***Please Read***

Monday, March 30, 2009


Lately I’ve been so frustrated. Forget the bailouts, the deficit, the economy and other major issues that plague us. I’m talking about all the finger-pointing that’s going on. The Republicans blame the Democrats for THIS. The Democrats blame the Republicans for THAT. The Left accuses the Right; the Right accuses the Left. The media omits an important part of a clip to manipulate the story for the benefit of THEIR side. If I hear one more time about inheriting a deficit or how more money has been spent with this administration than with all the presidents combined, I think I’ll spit…and trust me, I despise spitting.

I would like…no…exalt BOTH sides if they would get along and accomplish something! Just ONE thing. Is that so much to ask? Is it so much to request that our Congressmen and women and our Senators come together as a team and solve ONE problem? Resolve a problem WITHOUT acting like a bunch of little kids pushing and shoving on a playground. As it stands, when someone gets a black eye, everyone starts yakking at the same time blaming and pointing fingers at everyone else. It’s just so immature. These people are adults, for crying out loud! I feel, at the very least, I should put every one of them in a time out until they learn to play nice. But what I’d really like to do is give each of them a swat on their rear ends!

My fantasy of punishing those on Capitol Hill will stay a desire until we can obtain vengeance on Election Day. Or I have another proposition. I think the American people are more mature, have better ideas and can be more bipartisan than those in Congress. I would like to pick a topic and have us discuss it in a mature manner. I have faith that we Conservatives and Liberals can come up with some really good ideas and possibly a solution to some of the problems that plague our nation. These solutions may never go anywhere other than this blog; but it may make us feel better. At the very least it will prove to me that there is such a thing as Conservatives and Liberals working together toward a common goal.

Our first topic is going to be Health Care. This, as we all know, is a major concern for Americans and our country. Our debate goal will be to resolve the Health Care conundrum. We definitely NEED Health Care reform. I don’t think there is a person out there that will argue with me on that. I’ll post my ideas in the comment section and I look forward to hearing from all of you.


  1. Bravo Beth!

    Two immediate thoughts come to mind.

    1. We absolutely must reconnect the cost of care to the person requesting the care. Any service that is supplied 'cost no object' will of necessity have ever increasing cost.

    2. Whatever we do for paying for health care, it needs to not be job related. The reasons the whole employer supplied insurance thing started were odd and artificial, and they are holding us back now.

  2. Aging is part of the problem of funding healthcare - virtually all Western economies are experiencing the same shift in demographics - a higher percentage increase in the aging population relative to the working population.

    The Canadian healthcare system, praised by some and criticized by others, is looking at rising administrative costs as the first place to find efficiencies and lower costs to recipients. In the US, we have the same problem too: More than 50% of the healthcare pie is administrative. Why?

    The lack of a uniform standard - we have multiple HMOs and insurance companies using different forms and procedures with considerable duplication of effort and waste. Healthcare records - we have no uniform standard for patient medical histories and billing information. Profit - we have to ask ourselves seriously this ethical question: Is there too much expectation for profit in a system that is driving up costs far higher than the base inflationary rate while leaving millions of citizens without coverage?

    These are just a few random thought to start the discussion. One request: please DO NOT fling spin words like "socialism" and or engage in the usual partisan bashing. This is not what Pamela is asking for, and these contribute nothing to the conversation.

  3. A universal health care pool solves many problems.
    It takes the cost of health care off the employers back. Ends the health care by emergency room syndrome that is 40 times more expensive than treating an insured person. It allows purchases of drugs, technology, business services, and other operating costs to be lowered, and other cost saving measures that come along with large group purchases. The savings from eliminating most of the middle men (insurance companies) and the "cut" they take would be more than enough to pay for all Americans health care.

    The problem with universal health care is the stigma of "government health." What President Obama has been talking about is not government controlled health care, it is government financed health care paid by the taxes of all. There is a big difference. The current health care system would remain, it would be paid for in a different manner, mainly, not by employers. Getting health care costs off the backs of employers is essential.

    The only way to lower health care costs, is to have everyone insured. The government would be the insurer, not the health care provider.

    It's like everyone paying for schools, transportation, etc., etc...even if some individuals don't use those services, they help society pay for them. These are social programs in the sense that it is for the good of all citizens and the quality of life in America.

    Pre-existing qualifications should be eliminated. The idea that if one can't pay, one can just suffer or die philosophy, must be rejected as a moral value of our country.

    Doctors should have the last say in treatment. Doctors treatment decisions should not be overridden by some office administrator.

    Taxing a minority (like smokers) should not be the way to finance a health care system, as if smoking is the only reason people get sick and need health care.

    Bipartisanship means compromise. I don't yet see compromise in this debate in Congress. That means conservatives will have to accept some kind of federal financing and liberals will have to accept what they see as unnecessary regulations.

    Moral issues like right to die, abortion, etc., etc...will have to be debated and come to some kind of compromise. Here is where conservatives have a real problem. They don't want to pay for a medical service they see as immoral.

    When these discussions take place, what is the basic guideline? It should be an individuals right of choice. To eliminate choice is to diminish freedom, no matter who disagrees with that persons choice.

    What we do not want to happen in health care is what happened to GM today. The government dictating the operation of the provider. So it is scary (and something I would disagree with) that the government comes in and makes the decisions of how a product or service has to be offered.

    Health care is different than cars. The government will have to protect the rights of individuals.

    The other option is to keep the employer paid system and enlarge the Medicare-Medicaid system to cover the rest of our people who are not covered. There are many other ideas I have heard, none of which would take care of all citizens.

    As for debate, please read my essay "Can We Have An Honest Debate? at my blog: timetoo.blogspot.com

  4. The question with taxpayer funded healthcare is, of course, how do you keep the government from using it to control health care. It is quite frankly not enough to say that you disagree with it.

    None of the proposals for how the government will control the costs of health care that I have seen are sufficient to impact the inreasing costs. Stopping big drug companies from bribing smaller companies not to put out generic drugs is just about the only part of the Obama plan that looked realistic, and it will not be enough. I think you are mistaken in the amount of importance you put on the homeless using the emergency rooms; while it is a real cost, it should be a fairly static cost, not the ever increasing amount we are seeing.

    I persist in my belief that the reason costs are increasing is simply because we treat it as a 'cost-no-object' service. If you do not apply a cost/benefits analysis to any transaction, the cost will inevitably rise.
    If we have the government make that analysis, we will have de-facto government control of available care, with the attendant control of lifestyle choices.

    A health savings account paired with high deductible catastrophic coverage insurance would be my proposed alternative. This removes the attachment to employment, and causes people to actually see the costs of what they are doing, as it comes out of their savings plan. This will bring cost/benefits analysis back into the equation, and people will start shopping for maximum return on investment, forcing costs down.

    This of course will not immediately fix the problem of the uninsured, although if it is successful in reducing costs, it will go a long ways. Creating a subsidized clinic/urgent care system to steer the indigent away from emergency care would also be required.

  5. I've posted on this a hundred times so I figured I'd sit this one out until OMR's statement about health savings account. We buy insurance to cover catastrophes. Health savings accounts such as cafeteria plans are nice. But explain how asking everyone to set aside 10% or more of their income in case they get sick is ridiculous. Retirement saving makes sense to everyone. Health savings accounts are another catch phrase politicians use to make us think they have answers when in reality they're protecting a valuble, wealthy and generous contributor.

    I support single payer national health insurance. This topic might be busy for you Pamela. I did it at my old site and it generated almost 4000 hits and well over 100 real good comments. I look forward to following this one.

  6. The professionals are the ones yelling danger about the cost of emergency only health care.

    And of course, the number of homeless and uninsured are rising quickly.

    Are you underestimating the cost of having almost 50 million uninsured? We are all paying for them anyways, and paying for them through this present insurance system is more expensive than paying for them through a government insurance system.

    What the amount of a high deductible would be is critical. The figures I have seen would go anywhere from $1,000. to $5,000. That is unacceptable because most people can't afford it. Unless people have a chronic or persistent problem the average person does not use the services to out charge such a high deductible. So, in effect, they still have no coverage.

    Health savings accounts still pander to the wealthy of society. How long would it take an average worker ($40,000. a year) to save enough to pay a high deductible, or catastrophic expenses before they still have to go bankrupt. One of the reasons to adjust the system is to cease the financial bankruptcy of those trying to pay for health needs.

    Why stop at coming a long ways to a solution? We have solutions, they just go against the political ideology of what some think the government should be doing.

    Should we start taxing people for only what they use in society? That's great. I have no kids and school taxes are the biggest part of my tax bill.

    It seems we understand having to pay communally for some aspects (services) of our society, but not others.

  7. The idea behind a HSA/catastrophic coverage plan is to change the game. The size of the deductible would be very high, $1k is far too low, $5k would be about right, maybe $10K for people who are better at saving. If you are putting the money you are spending on insurance into savings instead, you will add up to that fast. Right now, HSA's are limited so that you can't accumulate over the years; fix that, and people can start saving when they are young and barely need coverage, and they will have a surplus as they get older and need it.

    And lets face it, $5K in the hole ain't exactly bankruptcy material. Hell, it ain't even a decent used car. And with a deductible that high, you can get serious coverage pretty cheap.

  8. I'm glad that $5k out of pocket is no problem for you, but it is for many people, in fact just the people who need and cannot now afford health care. And yes, for many people $5k out of pocket means bankruptcy. You obviously would have no problem coming up with that kind of cash, but don't you even consider when you think about these problems that a lot of people do not have that kind of extra money sitting around?

  9. Time - You are considering the $5K as out of pocket. When you do this, you are ignoring the HSA. The basic concept behind this system is that you use the HSA to pay for pretty much everything. The insurance plan is for flat-out catastrophes only.

  10. A thought - we are arguing here like ships passing in the night.

    It seems to me we have 4 primary issues to be addressed here, yes?

    1 - How to control costs.
    2 - How to insure everyone can get care.
    3 - How to keep control of our own lives.
    4 - How to maintain high quality of care.

    Am I missing anything here? (I realize it's not a detailed list, but hey, it's a comment thread, not a budget building retreat.)

  11. A lot has been covered here, and I'm a bit short on time this morning so I can't get into my thoughts right now. I do want to say, Welcome Time! I’m glad to have you here.

    I’d like to add quickly that I'm in total agreement with Octo that doctors should make the final decision in a patient's treatment. I've always had a problem with an insurance company approving or denying a procedure. The doctor treating the patient knows best what his patient needs better than any insurance rep with a computer screen. Are we all in agreement with this assessment?

  12. Thank you Pamela,
    Yes, that was one of my points also.

  13. You make some very good points Pamela, thanks you for your insight

  14. OK, so we all agree that the doctor, or more precisely the doctor and the patient, should decide on what care is provided.

    How do we make that happen?

  15. With a national health insurance program we all pay into OMR. Take the bureaucrats and profit mongers out of the equation. The first priority should be life and health. Not delaying and denying in hopes the insuered will die before having to pay a claim.

  16. You truly believe that we will have less bureactrats with a national health plan?

    It seems to me that although it is easy to knock the administrative costs of a health care plan, many (most?) of the functions that they do will turn out to be necessary.

  17. Having worked in the health care field for years in a variety of settings, I long ago came to the conclusion that allowing health care as a for profit industry is NOT in the best interests of the people.
    Having a single national system may not be a perfect answer, but it is better than the fractured mess we have now.
    There are people in this country dying from cancer because they don't have the insurance to cover treatment and can't afford the exorberent price. That should never happen.

  18. A bureaucrat who's priority is health and not profit I can live with OMR.

  19. My experience is that a bureacracy's priority is bureacracy. Period.

  20. I think taking the bureacracy out of the system would help emmensly. That's where a lot of the expense is currently. But how could that be implemented?

  21. It takes bureaucrats to run bureacracy. It takes politicians to run government. That's the way it is. Why anyone thinks they're better off in an HMO and limited to only the services it allows is beyond me.

  22. A consideration : Most of the processes done by the bureacrats in health care will still be needed. Claims processing, accounting, deciding what is and is not covered (face lifts, anyone?).
    If we shut down the insurance companies at the same time as we create a need for people with the exact same experience in givernment, who is going to get those jobs?
    That's right. The exact same people. And it will take them about, oh, five minutes to tell their boss they need all of the same people they had before, because 'that's what it takes'.

  23. I should’ve been more clear. I meant government bureaucracy. I realize we need organization and rules, etc., however, I believe the government has played a large part in making health insurance expensive with all the regulations. Again, many of the regulations are there to help, but some are extreme and have doubled the costs. And I thought we decided that Doctors were going to have the last say in a patient’s care, not someone in accounting. As far as a face lift? Elective cosmetic surgery would be great, but I think we can all concur THAT isn’t “health care.” Maybe another good topic. What should be covered or deemed as “Health Care?”

  24. So your argument against single payer national health care is that you don't want the government to run it. You're afraid a greaseball or incompetent will get a job, correct? It's sad but greaseballs and incompetents are everywhere. Private sector and public. Don't let fear of them getting us keep us from making health care affordable and available to all OMR.

  25. My point is that the primary problem with the current system is cost. And I fail to see how a single payer system will address this.

  26. Maybe it could be run like other working government institutions. For example: We all pay taxes for roads and bridges, even those that choose not to drive on them.

    To drive legally, we must pay registration costs at the DMV, buy tags, etc...

    We all pay for public school. But not everyone has kids in the system. Even those with their own, private, "better" schools pay for Public Schools.

    Those with kids in the system get a free education, but still have to pay for their own pencils and paper and supplies and backpacks and clothes to wear there etc.

    Maybe we could look to those and use those methods somehow?

  27. Yes OMR. The problem is cost. People can't afford the cost of health insurance or doctor visits on their own. Business is fast becoming unable to absorb the cost of employee health insurance and still be competetive with companies that don't offer health benefits.

    Now is the time for a single payer system. There will still be plenty of business for health insurance companies like AFLAC. Our Country needs this.

  28. Perhaps if you backed the right party you wouldn't feel so frustrated.

  29. The problem is in health care costs. They are much too high. There is no limit to how much money any health care related industry can charge, therefore they charge what the market will bear, and with the amount of money insurance companies earn, the market bears way too much. It is a vicious cycle. Health care related industries charge exorbitant costs, and the insurance providers meet the costs. Then, the health care related industries see that they are easily being paid, so they raise their prices further. And health insurance providers raise their prices for their services accordingly. And on, and on, and on.

    If the health care related industries would self-regulate themselves to a fixed profit margin, prices for health care would be reduced and more people who couldn't previously afford health care could pay their own costs.

    I think the key is in self regulation. Expecting any entity not related to health care is folly. We need to leave the regulation to those who know the health care industry best. The health care related industries themselves.

  30. competition may be the only way to solve a burgeoning health care system.... and like you pammy i myself too have tired of the debating style. it would be nice if more civil attitudes prevailed!

  31. For a candidate that claimed he was a Uniter, Obama has done a great job of polarizing the entire country in only about 90 days. One can only think of how the county is going to be in 4 years form now.

  32. Pat, I’ve been preaching competition for awhile now. I believe if there was less red tape and more companies competing for business prices would go down. In Western Pa, where I live, UPMC has dominance over our heath care plans AND our hospitals, which gives them carte blanche on what’s covered and prices.

  33. Competition and free trade does not exist in most medical fields, especially prescription drugs.

    This leads to an unnatural rise in costs. That is why it is so much more expensive in the USA than other countries.

    Price controls (an ugly thought to Americans) might be the only way to control costs in an atmosphere of price gouging and excessive profits by these pharmacy and medical companies.

    It's another reason why we (Americans) pay more for medical care, yet receive less services and are way down the list of countries judging how healthy we are as a people.

    Personal habits as a judge of how treatment or costs are determined, is a mine field. Scientists told us just last week that eating meat is a 20% higher risk of developing colon cancer. Then there was the story of how being vegetarian is unhealthy for young people. Smoking causes cancer, but then so do the chemicals in our food. And on, and on, and on.

    With all the complicated issues in medical care, the fact that our medical business does not operate as a usual supply and demand system, the fact that Americans could not cover their medical needs through a savings plan program, the pre existing conditions exemptions, the outright refusal of care based on cost, I'm leaning towards the single payer plan.

  34. Time: I agree about prescription drugs. The cost to produce a pill is astronomical. It takes years just to get the drug on the market, then the company gets to recoup its costs via a patent for about 10-15 years. It's not just price controls we need to think about, we also need to stop frivolous law suits. As far as being told what's good for us and what isn't...well that's like a see-saw. One day coffee is good the next it isn't. One day meat is bad the next it's not if it's X. It depends on what scientist you're speaking to. It seems we need to pick our poison and cross our fingers these days. A health savings plan will work for some, but not for others. Pre-existing condition exemptions will work for some, but not for others. Sounds like we need more of an a la carte health care system. One size doesn't fit all. And through all of this no one has addressed the illegal alien problem. Regardless of what type of system we have or get, how do we take care of the illegals? They are an ever increasing burden.

  35. Pam - I am uncertain that illegals can really be along term problem. I am generally of the opinion that anyone who comes to this country to work can only improve the economy (in a long term sense, at least).

  36. Pam: Actually, illegals aren't the burden the right paints them. While a burden individually on hospitals, as a whole they wouldn't be if we were on a tax based system. Most illegals do pay taxes straight out of their paychecks. I believe the number is around 75% of illegals are paying taxes, but because of their illegal status aren't filing tax returns and so they don't get anything back.

  37. I don't care what the moderates say. I blame Obama. For everything.

  38. I blame people that cast blame. It's all your fault Mark. Shame on you.

  39. I blame Obama as well. Sue me!

  40. Wow this got WAY off track. Mark you went from giving a good point on health care to blaming Obama, what's up? And NY Guy...you just went straight to blaming Obama. Any suggestions on health care that you'd like to share?

  41. We need to put more effort into preventative care. Especially in our poorer communities. Native American, black, Latino, Asian. Someday we will encounter the "Typhoid Mary" of the 21st century, and wonder how it got so out of hand. Having everyone covered by health insurance will not only save us money, it might save us from a medical national emergency.

  42. Hi PDH,

    Republican - Democrat / conservative - liberal can't come to terms because there's no common ground. Really, how can one reconcile a belief in fact with one based on relativism? It's rule of law verses rule of the mob, and the two don't mix well. The obvious result is that there will soon be another shooting war, like the Civil War, to determine the future of the country, which can clearly be seen in the opposition of liberals to our Second Amendment rights.

    the Grit

  43. One problem with bipartisanship... when things "get done" in Washington, the politicians usually doing us in. Frankly, I'd like to see the Federal government accomplish LESS.


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