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IT'S TIME FOR UNIVERSAL HEALTH CARE

 
 
Reply Fri 12 Jan, 2007 03:04 pm
There is an excellent chance that California will soon have universal health care. If our largest state can have it, why not the nation? The governor's plan is very flawed.


^1/12/07: Golden State Gamble

By PAUL KRUGMAN

A few days ago. Gov. Arnold Schwarzenegger unveiled an ambitious
plan to bring universal health insurance to California. And I'm of two
minds about it.

On one side, it's very encouraging to see another Republican governor
endorse the principle that all Americans are entitled to essential
health care. Not long ago we were wondering whether the Bush
administration would succeed in dismantling Social Security. Now we're
discussing proposals for universal health care. What a difference two
years makes!

And if California - America's biggest state, with a higher-than-average
percentage of uninsured residents -- can achieve universal coverage, so
can the nation as a whole.

On the other side, Mr. Schwarzenegger's plan has serious flaws. Maybe
those flaws could be fixed once the principle of universal coverage was
established -- but there's also the chance that we would end up stuck
with those flaws, the way we ended up stuck with a dysfunctional system
of insurance tied to employment.

Furthermore, in the end health care should be a federal responsibility.
State-level plans should be seen as pilot projects, not substitutes for
a national system. Otherwise, some states just won't do the right thing.
Remember, almost 25 percent of Texans are uninsured.

To understand both what's right and what's wrong with Mr.
Schwarzenegger's plan, let's compare what he's proposing with the plan
he rejected. Last summer, the California Legislature passed a bill that
would have created a single-payer health insurance system for the state
-- that is, a system similar to Medicare, under which residents would
have paid fees into a state fund, which would then have provided
insurance to everyone.

But the governor vetoed that bill, which would have bypassed private
insurance companies. He appears to sincerely want universal coverage,
but he also wants to keep insurance companies in the loop. As a result,
he came up with a plan that, like the failed Clinton health care plan of
the early 1990s, is best described as a Rube Goldberg device -- a
complicated, indirect way of achieving what a single-payer system would
accomplish simply and directly.

There are three main reasons why many Americans lack health insurance.
Some healthy people decide to save money and take their chances (and end
up being treated in emergency rooms, at the public's expense, if their
luck runs out); some people are too poor to afford coverage; some people
can't get coverage, at least without paying exorbitant rates, because of
pre-existing conditions.

Single-payer insurance solves all three problems at a stroke. The
Schwarzenegger plan, by contrast, is a series of patches. It forces
everyone to buy health insurance, whether they think they need it or
not; it provides financial aid to low-income families, to help them bear
the cost; and it imposes "community rating" on insurance companies,
basically requiring them to sell insurance to everyone at the same price.

As a result, the plan requires a much more intrusive government role
than a single-payer system. Instead of reducing paperwork, the plan adds
three new bureaucracies: one to police individuals to make sure they buy
insurance, one to determine if they're poor enough to receive aid, and
one to police insurers to make sure they don't discriminate against the
unwell.

The plan's supporters say that it would save money all the same. Those
who are currently uninsured would receive preventive care, which is
often cheaper than waiting until they show up in emergency rooms.
Insurers would spend less money trying to weed out high-risk clients and
more money actually paying for health care: the plan would require that
insurers spend at least 85 percent of premiums on health care,
considerably more than most of them do now.

Still, why all the complexity? The smart, well-intentioned economists
who devised the plan think they're being more politically realistic than
single-payer advocates -- that it's necessary to placate the insurers.
But that's what Bill and Hillary Clinton thought, too -- only to find
that their plan's complexity confused the public, while the insurance
industry went all-out to defeat it anyway.

So am I for or against the Schwarzenegger plan? That's a tough question.
As a practical matter, however, I suspect that the real question is what
to do after the plan founders from its own complexity. And the answer
is, damn the insurers -- full speed ahead.
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Type: Discussion • Score: 65 • Views: 206,714 • Replies: 6,767

 
LoneStarMadam
 
  0  
Reply Fri 12 Jan, 2007 03:56 pm
There's also a good chance that California will go bankrupt if this happens. The governor is a girlieman.
0 Replies
 
Phoenix32890
 
  0  
Reply Fri 12 Jan, 2007 04:20 pm
Wanna make a bet that if there is universal health care in California, many of the better doctors will move to other states, leaving California with a mediocre medical system?

Everyone is concerned about the patients, which is admirable. The problem is, that if the government gets involved in universal health care, ultimately the patients will suffer. Over time, IMO, the quality level of physicians will suffer. The best and the brightest will no longer consider medicine a viable vocational alternative, and medical schools will have to choose amongst candidates that might not have even considered years ago.

Look at what happens in Canada, where they have universal health care. If a Canadian needs an operation, or a sophisticated test, he can't wait for the universal health care to get around to treating him. He goes to the US, where he can get the care immediately.
0 Replies
 
Advocate
 
  1  
Reply Fri 12 Jan, 2007 04:54 pm
Even mediocre health care is better than no health care. There are about 100 million Americans now who have either no health insurance or inadequate coverage (high exclusions, deductibles, etc.). This can't be sustained. Moreover, I think every "rich" country but the USA now has a universal system, and the vast majority of people in those countries would not consider ditching it.

Further, more and more companies now favor a system, seeing that they can't afford providing decent coverage.
Advocate
 
  1  
Reply Fri 12 Jan, 2007 04:58 pm
As you are probably aware, MA now has a system, and it is very popular. Moreover, it is not costing the taxpayer any additional amount. Money formerly spent to provide health benefits for the poor, et al., is now used to buy insurance for those people. Mitt Romney deserves credit for this, and he will be campaigning on this initiative.
0 Replies
 
ebrown p
 
  1  
Reply Fri 12 Jan, 2007 05:15 pm
I would choose Canada's health care system over the US any day. The downside is longer waits for elective surgery. Perhaps private companies could suplement this by providing quicker service for people who are willing to pay for special service.

The advantages of the Canadian system are clear-- for one thing, everyone is covered!

The disease outcomes (i.e. what percentage of people survive a certain disease) are at least as good in Canada (and I recently read but can't find a link right now that for some cancers, the survival rate is measurably better in Canada).

The US is heading for a real crisis in three areas.

1) The cost of healthcare keeps going up at a rate far greater than what we are earning. Obviously this can't go on forever.

2) The US system, based on the free market, pressures hospitals to provide exactly the number of beds that are needed day to day. Any more beds cuts into profits.

This means that we are very unprepared for any type of large scale emergency. In these days with fears of flu outbreak or terrorism, this is not a good thing.

3) (related to number 1) The number of people who can't get health care keeps rising. This is a humanitarian problem (which will become a political crisis when people get upset their kids, brothers, parents are uninsured).

This is also economically stupid since treating someone dying of late stage cancer is much more expensive then giving them cancer screening resulting in the removal of an early stage cancer.

And... then there is the issue that people without health care don't get their cough checked out until they show up in the Emergency room with full blown, drug resistant TB. This not only maximizes the cost to treat their now severe health problems... it also maximizes the amount of time they are wondering around infecting the rest of us.
----

Incidently Canada has figured out how to solve these problems.
0 Replies
 
LoneStarMadam
 
  1  
Reply Fri 12 Jan, 2007 05:34 pm
Why do so many Canadians come here for their health needs? Is the wait shorter? Do we offer better health care? What is it?
No American is denied health care, no illegals are either, unfortunately.
0 Replies
 
Butrflynet
 
  1  
Reply Fri 12 Jan, 2007 06:16 pm
LoneStarMadam wrote:
No American is denied health care, no illegals are either, unfortunately.


This isn't exactly true in California. If you have a pre-existing condition or your weight is over a certain limit, you get denied coverage unless it is a group plan through your employer. (I had both.) If you become sick while unemployed, the only option open to you is a special insurance pool (funded by the very same provider that turned you down for individual coverage) at three times the subscription. Admittance into that pool currently has an 18-month waiting period because they only allow a specific number of members. By the time that 18 month waiting period expires, you can no longer afford to pay the higher rates if you seek temporary uninsured medical care while waiting.

If you are working or have more than $2000 in assets, you don't qualify for county/state medical assistance. If you are too ill to be able to work an extra job to pay for that special class of insurance, your only option is to rot away until you are impoverished and sick enough to qualify for emergency treatment, or seek medical treatment and end up on the streets while trying to pay those uninsured bills and fight off collection agencies. That's a problem that wouldn't be nearly as costly to the taxpayers if that person had been accepted into that original individual health care plan they were willing and able to pay for. Believe it or not, that original individual health care plan was with the exact same provider offered through the employer group insurance and the special insurance pool through the State, Kaiser Permanente or Blue Cross.

I just lived through that nightmare and I wouldn't wish it on my worst enemy. You're right, we aren't denied health care, but a lot of people are being asked to choose between their health and housing.
0 Replies
 
LoneStarMadam
 
  1  
Reply Fri 12 Jan, 2007 06:26 pm
I was speaking to ERs, it's against the law for an ER to turn anyone away.
It isn't like anybody is absolutely without health care Buterflynet. I believe that if gov'r gets into the business of universal health care that more than what there is now will be without health care, for sure quality healthcare.
Many people believe that military & their dependents get free healthcare, both active duty & retired. That isn't true, we pay for TriCare & the member or his/her family have to go downtown for any medical care, there is a co-pay. If one can get care on base there's no charge, but many bases now do not take retirees or their dependents, so, they do pay. I can guarantee you that this proposed universal health care will not be what congress gives themselves. I think it's a recipe for disaster.
0 Replies
 
maporsche
 
  1  
Reply Sat 13 Jan, 2007 12:32 am
LoneStarMadam wrote:
I was speaking to ERs, it's against the law for an ER to turn anyone away.
It isn't like anybody is absolutely without health care Buterflynet. I believe that if gov'r gets into the business of universal health care that more than what there is now will be without health care, for sure quality healthcare.
Many people believe that military & their dependents get free healthcare, both active duty & retired. That isn't true, we pay for TriCare & the member or his/her family have to go downtown for any medical care, there is a co-pay. If one can get care on base there's no charge, but many bases now do not take retirees or their dependents, so, they do pay. I can guarantee you that this proposed universal health care will not be what congress gives themselves. I think it's a recipe for disaster.



It's not like ERs are free to people without healthcare. They still get a bill, and it is several times more expensive than preventive care. And dion't try to tell me that the cost of going to the ER doesn't keep people away. I HAVE healthcare coverage through my employer, but when I broke my arm I waited an extra day to go to my normal doctor's office INSTEAD of going to the ER because my ER copay was $100 compared to the $15 I paid my doctors office. Cost is preventative to people. Healthcare is not available to many, despite your claims that the ER is available as a viable alternative.
0 Replies
 
maporsche
 
  1  
Reply Sat 13 Jan, 2007 08:30 am
LoneStarMadam wrote:
I can guarantee you that this proposed universal health care will not be what congress gives themselves.


I do think that those who can afford it should be able to purchase supplemental medical coverage or care. I'm sure that there will be a market for private doctors, and those doctors will make buku bucks. Let's just say I don't see Donald Trump having to wait an extra few days before getting his treatment, no matter what system we have.

Personally, if my medical care now requires me to wait 2-4 weeks for certain procedures or for a doctors visit. I will GLADLY do it if it means that every child will receive coverage. If it means that every uninsured or underinsured family today will receive coverage. Without a doubt it is the more humantarian thing to do. It is the RIGHT thing to do. It is the CHRISTIAN thing to do.
0 Replies
 
Advocate
 
  1  
Reply Mon 22 Jan, 2007 04:30 pm
Here is a take on Bush's take on universal health care.



^1/22/07: Gold-Plated Indifference

By PAUL KRUGMAN

President Bush's Saturday radio address was devoted to health care, and
officials have put out the word that the subject will be a major theme
in tomorrow's State of the Union address. Mr. Bush's proposal won't go
anywhere. But it's still worth looking at his remarks, because of what
they say about him and his advisers.

On the radio, Mr. Bush suggested that we should "treat health insurance
more like home ownership." He went on to say that "the current tax code
encourages home ownership by allowing you to deduct the interest on your
mortgage from your taxes. We can reform the tax code, so that it
provides a similar incentive for you to buy health insurance."

Wow. Those are the words of someone with no sense of what it's like to
be uninsured.

Going without health insurance isn't like deciding to rent an apartment
instead of buying a house. It's a terrifying experience, which most
people endure only if they have no alternative. The uninsured don't need
an "incentive" to buy insurance; they need something that makes getting
insurance possible.

Most people without health insurance have low incomes, and just can't
afford the premiums. And making premiums tax-deductible is almost
worthless to workers whose income puts them in a low tax bracket.

Of those uninsured who aren't low-income, many can't get coverage
because of pre-existing conditions -- everything from diabetes to a
long-ago case of jock itch. Again, tax deductions won't solve their
problem.

The only people the Bush plan might move out of the ranks of the
uninsured are the people we're least concerned about -- affluent, healthy
Americans who choose voluntarily not to be insured. At most, the Bush
plan might induce some of those people to buy insurance, while in the
process -- whaddya know -- giving many other high-income individuals yet
another tax break.

While proposing this high-end tax break, Mr. Bush is also proposing a
tax increase -- not on the wealthy, but on workers who, he thinks, have
too much health insurance. The tax code, he said, "unwisely encourages
workers to choose overly expensive, gold-plated plans. The result is
that insurance premiums rise, and many Americans cannot afford the
coverage they need."

Again, wow. No economic analysis I'm aware of says that when Peter
chooses a good health plan, he raises Paul's premiums. And look at the
condescension. Will all those who think they have "gold plated" health
coverage please raise their hands?

According to press reports, the actual plan is to penalize workers with
relatively generous insurance coverage. Just to be clear, we're not
talking about the wealthy; we're talking about ordinary workers who have
managed to negotiate better-than-average health plans.

What's driving all this is the theory, popular in conservative circles
but utterly at odds with the evidence, that the big problem with U.S.
health care is that people have too much insurance -- that there would be
large cost savings if people were forced to pay more of their medical
expenses out of pocket.

The administration also believes, for some reason, that people should be
pushed out of employment-based health insurance -- admittedly a deeply
flawed system -- into the individual insurance market, which is a
disaster on all fronts. Insurance companies try to avoid selling
policies to people who are likely to use them, so a large fraction of
premiums in the individual market goes not to paying medical bills but
to bureaucracies dedicated to weeding out "high risk" applicants -- and
keeping them uninsured.

I'm somewhat skeptical about health care plans, like that proposed by
Gov. Arnold Schwarzenegger, that propose covering gaps in the health
insurance market with a series of patches, such as requiring that
insurers offer policies to everyone at the same rate. But at least the
authors of these plans are trying to help those most in need, and
recognize that the market needs fixing.

Mr. Bush, on the other hand, is still peddling the fantasy that the free
market, with a little help from tax cuts, solves all problems.

What's really striking about Mr. Bush's remarks, however, is the tone.
The stuff about providing "incentives" to buy insurance, the sneering
description of good coverage as "gold plated," is right-wing think-tank
jargon. In the past Mr. Bush's speechwriters might have found less
offensive language; now, they're not even trying to hide his fundamental
indifference to the plight of less-fortunate Americans.
-----------------------------------------------------
0 Replies
 
Baldimo
 
  1  
Reply Tue 23 Jan, 2007 10:46 am
I would only support universal health care under certain guidelines.

This insurance if for US CITIZENS ONLY and not illegal or even legal immigrants.

Everyone gets a card to prove they have the insurance but before the card is issued you must prove citizenship.

The insurance ID card must be a pic ID with address listed on the card.

If a non-citizen applies for a insurance card and we find out that person is not a citizen then that person should be arrested and deported for trying to cheat the system.


A health system for non-citizens is not a problem for the US people but for their home countries. If they are from a country that has universal health care then we should setup a system where they can use our Dr's and hospitals but all charges for visits will be charged back to their home countries so that we are paid.
0 Replies
 
Advocate
 
  1  
Reply Tue 23 Jan, 2007 12:21 pm
B, you have some good thoughts. I do disagree about legal residents inasmuch they are on the way to being citizens and bear all the tax and other obligations of citizens.

I have a feeling that Bush's health plan will go across like a lead balloon.

I think that increasingly we will be hearing from corporations that we must have a universal system. They are besieged with costly problems in connection with the current system (or nonsystem), and the huge cost attendant with dealing with multiple, contentious, insurance companies.
0 Replies
 
Baldimo
 
  1  
Reply Tue 23 Jan, 2007 12:45 pm
Advocate wrote:
B, you have some good thoughts. I do disagree about legal residents inasmuch they are on the way to being citizens and bear all the tax and other obligations of citizens.

I have a feeling that Bush's health plan will go across like a lead balloon.

I think that increasingly we will be hearing from corporations that we must have a universal system. They are besieged with costly problems in connection with the current system (or nonsystem), and the huge cost attendant with dealing with multiple, contentious, insurance companies.


Not all legal aliens have the intention of being citizens. We have people here on student visas as well as just plain worker visas that don't want to become citizens. When they apply and get approved for citizenship then they can be covered. Untill then I say it should only apply to citizens and citizens only. We can't afford to pay for people who have no commitment to this country.
0 Replies
 
Advocate
 
  1  
Reply Tue 23 Jan, 2007 01:32 pm
I think that those on visas are not residents, but are visitors. I was referring to green-card people.
0 Replies
 
Advocate
 
  1  
Reply Tue 23 Jan, 2007 01:36 pm
Health Care -- Tax Incentive

What Bush Will Say: "We need to fix these problems, and one way to do so is to treat health insurance more like home ownership. The current tax code encourages home ownership by allowing you to deduct the interest on your mortgage from your taxes. We can reform the tax code, so that it provides a similar incentive for you to buy health insurance. So in my State of the Union Address next Tuesday, I will propose a tax reform designed to help make basic private health insurance more affordable -- whether you get it through your job or on your own." [1/20/07]

What You Need To Know: Bush's health care plan fails to help the nearly 47 million Americans without health insurance, will cause employers to drop health coverage without any real alternative, and put health care out of reach for millions of Americans.

UNINSURED AMERICANS WILL RECEIVE LITTLE HELP AND MUST TURN TO EXPENSIVE COVERAGE: This scheme would replace one regressive, flawed tax deduction with another -- and since most uninsured Americans pay low or no taxes, they would receive little help from this plan. In addition, Karen Pollitz, a Georgetown University researcher who co-authored a 2001 study on the individual health-insurance market for the Kaiser Family Foundation, found that people who aren't in perfect health are largely unable to buy individual health insurance. In her study, Pollitz found that "roughly 90% of applicants in what's known as less-than-perfect health were unable to buy individual policies at standard rates, while 37% were rejected outright." Individual health insurers may deny coverage to people based on their medial history, or put them in "a high-risk category that it makes health coverage too expensive."

BUSH'S PLAN WILL DISCOURAGE EMPLOYERS FROM OFFERING QUALITY COVERAGE: Sixty-one percent of companies offer at least some of their employees health insurance, a drop of 8 percentage points since 2000. Additionally, the Washington Post notes that there's "a danger that ending the tax privilege for employer-provided insurance will cause companies to discontinue coverage, driving more buyers into the individual market, where it's hard to buy insurance at a reasonable price." American Progress senior fellow Jeanne Lambrew added in a June 2006 piece in Tax Notes, that "the tax exclusion is a thread that, if pulled in isolation, could unravel health coverage in the United States" and even "minor changes to the exclusion could accelerate the recent trends" of employers dropping coverage for the 175 million Americans who receive employer-sponsored coverage.
--AmericanProgressAction
0 Replies
 
Baldimo
 
  1  
Reply Tue 23 Jan, 2007 01:56 pm
Advocate wrote:
I think that those on visas are not residents, but are visitors. I was referring to green-card people.


IF YOUR NOT A CITIZEN THEN NO INSURANCE ID CARD!!!!!!!
mysteryman
 
  1  
Reply Tue 23 Jan, 2007 02:10 pm
Will anyone please show me where in the Constitution or in the US Code anywhere that says the govt is required to provide health care to everyone.

I have looked and I cant find it anywhere.
0 Replies
 
Advocate
 
  1  
Reply Tue 23 Jan, 2007 03:00 pm
MM, most of the things that the government does are not required by the constitution. Is it your view that this makes those things illegal? Gee, the government must immediately give up ownership of federal highways, stop providing farm subsidies, cease disaster assistance, etc.
0 Replies
 
 

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