Long ago during the Clinton presidency I chanced to read the Clinton proposal for Universal Health-care and it was socialized medicine, plain and simple. Since Obama refused to divulge anything about his except, in name, and what seemed were empty campaign promises, there was nothing substantial for comparison. That’s what made us so nervous. I for one still cannot trust him until I actually see what is finally put on record. He has flip-flopped on us far too many times already. So I hope you can understand and appreciate our guarded skepticism. Were he a Republican or Independent, I’m sure you would feel the same.

As to the suggestion as to a form of limited free health-care (barring elective procedures) for those under a certain income level, I would have no problem with it, but it would require a screening process and I would want to see it offered only to U.S. citizens. I might bend to accept those on an approved working visa (and dependents who are here legally and residing with them here over one half of the year). After all they are active contributors to our society, just so long as they filed and pay their fair share of taxes here. Foreign exchange students may also be included since they are being hosted by a family here for that year. However, if you are a tourist or illegal, sorry but you have to pay full price. I would suggest setting it at something in the range of say $40-60,000 per year income with an additional, $15-25,000 for each additional dependent, with further adjustments for local costs of living expenses and increases as a start. Most making under that amount cannot afford to pay the cost for health insurance or are not offered it as part of their work package. This could also be used to transform our current medicare system so that the elderly do not risk loosing that which they would have willed to their children following their deaths to unscrupulous nursing home litigation under our current laws. For those making say $50-250,000 (With similar adjustments) then you could go with the higher steps for deductibles. Non-taxpayers such as the homeless would be required to show some form of ID such as state ID cards to be checked against the national databases to prove their identity and citizenship. Such security precautions would be required to screen for fake ID’s.

I would similarly include prescription drugs under that medical services umbrella so that no one could be denied the prescriptions or care they might desperately need for good health and survival. I would also tie in other medical procedures to include dental. So that incorporates pharma’s, services, and procedures. The greedy pharma’s, plastic surgeons, etceteras could still charge their outrageous prices to those who can afford it.

I would concede to expecting some minimal regulation to police substandard services and practices at a state level, much like Board of Health Departments. And perhaps a limited form of tort so that federal and state or even international government bodies might file suit individually or jointly against a company, charge them with anti-trust violations, and/or fine them (which may be appealed as high as the Supreme Court, the loser paying court costs) rather than the class action suits of the past. This would give the government an option to take legal action against malpractices such as we’ve seen with products from China.

I’m sorry Larry, but I do not understand how an intelligent guy like you voted for and ignorant idiot guy like him.

In one way, that is wise, altho I am hard pressed to determine who gets to chose who “can afford” vs “who cannot afford”. As a subcontractor in status… and aligned with small business owners… what looks “affordable” on paper to the government powers may not be.

Since most would purchase insurance … available only at a monthly cost… if they felt secure with that added “payment” to their montly nut, let’s go backwards one step that few are addressing. And that that is first how to make the US health care system less devoted to litigation protection, and how to decrease the base costs of supplies and manpower (including fed oversight employees that add to cost, but contribute little to personal care). That would be the starting point.

I’m not sure how the “outsourcing” would affect the overall outcome. The US pharmas can sell at a discount to foreign entities, who then resell to the US with the needed mark up. Negotiations has it’s value. But I agree… it’s also the devil in the details (and the add ons) in the negotiations that make the difference when giving this “approval”… thus the battles outlined above.

Second.. litigation protection. Big reason for the mark up. Spend a mil to avoid a 5 mil suit? Heck yeah. Something needs to be done about class action suits and other frivolous litigation that attorneys use to be prolific. Then again, for every action there is a reaction. So who knows if you’ll find your local class action attorney vying for the burger flipping job.. right? LOL

Yes, joke there. Altho put an attorney or 2 out of work, and you just increase the unemployment number, right?

Since I think the first step is to cut all the pork from the health care expense, I prefer a plan that evidently no one has offered. Obama’s offered to save money via putting medical records online (boy that makes me feel better… more privacy intrusion possible with the “savings”). And he’s also offered to cut costs by importing.

Then add his quasi universal health care that will turn into 100% government healthcare since it will drive out the competition.

I don’t see any way that we are preserving the quality and care, plus making a dent in the end goal of letting more people acces that end care.

BTW… and don’t take these any more seriously that your excerpted paragraph from Obama’s site (which is busy being cleaned of “promises” as we speak.. but I have saved PDF copies as a just in case…)

Here’s a (only slightly) more detailed marketing schpiel of Obama’s health care plan.

And, here’s his (only slightly) more detailed version of his cancer research plans.

I haven’t had a chance to go thru both with a fine tooth comb yet. I know his end goal… universal health care. That is a given that he freely admits – ala health care is a “right” given by God… if you use our founding father’s principles. Funny… I don’t see God stepping up to the plate to cover the costs… Must be that render unto Caesar what is Caesar’s, and to God what is God’s bit. Health care just doesn’t fit that category.

These PDFs are all he has provided as his first steps to achieving that end goal… but the financial costs (not included in these campaign marketing pieces) just don’t fit in the budget he has proposed via accountants…. at least combined witih the economy we have.. and “not what we wished we had”.

The Obama-Biden plan both builds on and improves our current insurance system, which most Americans continue to rely upon, and leaves Medicare intact for older and disabled Americans. Under the Obama-Biden plan, Americans will be able to maintain their current coverage, have access to new affordable options, and see the quality of their health care improve and their costs go down. The Obama-Biden plan provides new affordable health insurance options by: (1) guaranteeing eligibility for all health insurance plans; (2) creating a National Health Insurance Exchange to help Americans and businesses purchase private health insurance; (3) providing new tax credits to families who can’t afford health insurance and to small businesses with a new Small Business Health Tax Credit; (4) requiring all large employers to contribute towards health coverage for their employees or towards the cost of the public plan; (5) requiring all children have health care coverage; (5) expanding eligibility for the Medicaid and SCHIP programs; and (6) allowing flexibility for state health reform plans.

The plan also allows importation of drugs from foreign countries and allows Medicare to negotiate for prescription drug prices. Obama has said they will first focus on getting all children insured.

- Larry Weisenthal/Huntington Beach, CA

So how about some real straight talk for a change? If we separate those who can’t get coverage from those who can, we can focus more on helping the needy. “So if you can get coverage,” says Gillespie, “don’t wait for Washington. Go on out and get some.”

Don’t want to miss out on a (perhaps rare) opportunity for agreement. Agree on the above point, entirely. The only thing that I’d add is that people who can afford insurance and don’t buy it aren’t guilty of a victimless “crime.” They add huge costs on those of us who are responsible. Hence the need for a mandate, in my opinion, similar to the mandate that car insurance must be obtained in order to license a car.

- Larry W/HB

Nick Gillespie isn’t making a run for the White House, but he knows how to get coverage to at least half of the 45 million Americans who need it. And while Barack Obama and John McCain argue about who’s got the best health care plan, each ignores the simplest solution. Call it the Gillespie Plan: If you want health insurance, get some.

“Of people currently classified as uninsured, a conservative estimate says about 45 percent of them would be able to get health insurance right now if they wanted it,” says economist Glen Whitman. That estimate comes from a study headed by a Johns Hopkins University researcher, which separates those who could get insurance into one of two categories: Those who earn enough money to buy it, and those who qualify for existing government programs.

So how about some real straight talk for a change? If we separate those who can’t get coverage from those who can, we can focus more on helping the needy. “So if you can get coverage,” says Gillespie, “don’t wait for Washington. Go on out and get some.”

Previously linked in my comment #20:

HOW TO FIX AMERICA’S HEALTH INSURANCE CRISIS: GET SOME

SWEDISH MYTHS AND REALITIES
Johan Norberg discusses the “Scandinavian model”
http://www.reason.tv/video/show/508.html

[Mata Note: This one was battling the "embed" code, Craig. Tried a few times but their embed code results in nothing here. But gave it the ol' rah rah effort. Sorry.]

I don’t know where you got your idea of Obama’s plan. But this is not his plan at all. His plan is STRICLY a socialize universal Health care system. And there is nothing, NOTHING good in it.

Like I said Americans have a real good Health care system, why ruin it? It would take just a few things to make it perfect:

1- Make it compulsory for all Americans that have revenue over an amount of XXX dollars to get a private health care insurance. By compulsory, I mean that if they don’t do it, they will not be able to get free treatments that will be reserved only for the ones who can not REALLY afford it.

2- Go with the McCain’s plan and let people have a tax cut of 5,000$ to be able to purchase an insurance plan.

3- Again, go with the McCain plan and make a new law that will enable people to shop for their insurance plan in every States of the USA to get a better price with that competition.

4- Every Americans that REALLY cannot afford insurance plan because their revenues are lower than XXX dollars; will automatically be treated free by the government.

That is much better than Socialist Universal care system. You are assured by this way of doing, that the free plan for the poor will never get crowed with waiting lists. The Sweden Plan, I don’t like. Sweden citizen have a tendency just like Canadians to brag about their system, but in reality, both stinks. In Canada, everybody is on waiting list. In Sweden, only the poor are on waiting lists. With the system that I propose for the U.S., nobody will be on waiting lists.

Here’s a list of the top 50 companies:

http://en.wikipedia.org/wiki/List_of_pharmaceutical_companies

Note that Genentech (#19) nominally based in the USA (South San Francisco) is, in fact, owned by Hoffman-LaRoche (”Roche”), based in Europe.

Additionally, countries nominally based in the USA may do their clinical trials abroad and companies based abroad may do their clinical trials in the USA.

So I don’t know how “protectionism” regarding pharmaceutical companies would ever work, from the standpoint of “protecting” US jobs. When one pharma buys another, typically there is consolidation of management, but they don’t typically pack up research labs, marketing departments, etc. and move them out of one country to another. And the vast network of sales reps (biggest part of the budget, remember, is sales and marketing) has to be maintained within the US health care system, no matter where corporate offices are located.

- Larry Weisenthal/Huntington Beach, CA

I haven’t seen anything in Obama’s health plan proposals which would destroy the existing private health care system.

I agree, but then Obama is considering change this to a universal health care system. So I suspect that’s a premature assumption when relating to an existing system dominated by the private/free market.

But my question is INRE prescriptions drugs specifically. Obama proposes reducing costs by importation of drugs from out of country… i.e. what so many want to call outsourcing.

In one way, this provides needed competition for US based pharmas. On the other hand, how do you think this outsourcing affect the US based pharma business… i.e. job layouts, profit losses, etc.

So this is going to be the first health care priority: ensuring health care insurance, of some type, for children. The next priority will be an employer mandate. Somehow, between the employer and the employee, health insurance must be provided to everyone. That leaves, basically, the unemployed and the self-employed and employees of very small businesses. The self employed will get tax credits or expanded deductions; people who truly can’t afford it will get government purchased insurance.

All in all, it’s a much less “socialized” health care system than that existing in all the other western democracies.

This isn’t my ideal system, however. As I said, I do like elements of the Bush and McCain plans. I particulary like the concept of high deductible private insurance, with tax deductible health savings accounts. Making people personally responsible for the first 5,000 or 10,000 or (as in my case) 20,000 of health care costs actually does turn patients into consumers, with incentive to save on costs, not receive unnecessary MRIs, etc.

- Larry Weisenthal/Huntington Beach, CA

I don’t get it here. Obama wants a socialize Universal Health plan medicine… and of course it will be compulsory. What you like is exactly what I hate, the compulsory factor who gives you no other choices than to wait in line for medical attention. You are being taken care of. You have no more freedom and responsibilities for yourself.

“We have so many uninsured because people too often make irresponsible choices in the way they spend money. Entertainment (cable TV, etc.) and nice automobiles are too often prioritized over health insurance.” (Larry)

Here I agree 100% with you. Those idiots are brainless and ruin the medicals finances of your country. Americans sure can afford private Health insurance, they just have to cut a few beers, a few joints, a cellular phone and they will all be able to get insurances. Let them be responsible for a change. Irresponsibility is no virtue and doesn’t make a strong country. (see the video link in my comments #20)

“The Canadian system sucks, because it is a monopoly, which allows no competition.” (Larry)

Right on the dot! And it sucks also because everybody becomes irresponsible for their health. Why take care of it, government will pay for you if you are sick. So be happy, don’t worry, eat like pigs, drink like idiots, and get stone… no problems.

(In Sweden) “Everyone can access the public system. For those wanting private health care, they can purchase insurance and obtain private health care from a co-existing private system.” (Larry)

You have this system reversed in the States and I think it is a much better system. Almost every Americans can get private health care insurances, and for the ones who REALLY cannot afford it, the government takes care of them. You almost have the perfect system in the States, why ruin it? Make it compulsory for the idiots who can afford to get Health insurances. Go by their revenues… make it compulsory and make sure that they don’t get the free treatments reserved to the ones that cannot REALLY afford it. Then you will have the best system in the world. (Again watch the videos in my comments #20 and why not also in #9 and #25)

“I think a terrific reform would be allowing Medicare to negotiate drug prices, as in the case of the Canadian government being able to negotiate drug prices. Also, allow for the free importation of pharmaceuticals from Canada, Europe, Asia. ” (Larry)

I agree again 100%. Protectionism is an alienation for a country.

P.S.: I think that a Providence Government is the worst things that can happen to humans. It deprives them of their pride, their dignity and their responsabilities. A socialist country that takes care of the health of its people is only alienating people’s mind. Stand strong, be responsible and you will have a Great Country. Why do you think America is so great? This is why America is NUMBER ONE. But Obama will take all this away with his stupid obsession of socialism. By the way, watch my video link in comment #33… a funny but realistic conversation between a liberal Congressman and conservative Prime Minister on issues of Health, education and environment. It is really good.

I’d like to offer my perspective as both a provider and consumer of medical services, as well as one who has medical colleagues/good friends in Sweden and who has visited Swedish hospitals.

Where to begin?

The problem with turning medicine into a capitalistic market commodity is that, at the basic level of life versus death, the laws of supply and demand are no longer in operation. The demand increases exponentially. The number one cause of bankruptcy is health care expenses. People will bankrupt themselves and their families in search of health; they don’t generally do this in search of consumer electronics or entertainment or transportation.

It is true that Americans have greater access to health care than Canadians. But this isn’t an unqualified blessing. More health care isn’t always better. Boston has as many neurosurgeons as in all of England. With more neurosurgeons, there is more neurosurgery. Supply creates demand. There are literally scores of equally efficacious drug regimens for the treatment of breast, lung, colon, and ovarian cancers. Studies show that the choice of drug regimen is strongly correlated with the profit to the oncologist. Survivals for diseases like prostate cancer between countries is misleading. There is much more screening for prostate cancer in the USA. More urologists who wish to do prostatectomies in the USA, in a disease in which the effectiveness of prostatectomy is still questionable. So earlier diagnosis means longer survival from time of diagnosis, but it’s not clear that overall survivals are better, to say nothing of quality of life.

It’s been estimated that iatrogenic deaths (those caused by medical errors and mismanagement) in the USA total between 75,000 and 150,000. These medical errors are estimated to shorten life expectancy by between 6 to 12 months. In comparison, a total cure for all cancer would only increase life expectancy by 24 months.

http://ije.oxfordjournals.org/cgi/content/full/30/6/1260

Supply creates demand. Here’s another example: In the 1970s, the number one money making operation for general surgeons was the vagotomy (cutting of the vagus nerve, to reduce acid secretion) and antrectomy (partial stomach resection), for the treatment of ulcer disease. By the late 1970s, the first billion dollar drug emerged (Tagamet, for the reduction of stomach acidity in ulcer disease). Gastroenterologists made a fortune in performing gastroscopies to follow the course of ulcer treatment.

In the 1980s, an Australian pathologist proved that ulcers were not caused by too much acid but were instead caused by a bacterium (H pylori). The treatment switched from antacids and Tagamet and surgery to a two week course of antibiotics, which permanently cured most cases. The problem was, however, the pharmaceutical industry had developed a new class of anti-acid drugs (so-called “proton pump inhibitors, e.g. Prilosec/omeprazole) to treat ulcer disease. But now the disease (ulcer disease) had gone away. What to do? Hype a previously obscure disorder (gastroesophageal reflux disease or GERD) and promote the new “proton pump inhibitors” for treatment of this disease. Funny (actually, not so) thing has happened. We are now facing an epidemic of gastroesophageal cancer. Is this because of overuse of drugs like Prilosec? We don’t know. Stay tuned. But it does illustrate the point that more treatment is not always better, for drugs or for surgery.

American health care is much more expensive than health care anywhere else and there is no evidence at all that overall health care outcomes are better in the USA than in Europe, Canada, Japan, South Korea, etc. Health care causes numerous bankruptcies in the USA, but not elsewhere. So health care reform is a legitimate issue.

I actually favor a hybrid of the health care plans of Bush, McCain, and Obama. I personally pay $12,000 per year out of pocket for health insurance which has a $20,000 annual deductible, but which pays for 100% of everything beyond $20,000. I don’t need health insurance to pay for a few thousand dollars per year in medical expenses, anymore than I need auto repair insurance to pay for the odd catastrophic transmission failure. Were I to get a catastrophic illness or injury, that $20,000 deductible would be a major hit, but I won’t go bankrupt. I’d love to get a little government help paying my insurance premiums. I’d bank the savings (ideally in a tax deductible health savings account) as a reserve fund to pay that first $20,000 when I finally have my catastrophic medical problem.

What I like about the Obama plan (and Massachussetts plan) is the compulsory nature of health insurance. We have so many uninsured because people too often make irresponsible choices in the way they spend money. Entertainment (cable TV, etc.) and nice automobiles are too often prioritized over health insurance. People without health insurance are like people without car insurance. They make health care more expensive for everyone. So the idea of no health insurance/no work makes as much sense as no car insurance/no car license.

Closing now with pharmaceuticals.

I disagree with the notion that it is government regulation which is the cause of out of control drug prices. The problem is not too much consumer protection, but too little. I could give many examples, but won’t, unless asked to do so. Yes, drug development is expensive and drug development takes a very long time. But the pharmaceutical industry is wildly profitable. So profitable that it can afford to throw away billions of dollars on television advertising, with little data to show that this has any effect on driving sales. Multiples of money on marketing and sales, compared to R&D. Anyone remember reading about the need for a government bail out plan for the pharmaceutical industry? What industry is most “recession proof?” Answer, Big Pharma.

Again, the problem with creating a true market economy for drugs is that there is an unlimited demand for products which improve health and which save lives, as compared to any other consumer commodity.

I think a terrific reform would be allowing Medicare to negotiate drug prices, as in the case of the Canadian government being able to negotiate drug prices. Also, allow for the free importation of pharmaceuticals from Canada, Europe, Asia. As I wrote before, the net effect would be a reduction in the price to Americans and an increase in the price to the rest of the world (which is a good thing, because right now we Americans are pretty much single handedly bearing the cost of global drug development. And, again, much of the international pharmaceutical industry is based overseas, e.g. Roche, Astra-Zeneca, Novartis, Bayer, etc.).

One last thing about health care systems. The Canadian system sucks, because it is a monopoly, which allows no competition. It would be like outlawing private schools and colleges in the USA. In contrast, in countries like Sweden and Norway and Australia, there are parallel public and private systems. Everyone can access the public system. For those wanting private health care, they can purchase insurance and obtain private health care from a co-existing private system.

- Larry Weisenthal/Huntington Beach, CA

After reading the article that you have linked in your last comment, it reminded me of a video I had once seen before. I looked for it and I found it.

Do you want to watch a very funny discussion between a Congress leftist democrat and a conservative President on Education, Health and Environment?

PRIME MINISTER – THE NATIONAL EDUCATION SERVICE
http://www.youtube.com/watch?v=LLDb2V86Ei0&eurl=http://www.antagoniste.net/?m=200808&paged=2

Welcome, comrades, to the “new” USSR — the United States Socialist Republic. That’s the direction leftist President-elect “Robin Hood” Obama will nudge us in over the next four years.

Consider all his socialist campaign rhetoric about redistributing income and raising taxes. Will his threshold fornew taxes be$250,000, $200,000, $150,000 or even $120,000? We’ll see.When, pray tell, did higher taxes ever create more jobsand lure the unemployed back to work?

I’ve lived and worked for 35years in socialist Sweden, long the highest-taxed nation in the West. So, I have a fair idea what socialism can and can’t do for you and me.

Sweden provides universal government-backed health care — it isn’t even an option; it’s compulsory. That sounds comforting — until the day you might need access to that “free” care. The current waiting time for hip replacement surgery in Stockholm, the Swedish capital, is 16 months. It’s “only” 13 months to see an urologist.

How about 18 months for transplant surgery? A little less is the norm for heart-bypasses. That was no consolation to one of my former bosses. Despite a long history of heart trouble, he was sent home from the hospital to wait his turn for bypass surgery. He died waiting.

Another patient, in her late 70s, was the victim of Swedish selective surgery. She was simply told by her doctor she was too old for surgery. She was juggling blood-thinners, instead, when she died. Government-employed doctors were playing God.

continue reading at link above