Refuting healthcare myths

August 21, 2009

David Magnus– David Magnus, Phd, is the director of the Stanford Center for Biomedical Ethics. The views expressed are his own. –

The public discussion of healthcare reform has been full of so many lies and myths that it is less a policy debate than bad theater.

Critics of reform (conservatives hoping to score political points and oppose Obama on anything; free market ideologues; those with threatened financial interests) have stooped to absurdity in their public pronouncements. One publication declared that severely disabled physicist Stephen Hawking would never get life saving medicine in a national health system, ignoring that Hawking is British—virtually all of his life saving treatments were done through their National Health Service.

As debate over reforming health care continues, these are some of the key myths that get in the way of truly meaningful discussion.

Myth #1—We have the best health care in the world

This is probably true for some Americans. But on the whole our system is among the poorest of all developed nations. We spend far more per capita than any of our peers on healthcare, yet health outcomes measures are no better in aggregate. The World Health Organization ranking of health systems rated 36 other countries as having better health systems despite spending far less. The U.S. was right behind Costa Rica (and only two spots ahead of Cuba).

But the reality of the failure of our health system is best seen by the thousands of people being turned away in Los Angeles last week at the massive free clinic set up by the Remote Area Medical Foundation (see Reuters story). When the country spending the most money can not meet the basic medical needs of so many of its citizens, it does not have a good (or just) health system, much less the best system.

Myth #2—Health reform will lead to less personal freedom

There is nothing in any of the proposals that requires anyone to give up her existing health plan. In fact, Medicare proves that public-private partnerships can result in individuals choosing their own plans and their own physicians. Opponents of reform have argued that any government involvement means loss of freedom. This ignores the reality that insurance companies, employers, and financial limitations are already curtailing freedom for many individuals. When co-payments are too high, or someone has no insurance and health care means going bankrupt, those are real losses of freedom. It is ironic that unwavering faith in the free-market (and contempt for any government role) is being expressed at the same time the country is recovering from an economic meltdown caused by too much greed and too little government oversight.

None of the proposed plans involve socializing medicine, creating a single payer system, or government run or owned hospitals. They merely acknowledge the reality that a morally defensible health care system will only come about with some government involvement.

Myth #3—Health reform will control costs by depriving patients of needed medical treatments

There is absolutely nothing in any of the reform measures that suggests or requires that needed medical treatments will not be available. In contrast, within our existing system, those without insurance or “under-insured” patients who can not afford rising out of pocket payments are denied needed medical treatments on a routine basis. Reform makes it more likely that patients will receive needed medical treatments (not less likely).

Myth #4—Health Reform will deny older Americans medical treatments at the end of life

The lies about “death panels” that Palin, Gingrich, and others have been spewing have led the Senate to withdraw one element of the House legislation that would have both reduced costs and increased patient freedom. This is the proposal that would have allowed payment to primary care physicians who spend time with their patients talking about the patient’s wishes with regard to end-of-life decision-making. Right now, 25 percent of Medicare is spent on the last two months of life. Families in these contexts often face difficult decisions with no idea of what a patient’s wishes are. In those settings, we typically default to providing more aggressive measures, even if it increases suffering and may be at odds with a patient’s wishes. Encouraging patients to make choices ahead of time–whether for more aggressive measures or for a greater focus on comfort at the end of life– promotes freedom and has the potential to reduce costs (since 80 percent of people prefer less aggressive care).

This is the precisely the role that government should be playing—creating incentives for good medicine that promotes patient autonomy—and to counter existing incentives which all too often lead to less choice, more suffering, and increased costs. When Palin, Gingrich and others portray talking about our wishes with our doctors as “death panels”, when they attack scholars’ work out of context, when they misrepresent what is in proposed legislation, they undermine any hope of rational dialogue about the ethical challenges presented by health care and the very important and very real challenges and trade-offs that should be the subject of debate.

49 comments

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There is nothing wrong with high deductibles, co-pays, and out-of-pocket maximums. They are essential for any financially responsible system because they will induce the consumer to shop around or at least be cognizant of the true price. This will spur price competition and keep prices and costs down.

It is not unreasonable to expect people to pay a certain amount for something as vital to them as health care. They pay thousands for cars and entertainment equipment, even rent and mortgages. Why not health care? If a person does not care enough about himself or herself to pay deductibles, co-pays and out-of-pocket maximums, then why should society care any more than the person care about himself or herself?

The purpose of insurance is not to cover every last expense, rather to protect one from financially catastophic expenses.

Posted by Bruce D. | Report as abusive

You are ignoring two facts:

a) nearly all palliative care specialists adhere to the philosophy that persuading patients to sign Do Not Resuscitate (DNR) orders and to “proactively” opt out of life-extending treatment is a desirable means of reallocating resources to the treatment of others.

b) expanded resources for palliative care was provided for in this bill specifically for that reason.

Rather than simply scoffing at and ridiculing the ignorant, unwashed masses, why not discuss the reality beneath the so-called myths and conservative conspiracies.

This country can no longer keep what passes for a health care system. I believe the survival of the republic is at stake here. A healthy nation is a happy one, and we have a right to pursue happiness.

Posted by Paul Klein | Report as abusive

with all honesty i find the bottom line to be quite simple, in a civilized country people should not be left to die on the street if they have no money to cover medical costs, basic care should be provided for everyone – although to achieve this, the excellent private health care provided should not be destabilized but simply controlled so that financial interests are never more important that a patient’s health

Posted by matteo | Report as abusive

While HR 3200 ostensibly prohibits illegal aliens from receiving benefits, it includes no means to ensure implementation and enforcement. Moreover, another section says the states may consider “only the income of the applicant” in determining eligibility.

It is becoming increasingly clear that this smokescreen is deliberate. While not admitting that illegal aliens would be covered, the proponents have designed language that allows such a use of funds.

High deductibles and maximum payouts are just ways to increase insurance companies profits. Have you ever tried to price shop for health care it is almost impossible. Health care should not be a for profit business. Most western countries where health care is privately owned the government regulates the profits.

He knocks down a couple of straw men with ease. His argument depends upon his past credibility and the readers not having read the bill.

To blindly accept the bill means you totally trust politicians’ justice, wisdom and love. For them to demand you do so should throw red flags.

Beware of the Ratherites. Dan Rather was a news reporter who attacked a president with bogus documentation. When it became evident that it was bogus, he rallied a number of other reporters to create a united front. As they chanted the lie, they all lost their credibility — and their jobs.

It is good to see and hear voices of reason such as Dr. Magnus in this conversation, which has been distorted beyond all reality-based bounds by those whose main goals are to maintain the status quo, disrupt meaningful dialogue and score political points.

To “anonymous” above: YOU are ignoring one very important fact. The only “mandate” in the bill was for Medicare to reimburse physicians whose patients CHOSE to engage in a consultation about end-of-life issues. There was no mandate for such conversations. And since many people nearing the end of their lives–such as my parents, for example, who are fairly healthy octogenarians at this point–choose with no input from anyone to have no heroic measures in certain situations but rather to have palliative care, it was wise to include additional funds for such care. (I was informed by them that they had completed an end-of-life directive and that they did not want resuscitation; they did not seek my opinion.) My parents are well within both their rights and their right minds, but if they had chosen to ask their doctor about the subject, he would have had to counsel them basically for free. One would think that die-hard proponents of a market-based society would prefer payment in such a circumstance.

Conservatives can’t seem to decide which way they want it. They want government out of all personal decisions and just about everything else, but then feel that THEY should make personal decisions for others whose choices are not to their liking–and (gasp) often seek to do so through legislation. (See abortion, gay marriage, Terry Schaivo and now voluntary end-of-life discussions, among other things.) In my view, such people need to back off, take several deep breaths, quit seeing fictitious bogeymen around every corner, and allow their fellow citizens to make their own choices. The provision in the bill for reimbursement for counseling would have been a wonderful step in that direction.

As to the larger issue, it is way past time the U.S. stopped being the equivalent of a third-world country in its health outcomes. It is shameful. These statistics are not new; indeed, they have been available for years to anyone with an ounce of curiosity. People seem to choose ignorance of facts to maintain their own comfortable fantasies. We all are at peril from such behavior.

Posted by Reason is in short supply | Report as abusive

I agree with the author regarding how the insurance companies and employers are working hard to restrict our personal freedom. Currently, I have a choice to two or three companies to choose from based upon the agreement between the employer and the insurance companies. Now with the public option I would have another option. The fear is that this will result in losses for the private companies and therefore they will shut shop. As long as it is not mandated that all private insurance shut shop and leave (I don’t think that is the case), it will only lead to more competition and force all the private insurers to improve their services and become more “patient-friendlier” than the government. So, If I don’t like the bureaucracy of the government, I remain with the private insurers. It is a win-win for me as a consumer. Yes the private insurance companies will make lesser profits, so be it. Human health is not something to make a indecent profit of anyway.

Private insurers routinely deny treatments and prescription which the doctor feels is right for the patient. That is a major invasion into our privacy. We pay the premium and the co-pay so why should the insurance come between me and my doctor. This may happen with the public option too, but then we have a choice where reckless profiteering is not the only motive.

People don’t want government in healthcare but still want their Medicare. This is amusing. For discussion purposes, let us take Medicare out of the equation and let the entire population, including the young and the old, be the pool for the insurance companies. Can you imagine where the premiums would be and how many secret death panels be set up by the private companies who have shareholders to satisfy?

Posted by anonymous | Report as abusive

You hit all the “right” points–pun intended. The rightwing has decided that the way to bring down Obama is to reduce his healthcare plan to a circus and, unfortunately, the Dems are too feeble to stand strong against this idiocy. There is nothing in the 5 plans currently being discussed that would force DNR orders on anyone, and our medical providers do not try to talk patients into dying before their time–that’s just a lie. As for there being “nothing wrong with high deductibles, co-pays, and out-of-pocket maximums”–well sure, if you can afford it or if you even have insurance in the first place. I experienced healthcare in Europe–the doctor visit was free, no waiting, and the prescription drug was one-third the cost of what I would have paid in America. It is this kind of exhorbitant and excessive pricing in the American healthcare system that the reform bills are trying to correct. No one but an insurance company shill would oppose that, as it would be going against one’s own best interest.

Posted by JCon | Report as abusive

What Magnus says here is (A.) pretty much the straight facts, and (B.) mostly common sense.

What is amazing is that the rest of the comments on this post are likely to be similar to the first one posted by Bruce D. He actually DEFENDS the system of “high deductibles, co-pays, and out-of-pocket maximums” claiming that it will “induce the consumer to shop around”. Three questions for the Bruce-folks who advocate a so-called free market approach:

(1.) Have you considered that every other developed country (as Magnus points out), doesn’t need to “induce” consumers to shop for medical care?

(2.) Have you thought about the fact that if you really get hurt, you probably won’t have the time or capability to “shop”, but will need to go to the closest available medical facility by ambulance… in fact, you might not even be conscious enough to make choices at that point.

(3.) Since he defends the “purpose of insurance”, I’d like to hear his explanation of what actually function insurance really fulfills in the mission to keep people healthy. …Anyone?

The fact of the matter is that it is in the best interest of society and indeed, even businesses, to keep people healthy and not bankrupt whoever happens to become ill. This is the same reason that it is perceived as right and just to have state-provided fire & police protection that is even for the least well-off among us.

Access to basic health care is considered a fundamental human right in all other developed nations.

Posted by anonymous | Report as abusive

Question,

You are an MBA, you have many licences, certificates, skills and abilities,
you are unemployed, no savings,

you dont’ have any money!!

How do you get health care?

Posted by Jay | Report as abusive

the simple fact is, insurance companies make money through denial of services, its their business model, this is no secret or left wing spin, its plain fact.
I assist the elderly daily with phone calls to insurance companies, I can’t believe people sit and take that kind of abuse and then defend it. between the insurance company nitpicking every aspect of their medical care and the drug companies paying doctors to pump them full of drugs you’ve never heard of, then swapping blows with the insurance company over which ones are covered. these people are literally fodder for their profit machine, its quite simply inhuman and degrading. to support such a system is akin to treason against the human condition.

“The purpose of insurance is not to cover every last expense, rather to protect one from financially catastophic expenses” Bruce D (above)

the entire system is a catastrophic expense. people are already buried in debt, a visit to the emergency room can be mighty financial blow to people who didnt have mommy and daddy pay for college.
it only contributes to the rampant debt slavery most Americans live under. and puts a price on your very life.

if 2 people are on fire, and one is rich, they both get put out.(socialist fire department)
they then go to the hospital where the rich person is treated better than the other, is given more options and suffers less pain.

god bless America.

Posted by jeremy | Report as abusive

What is so bad about a basic single payer system amended by private insurance for those who want and can afford it? Economically this is the most reasonable solution of out greatest and gravest national problem.

Posted by Alex | Report as abusive

This article ignores what is actually in the Bill, and is a continuation of the Lies be portrayed on the American people. Everything he claims isn’t in the Deform Bill, actually is. For Example, page 13 of the Bill clearly states that you cannot keep your employer insurance plan.
It became clear to me, that he has no idea what is in the Bill.
Also his ranking of our health care is Faulty. There are plenty of studies and reports that say the exact opposite.
He is being a pundit for the Liberal party that is falling into desperation over this Hideous Bill.
People need to keep in mind, that this is an opinion piece, and does not have to be based on facts.
Wake up America, Don’t let them do this to us.

Posted by Rick Doberstein | Report as abusive

Dr. Magnus is correct about the misinformation around the healthcare debate, though he seems to a bit onesided. In reality both sides of this debate have both legitimate points and incorrect statements and unfortunately the large part of the public debate has sunk to a focus on the incorrect statements.

In Myth #1, Dr. Magnus quotes the WHO’s ranking of healthcare systems. The reality is that the WHO ranking has a significant weighting on the accessibility of equal quality healtcare.

Other statistics (such as life expectancy) shows the US as being behind other countries. These statistics do not incorporate lifestyle choices, such as unhealthy diets smoking, etc. For example, child obesity in the US is increasing at an alarming rate.

The reality is that for those who can afford it in this country, we do have the best healthcare in the world. Unfortunately this does not scale to everyone, and you will find that the best healthcare is delivered in only a handful of the major cities in the US.

The primary issue in healthcare is not insurance, but accessiblity, rising costs and most importantly preventative care.

I think the president is right to focus on healthcare, but wrong in execution.

BTW, I think what Stan Brock is doing with RAM can and should be scaled with public funding.

Posted by TomG | Report as abusive

Why can’t we have a single-payer system? That would provide the maximum freedom at minimum cost. I am so tired of the red scare crap coming from people who think UHC will lead to OMG COMMUNISM AHHHHHHHHH! If there is only one insurer, then you don’t have to worry about being forced to go to an in-network hospital, seeing an in-network doctor, and receiving only treatment that is approved by an insurer whose first goal is profit, not your health. With a government-insured healthcare, you could go to any hospital, choose any doctor, and receive the treatment you NEED instead of the treatment you can afford. The current cost of care is very expensive, even if you have insurance. The one-size-fits-all price tag on treatment leaves the lower and middle class behind because they can’t afford the co-pays and deductibles, and reserves care only for the wealthy. Not only that, but costs could be kept down with a single-payer system, because rather than paying high premiums, you could instead pay a small tax. The pool of taxpayers is much larger than any pool of policy holders. The money you rely on to cover expenses would be spread out over more people so rates wouldn’t have to be as high as they would for a smaller pool of people.

Posted by Tole | Report as abusive

Expect a two-tier medical system and needless ER deaths if Congress and the White House have their way as Viewed by Anesthesia.

Anesthesiology is a critical care specialty in which patient safety depends on maintaining the quality of care givers. It is a mentally and physically grueling specialty that demands perfection each and every time. If you want your patients to be at ease, you also have to do it in a seemingly effortless manner. From outside the profession, it is easy to be fooled by allusions to the anesthesiologist/patient relationship as merely provider and customer. That is simply not what goes through the minds of a quality anesthesiologist in a healthy practice environment. A good anesthesiologist focuses their entire attention on the patient’s medical condition and how to most safely and most comfortably convey you through the dangers of medical procedures. Professional satisfaction comes from knowing you gave superlative care AND that you feel fairly compensated. Both needs must be met to have sustainable quality.

In my practice, we isolate the individual payment issues from the point of care. If you come into the OR or go into labor, we take care of you. We don’t have to think about payment. The billing office takes care of that separately. We take care of you, the person. It does not matter if you are privately insured, on medicare, medicaid, or indigent. You are treated the same way. Concerns about getting paid would be a dangerous distraction. We learn your medical issues, formulate safe anesthetic strategies, tell you about your choices, agree upon a path, compassionately reassure you, and nimbly conduct you through a minefield of dangers during a highly compressed time span. You really should not be worrying about other things. When we do our job right, you never realize how much effort and skill is being brought to your benefit.

I can focus on taking care of you because I do not PRESENTLY have to worry about whether or not you can pay. I know that on average I can afford to take care of each person. It does not matter if you are rich, famous, well insured, on medicare, on medicaid, or indigent. I treat you the same way. We do quite a bit of care at reduced rate or no pay. That is part of being a physician. I am able to do so because I know I’ll be okay at the end of the month.

The present health care reform plan would gravely injure the anesthesia specialty because it threatens to move reimbursements far down to the less than market value medicare rates. The private insurance carriers would be naturally tempted to push their reimbursements down the the unsustainable government levels. I can afford to take care of medicare and indigent patients because other patient with normal reimbursement rates help make up the difference. Push everything down too far and the specialty becomes untenable. In Washington state we already have difficulty attracting anesthesiologists because our state has even lower than usual medicare reimbursement rates. Further, anesthesiology had its medicare rates erroneously set too low years ago. This error was scheduled to be corrected, but the present reform efforts would lock in that computation error permanently.

We cannot keep good people in anesthesiology if health care reform threatens to cut reimbursement down to medicare rates. The truly gifted won’t stay in the field nor will they enter it. We already had this demonstrated about ten years ago after a downturn in the anesthesia job market. Medical students diverted into other specialities and the candidate pool shrank. Those who would not normally have been trained as anesthesiologists were accepted into training. When it became time for those to graduate, we were quietly warned that class of residents was not recommendable for hiring. Anesthesiology requires top quality people to maintain patient safety. You might recover and get a second chance if a mistake is made by someone in another profession, but in anesthesiology you really want it done right EVERY time.

My anesthesia group has been fortunate enough to select and retain only the best. Only when in actual practice do you really see that anesthesiologists are not all the same. They vary in skill, knowledge, effectiveness during emergencies, and degree of ethical conduct. As a patient, you want the best. Yes, a lesser, perhaps willing to work for cheaper, practitioner may be survivable 95% of the time, but during intraoperative emergencies, is that who you want safeguarding your loved ones? It is not always a clear disaster that shows the differences between a superior provider and a mediocre one. Things may simply have been less than optimal because of poor skill or planning. You were unconscious and never knew how close you came to calamity.

So, please…. if you are a concerned reader who wants sustainable, quality anesthesia care, let your representatives know.

Posted by Sonja | Report as abusive

Well done, Mr. Magnus. I’m sorry to say that the country has become illiterate enough to believe hysteria rather than critical thinking. The Internet has confused information with intelligence, and allowed all the crazies to pose as knowledge. Health Care in the US will never be any good until we get some intelligent people such as yourself involved.

Posted by A J Franks | Report as abusive

When I see clips of people disrupting the town hall meetings, I can’t help but see how ideologies have blinded these people. They did not seem to be wealthy American themselves. However, they have been so brainwashed and indoctrinated that they can’t see what is good for them. They don’t have their own view on things but allows their political elites to whisper how they should think.

Deep down, they know for the fact that the health care in this country is only good if you have the resources.
I can only imagine what their stand would be when they’re experienced that themselves.

I have nothing against free market. However, it’s evidently clear that free market creates a cyclical downturns in the economy. Downturns mean mass lay-off. You can be safe now but the fears of lay-off will always there. Once you loose your job, there goes your health insurance.

I wish those who against Public Option well because their very actions today will be their own undoing in time of sickness and old age.

Posted by Jack | Report as abusive

This is Jack again. Let me take it back…those people that disrupted Town Hall meeting does not represent real American. I suspected they are paid to be there by the GOP and insurance companies

Posted by Jack | Report as abusive

The opponents to Obama’s plan say that it would restrict health care. But that is what happens now. Millions do not have access to health care because they do not have the MONEY!

When applying for private health insurance due to a job loss, you are in mortal fear that they won’t take you, that if they don’t, you could get sick and literally lose the roof over your head.

It is unconscionable that we do not have a national health care policy. Many of the opponents to a national option are on Medicare. Do you see them giving up Medicare to get a private plan? NO.

Let the rest of us have a chance. The industry that is supposed to be the most sympathetic at a vulnerable time in your life has become a pariah.

Posted by Dru Murray | Report as abusive

It is amusing but mostly sad that the right-wing ideologues who are attacking the legislation cannot document the language they say will create “death panels” and ignore that Bush’s Medicare drug legislation included the same language which they are now so violently fighting.
I challenge any of this ideologues to post the exact language in the bill that they say creates these panels. I am confident that none of them has the intelligence, integrity or courage to do so.

Posted by Bob | Report as abusive

There is never money for anything that benefit society as a whole, but always money for war and killing. We are number ONE in war spending, that we spend more than the whole world combined. That says it all. May be our government prefers that the population control is achieved by making sure the citizens do not live long healthy lives.

We spent billions to imprison our children instead of sending them to college and we spend billions to send others to war. Magically, there is no money for health care. What a stupid country we are lining in. What a shame!

Posted by Theo | Report as abusive

Health insurance companies are doing exactly what they are supposed to be doing in a capitalist economy, maximizing margins as advocates for their stockholders.

It is their obligation to use any and all resources to maximize revenues and minimize expenses. It is their obligation to act in any and all manner to neutralize threats to their profitability. Hence, perfectly legal advertizing that presents concepts in a slant that benefits their objectives. Hence, courting the politician whose survival is a constant battle to fund campaigns. Hence, stirring the debate with sensational interpretations directed toward groups known to latch on and passionately deliver the slant that benefits the company’s objectives. Remember that the objective is margin.

Capitalism and choice are central to the American way of life.

If you notice, I haven’t yet said one word about the overall maintenance of the health of communities. Because it’s not the prime objective of publicly traded health insurance companies. In fact, in support of maximizing the margin, it is incentivized to deny claims at any cause.

As a consumer in this great capitalist economy, I am happy to do my research, shop around, haggle, buy a car, contribute to the margin of an auto giant.

As well, I want to exercise my freedom of choice to put my healthcare dollars (and my personal life and death decisions) into a system that gives a hoot whether I live or die, and that means staying as far away from for-profit health care insurance as possible. I anxiously await legislation that will expand my freedom to choose a public option and excise Wall Street and my employer from my personal health decisions.

Posted by MD | Report as abusive

I offer a first hand account: My parents, both now deceased, refused “heroic measures” and signed and testified to numerous witnesses, about their end of life wishes. My Mother refused heart valve replacement which might have extended her life another 3-10 years because she did not consider it worth the risk, personal suffering, or considerable expense, even though Medicare would have paid for it. There seems to be a presumption that no one freely choses the DNR or willingly refuses costly procedures in the last few months of life. Some faceless evil “bureaucrat” is blamed, forcing the helpless to die so costs can be avoided. At every step, my parents were repeatedly and persistently questioned, almost to annoyance, “Are you SURE this is what you want?” Unfortunately, too few of us take time to really think through what will happen to us as we reach the end of our lives. These are symptoms of an intellectually and emotionally incompetent, extraordinarily selfish, “me first” society in denial of the reality of life and death. That denial is assisted by diversionary rhetoric of demagogues fostering a belief in entitlement to a health care system which delivers eternal youth and vigor. It makes a reasoned discussion about health care less likely than one about UFOs. The systems are so complex that few can see what is really in their own best interest, much less what is best for our whole country. Irrational madness is the result. Through it all, we continue to delay constructive change at great peril to our Nation.

Posted by Rob Mayer | Report as abusive

Two points – our “new” health care plan is based on the same principals used in Tennessee and mASSachusetts – both aren’t shining examples of success, nor for that matter is the track record of the social health care systems overseas. Strange Dr. Magnus doesn’t include these “myths” he refutes.

Come on….BOTH SIDES are going to enlist people like Dr. Magnus to try to move public opinion toward their position – conservative or liberal. This HAS to be done now because the public has lost all trust in the freaks we choose to keep sending to “represent OUR wishes” in government.

Sad to say it’s hard to believe ANYBODY anymore because we’ve all become “what’s in it for me” people.

My own person feeling is this – it’s personal CHOICE. If I choose to NOT have insurance and something happens to me I DON’T want anyone else to pick up the tab. I may lose everything and if I can’t pay I full expect the hospital or the doctor to turn me away…it was MY decision. Maybe that’d get me off my lazy ass and work so I CAN pay my own way or buy my own insurance instead of sit on my growing fatter-by-the-day ass waiting for someone else to GIVE me what I’ve come to believe is my “right” just because I happen to live in this country.

Posted by Roberto | Report as abusive

Insurance companies have one commandment and that is “Thou shall not pay”. Their goal is to make money. They don’t deliver any health care service to anyone.
I have been a physician for 25 years and have worked in the public and private sectors. By far, my patients have received better care in the public care facilities, including at the city, county, state and federal level.
Socialized medicine is only bad for those interested in making as much money off the “cash cow” patient.
There is much disinformation about socialized medicine that is offered by these greedy individuals, while the ignorant just follow along due to fear and prejudice.
If we are truly a “great nation” then we should lead the world in health care access for our whole population and not be governed by the insurance industry.

Posted by dennis | Report as abusive

Interesting comments and speaks to situation that the actual proposals / concepts in Washington DC have never been clearly laid out in the media for the public to see.

It seems to me that many politicians, President, Congress frequently have good intentions but the implementation details are left to someone else in the future and those are frequently filled with unintended consequences that make problems worse by analogy like making a 90 degree turn with a loaded semi-truck going 60 mph – the result is a big wreck. I head much about the fraud in Medicare and attempts to eliminate over last 25 years, and much about other waste and inefficiencies and bureacracy that will be “cleaned” to fund healthcare reform.

The Administration should focus on these cost savers now since no legislation is needed but just better management, controls, and clear intent to clean up the existing systems. If actual progress and cost savings can be made, I think the public will have some confidence that healthcare reform can be paid for and that there is someone who can successfully implement and manage turning the fleet of loaded semi-trucks going 60 mph.

In terms of healthcare reform, there is one element I have not heard anyone talk about but it is fundamental to a consumer driven, efficient market for healthcare. We know prices but not the benefits so it is difficult to shop for value. That is, I can find prices for healthcare and dental plan options but I cannot find the corresponding re-imbursable expenses that would be paid. I could get lower priced insurance but then find out later its re-imbursements are very low so the low price ends up being more costly in total to the consumer.

Similarly, for prescriptions, it is very hard to find prices from the various pharmacies for comparison shopping. Yet, I can use the Internet to find multiple providers, complete pricing, etc for medicines for my dog.

I hope someone is or will be an advocate in DC for complete transparency of pricing, benefits, re-imbursements in healthcare so consumers can utilize in making value-based decisions and become the driving force in reshaping healthcare delivery into a more efficient, effective, high-quality environment serving citizens of the United States.

Posted by Ken | Report as abusive

As a Stanford trained MD now in my 60s, I think it’s hopeless. That is, unless or until medicine is not run on a profit basis. As long as profit oriented entities such as the insurance industry and Big Pharma companies run the show, it’s the fox watching the henhouse. My sense is that they are simply too powerful and Washington will cave – both parties, though their styles are different. Neither party has the balls to create the sort of real change that is necessary to stop the madness. I sure wish it were otherwise.

Posted by Jon MD | Report as abusive

Part of the problem is that Obama has already given the people more change than we can stand, spent more than we can ever repay, and just this week, modified his deficit to match that of the Congressional Budget Office — 10 trillion dollars. If this weren’t enough, he has flip-flopped 180 degrees on what he said earlier -that his goal was a one-payer system. I am an American living in Central Europe. Every person has to pay in to socialized medicine, but they wait, and then the quality of care, cleanliness, and customer service is like a third world country. Also, Obama lied about the illegal aliens. There are no specific measures in any bill to ensure that they are not covered. If he didn’t intend to include them, he wouldn’t have included the 14,million illegal aliens in his skewed bleeding heart stats. Millions more are Young, healthy, double income families with no kids, who simply prefer to buy a SUV and plasma and plan to get insurance later in life.

Posted by Loren Ozanne | Report as abusive

Good Day to Everyone:

As depicted in the 1973 movie, Soylent Green, the Government instituted a national healthcare system and created dying centers to feed the masses. Today the Government is trying to create dying centers as part of Obamacare. It is no secret that the most significant cost in healthcare is the last six months to one year of life. However, Politicians should not be involved with end-of-life medical decisions whom have a direct conflict of financial interest in taking millions in lobbyist money from for-profit HMOs.

In looking at the socialistic perspective, Obamacare is the same failed great society theories from the 60s with a 2009 new marketing approach. Never do we hear about socialistic past or current failures. What about the current “uninsured” Government programs such as Medi-cal and Medicaid programs that were supposed to cover the millions of uninsured Americans — good luck finding a Doctor or Surgeon to treat you and nearly all of these patients end up at County facilities. What about all of the mental health hospitals that were so important in the 60s — they have been all closed here in California.

As with all of the Government run healthcare programs such as Medi-cal, Medicaid, the majority of Doctors and Surgeons have opted out of the program. Under Obamacare, the same will occur where Americans will pay cash to go to the majority of Doctors and Surgeons or have to find an Obanacare facility as now is the case with Medi-cal and Medicaid. If you have money, you will get good care. However, if you can not afford good care, good luck and forget it if you are old and sick or severely injured. For the poor, welcome to the 2009 version of Soylent Green!

Good day- It’s obvious you didn’t even read the article.

Posted by CG | Report as abusive

Ok, I see the usual suspects are out on both sides, spreading lies, distorting realities. Including the author of the piece. I have just one question:

If you think this administration will be benevolent and live up to its promise to fairly administer a health care system, do you also think that the next administration (or any of the ones following it) will also do that?

You see, that is the question you need to ask before you support a massive change such as this. Because it isn’t what you get today, it’s what happens tomorrow.

Oh, stop it with this claim that people who disagree with policy are engaging in “lies and deception”.

The White House lost the plot when they incited citizens to report on anyone with “scary incorrect thoughts” by writing to flag@whitehouse.gov. Disgraceful.

When you have a problem with people not understanding something or “getting it wrong,” that’s a sign that you may not have explained it well. And whitehouse.gov took an awfully long time to get the straight FAQs up without packaging them first in derision — the line shock troops of Twitter and YouTube of course took it further, snorting with hatred about Palin’s death panels instead of grasping that her take on it represented a legitimately expressed concern in a political debate, not a report.

One has to wonder if the option was so voluntary, what would happen in terms of a “nudge” given two major factors:

1) the motivation of doctors to give end-of-life counseling as they would get state reimbursement for it

2) the indication of Obama himself and his administration that end-of-life care was an enormous cost that had to be cut — Obama signalled this very plainly in his interview in the New York Times where he replied to a reporter’s query about old people lingering for a few more days and it costing $20,000 with his professorial and cerebral “exactly”.

Once you had those signals, and many more, it was very worrisome that a hidden agenda might be at stake. Asking questions about that agenda, asking for clarification isn’t being guilty of “scare-mongering” and “lies” — it’s democratic discourse in a free society.

Shame on the left for undermining basic institutions of democracy and freedom of expression — they reinforce the idea that to get social and economic rights, socialists will stop at nothing and denigrate civil and political rights.

And your own dripping scorn makes this less a piece of even opinion and turns it into a screed. The left infantilizes itself and the American people by imaging there are these evil monsters like Palin and Gingrich pulling people’s strings like puppets instead of coming to grips with the real truth:

the left is not persuasive, and did not make the arguments in this debate persuasive, and they have cost us health care reform as a result.

i am not a doctor, nor a scholar, but i am an american citizen who now has to live on my social security disability income for the rest of my days. funny how i thought contributing to my s.s. retirement since the age of 16 would insure me that i would be alright when it was time for me to stop working. however, living on $1,000. per month really has a way of slapping you in the face. now that i am on medicare, i owe my hospital and the several doctors who treated me during my last emergency visit, and i have no way to pay them. if i don’t go to the emergency room when my body starts giving up, i will bleed to death. but the next time i get sick, i will choose to stay home and die in my own bed. jon md said all that needs to be said, unfortunately, noone cares anymore.

Posted by susanc | Report as abusive

So, the government thinks it can run a health care program that does not raise the deficit, provide insurance to illegals, and will not interfere with most American’s current insurance. I call BS. I call it because there is no way to do all that is promised without taxing the life out of every day Americans. I call it because there is no way you could ever get members of Congress or the President himself to put himself and his family on it, which should be a REQUIREMENT for all elected/appointed federal employees. I call it because we already give health care to millions of illegal aliens, and in fact even allow them to get medicaid.

Somewhere between 12 and 20 million have jumped our borders to take our jobs and get our health care because our system is so “poor” that Mexico’s superior system is not worth their effort to try and get. What have we done to secure our southern border? Nothing. What have we done to ensure that Mexico pays for the debt it’s people have racked up on our health care system? Nothing. Instead we continue to treat these CRIMINALS to the best health care in the world(and most responsive, according to the WHO report) without regard to the needs t0 DEPORT THEM! If they will not go, then charge them with being a terrorist unless they do. It may sound extreme, but you could easily relate the enormous number of illegal aliens(Obama’s own Aunt living on the system in Boston among them) as the worlds largest single terror cell deliberately attacking the United States on a financial from where the undocumented aliens work under the table(tax fraud), recieve public benefits(welfare fraud), and use our health care system without the need or even desire to pay, because they understand that we are powerless to collect(outright larceny). This does not even cover those who are bringing massive amounts of drugs into this country, or those who ILLEGALY buy guns so they can go home and practice shooting border control agents. Remeber Cash for Clunkers? It dies tomorrow, and like all government programs, It was not sustainable as long as they said it would be, they have put dealers in a tight spot by taking too long to process applications, and many dealers had to outright stop the program because of FEAR that GOVERNMENT WOULD NOT PAY THEM IN TIME FOR THEM TO PAY THEIR CREDITORS. Obama is a world class manure salesman. Let’s see him be truly transparent and actually STAND BY WHAT THE HECK HE SAYS… “FOR A CHANGE.” Then and only then will I believe that anything he does is anything more than “Politics as usual” and a relentless power grab away from Congress, and most importantly, the American People.

Posted by M.R. Moses | Report as abusive

“… (conservatives hoping to score political points and oppose Obama on anything; free market ideologues; those with threatened financial interests)…” Amazing while pathetic!

This PhD, like all other proponents of Obamacare, has to put a label with a negative connotation to anyone who opposes Fearless Leader’s plans. How about us middle-class folks who are sick and tired of half the country getting a free ride on our backs? I guess that does put us in the group “those with threatened financial interests” since we do pay taxes.

Posted by Ben | Report as abusive

The rants are on. Big CAPITAL letters so you MUST PAY ATTENTION. It must be important if the writer uses a big font. Oh, and the DYING CENTERS being set up by the evil government. Yep, I can vouch for that. We have one about five miles from our home. Those cunning devils disguised it by calling it a “Hospice”, but we real patriots know what they’re up to. Sure, they recruit and train personnel to act with compassion and care to those who have been conned into thinking they have “terminal conditions”, but they are all in on the conspiracy. Want proof? Some who go to “die” actually get BETTER and then LEAVE to go home. Spoils all the fun of turning them into chicken feed. A socialist plot if I ever saw one. Don’t worry, though. The local militia will mount up the 50 Cal. on their pick-em-ups and go waste this den of commies. One dying center down, who knows how many more to go?

Posted by Rob | Report as abusive

I fix things and I know what is needed to fix our health care in the United States! Some very fundamental parts of our society need to be changed. One is, we need to take insurance out of the picture. If an American gets something done wrong they get a Lawyer and sue the doctors and health care providers thinking they have won the lottery. This requires the doctors and health care providers to carry massive amounts of insurance. Just look at the size of insurance providers even AIG. These companies are worth billions of dollars and the payroll for these companies is also massive. This is all money gleamed off of insurance premiums. A former President suggested that each person working put the money that would have paid premiums in an account that builds through-out the persons lives. When they need care they simply draw from their account. If they take poor care of themselves their account will run dry and they will need to pay out of pocket.
Insurance simply subsidizes the insurance carriers and people in very poor health. If a person knows they have faulty genes and has unhealthy children everyone else subsidizes their health care. Let the individual take responsibility for their own health care. Take the lawyers and insurance carriers out of the picture.

Posted by Robin Pierce | Report as abusive

Even criminals (the least among us) deserve civilized health care.

If we can afford to bailout Wall Street, then we definitely can afford to provide health care for Americans. Priorities.

Posted by Hilary | Report as abusive

DEAR JACK: I do feel and I’m proud people have stood up in the Town Hall meetings. They do represent my thoughts. And I WAS NOT PAID by the GOP or INsurance Companies. Sorry to burst your bubble

Posted by Zacharia Leto | Report as abusive

The thing that strikes me as being a real and genuine problem is the transfer of accountability (if you will) from person to person, or more accurately, from administration to administration. Why is Obama being held responsible for the massive economic failures, excessively high defecits, and other issues that drive Americans away from Health Care reform??? Some members of the far right (who by no means represent the average American conservative!!) would have us believe that it is ultimately more expensive, and thus more damaging, to repair the health care system (perhaps the most massive dragnet on our economy in history) than to have our horribly flawed system remain in the same awful condition that it is in today. These same radicals would then have us believe that the economic problems affecting our country are caused by Obama, and that all of the steps he has taken to fix the economy (including his campaign for health reform) are simply making it worse. This may or may not be true, but tell me, Sarah Palin and Rush Limbaugh, when did the Recession begin? Care to forward a guess? Who wiped out a budget surplus and created the largest defecit in history? Any takers on that one? Who created a whole new definition for the words “Discretionary Spending?” Who lowered taxes on the ultra-rich so that they could afford to move all of their factories off shore? Who allowed a business model focused on greed and taking advantage of the mid-lower income classes to thrive and expand on Wall Street AND on Main Street?? Who has fought one of the most expensive wars in history for no benefits (tangible or intangible) in Iraq? Who alienated us average Americans from both our foreign brothers/sisters (they are just as human as the rest of us, they are not some “idea” that we can be compared against) and each other? Who ramped up government spending to levels not seen since all Eurasia burned and suffered under the boots of Nazi Germany and Imperial Japan?? If the answer to this question is not the actual perpetrator of these events (I will not anyone’s intelligence by naming him here) and if people cannot associate these same events with our present economic woes, then there truly is some force at work in the United States with the awesomely powerful ability to move accountability from one person or group to another. If this is true, then our country, that me and all of us reading here love so much, is in greater danger than it has ever been in before. I consider myself very patriotic, but sometimes being patriotic means being able to recognize and repair problems with one’s country. Stating that there is a problem with a country is not being unpatriotic, it is being honest. Right now, honesty, accountability, and the ability to distinguish between truth and fact is needed by not only our leaders, but by us as well. The fact is, health care reform will be expensive. There will be taxes. There will be uncomfortable financial situations.

The truth is, not repairing this troubled institution, and not sacraficing something to do so is tantamount to looking the other way as the hole in the dike gets bigger and bigger. Violently ignoring the problem (as poor old Rush and Sarah are doing) is not what this country needs, and is indeed useless. The truth is, sacrafices have to be made, and hard work has to be done, in order to repair a hole in a dike. Those who disagree on whether or not to repair the dike are unwise. Those who disagree on HOW to repaire the dike are trying to arrive at the most effective solution, and are voicing legitimate concerns with the plan. However, let us remember that in this struggle there is no room for those who would argue that band-aids are the most reliable treatment.

Posted by LS | Report as abusive

PN: the left is not persuasive, and did not make the arguments in this debate persuasive, and they have cost us health care reform as a result.

The facts are there for those who seek them.

Such as:
* European countries have Public Option Health Care that costs half as much as the US (about $3200/per person) and one may chose their GP or Specialist or Pharmacist.
* European countries have both Universal AND Affordable Public Option Health Care because service prices are mandated. This is necessary because health care is an oligopoly (too little Supply, too much Demand), which means competition is non-existent. (Ask your GP who his/her \”competition\” is … they\’ll recommend to you a psychiatrist.)
* European Public Option Health Care is single-payer and in some countries covers up to 100% of both Primary AND Secondary Care costs. No one dies because they cannot get either.
* European hospitals are built, run and managed by the government, thus able to impose lower vendor pricing by means of \”bulk purchasing\”.
* American private HC-insurance for employees is paid for by whom? The cost of the insurance policy is factored into the prices of company produced goods/services. They are thus an indirect tax that we consumers pay. And, those who do not have HC-insurance pay that indirect tax anyway …
* European physicians earn about a third the wages of their American counterparts (who earn $165,000 per annum). They do so because their Medical School and Internship programs are paid for by their governments. They do not graduate from Med School with the albatross of a $100,000 debt hanging around their necks.

All the above \”facts\” are verifiable, if you want to take the pains to do so.

What planet do you live on?

Posted by Lafayette | Report as abusive

Success Requires Admitting the US Lifestyle is UNINSURABLE and healthcare delivery is BROKEN

POINT ONE America: you are overweight, you feel you need to eat 3 tons of sugar per day, you drink 60 cups of coffee, you don’t exercise, you barely even go outside, when you do the air is polluted, your water supply is deteriorating, the number of chemicals in your food and environment is skyrocketing every year, you don’t teach your kids how to be active and healthy, you take 12 prescription drugs every day, there is still a good chance that you smoke or dip or chew (or used to), you drink a little more than you should (and then you drive), you don’t wear your seatbelt, you won’t wear a motorcycle helmet – or a bike helmet (God forbid these constrain your “freedom”), you work too much, and you are stressed out all the time because you buy houses, cars, and junk that you can’t really afford or pay for.

In short, you are 100% uninsurable. Many will say “ah, but if we are uninsurable why then do we have a private insurance industry that is profitable?” Answer: people, an industry that has to raise the price of its product by 14% per year every year for the past 10 years isn’t profitable, it is just positioned – unlike all other businesses – to be able to pass 100% of its cost increases on to its customers every year (so it appears to be profitable).

This doesn’t happen because we have an insurance lobby (go ahead and hate them anyway, because you can!), but it really happens because there isn’t an alternative. Remember – you are not insurable! If private insurance companies didn’t pass cost increases on to you they would soon be out of business (unless they sold product that didn’t actually cover anything). Does this mean that the government should “compete” with private insurance? Answer: no, because the government would then just switch places with the private insurer – i.e. would have to pass ever mounting costs on to the public in the form of ever increasing spending and debts (leading to national collapse) or would have to cover less and less every year (politically difficult). Everyone needs to realize that the dilemma we face isn’t about public or private schemes. It is about an American lifestyle that is uninsurable at any cost other than increasing costs by 14%+ per year! And any of you who think Obamacare can reduce the cost of health medical record administration enough to reverse this trend is a lunatic.

America – we could afford to insure everyone and we could achieve that through private, public, or a combination of private and public schemes… but only if you weren’t all a grossly uninsurable society in general. America – like energy policy, the recent financial crisis, or any other massive f-up that faces the country, we seem to argue about cures instead of root causes.

POINT TWO America: you have a healthcare delivery system that won’t succeed no matter how much money you throw at it. Healthcare deliver in America has been developed by the American Medical Association and the Department of Health and Human Services (the first favors expensive treatments and procedures and the other sets the parameters for law suites). American’s have put much, much too much faith in “MD driven medicine” and the perceived benefits of punishing the industry with malpractice lawsuits. Don’t for a minute underestimate how much the medical establishment has at stake with reform – especially if reform were ever based on moving to an approach that required less chronic condition treatment!

Our system was not developed by the American Nurses Association or the Center for Disease Control – both of which would be better suited to the task of developing a system to promote society wide prevention and regular screening and treatment based care systems… and so we miss out on the benefits of a “public health delivery” approach. The scary thing is that many, many countries do much better than the US at a fraction of the cost. If you go to the following web sites:

American Medical Association (AMA): http://www.ama-assn.org/
On this site the entire home page has been made over to show that “AMA supports national health reform”. In fact, you can get a document that will try to recruit you to support reform – in just the way the AMA sees things.

Department of Health and Human Services (HHS): http://www.hhs.gov/ocr/privacy/
This is the central nervous center of the bureaucracy that gets heaped onto the healthcare industry both public and private alike. Currently the home page is promoting health information privacy, insurance portability privacy rule, and patient safety quality improvement (all great, but bureaucratic and certainly not revolutionary stuff).

American Nurses Association (ANA): http://www.nursingworld.org/
More helpful site that makes mention of health care reform but has 70-80% of the space devoted to some useful stuff, especially for practicing nurses.

Center for Disease Control and Prevention (CDC): http://www.cdc.gov/osi/goals/people/
The home page of this site offers the following topics without even a single click: safe schools (obviously a seasonal topic), preventing obesity, parenting tips, H1N1 flu. Also on the home page, easy links to sub topics in the following categories: common diseases and conditions, healthy living, how to deal with emergencies, injury and violence, life stages, and workplace safety and health. folks, obviously this is the only government organ that actually has any clue about what will be needed to succeed – or at least it is the only organization that seems to understand that the mission is about education and health maintenance.

America needs more flexible health clinics that are placed very close to the community. Every school should have a very strong school nursing staff that can deliver primary care to attending adolescents. Most health maintenance should involve much more frequent visits to clinics located easily in communities (not in far off or big hospitals) and should be staffed by experienced nurses and physicians assistants with a smaller number of MD interactions per 1,000 patient visits.

The country is a leader in the most exotic types of medical research imaginable. But most of us will never need such care. How we pay for it for those that end up needing exotic care is hardly the problem. The problem is paying for chronic nagging conditions like diabetes that are preventable, the problem is treating diseases at later stages instead of at earlier stages due to failures in screening, and the problem is spending outrageously stupid amounts of money on people who are on their death beds with exotic and useless treatments.

Solutions: 1) citizens should be expected to live healthier lifestyles or be taxed into oblivion for making the rest of us pay for their poor resulting health, 2) we need guaranteed access to screenings for all know chronic conditions whether paid by private, public, or public/private schemes and the clinics need to be closer to communities (probably nurses and physician’s assistants need to be leveraged more effectively in these clinics with less direct required involvement from MDs), and 3) we have to admit that we can’t spend endlessly for exotic end-of-life treatments (these treatments should be paid directly by patient or patient’s family, otherwise just die in damn peace). This type of action could actually reverse the spiraling healthcare spending trend, but guess what America – you won’t get it because you won’t change your lifestyle and you aren’t smart enough to require your politicians to reform the system around prevention.

Posted by Bob | Report as abusive

I agree with LS Aug 24, 2009. This person speaks my same thoughts so eleoquently.
Our country is not enjoying a healthy life, when so many people cannot afford any health insurance, or are refused insurance due to pre-existing conditions. When they are turned away from medical health, illnesses get worse. Prenatal care gets ignored. Women’s health is always being threatened by zealots who live with their heads in the sand. People die who should not be dying. Now that is more like “the death panel” we are dealing with. Those who fight Obama’s healthcare efforts with lies, scare tactics, threats, total rigid heel digging irresponsibility, are the very people who likely have their best health insurance in place and enjoy good wages every government payday, and who’s children were excluded from having to participate in the Irac War.
I have experienced the furror of an ignorant non-thinking tag along who is totally against Obama’s health inititive, but whos wife enjoys a clean nursing home, medication, good food, a doctor, nursing care around the clock, all covered by his insurance. How does this make sense? Why should one count on healthcare, but another is forced out because he lost his job, because our economy went South with the former administration and greedy companies moved to China and other contries so they don’t have to pay respectable wages, much less pay into our social security system. American citizens frequently have less to enjoy in their homes than prisoners in the big houses. We need to wake up and get our priorities in order. That means educating our minds correctly regarding the ills in this country that Obama is trying to correct and stop puppeting these nay sayers lies, myths, and scare tactics. Wake up! Get your heads out of the sand before YOU find yourselves without too and little hope of help for your heath and wellbeing.
Now our souldiers return wounded mentally as well as physically and the VA has not been properly set up to handle our men and women who severely need and definitely deserve the best care a country can give.

Posted by kathy Warren | Report as abusive

I do admire the progress medicine has made in the USA. But along with the progress, the welfare of the citizens of U.S.A regarding health care has taken a back seat. On my few visits to U.S.A I was always happy to be back in the U.K. I have all the security I need here, to survive and live a decent life, which I do not have in your country. My impressions of life in the States is based on my experience as stated below.

I had an american couple as friends in Germany in 1972. When the wife was admitted to the hospital for delivery, the husband, being a foreigner was asked to pay the costs. He was surprised to find that although he was insured, his insurance in the United States did not cover his costs. He was very disgusted about it.
On my visits to your country, I had the opportunity to meet many physicians and surgeons. Whenever there was a group of doctors at a party, I was surprised to find that their talk evolved totally on their income, number of patients they have and also how they were spending their money. Their life style was to the point where it could be considered vulgar in european countries. The wives competed as to who had bought the latest car and what their husband was planning to buy next.
Arshad Khan
I believe that Obama’s reforms will be stalled by the doctors, insurance companies and of course by the right wing groups. It is very obvious here in the U.K what the neocons are attempting to do by the vitriolic, rhetoric statements about the reforms. The mind bogelling statements of some politicians in your country shows the narrow vision of these people and the seeds of discontent they are sowing. They are holding american public hostage because of their lack of knowledge about other developed countries. It should be embarassing for the americans when Palin opens her mouth and blurts about health care when she was at sea to explain the Bush Doctrine.
I believe the americans can make a better choice without lookin at their TVs and reading the newspapers. I do believe that americans can then make a better choice and so will really make USA a truly great country.

Posted by Arshad Khan | Report as abusive

Does the USA deserve a World Class Health Care System? Yes, it does. Do I believe the Federal Government can impliment and effectively run such a system? No, I don’t. All the Government ever had to do was watchdog the existing industry and occasionally make laws to ensure it didn’t run roughshod over the citizenry. That’s all Government ever has to do with any industry be it banking, automotive, what have you. Instead, they do nothing, or create laws that make things worse. Then when things ultimately implode they stand on a soap box and insist on Federalizing everything. My simple question is, where were they before the dung hit the fan? And, as a follow-up, since they let us down by allowing the mess to happen how can we trust them to reinvent the wheel?

Posted by GLK | Report as abusive

Folks–Thank you!! Although, people can’t seem to help adding far-right this and far-left that examples, you are providing people a sound structure with which to debate! I hope everyone that is reading mails this article and its comments to their congressional representative!

I think the Democrats and the President have given the American public a reasonable start to what they are proposing for health care, but it is only a start! There are questions asked by reasonable people above and I want to hear the answers! I want to know how adding millions of people to the load of hospitals and doctors in this country will effect care, or not effect it!

Can we not get the best minds in this country to think about reasonable questions and discuss them? I would much rather hear all the news shows pouring over points made by people in these comments than an unending stream of left yes, right no, with no real thought or challenge behind their statements!

So thank you! You’ve given me more information than every news show to date!

Posted by Tim | Report as abusive