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Fast-track health reform faces increasing obstacles

July 13, 2009 by  

Fast-track health reform faces increasing obstaclesThe chance of the healthcare bill being ready before the summer recess appears to be diminishing as a group of 40 fiscally conservative House Democrats has objected to some key proposals.

The group signed a letter which states they would not support a legislation that did not include provisions for more significant cost cuts so the reform is "deficit neutral."

They also expressed their opposition to forcing small businesses to participate in a new system.

"We cannot support a bill that further exacerbates the challenges faced by small businesses," the group wrote in a letter addressed to House Speaker Nancy Pelosi and House Majority Leader Steny Hoyer.

In the meantime, Congress has published new figures which suggest a healthcare reform bill being worked on by Senate Democrats – which includes a public insurance option and requires employers to cover workers – would cost $611 billion over 10 years.

That is much less than previous estimates from the Congressional Budget Office which put the price tag at $1.6 trillion during the same period.
The planned reform is intended to ensure universal access to healthcare, while lowering costs and improving efficiency.

The project has already been under fire from congressional Republicans who object to a government-run insurance option which they say would be anti-competitive and drive private insurers out of business.ADNFCR-1961-ID-19263301-ADNFCR

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  • Joseph A Kraipovich

    All the money this country spends on helping other countries ,think of all the bills passed for nonsense billions and billions of wasted tax payers money.There is no reason why every american citzen shouldn’t have health coverage.John F Kennedy said it right It’s not what your country can do for you(All Dems and Rebs)its what you can do for your country(the people, we are the country, we elected all of you, now give us all HEALTH Insurance.

    • Brian Rawls

      Kennedy was shot for being to radical or socialist. I think we should stop helping all the other countries. Why should I have to work hard my entire life to pay for some other bastards health care who dont share my work ethic. So dope addicts and low lifes and good people all have it the same. Thats Fu*d Up! The political heads will have the best medical care not what the people get. We the people can do alot for this country by overthrowing this regime. Public hanging would do wonders for this country. We would let all the crooked political figures know what is in store for them.

  • Patricia Henson

    I’m so sick of the air of entitlement in this country. What happened to working for what you and your family need. Our fore fathers fought for Life, Liberty, and the Pursuit of happiness. That doesn’t guarentee happiness just the freedom to go after it. I was a single mother providing for my own children and never expected anyone else to give me anything. Sometimes I had to work two jobs to get what I needed for my family but I did it and my family didn’t go without much. Was it easy? No, there were times that I would have rather stayed home and just played with my children but I knew they were counting on me to do the right thing. If you want insurance,GET A JOB! I’m tired of working so some lazybutt can take it away from me and my kids. My children are just as important as anyone elses.

    • Brian Rawls

      I agree with you Patricia. This spread the wealth shit is for the birds.

      • Patricia Henson

        Thank-you for your kind reply. Not too many people agree with me anymore. I don’t know what happened to America. We used to be a hard working society. We worked hard and we played hard, now people just don’t want to get off the couch.

        • Brian Rawls

          Dont worry many people think like us. I think at some point many more people will come around as well. Dont get consumed with all the bs that is on this site. It will eventually take a toll on your health and make you a very bitter person.

      • Patricia Henson

        Dear Brian, No chance of me becoming a bitter person. I do worry about the American people as a whole though as I fear that they will wait to long to speak out. This govrnment is taking us places I know we don’t want to go. I worry about the children as they don’t know the America that I grew up in. I just want them to have that chance. I want to wake up one day and find the people banded together to speak up for what is right. Now that’s real change.

        • Brian Rawls

          If Obama trys to take away the 2nd amend people will band together on that. I think that there would be chaos abroad on that one.

        • Patricia Henson

          Yes Brian,I think you’re right. My guess is though that they will try. I think that by the end of Obamas term though that every constitutional right we have will be dissolved if we don’t do something quick. I also know that at some point that there will probably be a revolution in this country. That’s a little scary to me as I think that if we acted now we could escape all of that. Unfortunately though I think Obama still has too many people keeping his secrets so that means he still has too many people still beleiving in his lies. The longer he is in office though, the more strength he aquires,will make it harder to preserve what we beleive in. It will be almost impossible to put things back together if he keeps going.

        • Brian Rawls

          Every child that is born has a huge debt waiting for them.

  • ProfElwood

    We need to get away from health “insurances” and hide and disguise the real costs of treatment. Public insurance is bleeding debt uncontrollably, and private insurance has been destroyed by pushing employers to pay for it. Only around 5% of the population buys their own plan, which usually covers only major medical. Our system didn’t break on its own, it was broken by badly thought out laws. Now congress is trying to build on those failures.

    • Smilee

      ProfElwood on July 13th, 2009 at 11:41 pm:

      It is broken because we have few laws regulating it with the exception of Medicare. The reason the third payer parties (insurances, hmo’s, managed cares plans etc) can deny coverages, limit your access to care, limit you choice of doctor and hospital, co-pays, deductibles, out-of-pocket maximums etc and they have up to 40% in overhead not to mention their excess profits. Employers have dropped this benefit in many cases because of cost unless they are under union contract this is their prerogative. Medicare has only 8% overhead costs and coupled with a medigap policy that is regulated by law which will not let them deny coverages for pre existing condition or any reason, covers all without limiting of coverages, no co-pays, no deductibles, you can choose your own doctor, clinic and hospital including Mayo and Cleavland Clinics. You not only do nor understand why it is broken, you do not understand that it was congress that created Medicare and why is it you think they cannot repair our health care system based on their medicare success, if they have the will, my fear is they do not have the political will to stand up to the medical lobby’s who spend millions a year to block it which money could be used to lower health care costs if the insurance and medical people cared more about your health care and less about their profits..
      We need to ask why is it most other countries can cover all their citizens at half the cost per capita and show better medical outcomes than we do. We now are 37th in medical outcomes, that is 36 countries are doing better and doing it at half the cost and contrary to what you hear with a lot less rationing than our private plans in this country now do. Noone talks about that either except those having to deal with it personally, which is getting more and more and that is why congress is talking about doing something about it. . You hear your representatives talk about that or ask why can’t we. I am on Medicare with a medigap plan and have health problems and have never paid one penny out of pocket except for premiums, Medicare B and the mediap plan premiums cost me $270.00 per month. Many will tell you different but I have the best health care coverage available today and guess what it is a government plan coupled with a government regulated private insurance plan to pay for the gaps. Misinformation galore is tossed around by a lot of people who have no idea how health care in this country or others really works but to listen to them they sure seem to believe they do. Private plans have broken health care in this county and not your government albeit they have done nothing to date to stop them. Without government intervention it will never be fixed and only get worse, lets hope they do not just put a bandaid on it when it needs major, major repair.

      • ProfElwood

        “It is broken because we have few laws regulating it with the exception of Medicare.”
        Regulations, in and of themselves, don’t fix anything. There are plenty of regulations: the AMA regulates how many doctors get in medical school; the RBRVS regulates medicare and medicaid pay in a way that encourages too many specialists and not enough family doctors; states limit health insurance competition. But all of these regulations make the system worse, not better.

        “The reason the third payer parties (insurances, hmo’s, managed cares plans etc) can deny coverages, limit your access to care, limit you choice of doctor and hospital, co-pays, deductibles, out-of-pocket maximums etc and they have up to 40% in overhead not to mention their excess profits.”
        The 40% is both overstated and deceptive. Private insurances have higher overhead because they have to control costs or go out of business, as many smaller ones have. The excess profits are part of why we need to make the business competitive again.

        “Employers have dropped this benefit in many cases because of cost unless they are under union contract this is their prerogative.”
        Employers don’t want to be part of this system, but tax law pushed them there.

        Medicare has only 8% overhead costs ”
        Public insurances don’t pay for their own office space and utilities. It’s also much cheaper to rubber-stamp checks than to control costs.

        “and coupled with a medigap policy that is regulated by law which will not let them deny coverages for pre existing condition or any reason, covers all without limiting of coverages, no co-pays, no deductibles, you can choose your own doctor, clinic and hospital including Mayo and Cleavland Clinics.”
        According to social security itself, it’s also is growing wildly as a percentage of GDP. Cost control is not an option. I think that’s why it’s been pushed to urgently: once people see how medicare costs end up being controlled, we will no longer want it ourselves.
        http://www.ssa.gov/OACT/TRSUM/index.html

        “You not only do nor understand why it is broken, ”
        Actually, I’ve spent a lot of time in researching this issue, have you? I also look for causes before I look for solutions, just like a doctor is supposed to diagnose the disease before treating it.

        “you do not understand that it was congress that created Medicare”
        Are you suggesting that I thought someone else created it?

        ” and why is it you think they cannot repair our health care system based on their medicare success, if they have the will, ”
        I guess that depends on your definition of success. Since it’s not sustainable in its current form, and no one has the political will to control its costs, I would call it a failure.

        “my fear is they do not have the political will to stand up to the medical lobby’s who spend millions a year to block it ”
        That’s what scares me the most: Politicians depend on massive amounts of money to get (re)elected. They can’t care about the general population any more than the health insurance companies can. Until the entire political system is fixed, we need to fight its expansion on all fronts. This new health care system is even more open to abuse than the current one.

        “which money could be used to lower health care costs if the insurance and medical people cared more about your health care and less about their profits..”
        We should never expect them to care about health care over profits. That’s why it’s important to bring back true competition (and maybe bust up the current giants).

        “We need to ask why is it most other countries can cover all their citizens at half the cost per capita and show better medical outcomes than we do.”
        I agree that we need some thorough, objective research into the causes of our system’s breakdown. But the ones in power have vested interests in keeping that from happening. They distract us with symptoms, but avoid looking for causes.

        “We now are 37th in medical outcomes, that is 36 countries are doing better and doing it at half the cost and contrary to what you hear with a lot less rationing than our private plans in this country now do.”
        That statistic is from a biased WHO study that explicitly weighted the results based on out-of-pocket expenses. Since public insurance uses taxes to cover these, its results are skewed, and therefore, useless. The more lies like this that are used for backing a solution, the less legitimate it looks.

        “Noone talks about that either except those having to deal with it personally, which is getting more and more and that is why congress is talking about doing something about it.”
        There’s plenty of talk, and plenty of agreement that the system is broken. However, we don’t need to so “something”. With congress, everything is permanent. The bill needs to be well thought out, not rushed. The current proposals don’t address root problems, only symptoms. Since the root causes are not being addressed, nothing will be fixed.

        “You hear your representatives talk about that or ask why can’t we. I am on Medicare with a medigap plan and have health problems and have never paid one penny out of pocket except for premiums, Medicare B and the mediap plan premiums cost me $270.00 per month. Many will tell you different but I have the best health care coverage available today and guess what it is a government plan coupled with a government regulated private insurance plan to pay for the gaps. ”
        He who robs Peter to pay Paul can always depend on the support of Paul.

        “Misinformation galore is tossed around by a lot of people who have no idea how health care in this country or others really works”
        True, you’ve repeated some of it yourself. Also, notice that the people pushing this stuff, especially Obama, don’t allow people to ask questions.

        ” but to listen to them they sure seem to believe they do. ”
        I’m listening to a lot of sides and checking their facts. Anyone who knows a lot, knows that there is no simple solution, but ignorance breeds confidence.

        “Private plans have broken health care in this county and not your government albeit they have done nothing to date to stop them.”
        So how did private plans get so powerful? Health insurance bought by an employer is tax free. Health insurance bought individually is only tax deductible, which is a heavy penalty for most people. That’s why most workers get their insurance through their employer. Most all employer purchased health plans are expensive and covers part of almost everything from the start. Most individually purchased plans have large deductibles that encourage people to control their own expenses. Are you saying the government didn’t make this part of our tax code? That states don’t limit competition?

        “Without government intervention it will never be fixed and only get worse, lets hope they do not just put a bandaid on it when it needs major, major repair.”
        The current plan, like it’s proposed counterparts, isn’t a Band-aid, it’s a rusty knife. It will only get worse as they “sweeten” it to get it passed.

        • Smilee

          ProfElwood Reply:
          July 15th, 2009 at 5:29 pm

          “It is broken because we have few laws regulating it with the exception of Medicare.”
          Regulations, in and of themselves, don’t fix anything. There are plenty of regulations: the AMA regulates how many doctors get in medical school; the RBRVS regulates medicare and medicaid pay in a way that encourages too many specialists and not enough family doctors; states limit health insurance competition. But all of these regulations make the system worse, not better. *I was talking about government regulations and good regulations make things better Medicare is regulated by the federal government not the states except MN, WI and Mass who have waivers and to get them they had to offer regulations better than the federal regulations, others are by states except self insured managed care plans which are regulated by ERISA, which only protects the corporations and drives up costs,
          “The reason the third payer parties (insurances,
          hmo’s, managed cares plans etc) can deny coverages, limit your access to care, limit you choice of doctor and hospital, co-pays, deductibles, out-of-pocket maximums etc and they have up to 40% in overhead not to mention their excess profits.”
          The 40% is both overstated and deceptive. UP TOO some are about 25% IT IS ACCURATE BUT THEY DO NOT WANT YOU TO KNOW IT Private insurances have higher overhead because they have to control costs or go out of business, as many smaller ones have. The excess profits are part of why we need to make the business competitive again. BALONEY, OR COULD REPLACE WITH SINGLE PAYER then we will not have profits, they have higher overhead because of all the doctors, nurses and others they hire to only to manage the plans by talking to the treating facility and their doctors to see if its needed and etc, BEFORE MANAGED CARE THIS EXPENSE DID NOT EVEN EXIST, I had a relative who was a registered nurse do this and she tripled her salary when she left nursing to do this. I have had doctors tell me this has increased their costs 40%, had to hire extra office staff and their time spend by them on managed care so they have been forced to reduce patient load about 30% to find the time and their profits are excessive as well especially the pharmaceutical companies, just look at their ad budgets alone in the last five years.*

          “Employers have dropped this benefit in many cases because of cost unless they are under union contract this is their prerogative.”
          Employers don’t want to be part of this system, but tax law pushed them there. *NOT TRUE, if it was why then are so many employers dropping health care benefits. True they wish the government to take it over, makes strange bedfellows, look at WalMart and the SEIU sitting down together to work on solutions, especially when WALMART has no employees represented by Unions *

          Medicare has only 8% overhead costs ”
          Public insurances don’t pay for their own office space and utilities. It’s also much cheaper to rubber-stamp checks than to control costs. NOT TRUE EITHER, THIS FIGURE IS TOTAL OVERHEAD AND DEVELOPED FOR AN HONEST COMPARISON WITH PRIVATE PLANS AND SOME IS FARMED OUT TO PRIVATE COMPANIES, MY MEDICARE CLAIMS ARE PROCESSED BY BLUE CROSS IN FARGO ND

          “and coupled with a medigap policy that is regulated by law which will not let them deny coverages for pre existing condition or any reason, covers all without limiting of coverages, no co-pays, no deductibles, you can choose your own doctor, clinic and hospital including Mayo and Cleavland Clinics.”
          According to social security itself, it’s also is growing wildly as a percentage of GDP. Cost control is not an option. I think that’s why it’s been pushed to urgently: once people see how medicare costs end up being controlled, we will no longer want it ourselves.
          http://www.ssa.gov/OACT/TRSUM/index.html I am aware of this report TRUE ON IT PRESENT COURSE BUT CHANGES CAN CORRECT THIS BEFORE IT HAPPENS. VERY DOABLE IF THEY WANT TO, the changes you talk about are pure speculation on your part and they will go there, no politician would want to piss the electorate off that bad, SS & Medicare are considered the holy grail

          “You not only do nor understand why it is broken, ”
          Actually, I’ve spent a lot of time in researching this issue, have you? I also look for causes before I look for solutions, just like a doctor is supposed to diagnose the disease before treating it. STUDIED it for years dealt with it on my job for 40 years.

          “you do not understand that it was congress that created Medicare”
          Are you suggesting that I thought someone else created it?

          and why is it you think they cannot repair our health care system based on their medicare success, if they have the will, ”
          I guess that depends on your definition of success. < Since it’s not sustainable % KEEP MEDICARE WORKING AS IT IS 100% MEDICAL COSTS PAID IS TERRIFIC DON”T YOU THINK, I KNOW YOU DO NOT BELIEVE IT IS SUSTAINABLE AND CHANGES CAN CORRECT IT BUT IT IS DOABLE, REMEMBER MOST COUNTRIES CAN DO IT FOR HALF WHAT WE DO AND, people are demanding we fix the health care systems and this will generate the political will. in its current form, and no one has the political will to control its costs, I would call it a failure.

          “my fear is they do not have the political will to stand up to the medical lobby’s who spend millions a year to block it ”
          That’s what scares me the most: Politicians depend on massive amounts of money to get (re)elected. They can’t care about the general population any more than the health insurance companies can. Until the entire political system is fixed, we need to fight its expansion on all fronts. This new health care system is even more open to abuse than the current one. WE DO NOT HAVE A NEW SYSTEM AS YET, SO WHY ASSUME IT IS EVEN MORE OPEN TO ABUSE, YOU CAN”T SEE PAST YOUR PESSIMISM, THE SKY IS NOT FALLING.

          “which money could be used to lower health care costs if the insurance and medical people cared more about your health care and less about their profits..”
          We should never expect them to care about health care over profits. That’s why it’s important to bring back true competition (and maybe bust up the current giants). CAN”T YOU UNDERSTAND IT IS THE PRIVATE SECTOR THAT HAS WRECKED HEALTH CARE IN THIS COUNTRY AND UNTIL THE GOVERNMENT REGULATES IT, IT WILL ONLY GET WORSE. THERE IS A PLACE FOR THE PRIVATE THIRD PARTY PAYER BUT THEY HAVE GET WITH A BALANCED PROGRAM OR WE SHOULD GO TO SINGLE PAYER. WHY DO YOU SUPPOSE THEY ARE ALL AT THE TABLE THIS TIME. THEY ARE LOBBING TO MINIMIZE THEIR LOSSES AS THEY KNOW THEY CAN NOT STOP CHANGE. THIS IS A WORK IN PROGRESS AND NO ONE KNOWS THE END RESULT AS YET..

          “We need to ask why is it most other countries can cover all their citizens at half the cost per capita and show better medical outcomes than we do.”
          I agree that we need some thorough, objective research into the causes of our system’s breakdown. OH WE KNOW ALREADY WHY, IT HAS BEEN COMING ON FOR OVER 30YEARS AND STUDIED REPEATLY But the ones in power have vested interests in keeping that from happening. They distract us with symptoms, but avoid looking for causes.

          “We now are 37th in medical outcomes, that is 36 countries are doing better and doing it at half the cost and contrary to what you hear with a lot less rationing than our private plans in this country now do.”
          That statistic is from a biased study that explicitly weighted the results based on out-of-pocket expenses. MEDICAL OUTCOMES CAN not be measured by OUT OF POCKET EXPENSES AND THIS STUDY IS WELL ACCEPTED AS ACCURATE BY ALL COUNTRIES Since public insurance uses taxes to cover these, its results are skewed, and therefore, useless. The more lies like this that are used for backing a solution, the less legitimate it looks.COST of health care IS WHAT IS PAID FOR HEALTH CARE THAT IS MEASURED NOT WHAT IS COLLECTED IN TAXES OR PREMIUMS, albeit this effects your personal cost but not the cost of the health care itself

          “Noone talks about that either except those having to deal with it personally, which is getting more and more and that is why congress is talking about doing something about it.”
          There’s plenty of talk, and plenty of agreement that the system is broken. However, we don’t need to so “something”. With congress, everything is permanent. The bill needs to be well thought out, not rushed. The current proposals don’t address root problems, only symptoms. Since the root causes are not being addressed, nothing will be fixed. WE have talked it out it for years and we know all the root causes and cures, so there is no reason to wait, this argument is for hope on the part of those that oppose it with the hope the public can be scared from supporting it and thus kill the will to get it done.It is a BIOGUS argument

          “You hear your representatives talk about that or ask why can’t we. I am on Medicare with a medigap plan and have health problems and have never paid one penny out of pocket except for premiums, Medicare B and the mediap plan premiums cost me $270.00 per month. Many will tell you different but I have the best health care coverage available today and guess what it is a government plan coupled with a government regulated private insurance plan to pay for the gaps. ”
          He who robs Peter to pay Paul can always depend on the support of Paul. I am old enough to remember when we could afford to pay for out health care without insurance, in 1946 my mother had major surgery in Rochester at the Mayo Clinic and was in the hospital for a month, no insurance, dad borrowed at the local bank to pay the doctors and hospital and had it all paid back in 1952, then most hospitals where non profits owned by churches etc. Now we need insurance and the cheapest is MEDICARE weather the system is collectively done though government or private insurance it does not matter if it can be affordable, either way can be called robing peter to pay paul, you just hate it more when it is government and they have proven they can do it cheaper

          “Misinformation galore is tossed around by a lot of people who have no idea how health care in this country or others really works”
          True, you’ve repeated some of it yourself. ONLY YOUR BIASED OPINION Also, notice that the people pushing this stuff, especially Obama, don’t allow people to ask questions. I suppose it seems that way to the uniformed the rest of us know the answers to the questions.

          ” but to listen to them they sure seem to believe they do. ”
          I’m listening to a lot of sides and checking their facts. Anyone who knows a lot, knows that there is no simple solution, but ignorance breeds confidence. KNOWLEDGE BREEDS CONFIDENCE IGNORANCE BREEDS STUPIDITY, no one said it was simple just doable if there is the will, and not just excuses which you sure seem full of

          “Private plans have broken health care in this county and not your government albeit they have done nothing to date to stop them.”
          So how did private plans get so powerful? GREED AND LOBBYING GOVERNMENT FOR FAVORS Health insurance bought by an employer is tax free. Health insurance bought individually is only tax deductible, which is a heavy penalty for most people. SOMEHOW ITS GOT TO BE PAID FOR, STOP YOUR WHINING AND GET ON BOARD That’s why most workers get their insurance through their employer. MOST CANNOT AFFORD IN ANY OTHER WAY Most all employer purchased health plans are expensive and covers part of almost everything from the start. Most individually purchased plans have large deductibles that encourage people to control their own expenses. MOST EMPLOYER PLANS ARE HIGH DEDUCTIBLE TOO NOW, PEOPLE CANNOT CONTROL EXPENSES WHEN IT IS FOOD & HOUSING VS HEALTH CAREAre you saying the government didn’t make this part of our tax code? SURE WHATS THE POINT, WOULD COST YOU EVEN MORE IF THEY DIDN’T That states don’t limit competition?

          “Without government intervention it will never be fixed and only get worse, lets hope they do not just put a bandaid on it when it needs major, major repair.”
          The current plan, like it’s proposed counterparts, isn’t a Band-aid, it’s a rusty knife. It will only get worse as they “sweeten” it to get it passed. ITS OBVIOUS YOU DON”T BELIEVE GOVERNMENT CAN FIND SOLUTIONS BUT IN VIEW OF THE DISASTER THE PRIVATE SECTOR HAS MADE OF THIS AND THEIR UNWILLINGNESS TO DO ANYTHING TO CREATE REAL CHANGE. THE THE ONLY CURE IS THEM. I AGREE IF YOU ARE LOOKING FOR PERFECT ITS NOT GOING TO HAPPEN BUT BETTER IS BETTER AND THE PUBLIC DEMANDS CHANGE THERE WILL BE SOME AND THE MORE WHO DEMAND THAT FROM THEM THE BETTER IT WILL AND THE LARGER THE GROUP OF WHINERS WHO ONLY BITCH AND SHOOT EVERYTHING DOWN COULD DESTROY A SOLUTION. YOU ARE EITHER PART OF THE PROBLEM OR PART OF THE SOLUTION AND DOING NOTHING BUT WHINE MAKES YOU PART OF THE PROBLEM

  • ProfElwood

    I’m amazed at how much we can agree, yet come to different conclusions. Let me start with what we agree on:

    Health care used to be affordable. My father was telling me about the outrage caused when a local hospital raised its room rate from $23 to $28 per day.
    Government regulation is needed to keep business in line. I remember when the credit reporting agencies had to be forced to set up annualcreditreport.com, because previously almost everyone had access to your credit report, except you. One of the earliest examples, that we take for granted today, was when ancient governments created standard weights and measures to encourage honesty in trade.
    Insurance companies add a lot of overhead to medical care, without any real benefit. My father was also telling me that when insurance was becoming popular, the receptionist would ask you if you had insurance. If you did, they would charge more for the visit than if you didn’t.

    Now for where we disagree.
    1. Government regulations can also cause great problems. Prohibition is the first one that comes to mind. In the medical field, the employer funded tax deduction made medical “insurance” popular. Do you honestly think 158 million decided that they wanted insurance through their employer? Obviously, the tax law did. Now only 5% of people buy their own insurance. I’ve seen the difference in the HSA compatible plans that insurance companies offer to employers and those offered to individuals. The employer version was about $450 per month for comparable coverage that cost an individual around $150. Insurance companies obviously don’t like HSAs, but only the more competitive individual arena makes it worthwhile. States limit competition, because they force insurance to cover certain expenses. If people could purchase plans from out of state, they could bypass these mandates. In order for a free market to work, there must be a lot of buyers, buying for themselves, and a lot of sellers. Or do you not believe in free markets?
    2. Trying to compare overhead between Medicare and private health insurance is rather pointless, because we don’t have either a competitive health insurance market, or a cost controlled public one. When we do, then true cost comparisons might be possible. Currently, both private and public (but not individual) insurances pay at least part of every expense, which causes waste for both the provider and the patient. Cost control in both systems is difficult, because payments are made after the treatment has been given. This is also the biggest area of mischief for private insurances: the patient accepted the cost under the assumption that insurance would pay most of it, only to find out that they won’t.

    In the public sector, nationalized health care makes more sense than single payer, because it also reduces this waste, and costs are controlled at the source, not after the fact.

    Other countries can’t show us how our system would work here. We have a political system that’s out of control. You yourself noted that lobbyists have way too much influence in this debate. They will still have influence if this bill passes. The current house bill forces everyone to get either public or private insurance, but explicitly forbids people from buying individual private plans. This puts more people in private health insurance, not fewer. The last 5% (10% if you count the voluntarily uninsured) of the free market is also getting killed. Now, the entire nation will have to pay for treatments that aren’t helpful. Why would I think such a thing? Because it’s already happened. Remember the state mandates? Politicians get money for their campaigns, medical groups get a captive audience. After this, that captive audience grows to 300 million.

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