Democrats Prepare for Healthcare Reform Debate

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As a healthcare administrator for a critical care practice, we see the most dollars being spent in the last waning months, weeks, or days of life for many of our elderly critical care patients, often at the behest of family members no matter the expected eventual outcome or cost. If we don't begin to have the conversation as a nation about rationing healthcare and limiting spending our dollars for care that truly will meaningfully preserve and prolong life, then we are missing a key component of this debate.
I am also not sure how mandated individual insurance coverage
would be enforced. Would there be a task force formed to make sure people are buying health insurance? What happens if they lapse in premium payment? Can they be reinstated? If fines are imposed, how would those get collected and who gets paid the fine money?
As a small group employer, I would like to see costly insurance coverage removed from the backs of small employers who are increasingly opting not to offer coverage to their employees due to prohibitively rising costs by private insurance companies. There does need to be more competition so that people can choose their own plans, much like they comparison shop for auto coverage. Maybe that means changing insurance regulations so that plans can be nationwide instead of regulating and licensing companies state by state so that the risk is more widely spread and therefore more affordable.
Malpractice suits are becoming ridiculously common, so torte reform needs to be part of any package. Of course doctors are often ordering unecessary tests to cover their hides, they have to in order to prevent being sued for fear of missing something. Malpractice premiums are soaring, which gets passed onto the consumer in the form of higher fees, like any other business.
Unfortunately I hear little talk of regulating prices for insurance companies and pharmaceutical companies, which (sadly) speaks to how much clout those two industries carry in our government. Why does the burden of paying for healthcare seem to be placed upon hospitals and doctors in the form of limited fees and regulations? Why are insurance & big pharma companies exempt? Physicians deserve to be paid well for their services when you take into account how much their education costs in years and training just to be qualified to do the job. It only takes a four year college degree to be a pharmaceutical or insurance company executive, and yet those industries are by far making the most money out of the healthcare.
I don't know what the answer is for reform, but I am not hearing what I believe to be viable plans from either side of the aisle.

Debra of MI 1:45PM July 01, 2009

I am a National Healthcare Consultant who possesses years of experience with health policy reform. Based upon the past and current conduct of the key stakeholders, I am convinced that the primary participants are not prepared for the onerous and labyrinthine journey that lies ahead to meet Mr. Obama’s three health reform policy objectives. I maintain that we will have to experience a catastrophic event to compel all parties to the figurative table for substantive cooperation. I define such an event to be similar to the recent General Motor’s bankruptcy that brought the American auto industry to its knees. Here is an industry that has been aware of its internal problems for years, but had not been able to resolve the issues because the stakeholders’ desires were diametrically opposed. Once, GM emerges from the bankruptcy, I anticipate it will be a leaner company focusing on designing automobiles that travel over 100 miles per gallon, that cut emissions by 60% , and even reshape our American foreign policy. We will no longer amalgamate with regimes and foreign powers based upon potential oil reserves, but, instead, affiliate with countries that pledge an allegiance to our ideals and people. In sum, the health care industry needs to experience a symbolic bankruptcy to bring it to its bottom, which would rescind all parties’ hidden agendas and allow healthcare reform to flourish.

Layton Lang of TX 1:50AM June 27, 2009

“Obama said he has identified about $950 billion in savings to offset the cost of reform. As usual “he says” but we never see where if they even exist. “including more than $300 billion in savings from federal programs for the elderly and the poor.” We do not get the names of the programs or even what area of life they serve. His transparency is like a brick wall in a pitch black room. If they serve the poor why are they being cut? Do the poor and elderly no longer have value? Every time the Congressional Budget Office has given an estimate the actual cost has always been greater to much greater than that given by the Administration when in fact the CBO figures were even too optimistic and costs soared out of reason on many such instances.

Andy of CA 5:25PM June 20, 2009

Currently the key issue is about how to generate the $1 trillion or so that the government will need over the next decade to help pay for universal coverage.
The solution to this challenge could be a single payer system by the government with strong purchasing power etc as a vast majority of the public prefer it.
Accordingly the partial take up of it, public option, as a generous concession will hardly account for the key issue.
In that case, the private insurers are liable for the rest of the unexplained cost in return for the generous concession as they pledged cost-saving totaling $2 trillion before under the shared recognition of need for health care reform, which is also good for attracting their customers, I suppose.

hsr0601 5:32AM June 19, 2009

I am a health care provider. What would you do with the following and remember this is not an isolated case: A 51 year old lets say male, has lost his job, and is in need of medications to maintain his blood pressure, he says he can not afford them and would like me to furnish him samples for as long as he needs them. H tells me he is leaving on a trip tomorrow for a week and will need them this afternoon. He drives a new vehicle, his wife is dressed nice an oh by the way he smokes. Now we know smoking increases his chances of a major cardiac event, they cost money, and the trip for a week costs money. Would you provide him free medications? Know a side note, he has told me if I do not give him the samples he just won't take them> This is not an isolated case and it is what we see all the time in health care, but no-one sees this. My assistant can spend 15 minutes on the phone arguing with the patient it still ends up with me taking the time to speak to this patient. This is why there is a decrease in the next generation going into health care.
President Obama what would you do?????????????????

d. cook of FL 7:29PM June 18, 2009

WHAT DEBATE????????? THE REPUBLICAN'S WEREN'T ALLOWED IN ANY OF THE MEETINGS WITH THE DEMS & OBAMA. HOW DARE YOU CALL THIS A DEBATE!! THERE'S NO TRANSPARENCY & ONCE AGAIN PUSHING SOMETHING THROUGH AGAIN WITHOUT ANYONE KNOWING WHAT THEY ARE DOING AND HOW MUCH IT'S GOING TO COST THE TAXPAYERS.

CARMELLA of NY 6:37PM June 18, 2009

We have been mesmerized and hypnotized by the big bucks, getting to the top of the pile, winning at any cost, stepping on anyone to win. Remember the baby, pup, kitten, struggle to get to the mothers milk - survival- and maybe not get there and maybe not live through the night and end up in the garbage can. But, we don't do that with human babies - remember.
We help that baby. We know that child is precious. We know that little person is one of us and in a just and caring society will be helped along the way to become all that they can be. That child could have been you or the kid with the basketball, or the teacher, or priest, or the man that talks funny but always says "hello".
Everyone needs healthcare from time to time, a medical home would be nice. Some where that expects you to come in if you stepped on a nail, to make an appointment if you think you r=are pregnant, to call and say, "I'm really sad, I don't think I can take it any more."
Everyone of these people is "WE".
WE can do it. Everyone must be included in the human family where their community cheers them on, supports them when they are down. The Human Family is vastly better when they find the way to take care of each other, to count on one another, to love one another and to be loved in return.
We must not be enslaved to a health care system that is designed to neglect the poor, the disabled, the old, the immigrant the people of color. It is time we choose to care for each other and to abandon our centuries of privilege and privation.
We know a carefully constructed single payer plan such as California's SB 810, Senator Leno is such a proposal. We don't need to settle for less.

Carolyn Negrete of CA 11:55PM June 17, 2009

I remember a story concerning a small town in Montana with a population of less than 100,000 people having more than a dozen large hospitals. The locals explained they were full of Canadians coming to the US to get health care they could not get under the Canadian health care program.
If this get pushed through, all Americans INCLUDING ELECTED OFFICIALS FROM THE PRESIDENT DOWN must participate in the program. Those elected must not be allowed to work around such a system. They should be forced to participate in any such system forced on the American citizen.

KBC of TX of TX 4:48PM June 17, 2009

Frank of CA wrote: "If stupid people want to kill themselves slowly then let it be so. It's Darwinism. Why should everyone pay for it by way of healthcare?"
If you have health insurance, you already are paying for it, just like I am. Over the years I've seen my colleagues' waistlines expand in concert with my premiums. And you (again--assuming you're insured and/or are a taxpayer) and I pay for it every time someone goes to the emergency room and can't pay.
How about this (off the top of my head--I'm no expert)?
1. Require health insurance, within certain parameters, of every american. Open the market nationally to encourage competition. Requiring it will spread risk and eliminate the freeloading the occurs every time an uninsured individual receives medical care and doesn't have the means to pay for it.
2. Make it more actuarial to account for unhealthy choices, like obesity and smoking. I'm a fit non-smoker. There's no way I should be paying the same premiums as an obese smoker.
3. Cap (but don't eliminate) punitive damages for malpractice.
4. Make it all tax deductible.
Again, just a few thoughts.

Todd of PA 3:46PM June 17, 2009

We're steadily pushing our way to socialism. Why should the government take on health care? The two leading causes of illness in this country are obesity/lack of exercise/poor diet followed immediately by smoking/tobacco products, then alcohol. If stupid people want to kill themselves slowly then let it be so. It's Darwinism. Why should everyone pay for it by way of healthcare? Do we push personal responsibility and hold people accountable for their actions? No, we sue McDonalds and the cigarette companies for marketing products that people are dumb enough to abuse.
This will become an extension of welfare, where people with terrible lifestyle habits will sponge off of the system at the expense of the masses. You think costs will be low and stay low? More and more people will be on this bandwagon and it will spawn another splurging government buearacracy that will line the pockets of yet another government contractor exec contingent with exorbitant salaries and sickening pensions. Oh byt the way, those of us that pay taxes will be footing that bill as well. Let's not overlook their plan to cut tax breaks for employers? Hmmm, I wonder what that will do to the unemployment rate, wages and worker benefits. Businesses will be forced to cut costs which will precipitate union battles and employee walkouts due to cost cutting initiatives, all b/c the government took more out of their pockets to support the inept.
All this while we're bailing out banks and motor companies that were horrifically mismanaged. Can the government manage healthcare? NO! They have completely punted Social Security, which the majority of us will not see as it will be depleted by the baby boomer generation. What's another trillion on the pile to crumble our nation? Lunatics. You are driving this country into the ground at an alarming rate based on your philosophy of entitlement.

Frank of CA 3:04PM June 17, 2009