Time has come for single-payer care
What better place to start a single-payer plan than in a state with top-flight medical facilities? We would attract corporations happy to get great employees without the excessive expense of buying health insurance coverage, thus improving the company’s competitive advantage and Colorado’s economic edge.
Colorado workers might face a tax increase, but that will easily be offset by relief from the burden of high-cost health insurance premiums for themselves and their families, whether the employer pays part (a situation rapidly dwindling) or through private insurance.
Health insurance companies already decide what doctors get paid and what procedures will be performed. They already “deny or delay expensive procedures and medications to patients” if it will cut too deeply into their profits. Translation: Patients with chronic illnesses who now depend on costly treatments are already suffering.
The time has come for a health plan that covers all citizens.
Maria Guerra, Denver
What better place to start an individual based plan than in Colorado where great facilities can provide a full array of choices?
Colorado workers MIGHT face a tax increase? Then we will be safe from this plan because Colorado taxpayers were hornswaggled on Ammendment C and will see through another phony plan. The ones under study by the legislature are all stuffed full of government and taxes so we might even get the chance to vote one or more down. But let's look at what is really proposed by this letter writer if we were to be so stupid.
I see by the plans selected for proposal by the legislature we won't be voting on any health care plans that might allow us to choose for ourselves. None of them interested our professional politicians.
Health insurance already determines what THEY will pay. Individuals are free to choose additions to some plans and are always able to choose doctors although some have to choose from a list. Those individuals who are lucky enough to have Health Savings Accounts can usually negotiate deep discounts because the doctor won't have to go through reams of paperwork to get paid. Result is lower prices. Works already in areas where people know they are spending their own money. Look at cosmetic surgery and Lasix. Fast growing technology, competitive prices and, yes, usually NOT covered by insurance.
Insurance companies do deny or delay treatments in some cases but it is still possible, and common, for a denial to be changed, and the delay to be only that which a sensible person would take to obtain a second opinion.
The easy way to solve the problems with insurance is to allow the individual to choose his own plan, his own insuror and his own conditions. That makes him the insurance company's customer, not his employer. Insurance companies are very good at competing for customers by offering what each one wants to buy. Right now the all tax benefits from insurance payments are granted to an employer. Workers cannot deduct the cost of health insurance from their taxes. They must also have expenditures above a certain percentage before any deductions for medical expenses can be taken.
Let's allow everyone to pick for themselves. Also, let the poor them choose between private insurance and Medicaid via a program or tax credit. Best of all make it possible for everyone who wants one to obtain a Medical Savings Account. That will allow those with good health or lower expenses to save up money against high expenses from future unknown illnesses or injuries. That is before taxes money they save so they will be able to take home more because they won't be paying for insurance at work. Anyone who wants to change jobs can do so without worrying about health care. How many people, especially those in their fifties, are stuck in jobs at a lower pay than they could command elsewhere because the employer knows they have a health problem, or someone in their family has one, and can't afford to quit?
MSA accounts also allow those like me, with expensive, permanent and eventually terminal, problems to choose care providers and treatments that I need not the one some doctor, with fifteen minutes budgeted per patient by their plan, decided was the one I need.
A high deductable insurance policy, usually with 3000 or more in expenses before insurance begins coverage, is also part of the plan for catastrophic injuries or illnesses. The money goes in and comes out via a credit card like system and many pharmacies in all areas, as well as those online, will provide a competitive price system for medications.
No system is perfect. Please don't destroy our health care system in exchange for political promises. Choose freedom. Choose individual choice.
All much better than government health care. Those delays will be months, not days and to reverse a denial can take over a year. I'm not guessing. My husband has the current brand of US government health care..the VA. He's a disabled vet.
Want really long waits and care denials? Just ask any VA for non-injury or non-emergency care.
It is the same in countries with single payer care. Ask any Canadian you see in an American hospital. They are here because they had too long a line to wait in at home.
Don't short change Americans with socialzed medicine. They keep changing the name to single payer and oh, whatever names they think will fool the publc this time. It's still socialized medicine. Manure has many names but it still smells the same.
maria when you used the word 'might' it proved you have no idea of what you are talking about, other than you want a free hand out.
if the government took over health care there would be a huge tax increase and that you can take to the bank.
it also would be the worse care around.
Momma Y.
You failed to say what people who can't afford HSA will do and slide over what the poor will do by saying some kind of tax credit might, by chance, be available at some undefined point. 47 million people can't afford even the basic health care and also don't have the money to put in a personal health care savings account. What about them, what about their children?
Single payer....Isn't that what they used to call socialized medicine?
Posted by Jimminy on August 13, 2007 10:25 AM"47 million people can't afford even the basic health care and also don't have the money to put in a personal health care savings account."
Where do you come up with that? Just because they don't have insurance at the time the snapshot is taken, doesn't mean they don't get insurance the next day, week, or month. It also doesn't, necessarily, mean that they cannot afford it. A lot of people choose to go without insurance, or don't even think about it.
Please don't assume that every person who is captured in that snapshot of uninsured, is so because of a bad financial situation.
Posted by Mike on August 13, 2007 10:32 AMMomma y,
Great comparison, I can CHOOSE to continue to wear eyeglasses or have a flabby body, or to get the ELECTIVE surgeries you mentioned as an example of free market forces in medicine.
What of the elementary schooler whose mother chooses not to get them a checkup and they end up in the ER for a preventable asthma attack, and the kid misses school. What kind of choice is that?
Equality of opportunity demands equality of access to health care. Free markets do not ensure justice or fairness, only profit and loss.
Posted by on August 13, 2007 10:59 AMHey Maria,
Are your ready for a 35% increase in your taxes? That is the minumum increase our politicians want for this socialized medical plan...
Posted by legal on August 13, 2007 11:38 AMDems already plan to give us the biggest tax increase in history. They want to tax big corporations who only pass it on down to us. So much for the working class.
Posted by on August 13, 2007 11:46 AMTaxes will increase and premiums will disappear. A net gain for middle-class and poor Americans.
Posted by Charles B on August 13, 2007 11:48 AM"Taxes will increase and premiums will disappear. A net gain for middle-class and poor Americans."- Charles B
Nice assertion, Charles. Please back it up with some numbers.
Posted by Mike on August 13, 2007 12:44 PMThat's why when I talk to my Canadian family and friends in the UK they are so poor they can't afford to do much more then survival. Taxing us to death is not the answer. Middle class are already over taxed. Charles B. must have bucks not to have noticed.
Posted by on August 13, 2007 01:07 PMMike:
It's not hard to figure out. We spend twice as much as the next highest country per-capita for health care.
Countries with universal health-care spend less to greater effect. It stands to reason that middle and lower income Americans will spend less under our progressive tax system, since they won't be paying premiums.
Tell me why you think I'm wrong.
Posted by Charles B on August 13, 2007 01:25 PMCharles B,
If my paycheck were taxed at 20% (a low estimate) I would be paying $23,600 for "free health insurance". Right now, I pay $150/mo and a max out of pocket of $3000 (so a potential TOTAL of $4800) and that is pre-tax. True, I am in good health, but have had knee surgery, and rotator cuff surgery. But this is a "wash" right? Now, if taxes increased to 35%, now my cost is $41,300. This is "Free?" This is better?
So much for "free health care."
Posted by Paul on August 13, 2007 01:46 PMPaul:
Where do you get your "low estimate"?
How much does your employer pay to subsidize your health care and how much more could they pay you if they didn't? Hint: it's the same amount.
Never-mind that given your salary you hardly qualify as middle/lower income...
Posted by Charles B on August 13, 2007 01:56 PMCharles - You actually believe...
1) Paying more in taxes will save you money
2) Employers will pay you more money since they can eliminate health insurance benefits
But of course, the more you make the more taxes they'll take.
I follow you're line of thinking but to believe this will happen is dillusional.
Posted by KW on August 13, 2007 02:05 PM"Nice assertion, Charles. Please back it up with some numbers."- Me
"It's not hard to figure out. We spend twice as much as the next highest country per-capita for health care.
Countries with universal health-care spend less to greater effect. It stands to reason that middle and lower income Americans will spend less under our progressive tax system, since they won't be paying premiums.
Tell me why you think I'm wrong."- Charles B
I have now asked you 3 times on different threads for numbers. I have asked Truth twice for numbers after he made the same assertion.
I'm still waiting.
Posted by Mike on August 13, 2007 02:10 PMMy employer makes zero contributions. Because I own a small business, I pay for individual health insurance, and it rocks.
I never claimed to be middle income. Far from it. However, take away my ability to choose what works best for me, and now I am not able to afford health care.
It's about choice. It's about options. I am compassionate enough to believe that we should make some assurances that those who truly are unable to afford health care, should have a way to achieve it, without precondition. However, according to the WHO report, the United States has the #1 most responsive health care in the World. Let's figure out a way to help those that really need it, without totally revamping a system, that for most people, works just fine.
Posted by Paul on August 13, 2007 02:45 PMPaul:
I think people like us, with higher than average incomes, should pay more taxes so that poor people can get health-care who would otherwise go without, and you don't.
I guess that's the difference in our positions.
Posted by Charles B on August 13, 2007 04:38 PMKW said:
Charles - You actually believe...1) Paying more in taxes will save you money.
Not save me money KW, but people with middle and lower incomes, yes.
I know it's hard for you to fathom how someone could take a position that would hurt their bottom line. I guess that's just a difference in the way we think...
2) Employers will pay you more money since they can eliminate health insurance benefits.
You claim I'm delusional for believing this, but I'm counting on the competition in the labor market to make this happen.
Posted by Charles B on August 13, 2007 04:48 PMCB - I think people in all income brackets should be free to donate their own money to whatever group/persons they feel it will help the most.
Why do you only advocate forced charity thru taxation / redistribution?
Try giving just for the sake of giving and quit trying to use my money for your charities.
Agreed?
Posted by KW on August 13, 2007 04:50 PMKW:
"Try giving just for the sake of giving and quit trying to use my money for your charities.Agreed?"
No, I don't agree. I want you to be taxed more heavily (assuming you're in an upper-income tax-bracket) so that people without access to health-care can have it. It's a policy battle that we're on opposite sides of.
I'll do my best to see that your side loses.
So no, I don't agree.
Charles B - Please help me understand why those who make more should have to share with those who don't. I would really like to see both sides. I am just having a hard time with this one. I work as a para in a public school and my spouse works in HVAC. We make ok money and certainally more than someone who works for minimum wage. Since we work so hard for our money shouldn't we be able to afford nicer things for ourselves and keep our money for things we want? Why should we have to share?
I also volunteer for my kids schools, isn't that already sharing my time/money? Do I need to do more?
kg:
Based on your description of your jobs, I think you're among the middle income earners I'm talking about who will see a net savings from a well designed universal health care system. So no, you don't have to do more, and I commend you for your involvement in your community.
Posted by Charles B on August 13, 2007 07:07 PMCharles,
Please explain why someone who earns more owes anything to someone who earns less.
And, PLEASE, give me some numbers since you are so convinced this will be a savings for so many people.
Oh wait! You've already said that high income earners will be paying for the lower and middle income earners. This is yet another income transfer program.
How wonderful.
Posted by Mike on August 13, 2007 09:13 PMThe middle ground in the health care debate is ignored because it isn't the easy one. We are trying to solve a multifaceted problem with one solution.
Not going to happen.
We have to deal with different income levels, different health care levels, different and very different attitudes.
To do this we must prepare a system that takes care of people who have sudden emergencies, long term difficulties and those in the middle who are subject to the sudden changes in life that can upset plans.
We must also be very careful not to create a system where the individual is separated from the health care system. That is the source of many of our problems now.
People usually don't know how much health care costs because they either have an insurance company paying the bill or the government. The average person goes to the doctor for a physical and the doctor charges the patient the co-payment which is usually unimportant. The purpose of a co-pay is to limit the use of health care while still making it available to people. That same doctor charges the insurance co-pay 400 dollars. A person goes to that same doctor for a physical and the receptionist asks for an insurance card. The patient says he will pay cash and asks how much. 125 is the reply after a quick consultation with the office staff. This is not a guess. It happened last month to a friend of mine. The "cash" payment was from a HSA account.
Doctors can, and will, be able to charge less and provide the same care levels although some of the insurance clerks may need new jobs. Doctors can charge less if they are able to reduce their clerical staff too. People are very adaptable when they want to be or have to be.
We can create a new system by first removing employers from the health care equation. If working people had the ability and the encouragement to buy their own health care plans then the system would change. The insurance companies will have to market themselves to individuals instead of to companies. They will hope that people with pre-existing conditions don't apply for coverage but we can use either government subsidies or tax incentives for the companies. These people will most likely not choose an HSA but some will because the ability to make the choices can sometimes save more than just money. The working poor, my group, can either buy insurance or apply to be covered by Medicaid. The important point is that people who have health problems already know what they need and for the most part have to find a plan they can live with. Children are covered in Colorado by the CCHP which will provide them with care and coverage until they become adults. It might be possible to grant each individual a set "grant" to buy health care if they're are faced with lifelong severe health conditions.
Diabetes is a great example. Cheryl would be able to pick a health care plan by knowing what her family needs and selecting the plan that would supply them with the best possible care. She can decide if she wants a plan that pays for strips and insulin pumps and syringes and costs one thing or a plan that will ask for a co-pay for those supplies. She would select, not only by cost, but by services offered and what she needs, a health care plan to supply them.
Some would choose the lowest co-pays and the very best care at a high premium. They would be covered no matter what happened to them. It will be their choice and their money. Even I can make choices in my health care.
I would choose the HSA and hope to minimize costs the way I have to do now. First problem is that the care providers are very much used to simply giving orders to a patient and a bill to an insurance company. There is one orthopedic surgeon who still can't believe a patient told him she wanted a reason for the orders. She insisted on NO WALKING. OK I insisted. Called a podiatrist who specialized in diabetic foot conditions and asked him why no walking. He said it was to prevent the cast from breaking or causing pain. He suggested a post surgical cast boot which I had from another foot surgery. NO pain and when the cast was changed for a foot inspection the surgeon decided he didn't need to see me and I refused to let his office charge the insurance company for a visit with him. I called the insurance office from his office and told them what had happened. Also researched the medications I was given and grilled the cardiologist. Was able to exchange seven prescription medications for three and some over the counter products.
It will mean work and involvement and some people will want the old system back. We don't offer any kind of car insurance yet the state requires us to have it. Why are we competent enough to shop for everything else but we are too stupid to choose health care?
Let the government remove the tax benefits from the employers and give them to the individuals . Give the working poor a choice between choosing a plan and enrolling in Medicaid. Make it easy by offering tax credits which are like the earned income credit. You may get a credit several times the amount you paid in. This credit can be used for an individual policy or Medicaid. We can offer extra funds like the EAC by factoring in ongoing health problems, children with diabetes being one area and other factors that we need to include.
Give tax deductions to people not businesses. Allow medical expenses to be deducted completely without a floor for middle class incomes. As incomes increase, deductions can be reduced by a percentage determined in advance.
The important thing is to make people aware of the costs of health care. Then make them responsible for their choices. ER visits can continue to be mandated for everyone but a database can be constructed using a fingerprints that would discourage abuse of the system and skipping out on ER bills will be reduced. We can't predict everything but one thing we KNOW is that countries with socialized medicine have people coming here for medical treatments that they are not getting in what they consider a reasonable time frame.
The free market in auto insurance shows us that people can choose plans for themselves and insurance companies will compete for business. Even people with horrible driving records can get insurance.
Will there be problems to solve? Will there be failures? We always hope for perfect results but the reality is that when you deal with people you have problems that won't be wished away. We can do it. Watch us succeed and show the rest of the world it is possible. We did that a whole bunch of other times starting in 1776. Trust yourselves not government.
If anyone thinks all us on the bottom of the income ladder want government health care they are wrong. I spend several hours a week dealing with a bad insurance company and many bad health conditions along with the resultant bills. Our total income for a family of 3, including an 8 year old grand daughter, is less than 30K a year. Out of that we have 1000 dollars a month for housing expenses including utilities, food for two diabetic diets about 100 dollars a week and a child adds 50 dolllars to that some weeks in the summer, about 400 dollars a month for prescriptions and health care costs like co-pays. The rest goes to pay medical bills to satisfy the 2500 in medical expenses we already had this year. No amount of government help or interferrence, whichever you consider it, will change us into two healthy adults.
We know our expenses for everything will go up and when my husband retires our income will go down even if I am able to get my disability approved by Social Security. We have seen what our government will provide as health care. My husband is a disabled vet. Don't buy a pretty pig. Fight for individual rights and responsibility. We may not be able to prevent injury or disease but we can prevent silly solutions from making things worse. Think and plan and work for itl
Impertinent questions department:It's been asserted that if the price of a Rolls-Royce automobile had kept pace with the price of computing power since the '50s,you could now buy a Rolls-Royce for somewhat less that one cent.Since almost no one needs a Rolls-Royce,the price of that item has remained the equivalent of ten million cents.
Medicine is different-everyone needs some doctoring sometime.I'm starting to wonder if just maybe we should try to lower the price instead of trying to raise the money.
This drive for socialized medicine,single payer,universal, or any other masked version of governmental intrusion is a trend founded in the belief that the individual is neither strong enough nor itelligent enough to plan his/her own affairs and to bear the primary responsibility for his/her own circumstances ---and that the state has the wisdom (Only an idiot would believe in the wisdom of the state!) and capability (GULP!) to manage the individual's affairs better the the individual themselves!
Governmental intervention is always dangerous to us as a free society. (Maybe I should rephrase that and say somewhat free society!)
Several decades ago the American people were seduced into abandoning the principles of our ancestors. The state took control over our education, economic activity, (taxation!)social activity, (more taxation!) and charitable activity(more and more taxation!)
In the 1960's we were led by the nose and accepted Medicare and Medicade which is in my opinion, a form of socialistic medicine.
And now, the state wants to take complete control over our health care. If we permit this to happen, we will reap the whirlwind, for the results will be as disastrous as they have been in every other field of governmental endeavor!
Keep government out, and we can all breath easier and perhaps even breath longer!
I know our health care system isn't perfect by any means but I want the FREEDOM to determine if my health care is good or bad, and change it if I CHOOSE to!!!!
When people lose the power to choose..they have lost another freedom!!
Charles B:
"I want you to be taxed more heavily..., I'll do my best to see that your side loses, So no, I don't agree."
Wow! Talk about completely forfeiting ones last shred of credibilty on issues, that last post sure says a mouthful about you CB.
But rather than wasting my time trying to reason with someone who thinks the constitution was a waste of ink, I can take great comfort in knowing you are an incredible minority in your thinking and your desires will never come to fruition.
Best reccomendation anyone can make to you is MOVE!
You should be much happier in a place like France, no?
Posted by KW on August 14, 2007 12:08 PMKW:
Since when does honesty damage ones credibility?
In your world where up is down?
Posted by Charles B on August 14, 2007 12:49 PMIt's your belief system that has damaged your credibility CB.
In the USA one shouldn't advocate change to socialism if they want to be taken seriously.
Our founding fathers established this great nation as a Republic, complete with the Declaration of Independence, the Constitution and the Bill of Rights.
These items are in place to prohibit your desires from ever becoming doctrine in this country.
And thank God for that.
Posted by KW on August 14, 2007 02:09 PMK-Tel made little sense when he said:
"Our founding fathers established this great nation as a Republic, complete with the Declaration of Independence, the Constitution and the Bill of Rights.These items are in place to prohibit your desires from ever becoming doctrine in this country."
You mean they knew about me? Like my existence was forseen or something?
Wow.
Posted by Charles B on August 14, 2007 05:32 PM