patrick.net

OO,

Right, the current system is designed to reward those that can limp into Medi-care age on a wing and prayer and we'll take it from there! See? You made it! You are now officially someone else's problem.

By implementing 'some' kind of a Lifetime Cap we could legally say, Dude.

Oh, that's "it". Just... Dude.

Not just a lifetime cap, but NHS style rationing?

http://www.telegraph.co.uk/health/2512639/Kidney-patients-denied-too-expensive-life-extending-drugs.html

Niiiice! So now I'm painted into the corner of "clubbing baby seals"?

I mean, why NOT?! Since I'm so f@ckin' good at it.

At 24,000 pounds a year ( that's like what 50k USD? ) what am I supposed to say? Screw 'em? O.k, let's try this, how many starving school kids will go *without* a second helping to make sure we can keep a 62 y.o alive for another year? ( While we're tugging on heartstrings? ) :)

24,000 quid is about $36,000, or about $3,000 per month.

Why does the cancer treatment drug cost so much? Can't they buy it from Canada and bypass the "big pharma" obscene markup?

NHS is doing the right thing.

In UK, you can easily purchase private insurance on top of NHS coverage, I know plenty who bought BUPA (their BC BS equivalent) to cover stuff that NHS doesn't cover.

Why should I shell out $3000 a month for someone else whose chance of living on is very thin anyways? He should be shelling out for himself if he desires to live on so much. As a taxpayer, I am more than willing to pay $3k for starving kids or kids' education because they will have a much better chance to better my future than dying patients.

I am completely fine with buying my own insurance on top of national coverage, and in fact I will never rely on national coverage alone. Life is not fair, people are born into different financial and social situations, or even different inherent health, and medicine is not invented to level such playing field. Socialized medicine is only put in place to give us best effort to save every member of the society, knowing that it is IMPOSSIBLE to save every single one, we have to make tough choices and constantly let someone go.

These kidney cancer patients should have bought BUPA when they were healthy. Why didn't they plan ahead?

Terminal cancer drugs are expensive, no matter where you buy them. They are expensive because of the R&D cost, and such drugs usually have very limited targeted customer segment, so if you amortize $100M over 1000 patients per year, the drugs have to be expensive to recoup the initial investment.

These drugs are also NOT that effective. Their marginal lifetime gain is minimal at best (usually less than 12 months), at the expense of quality of life. Many terminal cancer patients are better off NOT going through the expensive chemo and die with dignity. I have seen two terminal cancer patients who expressed regret in going though the painful process, if they could choose again, they would rather opt for a peaceful death.

It is a sickness of our society to pursue the length of "life" at all costs.

pb3030,

you fail to understand one thing. In the current medical US system, it is precisely the savers, those with sizable home equity and savings, that will lose the most when disaster strikes.

How? Easy. Do you know that for individual insurances, the rejection rate for age group 50+ is as high as 40%? Do you also know individual insurance policies have a much higher denial rate than group policies? They can reject coverage for very minor reasons, acne, psy. consultation session, anything. If you lose your job, particularly in this environment, and your COBRA runs out, and you are rejected by PPO policies, what do you do? Even when you have an individual insurance, you run a much higher risk of being rejected coverage because of "pre-existing" conditions.

Dirt poor Americans, aged Americans are in far better situations. If you are dirt poor, you are covered by Medicaid, from the day you are laid off. If you are 65+, Medicare takes care of all. Now if you are in your 40s, have a paid off house, saved up a few hundred grands, you'd better pray that you don't fall ill, because you are
1) not covered by any government entitlement programs (while there are lot of Americans are covered!)
2) medical bills can clean out your lifetime savings and home equity in a month - and you are completely liable for it if you have money.

So I know the government screws up. But the way it is right now, I am more screwed because lots of other Americans are covered by entitlement programs but I am not, and I have much more to lose should I get into the dire situations. So f*ck it, I am going to get my gravy train as well, let's all have entitlement programs and bankrupt this country together. I am not going to pay for other people's entitlement programs while I am not entitled to anything.

"let's all have entitlement programs and bankrupt this country together"

LOL! I suppose there is... something to be said for "togetherness" 'eh?

I'm in no way saying that people can't make valuable contributions throughout their lives, but I think statistically OO is right. The lunchroom kids have a better liklihood of having a positive impact than an older poet, commentator ( or blogger for that matter? )

Any long time poster here will tell you that if "I" am diagnosed terminal I will make a beeline for TJ and get the most ridiculous sombrero I can find! Then I'll get a bottle of tequila' and a sleeping bag and "move in" to the bathroom! Hey, let's have some dignity here.

Probably been said, but, we are the only industrialized "western" country with no national health service.
Cowboys die alone.

Wow, quiet here today. Is everyone taking the International Worker's Day off?

4 bank failures recorded today ...

Single payer health care is a huge mistake. It is a true example of socialism. Socialism does not work. Why do people flock here for health care from countries that have national health care? It is because they can't get it in their countries. It is because of rationing or lack of services. How would you like to stand in a long line to see a specialist? Especially if you have a life threatening ailment that needs immediate treatment.

Single payer will work in the short term, but will be disastrous in the long run as it goes bankrupt (higher taxes, govt debt and money creation) and will be rationed due to great demand and limited number of doctors and facilities. It is about supply and demand. I heard that doctors are leaving the system in other countries. Who wants to be a slave or poor doctor after spending a tremendous amount of time and money training in med school and getting certified?

Medicare is in deep, deep trouble with tremendous future liabilities. I agree there is greed with insurance companies. I heard about a group of various doctors working outside the system (and medicare) offering their own clinic and services with very reasonable prices. Some doctors will offer charitable services and work with the poor and their ability to pay. That is what the free market is about.

I'm afraid that most of what you've written is just untrue and unsubstantiable, wcalleallegre.

Australians are more than happy with the way Medicare works, bar some tweaking around the edges. Such systems also seem inherently more efficient than the American system with its excessive administrative overhead and for-profit operators.

Rationing is generally not a problem except with the most expensive and exotic interventions. I have had 'free' consults, treatments, blood tests, even a CAT scan all for nothing over time in this system. Pharmaceuticals are automatically subsidised for all with no insurance required -- and some of the insurance schemes end up reimbursing the remaining low cost to $0. Pensioners pay $3 or even $0 for pharmaceuticals. It's mostly funded out of tax dollars in a '30% taxing' country, with a 1.5% Medicare levy top-up. I choose to have a minimal $150 p.a. health plan on top of this that reimburses for dental and optical, scripts, physio, and ambulance costs (none of which is covered by Medicare). You can end up breaking even on this.

A lot of British ex-pats in the US actually elect to return to the UK to get free medical treatment on the NHS rather than contend with the US system. That's a very common pattern.

The US health care system is ranked 37th in the world by WHO, with its low ranking largely due to 'denial of access to care to those who need it'.

Also, in the area of travel insurance, when you look at the zoning of premiums, it's interesting that Europe, Oz and even South America have much lower premiums than travel insurance in the US -- simply because of its dysfunctional billing regime and cost.

Slightly OT, something that just came to me from crikey.com on big pharma and medicos -- heavy US component. People will recognise the Sunshine Act etc. When you consider the extra 'perk' money that goes to doctors and other prescribers of the lavish hotels and meals and conferences and plastic pens going on to the cost of your pharmaceuticals, those little things in plain cardboard boxes in blister packs:

Time for MDs to get out of bed with drug companies
by Ray Moynihan

The powerful National Academies of Science in the United States released a report this week, calling for much greater distance between doctors and drug companies.

The report, written by the National Academies’ widely respected Institute of Medicine (IOM) — which advises America on health matters — calls for a ban on doctors accepting any gifts or meals from drug companies, a move which would have major changes for the diets of many medicos.

In Australia, according to figures from the drug industry, doctors, pharmacists and nurses are provided with free meals by drug companies at more than 30,000 events annually, many of them in fancy restaurants and at flash resorts.

The report calls on the United States congress to make laws requiring drug and biotech companies to disclose every single payment to every doctor, medical association, patient advocacy group and educational provider.

US Congress is currently considering the Sunshine Act, which would force companies to disclose some payments, but the new IOM report calls for more comprehensive disclosure.

The authors write that collaborations between doctors and drug and device makers can benefit society through discovery and development of new treatments, but financial ties “present the risk of undue influence” on doctors’ judgments and may “jeopardise” scientific integrity, patient care, public trust and the “objectivity of medical education”.

With doctors’ education, the IOM report urges the development of “a new system for funding high-quality accredited continuing medical education that is free of industry influence.” Significantly it also recommends clinical guidelines — which can carry great influence over what doctors to their patients —  should not be funded by industry and that doctors with ties to industry should be excluded from the panels who write guidelines.

The tough calls come at a time of continuing controversy in Australia about drug company connections with the development and promotion of blood clot guidelines, and a recent deal between a leading medical research organization and a drug company — both of which are being actively debated at Croakey.

Despite their closeness, doctors and drug companies are becoming increasingly uneasy bedfellows, with calls from the very top of the global medical profession for a major clean up.

A group of influential doctors writing in the Journal of the American Medical Association this month called for medical associations, to “work toward a complete ban on pharmaceutical and medical device industry funding ($0)” for their general budgets, although journal advertising and exhibit hall fees were acceptable. And like this week’s IOM report, the group suggested panels that write guidelines simply exclude doctors “with any conflict of interest ($0 threshold)”.

The new recommendations should give much food for thought, to medical groups in Australia currently debating their relationship with industry sponsors.

http://www.crikey.com.au/2009/04/30/crackdown-on-doctorpharamceutical-romance/

Demographics will be the nail in the coffin of any 'all illness covered except cosmetics' style single payor universal health care system.

it’s interesting that Europe, Oz and even South America have much lower premiums than travel insurance in the US

If medical care is free in those countries, what are buying travel insurance for? Certainly not the medical aspect.

By the way, travel insurance cost through AIG Australia for an Aussie traveling to the USA is the same price as for traveling to Canada or any other destination in North, Central, or South America (except Cuba, where the insurance is not available), or even Antarctica. You would pay about $154 for a one week trip. To go to Europe/Japan/Russia/Middle East, you would pay about $118. Hardly a "much lower premium," especially when travel insurance includes not just medical, but flight cancellation/luggage/legal/car rental/ and related travel coverage.

I thought the medical portion of travel insurance is mostly to cover the travel home?

Hmm, the premium is not so large that it matter a whole lot on an individual basis for a ONE-TIME expense. But what does it mean overall?

I think what matters is that 154/118=1.305, meaning that the expected medical costs for incidents in the US are 31% higher ( whether that is transportation home or medical care or some combination thereof ).

OO, with you on this one. The current US system is just socialized enough to make saving seem risky. If you don't save, your kids might get better financial aid, and you might qualify for Medi-Cal. Some people are afraid of making too much money such that they would lose Medi-Cal and be worse off. There is less and less incentive to accumulate something to lose.

IMHO, it would be better if we had basic universal health care. For one thing, it would cut costs by reducing paperwork. Right now, government agencies put a great deal of energy into making sure that people really qualify for Medi-Cal. That alone drives up cost. My own insurance company spends a great deal of money making sure that my modest expenditures qualify. Why are we paying so much for paperwork? Why not give everyone the basic right to go see a doctor if needed? Then we can all save some money that would have been spent on paperwork, and we can all stay a bit healthier, and we can even change employers and start companies without worrying about having health insurance.

It's not about socialism vs. capitalism. It's about efficiency and humanity.

HeadSet Says:
May 2nd, 2009 at 2:44 pm
it’s interesting that Europe, Oz and even South America have much lower premiums than travel insurance in the US

If medical care is free in those countries, what are buying travel insurance for? Certainly not the medical aspect.

Because only citizens of those countries qualify for free healthcare, not visitors without at least some sort of permanent residency visa level. this one is a bit obvious, surely.

By the way, travel insurance cost through AIG Australia for an Aussie traveling to the USA is the same price as for traveling to Canada or any other destination in North, Central, or South America (except Cuba, where the insurance is not available), or even Antarctica. You would pay about $154 for a one week trip. To go to Europe/Japan/Russia/Middle East, you would pay about $118. Hardly a “much lower premium,” especially when travel insurance includes not just medical, but flight cancellation/luggage/legal/car rental/ and related travel coverage.

your mileage will vary if you shop around between insurers. the US used to be a totally different zoning and much more expensive with the insurer I used, a very large, travel-oriented insurance service. this is just the explicit health component in the policy i'm talking about, nothing about lost luggage etc. they had a map of the world with zoning rates on it for health insurance, vs all the other inurance options you make reference to. interesting that russia or the middle east charges less than the US for the same service -- isn't that telling you something right away? as per the Cuban adventure on 'Sicko'.

I just realized that this thread is part of a completely different forum. I was waiting for a new thread o nn housing. Turns out there is one, just no following this page.

Because only citizens of those countries qualify for free healthcare, not visitors without at least some sort of permanent residency visa level. this one is a bit obvious, surely.

Not so obvious, since we are talking about emergency care and not some kind of medical tourist. Emergency care under the NHS for a visiting foreigner who is affected by accident or sudden illness is covered. I even saw this in action when living in Thetford, England when a Japanese friend of my wife and her two daughters came to visit. One of her daughters became sick and was treated at a London hospital. When the Japanese woman inquired about paying the bill, she was told the treatment was free.

US is the only developed country that is not a part of reciprocal medicare system among the league of well-to-do countries, because our cost is significantly higher than all other countries.

UK visitors can receive reciprocal medical care in Australia, or Spain, or Canada, etc. By reciprocal medical care I don't mean just emergency room visit, you can actually go see a regular doctor for checkups, treat pre-existing ailment just like the local residents. Their NHS benefits are PORTABLE.

Not so lucky for us. I was looking into reciprocal medicare before because my wife and I want to split our retirement time among a few countries, US, Australia, France, etc. and we are dismayed to find out nobody in the world will provide reciprocal medicare to stupid American system because we are so much more darn expensive than everyone else. That will limit our retirement alternatives quite severely. Either we have to pay out of pocket (and such alternative only exists for age below 84, beyond 84 we will be stuck in the US with a bankrupt medicare system for sure), or we need to start considering emigration to built our medicare credit in another "normal" developed country.

UK's NHS was doing fine before, but it was heavily abused by illegal immigrants or visitors from some poor countries, yep, through emergency room visits.

No country should provide free emergency room visit to a non-citizen, non-resident. It is just morally wrong for those who pay into such a system. People should be responsible for their own actions, if you travel to another country, buy travel insurance. If you cannot afford a travel insurance, don't travel, stay put.

If free emergency room visit is to be provided on humanitarian reasons, it should be rationed at a few hospitals only, on a first come first served, bigger than rationed capacity, not served basis.

OO,

If you are unable to build "medicare credit," will you be able to buy medical insurance?

No country should provide free emergency room visit to a non-citizen, non-resident.

The Mexican Consolate claims more than 300,000 cases of refering Mexicans to free medical care, just in LA County. I wonder if California itself is the world leader in providing free medical care to non-resident, non citizen people.

If this thread is getting too long, note that all readers how have the ability to create new posts. After logging in, just go to "User Control Panel" in the header. Should be clear from there.

Patrick

Headset,

if you want to retire (or spend several months out of a year) in another developed country, aside from the reciprocal medicare program, you can buy private medical insurance only up to a certain age. For some countries, that age is 70, for some that is 65, there is currently a worldwide medical insurance offered by Lloyds of London (if they don't go belly up by the time I retire) that will insure you up to age 84 for a lifetime max of $3M(or 5M?), which is plenty for other countries with much lower medical cost. The monthly cost is around US$1500 for the 65+. But you have to pay everything out of pocket first, and apply for reimbursement later (which you may or may not get).

Old people (migrants or tourists) are generally unwelcome in any country, unless they are rich of course. These private insurance offered to elderly tourists are usually prohibitively expensive if you want anything other than emergency room visit, and they also have a much higher deductible.

The fact that UK NHS program is portable is a major reason why the Brits have the highest percentage of elderly in any country retiring overseas, particularly to warmer weathers. It is a very sweet deal that you can get a medicare card in your new destination country and enjoy the same benefit as home.

I don't know why people talk about national coverage program and freak out about lack of choice. This cannot be further from the truth.

My parents are covered by basic Australian medicare, which is really quite, uh, basic. They have a national drug program that covers the most common hundreds or so drugs, so if you need one of these drugs, your out of pocket is $3.xx flat. Now, most branded or advanced cancer drugs are NOT covered, unlike our stupid medicare, their national drug program doesn't allow reimbursement of $20/pill drugs. If you happen to need these exotic $20/pill drug, you will need to buy your private insurance on top of the basic coverage.

So everybody gets some sort of safety net. Then my parents buy private supplemental on top of the national coverage, which is still cheaper than our medicare supplemental program of the same age group. They never have to compromise their treatment, always go to the best doctors and use the best private hospitals, no wait time at all. It is the same for British under NHS, there are plenty of private coverage on top of NHS that you can purchase. Their national+supplemental coverage is *better* than my group Blue Cross PPO, and certainly way better than my individual Blue Cross PPO. And their cost? Most definitely lower.

I have no idea what the complaint of wait time and lack of choice is about under national coverage. All those whiners are just too cheap to buy supplemental. It is not like these whiners will get a better coverage under the US system either, want to see the premium difference, coverage difference between Blue Cross PPO and Humana HMO?

OO Says:
May 5th, 2009 at 1:14 pm
I don’t know why people talk about national coverage program and freak out about lack of choice. This cannot be further from the truth.
Because that's why they've been told to believe by vested interests such as the medical fraternity and their lobbies (AMA, etc) for whom the false rhetoric of 'choice' can be used as a discourse to fool most of the people all of the time.

Similar to the way right-wing Republican thinktanks are kept busy manufacturing reasons for keeping people down and having them accept the reasons, believe them, and even parrot them to other people.

Most Americans who are fearful of losing "choice" under a national coverage medicare never had the choice themselves.

I have heard many times from people who have a much worse medical plan than myself saying that they are fearful of losing their "choice" if we adopt the same "socialist" medicare program, not aware of the fact that they are in fact under-insured for major illness, and they don't have the dough for "choices" available in the US. In fact, most Americans are not aware that their medical choices are TIED TO, CHAINED TO their jobs, once they lose their current job, they will lose their medical choice immediately, and their future employer may not offer the same medical plan. I keep the best individual plan that money can buy on the side just in case I lose access to the group plan, but the "choice" is really limited because of out-of-pocket cost considerations. I would rather have the option of most basic national plan and load up on my private, personal supplemental.

Many better-than-average American doctors do not accept low grade high deductible medical plans, some of them do not even accept low deductible individual PPO plans. Those Americans who think they have a great access to choices will only find out the painful way later than their prized medical insurance is basically, crap, that leave them no access to better doctors or better medical facilities, they are already living under a rationed, compromised socialist medical system under disguise. Especially for HMO subscribers, what "great choices" do they have right now?

DS and OO,

Very well put, by both of you.

OO,

Much like there is a a large group of Americans that are afraid that rich people will get taxed too much, although with almost certainty that same group will never make it to the income levels they are worrying about.

Just pasting this in here in its entirety, from crikey.com ;)

Guy Rundle writes:

Barely drawing breath after his ground-breaking Cairo speech, Barack Obama is charging into what will be one of the biggest stoushes in American politics, his plan to reform the hopeless US health system.

Obama launched his campaign in a speech in Wisconsin, urging people who supported him to get behind the plan and lobby their Congress members, because "this may be our one chance to get health care reform through."

It would be difficult to over-estimate the risks associated with trying to make even the most basic changes to US health-care. It was after all the failure of Hillary Clinton’s complex plan in 1993 that did more than anything to hole the Clinton Presidency below the waterline, at least as far as being a liberal regime went.

Clinton’s plan wasn’t even the dreaded "single-payer" system, the term the US Right uses as some sort of North-Korean image for what Australians would know of as Medicare -- baseline state-run universal coverage supplemented by private options.

Instead it was an attempt to continue to run health insurance through private providers, while explicitly mandating how much they would charge, how much they would pay out, limiting their ability to exclude people with pre-existing conditions, and so on.

It was a scheme designed to please no-one -- Big Health were always going to be against it, and the liberal-left wouldn’t get behind it because they were still holding out for a single-payer system, which would not -- as would have the Clinton plan -- flood rivers of gold into the insurance companies for stuff that could be done at knock-down prices by the state.

Since then, the organized left have been pretty much beaten down in Congress, and health care in the US has become much worse. This has given Obama a great political opportunity to get real reform through -- but only at the price of proposing a scheme so unthreatening to Big Health, that it will see the wisdom of acquiescing to it.

Why did American health get so much worse than it was at the time of the Clinton plan, when it was already pretty dead? Deregulation between 2000-2006 was one factor -- a release of the (fairly-worn) brakes that were on the insurers in terms of denying continuing care to the chronically ill, excluding pre-existing illnesses and aggressively using the bankruptcy laws to recover costs.

Another has been the open-ended nature of private medical care -- as new techniques and tests are introduced year-on-year, open-ended health plans are faced with spiralling costs, created by the increasing demands of patients, and the desire of GPs to bill for endless additional (and often unnecessary) services.

With no qualitative and triage-based control of health-care spending, the more consumerist options will crowd out necessity. The ideal health insurance client is a member of the "worried well", paying top-hole premiums for routine services, the lions’ share of the service fees going to the insurers. The worst client is the one for whom any rational health system should be designed -- the chronically ill, the suddenly desperately ill, the seriously injured etc, and health insurers spend most of their energy throwing these people off their lists.

The coup de grace has been the sharp rise in unemployment in the US, which has deprived many people of their employer-based health insurance--– the auto manufacturers bail-out deal alone cuts by 50% the health care available to up to a million former car workers and their families, just as many of them are ageing.

The core of Obama’s plan is what’s known as a National Health Insurance Exchange, which is a sneaky way of offering public health insurance to the 45 million Americans who don’t have any insurance whatsoever (and aren’t eligible for the below-poverty-line Medicare scheme) -- and simultaneously providing subsidised matching fixed-prices schemes offered by private providers, so that no-one can scream socialism.

Surrounding this are various measures such as $10 billion in grants to get nationwide electronic record-keeping up and running -- US hospitals are the last places in the developed word where the faxes run hot day and night with paper records being transferred -- and some real battles, such as prohibiting the exclusion of pre-existing conditions.

The advantages of the scheme are all political -- people are so angry with health insurers (average premiums have doubled in the last six years), terrified of bankruptcy (half of the million bankruptcies a year in the US are due to medical costs), and worried for their children’s health, that Congress members who simply roll over for their Big Health campaign donors will find themselves the target of grassroots attack in upcoming party primaries for the 2010 elections.

The disadvantage is that it’s a monstrously expensive way to achieve what single-payer cover does for half the cost, and twice the result -- provide universal optimum health. But if Obama can get this, and if the 2010 Senate vote gives an enhanced Democratic majority, then there is a bridgehead from which non-pauper public health cover can be expanded, thus denying the Right the chance to make a huge fight over it, and gradually converting the American people to the idea that public health provision is not socialism.

And also, if it succeeds, proving once again that the road of recent American political history is littered with the bones of those who underestimated Barack Hussein Obama.

If it fails? We may find out -- health insurers here are starting to make noises about unaffordable Medicare and transitioning to a US health system. So remember to choose which leg you’d like to save if they both get infected, because your plan may not cover both.

It isn't socialism unless the government owns the means of production. Paying the bills is not the same thing as owning the hospitals.

Kevin says

It isn’t socialism unless the government owns the means of production. Paying the bills is not the same thing as owning the hospitals.

Government has no money to pay for increased health care costs. We are facing record breaking budget deficits for the next several years.
Until the government spending is brought under control, the health care reform should be focused on reducing the health care costs, not expansion of government sponsored helath care coverage.
Printing money / borrowing from foreign investors to pay for ordinary budget items is selfish towards the next generation.

nosf41 says

Kevin says

It isn’t socialism unless the government owns the means of production. Paying the bills is not the same thing as owning the hospitals.

Government has no money to pay for increased health care costs. We are facing record breaking budget deficits for the next several years.

Until the government spending is brought under control, the health care reform should be focused on reducing the health care costs, not expansion of government sponsored helath care coverage.

Printing money / borrowing from foreign investors to pay for ordinary budget items is selfish towards the next generation.

And a single payer system would reduce costs. The fact that it happens to cover more people is just a nice bonus. Eliminate the paperwork, the middlemen, the people who only get treated at the ER, and you'd definitely lower costs dramatically.

Kevin says

nosf41 says

Kevin says

It isn’t socialism unless the government owns the means of production. Paying the bills is not the same thing as owning the hospitals.

Government has no money to pay for increased health care costs. We are facing record breaking budget deficits for the next several years.
Until the government spending is brought under control, the health care reform should be focused on reducing the health care costs, not expansion of government sponsored health care coverage.
Printing money / borrowing from foreign investors to pay for ordinary budget items is selfish towards the next generation.

And a single payer system would reduce costs. The fact that it happens to cover more people is just a nice bonus. Eliminate the paperwork, the middlemen, the people who only get treated at the ER, and you’d definitely lower costs dramatically.

I wish I had such faith in government efficiency. Past behavior is a good indicator of a future one. Promises do not mean much.

Just to remind you, the official word is that the health care reform is not an introduction of a single payer system - it is a competing plan to private insurers.

One of the problems with government sponsored health care plan is the possibility of mandated coverage of morally objectionable procedures (abortion).

nosf41 says

I wish I had such faith in government efficiency. Past behavior is a good indicator of a future one. Promises do not mean much.

Past performance is almost never a good indicator of future performance, actually. Our military kicked righteous ass during WWII. How's Iraq going?

nosf41 says

Just to remind you, the official word is that the health care reform is not an introduction of a single payer system - it is a competing plan to private insurers.

Yes, Obama's current plan is for a government insurer to compete with private insurers, which may very well lower costs enough to bring us back in line with other countries -- but that doesn't mean that single payer will never happen, nor does it mean it's not a good idea.

nosf41 says

One of the problems with government sponsored health care plan is the possibility of mandated coverage of morally objectionable procedures (abortion).

I don't follow. Your concern with government insurance is that it might pay for abortions (even though the dems have gone out of their way to exclude abortions from their legislation)? Can you name any private insurance program that does not pay for abortions today?

Feel free to debate abortion all you like, but that's a pretty weak reason to object to the program as a whole. Regardless of whether insurance pays for an abortion, it's going to happen anyway (it's not like it's expensive), and there are much better ways for you to argue against abortion if you're so concerned about it (bringing young women out of poverty and educating them about their own sexuality would be a good start).

Kevin,

the Iraq war is not a war. It is a "nation building/peacekeeping mission" with an unclear objective and an enemy which cannot be defined or identified. The only way to win is to leave.