So what is your plan to provide Universal Health Coverage?

[7 of 11]

What sort of plan would you like to see implemented in the USA for UHC?

We are the only developed Nation without medical coverage for it's own people. The only one that is willing spend hundreds of billions to go to war for other people yet let our own die of preventable diseases. To say this must stop is a complete understatement.

I don't want to hear about Obama's or Clinton's or Edwards' plan, or argue about the lack of plan from that gathering of ass clowns on the GOP side. I want to here what YOUR plans and ideas are.

* Where would we get the money to fund the plan?

* Would it be absolutely free for all?

* How do we handle those that are already covered under great plans by their employers (maybe because it's a union shop) and refuse to give up their benefits?....

Just give me a rough outline of what the plan should look like.

[gateley]

1. Canada's.

I don't know the specifics, but our Canadian friends who post here paint a mighty nice picture.

From what I've learned from them, I'd be THRILLED if we had the same plan.

[NanceGreggs]

10. As an American living in Canada ...

... I think the system here is great (and I should now, having had to take advantage of its many benefits last year over an extended period of time).

And just to dispel some popular myths ...

I can see ANY doctor I choose to.

If my regular doctor can't fit me in on short notice, I can go to one of MANY walk-in clinics and be seen by a physician within an hour or two.

The government does NOT run the healthcare system - the government's ONLY role is to pay the bills.

There is no such thing as being "declined" care on any basis.

Doctors here do NOT live in a van down by the river - they do quite well financially, and their accounts receivable are guaranteed by the government; therefore, they do not have to "write off" debts incurred by people who cannot afford to pay, or whose bills are declined by their insurance company after treatment has already been given.

NO doctor has to 'request' authorization from ANYONE before proceeding with any treatment he/she deems necessary. The government is billed AFTER treatment, not before.

Without insurance companies as the middle-man, healthcare costs are kept low because there is no 'profit motive' involved.

The misinformation I see on RW websites about how the Canadian system works never ceases to astound me.

[gateley]

12. Spruce up your guest bedroom, Nance, I may be standing on your front porch soon,

suitcase in hand. :hi:

So glad it's working well for you and all the fine people in Canada! :thumbsup:

[NanceGreggs]

17. Hey, the porch light is on ...

... and the coffee is always brewin' in the pot.

It literally breaks my heart to read the things I do about people back home being screwed by insurance companies. When my son moved back to the States - a perfectly healthy 24-year-old - and told me what his health coverage premiums were, I was floored!

My own little "medical misadventure" last spring (a traumatic allergic reaction to antibiotics, which I had taken in the past without a problem) would have literally bankrupted JeffR and I, were it not for our universal healthcare coverage.

I had four month's worth of doctors appointments, ER visits, specialists, tests, and home nursing care - and never paid a cent for any of it.

[gateley]

18. And even with the premiums your son is paying, if he were to have the same

type of reaction, he wouldn't receive the same level of care AND, regardless of the care he received, would not be able to say he didn't pay a cent for it.

That must have been scary! Happy to hear you're back to normal. (Nance Greggs definition of normal). :7

[NanceGreggs]

19. Thanks, it was pretty scary ...

... potentially fatal, but I came through it just fine in the end.

But here's the thing: I had taken antibiotics many times in my life. But being healthy and having no need for them, I hadn't taken any in over twenty years. Which is why I didn't know I had developed an allergy to them.

Imagine my "insurance company" getting that news. I would immediately have been turned down for coverage on the basis of a "pre-existing condition", i.e. an allergy which developed later in life.

The only way, of course, I could have known that I had developed this allergy would have been to be tested, every few months or so, by an allergist - which, of course, I wouldn't have done, because I had no reason to believe I had suddenly become allergic to certain drugs.

Now, what insurance company would have paid for those seemingly "unnecessary tests" over a twenty-year period?

That is just one example of the Catch-22 situations that insurance companies put people in every day.

[DadOf2LittleAngels]

29. Sorry

"If my regular doctor can't fit me in on short notice, I can go to one of MANY walk-in clinics and be seen by a physician within an hour or two."

But were you to need an MRI that would be a different story http://www.cbc.ca/canada/newfoundland-labrador/story/2005/01/13/nf-mri-wait-20050112.html 2.5 years for a post cancerous kid to get a checkup via MRI. In the us (with insurance) you can have one in weeks if not days.

"The government does NOT run the healthcare system - the government's ONLY role is to pay the bills."

Thats like saying Insurance companies dont run the health care system they just pay the bills, its a load of crap and the reason Any Canadian with means crosses the border for treatment. Were it up to the Canadian health care system my grandfather would have died within a few weeks of a cancer diagnosis not two and a half years...

"There is no such thing as being "declined" care on any basis."

My grandfather was declined Chemo or Radiation basically told they would cut out an organ and hope for the best. Though when the cancer finally got the best of him two years later they were nice enough to re-open the hospice offer they extended when he was first diagnosed.

"NO doctor has to 'request' authorization from ANYONE before proceeding with any treatment he/she deems necessary."


---

But rather than bicker with you I would forward the MA model for health care. If you can afford it buy it, if you are an employer give it and if you dont we will tax the hell out of you to fund a program so *everyone* can have insurance.

[NanceGreggs]

30. You obviously don't know what you're talking about ...

I have lived in Canada for thirty-four years, so I know whereof I speak. In all of those years, I have never heard of anyone being denied care on any basis.

The government pays the bills - there is no interaction between any government bureaucracy and any physician or hospital; therefore, NO authorization of any care at any point is sought. In fact, the government doesn't even GET the bills until the end of a quarter, so the treatment has already been given by the time they even know about it.

Saying that the Canadian government runs healthcare like a US insurance company is just plain bullshit. Insurance companies have to authorize many treatments before a doctor is "allowed" to proceed - and of course there is their profit margin to consider. The Canadian government does NOT make a profit on their system, nor do they "tax the hell" out us in order to fund it.

Canadians "of means" do not cross the border for their health care. In 34 years, the only people I know who have ever gone to the States for treatment is those who go for cosmetic surgery (which is not covered by our system - except in rare instances, such as severe burns, etc.) So a lot of women go to the States (or elsewhere out of the country) to make a vacation of their recovery time in warmer climes.

Of course, I've only lived with this system for 34 years - so I suppose that you, who don't live here, would know more about it than I would.

Apparently you've been listening to right-wing bullshit about how the Canadian system works. And it's just that kind of mis-information that keeps too many Americans from fighting for universal healthcare - because they swallow that utter crap.

[DadOf2LittleAngels]

33. Right CBC is lying we should just take youre personal experience

"In all of those years, I have never heard of anyone being denied care on any basis..."

Great Ive never known anyone with Breast Cancer I guess it dont exist either..

"In fact, the government doesn't even GET the bills until the end of a quarter, so the treatment has already been given by the time they even know about it."

Ummm spunky... Chemo takes longer than 3 months to administer....

"Saying that the Canadian government runs healthcare like a US insurance company is just plain bullshit."

Its truth the govt sets rates and thus affects the effectiveness of programs. Why does a 10yo cancer survivor have to wait 2 years in Canada for an MRI?

"Canadians "of means" do not cross the border for their health care."

Horse crap! I used to live in Buffalo NY and you would be amazed how many passed up Canada to go to Roswell for treatment (that included my Grandfather). Your MP's also cross the border for treatment

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20070914/belinda_Stronach_070914/20070914

And more than 150 critical patients have had to come to the US over the past two years because of lack of resources in the northland..

http://www.theglobeandmail.com/servlet/story/RTGAM.20080119.neuro191/BNStory/specialScienceandHealth/home

"Of course, I've only lived with this system for 34 years - so I suppose that you, who don't live here, would know more about it than I would."

I watched my grandfather fight the system in a nation that he lived in for 50 years! eventually he gave up and spent all he could to come to the US and get treated... but hey what do I know..

"Apparently you've been listening to right-wing bullshit about how the Canadian system works"

Right Wing bull shit, left wing bullshit I dont give a shit! I lived enough of the system to know is allot further from the panacea of medicine you claim it is and 150 patients in Canada who had to come here for treatment are a testament to that.

[NanceGreggs]

39. What on earth would chemo taking longer than 3 months ...

... have to do with anything?!? Do you think 'the government' calls the hospital and says 'stop treatment, we're not paying for it'?

Jesus H. Christ. I'll say it one more time for you - having lived here for 34 years, and having used the system for all of those years, I think I know a bit more about it than you do.

Yes, some Canadians go to the States if and when they want to - but to say that "all Canadians of means" are rushing over the border is utter BS!!! I would also add that I know a surgeon here who has an international reputation, and has patients come from the US for his services.

And that proves what?

Right-wing bullshit talking points - all of it. They'll tax you to death - the government has to pre-approve your treatment - the government can say no to your medical care if they want to.

UTTER, UTTER, B.S.

But if you want to believe it, you're free to do so.

[DadOf2LittleAngels]

41. The following

"What on earth would chemo taking longer than 3 months ..."

Well you claim, quite incorrectly, that cast is never a concern for a hospital (did you even RTFA I posted) because they send a bill to the govt every three months (quarter).. what happnes if a treatemnt takes more than a quarter (3 months)... Hmmmm

"Yes, some Canadians go to the States if and when they want to"

Did you read the article? If by 'when they want to' you mean the pressure around their brains is increasing to the point that can cause brain damage and not Canadian doctor can treat them then yea... "some Canadians go to the States if and when they want to"

Feel free to ignore the Canadian news services..

[NanceGreggs]

44. The billing comes in at intervals ...

... my point being that the Canadian government is NOT pre-authorizing any treatment, because in most cases, the treatment has already taken place before they even know about it. If something takes more than three months -- THE BILLS ARE SENT FOR PAYMENT EVERY THREE MONTHS FOR AS LONG AS THE TREATMENT TAKES. Jesus, is that REALLY so hard to understand?

No, I don't ignore the Canadian news. But I am ingnoring you.

But please feel free to continue believing that you, who have never lived in Canada, know more than the person who has lived here for 34 years.

[DadOf2LittleAngels]

40. Oh yea no candaian healthcare provider is motivated by profit..

http://www.theglobeandmail.com/servlet/story/RTGAM.20080119.neuro191/BNStory/specialScienceandHealth/home

"Neurosurgery is funded out of fixed, global hospital budgets and is viewed as a financial drain. Orthopedic surgeons, by comparison, are seen as money makers: The more operations they do, the more their hospitals are reimbursed."

So either the Canadian news is wrong abou how medicine is funded or you are... hmmmm...

[NanceGreggs]

45. You really blew it when you quoted the Globe & Mail ...

... which is known here as the Mop & Pail - for good reason. Right-wing gibberish!

[DadOf2LittleAngels]

50. So are you saying that

more than 100 Canadians have not been rushed to the US in the past two years for important surgery..

[warren pease]

47. Nance is doing a great job educating you, but I have a homework assignment for you...

Your willingness to swallow the big corporate lie uncritically is one big reason we will never get a decent, humanist health care system such as the rest of the advanced world takes for granted. The US, unique in the world in its child-like belief in corporate good citizenship, expects these rapacious profit machines to completely abandon their statutory obligations to churn out ever more money for their stake-holders and, instead, act in the best interests of their customers.

Never mind that those two objectives are locked in inexorable conflict. Never mind that medical insurance is a zero-sum game and, when the insurer pays a claim, it's recorded as a "loss" and is grudgingly subtracted from the bottom line. Never mind that the insurance industry employs an army of obstructionists – known ridiculously as claims adjusters – whose main job it is to find some quasi-legal way to "adjust" your claim all the way to $0.00. Never mind the inevitable outcome of those conflicts: that the US isn't even in the top 30 according to the landmark 2000 World Health Organization study.

And never mind the other inevitable result: according to the Institute of Medicine, a DC-based non-profit group formed to disseminate science-based advice on matters of biomedical science, medicine and health, this system is killing about 18,000 people a year for the sole reason that they lack medical insurance. And this is exactly what you'd expect since making gobs of money is incompatible with covering subscribers' medical costs. I think that number's been revised upward to around 24,000 deaths a year, but I can't find documentation on the web at the moment.

So your homework is to read these two articles. If you don't believe Nance, who's lived there for decades (lucky woman), they you might believe actual Canadians as they compare how their system works contrasted with an American woman's attempts to get her asshole insurance company to pay for a simple set of blood tests.

Or you can remain ignorant. I don't give a damn, as long as you don't claim to know what the fuck you're talking about on this issue.

Which brings to mind another question: What DO you know anything about? Just curious.


wp

[DadOf2LittleAngels]

51. And your homework

is to read my post and understnad my grandfather and grandmother *were* actual canadians, not right wing talking points..

[Mountainman]

2. We have to take the profit motive out of heath care. The only way to do that is with a single payer

system of government paid for through taxes health care for everyone.

[SoCalDem]

3. Prohibit "medical insurance"

Un-privatize hospitals & pharma companies

Make them "not-for-profit" entities..

Eliminate medicaid/the VA

Expand Medicare for EVERYONE..

Employers now are free to give employees REAL raises

Entrepreneurs are now free to open their own businesses

Employees are free to leave jobs they hate, and to change jobs whenever they like..

[lumberjack_jeff]

4. Medicare.

Canada can provide health care for everyone with what our government currently spends on health care on behalf of 40% of the public.

In other words, I'd pay for it with what we're currently paying for it.

[sam sarrha]

5. Edwards wants to repeal the original tax cut to the richest 2%, and use it as a tax to pay for a

commonwealth program

[7 of 11]

15. I like that sort of idea

But I would go further. Any income higher than 3.0 million per year gets a 15% tax surcharge (in addition to all otehr taxes) and every penny would go towards UHC for the most needy. Borrowing against this fund would be prohibited by federal law. Period!

[mdmc]

6. Medicaide and food stamps for all

paid for by estate, income and sale taxes.

[ileus]

7. One Trillion a year should come close to covering all Americans.

[7 of 11]

16. One trillion but at today's outrageous prices.

We also need to heavily regulate medicine on how much they can charge for whatever procedure. I'm tired of hearing about the $10.00 aspirin and the $5.00 band aid. We need to make a legal rate for all medical procedures and drugs.

[drbtg1]

28. There's problems on both ends

I also hate hearing about the $10.00 aspirin and the $5.00 band aid (although I tend to think I'm not hearing the whole story when I hear that). However, there's a problem on the other end of the spectrum with costs.

Full disclosure: I'm a dentist, therefore I know some DU'ers will reflexively hate me and move on (hopefully), but I also spent four years treating Medicaid patients which gives me some insight into how that works (in the state I was practicing in). I know some folks say that single payer in the US should be modeled on Medicare, but Medicare has no dental coverage. Thus, if single payer decides to include dental coverage, the powers that be may use Medicaid as the model. That's where the problems begin, as this can be representative of treatment for the rest of the body, too.

For example, if someone needed a crown under Medicaid, you'd still need preauthorization, forget the "only doctors and patients make the treatment decisions" crap. If it was a posterior tooth, forget it, the state would reject it. They'd only approve anterior teeth (I guess the state didn't want people to chew, just smile, kind of like window dressing). For anterior teeth, if they approved it, they'd only pay 20-25 cents on the dollar compared to a regular crown. Plus, it was illegal for the dentist to charge the patient a co-pay. That 20-25% payment was all they'd get.

Now, some shortsighted folks here may be cheering if this was applied for a single payer system, claiming doctors make too much anyway so screw 'em. But let's get past that Wal-Mart fan mentality and think about it for a second. Think about what you would have to do if you were running a business (and practices would still be businesses, I know conservatives run around claiming "EEK! Socialized Medicine!" but it's only the insurance that would be socialized, not medicine) and revenues were cut to 20-25% of what you got before. And you were going to try to stay in business (which may be impossible). Two options would be available. The first is to cut costs. Well, I can tell my biggest cost is payroll, so some employees would lose their jobs. It would get worse from there, because the next cuts in costs involve cuts in ethics as well. Perhaps getting materials that don't work as well or last as long. Perhaps taking short cuts in disinfection and sterilization.

The next option is to increase production. Well, increasing production is viable in some industries where employees are easier to get, but there's a limited population of doctors to draw from for patient treatment. (Of course, some would say make more doctors. To those I offer this: There's a joke about what you call the person who graduated last in the class for medical school. Answer: A doctor. Now, what do you call a person who graduated but only got accepted to the program and then pushed through the program not because of intellect and ability but rather because of forced recruitment goals, like Bushco's military. Answer: YOUR doctor.) Doctors still only have two hands. Increasing production would mean shortening treatment time. Again, short cuts with your body. Increasing production could also mean treatment on patients that aren't medically necessary, like a root canal, post, and crown when just a filling was necessary, just to get more money from the plan. Again, ethics are cut.

Insurance companies have this game called UCR to control "costs", although some use it just to deny justifiable benefits. Something like this would be necessary for single payer universal healthcare as well. But who decides to control the costs? If it's politicians, then we're screwed. I could see a Republican majority gaining control, slashing healthcare payments to Medicaid levels resulting in problems I just described. Then, when the problems are highlighted in the MSM (but, of course, not the Republican cause of those problems), Republicans will shout "See! I toldya so! Socialized medicine is no good! We need to get rid of it, and pass some more tax cuts for my buddies!".

To that end, are there any foreign doctors here at DU? Can any of them address how countries with single payer systems set fee structures? How are the fee structures protected to be fair and also protected from scumbag politicians who vow (like an anti-Hippocratic Oath) to DO harm? Because THIS factor is completely ignored here.

All of my employees have health insurance. That's MY sense of ethics. That's just the way I roll. I calculated, if HR 676 was passed as described, the health insurance premiums I pay would be cut in half. That would be great for business. Too bad I have more to worry about than just that.


Edit: typo

[gratuitous]

8. Call UHC a vital part of national security

Right now, we're spending half a trillion dollars every year on the defense budget. We could do with about 20% of that. I'm willing to bet that without insurance companies in the way, we could treat every bump, bruise, hiccup and hypochondriac in the nation for $400 billion a year. Want treatment? Get it.

We could also begin a national program designed to make America a fitter nation. If advertisers can spend however many billion dollars a year selling us junk food, they can pay a little premium that would then be spent on public affairs programming and public service announcements. We have kids who can sing the Oscar Meyer jingle note for note and word for word; can't we turn some of that ingenious creativity into jingles for healthy eating and exercise habits?

Some of that money could also be used to fully fund school physical education programs that emphasize the genesis of a healthy lifestyle and set our children on a lifetime of better habits.

How's that for starters?

[BlueJazz]

9. I t's Very Simple.

GET ...THE... INSURANCE....COMPANIES...OUT...OF....THE....HEALTH....CARE....BUSINESS.

[Elspeth]

11. And we do this by.....vaporizing Blue Cross?

Maybe arranging for a tsunami near the Aetna headquarters?

[BlueJazz]

22. Anything it takes....Our grandchildren will worship us for doing it.

[TahitiNut]

13. H. R. 676

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

[Fridays Child]

14. Second that. eom

[JanMichael]

20. Single Payer. Just look up the stats. nt.

[jwirr]

21. First consolidate all existing government programs under one

administration: Medicaid, Medicare, government workers, VA hospitals, Indian health programs, public health programs, school health, disability programs, military hospitals, etc.. This would cut down on the overhead for all of these programs and save money. The new program should be based on Medicaid (or Congress's health care program) because it includes drugs, equipment and long term care. Medicare does not include long term care and is a bitch when it comes to getting equipment for home care.

This then leaves small business and large corporations to bring into the program. Small business may need to be subsidized and big corps should be asked to buy in. As someone here said - they will do so because the program is more efficient.

A sliding fee payment could be considered but if it is it should be very liberal in scale.

This leaves us with the uninsured to cover and they can be in this program. This group is the only group not paid for already (all others are in the current budget or covered by some other insurance). Reversing the tax cuts to the rich and the savings from cutting the overhead can go toward paying for their care.

IF an insurance company is included in anyway it may merely be contracted to administer the government program as Blue Cross/Blue Shield does for many states now. They would have no say as to who is covered and ALL medical decisions will be made by a doctor of the patients choice.

[Djinn]

23. just look at almost

any other nation on earth and steal the way they do it. You could even look into the systems of many poorer nations who do this better than the US.

It's NOT rocket science, you don't need to reinvent the wheel.

UNIVERSAL coverage is just that, it covers EVERYBODY.

ZERO subsidies to any for profit health company whether that be hospitals/clinics or insurance.

If people want health care over and above what everyone else has they need to pay 100% of the cost, if they actually had to do that it would cut out all but the obscenely rich and making money out of sickness would no longer be profitable.

The fact that Democrats are arguing over who's BS plan for entrenching health profits is better tells me you guys aren't catching up to the rest of the world on health any time soon

[Jed Dilligan]

24. Find the richest, sickest people in America

force them into HMOs, and when they die a few months later, use their assets to buy insurance for everyone else.

[Thothmes]

25. May be mistaken

But I think the Consitution of the United States prohibits such seizures without due process of law.

[Jed Dilligan]

27. Unless you are black and deal drugs. nt

[Thothmes]

49. Last time I checked

dealing drugs was illegal in all jurisdictions in the United States.

[Jed Dilligan]

52. Spoken like a true rich white person!

.

[Thothmes]

26. UHC

I would use the single payer approach. The federal Govt collects the health care taxes and pays the bills for the entire country.
Health care taxes would be similar to current medicare taxes, except that they would apply to everyone in the country. They would be assessed on a sliding scale depending on income. All businesses would pay a health care tax. This would also be on a sliding scale, depending on gross sales.
The government would collect a nominal copay depending on income level. All existing HMO, health insurance plans, govt subsidized programs would be terminated. The program would reimburse all medical, dental, and pharmaceutical expenses. The exception being cosmetic surgery not supported by medical necessity. Hospitals, clinics, labs would remain as private business entities.

[Warren DeMontague]

31. Single Payer. Replace all the private insurance companies with one giant one funded by taxes.

It works for Federal Employees and Congresspeople, it can work for everyone else.

Beyond that, would it be "free"? No, and what we have now isn't "free", either. I suspect most people would have a co-pay, except for the poor.

I think we should look at creative ways to fund it, too- like cutting the Military-Industrial Complex Budget in half, ending the $40 Billion a yr. drug war, legalizing and taxing marijuana. Stop spending money on Nattering Nanny Idiocy and plow it into our peoples' health and nation's infrastructure.

[jmg257]

32. One that doesn't involve the federal govnt - they have enough power and control over us already. nt

[Lydia Leftcoast]

43. Oh man, as if the health insurance industry doesn't?

:eyes:

[Tierra_y_Libertad]

34. Here's what were likely to get..

[rucky]

35. Roll back the * tax cuts & remove the cap on SS

That should cover it.

[LSK]

37. yep

[7 of 11]

38. Amen brother

Roll back all the damn tax breaks for the rich.

[LSK]

36. Medicare for all

Allow anyone to opt into Medicare and let the market forces drive the insurance businesses into the ground. Oh and FUND Medicare, not wars.

[Lydia Leftcoast]

42. Whatever the Canadians do

sounds fine to me.

[porphyrian]

46. Nationalize all insurance, combine it with taxes, revoke/reverse "corporate personhood,"...

...eliminate "corporate welfare," take the best from the best examples of health care around the world and put people before profit in general to implement and fund health care for everyone. Bonuses and raises given to health care professionals will be for early detection and prevention rather than for saving money by denying expensive tests or treatments. And no more hospital or elder care employees would ever be overworked and underpaid again - we expect so much of them and pay them the least for literally dealing with other peoples' shit.

[annabanana]

48. Can we get some recs on this thread? It deserves to hit the "greatest page"

if only for the education that our Nance doles out! Extra bonus points for the Dentist!

[Defends Reason]

53. Oprah on UHC

Oprah had Michael Moore on her program to discuss universal health care.

It's very informative:

Part 1 of 6:
http://www.youtube.com/watch?v=T0Z_b_hHS70