The challenge of health insurance reform

February 26, 2009

Diana Furchtgott-Roth–Diana Furchtgott-Roth, former chief economist at the U.S. Department of Labor, is a senior fellow at the Hudson Institute. The views expressed are her own. –

Today President Obama submits his budget outline to Congress, and, with it, a $634 billion fund for health care drawn from higher individual and small business taxes and lower reimbursements to medical providers.

Reform of our health care system is long overdue.  If you’re unemployed, or work for a small business that offers no health plan, or someone in your family has an existing illness known as a “pre-existing condition,” your main concern might be how to get health insurance.

As Obama said on Tuesday night in his address to the nation, “We can no longer afford to put health care reform on hold.”  But setting up a $643 billion fund and raising taxes in the middle of a recession isn’t necessarily affordable either.

In testimony yesterday before the Senate Committee on Finance, Congressional Budget Office Director Douglas Elmendorf presented options for controlling health care costs.  He warned that “reducing or slowing spending over the long term would probably require decreasing the pace of adopting new treatments and procedures and limiting the breadth of their application.”  That’s rationing by another name, not a comfortable concept to Americans. (To read the testimony in pdf format, click here.)

Mr. Elmendorf pointed to the current employer-based health insurance system, where health insurance premiums are untaxed income to workers, as one of the main causes of price increases.  He suggested replacing the tax exclusion or restructuring it, so that patients have more incentives to control costs.  In that way the purchase of health insurance would be similar to the purchase of home insurance or auto insurance, services that consumers appear able to purchase without major problems.

President Obama has said he will consider all proposals.  During his campaign, the centerpiece of his health reform effort was to set up a new health insurance plan, similar to the Federal Employees Health Benefits Program. It would be open to all, with “affordable” premiums and co-payments.

In addition, he proposed a new National Health Insurance Exchange to set standards and regulate private insurance underwriters. Those who could not meet the standards would close.

In a third provision, some employers who offer health insurance now would have to pay higher premiums in order to raise benefits to the level of the new public plan.  Those employers who don’t offer health insurance would be required to pay into the new plan, a new tax.

One way President Obama proposes to save health care dollars would be to encourage or require doctors and hospitals to use electronic health records.  Although privacy concerns have stalled this effort, it could save billions of dollars a year in medical error.  The stimulus bill allocates $20 billion to this effort.

Yet setting up an electronic data base raises many questions.  Can people opt out of the national database?   Should the federal government or individual states mandate one type of standard that can be shared between institutions? Can private companies be allowed to compete among themselves to offer the most convenient method to the medical community?  These questions need debate.

Obama plans to fund his $634 billion fund through higher income taxes on those making over $250,000 as well as limiting itemized deductions by 20 percent. This would be a substantial increase in tax for those households, as well as for small businesses who file under the individual tax code.

Yet even these numbers might be understated.  The insurance program for federal employees is of a higher quality and more costly that typical private-sector coverage.  Expanding health insurance and providing better care costs more money, not less.

Everyone agrees that health insurance needs to be easily accessible and portable, like auto and home insurance.  The question facing us is how to get there and how to pay for it.

Diana Furchtgott-Roth can be reached at dfr@hudson.org. For previous columns, click here.

39 comments

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Firstly, bear in mind that the US presently spends approximately 15% of GDP while providing very uneven very inefficient coverage with enormous administrative costs and the ready adoption of new pharmaceuticals and other high-tech medical ‘solutions’ which often, once adopted, result in no improvement in outcomes whatsoever, while no other nation spends more than ~10% of GDP while often delivering superior coverage in all measurable respects.

The US system has long been broken, to put it mildly.

There are legitimate differences as to approach, and there is no magical and instant ‘solution’, but the problems are multiple, and on the present course they are growing. They need to be addressed, and addressed seriously, immediately, doubts and reservations as to achievable perfection notwithstanding.

Firstly, there needs to be national identification of data and the tracking on a statistical basis to determine outcomes of treatment modalities. The present course of treatment being driven in many cases by the conflicts between the pharmaceutical companies, the medical technology companies and the medical establishment on the one hand and the insurance companies on the other, is yielding catastrophic results. Raising nonsensical alarms about ‘privacy’ is precisely that–nonsensical. Adequate safeguards can be constructed. Just as in the case of a national ID, the privacy arguements are fallacious–in an age of computers the absence of a single national ID provides no additional security for the citizen whatsoever while it results in inefficiency and makes adequate identification for legitimate purposes inefficient and uneven.

With respect to tax issues it is entirely reasonable to take the modest steps proposed to raise taxes on higher brackets. They are at present very low by international standars, and the tax system is still riddled with needless complexity which exists only for politicians to pander and posture that they have ‘done something’ about this or that particular concern or for the benefit of a particular constituency. Tax reform, while vitally important, is not the most pressing priority we face, however, and will have to wait till more pressing matters are addressed.

Reagan was right to observe that the only thing that will constrain and generate increased efficiency in government was a squeeze between revenues and required expenditures. The squeeze produced by nationalizing health care and finite revenue will likely result in per capita/percentage-of-GDP health expenditures to improve in time to levels that are more rational and more sustainable.

These are problems that need to be addressed, and addressed immediately. The present state of US health care is a world-level disgrace, with needless inefficiencies and mistreatments, exceptional ‘medical miracles’ aside.

The US needs to grow up, and deal.da

Posted by AtomikWeasel | Report as abusive

This is a stupid debate kept alive by insurance companies. If you give any real thought you would feel the same way. The only reason we have a blood sucking middleman that comes between the American people and there healthcare is because the health insurance industry keeps people scared and confused. The health insurance industry spends billions of dollars in lobby donations (bribes) to congressmen and senators to make stupid laws allowing them to game every last blood cent from our health care dollars before it actually goes to a doctor, lab, and hospital. Ask this question to any flag waving American. If your house was on fire and your family needed help. Would you find it weird if the fire department knocked on your door and asked for your fire insurance card and copy before he saves your life and puts your house fire out? Guess what you were just saved by a socialized service. IF your car gets stolen and you call 911 would you expect the operator to ask for your police protection insurance card and a visa copy before they dispatch an officer for help. The military protects the rights and freedoms of all Americans to exist not just insured Americans. Maybe we all should be required to buy constitutional protection insurance to pay for our military as well. Wake up America. Stop putting a profit price tag on humans. Preexisting exclusion kills Americans everyday. IF you can’t get insurance because you will be unprofitable for the health insurance industry then you’re left out. The ER is for emergencies not preventive care. If a person has a small lump and no insurance he or she will stay home because there is not enough pain to justify 7 hours in a waiting room missing work to be a burden on society , six months later that lump becomes too painful to tolerate then he or she goes to ER and its too late. You catch stage 1 cancer with preventive medicine and stage 4 with ER medicine. The health insurance industry pays doctors more money if they don’t cure there patents to the best of there abilities. Its time to kill the parasite, that’s hurting American families.

Posted by Chris Cobb | Report as abusive

Health care in this country has gotten to complex, which is why the system is so broken. There are many problems but if you want to effect the biggest change in the shortest period of time then focus your attention on the insurance industry. That is where the big money is, which is where you will find the most waste. Cutting costs by reducing payments to providers is ludicrous. That amount of money is a drop in the bucket compared to the amount of money that is poured into the insurance industry which is like pouring money into a bottomless pit.
I am closing my private practice because I cant afford to pay my expenses, because my staff spends countless hours trying to get care approved by the insurance carriers because I have tried to provide heath care for my employees and my own family because I get paid 400 % less now than my father got paid for doing the same task twenty years ago. I get paid less for taking the colon out of an obese, diabetic and taking care of him for three months than a dentist gets paid for doing a root canal. Don’t believe me, look it up ! If you run us all out of business, then you won’t have a money problem because there won’t be any health care.
These rule makers and executives and administrators need to get out of their ivory tower and come see me and my patients if the want to learn where the waste is, they wont get the answer looking at statistics and reports and spreadsheets. God help us.

Deborah, you are one of the most orthodox conservatives in the press. Your opinions are so much biased, it is simly disgusting. AtomikWeasel has done way better job in his comment. And YES – it is already time to drastically increase the higher bracket taxes and take off the legal tax loopholes and intentional deductions allowed for that tax groups, and improve the fisk reveniew.

Bear in mind, private healthcare was essentially available three thousand years ago, but not to everybody. How exactly your neo-conservative proposals are more progressive than that?

Posted by Ananke | Report as abusive

The medical system in this country is so dysfunctional, I hardly know where to start and am frankly amazed that people have put up with the status quo for this long.

Having lived in both the US and Canada, allow me to compare my child birthing expenses:
- Canada: $100(monthly insurance premium only)
- US: $2600(birthing costs) + $740(monthly insurance premium)
As if providing for a new child isn’t already expensive enough! And of course these rates would have been x5 if I had not had insurance through my employer. People should not be punished for having kids. If there is one medical treatment that should be free, it it’s having a baby. Subnote: the medical treatment in both cases was very similar. Private birthing rooms, no complications.

Recently my employer advised that medical insurance premiums were being raised to $1656/month. Naturally I declined coverage and applied for a plan on my own. My family was approved, however because of a very very minor pre-existing condition, my coverage was declined. So now I have no health insurance and no coverage.

Mr. Obama I applaud you on your progress thus far in this area and hope it will continue.

Posted by Dave | Report as abusive

I agree with Ananke
Every time I read your comments I feel sick. You are so narrow minded and so far to the right that any reasonable discussion with just doesn’t make any sense.
You never offer constructive solutions, all you do is negate every attempt to clean the disastrous mess that your republican buddies brought upon this great country.
I think you should just quit because you have nothing constructive to offer.

Posted by PwlM | Report as abusive

The columnist uses a key word, and the weasel person uses one. The rest seem to be thin strips of shiny aluminum foil designed to fool the anti-aircraft radar: “chaff”.
One key word is “rationing”. She makes it sound like this Exchange is just a financial regulator of health insurance companies, but the context gives to it care of the “plan”, presumably the standard of health services set by the federal employees’ health program. This is the rationing, and this is the rationer.
If President Clinton got in a log-jam in the 90′s over this, do we ram it through now, fuming at the idiots who are afraid to try something new, or do we adopt the “marry in haste, repent at leisure” counsel of the ages and thrash this out for a few more decades?
The other key word is about the computerized health record. This thing, however, is not your social security number. It is various procedures and the opinions of those who supplied the procedures. Ten years ago, it seemed that confidentiality problems with this computerization was preventing it happening. When I was wounded in Iraq and evacuated, no records came with me, from one step to the next. Confidentiality issues? With all the “privacy act” declarations in my military medical record, you’d think confidentiality is a problem in computerizing health records still.
So rationing health care and computerized health records: are we ready to be treated like mass-production units? The answer is, when we trust the administrators, we’ll adopt these rationalizing steps. Can we be rushed or bullied into them? It’s an interesting experiment, now that we’re in a hurricane: let’s see if the laboratory blows up when we mix this mystery chemical with that harmless-looking household item.

Posted by Christopher Rushlau | Report as abusive

I think we can all agree that the US healthcare system is broken. Many patients are without insurance, others can’t pay their bills (co-pays and deductibles), and hospitals are left in the red. The only entities making out on the deal are the insurance companies.

I think a decentralized national electronic medical record initiative would be a major step forward. We’ve all heard the praises and concerns about electronic medical records, and many of them are well-founded. I’d like to project a couple ideas that address some of the concerns with eMRs.

First, I think decentralization is necessary. While it may be more expensive for each hospital to maintain part of the overall database system (specifically, each hospital would store information pertaining to its own patients), such a system would be more efficient under the assumption that patients are more likely to use the same hospital repeatedly, rather than switching frequently. Additionally, decentralization would put the responsibility clearly in the hands of each hospital, not in the hands of some government-appointed (or worse, government-run) bureaucracy.

That said, there would need to be an industry standard (a common schema) that the IT departments of the hospitals would need to conform to. While this might initially appear to restrict innovation in the market, I would argue that it eliminates one area of technical decision-making, thereby allowing companies to focus on providing a better end-user experience.

Privacy is, and should be, a major concern in this matter. I would propose giving individuals a “medical care number”, similar to a social security number. All records in the database would be indexed using this number, and *no personal information* would be in any way associated with it. The individual would be responsible for keeping his number and providing it at the time of care. Of course, the concern here would be if the person was incapacitated or separated from his number. I have no suggestions on how to handle such situations.

I’m particularly concerned about the talk of limiting treatment options. Treatment is the decision of the doctor and his patient, not any third party, including the entity that will be paying for the care.

Furthermore, the medical technology and pharmaceutical industries are industries of research and innovation. Limiting new treatments discourages research into new drugs and innovation of new technologies. Are some of these expensive? Yes, of course. For every successful innovation in medical technology or pharmacy, there are many more failures; that’s the nature of research-based industries. Limiting new treatments would put our healthcare technology future at risk.

When it comes to health insurance, the idea of universal coverage does not have to be as impossible as it seems. Senator McCain, last summer, proposed an idea that would have encouraged individuals to purchase their own insurance, rather than getting it through their jobs. This would have several benefits. One, health insurance would become a “real” expense to the individual, rather than just part of their income that they never see. Individuals would have to plan their budgets knowing that they have a health insurance bill to pay. Two, if a worker becomes unemployed, they still have their health insurance. This has the wonderful side effect of lessening the burden on our tax dollars and businesses.

I think the major reason we’re seeing such an expensive healthcare industry is the way we treat it. We seem to have forgotten, as a society, that a doctor is someone who is trying to save lives.

The prevalence of malpractice suits in this country has only caused healthcare prices to rise. Doctors must now worry about malpractice rather than quality and cost-effectiveness of care. They feel the need to order extraneous tests for fear that, if they do not and they miss something, they will be sued.

Anyways, just some of my views as an outsider to the healthcare world.

Posted by Xiera | Report as abusive

fix healthcare? simple, take all the middlemen out of the deal and run it like the Post Office, huh, the “Health Office”. with the money saved not paying insurance companies, some level of coverage and service could be provided for everybody. simple socialized medicene.
now that I’ve done the setup, let’s hear from the ignorant right about how crappy it would be and Canada this and Norway that, blah, blah…………….

Posted by naz dagg | Report as abusive

The root issue is still not addressed. Noone needs health insurance – we all need health care. It’s the insurance system theory that is the root of the problem(s)! As long as profit is the motivator for providing aid to the suffering, people will continue to needlessly die.

Posted by spaz | Report as abusive

[...] The challenge of health insurance reform – Reuters Blogs–Diana Furchtgott-Roth, former chief economist at the U.S. Department of Labor, is a senior fellow at the Hudson Institute. The views expressed are her own. – Today President Obama submits his budget outline to Congress, and, with it, a $634 [...]

Rationing = reducing current consumption. Spending less on new treatments (essentially R&D) is not rationing. It may be a reduction in future efficiencies, but it is not rationing. Considering the rate that prescriptions are granted here in the US, nobody is really concerned about efficiency.

OK, so let me get this right. You complain about raising taxes on people making over $250k (single filing, FYI) or a small business owner who makes over $250k AFTER expenses (in which case they should look at filing corporate, not individual), yet at the same time suggest that removing the tax-exempt status of health insurance as a solution. Wouldn’t the first be a progressive tax and the latter a regressive tax? After all, the second effects everyone who has health insurance. So have everyone pay more, have them complain, and over the long run force providers to cut services to reduce costs (which would be, in essence, rationing in the long term). If this is the Promised Land of laissez faire health care reform, I’m staying on the road to Perdition.

The health care industry is already getting slapped by the inefficient system that they created. More unemployed/uninsured and higher deductibles for employees means many fewer trips to the hospital (I’ve got to be pretty darn sick if I have a $10k deductible). The health care market is having its bubble burst. Markets aren’t always the most efficient allocators of resources, as much as conservative economists decry their ultimate power to resolve all issues. All markets have defining parameters, and those can be just as out of whack as any government intervention or altruistic motivation of the participants. Claim that the participants are irrational, intervention is unnecessary and that markets will always be most efficient in the long run. If only I had 50 years to sit back and wait for my health care to quietly fix itself by market economics.

Posted by Mike | Report as abusive

I would add that Employer based Health Insurance is hurting American business in the Global Market. Many Employer’s outside the U.S. do not pay for health insurance because the local governments do. Yes, there is an added tax, however, think of it from the companies standpoint. That is money they do not have to spend . . . Hard to comptete with that.

Posted by scott_mich | Report as abusive

Furchtgott-Roth misses the big picture when she likens health insurance to vehicle and homeowner’s insurance. While indeed, a car accident or house fire may render the owner uninsurable, it won’t – ultimately – be life threatening if this happens. But given the inherent instability of human health, is Ms. Furchtgott-Roth really comfortable with a pay-as-you-go system that can drop you like a hot potato if your medical expenses suddenly become unprofitable for an HMO?

Pull back and do some evaluation; worst case senario. You get sick, but there are no system in place to provide you the medical care necessary should the $$$ run out and you get dropped by the HMO. What happens then?

If you’ve never had to struggle with money in your life, then lucky you. But many of us have, and even though we may have insurance, one serious illness can EASILY suck a savings dry. Yes, it even happens to conservative republicans who believe that their savings and expensive HMO will be their safety net. Honest-to-God I have seen it happen! Your theory implies that HMOs would behave ethically, and since they don’t at this point in time, deregulation WILL NOT make them more ethical.

I agree that providing health insurance is very hard on the small business person. But when it comes to health care specificall, I lean toward Socialism. Many Scandinavian countries have it, Spain, Canada, and to a lesser extent, England. And how many times have we all heard “what are they doing over in Europe…” whenever medical innovations are the subject d’jour?

To everyone else I say, pity the poor near-sighted republican who can’t see past the money in his/her fist! They’re bewildered as to why this country is going to hell in a handbasket. Can’t figure it out! Little do they know that if they invested just a little into society at large, this country would improve by leaps and bounds!

I think we should just copy a good system. France would be my choice. They have more doctors per capita and the system covers everyone at less cost than our system. France’s system is very popular with citizens, ranks in the top 3 worldwide, and beats our system in almost all metrics used. We rank 37th.

But they do contain costs smartly. Medical schools are free so doctors don’t come out owing a half million. Panels, not lawsuits, settle malpractice claims. Local, non profit agencies provide administrative services at very efficient percentages. And doctors are paid salaries, about $80,000 per year based on 2000 dollars.

I have relatives in France and they love the system. And if this experience is any example, they game the system and go visit their doctor at the drop of a hat. Which may just be a French thing.

I wonder why people all over the world come the US to get medical treatment? Who does all the R&D for new drugs, procedures etc…?

So now we are going to turn everything over to the government?

I highly doubt $634B is going to cut it! Go to Barackobama.com and see what he plans on doing for national healthcare. Forcing companies and insurance carriers to do what the government wants always works out great! This is a slippery slope… and you can never climb up after it is implemented!

The entitlement bug in this country will destroy our edge in the world! We earned our position in the world… it wasn’t given to us! World rejoice… you have won! We are going to be just like you! No reason to be jealous anymore!

I am amazed at how it has become so PC to hate our own country! God help us!

Posted by Jason | Report as abusive

Sadly, there are too many so-called think tanks, so-called economists, so-called journalists and yes, so-called government servants whose true allegience is not to this country, but to whoever pays them to spin their lies. Their venue is more subtle, but just as treasonous as a spy who sold nuclear secrets during the cold war. Americans are dying for lack of health care, and this woman could care less. She’s been paid to put a spin on it.

Posted by Joe Mazzilli | Report as abusive

In my younger days, I was naive enough to support the concept of socialised healthcare. If life is a basic human right, and it is according to our Constitution, then healthcare should be a basic right, as it persists life.

But then I became aware of the real world. If we only had to worry about natural diseases, socialised healthcare would sound great! Unfortunately, that is not the case. It seems, based on articles I’ve read, that a sizable portion (I don’t have the numbers to back this) of our collective societal healthcare costs is actually caused by poor personal decisions. And here’s where I have a problem with socialised healthcare:

If I make good decisions and live a healthy life, why should I still have to pay for those who make poor decisions and live unhealthy lives? Similarly, why should anyone else have to pay for my poor decisions?

Why should I have to pay for someone who smokes two packs a day? Why should you have to pay if I decide to drink myself into a coma? Why should anyone have to pay for those who are having unprotected sex with strangers? Drug use? Obesity? Not paying attention when crossing the road?

The only way I would ever want to see socialised healthcare is if it was an opt-in/opt-out system. Yes, you can partake in the system, but only if you play by the rules. Once you break the rules, you’re out. (But then who defines the rules? What’s okay? What’s not okay? Where are lines drawn?)

One thing I would be interested in, regardless, is whether or not medical technology and pharmaceutical companies would still have the incentive to research and innovate if they received government funding. Maybe there would be a way to make the funding incentive-based, not guaranteed (so as to avoid wasteful or frivolous research/spending)? If such a system would viable, it could lower healthcare and drug costs.

Posted by Xiera | Report as abusive

When I was in hospital for 5 days for appendicitis, there was a sign next to my bed. “There’s no gain with pain… ask for medicine” Even with just a light pain which I said I can endure, nurses were anxious to inject more vicadine into my vain. At the end, the tests, surgery and 5 days in hospital came out to $30,000 which my insurance covered. Same procedure costs $1,800 in South Korea.
About a year ago, I went for a regular health checkup and said I sometimes have heart burns. The doctor was recommending $20,000 worth of tests… She repeatedly emphasized that the entire cost will be covered by my insurance.
The current health care system encourages these practices. Doctors trying to convince patients that these are no cost to you and many many stupid people falls for it. We ARE paying for these.
Just start eating healthy and exercising would greatly reduce health care spending and reduce insurance. Americans are fat elephants living off drugs. 1 out of 3 Americans are overweight. And they argue that this is free country and they chose to be the sick elephant. No, people needs to realize that the doctors and fast food chains are making you into drug eating elephants.

Universal health care will will inevitably come to the US. The Democrats want it, and in time, the corporate Republicans will demand it. General Motors is perfectly capable of building cars to compete with the rest of the world. However, they cannot be profitable if they are required to pay for their retired worker’s healthcare. The practical Republicans need take control of the party away from the dogmatic social activists and get back to business.

Posted by dwight | Report as abusive

There is a possibility that no one seems willing to consider: that our technological ability to prolong life has outstripped our ability to pay for it, and that we’re faced with the moral dilemma of rationing health care – deciding which procedures, however effective they might be, are too expensive for society to bear.

The whole idea of insurance is to spread the cost of rare but extremely expensive events across a large population, so that no one need fear financial calamity if they’re the ones unlucky enough to be afflicted. But the whole system breaks down when such high-cost events become routine, as happens with life-threatening illnesses the more we extend life expectancy.

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Here is a solution. We all are rewarded for economic suicide. The insurers and government pay a bonus to those who are too costly to cure for their families. You do not kill a person only with a weapon. You kill them when you prevent them for saving themselves in some cases of have decent quality of life.

The average American that was employed years past when we had major corporations may have paid 30-35 years before retirement for insurance he or she did not use nearly at all. Then they were dumped into Medicare. Today insurance is affordable to only a few. Whether they are young, single, or married or with children.

Can there be equality in a country where only the best treatment is afforded the few who could purchase it outright? And, pray, who or at what income could a person afford an illness, one that requires hospitalization, and recovery and good technology, without affordable insurance? Perhaps only millionaires.

Have you been sick, or spent time in a hospital and watched? Why have good drugs if we cannot afford them? Let no conservative talk to me. No one wants anything for free, they just want to afford it. At a reasonable cost. Who in God’s name wants to be sick? More than half the Senate and those on think tanks probably have not walked the walk, obviously. For themselves, or a dear one. If sick they could take the longest leave of absence. Many could outright pay everything else at the Mayo Clinic without insurance.

How much profit is enough for medical providers and pharmaceuticals? Do you know how much administrative overhead there is? How many people milk the system? Lets put the horse before the cart. Today the overhead of Profesional Association and specialists with 20 secretaries cannot answer your call. And those doctors, pledged to their patients have to spend their staff time contacting insurers even for prescriptions that require validation.

One would aspire to have insurance for oneself or one’s family to cure them and save them, and if impossible to give them a peaceful death. I thought that was America. But are we going to reward good health? Should for example a Jacqueline Kennedy, whom we knew to live a healthy life, if it were not her be punished if she got brain cancer?

The larger the base of healthy people, including the elderly and children, the majority of whom do not have major health problem, the more money whatever insurance means there are the better we would be.

Posted by G.Cardoso | Report as abusive

Here we go again, expecting the government that created most of the problem, now has the wisdom and backbone to fix the problem. Consider FDA regualtions that drive the cost of medicine to unbelieveable levels, then FCC rules that allow the pharmacuetical companies to advertise medicines that require a presrciption to obtain, which of course requires a visit to a doctor, who invariably will require a series of tests, so that he does not risk getting hit with a malpractice suit. This takes us back to the government that has passed laws permiting treble damages, and civil lawsuit settlements that are totally out of control, so that the Insurance companies get to collect their nice fat premiums for malpractice insurance, from the doctors who are getting paid by the insurance companies for all of their precious time and tests. Let the government fix healthcare? I think our government has messed it up enough.

Posted by Bill Geiger | Report as abusive

[...] The challenge of health insurance reform – Reuters Blogs–Diana Furchtgott-Roth, former chief economist at the U.S. Department of Labor, is a senior fellow at the Hudson Institute. The views expressed are her own. – Today President Obama submits his budget outline to Congress, and, with it, a $634 [...]

I’m not a smoker but here it is: Jaqueline Kennedy was a smoker and who knows if she did any other drugs we don’t know about.
I don’t mind paying for universal health care if it is well-thought out and well applied. I don’t mind paying for the health care costs of smokers because I know beforehand that the price paid by each pack of cigarretes purchased is almost totally tax money that federal and states governments place upon it. So we are already using tax money that smokers give in revenue. Even the people who only eat fast food pay taxes on their food purchases. People anywhere, regardless of their sexual behavior sometimes, are at risk of getting a venereal disease because not all VD’s are sexually transmitted (blood transfusions, for example), so it is a concern to us all to help as many as we can because viruses don’t care if you pay your taxes or not.
The fact remains that people interact with one another. It can’t be avoided. It’s part of life. And sometimes you can’t help being affected.
Why should I pay for another’s health care or irresponsible behavior: Because if you don’t live in a box, completely separated from everybody, you will always be affected. It’s basic social responsibility. You can’t detach yourself by saying “but the others…”. With public health, it doesn’t work that way. I can apply the same reasoning to the water and sewage system.

If left to the private sector entirely, we’ll again be in the position that 19th and early 20th century americans were in. Not a sobering thought, given the rampant epidemics of the time.
I fear, though, that the importance given to electronic records may be just another lobby worming its way into the deal to get federal money and a profitable federal contract. Less garbage surrounding a good Public Health Care Plan and the deal has a good chance to be approved by the overall majority of the american public. And be efficient.

Posted by Dan | Report as abusive

Within the next few years Americans are going to be forced to grow up – the hard way.

Posted by Bill | Report as abusive

What the government needs to implement is “Medicare” for the masses. It would give basic coverage without underwriting, and if individuals want more extensive coverage an employer could provide a supplement that would cover the gaps in coverage, or individuals could purchase it from a major insurer. Also, the politicians need to help fund Rx research to help keep the cost of medications down, so people don’t spend their life savings on medications needed to survive.

Posted by lance | Report as abusive

The number of people who have no health coverage, neither an HMO, nor medicare or medicaid, will show an increase when the next Commerce Department–the Census Bureau’s–report in August is presented to the Public. Today the report claims that about 46 million people are without any coverage. Yet we seek to make money by buying stock interests in “for profit” HMOs. In other words, we like to make money by being sure that people who can’t afford to buy insurance are kept down at heel. It’s hard for some of us to adjust to that.

I know that we are our brother’s keeper but I, and a few others, are in the minority–especially when some say it’s OK to make money off the suffering of others.

If, on the other hand, we passed laws making it illegal to have “for profit” HMOs, we would be taking a significant step towards making health care affordable, (I wonder why health care has to be “affordable”) for more people.

Dan Kanoza

C

Why not have the same health benefits given to us that we provide for our employees? (The politicians)
I can just about guarantee that if they had the same insurance as ours, things would improve quickly!
Can you imagine this conversation, “Sorry, Senator, you have to wait in line like the rest of us, and your co pay is $.”
(Remember the port a potties they had out for the inauguration this year? Who got the best ones? Taxpayers or our employees?)
Maybe we should ALL be politicians long enough to get the benefits??? (kind of like the draft)

Posted by Jane | Report as abusive

I am a small business owner. Let’s see right I am involuntarily paying for 4 health plans 1.family health insurance 2.Medicare(Ponzi’s) 3.Low income health insurance 4. employee’s. On top of that, I pay copay, deductibles, with a 1 million dollar lifetime cap. (which means if(knock on wood)something happens I need multiple surgeries and treatments it will easily be exhausted) Now you want to increase tax when my business is struggling. And how many more small business are closing as I’m writing this comment?
Hmmm, how about this for a change– force the big insurance companies to lower their profits, and make it illegal for them to be a public traded companies. How many billions of dollar BCBS, UnitedHealthcare, Cigna were making and I don’t have the mention the pharmaceuticals. (only in America) Don’t come up with a fake universal health plan that not truly helping everyone, esp when the sole winners are the insurance companies. (even the Canadians systems make more sense) Corruption still lingers, tackle the fat cat that’s causing all these problems in the first place– HMOs and the pharmaceuticals.

Posted by Yo | Report as abusive

The best thing that you can do is protect your health with education, independence, and self determination. Exercize, a healthful diet, plenty of water, a wholesome lifestyle, nourishing relationships and caring for yourself: this is not only good for you and your family; it is good for the entire society. Everything that the human being needs is organic to planet earth. You just need to find it.

Start with your own garden. You will be amazed at what this small creation will do for you.

I think the problem is so basic that most people aren’t seeing it. As long as medical care is only concerned with profit then those deemed unprofitable will suffer. Namely those who typically need the help the most, unless they somehow happen to be lucky enough to be well off. Profit isn’t concerned with making people healthy, although that is a side benefit since it is a medical industry, but as soon as you become an inconvenience to that profit margin then you are kicked to the curb. How do you produce a competitive industry that is concerned with profit, and yet tell it to be open, fair, and do whatever it takes to help their patients. I don’t think it can be done. Unless the medical industry is over hauled to be a benefit to its people without regard to profit then there will always be losers.

Posted by Chris | Report as abusive

I’ve got a suggestion – introduce universal health care and eliminate the health insurance rip off and the multiple layers profit taking at the expense of the person needing the final service. That is why health costs are so high in the US and many people cannot not get access to the most basic health services. I have grown up in several countries that have universal health care – it may not be perfect but anyone can access services and if you do want to pay for additional services you do have a choice.

Posted by Nexus | Report as abusive

I’m 30 years old and live in IL. I have no health insuranceand don’t need any. I live a pretty frugal life and hopefully will continue to be healthy. Thank God.

Barack Obama should have started small and went with a strictly childrens universal healthcare plan. I’ll support that but not this bureaucratic, special interest charged junk.

Universal Healthcare is not neccesary in America. Higher accessability and fairness and accountability should be the priorities that the feds should focus on. If they did a better job of taking care of those things then healthcare would be alot cheaper.

Posted by Jose | Report as abusive

It’s immoral to force Peter to support Paul, regardless of Paul’s need and regardless of Peter’s ability. Support of universal health care is using the government to steal from Peter for Paul’s benefit. This “problem” is government created, and the solution is for the government to get out of health care and leave it to the free market. Consider, when the government wasn’t involved doctors made house calls. Support for universal health care is immoral – anyone supporting this should be ashamed of themselves (as they are asking to take money from others for their own benefit rather than taking care of themselves). Charity would do a better job of taking care of the poor. We’ve too much of the attitude that government should take care of us.

Posted by ForFreedom | Report as abusive

We’re all going about this wrong way. Health care cost is increasing so let’s find a way to pay for it? Lower the cost!!! Our hospitals and big pharmaceuticals are charging 5~20 times of other countries. Are our doctors and drugs that much better? Is that why we are the sickest country in the world?

Pharmaceuticals always argue that their drugs are expensive because they’re spending into research. Into what? Boner pills like Viagra, hair loss drugs, and cosmetics is what they’re mostly investing. Drugs that can make money. All the life threatening illness are being researched mostly by private foundations.
Everybody’s mad at the insurance companies. I’m sure they’re part of it but the root of the problem is the hospitals and pharmaceuticals.

When my wife was pregnant, our doctor… who also happened to be the director at the hospital was suggesting amniocentesis. It’s a test to find out if the baby has any genetic disorder before they’re born. But what she did not mention was that the test itself has small possibility to cause the disorder. When I asked her about it, that’s when she admitted it and said she “forgot” to mention. Thank goodness I researched it before we went in. I can’t accuse all doctors but many of them have become low life salesmen to sell procedures. Reform must happen at the hospitals first.

Posted by Brian Choi | Report as abusive

Dear Sir:

We use to be middle class now we’re a members of the working poor, here’s why. Our co-pay for 18 yes 18 is all we get for a 90 day supply from Carenot which is what we are required to use is $177.32, my husband’s company pays $413.75. This is for Imitrex Spray, I find it hard to believe that those 20 mg actually cost $591.09. I have to pay extra for shipping and handling.

That $177.32 is about what I bring home in a week from one of my jobs. My husband works nights so we don’t have to have a babysitter, like a lot of people. I remember when I didn’t have to work because my husband made enough money to pay the bills, now the bills are just to much.

I can’t remeber the last time we went out to eat, bought new clothes, we’ve don’t go anywhere on vacation. We just work to pay the bills. We live in Michigan, I wish Jenny would come home to the block and work for her living.

Posted by Liz | Report as abusive

I understand that healthcare is expensive. I live in Utah and bill 188 just passed. I’m not sure how I feel about the state being involved in healthcare reform. I wonder how it will be paid for.

Jared Balis
Utah NetCare Specialist

If you think single-payer makes sense, read this article from New Zealand: http://www.nzherald.co.nz/nz/news/articl e.cfm?c_id=1&objectid=10575739&pnum=0

“Immigration New Zealand has told one pregnant woman that – despite her financial stability – she would ‘be putting an additional strain on our already short services’, which the department claimed were ;stretched in most areas of the country’.”

The government of New Zealand had to hire my cousin (a newly-minted psychiatrist) on a 6-month contract, because few doctors actually want to work in such an environment.

As screwed up as our health-care system is, single-payer is worse…

Posted by Ron | Report as abusive

We need more agressive education on preventive health care and eating right, excercise and the like. Healthy living should be rewarded and junk foods taxed.

Posted by Carol | Report as abusive

Just read the article and some of the comments. It’s seems to me that we forget that we are all paying for one anothers’ health issues. If a family goes bankrupt because of overwhelming medical cost, or a person recieves emergency care knowing they can not pay, or a person dies because they didn’t recieve preventive care, we all pay. We pay a price either through higher taxes, higher insurance cost, or the emotional strain of knowing we can not afford or own health care. It seems a universal program would help to, if not completely eleviate some of these issues. And when we talk of losing choices of care, I just don’t see it. Besides, you are already being force to use the service your provider deems needed, and to further your providers power, you can only use doctors they deem worthy of being on there list of of caregivers. So, you really don’t have freedom of choice to begin with, other than finding another health insurance company. I don’t know about the morality of health care, but I do know in a civilized country we take care of one another. I don’t want to live in a nation which would turn a person away from medical service if they broke there arm, just because the injured party could not pay. And it goes even further when you consider many health conscious, well meaning individuals are stricken by illness and disease by no doing of there own. Another option would be to regulate health care cost. I can’t understand how one doctor can charge my insurance $180. for a doctor visit, and another can charge $85. for the exact same visit. There is obiously some unscrupulous behaviors going on here. At least when a mechanic works on my care I know what I will be charge per hour and that I will not be charge the highest amount the machanic think I cab pay.

As stated, this is not an easily solved issue. But, it is solveable. The problem is, as it always is, there will need to be changes made and everyone will not be happy. But, if the overall consiquence is a more civil nation with less coruption and money involved with personal health care. Then the difficulties will be worth while.

Peace and Love……

Posted by Phil | Report as abusive

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[...] and his minions cannot accomplish outright, they will accomplish incrementally.  For more, look at this. In testimony yesterday before the Senate Committee on Finance, Congressional Budget Office Director [...]