Walt,
Thank you for the explanation of what universal healthcare really
comprises.  Too many times it has that dreaded "socialiazed" tag
attached to it in error.
Most of us who struggle to pay for health insurance and then are not
covered for necessities understand that changes must be made.  Those of
us without health coverage who fall through the cracks of having too
much to qualify for entitlement programs but not enough to pay high
premiums, are going without health care and will cost the government
more in the end.
Ann.

Thanks Walt,,,,  Well done.   Of what you have outlined,,,, does any party
have this in there plan?    Does anybody back univ. healthcare?

Harv

Hillary Clinton has a very well thought out universal health care
plan.  I don't think anyone else except John Edwards has really
brought a plan to the table.  Please correct me if I'm wrong.

Walt thanks for as usual bringing clarity to this issue

m

nice job of encapsulating a very important issue, walt!

i would add to your second point - or the working poor have employers who
provide very inadequate medical benefits (causing the working poor to avoid
medical care, because they cannot afford the co-pays, the ceilings, meds.,
etc.).

kate

I am starting a new thread under a new name because of the flame war that is
going on.  I just want to make a few points.

Point 1: Universal Healthcare does not equal socialized medicine.  Emotional
trigger words that have no real meaning do nothing to help build consensus
on what is a very real problem.  There are numerous models for universal
access to care.  Many do not involve taxpayer dollars.

For example, Hawaii has a very successful plan where uninsured individuals
and families are allowed to buy into the state Medicaid plan.  The premium
is on a sliding scale based on income.  They have been able to provide
universal access without significant tax spending.  Oregon has a similar
plan that has been far less successful because of the limitations that were
imposed.  In addition to state-wide plans, several county governments have
developed similar plans, with varying degrees of success.

Point 2: The self-employed are not a major part of the problem.  Having to
pay the full cost of your health insurance is part of the cost-benefit
analysis that should be done before venturing into your own business.
Rather, the majority of the uninsured are working poor.  They have employers
who do not provide benefits.  This is where the dialogue needs to be
focused.

Some of these employers are small companies that really can't afford to
provide coverage.  But many of the employers are large companies, like
Wal-Mart, that control their costs by employing large numbers of part-time
employees who they can legally deny access to benefits.  Some states are
addressing this by requiring companies to allow part-time employees to buy
into the company plan at full cost.  Other states are redefining "part time"
to require greater employee participation.  None of these efforts has been
particularly successful.

Point 3: Single-payer plans (what most people think about when they hear the
"S" word) do not have to be based on Federal involvement.  They don't even
have to involve government agencies at all.  There are many plans for
locally (county and large city) based single-payer plans utilizing
for-profit administrators, regulated much like a utility is regulated.  They
are, in essence, an attempt to redefine what "group" means in group
coverage.

Point 4: Rationing will always be a part of the health care equation.
Economically it simply has to be.  For me the real question is, do I want
those rationing decisions being made at the local level or at the national
level?  And, what input should the consumer have in those policy decisions.
Finally, what role does the public have in controlling the profit motive of
private healthcare companies?

Finally, none of this addresses the second healthcare crisis we are
experiencing - the death of primary care.  Every year the number of
physicians practicing primary care goes down, while demand goes up.  Home
care is already in crisis.  Very few physicians can afford the pitiful
amounts that they are paid for providing home care.  It is impossible to
make a decent living - and I'm not talking multiple six figures here.  I'm
talking about a living wage.  The number of physicians providing home care
has dropped 50% in the last 5 years.  All areas of primary care, except
pediatrics, are experiencing declines.

Anyway, let's see if we can have a rational discussion on these issues and
leave the name calling out of it.

Walt

As usual, Walt, you bring a reasoned voice to the discussion, but I have to
say more about the situation for the self-employed.  The numbers of uninsured
self-employed persons are skewed by the fact that many are technically
insured but have very rudimentary insurance and often pay considerably more
than the total premium for a superior group policy.

We worked the art show circuit over a decade and this was a common discussion
during slow parts of the show.  Everyone I spoke with would have been happy
to pay the total premium of many group policies if they would have received
comparable benefits for that.  When I finally quit at the hopsital and we
were on COBRA for a year, paying the full premiium, people positively drooled
at the insurance we were getting for the cost.

Meanwhile, we know the current full premium for our insurance is app. $1100
monthly for self & spouse.  It's a pretty good policy, with a $500 deductible
and standard co-pays beyond that.  My self-employed brother pays more than
twice that for the most reasonable policy he could find - one with a $10,000
deductible (yes, that is ten thousand dollars).  Oh, and that is also a self
& spouse policy - and he did epic amounts of research trying to find
something with better coverage, even at the same rate.  He'd be delighted to
pay our full premium to get our coverage.

ACCESS to *reasonable* insurance policies, even at the full premium of most
group policies remains a HUGE issue for the self-employed.  And I kno many
people who could not pursue self-employment full time because of the access
issue, not because they were unwilling to pay the full premium.  We have some
artists as family friends now who struggle daily with tryng to find health
insurance they can buy into.  I've known a couple of people who stayed
legally married but living apart simply so one could stay on the other's
insurance while pursuing self-employment.

COBRA in the 90s was a huge improvement and a big step forward, but there are
major holes in the system even for that.  Insurance companies can still
dictate exclusions in your conversion policy that did not exist in the
original.  Also, student policies are exempt from COBRA, so you need to get a
job with coverage FAST after graduation, or hope you don't get sick.  I've
dealt with both of these issues in recent years.

I honestly am willing to pay more for my health insurance if it would allow
others to get the same insurance for the same price. This country need to
find a way to provide equal access to equal insurance for equal premiums for
the people who are working to pay for the policies.  And we need to find a
way to provide at least basic coverage, including primary care to cut down on
inappropriate hospital visits, to ALL citizens.

-=> Quoting Kellcobb@hotmail.comspamt to All <=-

Judy Bay wrote:

Because that's what it cost the drug manufacturer.

And Kelly Cobb replied to Judy:

Only last week the same shot was being proposed for boys.  <g>

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Joe postulated:

And Judy Bay asked:

How does that relate to boys getting the shot?

... Straighten up the house? When did it become tilted?
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Carole wrote and quite properly complained:

First, I'm going to ask from whom you received the bill, and
does he accept assignment.

Second, I'm going to ask if you are paying Part B premiums.

Then I'll cut-and-paste from the Social Security Administration's
Medicare site about payments for shots.

(I had to plug in the name of a state, and got the same data
for both Washington and California.  Since Medicare is not a
state-operated program like Medicade, I can't imagine why that
step was required.)

*The Medicare coverage information matching your selection criteria
is shown below.*

Pneumococcal Pneumonia Shot

*Coverage under Medicare*
Medicare currently provides coverage for flu, pneumonia, and
hepatitis vaccinations. Other types of vaccinations and
immunizations are typically not covered by Medicare.

*Flu Shots:* Medicare covers one flu shot per flu season. You can
get a flu shot in the winter and the fall flu season of the same
calendar year. All people with Medicare are covered. The flu is a
serious illness that can lead to pneumonia. It can be dangerous for
people age 50 and older. You need a flu shot each year because flu
viruses are always changing. The shot is updated each year for the
most current flu viruses. Also, the flu shot only helps protect you
from the flu for about one year. There is a chance that you may
still get the flu, but your symptoms will be less severe.

*Pneumoccal Pneumonia Shot:* Medicare covers all people with Medicare
for the Pneumococcal Pneumonia Shot (vaccine). One shot may be all
you ever need, but you should discuss this with your doctor.

*Hepatitis B Shot:*  (We're not concerned with this)

*The amount you need to pay*
You pay $0 for a flu shot if the doctor or health care provider
accepts assignment.
You pay $0 for pneumococcal pneumonia shots if your doctor or
health care provider accepts assignment.

You pay 100% for all other immunizations and vaccinations.

100% of the Medicare-allowed amount is paid.
The Part B deductible and coinsurance do not apply.
Assignment is required.

For more information, you may call 1-800-MEDICARE (1-800-633-4227).

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And Carole replied to that:

This is what Uncle Sam says about the pneumonia shot:

*The Medicare coverage information matching your selection
criteria is shown below.*

*Pneumoccal Pneumonia Shot:* Medicare covers all people with
Medicare for the Pneumococcal Pneumonia Shot (vaccine). One
shot may be all you ever need, but you should discuss this
with your doctor.

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