Is it really only the REPUBLICANS who are against single payer?

[Rosa Luxemburg]

When we win back the House in 2014 will it be a direct road to single payer healthcare? What do Democrats really think of single payer? Is it a yeah?

[CTyankee]

1. I think single payer is great. I am in favor of Medicare for All

It is the easiest, most efficient and cheapest way to do this.

[Rosa Luxemburg]

3. Yes!

[Niceguy1]

6. me, too

but I'm concerned over government control and lack of options that we currently have in our system. I like being able to choose my providers and clinics and hospitals that I choose to go to. That might not be available under single payer.

[ChazII]

13. That is my main concern

as well.

[Niceguy1]

16. I will not support anything

That removes choice from the equation.

[ChazII]

17. Neurofibromatosis is the genetic

disorder/disease that my son and many of my cyber friends suffer from. For most of us, especially those in small towns across the country rely on going out of state to see specialist for treatment. The parents of the children with brain tumors, or plexiform tumors need these doctors as the average pcp only sees these types of patients when they are in medical school.

My point being that in some cases the insurance companies (and even friends) don't comprehend the reason why we choose to go out of state if there is a doctor or hospital in state that treats the NF. If a better hospital such as St. Jude, Cleveland Clinic, John Hopkins, etc.... has a better program, why should anyone be denied. Yet, it has happened. Back around 1993, Children's Hospital of Los Angeles told me that they would be unable to treat my son if Hillary Clinton's program were to become fact. The reason being that Phoenix had its own children's hospital that treated NF and we were not in their 'zone'. I believed the hospital as they had no reason to lie and at the point parents from all around the western states brought their child to that hospital.

I only use NF as an example and this could apply to anyone regardless of their health concern.

[Niceguy1]

18. I heard that is a problem with the ACA

That it can't cross county lines? I am from a rural county...all of the big best hospitals are an hour away in a different county along with the more specialized doctors. If the restriction is true its not good at all.

[ChazII]

19. Niceguy1, not a problem with ACA

to my knowledge. It might be one of those items that is 'hidden' such as "You can keep your plan." I was referring to the plan that Hillary Clinton was in charge of back in the 90's. As we all know that plan was never put in place.

What I was trying to say, which I failed to make clear, is that I am afraid for my friends with children 26 years and younger, that they will not be able to cross county or state lines. This is one topic I don't think has been addressed in a very public, get the message out manner.

I hope this makes sense and does not create unnecessary worries for you. Again, I do not know if this restriction is in place with the ACA.

[Niceguy1]

20. I heard it is

But who can tell? I guess we will find out.

[CTyankee]

21. I wonder what they do in Canada. They have universal health care and regional provinces.

They also have remote, rural places. If they are happy with it, I don't see why we couldn't adopt something similar. And as far as I have heard, they have excellent care and Canadians are happy with it.

[ChazII]

24. Hopefully some of our Canadian

friends will give us an answer. For example if you live in British Columbia but there is a top notch specialist for your condition/ailment in Manitoba could you go out of province. CTyankee, I have heard that the Canadians are happy as well.

[CTyankee]

25. Every other advanced nation in the entire world has universal health care in one way or

another, but definitely not with for-profit insurance for basic health needs. And none of those countries want our system. And they are constitutional democracies, just iike here...funny, ain't it?

[ChazII]

39. It is indeed funny but

I still want to know if my son would be able to keep his cranio-facial team (10 different departments) who have already completed 3 debulkings on his tumor. That was the case back when Pres. Clinton was in office and we were told would not be able to stay at CHLA. Thankfully, we dodged that bullet at Congress left the insurance alone.

[CTyankee]

47. I'm not convinced that universal health care would be the enemy of your child's situation. I can't

believe that every other advanced nation in the world has not had people facing the same situation as yours. Yet they manage to have better results at cheaper cost than our system. If they denied health care in those countries as you say you would be denied under the Clinton plan, don't you think their people would demand changes be made?

I suspect that it is not national universal health care that was necessarily to blame for the problems presented in the Clinton plan as you have explained them. It seems to me that if the care provided locally to you is insufficient for your child's needs, a waiver should be in place to cover the cost of going out of the local region. Surely, with evidence that your child will be better served elsewhere, you would be able to get your coverage where it is better.

[ChazII]

49. Parents would certainly demand as they should

that changes be made. Why should we need evidence that our child would be served better elsewhere? Many of us choose not to stay at our local hospital. Just because a doctor has the medical training does not mean she or he is an expert. Not all hospitals are equal and we need the experts at CHOP (Children Hosp. of Philly), St. Jude's, CHLA or CHOC.

In my son's case it was the cranio-facial team of Los Angeles that made the diagnosis. Prior to that my son had been to Barrow's Neurological Center - the one where Mohammed Ali was treated as well as the Queen Mother of Saudi Arabia and they were unable to help. Many hospitals fail to treat the families as we are members on the same team Instead opting to treat us by asking, "And where did you get your medical degree?"

Now, what does all of this have to do with the insurance? First, we need to feel comfortable with the team as there is often up to 10 different doctors or more treating our child. Second, who the hell as the right to tell me where my child would best be served? That is a decision that is best made by the parent(s).




http://www.google.com/search?hl=en&site=imghp&tbm=isch&source=hp&biw=1198&bih=687&q=neurofibromatosis&oq=neuro&gs_l=img.1.1.0l10.2236.3057.0.5830.5.4.0.1.1.0.13.35.4.4.0....0...1ac.1.32.img..0.5.39.Wapxw7fwLBs

The African-American in the second row, last picture is my friend, Reggie. Now tell me, would you want just any geneticist, ophthalmologist , dentist or plastic surgeon treating any patient. I sure as hell wouldn't.

Off topic - looking forward to your Friday art challenge.

[CTyankee]

50. no doubt about it that it's very complicated when you have multiple doctors treating a patient.

I would like to know how other countries with single payer/universal health care deal with the situation you describe. I really don't know what such a federal plan would include in terms of standards of care, but certainly if one hospital isn't meeting those standards, there should be no question that accommodations be made.

Please join me this afternoon a little before 5 for the Challenge...hope you enjoy it!

[ChazII]

58. Your challenges are just that challenging

It is not often I can name even one but I do enjoy learning.

Yes, it would be wonderful to learn how other countries manage. From my friends in Australia who also have NF, a great deal of time goes into co-ordinating all the necessary things that need to be covered. The doctors and different therapist do not meet in one place. Therefor e-mails, phone calls and faxing information back and forth is how it is often handled.

As parents we love our medical teams and do not want to be told that we have to change just for the sake of changing or for some bureaucrat who does not truly understand.

[enlightenment]

26. Most of the plans are state oriented,

but there are plans on the exchanges (I believe it is required) that allow you to use facilities in other states. I suspect they carry a higher premium, of course.

[Doctor_J]

32. Complete horseshit, right from the Gingrinch campaign slogan book

Every developed nation except one has SP or socialized medicine, and there are no such problems.

Thanks for stopping.

[Niceguy1]

42. diacounting peoples concerns

Like that doesn't win supporters. What other countries do doesn't mean that will happen here....

[eridani]

41. There is no other way to guarantee complete choice of providers EXCEPT single payer

Employers and insurance companies have increasingly narrow provider pools, which are constantly changing. Every single payer model gives everyone the choice of any provider, period. Naturally that doesn't help you much if you live 100 miles from the nearest hospital, but you're in exactly the same situation now.

[Doctor_J]

43. Yeah, that post came directly from the Gingrinch/Limpballs anti-HillaryCare campaign from 1993

Posts from Fox Nation are not hard to spot

[Lugnut]

14. Definitely!

Medicare for all would mostly eliminate parasitic health care insurance companies from bulk of the process. Providing supplemental plans to cover what Medicare doesn't would be their only market. That market would need to be well regulated to protect subscribers from out-of-control premiums.

I would like to see a Medicare that provides prescription coverage as well as dental and eyeglass coverage eliminating separate policies. That will never happen but I can dream.

[PassingFancy]

44. Absolutely - Medicare For All

Single payer is the only way we should have gone and that we should go. We are the only industrialized nation in the world without some form of a single payer system. It is the easiest, most efficient, and cheapest way to do health care.

As to the question in the original post - I'd have to say that it's primarily republicans who are against single payer; however, I also know there are some Democrats who may be very hesitant about a single payer system.

[ebbie15644]

2. Dems are against it too

The could have passed when Obama got elected, they chose not to.

[Rosa Luxemburg]

4. Who?

Blue doggies? How many do we have of these?

[CTyankee]

5. I don't really think they had a choice...the insurance companies had a "fix" going in....

Obama wanted some kind of universal health care and made the deal with those companies....it was baked in the cake...I am disappointed, but I will support the ACA (as a stepping stone to single payer).

[Rosa Luxemburg]

8. Then doctors won't be running businesses to make money

[enlightenment]

27. Unfortunately,

the for-profit insurance companies are now part of the path - and they aren't stepping stones, they're semi-submerged crocodiles.

[CTyankee]

28. But isn't it up to US to determine whether or not we'll have single payer health care?

And I mean that term in the broadest sense. Can't we get political leaders who will get us Medicare for all and let the insurance companies just insure the "extras"?

[enlightenment]

30. Of course it is up to us.

That being the case, I'm not holding my breath - we are as divided a nation as ever in our history right now; perhaps more than at any point.
I do not believe that a true " 'free' at the point of service" single-payer system can work unless it happens at a federal level and is applied equally to all states - so I do not hold with the idea of an incremental, state by state approach. There are too many variables - too many ways for states to implement such a system. What is required is a consistent plan, applied consistently - and that requires federal intervention.

"Medicare for all" is one option (I'm not convinced it is the best one, but at least people seem to understand the phrasing) and certainly well-regulated insurance could provide coverage for the extras - but that's not going to happen under the current set of circumstances, or with the current crop of politicians.

Personally, I don't believe we will see any substantive change in our political culture unless and until we achieve real and substantive campaign finance reform. As long as we believe a politician's value is in any way related to their ability to raise campaign funds; as long as we allow a system to stand that limits participation to those who have - or can raise - millions before primary season starts; as long as politicians can, essentially, buy their office . . . as long as all that is in effect, the only changes that happen will be window-dressing.

[CTyankee]

31. re: the state by state approach.

It occurs to me that Canada has already solved that problem and I would like to know how they achieved that. We often hear the argument that a remote, rural state can't and shouldn't be held to a standard that a more urban, highly populated state would have. Evidently, Canada did get over it's problem of having the same situation with its differing provinces.

[enlightenment]

36. Canada implemented a top-down approach that allows

the provinces leeway to make their own choices within a defined set of conditions:

http://www.canadian-healthcare.org/page2.html

[CTyankee]

37. I was in Montreal last monh and heard about the wait times for MRI's etc.

But if you need a test for a critical health issue, you don't wait (depending on the severity of the problem). Or at least that was what I was told by a Canadian citizen.

[enlightenment]

38. Wait times aren't too hot in the US, really.

I would anticipate slippage on wait times - toward longer waits - next year, when the flood of newly insured hit the marketplace.

[Rosa Luxemburg]

40. My husband had to wait 8 weeks to get radiotherapy here in the USA!

I've had to wait weeks to see a dermatologist or gyny. In the UK I never had to wait long.

[Laelth]

52. Excellent graphic.

Looks like the UK gets the most bang for their buck (or pound sterling, if you prefer). Perhaps we should do what they do.



-Laelth

[enlightenment]

56. The Commonwealth Fund

does great research - and many useful graphs on a variety of healthcare related topics. Their "Chart Cart" is fantastic.

http://www.commonwealthfund.org/

[Laelth]

57. Nice link. Thanks. n/t

-Laelth

[enlightenment]

59. You're welcome.

I would recommend caution on using their analysis - the research is good, but their board of directors makes me just a little leery of their overall agenda. I could be wrong; I don't know enough about the people on the board nor how much input they have . . . it's just that some of the members (like Simon Stevens) set off my alert siren.

I do like the research, though!

[Laelth]

60. I appreciate the heads-up. n/t

-Laelth

[enlightenment]

61. 'Ta! :) nt

[Doctor_J]

33. We already determined that we want it. Our "representatives" said no

And the ACA has codified the insurance companies' $600,000,000,000 per year profit. There is no way they're going to let go of that.

[Journeyman]

7. I will be astonished if any substantive change to healthcare is addressed in the next Congress. . .

The ACA is only recently implemented, it has had some issues in the startup, and no one yet knows how it will be perceived in three months, let alone three years.

I'm certain tweaks and adjustments will be made to the law in the next few years, but until its acceptance is an established fact, I doubt any politician will want to revisit that issue anytime soon. Perhaps President Obama's successor will have the political wherewithal to address some of the substantive issues about the ACA, and if we're fortunate they'll be able to explore the possibility of Single Payer.

[Half-Century Man]

9. The federal government is not the only path.

If we get a state to go with a public option replacing for-profit insurance and drop rates even more. I expect a domino effect to ripple through the system.

[Doctor_J]

10. The party leadership is against it. They are whores for Big Insurance too

And as we've seen many duers will go along with anything the president says and does. This is probably true of the rank and file too

[JoePhilly]

29. Sure, which is why no one thinks the Federal exchange creates a perfect platform for

single payer approaches as we go forward.

I mean no one has noticed this ... and Democrats are absolutely, positively, against it.

Right?

[Doctor_J]

34. Who thinks that? this was a definitive step AWAY FROM sp

It increased the insurance companies' customers from those who want insurance to every single American. And "Dems" like Blanche Lincoln President Obama, and Joe Lieberman helped to sink SP in 2009.

[JoePhilly]

35. Sure, and no states are considering adding their own plans either.

[Laelth]

53. Sadly, that's a pretty accurate statement.

However, the Democratic Party has changed a lot over the past few years.

But three developments suggest this time really could be different. The first is that, even at the elite level, the party has changed far more over the last few years than is widely understood. Chris Murphy, the Connecticut senator, estimates that not too long ago, congressional Democrats were split roughly evenly between Wall Street supporters and Wall Street skeptics. Today, he puts the skeptics’ strength at more like two-thirds.

http://www.newrepublic.com/article/115509/elizabeth-warren-hillary-clintons-nightmare

While that quote is specifically talking about the Democratic Party's attitude toward Wall Street, I think it's fair to say that the party, as a whole, has become more liberal recently. For a long time, the insurance industry was a sacred cow, and neither party would dare threaten its interests. Times are changing, though. As the party becomes more liberal, it's possible we may see enough courage emerge to actually challenge the power of the insurance industry.

Perhaps.

-Laelth

[el_bryanto]

11. I think that in the short term Democrats will be commited to making the ACA work

Which isn't single payer. And I think there are likely to be enough blue dog democrats or wall street democrats who would oppose it in any case to make it a hard row to tread.

I'd like to be wrong.

Bryant

[truedelphi]

15. What you say sounds ture. Especially given that the Big Insurers will have even

More money, offered up to them by the individuals who now MUST purchase insurance, and the various levels of government that now must subsidize it.

If the Big Insurers, and Big Pharma could get their way back in 2009, then how would they not get their way in the future, when their increased profits would enable them to purchase even more clout in congress?

[question everything]

12. Mary Landrieu

I remember her claiming that "small businesses" are against a universal system.

And I thought then and am thinking now that employers - small and large - do not belong in health care.

[bemildred]

22. All cheap labor conservatives and neolibs are against single-payer.

Single payer makes it easier to move on if the boss is an asshole, and it removes one of the excuses for paying less.

[Enthusiast]

23. "Corporatist" Democrats are against single payer.

Because they represent the insurance industry and the for-profit medical services industry. At our expense (I might add).

[PassingFancy]

45. Greedy People - Politicians and Otherwise - Are Against Single Payer

And, that is exactly why we must go with single payer and put these health insurance companies totally out of business. They are parasites (just like auto and homeowners insurance companies are parasites). Insurance is just a legalized scam - pay, pay, pay premiums and when making a claim, the insurance companies all try to find every possible way (legal and illegal) to avoid paying the claims. I worked in the auto/homeowners insurance industry for 11 years, and there is so much corruption and greed in insurance that it makes me want to throw up.

[Enthusiast]

46. I am with you 100%...........nt

[Arkana]

48. No, and anyone who pretends otherwise is living in Liberal Fantasy World.

The President himself isn't in favor of it--I believe he said in the 2008 primaries that if he had to build a system from the ground up, he'd use the single-payer model, but he feels that we have to improve the framework of what we have.

[Lns.Lns]

55. A couple of things have to happen first

The screaming and yelling has to stop first. Once it settles down and the "horror stories" from the right move on to the next "scandal" du jour.

Next, we have to stop limiting the amount of doctors. Start training more specialized nurses for many everyday visits.

Next, a big state like mine (California) has to pass single payer. We did twice under a Rep Governor who vetoed it. But I don't see that being a problem in the future. It appears to be Dem Governors as far as the eye can see.

I've read a couple of stories about insurers starting to diversify into other businesses... I can only assume they see the writing on the wall.

As for all those who are think single payer would have been such a great thing at the time the ACA was passed, have you ever thought of the employment disruption when the unemployment rate was between 9 and 10 percent? That would have changed, IMO, the dynamic. I watched every bit that was televised and it just got thru by the hair of it's chinny chin chin. It is a big deal and we should be patient and keep Dems in office and turn the house. Then when my state turns (fingers crossed), the battle will be well on it's way to being over.

There is a reason why budgets are designed over 10 years. It takes a long time to turn a large country in a new direction. Sometimes people don't realize what an action has on the long term. For instance, much of Clinton's economic success came from the Reagan's major tax reduction. Much of turning us away from another Great Depression came from the stimulus (small as it was) and the Fed flooding the system with liquidity. Both things are artificial in the long run. They get absorbed. Doesn't mean that I disagree with the latter. Sorry, I digressed... that is an entirely different subject.

[Half-Century Man]

51. I'm an ex-military brat and a vet.

I spent the first 24 years of my life under a universal health care system. There is no excuse for wasting money on insurance middlemen. They contribute nothing but unnecessary overhead.

I don't know if a majority in the House and Senate would result in implementation of a single payer system. I have hope. I do think that Vermont adopting a public option a couple days ago makes a huge difference. I see it as the first domino to fall.

[polichick]

54. The majority of Americans wanted it. Dems held the WH and both Houses of Congress...

It ain't just RepubliCons who don't want it.

[Rosa Luxemburg]

62. It shows how some of our party are influenced

by big corps