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Barb is also right that we need a public option. If we didn't have such an option here in New Mexico, the New Mexico Medical Insurance Pool, I wouldn't be able to get insurance. If that disappears, I'm sunk.
I've got a genetic predisposition for cardiac problems. My mother's father and my father both died of cardiac problems. While I do what I can in terms of diet and drugs, there's not much I can do to change my elevated risk. That elevated risk means that insurance companies don't want me. It also means that blaming my elevated risk on my lifestyle choices is simply insulting. I didn't choose my grandparents.
Suggestions that health care providers shouldn't be responsible when they screw up and have accidents that cause damage don't make any sense. When a surgeon screws up and maims someone the victim should be compensated, just as if I were to screw up while driving and have an accident I'd be responsible for the damages. While eliminating automobile liability would reduce the cost of driving, just as eliminating medical liability would reduce the cost of health care, it would lead to more damage and less justice.
I have just a couple of things to add to the discussion.
First of all, the idea that excessive litigiousness is responsible for high health care costs is a myth (http://www.factcheck.org/president_uses_dubious...). And frankly, it distresses me to hear from a doctor who seems to care more about her pocketbook than her patients. Americans need and deserve protection from incompetency, and serious consequences, thanks to its own regulation, await any member of the legal profession who wastes the court's time--and therefore taxpayer dollars--with frivolous claims.
Additionally, contrary to the claim that fear of lawsuits among physicians leads to excessive procedures and testing, I submit that limitations on expensive procedures and doctors' time by the corporations that currently "run" our healthcare system are a genuine detriment. A member of my family repeatedly sought help for a severe headache, and was treated with painkillers rather than sent for an MRI. He died, leaving two children, of the aneurysm the doctor's failed to detect--or even check for--in time.
We can and must do better in this country. I challenge those who object to a singe-payer system or even a public option to do the non-partisan research it will take to understand that it's worked in other industrialized nations to protect citizens, businesses, and governments. Surely, America can do the work it will take to catch up with the rest of the free world. Current healthcare costs are staggering, and economists (not talk show hosts or other partisan "commentators") have shown that significant reform reflecting that already made in other nations will greatly benefit our economy.
What's not to love, I ask you?
http://www.boston.com/bostonglobe/ideas/article...
Both systems sound pretty good to me.
For an explanation of even more alternate health care systems (Britain, Japan, Germany, Taiwan) see PBS's Frontline "Sick around the World" which discusses the pros and cons of each system. And the cons seem a lot less onerous than the ones we deal with here in the USA!
http://www.pbs.org/wgbh/pages/frontline/sickaro...
Yes, you occasionally hear of people who come to the US for treatment, but these are anecdotes, not significant statistics.. People in these countries have longer life spans, lower infant mortality, lower rates of obesity and disease, and spend a lot less than we do. None of these systems are perfect, but we can't stymie change for the better looking for (unobtainable) perfection.
Kelly
Unfortunately (in my view) there is not one bill in Congress that proposes adoption of a single payer system, so I don't know why Guessing is criticizing that plan.
What's wrong with offering people a choice -- with built in protections so that the entities that provide coverage are held to certain standards? An entirely deregulated system like Gessing proposes would only serve to confuse people and open the door to opportunities for fraud and abuse. How many real human beings can devote enough time to compare costs and quality on their own? Certainly no-one I know.
As for what a government option in the choice array can do better, it can significantly reduce administrative costs from the mid- to high teens to around 3-5% of spending. It wouldn't have to waste money on advertising, marketing, high-salaried CEOs or profits for shareholders. It could negotiate prices by virtue of its large, nationwide pool. And it could generate data that can be used for "best practice" analysis.
The first responsibility of for-profit entities is to maxmize profit. The first responsibility of a public care option would be to provide quality care to large numbers of people for the best price. We can't let something as important as health care be at the mercy of the same sort of deregulated profit seekers that produced our current financial and banking crises.
There is a place in the system for private insurers, but they must be kept in check by competition from a public option.
You could say the same thing about health care provided by private sector, education provided by private schools, the rising cost (until recently) of private homes etc. There is such a thing as inflation, although health care costs generated by private insurers go way beyond that. The point is that the costs of the Medicare program lag behind the skyrocketing costs of private insurers that provide care. Why? One big reason is that Medicare has dramatically lower administrative costs.
Dr. Perrigo's thoughts on getting the layers of "administrators" out of the way make a lot of sense.
That is the problem in my view. All of the presenters here go on in depth. Basically people want health care, pretty simple. It can be done. The insurance companies dont have to fold up...they will stay in business...everyone who wants to stay with the private insurance run healthcare can. Those who want to go into the government run healthcare can. Your choice, free market.
What I see is smoke screens, complaining, manipulating truths, excuses of why not? Let the people die I guess....or get in shape as the Dr says.
This is about human lives and suffering. It is not about money. Healthcare for profit should be banned. It is life and death. My hope is that some of our Drs. took their hippocratic oath seriously...to help people, to help people with their ailments. To use their art of healing and knowing to help sick people.
And dont get me started on the number of pill commercials on TV. How can that be right. Take this pill but you can not get to a doctor?
When I had a few actinic kerotoses frozen with a spray can, each squirt added $45 to the bill! An overnight hospital stay for a check-up cost well over $1,200. A family member is being charged $30,000 a month for an immune-boosting drug. My son's employer doesn't offer insurance and he can't afford to buy it.
With universal coverage--single-payer--all Americans would have peace of mind should they lose their jobs or run over insurance coverage limits. They wouldn't have to fear going bankkrupt or losing their homes.
People in most Eiropean countries live more stress free lives. No wonder they outlive us!
Besides a public option, we also need to regulate the industry so they can't turn prexisting condtions away or charge more. The industry should also not be able to throw people who are sick off their insurance..
At the rate congress is moving and backing away, we may need to go back to the issue of health care is a right and we may need a constitutional amendment.
Nancy Lee, Las Cruces NM
My daughter, Samantha, is 35 years old. She has developed melanoma. She pays for her own insurance with Kaiser in Denver, Colorado. After the cancer was discovered, Kaiser RAISER HER INSURANCE PREMIUM over 70%. There were several very expensive tests that she had to have that were not covered. She had to work to pay for the insurance, therefore, she had to undergo chemo therapy and work at the same time, which was extremely difficult. She needed a new car because hers was just about gone, but could not afford to purchase one because of the high insurance payments and the chemo therapy. Side effects from medications, etc. have exacerbated her situation. I seriously hope, Mr. President, that you read this letter and can help. I do not mean to whine, but it makes me sad. I cannot financially help her. I am 71 and have my own health problems.
John, Las Cruces NM
My health insurance premiums increased 39% in one year.
Christopher, Weed NM
I vote in NM by absentee ballot from my current residence in Japan. They have a good health care system here. My wife (Japanese) had excellent prenatal care and is receiving continuing support for our child's health from our local government. It's all covered. My child will have to choose her citizenship when she turns 20. I hope that by that time I will be able to openly and honestly recommend she choose to remain an American citizen, However, if choosing my home country means paying high taxes for military adventures and corporate welfare, without even receiving support for her basic health? As it stands now, Japan is a better deal! I hope Japan changes its law so my daughter could have dual citizenship, but if that doesn't happen, I hope things in the US really turn around. 18 years from now if she is forced to choose, I hope I can not only proudly but also practically recommend she choose American citizenship.
I also recommend a read of Paul Krugman's 2005 article, "Toyota, Moving Northward." http://www.nytimes.com/2005/07/25/opinion/25kru...
We are losing our competiveness in the global free market because of our expensive and poor quality health care.
On a final point, healthcare professionals do take their oath extremely seriously and that oath is their first and foremost reason for being a healthcare provider. That a physician’s commitment to that oath is questioned simply because she is addressing the financial side of her business is not fair and takes this debate in the wrong direction. I hope further posts will not question the personal integrity of the commentators and will address the issues.
Not true. There are no limits on automobile lawsuits, either. One of my nightmares is that I'll negligently run a school bus off the road, crippling a dozen kids. That'd certainly exceed the half million dollar liability policy I have, and I expect I'd lose most everything I have.
"The malpractice insurance company and the physician then spend untold dollars and hours fighting frivolous lawsuits"
That's largely false, also. This margin isn't big enough to contain the evidence, but the studies show that most people who are damaged by medical negligence don't sue, and most who are damaged and who do sue don't recover much. In any case, there are simpler and better remedies for frivolous suits: in most cases sanctions work, or we can go with the sort of system NM has where claims must go through an independent review before they can go to court.
"healthcare professionals do take their oath extremely seriously"
Some do, some don't. Go read the article by Atul Gawande in a recent issue of The New Yorker. He makes the point that some (many?) doctors are motivated to increase their income (a very capitalist, American notion) and thus will tend to increase both the amount of treatment and the expensiveness of the treatments they administer - thus making themselves rich.
An article in the New York Times yesterday about prostate cancer treatment suggested the same thing: given our crazy incentive system, it's better for health care providers to build the multimillion dollar facilities to provide the $100,000 treatment rather than providing the $2,000 treatment. This is true despite the fact that there's no evidence that the more epensive treatment produces better outcomes. Because there's money to be made in the more expensive treatments, there's nobody doing good careful controlled studies to discover which treatment offers better outcomes.
This thread is now closed.
I have a very dear friend who has been under a doctor's care for the last four years. At the same time, there is a co-pay for both medical and the several prescriptions she needs. Recently, she discovered that she would get better if she could separate from her husband. Unfortunately, her job does not provide health insurance coverage. The COBRA policy she might self-purchase is much too expensive, and it only is available for several months. So, she gets sicker and sicker....
Considering that I am a mother of six children who were born in the 70's and 80's while I was insured by my then-employer, and also considering that the total out-of-pocket cost for each child's birth was the combined total of a $5 co-pay for each doctor visit plus the $25 co-pay when we arrived at the hospital to deliver, it might seem that I would never consider anything but the traditional employer provided or shared cost health insurance plan. After all, because of insurance the total out-of-pocket personal medical expense for the birth of each of my children was less than $100.
However, since the birth of my children under those rather unbelievable circumstances, insurance premiums have quadrupled and as a result employers no longer cover 100% of those insurance premiums. In addition, insurance providers have placed expanded restrictions on who/where/what/when and why they will cover. Also, a more restrictive physician-to-physician "in plan" referral system has been implemented creating a critical and often negative time factor when patients need treatment that requires a specialist, and physician and hospital rates have skyrocketed.
Soon to be 55 and having experienced positive results at both ends of the health care spectrum, with and without using insurance, the health care issues we are facing with regard to insurance availability, coverage and cost have caught my attention. I don't know the answers, I am not a policy analyst, but I do believe that our great nation has no excuse for underinsuring our population and overcharging those who are insured. The free market economy, if allowed to function naturally, will take care of the issue equitably and in a cost-effective, market-driven, supply and demand manner.
After all, I am a real example of someone with a lifetime of health insurance that chose to forego the red tape, the delayed appointments, the preferred provider regulations, the limited coverage for a $600/mo premium and do the research to find a reputable and responsive doctor outside of the insurance industry's web of caregivers. I paid cash and was charged fairly and received attentive and considerate professional care.
One additional comment concerning malpractice litigation: yes, I feel that patients must have the right to "gain legal redress when doctors perform shoddy or even dangerous procedures" as Paul Gessing mentioned but I also believe the resulting litigation and compensatory fines should be capped as Dr. Perrigo noted.
Do I want to give up my insurance? No. I am 55 and health issues could arise that would be far beyond my budget, but for the occasional but real medical needs that I may have, I will go back to my cash-and-carry doc without a second thought.
I am unique, but in that uniqueness I am just like every other American. None of us fit the "one size fits all" models being considered.