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Second health-care 'phone town hall' goes well

Congresswoman Anna Eshoo's Monday night telephone session on health care wins praise

A second "telephone town hall" by Congresswoman Anna Eshoo Monday evening went smoothly and won praise from callers from Palo Alto, Mountain View and other 14th Congressional District callers. Two more are planned Thursday, 1 to 2:30 p.m. and 6:40 to 7:40 p.m.

Eshoo, D-Palo Alto, also announced Tuesday that she has scheduled a face-to-face forum on health care issues for Wednesday, Sept. 2, at Gunn High School in Palo Alto.

District residents can sign up to participate in the Thursday telephone town halls by filling out a form on her website. They are asked to choose the "Telephone Town Hall" option from the drop-down box on the form and submit their contact information.

Responding to questions Monday, Eshoo defended the need for health care reform and said that much of the added costs will be offset by savings by making health care delivery more efficient and rationally based.

She also said she has held more face-to-face town halls on public issues than almost any other member of Congress -- in response to earlier press reports that she hadn't scheduled a town hall session on health care.

While some members of Congress interacted with their constituents in face-to-face meetings plagued with shouting opponents of health care reform, Eshoo opted for a series of telephone conferences with residents from the 14th district.

An audio recording of her initial town hall is available on Eshoo's website.

Eshoo is a member of the House Energy and Commerce Committee -- one of three House committees charged with drafting portions of a health care reform bill.

See separate story for highlights of her comments on health care reform proposals now before Congress.

Comments

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Posted by YSK
a resident of Old Palo Alto
on Aug 21, 2009 at 5:12 pm

Funny I wrote Ms. Eshoo's office about an issue, never heard back. Then, when she wanted an audience or support for one of HER issues, I received an email. So that's how it works, huh?


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Posted by Perspective
a resident of Midtown
on Aug 21, 2009 at 6:06 pm

Sorry, don't need a translator, I can read for myself. I have read the only bill that is under discussion so far, and everything the propogandists are trying to claim is "Myth" is actually true. All you have to do is ask yourself, if these "myths" aren't true, why doesn't one single person point to the line that says "no undocumented people will be provided health care", or the line that says "care will never be denied in a timely, life saving manner for anyone, regardless of cost", or "there will be no political appointee to determine what is covered and what isn't every year", or the line that says "no non-life threatening abortions will be provided on the tax dollar" or..well, you get the point.

All of us who have read the bill can tell you exactly where the bill says what, but I have yet to hear anything in rebuttal that points to anything at all to refute what I have seen with my own eyes or connected the dots with my own brain.

I don't care what anyone tries to tell you, when we put everything into one pot for health care, which it will be when the private insurances are driven out of busines, we will have politically powerful groups taking away from the politically weak. This "option" is a crock..no new policies can be written after day one of the new bill, which means all private insurances will go broke. Simple. This is nothing more than a not so subtle stealth plan to destroy our health care choices and take the power into the hands of government, political, entities.

There are simple, pinpoint fixes to almost every problem we have, and if the Dems really want to do something good, they would do them.

1) No driver's license if you don't show proof of insurance. This would take care of the 17 million of the "uninsured" who can afford insurance, but choose not to, and the 14 million who are already eligible for MediCaid/Cal SCHIP but simply haven't bothered signing up for a govt program. There ya go, at least 30 million of that famous 47 million are gone.

2) No health care on the tax dollar for undocumented people. That would take care of at least 10 million of the "Uninsurend" number.

3) Any documented non-citizen must show proof of health insurance to remain here. That would take care of about 7 million of the non-citizens who don't have insurance.

3) Allow us to buy health insurance outside of State mandates so we can buy less expensive insurance, ie just catastrophic insurance, not insurance that covers language translation, chiropractors etc. That would allow all of us to choose less expensive care if we wished.

5) Tort reform that limits monetary damages from medical malpractice to reasonable amounts. That would lower billing rates.

6) 1-5 would lower the number, about 8-10 million, depending on who you believe, of chronically uninsured citizens who truly can't afford insurance, because there would be more affordable insurance for all. Those who still really can't afford insurance, fine, we can put them on SCHIP and/or MediCal/Caid. And we still get to keep a system which encourages innovative, life-saving drugs and devices.

These would be great fixes for the problems, instead of trying to destroy everything in order to get more power and turn us (more) into a European/Canadian socialist nation. If 30,000 Canadians cross our border every year to come get more timely and better care here, and if we have 10 times the population here than there, where will at least 300,000 of us go for more timely care when the "progressives" get their way and destroy the best health care in the world? Since virtually all new drugs and devices are invented here, where will we go, let alone the world, for the latest and greatest after we have destroyed all incentive?


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Posted by Liberty
a resident of University South
on Aug 21, 2009 at 9:24 pm

YSK, what did the email say? Can you post it? I'm still very interested in how she managed to get 7000 people on a phone call with 3 hours notice...


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Posted by Mike
a resident of Barron Park
on Aug 21, 2009 at 11:26 pm

Eshoo won't be around long - Carly's coming. Get rid of this woman who wants to handicap people even more by thinking the Govt is the answer to personal responsibility.


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Posted by chris
a resident of University South
on Aug 22, 2009 at 1:34 am

Perspective, you make some good points but they will do little to deal with the issue that Americans spend twice as much on health care as anybody else and the fact that the individual health insurance market is completely dysfunctional.

Until you deal with the big issues, you are just putting band-aids on a deep wound.

There will either be a public option or strict controls on insurance companies.


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Posted by chris
a resident of University South
on Aug 22, 2009 at 1:39 am

Mike, what does Carly have to do with Anna?

Your delusions may be a sign of mental illness. Does your health insurance cover that?

If your mind can focus, please make constructive comments. Health care / insurance is a serious issue that requires serious thinking, not silly throwaway lines.

I would prefer to make serious comments rather than spend time questioning your ability to contribute to the debate.


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Posted by Transparancy
a resident of Meadow Park
on Aug 22, 2009 at 2:13 am


Here's what Eshoo said:
Whether the bill will cover illegal immigrants:

>>> "The answer to that is an unequivocal no. The bill explicitly prohibits any undocumented aliens from receiving any federal dollars to subsidize health insurance." <<<

Here is what she is talking about:
HR3200 - Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.

This has to do with welfare credits and it has nothing to with the text of bill they will rely on to grant undocumented aliens access to medical care.
Watch Congressman Green of Texas use the EXACT obfuscating words. This is about payment of credits (welfare) not access.
Here he is: Web Link @1:00 into the video.

Here is the text of HR3200-
(a) IN GENERAL.—Except as otherwise explicitly permitted by this Act and by subsequent regulations consistent with this Act, all health care and related services (including insurance coverage and public health activities) covered by this Act shall be provided without regard to personal characteristics extraneous to the provision of high quality health care or related services.

SOLUTION:
If someone who is illegally in the county comes to an Emergency Room in the USA.
1) Patch them up, give them some clean clothes.
2) Ship them back to their own country as soon as practical.
3) Tell them if they come back illegally they will be breaking the law again in the USA and expect to be in jail next time.

PUT THAT SOLUTION IN THE BILL MS. ESHOO.


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Posted by Perspective
a resident of Midtown
on Aug 22, 2009 at 7:03 am

Thank you Transparency: You are correct. What few rebuttals try to claim legitimacy in the Bill are quickly demolished by reading the REST of the bill in context.

Your point is a great example of one of them.

Chris, thanks for the kind response. I know you really believe in a "public option" being the only way to cut costs, but what is that saying "If your only tool is a hammer, every problem is a nail"?

Please read my post about non-public option solutions again. You will see that our health care costs will lower dramatically without a "public option" and still retain what is great about our health care speed of access and quality of results ( both being the best in the world, even according to WHO!!) These 2 high points cost us a lot. The only way to cost less is to decrease speed of access and quality of results, which is what the "public option" will do.

A "public option" is just the camel's nose under the tent, and will overthrow our system rapidly, and turn us into France, England, Canada etc.

No thanks. If I am going to get sick, I would rather be sick here than any place else in the world, and I would like to keep it that way. Even our poorest 20% have better speed and quality of care than what I see in France, and read about in Canada and England. I would rather be POOR and sick here than anyplace else!



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Posted by seniordem
a resident of Fairmeadow
on Aug 22, 2009 at 10:12 am

Perspective I appreciate your discussion of the details. That is how this should be decided on the merits of the proposal. Eshoo is saying that the critics are misinterpreting the bill. Then, Eshoo needs to make sure the bill is clear.

And there is a problem with government having so much influence and control over our lives. Government will continue to want to intervene all for the "common good". Advice on diet, exercise, and yearly checkups sounds good, but will it eventually be used to monitor us and care denied if not complied with?

Another point brought up was the individual who takes good care but needs surgery at 80. Due to age it's denied, but the younger 60 gets the surgery but needs it due to some bad habits or just because of sports.

Doctors can't always tell who will live well beyond 80 and who will get dementia at 65. These complex details in the health bill need to be made clear before Congress rushes in to push this on us.


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Posted by Perspective
a resident of Midtown
on Aug 22, 2009 at 10:24 am

Senior Dem..Thanks. I posted this back to you on another thread, but I think I should have posted it on this one since it is the most up to date one.

You asked why the Repubs don't have a plan. The Republicans DO have a plan. It is almost what I wrote. Here is the link. I don't agree with all of it, but it is a heck of a lot more full of promise to fix the real problems than the Progressive "Destroy all the good in order to fix the bad" Philosophy!

Web Link

You never read about it in AARP newsletter or our papers, or hear about it on TV, because all of these sources have one aim..to turn us into Canada, France, England ..you name it. They care only about increasing Socialist Govt power models, only about the "hope" and the retroactive "change", not the results, not doing what is best for all of us.

The sooner we all realize that the main news sources here are completely tainted,the better off we all are. Latest example, nobody read anything about the 2,000 TeaParty protestors in SF a few weeks ago, did you, but you sure saw those awesomely well informed Raging Grannies, all 10 of them, with their "Health Care Reform Now" signs in the paper a couple days ago, photo and all!

I blame the Repubs for NOT fixing our problems when they had a chance, in health insurance, social security, and Medicare, ( and border control).I understood that 9/11 happened, and then Afghanistan and then Iraq, all of which sucked a lot of air out of anything else we could do in this nation for 6 years. And by the time we were putting that behind us, there was no Repub power left ( never forget, the DEMS have had all the power to enact bills or block Bush since 2006 when they took over the House)

Well, that was then, this is now. With any luck, the Dems will see the light and enact AMERICAN innovative changes, not the failed retreads of other countries. I don't care who gets the credit, Repub or Dem, I just want it done in a way that doesn't throw out the baby with the bathwater.

RE: LINK TO ACTUAL BILL: If anyone is interested, here is a link to the actual Bill under discussion so far ( granted..the Senate is working on another one, but we will read that one when it comes out.

It is in a site called "Open Congress" and there is a way for the public to comment on each line. So, it is kinda cool cuz one can skim the bill, and click on the comments when one wishes in order to understand how others are thinking about it. I have been impressed with some of the specificity of thought and "dot connecting" that some of these bloggers have done. Of course there are the usual "you are only afraid of change" or "single payer is the only way" comments but if you skim over those you can actually learn about the bill.

Web Link


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Posted by Dennis
a resident of Downtown North
on Aug 22, 2009 at 12:56 pm

Perspective - 1)If you are against government interference, why would you require proof of insurance in order to get a driver's license? Surely, a requirement to purchase health insurance is simply a way to further enrich the insurance industry. If a person can afford to pay medical costs, fine. If not, we have medicaid - no need to require anyone to "buy" private insurance. Hmmm, same logic applies to auto insurance I suppose.
2)"Turn us into Canada, England, France" - In an ironic and morbid way, avoiding "socialization" of health care may slow the increasing costs by keeping our life expectancy lower, thus reducing the time citizens are able to consume expensive medical services.
3) You call for specificity, yet I find little direct quotation in your presentation. Perhaps we can be enlightened with some good old chapter and verse referencing.


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Posted by Perspective
a resident of Midtown
on Aug 22, 2009 at 1:53 pm

Dennis, the problem is that many people choose to not buy insurance who can afford to do so, then complain when they get ill and have to "spend down" to be able to get into Medicaid/Cal. So, they want to live high and spend their money on something other than caring for themselves, then expect the rest of us to pick up the bill. A government can set up incentives to encourage wiser choices, I have no problem with that. In fact, I would welcome us to stop encouraging poor choices in our citizens, which we do far too often with our poorly thought out "helpful" policies.

As for your assertion that somehow we have a lower life expectancy, you are wrong. If you compare race to race across the multi-racial nations in the European/English/Canadian models, we are equal to or longer in life expectancy already. Our overall life expectancy is not "#1" for the whole country, because the nature of having the most multi-cultural/multi-ethnic country in the world renders us lower overall.

As for your #3 point, I am not sure what you are referring to. If you wish to read the bill in its entirety, please feel free. If you wish to be led by the hand, chapter and verse specificity, follow Transparency's posts...or go to the link I gave and read the comments sections that go along with the bill, line by line. I started a "chapter and verse" specificity thread a while back, but nobody was reading it, and I was already so fed up with the bill by the time I commented on the first 30 pages or so when it became glaringly obvious that this bill was designed to destroy private insurance in this country and turn us into a single payer, that I knew there was no way I was going to support it.


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Posted by 9 trillion deficit, and climbing
a resident of Greater Miranda
on Aug 22, 2009 at 1:58 pm

Web Link

Article about even Obama admitting that the deficit will be at least 9 trillion over 10 years now.

And he wants to do WHAT to health care?

How about the bad ol' days when government encouraged economic growth by getting out the way and lowering tax rates. Highest Fed coffers always happen a couple years after we get back to pro-business Fed policy. Universal Stealth Health won't contribute one bit to that goal.


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Posted by Dennis
a resident of Downtown North
on Aug 22, 2009 at 3:37 pm

Perspective - We agree on the culpability of the uninsured who can afford insurance. If they need medical services they can pay, or in some tragic instances, their heirs will pay.

As for life expectancy, your strawman argument is solely reliant on race and ethnicity, thus ignoring the very real and negatively consequential factors of economic and social status.

And as for 3) - you make claims regarding the contents of the legislation. Therefore, you should be prepared to quote verbatim from that legislation.

Let me add 4) - if the private insurance industry is so good, they'll be able to compete by doing the things free marketers do: innovate, invent, execute efficiently. Presently, much like their Wall Street peers, the insurance industry continues to battle obesity by getting fatter and fatter dining at the public trough.


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 22, 2009 at 5:31 pm

The following is written by a USA Critical Care MD (guy I know), internationally famous...

Handwriting on the wall..

"The entire culture must change, and that will be difficult and there is no guarantee that it is not already become bulletproof like the IRS and the former Selective Service. They've seen all the possible threats and have learned to effectively defend from them.

That said, there are some realities we as a society are going to have to face. We make too much money and we don't pay enough taxes. Go do London, a city with an economy virtually identical to that of New York City, and see what their taxes are and the cost of living and the value added tax of 17.5 in addition to the other taxes. Every other city in Europe is similar. We will be forced to catch up with that and that's just the fact.

My colleague in Auckland, New Zealand makes half what I do and delivers world class, good-as-it-gets critical care medicine for every citizen of the country. Part of the reason they are able to do that is because they put teeth in conservation of resources measures and they can and do "say no" to inappropriate usage at the physician provider level. They have an incentive to conserve because doing so benefits all. Alternatively, There are physicians in this institution that made 1.2 million dollars last year. The medical center administrator took home as I recall something like 4.6 million. These guys are able to make this kind of money because we currently live in a value added billing system. No one looks at whether the bill is for anything useful or needed or even legal. the adequate stimulus for reimbursing is whether the paperwork is filled out correctly. The more you do the more you make and there is a huge incentive to "do more", driving the current "customer satisfaction"
ethos in hospital care.

The only way a health care delivery system can possibly achieve any kind of realistic goal is to pay less for more efficient and higher quality services. Trust me, if I understand Obama's thrust, and I think I do, we will shift to a much more value subtracted system in the future, and when that happens, those physicians and especially administrators who have gotten rich doing more will get less doing more. When that happens, the current policies of this medical center administration will be as out of place as yarmulkas on biker gangs.
Every one of those policies will hemorrhage money. And the same guys that formulated them will not be able to adapt. They don't understand the concept.

There is a radical change coming soon in health care. The day of government allowing business to police and regulate itself is over.
We have evolved to the hope that government regulation will evolve to benefit society. That may not be the best hope and it might not work, but it's definitely here. Lord knows we have ample evidence of what happens when business is/was allowed to regulate itself so it couldn't be much worse than the last few years.

Providers are going to work harder and get paid less. Patients will not have unlimited access to an MRI on every corner. Patients will wait for non-emergent services. Patients desiring as much as they want for as long as they want will share in the cost thereof.
Terminal cancer patients will not be able to sue for a million dollar experimental treatment that might prolong their life a few days. That is the price we will pay for taking care of out citizens more or less the way every other country in the world does effectively. This is going to be a bitter pill for all of us to swallow. We've continued to live large for long after we read the handwriting on the wall and now the piper beckons."


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Posted by Transparancy
a resident of Meadow Park
on Aug 22, 2009 at 6:07 pm

@ A Noun Ea Mus I suggest you call your pal.

When you ask him if he has read the bill also find out what he likes about HR-3200 limiting his pay and effectively making him a blue collar worker of the government? Or that this legislation may prevent him from becoming a full professor thus another way of limiting pay.

I do realize that asking this of you may become a newer concept of futility, for I am sure you have not bothered to read the bill.


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Posted by Dennis
a resident of Downtown North
on Aug 22, 2009 at 6:40 pm

Perhaps Transparancy will be so kind as to quote the passages in HR3200 "limiting" doctors pay (any more than limits currently imposed by Medicare and private insurance companies.) while also preventing same from becoming "full professors" - just cut and paste the appropriate passages. thx


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Posted by Transparancy
a resident of Meadow Park
on Aug 22, 2009 at 8:49 pm

Thanks for asking, Dennis. I do realize your pal is a real doctor so with all courtesy to someone who may not have read the bill HR-3200, here you go. I hope this is of service for you. I know I always like to be informed when under force of law someone can limit my ability to make a living.

Page 127 Read: Lines 1-16 Doctors – the government will tell you what you can make.

1 (1) PHYSICIANS.—The Secretary shall provide
2 for the annual participation of physicians under the
3 public health insurance option, for which payment
4 may be made for services furnished during the year,
5 in one of 2 classes:
6 (A) PREFERRED PHYSICIANS.—Those phy7
sicians who agree to accept the payment rate
8 established under section 223 (without regard
9 to cost-sharing) as the payment in full.
10 (B) PARTICIPATING, NON-PREFERRED
11 PHYSICIANS.—Those physicians who agree not
12 to impose charges (in relation to the payment
13 rate described in section 223 for such physi14
cians) that exceed the ratio permitted under
15 section 1848(g)(2)(C) of the Social Security
16 Act.


Page 239, Lines 14-24 The government will limit and reduce physician services for Medicaid. Seniors.

14 (c) LIMITATION ON PHYSICIANS' SERVICES IN
15 CLUDED IN TARGET GROWTH RATE COMPUTATION TO
16 SERVICES COVERED UNDER PHYSICIAN FEE SCHED
17 ULE.—Effective for services furnished on or after January
18 1, 2009, section 1848(f)(4)(A) of such Act is amended
19 striking ''(such as clinical'' and all that follows through
20 ''in a physician's office'' and inserting ''for which payment
21 under this part is made under the fee schedule under this
22 section, for services for practitioners described in section
23 1842(b)(18)(C) on a basis related to such fee schedule,
24 or for services described in section 1861(p)


Page 240 / 241, Lines 3-4 / 6-8 - Doctors, no matter what specialty you have; you will all be paid the same.

3 (d) ESTABLISHMENT OF SEPARATE TARGET
4 GROWTH RATES FOR CATEGORIES OF SERVICES.—
/
6 Service categories established under this paragraph
7 shall apply without regard to the specialty of the
8 physician furnishing the service.''.


Page 317, Lines 13-24 - "No physician ownership or Investment." The government will tell doctors what/how much they can own.

13 ''(ii) The hospital (or any investors in
14 the hospital) does not directly or indirectly
15 provide loans or financing for any physi-
16 cian owner or investor in the hospital.
17 ''(iii) The hospital (or any investors in
18 the hospital) does not directly or indirectly
19 guarantee a loan, make a payment toward
20 a loan, or otherwise subsidize a loan, for
21 any physician owner or investor or group
22 of physician owners or investors that is re
23 lated to acquiring any ownership or invest-
24 ment interest in the hospital.


But wait if that is not enough, there are even more limits...

Page 675-685 - Government will regulate hospitals in EVERY aspect of residency programs, including teaching hospitals. In other words some government bureaucrat will now be dictating the science of Teaching Doctors and the associated personnel decisions in this area.

Have fun, smells like, looks like, reads like a labor contract to me. What if your politics does not match that of the bureaucrat in charge you say? Wonder if that promotion to full professor will get approved? Might not happen. Tell me what does this non-sense in HR-3200 have to do with access to health care?

There is more!

- Read the Bill


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 22, 2009 at 9:19 pm

My "pal"? As in "Pal around with..."? :)

The New Zealand MD he refers to is hardly a "blue collar worker". Interesting that a perceived economic decline (with perhaps not having to graduate from medical school with a huge debt burden) is viewed as such a fall from professional grace. See page 904 of the bill.

I have read/skimmed over much of the bill. It is cumbersome "legalese" and, unless one is a lawyer, the exact impact or implications are obviously open to hysterical spin and all. No doubt this bill is not aggressive enough for me anyway....I wish that the pro-reform forces had entered the fray pushing Single Payer---yes Socialized Medicine in the USA---from the start. Then the Public Option would have been the fallback position.

The Republican "reform" is merely a cosmetic band aid meant to placate, a mere pathetic smokescreen.


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Posted by Dennis
a resident of Downtown North
on Aug 22, 2009 at 10:55 pm

Transparancy - "pal" ?? I think you have me confused with Ea Mus.

The material provided does not support your claims that this is somehow different from any existing insurance guidance, i.e., HR3200 is loaded with legalize, we know that already about existing policies public or private.

Though obtusely worded, there is nothing in HR3200 which mandates that medical practitioners shall be required to participate in the public insurance option, just as they are not required to take Medicaid:
("who agree to accept the payment rate."
"Those physicians who agree not to impose charges."
"Those physicians who agree to accept the payment rate.")

We both know which professional group benefits from such obfuscation.
A lawyer "pal" was fond of claiming that the words "contract dispute" were two of the loveliest in the language; next to "I have a contract!" as a legal foundation for an opponent in litigation.


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Posted by Dennis
a resident of Downtown North
on Aug 22, 2009 at 11:03 pm

A Noun Ea Mus - you might be amused by this item from the FT:

"Ills at home send medical tourists overseas":
'Some US health insurers are already offering packages with significant cost reductions or the elimination of deductions and co-payments for patients who are willing to go overseas'
(FT, August 20 2009)


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Posted by Transparancy
a resident of Monroe Park
on Aug 22, 2009 at 11:49 pm

>>> We both know which professional group benefits from such obfuscation.

Exactly, then why would a doctor allow for his profession to be dictated by another?

Why would you allow all that scientific education to be limited by someone with 1/10th of your education? All the obfuscation, veiled measures, vague terms, and schemes in HR-3200 falls short of any direct help to anyone but government. Why you would stand to hand over this level of control to government.


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Posted by Dennis
a resident of Downtown North
on Aug 23, 2009 at 12:07 am

Transparancy - "falls short of any direct help to anyone but government" is not accurate - people not currently insured who cannot afford private insurance, people who want to be insured independently of their employer, people denied coverage due to pre-existing conditions, people who who might benefit if the public plan is allowed to negotiate favorable pharma costs, small business people who would quit their day jobs if they could get affordable coverage, the guy who just wants to tell his boss "no mas" - these are likely beneficiaries unless the obstructionists in the House and Senate manage to gut the positives out of the public option legislation.


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Posted by Mary Carlstead
a resident of Duveneck/St. Francis
on Aug 23, 2009 at 6:04 am

According to both Jackie Speier and Anna Eshoo, the Medicare Part C plan will be eliminated even though 25% of all Medicare participants are enrolled. This plan was crafted BY the government and combines Medicare Parts A & B and a supplement plan and usually an Rx plan. Participants still pay the required Medicare contribution to Medicare off the top of their Social Security, they may or may not pay a premium to their issuing group, e.g. retiree's company or a medical group,and they pay a co-pay for visits and a co-pay for Rx's. It is hassle-free. The government chose and certified certain insurance companies to manage the program - it is called "managed care' and urged those on Medicare to switch!! Two plans heavily used by local residents are Blue Cross Blue and HealthNet Seniority Plus. HealthNet is the plan of choice for retirees of Lockheed and Stanford, and the PA Clinic has its own version. Some versions are also HMO's. Kaiser has one.. It's efficient, virtually paperwork free, and the government PUSHED enrollment. Now it says its too expensive. This proposed cancellation of Medicare Part C is already causing panic among retirees who have it. Just the thought of having to again deal with the paper work of both Medicare A & B and the confusing Part D if they have it (the Rx part), it enough to get indigestion. There is an explanation Medicare Part C on the Medicare website.


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Posted by Perspective
a resident of Midtown
on Aug 23, 2009 at 8:02 am

Thank You Mary. This is a testament to the complicated nature of the Bill under discussion. Somehow someone in govt has already decided what program is going to be eliminated, yet this is nowhere in the bill, specifically, as every other objection raised by has HAS been.

So, Amerika, are you ready for your commissars yet? More bureacracy, paperwork and fear for the elderly and ill!

What is amazing about this is that Medicare C is a lot less expensive for all than A and B, because it is administered through GATEKEEPER HMOs like HealthNet!

As usual, governmennt efficiency proves itself to be an oxymoron.


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 23, 2009 at 9:41 am

Of course the bill is complicated. They are attempting to allow the old corrupt system to continue and yet somehow reform it's more odious aspects, and provide healthcare insurance for all.

You don't like your tax dollars to pay for abortions? Well apparently the new plans on the table don't do so. But I wish they would. I don't like my tax dollars paying for torture, Blackwater murderous assaults, wars started based on criminal lies, etc. etc.

The plan doesn't specifically cover undocumented workers/illegal aliens. But all this means is that they will still be coming into ER's and have to be treated, unless you are suggesting that we just leave them to die on the side of the road, or "load N go" after bandaging to deportation. The whole immigration/border/undocumented worker issue is, though not totally separate, a different issue. To attempt to hold healthcare hostage to the more drastic "solutios" is another Red Herring. At least if healthcare reform can batten down the practice patterns which are breaking the bank, then that care should at least be cheaper.

I suspect that eventually, one way or the other and no matter if something passes or not now, the only realistic way out of this mess is to just go the distance and have a single payer system, yes SOCIALIZED MEDICINE....just like we have socialized military defense (well except for the Blackwater Mercenary fiasco and murders), socialized fire protection, socialized police services, etc. Virtually every other civilized and developed country does this and has better outcomes. Of course there might not be things occurring like what did up in Redding, CA a few years back. Prison terms for MD's (with all that education 10 times that probably of their prosecutors!) who were found to have performed totally unnecessary open heart surgery on many patients. I knew of a nurse under protective custody who was a witness to that. It caused the virtual demise of the whole Tenet Healthcare empire.

I also have to laugh about the whole "Why would you allow all that scientific education to be limited by someone with 1/10th of your education?"

Big Pharma for years has known and shown that all it takes to trump all that education, make a mockery of any scientific principles or practice, is to send in legions of ex-Cheerleader (or ChipNDale guys) reps---all armed with cleaveage, free pens, samples and lunches.

One summation of the SO FAR plan...

Web Link

What I find questionable is how the Public Option would ever not be covered somehow by taxes and instead by paid premiums. Obviously the people opting for the Public Option would at first be a mix of those previously denied (though now to be made illegal I doubt the previously denied insurance would be retroactively re-instated), the working poor without a policy, and young people just starting out in life who think they are invincible (most probably couldn't afford the premiums for private insurance anyway). As these patients on bulk would probably be more high risk and expensive to cover I don't see how paid premiums could cover it without those amounts being mere tokens.

And for the public option to work there will have to be MD's and hospitals which accept (at least somewhat eagerly) these patients, from those in major cities to rural areas.

So it seems to me that a Public Option would bring on a bit of a "House Divided Cannot Stand" situation. More than just "Keeping the insurance companies honest". After all, if the Public Option is viable, realistic and more cost effective than the surviving private insurance, why would not an employer not then push employees to opt for the Public Option and then use the previous untenable hefty premiums to pay for the less expensive "tax" (er I mean Public Option payments) or pay directly into either wages or profits?

So perhaps the fears are justified, that having a Public Option will then necessitate a either/or scenario in which the vast bulk of people insured in this country will be via Socialized Medicine. The sooner the better.

But this is a convoluted and messy way to go about it. It would be far less messy and all if everyone just realized we have to create such a system and got to work on it.


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Posted by seniordem
a resident of Fairmeadow
on Aug 23, 2009 at 10:35 am

A noun ea mus -- Sure we do have some forms of socialism with SSN or Medicare, or in the military. But that does not mean more socialism is the answer to our problems. You clearly don't like how our military has been used lately (I also oppose the latest wars) but like the medical care and other socialized aspects of the military. It's one thing to have that system which you can opt out of. But you are for a system where no one will be able to opt out of. You don't seem to see the dangers of an over reaching gov't. The military obeys orders and if the current political leaders order them to fight wars in Iraq, that's what they have to do. The medical care in the military is often considered inadequate or substandard. Sometimes the care for soldiers is very poor -- gov't can't afford bullet proof vests so people donated them or sometimes soldiers have had to receive food stamps while on duty -- sure they all have jobs and medical care. But that is the kind of socialism for all that is scary.

This health bill looks like gov't will be fixing programs (Medicare and SSN which I think are good) by taking over the health insurance and then rationing medical care, particularly for the elderly. And gov't will get an over bearing reach into our lives all in the name of the greater good. Sounds like snake oil to me.




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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 23, 2009 at 11:12 am

Sure you can "Opt out" of a socialized medical plan. I am sure that a bunch of money could still buy more. Just like you could also "opt out" of police services by paying a Blackwater (now Xse) guard to stay at your house. Just as your taxes still support public education even though you might opt out to send your child to a private school.

But in both cases your tax dollars would still pay for universal police and medical coverage.

I agree that the support for the soldiers has been deficient. But why is this? These troops get to watch with obvious bitterness as alongside them are highly paid mercenaries, making six figure salaries and immune from any rules.

We've been down the privatization rabbit hole so deep, people purposely undercutting public soldiers, public education, public health, making prisons into another industry...that any attempt to climb out will necessitate crawling through a lot of mud. And then the people that dug the hole, pushed society deep down it, sit and complain when our hands are muddy as we try to crawl out.


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Posted by Kerry
a resident of Midtown
on Aug 23, 2009 at 12:09 pm

"Sure you can "Opt out" of a socialized medical plan"

Depends on the socialist plan. In Canada, it is illegal to buy private health insurance in Canada. Many Canadians, however, buy supplemental insurance in the United States.


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 23, 2009 at 12:30 pm

That would probably be a good thing to disallow any such "buy out" as all it would do is cause a drain on good provision for everyone. Sort of like how our system drains heathcare professionals trained at taxpayer expense from Canada. If we could plug this hole then that would be a good service worldwide.

I traveled widely in the Alberta area years ago, rural and urban. One of my relatives is a Pallative Care RN. I also was a speaker at a medical conference up in the Toronto area a while back. Virtually everyone I met, providers and citizens, were very happy and proud of their system. I often would hear utter amazement that we tolerate the mess we have.


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Posted by Kerry
a resident of Midtown
on Aug 23, 2009 at 12:59 pm

"Virtually everyone I met, providers and citizens, were very happy and proud of their system."

You probably tend to associate with like-minded people.

While most Canadians are proud of their system, and generally happy with it, it is situational. The same family of four that is very happy with the system, can be knocked into despair, if a serious situation develops. There are serious waiting lists, even if emergency care is initially good. For example, try getting physical therapy, a requirement to leave the hospital, only to find that you must stay in hospital, because the line is so long for the PT. During this extended wait, you may get put into rooms with many patients, some of whom are at the end, and moaning in agony.

It only takes one such experience to convince Canadians that they need to buy supplemental insurance in the USA, just in case something serious arises. Some Canadians are just breaking the law, and forming their own private insurance groups, with private doctors in Canada.

The Canadian system is imploding, despite the happy face that is put on it by the Canadian public.


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Posted by Dennis
a resident of Downtown North
on Aug 23, 2009 at 1:41 pm

Mary says, and Perspective agrees, although he admits that none of the proposed legislation contains such provisions: "According to both Jackie Speier and Anna Eshoo, the Medicare Part C plan will be eliminated . . .." Mary, I've grown weary of searching for the basis for such an inflammatory claim, so please reference your sources. This Palinesque rhetorical argument adds nothing to search for health care reform. It is interesting that this is the tactic which will be used eventually to attempt "privatize" Social Security and Medicare. I highly recommend Chomsky's "Manufacturing Consent": Here is the wiki which can be supplement by the dvd available at the PA library:
Web Link

The question of Medicare Part C will be resolved by how well providers can innovate and reduce costs. Presently, with taxpayer subsidies supporting for-profit providers, their is no effective cap on expenses. See the comparison of the cost to Medicare of the Texas cities of McAllen and El Paso.
Here is a link to a review of the report: Web Link
Here is a link to the original:Web Link


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 23, 2009 at 2:24 pm

"You probably tend to associate with like-minded people. "

Quite the contrary.... Alberta is generally a more conservative area than other parts of Canada. One relative I remember distinctly, a conservative farmer and who was disappointed that Canada didn't join the Iraq invasion, sat on the board of the local healthcare committee (not a Death Panel) and was apparently very proud.

You probably do have to wait a bit more for non-elective services than in the USA, there isn't an MRI on every corner, etc. But, and this is the big point here, OUTCOMES are at least as good for virtually every disease, global markers of health are better, etc. In the USA we do a TON of uneccessary tests and procedures. No one in Redding, CA had to wait in order to have their chests ripped asunder needlessly. Eager surgeons like pigs at a trough.

No doubt the created demand perception of the USA spills over into Canada. Another reason we'd be doing both ourselves and the world a big favor by cleaning up our medical cesspool.

And in Canada 20,000 people don't die each year simply because of a lack of healthcare coverage, 700,000 a year aren't forced into bankruptcy because of not having healthcare coverage, etc.


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Posted by Mary Carlstead
a resident of Duveneck/St. Francis
on Aug 23, 2009 at 6:36 pm

To Perspective:

Jackie Speier was quoted in the press, both in the Chronicle and the PA POST and Anna Eshoo wrote in a reply to me that the managed care plans would be eliminated. Since both claim to have read the entire bill, I'll take their word for it. They ought to know.


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Posted by Perspective
a resident of Midtown
on Aug 23, 2009 at 7:30 pm

Mary, I didn't doubt you, it was someone else. I knew you were right on, because I can actually use a computer and fact check, and I did..unlike,evidently, the person who questioned you, who had "grown weary of the Palinesque.." blah blah blah.

Sorry, Mary, on these posts there are some very disdainful, rude, name calling ..um..people..I do not treat anyone who dares use their real names in such a manner.

I salute your honesty and integrity. We agree on much. With many years in the military, and many family in the military...you are absolutely correct..the last thing we want is to trust ANY government to take care of our "health care", based on my experiences in the military "universal health" system. If this be how we care for those who risk their lives defending the very liberties we all take for granted, God help all of us if we are foolish enough to hand over the care of our own bodies to the "government".

Those who wish to hand over their choices to the government are free to buy the cheapest HMO they can find, then complain about how little service they get in return, then exercise their freedom of choice by procuring a more expensive plan if they wish to prioritize their funds in such a way. I have already gone that route, and have no desire to be FORCED back into it. I choose to spend my money on excellent health insurance, instead of new cars, fancy vacations or jewels. I will completely resist anyone who wants to force me into worse care.

Change rules to allow each of us more choice in what kind of insurance we want? YES...Change rules to incentivize everyone to actually be responsible enough to buy insurance when they are young and healthy?? YES. And all the other points I made above..YES. But force all of us into one size fits all health care, regardless of what our personal choices would be? NO.

Ok, I will hand this back to those who will revert to Alinsky's Rules for Radicals, ie name calling, derision, personal destruction, and plausible sounding but false assertions. I will await the links to support the absurd numbers brought up in the post above yours, Mary..I suspect I know where the fuzzy assertions are coming from, but have no desire to waste my time helping anyone else understand them until the poster can come up with some links to support his/her claims.


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Posted by Dennis
a resident of Downtown North
on Aug 23, 2009 at 9:12 pm

Mary and Perspective - I've written Eshoo asking her to clarify her position. Since you both make assertions that I have not been able to verify, please provide the quote and/or links thereto. And please, Perspective, lay off the rhetorical responses and get down to the business of providing backup for your assertions. Your slurs against the men and women who have diligently served our veterans and active duty personnel are tasteless and mean spirited. They would be retracted by a gentleman.


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 23, 2009 at 10:05 pm

I agree that those people who choose to post here using their real names deserve a certain amount of deference or special consideration. But calling something "Palinesque" hardly qualifies as something for someone else (who posts also anonymously) to manufacture undue umbrage over.

"very disdainful, rude, name calling...." give me a break.

I actually have some experience locally with the care available at the VA Hospital. In some venues the available resources there dwarf that of other local hospitals (they have only PET scan, best ventilator available). It used to be that the Stanford folks visiting their professional "brethren and sisters" at VA would travel a bit to a outback colonial setting...but no longer as the VA has even more modern facilities and TONS of various benefits for veterans--- Blind Center, Brain Trauma Unit (mysteriously revved up in advance of 9/11 as Project for New American Century held sway), etc. But there are other VA Hospitals in which the care isn't as stellar I know. Funny as when the Iraq war began a big push by Bush and Co. was to deny by rote any and all injuries or PTSD as "pre-existing conditions". And Obama has strived to reinstate the healthcare our veterans deserve.

But this whole issue really boils down in a way to "pick your poison". Unraveling the travesty and disgrace which constitutes the present situation is obviously going to be messy and not easy. To quote Betty Davis, "it's going to be a bumpy ride". But for reasons economic to social and ethical we can't continue. So people are going to pick their sides and the battle will be joined. I am confident that any temporary setback will only fuel the fires for a later more complete and robust reform.

Imagine it's 1859 and the slave states have started there secession moves. In the short term a lot of suffering and destruction will ensue if the slaveholders are suppressed and their system dismantled, their social order ripped apart--- and it wouldn't seem worth it to those unwilling to make the sacrifice. By way of further analogy we need to get rid of the McClellan's among us and stick with the Grants and Shermans.

But then I would have liked to have roasted marshmallows on the glowing embers of Atlanta GA or Columbia SC.


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Posted by chris
a resident of University South
on Aug 24, 2009 at 12:18 am

It has been widely reported that Medicare Advantage (Part C) providers are much more expensive to the government than regular Medicare.

The health care reform plans include major reductions in these excess subsidies as a major way of funding health care reform.

Both of these itemas have been extensively reported in recent months.
You may think that Obama has been hiding this proposal from you, but if you look at his speeches on health care, you will see that he has talked about this a lot.

Please pay attention. You can draw your own conclusion as to whether providers will continue to offer Medicare Advantage if these receive less money.


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Posted by Dennis
a resident of Downtown North
on Aug 24, 2009 at 1:06 am

Chris -

Reductions in the Medicare Advantage(Part C) have been enacted over the past few years. Most recipients are unaffected as the reductions have been targeted at largely "elective" and "cosmetic" services.

Whether health care reform happens or not, Medicare Part C is going to become more expensive, thus, reductions are not going to fund health care reform.

The reality is that if recipients don't want to, or cannot, pay individually, out of pocket, for medical services beyond the basics once provided by Medicare A&B, they will not get those services. Collectively, they can spread the costs, as is done now, thus providing support for some form of Part C and D.

Public Option, Single Payer, Coop, non-profit, for-profit - all require funding and all are in trouble financially, whether here in the US, or in Canada, France, UK, Netherlands, Scandinavia, or Germany.

How many people, now benefiting from government controlled Medicare Advantage (Part C), do not realize that their plan, whether with PA Medical Foundation, Stanford, or Kaiser, is a public plan and an example of how single-payer works with private providers.

Your final question is the key: With shrinking government subsidies, will these private providers continue to offer affordable "Advantage" plans?

This question stands independently of any health care reform legislation under consideration.


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Posted by Monique Kane Heinz
a resident of Duveneck/St. Francis
on Aug 24, 2009 at 10:48 am

I appreciate our representative helping me to understand the health plans being proposed.

I think it amusing to be so worried about government in our lives when insurance companies are running our health-care and someone in their HR Dept telling doctors, and therapist how to treat their patients.

We have public schools thanks to government, police and fire dept., Medicare and MediCal, Social Security, unemployment benefits, the armed services etc. to protect us. Go figure!


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Posted by Hugh
a resident of Terman Middle School
on Aug 24, 2009 at 11:52 am

Ah!, a well publicized "telephone" town hall meeting.
That, I'm sure, provided just what Ms. Eschoo needed, cover that she is "listening to her constituents and no possibility for those constituents to disagre. While it might appear that she is concerned with your views, she is actually insulating herself from those dissenting views.
This "Lady" is an IDIOT that should start planning her retirement from public "service", she no more cares about what you think than she cares to mingle with the unwashed public whom she holds in utter contempt.
I suppose she want's to be called Congresswoman Eschoo. Well Ma'am you have proven that you're unworthy of the title.

GOOD RIDANCE MS. ESHOO, we didn't want to hear from you either.


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 24, 2009 at 1:07 pm

"good ridance"???

Did she resign? Did her title actually change?

I am sure that Congresswoman Eshoo would have no problem answering QUESTIONS, or listening and answering succinct statements ONE AT A TIME. But the "over the top" crowd is part of a planned attempt to squelch any discussion, turn Town Halls into shoutfests, etc.

If leftists had decided to do these pranks at Republican Town Halls a few years back the spin from Coultier and Rush (the current default leaders of the Republicans) would have been cries of "terrorist" and "agitators". When Bush was President you couldn't even wear a T shirt with an oppositional message on it, lest the police escort you out, or arrest you. "Free Speech" zones were fenced off. And now we have outright disruptions, your surrogates carrying weapons at events where our President is at and you think this is all just "democracy in action"?


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Posted by Kerry
a resident of Midtown
on Aug 24, 2009 at 1:31 pm

Health care systems in all industrialized countries are under extreme cost pressures. The single payer systems are probably best situated to ration the care, but even those systems are now collapsing. The current head of the Canadian system just warned that the system is imploding.

Wouldn't it be better to discuss how the various systems are going to contain costs, than to slew about in the ideological pit?


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 24, 2009 at 2:10 pm

The problem is that one doesn't want to "ride the tiger" without first taming the tiger.

Yet one can't tame the tiger without first riding it a bit.

There are tons of ways that costs could be curtailed.....but should I or anyone list them then a hue and cry about governmental interference arises. We can't fix our healthcare mess without stepping on a lot of powerful toes. But if we don't all will suffer.

Cost containment.....

put a big boot down on Big Pharma. Disallow creation of new drugs like the one that Sally Fields is currently advertising for osteoporosis, new tweaks on old established drugs that don't really give an advantage. That and so many other things. Just look at the No Free Lunch website for a good description of how the drug companies have been playing the MD's as fools. Seeding studies for one---where they do "studies" merely to get the MD's ego invested and in the habit of ordering their drugs. The list goes on an on...so should the corresponding hit list.

A recent article in Science News described how premature labor complications are severely curtailed when simply the health of the mother is addressed pre-conception! Having all citizens able to get regular medical care and follow up would go a long way.

Pro active societal efforts to increase fitness and decrease disease. Let go of STAR TEST induced "no child left behind" nonsense and re-institute PE, fund sports for all, etc. Maybe subsidize good food and tax the junk more. In poorer regions across the country the morbid obesity rates are soaring. This is a time bomb which could be addressed. Does everything need to be infused with high fructose corn syrup? I think not.

Many elderly patients end up suffering mightily affixed to a myriad of devices, lines up every orifice, etc. It can be a real tortuous nightmare. Palliative Care needs to be instituted as a separate medical discipline as in many other countries. It's not just turn up the morphine drip, but covers a vast amount of suffering that patients can experience in end-of-life. This is different from Euthenasia or the fictional "Death Panels". We don't even need to have any euthenasia discussion if people could opt for true Palliative Care. People really don't want to die per se (usually) they just don't want to suffer unduly, want to be able to die with some shred of dignity. Instead we break the bank (and line the pockets of many) with torturous interventions. But many people profit mightily from this obscenity and will scream and kick if it's threatened.

Single Payer....having one payer would get rid of a ton of the paperwork and redundant bureaucracy. But again, stepping on a lot of toes.

Redoing the whole medical/surgical training such that healthcare education is subsidized to the extent that 1) people don't graduate with huge loan payments and 2) we attract people less motivated by flagrant greed, one played by Charlie Sheen, and something approaching an MD played by Jimmy Stewart in an old movie.

That is just a short list, more could be done.

We should have started on this before our economy spun into a depression. But more reason to get with it ASAP.


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Posted by SteveU
a resident of Barron Park
on Aug 24, 2009 at 2:22 pm

SteveU is a registered user.

Perspective says no Drivers License to people who do not buy Health Insurance. I left out his word "Afford" because it is undefined and open ended as the current system proves by charging a lot and frequently denying procedures.

The TV pitchman defines "Afford" as "how much money do you make", That is what we charge.

Anyone on "Assigned risk" auto insurance knows that the policy is minimum coverage" for a stiff payment.
Why would I spend my limited money on a product that "Will Likely Not" deliver when I most need it?
Mandatory Health premiums only guarantee huge profits for the plan operators and do nothing to lower the overall cost of delivery.


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Posted by Kerry
a resident of Midtown
on Aug 24, 2009 at 2:32 pm

Thanks for starting to tee up some suggestions to contain costs. Many of your suggestions are already contained in the Canadian system, yet it is also cratering. I think we need more.

Is there a reason that you did not mention tort reform?


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Posted by SteveU
a resident of Barron Park
on Aug 24, 2009 at 3:05 pm

SteveU is a registered user.

Torte reform to protect bad doctors or careless mistakes?
How do you propose Compensation and Prevention of future instances?
Two of my relatives had procedures that went bad. A friend of the family had the wrong leg amputated. 2 of the 3 were careless mistakes, the third took so long to discover the problem that recovery was severely impaired.
Not every case is high profile like Michael Jackson. If this had happened to your relative, do you think it would have been investigated as thoroughly?


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Posted by Hugh
a resident of Terman Middle School
on Aug 24, 2009 at 3:19 pm

A Noun Ea Mus,
Madame Eschoo's insistance on having a tightly controlled "Telephone" town hall meeting shows that she is more concerned with controling her statements TO her "constituents" rather than hearing FROM her "constituents". This is a defacto resignation from her responsibility to REPRESENT said "constituents". When I say "Good Ridance," I am simply ackowledging her disassociation from the people that she cares not to represent. Madame Eschoo is a public servant, she gains her power from the people, she does not have power OVER people. She has shirked her duty as a represntative by failing to seek the will of the people for whom she claims to represent. Our founders voiced their dissent loudly and publicly at great peril, Madame Eschoo would prefer to hold a meeting packed with her sheeple, and hold the ability to silence dissention at the push of a button.
I'm glad that you are happy A Noun Ea Mus, enjoy your "freedom", you will have it as long as you tow the party line.


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Posted by Kurious
a resident of Barron Park
on Aug 24, 2009 at 3:36 pm

Can any of the highly intelligent readers of this column point to just one thing that our government does well enough to earn the right to run our healthcare system?
Social Security, is that well run and sustainable? How about Medicare? Are you all happy with the way the government has run Welfare which actually rewards the disfunctional family unit?

Until government can point to one thing they do well and in a sustainable manner, I say we wait on any new legislation that will only further the dismal record they currently have.

The Congress has absoutely no grasp of the fact that they are spending real money. I remind you all that the government is not the source of wealth. Wealth comes from the hard work of the individual, government is a drain on wealth and can not create wealth.

It's really this simple, if you can't earn it, government can't give it to you.

Unless we can grasp that, we as a free people are doomed.


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Posted by Kerry
a resident of Midtown
on Aug 24, 2009 at 3:37 pm

Tort reform: Why not just set up a system like workmen's comp? Industrial accidents, under WC, are judged by WC judges, and specific compensations are provided by a compensation formula. In Canada, it is very hard to win a financial judgement against the doctors, in effect making it nearly impossible.


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Posted by John
a resident of Barron Park
on Aug 24, 2009 at 5:08 pm

Maybe we could get turned into France. The World Health Organization (WHO) says they have the best medical system in the world.


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Posted by Agnes
a resident of Crescent Park
on Aug 24, 2009 at 5:13 pm

Maybe we could do as the Swiss do. All insurance is from private companies, but no company is allowed to profit from health insurance. They still sell it at no profit, because it implies the idea that everyone has "my" insurance company, and I will buy fire and life insurance from them because they do such a great job on my health insurance.


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Posted by Kerry
a resident of Midtown
on Aug 24, 2009 at 5:30 pm

Agnes,

You seem to be saying that health insurance be sold as a loss leader, by the insurance companies. That is an interesting idea. Could you expand on that idea?


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 24, 2009 at 6:11 pm

By and large the whole uproar about tort reform is another red herring, like infusing immigration into the discussion. NOT that they aren't somewhat relevant and intertwined. But each are issues complex and controversial in their own rights. They should not be used to hold healthcare reform hostage.

IMO the main problem with malpractice is malpractice.

One other problem is that healthcare is being asked to do almost the impossible. We've gotten very good at keeping virtual corpses alive in ICU's tethered to every machine. And then we're compared to the airlines for safety and expected to mimic that. But the airlines aren't expected to fly the "planes of utter futility" that hospitals are expected to. If an airplane the reciprocal of a 101 year old patient, end stage renal failure, lungs tight as a drum, heart failure, pancreatic and liver failure, needing every drug to keep the blood pressure up and on a breathing machine....family wants "everything done because he's a fighter"...they would just say "this plane is grounded, are you nuts?". But hospitals have to have this plane sputter about the runway, taking off barely, banking around mountain sides, meanwhile crews shift, routine maintenance done with plane in the air....inevitably a "Medical error" will occur and that is laid at the door. So if we put a stop to flying these "planes of futility" it should help. I can hear the sounds of "Death Panels". But walk into any ICU and about half the elderly patients are not being done any big favor by all the interventions. The dying process is being prolonged, nothing more.

I would favor some reform which was balanced. The insurance companies writing the policies react to their investments plunging by then boosting rates to cover those losses. That needs to be stopped.

Also often a case will first be presented which has obvious "merit"..as someone screwed up bad, someone suffered, everyone knows some judgment will be paid out, that justice is due. But the insurance company's lawyers then stall and drag it out, run up their hourly bill "defending" it. They probably sell this wholesale tactic as a way to "hold the line", create an overall impression not to mess with us. But it only adds to the problem.

The other thing is that, according to a couple malpractice attorneys I know, "people don't sue doctors they like"! Time after time they tell stories where something has occurred and the family refuses to sue (one of) the doctors because they like him. A lot of the malpractice problem is based on the fact that people are pissed off about the abrupt and profit based healthcare system. By the time even a slight mix up or mistake occurs they're often at the end of their rope.

And I am sure there are ambulance chasers who need to be reigned in. But I see that as a minor problem. But,by and large,f you are an attorney handling malpractice cases and a potential client comes into your office and presents a case.....if it has merit then you have to be willing to expend a TON of effort and delay payment based on a contingency payment. So you would not stay in business long if you took cases without merit. Funny that all the "free market" advocates somehow miss this one.

And as for..

"Can any of the highly intelligent readers of this column point to just one thing that our government does well enough to earn the right to run our healthcare system?"

Well I would hate to see any hospital administration or HMO try to deliver the mail, manage police or fire, etc.

Private enterprise has bought us to the brink as regards healthcare.

The current system is a mess. People aren't insured and have no access to healthcare save clogging up ER's when things get really desperate. The foxes are guarding the henhouse on so many levels. Capitalism, or the free market, private healthcare, what have you, has made a mess of things. The free market works and has a valid role in alot of arenas...healthcare, fire protection, police services, national defense and so on the free market has no role. We've seen what happens when this is attempted---privatizing prisons and we've created a monster, privatized defense and we have the recent headlines about Blackwater----outright murder to torture. Some things the government just should do. The current mess is unsustainable and we have to find a fix.

Are you suggesting we sub-contract out our upcoming single payer system to the French or Canadian government?


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Posted by Dennis
a resident of Downtown North
on Aug 24, 2009 at 6:30 pm

"T.R. Reid is a veteran foreign correspondent for The Washington Post, a commentator for National Public Radio and the author of nine books, including three in Japanese. He is currently working on his 10th book, The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, to be published by Penguin Press in the summer of 2009."

Web Link


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Posted by Dennis
a resident of Downtown North
on Aug 24, 2009 at 6:52 pm

For the seniors amongst us who are worried about getting thrown under the bus, compare our LE at 60 with other countries. If seniors in other countries are facing rationing then it follows that life expectancy should statistically reflect the consequences as lowered LE after 60:

Search: life+expectancy+at+60+united+states

You search by country: life expectancy at 60 (country)

Web Link


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Posted by chris
a resident of University South
on Aug 24, 2009 at 7:07 pm

Just received the automated call to join tonight's town hall meeting but when I answered it didn't acknowledge that I was on the line and hung up.


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Posted by Dennis
a resident of Downtown North
on Aug 24, 2009 at 7:11 pm

"Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care":

"The most notable way the U.S. differs from other countries is the absence of universal health insurance coverage. Other nations ensure the accessibility of care through universal health insurance systems and through better ties between patients and the physician practices that serve as their long-term "medical home." It is not surprising, therefore, that the U.S. substantially underperforms other countries on measures of access to care and equity in health care between populations with above-average and below average incomes."

You can read the full study here: Web Link


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Posted by Kurious
a resident of Barron Park
on Aug 24, 2009 at 9:43 pm

By the Presidents own example, the post office is an unsustainable mess outperformed by the profitable (that means they employ people) United Parcel Service and Federal Express, who, contrary to uninformed opinion, are not actually related to the Government.
And the last time I checked, firemen and police are the first public servants threatened by dismisal whenever some government beareaucrat wants to raise your taxes to piss away on some other "vital" program.


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 25, 2009 at 12:17 am

I assume "Kurious" is referring to Obama's talk a while back where he attempted to portray any Public Option as being not a threat to private insurance companies....and he used the US Post Office as an example as they haven't driven out UPS or Federal Express.

Interesting news and discussion at..

Web Link

To compare the Post Office and UPS/Federal Express is to compare 3 track runners when one (USPS) has to run carrying an 80 lb. pack. Imagine if USPS just folded and left all mail delivery to be done via our choice of UPS or Federal Express....

Would they be required to deliver mail to every address the USPS does?

Does anyone doubt that without USPS they would jack up their rates even more?

An upside might be less junk mail, but that subsidy by USPS is another issue.

It is perhaps ironic that part of the comparison problem (exaggerated as "an unsustainable mess") is that the USPS funds EXPENSIVE healthcare for it's employees. Healthcare which could be made much more affordable if only single payer cold lead such a charge nation-wide.

There is currently no credible or serious plan on any table to do away with the Post Office, to privatize mail delivery in the USA (despite right wing dreams and fantasies). But there is a growing consensus and legislative fervor that at least a Public Option-- healthcare coverage for all-- is a minimum goal.


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Posted by Kurious
a resident of Barron Park
on Aug 25, 2009 at 6:39 am

So do you support the President and the Congress putting themselves under the same wonderful "Public Option" that they propose for the rest of us? If they are willing to do that then perhaps, as unsustainable as it is, it might turn out to be a good plan. My suspicion is that it will be a cold day in Hell befors they will do that, you see they are the "Elite Party Members" much the same as the communist party members in the former Soviet Union and deserve a much better plan than you and I do.

You are really living in a fantasy world A Noun Ea Mus. You also can't point to a well run sustainable government program. But I'm waiting.


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Posted by Kurious
a resident of Barron Park
on Aug 25, 2009 at 6:41 am

The federal government faces exploding deficits and mounting debt over the next decade, White House officials predicted Tuesday in a fiscal assessment far bleaker than what the Obama administration had estimated just a few months ago.

Figures released by the White House budget office foresee a cumulative $9 trillion deficit from 2010-2019, $2 trillion more than the administration estimated in May. Moreover, the figures show the public debt doubling by 2019 and reaching three-quarters the size of the entire national economy

DUH!!!


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 25, 2009 at 7:23 am

Funny how the debt was OK when it meant a criminal war in Iraq, lining the pockets of Haliburton and Blackwater, bailing out Wall Street (like being held up by criminals---you have to give them the money but where is the follow up----if not trials and incarcerations at least then get it back via taxes on the whole class).

But now that money is being spent to actually help out citizens the debt is a problem. I have some solutions.

There are links above to some books and lectures you could review.....while the current world-wide depression is affecting everyone (rightfully blamed on our privatized and deregulated mess) they are hardly viewing the USA healthcare system as any model to emulate. In fact when people criticize their systems the effective retort is often "so would you rather live under the USA system?".


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Posted by Kurious
a resident of Barron Park
on Aug 25, 2009 at 7:46 am

So do you support the President and the Congress putting themselves under the same wonderful "Public Option" that they propose for the rest of us? If they are willing to do that then perhaps, as unsustainable as it is, it might turn out to be a good plan. My suspicion is that it will be a cold day in Hell befors they will do that, you see they are the "Elite Party Members" much the same as the communist party members in the former Soviet Union and deserve a much better plan than you and I do.

You are really living in a fantasy world A Noun Ea Mus. You also can't point to a well run sustainable government program. But I'm waiting.


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Posted by seniordem
a resident of Fairmeadow
on Aug 25, 2009 at 8:45 am

A noun ea mus, there are problems with our current health care system, agreed. But many of us think it is best to have government oversight to rein in the excesses not take it over. If gov't runs it all, do you really think the savings will be reduced costs for the people. Or, will the savings go into some other pet programs our representatives love? Case in point, look at the mess SSN is in because Congress uses it as their slush fund.

This latest financial crisis was largely due to loosening up protective lending regulations so that just about anyone could get a loan. For a while, many people got loans who would not have qualified under the older rules. But politicians were pushing this in part due to PC (minorities and low income were encouraged to buy). So, what sounded good, turned out to be a disaster for the economy.

What about our watchdog SEC that knew about Bernie Madoff? Looks like he had friends in high places. Firms on Wall Street knew not to invest with him, and complaints were made to the SEC, but the SEC ignored them. What's going on with the SEC?

It is starry-eyed to think that power concentrated into the hands of the few (whatever the political spectrum) is the answer.


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 25, 2009 at 10:33 am

Gee where to start with all the misconceptions and spin.....as well as some concerns of merit mixed in....

I think the prime fantasy world is fixating on what the, less than 1,000, members of the Senate and Congress have for their health care vs. YOU. Millions of citizens have NO health care, save when they get into a bad car wreck and medical residents can practice on them, their child has a severe asthma attack, etc. That is the real world.

An offshoot fantasy is to project your "them's got it better than me) to the future and somehow compare that to the old Soviet Union. Between the current mess and the retro Soviet Gulag Health Care Scare....lies a ton of industrialized democracies who virtually all have Universal Coverage, Single Payor, Socialized Medicine. And while I don't doubt the current economic debacle is putting strain on every facet (is their economy "imploding") I seriously doubt any sane person is looking to the USA for the fix model.

As for the financial meltdown being pinned on the poor banks being forced by PC legislation to virtually give away houses to the poor and minorities...this Rush Limbaugh inspired absurd spin. All along the (defective) watchtower there were ample times that the credit ratings and the churned profits might have been curtailed. And those minorities are now the ones pushed out of their homes, the ones who committed the crimes now bailed out by our tax dollars.

The SEC, the FDA, just about every regulatory body (and the State Dept.) has for a long time been severely down-sized, neutered and told to adopt a pro-business stance, etc. Even Obama's team isn't all in place.

So, while I agree that there is ample room for concern as regards the government taking over healthcare the private side has killed the goose that is laying the golden egg. We have to bite the bullet and change.

If someone can come up with an "Oversight" that can reign in healthcare costs, reduce the obscene profits that HMO's and some medical providers are able to rip people off for, can provide Universal and affordable coverage, by all means that might be an alternative.

But instead the tactic seems to be rote opposition to any "Obama victory". The guys at the top of Big Pharma and the HMO's make backroom agreements and then fund the goons.

I don't doubt that, should the government run healthcare, that the run would be a bit rocky, that people would have to get active and complain loud about the inevitable screwups and growing pains. But at least there would be some avenue for continued reform. What we have now is a Medical Oligarchy.

Social Security really isn't bankrupt. The funds were raided and any "reform" needs to keep center stage that, based on accounting, there should be money able to pay retiring people a long time. The legislators are aware of this and any "reform" (institutionalized stealing) they fear as the backlash could be fierce. SS was first raided, I believe, to fund the Vietnam War.

Too bad we don't have a policy to automatically raise taxes a bit when the economy is strong, not get into stupid or useless wars, if we are forced into a valid war then we don't throw money literally down the drain, and pay off the national debt as much as possible. And then when a recession/depression hits reduce taxation, go into debt to stimulate the economy, etc. Instead the privatization/tax reduction/infrastructure destroying/greedfest continued meerily along and drove our country into the ground. Reagan be damned.

But now it's a perfect storm.


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Posted by Perspective
a resident of Midtown
on Aug 25, 2009 at 11:04 am

Fidel Castro joins our "Progressives" in denouncing all of us who are opposing government takeover of our health care, auto industry, financial institutions, and all the future takeover plans at ever spiraling debt as "racist, right-wingers".

Old saying "Birds of a feather, flock together" sound appropriate?

Look to Cuba, people, to see the beautiful effects of a full government takeover. I wonder how many jobs Castro said he "saved", how many people his "universal health care" saved, how many new life enhancing and life saving medicines and devices his country invented, and for how long he claimed to bring Cuba back from the "brink" economically, as he drove the country into dissolution ( all while investigating the horrible crimes of his predecessor)

BTW, Gary, where are you?


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Posted by Perspective
a resident of Midtown
on Aug 25, 2009 at 11:37 am

Editor: The comments on this thread were geared toward the first phone hall, and make no sense now that the initial post has been changed from the first Telephone "Town Hall" to the second one. Please put the original post back, and start a new thread for the SECOND phone hall.


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Posted by Kurious
a resident of Barron Park
on Aug 25, 2009 at 11:51 am

Ah Noun Eh Mus.

It really is a simple question to answer "name one government program that is well run and sustaiable"

Since you either can't name one or choose not to, I must assume that one does not exist and therefore another should not be started.

I could care a less about what health plan the congress has, but if the plan they propose for us is so wonderful, I would think they would all clamor to get aboard.

Remember, our goverment is of the people, by the people and for the people.

Apparently, the Congress is not made up of people if they would wish a seperate system for themselves.


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 25, 2009 at 12:02 pm

Did Fidel Castro weigh in publicly on the current USA debate as regards healthcare? oh I guess so, here it is from Reuters..

"Fidel Castro slams U.S. for battle over healthcare
Wed Aug 19, 2009 11:38pm EDT

HAVANA (Reuters) - Former Cuban leader Fidel Castro criticized the United States on Wednesday for being willing to spend billions on its high-tech military but finding it difficult to approve healthcare reform that would protect its poor people.

He wrote in a commentary published on a state-run Internet site that huge military budgets are approved easily by the U.S. Congress but U.S. President Barack Obama is struggling to convince federal lawmakers to pass a bill that would "deliver health services to 50 million Americans that don't have them."

"What hope can that society offer the world?" he asked.

Obama's plan, aimed at making healthcare less expensive and more broadly available, has come under fire in the Congress, primarily from Republicans who argue, among other things, that it is a step toward socialism.

Castro pointed out that a free health clinic in Los Angeles recently attracted 8,000 patients, some coming from hundreds of miles away because they said they could not afford to go to a doctor or dentist.

The Cuban government prides itself on providing free healthcare to all Cubans.

"The lobbyists in Congress spend their August working against a simple law that would offer medical assistance to dozens of millions of poor people, the biggest majority of them blacks and Latinos," wrote Castro.

"Even a blockaded country like Cuba has been able to do that," he said, referring to the long-standing U.S. trade embargo against Cuba that the communist-led Cuban government blames for its fragile economy.".....

Well here is another truly "Red" herring. Fidel Castro can state what is so obvious and then it's "Birds of a Feather". Next Castro will proclaim the sky above Havana to be blue!

For the record I hadn't read or heard about Castro's comments before I posted mine above....but then I guess people can now draw Castro's beard on Obama instead of Hitler's mustache. :)

Actually Cuba's medical and educational systems are highly regarded worldwide. They truly "leave no child behind" and export doctors, have contributed to genetic engineering discoveries. Compare that to say Puerto Rico, or Haiti, or any other similarly sized Latin American country. Plus they drove South Africa out of Angola years ago....despite plans to send "our Cubans" to Africa---Ricky Ridcardo is well versed in handling domestic upheaval and other "our" Cubans set about bugging all of Africa's phones!


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 25, 2009 at 12:10 pm

"Since you either can't name one or choose not to, I must assume that one does not exist and therefore another should not be started."

How do you define "sustainable"? From the business model of charging for services and then using the "profits" to sustain?

Much of what government should be doing, Police, Fire, defense, isn't "sustainable" in the traditional business model. In fact, if one thinks about it a bit, all entail a certain amount of (gasp!) socialism. With a progressive tax the wealthy get the same fire and police coverage as the poor and destitute (or at least should per perception---I know in the real world it's often not so equal).

For that matter, if it were up to me, I'd allow people X amount of free mail each day, supported by taxation. And X amount of free package delivery. Let Fed EX and UPS compete with that model!

No one gets charged for legitimate police and fire services (except for the late fees on Burglar Alarms in Palo Alto---ca ching!).

Of course they are sustainable in the ultimate sense. The government can raise taxes, print money, etc. Or, if we were to be invaded, would you say, "but the defense of our country isn't sustainable from a business model so we should surrender"?. Of course not, and I'm not willing to surrender the healthcare of our citizens.


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Posted by Mike
a resident of Crescent Park
on Aug 25, 2009 at 12:41 pm

Wow, as seen from remarks above, socialists are different folks.

They start from an entirely different belief system than capitalists, and there is really no reconciliation. At best I believe they feign some capitalist beliefs because it gives them cover as they incrementally move government along eventually to complete socialist nirvana.


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 25, 2009 at 1:58 pm

I don't need "cover"...incrementally or otherwise.


"Different folks"? A different species? Would you call a pro capitalist businessman, one with overall fairly conservative viewpoints, from Canada who supports their socialized medicine system a "socialist"? I have met many such people.

I don't support any imposition of a purely socialist state in the USA. I have a general concept that what an ideal construct would be-- a mix of socialism and capitalism, and democracy tweaked to prevent the rich from running roughshod over everyone else. Not an imposition of the Cuban political system (but then George Washington's army beat the British and didn't send Batista packing only to stare down the northern Behemoth). The best of both worlds.

But I realize that for many any support for anything remotely hinting of Socialism is enough to send them clutching old J. Edgar Hoover books like "Masters of Deceit" and digging trenches to stave off the Red Hordes coming to steal their big screen plasma TV's, before they could watch a re-run of Red Dawn.


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Posted by Kurious
a resident of Barron Park
on Aug 25, 2009 at 3:32 pm

A Noun Ea Mus,

I would define sustainable as being able to live within ones means, there isn't one Government program that has been able to do that. You cite Fire and Police services as the model however you must be aware that these are locally funded and not Federal. The Federal government is, I believe, who would be taking over "The Public Option". The Federal government has proven time and again that they are incapable of living within a budget or with restraint. The Federal Government, whom Madame Eschoo is a part of is simply unqualified to have our trust with regards to Healthcare.Iif you can point to your favorite, well run Federal Government program, I'm sure you will sway us over.

Are you sure you aren't from Berkeley? If not you might find a spiritual home there with many like minded people. If you haven't been there lately, I suggest you visit that Utopia by the Bay, take a ride up University Avenue and see what they've done with the place. Rent Control, programs galore, third world streets. And they haven't yet reached the dream of "Change" yet.

Good luck


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Posted by Dennis
a resident of Downtown North
on Aug 25, 2009 at 4:57 pm

Kurious -

You may be on the right track to true health care reform that will give us a purely free market solution to out of control price increases:

1) Eliminate all tax credits, deductions, set-asides for employer based plans. No Federal subsidies to either employers, employees, or insurance providers. The free market will be able to charge whatever the market will bear.

2) Eliminate Medicare Part C, the so called "Advantage" plan. Again, let the free market determine which health insurance plans will be supported.

3) Privatize the Veterans Administration Healthcare system. Let the free market determine what level of health care is provided to veterans and their dependents. No Federal tax incentives or supplements.


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Posted by Kurious
a resident of Barron Park
on Aug 25, 2009 at 5:46 pm

I think the whole point here is that we didn't have a chance to let out "Esteemed Representative" Madane Echoo how srtongly we take our positions on this sissue. We have been locked out of the debate and have been de facto silenced by our "Representative".

As strongly as you feel about your position, others feel just as strongly about theirs. The fact that Madame Eshoo hasn't taken the time to hear our views speaks volumes about how unseriously she takes her responsibility to represent those views. If Madame Eshoo doesn't want to hear from us in "town hall", then she will hear from us at the ballot box. Given the voting record of this region, I feel that she is relatively safe in continuing her long tradition of not listening to her constituents.

Frankly, she doesn't give a damn.


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Posted by Valet
a resident of College Terrace
on Aug 25, 2009 at 5:52 pm

A society that doesn't provide universal care to its members does not qualify as a civilized society, which ours is clearly not. Of course, if insurance providers corporate type weren't making tens and sometimes hundreds of millions of dollars a year and weren't receiving huge bonuses on to of it, even the current warped and immoral healthcare system wouldn't be so expensive that a serious illness could leave a family financially devastated. Corporatist Capitalism may be the friend of the small elite that runs this country and controls most of its resources and all the power, but it's the enemy of the rest of us.


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Posted by Dennis
a resident of Downtown North
on Aug 25, 2009 at 6:21 pm

Kurious -

Do you support the free market proposals I've posted above?

Just curious.



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Posted by Kurious
a resident of Barron Park
on Aug 25, 2009 at 8:17 pm

Dennis

I'll share my views with you publicly at the next open Town Hall meeting our representative holds.

See you there


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Posted by seniordem
a resident of Fairmeadow
on Aug 25, 2009 at 9:21 pm

Valet, you state: "A society that doesn't provide universal care to its members does not qualify as a civilized society, which ours is clearly not." Funny how everyone in the world wants to come here! What kind of nonsense to say we are not a civilized society. Surely we have problems. I do not think Socialism is the answer.


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Posted by Bob
a resident of Midtown
on Aug 25, 2009 at 9:58 pm

To Dennis:

Twenty-five percent of ALL Medicare participants are enrolled in Medicare Part C. It offers the cheapest premiums - BUT in addition participants still pay the almost $100 from Social Security to Social Security/Medicare plus the Medicare Part C premium. I wish I could get it, but my retiree plan requires me to be in A & B . I have the only retiree plan with my former company - but I can't get a dime paid by them except the Rx co-pay until I pay $2K out of pocket which happened only once in 22 years The book work for A & B can drive a person nuts.


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 25, 2009 at 11:39 pm

.."if you can point to your favorite, well run Federal Government program, I'm sure you will sway us over.".....

Please I'm sensing a "I'm trying to be cute" overload......

And then I'm being compared to "birds in a feather" Fidel Castro, suggesting I belong more in Berkeley. Note I have not made personal aspersions on anyone else here.

One the one hand I can't show you any federal programs which would ever meet your definition of "living within one's means" and doubt even if so I would "win you over". Do you expect, for instance, the Post Office to both fulfill it's overall societal/infrastructure tasks and yet fund all mail delivery via postal rates? Plus subsidize the junk mail (economic stimulus or caving to lobbying?). Plus have to compete with UPS and Fed Ex who can both cherry pick their service level and locale. ??

What about the interstate highway system? Is it supposed to "live within it's means" via charging tolls, by gas tax?

I can go down the line from Post Office to the military, FDA, etc. and point to positives and negatives. And often the negatives are (lately) due to under-funding and privatization schemes (Military with Blackwater, the State Dept. via virtual gutting under Bush/Cheney). Just taking the Post Office, I know one VERY good friend who worked pretty high up in the Post Office labor relations arena. And his wife ran a local post office (I was out to dinner with them downtown years ago and, walking into Cybersmith, showed them the new video game "Postal"). So I heard stories about some pretty nefarious things going on by some postal workers. But I also heard that there was this despicable attempt to ride roughshod over any and all workers challenging the Reagan era drive. The chief for this had armed guards, etc. And I've had good friends who delivered for UPS and told tales of an out of control productivity standard as well. But by and large I get my mail, no real downside. I mail things, they get delivered. People mail things to me and I get them. The mail carriers are polite and nice.

I agree that ALL bureaucracy's tend to engage in ever increasing self-inflation, waste, etc. This is true for them all, be it federal government or some large hospital like Stanford. Every once in a while a bit of stable cleaning is required (should we form a new bureaucracy to clean the others out regularly?).

Yes Police and Fire are funded locally, but the same rules apply as regards them paying their way.

The problem with all the rote opposition to health care reform is that, even if you win this battle temporarily it will probably mean that later you will lose the war even more profoundly. You need to learn to bend or you will break. Unless you are prepared to start infringing even more profoundly on voter's rights, or whip up more wars and pray for terror attacks on US soil, the demographics are moving away from you. And the Republican Party is resembling a bunch of crazed racist lemmings all following to "Rush" over the cliff. This is actually disturbing because, as much as you may want to paint me as a wannabe member of The Third Intenationale, without a credible and somewhat responsible opposition ANYONE can be lulled into over-playing their hand if not enough counter balance. If the responsible Republicans (are there any around anymore--someone to stand up to Rush or decry comparing Obama to Hitler?) become extinct and the entire Republican Party becomes a Rush Limbaugh fan club I actually worry that my perspective would be too unfettered (though we've got a lot of work to accomplish before that becomes a big problem). This is what happened with the whole Reagan/Milton Friedman era privatization/"the gov is the problem"/deregulation fad. The legacy of FDR built a solid middle class (guys like me we had it made), infrastructure was solid, educational system good, etc. So at first some discover "hey we can lessen taxes and stimulate the economy" or read Ann Ryand and freak about "them moochers". But it turned into an addictive drug and (if only you had studied Karl Marx a bit more seriously) that hand was overplayed. In the quest to amass ever more wealth the country has been leveraged, the infrastructure neglected, population unhealthy and under-educated, ...the list goes on and on. And yet you blame the victims and even today react with horror at the thought of a government taking responsibility for providing health care for it's citizens.

Unless people can somehow work together to achieve an agreed upon societal goal of universal health care, the ultimate fix will be still achieved, but the mess you predict may more surely fall. Reflex obstructionists don't usually win, but when change comes it can be a more bumpy ride.

Meanwhile the flu vaccines are being readied for Sept....I can't wait for the "watch out for the Feds" spin on this one.


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Posted by Dennis
a resident of Downtown North
on Aug 25, 2009 at 11:50 pm

Kurious -

It'll be interesting to hear you publicly state the consequences of free market, unsubsidized, health care insurance plans. I have a feeling you'll be booed more than any one else.

Bob -

My point is that according to Kurious' call for free market solutions, there would be no subsidies and you would pay the full amount that the market "fairly" establishes. The benefit to you would be no "book work" - the downside is that there would be no $2k cap on your out-of-pocket payments.

Notice that Kurious can not own up to the consequences of free market health insurance universe. Be sure to attend Representative Eshoo's Town Hall Meetings, so Kurious can explain what he plans for folks like you, especially seniors who rely on Medicare, specifically C & D:

Wednesday 2 September
7:00 – 8:30 p.m. Health Care Town Hall Meeting
Location: Gunn High School, Spangenberg Theatre
780 Arastradero Road
Palo Alto

Thursday 3 September
7:00 - 8:30 p.m. Health Care Town Hall Meeting
Location: Highlands Park Senior Center
8500 Highway 9, Highlands Park
Ben Lomond

By the way, Kurious' free market approach would make it very unlikely that you would ever have been offer the coverage you now have from your private employers plan. Do you think he will call for an end to the Federal funds that help support places like Highlands Park Sr. Center?


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 26, 2009 at 8:18 am

A few posts up someone alluded that my comments seemed to echo those of Fidel Castro, made a "birds of a feather" aside.

I went searching for what those comments were, and found the full English translation...

Web Link

Probably the most compelling and insightful words yet.

Just step outside your box and imagine how true these words ring for the majority of the world.

Is our nation destined to become the "Machines" in some Terminator SciFi beecomes reality scenario? And that juxtaposed with our own citizens not even having adequate healthcare. Perhaps the rising impoverishment will also bring on even more televised modern day versions of the old gladitorial arenas.


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Posted by Gary
a resident of Downtown North
on Aug 26, 2009 at 8:35 am

It is abundantly clear to me that the so-called "public option" will lead to single payer (socialist) health care. There will be rationing, period. The rationing will be controlled by official panels. Sarah Palin called them what they are: Death panels.

Aside from all these changes, I suppose it might be a good thing for the socialist thinkers. Cuba's socialist system is so good that people jump into the ocean with inflated inner tubes and try to escape. Most of them probably die to exposure or sharks, thus lowering the pressure on Cuban helth system. That's one way to bend the cost curve....


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 26, 2009 at 9:43 am

It says it all.....

Web Link


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Posted by Transparancy
a resident of Meadow Park
on Aug 26, 2009 at 10:43 am

This truth ms A Noun Ea Mus. Is people are unwilling to go quietly into change.

The change they are concerned with are years of government proven incompetence and frankly not once in your 20 posts on this forum have you offered any proof that the government will change to a customer focused operation.

The government will continue with the proven format of incompetence and you will have no choice in the matter. The town hall meetings and Obama poll ratings plunge mirror that people are not happy.

Take a look
Not even 8 months and this is what the American Workers are getting from Obama's spending spree!
1) $787,000,000,000 Stimulus Package, LOAN
2) A $3,600,000,000,000 Social Program, LOAN
3) A $1,500,000,000,000 Health Care Program, Entitlement (LOAN)

For a total of $5,887,000,000,000. Simple interest on just these three loans would be ~ $176,610,000,000 per year.
Yes, the ZEROs can give one a headache, so I'll write it out.
Yearly Interest would be One Hundred Seventy six BILLION Six Hundred Ten MILLION DOLLARS
or
$5,351.00 for every person in the US per year.

I don't know about you, but I could get one heck of a health insurance policy for that much but wait there is more

Take that number plus my spouse and kids I could afford to pay $21,407.00 per year for my whole family.


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Posted by Marvin Lee
a resident of Community Center
on Aug 26, 2009 at 11:06 am

Editor,

How about reminding Representative Eschoo and President Obama and our other representatives that President Johnson successfully phased in Medicare over seven to eight years for a relatively small portion of the population where many among them were potentially confronting very high cost medical expenses. Then lets consider extending Medicare now year by year for, say, the next 7 years by selected ten year age groups, such as 50 to 60, new born to 10, etc., to the rest of the population and get away from this current wide ranging debate about national health insurance that few people in the United States now really understand or have any experience with.


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 26, 2009 at 12:12 pm

"Transparency" seems to have added in the Wall Street bail out (again, like being held up--but why aren't the criminals fined?) along with the projected healthcare costs.

Reduce the ridiculous military spending. Tax the wealthy to not only put things back where they should be, but make up for lost ground, grab back what has been stolen.

Bring back the inheritance tax.

Our economy is akin to a poker game where one player has been cheating and grabbed all the chips. The other players could only stay in the game as long as they could get loans (read housing bubble). When that stopped the game is up. Depression lingers. Fine the cheating players, redistribute the wealth, bite the necessary bullets for a time......

I could think of a HOST of things which would bring in more money and cut expenses. But none of them would make the right wingers happy and the screams would go on into the night. Funny how this over spending wasn't a problem when it was Bush/Cheney and the war based on criminal lies (thankfully the trials should start soon!).

If you think the government is incapable of anything "customer service" related...do you support privatization of all mail service, turning over the military in total to a Blackwater type criminal enterprise, privatizing the nuclear arsenal, and virtually all Federal government services? Maybe even privatizing the US Congress and Senate and robots could perform that function as well (as Fidel suggested for you)?

Maybe to some degree we get the government we deserve. As Michael Moore pointed out in Sicko, the French government seems a bit afraid of the people. Unfortunately in the USA this has been manipulated by the powerful elites in a pathetic manner as shouts of Death Panels and delusions abound. Instead of standing up for our rights and demanding good service for our labors and tax dollars we are led like lobotomized lambs to the slaughter and then argue against our own self-interest (though many on this forum may be among the elite, and yes you may have a bit to fear from the coming impending changes).

As for Marvin's suggestion...there are a lot of delaying tactics being touted. From Lieberman to this and back.

I would answer Joe Lieberman with Jim Morrison...

"You know the day destroys the night, night divides the day, try to run, try to hide...break on through to the other side...."


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Posted by Gary
a resident of Downtown North
on Aug 26, 2009 at 12:13 pm

A Noun Ea Mus, above, posted a link to one his favorites, Castro. He then said, "Probably the most compelling and insightful words yet."

Here is a snippet from that post:

"If robots in the hands of the transnationals can replace imperial soldiers in the wars of conquest, who will stop the transnationals in their quest for a market for their artifacts? Just as they have flooded the world with automobiles that today compete with mankind for the consumption of non-renewable energy and even foods converted into fuel, so too they can flood the world with robots that would displace millions of workers from their workplaces. "

Not that I need a reminder of why I abandoned the leftist cause, but it certainly refreshed my spirit to know that the luddites are alive and well, and that they still need to be fought against.

The capitalist innovations have brought more people out of poverty and despair than any socialist program yet devised. Capitalist medicine provides the best for the many.


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Posted by Dennis
a resident of Downtown North
on Aug 26, 2009 at 12:35 pm

Gary -

Sounds like you'd like Ms Thatcher to rise up from the dead:

"The problem with Socialism is that eventually you run out of other people's money." - Margaret Thatcher (Seeking Alpha, 08/26/2009)

Given the 8 years of Bush whacking, Ms Thatcher would now say:

The problem with capitalism is that eventually the plutocracy and their oligarch managers run out of other people's money and have to bankrupt the commonwealth.


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Posted by Mike
a resident of Crescent Park
on Aug 26, 2009 at 1:11 pm

[Post removed by Palo Alto Online staff.]


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Posted by Gary
a resident of Downtown North
on Aug 26, 2009 at 1:15 pm

Dennis,

Margaret Thatcher travelled to Rome this past May to see the Pope. She is still alive. I fully accept her warning, in her own words, about socialism (OPM). I find it easy to ignore the words that you try to put in her mouth.

A low tax rate capitalist society will serve more people, in more and better ways, than any socialist society yet conceived. Margaret Thatcher and Ronald Reagan deserve credit for bringing us back to our senses. The UK, today, especially the Labour party, is back in the realm of reality, thanks to Thatcher.

The best thing to do with the current health care "reforms" is to block the entire thing. Then start off again with a free market approach, backed up with health vouchers from the government/private charities.


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Posted by Dennis
a resident of Downtown North
on Aug 26, 2009 at 1:45 pm

Gary -

My apologies to Ms Thatcher. I hope she is well.

Both Thacter and Reagan were "debt" capitalists: that's what deregulation means in financial markets; unregulated leverage = debt based wealth - last person to try to call in debt (US Taxpayer) is out of luck. Of course you'll probably ignore the enormous tax increases under Reagan. As you will ignore the enormous increase in Federal debt. Actually, their financial policies were basically the same: Wall Street banker plutocracy. Nothing has changed: Your capitalists are still in charge. Congrats!


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Posted by Gary
a resident of Downtown North
on Aug 26, 2009 at 2:01 pm

Dennis,

Reagan had to scrape up the mess from typical liberal policies, under Carter. It was called stagflation. Carter appointed Paul Volker, but he did not support him. Reagan kept Volker, and then supported him. Reagan also cut marginal tax rates. Inflation was slughtered under Reagan, and yes, debt increased. However, Reagan's approach began to pool capital for investment, and a very strong period of growth ensued. Bill Clinton was the beneficiary of this Reagonomics...it was called the dot-com boom. Clinton, stupidly imo, started to crash the boom by going after Microsoft on anti-trust issues.

The underlying issue, including medical care, is that leftists do not really care that our citizens are relatively prosperous under a capitalist system. The lefties have two main burrs up their behind: 1. It is a capitalist system, and not a marxist system (from which they could extract power). 2. Some people are richer than other people. That's it, really. The leftists strongly prefer that poverty be equalized, as in Cuba.


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Posted by Dennis
a resident of Downtown North
on Aug 26, 2009 at 3:11 pm

Gary

1987


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Posted by Gary
a resident of Downtown North
on Aug 26, 2009 at 3:13 pm

Dennis,

It is "Mrs.", not "Ms" Thatcher. She would be offended.


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Posted by dennis
a resident of Downtown North
on Aug 26, 2009 at 3:31 pm

Gary -

At this stage, she would probably prefer Miss.


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Posted by Gary
a resident of Downtown North
on Aug 26, 2009 at 3:49 pm

Dennis,

She would probably prefer Miss Margaret Hilda Roberts, before she married Mr. Dennis Thatcher. She was in love with the guy, and she still is, although he is dead. I think she is proud be Mrs. Thatcher.

BTW, what is wrong with 1987? Reagan was in his glory dismantling socialism, and winning the cold war, and expanding our economy. He succeeded. Where is the beef in your protest? Reagan refused the concept of containment...he went after them, with no apologies...then he was a magnanimous victor. Gorby even attended his funeral.

BTW, this is fun!


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Posted by Dennis
a resident of Downtown North
on Aug 26, 2009 at 3:58 pm

Gary -

She would blush at the Hilda while pondering the qualities of being Lady Margaret or Lady Maggie.

October 19, 1987
(Web Link)

BTW, think we should relocate and run for Parliament?


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Posted by Gary
a resident of Downtown North
on Aug 26, 2009 at 4:15 pm

Dennis,

I was able to retire in good shape, because I continued to invest in Reagonomics (supply side), while many others were abandoning ship, in 1987 I, basically, just banked their money in my account. I would like to thank all those who were silly enough to abandon supply side! Were you one of those who helped me out, Dennis?

I don't think we need to relocate to England, Dennis. Things are, finally and thankfully, distinct enough in our current system, that we can just have at each other. However, unlike Teddy Kennedy, I believe we should come together at the water's edge. How 'bout you?


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Posted by Transparency
a resident of Meadow Park
on Aug 26, 2009 at 4:28 pm


Madam A Noun Ea Mus

Jim Morrison, hahaha, now their was a picture of health to admire, not.

He indulged in:
smoking
excessive drinking (86-proof at that time)
open relationship sex
cocaine
heroin overdose
and ultimately death in a bathtub.

Now that's what you want your health care dollars to support. A freak. a talentless boring freak.

Seems like an act of desperation to call on the unhealthy dead for support.

Unanswered:
I could get one heck of a health insurance policy for amount of money Obama and company have squandered.


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Posted by Dennis
a resident of Downtown North
on Aug 26, 2009 at 5:15 pm

Gary -

As an investor, you know that money is to be made in spite of economic theories rather than as a result of any particular belief system - J. M. Keynes got it right when he said, and I paraphrase, "The market can remain irrational longer than most investors can remain solvent."

Volatility, irrational exuberance, the current bounce - these are market factors to embrace.

re Kennedy???

Are you talking Muddy Waters or King Solomon's riches?


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Posted by Gary
a resident of Downtown North
on Aug 26, 2009 at 5:30 pm

Dennis,

I threw out the theories when Reagan was elected. I thought he was so much smarter than his critics, and that he had the right ideas, thus he could not fail. I just invested on his coattails...and happily so. I would call it a fundamental investment decision.

Since I assume that you may challenge me on the current economic cirmustantes, I predict that inflation/stagfalation is in our future. I am investing in those things which profit from such trends, especially since the current talking heads are saying that deflation, not inflation, is the problem. Hint: I don't invest in gold, because it is too long of a play for me, and it is currently overpriced.


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Posted by Norm
a resident of Midtown
on Aug 26, 2009 at 5:59 pm

NEWS FLASH FOR GARY---------------------------

WASHINGTON - On July 22, 1987, President Ronald Reagan signed into law the McKinney-Vento Homeless Assistance Act {www.hud.gov/offices/cpd/homeless/rulesand regs/laws/} which created more than a dozen federal programs designed to offer a modern system of care for homeless individuals and families.

And some of those were HEALTHCARE options for "those" people.

The US government has commited itself to health care for decades - even after the demise of the US Public Health Care Service. BUT I bet Gary can't tell anyone who its fully committed, hands on health-care activity serves


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Posted by Dennis
a resident of Downtown North
on Aug 26, 2009 at 6:50 pm

Gary -

Those coattails were largely filled with taxpayer lucre - defense was mighty sweet, as I recall. I also recall that a factor in keeping the cap on Fed debt was an increase in payroll tax rates. Even so, Reagan started with an ~2.7% GDP, cruised to >6% GDP (a double!!) and ended in the area of ~5% GDP.

Gold - I think it prudent to keep a small position in gold, flip a coin, 50% up/50% down. Given the lunacy of the Wall Street crowd, The Fed, and the politicians they own, from the White House down to Rush Limbaugh's pharmacologist, this is the continuation of a trader's market (not "day trader")so invest in what tests well on whatever metric you use.


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Posted by Gary
a resident of Downtown North
on Aug 26, 2009 at 7:11 pm

Dennis,

Reagan won not only the cold war, but the domestic economic war. He devised an approach (supply side) that encouraged the accumulation of investment capital. Venture capital was dead in the Silicon Valley, under Carter. Reagan brought it back, big time...thus the dot-com boom. That is what I understood, thus I am now happily retired. I am always looking for fundamental economic models. Reagan had it. Carter did not. Obama does not. When I hear from a national political leader that stands up against the crowd that is crowing for socialsit healthcare, I will begin to place my money in the many private health care approaches. To tell the truth, I am already nibbling....

What is your investment approach, Dennis...you seem to be a player, or am I wrong? Either way, I am enjoying our back-and-forth.


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 26, 2009 at 8:52 pm

It is perhaps appropriate-- that as millions of American citizens are suffering under a depression and without any healthcare this Palo Alto discussion has degenerated into a self-aggrandizing investor conference of sorts.

Reagan was a godsend for very wealthy investors. He was an abomination for the great majority of citizens. His deregulation destroyed the middle class, plunged our country into a deregulated mess and left us with a crumbling infrastructure. This is so patently obvious and recognized. To laud this imbecile now is akin to shouting praises of Charlie Manson as his sentence was passed upon him.

When society switched from a demand side economy to a supply side it predictably created an even more wealthy upper crust, and plunged everyone else deeper down.

So some may try to take their money and run, invest in economiic failure spin offs.

And the Cold War? The changes in the Soviet Union were occurring anyway and this is just big spin job. Funny because now in Latin America the FMLN is in power in El Salvador, the Sandinistas in Nicaragua, leftist governments in Peru and Venezuala, Brazil, etc. And Castro still looks over the landscape and has become a kind of senior statesman for the world.

And instead of using Communist ideology as the Pressure Cooker release for frustrated nationalistic ambitions and desires, those desperate in the Middle East (and Indonesia, parts of the Phillipines) have turned to extremist Islam. Convenient to stoke the defense spending.

So rising nationalism in Russia and China with both ascending, left wing and anti-US governments and movements ascending across Latin America, Muslim extremism targeting the USA as "the Great Satan". And the combination of the Reagan era deregulation, Bush pushing the deficit high up without anything to show for it (except a legacy of torture, incompetence as regards Al Queda, and lining friends pockets) and we are rightly blamed world-wide for plunging everyone into a depression because of our profound stupidity and ineptitude. And then some tout this as a noble thing! Oh yeah we "won" the Cold War. A hollow victory.

Then there is Reagas most valuable campaign workers--the Iranian hostages kept until after he was sworn in (on the very day) in exchange for weaponry against Iraq. Plus his murderous assault on civilians across Latin America, his "we're Americans they will just back down" as he sent the Marines into Lebanon to their deaths (and then cut and run, made deals with "terrorists"). He (and John Wayne) were the precursors to our current spate of Chicken Hawks leading the Republican Party (and it's actually degenerated even below that).

Russia is on the rise again under Putin. Not a Soviet one, but nationalistic Russians with the same axes to grind. And all that oil. And China....

In fifty years someone should walk into a history class somewhere and ask "Hey teach, who won the Cold War?"


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Posted by Dennis
a resident of Downtown North
on Aug 26, 2009 at 10:21 pm

Gary -

Here's a link to a sign you might want to carry to Eshoo's next town hall meeting:

Web Link

A good slogan for a home made sign might read:

"NO SINGLE-PAYER: PROFITS BEFORE PEOPLE"

I should give credit to a wit who likes to twit:

(twitter.com/DinkyShop)

DinkyShop makes an outrageous claim that their dentist and GP favor single-payer. Personally, I think the investor class is short sighted in not pushing for single-payer. If I were a small business owner I would drop my membership in the Chamber of Commerce which seems to be run Big Pharma, Big Insurance, Big Banksters - hardly the friends of the average shop owner.

As for portraying Reagan as the warrior prince who put the mighty Soviets into an early grave and single handedly lead the smiting of the other evil empire, Granada - it's a great bit of Madison Avenue a la Hollywood fantasy. Some of us still wonder what was going on in the dreamscape of the "gipper' on October 23, 1983. Was that the seminal moment of the arms for hostages deals with Iran (aka Iran-Contra)?

Investment approach - the trend is your friend until it ain't. A rising tide lifts all boats, until . . . If you're wondering who the mark is . . . basically, research, research, research . . . profit is elusive take some every chance you get but don't cry if you missed the big run-up in C, BAC, WFC . . . make Keynes' axiom your mantra "The market can remain irrational longer that most investors can remain solvent."


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Posted by Dennis
a resident of Downtown North
on Aug 26, 2009 at 10:45 pm

Need some facts to counter the acid reflux of health care reform half-truths, baseless assertions, and out right lies?:

Web Link


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Posted by Gary
a resident of Downtown North
on Aug 27, 2009 at 2:58 pm

Dennis,

Hard to know where to go with your 'fact' checker. For example:

"The House bill actually increases the number of people who receive coverage through their employer by 2 million (in 2019) and shifts most of the uninsured into private coverage."

Now Dennis, does this make any sense to you? The vast majority of small businesses will elect to dump their plans onto the public plan, both to get it off their business plan, and to avoid administrative costs, even if they need to pay an 8% tax to do so. After all, they will just take back that 8% from their employees, in reduced wages, over time.

I have stated my view: A public option will lead to single payer. Single payer demands rationing. Rationing demands death panels. If you would care to argue these points, please do. However, please use your own voice, and not some absurd internet fact checker.


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 27, 2009 at 4:52 pm

OK I can see how MAYBE a Public Option could eventually lead to Single Payer. And we already have unofficial rationing. Many people realize that we can't go on spending so much money fruitlessly on people, doing them no good except lining the pockets of some and breaking the bank. But I agree that there is a tipping point between fixing this and a slippery slope. But for insured people we are so far from that----they end up getting virtually tortured to stay alive and often have their intent trampled on. And for the uninsured it's already one big "Death Panel" of sorts (though I wouldn't use that term, just that the absurd name has been invoked).

But to say that "Rationing demands death panels" is a new low in diatribe and vitriol. I mean before that you were barely tight walking on the rope of the barely possible and credible..OK yeah maybe it is possible after a few years of this, and then maybe later a bit more of that...... Then, like the Hunter Thompson who thinks he can do the 180 on a freeway offramp and impress the CHP ("Fear and Loathing in Las Vegas), you exit the car with a beer in your hand.

Whenever there is a discussion about Artificial Intelligence do you go off about "The Machines are going to take over!"? That would be a good Prez ticket...John Conners and Sarah Palin.


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Posted by Gary
a resident of Downtown North
on Aug 27, 2009 at 5:43 pm

A Noun Ea Mus,

OK, you seem be coming around on the reality path.

"OK I can see how MAYBE a Public Option could eventually lead to Single Payer"

No MAYBE about it, that is exactly where it is heading. That is why the lefites, like yourself, are so adamant about insisting upon it. As a former leftist, I fully understand the walking path to socialist control, and mass murder.

Single payer demands rationing. Rationing demands death panels, period.

I find it almost amusing that you lefties are trying to deny this fact. Is Sarah Palin so much smarter than you?



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Posted by Transparency
a resident of Meadow Park
on Aug 27, 2009 at 6:08 pm

>>>>Single payer demands rationing. Rationing demands death panels, period.

>>>>I find it almost amusing that you lefties are trying to deny this fact. Is Sarah Palin so much smarter than you?

Gary, Yes she is. I think, the level of denial of the above facts is that in animal farm some animals are more equal that others.

In other words, The liberal believes they are so much smarter than the common man and that rationing and limitations and yes even death panels would not apply to them. It will only apply to the less socially qualified.






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Posted by Perspective
a resident of Midtown
on Aug 27, 2009 at 6:12 pm

Glad to have you back, Gary! I missed your pithy remarks, always dead on.


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Posted by A Noun Ea Mus
a resident of Professorville
on Aug 27, 2009 at 10:39 pm

This is like being in a room and having the Twilight Zone tune playing..Rod Sterling narrating......

I don't know what leftist did what to you to get you to this place. ??

Obviously you have this "give an inch and we'll lose a mile" attitude as regards any reasonable healthcare reform.

My "MAYBE"'s were to give your paranoid and bizarre scenarios some benefit of some doubt, some shred of quantum probability that in some twist of some possible universe it might come to that........

But you lose it when you mention "Death Panels". It really is bad PR on your part. This might play in some area where the educational level was below HS grads, where the branches on the family trees were a bit thin, a "red" (pretty ironic heh) state where they enthusiastically voted for Bush en masse in 2004. You can keep repeating and insisting on it, stomp your keyboard like Rumpelstilskin and it just sounds ever more absurd. Death Panels. I have this image from the French Revolution and old people carted away to the guillotine, or a bunch of hooded people with little red stars on their chest, or......

And the "Mass Murder" part.....are you channeling David Horowitz and his profound guilt over the woman ordered killed (apparently) Erika Huggins?


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Posted by Gary
a resident of Downtown North
on Aug 28, 2009 at 9:12 am

[Post removed by Palo Alto Online staff.]


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Posted by Gary
a resident of Downtown North
on Aug 28, 2009 at 3:46 pm

[Post removed by Palo Alto Online staff.]


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Posted by anon.
a resident of Crescent Park
on Aug 29, 2009 at 2:57 pm

The Republican arguments here are all playing on people's ignorance by trying to scare them with what ifs.

Democrats and those for health care reform always seem to bring facts with them.

For instance the last McNeil/Lehrer report had an interview with a Dr. Reid who traveled around the world to actually investigate the truth of what other countries do.

The bottom line is that ever other country decided it was the moral thing to do to cover all their citizens, and then changed accordingly to the best of their ability. Once the had people covered the got into the hard problems such as coverage, rationing, costs, when everyone was on the same page and everyone had a stake in improving the system.

He said that was easy to understand ... but what was not, was why the supposed richest, brightest, most powerful nation would not make that committment, and used costs only as the rationalization for why, and then proceeds to spend twice as much as everybody else for not as good care or coverage.

I have been saying for a long time ... if we all have to see and pay for the health care problems we face, not only will it help health care,but it will help the food industry, and a lot of other industries that intersect with health care in some way, so that we are incented to lower our costs and risks and improve all aspects of our country ... which is what capitalism is supposed to be about.

WE need to put the incentives in place to begin improving things, and that is going to mean challenging those who appeal to the worst natures of our citizens for their own profit, leaving the mess for everyone else to pay for or ignore.


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Posted by alsoanon
a resident of Crescent Park
on Aug 29, 2009 at 7:23 pm

Anon., a lot of what you say makes sense. I agree that health care reforms are needed. But I disagree that gov't take over is the answer. The gov't will have more and more say in our lives. It won't be just the hopeless cases who now get expensive medical care will be rationed or denied by the health care panels to reduce medical costs. Many aspects of our lives will come under scrutiny. Since obesity leads to many illnesses, maybe the schools will be told to check children's diets. Suicide cluster -- maybe the health experts will want psychological screenings for that area. To keep the population healthy (and reduce medical costs) could result in the appointed experts examining and dictating more and more of our personal lives. For those who do not comply, benefits could be reduced. What will keep this from becoming big brother?


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Posted by Gary
a resident of Downtown North
on Aug 29, 2009 at 7:52 pm

"What will keep this from becoming big brother?"

alsoanon,

Nothing.



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Posted by anon.
a resident of Crescent Park
on Aug 29, 2009 at 8:19 pm

I reject the notion that only government can be "Big Brother", increasingly corporations are able to dig up info on us and react accordingly ... CRM software gone amok ... "customer relations management". At least with government there is some hope of public oversight, some transparancy, and at this time in the country's history I do not trust the large corporations to do anything right, even compared to the government.

That said, there is no indication that health care reforms is by definition going to be a government takeover. If someo of you would bother taking some time to listen to what you probably think of as the Liberal media, ie. Bill Moyer's Journal, McNeil-Lehrer Report, Frontline, etc you would know that not all of the developed countries that health care systems that are government run, but all of them did start by deciding that every one of their citizens deserved health care, and worried about all the petrifying paralysing questions to come - after they made that basic human rights decision.

That is exactly what we should do. It is always fears that are meant to keep us doing the same old thing - that is spectacularly broken. And we call ourselves the richest nation on the planet, that is PR, that is a private enterprise, that is manipulating people to give up something for the benefit of private interests, and Americans have been doing it without compensation for too long.


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Posted by Transparancy
a resident of Meadow Park
on Aug 29, 2009 at 8:36 pm

>>> At least with government there is some hope of public oversight, some transparancy, and at this time in the country's history.

Not with this fellow in the white house.

Web Link

Watch the arrogance @0:33 Where is the list?

and

The passing the buck @1:04.

Where is the answer on transparency Mr. President? You said you will find out.

I and others are still waiting.


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Posted by anon.
a resident of Crescent Park
on Aug 29, 2009 at 8:48 pm

It's always something with you ... well, compare the info from the Liberal media, ie. real information and data with the constant scare tactics from the guerilla right, some of them probably right here. I don't know of a more compelling source of information than from the testimony of Wendell Potter former health insurance executive ... which I hate to take up so much space, but for anyone interested in real facts from someone who knows ... do read on:

Testimony of Wendell Potter, Philadelphia, PA Before the U.S. Senate Committee on Commerce, Science and Transportation
June 24, 2009



Mr. Chairman, thank you for the opportunity to be here this afternoon. My name is Wendell Potter and for 20 years, I worked as a senior executive at health insurance companies, and I saw how they confuse their customers and dump the sick — all so they can satisfy their Wall Street investors.



I know from personal experience that members of Congress and the public have good reason to question the honesty and trustworthiness of the insurance industry. Insurers make promises they have no intention of keeping, they flout regulations designed to protect consumers, and they make it nearly impossible to understand — or even to obtain — information we need. As you hold hearings and discuss legislative proposals over the coming weeks, I encourage you to look very closely at the role for-profit insurance companies play in making our health care system both the most expensive and one of the most dysfunctional in the world. I hope you get a real sense of what life would be like for most of us if the kind of so-called reform the insurers are lobbying for is enacted.



When I left my job as head of corporate communications for one of the country's largest insurers, I did not intend to go public as a former insider. However, it recently became abundantly clear to me that the industry's charm offensive — which is the most visible part of duplicitous and well-financed PR and lobbying campaigns — may well shape reform in a way that benefits Wall Street far more than average Americans.



A few months after I joined the health insurer CIGNA Corp. in 1993, just as the last national health care reform debate was underway, the president of CIGNA's health care division was one of three industry executives who came here to assure members of Congress that they would help lawmakers pass meaningful reform. While they expressed concerns about some of President Clinton's proposals, they said they enthusiastically supported several specific goals.



Those goals included covering all Americans; eliminating underwriting practices like pre-existing condition exclusions and cherry-picking; the use of community rating; and the creation of a standard benefit plan. Had the industry followed through on its commitment to those goals, I wouldn't be here today.



Today we are hearing industry executives saying the same things and making the same assurances. This time, though, the industry is bigger, richer and stronger, and it has a much tighter grip on our health care system than ever before. In the 15 years since insurance companies killed the Clinton plan, the industry has consolidated to the point that it is now dominated by a cartel of large for-profit insurers.



The average family doesn't understand how Wall Street's dictates determine whether they will be offered coverage, whether they can keep it, and how much they'll be charged for it. But, in fact, Wall Street plays a powerful role. The top priority of for-profit companies is to drive up the value of their stock. Stocks fluctuate based on companies' quarterly reports, which are discussed every three months in conference calls with investors and analysts. On these calls, Wall Street investors and analysts look for two key figures: earnings per share and the medical-loss ratio, or medical "benefit ratio," as the industry now terms it. That is the ratio between what the company actually pays out in claims and what it has left over to cover sales, marketing, underwriting and other administrative expenses and, of course, profits.



To win the favor of powerful analysts, for-profit insurers must prove that they made more money during the previous quarter than a year earlier and that the portion of the premium going to medical costs is falling. Even very profitable companies can see sharp declines in stock prices moments after admitting they've failed to trim medical costs. I have seen an insurer's stock price fall 20 percent or more in a single day after executives disclosed that the company had to spend a slightly higher percentage of premiums on medical claims during the quarter than it did during a previous period. The smoking gun was the company's first-quarter medical loss ratio, which had increased from 77.9% to 79.4% a year later.



To help meet Wall Street's relentless profit expectations, insurers routinely dump policyholders who are less profitable or who get sick. Insurers have several ways to cull the sick from their rolls. One is policy rescission. They look carefully to see if a sick policyholder may have omitted a minor illness, a pre-existing condition, when applying for coverage, and then they use that as justification to cancel the policy, even if the enrollee has never missed a premium payment. Asked directly about this practice just last week in the House Energy and Commerce Committee, executives of three of the nation's largest health insurers refused to end the practice of cancelling policies for sick enrollees. Why? Because dumping a small number of enrollees can have a big effect on the bottom line. Ten percent of the population accounts for two-thirds of all health care spending. The Energy and Commerce Committee's investigation into three insurers found that they canceled the coverage of roughly 20,000 people in a five-year period, allowing the companies to avoid paying $300 million in claims.



They also dump small businesses whose employees' medical claims exceed what insurance underwriters expected. All it takes is one illness or accident among employees at a small business to prompt an insurance company to hike the next year's premiums so high that the employer has to cut benefits, shop for another carrier, or stop offering coverage altogether — leaving workers uninsured. The practice is known in the industry as "purging." The purging of less profitable accounts through intentionally unrealistic rate increases helps explain why the number of small businesses offering coverage to their employees has fallen from 61 percent to 38 percent since 1993, according to the National Small Business Association. Once an insurer purges a business, there are often no other viable choices in the health insurance market because of rampant industry consolidation.



An account purge so eye-popping that it caught the attention of reporters occurred in October 2006 when CIGNA notified the Entertainment Industry Group Insurance Trust that many of the Trust's members in California and New Jersey would have to pay more than some of them earned in a year if they wanted to continue their coverage. The rate increase CIGNA planned to implement, according to USA Today, would have meant that some family-plan premiums would exceed $44,000 a year. CIGNA gave the enrollees less than three months to pay the new premiums or go elsewhere.



Purging through pricing games is not limited to letting go of an isolated number of unprofitable accounts. It is endemic in the industry. For instance, between 1996 and 1999, Aetna initiated a series of company acquisitions and became the nation's largest health insurer with 21 million members. The company spent more than $20 million that it received in fees and premiums from customers to revamp its computer systems, enabling the company to "identify and dump unprofitable corporate accounts," as The Wall Street Journal reported in 2004. Armed with a stockpile of new information on policyholders, new management and a shift in strategy, in 2000, Aetna sharply raised premiums on less profitable accounts. Within a few years, Aetna lost 8 million covered lives due to strategic and other factors.



While strategically initiating these cost hikes, insurers have professed to be the victims of rising health costs while taking no responsibility for their share of America's health care affordability crisis. Yet, all the while, health-plan operating margins have increased as sick people are forced to scramble for insurance.



Unless required by state law, insurers often refuse to tell customers how much of their premiums are actually being paid out in claims. A Houston employer could not get that information until the Texas legislature passed a law a few years ago requiring insurers to disclose it. That Houston employer discovered that its insurer was demanding a 22 percent rate increase in 2006 even though it had paid out only 9 percent of the employer's premium dollars for care the year before.



It's little wonder that insurers try to hide information like that from its customers. Many people fall victim to these industry tactics, but the Houston employer might have known better — it was the Harris County Medical Society, the county doctors' association.



A study conducted last year by PricewaterhouseCoopers revealed just how successful the insurers' expense management and purging actions have been over the last decade in meeting Wall Street's expectations. The accounting firm found that the collective medical-loss ratios of the seven largest for-profit insurers fell from an average of 85.3 percent in 1998 to 81.6 percent in 2008. That translates into a difference of several billion dollars in favor of insurance company shareholders and executives and at the expense of health care providers and their patients.



There are many ways insurers keep their customers in the dark and purposely mislead them — especially now that insurers have started to aggressively market health plans that charge relatively low premiums for a new brand of policies that often offer only the illusion of comprehensive coverage.



An estimated 25 million Americans are now underinsured for two principle reasons. First, the high deductible plans many of them have been forced to accept — like I was forced to accept at CIGNA — require them to pay more out of their own pockets for medical care, whether they can afford it or not. The trend toward these high-deductible plans alarms many health care experts and state insurance commissioners. As California Lieutenant Governor John Garamendi told the Associated Press in 2005 when he was serving as the state's insurance commissioner, the movement toward consumer-driven coverage will eventually result in a "death spiral" for managed care plans. This will happen, he said, as consumer-driven plans "cherry-pick" the youngest, healthiest and richest customers while forcing managed care plans to charge more to cover the sickest patients. The result, he predicted, will be more uninsured people.



In selling consumer-driven plans, insurers often try to persuade employers to go "full replacement," which means forcing all of their employees out of their current plans and into a consumer-driven plan. At least two of the biggest insurers have done just that, to the dismay of many employees who would have preferred to stay in their HMOs and PPOs. Those options were abruptly taken away from them.



Secondly, the number of uninsured people has increased as more have fallen victim to deceptive marketing practices and bought what essentially is fake insurance. The industry is insistent on being able to retain so-called "benefit design flexibility" so they can continue to market these kinds of often worthless policies. The big insurers have spent millions acquiring companies that specialize in what they call "limited-benefit" plans. An example of such a plan is marketed by one of the big insurers under the name of Starbridge Select. Not only are the benefits extremely limited but the underwriting criteria established by the insurer essentially guarantee big profits. Pre-existing conditions are not covered during the first six months, and the employer must have an annual employee turnover rate of 70 percent or more, so most of the workers don't even stay on the payroll long enough to use their benefits. The average age of employees must not be higher than 40, and no more than 65 percent of the workforce can be female. Employers don't pay any of the premiums—the employees pay for everything. As Consumer Reports noted in May, many people who buy limited-benefit policies, which often provide little or no hospitalization, are misled by marketing materials and think they are buying more comprehensive care. In many cases it is not until they actually try to use the policies that they find out they will get little help from the insurer in paying the bills.



The lack of candor and transparency is not limited to sales and marketing. Notices that insurers are required to send to policyholders—those explanation-of-benefit documents that are supposed to explain how the insurance company calculated its payments to providers and how much is left for the policyholder to pay—are notoriously incomprehensible. Insurers know that policyholders are so baffled by those notices they usually just ignore them or throw them away. And that's exactly the point. If they were more understandable, more consumers might realize that they are being ripped off.



Thank you, Mr. Chairman, for beginning this conversation on transparency and for making this such a priority. S. 1050, your legislation to require insurance companies to be more honest and transparent in how they communicate with consumers, is essential. So, too, is S. 9 1278, the Consumers Choice Health Plan, which would create a strong public health insurance option as a benchmark in transparency and quality. Americans need and overwhelmingly support the option of obtaining coverage from a public plan. The industry and its backers are using fear tactics, as they did in 1994, to tar a transparent, publicly-accountable health care option as a "government-run system." But what we have today, Mr. Chairman, is a Wall Street-run system that has proven itself an untrustworthy partner to its customers, to the doctors and hospitals who deliver care, and to the state and federal governments that attempt to regulate it.


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Posted by alsoanon
a resident of Crescent Park
on Aug 31, 2009 at 8:54 am

Potter's testimony is powerful and rings true--and it's an important point, grant you that. But even though gov't is not profit driven, it is power driven. Gov't can push through health care rationing in order to save money and use the savings somewhere else -- fund wars, boondoggles, deficits, . . . Sure has raided Social Security. I'd rather see gov't as regulators and fix these problems that Potter was brave enough to reveal, than become the "new boss". It's fine to have some social programs but when we all become beholden to the gov't, we lose our freedom. Big gov't is not the answer.


 +   Like this comment
Posted by Perspective
a resident of Midtown
on Aug 31, 2009 at 10:21 am

To Alsoanon: Well said.


 +   Like this comment
Posted by ellieg
a resident of Palo Verde
on Sep 4, 2009 at 2:31 am

I cannot understand this hysteria about single payer health care insurance.

I have been receiving benefits from medicare for about 10 years and I have never had to forgo any care or treatment that was needed or prescribed by my doctor. Medicare always paid for the bulk of the cost and I had no trouble paying the small co-payment. No government agent ever told me where I should get care or which doctor I should see. I feel very fortunate to have these benefits and think that it is a great shame that poor working families do not have a similar health plan.

Also no one has forced me to say what kind of care I should have at the end of my life. Stanford Hospital gave me forms to fill out expressing my wishes if I were incapacitated but I did not have to fill it out to continue to get regular care from their doctors or to participate in a nutrition study that they were conducting.

What is so frightening abut having a plan similar to medicare for everyone? The overhead cost of medicare is around 3% of its total cost
while the private health insurance companies take 30% or more. Also I read that the plan congress members have is also similar to medicare.
It seems that the republicans want to keep all this as a secret rather than share it with the citizens of our country.


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Posted by the real "secret"
a resident of Meadow Park
on Sep 4, 2009 at 7:08 pm

With respect, the plan congress members have is private insurance, which won't go bankrupt. The plan you are on will be bankrupt by the time I get to 65.

that is the "secret" we are trying to get the American people to understand. the generation before me has taken my generation's money to use for their social security and medicare in an unbeknownst to them ponzi scheme..we don't want to continue the farce to our kids.


 +   Like this comment
Posted by Perspective
a resident of Greenmeadow
on Oct 13, 2010 at 12:58 pm

Well, I finally bit the bullet. I have a disabled "pre-existing" child that I put on health insurance years ago..paying $380/month because of his pre-existing.. I COULD have put him on Medi-Cal, but my pride insisted I take care of my own child, so I did. I COULD have left him uninsured, knowing that if nit came to grit, LPCH would take care of him, and put him on MediCal for me..but I didn't. I was a responsible parent.

I did not want Obamacare, I voted against this for years, knowing what I know about what happens the more govt gets involved in "health care". Seen it too much in Canada, France and UK..seen it evolve even here in California, as "laws" pushed by through by lobbyists have "regulated" our insurance premiums ever higher in an effort to "protect" me and my family from "bad insurance"..ha ha. Thanks, I would be happier without paying for insurance that provides language translation, chiropractors, etc. But here we are.

But, these new rules of Obamacare are the rules I have to live by now. So, I called the insurance provider, deciding that I didn't make the game rules, but I will live by them, and I wanted to get on the less expensive federally mandated health insurance for pre-existings.

HA HA HA HA HA. Guess what? Had I NOT been responsible and already had my kid insured, I would be eligible to sign him up for $201/month insurance..the exact same kind I have now..but since I ALREADY HAVE INSURANCE, the law is written in a way that I am not 'eligible".

Once again, our government punishing responsibility.

We must repeal this disaster, and do it right the next time. Let me choose the insurance I WANT to pay premiums on, not the one I MUST. Let me buy across State lines. Tort reform. Pre-existing insurance which rewards RESPONSIBLE choices, not irresponsible ones....


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