But if you are looking at health care outcomes, that is an indicator of long term health (not how long it takes you to die) and one reason that the outcomes are better is that everyone is covered. There’s much less reason for mothers to skimp on pre-natal care, for instance. There’s much less reason for someone with insurance to skip out on a colonoscopy because they’d have to pay for the anesthesia out of pocket.

No country is immune to the cost control problem — but coverage for all gets them further along the curve to work on that problem than we do.

So do the elderly in your family avoid using Medicare? Because that is what the public option would look like. I am not so sure why we think it would be OK for our parents to be on Medicare while avoiding this kind of coverage for ourselves. Especially if you have no employer options.

And if the government is the problem, I’d love to hear how you think all of the countries who do have government support for health insurance are able to do it for less money than us and with better health outcomes.

As I see it we’re now entrusting our precious resources to bureaucrats who are in it for profit. I don’t think that’s any better, and in fact, way worse. The insurance companies make money by denying claims for sick people and only insuring healthy people. That’s why we have such a disfunctional system, IMO.

http://www.youtube.com/watch?v=N92vnOhL0NQ

The systemic difficulty is the eternal conflict between the government, Doctors and insurance companies at the expense of the patient.

There are over 1300 medical insurance options in the U S so the public option is simply one more which will have a Fannie Mae presence and the backing of the taxpayer.

Watch the video and the others on health care to see what we need.

Remember this fact in the health care debate, to be right I don’t have to prove you wrong.

Mike Protack

Medicare/ Medicaid are definite problems without good fixes on the horizon. A strong public option would bring in some additional users to the system who won’t be as demanding on the system (so the system can act like a real insurance plan) but long term cost controls are an issue. But I don’t think you can get to those controls without covering everybody.

When there is no counterbalance, no competition, in that everybody in town tacitly agrees to do the same thing, milk the customer for personal gain, then there is not much that can be done to change the current healthcare context in this country. What surprises me is that there are not a lot more McAllen’s, or, maybe there are, maybe even right here in DE!

I wonder how much of a factor is our chronic shortage of doctors, which the AMA controls by controlling the number of admissions per year to medical schools?

There is no doubt that the government is going to have to step in to take some control, not only for the physical health of our citizens, but also for the fiscal health, or lack thereof, that we will be passing on to future generations, at intolerable/unsustainable levels, as per projections of our medical entitlement costs, a problem that we have totally ignored to date.

Obama recognizes these situations, and is prepared to act. He is going to have a really hard time getting past the selfish powers who oppose change. We are already seeing this, especially in the Senate. And we don’t have the Lion on the floor these days either!

http://www.delawareonline.com/article/20090621/NEWS/90621004/+VA+in+Philly+botched+cancer+treatments++report+says

Mike Protack

But there is some hope here — most of the Top Rated Insurance Plans by US News and World Report are not-for-profit. The plans cited in this must-read New Yorker article I wrote about previously — Mayo Clinic, Geisinger Health System, Kaiser Permanente as excellent examples as how the system might work are not-for-profits too. There are more companies like these too, so the foundations for competition are really there.

“Implementation is important and we can cherry pick a lot from every country and produce a great system here.”

The major problem, Mike, is that we have rich and powerful interests who have succeeded in opposing any change to our antiquated and drastically unfair healthcare delivery system for decades.

I will be interested to read what you and your son would propose to do so we can overcome their ultimate power.

Perhaps supersalesman Obama will be the change agent this time. I certainly hope so!

“These four models should be fairly easy for Americans to understand because we have elements of all of them in our fragmented national health care apparatus. When it comes to treating veterans, we’re Britain or Cuba. For Americans over the age of 65 on Medicare, we’re Canada. For working Americans who get insurance on the job, we’re Germany.

The United States is unlike every other country because it maintains so many separate systems for separate classes of people. All the other countries have settled on one model for everybody. This is much simpler than the U.S. system; it’s fairer and cheaper, too.”

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/models.html

Comparing the three different models, Beveridge, Bismark, and National Health Insurance, I note one significant distinguishing element compared to our hodgepodge system (except Medicare and Veterans Health Care), which is: The government controls costs either by fiat or by annual negotiations with providers.

On the contrary, in our system the profits to doctors, insurance companies, hospitals, and other providers, plus the administrative ineffiencies, are all the root causes why our per capita costs are significantly higher, why our coverage is not universal, and therefore why some of our key health outcomes are not as high. We have to be ashamed and change this outrage against the American people!!!

At a minimum, we need universal coverage, we need administrative cost reductions, and we need to take the profit out of health care provision.

The public option plan being considered right now by the House, is actually the Bismark model, practiced with some variations by Germany, France, Belgium, the Netherlands, Japan, and Switzerland. There is our head start. We can pick and choose from these variations to suit our specific needs.

Single payer (Beveridge model – Great Britain, Scandanavian countries, Hong Kong, Spain, New Zealand, Taiwan, Australia) has some strong attraction, but would probably never fly here politically due to the power of the right wingnuts, at least not right away.

I agree with you, Cassandra, that we cannot immediately change radically our for profit insurance companies to non-profits. So the solution is to work out a time schedule for gradual change over a few years.

It will be available tonight and Thanks for being relentless on health care.

I have traveled to all of the countries mentioned above and read all the studies. Implementation is important and we can cherry pick a lot from every country and produce a great system here.

Stay tuned. I am not stalling but I want to discuss two things with my son who is an MD and he is not available till 8 pm.

Mike Protack