The Soviet Union has been dead a while now, how long did the Republicans really think 'socialism' was going to remain scary?

How about "civil service medicine" or "public service medicine" versus "socialized medicine", as they don't call police & fire-fighters "socialized first responders".

Beware communist liberal fascist medicine!

That's the first thing I thought of when I saw that story -- these people have no idea what "socialized medicine" even means!' I'll bet a good 39% of them would be opposed to "socialized fire protection" until you explained the details to them.

This poll is even less meaningful than polls in which people are asked explicitly whether they support or oppose universal health care funded by the government. Almost always, a majority or plurality say that they support it. But every time a real-world proposal of this kind is subjected to the political process, it fails. The devil is in the details.

What matters is not what people tell pollsters they want in the abstract, but what they're willing to support in the real world. And they've never yet been willing to support socialized medicine.

The term "socialized medicine" is not really a term of art with a fixed, generally accepted definition. It is generally a term used disparagingly about whatever form of health-care funding and/or delivery is currently up for disparagement. As such, to say that Medicare "isn't" socialized medicine is sort of nonsense. It's socially funded medicine, which certainly qualifies in the lexicon of some people who throw the term "socialized medicine" around, although they rarely characterize the actual Medicare program that way because it's so popular.

Is it not already true that Government already pays most of healthcare cost?

Ezra,
If there is so much public support for Medicare-for-All (a.k.a., "socialized medicine)...

...why do you and Paul Krugman and Dean Baker hold so fiercely to the dictum that universal health insurance is politically possible only if based on private insurance -- that special interests will surely kill the bill otherwise? :-0

I've been following politics closely since 1961 and I cannot see any reason in the world why a universally popular medical program for the aged who are most vulnerable and in need of much care should be anything but the easiest thing in the world to sell as good for the young and strong also.

EVERYBODY understands what Medicare is. EVERYBODY can't wait to get it. Just tell them they wont have to wait until they are 65 anymore. :-)

Having read the "10 myths of Canadian health care" article, my NUMBER ONE reason for supporting single-payer health care is now:
"One unsurprising side effect of [not struggling with 100 insurers] is that the doctors [in Canada are] more up-to-date in their specialties."

In any doctor level profession -- maybe even with bloggers -- you can spend half your life keeping up with what's new. American doctors dealing with 100 sets of rules and fighting 100 sets of care deniers, cannot keep up with their specialties they way they really want to...
...what can you, mandate supporters, ever say again in favor of your position -- except maybe craven fear of insurance company lobbying? Just add the specter under training (!) to over charging brought about by (100+) private insurance outlets and the plea for single payer (Medicare for All) simply becomes unbeatable.

Don't see what is so encouraging about this poll. Looks to me that there is just a lot of confusion about what is "socialized medicine." Socialized medicine very much involves the government telling doctors how to practice medicine. Once free-market groups start educating people about that, plus other wonderful aspects about socialized medicine like waiting lists and canceled surgeries, the dream of so-called "universal health care" will be a lot harder to achieve.

That poll is good news overall. For some of the more radical who wanted to see a true socialized medical system, with the doctors and other providers all being actual salaried employees of the State (same as U.K.'s NHS and our own DoD and VAMC), single-payer was already the compromise!

Regardless of polling, Single-payer is not socialized medicine or health care. Yes, taxes take care of paying for access to services up front (everybody in, nobody out), but there is still full competition on the service delivery side. Private independent doctors, clinics, HMOs (in the original sense of the word), Hospitals, etc. all truly competing to attract patients.

Word should mean something.

http://www.pnhp.org

This is precisely why the Wydon-Bennett bill constitutes BAD REFORM for the Dems to rally around, especially progressive Dems fer chrissake!!! (the Wyden-Bennett bill has one huge and fatal characteristic, summarized in Ezra's words from TAP online: "The plan, to be sure, lacks some liberal priorities, notably a public insurance option.").

So how many co-sponsors does the Wyden-Bennett bill have?

Moving along to reform that's actually worth fighting for, John Conyer's bill HR 676 has close to 100 co-sponsors.

HR 676 would create a socialized national insurance program so that all Americans and residents would have quality affordable healthcare coverage, and lasting health security. It continues the current private delivery system but with one payor there could be much more effective oversight, QA standards,public health planning and programs, all of which are sorely needed.

And the Hacker plan (aka "Health Care For America" that is being supported by our friends over at www.OurFuture dot org) moves squarely in the direction of the Conyer's bill.

Both the Obama and Clinton plans, if passed as designed, would put us on track to move toward the Conyer's bill which is arguably the most cost effective approach of all - a national social insurance program -and an approach that might just be "politically feasible" after all. Is Hacker a stepping stone to Conyers? I dunno.

Huge grassroots movement-building is gonna be key for a health reform bill of any significance to pass, so remind me again, who's getting excited about the Wyden-Bennett bill? ...

Friday, February 8, 2008

Universal health care a moral, fiscal priority

By Ron du Bois
Opinion Columnist
British philosopher Bertrand Russell wrote, “Mankind has become so much one family that we cannot ensure our own prosperity except by ensuring that of everyone else.”

Part of ensuring that prosperity is through universal health care. The current system is ineffective.

Virtually every state in the nation with the exception of Oklahoma has a chapter of Physicians for a National Health Program.

Why is this?

The attitude of many Oklahoma doctors towards universal health care as it is practiced in every industrialized nation with the sole exception of the U.S. is identical to those of Canadian doctors 40 years ago.

After laws were passed mandating universal health care in Saskachewan, most Canadian doctors refused to obey those laws.

They were intractably opposed to a single payer system that covered everyone regardless of ability to pay.

There is little doubt this scenario will be replayed before the dinosaur mentality of today’s American doctors change, private medical insurance companies no longer exist, and universal health care becomes law in this nation.

Doctors, like the general public, refuse to think of health care in the same way they think about public education, fire protection, road construction, postal service, civil service, legislative, all levels of law enforcement, and all branches of the military (all with health insurance paid for through public taxation).

Health care of incarcerated persons and veterans are paid for through public taxation. So many people with subsidized health plans translates to 60 percent of Americans, yet few realize they are already well on their way to universal health care.

Canadian doctors 36 years ago (like most U.S. doctors today) held the notion that for-profit medical care was essential to the “best health care in the world.”

Like Canadian doctors decades ago, many U.S. doctors claim to have the “best health care in the world.”

Invariably they fail to add the phrase, “if you can afford it.”

They fail to see that 47 million Americans can not afford health insurance.

They fail to see that an equal number of millions are underinsured, a condition that is almost as bad and can spell stress and bankruptcy.

Unintended consequences have resulted in huge emergency room expenses at public expense.

Emergency care is the only guaranteed medical care in the U.S.

It is the most expensive and also the most punitive. Unlike other nations, the U.S. fails to understand that “an ounce of prevention is worth a pound of cure,” a failure that guarantees excessive cost. Inability to pay medical bills is now the leading cause of bankruptcy, and is a detriment to the health of the nation.

With regard to the number of Americans who have no medical insurance of any kind, Frosty Troy, editor of the Oklahoma Observer, writes in the November 2006 issue, “Thankful? For more than 46 million medically uninsured, up six million since Bush began his second term. Virtually every nation in the world has a national health care program — but not America. Yet we spend three times more on medical care.”

U.S. Representative Pete Stark D-California said, “For the richest country in the world not to have universal health care is a crime.”

He continued, “Couldn’t we just join the rest of the world.”

There is a growing conviction that it’s not acceptable “that people who are poor should die because they’re poor.”

Universal health care advocates are not willing to be grateful for what they have while others go without. They believe the attitude of “I’ve got mine, you get yours” is neither ethical or moral.

Advocates for health care reform think the attitude towards those 46 million without health insurance to “just suck it up and be grateful for what you have “, is not ethical or moral.

A Canadian legislator summed it up succinctly when he looked me in the eye and said, “For profit health care is immoral.” Dr. Patel, my Canadian doctor in Gimli, Manitoba, said, “I make plenty of money. .. I don’t have to lock my doors at night and I don’t have to worry about patients paying their bills”.

He added, “American health care is a money making machine.”

This story was published February 8th, 2008 under Opinion.

"Some new that the Veteran's Health Administration is."

I think you mean "knew," Yglesias

Denis Drew,

When universal, single-payer health care was put to a popular vote in Oregon and California, voters rejected it by a 3-to-1 margin.

If single-payer health care fails so miserably in two of the bluest states in the country, your chances of getting it at the national level are pretty close to zero.

Medicare is already a fiscal train wreck in progress. We're not even paying for its existing spending commitments. Extending it to everyone would bankrupt the government.

Extending it to everyone would bankrupt the government.
Posted by: Jason | February 15, 2008 2:08 PM

The government, bankrupt? No! Say it isn't so!
The government is running on maxed out credit cards and bonds owned by Chinese and Arabian gazillionaires, and this has been a totally acceptable circumstance for right wing "free-marketers" for a very long time now. We spend a quarter of a million dollars every minute for the military occupation of Iraq. It is the goal of the right wing to bankrupt the country. Please, don't make me laugh with the "we'll bankrupt the government" cry.

Medicare currently covers those most likely to use the system, what happens when all those 20-somethings who never even go to the doctor are also paying in at an appropriate level? Then add in the fact that we don't have to pay the 6% profit (or whatever it really is) and we only have to pay one Nate rather than dozens, and we don't have to pay a dozen multimillionaire CEOs and their golden parachutes and it seems hard to believe that the average American is going to be worse off. If we also relax the the costs of med schools (why not a little competition here?) and increase the benefits of going into nursing (hey, how about a tax cut for nurses...lower taxes yeah!) and I imagine the system would get along just fine.

Oh and if we end the war in Iraq we might actually not go bankrupt!

I'm putting this comment up not to engage w/Jason per se, but to fill in a hugely important missing piece:

IT'S ALL ABOUT THE AD MONEY

re: "When universal, single-payer health care was put to a popular vote in Oregon and California, voters rejected it by a 3-to-1 margin."

Take a look at the state's OCPF data on campaign spending by the Yes and the No sides in those single payer financing ballot questions and that's your way to more thoroughly/accurately understand the vote results - generating fear and uncertainty by pushing out in slick packaging with ads during every nightly newscast is quite effective in moving people away from voting their own best interests and common sense (look at what CheneyBush have gotten away with by using it, for god's sake).

MONEY buys access to the public microphone and corporate hc can ALWAYS buy the bigger microhone (as my activist friend Don B out in San Fran likes to say). Fear-mongering and lies are a powerful tool to confuse and sway voters - corporate hc has no problem using those tactics against us.

This is precisely why movement building with saavy semantics is vital to our being able to win far-reaching reform (so please don't say "single payer" to the average person, use "improved Medicare-for-all" - it really works well to describe what we're working toward without setting off false alarm bells of fear and uncertainty).

We're gonna have to be organizing on a massive national scale to innoculate the public against the fear-mongering that's sure to come, and we've got to toss some aggressive tactics toward the opposition, to FINALLY put them on the defensive which is where HMOs, insurers, and drug co's belong.

I encourage everybody who wants a humane and affordable US health care system to check out www dot herndonalliance dot org , especially if you're curious about the semantics and messaging dimension of health reform.

Universal health care for Americans only is no more moral that what we have now. The only reason to go with socialized medicine is to save money. Socialized medicine would be like ending an arms race we agree that we will all cut back on care, much of which is ineffective.

If you are motivated by altruism, you can get much more morality per buck sending your medical dollars to poor countries.

BTW If we the people of the USA could all agree we could set the medical spending level at 5% of GDP or even lower. IMO the effects on health would be small and so it would be a worth while thing.

Wrong Jason; precisely right on saleability Ann,

3-1 against was after insurance companies spent a zillion dollars lying about single-payer. But, the ground is already shifting as of last August: 12% had already moved in the right direction:
http://www.onecarenow.org/press/pressfp.htm

What is beautiful about Medicare for All is there is no way to lie about it. Medicare is what everyone salivates in anticipation of in their 64the year (I know; I'm in my 63 11/12ths year). Why should they be afraid of when they are young and strong something they know they will love when they are old and not so strong.

We know what Medicare is; we know what it does; we know what it costs -- works like a Swiss clock for my 85 year old mother. How are the insurance companies going to kid me?

Why not just repackage it as "national security" -- we need to be healthy or the terrorists will win.

Too late for me... no matter who wins in November, I can't wait that long to get medical coverage, so am moving to Mexico next month.

Denis--while I really like the idea of a single payer system in theory, I can't imagine that a sudden switch to a single payer system could ever be feasible. Private insurance is an enormous business--employing millions of jobs and generating billions of dollars of revenue per year--and the costs of nationalizing that--putting people out of work and devastating any shareholders in these companies--would be enormous, and enormously unpopular. (In my opinion, the costs would outweigh the benefits, though admittedly, I haven't looked closely enough at a single payer concept to be firm in this latter opinion.)

My point is though that while single payer would have been the way to go sixty years ago, the best reform you could hope for right now would involve public-private competition that allowed the potential for a single payer system to evolve over time.

Let's see: Medicare is growing at about 7% per year, on average, which is higher than inflation and wages. Medicare is already on an unsustainable path, and folks on this thread are proposing putting everyone in it.

Also, while Medicare works well for seniors, it does so because it has a private sector to keep it afloat. Medicare is less popular with providers because it often reimburses below cost. To make up the difference, providers often charge more to private insurance--hence the term "cost shifting." What would happen when Medicare becomes the dominant if not only payer in the health care system? For one, less talented people will go into medicine because of the less than optimal pay. Second, in order to receive more payments, doctors and other providers will have to see even more patients, which means even less time spent per patient. And with more patient visits, you'll see costs increase.

Thus, the dream of providing quality, affordable health care through "Medicare for All" is just that--a dream.

Ann Malone,

The left always rationalizes its failure to persuade ordinary people to support its grand social welfare projects as a mere sales problem. Well, keep believing that if you like--and keep failing.

Also, while Medicare works well for seniors, it does so because it has a private sector to keep it afloat.

Actually, wd, you could more effectively argue that the exact inverse in true - the private healthcare business stays afloat because it is heavily subsidized by the government.
Maybe this is news to you, but there are vast regions of the US where hospitals and doctor offices would not even exist were it not for government funding and government paid benefits. Hospitals in economically burned out mill towns across the South aren't booming, they are barely hanging on and they bend over backwards to keep that Medicare status on top. The doctors that have set up shop in those towns do the same. Without that funding they would have a trickle of the money they need to function at all.

Brad,
I'm have no idea how many people the insurance industry employs, but I doubt it is anything like millions (you may be thinking of the medical profession proper). The insurance industry is basically a bunch of insurance salespersons and their bosses I suspect. Anyway, a lot of people would opt to keep their current employer-based coverage under all proposals I have seen (don't want to scare off any voters) so the change would not be all at once.

Denis--without getting into too much detail, insurance companies are large organizations that have to employ lots of accountants, actuaries, underwriters, claims people, sales, customer support, marketers, bean counters and then, of course, all the general folk anyone employs (janitors, HR people, computer people, etc., etc., etc.) You also have a lot of collateral employment--for example, hospitals and doctor's offices have additional adminstrative staff dealing with billing codes. Local insurance agents not only have employees, but they rent office space, etc. Health spending totals 2.1 trillion dollars in the U.S., about half of which is private. That much money doesn't fly around by itself.

In any case, I think our point of disagreement is mostly academic. No major proposals actually suggest a sudden shift to single payer--you claim this is because it would scare voters, I think it's because a sudden shift would be a genuinely bad idea. Either way, it's not happening.

ChowChowChow, not just hospitals, but private insurers in particular benefit from Medicare. In effect, private insurers insure people until they hit 65, when people, as a general rule, are becoming increasingly likely to get sick or need medical treatment, at which point the government picks up the tab. It's a very nice deal for insurance companies, though not so good for taxpayers.

To quote, "Medicare works like a swiss clock."

Yeah a clock that's right twice a day. It is increasingly hard to find physicians that even take medicare. I had to call in a favor to get a family physician to see my grandmother in her hometown. 5 practices were closed to all new medicare patients and 3 were cash only. Medicare is hardly the panacea you think it is. Coverage without access isn't worth the piece of paper its printed on.

Denis Drew,

http://www.bls.gov/oco/cg/print/cgs028.htm

The insurance industry had about 2.3 million wage and salary jobs in 2006. Insurance carriers accounted for 62 percent of jobs, while insurance agencies, brokerages, and providers of other insurance-related services accounted for 38 percent of jobs.

Your assumptions and relity seem long parted. Even more so your claims that people can't wait to get Medicare while 100,000s fight to stay on their corporate retiree plans.

I don't understand why the US has this big health insurance problem. In Australia every single person is covered by medicare. I think we have a 2% medicare levi come out of our taxes. If you're >18 you have your own medicare,

We've been running a budget surplus for over a decade and our GDP/capita is a fair bit lower than yours.

Medicare covers doctor's consultations and the majority of the cost for essential treatment.

We have a system of private medical insurance (which is also subsidised by the government, in the way Obama plans, to make it more affordable and therefore reduce reliance on Medicare) which generally gets you 'better' and 'faster' medical service. ie: if you're privately insured, you can have that kidney transplant now, by the best expert, but Medicare might make you wait a few months and you may get a registra.

It isn't perfect, but its pretty damn good.

We do exactly the same thing with education btw (public universal system, plus government subsidised private and still quite expensive system).

Don't know why you'all have to make such a fuss about it.

Denis Drew,

But, the ground is already shifting as of last August: 12% had already moved in the right direction:

Yes, a whopping 36% of Californians supported it in August 2007, according to that poll. Slightly more than one in three. In one of the most Democratic states in the nation. And yet you seriously think it would have even a remote chance in the (much more conservative) country as a whole. You're living in a fantasy world.

And as I said, polling data exaggerates the level popular support for universal and single-payer health care, anyway. Any real-world proposal that actually had to get through the political process would be even less popular. That California plan, as I'm sure you're aware, is now dead.

Nate,
Don't panic. The 2.3 million is for the entire insurance industry -- not just health care, which will take a drop; it may be mostly waste at this point.

When I was a kid (early 60s) on my first job, there was a typing pool of 30-40 women in one room serving 5 office floors who did nothing but bang away all day. There may have been one typist per five office workers in those days just as a wild guess.

Along came Xerox machines -- which didn't make very nice copies at first; took about ten years before they could print something you could send outside the firm -- and put who knows how many millio typists out of work. Want to keep unnecessary typists on the job?

Since Medicare as currently constituted only pays 80% of set fees most people will want to keep corporate retiree supplemental if they can -- my mother has it from Standard Oil. Doesn't mean we want to get rid of the other 80% does it?

The 100,000 may ultimately pressure their congresspersons to make Medicare cover 100% -- as bean counter corporations squeeze unorganized American labor -- is supposedly cheaper overall in the first place.

Jason troll,
You made go though so much work to come up with this -- my computer kept freezing, not the research -- that you should be happy; that is a troll's measure of success isn't it?

48.Which would you prefer
[1] the current health insurance system in which most people get their health insurance from private employers, but some people have no insurance
[or]
[2] a universal health insurance program, in which everyone is covered under a program like Medicare that is run by the government an financed by taxpayers?

31% current system
61% universal health insurance system
8% don't know

This comes from a survey taken by the Public Policy Institute of California which most progressive hate because they stupidly oppose minimum wage increases and stuff like that:
http://www.ppic.org/content/pubs/survey/S_107MBS.pdf

Jason,
Its me again. :-)

The survey of California voters above was from January 2007.

I was sure you would want to be sure that you were wrong.

As long as we are on the subject of polls (national this time) IN FAVOR OF MEDICARE FOR ALL:
QUOTH:
"Yet another poll demonstrates that a majority of Americans support universal coverage under a single-payer system. A poll conducted during the week of December 14-20, 2007 by the Associated Press and Yahoo found that 65 percent of Americans support extending Medicare to everyone, and that 54 percent are willing to identify themselves as single-payer supporters. "

http://www.mnhealthreformcaucus.org/?p=8

Denis Drew,

I guess you missed my first post. Here it is again:

"This poll is even less meaningful than polls in which people are asked explicitly whether they support or oppose universal health care funded by the government. Almost always, a majority or plurality say that they support it. But every time a real-world proposal of this kind is subjected to the political process, it fails. The devil is in the details. What matters is not what people tell pollsters they want in the abstract, but what they're willing to support in the real world. And they've never yet been willing to support socialized medicine."

You can keep citing as many of these abstract-hypothetical polls as you like. They don't mean anything. A New York Times poll in 1993, shortly before the HillaryCare fiasco, found that 63% of Americans favored universal coverage. An NBC News poll in the same year found that 66% of Americans would be willing to pay higher taxes so that everyone could have health insurance.

That was 15 years ago. You still haven't achieved universal health care of any kind, let alone single-payer universal health care. When people find out what it would really cost--much higher taxes or premiums, lower quality, loss of choice--they don't want it.

Americans are brainwashed by the insurance companies and the government.All the insurance companies do is pay the bills.They are not a supreme being.My husband worked for a company that was "self insured"payed their own medical bills.Any State could do this for it's people.The insurance companies need to be stopped.Americans need a backbone.What does it matter what it's called as long as the bills are paid.Throw the bums out!

Jason, butterbrain,

61% of health care is already delivered by government through Medicare, Medicaid and county hospital type stuff -- children under 18 are about to be added. So it seem in the real world you talk about Americans are gradually figuring out that single-payer does a better job of paying.

If anybody didn't know any better than to listen to you they would think public pressure was mounting to roll back Medicare for the elderly!

Single-payer -- perhaps most importantly -- also allows doctors time to keep up with their specialty; to do their lifetime of learning -- instead of keeping up with 100+ sets of rules and prices and fighting with 100+ care deniers.

Hillary probably would have won last time around but the last time insurance companies fought tooth and nail against WHAT YOU SUPPORT NOW -- very ironically calling WHAT YOU SUPPORT NOW, universal health based on private insurance, crying silly wolf word "socialism" (won by calling private insurance THAT YOU SUPPORT "socialism", get it? :-]).

David Broder and Haynes Johnson wrote a 650 page book describing how Hillary mismanaged a perfect opportunity.

Funny thing is most progressive pushing mandates -- very possibly the owner of this blog -- personally prefer Medicare for All but for some reason are absolutely sure that the insurance industry will someway bribe and blackmail Congress out of doing what both Congress and the people want. That doesn't sound like "real world" opposition.

Wow, Norma almost brought a tear to my eye. I can’t think of more then a couple commenter’s who have shown that much logic. Which will give me a great excuse to rant about my biggest pet peeve. I don’t think Ezra has ever even mentioned the term self-funding let alone discussed how it could benefit our system. Back when insurance was affordable and people where happy with it over 60% of enrollees in employer sponsored plans where in self-funded plans.

For disclosure that is the majority of my background.

If you have an honest discussion about the issues people have with today’s system most aren’t prevalent in self-funding.
1. Carrier profits – Large self funded plans don’t have any carrier involvement thus 0% carrier profit. Smaller self-funded plans purchase stop-loss which is a fraction of normal premium, carrier profit is under 2% of total plan cost.
2. Efficiency – The total administrative cost of our large plans is around $240 per employee per year. A fraction of what it is under Insured Plans and Medicare.
3. Claim denial – employers want happy healthy employees otherwise they wouldn’t offer the benefit in the first place. You don’t have near the volume of claims issues as other plans.
4. Quality of Care – It is the employers money, if there is anything they can do to push better care that ultimately lowers cost they do it. If they need disease management or maternity programs they can be plugged in.

Self-funding has a 30 year record of success. It is a proven system with proven results. If Ezra and the Politicians are so concerned about the cost and quality of our Healthcare system why do they refuse to even discuss self-funding? Almost makes you think their “reform” is about something other then the average American? Why do numerous States pass legislation to limit self-funding? It would have nothing to do with lost tax revenue and control would it? Why are the Democrats in Congress blocking legislation that would allow small employers to ban together to purchase insurance in pools and by-pass the insurers or force them to compete?

Why do the Progressives on this blog get so quite when this viable solution is presented????

Hey Nate,
Take another look at Norma's comment and in particular this line:
"Any State could do this for it's people"

She's talking about single payer financing on the state level. I know this for a fact b/c I volunteer alongside Norma as a grassroots activist here in Massachusetts. We're trying to replace our sham corporate give-a-way individual mandate law with The Massachusetts Health Care Trust, SB 703 that's before the MA legislature (for its 10th year now).

Sorry to dissappoint you.

I'll believe you when you say that was what she meant. I'm curious why if it can be done successfully by the state why you would oppose employers having the same opportunity? Self Funding with or without reinsurance is the purest form of insurance possible. These plans have proven themselves effective like I said. Are you both opposed to strengthing ERISA and giving employers and AHPs a chance?

For the record you should really look into the history of Medicaid, States did/do self fund benefits for the poor and most states also self fund at least 1 or 2 options for state employees. They have a long history of inefficiency. Uncontained cost, fraud, and politics in general. I don't see why expanding it to a larger population would improve 2 decades of poor results.

I still think it showed more logic then displayed by most commentors and bloggers, she probably just doesn't have the exposure to the failures that have already happened. Right line of thinking just the wrong answer.

Nate,

Here is a fact about "self-funding" that may surprise you. I got it from a friend of mine who was Benefits Director for United Brands some years ago. They "self-funded." Here's what that meant: they contracted with Aetna to pay the bills and handle all the paperwork for United Brand employees when employees had a medical expenses. For every $100 in medical expenses (paid to a provider), Aetna tacked on a charge of $28. Yep, that's 28%.

And United Brands thought that was a better deal than purchasing insurance from Aetna. The "insurance" hawked by the companies not only denies care to the employees, it contains huge overhead.

So much for private industry. At Medicare, 4% of the bill goes to overhead.

Hey Michael,

I'll give you the benefit of the doubt and assume you didn't understand what they where saying. It's either that or your full of BS. I know this because for the last 16 years I have worked for a TPA doing exactly what Aetna was doing for United Brand. We never charged 28% admin fees. I have never seen a quote from Aetna, CIGNA or BC that charged 28% admin fees. The most expensive company I have seen is probably Blue Cross Blue Shield who charges around $36 per employee per month. For better service we would charge the same group around $18 PEPM. Seeing as how the average cost per employee runs around 7K plus per year even that high amount is only .06.

The only way your numbers might be accurate is if you’re including the cost of re-insurance with a low specific deductible. Reinsurance reimburses the employer for the cost of claims over the specific deductible so it would be counted as a claims cost not an administrative cost. Without it your claims would be higher but your admin fees the same and thus your ration lower.

On your Medicare claim of 4% overhead I have debunked that myth more then once on this blog. I’ll summarize it for you;
4% of 6K doesn’t equal 4% of 3.5K
You forgot CMS and Congress
You left out your taxes
Mandates are free when you don’t have to comply with them

Let me assure you there is nothing about self-funding you could surprise me with. FYI your description of tacking on $28 for every $100 of claims is referred to as cost plus, outside of the government that hasn’t been used in 20+ years. Administrative fees are calculated PEPM, PMPM, or shown as a % of premium.

The Best way to sell "Socialized Medicine" talk about "Socialized Dogs". A socialized Dog does their job (guarding, playing etc)and does not wreck the furniture, bite those they are supposed to protect, or leave surprises on the carpet.

Unsocialized Medicine does all these things (metaphorically at least)

It has finally occurred to my bird brain that while I used 2005 family income figures for my post above -- I used 2008 dollars for my poverty line (minimum needs level) -- which reduces my $33,345 poverty line for a family of three to $31,111. This adds up to (or subtracts down to) an (even :-]) more accurately drawn line of 35% (not 38%) of family incomes below poverty without food stamps and other helps.

HSPH has released a new poll on overall public sentiment comparing the US healthcare system to international healthcare systems. Check it out here: http://www.michiganindependent.com/2008/03/20/health-care-party-lines-redux/

Ezra,

In the past you've said you don't cover the "socialized medicine" bill HR 676 because you judge it politically unviable.

Does this poll change your opinion?

I see I'm not the only reader on this blog who hopes so (howdy Denis and Ann).

Please discuss!