Here's the full text of the House Healthcare bill released today July 14, 2009

[Better Believe It]

It's in pdf format.

http://energycommerce.house.gov/Press_111/20090714/aahca.pdf

[Cant trust em]

1. 1018 pages of fun. nt

[Dawgs]

2. Did you get to page 876 yet? Holy shit.

Just kidding.

:evilgrin:

[Better Believe It]

3. When will the public option kick in for all individuals and employers?

January 1,2010?

I don't have time to study the legislation now but could someone who finds information on when the public option kicks in please post it.

Thanks.

[high density]

4. We're looking at 2013

The public option will be offered as part of the "Health Insurance Exchange." (p 117)

[Oregone]

5. Does the exchange wait until then to start? (And hence, the subsidy)

[high density]

8. It says people can't start using Health Insurance Exchange until 2013

Eligibility seems to be phased in over three years, starting with 2013. (page 74)

[Oregone]

11. Ouchy. Thats unfortunate. Seriously, how long does it take to set something like this up?

A lot of the details look good. I don't agree with the overall approach, but the subsidization plan has great potential to fix a lot of problems for those who can enroll.


The big concern is correcting the problems associated with insured people still going bankrupt from medical problems.

[Davis_X_Machina]

64. The late start is to keep the 10-year..

..total below the magic $1 trillion mark. Otherwise President Nelson and President Landrieu and President The Other Lincoln and President Baucus will veto it.

[Better Believe It]

7. I couldn't find any date on page 117. What section of the document is

the date given along with the exact page number?

Thanks.

[high density]

9. It says Y1, which is set out as 2013 on page 14

Sorry it was on page 116, not 117.

[Better Believe It]

10. You're right. That's outrageous. It won't kick in until sometime in 2013!

And after the Senate is done weakening it perhaps it won't kick in until 2020!

[vaberella]

43. How is that outrageous? It's actually very realistic and makes sense.

You expect things to go 195 in a year?

[wroberts189]

60. Case in point Medicare passed and had 90% coverage in a YEAR

http://www.pbs.org/moyers/journal/05222009/transcript2.html

DR. SIDNEY WOLFE: When I hear something like that, you sort of have to say, "What about all the people whose health care is so disrupted that they can't even get in the door at all? What about the people that are underinsured?"

It's interesting, because before Medicare passed, which is in 1965, we had older people, either uninsured or going to private insurance. And within a year of the time Medicare passed, the disruption, meaning that they were actually able to disrupt not having health insurance or having under insurance, 90 percent of them were already in Medicare. So, we already have a model in this country of how non disruptive it is.

When you hear the word "disruptive" what you're really hearing is code for "it would disrupt the health insurance industry." And that's exactly what needs to be done. So, disruptive is the wrong word.

[SpartanDem]

61. But Medicare was enacted on of top existing Social Security legislation

By contrast the SS program itself took 5 years to be fully operational.

[wroberts189]

63. Only because of the source of funding .. our paychecks. nt

[wroberts189]

35. Why on God's green earth do they need FOUR YEARS !!!

Just expand Medicare and let people buy plans from it. It will take a couple months.

[vaberella]

44. Not really. Keep in mind there's a lot of bureaucracy.

Expanding medicare and possibly adding those who are part of medicaid into the system deals with enacting a whole new system. First and foremost you need the facilities, then you need the man power, but before all that you have to have all the logistics cleared and you have to make sure all departments are talking to each other. Then there's the whole reorganizing, books, manuals, new training and what not. This is not something that happens overnight. I'm just scraping the surface.

[wroberts189]

50. Then simply expand medicare coverage for all until they have had their 4 years.

Maybe that will make it happen faster.

[vaberella]

51. Hello...didn't you read my post?!

Can you imagine the administrative overload that would have on the current system. Shit would collapse before anything gets started. Medicare is already has understaffed and underpaid workers and then you're going to open the doors to several million people without any sort of regs which would flood the system to collapse. Logistical chaos is what you want and causing health care to fall flat on it's face. One of the key arguments of REpubs is that it opens the door for millions of people in an area that is highly understaffed---and they have a valid point. This doesn't mean that people shouldn't be given health care. However, when you implement something like this you need to make sure you have everyone under one umbrella. Which brings up one of the points I didn't mention, the medical systems that already established and having them all fall under this plan---this would affect Massachusetts set up as well. You have to these things into consideration.

Your statement, shows that, unfortunately, you are totally impractical in regards to health care reform. You don't change a mess that was created, sustained, and made worse over 50+ years within a few months. This could take years in it's own right to make sure it's bloody functional.

[wroberts189]

57. Yes I read it and do not agree. They could easily do it.

Why are you so vehement about it?

If they simply spent the money required. Expanding Medicare would not be the nightmare scenario you paint. Just ask Dr Dean.

We put people on the moon in less time then that. We did WW2 in less time then that.


Things become very practical and easy if you put up the cash.

[vaberella]

71. I study health economics...that's why.

It's not easy and since you can't see that...whatever.

[wroberts189]

72. Why not expand Medicare for all immediately, fund it, and see what happens?

Problems.. of course there are always problems. Fix them as you go. Simple.

You might even save the economy as business no longer has to worry about "benefits" and reaps the profit.


It might make a good study for you.

[vaberella]

74. You go for low hanging fruit. Again as I stated, your talking about logistical chaos.

The problem is not opening medicare and then fixing it. We don't have the facilities to even take care of our medicare patients already---and then you're flooding it with millions. You want the base or the infrastructure to be stable before doing that.

Let me give you an analogy of what you're suggesting: Your taking a condemned house with people still living in it and suggesting that they rent out more apartments and they'll fix it as they go along but the foundation is not even strong enough to maintain the people living in it let alone take in more people.


It's irrational. You'd rather people in the home move out and renovate the house and then move everyone in----logical. All of the health programs we have are having problems that are being addressed currently and so this is another thing. We don't flood people into the broken home---we at least make it work able and/or give them alternate homes until their main home is hospitable. This is exactly what their doing. I don't know how many ways to explain this though...because I've said it before.

[Davis_X_Machina]

65. The delay...

...is required to keep the 10-year total cost below the magic (don't say 'arbitrary', you'll hurt President Nelson's and President Baucus' feelings) $1 trillion number.

[WinkyDink]

77. Sure. AFTER the demise of our species in 2012.

[dflprincess]

6. From what I've read

I'm sure the health insurance companies are breathing big sighs of relief.

[vaberella]

45. Then you didn't watch the Health committee meeting yesterday.

There's a lot of language in here putting care providers, ie private insurance, big pharma, and private hospitals in check.

[ThomCat]

47. Yes, but there are no teeth behind it.

:(

The regulations on insurance and care providers seem to be setting very incredibly low minimum standards, little in the way of audits or verification, and nothing substantial for smacking any company that is out of line.

[LiberalAndProud]

70. K&R

& bookmarking.

[ThomCat]

12. Some good and bad, a summary review.

1. (Bad) Right from the beginning, the stated purpose in Division A (on page 4) is to reduce the growth of cost of health care. Not to reduce the cost, but to slow down how quickly it gets more expensive. How is health care going to be affordable if reducing the cost is not part of the goal?

2. (Good) Includes a Public Option.

3. (Bad) using the term Spouse when referring to partners who are dependents, so Domestic Partners are excluded by this language as long as DOMA is still in force.

4. (Good, sort of) Age based pricing on individual health plans cannot vary by more than 2 to 1. So the cost of a health plan for someone elderly cannot be more than twice as expensive as it is for someone young.

5. (Bad) Rates can still vary by region, with limit on how much they can vary, though the regions are not defined and can/will be defined by the commissioner for this insurance later. This will mean that lobbying is going to determine how much more we get charged in cities compared to suburban or rural areas, and how much more in big cities vs smaller cities. This is a big loophole as far as I am concerned, and could become a big giveaway to insurance companies.

6. (Good and Bad) There is an effort to make mental health care and substance abuse care more available, but there are a lot of caveats, complicated referrals between sections in this bill, so that only a lawyer can figure out if any health plan really has to offer any care, what types, and with what availability or restrictions. It's good that the attempt is here, but clearly a lot of lobbying was done to make this complicated, so this looks like it's probably just a symbolic attempt.

7. (Good, maybe) The commissioner will create standard guidelines for how to determine the Medical Loss Ratio, the rate paid out in medical coverage relative to the amount charged in premiums. This is good because each company won't have their own way of calculating their MLR to best hide their profits. One set of rules apply to everyone. Though, there don't seem to be any teeth for catching them if they don't use this methodology, or for doing anything about it. The commissioner "can" do audits "in response to complaints." That seems to means that if the rule-braking gets too blatant and obvious, and the complaints get too loud to ignore then the commissioner will do an audit, but otherwise anything goes.

8. (Good) Once a standard Medical Loss Ration methodology is set, the commissioner will tell insurance companies what MLR to use, in other words, how much profit they can reasonably make from the premiums they take in. The rest HAS to go towards providing health care. Again, I don't see anything in here for verifying this, or doing anything to companies that take extra profit. It's probably going to be buried in future rules.

9. (Good, maybe) There will be minimum standards for plans. Though, no word on how low the minimum will be, or how variable and confusing the minimum options and choices could be. It's good to have a minimum, but it's better if the minimum is clear, consistent and set at a high enough level to ensure quality care. Nothing here requires that it be clear, consistent or set at a useful level. It looks like this section was heavily influenced so that the minimum can be set very, very low just so they can say there is a minimum down there somewhere, and to weed about the grossest abuses without really effecting most plans at all.

10. (Very Good) "A qualified health benefits plan may not impose any restriction (other than cost sharing) unrelated to clinical appropriateness on the coverage of the health care items and services." This seems to be a very straight forward clause prohibiting plans from arbitrarily refusing to cover certain services if those services are listed as covered, or refusing to cover them for select or certain people. There are other, more explicit non-discrimination clauses in this bill too. So, to the extent that anyone obeys this bill it's wonderful, but to the extent that this bill is toothless and enforced by a toothless new agency (read below) it is symbolic but at least it's there.

11. (Very Good) Qualified plans are prohibited from having annual and lifetime caps on services! :woohoo: :)

12. (Very Bad) The standard for a Qualifying plan is the "average prevailing employer-sponsored coverage." So if employers start offering less to their employees, the standard for these government qualified plans goes down. They have pegged the quality of Everyone's care to employer provided health care as a way of making it Necessary to preserve employer provided health care. :grr:

13. (Very Bad) The Cost Sharing (amount they make you pay in co-pays and deductibles) starts out at $5,000 per year per person for the basic plan and can go up each year linked to the consumer price index. Enhanced plans can not only cost more, they can also have a higher rate of "cost sharing," meaning you pay a greater rate relative to what you get. If you want more than basic, you have to be willing to pay more, and then pay extra for it. How the Fuck is any of this considered Affordable? This section all by itself is going to keep health insurance out of the reach of the Vast Majority of Americans. :grr:

14. (Bad) An advisory panel of medical and "Other Experts" will recommend what is to be covered on various levels of plans. 17 members are appointed by the President, only 8 of whom are federal employees. 9 more are appointed by the Comptroller General of the U.S. There are guidelines for trying to avoid stacking the panel with lobbyists, but even so I can easily see at a glance that over half of the panel could be stacked. (Can you say "rewards for largest campaign contributors") This means insurance lobbyists, pharma lobbyists, health care lobbyists, "experts" on corporate payrolls, and a token public advocacy doctors.

15. (Good, maybe) There will be an Ombudsman's office to help people within this new Government Department. But the duties of the Ombudsman seem to be defined mostly as providing information and helping to fill out paperwork, not really acting as an advocate to resolve serious disputes. Nor does the Ombudsman have any authority, because even the Chairman doesn't seem to have much authority. The Chairman is referred to state agencies and directed to "work with them" to get anything done. The Ombudsman would have vastly less influence and authority than even that. Just what we need, toothless advocacy.

16. (Very Bad) Repeatedly, it is stated that nothing in here supersedes state laws. This means that this new government agency will have to negotiate a hodge-podge of 50 sets of rules to implement their influence over insurance, and has to be weaker than the weakest of those 50 sets of rules. This guaranteeing that this new government agency will be toothless and absolutely no threat to the insurance industry. It looks like the lobbyists won. :(

17. (Good, maybe) There is a whistle-blower protection section in here. But it simply gives whistle-blowers the right to bring legal action under existing laws if they face retaliation, and we know that existing laws are absolutely insufficient and ineffective in protecting whistle-blowers. So it's good that this is in there, but it's useless until the underlying law is updated and improved.



I'm sorry, that's as far as I can get right now. I'll dig into this further later tonight. :)

[Cleita]

13. Bad, too much invested in Medicare advantage programs and too many pages.

This should be eliminated altogether. This awarding of Medicare funds to private insurers and HMOs is one of the reason Medicare is in trouble.

[Cleita]

14. Wrong Place. sorry

[Massacure]

16. I don't agree with point 16.

It should read

This means that this new government agency will have to negotiate a hodge-podge of 50 sets of rules to implement their influence over insurance, OR has to be weaker than the weakest of those 50 sets of rules.

I bet the states in the northeast and west coast will pass laws that will make care there much better than that in the south.

[ThomCat]

17. I don't think this new agency will be in the business of

negotiating new laws state by state. What federal agency has every tried to write state laws, or done so to strengthen those state laws?

[Massacure]

18. If the a state's legislature passes laws requiring certain coverage

That law then supersedes this bill, correct? So then the federal agency has no choice.

[ThomCat]

21. That's true. But that is an entirely separate point from

what you claimed you disagree with in my post.

I said that that federal regulations must be weaker than state laws. Not that the states can't beef up their laws. Of course the states can change their own laws. But regardless of what the states do, the federal regulations must remain somewhat weaker than whatever the then-current state laws are.

You claimed in your post that the fed could work with the states to pass tougher laws, and that just doesn't happen. Fed agencies do not get involved in passing state laws.

[Better Believe It]

20. Thanks you for your hard work and thoughtful analysis

I'm looking forward to reading your further findings.

[Jennicut]

23. Awesome work. I owe you one.

The cost sharing...uggg.

[uponit7771]

24. HOW THE FUCK IS 5000 DOLLARS "AFFORDABLE"!?!??!

People, it's not...that's the problem we have now!!!

[wroberts189]

26. Thanks .. I also noticed mandatory coverage is in there

I bet that will kick in way before the public option is set up.

[wroberts189]

27. Did I read that right? 5k deductable on top of basic plan cost? nt

[uponit7771]

28. Yes, that does NOTHING to lower cost...it's what we're spending TODAY as a nation and

...a good reason there's a wage gap.

The insurance was half of that ten years ago.

[wroberts189]

34. Damn ..it sounds they they are killing the public option with delay and making it more expensive.

I also read in it that the public plan has to absorb all start up costs and initial operating costs. What the hell? How is it going to do that ? Huge high interest loans from Goldman Sacks perhaps?


sigh......

[ThomCat]

30. That is for co-pays and deductibles.

It doesn't say how that cost would be split between the two. But, yes, that is $5k on top of the cost of the premium if you actually need to use your insurance. :(

[polichick]

29. Thanks so much for that review! nt

[RandomThoughts]

32. If it turns out ineffectual, or toothless, there are always other options.

Things are going to change. I don't think of it as one side winning or losing, if the people lose so do the corporations, and with a population ratio correlation, and if the people get a good plan, then the corporations will continue in some form.

[Better Believe It]

33. Here's another option .... Sarah Palin's Healthcare Plan

"Jesus Will Make It Better" bandages along with a "Jesus Heals Hearts" sticker.

[Cleita]

40. Or there's a free bullet when you want to end it all. n/t

[ohheckyeah]

36. $5,000 a year?

How is that helpful to poor people?

[uponit7771]

55. ...you missed the PER PERSON part. So a family of four will spend 20,000.00 dollars

[ohheckyeah]

67. No, I just forgot to include that.

Well, shit, I have insurance now with a $3500 deductible and it's not very helpful.

[Cleita]

15. This plan won't save any money and the public option doesn't look all that

wonderful to me. It seems like not everyone will be able to participate unless they are within certain income classifications. Also that 3% not covered seems to come up to seventeen million uninsured according to a guest on Ed Schultz. This is hardly an answer. I read about 500 pages and scanned the rest.

[ThomCat]

19. That 3% not covered is a pipe dream. It's going to be much, much

higher than that. There is no way the basic plan is going to be affordable to people making less than upper middle class income.

After paying the premiums it will Start at $5,000 per year per person for co-pays and deductibles for a person who needs to use their insurance. How many people do you know who will be able to pay the premium, and then if they need to use the insurance pay $5,000 in co-pays and deductibles just to get access to that insurance?

That is for the absolute minimum insurance plan, the one that most people will end up with because (income distribution being what it is) most people are poor. :(

[Cleita]

22. Move over. I need to share that wall to bang my head on. n/t

[uponit7771]

25. ****5000.00 DOES NOT REDUCE THE COST OF HEALTH INSURANCE****

That's the average the MIDDLE CLASS (not the average of 7900 as a whole) pays right now...

The whole point of the reform is the middle class's premiums were going up and creating a bigger wage gap, well...there's nothing that helps is here.

We'll be STILL spending 2 trillion a year on health care and most of that on insurance.

[avaistheone1]

48. That's a big disappointment.

[Better Believe It]

31. Congressional aides say only about 9 million will be insured by public plan by 2019!

2019!!!???? Guess the private insurance companies will provide a better insurance deal which won't be much of a deal at all. That's a level playing field for ya!

------------------


Congressional aides said about 9 million people would be insured by the public plan, with 21 million insured by private companies in the exchange by 2019.

* Another 164 million would be insured through their employers.

http://www.reuters.com/article/governmentFilingsNews/id...

[ChiciB1]

37. Okay, Looks Like The Devil Is In The Details... And Details, And Details...

and MORE DETAILS! Thanks for the quick synopsis, but does anyone else think this thing really ISN'T what REAL HEALTH CARE reform is??

Seems to me that if you make one provision after another and then wrap it back around another caveat, it's just a bunch of mumbo-jumbo that needs some LAWYER or CONSULTANT on hand to explain it.

I know elderly people right now who are so CONFUSED about supplementals and are getting taken because they can't UNDERSTAND what they are signing up for. ONE THOUSAND pages plus is really going to bring them to their knees. Sure THEY have Medicare, I was just using them as an example, but what I'm really saying is when you have so much to digest, I'd be willing to bet that the INSURANCE COMPANIES aren't really going to have much to complain about.

Whose writing this anyway? Maybe I'm just too stupid, and perhaps shouldn't be making any comments, but I don't think THIS is what MOST people have in mind!

I thank you for pointing out some specifics, but some of them are REALLY scary and seems like just another mess and MASS of CONFUSION! Calling something "public option" doesn't actually mean it is, or so it seems. Calling a dog a cat doesn't change the fact that the dog IS really a DOG! How many people have I CONFUSED by what I've just said?? That's my REAL point!



JMHO...

[wroberts189]

59. This is what Sen Baucus said he would do with his comment

to the insurance execs afraid of a public option "there is more ways then one to skin a cat" then came up with a trigger idea ..shot down by progressive media.. a co-op idea ..shot down.

So since they know they would have to include due to overwhelming public support and the progressive caucus .. they instead are going to cripple it with hidden details like bootstrap start up funding , a 4 year delay, and making its more expensive then the private plans. They are going to do the same thing insurance companies do when paying claims (deny with confusing wording)... make it so confusing nobody can tell the bill is a sham.

[Better Believe It]

38. It appears that the "public plan" may not kick in for employers with more than 20 employees!

unless "the Commissioner" permits larger employers to join the public plan!

----------------------------------

The Health Insurance Exchange: It's run nationally, though states can opt out of the national structure and go it alone if they choose, and if they follow federal rules. In the first year, it accepts those without health insurance, those who are buying health insurance on their own, and small businesses with fewer than 10 people. In the second year, it accepts small businesses with fewer than 20 people. After that, "larger employers as permitted by the Commissioner." In other words, expansion is discretionary, not mandated. The only people able to access the public plan in the early years will be on the exchange, and the exchange will be, relative to the population, pretty limited. So the public plan will be limited, and so too will any anticipated savings.

http://voices.washingtonpost.com/ezra-klein/2009/07/the_house_releases_its_health-.html

[nightrain]

39. I am not impressed at all with the costs this plan has. Totally unaffordable

for me. Who the hell has a minimum of 5K sitting around?!!?? Congress is so out of touch. What a waste of effort.

Single payer would be much more efficient and costly. Silly Congresspeople. We all lose again.

[Cleita]

41. Yes, but our federal elected representatives and federal employees will

keep their health care and the hell with everyone else. However we, the taxpayers, get to fund their health care.

[Abq_Sarah]

68. Any government employee

Should be immediately transferred to the public plan, including Congress. Why should we pay for their platinum plans when there is a public option available?

[vaberella]

42. 1018? Alright...considering I want to study constitutional law...I'll do this. n/t

[Zavulon]

46. I only had to get to page 3 to know I don't like this at all.

The phrase "Comparative Effectiveness Research" is exactly what Canada and England hide behind when they say that a certain treatment just isn't worth the money. Once you get to a certain age, this is what they use to say that it just isn't a good bang for the buck to treat you.

Rationing IS coming. This sucks. This is exactly what I expected after hearing Obama's "It's either this year or never" - rushed bills are bad bills. I'd rather have no change at all than one which includes "Comparative Effectiveness Research," because just as the government pissed away the Social Security surplus, they'll do it with health care, too. Government can't even properly handle health care for its military, and it sure as hell can't do it properly for a nation of over 300 million.

[area51]

69. Unfortunately,

rationing isn't coming, it's already here. We ration healthcare based on personal wealth. Don't have the money? You won't get treatment.

[Zavulon]

76. Be that as it may,

Because I don't personally view health care as some sort of "right," I personally would be a lot more outraged at being refused treatment because I'm too old and noty worth the expense after bring forced to pay into the system than I would at being refused treatment because I couldn't afford it.

Also, when I hear all of these wonderful predictions at how good a single-payer system would be, I think of Social Security and the "That's all you'll pay!" promises that were broken a couple dozen times in the form of tax increases and benefit reductions after politicians pissed away the surplus to buy votes. The same will happen with health care. The government is simply not capable of handling the responsibility properly, and once we go single-payer (or with this "public option" silliness, which is a Trojan Horse for single-payer), we'll never go back. I wouldn't trust the government to handle this without massive and crippling fraud, waste and abuse any more than I'd trust a raging alcoholic in my wine cellar.

[SpartanDem]

49. I think people are forgetting to take into account the subsides

that will be provided to an individual to 43,000 and to 88,000 for a family of four

[uponit7771]

54. 4 x 5000.00 (MINIMUM) = 20,000.00...that has to be some HUGE subsidies to get that number down

[Davis_X_Machina]

66. Subsidies are scheduled...

..to keep per-annum premium cost down to 1.1% of AGI for 134% of poverty at the bottom (below which you're on expanded Medicaid) and down to 11.1% of AGI for 400% of poverty ($88,000).

Total co-pay and out-of-pocket caps won't be met by most people, most years. It's not like you've got to pay $5000 on top of your premiums every year. The sums involved are similar to copays required in other countries.

France's copays: An average of 70 percent of the cost of a visit to a family doctor or specialist is refunded. (That's a 30% copay) Reimbursements are on average of: 95 percent for a major surgery, 80 percent for minor surgery, 95 to 100 percent for pregnancy and childbirth, 70 percent for x-rays, routine dental care and nursing care at home. Reimbursements for prescribed medicines depend on the type of medication and range from 15 percent to 65 percent.

A $100,000 surgery, at 5% copay, equals $5,000. The pregnancy and childbirth coverage is very strong because of a general French national pro-natal policy.

[ThomCat]

75. "Total co-pay and out-of-pocket caps won't be met by most people, most years"

So it's okay because only the seriously disabled and those with serious health problems will get screwed? Those are the people who will max out their co-pays every year. Aren't those exactly the people who need protection the most?

Under my old corporate health insurance, with a relatively low co-pay, because of my disability I routinely pay over $3,000 per year in co-pays. So it is very likely I'll hit that $5,000 cap under this plan, and so will everyone else with health problems at least as persistent as mine.

That's a hell of a lot of disabled people to throw under the bus just because "Total co-pay and out-of-pocket caps won't be met by most people, most years"

That's really nice of you. Way to think like a progressive. :eyes:

[Vinca]

52. Well, I'm screwed. I need medical care now.

Ever since the election I've had a countdown going on in my head about how long I can live with the pain in my hip. I don't think I can last until 2013. I didn't expect immediate health care, but I never expected a 4 year wait.

[wroberts189]

73. MEDICARE FOR ALL NOW !!!! nt

[solstice]

53. This is bullshit and it will only be watered down. Then Obama will sign it and brag about it.

Oh, and I'm a retired Federal employee and for the record our health insurance sucks.

[ipaint]

56. A similar public option is already a failure in quite a few states.

DR. SIDNEY WOLFE: Well, we also have some experience. Because in seven states, ranging from Washington to Minnesota, to other states, Maine, they have tried what amounts to a mixture of a private and a public plan. And it's way too expensive as David mentioned. As long as you have private plans in there, everybody still has to do all the bookkeeping.

So, it has failed. I mean, as Einstein has said, the definition of insanity is doing something over and over and over again, and expecting to have a different result. We've seen the same unsatisfactory, unacceptable result, in state after state after state after state after state, why mess up the whole country with it?

DR. DAVID HIMMELSTEIN: And I'm suffering through it as a doctor in Massachusetts, where we've done really the closest model to what Obama is proposing. And our plan is already starting to fall apart. They're already draining money out of the community clinics and public hospitals that have been the safety net.


...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.

http://www.pbs.org/moyers/journal/05222009/transcript2.html


Taiwan starting from scratch passed their gov. health ins in 1995, by 2001 97% of the population was enrolled.

One more comment from Wolfe regarding the time frame needed to implement a workable government health insurance program-

"It's interesting, because before Medicare passed, which is in 1965, we had older people, either uninsured or going to private insurance. And within a year of the time Medicare passed, the disruption, meaning that they were actually able to disrupt not having health insurance or having under insurance, 90 percent of them were already in Medicare. So, we already have a model in this country of how non disruptive it is."

[chill_wind]

62. People need to read this.

Welcome aboard DU :hi:

[DevonRex]

58. Thank you for the link. K&R nt

[slackmaster]

78. Thanks for posting this

I'm not even going to try to comprehend it. I have a full-time job.