Hmmm - the entirely true statement “weight isn’t always a factor when it comes to health” kind of got lost in the other verbiage that seemed to suggest (anecdotally) that obesity probably isn’t a health problem in our society.  That makes about as much sense as the decades of earnest claims by the tobacco industry that no proven connections existed between smoking and cancer.

Many people indeed did not develop health problems due to smoking, even after decades.  Many people indeed do not develop health problems due to obesity, even after decades.  But STATISTICALLY they’re both significant health problems in this country and should be part of the discussion as long as that remains true (obviously, in a manner that strives not to create different problems like eating disorders in the process).

Shoes 4 Industry seems to have some real issues with
weight and has bought into the diet industries
mythology about the so-called connections between
weight and health.  As someone who has always
struggled with weight, and who has been very healthy
otherwise, I might ask, what would you charge for
healthcare to those with bulimia or anorexia?  There
are also quite a number of connections (if not more)
between those who are exceptionally scrawny and
health.  It isn’t about weight—it’s about nutrition
and environment.

As I mentioned above, I am large and with some
exceptions very healthy.  My only health problems
have arisen because of the healthcare industry and a
genetic disposition toward blood-clotting.  These
are factors I cannot control.  I have friends who
are thin yet have had multiple health issues
throughout the years I’ve known them.  My conclusion
is one that any person without prejudices and the
power of observation might conclude—weight isn’t
always a factor when it comes to health.  To
discriminate based on this alone, without taking
into consideration the factors that might lead to
health problems from the environment (pollution,
chemicals in food products, genetic engineering) and
one’s genetic heritage, reveals a lack of
understanding about the complexities of illness and
the factors that play a role in health issues.

No, they are not their own worst enemies: they are democracy’s worst enemies, they are justice’s worst enemies, they are sanity’s worst enemies and they are peace’s worst enemies. “The great strength of the evil is that they always support each other” - I think Orwell wrote that.

The only way the Healthcare issue will ever be resolved is by removing the
profit element and firstly considering the the Health needs of the Patient!  This
Critical element is the very Basic responsibility of a Government by and for the
People. The other 2 basic responsibilities are to Educate and to make sure that
everyone contributes equally to and shares in the Welfare of the Nation.
Everything else is fluff!
The only legitimate reason for a Military is to DEFEND the Nation from Harm in
case it’s attacked from outside it’s own Borders. 
As Citizen’s who elect members of the Society to represent our interest, it is
important to maintain a Check & Balance system, that, on matters that affect
the whole body of the country - a Voter Referendum should decide the
process’s. Referendums should be held at State level, and decided by
population within the State’s based on a point system to denote the population
influence for each State of the Republic.

Alas, still no one gets the picture. Political Hacks, controlled by inhuman
Corporate interests (now made human by SCOTUS) stump for the side that pays
them. Are YOU paying them?
Being on the Ideological or Religious “Bandwagon’s” is KILLING this Country! 
Taking the face value of the MSM & the Talking Heads “new’s” stories rather
than the basic lessons that you learn going through life from your experience
on “What works, what’s good, what’s bad, whats critical to your very survival
and protecting the future for your children is leading you down the road to
destruction folks…
It’s like jumping off a cliff. Or sending your kids to war. There is about a 10% or
less chance that you (or your son or daughter fighting) will walk away
unscathed.
After all, the paid media is doing what they are paid to do- Who’s paying them?
Are you paying the media to broadcast YOUR news? The people behind the
media, the wealthy owner’s who have become wealthy by charging someone to
put these stories out there are being made richer through complying with
where their incomes are derived.
Americans, and not just American’s but other Nations who allow themselves to
be driven by Paid “New’s Stories” that they know drive opinion in this world of
Greed and Money means power and control, somehow think that by subscribing
the the Mantra will make them wealthy happy and smart.
It’s just so saddening to see how, during the history of our race, mankind has
been suckled by news advertiser’s and media’s Teet, know that it is killing
them, but refuse to be weened!
Can you not clearly see that those in power are not listening to you, the little
guy with the zero influence?? They listen to the Quo Bono set….
Even more sad is there’s nothing outside of a Revolution of the masses that can
change anything away from the current path.
When Newspapers first started, they were funded by the people that bought and
read the news and most of those readers were smart enough to realize truth
from fiction. Today, news is virtually free and the Media is relying on
Advertiser’s and story’s from the Advertiser’s for their bread and butter - These
are not “real” they are contrived to drive wealth, power and control”.
The Carrosel will never stop until it’s unplugged from the power source people! 
It’s just another day of fun at the Fair, which is designed to escape the reality of
the real world…

To aacme88

I thank you for “ongoing plummet” which seems to me a strong phrase to apply to the descent along with Titanic analogies and the history of destruction of various empires etc. etc. As Mike Ruppert has said, “arrogance breeds stupidity.” The path to self-destruction we’re on certainly seems to fit this thesis. But we’re not spending enough time with this “plummet” possibility, being caught up in the various bits and pieces of the disintegration as with this weak Obamacare effort to control a runaway health industry and our struggle to understand it and deal with it.

Further, as witnessed so often in these commentaries, the toxic environment is furthered by backbiting and emotionalism. I would think just getting organized in a cooperative way is the first challenge, and very difficult under the “ongoing plummet” which includes the now standard poisonous attack response being modeled by politicians and MSM, and here in truthdig comments sections where people leap to vitriol and insult instead of dealing with the issues carefully.

To Bill—

Thank you for your explanation and time spent. Recommended: Scheer’s comments on the AV available Mar 31.

A single payer system is inevitable only if we assume the return of the US to the fold of civilized societies. That is looking to me like an increasingly iffy prospect.
And the broccoli argument reminds me of the onging plummet in the level of discourse, legal and otherwise, in this century and the nineties.
Comparing the mandate to a requirement to buy broccoli in the search for a limiting principle is infantile. Much of the spiraling cost of healthcare is due to the huge population of uninsured, creating a crisis of a proportion unimaginable in any issue surrounding broccoli.
Besides which one look at Scalia will tell you he doesn’t eat enough of it.

yes, Angel Gabriel…from the point of view of the people its not supposed to make
sense. We build bombs and destoy other countries to steal their resources and turn the
people into debt saves.

We do the same here, consumers eat the cheapest most fattening foods, because those
foods are the most profitable. Then when you start dying from them, you are used again,
as a profit for exprnsive chemo, or statins, bi phosphonates, or pych meds, until you die.

Whats most important is that big money is made off you, until you die. They don’t really
care about curing you. No cure is ever mentioned.

The mechanisim of why people are obese in this country is well understood, reading
jones. But nothing will be done because death is highly profitable. Next time you look at
a box of kids cereal, thats full of sugar, remember those manufactures know full well
what their doing.  But they make lots of money murdering innoscent little children by
poison.  Thats whats wrong with this country the corporate criminals have bought our
government, and as a result they can lie cheat and steal and murder babies in the night
with impunity.

I have for several years advocated for excise taxes
on added salt and sugar in processed foods as a way
to finance universal health care. I believe obesity
is mostly driven by by the processed food industry
with all their little nastys like excess salt and
sugar, BPA, GE foods, farm chemicals, the
environmental costs of food transportation and the
disposal of packaging, and on and on ad nauseum. Such
taxes would at least equalise the price of healthy
and unhealthy food. It would place the cost of
medical care on those who make unhealthy choices and
at least some of those who produce bad food. About
80% of our medical costs are driven by about a half
dozen chronic illnesses that in turn are closely
associated with obesity and I believe our epidemic if
obesity is in large part due to the food processing
industry. The biggest weakness in Obamacare is in its
failure to address preventive measures like healthy
diets, exercise and a clean environment. Bicycles and
electric vehicles are a force for lowered health care
costs.

This subject is much too complex for a simple
comment. My remarks are meant as a point of departure
not a settled conclusion.

God, I have to laugh at American’s! Health Care for profit is your problem…
Holding one’s life for ransom is a crime isn’t it? It’s either extortion, or kidnapping
isn’t it? But when it comes down to the basics of Government responsibilities to
protect it’s Citizenry it’s just fine to go out and kill (murder) people to protect
yourself from the interference of outside influences so you pay the government to
build bigger Bombs, and when it comes to healthcare for the people well that costs
people $$$ - Why not charge the people you’re killing while protecting yourselves?
Either that, or redirect your tax dollars to be spent on the preservation of life
rather than the destruction of it?  Yeah, I know - what a silly idea right?  Fits right
in there with charging for Water and Air. In God we Trust - all other’s pay CA$H..

Those in the West have a long history of brain washing by the financial elite. The
population has been brainwashed into the worshiping of corporate gods, complete with
corporate symbols, substituting for the once worshiped symbols of ancient religions.

The masses for the most part blindly follow their many generations of training to obey,
the symbolism, and authoritarian dialect of the one per centers. Despite death, and
betrayal, and the murdering of their children, it is difficult to question their belief system.

For on the belief system hangs their identity. that offers the under pinnings of an identity, 
for so many. 

So people will believe even when those beliefs kill them, and those they love. Health
care only offers hope, even though, health care itself, offers produces little in results, in
this country.

Yes, health care is expensive. Doctors have Mercedes payments to make, and
investments to manage, this costs money.  So their treatments will be expensive, as to
whether or not they work, it’s not as important as the belief system, that people have
toward them. But medicine today, is run by Witch Doctors, who count on symbolism,and
sleight of hand, to maintain control and public belief.

When the facts of medicine are understood, there will be outrage. Just remember
500,000 people each year in this country die of medical mistakes, and that is just the tip
of the Iceberg.

Thank you, Blueokie!

I always wonder what people who yodel about obesity are doing themselves to ruin their health. I can’t believe that screeching self-righteousness is good for one’s heart or mind.

We can go on and on that people who smoke, people who drink, people who have unprotected sex, people who don’t go to bed at a reasonable hour, people who watch too much TV, and people who are fat, should not have access to the same services we feel we deserve. By the time we’re done eliminating everyone who is not perfect, no one will deserve any services except those with the mountains of money to pay for them.

A rebuttal for a few of the reactionary comments.

The government HEAVILY subsidizes the corporate/industrial agriculture cartel to produce calorically dense, nutritionally deficient “food” filled with cheaply produced, subsidized salt, fat, sugars and untested chemicals.  The obesity, diabetes, and hypertension associated with this diet are symptoms of malnutrition and the deep structural flaws within the system.  NOT the moral hazard of the lack of “personal responsibility” with the poor, and minorities who have access to nothing else, despite the popularity of such narrowed, cognitively challenged,
bumper sticker sized solutions that are emotionally satisfying for bourgeois white men.

Lurking Fundamentals:
  1. Conservatives are most frequently Fundamentalists (Religious and/or political) which at least to them means “going back to” something “better.” (Which means anything recent or new can be presumed to be “not as good” or “bad.”’ 
Ergo: We have been “getting along okay” without a national health plan. Why change?
  2. “Conserve” means “don’t waste”, essentially. Ergo, saving is conserving; spending is wasting.
  3. Conservatives tend to fear all difference and change. It then follows that those who do not fear difference and change are “wrong”.
  4. The Bible teaches simple moral principles like what’s “right” and what’s “wrong.” If you follow what it says, you will be “right.” “Wrong” is “evil” and God teaches you to fight against evil.  Fight means fight; it doesn’t mean “understand,” “prepare
for peace”, “negotiate” or “stop wars. “Ergo:We are right, and war is inevitable because they are wrong.
  5. People “deserve” what they get or don’t get. If you are not well, it might be that you “deserve” to be ill. Something is “wrong with you”, evidently. I am okay, so nothing is “wrong with me.” Why should I pay for your health care. I don’t “deserve” that.
  The conservative mind-set is in reality a social mine-field.  IMO the only solution is education, education, education.  That education must from the very beginning involve illustrating the REWARDS for
empathy, generosity and open-mindedness in the form of acceptance, love (hard though it is) and patience.
Prejudices laid down in childhood are hard to remove.
  Be glad (but not self-satisfied) that you were raised to lean toward openness, welcoming differences and being hopeful about change. The fact that you were so lucky means you also have a big responsibility in an age that is trying to run away from itself, due to fear, confusion and blind reaction. (All this advice is for myself as much as for any other person here who pretends to be “liberal” or “progressive.”

Here’s a shot at an answer, tolstoy:

1.  Our own insurance covers routine eye exams with only a $25 co-pay (I don’t know whether Medicare covers them, but if not an extended Medicare-for-All system certainly should).  A single-payer system would reduce that cost to zero (for you) if it covered it - and reduce what the doctor actually received significantly (because a single-payer system can negotiate prices with such providers in a way that you as an individual cannot).

2.  The individual mandate does nothing in and of itself to reduce such costs (whether you or the insurer pays them) - but if private insurance covers the visit then you must at most provide a co-pay, and private insurers (like Medicare, but with somewhat less negotiating leverage) can negotiate down provider pricing.

3.  Obamacare obviously does nothing to drive down pricing for services that aren’t covered, whereas a good single-payer system would cover ALL necessary services (you wouldn’t pay anything to receive them) and negotiate to drive down their prices.  Obamacare should work like traditional insurance for services that ARE covered:  you pay a percentage or a fixed co-pay, and then the insurer tries to negotiate down the remainder because it otherwise comes out of their profit.

But Obamacare may introduce a new wrinkle to the last point, since it regulates the PERCENTAGE overhead an insurer can charge.  Granted, the regulations only enforce an overhead level about the same as the UNregulated overheads were in 2008, so it’s hardly a great imposition on the insurers, but it does create a situation in which insurers might find it to their advantage not to negotiate prices down any more but instead to pay them in full such that their allowed PERCENTAGE overhead (which includes profit) would rake in that many more TOTAL dollars from a given service (because their premiums would then be allowed to be raised accordingly).

Thus insurers would win, providers would win, costs would skyrocket even more than they have been, and the American taxpayer would be left on the hook to pay the higher costs of their OWN health care PLUS the higher costs of providing subsidies for those who could not afford to pay their own way.

By contrast, a single-payer system would have no comparable incentive to let prices skyrocket and could instead negotiate to drive them down.  Other overheads (principally, those which providers have dealing with well over 1,000 private insurers each with their own special quirks, which amount to around 10% of provider costs) would also decrease significantly.  The overall result of a single-payer system would be to drive down the total amount the nation spends on health care significantly while significantly extending what’s covered and including EVERYONE in that coverage - a great deal for us, but kind of hard on those poor private insurers who’ve been serving us SO well all these years…

Thanks for your comments and information.

Back to my specific from yesterday: recent 30 minute routine eye exam cost me 273 dollars, doctor’s attitude brisk and supremacist.

1) How much would single payer likely reduce that cost? Ten percent, twenty percent? more?

2) How much would individual mandate likely reduce that cost?

3) How do either single payer or obamacare prevent doctors’ fees from continually rising outrageously (as with my specific example above) once they’ve got the hook in with the individual mandate?

Since Obamacare should never have been passed in the first place (and would not have been had even a few of the 60+ members of the Congressional Progressive Caucus stuck by their written pledge to oppose any health ‘reform’ package that lacked a strong ‘public option’), getting rid of it now and forcing a new start on reform where (this time) the single-payer Medicare for All option would NOT be kept off the table by the Democratic leadership would be entirely appropriate.

The interstate commerce clause has already been stretched beyond recognition.  In the past some stretching (e.g., in the Civil Rights Act) has at least been in a good cause, but this one is ridiculous (especially given that other solutions - such as Medicare for All - are available that don’t require this stretching at all).

My prediction:  The Affordable Care Act will be
upheld by the Supreme Court, and for two rationales
that have little to do with the Constitution.

1. Economic rationale: in 2010 SCOTUS upheld
corporate “personhood” and increased the rights and
privileges of corporations AS PERSONS.  It would be
rather uncharacteristic of this same rightist court
to suddenly bite their corporate masters.  The ACA
mandate is a winning lottery ticket for corporate
health insurers—which is one of the many reasons
progressives aren’t so keen on the bill, either.

2. Political rationale: our friendly right-wing
activist judges do NOT want to provide and Obama
Administration with such a large crack in the
healthcare wall in which to wedge in a single-payer
system.  They must see the writing on the wall if
they reject the ACA.

I must wonder if the hard line of questioning levied
toward the Obama Administration’s lawyers was
sincere or just a ruse to convince the public they
were “putting up the good fight.”  Or, they are so
blinded by their own ideologies and the satisfaction
they might gain of a “win” against their political
rival that they’ll take the risk of “losing the war”
in order to “win the battle.”

With the sentiments of much of the public currently
surrounding the financial sectors, the on-going
activism of the OWS, the failure of Congress or the
Obama Administration to relieve unemployment in any
meaningful way [the BLS does not represent those who
have been unemployed for more than 2 years who are
still seeking living-wage work and cannot find it—I
know, my husband is one of them], and the
increasingly rapid demise of our planet, striking
ACA could simply be the tipping point that the 99%
have been waiting for.

SCOTUS would be wise to move carefully.

while I agree with the two comments below, it does seem that obama will at least have a bit of leverage on this one since the individual mandate being thrown out forces the insurers to at least come back to the bargaining table.. will be an ugly spectacle i’m sure.

Nothing in terms of health care reform is “fiscally inevitable” except protecting profits.  The power of the companies involved is deeply entrenched.  Just like the “defense” industry, they view it as their right and duty to profit from fear and suffering. You think the US war machine is going away?  I’d say about the same chance as the disease profit industry.  In a diseased “free market” society, profit from disease is the only inevitability.

And what makes Mr. Robinson think that a single payer system will not face the same onslaught of anti-bill pressure mounted by the Repubs?  What they want is health care for the rich…only.