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Anybody seen those taco trailers around? Don Pancho's has been stationing itself at a gas station up the street and those are some of the best tacos and quesadillas I've ever had.

You could argue that ILLEGALS get free health care. However you seem to make it a us versus them theme. However you might just want to take a real look at FREE medicine in other countries. Do your own research, to not listen to these blogs who are only repeating something they hear. Nothing is free, someone pays. I had a cancer operation last year, I had medicare, and private insurance, I still paid over $500 of my own money. The day I had it there was about 10-12 illegals* getting cancer surgery. I asked the nurse who's paying for them, she replied you are.
* my opinion!
So Bill Clinton is the one that set up free medicine for illegals, it a shame he left your friend out. So now I have copied you, I have made it a us versus you. We will never solve a problem, until we remove the us versus you attitude. Last time I heard it was us, getting screwed by our government. its there someone who works in health care, that could give us their take on this? Yvonne where you at?

"With the passing of Senator No, it is now time that we finally say 'yes' to give everyone medical care . . ."

The best way to understand what would become of health care in the U. S. if it were to become "universal" is to contemplate the fruits of "universal" compulsory government monopoly schooling.

That is: ZERO-innovation, factory-style schooling (but with much larger factories), curricula dictated by distant bureaucracies (commanded by the lowest IQ people sporting college degrees), parents-as-ciphers (in, at best, token decision-making roles) --- all at per-pupil cost about ten times what it was in constant dollars a century ago when local communities funded and ran their own schools.

So Gearld, the passing of these old relics is paving the way for socialism and it's time we got on with it huh?

Helms died at 86 and someone else died at 42...

What an eye opener! Where do I sign up for this Utopian plan...Husseinforpresident.com?

Thanks, neocon, for at least addressing the letter. Not sure what the other three have to do with it.

Anyway, it appears to me that we are already paying for healthcare for millions. But since people have no healthcare coverage, they show up at the ER (I think they call them ED's now) for treatment of a hangnail. And since public hospitals really cannot turn anyone away, taxpayers end up paying premium prices for mundane treatments, or in the example from the letter, prevetive care is not available, so we end up paying for more chatastrophic treatements.

I know there are specific cases where my examples may not be applicable, but I think this is the general plan behind universal health care. And to those of you, like neocon and Archie Bunker, who believe we're at the edge of the slippery slope towards a commie state, I would only ask: what is your alternative? (In fact, if someone other than neocon could speak for the group, that would be great, because I've asked dozens of times and all he replies with are insults -- and still no solution.) Anyway, if the answer is "pay as you go", and only those with $ get healthcare, then please explain what happens to those who do not have coverage. Mass graves? Launch bodies into space (and who pays for that)? Any insight would help to shape your side of the argument, because I don't think I've ever seen it adequately addressed. Thanks.

Howie, eating tacos off Don Pancho's trailer has a lot to do with medical care.

As for treating hangnails...simple:eliminate the 3rd party payer.

Now I'm really getting hungry for tacos.

Anyway, elimination of 3rd party payers might be a step in the right direction. But that doesn't address how to deal with people without coverage.

That "coverage" is the problem. Without it, we'd all be equal...and more in tune to the cost.

How do deal with people without coverage:

1. Get government out of the medical business. What does a Senator know about brain surgery or medical equipment or primary care medicine? Forcing insurance coverage for everything means higher costs for insurance.

2. Encourage a return to insurance for catastrophic expenses and personal payment for basic care. The cost of basic care would go down, since nobody would have to file insurance for every hangnail and strep throat and flu shot. Let people self-insure for the small stuff and buy insurance for the big stuff like cancer and brain surgery. Such insurance would be more affordable for everyone.

Maybe so. But if a test costs five grand, then only those who can afford it will get it. So what happens to those who cannot afford the test? The ailment goes undiagnosed, early intervention opportunity is missed, and the patient suffers. Then the worse ailment befalls the patient, creating an even greater medical bill -- say tens of thousands -- which the patient cannot afford either. So then what? Put on an ice floe and set adrift like the eskimo legend?

"What does a Senator know about brain surgery or medical equipment or primary care medicine?"

You undersetimate our senators. I've seen a senator overrule the diagnosis of a brain-dead patient just from looking at pictures and videotapes.

Caught right in the middle, Dog. I believe we should take care of our own but, at the same time, I am completely opposed to giving illegals ANYTHING. I am more than a little weary of having to pay almost $600/month for my own healthcare (and making $40k less than when it was $120/mo) while every hispanic I admit to the ICU (with the exception of one) has Medicaid. We have become a nation ruled by idiots. They see no correlation between illegals and the state of our economy.

We used to have poor houses to take care of indigents. Our churches basically supported the poor. Now a good portion goes to other countries. If the government did not help our (not those here illegally-charity begins at home) old, infirmed, disabled and poor, who would?

I think a modest insurance policy, based on a sliding scale, should be made available to all legal families. If someone receiving welfare does not participate, I think the amount of the premium should be deducted from what they receive. I'm not sure how it would be handled if someone is poor but not receiving any benefits. But, yes, I do believe anyone living in the US could spare $50/year to be covered by insurance.

Also, mama b, without facts to back up your argument, it's hard to gauge the impact. Here is one study that suggests your plan would have little benefit to overall costs, or improvement in coverage:

http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=274007

From the overview: "The major purported advantages of HDHPs [high deductible health plans] are that they will a) lower health care costs by causing patients to be more cost-conscious, and b) make insurance premiums more affordable for the uninsured. This report, based on the Commonwealth Fund Biennial Survey of Health Insurance (2003), finds that such plans are unlikely to have a substantial effect on either costs or coverage. Furthermore, HDHPs can undermine the basic purposes of health insurance: to reduce financial barriers to needed care and protect against financial hardship."

And that's just the first one I looked at.

Also, mama b, without facts to back up your argument, it's hard to gauge the impact. Here is one study that suggests your plan would have little benefit to overall costs, or improvement in coverage:

http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=274007

From the overview: "The major purported advantages of HDHPs [high deductible health plans] are that they will a) lower health care costs by causing patients to be more cost-conscious, and b) make insurance premiums more affordable for the uninsured. This report, based on the Commonwealth Fund Biennial Survey of Health Insurance (2003), finds that such plans are unlikely to have a substantial effect on either costs or coverage. Furthermore, HDHPs can undermine the basic purposes of health insurance: to reduce financial barriers to needed care and protect against financial hardship."

And that's just the first one I looked at.

I've often suggested the same thing as mamab did. Pay for little stuff out of pocket, get cheaper insurance for catastrophic stuff. Without insurance for the little stuff doctors will be more competitive.

I work with many doctors offices, many of whom provide medical services for employers and their employees. For insurance reimbursed services such as workers comp injury treatment, they tend to employ more elaborate and expensive treatment as they know the insurance company will reimburse. No need to economize and offer better prices. Third party payer as Neo states.

For services paid directly by the employer such as a physical exam or a drug test, clinics are VERY price sensitive. Why? Because employers shop around for the best deal. Imagine that. Competition.

What kind of test costs $5K Howie?

I forgot to mention there is already a government program, for children anyway, where a family can pay $54/year (may have gone up-?) for each child to be covered by insurance. Coverage is not sliding scale but is offered for the same rate to everyone who qualifies. At least three 100 year old trees are sacrificed so each person can fill out the forms to qualify.

Our current system of payments is so complicated that it is hard to see exactly what happens and who pays and where the costs are landing. A government-run system would make matters even more complicated. Despite good intentions, I don't think government can simplify anything--only muddy the waters further and add even more paperwork and expense to burden those of us who actually pay for things.

When people were paying their doctors with farm produce and with cash, at least everyone knew who was paying whom and for what.

I've heard of an MRI costing over eight grand. Did I use the wrong term? Rather than "test", maybe I should have said "diagnostic implement". I'm sure you know better than I. (A vet offered to do an MRI on my very old dog recently for $1,800 -- what a bargain.) But the point is not the dollar figure. There are people who can't afford a $500 test, let alone $5K.

Yvonne, I feel for those trees! You have to have a sense of humor to work with insurance companies and government, or else go insane.

Speaking of trees sacrificed, I just filled out the medical/liability forms for 2 kids to go to camp and 1 to try out for cross-country. I also get to take one kid to an orthopedic specialist, where I can fill out a whole new set of forms. If I got paid for filling out forms, I'd be so filthy rich!

Mama B, no direspect, but the "it was the best of times" stuff might not really apply here. In the days of paying kindly Doc Porter with sweet potatoes, the life expectancy was a little lower than I'd be willing to return to.

I will answer your question without all the extras that have been written. The answer is no!

Maybe that MRI "test" would come down if there were more competition Howie. Again, a $5K test, treatment whatever would come over the deductible so the majority would be paid by insurance.

What I'm talking about are the small items, i.e. a doctor visit for your kid with the flu. Even my wife is guilty of taking our kids to the doctor with a minor sniffle.

I did read your link and it was what I would have expected, lower income people can't afford a doctor visit. 1) This may sound harsh but people need to take more responsibility over their health and not have children if they cannot afford them 2) A health savings account can be created to pay for the minor things and 3) consumers who shop for their medical care in a competitive environment would seek lower prices for care. Again I see it all the time at clinics where employers shop for the best prices for employee physicals, drug tests, etc.

I think I'll go get a taco. No, wait, too much cholesterol. Veggie taco it will be.

Dan said:

"1) This may sound harsh but people need to take more responsibility over their health and not have children if they cannot afford them"

But Dan, then people might be expected to exercise personal responsibility. I mean, c'mon. We can't have people thinking for themselves. If people started accepting responsibility for their actions we wouldn't be able to complain that the government doesn't provide enough FREE birth control.

Howie, your credulity toward "studies" is touching. I'm sure the sponsoring organization had no agenda.

But do try to think about what would happen to taco prices if (a) your employer paid for them, (b) the government paid for them, or (c) you just showed up with no money and they had to give them to you.

As I've said before, right now we have the worst of capitalism combined with the worst of socialism. Doctors have huge incentives to practice heroic medicine: the threat of lawsuits, drug companies pumping out hugely expensive new drugs that are slightly better than the old drugs, customers who want the best care and either don't pay directly or don't pay at all, and their own paychecks. The only thing keeping prices down at all is the insurance companies (boo). No wonder health care consistently doubles or triples the rate of GDP growth.

Mr 444,

Fair enough point about the "studies" angle. I seldom use them just because of the agenda point. I've got a history of picking apart "studies" from the other side that are sponsored by everyone from insurance companies to Exxon. I try to rely on the safety and comfort of my own opinion, but occassionally that's not persuasive enough.

Unfortunately, no one has provided anything of substance to refute the conclusions of the study. Simply making the observations that "if there were less paperwork, it would have to cost less", or "back when I could pay for chemotherapy with a dozen eggs..." or "if only people would stop having babies..." is a bit of a waste of time.

In every suggestion, there is always the unaddressed issue of low wage citizens who would have to decide between fixing their car so they can drive to work, or getting the $1,000 MRI (is that better, Dan?).

Since we are devoid of useful solutions that are simply a waste of time Howie, perhaps you can provide yours. I think everyone can agree that govt. is incredibly wasteful with our money. They have used our money destined for social security for other purposes as just one example. With this track record I don't understand why some think govt. would be any more efficient running our health care.

Thanks in advance for your "useful" solutions.

Howie,

My mom use to get a $6,000 shot before her chemo (to build up her red blood count) if you want to use that as an example of heath care costs.

Dan,

Many was the time that my dad thanked LBJ for medicare during my moms illness. I thank you also for helping to pay for it. It kept them out of the poorhouse. People shouldn't have diseases they can't afford to pay for.

I'm not saying I have the answers Dan -- I was just asking some questions, and it appears no one else is much farther along than I am. You have to admit, asking people to wait until they can afford children is a bit naive -- especially considering your views on abortion. If I touched a nerve -- sorry.

In my opinion, if my insurance premiums go up 10-30% most years, and doctors' premiums are up so high that it's driving them out of high risk areas like OB, but the total cost of frivolous lawsuits hasn't really changed, then perhaps the ones with the hands in the cookie jars are the insurance companies. So in my simple view of the world, maybe John Edwards' plan of taking them totally out of the picture warrants at least some consideration. (I can hear the laughter now, followed by keyboards clacking -- blast away.)

Also, while I agree that government waste is rampant, that doesn't mean it has to be.

And finally, no one has addressed my original point about the system being broken. Can we at least agree on that? If we can, then the next step is look at the array of solutions. One thing we cannot seem to agree on is my position that the richest, greatest country of all time is willing to let its citizens die because of inadequate health care.

Insurance companies are definitely part of the problem. They spend so much time and paper (and money) trying NOT to pay benefits.

My problem with the catastrophic insurance only is mostly, how many people are actually going to buy it? Who thinks that the catastrophe will happen to them? Because those who do pay are still going to end up paying for those who don't.

Howie, I wouldn't go as far in saying the system is broken, we have one of the best health care systems in the world. Certainly it needs improvement but I don't think entrusting the govt. to manage it is a wise idea given their track record.

My father in law was recently diagnosed with a treatable colon cancer. He got right in for the initial visits and "tests", met with the doctor to discuss treatment options, and will start with treatment next week. Total time 2.5 weeks from tests to diagnosis to treatment.

I often mention this in LTEs on this subject. Please Google "Canada wait time", don't even have to mention health care, and you will be directed to the Canada Wait Time Reduction Fund. It's a $4.5 plus billion plan to alleviate wait times for medical treatment.

Luckily my paw in law doesn't live in PEI, apparently they are having problems with wait times for cancer care:

http://www.hc-sc.gc.ca/ahc-asc/media/nr-cp/_2008/2008_69-eng.php

Other than that PEI is a beautiful place, just had the fortune to visit in May.

"You have to admit, asking people to wait until they can afford children is a bit naive.."

Really? My wife and I have very little money back when I started my business, therefore we decided to delay starting a family. (Hint, hint, we used birth control). Once the business was doing well, about 3 years later, we decided to have children.

Imagine that, a couple exercising responsibility in family planning so that our children would be well taken care of emotionally and financially.

rahrah, it seems you indicate that people are too stupid to pay for their insurance. If that is the case perhaps the govt. could withhold it like they do taxes.

One more note about Canada, they have 1/10th the population we have. If they are having difficulty with wait times in govt. run health care just imagine what it would be like here.

CANADA, CANADA, CANADA!

Because our system will be just like theirs!

"One more note about Canada, they have 1/10th the population we have. If they are having difficulty with wait times in govt. run health care just imagine what it would be like here."

Is it possible that they have 1/10th the medical personnel also?

Dan,

First -- agree about PEI. I was there in '07 -- loveley place. Second, as rahrah points out, if Canada's system is not working, that's kind of their problem. Who says our solution has to be Canada's? What about the Netherlands, Australia, Germany?

I currently work in a society where healthcare is provided by the government. The people I've spoken to say two things. 1) The wait times for some things can be a pain, and 2) They cannot imagine a country like the US where one can only get quality care if they have a good insurance policy.

On the first -- I can tell you we've had no trouble getting our children in for vaccinations. A home health nurse came to visit us when we moved here, and the kids have all gotten their shots in a timely fashion. And when my wife got numbers on a test that were abnormal, the doctor called (personally) to discuss it with her. Those are my only personal anecdotes. I haven't had the need for elective surgery, so the 6-month wait (cited by 15% of the population) has not come into play. I've not been here long enough to gauge which is better. I have very good insurance in the US, so I think I'd prefer to get any "work" done there. But if I were my brother, who is not offered insurance and has to pay quite a bit for an individual plan that doesn't cover much, I'd probably have a different opinion.

On the second point. I struggle to justify it to my colleagues. We are the richest nation in the world. And as you say, it's the best health care anywhere. But if it's only accessible to a fraction of the population, then I think the system is broken. Your tale about your father-in-law is a great one. But what about someone else's father-in-law who can't get the care he needs because he doesn't have the right coverage? He's SOL.

"Is it possible that they have 1/10th the medical personnel also?"

Good point, Rufus.

Howie,

The problem in discussing universal health care with Dan is his attitude regarding poor people. Ever since the ltte blog started and he was posting as DJ, he has blamed the poor for being poor. His attitude of "I've been able to do this and that, so why can't everyone else do the same?" is sprinkled throughout his arguments. I don't mean to be harsh on Dan but his posts speak loudly.

While I am a firm believer in personal responsibility, I realize everyone is not equal in ability. Therefore, the old "If I can pull myself up by my bootstraps and pay my own way, others should be able to do so too" attitude doesn't make much sense to me. And although I have been blessed to experience an abundance of life, I remember being poor. I can safely say few choose to be that way.

Those who have never experienced being without have a hard time understanding raw poverty, imho.

Yes, I agree, the health care system is broken in this country (as well as other things). Ignoring this crisis, blaming people for being poor or expecting everyone to adapt to one's own perception of personal responsibility is solving nothing. I, too, wish people who can't afford things, be it children or material items, would not insist on having/purchasing them. The reality, however, is they do.

As many have pointed out, people who have insurance and pay taxes, are already paying for those who don't. Why can't we, as a nation, simply pay for insurance based on a sliding scale and have all US citizens covered? If illegals need anything other than emergency (life and death) care, let them get it in their country of origin.

"Is it possible that they have 1/10th the medical personnel also?"

Good point, Rufus.

You both missed the point. The point is the logistics of taking care and PAYING for 300 million people is totally different than 30 million people. If a country with 30 million people has to establish a $4.5 billion "wait times reduction fund", imagine what a similar endeavor would be here.

"Ever since the ltte blog started and he was posting as DJ, he has blamed the poor for being poor."

Nice view from the high horse Yvonne?

Sorry to see that you underestimate your fellow citizens Yvonne. Call me crazy, but I believe anyone with reasonable health and a sane mind has the ability to make decisions, educate themselves work hard, better themselves, and rise from poverty. You did it yourself. I'm not insinuating that every person will become rich.

Of course there are unforeseen circumstances that can change that situation, life indeed has it's risks. Any one of us could be run over by a bus today.

Your thinking is typical of the liberal establishment, i.e. people are not capable of taking care of themselves therefore govt. has to do it for them. I've also stated in this blog that I have no problem with govt. (taxpayers) offering TEMPORARY assistance to folks like you who needed it on a TEMPORARY basis. It should not however become a permanent lifestyle.

Yvonne,

While I do not know Dan personally, I know his philosophy well. It is shared by many of my good friends, so it is not new to me. The ultra-conservatives exhibit this trait frequently: "I got mine, you get yours." They tend to overlook things like the inheritance, support from their parents' country club friends, a call placed on their behalf by an influential person, even lucky breaks, and attribute all their successes to their hard work and determination. And if they can do it, anyone can. Things like illness, discrimination, unequal access to education -- those are someone else's problems.

And Dan,
For what it's worth, we waited a while to have children, and I still don't feel like I can afford them.
And if my parents had waited, I doubt I'd have ever been born!

"While I do not know Dan personally.."

There is the one sentence we agree on Howie. I'll let you know me a bit more. My parents provided myself and my siblings with an undergrad college education, we are fortunate for that. They knew the importance of an education and saved for that investment for all five of us. My two siblings who went post-grad were on their own.

They also provided a roof and food, the least thing parents should do.

There were no country clubs, no inheritance (they are still alive), no special calls to influential people. I started working raking leaves and cutting grass for the neighbors at age 12. I cleaned bathrooms and windows at a Mayberry's restaurant at age 14. I got a job "illegally" at the Friendly Road Inn at age 15. Illegal as we were supposed to be 16 but everyone lied about their age. At 16 I got a job at McDonalds and worked my buns off (pun intended) to buy my first car.

I worked all through college as tuition was provided but supplemental expenses were not. Out of college I got a job and have worked hard ever since. In 1998 took a leap and started my own business. It paid off after years of hard work, hard work which continues today. I'm not sure how many 14-16 hour days you pull Howie, I do it often.

So I'm not sure where the country club connections and influential calls come in Howie, like you said you don't know me.

Okay, Dan take it easy -- I wasn't trying to describe you. I was really trying to generalize the philosophy, not single you out. Upon a re-read, I guess I can see why you took it personally, but I wasn't attempting to paint your portrait.

Well thank you Howie. I too know the "club" you are describing but I'm not a member. I'll never forget the kid who's parents gave him a brand spanking new convertible Corvette on his 16th birthday. I had a moped when I was 16 and finally saved up enough money ($1000) for my first car, a 1974 Olds Cutlass with over 110K miles on it. Hey but it was mine, I earned the money to buy it, which instilled a sense of pride and accomplishment.

Dan, you gotta understand...liberals find it unfathomable for ANYONE to accomplish ANYTHING without the village...

Even without government loans, programs, grants, etc, ...you're still a white male, and that in itself makes you the beneficiary of some mysterious invisible helping hand. It upsets their apple cart when they see someone make good using their own talents and initiatives.

Might I add Neo, if you do become successful and self-sufficient and mention it as encouragement that others can do so as well.....then you automatically have disdain for poor people. See Yvonne's post.

Never mind the fact that money for poor people comes from wealthier people in the form of govt. income redistribution and charitable donations.

Dan -- I won't recount my own tale of work history. Suffice to say, similar to yours. But you did remind me of my third car. '71 Cutlass convertible (yes I paid for it myself). I loved that car.

I've always loved the 71 & 72 Cutlass convertibles. Classy car. My '74 was a good one too, I saved more money for a new landau top and new paint, redid the interior and of course added a Jensen stereo with a power booster to play AC/DC, Rush, Pink Floyd, and all my other favorites at 110 decibels.

That was back in the heyday of Oldsmobile, now it no longer exists.

BTW, today is one of those 16 hour workdays, start an all day class at 8 am in FL and get back to Greensboro around midnight.