Well, it's started. He's tossed out the first of, what I hope to be, many national health care proposals:

http://johnedwards.com/about/issues/health-care-overview.pdf

As one currently working hard to keep my house, due to an employer insurance lapse and major health problem happening near the same time, I'm watching this issue with great interest.

(I may have insurance again in a month or two, but this bill will have already hit and been classified as pre-existing.)

Summary of the proposal. Notably, it puts private health care in competition with Medicare, thus allowing the public to decide which is better for them!

Very interesting approach!

http://ezraklein.typepad.com/blog/2007/02/the_edwards_hea.html

It also puts the burden on the employers to provide coverage. It will be a shared burden system, with an interesting dynamic: Plans can compete to be attractive to both employers and employees. Employees will be able to choose from a pool as well, using their employer contribution.

I am happy to see Edwards stepping forward, throwing something at the wall and seeing if it sticks. I also admire his stand on poverty. The proposal makes a very compelling case, but I still see some crucial things missing that would vastly improve any future health plan. Here's just a few.

It does not fully address the dangers of making sweeping generalizations in reform.

It does not fully acknowledge the fact that many parts of the country have terrible health care already being paid for by private insurers.

It does not discuss the crippling bureaucracy of centralization.

It does not promise big rewards for cures, only for advancements.

It does not guarantee that we will be served by home-grown doctors.

I would like to see a state by state program in the original spirit of the Oregon Health Plan. Perhaps, only one federal action needs to be taken to make it work: Funding to each state that is proportional to taxes paid.

Beyond health care funding, this would vastly shift power to the states to make decisions about their friends and neighbors. I do have to confirm this, but my understanding is that Oregonians have always paid more to Uncle Sam than we have ever received in expenditures. This would even out the playing field all over the country. Sorry Wyoming.

"I would like to see a state by state program in the original spirit of the Oregon Health Plan. Perhaps, only one federal action needs to be taken to make it work: Funding to each state that is proportional to taxes paid."

BINGO!

If you are going to have some type of health care system, it MUST be at the state level. It must also be OPTIONAL.

The only federal interference that makes sense to me is some sort of parameters in an instance where, say someone from Oregon is traveling in Wisconsin, and has a heart attack. Of course they will be taken care of in Wisconsin, but the folks in Wisconsin need to be able to collect their funds from the folks in Oregon.

I still say we need to do something about the massive insurance shell game going on.

Edwards plan wants to tell doctors how to treat their patients, what deugs they can prescribe.

Wants to tax all Americans to pay for individuals lifestyle choices.

Socialism, here we come.

"I still say we need to do something about the massive insurance shell game going on."

Single pay system.

I like how this plan structures the market dynamics to more or less evolve something like that. Truth is, we should just go for it, but there are too many people collecting too many dollars for that to just happen.

So, we let it grow organically. We may find a middle ground people are happy with in the process that way as well.

I'm not for optional. It's either gonna be there for everybody or it isn't. Health is a shared burden. If we share it completely, then it's lower for everyone.

We all will get old, and we all get sick. Some more than others, some lifestyle choices, some just fate. It's a waste of time to sort all that out, other than to tax the hell out of known bad things. (Booze, smokes, etc...)

Should be limited to US citizens too. That would provide a powerful incentive to actually become an American instead of just a resident.

Nwokie, did get to that part yet. For a lot of things, standardized care makes sense. Did you see where the boundaries are? I won't have a chance to really explore this until this evening.

So, missig_kskd, if a pregnant woman, who is here illeglly shows up at a hospital with problems, they should just let her and the baby die?

Health care would not be denied Nwokie, just coverage. The same as when someone with no coverage goes to the hospital now - they get a massive bill. How they are going to pay that bill?...that is another matter.

Yeah, you aren't denied care today at a hospital whether you have insurance or not. But you'll get a huge bill if you have no insurance; whether you can pay that or not is a different issue. Many people go into bankruptcy due to health care bills like this. When that happens, the healthcare system absorbs the extra costs of unpaid bills and passes them on to the rest of us.

So what happens if we have a single payer system for US resident only? Sure, some illegals will show up and inflate costs due to unpaid bills. That's another reason to solve the problem of illegal immigration, which could be solved by enforcing laws forbidding employers to hire them in the first place.

By the way, if we do wind up with some sort of temporary worker program, I don't see why we wouldn't allow temporary workers to be covered as long as they are paying for the insurance.

Andrew

Why cant we hold the govt the non citzion is from responsible for their bills?

Subtract that money from any foreign aid to that country.

Just took a moment to read this plan:

Coupla comments for littlesongs

-It does not fully address the dangers of making -sweeping generalizations in reform.

I think this is FUD. Medicare was a result of one of these reforms, so was social security, our highway system, etc... Either we try or we don't. All of these came from initial ideas such as this one.

-It does not fully acknowledge the fact that many -parts of the country have terrible health care -already being paid for by private insurers.

The element of competition in the proposal would mitigate this.

-It does not discuss the crippling bureaucracy of -centralization.

Medicare has a 1 percent overhead. It is completely possible to reduce the burden on ordinary people and add serious value. Just look at the Bush drug plan. It's a huge mess. Lack of any added value in the way put forward in the Edwards plan is a big factor.

-It does not promise big rewards for cures, only -for advancements.

R and D is still gonna continue. Can't we get people covered while we continue to do this work?


-It does not guarantee that we will be served by -home-grown doctors.

I don't see where this is a factor. There will be an array of plans where you will be able to get coverage that matches your doctor preference. Of all the points you listed, this one intrigues me. How do you see that coming out of this proposal?

Missing, thanks for calling me out. I was too vague. I'll try to address the points you brought up. After reading the proposal, I was simply noting a few things that I felt should be factors in any plan. Like I said, I admire John because he had the swingers to be the first out of the gate with an idea.

"I think this is FUD." I am sorry that this first one came off that way. I agree with you. After her stroke -- once my Grandpa's pension dried up -- my Grandma lived on Medicare for several years. My family could not afford to pay for it all and it was a blessing to have a program that helped out. I was not attacking the reforms of the New Deal or Great Society, I was speaking of drastic future changes to the system that has served us -- for better or worse -- up to this point.

"The element of competition in the proposal would mitigate this." I must respectfully disagree about competition. Currently, competition does not hold doctors to the same standards as bus drivers, pilots and airline mechanics. The former can quietly continue to work even after he or she has killed or maimed, while the latter would not be able to work if they so much as injured someone. Killing in hospitals every day is hushed and covered up, while a bus or plane crash every six months is front page news and thoroughly investigated. Malpractice is why my girlfriend's Aunt has been in the hospital since early December. She spent some of that time in a coma. Her insurance is covering the bills from the butcher shop at K**s*r where the doctor is still practicing to this day. No plan has addressed this tragic issue.

"Centralization." I feel that any further centralization of any government program is potentially expensive and crippling. I like the Oregon Health Plan because it is for Oregonians. It takes care of a smaller group of people and therefore is potentially easier to manage. While the states could probably work together in most circumstances, I am concerned about any future national system being bogged down in bureaucracy and letting people suffer while they sort out red tape.

"R and D is still gonna continue." Research ought to be funded, I completely agree. However, if you have a cure, it is not given a greater reward in this plan or any other I have read. No big profits are made on wellness or we would have preventative medicine available to everyone already. Treating symptoms keeps you coming back and coming back makes money. I think that cures should be the top priority. Curing a cold would be a breakthrough, but treating a symptom puts you in the same league as Kleenex.

"Home-grown doctors." When a country like India invests thousands of dollars in a doctor, only to have that doctor stay in the United States, it does neither country a favor. This is not a question of qualification or race, simply fairness. It is unfair for us to take their professionals when those skills are so desperately needed at home. We need to invest in our own people, train them to high standards and reap the rewards of that investment.

Thanks again for asking me to clarify some of my points. I hope I made a bit more sense of my original post.

Doctor tragedy... Yep. Agreed on that score. I can only offer that what we are doing now does not address it either. I think it's a seperate issue. Getting people covered needs to happen regardless --they can always pick doctors. Having done that, maybe it's time to really address this problem.

(Our family was hit with this too. From then on, I've always let the doctor know they work for me and what they do must be defensible. A lot of them hate this, but will shut up and detail to you their reasoning, which can be verified with another doctor, or some very heavy reading.

My promise to them, for being open, is if their acts are defensible, there will be no lawsuit. If not, then we will nail them, or better just seek somebody else. They learn this right up front and decide to work with us or not.

I'll typically have this conversation in the hallway, or in the exam room before things really get started. I've had a few decline us as patients and that's fine. The rest open right up and tell you a lot! I think they feel it's difficult to do this sometimes because a lot of people won't do the work to really understand, so they trot out the medicine for dummies explanation and hope for the best. )

On centralization, you've really only expressed a worry. (It's one I share, BTW) Again, medicare works nicely. Heck, expanding that would suffice if the political winds would allow. I'm gonna personally know it's possible and wait for the details. Having to reform an existing plan is a great problem compared to not having one to reform in the first place!

Does preventative medicine not help in this? If we are not treating so many symptoms, perhaps actually engaging in cures might then be encouraged as there is plenty of money in preventative medicine. There could be more, given the right mindset.

I see where you are coming from with the home grown doctors. Agreed, but IMHO a different issue as well. Covering people lays the foundation for actually being a doctor that might be able to make money without all the high variance inherent in having a large percentage of the population without any coverage at all. As things stand right now, it's a tough call to actually do the work required to be a doctor.

Making that easier would help, as would the seperate issue of higher education funding.

That does clear it up, and this discussion is good. Lots to learn and bounce off one another. The more the merrier as I would love to see this move from a should we to a definite how.