EXCERPT:
"The biggest indictment of the American health care system is that 46 million of our citizens still have no health insurance. For that many people to live without health insurance is a betrayal of the Founders' promise of life, liberty, and the pursuit of happiness. Forty-six million sounds abstract, but it is more than all the people living in the following states combined: Mississippi, Iowa, Missouri, Arkansas, Louisiana, Oklahoma, Kansas, Nebraska, South Dakota, North Dakota, Montana, Wyoming, Colorado, Utah, Arizona, and New Mexico. If none of the people living in those states had health insurance, would we turn our backs on them? I don't think so.... If we gave it a moment's thought, we would know who they are: the cabdrivers, the waiters and waitresses, the workers who clean our office buildings, the young people who give up health coverage because they can't imagine being sick and want to have the money to rent an apartment. They are the people who care for our elderly parents and oversee our children while we work. They are laid-off workers who can't get insurance between jobs because their child has diabetes. They are, by and large, hardworking people who can't afford to buy insurance themselves. Many of them work for small businesses that cannot afford to provide it.
"I know people who stay in a job they don't like simply because if they left, they'd lose their health insurance. I have spoken with middle-aged men who describe all the symptoms of colon cancer but won't go to a doctor, because if it were cancer and they got treatment, they would be bankrupt. How do these stories make America strong? They don't."
Question: You write in The New American Story: "It must be mandatory for all Americans to have health insurance; low income cannot be an acceptable obstacle." How would you see this happen without adopting a socialist health care system?
Over 50 percent of all health spending is already done by the government. A single-payer system would increase that to 100 percent. With such a system, costs would be dramatically cut, and with value-based medicine in which hospitals compete for patients by revealing the outcomes (how successful they are at saving lives and curing illnesses) per dollar invested, costs would be cut further even as quality went up.
If you wanted to keep a role for the private sector in health care you could do that and cover everyone by requiring everyone to have insurance and then subsidizing those who can't afford to pay for it themselves.
Question: How can we maintain quality of care while still keeping costs in check?
Make hospitals compete on the basis of costs and quality, with all procedures of every hospital published on the Internet and measured against national standards. Reducing medical errors could also save billions while improving quality. Creating a system in which errors such as wrong dosage or surgical error will be readily admitted and corrected on a systematic basis will both reduce costs and increase quality.
Question: What are some other practical measures for fixing the health care system, and how would you see them enacted?
Reform measures that I have described will only become law when enough Americans demand it. That's what the New American Story is all about - seeing that we can solve our problems, such as in health care, because we have the political will to make it happen.
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Comments: 19
.I feel insurance companies and pharmaceutical companies have added a lot of additional expense to the medical field, they are suppose to help the public address...weird...and supposedly there is a nurses shortage in this country...how can that be??? Are the wages that bad....one might suggest there are some serious administration problems that most certainly could be changed to make medical assistance less expensive...Are not hospitals suppose to be non profit? Just a few extra points I thought about after reading this article...
You are right! The first thing is the 30 to 33% of the top that insurance takes for their profit. Then the drug lords need a comfy golden parachute.
I still say that the government that issues patents on intellectual property or drugs has an obligation to the citizens to make sure that patent is not used to the detriment of the citizens!
It's interesting to see just how quickly this type of discussion boils down to insuring that everyone has insurance. I don't give a rat's patootie about insurance, I want health care! The insurance companies, after all these years, have proven themselves to be pitiful stewards of Americas health care. I would vote to remove them in favor of a single payer system not founded in the profit motive, such as Medicare is for seniors today.
Effectively, about a third of all Americans have insurance through a single payer system, namely the taxpayers. All seniors, all government employees including senators and congressmen and their staffs, all state, city and county employees and school district employees and others. I don't hear any outcry from these people to change their system! Medicare has proven to be the economical of these systems and the most inclined to hold costs down. Looks like a no brainer to me!
Direct to consumer advertising costs a bundle but so does the money spent on over 1,000 lobbyists hired by the drug companies. I resent paying for either one!
TO PAY FOR THE ELECTIONS ALL WE TALK ABOUT WILL NEVER BE DONE. WE AS
A NATION MUST FORCE THEM TO CHANGE THE SYSTEM,THEY WRITE THE BILLS THAT
EFFECT THEMSELFS. IF THE GOVERNMENT JUST HAD PREVENTIVE CLINICS TO GO
TO, IT WOULD SAVE MILLIONS OF DOLLARS. THEY REFUSE TO FIX THE PROBLEM
JUST CHARGE MORE TO US. IT IS AN INSULT THAT THEY DO NOTHING TO HELP
THE AMERICAN PUBLIC,LAWS THAT ALLOW FOREIGNERS TO HAVE BABIES IN THIS
COUNTRY FREE AND MAKE THEM CITIZENS IS ABSURB,IT SHOULD BE CHANGED. YOU
CAN GO ON AND ON BUT LIKE I SAID AS LONG AS THEY PAY FOR ELECTIONS WE
DO NOT HAVE A DEMOCRACY FOR AMERICANS.
What if it was a blanket cost, say $30 bucks to go to the doctor's for a check up? $30 for blood tests etc..
I know, having no health insurance myself.. that when I have to go to the dentist or the doctor, I pay it all up front.
I do have to agree in some aspects.. if people were more in charge of their health costs, they probably wouldn't over use them... Parents who have the medical card will rush their child to the emergency room for a sniffle.. they don't pay for it so why does it matter if we go to the doctor or the Er?
People spend years paying off debts for cars, mortgages, etc... why would health care be any different? You go to the hospital, the surgury costs you 15,000.. you pay on it every month until it's paid off.
I guess I figure if you are working, having insurance through your employer could easily cost you 200-300 every pay (2wks) instead of paying for insurance that you might hardly use, you just pay when you need it?
I know that completely contradicts my review of this book.. I was just curious what others thought of a system like that?
My point is that if doctors and hospitals, the health care industry charges "x" amount of dollars annually for all the care they give to people, and you divide that up and compare it to what we pay in taxes and what the people who have insurance pay in premiums and compare it, what is the huge margin that just disappears into the Insurance Industry doing to help anyone except people who work for the Insurance Industry.
What value does this Industry provide, and how are they able to lobby politicians to increase their "salaries" every year and even try to force everyone to buy insurance. My answer unless I'm missing something is that they do nothing but insure their own survival and growth, and prop up the idea that lobbying and corruption is the real way to make money in these United States.
Will you please explain to me where I am wrong and what I am missing?
Today I finally went because I still can't walk straight, and I have numbness and a head pain - not really a headache. Still have no money to pay the bill, which outta be pretty costly: ct scan, x-rays, and doctor charge and emergency charge. It's a shame that health care costs so much that I could've had serious complications yet be too scared to receive medical attention. This is one bid that was attempted during the "New Deal," but was eroded from the remaining concepts due to insurance and medical refusal to comply. Let's finally get something done!
ps: I have a severe concussion and now lose two days of pay as well as incurring the medical costs, which should be 2 month's pay! Now I really need a doctor!
People don't want to be hit with a bill they cannot pay! Therefore, they will purchase some kind of insurance to protect themselves from catastrophic expenses. Not many surgeries come in for less than $50,000 these days, frequently accompanied by being off work with no income for a period of time to compound the situation.
Most people pay their insurance for a lifetime even though some actually receive that from their employer.
Bruce is right, the insurance company skims about 30 to 33 percent off the top of the health care dollars. Contrast that with Medicare which requires only about 3% for their overhead with the rest of their dollars going to patient care!
I once heard that Americans pay the brunt of R&D for pharmaceutical companies - we pay more for drugs than everyone else, and the difference goes to researching new drugs. What would be done to still provide that R&D money?
>> A lot who have health insurance still can't afford
>> to use it (co-pays, co-insurance and deductible
>> are beyond ridiculous).
I believe that whatever the cost if I am sick I am going
to the doctor and will pay for it, but when I do although
I pay almost $400 a month for insurance any visit to the
doctor costs me an addition $20, plus I never get out of
there without some tests that I end up paying about $100
for.
Lately they have decided to start charging for parking
too. This makes me almost apolplectic, but I cannot afford
to be since it will just cost me more money.
Once I was told I needed and MRI that turned out to be
negative, and was billed $800 for it because insurance
refused to pay.
The doctors do not know and cannot tell you how much
tests cost, so how do you make any decision on what to
do. Even is you have insurance health care is a total
rip-off.
We are being scammed, and if the USA does not shift its
area of expertise from being experts at scamming to producing
something of value that helps real people I do not know
about the future of this country.
>> Genine, if all the rest of us decide to be nice enough
>> to start paying for your medical care because you are
>> not capable of doing something in the economy that
>> will compensate you enough to take are of your own
>> medical needs ... then what are you prepared to do for
>> the country in exchange?
>> Will you refrain from engaging in risky behaviors such as
>> smoking, playing basketball, driving. Would you not
>> have children that you cannot afford and that we apparently
>> will have to pay medical bills for too?
>> I want to know from your point of view, what is fair?
>> What should the deal be for everyone that is just and
>> compassionate?
Is this not the heart of the issue?
If they prohibited direct to consumer advertising of drugs that would cover more than the costs of R&D. In addition, the amount spent on lobbying by the pharmaceutical companies is a staggering sum.
> I couldn't care less about insurance as such, I want to see everyone have health care.
My earlier point which no one addressed is trying to get at the idea that I have to pay for other people's health care, then those other people have responsibilities to me and everyone who is paying for them to minimize to the best of their ability my liability for them, not to mention having children that exponentially increase my liability for them. If there is nothing said about this - I'd rather give my money to the insurance industry which I detest than have a growing black hole of health care costs.
Failure by the Democrats to address this is the same as lying to the people to get elected and doing nothing, because it will never happen because most repsonsible people do not want to be stuck pyaing for a growing group of unproductive people.
I understand your feeling but you are paying now for a whole group of unproductive people and not only that you are not even getting efficiency our of your investment! Deadbeats will always be with us but we can make it as efficient as possible. And the Republicans have had a free rein on this matter for six years, what have they done?
The health care problem facing this country is massive and I've no disagreement with you there! While I have some ideas I don't believe we can totally monitor what everyone does at all times in order to accomplish this. Unfortunately, no one is listening to me about this problem, any more than you!
Lisa B,
And the insurance company takes 30% off the top of our health care dollar further increasing the cost of our health care!
We have a "37%" out of wedlock birth rate in America, at least according to Mitt Romney in the Republican Presidential Debate, held yesterday. That means a high number of these people will soon swamp the rest of us, and is on the verge of doing it now, as this has been going on for a long time now. The biological analogy of this is cancer. I read an article in "Scientific American" just yesterday that says all cancers "always" start from one malfunctioning cell, and expand until they destroy the coherence of an organism's systems.
I was not suggesting monitoring everyone, I was suggesting thinking about the staggering cost of this in money and in function of the cohesiveness of our society and its ultimate destruction. It is no small wonder Conservatives want to give nothing to the lower classes, and I agree with you too that this is not the answer either, it is inefficient too and will lead to the 3rd world nation we are all scared we are heading toward.