You libs have your panties all in a bunch over Bush getting into your lives while Edwards sneaks up behind you with a good one.

http://news.yahoo.com/s/ap/20070902/ap_on_el_pr/edwards_2

That's right, you go to the doctor whether you want to or not. "Ve haf veys aof dealing vis peoples like you".

I can see what's next. Mandatory no smoking. Get caught smoking and we'll bring on the storm troopers. Sig Heil Edwards.

I think it's a good idea. Preventitive maintence, no matter what, is better than waiting until it's an emergency. I say, Good Idea, Good Plan, Good For The Country & it's citizens

I don't have a problem with this.

The UK pays their doctors a bonus for success in helping someone quit smoking. It's a good thing.

Let's see what the treatment options are. If the people are given choices, there is no harm in this.

Edit: There are economies of scale in play here too. Tests will get cheaper.

...and what about that war on drugs! Heh. I've mixed feelings about that aspect. Again, depends on the choices and how it's handled.

Did you see the AP photo in that story??? Talk about awful! Edwards looks like he's deathly ill. I've taken some pretty awful pictures of Hillary in the past; wonder if someone from the AP wants to buy one?

Andrew

If it were a Bush proposal there would be some interesting responses, and they'd be the opposite of these.

Yeah, Deane, it's a good thing YOU would never engage in any sort of partisanship - just those "libs" as you call them with such non-partisan affection!

Andrew

I would welcome that discussion. And I would put the same qualifiers on it.

Health care is not a partisan thing.

Andrew, I'm sure somebody would want that photo. Things are gonna get ugly soon.

I would love to see tax breaks or credits for those of us who do the right things health wise. I'm a fitness freak. Regular workouts, good diet, great positive mental attitude and no bad vices.

Preventative maintenance is what we do using our chiropractor, naturopathic and western medicine doctors. My health standards are high, sadly health insurance in this country is not. I do not need insurance, just give me quality health care and let me continue to choose who I want to go too.

Hah you mean British doctors get compensated for getting people to stop smoking?

The Brits smoke a LOT more than we do. Maybe the compensation package isn't working so well!

DJ says>>>
Sig Heil Edwards.

And we call DUHbya a Nazi and get in trouble??? The old EXTREME RIGHT double standard.

Edwards and his plan can kiss my big fat, white, overweight a%&.

If they tell me I have to go to the DR. I'll stop going altogether.

I go to the DR when I want to go to the Dr.

Another F&^*#@G SOCIALIST program paid for with my tax dollars.

I can see it now;

Dr: You're too fat. I prescribe mandatory exercise.

Me: Ain't gonna happen.

Dr: [Picks up phone] Hello, exercise police? I have a fat boy who refuses to exercise. OK I'll hold him.

Exercise Police: You are coming with us we are going to throw you in jail and the socialists are going to have to pay for your stay!

NO THANK YOU.

I hope the food is good! Do you think it will be organic?

I wish we had Exercise Police with our current private health insurers . . . my premium would drop by 66.6%.

Exercise Police? YES, THANK YOU! (And my daughter thanks you too.)

Yep, the UK pays the ir doctors a bonus for a lot of things, thats because their so under paid, and why the see so many fewer patients a day than US doctors.

And why people with lower qualifications become doctors there.

I don't see the Brits all that upset over the basics.

Here, on the other hand, we've got major problems. A local establishment I frequent has some great staff. Young people, doing what they do well, having fun and making it interesting to do business there. I've gotten to know them over the years.

One of them fell, damaged a knee. Having no insurance, they were given the bare minimum support treatment. After that, they were told to go get insurance if they don't want to live in pain and limp for god knows how long.

This establishment is a low margin affair. Where pay is concerned, the owner (who I also know) does very well. He hires interesting and capable people and pays them all he can. Insurance is off the table, because he cannot compete with that cost burden.

Our service economy is growing rapidly, meaning the number of people in this position is also growing. It's not sustainable, if we expect any real quality of life and or affordable care for the rest of us.

I seriously doubt seeing a doctor on a regular basis is going to evolve into this mandatory body regulation being tossed around here.

I also seriously doubt UK doctors are compensated that poorly. The ones interviewed on Sicko didn't indicate that. They lived well and enjoyed what they did.

People generally like incentives over flat out orders. I don't see the harm in those things. If my doc is motivated to keep me in top shape, that rubs off and does me some good.

I've had proactive doctors in the past. I do better with them, than I do reactive ones.

There is a lot of appeal to really working hard on prevention. What if just 60 percent of us really engaged that process? As that 60 percent get older, the savings will be huge! Why not incorporate this then?

Edit: A doctor seeing the max paitents with the max pressure is more likely to slip up than one running optimally. I like that too, having had to deal with various medical errors over the years. No brainer.

OK, doctors are seeing more than the max patients now, go to social health care, they will see fewer doctors. You add in all these mandetory visits, then throw in all those without insurance now, where you gonna get the doctors?

Mandatory visits are intended to reduce, not increase the cost of health care. Finding a heart condition early and treating it before it becomes an expensive emergency room situation (likely with intensive care involved) WILL save money overall.

Under pretty much every universal health care proposal, doctors and hospitals are still private, not government-run. Its the INSURANCE that the government is taking over. I don't think anyone is looking to socialized medicine like Great Britain has.

Andrew

Agreed.

I want single pay. Don't care past that.

>>>"I want single pay"

Explain that.

Single pay? Why just for health care, food is a much higher priority, why cant you go into a store get all the food you need, and sign for it, and they bill teh govt, so you only have to pay one place? Or housing, move in, and the owner can bill the govt, so you only have to make one payment.

Wait isnt that what Karl marx wanted?

No it isn't what Karl Marx wanted. (and that shit gets really old guys. You do know I can always just start hammering you back.)

We don't need a ton of discrete billing systems for this stuff. We don't need those activities to be profit centers either.

None of it adds value.

Health care is really cheap for some of us and too expensive for others. Again, I'm a case in point. I don't need much. Never have. My wife, on the other hand, does. This issue has changed my life for the longer term. The primary change is driven by having way to many billing systems to deal with.

An ordinary person, without legal representation, or insurance, cannot deal with this. It's a full time job, and with one adult of a family sick, the other is then forced to work and work again to manage these things.

My point is not feel sorry for KSKD. Stuff happens, and that's not the greater point. The point is, if it can happen to me, it can happen to you. And that it should not be happening period.

I made a similar point, years ago with the police brutality incident. It's not a sympathy ploy, but good information, that when shared, yields good ideas for reform. Just wanted to make that clear.

Because the variance on these things ranges from near nothing to, life changing amounts, distributing these costs makes great sense, as does eliminating overhead.

That's what single pay is all about, particularly when combined with coverage for all.

Nwokie writes:
Single pay? Why just for health care, food is a much higher priority, why cant you go into a store get all the food you need, and sign for it, and they bill teh govt, so you only have to pay one place? Or housing, move in, and the owner can bill the govt, so you only have to make one payment.


Sorry, it's not the same thing at all. People are not putting off eating for a year because they can't afford it. You can eat extremely cheaply in this country to survive - ask starving college students. Health care by contrast is extremely expensive and that's the problem - the cost. No one would even be talking about universal health care if you could get health care as cheaply as you can eat.

Wait isnt that what Karl marx wanted?

No, he wanted to eliminate the class system. I don't see anyone (except extremists) advocating that. I'm guessing a universal health care insurance system would, like our Oregon Health Plan, only pay for basics. You could get your broken arm set or have a doctor see you about your strep throat problem, but a risky transplant surgery that could cost millions would not be covered.

Being wealthy would mean access to better health care, just like it today means access to better housing and better food. But no one should be denied economical access to at least basic health care.

Andrew

(had to do something)

Single Pay is essentially Uncle Sam handling the billing, ideally using the Medicare / Medicaid model. It's low overhead, allows for private providers and includes a cost regulation point of focus that can serve us well.

Anyone wanting better, different, faster, etc... can then just pay, or add on a private policy for those things.

That's the right way to do a value add of this kind.

The end result will be insurance companies actually serving those that might benefit. They will be smaller, better run and generally something most of us don't choose to worry over.

OHP is actually a great model. My adopted kids are on OHP, until age 18. We have contributed for high dollar items, but don't worry over all the little things that really can add up, particularly if ignored.

If our national model resembled OHP, it would be solid. (Hilary did contribute to the building of the plan, BTW.)

Big problem with your plan, doesnt actually increase the supply of available health care, IE number of doctors, nurses etc.

My idea, we establish a national medical school, along the lines of thte service academies. Those that attend get free education and a salary, just like service academy students. Upon graduation they serve 8 years at clinics and public hospitals across the country, in addition other doctors and health care professionals get a tax credit for working one day per week at these clinics/hospitals.

Anyone can go to these for free.

How to pay for these, national lottery, 10c tax on cigarette packs, + 10c tax on every alcoholic drink served at bars, and 1 dollar tax on every bottle of alcohol sold. 5c tax on every sugared soft drink.

If there is demand, it will be filled.

Too bad we don't have a doctor here. (anyone want to prod somebody into a post or two? Maybe an e-mail conversation?)

Right now, doctors have it tough, having to maintain their own billing, deal with god knows how many insurance companies, or outsource these things. One doctor takes several other people and that impacts them.

If that were gone, maybe being a doctor would be a more viable proposition.

At the least, there would be more dollars for doctors, not administrators. The schools are a great idea, but I don't think they are a solution in and of themselves.

Nearly all doctors are in a partnership with a group, and they have an admin staff. The billing for them is pretty simple, nearly all insurance co's use the same computer programs.

There used to be a big market for independent programmers to set up doctor offices, thats pretty much gone away, as the insurance co's provide the programs.

Remember an elephant is a mouse built to govt specs.

Being a doctor is very viable, if you can get through the 8 years of med school, you make a lot of money.

Currently the AMA limits the number of doctors, indirectly, by controlling the amount of med school positions.

"Nearly all doctors are in a partnership with a group, and they have an admin staff. The billing for them is pretty simple, nearly all insurance co's use the same computer programs."

Say what you want, current overhead is very high. It's driven by administrative tasks being profit centers, uninsured people, malpractice issues, big pharma, etc...

Medicare / Medicaid runs at a small fraction.

The difference is a cost burden we don't need and does not add value.

And it's not simple. There is a ton of communication related to nearly every medical transaction. Pre-existing, pre-authorization, tons of different coverage limits, co-pays, it goes on and on and on.

I do have some information from my pharmacists. Good people, both did their school and work hard to add value. One of them works full time at billing, instead of practicing. They are small, local business operators doing it all right.

Large chains and poor regulation limit their options with almost all insurance companies. This impacts their ability to deliver the kinds of services people want and need. Accepting coverage is a major issue, requiring lots of IT expertise and communication just to fill ordinary prescriptions most of the time.

A single pay system would eliminate this.

The same goes for my doctor. He's got the same issues and limits for no value added reason.

It ain't gonna happen.

I like Edwards idea the best so far. I don't think it [single pay] will happen either --at least not in the shorter term. Edwards does not think so either.

Putting something in place that forces competition is the next best thing, and that's exactly what will bring a solid balance to this whole mess. That's the American way to get this done. Establish market rules that reinforce delivering real value to people and let business have at it.

The Postal Service and FEDex, and company is a really great example of this dynamic.

The service run by uncle sam is self sustaining, and delivers a really great baseline service. Mail is a vital thing, and the Postal Service not only handles it well, they handle it at a nice low cost to everyone.

They do not take tax dollars anymore, BTW.

Now, people being how they are, not everyone wants to rub shoulders with the riff-raff. Also, some us need specialized services. Enter FEDex! Excellent solution. It's not a replacement for the Postal Service, but a really great value add.

They derive their profit by adding real value, not artificial value. Clearly they are getting it done as there are now lots of delivery services, in addition to the Post Office. Perfect!

If we didn't have a Postal Service, then things would be a complete mess! Probably would look at lot like the telephone landscape does. Having a baseline service established helps to define what is a real value add and what is not.

Single pay is the expression of the idea that we really need to focus on real value adds, not artificial ones, and the primary focus needs to be on people.

Most, if not all, health insurance companies make their money by NOT COVERING as much as they can. In other words, the less treatment they can deliver, per dollar consumed, the more profit they make!

Interestingly, the more coverage you have, the more problematic getting people paid is! (And I've been there. Had to get an attorney, and the whole affair cost 5 times what it should have and my kids have nice starter college funds now, in addition to their medical issues being resolved.)

A whole lot of people grok this now, after having watched the Moore movie.

I don't want a government health care division, like the Post Office. That's not cool, for a lot of reasons.

I do however see a total need for a billing and administrative service, that is similar to the Postal Service. It's called Medicare / Medicaid. It works, it's cheap, and it's effective. It, like OHP, is an excellent baseline service, from which we can derive real value adds people can pay for and those that produce them can profit from.

This is the model we need going forward. I think there is a very real chance of that happening and it's more than time.

Here in Oregon, it could work like this:

Say Oregon extends OHP to all comers. The moment that happens, it becomes like Medicare / Medicaid --accepted everywhere as a lowest common denominator. It becomes the baseline service.

Economies of scale keep it affordable and because it does not need to make money on the administrative crap, it delivers more value to those it serves. Remember all those small business owners bitching about their tax burden, having to provide coverage, etc...

Every last one of them could then have their people covered at costs that make sense. The coverage would not be a profit center. That's a big differentiator.

Think of more healthy and productive employees and the cost advantages of that. As an employee, not being tied to a job, because of specific coverages, providers, etc... is a huge gain overall. Work anywhere, get to see your same doctor.

Seems to me, all the choice people would understand the value in that right?

And that's key. Another way to put this is the word "lean".

I've been involved with lean manufacturing techniques for years. The focus is on real value adds, not artificial ones. We need lean health care systems, not heavy ones. That too falls under the single pay ideal.

From there, other coverage types could be optional. They would profit by adding real value that gives people options.

Right now, a whole lot of people don't have options. We are paying for them anyway, why not leverage that and do ourselves a lot of good?

Over time, we might end up with single pay, then again we might not. It's not a worry really, given the dynamic posted here.

What we don't need is to do nothing. That's unacceptable now, and it's only getting worse.

I've had a lot of conversations about this. The only people unwilling to really consider the idea are those, "I've got mine, screw you" types that are always a problem.

They are not the majority, so this will get addressed. It's just an advocacy problem, that's all.

Economics of scale dont always work, especially when there is a finat amount of resoure. Until you expand the amount of available health care, its not going to work. That is why it may take years to get a mid level medical problem taken care of in England.

Right, good thing no one in America is seriously considering England's model of socialized medicine.

Andrew

Thank God that we're trying to make up our own that in NO WAY SHAPE OR FORM resembles anyone else health care in the world.

Here's a brief look at Denmark's health care system. Something to use as contrast to the US.

"Denmark's health care system has retained the same basic structure since the early 1970s. The administration of hospitals and personnel is dealt with by the Ministry of the Interior, while primary care facilities, health insurance, and community care are the responsibility of the Ministry of Social Affairs. Anyone can go to a physician for no fee and the public health system entitles each Dane to his/her own doctor. Expert medical/surgical aid is available, with a qualified nursing staff. Costs are borne by public authorities, but high taxes contribute to these costs. As of 1999, there were an estimated 3.4 physicians and 4.5 hospital beds per 1,000 people. The number of hospital beds, like that in other EU countries, has undergone a major decline since 1980, from around 40,000 to about 23,000 in 1998/99. Deinstitutionalization of psychiatric patients has contributed significantly to this trend. The ratio of doctors to population, by contrast, has increased during this period.

The total fertility rate in 2000 was 1.7, while the maternal mortality rate was 10 per 100,000 live births as of 1998. Studies show that between 1980 and 1993, 63% of married women (ages 15 to 49) used contraception. As of 2002 cardiovascular diseases and cancer were the leading causes of death. Denmark's cancer rates were the highest in the European Union. In 1999, there were only 12 reported cases of tuberculosis per 100,000 people. As of 1999, the number of people living with HIV/AIDS was estimated at 4,300 and deaths from AIDS that year were estimated at less than 100. HIV prevalence was 0.17 per 100 adults.

Danish citizens may choose between two systems of primary health care: medical care provided free of charge by a doctor whom the individual chooses for a year and by those specialists to whom the doctor refers the patient; or complete freedom of choice of any physician or specialist at any time, with state reimbursement of about two-thirds of the cost for medical bills paid directly by the patient. Most Danes opt for the former. All patients receive subsidies on pharmaceuticals and vital drugs; everyone must pay a share of dental bills. As of 1999, total health care expenditure was estimated at 8.4% of GDP.

Responsibility for the public hospital service rests with county authorities. Counties form public hospital regions, each of which is allotted one or two larger hospitals with specialists and two to four smaller hospitals where medical treatment is practically free. State-appointed medical health officers, responsible to the National Board of Health, are employed to advise local governments on health matters. Public health authorities have waged large-scale campaigns against tuberculosis, venereal diseases, diphtheria, and poliomyelitis. The free guidance and assistance given to mothers of newborn children by public health nurses have resulted in a low infant mortality rate of 4 per 1,000 live births (2000). Medical treatment is free up to school age, when free school medical inspections begin. As of 1999, children up to one year of age were vaccinated against diphtheria, pertussis, and tetanus (99%) and measles (92%). In 2000, life expectancy at birth was 76 years for males and females. The overall death rate was 11 per 1,000 people in 1999."

Watch out Chris! Herr Herb and his band of idiots will brand you a socialist and muck rake you on FAUXNews.