Before we all become pinkos can we at least update the Constitution to make health care a right. If a Constitutional amendment can get through congress then fine.

I don't wonder much about the exclusion of the single payer option.

I worked for many years with Medicare as a single payer for long term care residents, where -- as soon as it became apparent that the law as passed would cost over three times as much as projected -- the bureaucrats were instructed to clamp down WITHOUT changing the law. And clamp down they did: claims disallowed over and over again, leaving the provider to provide the care for free. So providers opted out. Then they were REQUIRED to participate for state licensure. Then Medicaid chimed in, breaking the link between costs and payments. The result? Over 2/3 of long term care facilities in Minnesots pushed to the brink of bankruptcy -- a condition that remains to this day.

Still, some misinformed doctors even today tell their patients "Medicare will cover it." And the public mistakenly believes it.

Government single payer plans in my experience are good for only two things: creating huge bureaucracies to gobble up taxpayer dollars, and volumes of paperwork designed to give an excuse for not paying for legitimate expenses incurred in taking care of their client.

I've been on Medicare since becoming eligible years ago. I have yet to see Medicare pay one dime for any of my medical needs, and I don't expect they ever will.

So I don't wonder much about the exclusion of the single payer plan: I think most people aware of how OUR government pays in that instance would prefer a plan that actually PAYS for care provided.

Joe,
It is already in the pre-amble to the constitution. The common welfare clause.

John,
The idea that government run health payments cost more and are less effective just are not supported in a fact based world.

We pay more than all other nations for health care and our health is rated #37.

The facts, irrefutable, are that single payer countries spend much, much less and get better care.


Even worse, is our government, even under this private system, spends 7% of GDP on health care, and we don't even cover everyone. Then add to that 8% of GDP health care costs from private sources, and we spend 15% of our GDP for health care.

So, in essence, your taxes are already paying the price of universal health care but it is done in the most efficient way because the government only covers the most needy that are too expensive for the insurance companies. In essence, your tax dollars help subsidize the insurance companies profits because they only have to take on the most profitable clients.

So, the bottom line is that single payer is cheaper AND offers better care.

France spends half as much as us, and they are rated #1 in health care while we are #37.


P.S.
You cannot blame our poor health on us just being fat McDonalds eaters either. Some of the things that figure into the ratings is that our health system loses more infants to death than 30 other nations. Our health system loses more mothers to death during childbirth than more than 30 other nations.

Our health care is atrocious unless you are wealthy or healthy

Every Canadian I know has expressed their full satisfaction with their health care system. And all of them prefer it to anything like ours.

The current health care system is broken.

But so is our financial system.

So ..... can we have banks and health care that are in it to serve their clients (the presumption of single payer) or must we hope that clients will be served while profits are sought for business owners?

I'd have to say - in both sectors - the profit motive has been found wanting - it overruns everything else. So people cut deals that are fraudulent ... to get paid for deal-making in banking ... and health care companies find every conceivable way to compete ... except on price. When margins are squeezed, everything is cut before profits.

So I'm one in favor of single-source payer - and deliverer - of health care. And banking too - hear that, Mr. Cooper? TCF as a government enterprise, who knew it might work?

Socialism doesn't scare me as much as unregulated capitalisim .. not anymore.

Well spoken, Alec. There's also the hideous logic of carrying insurance from entities that essentially want to provide you with as little health care as they can get away with. Insurance companies inherently have opposite goals than the people they insure. The simple insertion of "profit" in health insurance creates this institutional irony.

We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.

So you're interpreting, "promote the general welfare" to mean health care for all? Wow!

The spin: "Just for the record, the Canadian single-payer system covers everyone, costs much less than the U.S. system and Canadians have longer life expectancies than Americans."

The facts: "We thought we could resolve the system’s problems by rationing services or injecting massive amounts of new money into it."

"We are proposing to give a greater role to the private sector so that people can exercise freedom of choice."

~ Claude Castonguay; the "father" of Canadian socialized medicine responding to the failure of his "child".
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"Patients in Atlantic Canada suffering from chronic pain have to wait for more than 18 months for their treatment in pain clinics. The survey found that more than 460,000 chronic pain sufferers are waiting for their treatment in pain clinics the long wait was due to inadequate doctors and hospital staffs in hospitals. But still lots of emergency patients are referred to these hospitals and these patients have to wait for their treatments.

Angus MacIsaac, Health Minister said that he his aware of the problem and has added an additional funding of $300,000 to this years budget which will help in upgrading the health facilities and recruit more physicians in the hospitals."
=============

Oh, yeah....we want *that*.

Everyone complains that health care is too expensive. The problem is that to make it less expensive requires someone, somewhere, to make less money.

The battle in congress is largely over who those losers are going to be. Not surprisingly, the status quo with no losers ends up the winner. If someone could design a reasonable health care reform that would allow the industry to make more money, we wouldn't have been debating it for over a half century.

Whatever the merits of single-payer, there is almost no doubt that all parts of the existing health care industry would make less money than they do now. Thus there is almost unanimous opposition from the major players to such a system.

BTW, I don't think anyone who is willing to pay for it has to wait for health care in Canada. You can always pay a private doctor directly. Of course, it costs just as much as in the United States and that is a lot more expensive than using the single-payer system. But given its financial impact on the health care industry, Baucus is right that a single payer system is a non-starter.

The Obama/Daschle/Baucus/INDUSTRY plan is not written to fulfill the Constitution's promise of government by and for the people.

It is written to salvage, at our expense, the failed system we now have because that's what the insurance companies and other health care corporate entities want. With a few sops to fairness for patients, it leaves the for-profit industry in charge of managing our health care in ways that maximize its profits.

On Saturday, one of the nationwide "Obama" events will be so bold as to present info on both the administration plan and national single-payer -- the plan that would save us taxpayers $400 billion per year while leaving no one without care, the one that actually serves us instead of the corporate donors that have so richly donated to Baucus and his committee.

The event, "Health Care Reform, Fact & Fiction," will be held from 2:00 to 5:00 at Good Samaritan United Methodist Church, 5730 Grove Street, Edina 55436. Y'all come.

Ross Williams: John Conyers' HR-676 plan would phase in over 10 years and, while saving money from Day 1, would let the insurance industry fade away mostly by attrition.

"Pinko." With such arguments were can certainly reason together.
If the Constitution included every single law and act in the United States that enabled or provided for something . . . Well, I leave that to your imagination.
Our founders in their wisdom made the Constitution deliberately vague and open to what might come about in the future--a future they knew they probably could not envision. They provided a rough framework and left it up to those who followed to fill it in.
That's why, even if you could define the terms "Activists" and "strict constructionists," they probably would still make no sense.

" I don't think anyone who is willing to pay for it has to wait for health care in Canada. You can always pay a private doctor directly."

Exactly right. The same is true for England and Germany.

So those that can afford to pay their own way in addition to subsidizing the public system are assured of quality service. Everyone else is forced to make due with what the government provides.

Hmmm, that reminds me of something.....oh *snap*!

It's just like the coast to coast disaster we call the public school system.

Oh yeah, sign me up for that!

Ross Williams:"The problem is that to make it less expensive requires someone, somewhere, to make less money."

Exactly. And therein lies the tale:

Let's say we cap MD TOTAL COMPENSATION at $120,000. That would cut costs. It would also mean a lot of people who are now attracted to the profession would look elsewhere. We already have a shortage of family physicians (average income under $200,000) because everyone wants to be a specialist (average income $300,000-500,000). We could then share Canada's problem of not having enough professionals to provide the promised care in timely fashion.

We could do what Medicare already does, and put HOSPITALS on a "one size fits all" fixed reimbursement schedule. Of course, as it already is meaning for small town hospitals, that would soon restrict health care availability to the major population centers. But the government would not mind: fewer centers is a good way to both limit what it has to pay and to lay the blame on someone else. (See my comment above on how Minnesota reduced it's Medicaid costs by forcing beds to be eliminated by bankruptcy -- we have almost 20% fewer beds available than we had in 1980. So the government still offers Medicaid, but there will be nowhere to go to get it as the boomers come online.)

Or maybe we put the DRUG COMPANIES on a "cost plus 10%" basis, block abusive patent practices where an old drug is changed just enough to get a new patent, and prohibit all media advertising for prescription drugs. Or we could just legislate that our drug companies cannot charge a penny more than the mininum price at which they sell their drugs worldwide. Might work, if we want to settle for the current drugs for the next fify years. Well, maybe not: we could buy our drugs from India. Or maybe we could use tax dollars to fund all research (as though THAT works for AIDS and Cancer).

Then there's that other big health care cost: LIABILITY INSURANCE fed by voracious lawyers willing to sue if you get a hangnail after you get care. We could ban lawsuits altogether, or we could limit claims to actual damages plus a fixed legal fee. This would be a piece of cake in a government single payer system: you can hardly ever sue the government, no matter how badly they screw up. Otherwise, good luck to you if you do in fact get substandard care.

We could put the MEDICAL EQUIPMENT MANUFACTURERS on a direct cost plus 10% basis. That would be a pretty good way to assure no new equipment will be designed or built -- at least not here in the US.

Or perhaps we could by law require all health care provider and related industries personnel to join a religios order and take a vow of poverty...

But somehow, I don't think any of these solutions would help much in getting what we all really want: a caring, knowledgeable person who is near when we need medical help, with the right equipment and supplies to provide that help.

One final thought: it's so easy to lie with statistics -- just don't consider the variables, gloss over the differences in what is measured, and ignore the relevant indirect consequences of any plan, and you can make it look great. I don't believe the statistics quoted about other countries for this very reason. It is very clear to me that ALL these statistical techniques have been used in those comparisons.

DR. DAVID HIMMELSTEIN: I guess the question is: do politicians actually want a legacy that's more than we got elected and made a lot of money for our later lives. So, you know, Tommy Douglas, who started the Canadian national health insurance program, his grandson is Kiefer Sutherland, the well known actor, was recently, in a Canadian survey, voted the greatest leader in Canada's history.

BILL MOYERS: The founder of the national insurance program?

DR. SIDNEY WOLFE: Yep.

DR. DAVID HIMMELSTEIN: And that's the kind of legacy that Barack Obama and the leaders of this Congress have an opportunity to create.

BILL MOYERS: So, what are you up against? Where is the balance of power in this fight in Washington right now?

DR. SIDNEY WOLFE: What we're up against, essentially, is the health insurance industry.

BILL MOYERS: What do the politicians have to fear from the industry? Does it come down just to the power of to the power of money? To the fact that campaign contributions really determine how elections go in this country?

DR. DAVID HIMMELSTEIN: Well, I think there are going to be campaign contributions. There are going to be massive TV advertising campaigns. There is going to be an avalanche of resources put into the field to try and protect the billions of dollars of profits they make each year. So, I think the politicians really are afraid that they're going to lose their elections. And lose the pot of gold at the end of their political careers.

DR. SIDNEY WOLFE: Money buys Washington, as you know. So I think we need a whole new culture there, we need a culture of courage, as opposed to a culture of cowardice. We need people who feel the pain of families who lose 20 thousand, 18 thousand people a year. And those are probably conservative estimates, which are probably much higher right now. This is a serious thing. It is a war on the American public being conducted, orchestrated, and thus far won by the health insurance industry.

DR. DAVID HIMMELSTEIN: I've been working on this for 30 years, and the encouragement is that the American people are much more mobilized than they were the last time we debated this issue. I'm old enough to remember that it looked like civil rights legislation was a lost cause, until we had Presidential leadership on it.

BILL MOYERS: Given that hope and these realities, what do you think will happen between now and August when Congress said it's going to act on health care reform? What should happen between now and then?

DR. DAVID HIMMELSTEIN: Well, I think the American people need to be very vociferous in standing up for what they need and what they want. And that means calling their Congressmen. It means demonstrations. It may mean civil disobedience. It means doctors in white coats coming down to Washington and letting them know that, in large numbers how we feel. And frankly, we need the President and we need the Speaker of the House and the Leader of the Senate to find their voice for the American people.

BILL MOYERS: Sid, you've been watching this and involved in this since 1971. What happens if they pass comprehensive health reform that is really just more of the same in disguise? What happens to health care after that?

DR. SIDNEY WOLFE: Well, the country, whether it's the employers who have to pay for it, or the patients who are paying for it, is going to go bankrupt much more quickly. It is not economically feasible to pass anything other than a single-payer, government collecting the money and paying the bills, and provide health care. It's never been done in any country. Taiwan, of all places, said, we don't like the fact that 40 percent of our people are uninsured. They passed, essentially, single-payer plan and within a few years 90-95 percent of the people were covered.

So, we have lots of models to draw on. Learn something from Canada, learn something from Taiwan, from a number of other places. It's inexcusable that we do anything but that. Anything that passes is not going to work. I guarantee that, 100 percent. And David will agree with me.

DR. DAVID HIMMELSTEIN: Well, and what happens is that the health care system gets worse and worse, fewer and fewer people can actually afford the care they need. And we will be having this debate again, unfortunately, relatively soon. And I guess I fall back to Winston Churchill's quote that you can always rely on Americans to do the right thing after they've exhausted every other possibility. So, that's what we're working on.

BILL MOYERS: David Himmelstein and Sid Wolfe, thank you again for being with us.

I'm married to a Canadian. All the Canadians I know complain about their system but much prefer it to the US which they view as rather backward in this regard.

Issues of cost: it costs way less for total healthcare in countries that have a single payer system. That's just the facts. See stats from others above. Anyone who says it will cost more than now is wrong and maybe on the payroll of the insurance industry.

Issues of quality: hard to get around that their citizens live longer and die less often as children than ours. Yes, it takes longer to get your bunion fixed. (unless you self pay) But it doesn't take longer to get cancer or heart disease treated, see the stats.

Issues of feasibility: I don't follow this argument. How are the Brits, Germany and Canada able to do this and we can't? In what sense are our neighbors to the north more capable?

I'm not saying single payer is the best option, only that all the above issues are bogus. We could do it, it would be a huge money savings and the results would be as good or better than what we have.

Doing nothing is bankrupting us. GM now, Medicare/Medicaid soon.

As I read of the actions and words of Max Baucus, I have the feeling that without public oversight, the fix is in on health care reform.

The miracle of socialized medicine!

CNN:

LONDON, England (CNN) -- Some English people have resorted to pulling out their own teeth because they cannot find -- or cannot afford -- a dentist, a major study has revealed.

Six percent of those questioned in a survey of 5,000 patients admitted they had resorted to self-treatment using pliers and glue, the UK's Press Association reported.

England has a two-tier dental care system with some dentists offering publicly subsidized treatment through the National Health Service and others performing more expensive private work.

*But more than three-quarters of those polled said they had been forced to pay for private treatment because they had been unable to find an NHS dentist.*

==============

AP:

As a steady stream of celebrities pay their last respects to Natasha Richardson, questions are arising over whether a medical helicopter might have been able to save the ailing actress.

Montreal's top head trauma doctor said Friday that may have played a role in Richardson's death.

"It's impossible for me to comment specifically about her case, but what I could say is ... driving to Mont Tremblant from the city (Montreal) is a 2 1/2-hour trip, and *the closest trauma center is in the city*.

Our system isn't set up for traumas and doesn't match what's available in other Canadian cities, *let alone in the States*," said Tarek Razek, director of trauma services for the McGill University Health Centre, which represents six of Montreal's hospitals.

===============

NYTimes:

Canada's Private Clinics Surge as Public System Falters

Accepting money from patients for operations they would otherwise receive free of charge in a public hospital is technically prohibited in this country, even in cases where patients would wait months or even years before receiving treatment.

The country's publicly financed health insurance system — frequently described as the third rail of its political system and a core value of its national identity — is gradually breaking down.

Dr. Day, for instance, is planning to open more private hospitals, first in Toronto and Ottawa, then in Montreal, Calgary and Edmonton. Ontario provincial officials are already threatening stiff fines. Dr. Day says he is eager to see them in court.

"We've taken the position that the law is illegal," Dr. Day, 59, says. "This is a country in which dogs can get a hip replacement in under a week and in which humans can wait two to three years."

"Why are we so afraid to look at mixed health care delivery models when other states in Europe and around the world have used them to produce better results for patients at a lower cost to taxpayers?" the premier of British Columbia, Gordon Campbell, asked in a speech two weeks ago.

============
CBS News:

(AP) A letter from the Moncton Hospital to a New Brunswick heart patient in need of an electrocardiogram said the appointment would be in three months. It added: "If the person named on this computer-generated letter is deceased, please accept our sincere apologies."

The patient wasn't dead, according to the doctor who showed the letter to The Associated Press on condition of anonymity. But there are many Canadians who claim the long wait for the test and the frigid formality of the letter are indicative of a health system badly in need of emergency care.

"It's like somebody's telling you that you can buy this car, and you've paid for the car, but you can't have it right now," said Jane Pelton. Rather than leave daughter Emily in pain and a knee brace, the Ottawa family opted to pay $3,300 for arthroscopic surgery at a private clinic in Vancouver, with no help from the government.

"Every day we're paying for health care, yet when we go to access it, it's just not there," said Pelton.

The average Canadian family pays about 48 percent of its income in taxes each year, partly to fund the health care system. Rates vary from province to province, but Ontario, the most populous, spends roughly 40 percent of every tax dollar on health care, according to the Canadian Taxpayers Federation.

*The system is going broke, says the federation, which campaigns for tax reform and private enterprise in health care.*

==============

Did you catch that? Canada's single payer health care system consumes 40% of every dollar; it's going broke and people are suffering.

We want this *why*??

Regarding the request that we update the Constitution before we all become pinkos:

Nothing in the current Constitution prohibits a national, single payer health plan. Congress (Republican or Democratic)can tax and spend its little heart out for whatever it decides is appropriate, with very few limits.

Which illustrates a very fundamental point about our system of government: its purpose is to do what we, the people, decide we want done. No more, no less. That's the purpose of a democratic republic.

When enough of us tell the politicians that we want a health care system that works for all of us, then we'll stand a chance of getting one. Until then, we'll continue to limp along with a bastardized arrangement that leaves the poor and the high risk people to be cared for by the government or not at all and those with health care coverage subject to the vagaries of a bewildering array of state laws.

The threat of a single payer system, or any governmentally operated health care plan in competition with private plans, may be enough to bring the current health care industry into line, but don't count on it. There's too much money at stake, despite industry claims to the contrary. No one fights to keep losing money.

Will someone have to make less money to make it affordable? Maybe. Will someone have to pay more? Again, maybe. There will be trade-offs. There always are.