Do any of our top three candidates have a plan to lower the COSTS of health care?

[GOPBasher]

I believe the only real solution to our health care crisis is single-payer, national health insurance, because it seems to me to be the only way to really cut costs. I know Kucinich supports that, but the three with the best chance of winning, unfortunately, don't. Now I'm going to support our nominee 100%, but I'll feel a lot better about it if supporters of Clinton, Obama and Edwards tell me that their candidates plan will cut costs of health care. I know they'll make it universal, but with the current costs, it will continue to cripple the economy if costs are not drastically reduced.

So, my question is, how does your candidate plan on controlling health care costs, so we can keep the quality and cover everyone, without continuing to destroy our economy as health care costs have been doing.

[Vincardog]

1. Don't forget that 30% of those costs are eat up by the Insurance companies.

The quickest way to cut costs is to eliminate the parasitic insurance companies. Why should we pay them to deny us care?

[GOPBasher]

6. Yeah, but that's why I believe in national insurance; it gets rid of the insurance

company middle men. It's just between the health care institutions and the government. No middle men, forget about the 30%.

[Vincardog]

12. That is why I believe in National Health CARE. Get rid of even the name of insurance

The health care providers like it because they know who to bill; how to bill them and that they will get paid. The only ones that do not like it are the parasitic corporate enablers and their bought and paid for Politicians.

[TwilightGardener]

19. There's no way that industry is going anywhere. Look at how influential

they are in trying to stop SCHIP.

[Vincardog]

21. WE have to make everyone eligible for Medicare and let the market sort it out.

[TwilightGardener]

22. Isn't there a lot of Medicare fraud and waste going on right now? I don't

know much about Medicare or the health insurance industry (which is sad, since I was a nurse for years), but until we clean up Medicare/Medicaid and get a handle on providers fucking around with prices and services to make a profit, we'll just be throwing more of our tax dollars down the rat hole. Reform it and make it more efficient first.

[Vincardog]

28. The Government runs programs at a cost of 7%. The insurance industry profit margin is 30%

There is a whole lot of savings in just having the government be the single payer.
There would be an immediate savings of 23% if nothing else happened.
Add in the fact that the government could negotiate for better rates and the savings add up.
If there is fraud in MEDICARE it is with the providers not the patients.
Why punish the patients by making them wait until all the bad practitioners are done in?
The rat hole we are throwing more money than any other country is the INSURANCE industry.

[TreasonousBastard]

39. Who told you it's 30%? I spent 20 years...

in the insurance business and never saw anything like that as an underwriting profit in any line. And the 7% government cost comes partly from other subsidies-- like it works from tax money rather than paying taxes.

30% overhead I could go along with, although that's also a bit high, but you can't get rid of all of the overhead-- someone has to count them money and make sure as little as possible gets lost or stolen. That's part of overhead.

I'm not against single-payer, but I still can't see how replacing many small bureaucracies with one large one will solve many problems.

[Yael]

2. Edwards plan is the closest path to 676

He proposes setting up the option for people to join in a national plan where the negotiations with providers and pharma will take place once and on a national level. He posits that the private insurance companies are welcome to compete, and the theory is that they will go out of business as people gravitate toward the national plan.

I was on state insurance after a job loss. It was $35 a month and covered a mountain more than the insurance I am currently paying $100 a month for through my work.

This is why I believe Edwards' plan will work.

Hillary's plan is nothing more than the Romney plan with a different colored bow -- forcing people to buy insurance from the private companies without the option of a government plan for them to opt into.

[GOPBasher]

7. That's really interesting. I like that. n/t

[Yael]

11. Me too -- and is the #1 reason why he is my guy for '08

Here is his page on it: http://johnedwards.com/issues/health-care/

You can download a PDF of the full plan from that link.

[GOPBasher]

15. Thanks for the link. n/t

[sandnsea]

16. Elizabeth says it's the same plan

So I'm not sure why you're saying it's better than Hillary's.

[Ino]

26. sounds good to me!

Edwards just took a giant leap forward on my list, thanks to your post.

Let the grubby insurance companies offer Gold plans to cover extras the national plan may not -- private rooms or whatever -- so the "haves" can feel special.

[robinlynne]

3. Edwards' history of fighting insurance companies suggests that he will do it.

(continue to fight against corporate bandits: insurance companies and drug companies).

[GOPBasher]

8. True, and I just heard his plan and I think it's the next best thing to national health care.n/t

[robinlynne]

25. I ahven't read his plan, but i didn't like it when he said Hillary's plan is just like his.....

But that is one issue. We need to end the war, end the corruption and get our civil liberties back!

[daninthemoon]

4. Unless we get the insurance companies out of the loop, my poor

old common sense doesn't see any way to really cut the costs. I'm thinking of just the extra administration: salaries, buildings, paper clips...Near as I can tell, our candidates are unwilling to stand up to them, let alone the pharmaceutical profiteers. The true religion of the rw is unrestricted capitalism, nothing to do and actually opposite Christianity. Some things just have to rise above this "religion", and healthcare tops the list.

[GOPBasher]

9. I agree, although one poster just told me Edwards plan and it seems pretty good, the

next best thing to single-payer health insurance.

[phillysuse]

5. Health Insurance is not the same as health care

and there has not been a serious debate about health care.

For example, Medicare, which is single payer health insurance, pays a ridiculous amount to keep very elderly people alive in their last few months of life, often in ICU's with tremendous expense and not very good quality of life. A serious discussion about this is unlikely to be had.

In addition, prevention is cheaper than treatment. We pay for dialysis for diabetics with renal failure but we do not pay for nutrition education, access to fresh produce and good protein for poor people whose neighborhood often lack grocery stores, exercise programs, and at the same time we subsidize the high fructose corn syrup products of agribusiness which contribute so much to obesity and diabetes.

Another example is asthma. If we get SCHIPS, we will have health insurance for poor children with asthma which is a good thing. However, if we really wanted comprehensive health care for children with asthma, we would do something about air quality and the housing stock in poor neighborhoods which along with parental smoking contributes to the asthma epidemic in black and Hispanic America.

I could go on and on....

[GOPBasher]

13. You hit a lot of good points. We need to overhaul the system tremendously. n/t

[phillysuse]

24. Again health care and health insurance are not the same

For example, if you have Medicaid, which is a form of health insurance, you will find that many physicians will not accept Medicaid. Hence you have insurance which does not necessarily give you the access to the health care you want.

Or if you live in a community where there are fewer and fewer obstetricians and none are taking new patients, having health insurance does not automatically give you access to health care.

The problem is that the media, the candidates and we the bloggers use these terms interchangeably whereas they mean different things.

Cutting costs of health care does not just mean cutting the costs of health insurance and cutting the costs of big pharma. It means having many more nurse practitioners and physicians assistants available to provide preventive care and management of chronic illness. It means engaging the patient to be responsible so that asthmatics get smoking cessation with followup, diabetics get subsidies for nutrition education, maybe for nutritional food, and for exercise programs/gyms etc.;hypertensives get home blood pressure cuffs to monitor their own blood pressure and a nurse practitioner to call weekly. In addition agribusiness gets told to take the salt out of canned items and to limit the production of high fructose corn syrup products. Maybe the switch to biofuels will reduce in less corn being available for HFCS production.

Effective treatments for drug and alcohol abuse would reduce the costs of health care irrespective of insurance.

[TreasonousBastard]

40. You're right-- insurance has little to do with...

hospital charges now. If anything, low and slow payments from insurance and government encourage them to charge astronomically anyone writing a check.

I've been saying for years that a large part of rising healthcare costs is simple progress in diagnoses and treatments-- we now are able to diagnose more and treat what we find and that costs more than it used to when we just let them die because we couldn't do anything.

Do the new diagnostic procedures and treatments need to cost so much more? Probably not, but that's another argument. Should we heroically spend millions to keep people on life support for a few more weeks? Another question more ethical than economic.

I would love to see more local walk-in clinics instead of hospital emergency rooms used for aches, pains and sprains. More midwifery and nurse-practitioners. And, if every group practice and hospital has to have an MRI, let's use them efficiently so the costs can be brought down.

And, when you are in the hospital for some reason, who are all those doctors walking in, taking a quick peek at your chart, and sending you a bill for 500 bucks?

[daninthemoon]

17. Good points. Quality of life should be a factor in determining things

like ICU vs hospice. Instead we've got rw wackos who pull things like they did with Terry Schiavo.

[OHdem10]

10. Not really---they pretty much accept the "Market Forces Argument

of GOP". Theoretically everyone having Insurance will
create competition and drive costs down. This Market Forces
argument has not worked for anything else.

To be fair, if they can get everyone covered that is a
first step and an improvement over current circumstances.

They cannot offer single payer--the GOP and the Insurance
and Healthcare institutions will knock it down before
they can get it explained.

jYou are correct when you say "Costs" are key.

[GOPBasher]

14. "Competition will drive costs down."

I really feel like hitting them in the head when they say that. What the hell do they think we have now? We already have competition, and costs are sky-rocketing.

[TwilightGardener]

18. What if insurers had to publicly disclose how much they charge vs. how much they pay out?

If people had a choice of insurers (not tied to jobs), and could compare companies, why not have a system like Progressive Auto insurance, where you can see at a glance the type of coverage, and compare and contrast? I think that would help, if we end up with a health-care plan that still relies on insurance companies.

[papau]

20. Hillary put out 28 pages of cost saving changes - the others have similar proposals n/t

n/t

[applegrove]

23. Just forcing everyone to have coverage will save money due to all

the preventive medicine that will be taking place. That way people will take better care of themselves. But I agree a single payer system would be even more efficient.

[phillysuse]

27. Having everyone insured does not provide access

In fact, if the 47 million uninsured became miraculously insured overnight, where would we find the physicians, nurses, dentists, PA's, NP's, obstetricians, psychiatrists etc to provide health care?

I'm the only Medicaid provider in my specialty in a county of 550,000. There is no way I could see more patients myself. There is only so much energy and so many hours in the day.

Health insurance is one step towards health care. It is necessary but not sufficient.

[Vincardog]

30. Which is why we should have a "Marshal plan" to make a hell of a lot more health care workers .

How about this we pay for everyone's training as long as they do 2 years of community service for every year of education they are granted?

[phillysuse]

33. Not a bad start but lots of other things to consider

Take nursing:

It seems like a great idea - just subsidize nursing education - if you build it, they will come.

However, we do not have the nursing school faculty to expand our nursing schools even if the money was available. So we would have to expand access to Masters and Ph.D. programs in nursing by offering scholarships to experienced nurses or we could import nursing faculty from other countries.

Currently, we are importing nurses from Third World countries such as the Phillipines, Nigeria, etc.

This is the problem with the simplistic rhetoric about health care coming from the candidates and reported in the media as well as in the blogosphere.

[Vincardog]

34. My Aunt was a nurse and my sister was too. My sister quit because of the lousy

way the hospitals treated her. The problem is one of supply. That supply is being restricted by the schools enforcing the labor shortage in the medical care fields IMO.

[phillysuse]

36. Not exactly, there is a shortage of nursing faculty

Teaching clinical nursing is done in small groups of a nursing instructor and several nursing students taking care of patients.

We don't have the nursing faculty to do this. I do not think the nursing school are enforcing this shortage but they don't have the money to expand and they couldn't find the faculty easily without importing them from other countries.

[applegrove]

37. Nurses like teachers suffer from the cobweb theory in economics.

There is usually an over supply or undersupply but very rarely is there the right amount. Has to do with the lead up to re: education but also vulnerable to the demographics of the times.

[Vincardog]

29. How are you going to "Force" an unemployed homeless person to have insurance?

[phillysuse]

31. Actually unemployed homeless people are eligible in

many states for General Assistance and for Medicaid. There are forms to fill out if the person has an illness in which you state that they have an illness and which medications are required. Then, atleast in PA, the person is eligible for what is called Access which actually is more generous in terms of medications than true Medicaid insurance.

So a homeless person can get health insurance.

Obviously mentally ill or substance abusing individuals are unlikely to seek shelter or insurance.

But there are many other types of homeless people - abused women with no where to turn, families who have been unable to afford rent, single men down on their luck.

Whether they can get health care depends on which providers in their area take this health insurance.

[Vincardog]

32. The real question is not one of eligibility it is in the efficacy of trying to "Force" people

without an income to pay for insurance.

[phillysuse]

35. You and I pay for Medicaid;

The person with no insurance in this country usually works at a job that does not offer benefits. He or she may even own a home but cannot afford insurance.

The person without an income or assets is still eligible in many places for General Assistance and Medicaid.

[applegrove]

38. No idea. What does Hillary's or Edwards plan say?