What is YOUR position on healthcare reform?

[Dawgs]

Whay say you?

[damntexdem]

1. Single-payer is needed; but the public option is important.

It scares the hell out of for-profit health insurers -- they don't want to have to compete against it. It can be much-more efficient than for-profit health insurance. And if successful enough, it can move us toward single-payer.

[Fire1]

8. +1.

[steelmania75]

2. We need a mix of single payer and a public option

[county worker]

6. ? Single means nothing else. You can have single and not single but not single plus something else.

[sharesunited]

13. Would you call Medicare single payer?

Because people can have all kinds of private supplemental, gap, and boutique coverage which responds alongside Medicare.

[county worker]

38. If I'm not mistaken, when we say single payer we mean that the single payer replaces all other

payers. That's why it is called single payer. I could be wrong and if so I don't understand how.

[sharesunited]

45. Here is the Wikipedia article on single payer.

It calls Canada's a single payer system, but also states that a majority of Canadians have private supplemental insurance to cover expenses not covered by the government plan.

http://en.wikipedia.org/wiki/Single_payer

[county worker]

46. In the debate about health care reform I have not heard about any supplemental insurance.

If we are going to still need insurance companies after a single payer system is passed it sure is going to piss off a lot of DUers.

[sharesunited]

48. A nearby thread asks if you could enroll in Medicare today, would you?

Lots of Medicare enrollees have supplemental/gap/boutique coverage to take care of things not covered by the government plan.

Medicare enrollees who don't have such supplemental/gap/boutique coverage pay out-of-pocket for what's not covered.

Medicare for All would be a tremendous victory for universal healthcare. Achieving it will certainly require that some private insurance is allowed to survive.

And allowing private insurance to survive actually gives people the choice of buying upgrades in those areas where the government plan makes compromises and is not "gold plated."

[walldude]

3. Until Politicians have to deal with the health care issues we all do

there will be no serious reform. You want to reform health care? The only way to do it is to take away the free health care given to politicians and let them have to deal with the same shit everyone else deals with. Until then there will be no serious reform.

[Romulox]

4. Mandatory private insurance = latest phase of corporate welfare program.

Should be paid for with the TARP.

[Cresent City Kid]

5. Some reform better than none

It will be easier to adjust a less than perfect plan than to start from scratch again.

[superduperfarleft]

7. Public option will be a disaster.

And when it fails, it will doom the progression to single-payer (assuming there's a progression at all).

[Aloha Spirit]

21. oops wrong place

[HughBeaumont]

9. First two.

Nothing short of a complete mowing of hyper-aggressive insurance lobbyists from DC is going to get you Single Payer, though.

[GeorgeGist]

10. Your bias is showing.

[OmahaBlueDog]

47. Huh?

:wtf:

[notesdev]

11. Other

My position is that nothing that doesn't solve the core problem - that we pay far too much for health care - qualifies as 'reform'.

There's only two good places to start in squeezing out excess costs - litigation and end-of-life care - if we're not talking about those things, then the conversation is nonsense.

[el_bryanto]

15. Litigation - is that a reference to tort reform?

As for end of life care, how exactly would you implement a squeezing out of excess costs?

Bryant

[notesdev]

20. That and more

Litigation has both direct costs - these amazingly large payouts - as well as a massive indirect cost in all the wasted time, materials, and equipment spent on 'defensive medicine' - things that the doctors know are not necessary but they do them anyway because self-protection demands it. And of course the single largest expense, by a mile, of any health care provider are the obscene malpractice insurance rates.

I estimate that if no other change were made, this change alone could save a third or more of our total national health care bill.

[el_bryanto]

22. How do you impose tort reform while also protecting the rights of the patients? n/t

[notesdev]

27. Take the lottery payouts out of the equation

Set up a fund for victims of malpractice, that will cover the costs of their care; this will be far cheaper than the current situation.

One thing I think we need to make clear is that there is no fundamental right to a big cash payout, even if you have been wronged. The lawsuit lottery is a huge distorting factor that simply cannot be sustained if we wish to have a health care system that serves everyone. A choice between the two must be made - if we have the payout bonanza, then we WILL have the defensive medicine waste and the malpractice insurance cost waste and the litigation waste, things that consume the resources that must be reclaimed if we are to have any type of universal coverage.

[Maru Kitteh]

37. Who pays into this fund, and what kind of compensatory damages would it pay?

Curious about how you would see this working for say, a baby maimed by a drunken surgeon that ends up being robbed of a normal sexual life and the ability to have his own children?

[el_bryanto]

39. So you think docters should not be held accountable for their failures?

Even if those failures lead to loss of life or permanent disability?

Bryant

[ret5hd]

16. damned trial lawyers

:sarcasm:

[Deep13]

17. We pay too much largely because of the cost of running...

...insurance companies. All that bureacracy, all those adjusters, advertising, the need for a corporation to pay profits. All that is very expensive. Plus the hospital billing departments, billing companies for independent contractors working for the hospitals etc. etc.

If you can think of a way to make end-of-life care cheaper without killing people, I'm all for it. It does seem ass-backwards that the end of life is so expensive while we skimp on prenatal care, vaccination, education, school lunches and other thinks necessary to raise a kid.

A national health care system will eliminate one of the most expensive parts of tort judgments: cost of care. I think civil litigation generally is much too expensive and takes too long. I also think a small minority of medical personel are responsible for most of the malpractice claims. The medical profession needs to stop protecting those few screw-up doctors.

[notesdev]

25. The bureaucracy is not the main cost driver

And switching from one bureaucracy to another is just a shell game that doesn't address the issues.

The end-of-life care issue is a huge and thorny one. One must take great care not to go down the path of classifying people as 'useless eaters', making an economic decision as to who lives and who dies.

But where we stand now is far on the opposite extreme; the terminally ill are effectively cash machines for unscrupulous institutions who can use them as a means of racking up enormous bills. We need to be mature enough to say that we cannot pay for every last ditch attempt to squeeze another minute of life out of a body. This practice I can only think of as a form of vampirism, the desperate urge to cheat death driving the old to suck the lifeblood out of the young, so that the former may live. It's unnatural and morally wrong to say that any person is so important that another should go uncared for for an entire lifetime, for the extra minutes or weeks of futile attempts to avoid the inevitable.

[Deep13]

28. We wouldn't be switching from one to another.

We would be switching from dozens of complex bureaucracies, each needing to know the exceptions and exclusions of their numerous policies to a single, simplified billing procedure.

Otherwise, I agree with you.

[notesdev]

29. I'm not so sure how simple it would be

I've worked for the federal government; I know what these bureaucracies look like from the inside.

I'll give an example. One system I worked on was simple and straightforward; an application system designed to serve generic platform needs for a particular organization. This system had so many rules and regulations to comply with that what would under normal circumstances be a 2-man job requires 3 managers and over a dozen staff members, with completely unnecessary excess waste running in the tens of millions. My personal bureaucratic burden in this mess was primarily (but not entirely) to determine what we had to do to meet the equivalent of a 150-page rules & regs manual, each and every month.

I've worked for plenty of private corps, too, and seen a decent variety of ways in which they do business. If I had to lay my money down as to which would do the job of sorting out what will effectively be the largest mountain of paperwork ever created, it would all go on the private corps.

I think the private insurers are an easy scapegoat because, well... they are completely unnecessary and do a lot of the wrong things, yes, but also because they are the point of contact for people who need services and the people who say no, when no is said. Changing the point of contact doesn't relieve the problem, though; it just switches it to something else. Looking at the money involved I don't see the huge saving there. Even if there is a savings, it might be dwarfed by the upfront cost to such a degree that it could be a hundred years before it actually pays off.

Looking at the dollars that we are spending, the first thing they will tell you is that half of all the money we spend is spent in the last year of life. Common sense tells us that when we spend 50% of the money over a period of 1.4% of a person's life, that's going to be the place where we are most likely to find significant savings.

Concentrating on payment structures as reform is concern for the arrangement of deck chairs on the Titanic. The problem is that our current trajectory takes us straight into the iceberg; it doesn't matter who is steering the ship, when it hits.

[Ms. Toad]

33. So what about those chronically ill -

like my daughter who, when properly cared for, is a healthy productive, member of society. (She is only a year out of high school - but with her chronic illnesses she managed to be productive enough to be valedictorian of her high school, earn honors in both academia and fine arts, earn 8 college credits while in high school, and dance around 6 hours a week outside of school.) Properly treated, she can be expected to live productively for several decades to come - but her care (and prophylactic cancer screenings) currently cost approximately $60,000 a year, when nothing goes wrong - and in years when something does go wrong (at today's prices) it will approach $500,000 dollars?

She is not the only person who has significant ongoing care costs who is not terminally ill.

[Flaneur]

12. Universal health care, please.

[Lydia Leftcoast]

14. A single payer option and also public clinics staffed by nurse-practitioners

to take care of minor medical problems, so that emergency rooms can be reserved for real emergencies, such as heart attacks and serious injuries.

There should also be a public education campaign telling people when it is appropriate to go to the doctor (high fever, etc.) and when they should just tough it out (most colds or cases of the flu).

[Aloha Spirit]

31. Definitely agree...Now, doctors never see me first, always to the NP then to the doctor

if necessary, except for specific appts.

I also would like pharmacists to play more of a role in prescribing drugs.
In other countries, traveling, this has been realllllly helpful for me.
Plus, my pharmacist knows more about drugs than my GP.

[Lydia Leftcoast]

41. That's certainly true in Japan

If you have non-life-threatening respiratory or digestive symptoms, you go to a pharmacy and ask what to do, at no cost other than the cost of whatever the pharmacist suggests. The pharmacist also tells you to go to the doctor if your symptoms don't clear up within a certain amount of time.

I once was struck with a severe headache and nausea during a summer trip after spending the afternoon with a friend who lived in a small, stuffy apartment. On the way back to my hostel, I stopped in at the nearby pharmacy and explained my symptoms to the pharmacist on duty. He questioned me in detail and concluded that I was suffering from heat exhaustion. He told me to drink some cola from a vending machine to settle my stomach, go back to the hostel (it was air conditioned), take two aspirin, drink a full glass of water slowly, and lie down until my headache went away. If my headache didn't go away in two hours, he said, I should go to the hospital.

Fortunately, a couple of hours in a cool room cured the headache and nausea.

[Ohio Joe]

18. Other

Our current system is broken, in some ways worse then broken. A number of different alternative have been put forth and to be honest, I have not been able to decide which would be best yet. I still have a lot to learn about them in order to make a proper judgment.

[WeDidIt]

19. Public Option or kill the bill. n/t

[mvd]

36. That's my position

Though I want single payer. A public option would help a lot of people, and in the meantime, we can work on getting single payer.

[Aloha Spirit]

23. I like the idea of having basic needs for people under 18 as single payer

at least to start

and a pubic option for basic need or more for everybody.
I am also not opposed to healthcare savings accounts as part of the pubic option.

[ConcernedCanuk]

24. Other

.
.
.

look North

[Stinky The Clown]

26. I didn't vote. I **want** No. 1 ....... I'll settle for No. 2

[Ms. Toad]

30. I want access to health care that is not dependent on

Health
Wealth
Employment
or Ability to maintain status as a full time student.

I don't care what structure it takes, or what it is called.

[Aloha Spirit]

32. I think as a board we should come up with several specific changes and vote...

then promise to call our representatives on each change we support.

[Maru Kitteh]

34. I don't have the luxury of holding out for perfection. Neither of my children are insured at all.

I want something done now. If that means an imperfect plan that will evolve later, so be it.

[quiller4]

35. Basically I'd like to see Medicare extended to all with purchase of

supplements optional. I doubt that kind of plan will emerge. I'm ready to support anything that expands coverage and reduces cost over time.

[Sen. Walter Sobchak]

40. I work for a law/accounting firm that represents many foreign companies in the US

and I have watched a number of projects go up in smoke when the foreign company discovered just how expensive it is to be a responsible employer in the United States.

The cost of doing business in the United States is relatively low in many places, but just add healthcare and we shoot to the most expensive place on earth to do business, and while third world america has decided to enter the race to the bottom - but if you aren't in the race to the bottom and looking to hire high school dropouts for $6 an hour that doesn't really help your business.

In the case of a Canadian company, their union went along with the US factory on the grounds they matched the benefits provided by the Quebec provincial healthcare plan and their supplemental dental/vision/prescription. Naturally this made building a factory in the US completely impractical.

[harun]

42. My company employs a lot of consultants over seas

and I see the same thing. Having a real health care system, in my opinion, is the most pro-business thing they could possibly pass.

In terms of cost and in terms of new entrepreneurship. A lot more people will start new business's if they could afford to hire people with real coverage they don't have to worry about, or come up with the money for.

[Sebastian Doyle]

43. There are only three possibilities here

Best scenario: Single Payer

Acceptable scenario: true public option

If both of those fail: Do NOTHING. Because a shitty bill will be WORSE than the status quo. And more than likely it would be deliberately designed to make any REAL reform extremely difficult if not impossible.

[and-justice-for-all]

44. National Health Care or bust...

there is no fucking excuse for us not having a national health care system; it is absolutely fucking wrong that we do not.

[HughMoran]

49. The majority are still asking for something that has a snowballs chance in hell of getting passed?

:wtf:

A public option is all that's needed at this time.