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How to Get Universal Health Care

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Hillary Clinton and Barack Obama say they believe in giving Americans universal health care. I don’t believe them. Anyone who takes the time to understand universal health care should conclude that only a simple single payer system will reform the current outrageous system that benefits the insurance and pharmaceutical industries.

The contorted plans from Clinton and Obama are not sufficient reforms. And what John McCain has proposed is sheer nonsense and by itself should cause any conscious American to avoid voting for him.

Fights for health care system reform are centered in Congress, as if legislators will do what they have never done before: achieve true, major and systemic reforms that only serve the public interest, not lobbyists and campaign contributors from business sectors.

Both Clinton and Obama believe that Americans have a moral right to universal health care. If this is correct and if this is what you believe, then achieving universal health care that covers absolutely everyone by making health care affordable to absolutely everyone, as it is in many other nations, requires a different kind of government action. What exactly?

We must expand the Bill of Rights as embodied in the US Constitution to include the right to affordable universal health care. The time has come for the public to conclude that the right to universal health care is as important and necessary as the right to free speech and all the other beloved constitutional rights.

After all, what good are our current constitutional rights if you are ill or dying prematurely because of a lack of good health insurance? Certainly the pursuit of happiness cannot be successful when individuals are suffering from poor health because of inadequate health care.

Why would sensible, caring Americans be against a constitutional right to universal health care? Are there people who would stand up and publicly condemn the right of all Americans to have first rate health care? The only ones I can imagine doing this are those who are now benefiting financially from the current unjust system and want to keep blocking necessary congressional actions.

What Obama and Clinton should explicitly and loudly advocate is a constitutional amendment that makes universal health care a nonnegotiable right of all Americans.

Why has no member of Congress submitted legislation to get Congress to propose such an amendment for ratification by the states? Clearly, the only rational answer is that the many business interests that have corrupted Congress and that benefit from the current system have prevented proposal of such an amendment.

Article V of the Constitution provides only one alternative to Congress proposing amendments. That option has never been used in the entire history of the US. The Article V convention option was put in the Constitution because the Founders and Framers believed that one day, Americans would lose trust and confidence in the federal government. With 81 percent of Americans believing the nation is on the wrong track, and with so many millions of Americans lacking good health insurance and care, that day has surely arrived. With abysmally low levels of confidence in Congress and the president, an Article V convention – a temporary fourth branch of the federal government – is clearly the right path to obtaining a universal health care amendment. A convention of state delegates could debate such an amendment, and if they agreed to propose it, then the standard ratification by three-quarters of the states would still be necessary.

Yes, this would probably take a few years. But it would be worth it. The prospect of Congress, even with Clinton or Obama as president, achieving true universal health care without loopholes benefiting various business sectors faster than the amendment approach is not good. The process of pursuing such an amendment, moreover, would help keep pressure on Congress to do the right thing.

If this sounds reasonable and necessary, then learn the truth about the Article V option at Friends of the Article V Convention and start talking up a universal health care amendment.

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About Joel S. Hirschhorn

Formerly full professor Univ. of Wisconsin, Madison, and senior official Congressional Office of Technology Assessment and National Governors Association. Author of four nonfiction books and hundreds of articles.
  • Clavos

    Why stop at “affordable healthcare?” If it’s a right, shouldn’t it be free? We don’t pay for our speech or assembly rights, do we?

    In fact, why not build a health system like the VA’s, wherein the government not only owns the hospitals, but all the medical personnel are government employees.

    Then, nationalize the pharma industry, and we’re all set.

  • Zedd

    Clavos,

    You are stating things as if there is a universal principle that would make your pseudo suggestion unthinkable.

    Try again.

  • Clavos

    Huh??

  • http://www.republicofdave.com Dave Nalle

    Wow, is there nothing Joel won’t consider to junk up the Constitution?

    Dave

  • http://federalistblog.blogspot.com Sir Andrew

    Your idea, sir, is exactly the reason why the founding fathers made it difficult to create an amendment.

  • http://www.futonreport.net/ Matthew T. Sussman

    Know what I want? Universal punch and pie.

  • http://www.elitebloggers.com Marion Barry

    Universal crack and hookers?

    Dave

  • Matt

    Did you see the Bunk study stating 2/3 of doctors in America want National Health Care. The doctors who did this study also conducted one in 2002 and found that the majority of doctors did not want national health care, the problem with this is that the 2 question surveys drastically differ in there 2nd question. I found this article, 60% of Physicians Surveyed Oppose Switching to a National Health Care Plan, It’s worth a read.

  • STM

    There’s no reason why Americans can’t have great universal health care.

    The single-payer system, however, doesn’t seem to work that well without private input. It seems to lead to an enormous bureacracy, and in a country of 300 million, do you really need that?

    There’s a compromise: a government single-payer system that covers the bulk of medical expenses for every citizen, with no need to have private insurance, but with complementary private care and a corresponding tax break for those who choose that option, which also relieves the burden somewhat on the government and maintains a large number of private-sector jobs and health care options.

    That’s the kind of option that sees a private patient in a private room in a public hospital, with doctors/specialists of their choice, and no waiting lists. It also ups the ante somewhat on the level of care provided to patients who are choosing the full public option, because while they can’t choose their doctors or a private room, they will still often get the same doctors and certainly the same excellent facilities.

    You need a combination private/public system that can be accessed by everyone and that gives a level of universal public care (and cover) way above what is currently offered in the US.

    The wallet triage has no place in any medical system – but neither does a giant, unwieldy buracracy of the kind experienced in places like Britain and Canada.

    Embrace the compromise. It works, and it works well.

    Yes, it’s still two-tier, but it does share the love around a bit better without taking that one important thing away: choice.

    It’s worth mentioning too that the system above, when first introduced, led to the samwe kind of fear, wailing and gnashing of teeth now seen in America.

    It took 20 years to work the bugs out of it, and the US doesn’t need to repeat the same mistakes if it draws on the experience of others who’ve cocked it up royally, and those who haven’t.

    It’s so popular now, no government would be stupid enough to dismantle it.

    Which just goes to show: contempt based on lack of knowledge or experience, and prior to investigation, can lead to serious misconceptions.

  • Arch Conservative

    “Wow, is there nothing Joel won’t consider to junk up the Constitution?”

    Apparently not.

  • troll

    (#7 – slippery slope alert

    before we know it Marion will be recalling Vox – I miss that man of mystery – from his present posting at the University of Padua)

  • Dan Miller

    Joel,

    Great idea! Absolutely Great!

    But why stop there? While we are setting about to amend the Constitution to include Universal Health Care, how about including some other neat stuff, which everybody needs as well:

    Universal Food Care;
    Universal Clothing Care;
    Universal Adequate Housing;
    Universal Home Heating (and Cooling) Care;
    Universal Fuel at $0.28 per gallon, adjusted according to the same inflation standard as Social Security
    Universal Superior Education;
    Universal Employment for All who Ask for It.

    Oh, Yeah. I almost forgot: Mandatory Universal Education to Eliminate what minor vestiges of Self-Reliance and Personal Responsibility remain.

    Utopia, here we come! Sound the Bugles! Sound the Trumpets (opps, I forgot to include Universal Music Education).

    Dan

  • troll

    …I’ll bring the fairy dust

  • Clavos

    Dead on, Dan…

  • Dan Miller

    Thanks, Troll

    However, fairy dust is one thing of which we already have a more than copious supply. I come not to praise fairy dust, but to bury it.

    Dan

  • Joel S. Hirschhorn

    From the mostly insipid comments posted here – clearly by people not suffering from no or suboptimal health insurance – we have still more evidence of the massive degree of stupidity and lack of concern for our fellow citizens that this website seems to attract.
    By the way, we have in the good old USA a fine example of a single payer health insurance system: Medicare. And for your information, the administrative costs in Medicare are a small fraction of the administrative costs of the whole private medical insurance industry. So we have proof positive that converting over to a single payer government system (that in no way makes the government a provider of medical services)would save billions of dollars nationally. More to the point, the US has abysmal health results compared to nations with single payer universal health care and worse yet our per capita costs are enormously higher. In other words, mental midgets favoring this website: the current US medical insurance/delivery system (outside of Medicare)makes tons of money for the insurance and pharmaceutical industries, while providing terrible health coverage for Americans.

  • http://www.republicofdave.com Dave Nalle

    Dan, you forgot Universal Pet Care. I’d love to have that when I go on vacation. Hey, and maybe the government could take over all those worthless timeshares people bought and apportion vacation space based on need.

    Joel, the reason you get insipid and flippand comments is that no one takes your article seriously – for good reason.

    Dave

  • http://theugliestamerican.blogspot.com Andy Marsh

    You want cheap health care…earn it! Make the military a career and you get health care for you and your family for $460 a year.

    Gimme gimme gimme! Fuck you! Gimme!

  • Baronius

    Meow, Joel.

    You wanted to know if any sensible, caring people could possibly disagree with you. Here we are.

  • Alessandro

    I’m just pouring on the for the sake of it.

    #12: Hehe.

    Um, my turn. I want Universal Parenting. I mean, no one seems interested in raising kids anymore, right? Right. Let the government raise our kids!

    Who’s with me? Let them deal with the bad grades our kids get.

    Me? I’m heading to bumper cars.

  • Alessandro

    “…to the bumper cars.” Sheesh. I want a Universal Editor too.

  • Clavos

    Joel thinks the government that brought you the Katrina aftermath, the Iraq and Vietnam wars, Walter Reed Hospital, the weeks of warnings we had about 9-11 before it happened, bridges falling down, and children who are graduated from high school unable to read or write, that government is going to keep us all healthy, provide us all the medical care we need, and do it efficiently???? HA! In a pig’s eye!

    You and bliffle keep repeating the same lame figures (produced, no doubt, by Medicare itself)that “prove” Medicare is more efficient than the private sector.

    I call bullshit, and I speak from 2 1/2 years experience as a Medicare consumer. This “efficient” Medicare paid twice as much for my wife’s wheelchair as the manufacturer charges for it on its website; PLUS, it took Medicare three months to get it delivered, whereas the manufacturer told me they could get it to me in a week. When i suggested to Medicare that we save the taxpayers money and buy the chair my way, I was told, “No, we only buy through authorized suppliers.” (Read: the suppliers who “greased the wheels”).

    You guys talk about Medicare’s “low overhead,” as reflected in those mysterious figures; sure, Medicare’s own overhead is low; they don’t do anything except shuffle papers, and even much of that is farmed out to the very same medical insurers you so despise. Medicare’s error rates in billing are awesome; more than once I’ve received bills in the thousands of $$$$s, reviewed and analyzed them as published in their manuals, and figured out that a bill for $2500 should only have been for $75 or $80. And Medicare has acknowledged their errors and accepted my figures.

    Medicare is continuously and egregiously ripped off by doctors, hospitals, nursing and rehabilitation centers, and most especially, by durable medical supplies providers. None of these ripoffs enter into the calculations of Medicare’s “overhead,” because they are not accounted for as part of Medicare’s overhead; they are the costs of patient care, not Medicare’s “overhead.”

    In South Florida alone, tens of millions of dollars are ripped off from Medicare; just the local busts reported in the papers on an annual basis are in the millions of dollars, and that’s just the miscreants who are caught.

    I’m not against everyone being covered by medical insurance; I AM against the government handling it without strict civilian, non-government oversight, and I am against civil servants who cannot be fired being in charge of it.

    But most of all, what scares me the worst as a taxpayer is that responsibility for it might be handed over to Medicare.

    Woe betide us all if that happens.

  • Baronius

    Clavos, let’s pretend that you’re wrong, and Medicare is the gold standard of efficiency. What happens to health care prices the day that Medicare says it’s going to pay all the bills?

    And what happens the next day, when Medicare decides prices are too high? What will happen to health care availability when the government starts “negotiating” prices?

    I caught a little bit of Governor Jindal on C-SPAN today. He was talking about the recovery after Katrina. He told the story about one sheriff who lost his department’s vehicles in the storm. He put in a call to Ford, and received donated trucks that same day. He’s still waiting for the vehicles promised by the federal government.

    Of course Medicare isn’t efficient. It can’t be. But even if it were, it’s not equipped to manage the nation’s health care market.

  • Dan Miller

    Dave and Alessandro

    Yeah. That too. Let’s come up with a comprehensive list of gimmes, so that when the Constitutional Convention is held we won’t have to do it again soon.

    As to the astute author of the article, who says

    From the mostly insipid comments posted here – clearly by people not suffering from no or suboptimal health insurance – we have still more evidence of the massive degree of stupidity and lack of concern for our fellow citizens that this website seems to attract.

    Pile it on.

    Dan

  • http://stacischoff.blogspot.com/ Staci Schoff

    Joel, you’re pretty much SOL if you don’t even think Clinton’s health care proposal goes far enough. It’s already too radical to ever happen. I agree with you that we need health care reform, but amending the constitution? Don’t waste your energy fantasizing about it.

    I’m happy at this point to work on changing the coverage/employment link so that people are not dependent on a particular employer for their health insurance. There has to be a better way, but handing it all to the government isn’t going to be the answer either — anything the government can do, pretty much anyone else can do more efficiently.

  • Clavos

    Excellent points all, Baronius, and an entire additional dimension to the horror I was trying to depict…

  • Biros

    Universal Armaments Production.

    Oh right, been there got that.

    “Of all the enemies to public liberty war is, perhaps, the most to be dreaded because it comprises and develops the germ of every other. War is the parent of armies; from these proceed debts and taxes … known instruments for bringing the many under the domination of the few.… No nation could preserve its freedom in the midst of continual warfare.”

    James Madison, 1795

  • Robert Recht

    Much of the comments of gov’t innefficiency and over charging is correct in the Medicare system. BUT as a medicare senior w/ serious health problems I had the best of care and I guarantee better than the private system I came from before I was on Medicare. Total cost is less/patient for Medicare than the private system of healthcare and this is for the “sickest” members of the population. Medicare has room for improvement and this can be done w/more activism on our part instead of constant complaining about it. It still is head and shoulders above the rotten private system we have w/ exclusions, denials of care, cancellations and raising of rates astronomically etc etc. AND because it is non-profit, it does, in spite of its drawbacks, operate at far less cost than our for-profit system foisted on you people who are not on Medicare. HR 676, Rep John Conyers, MIch promises to bring about a better Medicare to all of us–check it out!

  • Clavos

    Robert Recht sez:

    Total cost is less/patient for Medicare than the private system of healthcare and this is for the “sickest” members of the population.

    This is not true. The government pays just as much, and in some cases more, for medical services than private insurers do.

    This is especially egregious when one considers that the government, as single payer for an enormous cohort of patients, actually is in a strong bargaining position with medical suppliers; but because Medicare is administered by government employees who are not held accountable and who are not subject to oversight or review, the government loses its inherent advantage as these functionaries invariably take the easy way out and merely settle for what the private insurers are accepting for payment.

    Robert also mentions “denial of care,” implying that it won’t happen under a government-run single payer system. Yesterday I had to drive over to the rehab center to which my wife will be transferring from the medical hospital some time next week, to drop off a check for $1,000.00, in payment for the first week of her stay, because Medicare says her rehab benefits have “run out” for this benefit period. If she stays another two weeks (highly likely), each additional week will cost me another $1K.

    Universal health care is coming. Before it does, we all need to start harassing those clowns in Washington who supposedly represent us and FORCE them to investigate systems such as Australia’s, which appear to actually work, because Medicare is a very poor imitation of a medical plan.

  • Alesssandro

    #24- I’m too busy drinking blood and designing plans to hurt my fellow man to pile it on just now. Maybe later.

  • Mooja

    Joel, imagine a nation of two people; you and me. In this nation we have a right to free speech and right to universal health care. In order to allow your right to free speech I simply do nothing and allow you to proceed. In order to allow your right to universal health care I must be FORCED to provide it to you. Do you see this important difference between a right to free speech and a right to universal health care? One right does not limit the freedom of another, the other right does.

    Your suggestion, though well meaning, flies in the face of the principals on which this nation is built.

  • Clavos

    Nice point, Mooja.

  • Baronius

    Exactly, Mooja. Earlier in the thread, people were listing all the free “cares” that they wanted guaranteed. I couldn’t help but think about something most every guy would want guaranteed access to. But if we guys tried to pass that amendment, the women of the country would be right to protest it. Something can’t be a universal right if it costs someone else.

  • http://drdreadful.blogspot.com Dr Dreadful

    Don’t mind Joel. His basic aim is to tear down the Constitution and rebuild it in his own image. He’s not doing his own argument any favors.

    But consider this: the government forces you to pay taxes. You pay them, even though doing so limits your freedom, because you expect to receive certain services in return – governance, national defense, infrastructure and other things.

    It can be argued that mandated health care actually enhances your natural right to life, liberty and the pursuit of happiness. A man who has to forego a heart bypass operation because he can’t afford the health insurance to pay for it certainly finds his First Amendment rights severely curtailed.

    And of course, as STM is so fond of reminding us, there’s always that pesky Ninth Amendment…

    Rights are always going to be in conflict with each other at some point. By Baronius’s definition above, it’s hard to think of any rights that would be universal – except perhaps speech, and even then words can easily be used to impinge upon others.

  • Baronius

    True, Dread. There aren’t many things that can be called universal or human rights. Speech, religion, a few others.

  • http://drdreadful.blogspot.com Dr Dreadful

    I’ll expand on my above points a bit. I think Joel’s right in that health care should be a right, but he’s mistaken in believing that it currently isn’t. It falls, in my opinion, under your so-called universal rights – to Life, Liberty, the pursuit of Happiness and indiscriminate initial Capitalization of Nouns. The failing at the moment is that they are not, in that sense, being guaranteed.

    I understand the concerns of some commenters, especially those on the right wing. The state helps to guarantee your rights by levying taxes to pay for national defense and for the three branches of government. This squeezes your freedom to a degree, but most people would agree that the benefits outweigh the infringement.

    And this is the crux of the debate. Over the course of 200-plus years, the government has proven itself to be pretty darn good at defense. But I grant you that its performance in other areas doesn’t inspire great confidence in its ability to guarantee the health aspects of your rights.

  • Marlowe

    Joel… Don’t let these guys get to you – they’d argue against the stay of their own impending execution. Most of them belong to the realm of the Big-Little Republican: angry, frightened, slightly overweight White men who have their car radios tuned to either Rush Limbaugh or Easy Listening…

    There isn’t a need to insert another amendment into the Bill of Rights concerning health care. It is right there in the Ninth and Tenth Amendments.

    You’re right of course. With a four lobbyist for every congressman inside the Belt Way there is no way to break the logjam they’ve thrown up.

    This is one reason you’re seeing more states going at affordable/universal health care on their own. Likely too the only way to have the RIGHT of adequate health care recognized is VIA the state-by-state route.

    And actually, there are OTHER ways to amend the Constitution besides Article Five…

    P. Marlowe

  • Maurice

    I am always sensitive to stereotyping and profiling. This Marlowe dude is extreme!

    Put the broad brush aside, man!

    There are some very sensible remarks here (Staci #25 is one…) made by people that don’t fit your predjudiced description.

  • Zedd

    Folks,

    Universal HC is a standard around the world. What is the debate about? Are you all alright? Its like insisting on using horse and buggy and debating on whether man can fly. Uhmmmm Its done every day. Is it me???

    Are you saying it cant happen on principle? Or you don’t want to feel socialistic even though it would work or you don’t want to put saddle makers, blacksmiths and buggy lots out of business? What is the real problem? It’s odd. I’m guessing its like the switching to the metric system. We don’t wanna cause……. well, we just don’t wanna.

  • Maurice

    Zedd,

    read Clavos #29

  • bliffle

    UHC is cheaper than this system we have now. We pay extra to prop up this ramshackle system.

    So, why not just abandon it and embrace UHC?

  • http://www.republicofdave.com Dave Nalle

    You do not have a right to healthcare, you have a right to equal access to healthcare.

    To say that you have a right to healthcare is to say that you have the right to compel others to provide goods and services to you at no cost. It is to say that you have the right to make doctors and nurses slaves of the state. It is to say that you have the right to use the force of government to take money out of the pocket of your neighbor to provide for your needs. To demand a right to healthcare is to demand tyrrany.

    What you actually have is the opportunity to be responsible for your own healthcare and to demand that it be provided in a fair and equitable way. You have the right to have the government protect your access to healthcare as part of the ‘general welfare’ guaranteed in the constitution. That does not mean compelling others to pay for or to provide your care free of charge. It means assuring that health care and insurance are regulated and provided at a fair price and without unreasonable restrictions or conditions.

    Dave

  • Clavos

    UHC is cheaper than this system we have now

    Since we’ve never had UHC in this country, that is an unwarranted, baseless assumption.

    The closest thing we have to UHC at present is Medicare. I am very familiar with Medicare and the prices it pays for goods and services. It consistently and regularly overpays for nearly everything.

    We MIGHT be able to provide UHC more cheaply, as long as we don’t let the government do anything but pay the bills, without ANY administrative responsibility, and especially, without regulatory authority.

    For the reasons why, see my #29, above.

  • http://www.foavc.org Joel S. Hirschhorn

    As usual Nalle and Clavos demonstrate their complete bias and/or ignorance. UHC is all about providing affordable insurance available to everyone (despite prior medical conditions) and that emphasizes preventive care and includes mental health care and drugs.
    It is ALL about ensuring access to medical care, leaving the choice of medical care to the individual. Right now access is denied because health insurance is either too expensive or just not available at all because of a person’s medical history. Then too, increasingly even health insurance that is available imposes such huge costs for copays etc that it prevents use because the costs are just too high for millions of people. Employers increasingly are either not offering subsidized health insurance or offering only limited/costly insurance of little use.
    As to Medicare, here too there is nothing but disinformation coming from the usual right wing loonies on this site; in fact, Medicare is more financially efficient than the entire private health insurance industry; while there is always some fraud waste and abuse (including in the private insurance market), the fact is that the administrative costs in Medicare are profoundly lower than the private health insurance industry, because PROFIT levels are so extremely high in the private health industry sector. STOP confusing insurance to get access versus health delivery that without insurance is simply too costly for all but the wealthy.

  • Clavos

    the fact is that the administrative costs in Medicare are profoundly lower than the private health insurance industry…

    As I have mentioned repeatedly in the past, this is true, as far as it goes. However, “administrative costs” are a drop in the bucket compared to what Medicare pays overall for the services and goods it pays on behalf of its clients, and I have 2 1/2 years worth of EOBs to prove it.

    As I’ve also said repeatedly: I’m not opposed to providing health care for all Americans; I’m not even opposed to paying for it with my taxes.

    Just don’t let the corrupt, crooked inept American government handle anything but paying for it. And watch them carefully. Can you say $600 hammers?

  • bliffle

    Speaking as one who spent several years in the Medical Fraud Detection business, I can attest that ALL medical systems suffer from extensive fraud. Both providers and recipients commit fraud. If someone breaks an arm it may get reported six times for payment, by either the recipient or the provider.

    Fraud is so extensive and common that we could send a salesman to give a seminar on Fraud Detection to prospects and he would find actual live frauds in the prospects database.

    That is true of both government systems and private systems.

    The difference between government and private systems is that Federal Medicare (and medicaid) law REQUIRES that the State systems employ a certified fraud software system in order to participate, which means that every state hires a certified system.

    No such fraud detection software is required for private systems. In fact, private systems (perversely) have a vested interest in leaving fraud undetected because their profits are basically derived from a surcharge on expenditures. There is no competition because Federal regulation is prohibited by a 1945 law. It’s a racket.

    As a result, while Medicare overhead runs about 3% private insurance runs about 40%.

  • http://www.republicofdave.com Dave Nalle

    As usual Nalle and Clavos demonstrate their complete bias and/or ignorance. UHC is all about providing affordable insurance available to everyone (despite prior medical conditions) and that emphasizes preventive care and includes mental health care and drugs.
    It is ALL about ensuring access to medical care, leaving the choice of medical care to the individual.

    As usual, Joel sets up straw men to argue with because he can’t address the actual issues we’ve raised. If his description of universal healthcare were true, accurate and representative of ANY of the proposed plans, then there would be no argument here. But the truth is that the plans which are being proposed are not about providing choice and affordable care. They are about mandating care and replacing the free market with government micromanagement. All we’re asking for is a better way than putting it all in the hands of government bureaucrats.

    Dave

  • Clavos

    It’s not just the fraud, bliffle, it’s the stupidity and indifference of the government employees who staff Medicare, as well.

    I have a number of EOBs I could show you in which we are billed $2 or $3K by CMS, the Medicare billing division. In each case, my wife, who is a REAL insurance expert, has taken them, and after a few days of calling Medicare, usually escalating up to senior management before she finds someone who knows as much about medical billing as she does, brings them back to me with instructions to pay $80 or $100 on a bill originally submitted for $2,500.

    I can well imagine how much overcharging goes on in the households where the family doesn’t know enough to object cogently.

    By contrast, similar mistakes from our private carrier (for me; I’m not Medicare eligible) are much rarer.

    But then, employees in the private sector are held accountable for their work.

  • Maurice

    Clavos, my friend you make very good points.

    Well written.

    No doubt all us want good, affordable health care and certainly you and I have worked the system. I keep thinking about Staci’s comment #25. I have to agree. It is weird that insurance is connected to the employer. Why couldn’t there be a group insurance plan that is not associated with the employer?

  • Zedd

    Dave,

    I am frightened by your legalistic description of what humanity owes one another. We would not have made it as a species had everyone been as selfish and legalistic as yourself.

    In your romantic libertarian society of the past, it was an unspoken rule to come to the aid of the ill. Not doing so would not have been looked upon as a choice to be made, one would be shunned and thought to be lacking in the qualities that distinguishes us from other species. Now that we have evolved and have become more “civilized” we organize ourselves through more elaborate systems. The unspoken expectations of old are spelled out through policy and regulations. Perhaps you should embrace the evolutionary process of mankind and adjust.

  • Clavos

    Maurice #49,

    Thanks!

    You’re right; we must insist that any proposed new plans must include portability.

  • bliffle

    “But then, employees in the private sector are held accountable for their work.”

    They are held accountable for costs and revenues but not health delivery. The cost accountability is what has led to a lot of abuses, especially about ‘pre-existing’ conditions and elective surgery , etc. Revenue accountability has the perverse effect of motivating them to inflate your bills.

    If the private insurance business were truly competitive then ‘clients’ would be able to hold the companies accountable, but it is not. The McCarran-Ferguson act of 1945 specifically exempts them from federal regulation, leaving only the ultra-weak state regulators. As a consequence they have formed an oligopoly wherein they share markets by mutual consent. The client is closed out of the decision system.

    What we have is an administered economy, not a Free Market economy. And it’s administered by the companies themselves. For their own benefit, not the clients.

    Employer provided healthcare became common after WW2 when employers sought to add non-wage benefits to employment offers in order to use non-monetary compensation to build loyalty at low cost through insurance. Large companies had the management and fiscal skills and market clout to keep the insurance companies honest. When the insCos tried to screw the corps with unreasonable premiums the corps retaliated by ‘self-insuring’, whereby the corp would endow the pool funds themselves and just hire out the paperwork at low rates to the insCos. That worked good because the corp generally looked out for their employees.

    But that excluded non-corp people like the self-employed and unemployed or retired, who found themselves confronted by ultra-high premiums and exclusions.

    Now, in these modern times, the corps don’t care about their employees or their loyalty, in fact may be antagonistic to their own employees, so even corp employees are thrown into the pool of lonely disorganized individuals easily exploited by Big Bully insurance cos.

    The only organization remaining to represent the interests of individuals is the government, and that’s why UHC is in our futures.

  • Clavos

    The only organization remaining to represent the interests of individuals is the government…

    And it doesn’t (thank goodness!!).

    You certainly paint a grim picture, bliffle.

    You think health care is bad now…

  • bliffle

    Clavos insists on ignoring the information available at the end of his nose. UHC exists in most of the other industrialized nations and is always less expensive and easier to use than the ramshackle USA system.

    Habitually ignoring evidence is what leads people to be called ignorant.

  • Fraud hunter

    Regarding Bliffle in the Federal Fraud hunting busienss. The current systems employed by Mewdicare and Medicaid amount to counting the number of horses rounded up afer the barn door is unlocked. This is the only business in the world where the customer (us) pays bills without any verification that any service was acutally delivered. At least in the private sector you get an explanation of benefits and have an increasing portion you are responsible for. In medicare and Medicaid, providers can bill to their hearts content and nobody gets a notice saying “this doctor billed on your behalf” . Furthermore, there is no way to adequately report fraud.

    Instead of playin cops & robbers, they should use existing technology to precent fraud. It can be done.

  • Clavos

    UHC exists in most of the other industrialized nations and is always less expensive and easier to use than the ramshackle USA system.

    You obviously haven’t read any of the horror stories emanating from countries with UHC, bliffle.

    In those countries where it works, they don’t have the US government operating it for them; if they did, it wouldn’t be working. As I’ve said a multitude of times before, I have direct, hands on multi year experience with US government health insurance.

    It’s a nightmare, with deficiencies in every area the consumer is forced to deal with.

    Your endorsement of government interfering yet more in people’s lives, while not ignorant (except for your faith in the integrity and efficiency of the US government), does seem to be one of advocacy beyond the well being of the people. Are you a government employee, active or retired?

  • bliffle

    Not at all. Medical care that I and my relatives and in-laws have experienced in Europe is easily available, good quality, and inexpensive.

    And no one in Europe wants the US system.

  • Clavos

    And no one in Europe wants the US system.

    Understandably. What’s not understandable is your desire to turn the management of the health care of the people here over to the worst possible entity in the country.

    Let the Feds (i.e. US) pay for it, but hell give it to Mrs. Smith’s third graders to run rather than letting our government of bumblers and slackers do it.

    The kids will certainly do it better.

  • Zedd

    Clav,

    Come on. The entire world is aboard and they are all fine. What are you arguing? Who says that UHC would be administrated in the same way that you’ve experienced state medicine? Who said that? That seems to be the premise by which your argument arises from. But I have heard NO ONE say that the administration of UHC would be the same as what exists or has existed. So what are you all in a tizzy about? Okay, we get it, you were annoyed by the processes that you had to under go. But what does that have to do with the ridiculous system which leaves millions of Americans in a bind, especially as the population ages?

    OMG I just realizes something. You’ve been discussing substantive issues for three days. Are you alright? Now we have to work on you being right :o)

  • Cannonshop

    A couple of observations- we have TWO examples of “Universal Healthcare” to look at in operation in the U.S.

    1. Medicare.

    2. VA (Veteran’s Administration) or Military health-care.

    Neither has a good record for providing good quality of care. Both are notorious for financial mismanagement, poor patient care (Walter Reed anyone?), frequent mistakes (Overbilling, fraudulent payment, “Losing” money and resources, not to mention poor response to consumer issues!)

    Now,there are lots of countries that don’t have these problems (or, at least, don’t admit to having those problems.)

    those countries don’t have guys like Karl Rove or George Soros influencing who holds office, nor do they have the kind of corruption the U.S. Federal Government suffers from and has suffered from since the Grant Administration.

    y’see, here in the U.S. the people who make a life of Civil Service usually do so, because they lack the ability to make a life OUTSIDE of civil Service. It isn’t like much of Europe, where Merit actually matters and kids WANT to go into government, study to go in, and it has a respectability. HERE, everyone knows what a “Civil Servant” really is-he’s isolated from economic down-turns and can’t be fired, is never held accountable for mistakes, and is usually someone incapable of earning a living outside of a Federal office.

    “Rule by the Worst” or Kakocracy.

  • bliffle

    All are arguable points, cannon, but I have more interesting things to do at this moment.