http://www.pnhp.org/facts/what_is_single_payer.php Is one take on the single payer system. I would start with a hybridized approach where people who do not currently have insurance, along with anyone else who decides to join the program, would be covered under the single payer system. People and businesses that wanted to keep their current coverage could do so.
As a general rule, I'm against anyone getting anything (food, shelter, healthcare) for free. It's all a cost of existing and people have to make their own way. Also, as a general rule I'm against taxes paying for healthcare; however, I do think our country has to figure something out with regards to this mess. Forget the obvious humanitarian reasons... it really puts us at a disadvantage to Europe with regard to the costs of doing business. Companies in Europe don't have the problems that GM has with regard to pensions and healthcare (they have their own sets of problems but this isn't one of them). So, how do you create a system whereby people have to buy their own healthcare (not have it automatically given to them just for existing) for a reasonable price for reasonable coverage? Also, I think the health care simply costs too much.
you such an humanitarian *grin* I enjoy your capitalistic ideals I truly do the issue i think is GOUGING I think Insurance Companies GOUGE and I think they use unfair business practices and unfair influence in Congress Take away their advantages and let the market do what it will do Rocket River
Cohen, don't try to pull rank just because you work with private health insurance. YOU would cut employers out of the loop, but it is important to cut insurance companies out of the loop. Health insurance has little to do with rugged entrepeneurialism and free enterprise. Such expenses/ "costs" as advertising, screening out the unhealthy, profits etc. eat up a big portion of the insurance payments from ordinary folks. This is not needed. The social security system runs at about an overhead of 1%. The State of Wisconsin, where I was an employeed for a little over a year had a State life insurance program. Premiums were higher with decreased cost. Why? No needless insurance middle men doing physicals, running TV adds etc.
I'll give up my State of Texas defined benefit coverage when they pry it from my cold, dead fingers. God knows, state employees are screwed enough as it is. (and I'm not a state employee, never have been.) Keep D&D Civil.
Did this insurance company exist <b>just</b> to insure employees of the state of Wisconsin? Generally rates are approved and "set" by the state based on company projections of operating expense, investment return, and mortality projections. It is very likely that this company got the state business by being a well-known provider--- which means they had to earn their business piecemeal not in one fell swoop with a state contract.
Deckard, same with me, as my wife is a school nurse and working on her TRS pension. I like defined benefit plans. Texas Tomorrow Fund, also like me. I'm starting to wonder about your faith in the free market, boy.
I don't have faith in the current crop of government leaders, along with their political party, on the State and Federal level. A combination of free market capitalism, government regulation of things like the environment, the insurance industry, the pharmaceutical industry, and the like is vital. Republicans have castrated government regulations for those and other industries, IMO, and at a terrible long term cost to average Americans. Social programs for those in need is one of the vital functions of government. Here in Texas, and in Washington, we have seen those programs slashed as taxes have also been cut for those who need those tax cuts the least. Hell, Ronald Reagan, a man I enjoyed voting against twice, produced a fairer tax system than what we have today. His program gave a huge tax cut to the wealthy, and middle income Americans got a big break as well. Reagan's tax program did away with the loop-holes the rich had used to escape taxation, so it justified (in his mind, anyway) the large cuts for the wealthy. Those loop-holes have returned to a great extent, without a rise in real rates of taxation for the wealthy. The rich are getting richer and the middle class are getting screwed. I don't see "free market capitalism," as a blank check for big business at the expense of the average American, which is what we've been seeing for far too long. Big business, in their wildest fantasies, never dreamed Bush and his cronies would have given them the largess they've received since he was "elected." Honestly, they must feel like they've died and gone to heaven. Our defined benefit programs? Our wives will say they've earned every bit of benefit they are getting, and they have. (and do! ) It's one of the few attractive things about working for the State of Texas, when most state employees could probably make more money in the private sector. (I know my wife could) Believe it or not, there are many, many people working in government, at all levels, who are doing it because they think they can make a difference... not to their bank balance, but for the general public. You know, a spirit of service, like Jack Kennedy used to talk about. I know that you know that, but too many people are full of cynicism about the role government has to play, and about those who work in government. What they should be doing is paying more attention to those they vote for to place in charge of it. Does anyone here know that Governor Rick Perry has told all state agencies to cut their budgets by 10%? This is after huge budget cuts in state programs and state agency budgets over the last several years, due to an unwillingness of the Republican government of Texas to raise any revenue to cover budget shortfalls in vital areas like our state highway system, our state parks system, our state's social programs, such as they are, and this is during a budget surplus? There are many things we disagree about, glynch, but the vital role government has in our lives, and the dereliction of the current political party in power to govern in a manner that benefits the people, and not just big business, is not one of them. Keep D&D Civil.
No it did not exist to just insure state employees. It is a holdover from back in the Progressive Era. Private insurance compannies, as you might expect, have tried to eliminate it. Funny thing is when they do so, it draws attention to its existence. The closest they came was a provision that said it could not advertise, which futher increases its effciency. Sorry, Giddy and Cohen, and me, it is only open to residents of Wisconsin. Insurance or pooling the risk was an invention hundreds of years ago. For straight forward insurance like heath and life insurance it has no element of innovation, or rugged risk taking such as you might imagine with say small biotech.
I have no bias...I understand why HMOs are here, their benefits and their failures. Can you say the same? The last thing one needs when drastically reworking an industry is to do it with ignorance. I'll pull rank because I am an informed stakeholder. Your analogies to a social security system and life insurance program identify you also as an ignorant participant on the healthcare debate. Healthcare is nothing like social security or life insurance. Life insurance, please. They use actuarial tables...there's nothing else to it. You're trying to compare that to the delivery of healthcare? Good Lord, is it ignorance, arrogance or naivete? A little history... Healthcare cost inflation was out of control. Market forces were perverted (e.g. more medical specialists in a given geographic area does not result in price competition, but increased volume of procedures to guarantee individual physician revenues), and value was nearly impossible to judge since outcomes were not measured and the knowledge base of superior practice patterns did not even exist. Managed care came about try to fix the some of the problems. Estimates placed unnecessary or inappropriate care as much as about 1/3rd of all care rendered. This is not just an issue of cost, but quality also since many many patients are injured or killed due to iatrogenic illness each year. Since there was few guidelines on which ambulatory care should be provided and very limited information to assess those that existed, and since most healthcare costs are physician-initiated, capitation was implemented. A crude mechanism to control cost inflation, but there was nothing better available at the time. On the inpatient side, some Plans were more aggressive about managing care, but there was also a dearth of knowledge on the subject, and risk-sharing with primary care physicians was often implemented again to make sure they knew their decisions had financial ramifications. That was the genesis of managed care. Few in the industry developed a vision on where to take it next by muilding a knowledge base on the best ways to practice medicien, to help providers do their jobs better. A study showed that physician's practice pattern were more closely correlated with thei peer group (i.e. 'word of mouth') than what medical school they went to or which medical journals they read. The creation and dissmeniation of knowledge in the industry is woefully inadequate. For the sake of brevity I'll leave the history of it there for know, but be fully aware that this industry is so complex and demands so much innovation and advancement that it needs the private sector (you can see it today when some moderately inept HMOs can both guarantee more coverage for members and get their profit with revenues of 95% of what the federal gov would have spent on Medicare benefits).
Again, sorry glynch, but you don't understand the healthcare industry or the delivery of healthcare at all. Stop embarassing yourself.
Okay, now I'm really confused. What kind of organization is it? It's not a private insurance company, so it's a what? I figured it was only open to Wisconsin residents. I was only alluding to the fact that if it were a traditional insurance company, it had to earn its stripes the hard way-- by selling policies (lots of them) one at a time. You form a company and hire employees and pay the appropriate fees to the state and deal with all that rigamarole and you don't know if anyone will buy the first policy. Then what if you just sell a thousand or so? There is a substantial risk; risk was not invented with the rise of biotech...
how anyone can believe that people who cannot afford healthcare should not get healthcare is beyond me. in a civilized nation which has an 11 trillion dollar economy people should not have to sit in ER because they have a really bad case of the flu or worse cancer. anyone who doesn't believe healthcare should be provided for the needy certainly doesn't share the values of this country.
Well at least Cohen has deigned to say something, not just trying to pull rank. More to follow. BTW I a stake holder. My insurance goes up and all day long I talk to people who do not have health insurance and are ill. I remember a discussion in which I was quoting doctors from the Harvard Medical School and Cohen was just citing himself as a source. To quote from Upton Sinclair and from the recent Al Gore Movie, "An Incovenient Truth". Still on at the River Oaks as of Saturday. "It is tough to get a man to understand something, if his livelihood, depends on him not understanding it." Hey gang, help me out. It is only fair when I as a mere non- insurance industry guy or consultant am I trying to take on a constantly proclaimed expert.
If we can afford to fight a perpetual war to keep oil spigots running, we can afford a way to ensure that all Americans have access to affordable, reliable health care. I honestly have no idea how to do that. But there have been several interesting ideas in this thread, though.
It's coming. The country needs it. I just look so forward to the way government efficiency will cut the waste and fraud.
