If they didn't want to know, they shouldn't have asked. In 2003 Congress passed a bill creating the Citizens' Health Care Working Group. The bill was the infamous Medicare prescription drug "benefit."
The Working Group was something else. They just recommended universal health coverage.
"Assuring health care is a shared social responsibility," says the interim report of the Citizens' Health Care Working Group, a 14-member committee that went to 50 communities and heard from 23,000 people.
The committee describes its recommendations as a framework. The recommendations don't say who would pay for universal health coverage or how much it would cost. The concept of government-guaranteed coverage runs counter to the Bush administration's position that consumers should bear more responsibility for their initial medical expenses. (CNN)
Universal coverage? Isn't that, like, un-American? Who is this commie group, anyway? It was the brainchild of Sen. Ron Wyden, D-Oregon and Sen. Orrin Hatch, R-Utah. Wyden. I understand. Hatch? Not a clue. Here's Wyden's rationale:
"We decided, let's try something else. Let's go to the public and give them a chance, not in terms of writing a bill, but let them provide a kind of general roadmap where the country ought to head," Wyden said.
So what did the public say? Universal coverage. But, counter the critics, they didn't say how they were going to pay for it (unlike the Iraq War, for example):
"It implies massive new funding sources, massive new laws would be needed," said Sarah Berk, executive director of Health Care America, an advocacy group that pushes free market approaches to health coverage. "We want universal access, but this report just pushes all the difficult problems onto somebody else's plate. It says government needs to do it all."
Your point, Ms. Berk?
The Group's executive director shot back:
"We're already paying for health care for everybody who gets it, including people who don't have health insurance coverage who are taken care of when they go to the hospital," Grob said.
The group's stated values and principles were as important as the recommendations, Grob said. Those principles said all Americans should have a set of health coverage benefits guaranteed by law. Those benefits should be "portable and independent of health status, working status, age (and) income," the report said.
The public has 90 days to comment, after which The Decider will give his response to Congress, after which five congressional committees will hold hearings. Let me see if I can guess The Decider's response: "It's not about universal access for the American people. It's about freedom for the Iraqi people."
I remember vividly the agitation around national health insurance in the late 60s and early 70s. Not a question of "if." but "when," progressive health care pundits were saying.
Now all we say that about is an influenza pandemic.
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I respectfully suggest to anyone looking to submit proposals to glance over the mechanics of how Tommy Douglas did it. Granted, you're working with a completely different system, but you might glean some useful information. Never reinvent the wheel when you can knock the corners off the octagon you've got lying around, after all.
The Working Group's website is www.citizenshealthcare.gov for those wish to read the report and/or submit comments.
Don't get me wrong: I love so-called universal health care. I live in a country where it's been around for a while now.
However, it isn't perfect, or even universal. While it's an improvement, it's not the panacea some would believe it to be.
attack rate: We understand. It's basic shelter, not a luxury condo or a mansion. Basic shelter is still pretty important, however, if you don't have it. It will also make the US more competitive. $1200 of every car GM builds is UAW health insurance. For the Japanese, it's about $200.
Total expenditure on MEDICARE in the US divided by TOTAL population (NOT the fraction actually covered by MEDICARE) is about the same as Canada spends per capita on a system with universal coverage. Tbe same amount per taxpayer in the US that buys a system that covers only the old and indigent in Canada buys a universal system. Draw your own conclusions about funding.
I am Canadian and I know the Canadian system is not perfect. Funding and improving the system is a major issue in Canadian politics, which is as it should be. Even Conservative provincial governments (the Canadian system is in fact a collection of provincial systems) have found there is no public sentiment to radically alter the system.
Even Alberta, the Texas of Canada, recently backed off on plans for a parallel private system due to public backlash.
My own family experience with the Ontario system is generally positive.
A recent Harvard study, published in the American Journal of Public Health July 2006, reports Canadians are generally healthier and have better access to health care than Americans.
You can read it here:
http://www.challiance.org/news/press_releases_06/060525_cross_national_…
Universal healthcare....the investors will not be pleased.... (sarcasm)
For those of us who don't have any form of health insurance, a tent would be a welcome shelter. I have medical coverage on my Jeep but that's pretty much it. If I break a leg while doing my job (a very likely injury considering what I do), I'm SOL. Would be nice if working folks like me had some cheaper health insurance alternatives.
I heard a talk about this on the radio yesterday. Unfortunately, I didn't catch the beginning, so I don't know who the speaker was, but he seemed pretty thoughtful and reasonable. He talked about how people stay in jobs, or even stay or get married, to get or keep health insurance; that we're all held hostage to it, in a way.
He pointed out that larger businesses spend a huge amount of money on health insurance for their employees now; smaller companies who can't or don't offer insurance can't compete for employees. Companies like GM who have plants in Canada vociferously support Canada's national health plan, and write letters every year to the Canadian government about how much of a competitve advantage it is to them to have that. He said one of the mysteries was why businesses aren't vocal proponents of single payer health care (or Medicare for all). On the other side, the insurance and pharmaceutical companies are far more powerful now than they were when Truman first proposed nationalizing health care. (He said Truman was blocked partly by Southern politicians who didn't want hospitals to be integrated... but if he'd instituted it then, it would be seen as American as apple pie.)
One thing he didn't mention was how even people who have health insurance don't really have health insurance for serious health problems. If you're too sick to work for long enough, you lose your job, and thus your health insurance. (You can COBRA it, if you somehow have the money to pay the premiums after you've been laid off.)
The Citizens' Health Care Working Group is largely a sham, and if you look closely at their recommendations, you'll see that they fall short of recommending a comprehensive, public system of coverage that treats access to healthcare as a basic human right.
Why would the Republican Congress and President Bush create such a group in the first place?
There has been more and more organizing in recent years for single-payer healthcare (translation: Canada). See www.healthcare-now.org. This movement appears to be gathering momentum and may soon reach a critical mass. In California, there is a bill to create a statewide single-payer system. Given the allegiances of California's governor (and much of legislature), this will likely be in front of voters in 2008.
This is a growing concern for insurers, because under such a system, they would cease to exist.
Imagine that.
Pharmaceutical companies are concerned because such a massive overhaul of health insurance would almost certainly contain a provision enabling the government to act as a bulk buyer for the entire country, forcing Big Pharma to concede big discounts.
So the Working Group was devised to co-opt these efforts and steer them toward something more acceptable to the coporations that make obscene profits by acting as gatekeepers to care.
"Universal health coverage" can mean lots of things.
Just look at the recently-passed Massachusetts plan, which essentially guarantees profits to insurers by making it mandatory to purchase their products. But there's no guarantee that everyone will receive the same coverage, and that state will see continuing disparities in coverage based on economic status.
So, let's see the Working Group for what it is, and keep our sights set on real reform whose goal is providing a single standard of quality healthcare for everybody.
Oh, and? Contrary to the cultural meme that government bureaucracies are wasteful, in Medicare, 98% (or some number in the high 90s) of the cost is spent on care. Private insurance, that number is more like 80%.
CAIA - Do you have the numbers handy? Several years ago, I heard a presentation by someone who proported to know that the admin overhead for Medicare was 7%, and the overhead for private insurance was about 30%. (does that have to do with golden parachutes???) Anyway, he also said that if all the money currently applied to private insurance and public re-imbursed healthcare (medicare/medicaid) was applied to universal coverage with Medicare's efficiency, we could provide everyone in the USA with the coverage that our Congressrats currently enjoy. (ie. gold plated coverage)I don't know if it is still true, but I bet it isn't far off.
Man: I'm sorry, I don't. I went to the Pacifica radio site, and my local station site, to look for an audio file or just a mention of who was speaking, but I couldn't find it. (I'm not even sure it was a Pacifica program, but a Pacifica program came on next, so I checked.)
It's probably not far off. If nothing else, as Revere mentioned in passing, prevention is cheaper than treatment, and early treatment can be cheaper than later treatment. I.e., it's cheaper to send a Type II diabetic to a nutritionist, monitor their blood sugar, and give them diabetes medication than it is to treat complications of untreated or unmanaged diabetes, from heart attacks to blindness to amputations.
I sometimes think we look down on prevention because it seems too "touchy feely" or something... and we're a rather macho culture, that mocks anything seen as soft. Because all logic is for it. Of course, our leaders hate logic and facts, as well. ;-p
Did the group call for Universal Coverage or Single Payer?
There is a difference, and I'm not sold on a Candaian type single payer system. I would be more interested in a French style universal coverage system.
The most frequently cited source for much of the cost info that people are asking about, is in the NEJM article by Stephanie Woolhandler:
http://content.nejm.org/cgi/content/short/349/8/768
It requires a subscription to view. However, I found a copy that someone posted openly, here:
http://www.uab.edu/dcdc/hsa/Glandon/HA605/WoolhandlerNEJM03.pdf
Although people argue about the numbers, I don't think there is any real doubt: private insurance companies have very high overhead. In contrast, Medicare and the VA have very low overhead. Some people just can't believe this, because it contradicts the widely-held notion that "private business is always more efficient that big government."
I would like to see someone do a comparison of the Medicare Part D drug benefit, and the cost of state Medicaid programs that provide comparable benefits. I would bet that state programs are much more efficient. This relates to what JN said. The insurance industry wants to get a piece of the pie. There is no reason to give it to them. They've had enough already.
I am still convinced that universally mandated coverage is the ticket: premiums would cost vast amounts of money, and create an incredible backlash towards single payer. It would break a few too many eggs to make an omelette, but I don't see an omelette on the horizon. And at 45, I have a strong interest in seeing an omelette in place within the next few decades.
Cervates, over at his blog Stayin' Alive back in April or May had a series of posts on the nature of health insurance. One point that I recall is that in our current system of health care, people switch jobs, and hence insurance companies, often. Any particular company, therefore, figures that if you get sick later it won't be their problem since you'll be with another insurer. So it does not make economic sense for them to spend *any* money on preventative care for you. A single-payer system would not have this economic impediment.
hafabee: Good points. And I strongly recommend Cervante's blog, Stayin' Alive for these and many other public health issues.
I guess regardless of how you feel about Iraq you have to decide whether your want a 45-60% universal tax rate levied on you for the universal health care system. Then as they did in every country in the world, those drug companies, those equipment manufacturers all raised their prices right up to the limit of what was being taken in as taxes. Everything becomes a fixed cost and then the service goes down. Look at the UK. MONTHS waiting to have procedures done. Second rate doctors in a lot of cases doing it too (well we have a few of those here too).
The Canadians hate their health care system. Ask them.
Except for the UK none of them have any sort of real defense budget and its because we pick up the tab. The EU countries have it... but its the same. They all pretty much hate it. Then we have a big problem looming in the illegals. You start providing universal health care and they'll be tunneling all the way to Dallas just to get in. Probably pass out those impossible to reproduce cards as they come up too.
It all sounds so very good. But someone has to pay for this stuff. It will initally if implemented be really good. Then as costs rise to meet all of the available money, they will want more. There are those that think that this is the way to go. Those are the same that thought that managed healthcare was the way to go. In the last 30 years we have gone from the best medical care in the world into just about third world. Doctors dont make decisions, clerks do. You cant have that procedure, it costs too much. By signing up for these HMO's and PPO's we signed literally our lives away. You had to do it because the costs to do it were too high for traditional insurance and the managed health care providers simply made billions.
In Tennessee which was hailed by then President Clinton of the "TennCare" plan as a guide for the rest of the nation towards universal healthcare, we just shut it down because it suddenly accounted in just 12 years for 100% of the State budget. I say again, 100%. The State in the first two years lost 200 million on it. What did they do? Raised taxes and businesses left. Decisions, decisions. After a smooth 2.5 billion dollars in shortfalls it fell apart like a two dollar watch.
Iraq has absolutely nothing to do with what is suggested and that is universal healthcare. This war is near over whether anyone can see the signs or not. I can. Deployments are dropping. Heavy weapon materials are coming back on trains (dust and dirt all over them) . Then anyone think that will free up money for social programs? Not unless you get the drift of a 2 trillion dollar budget. Health problems aside, we could stop the military entirely and still not pay off the debts we already have. We are just marking time here against the inevitable train wreck thats coming.
We will have a presence in Iraq and Kuwait, but we are outta there within two years. Then what? Universal healthcare? Entitlements (Where is THAT in the Constitution? Entitled to what? ) will account for all of the money taken in anyway in about 8 years, regardless of the defense budget and they are going to have to shuck something. Defense will suffer, but its far more needed than healthcare. Why? Because it makes not one whit of difference whether we have healthcare or not. One whack in LA, Chicago, and/or New York ensures that we are done as a nation. Losing one of those would do us. Make your decision. Healthcare or dead? I dunno. Decide which you want to pay for and then tell me later if you were right. You think Osama cares whether you get health care? He is trying to ensure that you need to get it.
You have the right to be dead but we are going to pay just about anything to keep you alive. Anything you could or can say in a court of law will have no bearing we have expert testimony. You have the right to an overpriced ambulance chasing attorney who will sue the hospital, the doctor, and the janitor if he can. If you cannot afford an attorney or the doctor you have the right to healthcare even though someone else is unable to feed their family or compete in a world economy, because you have "rights" in this country.You dont have to pay for it, someone else does.
Do you understand the law as I have explained it to you.
Do you have a source for this claim? From all I've read, Canadians and Brits feel their system has shortcomings, but don't think they should get rid of universal coverage. In fact, I've only heard Americans (usually ones with health insurance) claim our system is preferable to theirs.
Most of the people I deal with in the cargo industry hate their system. Their tax system is pretty whacked out as ours is for the provision of services that both the systems can no longer afford. I love the Reveres for what they want to do, but man when someone says that the money in my pocket belongs to someone else and that they are entitled to it because I do too well then there is something very fundamentally wrong. I work way too hard for the money.
Canada cranked up their socialist state in 1962.Now they are waiting and waiting for things to be done. They just had to pump a billion dollars into the system across the board. Sure they are moderately happy with the system, but even now they are tring to change it to reflect more like our system...Yikes! Uh, and their taxes just went up...again. They got old people too.
Universal payments, universal lack of service. Doctors will become lawyers just so they can sue because you aint going to see this come into effect with boomers outnumbering the kids 8 to 2 next year, 10 to 1 in five and I am not even sure what the 10 year is. Broke is what it means as entitlements will take up 100% of our budge very shortlyt. So the only answer after that is inflating the economy with dollars. Better get used to high taxes, high unemployment and high interest rates. The first and the last will result in the middle. Old people are going to go hungry because of that, so healthcare is going to go down the toilet no matter what anyone thinks. They will likely push the retirement out to 73 or 75 to accomodate it. Still survival of the fittest in the face of big problems. They even have to have co-insurance just to get ENOUGH care when they CAN get it.
Ambulance rides...not paid for. Yeah, that little trip in from the boonies on the airplane is going to cost you... I thought it was universal. Universal B.S. is what it is. I will diverge very strongly with the Revere's on this. They complain about Bush and Frist and quite a few things governmental... Okay who doesnt? On the other hand, do we want our illustrious government to run our healthcare system? Thats what they are saying... Lets just give it to government to mismanage, waste and abuse. Healthcare dollars outweigh I believe if the number is correct the defense budget by 25 to 1 from both private and public money already. It would swamp the DoD budget like a teacup in a tsunami.
But you asked for references...Okay.
Links
www.cbc.ca/news/background/healthcare CBC in depth from feb 16, 06
www. canadian-healthcare.org They are advocating a move towards our system
And the piece de you know what....
www.onthefencefilms.com/video/deadmeat Dont watch this if you are squeamish. Its a take off of an actual case in the Canadian Health Care system.... The guy tanked it.
Make sure you read down on that onthefencefilms.com site that I put in. It goes into a lot of detail that doesnt jump up at our arm chair Americans. I always will say that I can be wrong about many things. On the other hand when the preponderance of the evidence goes the other way, then well hey, I could also limit the number of doctors and call it healthcare too. I sure can keep the costs down that way.
Right here in Memphis TN there are 750 Canadian nurses who have left the socialist system to the north because they said it was falling apart. Not enough clinics, not enough docs, not enough nurses. Damned sure not enough beds.
Hit this one: http://liberyonline.hypemail.com/hnr.html
Again socialized medicine puts all of that money in the hands of politicians. That is one hell of a lot of temptation to balance the budget with. Lets see, we've gutted Social Security, we've floated bonds, we've done everything but what we should have which is to revalue our gold reserves. Cant do that because it would crush the economies of the world to do that! All of a sudden our money is worth something again...
As for Canada, there are all sorts of other stories about healthcare fraud on the part of the purveyors of supplies, political payoffs, actual payoffs...You know, like the United States and the DoD. They have their crooks, we have ours. Do you sing the Star Spangled Banner or Oh Canada?
Next thing you know they'll say the French system is better than ours.
Randy: Right now the health care money is in the hands of insurance companies. An insurance company is just an investment bank. They don't care about my health. I'd rather have politicians, who are (theoretically at least) accountable to me be in control than a 19 year old clerk in Kansas City deciding whether he should approve my Emergency Department visit for kidney stones.
Yes, both the Canadian and French systems are better than ours. I have an American colleague who has lived in France for many years (still an American citizen) and wants to come back to the US to live. I asked him what he would do if he got sick. He said he'd go back to France for medical care.
Canadian system, viewed by a Canadian ( from Ontario ).
System is not perfect. Addressing problems in system is a hot political topic and has been for last decade. This is as it should be. There is widespread public and political support for maintaining a universal public system. The debate is about how to administer and fund it. Hard right governments have not challenged this, with one exception:
Alberta, the Texas of Canada. In that case the public backlash forced Ralph Klein to back down. The Canadian system is run provincially - each province has it's own system. The Federal government funds about 25% of it, the rest is funded by the province. Coverage is transferable for Canadians, if you get sick or hurt in another province, or the nearest treatment centre is in another province, there are no coverage issues.
My own family's experience with the system is overwhelming positive.
We aren't too far of the mark on either side of the fence Revere. You are COMPLETELY correct about the insurance company thing and with a few minor fixes this could be made right again.
With avian, I can see that this will do us all in the medical insurance field. Sure they will HAVE been siting on a bunch of computerized 1's and 0's saying that before it happened, they were worth "x". Fifteen minutes after it starts its going to melt down. They will ask for and get a federal govt. bailout like the airlines and it will still collapse.
How many people will be around afterwards to pay into a then immediately defunct Soc. Security system, or taxes in general? How many will be able to pay?
Everyones healthcare costs went up after 9/11 to cover the insurance companies losses. We could end this with on piece of legislation and that would be to prohibit the use of the premiums that we pay for car, airline, doctors malpractice, general liability from being invested in the stock market. That would turn into the biggest bloated pile of money on this planet. There would be so much that they would have to stick it in old salt caverns. They would be rich on paper and in paper.
Thats the reason we get killed every couple of years, something happens and they sock us for the 9/11's, Katrinas etc. The stock market tanks and we get the bill. Not this time around, not with avian. This will be a full blown system collapse if it goes beyond about 10% on the mortality rate. Complete meltdown.
That last link should be "libertyonline" by the way folks on the previous post. I have to shift between larger case letters down to this small stuff when I post. Hard to read..
Sadly, I can verify that MRK is correct about at least some of his assumptions on what happens when you have free healthcare. In the UK we have healthcare shoppers (don't know why they're called shoppers as they don't pay) come from other countries. I don't grudge anyone healthcare, but UK taxpayers are already squeezed paying for a welfare benefits system that does nothing to get the able but lazy off their butts and working, and encourages indiscriminate procreation at no cost to the procreants.
We can buy private healthcare too though, and it's not as expensive as that in the US. What it often does is push you to the top of the NHS queue. If your condition is serious you are treated in an NHS hospital and you get your own room etc. Same consultants do both public and private care, but when you see the consultant privately you get half an hour rather than 10 minutes and they explain things properly. The private insurers pay the NHS to care for you which I don't think is necessarily a bad thing, as it means those of us who can afford it prop up the NHS for those who can't. However, still they screw it up.
We're all being manipulated for the benefit of a few white collar psychopaths. A decent education effort on diet and nutrition would go a long way to preventing huge numbers of people from becoming ill, but big food lines the pockets of government and they in turn fail to regulate marketing of junk food, and the marketing works. We are worked into the ground to pay back the massive debt we've run up that's kept the economy afloat, and the huge mortgages that have resulted from runaway house prices, so we fail to take time to prepare healthy food and live on microwave meals full of sugar, salt, fat and little in the way of real sustenance. We then indulge our addictions to get some temporary escape from it all. Voila! Diabetes, high blood pressure, heart disease, cancer, etc., etc., etc. Then in steps big pharma to complete the rogues gallery, keeping us alive until just before we get to collect our hard earned pensions (another debacle).
A quick look at the list of business contributors involved in the recent Labour party 'loans' scandal reads like a Who's Who of who is making out of all this.
It's not just healthcare, the whole system is rotten to the core and the elements so entwined we'd have to pull the whole lot down and start over again. Maybe panflu won't be so bad after all.
Reading my own links down to the hard core folks I have just found another part of it that was scary. The Canadian government sued because people were opting out of the program in lieu of traditional insurance for things that they already covered. They didnt want the people to have the right to pay traditional insurance for coverage and to go to the private docs, and that included going to the US to be treated. They were actually going to try to have it criminalized.... ? ! ?
Weird we climb buses to go and get meds that we are subsidizing here for them to have in Canada, by 1/2 higher prices. They climb buses armed with insurance cards and Canuck bucks and come here to get treated.
Anyone have the number to Mobambo the Witch Doctor? I think I feel a headache coming on.'
Randy, that number is 555-VUDU. Dizzy brought up an excellent point about eating habits and nutrition. We eat garbage, drink garbage, sit on our butts all day, and expect to take some magic pill to keep us healthy. No wonder 60+% of this country is overweight. What's the percentage of the population that is considered to be "unhealthy?" Throw in skinny smokers and it's probably over 80%. If people lived healthier lives - from birth to death - health care wouldn't be as much of an issue IMHO. Like that damn commercial about taking a fiber pill because "if you ate all the fiber you should in a day, you wouldn't have time for anything else." Lay off the Big Macs and fries and eat more veggies. Duh. What we need in this country is a grass-roots educational program to teach people how to live healthy lives. Eat right, exercise, take care of your body, be less of a burden on the health care system. Sorry to rant about this, but we THE PEOPLE are responsible for the public health crisis too. We all need to do our part to correct the problem. In the meantime, here's an idea: tax the hell out of all unhealthy food, sugar-loaded soft drinks, cigarettes, candy, etc. and pump that money into the health care system. I mean if it comes down to paying $10 for a burger and fries or $3 for a grilled chicken salad, hmmmm.... OK, rant over.
Check out this site. It lists many private clinics across Canada by province and city.
Private clinics are almost accepted in Quebec. Everyday 1 private clinic opens up in Quebec.
The other provinces will soon follow ;-)