Health care reform: What small business wants

From Marty

The goverment runs public schools, private schools still are full and doing well. The goverment runs the U.S. Postal service, UPS and Fed Ex are not seriously impacted. The goverment runs a national military and private security is still available. The bogus arguments about socialism and goverment intervention is much to do about nothing. In all three cases, the private option is more expensive and of almost equal value.

From Larry Newland, Pinellas Park Fl.

I think health care should be non profit. Pay the Hospital, Doctor, Nurse, no problem. Why should someone at the Insurance Co. make a profit on someone being sick? The insurance co. is motivated to keep cost down so profit goes up. The insurance co. runs your health care. How stupid.

From Mark, Irvine, CA

The government can't run anythning right. How about the govt option being medicare??????????? Let individuals buy in now, not at 65.

Reduce doctor's costs with tort reform.
Offer to forgive student loans if they see medicare patients.

To Obama and Pelosi, the ones with the hammers, everything looks like a nail. If you think socialism is good, quit griping and get a job.

From Brad, Dallas, TX

The high cost of health insurance is a function of the high cost of health treatment , not greedy insurance companies trying fleece everyone. We do desperately need coverage that is not rated for health conditions for small employers and individuals, this process puts many small employers in a very difficult situation, in Texas one sick employee or dependent can cause the whole group's premium to rise up to 67%, effectively making coverage too costly for anyone in the company. This is a very unethical system. Rates should be pooled by geographic areas. This was done several years ago when HMO's were introduced but when some companies started asking health questions in their underwriting the whole system imploded due to the healthy groups switching to the underwritten companies with lower rates, leaving the original companies with the higher risk groups.

The real problem lies with the inefficiencies and the build up of our current medical system, it is so intergrated into our economy that any major change would have a large economic effect. So many industries are making so much money off of our healthcare. We try to justify this by saying how great our healthcare is, but as is stated in other comments, it is not. Our country was built on entreprenuers and they have played a miraculous role in our healthcare system. The problem is that at some point, they are taken over by large corporations that are motivated by stock price, which is not always in the best interest of the consumer. Our innovation does not come from these companies, they come from brilliant individuals who are driven for reasons other than profit.

Our main goal in America now should be in preventative medicine, which could easily be achieved cost efficiently with Physician Assistants and cost efficient access to routine procedures. I believe that many people put off known conditions due to costs until it becomes a large and very expensive problem.

The medical business is the only for profit business that very few people ask the cost and the providers pretty much have an open check book. When one loop hole is closed, 5 more show up. I think that the vast majority of providers are trying to do the right thing, but the system is so protected that there is an extreme amount of corruption and overbilling (justified as cost shifting). If we are proposing a government run insurance system to keep the insurance companies honest, then we should also have government run hospitals and providers to keep the private system honest. But as we have seen in the VA hospitals, this does not work and neither will the insurance system.

Right now we need jobs and heathcare, any major changes to the system could have many unintended consequences. We need to focus on removing the health pre-existing condition rate up system, bringing coverage to the uninsured, offering affordable coverage to the insured, and most importantly, transform our health care system. We can no longer afford for it to be used as a way to make large amounts of money on technoligies or systems that have been out there for many years.
When new technology is invented, yes they should make money. But at some point, there needs to be an open pricing system based on the cost to produce, not what they can negotiate or pad through cost shifting. People who want to become very wealthy, need to find another way, our system can not handle it and can be ethically opposed to moral and efficient patient care.

In conclusion, we should pass legislation requiring insurance companies to offer coverage to everyone with rates based on geographic areas, require individuals and employers to have coverage or face penalties (subsidies will be necessary – some will have higher taxes but most should be offset by lower insurance premiums), we need to give Americans incentives to control costs through healthy lifestyles and taking an active role in reducing the cost of their health care, and the cost of health care needs to be based on a realistic cost of treatment without all the smoke and mirrors.

We still want to leave room for entreprenuism, but cut most of the bureaucratic inefficiencies. The problem is that the corporations that are making the most money, have the most influence through their campaign contributions and lobbying efforts. Alot of very tough decisions will have to be made to fix the system. But as has been said about why democracies eventually fail, either a few people have to suffer now or many will suffer in the future, and in a democracy, no one wants to be the group that suffers now and so problems keep getting put off until it overwhelms the system. With our aging population and unhealthy lifestyles, that day is not to far off, if something is not done soon.

From Kelly, Austin, Texas

Many small businesses will not be able to afford even the government's "affordable" option. This means that many will have to reduce their payroll to fall below the proposed $250,000 a year payroll mark (the figure they are considering to begin forcing small businesses to purchase insurance). For those who do not understand business and P&Ls, it doesn't matter if you can "write something off" because you have to bring the money IN before writing it off is even an option.

Many small businesses have been keeping employees on, in spite of LOSING money, hoping things improve (this means they have no extra money for insurance premiums at ANY cost). If this bill passes, most of these sm. businesses will no longer be able to keep those employees and will cut back accordingly. More jobs will be lost so more people will be left without insurance. It's not a solution.

One solution is to stop the prescription drug companies from creating addicts who *think* they *need* certain drugs "to survive" when in fact they don't. Many of these companies are based outside the U.S. and do not even have a market in their own countries for the same drugs we are told "we must have."

The payroll limit for small business should be set at a higher dollar amount – probably at $500,000 because many small businesses with only 10 or so employees are paying this amount in payroll but have no profits and no way to afford additional business expenses unless they do across the board pay cuts. I'm assuming this will be the other thing that happens if the bill passes – people WILl be forced to take pay cuts or be terminated.

Obama does not understand economics and his advisors obviously do not seem to be living in reality. Small business is what was driving the U.S. economy.

From adolph, wichita, ks

Note: I'm talking about USA citizens only……Mexico is gonna have to cover the illegals.

Every kind of health care system in the world is "rationed" one way or another.
Our USA health system is rationed by "dollars".

So please, the real issue is: are those of us fortunate to have health care insurance willing to share with those USA "citizens" who don't have health care insurance ?

Note: I'm talking about USA citizens only……Mexico is gonna have to cover the illegals.

From Rod Goult, Salem, NH

Seems to me that the basic premise from which too many commentators start addressing health care is the US health care is 'the best in the world'. Well, try looking at the facts – using the WHO reports from 2000, the US ranks 37 in the world. So the others must be doing something right – maybe even better, dare one suggest?

One of the great hidden stories is the success of Medicaid and Medicare in containing costs and limiting administrative expense. Compare what they spend on administration with the private sector, and cry.

The US spends more than twice as much of its GDP as any other developed nation to provide a lesser level of care to 85% of its population. Yes, if you have good insurance, or plenty of money, the care you can get is of the first rank. But an increasing number of people have neither.

Yes, government financed systems have their problems, and in the UK, for example (of which system I have a lifetime of experience,) waiting lists can be lengthy, depending on where you live, for elective surgery – but you will get it. Here the decision as to whether or not you get treatment rests in the hands of an insurance company bureaucrat. And waiting lists can be longer than in the UK. A friend of mine recently waited two months to see a doctor about a damaged knee. On a visit home to Scotland recently I wanted a check-up, and it took me all of two days to get the appointment.

The private sector doesn't have to be dismantled here but it needs regulation. Charges should be based on a standardized risk profile which is based on the average risk across the entire population. That basically means that all policies would cost the same regardless of age or pre-existing conditions. Then the insurance companies would have to compete on efficiency and service, which can only be good for the user community.

Let's dump this silly term 'socialized medicine'. It makes no sense. No-one talks about 'socialized policing' or 'socialized education' or 'socialized roads' or 'socialized space travel' but these are all publicly funded activities, where everyone contributes and the results serve us all.

Taxes, folks, pay for services. I hear a lot of complaints about high taxes, but I never hear anyone say no to state or federal aid when a storm causes damage or similar. It is all part of the same concept – in a civilized society we pay taxes to provide for the services which that society needs. Some people need them at one stage of their life, others at another, and a few need society's help all their lives because of a birth condition or whatever.

Seems to me that health care is one of those basic rights in a civilized society, the the current US system fails miserably to provide that.

From andrea danville il

private health care has failed badly if you go to a doctor you always see a drug co. rep there what is this this is why it has failed letting doctors take money from the drug rep.This would stop all that cold one could say there there to train doctors on drugs but there's a hole in that if you look at it that way then why do doctors go to school for 6 years?A goverment run insurance plan would take drug reps out of the way.

From Andrew, Blauvelt NY

health care should be paid for by the Government for all Americans, just like all other advanced countries do. There should be free government clinics, no more entrepreneur multi-millionaire Doctors.

Private care could also exist providing you pay extra on your own or via your employer

From Jim, Columbia, NH.

I have heard for years that our Senators and Representatives have the best health care plan in the country. This leads me to 2 questions….
1. Will their proposed plan be this plan ?
2. Will they be forced to use whatever plan they propose ?

From Tim Redmond, Syracuse, NY

our government has an agenda aimed directly and solely at the middle class. it's remarks about a "side-by-side" (federal and private) system will predictably and permanently destroy private health care and create bigger government.

HOw did we come so far so fast – from JFK's "Ask not what your country can do for you. Ask what you can do for your county."? We are now enfranchising our most non-prductive citizens and considering enfranchising millions of people who are here illegally.

By eliminating the primary prosperity enging in America – its ambtious. We spent billions on the "Great Society" and our public assistance roles (and the government bureaucracy that feeds from it have swollen.

The aim is to eliminate the self-determination of the states and localities and engorge an already engorged federal government.

Find another (private) way for health reform. We're out of Trillions of dollars which will lead to running low on the freedoms guaranteed by our Constitution.

Tim Redmond

From Jay Ehret, Woodway, Texas

You cite The Main Street Alliance in "Health care reform: What small business wants" What you fail to mention is that they are obviously a group formed to advance government-run health care. There is no detail on their website on who is behind the organiation. Contact information is sparse. If you're going to use them as a source, CNN, please show some diligent journalism.

From Tim in Michigan

"In fact, here’s a flash. The private enterprize approach to a whole lot of things in this country has failed miserably. Why are we going to let private business have yet another run and ruining the economy?"

Here's another flash. The politicians have succeded in getting you to buy into the myth. Private enterprise works just fine when the government does not get involved. The financial crisis would have been avoided if our government would have left the regulatory laws alone that were in place. Instead they muddled in the market, (becasue of huge money being lobbyed by the financial industry)and changed the very laws that allowed the banks to mix banking with brokerages and we are paying for it dearly. That is not private enterprises fault, it is the fault of YOUR GOVERNMENT.
If we have the government involved in our heatlhcare we are going to create another huge entitlement program that we cannot afford. This along with the fact that the government running healthcare will be a disaster just like every other governement agency. If a public program is instituted then we will all lose our employer healthcare period. Companies will not pay for a public plan at the same time while bearing the expense of a private plan. It will be a business decision. The government knows this. It is all part of the plan to control this through a single payer system. That will leave us all with a horrible government run health system that will be vastly, inefficient, bloated, and rationed. Those who don't have healthcare will be happy they have something and those who had good healthcare will kiss it goodbye. You will only get the care if they decide that it is "necessary". If not be prepaired to stomach the consequences because it might very well cost you your life one day.
There are plenty of opportunities to reform our current system.

From Barry Salsberg, Toronto, Canada

I'm a Canadian physician, living and working in Canada. As a physician, I'm not happy having the government run health care, but, as a patient, thank G-d for our government run system.

From Rockne, Denver, Colorado

I am a small business owner for over 30 years. I do provide good health insurance to my employees. I pay 100 percent of it. This president of ours is ruining what competition we have left in the business world. These policies will drive out businesses like mine to other countries because I simply will not be able to compete for good employes as well as not being able to produce product economically enough in this country because of all the regulation. I will close down and either become a one man business or I will move production to a more friendly business environment in another country. These policies will financially devastate our already crippled financial system. Get this guy out of office and lets elect a capitalist successful business man.

From Ted, CA

What wrong is people in general?!!! Why is so wrong if the Govt just provide access to basic medical care? So what if its slow?!

The private sector can cover where the Govt does not. Not everyone needs specialized care, if you take care of you health!

Why can't we just have a hybrid system? Why are you so extreme?!

From matt newington, ct

I am curious about your take on these (please read in order):

Insurance comment:
A.http://www.nytimes.com/2005/02/02/business/02insure.html?scp=1&sq=harvard%20medical%20bankruptcy%20study&st=cse

Pharma comment:
1.http://www.nytimes.com/2008/11/10/health/10heart.html?scp=3&sq=jupiter%20heart%20study&st=cse

2.http://www.nytimes.com/2008/11/18/health/18well.html?scp=5&sq=jupiter%20heart%20study&st=cse

3.http://www.nytimes.com/2009/07/01/health/01heart.html?_r=1&scp=1&sq=jupiter%20heart%20study&st=cse

From Lisa Omaha, NE

I understand that your premiums having been going up and no one has gotten sick, but the philosphy behind health insurance is to pool the dollars from all and pay the claims for those that are sick. When the healthy ones jump off and the sick stay the claims ratios go up and the costs rise. To say that your employee's go out and get their own, is not going to solve the problem. The healthy ones won't get it till they need it, and the sick ones will, and you still have medicare and medicaid undercutting what they pay to physician's which has to made up somewhere. Again, I am not saying that insurance companies our guiltless, but to have such a venomous view of this industry is not helping.
We always hear the awful stories of people getting screwed, but I am hear to tell you, I have seen the incidents where my clients have had over $600,000 paid in claims paid for a massive head injury due to a car accident, and they only paid in $2400 in premiums that year. We are here to help, when the chips are down. I have been in this business for 21 years, and do it with conviction and belief that we are helping.

And may I need remind you, how much have you paid in self-employment taxes over the years for social security? The current estimates indicate that if the social security system isn't fixed – by the year 2041 your estimated social payment will be reduced 22%, and this is just estimate. Don't believe me – read the fine print in your Social Security Statement. If I told you that if you paid in 10,000 a year to guarantee a income payment in your retirement years, and oh by the way you had to pay this in every year no matter what or you will be fined and penalized and maybe sent to jail, but in return I guaranteed you a monthly income. But then somehow as an insurance carrier, I failed – you would sue me and win. And if you die before you reach the payout time, I get to keep the money not your beneficiaries, you buy this from me. Probably not, but welcome to the wonderful world of social security.

Another social program our wonderful government has created for us.

I do not mean to be rude, but again, I feel the an education process needs to be provided so that people can make an educated decision about whats the best solution for all, without shaking down the tax payer and the small business owner.

From Roy, Seattle WA

Government limits the number of doctors and only allow doctors to diagnose
and prescribe.

They created a medical monopoly, a non-competitive situation for the usual financial reasons.
No monopoly wants competition.

Starting today, they could allow Nurses, Physician Assistants,
and Pharmacists to diagnose and prescribe for the most common simple ailments.

They could create Medical Technicians that require minimal training to handle routine procedures.

Doctors and Surgeons can be on call and paid more for the non-routine, complex cases.

Why not increase the supply of doctors or make the distribution of basic medical services more of a commodity?

From M Stranko, MSPT Newington, CT

Lisa:

I understand your explanation but you are forgetting a huge part concerning premiums and utilization.

Since the 1960s the majority of people have been covered by employer sponsored plans. Realize that this is a business TAX DEDUCTION to the employer. This (or any b'ness tax deduction) by definition means it is at least partially subsidized by the public. The gov needs its money. They are either getting from b'ness taxes or people taxes. In this case the small or large business owner is getting part of their premiums paid by me. The same goes for pharmaceutical usage.

Prescription drugs are mostly purchased under a persons health care drug plan. The same plans that are once again a business tax deduction. Moreover, when you look at the top five drugs (2 statins, 2 dyspepsias, and an anti-anxiety) they do nothing for health, other the treat symptoms that are secondary to inactivity and poor diet.

Q: Why are my taxes going to employers providing HC plans that do not promote health and mostly treat symptoms?

Reduce the tax deductibility of the plans and employers will make their employees either exercise and eat better otherwise their insurance utilization will go up and hence their premiums. Health people should equal less utilization and lower premiums.

From MC, Austin, TX

Al from Raleigh,

I wholeheartedly agree that most costs should be shouldered by individual consumers so as to make the free market work the way it is supposed to. However, this won't solve the whole problem. Even to the extent that this will reduce costs there will still be far too many uninsured and underinsured people, especially seniors.

I believe that individuals must shoulder enough of the cost that they are motivated to bargain hunt but the government must still provide a means to ensure that everybody can afford health care and that they don't get ripped off by insurance plans with loopholes that prevent them from getting life-saving care. I believe that this can be done without having to expand Medicaid or create som new government-subsidized insurance program.

http://www.geocities.com/mcorazao/health_care_crisis.pdf

From Lisa Omaha, NE

I am a broker in the insurance industry working with small business owners varying in size from 2 to 50 employees. I truly understand the frustration regarding health care. But I think that an education process has to be provided to help business owners understand part of the reason why health care as skyrocketed over the years. One of the main reasons why health care has escalated in cost is due to Health Insurance Mandates such as HIPPA which requires health insurance carrier to offer coverage to an employer, no matter what the health risks are. So for instance if I work with an employer who has seven employees, and one has heart disease, one has cancer, one is pregnant, and the rest are healthy – the insurance carrier has to take this case. They can adjust the premium, but it is never enough to cover the actual monthly claims being paid out. So in essence the government has shifted their social responsibility on to the private sector. The other issue is that medicare and medicaid pay significantly less to physicians and hospitals for claims incurred. So to meet their overhead responsibilities the physician's and hospitals charge more to the insurance carriers. This in turn raises the cost of doing business for the insurance carrier. Ultimately health insurance premiums rise, the healthy people jump off and buy individual insurance and the sick stay on, until it becomes unaffordable and the employer gives up. So now if we offer a government plan to keep the insurance companies "honest" – this is like having the government set up shop accross the street from your business and start up in the same business as you have. But they get to sell their product at 50% less and pay their vendors 50% less, how long our you going to keep your doors open. It never has been fair and when the government shoves the private insurers out, who are the physician's and hospitals going to cost shift their expenses to. Now the quality of care goes down and the good doctors get out. Not to mention the hundreds of thousands of employees, sales force and anyone remotely involved in the insurance industry our out of a job. That will make 10% employment look like nothing. I am not saying the insurance industry is guiltless, but there are so many layers of issues here, from the government, to health providers, pharmaceutical companies, consumer fraud, illegal immigrants receiving free health care, etc. Please as a business owner recognize that the government is not the solution, but part of the problem.

Please note that I too am self-employed and my husband owns his own business who employees 10+ people.

The other issue you should be concerned with is the government forcing small business owners to pay 75% of the premium for individuals and 65% for families. So if a family premium is say $750 per month and you are required to $488 of it, that's quite a raise to your employee and you might not get to deduct it.

Get involved and say no to the government meddling in the personal freedoms of our health care.

From Al, Raleigh, NC

the cost of US healthcare is currently paid for by:
1- gvt(medicare/medicaid)
2- private health insurers (paid for by businesses) and
3- uninsured minority who pay out of pocket.
US businesses are paying for the bulk of US healthcare costs.
medicare/caid are inefficient and wasteful, so it's ok to bash the gvt for being bad at managing these (supposed to be businesses, instead they are bureaucracies)
BUT, US businesses are also paying more to support the for-profit private insurers.

Dollar for Dollar, medicare/caid treats more people and illnesses than the private insurers. if you measure private insurers business efficiencies, YES, they are much better than the gvt bureaucracies. but as far as where the dollars go, private insurers suck a lot of money out of the system, that doesn't get spent on healthcare. Their premiums are like a tax ( a very high tax) that is spent only by businesses. the people pulling for the private system, in this debate are clueless. the premiums are a huge tax that does NOT go to the gvt. it goes to the insurers that may give you a better service, but very little of it.
I have a very small business. my premiums have been going up every year, every year, though none of us have been sick (our highest expenses have been our yearly visits for check-ups) for dental it's all out of pocket money. this is a racket too. very few dentists accept insurance. even with insurance they charged us the difference of what they were going to collect from insurance, then tacked a fee on it. so it was cheaper overall not to have dental insurance, and pay out of pocket.

the system has gone crazy. encouraged by all the past years of excesses. anytime money is easy to be had, prices will go up. insurers, will keep raising premiums to keep their profit margins intact, and businesses complied, because they did not have much choices. competition among private insurers is a joke. it's more of a many monopolies who act as if they compete. overall prices and coverages are all the same among all private insurers. as if they copy each others price lists.

SOLUTION
US businesses shud remove that burden off their books, balance sheets and unload it onto the employee. let the employee out of their own salary shop for the best insurance. that force competition among insurers. instead with the current system, insurers have a lock-in with a company.

spread the cost of US heatlth care among more people instead of just the employed, via the businesses they work for. because the more people you have to divide the overall financial burden of healthcare, the lower the cost becomes per individual.

create a huge pool of money dedicated to healthcare, run by an independent agency, that has to run like a private corporation, with an executive and an independent board of directors. so, it has a public charter, but, run as an independent company. no political appointees. the other part of this pool of money would be the servicers. insurance conmpanies become insurance servicers. they get paid by this new entity/agency. this way they get graded by the agency, and by their clients (the insured, which is the general public) about the quality of their service, their coverages, etc. and do not limit their charters on a state by state. give them nationwide operational area. so they can be motivated to get more clients. so, they have to compete for clients and compete for payments from the agency. this competition will create more checks and balances in the system. if something is going wrong, they can complain loudly, because money flow and profits are huge incentives.

From Disillusioned Republican, Providence, RI

Ken of Madison – you live in a dream world. My grandfather worked as a white collar employee his whole life, except for when he fought in WWII and he has decided he can't afford his weekly injections that keep him alive so he's prepared himself and our family for the fact that he will pass away later this year when he can't get his shots. My parents still are working at 64 and are not covered by medicare. They are going to have to stop getting medications they need once they go to Medicare because the plan won't pay for them and my mom, for example, can't afford $333 per pill for one medicine. My mom has been an RN her whole life and at times worked two jobs to raise us. My dad was a white collar employee who went to college at night to get a degree and better himself. He also worked 2-3 jobs until I was in my teens and he got ahead with his night school degree. They are paying $20k/yr for private health insurance while they could be fined $4000 for not having insurance (MA requires it of residents) and get their care from the state at a savings of $16k per year. They have integrity but are faced with the reality that they will go with inadequate coverage.
Health care reform is not about people who are afraid to work or support themselves. It is about doing what every other country does for the people who create and improve the nation. It is about removing profiteering and protected status from an industry that is not exportable, decreases our ability to compete internationally, is on the path to destroying our society and creating social division we haven't seen since the Civil War and the race riots of the middle part of last century. Do you really think that people will stand for watching their hard working family members dying on the street? Do you really want to support a system that will bankrupt our companies and citizens? Where does the US go when consumer spending (our largest component of GDP) drops by 30% because that money is going to health care and drugs? I can tell you that – read Paul Kennedy and other authors on the subject of the fall of great powers. You are watching it happen in front of your eyes but you are too brainwashed by dogma with no validation in the real world. We are the example of how to waste money and provide terrible services in health care. Don't he so self-righteous as to think that America does everything right – the rest of the world can still teach us better ways to do things. There are plenty of examples of successful implementations of health care systems with both private and public options competing. It is a crock to say that it won't work here as well.

From MC

I think at this point having a public option is better than doing nothing at all. A lot of people still don't realize just how critical the crisis is getting.

Still, though, I don't think simply creating a public insurance agency is the best solution. I believe the best solution is to create a Fannie Mae-type of organization underlying the insurance industry which specifically balances costs to guarantee insurability for everyone and which increases transparency and reduces liability for insurers thereby helping to reduce costs.

See the following for more info:
http://www.geocities.com/mcorazao/health_care_crisis.pdf

From koya, odessa,texas.

I am not for goverment run insurance plan either. But, if by goverment becoming a player in the insurance market forces the other players to compete or else then aren't we the one's getting the benefit. I don't think goverment is forcing us to buy insurance from them. Afterall lower insurance costs is what most small business wants.

From Roland

More of the same in healthcare is the definition of insanity. So what if the AMA and the insurers, and even some small business groups don't want a public approach to healthcare. The private approach has failed miserably (what else could you possibly say when 20-25% of the richest country in the world cannot afford healthcare and has to rely upon emergency room visits?).

In fact, here's a flash. The private enterprize approach to a whole lot of things in this country has failed miserably. Why are we going to let private business have yet another run and ruining the economy?

From Ken, Madison, GA

Let me tell you what is going to happen with health care reform… WE WILL NOT GET ANY DISCOUNT FOR OUR PERSONAL HEALTH CARE PREMIUMS..further our taxes are going to go up to pay for all the non-insured to get insurance. In the end this reform will cost us more than the current crappy situation we all are in (unless you don't currently have insurance…then your life is going to be sweet…congratulations!)

From AJ, Philly, PA

>>This bill needs to go down in flames at all costs, or god help us all, because with the OBAMA plan, you’ll really needs god’s help to survive.

Maybe when your job goes and you can't afford anything you'll change your tune. When you need health care and there is not even an option to get it anywhere without going bankrupt.

>>These “health” care options do nothing for heath. It is all “sick” (reactive) care.

Amen!

It comes down to the food we eat and how active we are. Learn to eat real food, get off your butt and exercise and offer serices that facilitate a healthier lifestyle and offer care when needed. Unfortunately the $$ incentive in the "health care" industry is to make people sick and feed them lifestyle meds/drugs.

Thier needs to be a public backstop for costs, small biz really needs the help and we need to change our lifestyles and provide incentives that will help people do that.

From Mike, Redwood City, CA

Insurance costs are killing ALL firms in the US, big (Chrysler, Ford, GM, and the list goes on) and small. We DO need a public plan. The simplest way to do it would be to expand Medicare Part A (very low cost preventive care) eligibility so that people can join it if they want and if:
– They are 50 (instead of 65) or older
– They have been denied coverage by any insurer for any reason
– They have been hit by a layoff at work or the closing of the entire company
– They cannot purchase insurance through work because it is not offered
– They cannot otherwise afford insurance

The health insurance companies don't want any of the above groups, so let them join the Medicare program; otherwise, their alternative is to go without insurance.

The health insurance companies probably won't fight this very hard. They want to insure the young, healthy, employer-sponsored people, which is where they make the most money.

A very low cost preventive care plan like Medicare Part A would do the job.

From PW

Nothing will fix our health care system until for-profit insurers are kicked out. People whose fondest wish is to sabotage any meaningful competition should not be allowed a seat at the table.

People like Walt think their private insurance is great until they actually get sick. Then insurers find ways to deny claims and do recissions that kick sick people off their policies (note that when policies are rescinded, nobody gets a refund of all the premiums they have paid in over the years until they got sick). No industry but insurance is allowed to operate in such a willy-nilly bait-and-switch environment.

My greatest fear about "reform" is that we will end up with this absurd substitute of privately run insurance co-ops. The government will force us all to buy health care from the same people who are screwing us now, with no further regulation forcing insurers to cover preexisting conditions or end recissions.

Private insurers are in the business of denying/avoiding paying out claims. It is the core of their business model. Any plan built on that model will only make things worse.

The argument that single-payer would mean a government bureaucracy between you and your doctor is completely bogus, as long as for-profit insurers are between us and our doctors now.

HSAs could be part of a solution if you could carry over your health savings from year to year and if you could take out money for things like exercise or yoga classes and other fitness and preventive measures.

From Rick Seattle WA

I think the NFIB, AMA, and others that are funded by those corporate interests that make their profits from the misery and deaths of their customers should be disbanded.

I will contend that I would rather have a Health System in which I can work to remove, replace, or heavily influence the decision makes than one in which I have no input at all.

The wealthy board members and executives in private, corporate, death dealing insurance companies only care about their profits and nothing about providing an honest, fair, and usable health maintenance system only profits and bonuses.

Our government was designed to be "of the people, by the people, and for the people" not of the shareholders, for the maximization of profits and minimizing of expense (YOUR HEALTHCARE), by the CEO.

From Steve, MN

Insurance companies and even hospitals need to be ran as non-profits and taken off the stock exchanges.
Take away the incentive to charge patients more to boost the stock price.

From larry frederickburg va

Its time these big mega giant health care companyswho make giant profits are taken over with controls , we are the only major country without universal health care if they can bail out banks wall st and the auto makers its time now to bail out all americans who lack health care with some sort of a universal govenment run system .

From Jean Maltz Staten Island, N.Y.

I think it is criminal and immoral that the U.S. does not have national health care coverage as all of the western industrial countries have had for many years. Shame on our government and on our leaders.

Most sincerely,

Jean Maltz

From Jack NY

The government option won't significatnly decrease costs. Private insurers will no longer have the cost of figuring out who NOT to cover. That will be the only savings.

When and ONLY when healthcare becomes consumer driven will costs decrease. The day I can purchase an appointment for an MRI at amazon.com will be the day I get the cheapest price.

When I can't see star ratings for hospitals or doctors, costs for procedures, etc. we are all doomed.

Additionally, we need to stop doctors from running every test in the book to prevent lawsuits(defensive medicine) and focus on prevention. Not being a Type II diabetic is much cheaper than taking a pill for the next 30 years.

From Mike Davis Barre, Vt

The discussion is very good and outlines the philosophical divide. "I want cheaper health care, but not at the expense of gov't promising to provide it." I submit:
1) The idea that the "free market" can fix this with more insurance plans fails to consider that we use our care disproportionately over time and that some individuals will have a lifetime of costs that could only be afforded by a very few.
2) Insurance company business models are not designed to lower "sales" (premiums) but to increase them since a portion of each dollar is for profit.
3) Certain insurance products give the illusion of coverage for low premiums but really don't address one's health care needs over time.
4) If government run health care is so bad, why isn;t anyone advocating getting rid of Medicare? It's far from perfect but at least it provides most everyone with some coverage.
5) Medicare does try to reduce costs but is often overruled by other interests.
6) We need to examine real cost/benefit analyses of certain exotic treatments and not be afraid to set some limits.
7) Physicians need to come to the table to help solve the problem – not just blame gov't & underpayment of services.

thx for listening, Mike

From Matt Stranko, MSPT, Newington, CT

These "health" care options do nothing for heath. It is all "sick" (reactive) care. Other then annual physicals where is the preventative care, where is the proactive component that will reduce the increasing rates of metabolic syndrome, diabetes and obesity that we are seeing?
Chronic diseases are the new plagues of our time. In my 10 year as an orthopedic physical therapist, I have been a large part of the reactive care system. Clinical work and patient contact has lead me to realize people age or retire one of two ways: they either run from doctor appointment to doctor appointment with aches and pains or from test to test, only to be reactively treated (surgery, pharmaceuticals, hospitalization, etc..) . Then there is the other group that walks on beaches, golf courses and parks while enjoying the healthy, pain-free, happy process as it should be. The key is 2 things: proper diet and exercise (not part of the discussions), not pharmaceuticals (discussed), not rehab (discussed), not chemo/surgery (discussed) just to name a few. HSA are a great invention for the health conscious person. However, proactive care is not a qualifying expense in this situation either.
I have had 10 successful years in private practice physical therapy, but have decided to promote true health. Proactive health. The missing discussion topic. 4×4 Fitness, LLC is what I have created (fitness and nutrition). How is it that a physical therapist can have greater insight into health, disease prevention and proactive care to stave off chronic disease then those funded by our tax dollars?
Treated the disease is not the answer, avoiding it is. Professional exercise guidance should be promoted and funded while people are taught true, proper nutrition (not the industry influenced food pyramid).

From steve brown

I own a small business and I am 110% for a government-funded single payer universal health care, with NO profit motive in health care. I know many of my fellow "entrepreneurs" also FULLY agree with me. there's no BUTs about it. i do NOT trust my own doctor and i know insurance and pharmas are criminals.

From Bob, Detroit, Michigan

We have a small business, and nfib does not talk for us. We want universal healthcare, single payer system. NFIB is a bunch of right wing whackos!! They don't have a clue.

From walt

No way, no how. We all know whats really going to happen – this is goping to force employees like me off private plans, and unto the goverment managed healthcare plan. I don't care waht they do or say, it will happen if this goes through, then we'll see the same old srtach their head and "We didn't know this whats going to happen" routine, just like the porkulus plan.

Obama: If we don't pasas this plan now, unemployment will go over 8 percent. If we pass it now, unemployment will drop lowe then 8 percent.

Remember that quote anyone?

Well, here we are nationally approaching 10 percent unemployment and we'll clearly be at 11-12 by the end of the year. Note to CNN – I said it first. So when they're again scratching their heads in December saying "unemployment like this was unexpected", quote me please, an average working guy who's got a better sense on the economy then the idiots in washington.

Government tun healthcare will be disasterous.

Does anyone really think that a country which can not manage medicaid or social secutiry without having billions in annual defecits, can actually run a cost effective healthcare program? Absolutely not.

Additionally, this plan exempts Senate, congressional, house and other governmental employees from participaiting in the plan (page 135, kennedy-dodd healthcare bill).

Anotherwords, that "same insurance we get" OBAMA promised you, and is still waving in front of ALL your noses, is a complete lie!

We'll get denied procedures we need because it isn't cost effective based on our age (see the "managed healthcare provision" – also in kennedy-dodd plan), but our poiliticians will get whatever they need, no matter what it costs BECAUSE THEY ARE STILL EXEMPT.Any system that isn't good enough for them, sure isn't good enough for any of us or our children.

This bill needs to go down in flames at all costs, or god help us all, because with the OBAMA plan, you'll really needs god's help to survive.