universal health care coverage -- what should our goal be?

[stranger81]

I've always believed in the necessity of universal health care coverage, to make sure that the tens of millions of Americans without health insurance are covered. It has always seemed to me to be a clear and manifest injustice that health care in this country is a privilege, not a right.

I've been thrilled to hear so many Democratic candidates focusing on universal health care, but was dismayed to read this in today's New York Times:

"Senator Hillary Rodham Clinton of New York and John Edwards, the former North Carolina senator, support a mandate. . . . 'The sad reality is that the uninsured don't just struggle with costs themselves, they impose costs on the rest of us,' Mrs. Clinton said in September. 'It's a hidden tax: the high cost of emergency room visits that could have been prevented by a much less expensive doctor's appointment, the cost of unpaid medical bills that lead insurance companies to raise rates on the rest of us.' Mr. Edwards echoed those remarks a week later. 'The reason the mandate is necessary is because you cannot have universal health care without it,' he said. 'Does not exist, and anyone who pretends it is, is not being straight.' Senator Barack Obama of Illinois sees it a different way. He argues there is danger in mandating coverage before it is clear it can be affordable for those at the margins. . . . 'I don't think that the problem with the American people is that they are not being forced to get health care,' Mr. Obama said. 'The problem is they can't afford it.'"

So what do you think? Do you think, like Clinton & Edwards, that the problem of uninsured Americans is pressing because it affects people who are insured by driving up costs? Or like Obama, do you believe the problem of the uninsured should be addressed because it affects people who can't afford insurance? Should our focus be on improving the lot of those who already have, or on improving the circumstances of those who have so little?

[LWolf]

1. HR 676

Our goal should not be for universal insurance, but universal care. Provided by a not-for-profit system.

[bluerum]

3. Do you really want all those health care administrators and insurance

peddlers to be out looking for real work? Can they be trusted to transition into working for non-profits?

How do we pay for medical staff and facilities? We may have to cut the war short by a week or so.

[rodeodance]

6. 'Creative' minds should be able to cobble together the best of 'european' stytle health care and

the US style. If they are WILLING!

[LWolf]

12. A conversion period is built into the bill.

A 15 year conversion period, with the added stipulation that displaced workers will be the first hired and retrained under the act.

It's paid for by maintaining current federal and state funding for existing health care programs, an employer payroll tax of 4.75, an employee payroll tax of 4.75; establishing a 5% health tax on the top 5% of income earners; 10% tax on top 1% of wage earners, 1/3rd of 1% stock transaction tax, closing corporate tax loop-holes; and repealing the Bush tax cut for the highest income earners.

[bluerum]

26. Wow. Thanks for digging that up. It sounds equitable and if those sources

of funding will be sufficient then I consider it a master stroke of management.

It would be fabulous if we could actually do away with the bloated health insurance structures that exist today. A large part of the industry is engaged in finding ways to deny paying benefits and making good on claims. Premiums rise yearly.

How refreshing it would be to have a health care industry whose job is making sure people who need health care get effective health care.

One weeks worth of the money that we are pouring into a pointless war that seems to have no end in sight could jump start the program and get it off to a healthy start.

[LWolf]

27. Agreed.

That's why I support HR 676, and one of the excellent reasons I support DK.

[stranger81]

4. I totally agree.

It was just so disillusioning to realize that some of our candidates are concerned about lack of health insurance coverage not because it means 40 million Americans have no access to regular health care, but because they don't want to pay an extra dime themselves if it can be avoided.

[Fridays Child]

2. The solution is H.R. 676 and the only candidate supporting it is Kucinich.

http://www.house.gov/conyers/news_hr676.htm

[NorthCarolina]

16. I Agree

HR 676 is the only real plan that actually benefits the people, and it is also the only plan that can correctly be referred to as a plan for "Universal Health Care". The others are merely "Universal Mandate for Health Insurance" where the "Health Care" aspect will still be at the discretion of the For-Profit Health Insurer's who will still be making the calls on what's covered and what's not.

Give me your best guess, will the primary interest of the insurer's be YOUR health or their bottom line?

Kucinich 08...Right Then...Right Now...Right For America :patriot:

[magellan]

5. The "hidden tax" is imposed by insurance companies

Anyone who isn't for removing insurance providers from the equation completely is only putting a band-aid on the problem. The focus should be on improving the lot for ALL.

[stranger81]

19. it seems like such a RW meme to blame the "hidden tax" on

the uninsured person rather than the insurance companies who choose to impose it. I can't understand why Edwards, particularly, would frame the issue this way. I'm voting for Kucinich anyway, but I really expected more from Edwards.

[panader0]

7. Legalize grass, tax it, and pay for the whole thing

[Warpy]

8. It's both, some people who can afford it are denied coverage

and some people who are low risk enough to be eligible for coverage have simply been priced out.

As long as the profit motive drives health care, this will be the case. Even mandating coverage with sliding scale schemes will not address the fact that insurance companies are in it to make money and they will delay or deny care in order to do it.

It depends on what the focus is, to give people the illusion of coverage or to provide all people in this country with health care when they need it. Only a single payer plan that takes the profit out of providing coverage can possibly achieve the second objective.

Alas, it's one lesson Hillary Clinton especially has failed to learn Her plan will protect the insurance companies at the expense of the American people.

[pinto]

9. Medicare for all.

And, politically, it ought to be *sold* that way. Most people understand the value of Medicare. That approach would soften the inevitable fear mongering about 'socialized medicine' usually trotted out to slam universal coverage.

[Liberty Belle]

18. Medicare has many gaps. For instance,

If you go into a nursing home, there is ZERO coverage from MediCare after the first 100 days, no matter what. It can be terminated even earlier if you don't have physical therapy or need other skilled nursing care (such as an IV or wound care). My Dad has Alzheimer's, which is considered "maintenance care"; there is NO long term coverage for this under MediCare!

I would balk at "Medicare for all" as it provides no dignity or assurance of quality care for the growing senior citizen population in the u.S.

Any universal healthcare plan MUST include long-term care for our elderly, particularly those with Alzheimer's. Even if you have other insurance, many of the better facilities won't take it, and many also refuse to take Alzheimer's patients. This is wrong.

[pinto]

23. Good points.

Those gaps ought to be closed, especially long term care.

And overall, reimbursement rates need to be updated - they are woefully out of date.

Yet, I still favor Medicare for all as the format. I've not found any lack of dignity or any less assurance of quality care in my experience.

[glowing]

10. For now no... in long term yes.. Affordable care and annual check ups

and going to the dr. before the problem would help.. Would also help if McDonald's was more expensive than making a salad from the grocery store. The idea is if you take care of yourself and check in with a Dr... long term you will be healthier before diabetes, heart disease, or whatever sets in... Then again, unless the food and habits of Americans don't change, then you can forget about saving money long term.

A grocery store should be mostly fruits and veggies with some meat, grains, and perhaps a tiny aisle of sweets. As of now, the stuff in the middle aisles is junk. America's work week needs to be reduced and adequate to meet financial needs. Real public transportation needs to be implemented, and walking needs to increase, in general.. Box stores spralled between suburban meccas is not beneficial to the American Ass.

Its not just the Dr.s that mean healthcare. Its excercise, peace of mind, and time to relax. We are rushed and don't take the time to enjoy food, excercise, family and friends, or our children.

[Turbineguy]

11. Health should be a social good

and in a perfect world it would be. Our current system is based on profit and is inefficient as well. Economically it has become a large part of the economy. Making it into a perfect system will throw millions out of work and create chaos. It has to be changed, but slowly enough to absorb the change.

So the first step would be to look at the most overburdened part and improve that. It might be the Emergency Room situation created by lack of primary care and go from there.

[Fovea]

13. The uninsured don't impose a cost on the insurance companies

the insurance companies shift the costs to the uninsured.

I think like Kucinich, that single payer universal health care is an inalienable right, requisite to life and the pursuit of happiness.

[flashl]

14. Change the U.S. system from pay for service to preventative health care. n/t

[Rex]

15. Easy - every man, woman and child gets treatment for illnesses and

accidents. No fee or charge, the government takes care of the bill. We pay for it as taxpayers so really we ALL take care of each other, like Adam Smith meant for us to do. We take care of the needs of others out of our own self interest in basic human needs/survival.

[ljm2002]

17. Universal, single-payer, not-for-profit health care for all...

...that is what our goal should be.

Only Dennis Kucinich is proposing this, and that is one of the many reasons he is my preferred candidate.

[K Gardner]

20. No "MANDATED" insurance

This solves nothing, only creates more problems. The ones proposing it are straddling a fence because they're too chicken to take on the insurance/pharm giants who control everything. As a nurse, it makes me sick. I keep hearing, "they're easing us into it"... well, that remains to be seen. I dunno.

HR 676 - true universal single-payer - is the only way and it WILL eventually come to pass. Just how many years and how many arguments have to pass before we get there, with the rest of the civilized world, god only knows.

http://www.guaranteedhealthcare.org

[stranger81]

21. the mandated insurance concept gives me the creeps. . . .

how do they plan to enforce it? Bringing back debtors prisons?

People without health insurance need coverage, not criminalization.

[K Gardner]

24. Exactly.. it's just a creepy concept..

I imagine Insurance Police, who are sent to have a chat with you when you decide it's more important to feed your kids than buy a "policy" you can scarcely afford. Then the Wage Garnishment Police, who take what they need so you'll be part of some plan, whether you like the plan or not. Then the "affordable deductibles and co-pays".. who gets to be the Decider on that one, telling you what you can afford? And, in the middle of it all, we still have the INSURANCE COMPANIES. And what about the 2 million people who earn their living by finding ways to deny coverage to the "insured"? Do they go away, or just assume another role?

Now, I know I'm probably overexaggerating and being way toooo paranoid, and also refusing to educate myself on the wonders of MANDATED REQUIRED ENFORCED INSURANCE, but that's because Universal Single Payer is just too simple and too civilized to be messed with :-)

[aquart]

22. Afford insurance? Obama hasn't seen Sicko, then?

Because he would learn that even having the best insurance won't get your claim honored if you get sick.

Profit and the middlemen have to be removed from our medical care system.

[postulater]

25. Whatever plan pays must include the true costs of all medical

failures and iatrogenic deaths.

For instance:

Insurance pays for back surgery. Most is somewhat successful at least for the short run.

But there are people for whom the surgery fails. And, yes, the insurance will pay for whatever further surgeries are done (I talked to a nurse on a surgical ward who said she took care of a woman after 23 back surgeries). But these people many times become disabled, like the housekeeper who lost her business when she couldn't work after the fusion led to a 5th lumbar fracture.

Who do you think pays for the disability? Not the hospital, they just provided the room. Not the surgeon, it wasn't malpractice, he went by the book, she was just an anomaly. The government does, if anyone.

If the insurance company is going to hold the purse strings, dictating what is appropriate care and if they authorize the surgery they should be responsible for any effects related to it, including the disability.

Only when they become responsible for the bad outcomes and the disability related to them will think twice about what procedures they authorize in the first place.

Lots of deaths can be avoided by insurance companies investing in preventive care and conservative care that "above all does no harm."