‘Americans clearly want a system that guarantees health care for everyone’

September 26, 2006

One of these days, one of these studies will lead political leaders to seize a national policy opportunity.

So what do Americans want when it comes to health care? Two things, according to a citizens group created by Congress: protection for all from high medical expenses and guaranteed coverage for specific checkups and treatments.

The group’s call for universal health benefits will be delivered to President Bush on Monday. But, in many ways, the recommendations clash with Bush’s stance that consumers should bear more responsibility for their initial medical expenses.

“Americans clearly want a system that guarantees health care for everyone,” said the Citizens’ Health Care Working Group, whose 15 members represent consumers, the disabled, business, organized labor and health care providers. Health and Human Services Secretary Mike Leavitt also is a member.

This wasn’t just some random poll. The Citizens’ Health Care Working Group, created by Congress, heard from 6,650 people at 84 meetings around the country over 18 months, and solicited 14,000 responses online. The bottom line: the vast majority of Americans want the polar opposite of what Bush wants in a health-care system. Indeed, let’s not forget that as far as the president is concerned, Americans are already over-insured.

Nevertheless, given the media’s characterizations of the group’s report, it certainly sounds like people are open to a single-payer system. Maybe someone could offer them one?

To quote something Ezra said a month ago in a slightly different context, a “savvy politician could make some great gains by tapping into” the anxiety Americans feel about the existing health-care system.

I completely agree. Between the data showing Americans (including the middle class) can’t afford the status quo, and additional data showing that the vast majority of Americans already believe the government should spend far more on health care, while individual families should spend far less, a single-payer message is likely to land on fertile soil — if only someone would bring it up.

never mind what the people want – Congress never pays attention to that – what’s important is what do Harry and Louise want?

  • HELLO– Hillary? Didn’t you front a single payer style national health plan early in Bill’s administration? Now the majority of Americans are for this idea. Hey, you need a majority of the people to vote for you as president. HMMMM…..

    I do agree that Americans are over insured. We should outlaw insurance as criminal extortion. What we need is access and cost control, not insurance.

  • protection for all from high medical expenses and guaranteed coverage for specific checkups and treatments.

    The obscenely rich, and the politicians they buy, already have that. Who else matters?

  • Unfortunately, the pinstriped pimps of the insurance industry have millions to spread around,buying off the easily-bought-off, i.e., every one of the morons – Democrat and Republican – in Washington, in office and out, and sadly when it comes down to dollars and votes, the dollars will win because the issue is Really Important to them, while it’d be Nice to Have to the majority of voters, who don’t believe they could get it anyway. It’s like gun control – the majority would like to have it but aren’t organized, and the minority who want to be armed to the teeth are super-organized.

    I would love to be proven wrong on this, but I ain’t holdin’ my breath.

  • The World Economic Forum has released 2006 competitiveness rankings. Switzerland tops the list, with Finland, Sweden, Denmark and Singapore following. The US came in 6th, followed by Japan, Germany, the Netherlands and the UK. The US topped the list a year ago, but the burdens of war and security spending, plans to lower taxes further, and medical and pension obligations combine with low savings and a record current account deficit to create “risk to both the country”s overall competitiveness and, given the relative size of the US economy, the future of the global economy” according to the Forum. Other slippage came for Italy (42nd vs 38th last year), Russia (62 vs 53) due to worries over judicial independence, and China (54 vs 48) on worry over weak banking and education, and sluggish technology penetration.

  • Most Americans also support restrictions on media conglomeration. In fact, almost ALL Americans support that idea. But we don’t get that, or universal health care, for the same reason. The corporations who benefit from the status quo bribe and/or threaten our politicians. Harry and Louise are waiting to smack us down with a bazillion dollars of misleading ads.

  • But… but.. if everyone has access to health care, that will mean the terrorists have already won!

    Stay the course, people!

  • WARNING! RIDICULOUSLY LONG COMMENT AHEAD. WARNING!.

    First, my bona fides:
    I have medical debt in the five figures (two back surgeries in the past three years).

    I have worked for an insurance company (and know the tricks they use to try and get out of paying damn near everything).

    I have a parent who’s worked as a nurse for nearly 40 years (and, thus, has met countless doctors and nurses).

    I know to NEVER, EVER pay the first bill sent my any medical practitioner (and EVERYONE HERE should always question their bills as well).

    In short, I have some insight into this whole mess. Not saying I’m an expert, but I’m probably as close as one can get without having a degree in the field or employment at some think tank (which would have to be a very, very shallow tank in my case 😉 ).

    With that out of the way …
    Yes, there has to be something done on this issue. Too many lower- and middle-income Americans are without even basic health care.

    But nationalized health care could – no, would — turn out to be a clusterf*** of Biblical proportions. If anyone doubts that, just take a look as the Medicare drug benefit. All that has done is increase costs for some seniors and profits for pharmaceutical companies.

    Nationalized health care would do the exact same thing – consumers would wind up with gaps in coverage, and insurance companies would manage to craft a bill so egregious to the true concerns of Americans that every insurance company executive would be able to buy about a dozen of these.

    The problems with the current system are nearly too numerous to mention, but some of the highlights include:

    1. The “negotiated rate” — Every insurance company sets a different price for certain services. So the docs just bill as much as possible to see what sticks. The insurance company then says, “We’ll only accept $XXXX amount.” If you have health care, the doc then just wipes a certain amount of the books and charges you the out-of-pocket max. If you don’t have health care, then you have to pay whatever the insurance company won’t accept.

    Solution: Have every company set the same rate for the same service. If Blue Cross only, say, accepts $45,000 max for a back surgery, then Aetna should have the same limit. This would eliminate the “charge an insane amount and see what sticks” method that docs use to charge insurance companies.

    2. No doc has ever told me how much a certain procedure will cost — If I purchase any other service (say, having my house’s roof replaced), I’m told up front what that service will cost. But, for reasons I still don’t understand, the medical profession is the only one that hides the true cost of the service.

    Solution: ALL of the costs should be given up front, put in writing, and agreed to before anything is done. This includes the doc’s services, the materials, nurses, etc.

    3. Multiple bills for what should be one service — After my first back surgery, I literally received nine different bills. It’s as if every doctor who walked by the door charged for a “consultation.” Add in the anesthesiologist, the nurses, the hospital, the rehab person, the guy who mopped the floor after I left the hospital … it’s insane.

    Solution: Give consumers one bill with all the charges itemized. Believe it or not, you have to ASK for an itemized bill. It should be mandatory.

    4. A society that treats doctors like gods — Docs are often seen as infallible, always knowing the right answer to all problems. But I went through 13 doctors for my back before the problem was actually … well, it’s still not solved. But it is better. Doctors also make entirely too much money — seriously … how many doctors have you met that drive a used Kia?

    Solution: Before any surgery or procedure that isn’t connected to saving a life (i.e., if someone needs immediate bypass surgery), a patient should be required to get a second opinion at a reduced rate. Also, every doctor should be required to either offer services for a discount (or even free) to a certain number of financially strapped patients each year, or they should be required to ply their trade for a certain number of years in lower-income areas.

    I don’t know how many times my mother (the nurse) has went off on a doc for not even knowing the patient’s name, let alone the procedure he/she is doing that day. By forcing docs to provide compassionate care, maybe they will apply that same compassion to ALL their patients. I’d love for them to do it on their own, but I’ve heard way, way, way, WAY too many stories of docs who went into the profession not for the greater good, but for the status and income that comes with it.

    Now, I realize some of these solutions are probably just plain stupid. But some are just stupid enough to actually work.

    But the bottom line is this: To have the federal government manage the health care for a nation of 300 million people is a recipe for utter, unmitigated disaster. Political battles, lobbying money, cronyism, and just plain incompetence are too pervasive in all levels of our government as it is.

    Do any of us really want those issues to wind up affecting our health? I, for one, sure as hell wouldn’t.

    Now, a state-by-state system may be a better solution, In theory, it would be smaller, more agile, and better meet the needs of its citizens. Of course, if Missouri is any indication, maybe that idea is clinically retarded as well.

    Okay … sorry for the freakin’ 1,000 word thesis.

    But, to be honest, I’m tempted to trash my blog and start one that focuses on health care issues in this country. Of course, I bet that’s already been done, probably by someone more competent than me. I just don’t want anyone less fortunate than I am (and I’m not all that fortunate) to go through the medical care nightmares I have.

    The problem is that I’m fairly confident that a national system would make things worse.

  • Why the business community, which right now pays for a substantial portion of the health insurance to provide health care delivery, doesn’t rise up and support nationalized health care, I don’t know. I suppose they wouldn’t want to mess up their golfing foursomes by upsetting their insurance agents.

    I think Unholy is unholily wrong. Medicare has a administrative cost of 2% for providing health care. His insurance companies run 23%.

    Does it take anything more than that to understand?

    We should not have an industry that draws profits from Americans in regulating their access to health care. It is just plain stupid.

    I don’t know how accurate her figures are, but a conservative commentor on a TV show asserted that right now in America, between Medicare, Medicaid and Veterans Affairs, more than half of Americans get their health care insurance through the government. Toss in the U.S. Military, the various government employees at all levels of government, and you see we already have socialized medical insurance. Why not take the burden off the backs of businesses, consolidate the liability pool, and make one system?

    ‘Cause it would be too obvious?
    ‘Cause it would convince Americans that government actually works?
    ‘Cause it would be the death knell to Republican’tism?

  • Unholy moses, the reply to your argument is that U.S. universal health care for veterans works well. And seniors are, by and large, satisfied with Medicare. Not only is it possible to have a “national” system, but they are pretty satisfactory to the rest of the world, too. Will it be perfect? No. But nothing is. Forecasting disaster is pretty extreme…..the current situation is headed for disaster – the number of people in debt is only rising.

    Also, MNProgressive – Hillary Clinton did not propose a single payer system in the early 90s. That was an HMO based proposal. Turns out that people don’t like HMO’s so much, though.

  • Okay … sorry for the freakin’ 1,000 word thesis.

    1037 words. Still, much more concise than my own personal best (worst): 1674. 😉

  • Lance and Frank–
    You both bring up current government-ran health care programs. But those only cover a few million people. I still don’t think a 100% gov’t ran system for 300 million would be nearly as effective.

    I was going to say that VA hospitals offer crappy care, but, apparently, that ain’t so. To be honest, I’m surprised by that. Maybe this thing can be done.

    Also, don’t get me wrong — I am NOT saying that everything is just peachy with the current system. Something has to be done.

    I just see this as a potential problem due to the above-referenced cronyism (could you imagine political appointees heading these things up?), politics (what if they suddently decided to cut benefits for a certain class of people, like Blunt did in Mo.?) and lobbying (I can just see insurance companies getting a sweetheart of a deal).

    Maybe the past six years have so utterly destroyed my trust in our government — at all levels and within both parties — that any thought of nationalizing anything just makes me cringe.

    JTK–
    Hehe … pretty good on my part for just a guess. 😉

  • Unholy, the Veterans Affairs Department health care system is indeed a lobbying nightmare. All those rear echelon “Professional Veterans” (as Tom Cleaver likes to say) who don’t want to give up their “Private” hospitals only ten minutes away with their 25% hospital bed occupancy rates.

    That said, there are real problems with the facturization of health care risks and costs. Not the least of which is the continuing degradation of effectiveness of anti-biotics over prescribed and improperly used that is creating new and dealier strains of Staph and Tuberculosus and who knows what other diseases.

    We are all going to die if we continue to follow this idiotic model for no other reason than to continue to line the pockets of insurance executives.

    We need change. America knows we need change. Let’s not argue against every idea proposed on the grounds of unwarranted fears. Unintended consquences should be dealt with as they arise. Anticipated consquences should be dealt with before they arise.

    Which, considering the track record of the Republican’ts, leaves them out of the discussion.

  • I’ve got to chime in with my two cents.
    National healthcare makes a lot of sense to me. One major problem with our healthcare system is that businesses are forced to pick up health insurance costs for they’re employees. This adds a significant amount on to American wages. The numbers I’ve heard range to a high of 40% salary for benefits.

    The other larger problem is that healthcare cannot be run as a consumer market. There is really two broad categories of healthcare, preventative and emergent, and the two are treated very differently by comsumers. Annual physicals, mammograms, and other screenings fall into the preventative category. This is care that is not really necissary, but can detect and ‘fix’ problems before they become out of control. Economically speaking, preventative care is highly elastic. If people do not have the money to spend, they will skip out on this care. Many people without health insurance fall into the mindset of ‘if it ain’t broke, don’t fix it’, and if you’re on a fixed income, you probably have other bills to pay rather than getting that annual physical. Unfortnately, this forces many lower (and middle) income people into a situation where they now need a much more expensive trip to the emergency room. Emergent healthcare is highly inelastic. People will not shop around for a better price or haggle when they are having a heart attack. They will pay whatever the hospital charges when their lif is on the line. Healthcare should not be run as a for profit business.

    I do think nationalized (or socialized, let’s not be afraid of the word) healthcare would be a good thing, but we are going to have to be very careful in its implementation. I do not want to see every American get stuck in the ‘doughnut hole’ like the current medicaid drug program. That will not solve the problem of no healthcare. Unholy Moses makes some good points. There needs to be some kind of oversight in the cost of healthcare. We talk about price gouging at the gas pumps, but what about price gouging in the emergency room? Some form of stanardized pricing would be a good start, with either a standard price per procedure, or a time and materials charge with an itemized breakdown.

  • We need change. America knows we need change. Let’s not argue against every idea proposed on the grounds of unwarranted fears. Unintended consquences should be dealt with as they arise. Anticipated consquences should be dealt with before they arise.
    –Lance

    Yeah … you’re right. To just discount something as “OH MY GAWD IT WILL NEVER WORK!” was a bit hasty on my part. Like I typed — I have become so disillusioned with this country since … oh, when was the Florida recount considered “over”? … that, whenever someone suggests the government do something, I have this visceral reaction.

    Combine that with the countless hours I’ve spend dealing with doctor’s offices and insurance companies (both of whom, you would think, would give a shit about customer service) and I have the tendency to get a bit worked up and not wholly think everything through.

    It’s like I’ve developed anti-government Tourette’s. Hmmmm … I wonder if they make a pill for that?

    😉

  • As far as the gaps and “doughnut holes” that a number of commentors are concerned about… those are only there because of the privatized and stop-gap nature of health insurance in America today. There are no doughnut holes or payment gaps in countries implementing universal health care, whether you’re talking about strictly state-financed health care or those that use some combination of taxes, social security levies, and private (corporate) payments.

    VT idealist: your terminology is somewhat wanting. There may indeed be nationalized or socialized health care, but likely universal coverage in the U.S. would not be nationalized or socialized. Health care is nationalized in the U.K., while it’s merely a single-payer system in Canada and France, with private doctors and hospitals quite common. That sort of distinction is VERY important in this discussion. Single-payer mostly eliminates the role of insurance companies in the health care system, but not the independence of the health-care system itself.

    The VA medical system is of course a “socialized” system within its orbit, but maybe one of the goals of a universal or single-payer system would be to drect patients into the same type of system, a cradle-to-grave system that looks at the health-care needs of patients holistically instead of on a piece-meal basis.

  • The question needs to be asked: Are people more terrified of an Arab that doesn’t like them or are they more terrified of having to suffer the insane costs of getting sick? What’s the bigger terror for most people? Day in day out, my bet is that healthcare is a bigger concern in most people’s lives. Everybody these days has a horror story about healthcare.

  • Don’t expect any meaningful change as long as the Politicians and Leaders in the Administration can get the benefits of “socialized medicine”. While hypocritically preaching against it, They expect everyone, including those who do not have insurance, can not afford it and are in debt because of it, to pay taxes for Their “socialized” medicine.

    That’s why I would like to see the MSM ask Bush, Cheney, et al when they go in for their, usually unnecessary, treaments, if they are private paying or if they are using their “socialized” entitlement benefits. Of course, the MSM usually don’t have the character or intelligence to ask.

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