6. Healthcare for All

Healthcare for All. Medicare for all or adoption of a universal single-payer healthcare system. The broken Medicaid program will be eliminated as redundant. Affordable healthcare for all shall be a human right. The Social Security trust fund shall be secured against government borrowing to fund unrelated spending. The earnings loophole shall be abolished by removing the $110,000 cap and lowering the tax rate which will keep Social Security solvent for future generations.

Article 25 of the U.N. Universal Declaration of Human Rights (1948) reads:

Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. 

Article 12 of the U.N. International Covenant on Economic, Social, and Cultural Rights (1966) reads:

1. The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. 2. The steps to be taken by the States Parties to the present Covenant to achieve the full realization of this right shall include those necessary for: (a) The provision for the reduction of the stillbirth-rate and of infant mortality and for the healthy development of the child; (b) The improvement of all aspects of environmental and industrial hygiene; (c) The prevention, treatment and control of epidemic, endemic, occupational and other diseases; (d) The creation of conditions which would assure to all medical service and medical attention in the event of sickness.

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Showing 91 reactions


Jeffrey McCollim commented 2012-03-29 08:01:54 -0700 · Flag
In some of our comments, especially the ones suggesting a choice in a single payer plan, why would you need a choice when every doctor, hospital, pharmacy, clinic, etc would have to be enrolled in the new single payer plan. If not enrolled, how could they practice medicine, rehab, dispense medication, etc. The single payer pays them. Every citizen would have a choice of which doctor, hospital,pharmacy, etc. Our only worry would be in how many 2nd or more medical opinions would we be allowed.
As far as cost increase in medicare taxes, the U.K. pays 8% of their income. Other countries pay up to about 12%. The U.S. is the 3rd largest country in the world, 5 to 6 times the size of the U.K. I would think our cost would be less than theirs. We are the biggest consumer market in the world. Currently, we are paying between 16% to 18%. the highest percentage in the industrialized world. Just think of no out of pocket expense and no fear of bankruptcy because of medical expenses. And no worry of doctors, hopitals, etc closing, we are the world’s largest market and the medical providers are guaranteed payment and the cost is controlled by the single payer plan. What a dent applied to inflation.
Suzanne Coleman commented 2012-03-16 12:28:07 -0700 · Flag
All provisions should be written either in gender neutral terms or be gender inclusive, i.e. “she/he” or “they.”
Nathan Dunn commented 2012-03-13 21:35:38 -0700 · Flag
Followup: I did a little looking, and while I can’t find specifics (Loratadine went O-T-C in 2002), I did find this:

http://www.ncbi.nlm.nih.gov/pubmed/15974556
which links to:
http://www.ajmc.com/publications/issue/2005/2005-06-vol11-n6/Jun05-2065p374-382/

This says that three things happened. First, insurers were eager to get Loratadine out of the pharmacy, since they no longer had to pay for it. Second, usage of the drug diminished. I’m extrapolating a bit, but it looks like because it became easier for consumers to get the drug, they were more efficient at self-medicating (as versus continually refilling a script). Third, cost lowered. The study says specifically cost to society lowered, but it seems to suggest that individual cost lowered as well. Also, keep in mind that when you need a script for a particular drug, you have to add in the office visit and any tests that may be run. When a drug is over the counter, you just walk in and buy it.

Anyway, I’m not arguing against prescriptions as a whole. Mostly what I’m trying to point out is that if you can offer a pill over the counter for 12 cents a pill, it’s not production costs that make prescriptions so expensive.

A friend of mine suggested that R&D plays a large role. Since everything is patented, there are licensing fees just to do research. That may be something that can be looked at.

Once again, I’m finding that an issue is way more complex than we can deal with properly. We really need to keep it simple and outline what the ideal situation looks like, leave the specifics to those who know what they’re doing, and encourage incremental change to get us there.
Nathan Dunn commented 2012-03-13 11:42:13 -0700 · Flag
Tony: Good point about Amazon. That escaped me. Walmart shows the same 30-day supply for $18.88. Their brand is $7.42 for a 60-day supply.
Claritin was just an example of a prescription product turned over-the-counter. I’ll see if I can dig up how much it cost when it was Rx-only.

As to birth control: I would consider that preventative care.
Tony Hanes commented 2012-03-13 06:52:48 -0700 · Flag
Nathan, it is a very complex topic here. I can speak to two points you made. One being that having affordable birth control available; or even better, insurance provided birth control will naturally help to sqease down increasing birth rates numbers. I do not know what the current republicans are thinking?

Also, the $13 dollar Claritin is probably there because a booster hit up a drug store somewhere, and now its sold on the internet. (I’m guessing, I do not really know what the normal retail price is)

You know, it just occurred to me, if fuel was priced so high that the only way you could afford it, was to have an insurance company that you would have to pay $1000 dollars a month for coverage, to purchase your fuel when you needed it; our nation would go to another war to secure some kind of oil reserves. Yet, we could survive without fuel. We could use bikes, we could car poole in buses, we could purchase electric cars.

Humans in many cases literally can not survive without healthcare at some point in life. 50k die each year for lack of affordable care. Thousands more become bankrupt over one medical instance.

The medications (pharmaceuticals) are for profit. The doctors are for profit. The insurance companies are for profit. Lab work and MRI’s are for profit. Drug stores are for profit.

And if one cant fill those 5 hands with cash; avoids the medical attention one needs, and dies; even the morgue gets whats left of your estate because they too, are for profit.

Beneath all that profit, is somewhere a reasonable value (perhaps affordable) for healthcare services.

If we remove the for-profit aspect from pharmaceuticals – I can see a decline in medical advancement as it is the profit that compels them to create new “wonder drugs”. You know, the kind of drugs that will make your eyes bleed, will make urine run from your nose, but will cure your hick-ups.

Doctors of course spend many years in education; have huge college bills, and rightly want to make a profit at the end of the day.

Even though Tashia seemed to be flying around in circles, with one right-wing, I can see her point that a single payer system (like in Canada) may in some cases ration some aspects of healthcare. But I can not see how to make the system (profit-less) and that only leaves a single payer solution.

However, my mind is still wide open; and I watch this thread on healthcare like a hawk.
Nathan Dunn commented 2012-03-12 23:10:36 -0700 · Flag
Sometimes there’s a lot to say. :D
That’s boiled down to the basics… I could go on. :P
Mary Bowers commented 2012-03-12 22:35:03 -0700 · Flag
I love to read the posts, but guys, sometimes they are toooo long!
Nathan Dunn commented 2012-03-12 21:37:59 -0700 · Flag
I’m considering running for a delegate spot, so I’ve been going through the declaration’s suggested points, item by item, and writing mini-essays. I’m posting them all on a blog at http://99essays.blogspot.com
The purpose of the blog is solely to organize my thoughts and discussions on each topic.
Here’s my entry on this topic:

This is a gigantic, complex, and emotional issue, so I really can’t write about all of the ins and outs here. What I can do is try to touch on a few key points that I think should shape the discussion.
First, though, I need to disclaim myself a bit. I work as lower management at a retail drugstore. We have a pharmacy, and the company also operates retail clinics (though we don’t have one anywhere near where I work). As part of my 401K, I do own a small amount of stock in the company.
I also need to apologize in advance, because in order to discuss this issue, I have to strip away the emotion and just look at practicalities. Some things might seem harsh and unfeeling. Please bear with me through them.

In my view, healthcare is a slice of a larger issue that we as humans are facing. We are living longer, increasing our numbers, and depleting our natural resources. The combination of these three things is not sustainable. At some point, all of humanity is going to have to discuss what it is that we want to do to ensure the viability of future generations. Do we sacrifice our own longevity for our great-grandchildren? Do we limit our reproduction so that the population stays static? Do we find more efficient ways to use renewable resources so that there will be plenty for future generations? Do we start looking for a new home on another planet?
I’m not saying that we’re going to go extinct tomorrow, but we need to start the discussion, so that our children can start the work, so that their children can flourish.

Now, to healthcare specifically. I have to wonder what we even mean by healthcare. Are we saying that every citizen can have access to affordable solutions for every potential health problem out there? Are we saying that if I get an infection, I shouldn’t have to skip paying my electric bill for a month so that I can get an antibiotic (which requires paying for an office visit, at least one culture test, and then the script itself — quite a bit of money when you’re uninsured)? What exactly is the scope here?
Even if we assume that — for instance — cancer treatments should be available and affordable for everyone, I have to wonder why we tend to just look at treating cancer. Why aren’t we focusing on preventing it in the first place? I think that preventative care is probably more important than treatment. If we can reduce the amount that people get sick, we can significantly reduce the costs associated with treating them.

I’ve long been uncomfortable with the idea of insurance companies. Since they are for-profit businesses, it is necessary that the average person pays in more than he’ll ever get back out. They also seem to keep prices high, at least for pharmaceuticals. Let’s take imaginary drug “Imaginex”. Imaginex has a retail price of ten dollars a pill. It makes no difference what pharmacy you go to, they all sell it for right around ten dollars a pill (let’s say there’s a 50 cent spread). Now, I come in with my prescription for 30 pills.
Scenario 1: I don’t have insurance. In this case, I pay $300 for my 30 pills. It doesn’t much matter where I go, I’m still paying $300.
Scenario 2: I have insurance. In this case, I’m paying whatever my insurance says my co-pay is. For a 30 day supply of Imaginex, it happens to be ten dollars. I get 30 pills for the cost of one! What a deal! Again, it makes no difference where I go, I’m paying ten dollars. However, my insurance company has used me and all of its other customers as leverage to get a lower price. They pay the pharmacy $200. So the pharmacy collects $210 for a $300 script.
In both of these scenarios, the consumer doesn’t care where he gets his script filled as far as price, because he’s paying the same amount regardless. Meanwhile, the pharmacy is going to charge as much as it possibly can, because the average customer doesn’t care what they’re actually charging the insurance company, and the cash customer pretty much has no choice.
I’m really not sure how you fix the problem. I don’t know if increased competition could lower prescription prices to a manageable level without insurance companies. I’m sure that there are a lot of facets to this that I’m not seeing, but if I can buy a 30 day supply of Claritin (which used to be by prescription only) on Amazon for $13, it makes me think that there must be something that we can do for the rest of it.

I think that if we focus on getting at least basic healthcare affordable for everyone, increase preventative care, and start looking into the economics of prescription drugs, we can get to something that’s manageable and effective for every citizen.
Tony Hanes commented 2012-03-12 18:19:44 -0700 · Flag
I’m just glad the moderator must of figured out how to ban the IP address of the multiple Karl personalities.
chuck gregory commented 2012-03-12 16:19:54 -0700 · Flag
Tashia, I am really happy to see you and Dorothy fighting the good fight for the one percent here! Keep up the good work; we need to be reminded of them.
Tony Hanes commented 2012-03-12 07:27:36 -0700 · Flag
Tashia

You seem to be a very passionate person, and I like that. But it also seems that you get your information exclusively from fox. I say that because you recite their message verbatim. And that’s a shame for someone as interested in politics as you are. Reason being, a study released by Fairleigh Dickinson University proved that fox viewers know less about world and national news than do people who watch no news at all.
released by Fairleigh Dickinson University. That’s because fox is owned by an insanely conservative (corporatist advocate, Rupert Murdoch)

http://articles.nydailynews.com/2011-11-22/news/30431182_1_fox-news-results-show-viewers

You said; “They managed to insult my belief system, by requiring that Christian and Catholic institutions and businesses provide and/or pay for and/or participate in both birth control and abortion.”

Now you must know, that the final decision removes catholic institutions from providing birth control, and placed this provision directly between the insurance company and the individual. Is that not good enough for you? What if Muslim institutions demanded that all American female employees place a wrap around their heads, pray to ala 3 times a day, not vote, etc. etc. etc. Religious institutions can not trump the laws of the land. When any institution enters the realms of business, they must conform to the laws of all.

You said; “They managed to insult my good common sense and ability to decide what is best between myself and my doctor, by limiting care based not on MY ability to pay or get funding, but on THEIR assertion of whether or not it was cost effective.”

Don’t you understand that is exactly what a current HMO plan does? If you have any proof that the universal healthcare bill, will restrain a doctor from providing any medical procedure any more than would a conventional HMO; please post your proof.

You said; “The “death panels” may not be called that in the text, but that is what they equate to anyway.”

That is one of the biggest conservative dis – informative myths ever told. That catchy one liner, only refers to a medicare reimbursement provision that provides a consultation of what the patients options are. This is a responsible measure that outlines whether you want stay on life support or not; if the time comes.
http://www.factcheck.org/2009/08/palin-vs-obama-death-panels/

Tahsia, its very time consuming to dispel these one liner myths on my part. Please if you feel inclined, explain how you think it would work to establish a not-for-profit market as an alternative. I had suggested that you do that before, but you became side tracked on how insulted you are.

Even as most of us would support the single payer system; I think everyone here would be interested in how to set up a not for profit alternative; if only to be educated on how it might work.
Mary Bowers commented 2012-03-12 03:28:41 -0700 · Flag
Tashia,
that does not happen now, why would it start? And, it is NOT in the healthcare plan.
Tashia Berman commented 2012-03-11 21:01:53 -0700 · Flag
Not true, Mary.

Just as with insurance companies, the government is not going to allow anything it does not believe is cost effective. The “death panels” may not be called that in the text, but that is what they equate to anyway.

I have already heard from doctors that have been advised on the pending implementation of Obamacare that in patients presenting with life-threatening conditions, such as heart disease, kidney failure, cancer, etc. over age 70 were to receive “paliative care only”.

Now I just wonder how the government knows which ones of these, with the proper care, might live another 30 years? No matter, just decrease the surplus population, right? Better hope it’s not your Mom or sister or husband…
Mary Bowers commented 2012-03-11 20:49:06 -0700 · Flag
And the Veteran’s health care system.
Mary Bowers commented 2012-03-11 20:48:33 -0700 · Flag
There is nothing in the healthcare plan which dictates to doctors what to do with end of life decisions.
It only states that doctors will be paid to have discussions with patients about end of life care. They get paid to discuss your arthritis or heart attack, and end of life care is no different.
The federal government already runs a health care program, Medicare, and it does not dictate to doctors or patients, there are no “death panels”.
It’s funny to see people rail against government run health care, while forgetting what Medicare is.
Tashia Berman commented 2012-03-11 20:38:05 -0700 · Flag
The single-payer system is also a single-decision system. Uncle Sam knows best — not!

Within the 3,000 page Obamacare manifesto they managed to insult my dignity, by removing my freedom and liberty to choose whether or not I could or wanted to afford a healthcare insurance plan.

They managed to insult my belief system, by requiring that Christian and Catholic institutions and businesses provide and/or pay for and/or participate in both birth control and abortion.

They managed to insult my good common sense and ability to decide what is best between myself and my doctor, by limiting care based not on MY ability to pay or get funding, but on THEIR assertion of whether or not it was cost effective.

They managed to insult my sense that I can properly tend to the needs of my family by providing a behind-the-scenes, insidious decision-making process about how much end-of-life care I or my loved ones should have, when sometimes that care might make the difference in whether or not it IS the end of life.

This system of single-payer care has been tried in Canada, the United Kingdom and many other countries with socialized medicine. I have spoken directly with Canadian citizens, both in the healthcare industry and outside of the healthcare industry. What I know is that the do like knowing that the care is there and available to them.

However, there is rationing and sometimes the inability to tend to those who are most in need first inhibits the effectiveness of the system. Sometimes Canadians have to come here to be able to pay for care privately that they cannot get there, due to the constraints of that system. Where will they go now? I do also know that the taxes that go along with this system are exhorbitant. The higher taxes, rationing of care and government decision making about what care will be given, to whom and when is not an acceptable situation to me and many other Americans.

When I was a child there were both for profit and not for profit hospitals here in the Nashville area. Some were affiliated with teaching colleges, some with churches, but I can remember when these big healthcare corporations came along and bought them up. Everyone was abuzz with talk about where would people go now for care? Of course, the hospitals remained, were upgraded, renovated and made for profit for those corporations (i.e. HCA, HealthSouth, etc.)

In my mind, that is when the face of healthcare began to change. Up until that point whatever your doctor said was what you did. There was no discussion about whether it was “cost efficient” or anything such as that. You could probably have gotten a vacation to the Bahamas if your doctor prescribed it…though they knew better.

At that time, your doctor sent the bill to YOU and you sent it to the insurance company. The insurance company would determine if your doctor charged the “usual and customary” amount, subtract any small deductible and send you the difference. Then you paid the doctor.

Now can you imagine WHY that worked better than today’s system? I’ll explain why. It was because you and I cared less about “treatment codes” and “cost effectiveness”, we got care from good doctors and we just wanted the insurance company to pay for it, and they did. If they didn’t you can bet they’d get an earful from us and we might just take our premiums and go elsewhere. (That’s called competition in the free market.)

If they told you the charges were more than the “usual and customary”, guess who got an earful then? The doctor! What do you mean overcharging me for more than the “usual and customary” price? We might take our business to another doctor down the street! (That’s called price controls, due to competition in the free market.)

I can remember making just such phone calls on behalf of my boss at work and having the doctor adjust the bill downward to the “usual and customary rate”.

What has happened is that you took the “free market competition” out of the equation when you cut the customer, that’s you and I, out of the interaction between the biller and the payer. The same thing happens when you talk prescriptions.

How many of you see a bill for anything except what the insurance company DIDN’T pay? Any idea why they didn’t pay or exactly what was billed? Probalby not. We’ve got to get the people back involved in the process of examining their own healthcare and get the insurance companies, big pharma and big government OUT of that process.
Mary Bowers commented 2012-03-11 20:34:19 -0700 · Flag
The government does a great job running Medicare, low overhead, no profit motive.
If everyone is covered, health care costs would come down. When people get regular checkups, many disease can be caught at an early stage and managed better.
Insurance companies have no motive to cover those who get sick, it cuts into the profits.
Tony Hanes commented 2012-03-11 19:56:07 -0700 · Flag
Tashia, your last post was a well thought out contribution! You left out the one liners ! I’m so happy !!

Now, lets discuss why you think not for profit is better than the single payer? And tell us your ideas on how to implement not for profits. How, and what would the ramifications be?
Tony Hanes commented 2012-03-11 19:50:03 -0700 · Flag
Chuck, you are as well studied, as you are traveled !!
Tashia Berman commented 2012-03-11 19:45:35 -0700 · Flag
Chuck, I understand completely what the medical system would have our children’s outcome be. I have one child who is autistic after being held down for every single one of his required vaccinations on time. I have another child who got some of his rather late, as we had less money and had to slightly delay some visits. Thank God he did, because he was able to recover from the speech delay and ADHD he suffered from those he got on time. I have another who I have saved from that fate and he is a brillian and talented young man.

No doubt our healthcare system has big plans for our children, but I had just as soon they keep their grimey paws off mine.

And Tony, you do have some valid points that I am considering. I am not totally beyond the ability to consider other points of view. There has been a vast redistribution of wealth, but I’m not sure it has been through the healthcare system and that is not the way I would prefer to fix it either.

After my last child, I came down with cardiomyopathy and when my Cobra ran out had to go on TennCare (Medicaid), which soon dropped me and a lot of other adults — too expensive to care for us. So, I went about 5 years with NO INSURANCE, since I was self-employed and nobody would write my coverage with this pre-existing condition.

I began asking doctors to discount the fee they charged me to what the average insurance reimbursement would be, if I had insurance. After all, I was paying cash on the barrelhead and thought I should be due that small consideration, since I had not insurance. NOT ONE would do so. How do you like that? The one who was least able to afford coverage was charged the most.

So, I asked my State Representative to introduce a bill requiring doctors to charge no more than the Medicaid rate for patients with no insurance, if they agreed to pay cash at the time of service. Guess what? It didn’t pass.

There are some deep pockets dead set against changing the system, but it has to be changed. Why though, would I want to put a corrupt government, which I don’t even trust, in charge of my healthcare? In my mind it is just opening the door for them to find one more way to suck us dry, all in the name of providing healthcare.

No sir! Take the big corporations out of healthcare and encourage non-profit hospitals and clinics again.
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