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In a Reasoned Debate, Single Payer Will Come Out on Top

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Posted on Aug 19, 2009
Single Payer
green-rainbow.org

By Laura S. Boylan, M.D., and Joanne Landy, M.P.H.

This piece was originally posted at the Web site of Physicians for a National Health Program (http://www.pnhp.org).

One can only feel sorrow and dismay at the bullying and hate-mongering that is taking place at health care forums around the country.

Massive job losses, the devaluation and foreclosures of people’s homes, and precipitous declines in lifetime savings produce widespread fears of further loss. In an era of insecurity, mainstream Democratic Party proposals for reforming the health system have played into such fears.

A health care “reform” that protects private insurers and massive profits for the pharmaceutical industry inevitably becomes an ugly game where ordinary people’s interests are pitted against each other. Witness, for example, the proposed cuts to Medicaid and Medicare to fund an initiative that subsidizes the mandated purchase of private insurance with taxpayer dollars. Relatively little is offered to the already insured majority who are told of upcoming belt-tightening.

The near-total exclusion of single payer from the health care debate by our political leaders and the media has contributed to the present state of affairs. Single payer is an expanded and improved Medicare for All (“Medicare 2.0”). Many, perhaps most, Americans have come to believe in the false choice between universal coverage and quality health care.

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Our nation needs a meaningful dialogue, including a fair hearing of the views of the 20 million constituents of the Leadership Conference on Guaranteed Health Care (of which Physicians for a National Health Program is a founding member), who advocate for single-payer national health insurance. Polls show that most of the public and their physicians favor such an approach.

There is simply no other viable solution to the problems facing us all, insured and uninsured. With Medicare 2.0, the already insured would benefit from radically reduced out-of-pocket costs for comprehensive insurance and expanded choice of doctors and hospitals. Medicare 2.0 stays with you for life, independent of your employment. The epidemic of medical[-related] bankruptcies would be just a bad memory.

It is unnecessary to pit the insured against the uninsured, or those with Medicare and Medicaid against those with private insurance.

Multi-payer, for-profit health insurance adds cost but not value to American health care. Savings of $400 billion a year can be obtained through the conversion to a single-payer system. With the money we are now spending (twice as much per capita as other developed nations), we can provide full service “what you need, when you need it” health care for everyone and control costs going forward.

With the “everybody in, nobody out” approach of a Medicare 2.0 system, we can all get more freedom, choice and security.

Single-payer advocates have been excluded from debate not because our premises or facts are wrong but because special interests, including the private health insurance industry and the big drug companies, have been allowed to define the limits of “politically feasible.”

We support the right to lively and dramatic expression of all views about health care and other issues in American political life. We share a common sense of frustration expressed by many protesters that it often seems that Washington’s ear is tuned to special interests over public interests. However, we strongly condemn the bullying and hateful speech that has precluded meaningful discussion at many town hall meetings.

The ugliest language suggests that the uninsured or undocumented should be allowed to “die in the streets” and asserts that areas with less racial and ethnic diversity are “the real America.” President Obama’s citizenship is questioned and he is likened to Hitler.

These actions have been facilitated and promoted by networks of well-funded, right-wing interest groups who have tapped into a vein of fear and discontent in a time of rapidly rising hardship and anxiety.

With this deteriorating public dialogue, we should affirm that we can get better health care by sticking together to support single payer. We support meaningful dialogue. We affirm the dignity of all persons and insist that health care is a universal human right.

Health care is instrumental to “life, liberty and the pursuit of happiness.” We continue, as ever, to insist that “everybody in, nobody out” is best for all of us and embodies the best of American values.


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By DeannaLee1369, August 23, 2009 at 9:58 pm Link to this comment
(Unregistered commenter)

I have written letters, emails, tweets to Obama and Congress to demand the CBO to do a study on single-payer for HCR.  The Obamacare will cost at least $1 trillion over ten years says the CBO, well what about single-payer over ten years CBO? From what I have read it will save $400 billion annually and will generate funds about $2 trillion over ten years. If this is true then single-payer is a no brain er.

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By Anarcissie, August 22, 2009 at 7:50 am Link to this comment

So Krugman’s shocked, is he?  Heh.  We live in interesting times.

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By guntotinsquaw, August 22, 2009 at 7:20 am Link to this comment

Most of us are not against insuring the uninsured or reform, when the left gives us a bill that is clear and says no illegals, leaves our private care out of the government control. When the bill doesn’t make you take a product you don’t want and it doesn’t exempt federal employees, congress, or the president. Obama tells us we can keep what we have, he forgets to add- but it won’t be the same when I take over. I’ve read 2 of the bills and will fight to the polls to stop them. If there is a problem with the coverage you have take it up with your state, it’s their power not the feds. Let the uninsured buy in to medicaid. Let the illegals go home.

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By Mark, August 21, 2009 at 5:16 pm Link to this comment
(Unregistered commenter)

I would like for somebody that is pushing for the reform and states that big
companies are looting us to please answer this question;why is Obama holding
closed door meetings with Big Pharma companies promising them government
WILL NOT ask for price restrictions on drugs in return for a “promise” of overall
savings in the future.This “savings"will add up to around 80 billion dollars,roughly
2% of actual costs.Does this sound like Obama is worried about saving money?
Wake up and smell the coffee,Obama is sleeping with the enemy just like all the
others.EVERYBODY will end up paying for it.

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By Sepharad, August 21, 2009 at 2:59 pm Link to this comment

How about a non-reasoned debate from our side? Krugman’s column today noted that Obama and his people were shocked, SHOCKED, at all the flack from the progressive left. Let’s hope they are shocked enough to climb that universal mandatory health care mountain. So far Obama has not been tough enough, not even close.

I wrote my state and national Dem legislators and said if we do not get a public health plan, I will NOT vote for another Democrat in any office, no matter if the opponent is Attila the Hun. (Also we need to pull together the socialists, greens etc. into one big populist party that can attract as much as backing—human and financial—as the two other “serious” parties then focus everthing into getting that party in power.

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By Rockytonker, August 21, 2009 at 2:26 pm Link to this comment

reason, you omitted another point: the claim that “there just aren’t the votes” to enact Medicare For All arises from misinformation and lies spread by opponents aided by mainstream media that don’t dare tell the truth because the insurance companies buy a lot of advertising.

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By reason, August 21, 2009 at 1:42 pm Link to this comment

Private insurance companies and those aligned with their continued monopoly on healthcare see healthcare reform proponents as the enemy and will stop at nothing to discredit them and their supporters. The lies, misinformation, character assassination heaped on the American citizens supporting healthcare reform in the last eight weeks is analogous to the reasons for going to war against Iraq. (Weapons of mass destruction and Saddam Hussein was supporting terrorists?)
I like everyone have read and heard the arguments against instituting a national health insurance for all citizens and wonder at the ridiculous statements of those arguing against it. National healthcare is not “socialism”, however it is an alternative to insurance companies who want to preserve their complete control over how and what treatment medical providers offer to the sick.
To those who can afford medical insurance as it is today, I can only say; I am happy for your good fortune and I hope it continues. To those who cannot afford any insurance or are underinsured, I only hope you can put your biases aside long enough to see you are being misinformed and manipulated by those whose only interests are self serving.
I believe the following to be true for most of us and the following beliefs dictate support of national healthcare:
1. All of us wish to enjoy reasonably good health, and to do so is to be able to get medical help in a timely manner (not just when you have enough money left over in the weekly budget).
2. The health of the country isn’t just financial; it is also the publics physical health.
3. Private insurance companies are bastions of capitalism and they will not sacrifice their bottom line for any reason.
4. None of us live forever and there are limits to what medicine can do. It is not reasonable to offer a person 90 years old a heart transplant procedure (even if he could survive the procedure). There will need to be hard choices made but that is no different than the realities of insurance and medical care as it now is.
5. Medical treatment and the drugs necessary to sustain a reasonable existence should be available to those who need them (no matter what their financial status).
6. If someone needs medical treatment and doesn’t receive it because they don’t have the money to pay, it is inhumane. (Most of us would not want even an animal to suffer because they can’t pay).
7. No one is trying to destroy the private insurance business, but it is not going to allow any interference with the monopoly it has enjoyed for many years.
8. National healthcare is not just a privilege it is a necessity, if we are to have an overall healthy country that affords all citizens the right to life, liberty and the pursuit of happiness.

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By GW=MCHammered, August 21, 2009 at 1:26 pm Link to this comment
(Unregistered commenter)

Dying for affordable healthcare — the uninsured speak
(even doctors fall into U.S. health scare catch-22)

So how does he feel about the way the debate in the US has come to be dominated by Republican-inspired attacks on Britain’s NHS and other “socialised” health services which give people the treatment they need even if they cannot afford to pay for it?

“I find that repulsive and an absolutely bone-headed way to go,” he says. “When I started out practicing I certainly didn’t expect this would happen. I thought the system would take care of everybody.”

http://www.guardian.co.uk/society/2009/aug/21/healthcare-provision-us-uk

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By oldog, August 21, 2009 at 12:07 pm Link to this comment

Count me in. But we may end up waiting a few years.

I think we may be seeing the last gasp of corporate
dominance in this decade, with the glaring exposure
of the internet.

As more people become aware of the true nature of
politics, foreign wars and business ethics (as in the
lack thereof) I hope to see more pressure from voters
to deliver on all those patriotic speeches and less naivety over smear campaigns and false advertising.

Unfortunately this year, not everyone got the memo…

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By HGN, August 21, 2009 at 10:12 am Link to this comment
(Unregistered commenter)

It is an irony and a tragedy: the Single Payer system is already in place: it’s called Medicare. Just extend it to everybody who is not in it now, even those who are so happy with the insurance they got. The happy and lucky idiots are those who never needed their insurance and never faced its limitations. And that’s where the pain begins. They can’t think ahead and imagine that they may lose it, sooner or later, guaranteed, because circumstances always change and the unexpected always happens. Medicare is permanent and nearly all inclusive, it follows you around like a doggy. Besides, we need the largest premium paying pool possible or the system will feduciarily not work. Cost? Get rid of the insurance companies and save 400 billion a year. We just need to add our names to the list of Medicare participants. The whole thing will be organized and up and running in well under a year. Medicare broke? Not so, the government just needs to honor the ‘I-owe-you’ it placed in the Medicare kitty when it raided it.

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By konnie, August 21, 2009 at 10:06 am Link to this comment

well, there are no public funds for abortions in any of the drafts, nor will there ever be.  nor death panels, and there are lines now….....you have been influenced by the wrong people. i stand by my previous comment.

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By Rockytonker, August 21, 2009 at 8:52 am Link to this comment

Konnie, the private insurance premium would be quite a bit more than the tax credit.  If people want to spend the extra money to avoid paying for someone’s abortion, to avoid “standing in line to see a doctor,” or to stay clear of “death panels,” that will not have the negative impact you fear.  The tax credit would be equivalent to the cost of providing the health care for the person (on average.)

In reality, even those with objections to it will mostly buy a private supplement rather than opting out.

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By konnie, August 21, 2009 at 8:29 am Link to this comment

rocky, there should NOT be a private option INSTEAD of medicare for all.  maybe a supplemental like there is now for retirees with medicare, but the only way this is going to work, is if everyone is in the pool - paying in and taking out.  the healthy and the wealthy right there beside the sick and poor.

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By Rockytonker, August 21, 2009 at 8:07 am Link to this comment

I forgot to add one item.  Currently, health insurance is regulated by the individual states, although some members of Congress are trying to change that.  That means insurance fraud is a state crime and investigated by state and local law enforcement.

Medicare fraud, however, is a federal offence, and brings the weight of the FBI down on the perpetrators.

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By Rockytonker, August 21, 2009 at 7:22 am Link to this comment

First, let’s stop calling it Universal Single Payer.  No one knows what that means.  Not even Medicare 2.0, but Medicare For All.  That is language most Americans can understand.

Second, insurance company profits are not out of line, about 4% of revenue after taxes, 6% pre-tax.  The greater problem is the administrative costs of 12%; Medicare’s administrative costs are less than 2%.

There are many reasons for the rise in healthcare costs, but a major one is hospitals getting stiffed when a patient can’t pay his bill.  That is why we need everyone insured, and adequately.  More than half of the personal bankruptsies are triggered by medical expenses, and many of those had insurance, but not enough.  Those bankruptsies are a significant drag on the economy, leading to more job loss and therefor more bankruptsy.

It is imperative that healthcare reform not just be enacted quickly, but actually up and running.  It could take 4 years to get co-ops or some “public option” functioning.  It only took a year for Medicare.  Over a quarter of Americans are already covered.  Scaling it up would take less than a year.

The cost?  To achieve universal coverage through the private sector means mandating the insurance companies issue policies to people with pre-existing conditions.  That will drive everyone’s premiums even higher.  The increase in taxes to fund Medicare For All would be much less than the cost of private insurance.  Remember the difference in administration costs?

The net effect would be an economic stimulus, as consumers would have more money to spend, and businesses would have lower labor costs.

For those who object to “paying for someone else’s abortion,” or whatever, include a “private option.”  You must have insurance at least equivalent to Medicare; if you choose to get it through a private carrier, you will get a tax credit (not just a deduction on your taxable income) up to the per capita cost of the Medicare program.  It would be much simpler and less costly than a subsidy to help pay for private coverage.  It needs only a statement from your carrier of the amount you paid in premiums, and a report to the IRS.  No complicated system of government embursements.

Because the cost of healthcare is dragging the entire economy down, this is a nation security issue of the highest priority.

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By Anarcissie, August 21, 2009 at 6:16 am Link to this comment

BlueEagle:
‘This is all nice and dandy, but unfortunately the USA is broke. 6 Trillion in debt and counting.  [ http://zfacts.com/p/461.html ] Medicare is broke. Not broken - broke.

Where is the money going to come from? ...’

When it comes to money, the Federal government just plucks it out of the void.  The question ought to be, where is the wealth going to come from?  And since value can be produced en masse only by labor, where is the labor going to come from?  There can be lots of money running around and no value.  This is the situation which was developing under Bush and now we have seen it continued under Obama.  But I don’t think these guys can stop.  It’s all they know.

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By csavage, August 21, 2009 at 5:53 am Link to this comment
(Unregistered commenter)

Our system we have now is going to collapse-it’s unsustainable in it’s present form. The private sector got a notice in the 90s with Clinton’s healthcare proposal that multiple millions of uninsured Americans is unacceptible. Their response was to do nothing. The argument of letting the private sector solve the problem denies reality for that 1 reason. I have spent my career as an internist who works in the ER listening to leaders of the American College of Emergency Physicians tell the public the system is at a breaking point. We will have a change-it’s obvious to me at this point that it will have to be a hastily thought out decision that benefits no one except the policymakers at the time, because we cannot discuss this as a culture. We still have too wide a gulf between those who see healthcare as a privilege and those who see it as a right. The really dismaying thing is that those who see it as a privilege are linking it to a threat of violence by bringing guns to town halls and no one from the GOP-pundits to politicians-is saying that’s wrong

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By BlueEagle, August 20, 2009 at 6:34 pm Link to this comment

This is all nice and dandy, but unfortunately the USA is broke. 6 Trillion in debt and counting.  [ http://zfacts.com/p/461.html ] Medicare is broke. Not broken - broke.

Where is the money going to come from? The people are taxed to the hilt. Governments don’t want to lend us any more money.

When you have no more money and no one will lend you any, you have to stop spending and most ideally you need to cut your spending. Most Americans are doing this today. The state of CA is doing it. It’s time the US Gov’t does as well.

First cut warfare. If more is needed, we need to cut welfare.

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By HGN, August 20, 2009 at 6:21 pm Link to this comment
(Unregistered commenter)

One keeps getting encouraged ‘to call your senator, call your representative’ and ask them to please, please vote for Single Payer. We need to demand Single Payer, demand it, Obama needs to demand it, everything else is a copout. But you must realize these men and women in the House and Senate are your biggest enemies. They are bought and paid for. Now they face this mutually exclusive piece of trickery and treachery to serve their paymasters on the one hand and pretend to ‘fight’ for their constituents interests on the other, who after all may or may not vote them back into office next time around. How do they do this? They debate up a storm. Bring up dozens and dozens of irrelevant issues, make things appear complicated, mislead, misrepresent, speak with forked tongue. And in the fog and haze of this confusing, contradictory and deceitful fake debate they bury and obstruct and delay the real issue of plain and simply health insurance. They even succeed in misleading and convincing you, the pro Single Payer person, into believing their falsehoods by the simple psychological fact, that if you repeat a lie often enough, eventually it will be believed. What to do? Obama needs to stand up, raise his voice, pound his fist on the podium and demand Single Payer, fight like a roaring lion. But, alas, he is not this kind of guy, he is ‘too nice’. Please! Every senator, every representative who opposed single payer must be put on a list. In the next election we need to specifically remind the general electorate again and again who the culprits were who sabotaged Single Payer and who to absolutely vote out of office for all time to come. Put them in the unemployment line, without health insurance, and make them taste their own medicine!

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By Mark, August 20, 2009 at 6:13 pm Link to this comment
(Unregistered commenter)

From the posts I have seen on here,a person that didn’t know any better would
think our president is reforming health care because he actually cares about
the little man and will make sure no conglomerates make a killing from it.But
because most Americans know enough about our government,they have every
right to question their motives.Ray Charles himself could see by the language
included in the 1000 plus page bill that they leave just enough room so that
once the bill passes they can do whatever they want,most times leaving the
citizens scratching their collective heads.
  All one need do is look at the strange and questionable group Obama has
surrounded himself with and conclude nothing good can come from this
reform.When your adviser claims that doctors take the Hippocratic Oath too
serious people have every right to be outraged.When your Health Czar(1 of
44)has been quoted as saying the population could be controlled by
sterilization in the water system people have the right to be outraged,I think
the people that should be looked at as being out of line are the ones standing
behind this eugenics plan called reform.

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By jmr, August 20, 2009 at 2:33 pm Link to this comment

A big reason single-payer is off the table is a difference in constitution between healthcare reformers and their opponents.  While opponents’ attributes are outrage and anger, the reformers’ are “sorrow and dismay”.  It’s time the reformers stopped acting like a bunch of wuzzes!

OF COURSE in a reasoned debate, single-payer is a no-brainer.  But his is not a reasoned debate.  So, what do we do?  Demonstrate our superior sensibilites by refusing to lower ourselves to “their level” and get dirty?

It’s obvious to me that reason will not win this fight.  The question is whether the right (moral) has the might (political).

It’s outrageous that single-payer is off the table.  It’s beyond outrageous that apparently even “the public option” is off the table.  Congressional Dems are caving.  Obama had already caved since saying, in 2003, that single-payer was the way to go.

From my comments at Joe Conason’s piece about The Real Death Panels:

Obamacare bends over backwards to accomodate the healthcare profiteers.  This has been the fatal flaw of all healthcare reform proposals.  The attempt to accomodate the industry has resulted in bloated, 1000-page, tricked-out proposals that actually play into the people’s fears of big government “taking over” their healthcare.

It would be easy to provide universal health care, no muss, no fuss:  merely extend Medicare to everybody.  This is, in effect, single-payer, but doesn’t need to be called that.  It would be a one or two page bill—requiring only that the administration and budget of Medicare be scaled up—that Congress could quickly pass and the president sign into law—a fait accompli that people would barely notice until it was in place and they realized they didn’t have to deal with the bloodsuckers to get care, and the bloodsuckers realized they were out of business.

SINGLE-PAYER IS THE ONLY WAY, FOR CHRISSAKE!!!

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By NYCartist, August 20, 2009 at 11:46 am Link to this comment

Americans want single payer.  It is logical.  It will
happen.  Let’s make it happen sooner rather than later.
Congress, the President and the media & big medical care/pharmas don’t want it.
See http://www.blackagendareport.com for Bruce A. Dixon’s articles on Single payer as well.
Also, see Paul Street’s article, Aug. 15, 2009,
Znet “...Obama, Corporations and the ‘Punking’ of
America” for a great review of the political Obama,
  includes health care, etc.
http://www.zcommunications.org/znet

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By Outraged, August 20, 2009 at 11:39 am Link to this comment

Government-run Healthcare…?!!!!  How awful…. How scary…. Kill Gramma!  That’s what they say, but what do they do?

Newsweek, Daniel Gross: “Health Care Hypocrisy”

“As we’ve noted before, if you add the failure of employer-linked health care with Medicare, Medicaid, government employment, and the military, a huge chunk of Americans already have taxpayer-funded health care. It’s a diverse lot. Rich old people and poor kids, university professors, congressmen, teachers, DMV clerks and their families. Pretty much everybody you see on CNBC yelling about socialism? Their parents and grandparents (if they’re still living) get taxpayer-funded health insurance. Mine do. Charles Grassley, the septuagenarian Iowan who is doing his darnedest to torpedo meaningful health care form, has it. Arthur Laffer, the 69-year-old economist who went on television and suggested that Medicare isn’t a government health care program, is eligible for Medicare. Dick Armey, who spent many years teaching at a state university and served several terms in Congress, has had taxpayer-funded health insurance for much of his adult life. Same for Rudy Giuliani and Newt Gingrich. Democratic senators like Max Baucus, Kent Conrad, and Ben Nelson? Yes, yes, and yes. Law professors at the University of Tennessee have it. The employees of George Mason University, which houses the free-market Mercatus Center, do, too. Policy analyst Betsy McCaughey, currently reprising her 1990s role of health care bamboozler, will be eligible for it in a few years’ time.
http://www.newsweek.com/id/212915

It’s so horrible…. so, so horrible.  Boo.

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By konnie, August 20, 2009 at 11:28 am Link to this comment
(Unregistered commenter)

stand on top of the damm “DININGROOM TABLES” and
don’t leave center stage until single payer is
back on top of the DININGROOM TABLES.

ARE WE MARCHING SEPTEMBER 12TH OR NOT~!

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By Swami Barmi, August 20, 2009 at 9:47 am Link to this comment
(Unregistered commenter)

You gotta love these people: they do their best to stifle or entirely prevent debate, then they complain when the reaction is heated.

These people attempted to ramrod this bill through congress in the brief time before their summer recess, PREVENTING the degree of “reasoned debate” that such a drastic change to our lives would entail. People very understandably became upset by this, and NOW they’re CLAIMING the desire for “reasoned debate.”

It’s the same with the global warming issue: debate never happened, yet the alarmists proclaim that the “debate is over”. And the same again with the war in Iraq: opponents were not allowed to debate; the “problem” was self-evident and we HAD to invade and murder hundreds of thousands of people.

I’m sick of all of you manipulators trying to pull the wool over our eyes and feigning shock when we don’t fall for it.

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By Susan J., August 20, 2009 at 7:52 am Link to this comment
(Unregistered commenter)

@Underwriter:

Deduct 30%+ ‘insurance overhead’ from current doctor/hospital charges, and that
will give you a realistic number for health care costs.

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By Anarcissie, August 20, 2009 at 7:42 am Link to this comment

Fat Freddy:
‘Single payer is by no means perfect. ...’

Well, we have long since left the realm of rational discourse on this issue, as on most others.  Part of the problem is industry muscle, money muscle—the discussion has been so heavily propagandized by the Industry that there are can be only two sides.  It reminds me of the debates about nuclear power, wherein the nuclear industry irradiated its own goose by similar rule-or-ruin means.

Yesterday I received a rant from a rightist mailing list I’m on (Newsmax) which was mostly a vehement denunciation of cooperatives (the so far ghostly substitute for the Public Option which the proponents thereof believe is merely a trick substitute).  I think the rule is, if it moves, shoot at it with the heaviest guns available.

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By Rodger Lemonde, August 20, 2009 at 7:14 am Link to this comment
(Unregistered commenter)

Keyword here is reasoned.
With the decline of newspapers and the pitiful state of
television journalism ‘reason’ is an endangered
species. Fox news alone would be happy to see reason
become extinct.

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By hsr0601, August 20, 2009 at 7:10 am Link to this comment
(Unregistered commenter)

5. CONCLUSION = THE WILL OF REFORM, NOT COST.

The runaway premium similar to the peak fuel price last year and left so many folks in despair insists on staying the course with the attitude ‘unchanged’, clearly this trend could bankrupt individual, business, and government. Now the government subsequently is tasked with these two main assignments, first, to address premium inflation, second, to expand coverage to all in urgent need.

In order to cover all and not to add to the deficit, the public option can not set the same rates of private market, rather, it needs to have BALANCING function to keep it in check in terms of INFLATION, too. Unfortunately, this ‘unavoidable’ direction is being aggressively accused by the runaway premium, citing government ‘take-over’ .

Under the circumstances the energy bill to determine human future and the other major issues are presently piled up, who wants to waste time making enemies ?, which also does not benefit the forthcoming election.

with the heartbreaking tears in mind (Nearly 11 Million Cancer Patients Without Health Insurance), private market also needs changes and should join together to complete this reform , as promised, otherwise, the runaway premium only has itself to blame while new firms are filling the void with competitive deals.
And It can be said that fair competition starts with a fair, sustainable market value.

However, the plan in the House is designed to keep people in an employer-based health insurance system, and the public option would be offered to those for whom employer-provided insurance is not available. And job-based coverage (indirect payment)  mandate code, and ample capital, reduced ER costs, IT base to streamline the administrative processes and trim the costs might be favorable to the private market. Over time, supposedly, the public plan will concentrate more on basic, primary cares, and the private insurers will provide their clients with differentiated services.

Let me repeat;  No More Health Catrina, No More Bankruptcy Of Middle Class !

—Americans’ Best Friends Are The Envy Of The Planet !—
—Except For The Underinsured, The Uninsured Alone Outnumber The Entire Population In Canada—

Thank You !

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By hsr0601, August 20, 2009 at 7:09 am Link to this comment
(Unregistered commenter)

No More Health Catrina !


Let’s set up the Equation !

1.  All across the spectrum share the urgent need for the reform as the course today is financially unsustainable. By the way, how do we pay for it ?
    Let’s make it affordable while improving quality.

2.  Of all choices on the table, saving via efficiency is the best, and Removing Wastes alone is Enough to Meet the Goal.
   
  As one instance, please visit http://www.npr.org/templates/story/story.php?storyId=111967435, you will be stunned !

  No one knows just how much medical fraud there is, and estimates range from $600 to $6000 billion over the next decade lost to it.
  And, in May 2009, the Obama administration announced a new task force made up of officials from the Department of Justice and the Department of Health
  and Human Services to work on health care fraud.

3.  Enough Room For Savings !

Many reformers recognized roughly 30 percent of all health-care spending in the U.S. -some $700 billion a year- might be wasted on medical abuse, unnecessary procedures, unnecessary visits to the doctor, overpriced pharmaceuticals, bloated insurance companies, and the most inefficient paper billing systems imaginable, and payment reform could solve this problem.

Provided the American people pay around twice the amount of the efficient systems, the result is still well below them, the ratio of waste might be estimated to reach far more than 50% in the U.S. 

Let’s be conservative regarding the ratio.  Even If as little as 10% of savings apply to the combined Medicare and Medicaid cost of $923.5bn per year, as of July, the savings of $923.5bn over the next decade are possible.

And when these savings add to the already allocated $583 billion, the savings of wastes involving so called “doughnut hole” , the unnecessary subsidies for insurers, medical abuse, exorbitant costs by the tragic ER visits etc, the concern over revenue might be a thing of the past.

As a matter of fact, with the promising redesign in the pipeline, some patient-focused clinics in 10 regions have already achieved 16% of savings in Medicare while their quality scores are well above average.

Please be ‘sure’ to visit http://www.nytimes.com/2009/08/13/opinion/13gawande.html?hp  for credible evidences !

Thankfully, the provisions in the reform include more expansive, systematic policies such as ‘a patient’s outcome-based payment system’ than they have. I for one firmly believe this American innovation, ‘a patient’s outcome-based payment system’ , is capable of turning profit-oriented practices into patient-focused system / value.
Dr. Armadio at Mayo clinic says, “If we got rid of that stuff (waste), we save a third of all that we spend and that is 2.5 trillion dollars on health care. A third of that and that is 700 billion dollars a year. That covers a lot of uninsured people.”
Please visit http://www.kare11.com/news/news_article.aspx?storyid=820455&catid=391 for detailed infos
 
—Americans’ Best Friends Are The Envy Of The Planet !—
—Except For The Underinsured, The Uninsured Alone Outnumber The Entire Population In Canada—


4. Some say, if the reform package is affordable and improve quality, then the inflation/bankruptcy-oriented market can not last, thereby competition should begin with our unfair, unsustainable market value, or let’s make another insurer-friendly scheme, even though the inflation/bankruptcy-oriented market share the need for change.

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By Steven, August 20, 2009 at 5:34 am Link to this comment
(Unregistered commenter)

“With the “everybody in, nobody out” approach of a Medicare 2.0 system, we can all get more freedom, choice and security.”

“We affirm the dignity of all persons and insist that health care is a universal human right.”

How can one have a reasoned debate with someone taking such an illogical position?  Quite simply, in a free society, one cannot have a right to something that must be provided by someone else.

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Ouroborus's avatar

By Ouroborus, August 20, 2009 at 5:03 am Link to this comment

My heart truly goes out to you Americans who’ve been
robbed of even having a choice. A reasoned debate
seems to be out of the question; in fact it appears
you’ve been robbed of any choices at all. Your
government is ramming a mandatory plan down your
throats that will be the insurance industries dream
come true.

The thing I don’t understand is this; why have you
allowed the lobbyists to divide/conquer and split you
into so many factions who all seem to be at odds with
each other? Where are the 46 million people who have
no insurance? Are they so down trodden they have no
voice? I mean 46 million is a heck of a lot of
people, yes?

No offence; but I’m sure glad I’m not there because
I’m not rich, but I have free healthcare. If I were
there, I’d be one of the 46 million and maybe even
dead, because I do have health issues as does my
wife.I sure hope you figure it out; really, I like
America, your people are pretty good for the most
part. Best of luck.

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By Fat Freddy, August 20, 2009 at 4:36 am Link to this comment

Single payer is by no means perfect. There will be problems associated with it. It is much easier to knit pick the “possible” problems than accentuate the benefits of such a system in an 8 second sound bite world. There are legitimate concerns, but you you won’t hear them either.

I watch these “political pundits” argue about health care reform on the “news” channels, and neither side knows what the fuck they are talking about. At least, it appears that way. More Band-Aides on a broken system is all they can talk about. Amazing.

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By KDelphi, August 19, 2009 at 11:01 pm Link to this comment

Not much more to say from a group that has it all right…

Hulk2008—Unfortunately, yes.

This may not be a “perfect analogy” peeps, but think of it as a “keystone”—if a “civilization” cannot take care of it members when they are at their most vulnerable, it is not a civilization at all. Hence, the lack of universal health CARE, holds up a mirror that is very difficult for USAns with a conscience to look into—or should be.

Some will just not understand until they get sick. Others will just be fortunate, and have money or be covered.

It is not complicated (unless you work for an insurance company and would have to get another job)

Ask Canada, Denmark , Sweden, UK, etc. We already have Medicare and we have HR 676. Check it out—Conyers has already figured it out for us.

If we’re going to have a ‘reaoned debate” the “stakeholders” cannot include an industry that has been killing 20,000 people a year for profit—if so, why not just include Blackwater or Xu.

The Senate , in particular, has behaved so badly on this, that they have already lost the Left…there is a way to get them back. And there ia a way to lose them forever.

BaucASS, you choose.

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By DE Teodoru, August 19, 2009 at 8:15 pm Link to this comment
(Unregistered commenter)

IS OBAMA FULL OF BUSH-IT? At a Conyers townhall for his single-payer bill some months back I pointed out that if the bill passes we would never get the universal health care we want because there are not enough physicians to do all the preventive care, the health care and the chronic care needed. Furthermore, doctors’ offices and hospital are so swamped with the unmanageably large volume of patients needed to cover the overhead of their practices that they don’t have time to update their knowledge to the cutting edge stuff on whose threshold we now stand….And it gets worse. HMOs in effect decide what tests and therapies patients get—not the doctors and patients. Vendors for office supplies—clerical and medical—charge a fortune at high mark-up for everything that is “for medical use,” including garbage disposal. I need not mention insurance. Between doctor and patient there are deep layers of “entrepreneurs” (French for the-taker-in-between) who produce nothing, just cannibalize you in your desperate and vulnerable moments needing health care for outrageous profits. So the best reform we can get, if providing universal access to health care is Obama’s only goal, is 1950s medical care for all because we won’t be able to afford the needed revolution in medicine required to make it up-to-date. A modern high-tech health-care system demands a big up front investment that eventually makes for amazing cut in expense due to prevention and modernization. Without that investment there can be NO AFFORDABLE UNIVERSAL HEALTH CARE because 1950s medicine is expensive, not preventive, and bureaucratically a nightmare open for fraud. That up front capital to modernize and reform, FOR PROFIT HEALTH CARE PROVIDERS *REFUSE* TO LAY OUT. Therefore, there can be only one healthcare provider able and willing to lay out the up front costs: THE FEDERAL UNIVERSAL HEALTH CARE SYSTEM. Of course, since it would allow no cherry-picking of patients, no varied bureaucracies each with its own policies and continued expensive proprietary price-fixing such as today’s Bush-made Part D drug coverage for Medicare, nor will it protects the corporate monopoly interests of HMOs and PHARMA, it could soon provide costs decreases and high-quality health care in general far exceeding Canada’s or Europe’s. As doctors are better payed (a doctor gets per hour of patient care less than a plumber) and are given payed time to educate themselves in updating programs, they can bring genomics on line providing tailored to your genetic make-up medicine and can begin to pass beyond the current shooting blind of PHARMA. The 20% of the nation’s dollars-pot for healthcare (12% of GDP) set aside for coporate dividends for investors in the for profit industry will be available for healthcare instead of for profits. Our Senators and Congressmen can be used by the same raging townhall ravers, keeping the feet of Congress in the fire, to make sure that what our national healthcare non-profit single-payer system provides us the best in the world. Unlike HMOs, the Gov can sent the FBI to catch cheats, be they at the top or the bottom of the healthcare food chain. No sane person can doubt that decisions made on the basis of proven medical science by the Federal single payer are worse than heartless decisions made by the many for-profit HMOs based on their profit margins. If Obama accepts some plan that allows for-profits to monopolize healthcare again, then, like many Democrats in Congress, he will prove to be, not for change, but just for the same old Bush-it!

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By Underwriter at a health insurer, August 19, 2009 at 7:12 pm Link to this comment
(Unregistered commenter)

It’s complicated. I work for a not for profit company, but we are paying hospitals and doctors and drug companies’ ever increasing fees and that is really driving the costs. That is the primary driver of health care costs that no one will address. It simply costs too much. And there is no easy answer to that because it will require reductions in revenue for doctors, hospitals, nurses, drug companies, etc. and job losses in those industries and changes in the way we provide medical services to address those issues.

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By RobertinWestbury, August 19, 2009 at 5:54 pm Link to this comment

“In a reasoned debate..” 

And how would we have that?  We’ve seen this summer that is not possible..

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By M Currey, August 19, 2009 at 3:57 pm Link to this comment
(Unregistered commenter)

People will not see the other side of the coin until like the fisherman they have walked in his/her shoes.

Pre-existing conditions do affect people weather the me first people see it or not.

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By Sepharad, August 19, 2009 at 3:20 pm Link to this comment

Of course a single-payer plan would come out on top in a reasoned debate. But that is precisely what we haven’t got. If we can’t bring our green, socialist, and other candidates into one big populist party and get it elected, we’re reduced so factional rants that go nowhere. And that is precisely what we HAVE got on TD.

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Allan Krueger's avatar

By Allan Krueger, August 19, 2009 at 3:04 pm Link to this comment

Dear Hulk2008,

Yes, at least 30% could not find their ass with both hands, will believe anything and watch FOX News…

Health care is the tipping point! If we don’t fix it, our way of life goes down - in the rock of Afghanistan!

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By Carlton, August 19, 2009 at 2:48 pm Link to this comment
(Unregistered commenter)

The problem with single-payer is the complexity in selling the plan to the public. The simple solution is to gradually expand Medicare eligibility downward, to age 60, then age 55 and so on. I’ve written an article on this. Truthdig may want to post it. Just e-mail me.

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By doublestandards/glasshouses, August 19, 2009 at 2:40 pm Link to this comment
(Unregistered commenter)

Thinkprogress.org says today that 39% of Americans
think that the government should “stay out of Medicare”
according to a just released poll.  How can you have a
serious discussion of health care when 4 out of 10
adults don’t know what Medicare is?

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By JenniferBedingfield, August 19, 2009 at 2:19 pm Link to this comment

Thank you Drs. Boylan and Landy. I think the problem also goes beyond Congress itself. Despite the fact that most people, even some conservatives, would love single payer for a change, we do not live in a society where collective thinking and responsibility along with sharing and helping one another are the norm. I have come across even progressives and liberals who fall into the Strict Father morality frametrap with the “I got mine, screw you” mentality when it comes to health care. Interestingly, even my conservative parents want to see single payer put on the table although that was after they watched my cousin struggling through unemployment and not being insured and later when I was sick earlier this year and had to take a month to recover. When people are so individualist, their tendency to elect pols based on personality, party affiliation, celebrity status, etc ... is greater rather than judging candidates by where they actually stand on the issues. This is why most voters are seduced into electing corporate bully puppets.

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By Hulk2008, August 19, 2009 at 2:03 pm Link to this comment

Just for grins I prepare an Excel spreadsheet of our family uncovered medical expenses and our health insurance premiums from 1999 to the present.  Basically our health premiums have increased by a factor of 2.49.  The “uncovered” costs varied by year since some years we had more services than others; but, in general, those costs have quadrupled. 
  What that means is that not only are we giving the insurance company 2.49 times the premiums, but the insurance is covering only 1/4 of the actual out-of-pocket costs after insurance paid.  That also means increased planning, negotiating, following-up and inconvenience dealing with insurers and providers.  And one should remember that the employer is also paying a sizable chunk of the health care premiums ..... and the employer represents a large metropolitan pool of people. 
    I read an article at the Fidelity.com website entitled “Why health care reform is critical for the U.S. economy”.  I cannot imagine that Fidelity is considered a “liberal” company; so I really don’t understand why so many people believe there is no problem.  I see SO many blogs indicating there “is no crisis” or “the sky isn’t falling” or “the US has the best health care”. 
    Are US citizens really that STUPID and uninformed?
(See https://news.fidelity.com/news/article.jhtml?guid=/FidelityNewsPage/pages/viewpoints-healthcare-economy&topic=saving-for-retirement )

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