but not forget the goal.

[no name no slogan]

52. Nobody is saying it would become law immediately

Also, keep in mind that a majority of Americans of BOTH parties believe we should have a single-payer universal healthcare system. If the Democrats were to support their platform (which has called for universal healthcare for 30 years or more) and actually put forth a TRUE single-payer plan, it would pass. Public outcry alone would be a lot of pressure on obstinate congresscritters, who are always looking to get re-elected first and foremost.

Unfortunately most Dems spend their time worrying about what some big-money corpowhore is going to do than fighting for what is right-- maybe if they stood up once in a while and actually CHALLENGED some of these GOP thugs we may actually have a party to take seriously, but I digress.....

Most single-payer plans have a gradiated start-up period. Kucinich's own plan includes a 10-year phase-in. I think most of the other plans put forth already have such a provision as well, as it would take some time to transition to a non-profit system.

And keep in mind that we've been moving toward this kind of system since FDR. So in a way, we've been gradually getting universal coverage for seventy years. IMHO that's pretty slow.

[LWolf]

71. Actually,

Kucinich's plan doesn't call for us to jump into it immediately. He phases it in over ten years, if I remember correctly.

That's a detailed plan on the table now, with a timetable to phase it in one step at a time.

[Mairead]

82. "we can't expect to jump right into single-payer immedietly"

What? Of course we can! There's nothing easier.

You put up websites at several places on the backbone, with forms, and you send 'round a message to all practitioners saying 'Here's the schedule for starting to bill us. As from 1 May we'll be the insurer for all patients whose surnames begin with the letters A through C (or whose birthdate is before 31 December 19xx, or whatever)'. The Medicare office--which the practitioner's staff already deals with--becomes the 'insurer' for more people. And you keep that up til all other insurers have dropped off the perch.

This isn't about installing a totally new system, it's about expanding an existing, well-understood one.

[iverglas]

84. Maine's doing it

I haven't had much luck keeping track of how Maine's doing in getting it up and running, but I gather they're actually doing/going to do it.

A few years ago when a universal single public payer plan was on the ballot in California, it got, if I remember vaguely correctly, 25% of the vote. The bottom had fallen out of what was much broader support in the couple of weeks leading up to the vote, when (a) the pharmaceutical and insurance companies pulled out all the stops on deceitful/scare advertising, and (b) the issue got sidetracked into a debate about whether the plan would cover abortion (obviously a fifth-column attack by the same interests, exploiting right-wing sentiment on another front).

http://bcn.boulder.co.us/health/healthwatch/canada.html

This single payer ballot issue will appear in various states in the upcoming years. It is anticipated that, just as with the 1994 California single payer ballot issue, the health industry will spend enormous amounts to defeat them. It is also anticipated that the issue will receive very little press coverage just as happened in California.

FAIR (Fairness and Accuracy in Reporting) reported after studying the 1994 California ballot issue that there were no articles in the media during the entire pre-election period that pointed out that other countries have single payer systems or what their experience has been. Americans might be interested to know that Canadians live longer, have lower maternal mortality rates, and lower infant mortality. Before single payer was implemented in Canada, infant mortality was similar to that in the U.S.; today there are 9.1 deaths in the first year of life per 1000 births in the U.S. and 6.8 in Canada. In addition, they have more hospital admissions, more hospital days, more physician visits, more immunizations, and more surgical procedures per person than we have in the U.S.

It may indeed be wise to start at a state level -- it started at a provincial level in Canada. The Premier of Saskatchewan, Tommy Douglas (Kiefer Sutherland's maternal grandfather ;) ) brought it in when the CCF, precursor of the NDP, was elected, in 1961.

Within less than a decade, the federal Liberals adopted it and created the framework for a national system -- federal funding, under the federal spending power in an area under provincial jurisdiction; the funding depends on compliance with federal standards. (Alberta is again musing about pulling out of the national arrangement and funding its own system, which would likely be two-tier and include all sorts of now-forbidden things like extra billing, user fees, access to care for cash, new private hospitals, etc.)

Perhaps a federal strategy in the US could involve something similar -- encouraging state-based systems, funding, setting standards.

.

[StopThief]

39. Nothing that imposes a duty of affirmative action. . . .

on anybody elses part is a right.

On the other hand, I do believe that quality healthcare for everyone in society is good public policy.

[muffin_man]

41. If health care should be a right

what about housing,food,clothing? I mean if you can get treated for strep throat but then have to go sleep under a bridge and eat out of dumpster what good will the penicillin do you? Given that there are less people w/out housing then health care but what passes for housing is quite horrible.I still view health care as a Utopian idea.Like every government program once it goes through all the processes its like a rumor told person to person, when it finally gets to you its something completely different. BTW no I don't have an alternative idea or "fix" in mind I'm just addicted to arguing!

[redqueen]

43. Food already is

Government will provide emergency help -- also charities do.

Dallas is working on a shelter for the homeless. I know most other cities have these as well.

So... ?

[muffin_man]

47. So is emergency care

you cant be turned away regardless of ability to pay.Not saying it is enough but it is similar to the level of "food right" and "housing right". There are programs out there. So.....the no healthcare your left to die is not valid. Yes it may ruin you financially but your alive and now like most Americans your drowning in debt!

[diamondsoul]

49. "Yes it may ruin you financially..."

and therein lies the difference. People who make use of shelters and food-banks are not attacked via their finances when they can't pay for those things. People who make use of emergency care ARE financially assaulted for the money.

[muffin_man]

51. I know I know

I had to have stitches w/out insurance and it cost me 2300.I was an unemployed student at the time,so it was more debt added to my school loans.I have no solution for the health care problem only see the problems w/proposed solutions so I will recuse myself from this discussion:)

[democratreformed]

54. Didn't you see that movie?

John Q - was that the name of it? Where the dad held the hospital people hostage to make them get a heart for his son?

My daughter worked with a lady whose husband was in that type of situation. I think his may have been a liver transplant. They had to come up with several thousand dollars to even get put on a list.

One of my co-workers just found out he has liver cancer - just a few spots at this point. I read about some celebrity (forgot who) who got a transplant b/c he had cancer spots on his liver. You think my co-worker has even thought about or discussed a transplant? No, b/c he doesn't have millions of dollars he made from entertaining people.

[muffin_man]

56. Right

I agree with the idea, it's just making it real that seems to be impossible. What can I say? Money talks. Is that right? Not at all but it is reality right now. Honestly, as long as there are rich and powerful we don't have much voice.I don't believe in socialism though. Any system of government/rule is inherently corrupt and will be abused. Any good we try to do will be corrupted. I am not saying you guys should not try though. I myself am useless though as I have no hope and therefore can only argue for the sake of arguing. Seriously if you guys were saying the opposite of what you are I would still argue w/ you from the other side!

The urge to save humanity is almost always only a false-face for the urge to rule it........Dont know who said it

[democratreformed]

58. Aw, muffin man

No hope? There is always hope. Admittedly, it is often hard for me to find, but I usually manage somehow.

And, by the way, your argument has been stimulating. At least you are honest and you are talking about ideas. That's quite unlike some conversations on here where the other person just wants to point out stupid the other person is. Actually, I would call this more of a discussion rather than an argument.

[muffin_man]

61. So right

It has been very stimulating compared with how many around here do go straight for each others jugular! For a progressive/liberal place there is a lot of anger toward each other here!

[democratreformed]

62. I've never quite figured that out

Most times, I try to stay away from those. But, every once in a while, I fall into a trap. :D

[Armstead]

44. Different situations

Housing, food and clothing are also basic rights. But -- and not to denigrate the problems in those areas -- they are more easiuly corected. Poeple can always buy a pair of pants at a place like Salvation Army for a couple of dollars, and there are clithing giveaways for those who are really desperate.Similarly with food -- at least it's possible to survive on a very basic and inexpensive diet. And it's possible to have food banks and otehr things for those who can't even afford a basic diet.

Housing is a definite problem, but there are at least alternatives like shelters, relatives and otehr methods to provide for those who need it.

Health care is a different matter because it requires the support system of physicians and otehr professsionals and facilities. The average person can't just "donate" good health to someone.

Also healthcare is an increasing problem for peopel of most income levels, and to businesses who provide coverage to employees. So it's a more broadly based need.

[muffin_man]

48. So health care

like the current housing,food,clothing programs should only be for those who can't afford it or get coverage? That makes more sense than coverage for 300 million people. I just don't see it has a reality to provide free health care for 300 million, 30 million seems more plausible.

[diamondsoul]

50. Not quite.

What you're overlooking is that current expenditures on healthcare combined between what the average insured individual pays, what the employers pay and what the Government pays is enough money to cover every single citizen to an even higher standard than Canada has!

The point being if the money is there, and we're already paying it anyway, why the hell NOT pay it and cover enveryone?!

[muffin_man]

53. Sounds great!

If you have anything to verify that please post it! I have no idea, but just using a layman's logic that does not appear to be possible. Although if I twist my brain at the correct angle I think I can see it being true.(no sarcasm meant I'm serious)I would love to see that statement being true! It could change my perception and perception is everything ya know! !

[diamondsoul]

57. It's logic, my friend.

The US is one of the wealthiest nations on the planet as far as income goes, and definitely wealthier than Canada over all. Now you can run a search and find out how much of Canada's federal budget goes to fund healthcare, then compare that with how much the US pays for healthcare annually. You'll find we pay more every year than Canadians do for universal care.

With those two figures, go check out Kucinich's proposal. His plan actually lowers the cost for most employers, factors in all government medical care spending, and phases in over a 10 year period so the cost doesn't overwhelm the economy. He figures the excess we spend on healthcare annually makes it feasable to cover everything from preventive care to alternative care, and please bear in mind this is a man who has had to count pennies just to survive from one day to the next. He's a far cry from stupid when it comes to calculating what can be done with a small amount of money!

I'll take a few minutes now to go hunt up those figures for you, I just wanted to post a general explanation and give the thread a kick so I don't lose it.

[iverglas]

66. an excellent site

For any USAmerican who would like his/her "perception" changed:
http://www.newrules.org/equity/CNhealthcare.html
(It's written from a US perspective, to explain the Canadian system and current issues to USAmericans.)

Since 1971 all Canadian citizens, regardless of income, employment or health, have enjoyed access to basic health care, whether it's provided in a hospital, home or clinic. Canada provides this coverage at a fraction of what the United States pays in health care costs. Americans spend 14 percent of their GDP on health care expenditures; Canadians only 9 percent. Yet despite its high cost, the U.S. system fails to insure more than 44 million of its citizens. Some analysts predict that figure will grow to 60 million by 2008.

Please feel free to click around the links on that page, muffin_man.

You might find arguing the way you do fun -- but believe me, it's even more fun when one knows (or acknowledge knowing) what one is talking about.

.

[Mairead]

83. Verification

The Harvard studies by Himmelstein and Woolhandler, and Himmelstein, Woolhandler, and Wolfe found that

Bureaucracy in the health care system accounts for about a third of total U.S. health care spending – a sum so great that if the United states were to have a national health insurance program, the administrative savings alone would be enough to provide health care coverage for all the uninsured in this country, according to two new studies. {emphasis added}

The first study, which is to be published Thursday in The New England Journal of Medicine, finds that health care bureaucracy cost U.S. residents $294.3 billion in 1999. The $1,059 per capita spent on health care administration was more than three times the $307 per capita in paperwork costs under Canada’s national health insurance system. Cutting U.S. health bureaucracy costs to the Canadian level would have saved $209 billion in 1999, researchers found.

The study, the most comprehensive analysis to date of health administration spending, was conducted by researchers at Harvard Medical School and the Canadian Institute for Health Information, Canada’s quasi-official health statistics agency. The authors analyzed the administrative costs of health insurers, employers’ health benefit programs, hospitals, nursing homes, home care agencies, physicians and other practitioners in the United States and Canada. They used data from regulatory agencies and surveys of doctors, and analyzed Census data and detailed cost reports filed by tens of thousands of health institutions in both nations.

The authors found that bureaucracy accounted for at least 31 percent of total U.S. health spending in 1999 compared to 16.7 percent in Canada. They also found that administration has grown far faster in the United States than in Canada. Between 1969 and 1999, administrative and clerical personnel in the United States grew from 18.2 percent to 27.3 percent of the health work force. In Canada, those personnel grew from 16 percent in 1971 to 19.1 percent in 1996.

http://www.pnhp.org/news/2003/august/administrative_costs.php

[democratreformed]

55. Neither do I think it has to be "free"

Just more affordable and more accessible. Some people can't even get insurance. I just went through that a couple of years ago. My husband and I decided to start our own business. I could get coverage for my employees but they refused to sell me any. I finally went back to work somewhere else and, after a year, was able to get on their plan.

[Armstead]

72. Not free -- AFFORDABLE

"I just don't see it has a reality to provide free health care for 300 million, 30 million seems more plausible."

I didn't say healthcare should be free. But it should guaranteed and affordable to everyone. It's possible to have a public healthcare system based on a percentage of income and/or sliding scale fee structure that keeps it within the affordable level.

[iverglas]

76. sliding scales in Canada

Some provincial plans, like Ontario's OHIP, cover the costs of the health care plan out of general tax revenues. (Ontario did institute a payroll healthcare tax to supplement tax funding a few years ago, under our decade of vicious right-wing Tory provincial government, accompanied by a separate tax on the self-employed maxing out at about $1000 a year, but I think that's gone now.)

British Columbia's Medical Services Plan is an example of a universal system where premiums are still paid by individuals.

http://www.hlth.gov.bc.ca/msp/infoben/premium.html

In B.C., premiums are payable for MSP coverage and are based on family size and income. The monthly rates are:

$54 for one person
$96 for a family of two
$108 for a family of three or more

... The current adjusted net income thresholds are:
$16,000 - 100 percent subsidy
$18,000 - 80 percent subsidy
$20,000 - 60 percent subsidy
$22,000 - 40 percent subsidy
$24,000 - 20 percent subsidy

(I gather that a family of 4 with employer coverage in the US pays $500-$1,000 per month in premiums, with co-payments and limitations on services.)

What Canada's plans do not allow at present is "user fees" (co-payment) or "extra billing" by physicians and other providers. It is pretty unanimously agreed that user fees will simply be a deterrent to the low-income from seeking medical care, and that establishing the kind of system that would be needed to collect fees and refund them to those qualifying for full subsidy, for instance, or determine who was eligible for exemption, would not be cost-effective. Extra billing (a charge by providers directly to patients on top of the covered fee) was allowed at one time, but no longer is, for obvious reasons. And of course there are no lifetime limits, or "prior existing conditions" or other exclusions from the plans.

Also, most Canadian provincial plans do not cover prescription drugs or dental services; drugs are free (sometimes with a very small co-payment) to seniors and social assistance recipients and the very low-income (social assistance recipients also qualify for dental and eyeglasses), and most major employers provide supplemental, jointly paid insurance coverage for drugs, eyeglasses and dental. A universal healthcare plan doesn't have to cover *everything*.

It always strikes me that the proposal that health care not be "free", and instead that there be some more or less complex way of delivering health care on a universal basis employing user fees or means tests or sliding scales or what have you, or splintering the user base into groups based on employment or income or age, derives more from ideology than from any sound economics.

Yes, modest, adjustable premiums are a not unreasonable supplement to 100% tax-funded coverage. But proposing anything beyond that really is seems to me to be more indicative of (a) some fundamental distrust of members of the public and the health care professions and a nearly punitive approach to recipients of public goods, and/or (b) an unproven assertion that such measures make for a more efficient and effective system.

.

[muffin_man]

42. Sorry, did not mean for that to be in reply to you StopThief!

[muffin_man]

59. Thanks for the discourse

I don't think the idea or policy suggestions you guys have are the problem. All sound like good ideas to me and I hope they come to pass!

[LWolf]

73. You're welcome, and

thanks for stopping in to talk.

:hi:

[jmoss]

60. I admire edwards for standing behind more realistic rhetoric than Kerry

....So if you're looking at casting votes for one of these two major vote getters, you should consider how honest Edwards has been in his stance that unversal health care will not be a quik process (as has been promised by other Dem candidates).

Since we're discussing values in the "Primary 2004" room, I find my posting to be quite relevant. :-)

[LWolf]

74. Sure!

Of course, I'm not sure who has promised a quick process. Dennis' plan covers 100% of americans...period...for less than we are spending now. It's not a quick process though. It's phased in over ten years. That gives us a decade to make it happen. If we start now.

Can we Kucitizens call ourselves major vote getters now that we've got a 2nd place and 30% of the vote under our belt? ;-)