Being too lazy to dig in myself, but knowing you're going to be reading more, how will this impact small businesses (say the type that only offer the reimburse up to X dollars a month because of the IRS rule that lets them)? This sounds like it'd be hard on people that don't have insurance today. Or maybe the pool that's not around the poverty line, and doesn't have some sort of employer-given health insurance option is that 1%.

What are you going to do about preexisting condition exclusions? I am without health insurance for exactly that reason -- unless those rules are hereby prohibited even for private insurance companies (discrimination based on disability? in many cases at least) then all the best and cheapest private plans in the world aren't going to do the entire population right.

Sounds great! Throw in subsidies for poor people based on the 5% spending rule (healthcare shouldn't account for more than 5% of income), and it's perfect.

Hello, reading comprehension -- feel free to delete both comments.

The law forbids preexisting conditions exclusions -- that's what the community rating does.

What about employees whose employers do not currently offer health insurance? Sounds like they'd be royally screwed -- no raise to cover the cost of being forced to purchase insurance, yet a legal mandate to buy some.

Granted, many of them would likely fall into the "up to 400%" category and receive some subsidies, but it's something to take a hard look at.

fiat,
As much as I hate to let the market work this out, I would count on those employers giving raises so their workers show up the next day.

Based upon what you've said, Ezra, I would like this plan without mandated raises of any kind. The number of people who would be able to finally get insurance coupled with the savings this plan would posssibly represent sounds good enough for me.

I wonder if this is what Wyden is betting on - making it a much more palatable piece of legislation by eventually "compromising" with the business community on the mandatory raise issue, while keeping the truly important parts of the legislation intact.

The more I read and hear about Wyden's plan, the better it sounds. And he's clearly done some major homework and made provisions to cover the objections that will be raised.

Health Care is a major issue here in Oregon, and Oregon's Legislature (Dem. controlled) and Dem. Governor are committed to a statewide solution in the coming session. I'd bet they enact something that looks a lot like Wyden's plan even if Congress drags its heels (almost typed heals LOL).

As I said in the post below on Speed Reading, I'd much prefer eliminating the insurance companies completely, but that's just not in the political cards. But forcing a mandate to ensure all applicants (community rating), and allowing premium differences only for geography, family size, and smoking status, plus a firm mandate on minimum coverage being equal to the US Govt. employee package. takes much of the sting out of private insurance. It will be hard for the insurance companies to game this approach - but I'm sure they'd try. I can't wait to hear their response to Wyden's plan.

I'd expect that the medical provider groups (including hospitals) to get on board since this approach would eliminate the major headache and moral/ethical dilemma posed by uninsured sick people.

And note, the plan is aimed squarely at promoting preventive medicine (and thereby cost reduction) with solid prohibitions against deductibles and co-pays for preventative medicine and lifelong illnesses.

I surely hope the progressive forces, including the netroots blogs get on this pony and ride ride ride. This is the best we could hope to get pre-2008, and would be a great triumph is we get it. For that reason alone, the GOP faces a major dilemma: support a plan that is likely to be very popular (but aids the Dems - unless the GOP joins in as a party), or oppose it and risk the wrath of the voters in 2008.

My guess is that the GOP will attempt to put in some poison pills (like the anti-union provisions in the Homeland Security Dept creation) to try to undermine Dem. unity.

Let's beat the drums for this plan, progressive folks! Write/email your Senators and Congressmen now and demand this bill be considered and passed right after Pelosi/Reid's 100 hours marathon.

Hold on Amanda, dont delete just yet. We havent excluded all the ways the friendly insurance industry could deny you health care because you are sick. Yes, the prices and coverage are regulated, but that doesn't mean they can't JUST SAY NO. And does the community rating and coverage floor apply if you lose your coverage and have to buy a second time? And then of course there is the "stealth underinsurance." Private health insurance companies have an incentive to deny your claim and will often just arbitrarily refuse to pay, illegally discourage provision of health services, etc... These are parasites, and they capture the agencies that regulate them.
Hold the champaigne bottle, fellow travelers.

Interesting indeed. Maybe I'll work up the energy to dig in.

I'd like to see obesity be an additional basis for raising rates, though. Obesity-driven health problems (from diabetes-related pathologies to spinal fusions) are a *huge* driver of cost. Tobacco actually drives down costs to the system (although not to the economy), because it kills people before their expensive senior citizen years. We definitely need to permit higher costs for the morbidly obese.

anonymous, Whose theory is it that "healthcare shouldn't account for more than 5% of income"? Even the Brits spend more than that, and nobody wants their system.

May I humbly suggest that there is no percentage of either national or personal income that is a priori inappropriate to spend on healthcare. For starters, a huge proportion of "health care" is really health services, and substantial unrelated to one's mortality or even morbidity. Much of health care is a luxury or purely a function of personal preference (do I really need that pylar cyst removed?), and any system needs to recognize that.

So employers pay this year's costs agin, plus premiums for next year? Who pays for the subsidies for people with no employer? Does this do away with Medicaid? What about recent immigrants, legal and illegal? (Medicaid now won't cover anyone who can't show that they have been here legally for at least 5 years). Does it cover Dental?

Maybe insurance companies can make up some of their lost revenue by doing claims processing, like for Medicare. Does it do away with Medicare?

How are these private companies mandated to offer the same quality of service (or better) going to compete? By denying claims by whatever means possible?

Hey everybody... My name is Kari Chisholm, and I'm helping Senator Wyden with his netroots site on this - Stand Tall for America.

I'm no policy wonk -- Ezra would kick my butt in that dept -- but let me try and answer some questions. (I've been living with all the background materials for a few days now.)

Tom in AZ: This sounds like it'd be hard on people that don't have insurance today. (And fiatlux asked the same thing.)

Well, folks who are low-income and middle-income (up to 400% of poverty line, which is roughly $40,000/year) would get subsidies. But if you're asking about higher-income folks who don't get it through work and don't pay for it themselves (like my buddy who bartends at an upscale bar, making 60 grand a year)... those guys will end up paying for health care, but they're the ones that are taking chances every day - hoping they don't get in a car wreck, hoping they don't have some calamity hit. Of course, part of the reason they don't buy their own is that it's expensive and there aren't many choices. Now, they'd have plenty of affordable choices.

RW: Yes, the prices and coverage are regulated, but that doesn't mean they can't JUST SAY NO.

Actually, under the Healthy Americans Act, they would be explicitly prohibited from turning anyone down. And everyone in a state pays the same rate for a given plan.

Michelle Meaders: Does this do away with Medicaid?

Yes. All low-income folks would get health insurance now - the same health insurance as everyone else. If you're under the poverty line, it would be fully subsidized. The subsidy extends on a sliding scale to everyone up to 400% of poverty (roughly $40,000 a year for a single, double that for a family.)

Phoenician: How are these private companies mandated to offer the same quality of service (or better) going to compete? By denying claims by whatever means possible?

By keeping their people healthier. Remember, preventative care reduces costs dramatically. You can imagine a plan where they work really hard to test people early for cancers, high blood pressures, cholesterol, etc. -- those companies will save money because that stuff is cheap compared to cancer treatment and pacemakers.

Jim in Portland: I surely hope the progressive forces, including the netroots blogs get on this pony and ride ride ride.

Yes! Come on over and join us at Stand Tall for America.

Tiger Hawk, you're falling prey to a common misperception. The costs of obesity are vastly overrated, the number of obesity-related casualties in the most-often cited CDC study (400,00) was admitted later to have been ridiculously inflated. There are many reasons why people are overweight, from genetics (yes, people do naturally come in different sizes), to glandular disorders, to not having access to healthy food (research urban food deserts - places with no supermarkets for 20 miles).

A number on a scale is *not* an indicator of someone's health, nor is it an indicator of the amount of healthcare they will use. Basing someone's insurance rates upon that number is nothing more than discrimination.

Someone's diet and activity level, and general health cannot be determined by weight. Though that assumption has been reinforced by one of the most wildly successful industries in history.

Cellar door, all your points are true, but really only at the margin.

First, I *wasn't* talking about weight, I was talking about obesity. No, I was not proposing the use of the Body Mass Index.

Second, I know the casualties for obesity were overstated in that original CDC report, but it isn't the casualties that burden the healthcare system. If you actually die of a heart attack at a John Belushi, Chris Farley, John Candy-like age, you leave the system and probably cost insurers less in your lifetime than a vegetarian marathon-runner who lives to be 100 (and, yes, I realize that the economy also loses your productivity, so we are worse off in total if you die young, even if your aggregate healthcare costs are lower).

Third, there is simply no getting around the fact that the costs to the healthcare system that derive from the fact that people are "sedentary and eat too much food" (if you prefer that description) are *huge.* The fact that some small percentage of those people would also have been fat in, say, 1920, is really beside the point. Same with your people who don't live within 20 miles of a supermarket. What percentage of the American population fits that description? I'd be surprised if it were even 2% at this point. And that, by the way, is also a choice that those people have made, so I'm not sure why the healthcare system should not charge them a bit more for it. They surely make a bit of it back with much lower homeowners insurance rates, owing to the lack of crime in places that are 20 miles from the nearest supermarket.

I think a smart feature of this scheme would be the taking of a medical history during the enrollment process. That way we can separate people who are sedentary and eat too much food from the few people with genetic disorders who are obese as an immutable fact (or a barely mutable fact). Enforce truth by saying that anybody found to have lied in the submission of their medical history faces a 20% surcharge for five years, or something like that. Most people will be honest.

"Of course, part of the reason they don't buy their own is that it's expensive and there aren't many choices. Now, they'd have plenty of affordable choices."

Maybe there is detail in this plan that alleviates my concenr, but, Ms. Chisolm, I don't see anything in this plan that ensures the coverage will be affordable. I have been a contractor, and I can assure you that plans for indivudals are expensive and come with ridiculously high deductables. Why would that not continue to be the case?

And since you mentioned that Medicare would go away, what in this plan guarentees that the private insurance plans would provide cheaper, better quality care than what already exists? I don't think that commuity rated features or the requirments that plan price variation meet those standards, as the starting points for individual plans are already exhorbinantly high.

Again, I haven't had time to read the details, but nothing in the descriptions of the plan I have seen says to me "cost control." And without that, you are forcing people to either pay fines to do without, and ending all hope of ever getting health insurance through work, or forcing them to pay money that they cannot afford for probably less coverage than they have now.

Community rating takes into account behaviorally acquired health problems (probably a lot more than we know about already) as well as other pre-existing conditions. I'd say let the free market worry about those.

For kevin, what makes individual plans exorbitant, is the restricted pool of insureds.
Bringing all the healthy uninsureds into the system lowers prices for everyone.
Deductibles and co-pays make premiums cheaper also, as well as preventing over-utilization. It would be fair, and more economical I believe to preserve Health Savings Accounts and high deductible policies for those who want them.

Has somebody figured out how to guarantee that everybody purchases health insurance? Here in CA everybody is required to have can insurance, but a lot of folks don't.

Why would I want to buy insurance if I've never been hospitalized? I'm perfectly healthy and don't want to waste my money on insurance, why force me to take the risk, which ammounts to my spending my very limited disposable income subsidizing some smoker's cancer? I jog, I eat well, and I make rational decisions . . . to save myself the money.

Besides, I don't want people assuming that I'm insured. It's like the bicyclists-with-helmets article recently blogged here: if people think I'm covered, they'll take more risks with my saftey or health. My employer has insurance for anything that should happen to me at work, I have insurance if I get hurt in my vehicle, and those are the two most dangerous things I do.

Forgetaboutit.

For those progressives who want gold plated health care for all at no "cost," (somebody mentioned dental). This just is not possible. Even Canada has sharp restrictions on the benefits offered by their almost broken single payer system. Settng the benefit package to equal Congress's is fair. Many states mandate benefits which increase the cost of insurance to purchasers. I am as right wing on healthcare as they come, but this has great merit. firgure out how to get everybody to buy it, and I'm there.
One thing? Won't all the "Single Payer" "Progressives" out there scream bloody murder when their reason to take over a quarter of US GDP is removed? Hillary?

Right now we have the problem where insurers avoid investing in preventative care and outreach because it's a good bet that the insured will be at another job, with another insurer, before that would pay off. Does this address that problem at all? With multiple competing insurers in a geographic region, it sounds like it would have exactly the same problem, with people potentially switching plans (based on advertising or lower rates - plus the high possibility of moving outside of the region).

I'd propose two improvements:

1) Instead of using "what Congress's plan covers", use something like the Oregon list from a few years ago, that covers procedures based on cost/benefit. Make the mandated coverage be everything up to some specified cost/benefit ratio. (Make Congress buy off the same list--but there's no point leaving out high cost/benefit services because Congress doesn't have them now.)

2) Require insurers selling through HHA's to all use the same claims forms, to simplify the paperwork in doctor's offices.

I can't believe that $40K is 400% of the poverty rate. Before anything is enacted, the poverty rate should be adjusted based on current costs of housing, food and energy. My husband and I together make more than $40K, but we are just making ends meet every month - our gas bill increased 71% last year and it's not going down this year, for example. We're not poverty stricken, we're not even poor, but we're not quite middle class, either - no new cars or vacations or big screen TVs.

SR

You are right about the justification for the cost of individual plans, but consideirng that they are goning to sell indvidual plans to people who are required to buy them, what is to keep them form pricing them similarly to the individual plans that exist now? Nothing in the plan seems to guarentee that.

maurinsky, ~$40K is 400% of the poverty level for single people. The poverty level for a couple, as well as a family, is higher. The exact figures (for 400% of the poverty line) are 39.2K for individuals, 52.8K for a couple, and 80K for a family of four.

This plan looks like a good piece of legislation for the present political environment (i.e., sufficiently ambitious to meet some of the major goals that any such plan should meet, but realistic enough to have a chance at success). The one major concern that I might have is how a determination can be made on what claims will be paid out and what claims will not be. This plan doesn't appear to address any of this, so presumably it would be up to the insurer, with the information available to people on what claims they will cover and what claims they will not. However, there are a lot of gray areas when trying to match a patient with the optimal treatment (from a cost benefit perspective).

It seems that a lot of people want some sort of cost control or price control... I don't think that is possible without making very clear (and potentially discriminating) choices between what will be covered and what will not be covered. Let's say that someone's parent is dying, and there is a treatment that would cost a pretty bundle and has a 20% chance of allowing them to recover and live, say, 10 years longer. Otherwise, they are likely to die in the next few weeks. Does insurance cover this or not? I do not believe that cost controls can ever satisfactorily resolve the issue of rising health costs. The problem now is not so much that health costs are rising, it is that the US's health costs are so much greater than many other countries. This plan takes some steps towards a comprehensive health care policy that have the potential to bring the US more in line with the rest of the world. It is not perfect, but it is more realistic than many other possibilities out there. Caution should be taken in comparing specific facets of this plan to an "equivalent" in our experience... for example, individual health insurance would most likely cost less under this plan than it does now for the simple reason that the health insurance companies would have no capability to create group health insurance plans and would be forced to compete for each individual customer in order to make money.

kevin,

If all the companies got together and decided to conspire to sell health insurance at a cost higher than practical, then a scenario like what you indicate could occur. But if there is just one company that prices their plans fairly, the other companies would lose customers very quickly. I think that the strength of this plan may very well depend partly on the existence of a fair number of large, national health insurance companies on the menu in every state.

Toby, your perspective would change very quickly if you found out that you had cancer, or if you got hit by a falling tree branch while jogging and sustained severe internal bleeding. No matter how well you manage your risk for health complications, there will ALWAYS be some risk.

Why would I want to buy insurance if I've never been hospitalized? I'm perfectly healthy and don't want to waste my money on insurance, why force me to take the risk, which ammounts to my spending my very limited disposable income subsidizing some smoker's cancer? I jog, I eat well, and I make rational decisions . . . to save myself the money.

And that, Toby, is where we come down to the issue of collective vs individual good, of superrationality vs rationality.

The system proposed appears better overall for everyone than the current system in the US. However, it's not better for you because you're at the margin. But if you opt out, then it becomes just that slightly worse. If everyone at the margin opts out, the margin keeps moving, and the system dissolves. And overall, society is worse off.

To give an analogy - why should you stop when the traffic light turns yellow? If you just keep moving, nosing your way into traffic, you'll get there faster that you would if you stopped. But if everyone does this, traffic jams and everyone suffers.

Toby is relying on somebody else to take care of him.
47 million people do that right now. It would be OK if nobody
were obligated to take care of him when he shows up in the ER,
but for now, it is the law that he must be taken care of. It's fair
that the law require that Toby pays for the care he gets, or else someone else has to.

Why don't y'all just come out and say it...

Fat people and smokers are not worthy of being included in your health club!

You're all so busy discriminating against others, rationalizing your prejudices because you're holier than those filthy, fat smokers that you all hate so much. Why not exclude alcoholics, mentally ill persons, those genetically predisposed to cancer. Ohhh, I forgot. That's what the private insurers try to do now.

Don't compound the problem by culling the herd. This is a civil rights issue. EVERYONE...EVERYONE should be covered. People aren't perfect. Get over it. Expect to pay more for people's personal fallibility.

People aren't perfect. Get over it. Expect to pay more for people's personal fallibility.

And, come to think about it, don't the taxes paid on cigarettes more than make up for additional health costs of smokers?

I should have ended my last sentence:

"Expect to pay more for people's personal fallibility and pre-existing conditions."

Join my club! It's the human race...all inclusive, no discrimination. Membership has its privileges.

I assume Toby is satire.

If not, I'll bet a zillion bucks he gets hit by a car and needs an organ transplant. Hell, I'll drive!

Wow. Posting comments here always results in great discussions. Last time I was asked to go fuck myself, this time commenters want me to get hit by a car.

My point? I'll get to it. I spend a lot of time and energy staying healthy. And before I did, my conservative stay-at-home mom who traded status (the money she could have earned with a college degree) for family spent a lot of her time an energy keeping me healthy. I grew up below the poverty line (I never asked, but we qualified for the discounted school lunches) and gave my parents hell for what they didn't buy me. Only later did I see the difference that breastfeeding made (I never get sick) or a solid diet. I'm thankful.

Now, you say that if I get hit by a car (something the driver's insurance should actually pay) or a falling tree branch (here, the owner of the property on whose sidewalk I was jogging) or otherwise struck by lightning and need medical care, it's wrong to expect taxpayers to subsidize my emergency medical care. I say it's wrong to expect me to subsidize--which is what my insurance premium, and it'll be pricey because I can't opt out of it, amounts to--the medical expenses of smokers, the obese, or, really, anyone else. I at least avoid incurring medical expenses, as far as I'm concerned, they're too lazy.

I can get on board a lot of Democratic price-raises--gas taxes are big with me--but just like I don't expect my children to pay for our mistakes (national debt, global warming, Iraq) I don't expect to pay for anyone else's.

Toby,

What you are saying is that you're fine with other people subsidizing your bad choices regarding healthcare. Of course, to you it's a good choice, because you want to use the money to go to something else.

As good a job as your parents did raising you, apparently they forgot to teach you that people are not personally responsible for every bad thing that can happen to them. It's funny how you justify your selfishness and, let's face it, your arrogance (about your stellar decision record) by pointing out the bad choices of others.

There are education campaigns against smoking, cigarettes are taxed pretty heavily, and cities all over the country are imposing smoking bans in public places. Now that obesity is recognized as a real problem, steps are being taken to help people understand how to make better choices in their diet and to get food suppliers to quit injecting our food with additives created in a laboratory that, while cheap and long lasting, are wreaking havoc with our bodies.

It looks like there is quite a bit of effort aimed at reducing the problems you don't want to subsidize. How about you take some personal responsibility as well?

And I have no desire to see you get hit by a car. Getting injured is no picnic, and most auto liability insurance has limits on medical payments. An extended stay in a hospital and/or some surgery and physical therapy will tap out those limits very quickly. And, since the insurance policy will match state law regarding those limits, there pretty much won't be anything for you to do to get more money out of the person who hit you. Never mind that a car accident could - gasp - be your fault, at which point your medical costs belong exclusively to you.

"Tobys" come into our ER every day and complain about waiting. We are required by law to evaluate treat their acute problem. If it is part of a generally more chronic illness, they come back for more. There is an economic term for it: "free riding."
It is really too bad she doesn't get it. By the way, there are free riders in California who don't have auto insurance even though it is required by law, so watch out on the highways, Toby.

How again is Senator Wyden going to get everybody to purchase their own insurance?

I missed the comment posted by "Phonecian" where he said that my choice, though great for me individually, lets the group suffer. As a consequence, I should suck it up and but the mandatory insurance. I'd say fine, under two conditions:

1) I'd want rebates for the fact that, call me arrogant but the insurance companies would agree, I make safe choices.

2) I'd want Senator Wyden to propose a fix to the Social Security system based on the same logic. If the problem is that the ratio of retirees to workers is going out of whack, we'll just have to ask people to "suck it up" and do what's best for the group. We'll ban abbortion. Sure, it's great, individually, for the women who are either traumatized by rape or think a kid will be in the way of their career, but they've got to think about my retirement check. I'm part of the group.

Until then, I maintain that it's my body, I get to do with it what I want. And that includes insuring it.

Toby,

So what happens when you have an aneurysm, spend 40 days in the ICU and accumulate $2M in hospital costs, as my very healthy, marathon running friend did last year? Are you independently wealthy and have $2M to spend? Or, do the rest of us pick up the tab when this happens?

Choose the most bare bones plan possible, since you're such a healthy guy. But at the end of the day, no one is immune from catastrophic illness. You need to pay your share.

Toby Toby Toby -

So there you are, exercising away, feeding your superior genes the best food money can buy, and meanwhile, Intergalactic MegaCorp is busy polluting the groundwater under you, or the air you breathe, or the mis-labeled food you eat. The product you thought was safe, turns out to be full of asbestos. Or lead. Or something we don't even know is dangerous yet, but we will when you and 200,000 other people get cancer.

Or you marry and impregnate a marathon-running vegetarian, whose DNA you have previously checked out, and yet - goddam! - the birth is complicated and the child has a hole in its heart. Sorry! No insurance for Toby Jr! Because, of course, a child with a hole in its heart (actual case I know about personally) cannot get insurance, since pretty much by definition it is going to need medical care, and insurance companies are not in the business of providing medical care. They are in the business of collecting premiums.

Luck certainly is a bitch.

Cragie

I didn't say I'd never get insurance. If I get married, I'll insure my family. Until then, I'd rather save that money. And why don't the posters here accept that--just as when I fail to wear a seatbelt, sit in a smoke-filled bar, or--as in a post I've read on this blog recently--wear a helmet while biking, I understand that not carrying insurance could be lethal. I get an annurism and I can't afford treatment, I die. It wasn't that long ago that there WASN'T treatment, so just think of me as living in the past.

If the taxpayers don't want to pay for me, fine. I'm dead, a statistic. It happens to more people than we can help, so why make my life more difficult by disguising an attempt to have me subsidize others as "taking care of me"?

I'd rather focus on saving and paying down debt with my disposable income, so that when I get married and need insurance, my wife and I aren't working three jobs apiece. Or maybe even so that one of us could stay home. (Preferably me, these online arguments are so much easier when work isn't distracting you.)

Wow, I didn't mean to kill all conversation in this thread. And I certainly hope that I'm not stubborn, I just don't think I've been convinced that, if I buy insurance, I'm helping myself more than I'm subsidizing other people. And I don't want to do that.

However, I've had a thought: a lot of what you're warning me about--$2 million anurisms--is a pretty rediculous thing for me to spend my time thinking about. What I WOULD (and sometimes do) worry about, is the chance of something stupid happening to me, like falling off a later, tripping in on the stairs and getting relatively minor injuries that take a healthy bite out of my savings or leave me in debt.

So, why not introduce health insurance on what I consider a 1950s plan. You know, that covers the kind of care that was available sixty years ago, like repairing broken limbs and stitches, getting an appendix or gallbladder out. (You understand I'm not saying we need to use 50s technology) Insure me against things that regularly happen, and about which I could worry.

If such a plan agreed to not pay for my crazy, obscure bills (anurisms, polonium poisioning), and gave me considerable savings by not paying for the same treatments for others out of my money, we could talk about insurance.

Of course, we could also have a conversation about liability costs, as well.

My point is that, if you want universal insurance, you need to not make it about 'needing' to subsidize insurance for people who are expensive--the state already pays their bills, consider them covered and go home--but about creating an insurance product and an insurance environment that benefits the people who have decided against insurance. (And, for all the uninsured people I know--there are lots of us--it's generally a conscious choice to take the money we could be putting towards insurance and put it towards something quaint, like college loans.)

Toby "needs" to learn how to spell.

No plan I have yet seen deals with disability-by-overmedication as an issue. Using the Oregon plan might have a chance at morphing into this some day. A rigorous cost-benefit analysis of each case already covered by an entitlement program might yield incredible savings in Oregon, even without a change in system. Until this sort of reform is made, I have a hard time understanding how a corrupt system isn't just made more corrupt. Do we want to recruit working poor into 100-pound weight gains from psych meds they couldn't afford before?

I would love to beam all my hopes for a humane system on this plan. Kitzhaber was extraordinarily brave with the Oregon plan, but maybe excess disability from over-medication was too hard to implement? I was told by someone from NAMI that there are supposed to be medication audits. I know of no reports on that.

It would be great if this issue could be put on the table and dealt with.

Mary

I just don't care for the government forcing me to do something, even if it's for my own good. What if I don't get sick much and want to have a bare-bones plan, such as one that only covers hospitalization?

I learned in law school that the law gives a person the right to be a damned fool. What if I want to be foolish and not get insurance and keep the extra money?

When I was just out of law school, my first employer had no health plan. My parents arm-twisted me into getting a major-medical policy. They kept saying, "What if you became very ill and had to go into the hospital?" Guess what? I didn't go to the doctor at all for 3 years, let alone the hospital, and I would have rather have had that money to put into my IRA or towards the purchase of my first car.

Will this plan cover self-employed Americans?

How would this plan impact doctors and other healthcare practitioners who bill insurance? Will claims for injuries sustained in car accidents or on the job (Worker's Comp) be affected? Will healthcare practitioners suffer a huge drop in income if there are no traditional insurance companies to bill?

Lastly, what are the chances of this act passing?

This is not the answer. A huge issue that is not addressed is the fact that administrative costs have skyrocketed, thus greatly increasing cost of health insurance and that health insurance is a for-profit enterprise. We need to take out the middle man that is diverting so many resources that would be available to patients in a true universal health care plan.

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