Issues have mattered hardly a whit during this whole election season. Why do you point to healthcare as if it were somehow uniquely being overlooked?
12
Both Trump's indifference, as well as his ignorance of what health insurance means to the masses, is beyond the scope of his privileged lifetime. How can a Wealthy Person truly understand poverty, hunger or what bad health means for those who have known nothing but poverty? And yet, his followers--a sucker born every minute--fall for this False God. Mere snake-oil sales from a helicopter.
Donald Trump's Health Care "Plan", as far as I can see, is composed of three ridiculous points: Repeal Obamacare; Outsource it (allowing the health insurance equivalent of bank credit card schemes to handle it) and do away with the Universal Mandate.
The dangers of the first two are self-evident. But, telling people that you can decide for yourself if you want the insurance or not is absurd. Tell me: where can you buy auto insurance after an accident; homeowners' once your home burns down; and life insurance after you're dead?
No one knows when you will have an accident, get sick, or develop a horrendous condition. Once you do, it's too late to get insurance. So, you need to get it earlier-on in life, before you need it. Also, if health insurance were optional, only the old and sick people would buy it. That means that the insurance would become extremely expensive, and the number of health insurers\
would dwindle.
And, the E. R. is not an option!
https://thetruthoncommonsense.com
Donald Trump's Health Care "Plan", as far as I can see, is composed of three ridiculous points: Repeal Obamacare; Outsource it (allowing the health insurance equivalent of bank credit card schemes to handle it) and do away with the Universal Mandate.
The dangers of the first two are self-evident. But, telling people that you can decide for yourself if you want the insurance or not is absurd. Tell me: where can you buy auto insurance after an accident; homeowners' once your home burns down; and life insurance after you're dead?
No one knows when you will have an accident, get sick, or develop a horrendous condition. Once you do, it's too late to get insurance. So, you need to get it earlier-on in life, before you need it. Also, if health insurance were optional, only the old and sick people would buy it. That means that the insurance would become extremely expensive, and the number of health insurers\
would dwindle.
And, the E. R. is not an option!
https://thetruthoncommonsense.com
4
Redistribution is when a thousand middle-class families are made much poorer so that the federal gov't can fund a couple of patients and some bureaucrats so that elites can feel so much better for how generous they are.
5
Twenty million Americans have gained health care coverage in the six years since the law was passed, bringing the uninsured rate to a record low.
-----
There may be about ten million more people insured now than before the AHC but that does not mean that THEY ARE COVERED. If the out of pocket expenses average about$1,200 under the employer provided plans, they hover in the range of $6,000 under Obamacare.
HRC wants to provide tax credit of up to $5,000 to help pay out of pocket costs. Hello, we already have it, if you itemize your deductions and if you are not in the upper income brackets. Of course, she wants to tax the rich more to pay for this manna from heaven. What else is new?
You argue in the last paragraph that she should talk more about health care to win support. If she talks about Obamacare, she has to mention its problems or conjure up visions of horror associated with this boondoggle, and that is a vote-loser.
Even if Hillary wins, and if the Congress is under the control of Republicans as it looks it will be at this moment, then she is going to be lame-duck on day 1.
So, if we want anything done on anything at all, it is best elect Trump, who is already toning down his rhetoric (when the pastor in Flint asked him not to bring politics into the Flint crisis, he graciously said sorry and moved on. Changed man), and can count on Congress supporting his agenda. Or, Ryan and McConnell can work with Trump to implement the agenda of the party.
Forget Hillary.
-----
There may be about ten million more people insured now than before the AHC but that does not mean that THEY ARE COVERED. If the out of pocket expenses average about$1,200 under the employer provided plans, they hover in the range of $6,000 under Obamacare.
HRC wants to provide tax credit of up to $5,000 to help pay out of pocket costs. Hello, we already have it, if you itemize your deductions and if you are not in the upper income brackets. Of course, she wants to tax the rich more to pay for this manna from heaven. What else is new?
You argue in the last paragraph that she should talk more about health care to win support. If she talks about Obamacare, she has to mention its problems or conjure up visions of horror associated with this boondoggle, and that is a vote-loser.
Even if Hillary wins, and if the Congress is under the control of Republicans as it looks it will be at this moment, then she is going to be lame-duck on day 1.
So, if we want anything done on anything at all, it is best elect Trump, who is already toning down his rhetoric (when the pastor in Flint asked him not to bring politics into the Flint crisis, he graciously said sorry and moved on. Changed man), and can count on Congress supporting his agenda. Or, Ryan and McConnell can work with Trump to implement the agenda of the party.
Forget Hillary.
4
I don't believe HRC has changed her mind regarding universal health care since Bill's administration. If a universal health care bill was placed on her desk, she'd sign it. She deals in what is possible, which is, without a friendly Congress, piecemeal reform of the current system.
5
I'm surprised no one has referenced or commented on the fact that Woody Gutherie lived in Fred Trump's housing project, and wrote a song titled "Old Man Trump".
4
it would be given more attention if the mainstream media would focus on issues rather than personality. The media has spent thousands of stories examining Hillary Clinton's emails and the Clinton Foundation, smearing her with innuendo but finding nothing she did wrong. imagine how more informed we would be if you had spent those thousands of news articles actually talking about issues.
10
While this Editorial Board gives kudos to Mrs. Clinton for her health care proposals you'd never know it from this headline. And it is ruefully laughable that the New York Times Editorial Board chastises her (yet again!) over not speaking more on her sensible health care policies. Surely the Board must know that it is the media after all that has pushed the election cycle into a circus cum reality show eschewing competent reporting on issues and analysis of the policies. Instead, focusing on the 'drama' of the cycle - and giving one candidate who has almost no real proposals billions of dollars of free publicity. Would that the Editorial Board look in the mirror and write a piece chastising themselves and their brethren for so utterly diminishing their own value, and power of the Fourth Estate!
9
"Health Care Deserves More Attention on the Campaign Trail"
Funny that the Times editorial board thinks that an issue deserves more coverage than Mr. Trump's latest outrageous statement or Mrs. Clinton's struggles with her perceived dishonesty. Not only health care but the candidates' positions and policies on the economy and jobs, the environment and climate change, foreign policy, immigration, education, trade policy, race relations, etc hardly ever make the front page of the Times. Much has been made lately of false equivalence by journalists, but the greater bias may be in story selection and placement - choices made by the Editors.
Mrs. Clinton and her campaign would be only too happy to have extensive coverage of policies contrasted with Mr. Trump's featured on the front page of the Times instead of stories about her emails or her difficulty reaching young voters. Maybe if these young voters saw more about her policies they care about - jobs, climate change, education, college affordability, women's health care and child care policies, compared to Mr. Trump's, perhaps they would see the differences between the candidates instead of believing they are both equally bad and they might as well not bother voting.
NY Times Editorial Board - if an issue deserves more attention maybe there's something that you could do about that, like giving it more attention, say, on the front page above the fold? Focus on each major issue for a few days from now until the election.
Funny that the Times editorial board thinks that an issue deserves more coverage than Mr. Trump's latest outrageous statement or Mrs. Clinton's struggles with her perceived dishonesty. Not only health care but the candidates' positions and policies on the economy and jobs, the environment and climate change, foreign policy, immigration, education, trade policy, race relations, etc hardly ever make the front page of the Times. Much has been made lately of false equivalence by journalists, but the greater bias may be in story selection and placement - choices made by the Editors.
Mrs. Clinton and her campaign would be only too happy to have extensive coverage of policies contrasted with Mr. Trump's featured on the front page of the Times instead of stories about her emails or her difficulty reaching young voters. Maybe if these young voters saw more about her policies they care about - jobs, climate change, education, college affordability, women's health care and child care policies, compared to Mr. Trump's, perhaps they would see the differences between the candidates instead of believing they are both equally bad and they might as well not bother voting.
NY Times Editorial Board - if an issue deserves more attention maybe there's something that you could do about that, like giving it more attention, say, on the front page above the fold? Focus on each major issue for a few days from now until the election.
15
Mrs. Clinton will find it nearly impossible to build congressional support for her sensible health care proposals in a GOP-dominated Congress. As usual, Republicans of this electoral cycle are ginning-up ad hominem bile for Hillary just as they have done for eight years against Obama, obstructing everything for no better reason than to rile up their rage base.
The best single and least disruptive tactic to improve health care is to introduce the public option to the current ACA enabling the private sector to compete if it chooses but leaving a high-standard, affordable choice when private insurers opt to flee low-density areas where affordability counts the most.
Even better than this is a single-payer system, but science has proven that unicorns exist only in the pure imaginations of children. Would that we adults could think so creatively.
www.endthemadnessnow.org
The best single and least disruptive tactic to improve health care is to introduce the public option to the current ACA enabling the private sector to compete if it chooses but leaving a high-standard, affordable choice when private insurers opt to flee low-density areas where affordability counts the most.
Even better than this is a single-payer system, but science has proven that unicorns exist only in the pure imaginations of children. Would that we adults could think so creatively.
www.endthemadnessnow.org
2
Your editorial describes a term that has virtually disappeared from national media discussions of health care reform since the passage of the ACA: "underinsured:" The mainstream media are so enthralled that more Americans are "insured," that they rarely remind Americans that the high deductibles and co-pays, narrow networks, and higher premiums are all symptoms of risk shifting by the insurance industry -- with the blessings of state and federal legislators and regulators who are in the pocket of the insurance industry -- which realistically has all the money in the world. So, your editorial writers should have spelled out the reality that Obamacare has provided more people with effective insurance only on paper. Neither candidate is likely to buck the lobbyists for Big Insurance and Big Pharma who control health policy. The policy experts at medical schools and schools of public health are just used to put a scientific veneer on what the politicians and their patrons in business work out behind closed doors. For those who advocate Medicare for all, the same risk shifting is going on there with the processes of bundling, capitation, and alternative payments models. As for transparency, remember that Mrs. Clinton's secret health care planning process led one federal judge to recommend a perjury indictment for Ira Magaziner, which Eric Holder declined to pursue.
2
Yes, health care should get serious discussion in the presidential race, but it won't. On the GOP side they have no plan other than to attack Obamacare. On the Democratic side there is no willingness to push for what the country needs, which is universal single-payer coverage -- extending Medicare to all, but without Medicare's 80% payment limitation.
It is unlikely that anyone alive today who is over 21 will ever see the U.S. implement a health plan that covers everyone completely and affordably -- and that is properly administered (unlike the VA system).
It is unlikely that anyone alive today who is over 21 will ever see the U.S. implement a health plan that covers everyone completely and affordably -- and that is properly administered (unlike the VA system).
Many comments on this editorial have advocated for a single-payer national healthcare program such as promoted by Sen. Bernie Sanders. As a surgeon, I am also in favor of this for a number of reasons. It would be a much more fair system to all citizens, promote racial equality, reduce excessive wasteful costs, greatly improve access, promote continuity of care, and be much more easily administered. It would also improve quality by allowing patients, not health insurance companies or employers, to choose their doctor. If you didn't provide quality care, the patient could find a different doctor of their choosing.
However, one of the main obstacles obstructing a single-payer system is the medical profession itself. Not so much primary physicians, as they are generally for it, but the high paid specialists such as surgeons, radiologists, anesthesiologists, and other highly compensated medical subspecialists.
When I mention and promote a National Health Care Program such as single payer in the surgeon's lounge, the room goes still.
We profit greatly by applying our trade, however, and Americans didn't invent healthcare alone. Much of what we make a good living & profit from was developed in countries with "socialized medicine". Insulin - Canada, Blood transfusion - Austria, X-rays, Radiation Therapy - Germany, heart transplantation - South Africa, ultrasound - Japan, DNA and CT scan - England, etc.
Health care inequality unfortunately was invented in the U.S.
However, one of the main obstacles obstructing a single-payer system is the medical profession itself. Not so much primary physicians, as they are generally for it, but the high paid specialists such as surgeons, radiologists, anesthesiologists, and other highly compensated medical subspecialists.
When I mention and promote a National Health Care Program such as single payer in the surgeon's lounge, the room goes still.
We profit greatly by applying our trade, however, and Americans didn't invent healthcare alone. Much of what we make a good living & profit from was developed in countries with "socialized medicine". Insulin - Canada, Blood transfusion - Austria, X-rays, Radiation Therapy - Germany, heart transplantation - South Africa, ultrasound - Japan, DNA and CT scan - England, etc.
Health care inequality unfortunately was invented in the U.S.
5
Of course health care deserves more attention on the campaign trail. Why doesn't it get more attention? Because, along with poverty, infrastructure repair, how to fix public education, and the corruption behind prisons for profit, it is not especially amusing, and in today's media, even when covering a presidential campaign, the "amusement" factor counts for more than anything else.
Heaven forbid that the Fourth Estate do anything to actually inform voters.
Heaven forbid that the Fourth Estate do anything to actually inform voters.
2
You forgot one more important problem with the current system, health insurance costs have fallen primarily on the shoulders of employers. This means that in order to provide good coverage they have to trim benefits or pass costs on to employees in terms of co pays and deductibles. This makes it difficult or impossible to give raises, especially in the non profit world. This is a major contributor to declining and stagnant wages.A single payer system like the rest of the world has would balance this out. Medical care should not be left to marketplace dynamics.
6
A first step toward serious health care reform would be to detach health insurance from employment. It makes absolutely no sense because (1) when someone experiences a medical crisis and is unable to work, they eventually lose their health insurance and either will inevitably or simply must become impoverished to qualify for Medicaid; and (2) it is a drag on the competitiveness of American businesses in the global marketplace that includes other businesses from countries that do not tie health insurance to employment and have managed to provide health care to all their people.
4
I see many comments here and elsewhere calling for a "Public Option" i.e. Government run insurance. My question to all of those people who think our Government can run a public option is who will pay for this? More taxes? More entitlements that go unfunded? Social Security will be bankrupt despite the promises made. Medicare for all? Medicare is under funded and will be bankrupt before we know it.
My suggestion is to fix the ACA. Allow competition across state lines for those looking for insurance. I know everyone believes the insurance companies are only in it for the money. Maybe so. But why then does our Government allow insurance companies to merge into one big conglomerate? If people were not limited to one or perhaps 2 plans available in their state but allowed to shop on an open market that includes many more insurance companies then the system will do what it is meant to do. Create competition and therefore, in time, bring down prices.
My suggestion is to fix the ACA. Allow competition across state lines for those looking for insurance. I know everyone believes the insurance companies are only in it for the money. Maybe so. But why then does our Government allow insurance companies to merge into one big conglomerate? If people were not limited to one or perhaps 2 plans available in their state but allowed to shop on an open market that includes many more insurance companies then the system will do what it is meant to do. Create competition and therefore, in time, bring down prices.
4
Obamacare will sink us if we don't prepare now- We need to practice a Judo like maneuver and use the force of its collapse to our advantage. My biggest fear right now is if Hillary or Trump is elected and revokes the "can't be denied coverage for preexisting conditions," as part of a re-build settlement with Health Care Providers. Both have their own reasons for wanting this removed, and nobody in the media has had the guts or foresight to ask them about this..
1
Only the the United States allows a profit in the management of health care. repeat the management. In the ACA which was watered down behind closed doors allows 20 percent for profits etc., this 20 percent is more than 640 billion dollars each year, year after year, a disgrace in the greed of the insurnance industry. Pharma spends 18 percent of revenues on research and development leaving 82 percent for profits, marketing, management and the legal bribery of the government via lobbying i.e. donations to congressional members. Most would be eliminated with government financed campaigns as was Ford in 1976 and Reagan in 1984, neither of which received donations from other sources, a corrupt campaign finance system is at the heart of these and many other problems. WAKE UP
4
How calmly the newspaper of record comments on the national debate. When nearly half the country is willing to put a racist, sexist, mountebank and tax cheat in the Oval Office, I would like the media to ring the tocsin with vigor until November 8.
3
Dear Editors:
Why no mention of the public option?
Hillary Clinton's website (to which you provide a link) confirms her support for a public option in healthcare coverage (Medicare for those 55 years and older). This was a hard-won plank in the 2016 Democratic Party platform which enjoys the enthusiastic support of millions. They understand the considerable weaknesses of the current system which have been underscored by recent actions of private insurers re. the ACA. Many see the public option as an incremental advance toward the national health insurance system we really need and which is enjoyed, Canada, Scandinavia, et al.
It remains to be seen if a Clinton administration will really fight for the public option but making sure that this plank in the Democratic Party platform is front-and-center in the campaign and the public discussion is critical to ensuring that it will.
Why no mention of the public option?
Hillary Clinton's website (to which you provide a link) confirms her support for a public option in healthcare coverage (Medicare for those 55 years and older). This was a hard-won plank in the 2016 Democratic Party platform which enjoys the enthusiastic support of millions. They understand the considerable weaknesses of the current system which have been underscored by recent actions of private insurers re. the ACA. Many see the public option as an incremental advance toward the national health insurance system we really need and which is enjoyed, Canada, Scandinavia, et al.
It remains to be seen if a Clinton administration will really fight for the public option but making sure that this plank in the Democratic Party platform is front-and-center in the campaign and the public discussion is critical to ensuring that it will.
4
The editorial ignores the critical reality that the U.S. Is the only nation that doesn't attempt to regulate costs of essential disease services.
This - the opportunity to make almost whatever profit you wish from sick patients (and the worried well) - is the driving force for the massive over "consumption" of "health" services and products.
Until this "wound" is treated, our economy, nation and ordinary citizens will continue to suffer.
This - the opportunity to make almost whatever profit you wish from sick patients (and the worried well) - is the driving force for the massive over "consumption" of "health" services and products.
Until this "wound" is treated, our economy, nation and ordinary citizens will continue to suffer.
2
Healthcare in America is both undergirded and undermined by the "market principles" politicians make it adhere to.
I have what is regarded as an excellent healthcare plan provided by my employer. Every year the costs of everything goes up, with no expansion of services: premiums, deductibles, co-payments, co-insurance - they only ever go up.
There is no market in healthcare. I am locked into my healthcare plan with my employer, since I would never find as a good a deal as they provide, even if it always costs more ever year.
I cannot "shop" around for doctors or ambulances or emergency rooms, since as a patient I am not a customer.
There is no market in healthcare. The "customers" are captives of the system. Furthermore, our "market"-based system, which is run for profit, restricts freedom of choice for patients. In national health plans anywhere else in the world (which I've experienced), such as in Canada, you can search out any doctor you want, since they are all part of the one system.
Americans are duped in this matter, as in so many others, by the obfuscations and lies of the right-wing propaganda machine.
I wonder how many die every year for lack of ready access to a doctor or leaving a doctor's visit too late for fear of costs?
I have what is regarded as an excellent healthcare plan provided by my employer. Every year the costs of everything goes up, with no expansion of services: premiums, deductibles, co-payments, co-insurance - they only ever go up.
There is no market in healthcare. I am locked into my healthcare plan with my employer, since I would never find as a good a deal as they provide, even if it always costs more ever year.
I cannot "shop" around for doctors or ambulances or emergency rooms, since as a patient I am not a customer.
There is no market in healthcare. The "customers" are captives of the system. Furthermore, our "market"-based system, which is run for profit, restricts freedom of choice for patients. In national health plans anywhere else in the world (which I've experienced), such as in Canada, you can search out any doctor you want, since they are all part of the one system.
Americans are duped in this matter, as in so many others, by the obfuscations and lies of the right-wing propaganda machine.
I wonder how many die every year for lack of ready access to a doctor or leaving a doctor's visit too late for fear of costs?
2
As a self-employed entrepreneur, I was forced to pay exorbitant premiums and high deductibles for health insurance for many years.
Finally, Medicare entered my life.
What a fabulous difference.
It is way past time the politicians in Congress accept the inevitable and resign from Big Pharma's payroll.
Medicare for all.
It is a human right.....not a privilege.
Finally, Medicare entered my life.
What a fabulous difference.
It is way past time the politicians in Congress accept the inevitable and resign from Big Pharma's payroll.
Medicare for all.
It is a human right.....not a privilege.
4
After a 15 year pro bono practice at a federally mandated youth and indigent health care center, I must say that nothing raises the self-worth of a person more than universal health care, without which employment and a degree of economic security are impossible for so many. Likewise, nothing would improve the self-worth and mutual respect of Americans for their government than the gestalt of universal health care. The time has come to revive the American Dream for each individual, for the well-being of all.
6
I have Medicare, so for me the cost of Prescription Drugs is the problem Even the cost of generics are getting very high. I think the government should work on reducing the cost of these Drugs. Every other country in the EU pays less then we do for these medications. It is time the government held down the costs. Even with a prescription drug insurance, I have a few medication in the Formulary 4 category,
To me the government should be able to negotiate a prices for medications as is done in other countries.
To me the government should be able to negotiate a prices for medications as is done in other countries.
3
It is all about the money and risk. Healthcare is following the incentives, activity equals income, results are not profitable for many in our healthcare system. There is even a separate language to cloak what is happening. "Medical Loss Ratio," in insurance-speak means the money insurance companies spend on actually paying for care. "Up-coding," is the practice of healthcare providers to increase their level of payment by using codes that reflect a more serious condition so that they will get paid more.
In healthcare, risk determines who is financially responsible. Many insurance companies have converted to managing employer benefits, the risk is increasingly shifted to the employer. The employer is shifting the risk to the employee and while the percent increase in salary is often in the low to mid-single digits, the percent increase in cost of healthcare paid by employees is often more than twice the salary increase. The math is simple, employees are losing ground every year. Despite the cries by some that government can't do anything right, it is Medicare and not the private sector that is leading the move to align the incentives of healthcare with patient outcomes. Some of same opponents to government are often opposed to taxes. Employees are paying the heaviest "tax" in the world for healthcare, only this "tax" is going into the pockets of the healthcare system, "a rose by any other name..."
In healthcare, risk determines who is financially responsible. Many insurance companies have converted to managing employer benefits, the risk is increasingly shifted to the employer. The employer is shifting the risk to the employee and while the percent increase in salary is often in the low to mid-single digits, the percent increase in cost of healthcare paid by employees is often more than twice the salary increase. The math is simple, employees are losing ground every year. Despite the cries by some that government can't do anything right, it is Medicare and not the private sector that is leading the move to align the incentives of healthcare with patient outcomes. Some of same opponents to government are often opposed to taxes. Employees are paying the heaviest "tax" in the world for healthcare, only this "tax" is going into the pockets of the healthcare system, "a rose by any other name..."
2
The anxiety of many about being forced to pay for poor people's healthcare is a major factor in public anger toward Obamacare. Some individual plans were cancelled or had premiums increased (premiums that have been rising for years at 10-15% annual clip before ACA!!).
But the real way to promote a rational fix is to understand that costs go down with two basic features:
-everyone is in
- economies of scale
These are not socialist theories- these are economic realities.
Having tens of milluons of uninsured people maximizes costs by delying care until problems are acute, forcing hospitals to shift costs to the insured since they are mandated to provide care to the uninsured and perpetuating the cherry-picking, denials and profiteering that corrupts insurance, pharmaceutical & procedure/device companies.
Gradually expanding Medicare as a public option appears the most pragmatic route to universal coverage. Everyone will have a 'premium' deducted or subsidized. Medicare is an imperfect system but is immensely more cost efficient than the private market which has had 30 years to bend the cost curve thru managed care and failed. The Market only added administrative costs, skyrocketing costs and shoddy care.
But the real way to promote a rational fix is to understand that costs go down with two basic features:
-everyone is in
- economies of scale
These are not socialist theories- these are economic realities.
Having tens of milluons of uninsured people maximizes costs by delying care until problems are acute, forcing hospitals to shift costs to the insured since they are mandated to provide care to the uninsured and perpetuating the cherry-picking, denials and profiteering that corrupts insurance, pharmaceutical & procedure/device companies.
Gradually expanding Medicare as a public option appears the most pragmatic route to universal coverage. Everyone will have a 'premium' deducted or subsidized. Medicare is an imperfect system but is immensely more cost efficient than the private market which has had 30 years to bend the cost curve thru managed care and failed. The Market only added administrative costs, skyrocketing costs and shoddy care.
7
The planet, safely through the autumnal equinox, appears indifferent to the persistence of binary choosing of chief executive in.the most powerful of human institutions on its surface. The fault lies not with Mrs. Clinton who can more easily imagine a threat to the hegemony of this country than understand that health care is not a commodity. Not even in a polity attempting to impose its model on the civilized world, some whose ‘capitalist’ countries have made health care a governmental responsibility rather than another field of investment for private capital. But one of the chief reasons for instituting a federal system (people are not prevented from crossing state borders to seek the best care for their bodies) is in fact cost control. The good of the planet at this time can be pursued by governmental reduction of new fields of investment for gain; rather than expansion. Protecting that cancerous growth by law, enforced by the courts and the threat of a nuclear arsenal, interferes with the protections required by the present, the impending, and unforeseeable consequences of climate change. The situation is critical. The electoral discussion in the U. S. is closed to parties that could bring these recognitions to the table. Mrs Clinton, backed by her party is willing to debate these matters with Mr. Trump, Neither is prepared to entertain analyses from third parties such as that represent by Jill Stein. Why not? This is a truly political question.
America's political and economic philosophy: Never give a sucker an even break. The people had alternatives but they allowed themselves to be corrupted at every level. People needed to resist or at least opt out where possible but they never did so in meaningful numbers. Instead, they chose to go along to get along and play the blame game. Thus, they're going to ride their rotting system all the way down to zero just like the erstwhile soviets did.
4
Why not enough attention? Because no one wants to take-on the monoliths, like the Medical Industry. Obama tried and barely survived, and Hillary knows IF she brings it up, the Right will remind us of her failure when Bill was President.
We don't have Dragon slayers anymore. Except for Elizabeth Warren. She seems to be the ONLY one in Congress with the moxy to take on the dragons and giants. She's like Snow White, but there are no helpful dwarfs around her, instead its mostly wicked trolls. Trolls who manage to get elected by never doing anything meaningful for the voters. Just spout their ideological mantras; "give more to the rich, and let Corporations run wild!"
I see a poster here wants to blame the press and academia. Sure, blame the press (which could do a better job) and the smart people...just like every other nation about to be taken over by a despot. "Its the academics and the loathsome press behind our woes...as well as immigrants." (same poster)
Its so NOT any of those parties running us down. Its that voters like that poster have been voting against their own best interests, mostly in GOP candidates for decades now. Electing men and few women, who take from the electorate, not give to. Electing those who undermine employer protection laws, bust unions, talk about our children as the future, but then fail to support education and after school activities for all kids, not just the wealthy. Elect people who wont regulate predatory financial institutions.
We don't have Dragon slayers anymore. Except for Elizabeth Warren. She seems to be the ONLY one in Congress with the moxy to take on the dragons and giants. She's like Snow White, but there are no helpful dwarfs around her, instead its mostly wicked trolls. Trolls who manage to get elected by never doing anything meaningful for the voters. Just spout their ideological mantras; "give more to the rich, and let Corporations run wild!"
I see a poster here wants to blame the press and academia. Sure, blame the press (which could do a better job) and the smart people...just like every other nation about to be taken over by a despot. "Its the academics and the loathsome press behind our woes...as well as immigrants." (same poster)
Its so NOT any of those parties running us down. Its that voters like that poster have been voting against their own best interests, mostly in GOP candidates for decades now. Electing men and few women, who take from the electorate, not give to. Electing those who undermine employer protection laws, bust unions, talk about our children as the future, but then fail to support education and after school activities for all kids, not just the wealthy. Elect people who wont regulate predatory financial institutions.
6
Bo Regard: I Agree with much of what you say but Elizabeth Warren was a huge disappointment , had she supported Bernie we might not be having this conversation as there would be someone in the race who truly cared for Americans and wasn't in the pocket of all the usual suspects. Elizabeth Warren was my hero I wanted her to be the first woman President but it turns out she was part of the status quo, all foot stomping, yammering away and nobody goes to jail, for the millions these clowns have gotten away with I would be glad to be humiliated for a half hour before a Senate Committee, we know after all it's showman ship, in good fun, see you later at the club. Sort of a Mary Jo White or Janet Yellen all posturing and in the end it means nothing except the rich get richer and the rest of us poorer.
All these complaints from people about healthcare plans. Vote for a Democratic Congress. Republicans don't believe philosophically or in their platform in healthcare. It would be "tremendous," a truly "great" thing to have a functioning Congress again. Get rid of your dead log Republicans. Can you hear that Ohio? Iowa? Has the last 8 years of Republicans gotten you anything? Another few years won't get you any more. You'll continue to get kicked around.
15
Hillary is not not only going to make our health care system perfect but invite the entire world here to enjoy it with us.
I picked out a blue flying unicorn. What color will yours be? Will yours talk, or sing?
I picked out a blue flying unicorn. What color will yours be? Will yours talk, or sing?
4
Were I silly enough to be a Trump cheerleader, I'd ixnay on the sky-a i-pay.
Seriously, your boy seems to have nothing whatsoever to offer by way of actual plans--he simply promises that they'll be yuge, and spouts nonsense about how he'll have everything fixed in a year.
Oh wait, I have been unfair. He's pretty clear about his plan to hand himself a 21% raise, by way of trillions in tax cuts for the wealthy.
Seriously, your boy seems to have nothing whatsoever to offer by way of actual plans--he simply promises that they'll be yuge, and spouts nonsense about how he'll have everything fixed in a year.
Oh wait, I have been unfair. He's pretty clear about his plan to hand himself a 21% raise, by way of trillions in tax cuts for the wealthy.
2
As a physician for 35 years, it has been heartbreaking to see the way that the American public has allowed itself to be at the mercy of profit making insurance companies, with the incredible financial waste that is inherent in their bureaucracies and business model: CEOs that are paid in the tens of millions of dollars per year and policyholders' money going to make stockholders more wealthy. It is sad that we live in a country where health care is treated like any other widget that is bought and sold, my labor included. Health care is not getting attention in this campaign because there is very little to discuss, according to the two party ruling system we have here. How about phasing out the insurance companies in favor of a national plan like Canada or the European countries have, where the people who run the system do not fly off to vacations on corporate jets? Perhaps it is time in this country to look beyond the two parties that are basically brought to us by the corporations that profit from the party leadership and government control they have in their grip. The Green Party with Jill Stein as Presidential candidate stand for real change in our health care system - a national health care plan, where our money would go to provide health care instead of being siphoned off to make rich people become richer. It's time for people in the U.S. to wake up.
23
It would help if Jill Stein offered ANY details of how she plans to get there, what the costs would be like, and what precisely plans would be.
Adjectives and a claim that the savings would be--this is a quote--"huge," are not the same as details and explanations.
Adjectives and a claim that the savings would be--this is a quote--"huge," are not the same as details and explanations.
2
It's called culling the herd. Being poor, old, sick, diseased and or handicapped is not allowable in our country. Matter of fact you are disgraced if you are.
Please go away invisible humans! You're costing us money for your useless existence is what the powers that be tell millions of Americans.
Until you yourself go bankrupt and must sell everything you own to pay for your or a loved one's unexpected medical costs or treatments, due to accident or illness, don't say anything against those with less. Happens.
Please go away invisible humans! You're costing us money for your useless existence is what the powers that be tell millions of Americans.
Until you yourself go bankrupt and must sell everything you own to pay for your or a loved one's unexpected medical costs or treatments, due to accident or illness, don't say anything against those with less. Happens.
7
$1221 out-of-pocket to pay for a year of healthcare. Bet you that's less than average person is paying yearly to have their smart phone. What's more important?
6
Only $1,221? Check your coverage, especially your deductibles, copays, and drug coverage.
2
The average deductibles quoted in this article sound perfectly fine to me. Prior to the Affordable Care Act, my spouse and I (both of us self-employed) had a policy with a deductible/out-of-pocket maximum of $4800 per person. Our premiums were $469/month. After the passage of the ACA, the California exchange quoted us $10,800/month for a Bronze Plan (the cheapest) with a deductible/OOP of $6350 per person.
We don't like having to pay 2.5% of our income in fines to the IRS for the sin of not being able to afford health insurance, but the alternative would be ruinous for us.
Donald Trump clearly has no clue how to solve this (or any other) problem. And Mrs. Clinton insists we will "Never, EVER" have true national health care like they do in every other first-world nation except ours.
Not much hope on offer in this election.
We don't like having to pay 2.5% of our income in fines to the IRS for the sin of not being able to afford health insurance, but the alternative would be ruinous for us.
Donald Trump clearly has no clue how to solve this (or any other) problem. And Mrs. Clinton insists we will "Never, EVER" have true national health care like they do in every other first-world nation except ours.
Not much hope on offer in this election.
3
I hear you, Frank. And agree. When I was 63 1/2 I went from a group policy at Kaiser costing me $525 a month and no deductibles (minimal copay) to ACA Bronze Plan at Kaiser with $550 a month and $6000 max deductibles per year. I was the same person, why the doubling of costs?
2
Given that privilege and entitlement disables Trump from understanding the awful predicament that the poor go through (when sick), he has not earned the right to criticize, let alone, destroy the Affordable Care Act. Vulgar Trump hasn't the faintest idea how the majority lives and struggles to make ends meet, given that this poor rich guy never grew up to understand others by walking in their shoes. And yet, he demagogues the health care issue at will. Fortunately, we can predict fairly accurately that, in the coming debate, his bottomless ignorance will be unmasked, and his vainglory subdued. As to you Hillary, please relax a bit, don't take yourself too seriously, and enjoy the show.
6
My brother is a doctor in private practice, and he told me how he has to set prices to break even under our current insurance system. As a preferred provider, he is supposed to accept anywhere from 35-50% of the "list price" for each procedure as full payment. This means that he has to set his "list price" artificially high to break even. Say that a certain procedure costs out at $1000, including overhead and a bit of profit.
In order to obtain that $1000, he has to set the procedure at a "list price" of $2800. Not only that: he frequently has to fight the insurance companies for payment, because they will think up reasons to deny coverage, especially in the case of married couples who receive different insurance through their respective jobs and are required to take family coverage.
He recently dropped out of the network of one of the three insurance companies that operates in Minnesota, because they tried to weasel out of nearly every bill he presented.
He added that sometimes patients ask him how much a procedure will cost, and he has to tell them that he doesn't know: it depends on whether they have insurance, who their insurer is, and what their deductibles and co-pays are.
Far from being a solution, private insurance is a drag on efforts to rein in medical costs. We need single payer, or at least a public option that will give the insurance vultures some real competition.
In order to obtain that $1000, he has to set the procedure at a "list price" of $2800. Not only that: he frequently has to fight the insurance companies for payment, because they will think up reasons to deny coverage, especially in the case of married couples who receive different insurance through their respective jobs and are required to take family coverage.
He recently dropped out of the network of one of the three insurance companies that operates in Minnesota, because they tried to weasel out of nearly every bill he presented.
He added that sometimes patients ask him how much a procedure will cost, and he has to tell them that he doesn't know: it depends on whether they have insurance, who their insurer is, and what their deductibles and co-pays are.
Far from being a solution, private insurance is a drag on efforts to rein in medical costs. We need single payer, or at least a public option that will give the insurance vultures some real competition.
23
The reason we even have ACA is because the free market system wasn't working - costs were going up crazy amounts every year. BUT, ACA didn't solve that problem, because we STILL have PRIVATE insurance companies running the show, and we did nothing within ACA to control the costs/prices that PRIVATE medical device companies, pharma, etc. charge to the consumer and the insurance companies.
I live in northwest Montana and have many Canadian friends - some that have second homes here and also just come down to vacation. Is it fair that I can drive to Canada and buy the same drugs there at a fraction of the costs as in the U.S.? Canadians I know have few complaints about their healthcare system. They say the media has overblown the 'access issue'. If you need immediate surgery you get it. If you need emergency service you get it. You're not waiting around all the time. And a few of those same Canadians DO have supplemental private insurance. It costs very little. And if they want elective surgery/procedures and have to wait for it a long time to have it done in Canada then they will drive down to the U.S. and get it done.
I believe some kind of public option is needed. There is no true competition when all these private companies OWN the markets. Medicare may have fraud issues which definitely need to be addressed, but I don't know anyone that does not like their Medicare coverage. And I do not know of anyone who has access issues with Medicare - even here in Montana.
I live in northwest Montana and have many Canadian friends - some that have second homes here and also just come down to vacation. Is it fair that I can drive to Canada and buy the same drugs there at a fraction of the costs as in the U.S.? Canadians I know have few complaints about their healthcare system. They say the media has overblown the 'access issue'. If you need immediate surgery you get it. If you need emergency service you get it. You're not waiting around all the time. And a few of those same Canadians DO have supplemental private insurance. It costs very little. And if they want elective surgery/procedures and have to wait for it a long time to have it done in Canada then they will drive down to the U.S. and get it done.
I believe some kind of public option is needed. There is no true competition when all these private companies OWN the markets. Medicare may have fraud issues which definitely need to be addressed, but I don't know anyone that does not like their Medicare coverage. And I do not know of anyone who has access issues with Medicare - even here in Montana.
18
Isn't Obamacare enough?
4
I believe Trump will shock everyone at the debate with his single-payer-by another name plan. It's the press's obsessions with his personality that will let him spring this surprise - they simply never asked.
3
The CEO of the company that manufacturers the Epipen is the daughter of Manchin (D, W.V). Mylan has made contributions to many Ds as well as to the Clinton Foundation.
The FDA refuses to approve products that compete with the Epipen.
If you believe that Hillary is going to do anything that will disadvantage her cronies, I have a bridge in Brooklyn that I'd love to sell you. [Meanwhile, in another part of town, the Clinton Foundation, acting as an agent for government funds flowing through the UN, is buying AIDS drugs from Mylan. How much would you like to bet that the premium Mylan is being paid exceeds the price they paid in tribute to the Clinton Foundation.]
Michelle Obama was paid $350,000 per year for a part time job at a "charity" hospital in Chicago while Barrack was a US Senator. Her pay doubled from $175k when he moved from being a state legislator to the US Senate. That hospital has raised its rates under ObamaCare and is now charging even more than before.
The only winners in the ObamaCare legislation are big medicine, as intended. Anyone who believes that Hillary's detailed plans to make modifications are going to correct the glaring structural defects or will reduce the profits of her cronies is delusional.
The Obama/Hillary administration is corrupt, as are the executive branch FDA, EPA and IRS.
The FDA refuses to approve products that compete with the Epipen.
If you believe that Hillary is going to do anything that will disadvantage her cronies, I have a bridge in Brooklyn that I'd love to sell you. [Meanwhile, in another part of town, the Clinton Foundation, acting as an agent for government funds flowing through the UN, is buying AIDS drugs from Mylan. How much would you like to bet that the premium Mylan is being paid exceeds the price they paid in tribute to the Clinton Foundation.]
Michelle Obama was paid $350,000 per year for a part time job at a "charity" hospital in Chicago while Barrack was a US Senator. Her pay doubled from $175k when he moved from being a state legislator to the US Senate. That hospital has raised its rates under ObamaCare and is now charging even more than before.
The only winners in the ObamaCare legislation are big medicine, as intended. Anyone who believes that Hillary's detailed plans to make modifications are going to correct the glaring structural defects or will reduce the profits of her cronies is delusional.
The Obama/Hillary administration is corrupt, as are the executive branch FDA, EPA and IRS.
5
One obvious answer to this problem is to streamline our system with a single-payer option and completely divorce health insurance from employment. The reason we even have employer-sponsored insurance goes back to the years immediately following WWII when unemployment was low and companies were competing for workers; health coverage was added as a benefit to attract qualified candidates. With rising health care costs in the 21st century and a completely different health care system than we had 65 years ago, there is simply no justification for maintaining the status quo. Given that the GOP is supposedly the party of business, I have been scratching my head for years over the fact that they haven't advocated for this change since, in their own words, the cost of health coverage is damaging to small business. Health insurance coverage is a personal/family and public policy issue with no connection to employment, and we need to move towards structuring our health care system as such. This is the way it's done in other First World nations where they pay much less for health care and get much more than we do.
9
I am not planning to watch the debate.
I already know what Roger Ailes, Stephen Bannon and KellyAnne Conway are thinking and I don’t want to know any more.
I already know what Roger Ailes, Stephen Bannon and KellyAnne Conway are thinking and I don’t want to know any more.
2
Clinton has been talking about health care for years and actually knows something about the issue. Republicans have essentially ignored the issue for the past 30 years and think there is a free market solution. Sadly the real money in medicine is in administering the care not actually providing it. I told my son to get a degree in health care administration not medicine and he'd be a millionaire before he was 40. I was right.
6
Gee -- and I thought the ACA was supposed to drive down medical costs. Hmmm......
4
"Health Care Deserves More Attention on the Campaign Trail"
No, actually, it doesn't. "Health care" is not among the enumerated powers granted Congress or the federal government.
The only sense in which "health care" merits "more attention on the campaign trail" is with regard to the plan of each candidate to abolish Obamacare and start the phase-out of Medicare and Medicaid.
No, actually, it doesn't. "Health care" is not among the enumerated powers granted Congress or the federal government.
The only sense in which "health care" merits "more attention on the campaign trail" is with regard to the plan of each candidate to abolish Obamacare and start the phase-out of Medicare and Medicaid.
1
And replace it with?
1
We can't have single payer health care because our politicians -- who are supposed to represent us - -represent Big Health Insurance and Big Pharma who pay for their campaigns. Both parties are guilty.
7
I think we all should know by now, unless one has been in a coma the past year (hopefully covered), where the candidates stand. Hillary is for expanding the PPACA to include those not covered, and proposes a government option.
Trump is a repeal and replace guy. Following long-held Republican talking points, Trump is big on the repeal part, extremely vague on the replace part. Yes, I've read how Republicans want to keep the "good" parts of what they refer to as Obamacare (the longer it is in place the more Republicans will be sorry they put President Obama's moniker on it), and get rid of the "bad" parts, parts which will be named at a future date.
You see, Republicans just want to "help" President Obama. They want to repeal Obamacare and, well, eventually get around to replacing it with a free market system where every consumer can individually bargain with the mighty insurance industry. How kind of them. I can just picture my 95 year old semi-coherent mother making such a choice. Hey Mom, you're free! You can do as you please, and pick your own plan. What do your think about that, Mom?... Mom?... Oh, Mom?
Republicans, always so helpful. I remember how helpful they wanted to be "improving" FDR's Social Security Act. FDR said, "Not only do Republicans now love it. They want to make it better! They want to "improve" it! And, it won't cost taxpayers a thing!". Yes, those are the Republicans I remember. With friends like those...
DD
Manhattan
Trump is a repeal and replace guy. Following long-held Republican talking points, Trump is big on the repeal part, extremely vague on the replace part. Yes, I've read how Republicans want to keep the "good" parts of what they refer to as Obamacare (the longer it is in place the more Republicans will be sorry they put President Obama's moniker on it), and get rid of the "bad" parts, parts which will be named at a future date.
You see, Republicans just want to "help" President Obama. They want to repeal Obamacare and, well, eventually get around to replacing it with a free market system where every consumer can individually bargain with the mighty insurance industry. How kind of them. I can just picture my 95 year old semi-coherent mother making such a choice. Hey Mom, you're free! You can do as you please, and pick your own plan. What do your think about that, Mom?... Mom?... Oh, Mom?
Republicans, always so helpful. I remember how helpful they wanted to be "improving" FDR's Social Security Act. FDR said, "Not only do Republicans now love it. They want to make it better! They want to "improve" it! And, it won't cost taxpayers a thing!". Yes, those are the Republicans I remember. With friends like those...
DD
Manhattan
3
I wish I could give all Americans what I have ; Single payer health care.
I cannot, so I rail against the profit gouging system that you do have that is not the best system in the world. The best systems in the world cover the most amount of people while being efficient and low cost. The best systems in the world do not let their patients suffer or die. The best systems in the world do not wipe out a lifetime of savings for getting sick.
For all of the above I just go see my local GP and that is that, I have time to blog about it afterwards. For you an odyssey begins every time you might feel a pain and you then have to decide if it is worth it to go see someone, If you have insurance or the time or the inclination to go through the maze of a system.
My empathy to you Americans. I hope you can join us in the civilized world as soon as possible.
I cannot, so I rail against the profit gouging system that you do have that is not the best system in the world. The best systems in the world cover the most amount of people while being efficient and low cost. The best systems in the world do not let their patients suffer or die. The best systems in the world do not wipe out a lifetime of savings for getting sick.
For all of the above I just go see my local GP and that is that, I have time to blog about it afterwards. For you an odyssey begins every time you might feel a pain and you then have to decide if it is worth it to go see someone, If you have insurance or the time or the inclination to go through the maze of a system.
My empathy to you Americans. I hope you can join us in the civilized world as soon as possible.
8
Any public official that takes money from the health care industry is automatically biased. Money talks, few congressmen walk. Health care is an incestuous relationship between congressmen, the health care lobby, physicians, pharmaceutical companies, hospitals and insurance companies. The only people left out of the profiteers of health care is the consumer. We don't even get the benefit of free market transparency. How can we have a free market health care when the consumer is not provided a price?
I understand that healthcare consumes 25% of the average income of Americans, rising costs that far outstrip inflation and yet we have uninformed FOX news republicans defending it.
I understand that healthcare consumes 25% of the average income of Americans, rising costs that far outstrip inflation and yet we have uninformed FOX news republicans defending it.
4
What problem? The President assured us "You can keep your present doctor" "If you like your plan you can keep your plan." "The first year alone you will save $1,800." He didn't lie to us did he?
The answer is obvious, just ensure that all Americans have a health care plan that is at least as good as the President and members of congress, and make sure they pay no more then our "Public Servants" do.
Problem solved!
The answer is obvious, just ensure that all Americans have a health care plan that is at least as good as the President and members of congress, and make sure they pay no more then our "Public Servants" do.
Problem solved!
4
As part of this campaign I would have liked to hear a discussion of dental care expenses. I live in the South and you would be astonished at how many young people have rotting teeth. Why is this? There is very little transparency when going to a dentist for major work.
5
>>>
Like why my bi-weekly Aetna payment went from $59 to $149 this year. N.B., I'm single, just me, myself and I.
Yeah that will be a real popular topic.
The ACA must be changed to single payer
Remember Trump only needs to point out the negatives to every issue never the solutions, and the ignorant masses eat it up.
Like why my bi-weekly Aetna payment went from $59 to $149 this year. N.B., I'm single, just me, myself and I.
Yeah that will be a real popular topic.
The ACA must be changed to single payer
Remember Trump only needs to point out the negatives to every issue never the solutions, and the ignorant masses eat it up.
7
The health care mafia owns both parties period: you can jump up and down and scream all you want but this is not G.O.P. Created problem, there were the votes to push through a single payer system even after Teddy Kennedy died but the current administration chose to compromise resulting in essentially no change other than Insurance Companies were no longer allowed to turn down patients with pre existing conditions. This could have been written on one page the other thousands of pages were written to insure the health care cartels profits remain at obscene levels. There is no talk about it from Hillary because both parties representing the status quo are owned by big health, big pharma, big banks and the war machine. The day after the A.C.A. passed the health care stocks went on a tear and haven't stopped as the care gets worse or disappears as in the rural area of Oregon we live in and the deductibles, co pays continue to rise and what they will cover whether RX or care is whittled down. Bernie wanted to change that and the D.N.C. threw him under a bus. Meanwhile C.E.O.s pay packages remain stratospheric none more so than Wm. McGuires stunning golden parachute from United of $1,600.000,000.00. Some was clawed back due to back dating of options that would have put the average American in prison. Both major parties have shafted the American people we must clean house and if that means having a blowhard who might turn out to be another Truman in office for four years so be it.
7
Why hasn't health care received more attention on the campaign trail? That's easy. Because Obamacare is the source of most of the problems and the media continues to cover for the guy who signed it into law.
6
I'm so old I can remember when the media was independent and covered for no one's arrogant, stupid mistakes.
4
One need look no further than one headline over to see how incoherent the political philosophy of the neoliberal establishment has become.
America cannot provide decent housing, education, medical care or jobs for its own citizens, but "we" are told we need to open our doors to 65 million displace refugees from countries we've spent trillions of dollars bombing into rubble. Moreover, when the refugees get here, they will fill schools and hospitals and highways and line up for jobs and the standard of living in America, already in freefall, will fall further and faster.
I cannot recall a worse time for the working class of this country in my lifetime going back to 1952. The people have been sold out by their own leadership and brainwashed by their own academics and press apparatchiks.
It is beyond sad.
Hopeless...
America cannot provide decent housing, education, medical care or jobs for its own citizens, but "we" are told we need to open our doors to 65 million displace refugees from countries we've spent trillions of dollars bombing into rubble. Moreover, when the refugees get here, they will fill schools and hospitals and highways and line up for jobs and the standard of living in America, already in freefall, will fall further and faster.
I cannot recall a worse time for the working class of this country in my lifetime going back to 1952. The people have been sold out by their own leadership and brainwashed by their own academics and press apparatchiks.
It is beyond sad.
Hopeless...
7
Many Americans on Medicaid cannot find a doctor who will take them. If/when they do, they often must wait an unconscionably long time to be seen. No one wants to talk about this (as no one wants to talk about the plight of the poor generally).
There's only one solution; everyone knows it. Single payer, Medicare-for-All; call it what you will. Unlike the ACA, it will not be means-tested. Everyone will pay according to their ability; everyone will receive the same benefits.
Such a program will have the muscle to negotiate all prices, including drug prices. And it will have the political support that broad-based programs like Social Security and Medicare now enjoy.
If Hillary wins, she should give a high priority to the midterm elections, with a focus on the House of Representatives. Only by controlling Congress can Democrats advance health care and all the other important issues facing us today.
There's only one solution; everyone knows it. Single payer, Medicare-for-All; call it what you will. Unlike the ACA, it will not be means-tested. Everyone will pay according to their ability; everyone will receive the same benefits.
Such a program will have the muscle to negotiate all prices, including drug prices. And it will have the political support that broad-based programs like Social Security and Medicare now enjoy.
If Hillary wins, she should give a high priority to the midterm elections, with a focus on the House of Representatives. Only by controlling Congress can Democrats advance health care and all the other important issues facing us today.
15
Everyone will give according to their ability. Everyone will take according to their needs. It seems like I've heard something like that before.
Medicare for all will quickly become Medicaid for all. How can it not?
Medicare for all will quickly become Medicaid for all. How can it not?
1
Reply to PWR,
There's no way to provide universal health insurance without some redistributive effects – from young to old, and from affluent to poor. In fact, there is no way to maintain a safety net generally, without redistributive effects, including from wealthy states to poor states.
There's no way to provide universal health insurance without some redistributive effects – from young to old, and from affluent to poor. In fact, there is no way to maintain a safety net generally, without redistributive effects, including from wealthy states to poor states.
3
Single payor will be Medicaid for All, because that's all we can afford. (I believe you do realize Medicaid is "single payor" for the poor and why would single payor for rest of us be any better)
Maybe she could bring up health care on her own in the debate? Surely it would capture the attention of many voters who should not consider ever voting for her opponent.
5
Hillary is beholden to Big Pharma and Big Health Insurance. She may talk - -but she will never go against her campaign financiers.
2
In general, the media has shamelessly let Republicans repeat the empty "repeal and replace" mantra while rarely calling their bluff on the "replace" by challenging them "with what?" Trump, with no idea of his own, has simply jumped on the bandwagon of absurdity. This has been going on for years and now Trump's juvenile "with something beautiful" is staring us in the face. Too bad it's a matter of life and death.
4
To the Editors,
Cogent, reasonable arguments but I think I would be better served by the NYT if this paper told me how much money, in legal "donations", each candidate has taken from:
a. The insurance companies
b. The health care providers, ie, doctors and the like
c. Big Pharma
Perhaps the reason both candidates are reticent to speak on health care is the desire not to upset the flow of cash.
Cogent, reasonable arguments but I think I would be better served by the NYT if this paper told me how much money, in legal "donations", each candidate has taken from:
a. The insurance companies
b. The health care providers, ie, doctors and the like
c. Big Pharma
Perhaps the reason both candidates are reticent to speak on health care is the desire not to upset the flow of cash.
4
here in Indiana, according to the tax code, there is no difference between a doughnut, or spinach. Both are treated as food. Neither are taxed. Like doctors, politicians (lawyers), are trained to treat the disease, not prevent. There are no lobbyists for the prevention industry. Ask Hillary. She'd know.
Neither of these clowns will do anything to help you here, America. One is a crass idiot. The other is owned, lock, stock and barrel. Plus as members of the Ruling Class, their healthcare is covered. They DO NOT feel your pain
My advice? Eat right. Exercise. And don't get sick or have an accident. Good luck America. You're gonna need 4 more years of EXTREMELY good luck to get past this debacle
Neither of these clowns will do anything to help you here, America. One is a crass idiot. The other is owned, lock, stock and barrel. Plus as members of the Ruling Class, their healthcare is covered. They DO NOT feel your pain
My advice? Eat right. Exercise. And don't get sick or have an accident. Good luck America. You're gonna need 4 more years of EXTREMELY good luck to get past this debacle
3
There is only one answer for our problem and that is a single payer national healthcare system. Curiously Trump was previously for this and Clinton was for something similar when she was first lady.
Insurance companies with billions of dollars to lose have no intention of letting this happen.
As for buying into Medicare, I think many people not yet eligible for this believe that it is free. For basic Medicare, a supplemental plan to cover the 20% of fees not cover by the basic plan, and a required drug plan, I pay $270 per month plus a $166 deductible and $20 per doctor visit. I fortunately have the money to pay for it but I know that for many people this is a stretch. And yes lower income people can qualify for Medicaid but in many places it's hard enough to find a physician who will accept Medicare and almost impossible to find a competent one who will accept Medicaid.
Insurance companies with billions of dollars to lose have no intention of letting this happen.
As for buying into Medicare, I think many people not yet eligible for this believe that it is free. For basic Medicare, a supplemental plan to cover the 20% of fees not cover by the basic plan, and a required drug plan, I pay $270 per month plus a $166 deductible and $20 per doctor visit. I fortunately have the money to pay for it but I know that for many people this is a stretch. And yes lower income people can qualify for Medicaid but in many places it's hard enough to find a physician who will accept Medicare and almost impossible to find a competent one who will accept Medicaid.
6
As a physician, I created the only plan I can think of that actually decreases costs, empowers patients, and restores physician autonomy. In sharing my idea, (www.changehealth.today ) I am shocked how appealing everyone thinks it is and the lack of reception it's getting from news media.
NYTimes, you stand in a unique position to vet the idea and share it with your readership. Change America by sharing this idea.
NYTimes, you stand in a unique position to vet the idea and share it with your readership. Change America by sharing this idea.
2
If you wonder why so many middle class and working class registered voters in this country are going to vote for Dr. Jill Stein on November 8th. You need look no further than Health Care and Health Insurance.
We need a single payer health care system that covers 100% of The US population. We are certainly not going to vote for Donald Trump and when it comes to health care and the cost of a college education Hillary Clinton is little better.
We need a single payer health care system that covers 100% of The US population. We are certainly not going to vote for Donald Trump and when it comes to health care and the cost of a college education Hillary Clinton is little better.
4
Only in the U.S. is so much of the money collected for health care distributed to the administration of that health care, rather than the actual delivery of health care.. Look to Europe, Canada Japan and most of the rest of the Civilized world for an affordable health care system. A single payer (i.e. the Federal government) that has control over the real cost of that health care is the only way the system can deliver the best care to all citizens, at the lowest cost. A republican Congress will never allow that to happen.
9
"Europe" does not have a unified approach to health care. Many countries have retained or returned some semblance of a free market. Others, like the single payer system in the UK are falling apart.
1
In US 65% of healthcare is funded by Government programs, the rest by private payors. If we want to solve the problem of cost of HealthCare in US, perhaps we should start where 65% of the problem is
I suppose in a normal time it would be nice to have some debate over issues, but this isn't a normal time. No one is going to do anything about health care (whatever that means) anytime in the next 4+ years.
What would be the point of this attention? Bait and switch? Pandering, posing, and posturing? Demagoguery? This campaign is a freak show. The sooner it ends the better. The less said, the better.
I'd ask the NY Times to simply stop covering it. Why do you bother? It is a waste of time and, actually, quite counterproductive. You've all done enough damage this year. Be quiet.
What would be the point of this attention? Bait and switch? Pandering, posing, and posturing? Demagoguery? This campaign is a freak show. The sooner it ends the better. The less said, the better.
I'd ask the NY Times to simply stop covering it. Why do you bother? It is a waste of time and, actually, quite counterproductive. You've all done enough damage this year. Be quiet.
6
This article fails to even mention one of the biggest burdens of healthcare insurance today, which is the insurers' insertion of balance billing clauses, mainly into emergency coverage provisions. Under these clauses, in-network providers can contract to doctors (mainly anesthesiologists, but also orthopedists and cardiologists, etc.) who are out of network--without informing the patient. These contractors are allowed to bill for balances due above and beyond the insurer's allowable amount. These balances don't hit the patient's out-of-network deductibles or out-of-pocket maximums. A google search will reveal a growing number of articles attempting to bring this subject into the political discussion.
8
The answer to the question posed by the editorial seems straightforward. Mrs. Clinton does not want to appear to distance herself from President Obama's ACA and making too many suggestions about fixing it would do just that. Her opponent does not talk about improvements because he has no plans regarding it and it is politically expedient to just denounce the ACA. I have not expected much from either candidate so I am not very disappointed.
5
The crisis in USA Health Care actually threatens the principals of our free market system. We have evolved to having no free market pricing at the HC check out counter. HC is a Frankenstein system with insurance companies, HC providers and Pharma fighting for the HC cash flow from the citizens of our country creating a manipulated system. Essentially there is no advocate for the individual in this system. The bad news is that people are beginning to not pay their bills and this breaks down financial integrity in our culture. The good news is that people realize for the most part the HC system is not their friend and they have to take care of their own health and improve lifestyle etc. This industry will radically shift in the next decade and many of the current business models will be “shorts” in the market eventually.
5
A lot of issues deserve more attention --- like the entire Eastern seaboard disappearing, but no, we focus on colds and emails and whatever inane comment Trump makes.
9
The entire eastern seaboard is not going to disappear.
2
The only reasonable, intelligent, humane way to take care of the health needs of all of us humans on earth is to fund it through our taxes. Not "insurance," which is merely a method of providing profit to the mega-business of insurers and the horses they rode in on.
We all pay according to our earnings -- excusing us from paying if we don't earn enough -- into the universal health care fund. We watch, very very closely, to keep us honest in our medical dealings (tracking both patient and doctor.) And fund drug researchers and manufacturers -- whose numbers should be limited; whose profits should be reasonable.
None of this will happen. Too weird to think that health care shouldn't make some people richer than Croesus ever dreamed of being.
We all pay according to our earnings -- excusing us from paying if we don't earn enough -- into the universal health care fund. We watch, very very closely, to keep us honest in our medical dealings (tracking both patient and doctor.) And fund drug researchers and manufacturers -- whose numbers should be limited; whose profits should be reasonable.
None of this will happen. Too weird to think that health care shouldn't make some people richer than Croesus ever dreamed of being.
13
why? because the ACA is supposed to be so great for people according to our right wing , corporatist Democrats.
6
The ACA is certainly not without its faults but it has resulted in more people with some form of health insurance coverage. I would be interested in hearing about your proposals for alternative ways to improve health care coverage if the ACA is repealed.
4
...As opposed to our right wing, corporatist Republicans who invented the thing and now want to take away even that.
4
Trump is a joke, but Hillary is bought and paid for by big-moneyed interests. I want no part of President Trump, but I am disturbed that Hillary is already a bad candidate and will be an even worse President.
This election is a disgrace.
#neverTrump
This election is a disgrace.
#neverTrump
8
RE: "...but I am disturbed that Hillary is already a bad candidate and will be an even worse President."
We won't know if Hillary will be a bad or good or even great President unless she is elected. As surgres stated he wants no part of a President Trump because he is a joke.
So, let's elect Hillary Clinton and see how good she can be. Health care has been an interest of hers for decades. Maybe she will be able to improve medical care in this country. I'm sure she'll try.
We won't know if Hillary will be a bad or good or even great President unless she is elected. As surgres stated he wants no part of a President Trump because he is a joke.
So, let's elect Hillary Clinton and see how good she can be. Health care has been an interest of hers for decades. Maybe she will be able to improve medical care in this country. I'm sure she'll try.
4
According to the CDC only 10% of healthcare costs in the US are spent on prescription drugs. The remainder are spent on hospital care, nursing care, medical clinics and physician services.
So why does the NYTimes focus on drugs?
Because pharma companies are easy targets with their over compensated executives and and lower tax rates.
Yeh - try starting up with hospitals and doctors, and see how far you get with them!
So why does the NYTimes focus on drugs?
Because pharma companies are easy targets with their over compensated executives and and lower tax rates.
Yeh - try starting up with hospitals and doctors, and see how far you get with them!
7
I am one of many senior citizens who can no longer afford my medications. I do just what so many others do -- take half the dosage, instead of the full amount and hope for the best. (BTW,the same meds cost 1/5 as much in Canada.)
3
The ACA was set up for the first and foremost purpose of providing revenue streams to investors and shareholders by allowing insurers and big pharma to have carte blanche power to underwrite their policies to their monetary advtantage instead of ours, the patients. Neither one of these candidates thinks this is the wrong way to run what really should be a patient centered national health system.
Sadly, this is what happens when you have a medical system based and run on for-profit basis and allow private sector providers to run health care as a revenue producing stream for investors. I will not vote for either one of these candidates.
Sadly, this is what happens when you have a medical system based and run on for-profit basis and allow private sector providers to run health care as a revenue producing stream for investors. I will not vote for either one of these candidates.
8
What we need, as always, is more freedom.
As a participant in the healthcare market as both I buyer and a seller, all I want is more freedom.
As a buyer, I want to buy the insurance or healthcare service that is right for me, or not at all if that is my choice. I want price transparency so I can comparison shop. I want to know what I am buying from healthcare vendors before I buy. And from insurers I want to cover only what I need to cover, and I want it to be "consumer driven". For me, a low price, high deductible plan with narrow coverage would be ideal (pre Obamacare, I insured my family of 4 for $200/month with such a plan).
As a seller, I want to compete in an open market. I don't want prices to be dictated to me by govt or third party payers. I want to offer my product in a competitive marketplace and let the consumers decide.
A single payer that dictates all my prices to me would akin to an anti-freedom Stalinist outcome, and has no place in a free society. Ask yourself if you want the govt to dictate to you the price for everything you sell.
Reforms along these lines would rationalize 80% of healthcare transactions and drastically reduce administrative costs.
As a participant in the healthcare market as both I buyer and a seller, all I want is more freedom.
As a buyer, I want to buy the insurance or healthcare service that is right for me, or not at all if that is my choice. I want price transparency so I can comparison shop. I want to know what I am buying from healthcare vendors before I buy. And from insurers I want to cover only what I need to cover, and I want it to be "consumer driven". For me, a low price, high deductible plan with narrow coverage would be ideal (pre Obamacare, I insured my family of 4 for $200/month with such a plan).
As a seller, I want to compete in an open market. I don't want prices to be dictated to me by govt or third party payers. I want to offer my product in a competitive marketplace and let the consumers decide.
A single payer that dictates all my prices to me would akin to an anti-freedom Stalinist outcome, and has no place in a free society. Ask yourself if you want the govt to dictate to you the price for everything you sell.
Reforms along these lines would rationalize 80% of healthcare transactions and drastically reduce administrative costs.
2
I've not had expensive spinal surgery (though one doc initially said I should) for long term lumbar condition because of quality chiropractic and neuromuscular massage. But this has been covered sparsely in the case of chiropractic and not at all with massage therapist. Along with specific kinds of exercise, I've kept going , progressing, but the cost has set me back from the rest of my life.
Thank you NYTImes, for writing on this important subject.
Thank you NYTImes, for writing on this important subject.
1
Didn't Obama solve healthcare by ramming Obamacare down out throats? The mess you describe in this editorial is all on the Obama/Clinton/Democrats.
The Democrats want you to believe everything is hunky-dory. If you believe that fable, vote for Hillary to continue this mess.
The Democrats want you to believe everything is hunky-dory. If you believe that fable, vote for Hillary to continue this mess.
4
As illustration of your point. So many complaints here about rising deductibles & copays under ObamaCare. But ObamaCare requires that deductibles/copays increase EVERY year for Individual and Small Employer insurance. (As reference, read regulations regarding "actuarial value" of ACA plans). (BTW Medicare deductibles increase most years too)
How condescending....telling us we ought to spend less time talking about debate prep strategy, tax returns, polling data, ad budgets, celebrity endorsements, campaign-trail gaffes, Putin and the candidates' pasts (and pets)...I mean, really, who wants to talk about real stuff? Who has the time? Gerrymandering, anyone? Economic sustainability? Carbon taxes? BORING!!!
If Clinton could manage to bring socialized medicine to the U.S., which despite the negative connotation that has been given to the word "socialized," is an idea favored by most Americans. ( OK, call it "Medicare for all" then...) she no doubt would be considered one of the greatest presidents of this century. It would take a while for the howling of the profiteers to die down - I suppose that's putting it mildly - but Medicare for all is inevitable. She should try and make it happen on her watch, because otherwise she'll be remembered as yet another president that kicked the can down the road. C'mon Hillary, think big!
1
Universal health care for all, you're born and you are in. No 500 pages of documents from 10 different providers trying to get your business.
Why aren't corporations jumping up and down for this. Oh, they don't really provide it anymore but some do.
I am medicare and have health net and just got my first set of books to review changes, doctors now covered, drugs and tiers now covered. I need a medical interpreter to help me thru this. Ridiculous and expensive so they have to skimp on actual health as CEO have to have their millions and billions of salaries and benefits.
Why aren't corporations jumping up and down for this. Oh, they don't really provide it anymore but some do.
I am medicare and have health net and just got my first set of books to review changes, doctors now covered, drugs and tiers now covered. I need a medical interpreter to help me thru this. Ridiculous and expensive so they have to skimp on actual health as CEO have to have their millions and billions of salaries and benefits.
2
Of course this is what you get in a "very much for profit" health care system.
We fixed the parts of healthcare that were horrible. Like sick people not getting healthcare. People not going broke if family member has illness etc. But the profit need numbers by insurers because the ACA is based on private business needs
makes the tipping point for companies to demand profit. They are dropping out.
Half the states didn't take the medicaid option. Know one is asking why an operation is 150k. Or why my medicare bills are so low. It all makes no sense.
We fixed the parts of healthcare that were horrible. Like sick people not getting healthcare. People not going broke if family member has illness etc. But the profit need numbers by insurers because the ACA is based on private business needs
makes the tipping point for companies to demand profit. They are dropping out.
Half the states didn't take the medicaid option. Know one is asking why an operation is 150k. Or why my medicare bills are so low. It all makes no sense.
The Democrats all by themselves did nothing to fix the problems of health care costs. They wrote a plan that was essentially authored by the industry. As long as Mrs. Clinton and members of Congress spend most of their time seeking donations to maintain and gain their positions of power the idea that anything significant will be done to lower the cost of delivery and make health care more affordable is a pipe dream.
How much of the slow down in the increase in cost of delivery is related to the slow down of the economy? Saying health care cost haven't risen as fast during a period of deflation and negative to zero interest rates isn't exactly an endorsement of the current policy devised by Democrats many of them who are no longer in office.
We need to elect a completely different Congress and President, one not beholden to the health care industry. Where is the plan on reducing the cost of health care like no fault liability and free tuition for medical school?
How much of the slow down in the increase in cost of delivery is related to the slow down of the economy? Saying health care cost haven't risen as fast during a period of deflation and negative to zero interest rates isn't exactly an endorsement of the current policy devised by Democrats many of them who are no longer in office.
We need to elect a completely different Congress and President, one not beholden to the health care industry. Where is the plan on reducing the cost of health care like no fault liability and free tuition for medical school?
3
Free medical school tuition, free health care, free college tuition. What's the flaw in that?
Obamacare has wrecked the American health care system. Premiums are skyrocketing, as are drug prices. Many families simply cannot afford Obamacare's prices.One health care provided after another is rejecting Obamacare membership. The promised savings of $2500 per family made by Obama turned out to be a big lie. No wonder Hillary is avoiding any mention of Obamacare. Trump will skewer her on this disaster Monday night. That is if the moderator has the courage to ask the question.
7
Typical GOP response. Propose nothing, but criticize everything the Dems try to do. All of this "kill Obamacare" must be ignored until a specific Republican replacement is proposed. Then the American voter can make an informed choice
Your premise that Hillary speaking more about important issues in order to expose the shallowness of Trumps agenda is funny. His whole agenda has been empty of details and very shallow, yet the media talk about Hillary's emails. His followers dont seem to have the brain power to understand anything on how our country works so they listen to his one liners and like him and actually believe he can accomplish all the stuff he promises (again no details, believe him). What is wrong with those people?
2
Nothing better illustrates how medical care is just one more profit driven industry that controls gov't decision making than the mind boggling fact it is ILLEGAL for the gpv't to negotiate the prices it pays pharmaceutical companies for the hundreds of billions of dollars it pays them for drugs purchased under Medicare.
Why because that would reduce drug companies profits. How is that NOT massive welfare for these huge drug companies at tax payer expense.
These same hypocritical wealthy companies that of course negotiate the lowest possible prices from all their suppliers all the time.
Our medical care system is nothing but institutional CORRUPTION.
Why because that would reduce drug companies profits. How is that NOT massive welfare for these huge drug companies at tax payer expense.
These same hypocritical wealthy companies that of course negotiate the lowest possible prices from all their suppliers all the time.
Our medical care system is nothing but institutional CORRUPTION.
7
I hear this mantra repeatedly, so I ask you, what price do you think Medicare pays for it Part D drugs? Do you think they pay what Pharma "charges" without discount?
Both candidates should be discussing the issue. Consumers are often hoodwinked by Health Care providers.
When I recently retired, I was moved to Part D Medicare by my provider's arrangement with Medicare for a prescription plan. Because of a change in accepted prescription coverages, when I called to opt out and back to the plan's prescription coverage, I was told that would mean termination of my health plan. This was not optional. Retirees paid premiums but didn't get the same coverage as everybody else.
I should have read the fine print.
As a former civil servant, the customer representative asked, do you have any other health care provider options to switch to? That seemed to be the only solution offered.
My co-pays have gone up; some of my prescriptions are being denied and I have to jump through hoops to get some medical treatments that I had received before--all because I retired and now am required to have Medicare as primary while I still maintain the same health insurance policy that I had before.
Why do I have the feeling that eventually my health care provider will be factoring in my age when approving expensive life sustaining medications?
When I recently retired, I was moved to Part D Medicare by my provider's arrangement with Medicare for a prescription plan. Because of a change in accepted prescription coverages, when I called to opt out and back to the plan's prescription coverage, I was told that would mean termination of my health plan. This was not optional. Retirees paid premiums but didn't get the same coverage as everybody else.
I should have read the fine print.
As a former civil servant, the customer representative asked, do you have any other health care provider options to switch to? That seemed to be the only solution offered.
My co-pays have gone up; some of my prescriptions are being denied and I have to jump through hoops to get some medical treatments that I had received before--all because I retired and now am required to have Medicare as primary while I still maintain the same health insurance policy that I had before.
Why do I have the feeling that eventually my health care provider will be factoring in my age when approving expensive life sustaining medications?
2
When I was a 7th grader in 1958 my math teacher spent a few days educating us about finances. He presented a clear difference between utility stocks, where he was primarily invested because of their safety and regulation, and speculative market driven stocks which offered higher returns with much less regulation. There was a clear difference between regulated utilities that everyone needs like electricity, water, schools, highways etc. and speculative market driven for profit free market businesses. Health care, like water and electricity, is a necessity, not a discretionary cost. It is a ulility, not a business. Nonetheless from hospitals to pharmaceuticals to insurance to your doctor we have seen a takeover by big business of nearly everything that is health care related. Healthcare stockholders and their corporate executives are the owners and the winners and affordable health care for all is not feasible under the current system. $600 a shot for cornering the market on $8 worth of life saving epinephrine is good for business, bad for people!
74
It's not mentioned because there is no way to control health care costs without making someone unhappy. Right now, Obamacare has shifted the costs for the poor and very sick onto a very small pool of healthy people with individual insurance. Their premiums are skyrocketing as a result. Honest truth is you'll need to spread the pain; ration care, deny services, cut reimbursements, and charge all taxpayers more to make it work. Who wants to tell the public that?
24
My low number of "recommended" clicks proves my point. Canadian doctors make 50% less than US doctors, on average, wait times are extensive for most procedures, taxes are high, reimbursements are low, almost impossible to win a malpractice lawsuit, and yet the entire system is still in the red by over $32,000 per taxpayer. I'm not saying there aren't some features that look appealing, but think twice before we bring the Canadian system here. The "truth" won't win many votes.
1
Given that you have spoken nothing less than fact - apolitical reality - and received only 11 recommends after 2 hours, I'd say no one wants to hear it, so no one will say it. We spread the pain equitably, or inequitably, but we spread the pain.
The problem is both candidates are willing to cave to the profit making corporations rather than going single payer which would be non profit. Hillary is taking money from them and Trump is simply a Republican, say no more. Obama caved to the corporations; now Hillary is doing the same. When American had a chance to go the single payer route with Bernie, it turned its head the other way. No one should be making a profit on health care. Simple as that.
39
Obama caved to the American people who delivered a Republican controlled Congress to him. The obstruction of the GOP is the greatest obstacle to a decent standard of living for all Americans. Let's stop blaming presidents and actually elect a government that works.
Why haven't we heard more about this issue? Oh, I dunno ... maybe because the Donald has played the press masterfully and ensured that he's dominated the headlines every day due to the outlandish things he's said (which the media has almost NEVER even called him on). You've been chumps. There might be time to salvage this if you start truly covering the issues and doing real coverage of this campaign and what's at stake. This isn't entertainment! There are real nukes involved, and real people who would lose health care.
1
Really NY Times? The solution is staring us in the face and you are not able to come out and state the obvious dire need for Universal Health Care? You fail to mention that we are the only advanced Democracy that does not offer this basic right to our citizens. Shame on you.
6
I would think that your points don't need stating because they are patently obvious.
Is this a joke? The NYTimes has spent 5 years shilling for the ACA, crowing about each and every success and then writes an editorial lamenting teh state of health care?
Maybe the good to come of this article is that in the future it can be used by aspiring journalism students as a cautionary tale about how to avoid the lessons of lost media credibility in the late 20th century.
Maybe the good to come of this article is that in the future it can be used by aspiring journalism students as a cautionary tale about how to avoid the lessons of lost media credibility in the late 20th century.
8
Ridiculous.
President Trump is awaiting coronation by his flock and you sully it with reason?
But fine job otherwise in helping establish the false equivalences that have kept him viable as a candidate.
Or wait...could it be that our 2-party Republic is showing signs of strain? The whole up/down vote of this Republic is very Roman and Empire like.
President Trump is awaiting coronation by his flock and you sully it with reason?
But fine job otherwise in helping establish the false equivalences that have kept him viable as a candidate.
Or wait...could it be that our 2-party Republic is showing signs of strain? The whole up/down vote of this Republic is very Roman and Empire like.
1
Universal, unipayer federal health care for all is the simple answer.......the elephant in the room.
****A Connecticut physician
****A Connecticut physician
9
"Mrs. Clinton clearly understands the issues". Mrs. Clinton either does not understand or does not care about the issues -- if she did she would be fighting for medicare for all.
3
Medicare is prohibited from negotiating prices with the drug companies. I can't imagine a more asinine law than that.
9
So you believe Part D pays Pharma what ever they charge? Another Liberal swallowing the Democrat party line without question. Do some research on how Part D operates. There seems to be an undying belief the Federal Government can negotiate better prices than private industry.
This comes of having one political party for the rich, and one for the very rich, and a very high cost of entry, so that only the rich can afford to play politics.
The rich are not really bothered by high health costs.
The rich are not really bothered by high health costs.
6
Why not a big issue in the campaign? Because Americans are more concerned a Muslim might shoot or bomb them, that some man might marry another man and they can't freely follow Jesus and deny that couple a wedding cake, that Big Brother is coming to take their guns, and that our military can't rule the world. So they're willing to pay more and more of their hard-earned paychecks to make medical predators richer or go without medical care until they're on their death beds. Makes perfect sense to me.
5
And wouldn't you know it, all of these overly-hyped issues are brought to you by the Republican Party. They have demonstrated for years now that they are the *true* enemy of the American people.
1
The moment anybody (Congress, President) will do anything to make the Medical Industry for the People all their stocks will collapse and lose much of their value. It's a vicious circle. Until people's lives and well-being is less important than the stock market, nothing will change.
3
The Commonwealth Fund published a study yesterday, based on analysis by RAND, comparing the health care plans of Clinton and Trump. Bottom line is that under Clinton's proposal to maintain the ACA 9 million people would gain health insurance coverage, while under Trump's proposal to repeal the ACA about 20 million people would lose coverage.
http://www.commonwealthfund.org/publications/issue-briefs/2016/sep/clint...
http://www.commonwealthfund.org/publications/issue-briefs/2016/sep/clint...
2
Trump has it easier than Clinton. She can't criticise Obamacare in any meaningful way, much less advocate scrapping it and replacing it with something else, without implicitly admitting that it doesn't do all the wonderful things the Democrats have been stridently insisting it does. For six years the party's been pushing the law, denying its grievous faults and attributing all criticism to racism. She's stuck with it.
Trump, by contrast, can stick to a simple, two-word message, 'repeal Obamacare'. He doesn't even have to offer a replacement.
Trump, by contrast, can stick to a simple, two-word message, 'repeal Obamacare'. He doesn't even have to offer a replacement.
I am an employer of an architectural firm of less than 30 and we are just getting killed by these increases every year. We waste an incredible amount of time annually comparing insurance proposals because the proposed increase by our existing insurance company is always in excess of 20%. And usually for eroded coverage. We are so sick of it. And if you extrapolate the trend it will eventually put us out of business.
3
Neither of the ancient corrupt crony capitalist corporate plutocrat oligarchs running for POTUS in 2016 have ever had to worry about the cost nor availability nor quality of their personal nor their families healthcare. These two Triassic era dinosaurs the Hillary and the Donald are also well into their Medicare years. No empathy and no humility means no progress nor discussion.
And while candidate Senator Barack Obama was opposed to the individual healthcare mandate and for a robust public option, President Obama was for a private healthcare mandate and no public option.
The Patient Protection and Affordable Care Act aka Obamacare does not protect all persons needing healthcare and it is not affordable as private healthcare organizations are focused on shareholder return, profits, bonuses, stock options and promotions. Putting a greedy private bureaucrat between you and your healthcare provider and your best healthcare option choices.
Quality affordable healthcare should be a human right for each and every human being divinely naturally equally born with certain unalienable rights including life, liberty and the pursuit of happiness in any civilized 1st world nation.
But for selfish inhumane bipartisan political opposition single payer medical care would be reasonably available to all today, tomorrow and forever. I still have my dream and they still have their scheme.
And while candidate Senator Barack Obama was opposed to the individual healthcare mandate and for a robust public option, President Obama was for a private healthcare mandate and no public option.
The Patient Protection and Affordable Care Act aka Obamacare does not protect all persons needing healthcare and it is not affordable as private healthcare organizations are focused on shareholder return, profits, bonuses, stock options and promotions. Putting a greedy private bureaucrat between you and your healthcare provider and your best healthcare option choices.
Quality affordable healthcare should be a human right for each and every human being divinely naturally equally born with certain unalienable rights including life, liberty and the pursuit of happiness in any civilized 1st world nation.
But for selfish inhumane bipartisan political opposition single payer medical care would be reasonably available to all today, tomorrow and forever. I still have my dream and they still have their scheme.
6
"The reaction to opening a medical bill these days is often shock and confusion — for the insured and the uninsured. Prices and deductibles keep rising, policies are drowning in fine print, and doctors are jumping on and off networks. So why hasn’t the growing burden of health care gotten more attention in the presidential campaign?"
If this wasn't so sad, it would be hysterical. So, the Democrats passed the PPACA without a single republican vote based on a pack of demonstrable lies. You can keep your Dr, the average family will save $2,500 etc. Nancy Pelosi famously said, "Everyone will have lower rates, better quality and better access to care!"
It is a mess now. The editorial boards view. We need more democratic plans.
When will the Editorial board admit that almost everything that the opponents of Obamacare warned of has happened?
If this wasn't so sad, it would be hysterical. So, the Democrats passed the PPACA without a single republican vote based on a pack of demonstrable lies. You can keep your Dr, the average family will save $2,500 etc. Nancy Pelosi famously said, "Everyone will have lower rates, better quality and better access to care!"
It is a mess now. The editorial boards view. We need more democratic plans.
When will the Editorial board admit that almost everything that the opponents of Obamacare warned of has happened?
4
One man gets shot by the police generating headlines, videos and reader comments by the thousands. A thousand people die in one day from inadequate health care and there are no headlines, no videos of people dying from the lack of care, and less than a hundred reader comments here.
Obviously an insane healthcare system that is killing thousands daily does not make news and does not sell news as entertainment. No mysteries here.
Obviously an insane healthcare system that is killing thousands daily does not make news and does not sell news as entertainment. No mysteries here.
11
@Nor cal rural
Maybe you should actually look at where that number came from:
https://benjaminrushinstitute.org/how-many-americans-die-each-year-becau...
http://www.factcheck.org/2009/09/dying-from-lack-of-insurance/
Maybe you should actually look at where that number came from:
https://benjaminrushinstitute.org/how-many-americans-die-each-year-becau...
http://www.factcheck.org/2009/09/dying-from-lack-of-insurance/
1
Trump has captured the attention of blue collar America by falsely claiming that their economic plight is due to trade and immigration. Completely false. The reason they are where they are can be plainly seen by the chart in the article. If healthcare costs rise at the same rate as inflation our middle class would be much better off and there would be no Trump running for President.
The bottom line is that we have Rube Goldberg healthcare system of monstrous proportions. How to fix it? Who pays for healthcare? Mostly employers. Employers have been asleep at the switch and just pay more for less every year. On Monday morning walk into your HR department and tell them to do better. There are solutions out there. Just search for David States and you will get a lot of good ideas.
The bottom line is that we have Rube Goldberg healthcare system of monstrous proportions. How to fix it? Who pays for healthcare? Mostly employers. Employers have been asleep at the switch and just pay more for less every year. On Monday morning walk into your HR department and tell them to do better. There are solutions out there. Just search for David States and you will get a lot of good ideas.
Perhaps if the press would ask and then hold the candidates to answering, we would here more about this issue. If the press cared about substance, reporters would bring this issue up at multiple campaign stops. It would be a perfect debate topic.
We won't here a word about it.
We won't here a word about it.
3
Oddly enough the opinion doesn't touch on the cause of rising premiums, deductibles and out-of-pocket costs.
Why?
Healthcare costs have been rising for 20+ years, often dramatically, without warning or indication of why? This certainly happened under Bush, and again with Obama administration.
Where's the clarity of cause vs 'solutions'?
Why?
Healthcare costs have been rising for 20+ years, often dramatically, without warning or indication of why? This certainly happened under Bush, and again with Obama administration.
Where's the clarity of cause vs 'solutions'?
1
The cause is obvious: it's the billions of dollars in profits that are being chased by the health care industry. Why else is health care the only consumer service we pay for without knowing what the cost will be up front?
1
"The reaction to opening a medical bill these days is often shock and confusion — for the insured and the uninsured. Prices and deductibles keep rising, policies are drowning in fine print, and doctors are jumping on and off networks."
A surprisingly candid assessment of Obamacare by the NY Times editorial board.
A surprisingly candid assessment of Obamacare by the NY Times editorial board.
3
Let's face it: the national health care problem and other important issues, (such as crumbling infrastructure) won't be properly addressed so long as our dysfunctional Congress rules the land. Good luck Hillary...
1
Candidate Clinton has taken millions and millions from Big Pharma. In fact, they have given her the most money from the get-go in this campaign. She can't say she wants to crack down on the drug companies and other big corporate players while she's raking in all those millions. It's just common sense.
Raking in all that bad money won't stop when she's elected, either. She will want a second term, so she will start lobbying from day one for millions more from Big Pharma, bankers and the military industrial complex.
That means her supporters can't say, well, she took their money, but she won't have to do what they dictate once she's elected. Her supporters will be stuck saying, well, after she wins her second term, she won't have to do what the big corporations tell her to do. Sigh.
Raking in all that bad money won't stop when she's elected, either. She will want a second term, so she will start lobbying from day one for millions more from Big Pharma, bankers and the military industrial complex.
That means her supporters can't say, well, she took their money, but she won't have to do what they dictate once she's elected. Her supporters will be stuck saying, well, after she wins her second term, she won't have to do what the big corporations tell her to do. Sigh.
The media needs to cover it, then the candidates will have to talk about it. If you are the "mouthpiece" for the candidates, and they do not want to talk about it...
1
Why are drug prices significantly higher in the US vs. Canada and the EU? Time to level the playing field.
2
Because marketing directly to the end user is not allowed when building their costs-of-goods-sold for justification on the return on investments, nor are the outcomes of the various fiscal gymnastics of the Street. Both add more than the actual R&D (which government grants support anyway) that affect the bottom line rather nicely. So many "pharma-tourist" busloads of Americans were showing up at border towns the fill scripts they voided local inventories making it necessary to forbid the filling of any more foreign scripts by chemists.
So many calls for Medicare for all. Why no calls for Veteran's Admin Healthcare for all, which is the actual system we will get when Government decides to run the healthcare system.
I work in a VA and almost every Veteran I care for is very happy with the care they receive at our center. I've worked in many settings and no where else do I get the compliments on the care patients receive than at our VA. The New England Journal of Medicine published two reports two years ago showing that Veterans have the same or better healthcare outcomes compared to civilian practice at a much lower cost. Yes, there is the occasional "scandal". There are problems in every system. We are required to see patients within 14 days of their request to be seen. When was the last time you had that level of care? If civilian medicine were held to the same standards, there would be scandals galore for the media to discuss, trust me. Please think before you type.
2
Clinton has promised the public option, a buy in to Medicare. Most employers will choose that. The math compels it.
Americans are learning that other countries pay less for health care and get more. We are also learning that claims that we can't afford to pay less and get more are stupid.
Americans are learning that other countries pay less for health care and get more. We are also learning that claims that we can't afford to pay less and get more are stupid.
2
Healthcare and Health insurance costs are rising by leaps and bounds, yet the Progressives in this country are more worried about how many tenths of a degree Celsius the temperature may get 100 years from now.
Progressives: Can't do math, can't do science, can't accept that reality disagrees with their utopian delusions.
Progressives: Can't do math, can't do science, can't accept that reality disagrees with their utopian delusions.
2
everything deserves more attention than the effluent flowing from this campaign, but, alas, the retailing of it seems to be more profitable than health care, education, foreign policy (ok, mid-east disaster)...see tv anytime for confirmation.
The public option is in the Democratic Party platform.
1
Where is treatment of the well-documented fact that of all the OECD countries (and this data is produced--if I'm not mistaken--annually) the per capita cost of medical care in the United States is just about double the cost of ANY other developed nation, with NO statistically significant difference in outcomes attributed to medical care. If I said to any American: "Have I got a deal for you! how'd you like to pay TWICE as much as anybody else in the world for the same product?" how many of us would leap at the opportunity? WHERE DOES THE OTHER HALF OF THE MONEY GO? That's over $4,000/person/year.
1
In US 65% of healthcare dollars are funded by Government (Medicare, Medicaid, VA, CHAMPUS, WC, ACA, etc) and only 35% private payor. So why dont you at least attribute 65% of the blame for high health care costs in US to Government run system?
Why we should be the 99% that wants substantive change. Our candidates want to offer tax credits/deductions rather than the cost abuse and largess of the entire health system.
The big problem is that people keep voting. They may vote like it's a team sport, paying no attention to what they're voting for, as long as their side wins, but they vote. The problem? Voting actually means something.
1
My doctor quit and moved to the UK because the management group that controlled her practice told her to only treat ONE symptom a visit so that she could see a lot more co-pays, I mean patients, she refused because no illness has only 1 symptom, not even a cold...so they punished her by taking away half of her support staff!
All the other doctors went ahead and let the management companies blackmail them into being horrible excuse for doctors now no one gets any treatment...just the brush off. You still have to pay for the office visit for the doctor to tell you that there is nothing they can or will do for you though. So sick people are going from doctor to doctor to find one with the guts to still treat patients but most never find one.
The NYT needs to do an article on this because the US is now the sickest first world country in the world because most doctors do not even try to treat patients any more.
All the other doctors went ahead and let the management companies blackmail them into being horrible excuse for doctors now no one gets any treatment...just the brush off. You still have to pay for the office visit for the doctor to tell you that there is nothing they can or will do for you though. So sick people are going from doctor to doctor to find one with the guts to still treat patients but most never find one.
The NYT needs to do an article on this because the US is now the sickest first world country in the world because most doctors do not even try to treat patients any more.
1
Healthcare is not a soundbite issue. It seems to have become something of an albatross for American politicians. Certainly for the evening news that's true, the networks would rather show a new video of a shooting than discuss the intricacies of health care. I didn't know what Trump's proposals were until I read this article.
Hillary Clinton has spoken out health care and on mental health but the media ignores her. Her last speech on mental health and dealing with disabilities, the media cut away after five minutes to go to a Trump hate fest speech.
1
The rest of the developed countries provide single payer health care to all citizens.
When do we finally get there?
Do we really need to wait until our Rube Goldberg inspired medical quagmire collapses?
When do we finally get there?
Do we really need to wait until our Rube Goldberg inspired medical quagmire collapses?
Wow, tell me where that average deductible of $1,221 is. Anyone who is self-employed buying an Obamacare compliant plan without the subsidy at my age is looking at close to $7,000 this year. So much for the rosy gig economy.
I have to wonder what the press would cover if Hillary did what you ask. Probably the antics associated with a smear campaign funded by tens of millions of dollars from special interest groups. Certainly not the substance of her ideas.
Some cost saving options:
1) Change the 340B program to a pricing structure that does not allow for Health System or Center profiteering from the sale AND to an eligibility structure that allows for eligibility to get 340B drugs at 340B discount prices from ALL physicians if the patient is eligible for 340B drug pricing. In Ahoskie NC there is a drugstore that has two 340B contracts arranged with a Community Health Center in Ahoskie and with an FQHC in Windsor NC. If a 340B eligible patient takes a prescription for an albuterol inhaler to this drugstore from the FQHC that inhaler will cost about 52 dollars. If that same patient takes the same script but written by the CHC it will cost the patient 18 dollars. Go figure why. The FQHC is trying to make a profit off 340B drugs and the CHC is not making a profit.
2) Disallow facility fee charges that represent profiteering. A urine culture done at the Ahoskie Hospital comes at a retail price of 500 dollars. That same urine culture done through a private practice physician's office costs about 45 dollars. Go Figure. A Medicare or Medicaid patient has those charges disallowed to some extent.
3) Disallow BIG and little PHARMA's ability to set prices, disallow Drug distributors to set prices. Disallow Pharmacy "benefit" managers from setting prices. CVS CAREMARK U&C price for clobetasol for seven tubes rose from 450 dollars to 2,900 dollars between June and July 2014. U&C means "Usual and Customary"?????
1) Change the 340B program to a pricing structure that does not allow for Health System or Center profiteering from the sale AND to an eligibility structure that allows for eligibility to get 340B drugs at 340B discount prices from ALL physicians if the patient is eligible for 340B drug pricing. In Ahoskie NC there is a drugstore that has two 340B contracts arranged with a Community Health Center in Ahoskie and with an FQHC in Windsor NC. If a 340B eligible patient takes a prescription for an albuterol inhaler to this drugstore from the FQHC that inhaler will cost about 52 dollars. If that same patient takes the same script but written by the CHC it will cost the patient 18 dollars. Go figure why. The FQHC is trying to make a profit off 340B drugs and the CHC is not making a profit.
2) Disallow facility fee charges that represent profiteering. A urine culture done at the Ahoskie Hospital comes at a retail price of 500 dollars. That same urine culture done through a private practice physician's office costs about 45 dollars. Go Figure. A Medicare or Medicaid patient has those charges disallowed to some extent.
3) Disallow BIG and little PHARMA's ability to set prices, disallow Drug distributors to set prices. Disallow Pharmacy "benefit" managers from setting prices. CVS CAREMARK U&C price for clobetasol for seven tubes rose from 450 dollars to 2,900 dollars between June and July 2014. U&C means "Usual and Customary"?????
1
A few years ago, the Times ran a series of articles about abuses in New York's Medicaid program. New York spends around $50 billion to provide care for about 5 million people. Many of the services covered by NY Medicaid--Home Care, Adult Day Care, substance abuse counseling, transportattion etc.--are subject to abuse. Today, Times had an article about possible fraud at Visiting Nurse Service of NY, a major provider of home care http://nyti.ms/2cIPCrL. Apparently the abuses the Times identified years ago still remain.
Publicly funded Medicaid is one end of the spectrum, where government, thanks to lobbying, provides quasi-medical care (such as adult day care) for millions of dollars, money that could be used for providing real medical care for more people.
The other end of the spectrum is private insurance companies that make it difficult for people to get the care that they need.
Excessive cost of care, something covered in considerable detail by Steven Brill in Time magazine ("Bitter Pill: Why Medical Bills Are Killing Us" http://ti.me/1fCgcBp) is another factor adversely affecting healthcare. The US spends the most per capita for health care and gets precious little in return.
Yes, healthcare is a serious issue that requires serious attention from the candidates. Trump is not a serious candidate and it is foolish to expect anything from him. Let's hope the policy wonk in the race, Mrs. Clinton, takes on the issue head-on with all the seriousness it deserves.
Publicly funded Medicaid is one end of the spectrum, where government, thanks to lobbying, provides quasi-medical care (such as adult day care) for millions of dollars, money that could be used for providing real medical care for more people.
The other end of the spectrum is private insurance companies that make it difficult for people to get the care that they need.
Excessive cost of care, something covered in considerable detail by Steven Brill in Time magazine ("Bitter Pill: Why Medical Bills Are Killing Us" http://ti.me/1fCgcBp) is another factor adversely affecting healthcare. The US spends the most per capita for health care and gets precious little in return.
Yes, healthcare is a serious issue that requires serious attention from the candidates. Trump is not a serious candidate and it is foolish to expect anything from him. Let's hope the policy wonk in the race, Mrs. Clinton, takes on the issue head-on with all the seriousness it deserves.
I pay like $400 a month for my Gold Level Obama care plan. I got it 3 months ago thinking it would be cheaper than just paying cash. I can't believe how impossible it is to get care.
For example, I have been taking Suboxone for 4 years, and it literally saved my life from a heroin and oxycontin addiction. My Gold Level plan denied coverage and told me to take a drug called Zubsolv. I researched it, and found literally hundreds of stories of people who were forced from Suboxone to Zubsolv that experienced cravings, insomnia, and relapse amongst other negatives. I called my insurance but they didn't listen to me.
I took zubsolv for 2 weeks. I got incredibly sick, almost lost my job, couldn't sleep, and felt a craving for heroin that I hadn't felt since 2012. It was so scary.
Now, I pay $400 a month for insurance plus $200 a month for suboxone.
I am a Millenial liberal who voted for Obama twice, but I hate Obamacare. It was such a cop out. Insurance companies jobs are to deny coverage and prevent people from actually getting care. Now that I'm insured it's costing me even more money for the same care.
I want Universal Healthcare. Every Millenial I know wants Universal Healthcare. We need it now!!!! Repeal Obama care and put every insurance company out of buisiness. Too bad Hillary will never do it....for her Obama care is the bees knees because she has NO IDEA of the suffering of the average young person like me. She is a Baby Boomer multimillionaire, how could she?
For example, I have been taking Suboxone for 4 years, and it literally saved my life from a heroin and oxycontin addiction. My Gold Level plan denied coverage and told me to take a drug called Zubsolv. I researched it, and found literally hundreds of stories of people who were forced from Suboxone to Zubsolv that experienced cravings, insomnia, and relapse amongst other negatives. I called my insurance but they didn't listen to me.
I took zubsolv for 2 weeks. I got incredibly sick, almost lost my job, couldn't sleep, and felt a craving for heroin that I hadn't felt since 2012. It was so scary.
Now, I pay $400 a month for insurance plus $200 a month for suboxone.
I am a Millenial liberal who voted for Obama twice, but I hate Obamacare. It was such a cop out. Insurance companies jobs are to deny coverage and prevent people from actually getting care. Now that I'm insured it's costing me even more money for the same care.
I want Universal Healthcare. Every Millenial I know wants Universal Healthcare. We need it now!!!! Repeal Obama care and put every insurance company out of buisiness. Too bad Hillary will never do it....for her Obama care is the bees knees because she has NO IDEA of the suffering of the average young person like me. She is a Baby Boomer multimillionaire, how could she?
2
According to one poster Bernie 'did a decent job, but couldn't figure out how to get it [healthcare reform] done.' This simply isn't true. His plan was simple, paid for, laid out, and would have saved $5 trillion over ten years. Then the entire pro-Hillary media lined up, this paper foremost among them, and shot down Bernie's sensible plan as 'unreasonable', 'unicorns' and 'puppies and rainbows'. The poster in question even used the term 'unicorns' herself, which shows how effective the attacks were.
So here we are, Democrats. We had a chance to move forward, to join the rest of developed world, and you did everything in your power to make sure that DIDN'T happen. The failure of American healthcare now rests firmly on the shoulders of Hillary Clinton voters. Congratulations.
How many times did this paper viciously attack Bernie Sanders only to publish editorials a few weeks later extolling his exact positions (but never mentioning his name in relation to them)? Universal healthcare, reducing income inequality, higher minimum wages, ending marijuana prohibition, ending Citizens United...these are all positions I've seen the NYT and most liberals take, yet when Bernie forcefully argued in favour of them they were 'puppies and rainbows'.
Democrats have failed this country by abdicating their position as the sensible left-wing choice in favour of full blown pro-corporate Republican-lite. They were aided and abetted by their friends in big media.
So here we are, Democrats. We had a chance to move forward, to join the rest of developed world, and you did everything in your power to make sure that DIDN'T happen. The failure of American healthcare now rests firmly on the shoulders of Hillary Clinton voters. Congratulations.
How many times did this paper viciously attack Bernie Sanders only to publish editorials a few weeks later extolling his exact positions (but never mentioning his name in relation to them)? Universal healthcare, reducing income inequality, higher minimum wages, ending marijuana prohibition, ending Citizens United...these are all positions I've seen the NYT and most liberals take, yet when Bernie forcefully argued in favour of them they were 'puppies and rainbows'.
Democrats have failed this country by abdicating their position as the sensible left-wing choice in favour of full blown pro-corporate Republican-lite. They were aided and abetted by their friends in big media.
2
The only time Clinton ever hears about these problems is when she is on one of her "listening tours", nodding empathetically to the woes of the less fortunate while thinking about what's for dinner tonight. I'm sure the subject never arises during any of her billionaire jamboree fundraisers. Those people have doctors that follow them around like luggage.
4
"Health care is just the kind of difficult subject that presidential candidates ought to talk about more."
Come on, don't be so naive. Everybody knows the answer: Single payer health care. But Hillary is against it because it would hurt the insurance industry and Trump, well, never mind.
Get big money out of politics and Politicians who care about the people, like Sanders and Stein and probably Warren and others might have a chance to get elected and do the things that big money don't like but that would help the people, all the people, even the rich, even the corporations who would cease to be burdened with the health insurance of their employees like their competition almost everywhere in the world.
This isn't rocket science, by any means.
Come on, don't be so naive. Everybody knows the answer: Single payer health care. But Hillary is against it because it would hurt the insurance industry and Trump, well, never mind.
Get big money out of politics and Politicians who care about the people, like Sanders and Stein and probably Warren and others might have a chance to get elected and do the things that big money don't like but that would help the people, all the people, even the rich, even the corporations who would cease to be burdened with the health insurance of their employees like their competition almost everywhere in the world.
This isn't rocket science, by any means.
3
The Epi-pens made news, but what about insulin for type 1,diabetics!?! The cost was $60 a bottle just 3 years ago. It is now $318 a bottle!
The real criminals are the legislators... they allow the pharmaceutical industry to act as for profit companies like companies selling any consumer good like shampoo or designer jeans. Pharmaceuticals must be treated as a public good. Regulation can allow a fair profit and outlaw the price gouging. What the market will bear for life saving drugs without competition is destroying people.
The real criminals are the legislators... they allow the pharmaceutical industry to act as for profit companies like companies selling any consumer good like shampoo or designer jeans. Pharmaceuticals must be treated as a public good. Regulation can allow a fair profit and outlaw the price gouging. What the market will bear for life saving drugs without competition is destroying people.
1
Why not focus on that which leads the people of this great nation to the road of health care facilities?
Focus on how the people will be able to live a healthier life style .
Focus on how there would be a reduction of junk sold at the stores.
Focus on an how there would be a proper work -life balance in everyones life.
Focus on how the people will be able to live a healthier life style .
Focus on how there would be a reduction of junk sold at the stores.
Focus on an how there would be a proper work -life balance in everyones life.
1
Yup, Obama's attempt to socialize medicine worked out so well; let's go ahead and double down and create another plan!
Please, for the love of everything that is good, read "Wealth of Nations" and throw "Das Kapital" in the trash.
Please, for the love of everything that is good, read "Wealth of Nations" and throw "Das Kapital" in the trash.
1
The Times is selling out. Only universal health care coverage and nothing but that is worthy of American rights to LIFE, LIBERTY AND THE PURSUIT OF HAPPINESS.
When people protest in the streets for this it will come!
RB
When people protest in the streets for this it will come!
RB
2
"Donald Trump, meanwhile, rarely ventures beyond his 'end Obamacare' slogan."
There's a reason Mr. Trump does not verbalize details regarding how he would actually address this complex issue: He can't.
There's a reason Mr. Trump does not verbalize details regarding how he would actually address this complex issue: He can't.
1
The obvious answer is that the big contributors to both parties do not want it discussed.
Money talks to both parties equally.
Money talks to both parties equally.
1
Because you, the media , are obsessed with trivialities and 'gotcha' moments ; because it sells.
1
Each individual can do a great deal to affect health care costs. From the perspective of a retired family doctor, here's how:
First, write down a list of all of the medical issues you have.
Second, refine that list in concert with your health care provider.
Third, write out your GOALS for management of each ongoing problem.
Fourth, talk about choices you might need to make at end-of-life with your FAMILY *and* your health care provider; write out a living will.
Fifth, LAMINATE these questions in plastic and bring the list out at each health care visit:
- How will this test, drug or procedure change management?
- How does this test, drug or procedure help me get to my goals?
- Are there alternatives to this approach, especially cheaper ones?
In summary, ASK QUESTIONS. When doctors and nurses encounter activated patients, they can more effectively get you where you want to go and keep you farther from outcomes not to your liking. Finally, BOOKMARK and USE this website: http://www.choosingwisely.org
First, write down a list of all of the medical issues you have.
Second, refine that list in concert with your health care provider.
Third, write out your GOALS for management of each ongoing problem.
Fourth, talk about choices you might need to make at end-of-life with your FAMILY *and* your health care provider; write out a living will.
Fifth, LAMINATE these questions in plastic and bring the list out at each health care visit:
- How will this test, drug or procedure change management?
- How does this test, drug or procedure help me get to my goals?
- Are there alternatives to this approach, especially cheaper ones?
In summary, ASK QUESTIONS. When doctors and nurses encounter activated patients, they can more effectively get you where you want to go and keep you farther from outcomes not to your liking. Finally, BOOKMARK and USE this website: http://www.choosingwisely.org
Because we have an issue-free campaign?
1
None of these proposals discusses how to cut actual costs. The cost per medical procedure in the US is more than twice as much as any other country. Just fiddling around with various ways to pay these enormous costs is not going to help.
1
Exorbitant premiums. People are bracing themselves. Clinton cannot risk raising the topic. The Obama Administration actually tried to deny that premiums were rising.
Access is still limited by by high out-of-pocket costs despite all the "newly insured" data. It's not being discussed for the same reason it wasn't discussed in the mid-terms. Too many people have lost plans, doctors, access because of Obamacare. It is unpopular with those negatively impacted. To them democrats have had little to say. In fact they have been almost invisible to democrats.
Access is still limited by by high out-of-pocket costs despite all the "newly insured" data. It's not being discussed for the same reason it wasn't discussed in the mid-terms. Too many people have lost plans, doctors, access because of Obamacare. It is unpopular with those negatively impacted. To them democrats have had little to say. In fact they have been almost invisible to democrats.
2
If you wonder why the campaigns are not talking more about health care costs, perhaps it's because the media isn't interested in anything that can't be reduced to sound bites or scandal. There has been much more about the candidates' health than what the candidates would DO about health.
But let's keep it simple. One party is working to expand health care to all Americans and make it more affordable. The other party's plan is still "Don't get sick, and if you do, die quickly."
Any more questions?
But let's keep it simple. One party is working to expand health care to all Americans and make it more affordable. The other party's plan is still "Don't get sick, and if you do, die quickly."
Any more questions?
Hillary's ideas are lame and theoretical. Drug companies are now price gouging in generics. Tax credits aren't enough for people who have $50,000 medical bills and no job. Hillary has made no mention of the 400,000 people killed by our health care system, that makes medical error the third leading cause of death in the USA.
Bernie Sanders knows more about what is necessary than Hillary, but the NYT had to participate in the Bernie blackout so that the citizenry was ignorant of his knowledge and plans. Now we are stuck with band-aid measures of Her Inevitableness.
Bernie Sanders knows more about what is necessary than Hillary, but the NYT had to participate in the Bernie blackout so that the citizenry was ignorant of his knowledge and plans. Now we are stuck with band-aid measures of Her Inevitableness.
Take away the free top tier health care we give the well heeled clowns in the Congress. Let them fend for themselves like the rest of us. We'd have a bi-partisan, workable plan in no time.
There has been no discussion of any substantive issue that affects the daily life of Americans, because it seems that they don't want to hear it. Politicians will deliver what they think will get them votes. The media will report what sells papers, gets TV ratings, and gets clicks.
Faux issues like email servers and the latest rants from the deranged do just that.
I said 'seems like Americans', a good proportion of them anyway. I don't think that is really true, but the level of national discussion about anything has been so debased for so many years (which bathroom can I, or you, use?) that I think everyone has forgotten what rational discussion about real issues is.
Bernie tried to talk about health care and a whole lot of other issues, too bad he didn't succeed. I wonder if things go sideways, and it looks like it might, if the Democratic Party establishment will have buyers remorse about that? Or will they bury their heads in the sand and blame others?
Faux issues like email servers and the latest rants from the deranged do just that.
I said 'seems like Americans', a good proportion of them anyway. I don't think that is really true, but the level of national discussion about anything has been so debased for so many years (which bathroom can I, or you, use?) that I think everyone has forgotten what rational discussion about real issues is.
Bernie tried to talk about health care and a whole lot of other issues, too bad he didn't succeed. I wonder if things go sideways, and it looks like it might, if the Democratic Party establishment will have buyers remorse about that? Or will they bury their heads in the sand and blame others?
By law medicare premiums cannot increase unless social security cola increases so what happens, co pay and deductible increases. Put everyone on medicare and negotiate drug prices like every industrialize country does. Health care is a right not a financial crisis.
Both are avoiding the only solution to control health care costs while expanding coverage to everyone, namely single payer, national health insurance. If you can fog a mirror, you are covered. Simple, understandable, affordable. I hope the debate moderators ask them how they plan to get there.
Hillary has my vote BUT gosh, I miss Bernie. He had the courage and the vision to speak about what really matters in bold and candid terms. In some real sense, a president has to a visionary. If s/he gets bogged down in all logical details why something might not work from the get go, half the battle has already been lost.
When you have a diabetic on insulin voting Republican you can understand why HRC doesn't bring up "healthcare for all". A good portion of Americans would rather be dead, dying and broke then have government sponsored healthcare program. Don't ask me why, but it is losing issue.
1
And this from the Editorial Biard that endorsed Hillary Clinton!
The public option is the only way to fix this! But YOUR CANDIDATE says that is pie in the sky. She has not intention of doing anything that will upset her corporate and billionaire donors.
If there is a serious problem here of lack of interest in fixing health care from either side, it's your fault. You covered him like a star and you endorsed her instead of Bernie because you no doubt had made commitments to a higher powers: the corporations.
Words don't matter actions do and your actions helped bring us here. Are you happy NOW?
The public option is the only way to fix this! But YOUR CANDIDATE says that is pie in the sky. She has not intention of doing anything that will upset her corporate and billionaire donors.
If there is a serious problem here of lack of interest in fixing health care from either side, it's your fault. You covered him like a star and you endorsed her instead of Bernie because you no doubt had made commitments to a higher powers: the corporations.
Words don't matter actions do and your actions helped bring us here. Are you happy NOW?
2
Dean/Andrew, you gotta be kidding me...
Whatever the quality of Medicaid - or the cost inefficiency of its delivery - it's essentially free, to completely poor people...
Make a bit too much, or own a bit too much, though - your free taxi ride to the doctor or ambulance to the hospital turns into a pumpkin...
Yes, your insurance is still heavily subsidized - but enter the Kafkaesque world where the physician standing on the right side of your bed is in-network - but the one standing at the foot of your bed isn't...
Your key life-saving pharma is in your plan this year - but you just found out it isn't, next year...
In fact, your entire plan and insurer are disappearing next year, in your corner of the country...
But - the people that get hit the worst are the ones that make just enough money to get no subsidy at all...
Their junk insurance is not only dangerous to their physical health - as in some co-pays are unaffordable - it's as dangerous to their financial health as any junk mortgage or junk bond was to them...
And who pushed this through...
And who insists that the only thing now better than the state of the economy in this country is the state of the health care system...
So - the best you can do is tell us that Trump is going to change the health care system to benefit the rich???
That's probably the one place where a tax benefit means little to them...
So - continue to elect Trump, while I sleep...
Go, Andrew, go...
Go, Dean, go...
Whatever the quality of Medicaid - or the cost inefficiency of its delivery - it's essentially free, to completely poor people...
Make a bit too much, or own a bit too much, though - your free taxi ride to the doctor or ambulance to the hospital turns into a pumpkin...
Yes, your insurance is still heavily subsidized - but enter the Kafkaesque world where the physician standing on the right side of your bed is in-network - but the one standing at the foot of your bed isn't...
Your key life-saving pharma is in your plan this year - but you just found out it isn't, next year...
In fact, your entire plan and insurer are disappearing next year, in your corner of the country...
But - the people that get hit the worst are the ones that make just enough money to get no subsidy at all...
Their junk insurance is not only dangerous to their physical health - as in some co-pays are unaffordable - it's as dangerous to their financial health as any junk mortgage or junk bond was to them...
And who pushed this through...
And who insists that the only thing now better than the state of the economy in this country is the state of the health care system...
So - the best you can do is tell us that Trump is going to change the health care system to benefit the rich???
That's probably the one place where a tax benefit means little to them...
So - continue to elect Trump, while I sleep...
Go, Andrew, go...
Go, Dean, go...
Of course the solution is single payer. And of course a jump to that right now is politically impossible. So. The next steps should include the Public Option and negotiating the cost of drugs for Medicare & Medicaid. That is doable.
Given literally a 115 years or so of resistance, since TR first proposed change, to any reform of Americas health care system about all we can expect is slow incremental change.
And if anyone out there wants to go faster all you have to do is vote Republicans out of office at all levels. Yup. It's up to us.
Given literally a 115 years or so of resistance, since TR first proposed change, to any reform of Americas health care system about all we can expect is slow incremental change.
And if anyone out there wants to go faster all you have to do is vote Republicans out of office at all levels. Yup. It's up to us.
It seems to me that we have no one in the political arena that represents the views of the majority of us.
Drug overdoses, jobs in this country for all of us, health care and a stable social security as well as full mobility are the criteria I mark political candidates by ... and unfortunately, I do not see any leadership whatsoever.
Are they EVEN trying to figure out what we want? It seems so very, very basic.
Drug overdoses, jobs in this country for all of us, health care and a stable social security as well as full mobility are the criteria I mark political candidates by ... and unfortunately, I do not see any leadership whatsoever.
Are they EVEN trying to figure out what we want? It seems so very, very basic.
She can't talk about healthcare, that's The President's program and she's running on keeping him in office in abstentia. The Public Option, 'Keep Your Doctor', these can not be re-animated, implying that The President's signature program is not as wonderful for the nearly-but-not-quite poor as it is represented as being. Gee whiz, I saw the headline 'the candidates' and I thought for a brief second you were going to treat them equally. But alas.
1
ACA, aka Obamacare, hands out cards intead of care. Now, real care costs too much cash and ACA is completely confusing; card holders, care providers, care insurers all start to cop out.
1
Assuming divided government won't tweak a system with Obama's name on it, do you want to keep it as is or upend it? If you like your plan....vote Hillary. Otherwise, good luck; you may need it.
You criticize Trump for promising to end Obamacare. And yet, wasn't Obamacare the "solution" to rising health care costs? Having been sold one Democrat lemon, you're asking us to trade it in for a new one? I think you underestimate the intelligence of the American people.
2
Why does every politician and media equate health INSURANCE with health CARE??
The two are vastly different.
Health Insurance is simply how large corporations earn money by charging people fees so that some of the bills that are presented for health Care are paid.
Health Care is what is given to people who are ill or injured who can afford to pay for Health Insurance.
Obama'care' is really not care at all but Obama health insurance; which, by the way, is getting more and more expensive through higher purchase rates, deductables and copays. Obamacare never said the insurance companies had to give reasonable rates only that they had to start with reasonable rates.
Now many with Obamacare don't go to a doctor because they can't afford the copays and decuctables.
So, NEW YOTK TIME EDITORS, get your words straight. America HAS great health care. Unfortunately fewer and fewer can partake of it because of sky high health Insurance!!!
The two are vastly different.
Health Insurance is simply how large corporations earn money by charging people fees so that some of the bills that are presented for health Care are paid.
Health Care is what is given to people who are ill or injured who can afford to pay for Health Insurance.
Obama'care' is really not care at all but Obama health insurance; which, by the way, is getting more and more expensive through higher purchase rates, deductables and copays. Obamacare never said the insurance companies had to give reasonable rates only that they had to start with reasonable rates.
Now many with Obamacare don't go to a doctor because they can't afford the copays and decuctables.
So, NEW YOTK TIME EDITORS, get your words straight. America HAS great health care. Unfortunately fewer and fewer can partake of it because of sky high health Insurance!!!
It's really simple: the rich are doing very well, thank you, with their health care. Those who work get it as a free perk for their high level job (do you think CEO or University Presidents ever pay for medical care?). Those so rich they don't need to rich are not going to find the cost very high relative to their wealth.
So really there is no problem. Those not destined to wealth should stop complaining.
So really there is no problem. Those not destined to wealth should stop complaining.
LOL. Most politicians will, if they say anything about health care, will just repeat the old bromide about the US have the best medical care in the World. Ah right (heavy sarcasm), if you look at the statistics like infant and maternal mortality and life expectancy, you will find that we are about 50th (just behind Cuba that spends 1% of what the US spends on health care).
When are we going to wake up to the fact that this country needs a simplified universal health care system rather than the complicated budget breaking, doctor frustrating insurance system that's profit rather than care based.
We have the most expensive system, by far, while ranking 39th in outcomes compared to other advanced countries around the world.
And no candidate is offering anything that will significantly change this.
Exceptional, indeed..
We have the most expensive system, by far, while ranking 39th in outcomes compared to other advanced countries around the world.
And no candidate is offering anything that will significantly change this.
Exceptional, indeed..
Rest assured hard working non-wealthy American taxpayers that we will not see any policy progress or change involving the punitive penalizing nature of the current ACA law with either of these candidates. Why? Because they and their families and their millionaire friends at the banks and big pharma are already insanely wealthy and have not real 'stake' in repealing a law that keeps their retirement portfolio's revenue streams from their medical investments at 200%.
For Trump and Clinton, paying a $14,000 per year premium payment is merely a drop in their vast bucket of wealth. To the rest of us, it is a true economic hardship. Why on earth we've voted to elect either of these two out-of-touch candidates to lord over us, is beyond me. They see no problem with the medical industrial complex system as it stands currently, since it benefits them. God help us all.
For Trump and Clinton, paying a $14,000 per year premium payment is merely a drop in their vast bucket of wealth. To the rest of us, it is a true economic hardship. Why on earth we've voted to elect either of these two out-of-touch candidates to lord over us, is beyond me. They see no problem with the medical industrial complex system as it stands currently, since it benefits them. God help us all.
7
Both parties are complicit with respect to the American system of extraction, the one that replaced income and equity with debt and the safety net with a protection racket. Whether it is the crooked health insurance scheme, the rigged financial markets or the university bubble, the working class gets the short end. Nothing will change until everything does but that day is coming soon because the people are running out of money to steal.
8
Perhaps the Ed Bd could compile a laundry list of all of the issues which have received short shrift during the campaign; while each insult and slogan is publicized.
Healthcare including revamping the ACA to address the escalating costs of care - is one of the big ones. However an editorial in the Times doesn't have the impact of hard questioning, with immediate fact-checked clarifications, shown repeatedly in tv - cable and social media.
Healthcare including revamping the ACA to address the escalating costs of care - is one of the big ones. However an editorial in the Times doesn't have the impact of hard questioning, with immediate fact-checked clarifications, shown repeatedly in tv - cable and social media.
5
The US has 50 states with 50 different versions of Medicaid, and different sets of private insurance plans. Along with that we have the VA system. We need to consolidate. But we cannot blame our crazy quilt of insurance alone. We have a system that prices medicine as it if was a normal commercial product. It is not. Older drugs are often rising in price for no good reason, other than that new investors can make a killing. We need to borrow from other countries, they all spend less than we do.
5
Why hasn't health care gotten more attention in the presidential campaign? Because this election has nothing to do with actual policy. What we are witnessing is the betrayal of the democratic ideal of self-government and the revelation that American democracy is just an exercise in polling an uninformed electorate about their gut reactions to the celebrities who appear on the ballot. So much for the last best hope of earth.
5
The ignorance of the remarks show the reason the campaigns don't touch on the topic.
Folks upset since they are "healthy and have no need" (birthed at home, with herbs, w/ the neighbors helping; unable to get into an accident via superpowers; and will just suddenly drop dead with no warning, unattended).
People irate b/c the ACA started passing on costs to them (and their group alone - nobody paid the unpaid costs before, magic was afoot with the $1,000 aspirins).
People are so poorly educated about the subject, and engage in such magical thinking, it is impossible to have a dialogue or present a policy that would appeal to the majority. With the bar that low, and the complexity of educating so high, why not just take the easy way out? Easier than explaining why we must have a single payer system.
Folks upset since they are "healthy and have no need" (birthed at home, with herbs, w/ the neighbors helping; unable to get into an accident via superpowers; and will just suddenly drop dead with no warning, unattended).
People irate b/c the ACA started passing on costs to them (and their group alone - nobody paid the unpaid costs before, magic was afoot with the $1,000 aspirins).
People are so poorly educated about the subject, and engage in such magical thinking, it is impossible to have a dialogue or present a policy that would appeal to the majority. With the bar that low, and the complexity of educating so high, why not just take the easy way out? Easier than explaining why we must have a single payer system.
2
A simple example of our American selfishness and lack of humanity in health care: Medicare is not extended to any Americans retiring outside the United States forcing those uncovered citizens to purchase expensive private health insurance.
Are Americans aware that their country provides the most backward health care coverage of all the developed western nations?
Are Americans aware that people around the world consistently poll that the United States is the most dangerous country in the world?
Europeans are speechless at the behavior of the American government and the violence they observe between Americans.
America's soul has been stolen by the greed of aggressive capitalism and the loss of caring between citizens.
Is it possible to reverse the decline of a society through the electoral process?
Are Americans aware that their country provides the most backward health care coverage of all the developed western nations?
Are Americans aware that people around the world consistently poll that the United States is the most dangerous country in the world?
Europeans are speechless at the behavior of the American government and the violence they observe between Americans.
America's soul has been stolen by the greed of aggressive capitalism and the loss of caring between citizens.
Is it possible to reverse the decline of a society through the electoral process?
5
Nothing will change until we have a president who understands and admits the real problem with health care in this country is greed. The United States needs to recognize health care as a basic human right and not another source of profit for the plutocracy. We need medicare for all.
4
The U.S. has a healthcare racket rather than a healthcare system. Until the underlying financial issues are addressed -- including the outsized profit margins of the medical-industrial complex and doctor pay that is, on average, the highest in the world -- not much will change. That involves disregarding the pernicious arguments and threats of an army of lobbyists paid for by Big Pharma and other healthcare players to finally do what's right for country, not just somebody's bottom line.
5
The ACA gained approval because both pharmaceutical companies and insurance companies backed it. However, one of the original goals of the ACA, beyond providing insurance for more Americans, was also to preserve the current for-profit based system and to prevent the insurance companies from going into "death spirals", in which fewer and fewer well people signed up for coverage, and more and more sicker ones cost ever-more money to care for. Unfortunately, given the vicious , everybody-in-it-for-himself state of the American healthcare system, the ACA has not been able to prevent this deterioration. The only rational ultimate solution that I can see is for single payer.
8
Talk about Healthcare?
The current system has two beneficiaries
1) The 1% of the Medical-Industrial-Complex(including Big Pharma)
2) Folks with Cadillac Health Insurance Like Government Workers, that is mostly paid for, and massively subsidized by everybody else but them
The problem is that those folks are the winners, and everybody else is a loser
The upper echelons of our Medical Industry have profit-margins around double of that in other countries with better overall healthcare. And like everywhere else, the folks at the bottom of the Medical Industry are not well compensated, while the folks at the top are fabulously compensated
It will prove to be virtually impossible to pass anything through Congress that will change anything fundamentally in regards to the folks at the top of the Medical Industry
The GOP Plans are nothing but nonsense
** Health Savings Accounts, only multimillionaires can save enough money to pay for healthcare without the sweetheart deals that Big Insurance Companies can extract
** Competition across State Lines: There isn't anything keeping any Health Insurer from selling in any state. THE GOAL here is to be able to offer "pretend" health-insurance, that provides virtually no benefits, except that it wouldn't cost much
* * * *
REAL SOLUTIONS
* Buy drugs from other countries
* Tort Reform that limits almost all Health Related Lawsuits to Actual Damages, caps Lawyer Fees, gives quick payments
* Replace most doctors with public health clinics
The current system has two beneficiaries
1) The 1% of the Medical-Industrial-Complex(including Big Pharma)
2) Folks with Cadillac Health Insurance Like Government Workers, that is mostly paid for, and massively subsidized by everybody else but them
The problem is that those folks are the winners, and everybody else is a loser
The upper echelons of our Medical Industry have profit-margins around double of that in other countries with better overall healthcare. And like everywhere else, the folks at the bottom of the Medical Industry are not well compensated, while the folks at the top are fabulously compensated
It will prove to be virtually impossible to pass anything through Congress that will change anything fundamentally in regards to the folks at the top of the Medical Industry
The GOP Plans are nothing but nonsense
** Health Savings Accounts, only multimillionaires can save enough money to pay for healthcare without the sweetheart deals that Big Insurance Companies can extract
** Competition across State Lines: There isn't anything keeping any Health Insurer from selling in any state. THE GOAL here is to be able to offer "pretend" health-insurance, that provides virtually no benefits, except that it wouldn't cost much
* * * *
REAL SOLUTIONS
* Buy drugs from other countries
* Tort Reform that limits almost all Health Related Lawsuits to Actual Damages, caps Lawyer Fees, gives quick payments
* Replace most doctors with public health clinics
4
If you're on the other side, working in healthcare, it's a bonanza of being very well-paid, sometimes, exorbitantly, for less and less real delivery of care. We have a new system of hospitalists making $300,000+ who no longer have their own patients, but log in, charge, and log out. We see no limit on what we can order or spend. We are now relegated to being typists in a colossal computerized system of data transfer--that allows easy billing--with an exponentially growing mess of regulation. So, despite a gnawing sense of dissatisfaction, you try to enjoy the security of the continued shower of money.
4
Aaah yes. The Black Hole of Information. Useless, but the greatest Tax Weapon ever invented. Keeps the Peasants on the treadmill, constantly providing more and more information that just winds up in useless Black Hole.
Pioneered by the Government, caught onto by the banking and insurance industries. With more industries signing up ! Keep gouging the peasant for information. Charge him to process it. Charge him to store it. Charge him. And provide no service. Repeat.
Pioneered by the Government, caught onto by the banking and insurance industries. With more industries signing up ! Keep gouging the peasant for information. Charge him to process it. Charge him to store it. Charge him. And provide no service. Repeat.
1
The elephant in the room issue that no candidate will address: over half of our healthcare costs are spent on people in their last six months of life. We should be talking about the use palliative care and hospice care instead of the intensive care unit (our default use of the ICU in the last one week of life is seven times greater than the second country, per capita). We should not be insuring $200,000 drugs that extend life for only a couple of months (let people pay for these out-of-pocket).
Our healthcare costs are rising exponentially – and the baby boom generation is only now beginning to enter the years that require the most health care. We better figure this out soon or we are going to bankrupt the country.
Our healthcare costs are rising exponentially – and the baby boom generation is only now beginning to enter the years that require the most health care. We better figure this out soon or we are going to bankrupt the country.
4
Why aren't you up in arms about the fact that the Patient Protection and Affordable Care Act hasn't lowered the costs of health care?
Oh, that's right - because that would be an admission that Obama, Kennedy, and all the other Progressives were completely, totally, utterly wrong; that their beliefs are actually Regressive and poisonous to Americans and America; that their goal was to make health care more expensive for everyone; and that their ultimate destination is to make everyone equally poor and miserable. Well, except for their donors, bundlers, and campaign fundraisers.
Oh, that's right - because that would be an admission that Obama, Kennedy, and all the other Progressives were completely, totally, utterly wrong; that their beliefs are actually Regressive and poisonous to Americans and America; that their goal was to make health care more expensive for everyone; and that their ultimate destination is to make everyone equally poor and miserable. Well, except for their donors, bundlers, and campaign fundraisers.
4
Notice the clamoring for "truth" and "fact checking" completely bypasses Obamacare. It was sold as a lie. We know that now. It has failed to achieve promises regarding cost savings. We know that now that.
President Obama and democrats forced this on Americans, and he moved on to the next big thing. He should have spent the remainder of his presidency making it right. Instead he left us with a lemon. And to all those who claim it was the republicans who prevented an agreement, President Obama managed to reach an agreement with the Iranians, but he could not compromise with his own Congress. The Iran deal was his next new shiny legacy opportunity. He had moved on from Obamacare. No gain for him there. Too bad his legacy didn't actually depend on Obamacare's actually working.
Fact check that.
President Obama and democrats forced this on Americans, and he moved on to the next big thing. He should have spent the remainder of his presidency making it right. Instead he left us with a lemon. And to all those who claim it was the republicans who prevented an agreement, President Obama managed to reach an agreement with the Iranians, but he could not compromise with his own Congress. The Iran deal was his next new shiny legacy opportunity. He had moved on from Obamacare. No gain for him there. Too bad his legacy didn't actually depend on Obamacare's actually working.
Fact check that.
1
You didn't read the article. The ACA has allowed 20 million more Americans to buy Health Insurance, including my son.
Unfortunately, even with this new pool of customers, subsidized by the Federal Government, the Insurance industry had to gouge people even more with increasing deductibles, and co-pays. This is also designed to encourage the insured to stay at home, when they need care, (for fear of Out of Pocket expenses), which saves the insurers more money.
So if the ACA had cost controls built in to stop these rising "extra charges" it would be a better system.
You pay your premium, and that should be it. No added charges, co-pays, or deductibles from your friendly insurer.
Unfortunately, even with this new pool of customers, subsidized by the Federal Government, the Insurance industry had to gouge people even more with increasing deductibles, and co-pays. This is also designed to encourage the insured to stay at home, when they need care, (for fear of Out of Pocket expenses), which saves the insurers more money.
So if the ACA had cost controls built in to stop these rising "extra charges" it would be a better system.
You pay your premium, and that should be it. No added charges, co-pays, or deductibles from your friendly insurer.
Skier: You didn't read my comment, or pay attention to reality.
The ACA has "allowed" 200 million more people to pay for your son's, and 20 million other Americans', health insurance. Yet you never ask why health care is expensive.
The reason: Government interference in the marketplace. How do I prove this? Because two vectors of health care - LASIK and cosmetic surgery - have not seen price increases like "regular" health care. Why not? Because they're not covered by anyone's government-mandated insurance, and they're not covered by Medicare.
The "insurance industry" is acting based on the confinements placed upon it by government. Get rid of that - something you are incapable of conceiving, let alone understanding - and see what true freedom in health care means.
Health care is not a "right". There can be no "right" to force doctors, nurses, hospitals, drug makers, etc., to give your son something he wants just because he cannot earn enough to pay for it. There is no "right" to force anyone else to pay for your son's wants, either.
The ACA has "allowed" 200 million more people to pay for your son's, and 20 million other Americans', health insurance. Yet you never ask why health care is expensive.
The reason: Government interference in the marketplace. How do I prove this? Because two vectors of health care - LASIK and cosmetic surgery - have not seen price increases like "regular" health care. Why not? Because they're not covered by anyone's government-mandated insurance, and they're not covered by Medicare.
The "insurance industry" is acting based on the confinements placed upon it by government. Get rid of that - something you are incapable of conceiving, let alone understanding - and see what true freedom in health care means.
Health care is not a "right". There can be no "right" to force doctors, nurses, hospitals, drug makers, etc., to give your son something he wants just because he cannot earn enough to pay for it. There is no "right" to force anyone else to pay for your son's wants, either.
1
Under a Trump presidency I can look forward to many trips overseas to take care of my ongoing oncology and post-operative issues. Fortunately I can afford to board an aircraft whenever the need arises for this attention and have superior benefits, in fact the same ones enjoyed by our illustrious Senators and Congressmen. For the rest of you, I can only say, Darwin.
6
It's not Rocket Science, every other Western Democracy and others have Universal Health Care Systems that are far cheaper, fairer and often better than what America has.
Even if it were Rocket Science, who better than America which sent men to the Moon because of its superior, more advanced Rocket Science than any other?
The fact is America does not want an effective, universal, affordable Health Care System, and by America , I mean those who hold the power and the influence to get things done and make things happen.
Unless this changes, nothing else will... except to better serve and benefit those who decide how things should be.
Even if it were Rocket Science, who better than America which sent men to the Moon because of its superior, more advanced Rocket Science than any other?
The fact is America does not want an effective, universal, affordable Health Care System, and by America , I mean those who hold the power and the influence to get things done and make things happen.
Unless this changes, nothing else will... except to better serve and benefit those who decide how things should be.
5
Can I suggest that if healthcare is brought to the forefront, the media will rehash (as it already has) Hillarycare as more proof of her penchant for secrecy and the overall incompetence of "government." It will remind everyone of how the country felt about a First Lady that tried to do something "above her pay grade."
You see, Trump is at an advantage. He has no record of public service and can fuel and ride the feeling of discontent with his tell it like it is "straight talk." And at the same time promise his supporters that they will be blessed by his Midas Touch.
This election cycle is all about the "gut" and not about the brain. No one cares about experience and competence.
While this conversation would be nice. Trump and the electorate will not allow it.
You see, Trump is at an advantage. He has no record of public service and can fuel and ride the feeling of discontent with his tell it like it is "straight talk." And at the same time promise his supporters that they will be blessed by his Midas Touch.
This election cycle is all about the "gut" and not about the brain. No one cares about experience and competence.
While this conversation would be nice. Trump and the electorate will not allow it.
4
Health care should indeed be one of the most discussed policies since the situation of the health care system is one of the most pressing problems in the United States.
But this election isn't really doing well on facts and policies. In the article you say "She would also further expose the shallowness of Mr. Trump’s agenda." Expose to whom? His supporters do not care about this shallowness or they would have never supported him, because there was never any substance to his policies to begin with. By now there should be very few people who care about actual policies that still support Trump. He gets his supporters through a very emotional, fear-driven style of hollow phrases meant to make him look like a strong leader, ready to act.
But this election isn't really doing well on facts and policies. In the article you say "She would also further expose the shallowness of Mr. Trump’s agenda." Expose to whom? His supporters do not care about this shallowness or they would have never supported him, because there was never any substance to his policies to begin with. By now there should be very few people who care about actual policies that still support Trump. He gets his supporters through a very emotional, fear-driven style of hollow phrases meant to make him look like a strong leader, ready to act.
7
Bernie tried to get the public to understand that Obamacare needed to be replaced with universal health care and he was derided by the Clinton-Obama crowd as a dreamer. As long as there is ANY element of "competition" that involves the for-profit health insurance industry consumers (i.e.patients) will pay higher prices so that shareholders can be rewarded. This is an area where the government should take over but neither candidate wants to say that "government is the answer" because both the neoliberals and Republicans have convinced us that government is the problem and markets are the solution.
7
What do you think the net margin to shareholders is of for-profit health insurance plans on the public exchange? (Hint: it's less than zero)
Campaigns aren't talking about it because none of them have any material solutions.
To Clinton's credit, she at least has some ideas, but at the end of the day they amount to little more than rearranging the deck chairs to create the perception of improvement.
But more broadly, for Democrats, talking about problems with health care means talking about the failings of the Affordable Care Act. Doing so is problematic on many levels -- Clinton would risk disparaging Obama's legacy and it would only give ammunition to their political enemies who want to repeal it.
The Republicans don't talk about it beyond repealing the ACA, and much of that talk is ideological, not practical. They know that repealing the ACA would simply bring back some of the problems ACA dealt with successfully (ie, pre-existing conditions) and really wouldn't address the core problems of spiraling costs.
To Clinton's credit, she at least has some ideas, but at the end of the day they amount to little more than rearranging the deck chairs to create the perception of improvement.
But more broadly, for Democrats, talking about problems with health care means talking about the failings of the Affordable Care Act. Doing so is problematic on many levels -- Clinton would risk disparaging Obama's legacy and it would only give ammunition to their political enemies who want to repeal it.
The Republicans don't talk about it beyond repealing the ACA, and much of that talk is ideological, not practical. They know that repealing the ACA would simply bring back some of the problems ACA dealt with successfully (ie, pre-existing conditions) and really wouldn't address the core problems of spiraling costs.
5
I'm almost 58 and I can recall when I was about 4 years of age a doctor coming to our house carrhying his black bag to check on me for a fever. We were a middle class family. That's unheard of now unless you belong to a class of ultra rich that can pay for it. The ratio of doctors to population is still about the same as in the early 1960s. We have to ask what changed that created a system whereby costs keep rising dramatically every year. Is it due to the rise of health care corporations and shareholder demands for increasing profits?
6
I can recall when most doctors where in family practice and didn't have mountains of paper work needed to comply with insurance and government regulations. I can also recall many of my family and friends family members died in their 40's and 50's from lung cancer and massive heart attacks.
My wife recently died of cancer. She survived 3 plus years after a stage 4 diagnoses. The $350,000.00 dollars of chemo therapy and the 2 surgery techniques, one that gave her a year and a half of remission didn't exist when you were 4 years old.
My wife recently died of cancer. She survived 3 plus years after a stage 4 diagnoses. The $350,000.00 dollars of chemo therapy and the 2 surgery techniques, one that gave her a year and a half of remission didn't exist when you were 4 years old.
Andy,
Unfortunately, we have a healthcare system that willingly pays for unnecessary care and much of that care is among the most costly. Tens of billions of dollars are spent each year on unnecessary tests and surgery for back pain and no one has done a thing about this.
We have yet to pay for true preventive care. The only truly preventive care that is now paid for are colonoscopies (mammograms are not preventive as they prevent nothing. They only detect disease once it is present).
Unfortunately, we have a healthcare system that willingly pays for unnecessary care and much of that care is among the most costly. Tens of billions of dollars are spent each year on unnecessary tests and surgery for back pain and no one has done a thing about this.
We have yet to pay for true preventive care. The only truly preventive care that is now paid for are colonoscopies (mammograms are not preventive as they prevent nothing. They only detect disease once it is present).
Steve, no one is preventing you from eating healthy and regular vigorous exercise. One of the reasons we have high health care costs is we are a fat society that eats a lousy diet.
There is no way to avoid saying it. We are at the mercy of the banks and insurance companies, and so is the United States government. Also, although the movement exists and may be growing, there is no way the country is prepared to accept what is dismissed with horror as 'socialized medicine'. Social Democracy is embraced by Bernie Sanders and few other high level elected officials. Trump's call for change is a cynical and nihilistic push toward chaos. Clinton is for incremental change that may be too slow to avoid catastrophe of it's own kind.
6
I would like to see more people run on expanding Medicaid. Many Republican states still have not expanded it. As a result an estimated 3-4000,000 people on my state of NC are missing health care. Expansion is a job builder. Imagine how many jobs have already been created to provide health care to the 20,000,000 people served by Obamacare. Those who call Obamacare a job killer are just fibbing.
5
I'm always amazed by how many comments relate to "single payer" when none of the discussed problems in the article relate to single payer. Drug costs are not a single payer problem or a single negotiator problem. They are a problem with the rules of negotiation, and ultimately a problem with where Congressional Representatives get the money to run campaigns. Instead of single payer, why isn't their a demand for single drug company, single physician group, single hospital group, single device maker? Single payer is a slogan covering up ignorance on how to solve the problem of high health care costs.
9
Ignorance will not solve this problem. Why not simply look at countries in the rest of the world where every citizen gets the best available health care in the world at affordable cost. Most of these have some sort of "single payer" system that has the power to negotiate real costs from a position of strength.
Hillary Clinton, most recently, spoke strongly against the arbitrary cost-raising by Mylan for the life-saving Epipen, which is critical for untold numbers of Americans. She also has a plan to go after manufacturers who arbitrarily hike medication prices. That is a crucial, life-or-death issue and she is bringing the message across the country.
This is after her unflinching support for the ACA, even as other Democrats distanced themselves, and giving President Obama credit for being the first American leader to realize universal healthcare.
This is after decades of fighting for guaranteed healthcare, no matter the ramifications to her.
This is after being a stalwart champion of women's healthcare, even as that has become a political third rail. She was endorsed by Planned Parenthood early on from her strong record.
And she gets accused of not making healthcare a prominent national issue? And she finds herself analogized with Trump, who has said his healthcare plan is to immediately end Obamacare and replace it with something terrific? Please.
This is after her unflinching support for the ACA, even as other Democrats distanced themselves, and giving President Obama credit for being the first American leader to realize universal healthcare.
This is after decades of fighting for guaranteed healthcare, no matter the ramifications to her.
This is after being a stalwart champion of women's healthcare, even as that has become a political third rail. She was endorsed by Planned Parenthood early on from her strong record.
And she gets accused of not making healthcare a prominent national issue? And she finds herself analogized with Trump, who has said his healthcare plan is to immediately end Obamacare and replace it with something terrific? Please.
While Donald Trump, as usual, is devoid of ideas, and Hillary Clinton has any number of possibilities she is pondering, this situation is at the very heart of why health care doesn't get more attention on the campaign trail. To the wealthy, to the winner and loser of the upcoming presidential election, to every man and woman occupying a seat in Congress, fear of the cost of health care is an abstraction. They're covered from their heels to the top of their heads. They are not standing in line at a pharmacy near tears because they can't afford the medication they or another member of their family desperately needs. They're not the ones rolling nickels and dimes so they can use public transportation to get to a doctor whose co-pay they can't afford anyway. Let those in charge be inspired this way for a start: Have them pay the actual retail price that the pharmaceutical companies sell their wares for. Maybe then they might see the wisdom in allowing Medicare to negotiate drug prices. If they get breathless just thinking of the possibility, let them buy a $600 EpiPen two pack that costs about five bucks to manufacture.
1
Problems with the health care system are government created. Therefore, arguing that the solution is more government makes no sense. Tampering with the free market only creates more inequities because there are no free lunches. If people want "free" health care then someone is going to have to pay for it. For example, high deductibles discourage wasteful use of resources (such as going to the doctor for minor issues). If we eliminate these disincentives then everyone will waste the limited resources and the supply will not meet the demand. You can't have it both ways. Either we have limited supply or we limit demand. Choose your poison.
The problem is that the voters know the only answer is universal health care, a.k.a. Medicare For All, but Hillary slammed Bernie for pushing for it so she can't now embrace it, while Trump can't push for it because most RepCons are against "socialized" medicine. No matter which one wins, it will be the American people who lose, as always.
But beyond that, no meaningful discussion of ideas will occur, as we have seen that Trump is "All hat, and no cattle", and has successfully bullied the MSM into giving him a free pass. Against that, Hillary, and her wonkiness will be skewered, as she tries to defend herself with ever more details, that serve only to provide Trump with more ammunition.
This election will not be decided by ideas, but by ideology, and which ideology can bring out more voters: the ideology of fear and exclusion, or the ideology of hope and inclusion. There really isn't any middle ground.
But beyond that, no meaningful discussion of ideas will occur, as we have seen that Trump is "All hat, and no cattle", and has successfully bullied the MSM into giving him a free pass. Against that, Hillary, and her wonkiness will be skewered, as she tries to defend herself with ever more details, that serve only to provide Trump with more ammunition.
This election will not be decided by ideas, but by ideology, and which ideology can bring out more voters: the ideology of fear and exclusion, or the ideology of hope and inclusion. There really isn't any middle ground.
It's proper term is a "cash cow". No one wants to gore the cash cow. I have seen no study that has looked at what segment of the economy produces the most millionaires - billionaires, but it seems quite possible that the medical industry now makes more millionaires - billionaires than the military industrial industry. Neither serves the interest of the American people, they are both just a means of extracting wealth from the many for the benefit of a few. Who can say no to "I want the best military - health care in the world" to keep me safe and healthy. Give anyone a free pass to charge as much as they want and you will surely get charged much more than you wanted. When elected officials begin to serve the public and not the corporations that fund their elections they just might begin to look at what is good for the public, not what is good for the corporations. Healthcare in America is a corporate run industry, which is why the doctors that used to be an independent professional organization are so disgusted with our current medical system. They have been forced into the corporate mentality, and cant seem to find a way to regain their independence.
2
Climate change is a hoax.
Barak Obama is the only president whose birthplace was ever questioned and even a birth certificate was not believed. Never mind that Ted Cruz was born in Canada and John McCain was born in Panama. Hatred can make people believe anything.
The list goes on.
People with a lot of life ahead of them will, of course, hope that human beings will cooperate, devise a sane health care system, stop hating each other and maybe even save themselves from climate destruction. At my age I have learned those things aren't going to happen. In fact, when you think about it, the fact that Americans ever created Social Security and Medicare is an absolute miracle. It could never happen again. I feel truly fortunate to have secured them both and now hope I don't live longer than it takes madmen like Donald Trump, Paul Ryan and all the rest to destroy them. For the rest of you, all I can say is you are sharing this country with some real sick puppies. They control practically every state government, congress, the Senate, and the Supreme Court (until Scalia died). It is really beyond me how they have done it. Republicans are kind of like rats. This country is quite capable of electing Trump, who is a lying, lunatic predator, and he is quite capable of resorting to nuclear weapons for a quick solution in North Korea, Iran, Syria or anywhere else his ADD is inadequate to deal with. You are hanging by a thread. Not the way I thought things would turn out, at all. Sad.
Barak Obama is the only president whose birthplace was ever questioned and even a birth certificate was not believed. Never mind that Ted Cruz was born in Canada and John McCain was born in Panama. Hatred can make people believe anything.
The list goes on.
People with a lot of life ahead of them will, of course, hope that human beings will cooperate, devise a sane health care system, stop hating each other and maybe even save themselves from climate destruction. At my age I have learned those things aren't going to happen. In fact, when you think about it, the fact that Americans ever created Social Security and Medicare is an absolute miracle. It could never happen again. I feel truly fortunate to have secured them both and now hope I don't live longer than it takes madmen like Donald Trump, Paul Ryan and all the rest to destroy them. For the rest of you, all I can say is you are sharing this country with some real sick puppies. They control practically every state government, congress, the Senate, and the Supreme Court (until Scalia died). It is really beyond me how they have done it. Republicans are kind of like rats. This country is quite capable of electing Trump, who is a lying, lunatic predator, and he is quite capable of resorting to nuclear weapons for a quick solution in North Korea, Iran, Syria or anywhere else his ADD is inadequate to deal with. You are hanging by a thread. Not the way I thought things would turn out, at all. Sad.
It is in this area -- health care -- as well as the buying fresh foods, produce, fish etc, that
inflations is clearly seen across the board.Everyone
at the govn level can claim low inflation but consumers know the difference. (We won't even
address cost of renting in this article and inflation.)
Everyone is effected except perhaps the so-called undocumented who go to free community clinics
at lease in CA.
Inflation has hit the rest of us and many retirees
of age 70+ are seeking jobs as a result.
inflations is clearly seen across the board.Everyone
at the govn level can claim low inflation but consumers know the difference. (We won't even
address cost of renting in this article and inflation.)
Everyone is effected except perhaps the so-called undocumented who go to free community clinics
at lease in CA.
Inflation has hit the rest of us and many retirees
of age 70+ are seeking jobs as a result.
1
It it is illegal to advertise prescription drugs to the general public in France, but it is permissible to have rather vague advertising for pharmaceutical companies touting the good they are doing in the field of healthcare. Recently my radio station has been playing some "warm and inspirational" type commercials for "Mylan." Heather Bresch can do all the advertising she wants here, but she still won't be able to price gouge the way she has done with Epipens in the US. Thank god the French Health Ministry negotiates seriously with Big Pharma on drug prices and we have single payer health care.
Going to sleep at night knowing you won't be financially ruined by illness- Priceless!
Going to sleep at night knowing you won't be financially ruined by illness- Priceless!
1
It would be nice if rank and file Democrats would acknowledge this growing problem. The ACA, while successful in increasing access to insurance, has done an abysmal job at making it affordable, which was the other main aim of the legislation. The late omission of the govt. funded option really diluted the law into a subsidy for commercial insurance companies who have taken advantage by consistently raising premiums and deductible amounts. Basically what millions of folks have purchased is health insurance that covers for catastrophic events not average but necessary preventive care. Your average American is not going to continue to pay out of pocket for a doctor's office visit when they cannot afford it. Senator Sanders is clearly on the right track with his suggestions to expand govt. funded health coverage...even it is deemed "too costly" by everyone else. The main goal should be improving the overall health of the country not save money.
4
As much as I think Mr. Obama has done a generally creditable job (admittedly his predecessor set the bar alarmingly low), his signature health care legislation was a mishandled half-measure. This was an FDR moment if ever there was one, and the President's decision to let others drive the boat was a poor one. Whether we as a nation will have the energy to address this issue again any time soon is anybody's guess. Let's hope we haven't squandered our last, best hope of obtaining what all the other industrialized nations have had for quite some time now, genuine first world universal health care.
2
"Health care is just the kind of difficult subject that presidential candidates ought to talk about more." Really? I seem to recall that Bernie Sanders talked about a single payer system quite often, but The NYT hardly ever covered him in the crucial early days of the primary campaign, and the Editorial Board endorsed the wrong candidate.
The inflation rate of healthcare in the US has far exceeded the CPI for the past 50 years. The only way to fix that is to have a single payer system, such as the one proposed by Sanders.
Most of Hillary's supporters made excuses for her, like saying that Sanders' proposal would never become law. I say that until we have a single payer system, we will not solve our huge problems with healthcare.
The inflation rate of healthcare in the US has far exceeded the CPI for the past 50 years. The only way to fix that is to have a single payer system, such as the one proposed by Sanders.
Most of Hillary's supporters made excuses for her, like saying that Sanders' proposal would never become law. I say that until we have a single payer system, we will not solve our huge problems with healthcare.
7
Donald Trump doesn't have a plan and Hillary's plan is lame.
And there is no political will to push for single-payer health care, or Medicare for All, while the wheels of politics are greased by campaign contributions and the revolving door between legislators or their staff and industry remains unchallenged.
Her policy proposals are better than the "shallowness of Mr. Trump’s agenda", but surrounding herself with people like Jim Messina and cozying up with Mark Bertolini render her proposals as sincere and credible as her opposition to TPP.
Obamacare is neither affordable nor does it deliver good health care to all people and Mrs.Clinton's "range of interesting ideas on how to tackle costs and improve care" is nothing but extending life support for a failed system.
Therefore Americans, especially poor Americans, will continue to suffer and be exploited by insurance companies, Big Pharma, and giant health corporations, so that Democratic and Republican lawmakers alike, including Mrs.Clinton, can line their pockets with cash from those very same entities.
And there is no political will to push for single-payer health care, or Medicare for All, while the wheels of politics are greased by campaign contributions and the revolving door between legislators or their staff and industry remains unchallenged.
Her policy proposals are better than the "shallowness of Mr. Trump’s agenda", but surrounding herself with people like Jim Messina and cozying up with Mark Bertolini render her proposals as sincere and credible as her opposition to TPP.
Obamacare is neither affordable nor does it deliver good health care to all people and Mrs.Clinton's "range of interesting ideas on how to tackle costs and improve care" is nothing but extending life support for a failed system.
Therefore Americans, especially poor Americans, will continue to suffer and be exploited by insurance companies, Big Pharma, and giant health corporations, so that Democratic and Republican lawmakers alike, including Mrs.Clinton, can line their pockets with cash from those very same entities.
2
Healthcare does indeed require more attention from the campaigns.
The answer is not going to be easy, because to provide affordable healthcare to all, everybody has to give something up. We like to believe that it will be executive Shkrelis and medical administrators and that idiot you had to deal with at the hospital who was only slightly less evil than the insurance person.
But all that cost is someone's income. The drug developer and the salesman, the person who puts together diagnostic testing machines, and the ones who test medical devices like insulin pumps. It affects the retiree with Big Pharma in the pension paying the bills. It affects millions of doctors, nurses, PAs, technicians, aides, billers, cleaners, claims processors, office staff. There are landlords who have medical tenants in their buildings and construction workers building new wings.
We have both a vested interest in obtaining care, and an interest in keeping our jobs.
We can figure out how to make incremental approaches to regulation work, as the ACA does, or we can create chaos from scrapping the present system and either trying to nationalize the insurance industry or frankly, the more likely outcome, in which we scrap the system, get employers out of the middle and let everyone fend for themselves.
It is easy to say "Medicare for All!' or "Repeal Obamacare!" It is a lot harder really to do either.
The answer is not going to be easy, because to provide affordable healthcare to all, everybody has to give something up. We like to believe that it will be executive Shkrelis and medical administrators and that idiot you had to deal with at the hospital who was only slightly less evil than the insurance person.
But all that cost is someone's income. The drug developer and the salesman, the person who puts together diagnostic testing machines, and the ones who test medical devices like insulin pumps. It affects the retiree with Big Pharma in the pension paying the bills. It affects millions of doctors, nurses, PAs, technicians, aides, billers, cleaners, claims processors, office staff. There are landlords who have medical tenants in their buildings and construction workers building new wings.
We have both a vested interest in obtaining care, and an interest in keeping our jobs.
We can figure out how to make incremental approaches to regulation work, as the ACA does, or we can create chaos from scrapping the present system and either trying to nationalize the insurance industry or frankly, the more likely outcome, in which we scrap the system, get employers out of the middle and let everyone fend for themselves.
It is easy to say "Medicare for All!' or "Repeal Obamacare!" It is a lot harder really to do either.
1
Ever since insurance companies could not bar people from being insured because of their "pre-existing" clauses, albeit a pre-existing condition could just about be a hangnail, they have jacked around consumers to make their money in other ways, such as high deductibles. No seeming protection from that.
That's bad enough, but when a mom or dad has to fork out over $600 for two injectable means of medication for their child who has a peanut allergy, something is blatantly wrong with a country that accepts that. And then the pharmaceutical tries to find another way, calling this a life sustaining medication, to still rake in their ridiculous amount of profit.
As a retired nurse, I cannot stand to hear of these continued struggles. I worked for an insurance company once. It seemed the individuals who made the most non-approvals were the favorites. What does that tell you?
That's bad enough, but when a mom or dad has to fork out over $600 for two injectable means of medication for their child who has a peanut allergy, something is blatantly wrong with a country that accepts that. And then the pharmaceutical tries to find another way, calling this a life sustaining medication, to still rake in their ridiculous amount of profit.
As a retired nurse, I cannot stand to hear of these continued struggles. I worked for an insurance company once. It seemed the individuals who made the most non-approvals were the favorites. What does that tell you?
5
Of course health care deserves more attention; a lot more. The outrages of our current system are factual and begging to be addressed.
But so are a number of other serious issues.
Instead we are obsessed with Hillary's pneumonia and the oh-so-tired issue of her email server. BTW, What ever happened to the brief announcement that an email had been discovered (in amongst those that outlined Hillary's evil plans to overthrow the government) from Colin Powell advising her to set up her own server? That came and went in less than one news cycle.
And, we are forced to not only digest Donald Trump's continuous outrageous behavior, we have to defend against it to a large portion of the population that has abandoned the idea of the Presidency as a position of dignity and decency.
While we're on the subject of health care, can anyone tell my why businesses continue to tolerate the high expense to them to offer and maintain a health care benefit for their employees? They own Congress. One would think if this responsibility was as onerous as some have pointed out in these comments (+$17,000 per employee per year) that they would be leading the charge for a single payer system. Why are they silent? I for one don't believe for a minute that they give a hoot about the health care burden of their employees. Do they cut tax benefits that end up making these benefits attractive to the bottom line?
But so are a number of other serious issues.
Instead we are obsessed with Hillary's pneumonia and the oh-so-tired issue of her email server. BTW, What ever happened to the brief announcement that an email had been discovered (in amongst those that outlined Hillary's evil plans to overthrow the government) from Colin Powell advising her to set up her own server? That came and went in less than one news cycle.
And, we are forced to not only digest Donald Trump's continuous outrageous behavior, we have to defend against it to a large portion of the population that has abandoned the idea of the Presidency as a position of dignity and decency.
While we're on the subject of health care, can anyone tell my why businesses continue to tolerate the high expense to them to offer and maintain a health care benefit for their employees? They own Congress. One would think if this responsibility was as onerous as some have pointed out in these comments (+$17,000 per employee per year) that they would be leading the charge for a single payer system. Why are they silent? I for one don't believe for a minute that they give a hoot about the health care burden of their employees. Do they cut tax benefits that end up making these benefits attractive to the bottom line?
Since the day the law was passed, I have referred to it as the Unaffordable Care Act. Now perhaps people understand that I wasn’t wrong. It is unaffordable to individuals and unaffordable to us as a society. It’s only success is it has decreased the number of uninsured – but you would hope any entitlement program would at least deliver entitlements! The fact that we still have ~10% uninsured means it has failed at even being an entitlement program (!!) – and at an exorbitant cost.
Yes, we need more thought given to how to solve this mess. Neither candidate nor party has a credible plan.
My own view is we need more competition, not less.
Yes, we need more thought given to how to solve this mess. Neither candidate nor party has a credible plan.
My own view is we need more competition, not less.
2
Some day (I hope soon) even in the US we should reach the point of agreeing that while "Government is not the answer", neither is a totally "free" market (which, in any case, is just an abstract construct found only in textbooks of economics...). The answer, like in most of life, is in finding the right middle ground. The current health system, controlled by the insurance companies, is clearly not working. They keep telling us that they can manage the problem better, faster and more cost-effectively than a government-run scheme. Let them prove it by putting in place an alternative government-run plan to supplement the coverage they do now want to offer. The reality is that they like to pick and choose who they want to cover, and to what extent. That clearly is not the answer.
2
The only solution that makes sense is Medicare for all and allowing Medicare to negotiate the costs of prescription drugs. It would be much easier to "fold" everyone into an existing system then to create a new one or to make adjustments to satisfy health insurance companies who no longer are competitive. If one considers the costs one now pays for health insurance (which would not be required with a Medicare for all plan) plus an increase to Medicare premiums (to compensate for all or most of the additional cost) the net result would be LESS cost to the consumer, not more. Bernie Sanders did the math and it works !!
11
Health care should get more coverage in the election. Dems should thank their stars that they get a 2nd election cycle where Obamacare will not be an issue. Romney didn't want to discuss it because of the similarity to Romneycare. In this cycle, Hillary doesn't want to discuss it because of the unpopularity of Obamacare. And Trump doesn't discuss much of any policy detail.
People lack health ins for many reasons - losing a job that had healthcare, high risk, working poor, etc. For the last group (working poor), it's not just healthcare. You could just as easily ask whether society should provide housing, food, etc. Given that many of the poor drop out of school (29%) or are part of single-parent families (40%), you've got to ask at what point society should ask individuals to take more responsibility for their own lives ?
Last, consider the cost of Obamacare - even using the numbers in the article. Per the CBO, Obamacare is now projected to cost $1.4 tn over 10 yrs.
The article says that due to Obamacare, "twenty million Americans have gained health care coverage". That's $70,000 per person for what is often very sparse coverage.
Obamacare is a failure. Three of the biggest insurers (United, Humana and Aetna) are getting out. And the fourth, Blue Cross, is losing money on Obamacare. What's left is basically just Medicaid expansion. For all the talk, shouldn't we do more to encourage the poor to go to school and form families to become self sufficient ?
People lack health ins for many reasons - losing a job that had healthcare, high risk, working poor, etc. For the last group (working poor), it's not just healthcare. You could just as easily ask whether society should provide housing, food, etc. Given that many of the poor drop out of school (29%) or are part of single-parent families (40%), you've got to ask at what point society should ask individuals to take more responsibility for their own lives ?
Last, consider the cost of Obamacare - even using the numbers in the article. Per the CBO, Obamacare is now projected to cost $1.4 tn over 10 yrs.
The article says that due to Obamacare, "twenty million Americans have gained health care coverage". That's $70,000 per person for what is often very sparse coverage.
Obamacare is a failure. Three of the biggest insurers (United, Humana and Aetna) are getting out. And the fourth, Blue Cross, is losing money on Obamacare. What's left is basically just Medicaid expansion. For all the talk, shouldn't we do more to encourage the poor to go to school and form families to become self sufficient ?
3
This is a very good editorial and I wished the NYEB focused more on issues than on Trump's character assassination and the nonstop propping of Hillary's missteps.
The problem with the solution offered by both Trump and Clinton, tax credits, is that is socialism for the healthcare corporatocracy, it subsidizes the healthcare industry, gives them money from uncle Sam to people (customers) to afford to but their expensive product, instead of making the product affordable. In short it subsidizes their greed instead of sharply reorganizing the current health care model and cut its obscene profits.
With healthcare being a major lobby force, major advertiser for the media, major donor for Congress and for Hillary, who is going to fight it?
Sanders wanted with the public option, but then the NYT was silent instead of singing him praises.
Obama was shown in wiki-leaks that he was auctioning off his government positions to the biggest donors, who often came from the very lobby they were supposed to oversee.
I applied for Obama care and the first time I had a health problem I had insurance but no doctor was in the network.
The problem with the solution offered by both Trump and Clinton, tax credits, is that is socialism for the healthcare corporatocracy, it subsidizes the healthcare industry, gives them money from uncle Sam to people (customers) to afford to but their expensive product, instead of making the product affordable. In short it subsidizes their greed instead of sharply reorganizing the current health care model and cut its obscene profits.
With healthcare being a major lobby force, major advertiser for the media, major donor for Congress and for Hillary, who is going to fight it?
Sanders wanted with the public option, but then the NYT was silent instead of singing him praises.
Obama was shown in wiki-leaks that he was auctioning off his government positions to the biggest donors, who often came from the very lobby they were supposed to oversee.
I applied for Obama care and the first time I had a health problem I had insurance but no doctor was in the network.
1
Campaigns are increasingly being fought using the idea, "What they don't know won't hurt me." Candidates know that an emotional, uninformed vote is as good as one from someone who has studied the issues. And there are many, many more in that first category. So the percentages favor emotional, uninformed ads and slogans, not real solutions.
Unfortunately, as the article notes, health care is complex. Also unfortunately, it's easy to create emotional ads and slogans around it. The answer to, "Why hasn’t health care gotten more attention?" is that discussing it doesn't help either candidate.
Hillary knows people are simply confused and no amount of discussion will attract enough votes to make it worthwhile. She has positions to backstop her base and that's as much as she can get from the health care issue.
Trump has used the right emotional slogans to backstop his own base, but he knows that outside of that base, the numbers are against him so he just hopes that enough uninformed people will forget what he told his own hard core. (They will.) Besides, he doesn't understand it either and would just dig his hole deeper if he tried to talk about it.
Our only hope is the realization that Hillary selected the right answer - single payer health care - as a personal mission as a new First Lady. Since all politicians lie and Hillary does too, if there is a sufficient change in Congress in the next term, Hillary might try to do the right thing again when she is elected.
Unfortunately, as the article notes, health care is complex. Also unfortunately, it's easy to create emotional ads and slogans around it. The answer to, "Why hasn’t health care gotten more attention?" is that discussing it doesn't help either candidate.
Hillary knows people are simply confused and no amount of discussion will attract enough votes to make it worthwhile. She has positions to backstop her base and that's as much as she can get from the health care issue.
Trump has used the right emotional slogans to backstop his own base, but he knows that outside of that base, the numbers are against him so he just hopes that enough uninformed people will forget what he told his own hard core. (They will.) Besides, he doesn't understand it either and would just dig his hole deeper if he tried to talk about it.
Our only hope is the realization that Hillary selected the right answer - single payer health care - as a personal mission as a new First Lady. Since all politicians lie and Hillary does too, if there is a sufficient change in Congress in the next term, Hillary might try to do the right thing again when she is elected.
The premium for the least expensive bronze level PPO policy in our area of Pennsylvania, for a family of four, two mid-sixties adults, two early twenties adults, increased from about $980/month in 2014, to $1,200/month in 2015, to $1,800/ month in 2016. Deductibles rose from $4,000 per head to $6,000.
So, approaching retirement, we are forced to dig into tax-advantaged accounts to pay for health insurance, which increases our taxable income, which increases our tax liability.
Bottom line, almost 1/3 of our "income" (better stated, income plus erosion of savings) goes to "health insurance", which includes a healthy subsidy for others who pay less or nothing for a more generous insurance plan.
My guess is that, to the architects of the ACA, we are considered at best, collateral damage. Benighted folks who, absent the police power of the state, would not make our contribution to the general good.
Then we can look forward to the future...where the ACA individual policy premiums will continue to rise and coverage will continue to narrow. Medicaid for the upper middle class with high premiums and high deductibles.
So, approaching retirement, we are forced to dig into tax-advantaged accounts to pay for health insurance, which increases our taxable income, which increases our tax liability.
Bottom line, almost 1/3 of our "income" (better stated, income plus erosion of savings) goes to "health insurance", which includes a healthy subsidy for others who pay less or nothing for a more generous insurance plan.
My guess is that, to the architects of the ACA, we are considered at best, collateral damage. Benighted folks who, absent the police power of the state, would not make our contribution to the general good.
Then we can look forward to the future...where the ACA individual policy premiums will continue to rise and coverage will continue to narrow. Medicaid for the upper middle class with high premiums and high deductibles.
It is not understandable why America ignores a failing (failed) health care system when health care for all should be a goal of any society who seeks equality for it's citizens. There is no plan being proposed which will create an affordable and efficient health care system. As long as a capitalist based and for profit system stays in place the health of millions of Americans will never improve. The only possible system which could deliver reasonable health care to all persons-and to those who have no money-must be a not for profit system-and one which has a single payer. The reason health care has a low-and nearly invisible-profile in candidates speeches and discussions is that they know there is really no adequate system possible in the United States without a major overhaul in thinking and in administration. Neither candidate will risk the shouts of "socialized medicine" if they propose an accessible system for all Americans. Nothing is going to happen of benefit and America will continue to pay the price of loss of vigor of citizens. Already America ranks poorly in countries of the world in indices of health care and public health, such as infant mortality, maternal mortality, for example, with poor returns per dollar. Does America really care so little about their citizens? Lack of health care is a sign of becoming a failed state.
1
Of course a single payer system that works in other 1st world countries is the only solution. But show me a Republican who would seriously consider it. Obama's choice was 2nd best in that it preserves the role for insurance companies.
And what was the republican response? Lies about totally non existent death panels. Absurd complaints that bureaucrats would get between the people and their doctors when in fact that insurance companies did that and that huge numbers had no doctors. Fighting tooth and nail to prevent crucial components of the plan. Vote after vote to abolish without any other solution to the lack of medical care for large portions of the public. Smearing Obama as a tyrant for adopting regulations to help the program.
The republicans have no meaningful proposal to give access to the "world's best medical system" to the people. But they gloat over the shortcomings of an imperfect system rather than help improve it.
Hillary, for all her shortcomings, has a real record of caring for and trying to help rectify the shameful denial of healthcare to so many.
And what was the republican response? Lies about totally non existent death panels. Absurd complaints that bureaucrats would get between the people and their doctors when in fact that insurance companies did that and that huge numbers had no doctors. Fighting tooth and nail to prevent crucial components of the plan. Vote after vote to abolish without any other solution to the lack of medical care for large portions of the public. Smearing Obama as a tyrant for adopting regulations to help the program.
The republicans have no meaningful proposal to give access to the "world's best medical system" to the people. But they gloat over the shortcomings of an imperfect system rather than help improve it.
Hillary, for all her shortcomings, has a real record of caring for and trying to help rectify the shameful denial of healthcare to so many.
Despite media attention to the anomalies, if the rest of healthcare behaved like prescription medications we'd be a lot better off. According to the Express Scripts report (cited in this article), prices for traditional (i.e., non-specialty) medications were *down* 2% last year. That's because expensive branded products have to compete with generics... and with each other. (Specialty medication prices could moderate as well if we allowed more aggressive competition between them.)
Competition can work in health care, but it requires three things:
1. High quality, head-to-head data to determine what interventions work and how well.
2. The ability to manage access (i.e., the equivalent of formulary and networks) so that more expensive, less effective interventions are disadvantaged.
3. A practical understanding of how to get patients to switch to higher-quality, less costly options.
It's work but it's not rocket science. And the sooner we get to it, the better.
Competition can work in health care, but it requires three things:
1. High quality, head-to-head data to determine what interventions work and how well.
2. The ability to manage access (i.e., the equivalent of formulary and networks) so that more expensive, less effective interventions are disadvantaged.
3. A practical understanding of how to get patients to switch to higher-quality, less costly options.
It's work but it's not rocket science. And the sooner we get to it, the better.
Every industrialized nation has a health care plan which includes coverage for all their citizens. All offer coverage at much less expense than what we face in America. Health costs in America allow corporations to suck every dollar from family accounts. Apparently a decision has been made to make sure the majority of Americans leave their savings to corporate health care rather than pass some funds on to family. We are making CEO's and managers very wealthy. Health care is needed by everyone. We can no longer allow an expensive system to limit who receives care. It is injustice provided by an unjust system.
The only solution to exorbitant health costs in this country is to offer a national policy - as does every other industrialized nation - and reduce the greed so prevalent in our for-profit system.
The only solution to exorbitant health costs in this country is to offer a national policy - as does every other industrialized nation - and reduce the greed so prevalent in our for-profit system.
2
It’s certainly easy enough to understand why neither candidate is saying much about health care. Mr. Trump has little to offer, and Ms. Clinton is afraid that anything she says will be taken as an admission that the ACA, a law that is entirely the work of the Democrats, is failing. Which, in fact, it is.
Bipartisan reform is clearly necessary. Let us wish ourselves good luck with this.
The government needs to reform regulation. Drug monopolies are responsible for much of the high cost of medicines, and to a large extent these derive from poorly implemented government regulation, with abuse of the patent system, excessive regulation by the FDA restricting competition, and even overregulation by other agencies, like the EPA forcing some asthma rescue inhalers off the market.
Medical providers should be required to let consumers know what care will cost before it is rendered. This is long overdue, and a no-brainer.
Politically motivated coverage mandates should be removed from the ACA.
Excessive and counterproductive regulations on how medicine is practiced beg for reform, including the “meaningful use” and other requirements imposed by Medicare that often require physicians to spend more time on their computers than speaking to patients.
Malpractice reform (reform means reform, not elimination, of tort law) at the Federal level could help immensely, people underestimate the financial and emotional cost of defensive medicine.
The list goes on.
Bipartisan reform is clearly necessary. Let us wish ourselves good luck with this.
The government needs to reform regulation. Drug monopolies are responsible for much of the high cost of medicines, and to a large extent these derive from poorly implemented government regulation, with abuse of the patent system, excessive regulation by the FDA restricting competition, and even overregulation by other agencies, like the EPA forcing some asthma rescue inhalers off the market.
Medical providers should be required to let consumers know what care will cost before it is rendered. This is long overdue, and a no-brainer.
Politically motivated coverage mandates should be removed from the ACA.
Excessive and counterproductive regulations on how medicine is practiced beg for reform, including the “meaningful use” and other requirements imposed by Medicare that often require physicians to spend more time on their computers than speaking to patients.
Malpractice reform (reform means reform, not elimination, of tort law) at the Federal level could help immensely, people underestimate the financial and emotional cost of defensive medicine.
The list goes on.
Tort reform will never happen! The trial lawyers fill the democratic campaign coffers. Even if Trump won and the Repubs retained Congress, the Dems would filibuster Tort Reforem. It is just like the "Cadillac Tax." This was supposed to be one of the key features generating revenue to PAY for Obamacare. The unions (who fill the democratic campaign coffers) are violently opposed to the Cadillac tax. That too will NEVER be implemented.
1
The USA spends somewhere from 16% to 17.5% of your GDP on healthcare, figures dependent upon source. Millions still have no insurance. Millions more pay premiums for little or no benefit. Millions more have deductibles that make them reluctant to seek medical care. Many people are shackled to employers they would prefer to leave due to the provision of some sort of health insurance by said employers. Billions if not trillions have gone, and continue to go, to the profit bottom line of insurance companies. Correct me if I am wrong.
Canada has an imperfect single payer system, that still manages to provide fairly decent health care for almost everyone. As do most industrialized nations. We pay somewhere less than 40% of our GDP on healthcare than you do, we should pay more to improve the service. The estimated USA GDP for 2015 by the IMF is
$18,558,130,000,000. That number deserves a separate line,.
If you spent the same amount as Canada as a % of GDP you would save
$7,423,252,000,000. That number also deserves a separate line.
It is a lot of money, I am not sure how to even say it in words, that could do all sorts of things for the good of the people. It's not peanuts, and appears to be ideology. Otherwise known as cutting off your nose to spite your face.
How do you stand it?
Canada has an imperfect single payer system, that still manages to provide fairly decent health care for almost everyone. As do most industrialized nations. We pay somewhere less than 40% of our GDP on healthcare than you do, we should pay more to improve the service. The estimated USA GDP for 2015 by the IMF is
$18,558,130,000,000. That number deserves a separate line,.
If you spent the same amount as Canada as a % of GDP you would save
$7,423,252,000,000. That number also deserves a separate line.
It is a lot of money, I am not sure how to even say it in words, that could do all sorts of things for the good of the people. It's not peanuts, and appears to be ideology. Otherwise known as cutting off your nose to spite your face.
How do you stand it?
As other commenters have pointed out, Mrs. Clinton's ideas are interesting, but they get into the weeds, and politically it probably would not be helpful to her chances if she started discussing them in more detail.
As political journalists and pundits have emphasized, she need to focus on what she would do to mitigate economic inequities, provide more good-paying jobs (infra-structure spending), immigration reform, and national security (strengthening intelligence-sharing with other countries, cyber-security, a continuation of President Obama's realistic foreign policy).
These are almost more than that the public can absorb at this time. After the election, she could set up a task force to revise and improve the ACA, which will be no easy task, both technically and politically.
As political journalists and pundits have emphasized, she need to focus on what she would do to mitigate economic inequities, provide more good-paying jobs (infra-structure spending), immigration reform, and national security (strengthening intelligence-sharing with other countries, cyber-security, a continuation of President Obama's realistic foreign policy).
These are almost more than that the public can absorb at this time. After the election, she could set up a task force to revise and improve the ACA, which will be no easy task, both technically and politically.
This analysis of financing health care in the US, identifies several important issues. Of course,Medicare should be able to negotiate for lower prices from the pharmaceutical companies. And yes, policies that would reduce unnecessary medical procedures would be a good thing. Donald Trumps's proposals are empty and dangerous. The problem with this editorial is one i see occur over and over in the media coverage of health care policy.
The main point is missed. Our health care system cannot be fixed with incremental shifts. Our system is broken precisely because we rely on a fragmented multi-payer insurance infrastructure. Relying on insurance companies costs over 400 billion a year to support a bloated bureaucracy. We don't even get good results for all our efforts. Just this week a report on high maternal mortality rates was released, adding more data to the argument that our health care system is ineffective. There is strong empirical evidence to support a much better answer - a single -payer system. Please analyze at all the evidence when you discuss health care in the US. The American public needs to understand this issue in order make the changes that are are going to make a difference.
The main point is missed. Our health care system cannot be fixed with incremental shifts. Our system is broken precisely because we rely on a fragmented multi-payer insurance infrastructure. Relying on insurance companies costs over 400 billion a year to support a bloated bureaucracy. We don't even get good results for all our efforts. Just this week a report on high maternal mortality rates was released, adding more data to the argument that our health care system is ineffective. There is strong empirical evidence to support a much better answer - a single -payer system. Please analyze at all the evidence when you discuss health care in the US. The American public needs to understand this issue in order make the changes that are are going to make a difference.
Clearly the current economics of healthcare in the U.S. are failing the public. However, a single payer federal system is not the answer. The mess the administrtion has made of the ACA and recent adverse developments at the Center for Medicare Services show clearly that putting the same institutions in charge of global U.S. healthcare would be a singularly bad idea. Similarly, additional subsidies to prop up the current system is a bad idea. An underlying problem is that the U.S. profit margin of pharmaceutical companies is the major source of capital worldwide for drug development. Perhaps a combination of strenuous trimming of the nightmarish tangle of multilevel over-regulation and documentation required of healthcare providers and institutions in order to increase productivity and reduce costs, combined with more effective preventive efforts on things like hypertension and obesity and regulation of pricing of generic drugs, combined with some kind of subsidies for drug development would work with the fringe benefit of recapturing for the U.S. some of the lost share in major pharmaceutical companies.
1
Mr. Trump's proposals on dealing with health care costs and delivery are the result of his usual curiosity on a subject other than himself, followed by the same diligent research that he is at this moment doing in preparation for his "debate" with Hillary Clinton two nights hence. His figures add up the way his tax forms do, too, we can reasonably assume.
Costs of production, in the world of medicines in particular and a bit less so in health care in general, have little connection to the price printed on the bill presented to the person unfortunate enough to need them. Case in point: During my annual Medicare wellness exam I was asked when my last tetanus/diphtheria immunization was. No idea, maybe 10 years ago? Better get caught up, then. Medicare doesn't cover the dip/tet injection. Neither, then, does the Part-B supplemental insurance. For me, it was $108.00 ($60 for the shot, $48 for the nurse's minute of time to give it and document the procedure). Curious (when I got the bill in the mail), I googled the cost of a dip/tet dose and found that in multi-dose vials, it is a mind-boggling $.14. That's right, 14 CENTS. Putting it in a pre-loaded, single dose syringe added $59.86 to the cost. $48 for the nurse is a tad high, too.
At least Hillary would attempt to get Congress behind allowing Medicare to bargain with drug makers. Trump, on the other hand, from the world of profit-is-paramount capitalism, would lead the pack running away from such a proposal.
Costs of production, in the world of medicines in particular and a bit less so in health care in general, have little connection to the price printed on the bill presented to the person unfortunate enough to need them. Case in point: During my annual Medicare wellness exam I was asked when my last tetanus/diphtheria immunization was. No idea, maybe 10 years ago? Better get caught up, then. Medicare doesn't cover the dip/tet injection. Neither, then, does the Part-B supplemental insurance. For me, it was $108.00 ($60 for the shot, $48 for the nurse's minute of time to give it and document the procedure). Curious (when I got the bill in the mail), I googled the cost of a dip/tet dose and found that in multi-dose vials, it is a mind-boggling $.14. That's right, 14 CENTS. Putting it in a pre-loaded, single dose syringe added $59.86 to the cost. $48 for the nurse is a tad high, too.
At least Hillary would attempt to get Congress behind allowing Medicare to bargain with drug makers. Trump, on the other hand, from the world of profit-is-paramount capitalism, would lead the pack running away from such a proposal.
Recently, when discussing 'benefits' that workers should have, the concern of an entire ninth-grade class was healthcare. They did not state vacations, they did not state safety mechanisms, they did not state reasonable work hours, they were all concerned about healthcare.
My own child, turning 26 this year, will have to pay upwards of $1200 a month for healthcare. My child will need upwards of $14,000 a year to cover healthcare premiums!
The Affordable Care Act will soon be a government-run entity as providers continue to drop out; another 'control of the people' by the government. I have researched the website for PA that shows the percentage of increases the healthcare providers are asking - anywhere from 18% to 62%. I would like an 18% pay increase!
Why isn't it being discussed? It is, in many homes across America. The media has failed to discuss is honestly and openly. It is the media that has failed the American people.
It is easier to write a sad story on a family with no healthcare than it is to ask members of the middle class and the upper-class to show receipts of how healthcare costs of soared.
The real story is in the receipts from the past to the present. To get control of the increasing costs, a pattern of increases has to be shown. The real story is in the absurd amounts charged for services which can vary widely across health facilities.
Reporters and the media are just not doing the real job of reporting.
My own child, turning 26 this year, will have to pay upwards of $1200 a month for healthcare. My child will need upwards of $14,000 a year to cover healthcare premiums!
The Affordable Care Act will soon be a government-run entity as providers continue to drop out; another 'control of the people' by the government. I have researched the website for PA that shows the percentage of increases the healthcare providers are asking - anywhere from 18% to 62%. I would like an 18% pay increase!
Why isn't it being discussed? It is, in many homes across America. The media has failed to discuss is honestly and openly. It is the media that has failed the American people.
It is easier to write a sad story on a family with no healthcare than it is to ask members of the middle class and the upper-class to show receipts of how healthcare costs of soared.
The real story is in the receipts from the past to the present. To get control of the increasing costs, a pattern of increases has to be shown. The real story is in the absurd amounts charged for services which can vary widely across health facilities.
Reporters and the media are just not doing the real job of reporting.
1. With the possible exception of Germany, all other developed countries have tried a health insurance system based mainly on loosely regulated private insurance. None of them could get it to work. The only one using it today is Switzerland, but there the federal gov writes a basic policy which all insurances cos must offer and are not allowed to profit from it. Also while their cost per person ($6325) is much less than ours ($8713) it is still much higher than the (OECD) average ($3453).
2. As we see, when faced with the sicker patients, private insurance cos fold. This is the trouble with the public option. The private cos will find a way to avoid the poor & sicker patients who will flock to the public option thus raising its costs. Republicans will point to its higher costs as an example of why gov. health care does not work.
In addition, one of the main advantages of a universal gov run system is that there is only one entity dealing with the problem. Insurance 101 teaches us that statistically the larger the pool, the more efficient the plan. Also, there are large administrative saving. The overhead and compliance costs of private insurance cos waste over $600 Billion each year without even counting patient compliance costs.
3. The bottom line is that HR676 which simply gave an improved Medicare to everyone and was only 70 pages long would have given Americans better care at much, much lower cost. Is it to late to change our mind?
2. As we see, when faced with the sicker patients, private insurance cos fold. This is the trouble with the public option. The private cos will find a way to avoid the poor & sicker patients who will flock to the public option thus raising its costs. Republicans will point to its higher costs as an example of why gov. health care does not work.
In addition, one of the main advantages of a universal gov run system is that there is only one entity dealing with the problem. Insurance 101 teaches us that statistically the larger the pool, the more efficient the plan. Also, there are large administrative saving. The overhead and compliance costs of private insurance cos waste over $600 Billion each year without even counting patient compliance costs.
3. The bottom line is that HR676 which simply gave an improved Medicare to everyone and was only 70 pages long would have given Americans better care at much, much lower cost. Is it to late to change our mind?
Our national political conversations have deteriorated to the point of polar, bumper-sticker conversations for so many subjects. Several cable news pundits say that Secretary Clinton should avoid too much detail--probably an accurate statement for a public with increasingly shortened attention spans. At least one pundit says that people who watch the forthcoming debates should turn off the sound and rely on the visuals to determine who "won" the "debate." Based on history (Kennedy v Nixon and others) this is possibly true. It would be nice if the debate were restricted to voice only, so maybe the ideas and discussions would matter more. But that is not who we are.
As for the specifics of how to keep medical insurance costs affordable for the majority of the population--while making sure most major problems are covered--, that cannot be adequately discussed within the realm of media circus.
The cost of all pharmaceuticals, brand and generic, is a complex concern: http://annals.org/article.aspx?articleID=2506848 and http://www.wsj.com/articles/how-do-we-deal-with-rising-drug-costs-146034... . Just scanning those two articles indicates that if these issues were discussed in the televised debates, many people would simply tune out.
As for the specifics of how to keep medical insurance costs affordable for the majority of the population--while making sure most major problems are covered--, that cannot be adequately discussed within the realm of media circus.
The cost of all pharmaceuticals, brand and generic, is a complex concern: http://annals.org/article.aspx?articleID=2506848 and http://www.wsj.com/articles/how-do-we-deal-with-rising-drug-costs-146034... . Just scanning those two articles indicates that if these issues were discussed in the televised debates, many people would simply tune out.
HILLARY'S Plan is flawed since giving a tax credit to help people of limited means pay for healthcare as well as other necessities of life will not work by using a tax rebate system. What recipients of the tax credit need is to be able to continue paying bills for other things such as food, clothing and shelter. If they have to wait till tax rebate time, many will have to cut back deeply in paying for the basics (i.e., flood, clothing and shelter) in order to pay for health insurance. The result would be potential loss of housing and/or fines for other unpaid bills in order to meet medical expenses in anticipation of the tax rebate. Clearly in order to protect the rights of tax credit recipients, there must be some monitoring of ongoing enrollment in medical insurance, in case some try to game the system by paying for an initial period then canceling the insurance. It's easy enough to enter such data into a computer database to prevent such problems. Another option is for the government to release quarterly payments for health insurance carriers directly (of course with knowledge and approval of recipients of tax credit). Helping those in need is fine; enabling those who wish to game the system is not. By contrast, Trump is doing what Trump does by using slogans, including the phrase "repeal Obamacare" that has already been used ad nauseum for bills introduced by the GOP a disgraceful number of times. Once again, Trump shows that he is an incompetent loser.
Like most of our self-imposed dilemmas, America will begin tackling this issue when WE decide to. It starts with self examination, something that's increasingly foreign in The New Age of Personal Entitlement. And by the way, for those who can't comprehend anything outside the realm of political labels, I'm considered fairly liberal.
First, a third of us are clinically obese (myself included), and another third border on hypochondria. For confirmation on the aforementioned, interrogate anyone in the health field. So far, I've encountered NONE that would debate these facts. Using myself as an example, I've abused healthcare for the last 5 yrs, because I've abused myself for the last 5 yrs. And there's no way around that basic fact, no matter how much money I'd love to believe would bail me out of my "crisis." I shortchange myself, and more importantly, I feed the system dysfunction that makes it all the more difficult for those who are legitimately ill. I make no bones about that, and neither should anyone else whose self-imposed physical "dilemmas" have helped castrate the system.
Second, the resolution to this will materialize when we decide to pragmatically address the growing economic inequity that's at issue. We've waited for 4 decades for the impotent idealism of "trickle-down" to take hold. No need to say any more there.
This can be reversed. For the collective good, we've got to make some personal decisions we've, so far, been unwilling to make.
First, a third of us are clinically obese (myself included), and another third border on hypochondria. For confirmation on the aforementioned, interrogate anyone in the health field. So far, I've encountered NONE that would debate these facts. Using myself as an example, I've abused healthcare for the last 5 yrs, because I've abused myself for the last 5 yrs. And there's no way around that basic fact, no matter how much money I'd love to believe would bail me out of my "crisis." I shortchange myself, and more importantly, I feed the system dysfunction that makes it all the more difficult for those who are legitimately ill. I make no bones about that, and neither should anyone else whose self-imposed physical "dilemmas" have helped castrate the system.
Second, the resolution to this will materialize when we decide to pragmatically address the growing economic inequity that's at issue. We've waited for 4 decades for the impotent idealism of "trickle-down" to take hold. No need to say any more there.
This can be reversed. For the collective good, we've got to make some personal decisions we've, so far, been unwilling to make.
1
From the comments, many people are under the impression that all countries with universal health care have single payer systems. Not True.
As Paul Krugman has pointed out, Germany and Switzerland both have private regulated insurance systems and, arguably, the best health care in the world without the kind of long waits for some procedures that have plagued the British and Canadian systems.
There are problems with the Affordable Care Act, but opposition to single payer was one of the many reasons it was so difficult to get any health care. It makes far more sense to fix the current system, than to throw out the baby with the bathwater by trying to change to single payer. Instead of an omnibus 1000+ page bill that tries to list every condition, an agency -- comparable to the EPA -- should have been established to oversee this and establish guidelines.
We also need to increase the number of medical schools in the US. With universal care, there is a shortage of PCP's. Cuba has over 6 physicians for every 1,000 people; Germany close to 4; Britain just under 3; the U.S. 2.5 and Canada less than 2 physicians per 1,000 people and India less than 1. Moreover, residency programs in the US have many doctors from India and other foreign countries in subspecialties like radiology. Instead of training more physicians to meet our needs and helping underdeveloped countries, we are draining them from their medical schools.
As Paul Krugman has pointed out, Germany and Switzerland both have private regulated insurance systems and, arguably, the best health care in the world without the kind of long waits for some procedures that have plagued the British and Canadian systems.
There are problems with the Affordable Care Act, but opposition to single payer was one of the many reasons it was so difficult to get any health care. It makes far more sense to fix the current system, than to throw out the baby with the bathwater by trying to change to single payer. Instead of an omnibus 1000+ page bill that tries to list every condition, an agency -- comparable to the EPA -- should have been established to oversee this and establish guidelines.
We also need to increase the number of medical schools in the US. With universal care, there is a shortage of PCP's. Cuba has over 6 physicians for every 1,000 people; Germany close to 4; Britain just under 3; the U.S. 2.5 and Canada less than 2 physicians per 1,000 people and India less than 1. Moreover, residency programs in the US have many doctors from India and other foreign countries in subspecialties like radiology. Instead of training more physicians to meet our needs and helping underdeveloped countries, we are draining them from their medical schools.
2
You can add dental care to the conversation: the number of Americans who face horrible dental problems — or who are forced to choose between life essentials and their teeth — is deplorable for any nation, least of all one as wealthy as ours. This includes poor children, of all the travesties.
The fact that we don't even focus on this crisis — and that some even make jokes about those at society's margins, who suffer because we leave them without a life basic — speaks volumes about our warped agendas.
The same mentality leads to mockery of people who live in trailer parks — yes, the two are related: those who ridicule people suffering for lack of dental care also tend to find "funny" those whose housing options are limited to mobile homes. This "humor" is part of a collective dehumanization process that lets us continue to ignore these grave matters.
Nor can I omit the obvious: if the people being feted by both major party candidates were not ones who can pony up $10,000 for fancy dinners — if they were our citizens who struggle to get by, who suffer things like appallingly inadequate dental care, and who are too poor to afford better housing — I'm confident the non-$10K Dinner Class issues, like dental care, would also be the focus of attention.
Here's to November and our next exercise in choosing the least worst party. What a depressing shame it will take the support of the ignored poor, too, to defeat the monster Trump. Or maybe that's why he stands a chance?
@ricfouad
The fact that we don't even focus on this crisis — and that some even make jokes about those at society's margins, who suffer because we leave them without a life basic — speaks volumes about our warped agendas.
The same mentality leads to mockery of people who live in trailer parks — yes, the two are related: those who ridicule people suffering for lack of dental care also tend to find "funny" those whose housing options are limited to mobile homes. This "humor" is part of a collective dehumanization process that lets us continue to ignore these grave matters.
Nor can I omit the obvious: if the people being feted by both major party candidates were not ones who can pony up $10,000 for fancy dinners — if they were our citizens who struggle to get by, who suffer things like appallingly inadequate dental care, and who are too poor to afford better housing — I'm confident the non-$10K Dinner Class issues, like dental care, would also be the focus of attention.
Here's to November and our next exercise in choosing the least worst party. What a depressing shame it will take the support of the ignored poor, too, to defeat the monster Trump. Or maybe that's why he stands a chance?
@ricfouad
3
Having insurance doesn't help if you can't access care. There is another, equally serious, issue related to health care that, although related to the payment structure, is separate from it. Large areas of the country are experiencing a shortage of health care providers both in general family practice and in specialty areas such as mental health. Many providers don't accept new patients; others don't accept those on Medicare and Medicaid; still others don't accept insurance period. I recently spent three days on the phone attempting to establish care with a family practice physician and a psychiatrist for my adult child covered by insurance but living in a semi-rural area. Every practice I called was closed to new patients, and several of the office managers I spoke with told me their practices had providers planning to retire in the next two years and unable to find younger people to replace them.
2
The cost of health care and the cost of healthcare insurance are topics not addressed by most politicians in an honest, informed way because they comprise a subject most politicians don’t even understand.
For example, most politicians and most Americans are unaware that the cost of the care and the cost of the insurance, while related, are different. They are not aware that the rapid rate at which the cost of care has risen is lower since implementation of the Affordable Care Act.
Donald Trump does not have the foggiest notion what the true issues are, and it seems to work for him politically simply to blame everything on Obamacare – even though Obamacare has been a success in the face of daunting Republican opposition.
Hillary Clinton does understand these issues. She knows the issues far better than other politicians and even better than President Obama. She has spoken about health care on the campaign trail, and she probably should do more of it.
The difficulty for Clinton, however, is that while serious voters for whom healthcare costs are a big problem want to learn more, her informed comments on the subject get lost. The media turn their attention to the latest, outrageously false statement by Trump on a wide variety of topics. Reporters trip over themselves rushing to cover Trump, and networks feverishly give him free TV time.
For example, most politicians and most Americans are unaware that the cost of the care and the cost of the insurance, while related, are different. They are not aware that the rapid rate at which the cost of care has risen is lower since implementation of the Affordable Care Act.
Donald Trump does not have the foggiest notion what the true issues are, and it seems to work for him politically simply to blame everything on Obamacare – even though Obamacare has been a success in the face of daunting Republican opposition.
Hillary Clinton does understand these issues. She knows the issues far better than other politicians and even better than President Obama. She has spoken about health care on the campaign trail, and she probably should do more of it.
The difficulty for Clinton, however, is that while serious voters for whom healthcare costs are a big problem want to learn more, her informed comments on the subject get lost. The media turn their attention to the latest, outrageously false statement by Trump on a wide variety of topics. Reporters trip over themselves rushing to cover Trump, and networks feverishly give him free TV time.
I had what I thought was good insurance through my employer. All I had to do was stay in network. Then I was diagnosed with a probable cancer. Then I found out there was no one in network who could treat me. Then I found out about the Inadequate Network Exception (my term). The insurance company would pay, but only if I first obtained prior authorization. Sounds simple right? Wrong. I've been told I needed prior authorization for the anesthesiologist, not just the surgery and the anesthesia in the OR. I needed prior authorization for the pathology, not just the operation to remove a tumor. I needed prior authorization for the x-rays, not just the doctor who ordered them and the hospital where he worked. I had to file a grievance when I was trying to recover from surgery with a six inch incision and foggy brain from the anesthesia. I could go on. Suffice it to say that this system is so broken it can't be fixed. We need Medicare for the rest of us.
3
NY Times, I disagree with your oft-invoked "statistic" that we now have 20 million people now insured because of Obamacare. First, a great majority of those just enrolled in Medicaid...a plan wherein their insurance premium and care is borne mostly by other people, through the government. But many of the newly "insured (not counting Medicaid)" are on plans such as bronze or silver which have such high deductibles (say, $5,000 to $12,000) that they really are not insured at all, except for catastrophic events. That is not really health insurance in the minds of those who have insurance for anything else, nor what they expected nor were promised.
Mrs. Clinton clearly understands the issues? Probably. So why did her party ram Obamacare down the throats of Americans, with all Democrats voting for it and no Republicans voting for it? Obamacare is now, by surveys, disliked by over half the people. Yes, Mrs. Clinton understands it. She is from the party (notably strutted and proclaimed by Obama) that promised that premiums for a family would decrease by $2,500 a year. She understands that she has to promise something, whether it is true or not. And, if you watch one of her speeches, she promises many such things, including a free college education, with no financial means of supporting her promises.
You are apparently unaware that many generic drugs are not fully equivalent to brand name drugs. But you are correct in saying that they are cheaper.
Mrs. Clinton clearly understands the issues? Probably. So why did her party ram Obamacare down the throats of Americans, with all Democrats voting for it and no Republicans voting for it? Obamacare is now, by surveys, disliked by over half the people. Yes, Mrs. Clinton understands it. She is from the party (notably strutted and proclaimed by Obama) that promised that premiums for a family would decrease by $2,500 a year. She understands that she has to promise something, whether it is true or not. And, if you watch one of her speeches, she promises many such things, including a free college education, with no financial means of supporting her promises.
You are apparently unaware that many generic drugs are not fully equivalent to brand name drugs. But you are correct in saying that they are cheaper.
2
We need a public option on the health exchanges. Ultimately, we need medicare for all.
20
'Medicare for all' is a good idea but it won't solve all the problems. It won't do anything about the cost of medications, for instance. My sister, who is autistic and has never had a job, is now over 65. This means her Medicaid is cut off because apparently you can't be on Medicare and Medicaid both. Unfortunately, this now means an additional $300 a month for her multiple medications, and I don't know where that money's going to come from.
Also, Medicare for All will involve deciding what will and won't be covered. Prepare for a lot of screaming matches.
Example 1: Recently I read 'Avalanche', in which an Australian woman recounts her fruitless quest to have an IVF baby. Tens of thousands of dollars, none of it covered by national health. Would American women - or gay men - demand IVF as a 'right'?
Example 2: Terri Schiavo. Suppose her husband hadn't disagreed with her parents. Would she be kept going at public expense forever? If not, I hear Palin's 'death panel' drumbeat starting up ....
Example 3. How about unproven 'alternative' medicine?
I'm sure if you think a bit, you can come up with more stumbling blocks.
Just passing 'Medicare for All' will not be that simple. I think it needs to be done, but we should be aware of the rocks in the road ahead.
Also, Medicare for All will involve deciding what will and won't be covered. Prepare for a lot of screaming matches.
Example 1: Recently I read 'Avalanche', in which an Australian woman recounts her fruitless quest to have an IVF baby. Tens of thousands of dollars, none of it covered by national health. Would American women - or gay men - demand IVF as a 'right'?
Example 2: Terri Schiavo. Suppose her husband hadn't disagreed with her parents. Would she be kept going at public expense forever? If not, I hear Palin's 'death panel' drumbeat starting up ....
Example 3. How about unproven 'alternative' medicine?
I'm sure if you think a bit, you can come up with more stumbling blocks.
Just passing 'Medicare for All' will not be that simple. I think it needs to be done, but we should be aware of the rocks in the road ahead.
We had one candidate who actually tried to bring the U.S. in line with the civilized world by proposing single payer. His supposedly liberal opponent said that would, "never, ever" happen and Krugman called affordable healthcare for EVERY citizen a "Happy Dream."
Donald has no interest in providing healthcare for every citizen. Neither does Hillary, although she pays lip service to tinkering with the ACA as 30 million continue without coverage and millions of others are drowning in high deductibles, copays and drug costs. All thanks to the Medical Industrial Complex which is donating millions to Hillary's campaign.
As with ending the never ending war, healthcare is just a distraction to what is really important--Obama's country of birth, Donald's alignment with Putin and Hillary's health.
In a country not controlled by special interests and their money we would be like every other civilized country with single payer healthcare. But those darn young folks just don't want everyone to have healthcare.
Donald has no interest in providing healthcare for every citizen. Neither does Hillary, although she pays lip service to tinkering with the ACA as 30 million continue without coverage and millions of others are drowning in high deductibles, copays and drug costs. All thanks to the Medical Industrial Complex which is donating millions to Hillary's campaign.
As with ending the never ending war, healthcare is just a distraction to what is really important--Obama's country of birth, Donald's alignment with Putin and Hillary's health.
In a country not controlled by special interests and their money we would be like every other civilized country with single payer healthcare. But those darn young folks just don't want everyone to have healthcare.
37
I think you'd find that most Democrats, me included, think a single payer plan is the best program, but that's beside the point. That program NEVER had, nor does it have the votes now to pass. The Affordable Care Act is a necessary if awkward, first step to start the process. The eventual transition will come after the Baby Boomers are all on Medicare. As the Affordable Care Act wrings the profits out of health insurance, health insurance companies are going to willing abandon that market and find other things to do with their capital that make more money. A local former health insurance giant, Mutual of Omaha, is now more of bank and real estate developer than an insurance company. They made a business decision to get out of health insurance because they could make more money doing other things. Others will follow.
SctottW: Please wake up! Sanders "tried?" He tried to get the nomination in spite of the fact obvious to anyone who knows America in 2016 that he could not be elected.
The problem, though, is that when you run the numbers on Sanders' proposal - as too few in the media, and absolutely none of his supporters, did - it did indeed turn out to be a pipe dream. Here's a link to a New Yorker article from January explaining why:
http://www.newyorker.com/business/currency/what-bernie-sanderss-health-c...
Single-payer health care is a great idea. I'm all for it. But Sanders' plan was not the panacea his campaign touted, and those who repeat the Medicare for All slogan usually gloss over the details and paint indeed a happy dream in which the government pays for everything. Even in nations that have a good national health - Canada, Australia, the UK - you still have to pick up some bills yourself, and you might be surprised what's excluded. (South Africa has a national health, but like everything else in that beleaguered nation, it's only intermittently functional and riddled with corruption, waste, and inadequate conditions.)
Bernie Sanders was asking the right questions. Unfortunately, he didn't have workable answers.
http://www.newyorker.com/business/currency/what-bernie-sanderss-health-c...
Single-payer health care is a great idea. I'm all for it. But Sanders' plan was not the panacea his campaign touted, and those who repeat the Medicare for All slogan usually gloss over the details and paint indeed a happy dream in which the government pays for everything. Even in nations that have a good national health - Canada, Australia, the UK - you still have to pick up some bills yourself, and you might be surprised what's excluded. (South Africa has a national health, but like everything else in that beleaguered nation, it's only intermittently functional and riddled with corruption, waste, and inadequate conditions.)
Bernie Sanders was asking the right questions. Unfortunately, he didn't have workable answers.
1
The numbers presented by the editorial board — a 63% increase deductibles and a 23% increase in workers' contributions — do not tell the full story of the absolutely repressive and regressive nature of America's mandated health insurance extortion racket. There's no other way to phrase it.
Lucky employees have seen "individuals'" deductibles increase by $1221/year and increases to their yearly contributions to premiums of just $1129. Family plans, however, have increased much more. At my worksite deductibles are now $3000/year.
And the editorial board has not factored in huge increases in premiums borne by employers. Family plans — even those with $3000 deductibles — cost more than $17000/year.
Imagine how much fatter workers' paychecks could be if $20000 dollars/year were not being skimmed off the top. Not for actual health care but for health insurance — a difference the NYT fails to make.
No wonder the Fed is so hesitant to raise interest rates. The economy hasn't moved because so much of employers' income or so much of workers' earnings are automatically paid out for health insurance premiums.
The editorial board rightly claims that the campaigns should be paying more attention to the problem, but it minimizes the issue in an editorial specifically written to address it.
The economic strain to the economy and the financial slaughter experienced by families is a national crisis.
The USA health insurance extortion racket is a crime crying out for justice.
Lucky employees have seen "individuals'" deductibles increase by $1221/year and increases to their yearly contributions to premiums of just $1129. Family plans, however, have increased much more. At my worksite deductibles are now $3000/year.
And the editorial board has not factored in huge increases in premiums borne by employers. Family plans — even those with $3000 deductibles — cost more than $17000/year.
Imagine how much fatter workers' paychecks could be if $20000 dollars/year were not being skimmed off the top. Not for actual health care but for health insurance — a difference the NYT fails to make.
No wonder the Fed is so hesitant to raise interest rates. The economy hasn't moved because so much of employers' income or so much of workers' earnings are automatically paid out for health insurance premiums.
The editorial board rightly claims that the campaigns should be paying more attention to the problem, but it minimizes the issue in an editorial specifically written to address it.
The economic strain to the economy and the financial slaughter experienced by families is a national crisis.
The USA health insurance extortion racket is a crime crying out for justice.
91
I'm a pretty Liberterian guy (big fan of Milton Friedman) who believes in free market solutions to most problems.
With that said I firmly believe we need a nationalized medical system (single payer or Medicare for all) with perhaps a supplemental private insurance overlay (like the UK and Australia). My reasons are as follows:
1. We pay more for healthcare than any other country and do not fully cover our population - this is unacceptable.
2. Nationalized health care enable employees to switch jobs much more easily which is good for employees and the economy.
3. We are effectively subsidizing the development of pharmaceutical products for the entire world as every other country negotiates much lower prices and we pay top dollar (both Medicare and private insurance).
4. Health insurance is a scam. I have a high end private plan paid for by my employer and it is terrible. They try to deny paying as much as possible and put a huge administrative burden on the individual to challenge unreimbursed expenses hoping they will give up. A 1 hour trip to the emergency room for my wife for a mild concussion (no tests done) resulted in over $1,000 of out of pocket expenses (and I supposedly have a high end plan).
With that said I firmly believe we need a nationalized medical system (single payer or Medicare for all) with perhaps a supplemental private insurance overlay (like the UK and Australia). My reasons are as follows:
1. We pay more for healthcare than any other country and do not fully cover our population - this is unacceptable.
2. Nationalized health care enable employees to switch jobs much more easily which is good for employees and the economy.
3. We are effectively subsidizing the development of pharmaceutical products for the entire world as every other country negotiates much lower prices and we pay top dollar (both Medicare and private insurance).
4. Health insurance is a scam. I have a high end private plan paid for by my employer and it is terrible. They try to deny paying as much as possible and put a huge administrative burden on the individual to challenge unreimbursed expenses hoping they will give up. A 1 hour trip to the emergency room for my wife for a mild concussion (no tests done) resulted in over $1,000 of out of pocket expenses (and I supposedly have a high end plan).
227
Saying that you believe in free-market solutions but favor a government sponsored, single-payer health system is fickle if not inconsistent. Health care costs make up almost twenty per cent of our national budget. It certainly would not be consistent with a belief in limited government.
National health insurance has many virtues, primarily cutting out the insurance sector, but one serious deficiency: reducing the private sector's role in developing new drugs and new medical technologies. The United States is the world leader by far in extending research and cures for cancers, heart disease, and diseases of old age.
National health insurance has many virtues, primarily cutting out the insurance sector, but one serious deficiency: reducing the private sector's role in developing new drugs and new medical technologies. The United States is the world leader by far in extending research and cures for cancers, heart disease, and diseases of old age.
There are few free markets. Health care are oligopolies and economies of scale and most products funnel through them.
2
Very well written. But not only the UK and Australia but also Canada, Germany, Japan and all of the democracies in the world. Essentially the US is the only major country that does not have universal health care.
However it sure does a employ a lot of people!
However it sure does a employ a lot of people!
The answer? It's called universal health care or Medicare for all. Look to Canada or Europe for answers. They live longer and and health care costs much less per person. Obamacare is a start but that's all. And I'm sick of politicians and people who say there is no money for health care. Always plenty of money for wars. Trillions in fact.
272
The answer is called electing a candidate who is not bought and paid for by every special interest imaginable. But the mainstream Democratic party made sure that was not possible.
So--the status quo will remain intact just as the power elite desires. Mission accomplished.
So--the status quo will remain intact just as the power elite desires. Mission accomplished.
11
We do have Medicare for all. You get it when you are 65. At that time you have paid Medicare premiums for 40 years without being covered one bit for your medical expenses under the insurance plan, Medicare, required by government. To suggest, as many do, that people should just be able to have the same benefits as those who have paid into a system, with no ongoing benefits, for 40 yrs or more, is fiscally naive.
Medicare, even when attained, is fairly lousy insurance. It does solve the problem of being old and having to pay huge premiums...but you have already paid into the system for 40 years. It does not cover dental, hearing, or vision (except glaucoma, cataracts,and macular degeneration). It pays doctors so little that it is often less than overhead, and therefore many doctors accept few or no Medicare patients. More claims submitted by doctors' offices are rejected by Medicare than any other insurer. There is rationing of procedures and drugs.
Further, Medicare only pays 80% of what they regulate by their fixed pricing. Therefore it is necessary to purchase insurance in addition to your Medicare policy, called a Medicare supplement.
If you eliminate the trauma of gun deaths and our large number of auto accidents from those death tables, Americans live longer than almost any other nation.
Our survival rates for such problems as lung, breast, or prostate cancer are far longer than Britain.
Obamacare is a disaster, not a start. Insured? $6-$12K deductible on many policies.
Medicare, even when attained, is fairly lousy insurance. It does solve the problem of being old and having to pay huge premiums...but you have already paid into the system for 40 years. It does not cover dental, hearing, or vision (except glaucoma, cataracts,and macular degeneration). It pays doctors so little that it is often less than overhead, and therefore many doctors accept few or no Medicare patients. More claims submitted by doctors' offices are rejected by Medicare than any other insurer. There is rationing of procedures and drugs.
Further, Medicare only pays 80% of what they regulate by their fixed pricing. Therefore it is necessary to purchase insurance in addition to your Medicare policy, called a Medicare supplement.
If you eliminate the trauma of gun deaths and our large number of auto accidents from those death tables, Americans live longer than almost any other nation.
Our survival rates for such problems as lung, breast, or prostate cancer are far longer than Britain.
Obamacare is a disaster, not a start. Insured? $6-$12K deductible on many policies.
Well said! But we Americans like to be different and more complicated.
There is plenty of money for health but much of it goes to unneeded paperwork.
There is plenty of money for health but much of it goes to unneeded paperwork.
Obamacare is a total disaster. The right solution is to abolish it and then to eliminate the tax deduction for employer funded health insurance and thereby eliminate all of the distortions in our system.
At the same time we must limit or eliminate medical malpractice suits to only the most rare cases where a panel of impartial competent doctors, not unknowledgeable jurors concludes that the doctor was grossly negligent.
We must also force other countries to pay fair prices for drugs by prohibiting US pharmaceutical companies and foreign companies with US subsidiaries from selling them at prices below the prices they sell them in the US; if they do they will be fined for the difference -- which will not be tax deductible.
Anyone with sufficient income to pay for health insurance who does not have it and does not have the resources to pay for the required health care when being treated should stop being treated by the doctors/hospitals when their money runs out. The fact that this happened should be fully publicized to invent everyone to purchase health insurance.
At the same time we must limit or eliminate medical malpractice suits to only the most rare cases where a panel of impartial competent doctors, not unknowledgeable jurors concludes that the doctor was grossly negligent.
We must also force other countries to pay fair prices for drugs by prohibiting US pharmaceutical companies and foreign companies with US subsidiaries from selling them at prices below the prices they sell them in the US; if they do they will be fined for the difference -- which will not be tax deductible.
Anyone with sufficient income to pay for health insurance who does not have it and does not have the resources to pay for the required health care when being treated should stop being treated by the doctors/hospitals when their money runs out. The fact that this happened should be fully publicized to invent everyone to purchase health insurance.
3
Ha Ha Ha Ha Ha Ha sorry I just can`t stop. So your solution is if you can`t afford the medical care you need-Just Die and get out of the way. Your Money or Your Life!
1
Sounds a little harsh. There are plenty of good solutions that don't require us to watch someone die because they ran out of money. In fact, solutions abound. What we have is a political system that won't let any of them be implemented.
1
To have a real discussion about health care we really need to have a real discussion about EMTALA ( law that mandates ER care). It is a bandage on a wound that need serious stitching and in order for people to realize the severity of the problems with our health care system it has to be removed. It has killed the free market in health care and because people think they can get care in the ER when they need it is has also killed the political will need for a universal health care system. If Health care is a right ( as i believe) then create a universal health care system but if you do not think it is then get rid of EMTALA and let the free market work. This current model is not working!!
3
Why hasn't health care gotten more attention? the headline asks. Could it be because one campaign has been completely devoid of serious, detailed, viable, and consistent policies, while the very detailed policies and proposals of the other campaign have been largely ignored by a media obsessed with the circus show? There's also a problem for Secretary Clinton's campaign: given the tenor of Mr. Trump's campaign and the nature of media coverage, her proposals end up like the sound of one hand clapping. There's no debate, no discussion -- she's campaigning in what has become a policy void. Secretary Clinton and her campaign have their weak points, but lack of depth and detail on policy are certainly not among them
21
As a self employed hard working single woman in NYC who was diagnosed with stage 2 colon cancer 5 years ago, the ACA is a disaster. Thankfully, I was insured through my association with the Freelancers Union before the ACA when I was diagnosed. Five years out and thankfully cancer free, I am now FORCED to get my plan off the exchange (even without applying for subsidies) only to be told by most of my doctors that they accept United Health Care but not INDIVIDUAL plans from United Health Care off the ACA exchange. And for this, I am told my premium with a huge deductible would increase 43% next year from $450/month to $ 650/month and that doesn't even cover a basic blood test once a year (let alone colonoscopies). There is nothing affordable about the Affordable Care Act and to be told that it's somehow a good thing to be able to frantically shop around for my necessary doctors every year around the holidays is insulting and depressing.
31
Has it occurred to you ACA is only as good as the providers, including the insurers allow it to be. Medicare for all.
This week we saw Mylan's CEO, Heather Bresch, try to explain why a nearly 500% cost increase for life saving EpiPens was justified. Her father is a U.S. Senator and former governor of West Virginia who Bresch credits with getting her the job at Mylan. Bresch's mother, Gayle Manchin, has bolstered EpiPen sales by using her position as the President of the National Association of State Boards of Education. to push EpiPens into schools. Her daughter received a $18 million dollar salary based in large part on EpiPen (and nearly 2 dozen other drugs Mylan has skyrocketed the prices on) revenues .
In a climate where the healthcare industry spends billions to bribe our politicians, do we really believe the President can make any tangible difference? We need first to eliminate the health insurance, pharmaceutical, medical device and healthcare provider lobbyists and have a no tolerance policy when it comes to elected officials accepting "donations" (read: bribes) from the industry. Only then can we stop the corruption in our political system as it relates to patient care.
In a climate where the healthcare industry spends billions to bribe our politicians, do we really believe the President can make any tangible difference? We need first to eliminate the health insurance, pharmaceutical, medical device and healthcare provider lobbyists and have a no tolerance policy when it comes to elected officials accepting "donations" (read: bribes) from the industry. Only then can we stop the corruption in our political system as it relates to patient care.
71
"This week we saw Mylan's CEO, Heather Bresch, try to explain why a nearly 500% cost increase for life saving EpiPens was justified. Her father is a U.S. Senator and former governor of West Virginia who Bresch credits with getting her the job at Mylan. Bresch's mother, Gayle Manchin, has bolstered EpiPen sales by using her position as the President of the National Association of State Boards of Education. to push EpiPens into schools. Her daughter received a $18 million dollar salary based in large part on EpiPen (and nearly 2 dozen other drugs Mylan has skyrocketed the prices on) revenues."
And the Manchins are DEMOCRATS. Is there any wonder that the HRC campaign is practically having to beg Democratic voters to show up at the polls in November?
And the Manchins are DEMOCRATS. Is there any wonder that the HRC campaign is practically having to beg Democratic voters to show up at the polls in November?
1
Not only the rise in patient deductibles is leading people to forgo healthcare, ever more aggressive billing and collection repels patients, too. In my county of 30,000 people, 2,000 are being sent to collection for their deductibles this year, and if trends continue, the number of patients who are sued and who will have their wages garnished will double for the third year in a row. These are all insured patients, many under the ACA, who are disillusioned and angry that their insurance policies are mostly useless. What they perceive is that healthcare providers are saying, "Your money or your life." What is needed is mandatory financial aid, which providers can well afford, especially after they got the Medicaid windfall (in states that expanded it). We also need to ban punitive tactics such as sending patients to collection and suing them. The revenue cycle industry needs to be reined in. Ruining patient credit records results in difficulty not just in getting credit, but also getting housing, even employment. One man here was sued for his share of a $3,000 MRI after insurance paid $1,500. He could not afford $1,500 so he was sued. Afterward he could not get a loan for a truck he needed for work and he could not co-sign for his daughter's college loan. At the very, very least can we please put an end to punitive billing for medical bills? I suspect that overzealous billing and collection is causing serious harm, not only in financial prospects, but also in health.
40
There are no protections built in for patients; to your comment I'd add the multi-layer billing that medical "providers" are allowed to engage in, charging insurers one price, but chargin individuals -- including all those who cannot pay in the first place - more than the going price of procedures.
1
Welcome to for profit medicine and for profit medical insurance. These parasites have a lock on the governing bodies of the United States. The only way out of it is a collapse with a hopeful improvement as the pieces are reassembled. Not likely. There are many rational ways to fix the problem but the big money is too strong to allow them. Look what big money has done with gun control. Eat right, exercise, stay away from modern medicine and vote against the 0.1%.
38
If there was even a competent GOP candidate (instead of the mental defective we have now), there would be plenty of discussion on health care and other serious issues. The lack of serious policy debate is one thing you can't pin on Hillary.
26
Actually you can. The last thing secretary Clinton wants to get into is a discussion that involves or will involve ACA.
Other than the 20 million insured number all other numbers are MAJOR failures - cost, deductibles, complexities, companies leaving, websites failing.
Other than the 20 million insured number all other numbers are MAJOR failures - cost, deductibles, complexities, companies leaving, websites failing.
The only serious policy proposal now is single-payer, or some other form of non-profit universal care. Clinton and her followers, including the editors and columnists of the Times, stifled discussion of it. They said we had to stick with Obamacare, the cornerstone of which is maintaining the profits of the insurance industry.
1
Clinton is in a tough spot here. She's would love to run on the successes of the Affordable Care Act but they are hard to come by. Sure, many have benefited but not enough to justify the breath, complexity and cost of the program. Meanwhile costs have continue to skyrocket while available services have declined for many. Making healthcare a focus of the campaign will remind Americans how little we got out of the last effort that cost so much in financial and political capital.
5
There is no improving a Health Care system whose paramount goal is the profits of drug companies, hospitals, doctors, medical device companies and health insurance companies.
A system where the only rule is to charge as much as the market will bear can only be fixed by drastic change, of which our bought and paid for politicians are completely incapable.
A system where the only rule is to charge as much as the market will bear can only be fixed by drastic change, of which our bought and paid for politicians are completely incapable.
47
No there IS improving it. It is improved when the system becomes socialized, and that happens when everyone realizes that health care is a fundamental right. In most other developed countries that has already happened, the US is the outlier.
Wasn't it like 2 weeks ago these very same editors did a an article on how everything's all hunky dory with the ACA ?
24
Paul Krugman regularly defends the ACA. When he admits to problems, his only targets are the health insurance and pharmaceutical companies and, of course, Republicans.
Hypocritical, yes! Always! Just stumping for their candidate again! Another chance for them to say HRC has better ideas than Trump! True or not!
R, they said no such thing, so I don't believe you read the article.
Secretary Clinton is undeniably more knowledgeable about the health care system and offers better solutions than Trump. Certainly allowing Medicare to negotiate drug prices is an obvious, and long overdue, approach.
But HRC still misses the obvious solution that Bernie Sanders proposed and that mirrors what many other industrialized nations offer: Single-payer health insurance.
She has spoken of letting people age 55 buy into Medicare. Not a bad idea, but still short of the mark.
Medicare for all! Let's finally join the rest of the civilized world.
But HRC still misses the obvious solution that Bernie Sanders proposed and that mirrors what many other industrialized nations offer: Single-payer health insurance.
She has spoken of letting people age 55 buy into Medicare. Not a bad idea, but still short of the mark.
Medicare for all! Let's finally join the rest of the civilized world.
157
Hillary failed to list on her healthcare positions the provision to negotiate drug prices. Trump had it last year, believe it or not!, but after he won the nomination, it quietly disappeared from his healthcare positions. I guess the Establishment told him they don't want this to happen.
I'm afraid that with the current house and Senate actually developing a one payer system is impossible. Doing it gradually by allowing people over 55 to buy into Medicare is a good idea. I agree we need Medicare for all. But we have to live with reality.
A single payer health care provider, Medicare, exists and functions exceedingly well but the problem was and still is that the Republican controlled Congress would never extend this law nor fund it. There was Obama's problem in a nutshell and remains unchanged.
"Mr. Trump says he would replace the law’s subsidies and Medicaid expansion with tax deductions for health insurance premiums paid by individuals and families. But that would primarily benefit the rich, not the millions of low-income and middle-class people who would lose coverage if the law were dismantled."
I love the way the GOP, (although Mrs. Clinton is cited for this too), suggest "tax credits" every time there's a disconnect between a program's projected versus actual cost.
What good do tax credits do if you're poor and/or have no income?
Let's face it, healthcare IS boring. Having spent the better part of my professional career describing reimbursement rules, I know how the eyes can glaze over trying to understand codes, Medicare rulings, and the difference between drugs consumed in the hospital versus purchased for home use.
Of course, there's an easy fix for the arcania of health care that would eliminate a lot of "fraud, waste, and abuse." It's called national health insurance with price fixing, which would prevent some "entrepreneur" from buying up old drugs and jacking up their price 1000%.
But Americans--and candidates- can't abide the thought of having a health system like the rest of the industrialized world. And so we continue to spend more for less in terms of healthcare delivery and services.
Maybe the candidates could discuss THAT fact, assuming moderators ask questions on policy versus private servers and the purpose of tax-free foundations.
I love the way the GOP, (although Mrs. Clinton is cited for this too), suggest "tax credits" every time there's a disconnect between a program's projected versus actual cost.
What good do tax credits do if you're poor and/or have no income?
Let's face it, healthcare IS boring. Having spent the better part of my professional career describing reimbursement rules, I know how the eyes can glaze over trying to understand codes, Medicare rulings, and the difference between drugs consumed in the hospital versus purchased for home use.
Of course, there's an easy fix for the arcania of health care that would eliminate a lot of "fraud, waste, and abuse." It's called national health insurance with price fixing, which would prevent some "entrepreneur" from buying up old drugs and jacking up their price 1000%.
But Americans--and candidates- can't abide the thought of having a health system like the rest of the industrialized world. And so we continue to spend more for less in terms of healthcare delivery and services.
Maybe the candidates could discuss THAT fact, assuming moderators ask questions on policy versus private servers and the purpose of tax-free foundations.
118
Tax credits help thugs, I mean people, like Trump avoid paying any. That's how he thinks because that's how he makes his supposed billions. But we will never really know, will we.
Actually, most Americans WOULD like to have a health care system resembling that of the rest of the industrialized world. The problem is that our elected officials work for the .01%, who for obvious reasons like the health care system just the way it is. Why do you suppose the DNC wanted to get rid of Bernie Sanders? Who do you think they take orders from? (Hint: it isn't the 99.99%) Clinton plans to keep everything pretty much the way it is. What the American People need to do is hire a few hundred good lobbyists to represent them in Washington.
Tax deductions are of little use if an individual does not owe enough taxes to take advantage of the benefit. For a number of years at one point in my ministry career, my SSA/Medicare taxes (ministers pay all of it, not 1/2) were far more than in income tax. Credits are of use, but if the gov't is going to be sending lower income folks because the credit ends up meaning that the gov't owes them money, then, yes, it would be far better for them to receive that money through the year rather than weeks after tax time. The 'credit' set-up enriches outfits which offer tax refunds as a loan and take their cut rather than fully helping those who truly need the help.
Of course Trump has no plan - he has no plans about anything except pathological certainty that he is the greatest and everything he does will wow the crowd.
Of course Trump has no plan - he has no plans about anything except pathological certainty that he is the greatest and everything he does will wow the crowd.
22
Tax credits are based on the psychology of the "You have won a free trip to the Bahamas!" marketing strategies. What is required to take advantage of the offer is, first and foremost, money. A tax credit towards child care is only useful to the person who can afford to pay for child care all year long, then wait for partial reimbursement. Still, what's not to like about a free trip to the Bahamas? Or a tax credit?
The authors of some of the comments appear to have read only the headline and not the content of the editorial.
As you point out in the editorial, Clinton has been working on this problem for decades (against considerable Republican-enabled opposition) and has described to us voters specific ideas for improving what we have now. I have seen in her speeches on line that Clinton has been talking about health care, along with many other challenges, describing with specific proposals, but for this she is dismissed as too wonky and unexciting.
The headline more properly should be, why aren't the ( emailemailemail) reporters asking about healthcare policy?
I do hope that the Times reporters who are covering the campaign read this editorial.
As you point out in the editorial, Clinton has been working on this problem for decades (against considerable Republican-enabled opposition) and has described to us voters specific ideas for improving what we have now. I have seen in her speeches on line that Clinton has been talking about health care, along with many other challenges, describing with specific proposals, but for this she is dismissed as too wonky and unexciting.
The headline more properly should be, why aren't the ( emailemailemail) reporters asking about healthcare policy?
I do hope that the Times reporters who are covering the campaign read this editorial.
11
Thsnk you for saying this. a misleading headline is often all people read, and this one is falsely equivqnt and the article is not. I find this very frustrating as it prevents me from posting it on social media, where more often than not, only the headline is read.
1
Lynn, could you give us one specific proposal from Hillary.
1
Health Care Deserves More Attention - From the Press.
Many Americans do not understand what is happening and why in health care and health benefit coverage. The press could do a much better job of providing more complete information and better explanations.
This editorial, for example, gives the impression that health benefit costs are rising rapidly. Many Americans think total benefit costs are rising rapidly. This editorial does not tell readers that employers' contributions to health benefit coverage have increased by low single digits between 2011 and 2016. It is the employees' contributions that have increased rapidly. As cited in the editorial deductibles for individual coverage increased 63% and contributions from the paycheck increased by 23%. The increases were greater for family coverage. So, readers are given the impression that total health costs must be increasing rapidly when in fact the rate of increase has been lower than it was for the 20 years before 2011. What has happened in the past 5 years is that employers have shifted more of the cost increases to employees in order to keep the employer cost increase to 4% to 5% each year. And insurers are doing the same thing on the Obamacare exchanges - but they need to keep premiums competitive so they have mostly been increasing deductibles and co-payments.
So, Editors, let's not blame the candidates for not explaining these trends when you limit their coverage to sound bites
Many Americans do not understand what is happening and why in health care and health benefit coverage. The press could do a much better job of providing more complete information and better explanations.
This editorial, for example, gives the impression that health benefit costs are rising rapidly. Many Americans think total benefit costs are rising rapidly. This editorial does not tell readers that employers' contributions to health benefit coverage have increased by low single digits between 2011 and 2016. It is the employees' contributions that have increased rapidly. As cited in the editorial deductibles for individual coverage increased 63% and contributions from the paycheck increased by 23%. The increases were greater for family coverage. So, readers are given the impression that total health costs must be increasing rapidly when in fact the rate of increase has been lower than it was for the 20 years before 2011. What has happened in the past 5 years is that employers have shifted more of the cost increases to employees in order to keep the employer cost increase to 4% to 5% each year. And insurers are doing the same thing on the Obamacare exchanges - but they need to keep premiums competitive so they have mostly been increasing deductibles and co-payments.
So, Editors, let's not blame the candidates for not explaining these trends when you limit their coverage to sound bites
19
Neither candidate, or their respective parties, have the will to deal with the root causes of rising Health Care prices. (Costs are not rising much more than inflation, what is rising are the prices that Pharma companies and Insurers are charging in order to meet unrealistic investor expectations.)
Health Care is a necessity; a requirement for life like water & sanitation. Therefore, from an economic perspective, health care should be treated as a utility rather than a commercial enterprise in our economy. It could be a public entity like Britain's National Health Service (the 'Liberal' approach). Or, it could be privately owned like an electric company (the 'Conservative' approach), where rates & rate increases have to be justified by the utility and approved by a public oversight body. Whatever approach it is, phase it in over 5-10 years to make for a less traumatic transition. There are plenty of viable solutions for the problem.
However, while political leadership is focused on idealogical purity and serving their respective benefactors rather than searching for effective solutions, expect health care proposals to be immaterial changes rather than the systemic changes required.
Health Care is a necessity; a requirement for life like water & sanitation. Therefore, from an economic perspective, health care should be treated as a utility rather than a commercial enterprise in our economy. It could be a public entity like Britain's National Health Service (the 'Liberal' approach). Or, it could be privately owned like an electric company (the 'Conservative' approach), where rates & rate increases have to be justified by the utility and approved by a public oversight body. Whatever approach it is, phase it in over 5-10 years to make for a less traumatic transition. There are plenty of viable solutions for the problem.
However, while political leadership is focused on idealogical purity and serving their respective benefactors rather than searching for effective solutions, expect health care proposals to be immaterial changes rather than the systemic changes required.
10
If the attention given healthcare isn't about a single payer system or some other sort of public option, then, no, healthcare doesn't deserve more attention.
6
Dear Editorial Board of NYTimes:
YOU could have made a difference in this health care area when a certain Bernie Sanders laid out his vision for single-payer universal coverage. INSTEAD, you short-shrifted him at every turn. [And believe me, so-called Obama Care is merely a band-aid on a gaping wound. And I mean a BAND-AID.]
I ask: Should not the wealthiest and most advanced nation on the earth be able to provide a modicum of basic health care—like assuring people food and water—to its citizens? What must other advanced countries think of us.
There is still time! With the recent literal physical collapse (euphemistically called "stumble" by the Times) of Ms. Clinton (and not at all the first time according to husband Bill) and her continuing collapse in the polls—why not do what you should have done long ago: Endorse Bernie Sanders.
And call on Hillary Clinton to step down and take care of her health, and thereby the health of this country.
A physician MD
YOU could have made a difference in this health care area when a certain Bernie Sanders laid out his vision for single-payer universal coverage. INSTEAD, you short-shrifted him at every turn. [And believe me, so-called Obama Care is merely a band-aid on a gaping wound. And I mean a BAND-AID.]
I ask: Should not the wealthiest and most advanced nation on the earth be able to provide a modicum of basic health care—like assuring people food and water—to its citizens? What must other advanced countries think of us.
There is still time! With the recent literal physical collapse (euphemistically called "stumble" by the Times) of Ms. Clinton (and not at all the first time according to husband Bill) and her continuing collapse in the polls—why not do what you should have done long ago: Endorse Bernie Sanders.
And call on Hillary Clinton to step down and take care of her health, and thereby the health of this country.
A physician MD
16
Hello, since you are a doctor may I ask you a question? My doctor quit and moved to the UK last year because the management company for her practice forced all the doctors to only treat one symptom per visit so they could get patients out of the office faster to see more new patients. One specialist and 2 NPs in different practices in different cities told me the same thing when I asked, so I was wondering if it was just Louisiana or were other doctors being told the same thing? Not even a cold only has one symptom and when I told a doctor that it could not work that way, he told me it did in his office then said tell him 3 symptoms. my illness has more than that, so no doctor will ever diagnose it because no doctor will even read the symptoms if I print it out. Have you been pressured to do something like that?
The issue may be too complex for Donny. And HRC is too afraid of criticizing Obama.
What an abysmal pair of candidates.
What an abysmal pair of candidates.
8
Not sure she is afraid to criticize Obama, but afraid to rehash Hillarycare.
What health care providers charge in this country is nothing short of robbery. It's a license to steal from the sick and injured.
We need Medicare for all to stop the greed that only exists in this country.
We need Medicare for all to stop the greed that only exists in this country.
16
The Times writes: "Health care is just the kind of difficult subject that presidential candidates ought to talk about more."
Really? Yet not a single word about the fact that presidential candidate Bernie Sanders made just that "difficult subject" the cornerstone of his campaign? No recognition at all of his call for a single-payer health care system?
No, The Times now wants to whitewash its grotesquely biased coverage of the Sanders campaign, and its unprecedented early endorsement of Hillary Clinton. Now The Times wants to complain that the "presidential candidates" ought to be talking about health care.
The Times endorsed the wrong candidate. The Times trashed the wrong candidate. And now The Times wants to pretend that id did nothing of the sort.
Pure hypocrisy.
Really? Yet not a single word about the fact that presidential candidate Bernie Sanders made just that "difficult subject" the cornerstone of his campaign? No recognition at all of his call for a single-payer health care system?
No, The Times now wants to whitewash its grotesquely biased coverage of the Sanders campaign, and its unprecedented early endorsement of Hillary Clinton. Now The Times wants to complain that the "presidential candidates" ought to be talking about health care.
The Times endorsed the wrong candidate. The Times trashed the wrong candidate. And now The Times wants to pretend that id did nothing of the sort.
Pure hypocrisy.
19
Finally, the NYTs admits, though a bit obliquely, that Obamacare has made the health care situation worse that it was before.
8
It's not clear to me that health care costs are necessarily rising drastically. Doctor visits, lab costs, dental visits--these seem to be rising, but not as fast as insurance premiums. Each year, my high-deductible bare-bones policy has risen 25%. This kind of price rise, for anything, is clearly unsustainable. What will eventually happen? Many will simply pay the penalty and go without insurance, just like they did before. And when the occasional health crisis occurs, they will lose their house, just like they did before.
I was one who didn't take Bernie seriously. I assumed that socialized medicine was politically impossible in this country. But as private insurers drop out of the markets as they have here in Oregon while premiums skyrocket, it is becoming clear that the government, whether at the state or federal level, will be forced to step in. We will have socialized health care whether anyone wants it or not because unless people can pay for the doctors, hospitals, and labs, those entities will no longer be financially viable. In spite of the monopolistic networks that serve only to limit insurance options and protect medical profits...
Many like Nick Metrowsky feel the middle classes shouldn't be subsidizing the health care of the poor. Of course we should. The fact is that health care, like highway maintenance, or nuclear subs, is simply too expensive for the average person. We have no choice but to spread the costs across society.
I was one who didn't take Bernie seriously. I assumed that socialized medicine was politically impossible in this country. But as private insurers drop out of the markets as they have here in Oregon while premiums skyrocket, it is becoming clear that the government, whether at the state or federal level, will be forced to step in. We will have socialized health care whether anyone wants it or not because unless people can pay for the doctors, hospitals, and labs, those entities will no longer be financially viable. In spite of the monopolistic networks that serve only to limit insurance options and protect medical profits...
Many like Nick Metrowsky feel the middle classes shouldn't be subsidizing the health care of the poor. Of course we should. The fact is that health care, like highway maintenance, or nuclear subs, is simply too expensive for the average person. We have no choice but to spread the costs across society.
17
You were right not to take Sanders seriously, as he wasn't a serious person. I'd advise you to think likewise of many of the most popular commenters here. Here, in my opinion, is a good explanation of why single-payer is not going to happen in America: https://www.brookings.edu/opinions/the-impossible-pipe-dream-single-paye...
Beyond that, Kenneth Thorpe at Emory, in Atlanta, calculated that Sanders had vastly overestimated savings, and thus understated the tax increases that'd be necessary to cover the cost, to the tune of $1,000,000,000,000 per year.
As with so much else, there's an issue with influence peddling in the legislature that is risibly -- tragically, actually -- ridiculous vis-à-vis healthcare. Reforming that problem, which is not directly related to healthcare, would help us reform so many other problems. But despite the fact that far leftists like to pretend the existing reality of the world doesn't matter, it certainly does.
Few dispute (though some do) the superior quality of healthcare in Western Europe. But that is hardly the issue. We can't begin at the beginning. We are where we are; and last I checked this isn't fantasyland. There's much that's good in Obamacare. It can, should, and, in time, will be reformed.
http://www.politico.com/agenda/story/2016/07/obamacare-what-we-didnt-see...
Beyond that, Kenneth Thorpe at Emory, in Atlanta, calculated that Sanders had vastly overestimated savings, and thus understated the tax increases that'd be necessary to cover the cost, to the tune of $1,000,000,000,000 per year.
As with so much else, there's an issue with influence peddling in the legislature that is risibly -- tragically, actually -- ridiculous vis-à-vis healthcare. Reforming that problem, which is not directly related to healthcare, would help us reform so many other problems. But despite the fact that far leftists like to pretend the existing reality of the world doesn't matter, it certainly does.
Few dispute (though some do) the superior quality of healthcare in Western Europe. But that is hardly the issue. We can't begin at the beginning. We are where we are; and last I checked this isn't fantasyland. There's much that's good in Obamacare. It can, should, and, in time, will be reformed.
http://www.politico.com/agenda/story/2016/07/obamacare-what-we-didnt-see...
Perhaps w Sanders, but neither w DJT of course nor w HRC, despite all aspirations of Americans and demonstrations of more efficient health-care delivery programs in other nations, do readers / voters actually expect in the next four-eight years any slightest benefit to citizens might accrue which would in the least threaten the profit margins of those major lobbying interests which control all aspects of legislative debate and manufacture. Happy to be proven wrong, but not holding our breath out here . . . Hillary.
4
Yes, we still need "Medicare for All" via the "public option if need be. And, we need to mandate access to health care via Medicaid expansion to all our most needy citizens. It was a cornerstone of the Sanders' campaign, but Sec. Clinton has, as you note, not been campaigning on this or the other major accomplishments of the Obama Administration. Nor was health care even mentioned in her Op-Ed piece on poverty the other day. We do need to change the conversation from "birtherism" to health care as a birth right. But, the Democrats must lead and so far it's been all Trump 24/7 with little of note from the Democrats who really have a lot to boast about and a foundation of accomplishment to build upon. Time is running out, the polls are narrowing, and this Democrat is both frightened, worried, and wondering where's Bernie and where's Barack to hammer this message home to the American voters before it's too late and we end up, as President Obama has said, "back in the ditch of 2008."
4
Trump's ideas are horrible but Clinton's aren't much better. The sheer magnitude of the problem is overwhelming. We need single payer yesterday, and negotiated drug prices or importing drugs at what other countries pay.
9
Trump's ideas, if they exist at all, are indeed horrible. But Clinton's are indeed much better. For one thing, allowing people 55 or older to sign on to medicare (with appropriate premiums) is something that may pass, and is a serious first step towards single payer. There are many other parts of her plans, I wonder if you have looked at them carefully. The $5000 tax credit (not deduction) for medical expenses is also helpful, though I am worried about how much of this money will end in the wrong pocket.
Allowing medicare to negotiate with pharmaceutical companies is also a good idea.
Don't forget that Clinton's health care plan from the 90's was a single payer plan. It got shot down because it didn't pay sufficient attention to the interests of the insurance industry. I don't care about those interests, but congress does. Clinton learned her lesson, and her plans are realistic. Go Hillary!
Allowing medicare to negotiate with pharmaceutical companies is also a good idea.
Don't forget that Clinton's health care plan from the 90's was a single payer plan. It got shot down because it didn't pay sufficient attention to the interests of the insurance industry. I don't care about those interests, but congress does. Clinton learned her lesson, and her plans are realistic. Go Hillary!
1
Healthcare as well as most other substantive issues disappeared from the debate when Bernie Sanders' campaign ended. That's one reason why it was important for him to stay in until the last possible minute and one measure of how much the country has lost along with his candidacy.
19
With Anthem our premiums now are nearly $1200 a month for a family of 3, no subsidies. Doesn't even cover the single prescription medicine I'm on - an inhaler for asthma. Refilled last week at Walgreen, it cost $77 out of pocket. Insurance covered $9. Same prescription I've had for years that used to cost $10 in total. Universal health CARE (as opposed to health insurance) cannot come soon enough. Otherwise, at this rate, we're headed to the poor house. Meanwhile, health insurance and pharma CEOs shamelessly take home tens of millions of dollars a year.
28
Assuming that we want affordable health care for absolutely everyone, patching the fragmented, dysfunctional financing system supported by Hillary Clinton will never get us there, and Donald Trump’s proposals would only make things worse.
A well-designed single payer system would not only cover everyone, but it would also slow the increase in health care costs to sustainable levels. Funding it through equitable taxes would make health care affordable for each of us.
The “not feasible” argument is getting tired. Let’s just do it.
A well-designed single payer system would not only cover everyone, but it would also slow the increase in health care costs to sustainable levels. Funding it through equitable taxes would make health care affordable for each of us.
The “not feasible” argument is getting tired. Let’s just do it.
22
Health Care has not received the attention it deserves because Obamacare is failing and that does not fit well with ensuring Hillary get elected.
The "powers that be" in media that support Hillary do not want to discuss how Medicaid is bankrupting states (mine), how most of the coops have failed, how Medicaid coverage is being dropped by many insurers and how the co-pays, co-insurance and deductibles have ballooned.
I hate to say it, but when (if) Trump gets elected, we will be back to where we were in 2010 without the ACA. This will also place us back on track to the societal discussion on how to do health care that has to occur if the result is to be supported through time.
I said, when the ACA was passed, that we were likely marking time and wasting years because unless there is a general societal agreement, the result will not be lasting.
Fortunately, it's only been 6 years, and really less given the slow roll-out and the rather sparse adoption rate, it won't be that traumatic. It's obvious those that can't be insured are still, and will always, be with us. Like the kidney dialysis program, such situations can be identified and dealt with - this might be a good target for a first "societal discussion."
Union folks, and many State, County and Municipal employees are facing a doubling of rates because of the ACA this next year - people are not happy with the ACA at all levels.
The "powers that be" in media that support Hillary do not want to discuss how Medicaid is bankrupting states (mine), how most of the coops have failed, how Medicaid coverage is being dropped by many insurers and how the co-pays, co-insurance and deductibles have ballooned.
I hate to say it, but when (if) Trump gets elected, we will be back to where we were in 2010 without the ACA. This will also place us back on track to the societal discussion on how to do health care that has to occur if the result is to be supported through time.
I said, when the ACA was passed, that we were likely marking time and wasting years because unless there is a general societal agreement, the result will not be lasting.
Fortunately, it's only been 6 years, and really less given the slow roll-out and the rather sparse adoption rate, it won't be that traumatic. It's obvious those that can't be insured are still, and will always, be with us. Like the kidney dialysis program, such situations can be identified and dealt with - this might be a good target for a first "societal discussion."
Union folks, and many State, County and Municipal employees are facing a doubling of rates because of the ACA this next year - people are not happy with the ACA at all levels.
7
And your solution is?
How about Bernie's solution, Medicare for all as an option? Every other "civilized" country has it, as well as many third world countries. How about getting medications from Canada? They pay less than half of what we do.
Sorry, how ridiculous. There are all those lobbyist in Washington for the Insurance and Pharmaceutical companies.We would not want them to be suddenly unemployed. Certainly cannot cut into their salaries, or the campaign contributions, to the usual DC throng. Cannot cut into the hospital monopolies, and their CEO's millions of dollars per year salaries. Horrors, that the "leaders" of big Pharm and the Insurance companies, would have to earn less than millions a year.
Sorry, how ridiculous. There are all those lobbyist in Washington for the Insurance and Pharmaceutical companies.We would not want them to be suddenly unemployed. Certainly cannot cut into their salaries, or the campaign contributions, to the usual DC throng. Cannot cut into the hospital monopolies, and their CEO's millions of dollars per year salaries. Horrors, that the "leaders" of big Pharm and the Insurance companies, would have to earn less than millions a year.
58
I do not wholly disagree with you.
The real problem lies in the power to control government by big business and lobbyists.
At the same time, Medicare is not free; not even for the elderly. Money is taken out of their Social Security to pay towards the Medicare costs. And, they still need another health insurance for the other 20% (Medicare covers 80%).
The real problem is the soaring costs.
The real problem lies in the power to control government by big business and lobbyists.
At the same time, Medicare is not free; not even for the elderly. Money is taken out of their Social Security to pay towards the Medicare costs. And, they still need another health insurance for the other 20% (Medicare covers 80%).
The real problem is the soaring costs.
Medicare for all was hardly only "Bernie's solution." Are his supporters oblivious of history?
Obama and others were well aware that Medicare for all was the solution, but the GOP and Senator Lieberman said NO.
Obama and others were well aware that Medicare for all was the solution, but the GOP and Senator Lieberman said NO.
If voters vote based purely on how they have progressed or suffered from the Obamacare regime, the Senate will have a veto-proof Republican majority to help out Pres. Trump.
This will happen even before A.G. Christy has a federal grand jury review the Hillary money-laundering scheme and the releases of national secrets that she caused.
This will happen even before A.G. Christy has a federal grand jury review the Hillary money-laundering scheme and the releases of national secrets that she caused.
3
"Obamacare regime..."
Puerile rhetoric from a Palin voter still bitter after all these years. Oh, to return to the glorious days of economic ruin and imaginary WMD!
Heaven.
Puerile rhetoric from a Palin voter still bitter after all these years. Oh, to return to the glorious days of economic ruin and imaginary WMD!
Heaven.
1
We need a non-profit healthcare system using private and public money. We need the ability to set reimbursement rates for healthcare and medications. It's not the ACA that is raising prices, they were rising rapidly at about twenty percent per year before it started. It's our for profit healthcare system, greedy insurance insurance companies and big pharm raising prices. We spend almost three times as much as other industrialized nations and we rank 38th in outcomes and longevity. We must do better for all Americans
25
The NATIONAL discussion on health care has degenerated into whether you want to repeal Obamacare, or protect it. If you can't get beyond that, it's hard to have a reasonable discussion.
80
The health care industry's corporate lackeys, the politicians and the New York Times, which ruthlessly attacked Sen. Sanders and others for supporting a nationalized health care system in place in every other industrialized country for decades, aren't going to stop being lackeys.
Only the U.S. Supreme Court can step in and say that health care is a right. Since they have lifetime jobs, the justices can absolutely afford to ignore the corporate lackeys who got them their jobs and, at last, do the right thing. It's a long shot, in fact, the very longest shot, but it's the only shot that we have in this country.
Only the U.S. Supreme Court can step in and say that health care is a right. Since they have lifetime jobs, the justices can absolutely afford to ignore the corporate lackeys who got them their jobs and, at last, do the right thing. It's a long shot, in fact, the very longest shot, but it's the only shot that we have in this country.
1
I met a guy last month who told me that he had recently purchased medical insurance on our state's healthcare exchange. I asked what he thought about Obamacare and he became downright belligerent, insisting that he had private insurance, not Obamacare.
I'm actually quite interested to know just how many other people in the same boat with "private" insurance will vote for Trump. Thousands? Tens of thousands? More? I wonder what they'll tell their wives and kids about how they no longer have insurance if Trump should actually win.
Just kidding. I'm sure they'll blame Obama.
I'm actually quite interested to know just how many other people in the same boat with "private" insurance will vote for Trump. Thousands? Tens of thousands? More? I wonder what they'll tell their wives and kids about how they no longer have insurance if Trump should actually win.
Just kidding. I'm sure they'll blame Obama.
112
Actually you could always get private insurance as an individual. The year before Obamacare paid $800 a month for a family of 5 and the coverage was very good. Immediately after Obamacare went into effect my costs jumped to $1600 a month but the coverage was about the same quality. Today I pay $2000 a month and my coverage is horrible. $6000 individual deductible. So, we basically pay $2000/month and then pay 100% of costs. I voted for Obama twice and bought everything that the NYT and DNC sold me. Now. I know better. The fact is that the ACA is a complete disaster for people who work for a living.
The problem with most of the older and cheaper plans was they had a life time cap in total benefits so if you had a major health problem, your costs could exceed your lifetime cap and suddenly you would be bankrupt. The average health care cost per person in the US is about $9000 per year or $45000 for a family of 5 (although much of the cost is for the elderly). There is nothing magical about why insurance is so expensive. Health care is too expensive in the US. Insurance company premiums have to exceed insurance company payments or the insurance companies go bankrupt. This article focuses on the high cost of health care in the US which is where the problem is.
I'm sorry about that, Bruce. I really am. Interestingly, the guy I was talking about had a similar story. Although it worked out differently for him.
I joined a pick up game of football in the park and I was amazed at how far this guy could throw the ball - maybe 60 yards! We got to talking at one point and he told me that his old doctor wouldn't take his new insurance. So he got new a new doctor. And the new doctor was finally able to diagnose and treat a nagging stomach problem, something his old doctor had never been able to do. And - now that he wasn't in miserable pain all the time - he could finally get outside and throw the ball around again. He was extremely happy things had worked out the way they did. Of course...he became a jerk once I mentioned Obamacare, but...that just made it feel all the more sweet when my team won :)
Also...$800 for a private policy for a family of five? Wow! That was crazy cheap! I know people who were literally paying that same amount for single coverage before the ACA went into effect.
I joined a pick up game of football in the park and I was amazed at how far this guy could throw the ball - maybe 60 yards! We got to talking at one point and he told me that his old doctor wouldn't take his new insurance. So he got new a new doctor. And the new doctor was finally able to diagnose and treat a nagging stomach problem, something his old doctor had never been able to do. And - now that he wasn't in miserable pain all the time - he could finally get outside and throw the ball around again. He was extremely happy things had worked out the way they did. Of course...he became a jerk once I mentioned Obamacare, but...that just made it feel all the more sweet when my team won :)
Also...$800 for a private policy for a family of five? Wow! That was crazy cheap! I know people who were literally paying that same amount for single coverage before the ACA went into effect.
Obsessed with their own health issues and reluctant to share it with public, how could it be imagined that the issue of public health would ever catch the attention it deserves during the campaign run beyond, of course, what's customary?
7
Hillary need not recite all those interesting ideas. That would be wonky and boring, and probably do her harm. She needs to generalize, and then refer for details to what she published.
She does not mention it enough. There is a reason. When generalized, her ideas are not for universal coverage. They are not to help everyone with costs. They are bits and pieces of interesting ideas, but they never over come her initial problem, her reaction to Bernie of "we can't do that."
She dare not sell a summary of her ideas, because it is "we can't do that." With that basic problem, she touches on it all lightly.
Meanwhile, Trump has said all sorts of things about health care, as with so much else. He has said that we must provide coverage for everyone. He has not said how. He has also said the opposite, depending on the audience. He dare not resolve the ambiguity, so he touches on it lightly.
They don't discuss it because they dare not. They don't dare push real answers, either one of them.
She does not mention it enough. There is a reason. When generalized, her ideas are not for universal coverage. They are not to help everyone with costs. They are bits and pieces of interesting ideas, but they never over come her initial problem, her reaction to Bernie of "we can't do that."
She dare not sell a summary of her ideas, because it is "we can't do that." With that basic problem, she touches on it all lightly.
Meanwhile, Trump has said all sorts of things about health care, as with so much else. He has said that we must provide coverage for everyone. He has not said how. He has also said the opposite, depending on the audience. He dare not resolve the ambiguity, so he touches on it lightly.
They don't discuss it because they dare not. They don't dare push real answers, either one of them.
54
Mr. Thomason: Bernie supporters often wrongly think the only universal healthcare system is the single payer plan Bernie proposed. Many countries have universal healthcare with other systems, and few, if any, countries have a single payer system with no premiums, co-pays, or deductibles as Bernie proposed. Some countries, such as Switzerland, use a compulsory health insurance system, with premiums, deductibles and a co-pays. The Swiss can also purchase non-compulsory "complimentary" insurance to pay for some things not covered by the compulsory insurance. Each person pays the premiums up to 8% of their income. The German system is also compulsory insurance, with most Germans enrolled in public non-profit "sickness funds" paid for by employees and employers. Private insurance is available to some. The French system is compulsory, and is funded by obligatory health contributions levied on all salaries, and paid by employers, employees and the self employed; by central government funding; and by users who have to pay variable amounts for services. They also have voluntary private health insurance to cover things not covered by the basic insurance. Patients pay about 20% of all healthcare costs in France. Canada has provincially based single payer plans that pay about 70% of Canadian's healthcare, with the rest paid by patients or private insurance. Hillary's proposals would improve on the ACA and have a chance of becoming law. Bernie's 100% pay for everything plan doesn't.
1
Good Morning, Mark....agree with your assessment. But please don't put forth the possibility that Drumph's side-winding spin is calculated. LIke his following, his talk is embarrassingly shallow, incoherent and uninformed. He continues to offer NOTHING in the way of how, no matter what the issue is, because, again, like his following, he's utterly clueless. Minus the recently discovered teleprompter, he's got absolutely no idea what he's talking about. If the last 1.5 years of a "campaign" isn't testament to this, none of us know what is...
1
KStew -- "he's utterly clueless. . . . he's got absolutely no idea what he's talking about."
That is dangerous underestimation. Oppose what he says. Don't risk dismissing what he says.
Also, he does come up on both the right and the left of Hillary. He does that because that is where the opposition to Hillary is to be found. He is following the voters. That makes him more dangerous.
That is dangerous underestimation. Oppose what he says. Don't risk dismissing what he says.
Also, he does come up on both the right and the left of Hillary. He does that because that is where the opposition to Hillary is to be found. He is following the voters. That makes him more dangerous.
1
Universal single-payer health care is the answer, and everyone who isn't wealthy or profiteering knows this. But it is politically impossible.
Hillary got branded a liar for trying in the 1990s. Meanwhile, self-dealing becomes ever more socially acceptable.
Republicans have done a good job of chipping away at the corners of Romneycare/Obamacare, making it dysfunctional by removing the moving parts that were needed make it work, after cutting deals to dilute it during the negotiations. No profiteer left unpaid ... But blaming Democrats for Republican obstruction is a loser's game.
We could make some progress towards Medicare for All if we elected Democrats across the board and offered our support. But we're too busy condemning those working in the real world and trying to find ways and means to realize we've invited in the real monsters.
It's easy to demagogue it; Bernie, a great guy, did a decent job of insisting without figuring out how to get it done, but Jill Stein is not helping at all, with her acceptance of fringe believes and willingness to exploit the situation.
I don't have the answer but I hope we will all support real public servants running for office: nowadays that would be Democrats. Throw the bums out and get working for each other again, not just the power brokers and big funders of infotainment and election funders.
Idealism is fine as long as you don't take your toys and go home when your unicorn doesn't win. Keep on tryin' please.
Hillary got branded a liar for trying in the 1990s. Meanwhile, self-dealing becomes ever more socially acceptable.
Republicans have done a good job of chipping away at the corners of Romneycare/Obamacare, making it dysfunctional by removing the moving parts that were needed make it work, after cutting deals to dilute it during the negotiations. No profiteer left unpaid ... But blaming Democrats for Republican obstruction is a loser's game.
We could make some progress towards Medicare for All if we elected Democrats across the board and offered our support. But we're too busy condemning those working in the real world and trying to find ways and means to realize we've invited in the real monsters.
It's easy to demagogue it; Bernie, a great guy, did a decent job of insisting without figuring out how to get it done, but Jill Stein is not helping at all, with her acceptance of fringe believes and willingness to exploit the situation.
I don't have the answer but I hope we will all support real public servants running for office: nowadays that would be Democrats. Throw the bums out and get working for each other again, not just the power brokers and big funders of infotainment and election funders.
Idealism is fine as long as you don't take your toys and go home when your unicorn doesn't win. Keep on tryin' please.
82
"Universal single-payer health care is the answer, and everyone who isn't wealthy or profiteering knows this. But it is politically impossible."
Of course.
It would not have been impossible for someone like Kennedy or Johnson, or even Nixon of the EPA and opening to China. It is politically impossible for these two candidates.
I don't mean to be unfair to these two, because Bush and Gore and Kerry and McCain and Romney could not have done it either. Those who fund our politics don't seem to want anyone who might actually have and use the such political power.
Obama came close. My second guessing would be to try for a public option, but there is no way to be sure with hindsight if it would have defeated what we did get. We had to start. We at least did that.
Of course.
It would not have been impossible for someone like Kennedy or Johnson, or even Nixon of the EPA and opening to China. It is politically impossible for these two candidates.
I don't mean to be unfair to these two, because Bush and Gore and Kerry and McCain and Romney could not have done it either. Those who fund our politics don't seem to want anyone who might actually have and use the such political power.
Obama came close. My second guessing would be to try for a public option, but there is no way to be sure with hindsight if it would have defeated what we did get. We had to start. We at least did that.
22
The route to fixing our healthcare system begins with a public option but that's just a start. The ultimate goal is single payer. I hate to say it but the Republicans are right when they say the Affordable Care Act is a failure. It fails to address the main problem in our healthcare system which is that insurance companies should not be running it. Insurance is to protect us from financial loss not loss of good health. That's for doctors to do.
4
Mark - or the Dems could have gone with Bernie, supported his ideas, and given it a run, instead of an automatic thumbs down. There is a lot left to lose here.
2
Hillary Clinton wants to force drug companies to negotiate their prices and she wants to allow people to import lower cost drugs from other countries.
I hope she talks more about those policies in the debates because most people don't seem to know about it....
I hope she talks more about those policies in the debates because most people don't seem to know about it....
51
No she doesn't. That all talk stolen from the Bernie campaign just like the nomination.
2
> "Hillary Clinton wants to force drug companies to negotiate their prices and she wants to allow people to import lower cost drugs from other countries"
* * * *
REALITY-CHECK: The GOP forced through the disastrous Medicare Part-D, specifically to remove the necessary pressure to force these things through
** Disallow Drug Companies from being able to sell their products at different prices to different people & groups. SAME Prices for everyone
** Eliminate ALL the games that Drug Mfgs now use to keep extending their protection from Generic Competition. THAT, is the only reason why EpiPen was able to raise its prices. There should have been at least one generic competing product on the market by now, and there are several others available in Europe that the FDA is blocking here in the US
* * * *
REALITY-CHECK: The GOP forced through the disastrous Medicare Part-D, specifically to remove the necessary pressure to force these things through
** Disallow Drug Companies from being able to sell their products at different prices to different people & groups. SAME Prices for everyone
** Eliminate ALL the games that Drug Mfgs now use to keep extending their protection from Generic Competition. THAT, is the only reason why EpiPen was able to raise its prices. There should have been at least one generic competing product on the market by now, and there are several others available in Europe that the FDA is blocking here in the US
1
She has gradually evolved to say what Bernie said about this and the TPP, up till but not past the election. WWGSS. What would Goldman Sachs say!
It certainly does. But the distribution of our healthcare is very badly broken even if actual quality of its provision isn’t. And I’d argue that the broken state of that distribution is what makes the costs so unbearable. The candidates can’t simply ignore this, and Mrs. Clinton’s defense of the ACA may be pro forma, but the ACA is merely an accretion to a broken system and it’s the ENTIRETY of the system that’s broken. Neither candidate is addressing this because it’s the hottest political potato of them all. As the editors assert, they shouldn’t be allowed to get away with it.
I have a recommended approach that I’ve outlined in my (very long) comment to Gail Collins’s piece that I’m not going to repeat here – it spans two linked comments that can be read at the following links. The healthcare piece is in the first one.
http://www.nytimes.com/2016/09/24/opinion/and-now-presidential-dog-days....
http://www.nytimes.com/2016/09/24/opinion/and-now-presidential-dog-days....
I have a recommended approach that I’ve outlined in my (very long) comment to Gail Collins’s piece that I’m not going to repeat here – it spans two linked comments that can be read at the following links. The healthcare piece is in the first one.
http://www.nytimes.com/2016/09/24/opinion/and-now-presidential-dog-days....
http://www.nytimes.com/2016/09/24/opinion/and-now-presidential-dog-days....
5
Most Americans agree on the voracious appetite for profits by the medical industry, which pushes pills, tests and procedures at ever escalating profits on the unsuspecting patient.
Many Americans understand that our own health habits and resulting chronic disease are also a significant contributor to growing cost.
But the big disagreement comes in discussing solutions.
Sadly, a large group seems to believe that some are entitled to health care while others aren't, a unique view in the developed world today.
Those in the GOP who want to project a friendlier image promote privatization of Medicaid and Medicare as market solutions, hoping we won't notice that the government role in setting prices for procedures is the only thing that makes these programs viable.
And more every day realize, with the assistance of people like Heather "Epi-pen" Bresch, that price controls are essential to the future of affordable health care in the US, since health care is not a discretionary good or service suited to pure market forces.
Many Americans understand that our own health habits and resulting chronic disease are also a significant contributor to growing cost.
But the big disagreement comes in discussing solutions.
Sadly, a large group seems to believe that some are entitled to health care while others aren't, a unique view in the developed world today.
Those in the GOP who want to project a friendlier image promote privatization of Medicaid and Medicare as market solutions, hoping we won't notice that the government role in setting prices for procedures is the only thing that makes these programs viable.
And more every day realize, with the assistance of people like Heather "Epi-pen" Bresch, that price controls are essential to the future of affordable health care in the US, since health care is not a discretionary good or service suited to pure market forces.
201
How do you intend to set these prices? Apparently the US consumer is paying a higher price to subsidize socialized costs in other countries. Are those prices going to rise when we set prices lower? Are there going to be drug shortages? Is the government going to set minimum usage for drugs to subsidize the lower cost? Are we going to make the drug companies government run like the former Soviet Union did with all of their industry? Is it possible that will lead to less drugs, less innovation and shortages? Will the government allow companies to make drugs and compete with the government run drug makers? If profit won't be allowed in health care which competing governments are going to enter the drug market?
If the FDA would approve competitors to the out-of-patent Epipen, competitive market forces would cause the price to decline. Why is the FDA unwilling to approve competitors? The delivery technology is 50 years old. Heather is the daughter of Manchin (D, W.V.)
Price controls would not be needed if the FDA would take its finger off the scale and allow market forces.
Price controls would not be needed if the FDA would take its finger off the scale and allow market forces.
1
Yes, Heather Bresch is the shining example of "free market" in pharmaceuticals. She, and her company, are the Joseph Mengele of power, control and moral absence toward the public. They have bought off the U.S. Government where they have life or death control over human beings.
How is this any different then the immoral depths that doctors had in the camps? U.S. citizens, children, will undoubtedly die because of this monsters myopic greed. The rest of us watch, helpless. Pathetic.
How is this any different then the immoral depths that doctors had in the camps? U.S. citizens, children, will undoubtedly die because of this monsters myopic greed. The rest of us watch, helpless. Pathetic.
A "tax credit" would only intensify the economic damage of Obamacare, by providing another mechanism to transfer wealth to the insurance and health-care industries, at the expense of working middle-class Americans who don't get the tax credit. Rather a "shallow agenda" in that plan. Neither candidate appears willing to address the exorbitant costs of medical tests and procedures in the US, which the NYT has previously demonstrated are the fundamental problems with health care in our country. Perhaps that has something to do with Wall Street?
74
The health insurers all lost huge sums on Obamacare. Reading only the Leftist blogs will make you a less-prepared voter. There have been huge headlines about Aetna just over the past month.
2
No, it has to do with "for profit" medical systems and overpaid executives. Heather Bresch and her company didn't invent the epipen or the medication it delivers. They have been around for years and used to cost a few dollars. I just picked up my new set yesterday. The charge was over $600 but I was only charged $45 and the rest was paid by medicare. Hopefully I won't have to use them but if I am accidentally exposed to a food I am allergic to it could be fatal so I need them. Unfortunately they supposedly go out of date and have to be replaced every year. What a racket.
7
Oh, middle and working class Americans WOULD get that tax credit. That's not the problem.
The problem is that a tax credit is worthless when you are actually sick and need healthcare -- and April is 10 months away. What people NEED is good comprehensive coverage that starts from DAY ONE, and gives them benefits NOW....first dollar coverage, 80-20 plans that let them go to the doctor when they are sick and not wait!
I am not sure what privileged imbecile thought that ordinary working class people happened to have an extra $7000 A YEAR, sitting around in their checking accounts, so they could go to the doctor when they were sick! Most Americans provably don't have $400!!!! so that means, going into debt, borrowing....or most likely, not going at all.
The problem is that a tax credit is worthless when you are actually sick and need healthcare -- and April is 10 months away. What people NEED is good comprehensive coverage that starts from DAY ONE, and gives them benefits NOW....first dollar coverage, 80-20 plans that let them go to the doctor when they are sick and not wait!
I am not sure what privileged imbecile thought that ordinary working class people happened to have an extra $7000 A YEAR, sitting around in their checking accounts, so they could go to the doctor when they were sick! Most Americans provably don't have $400!!!! so that means, going into debt, borrowing....or most likely, not going at all.
1
Because they don't have any answers.
15
You seriously don't expect Ms. Clinton to bring up the expensive disaster that the ACA is.
22
Maybe she should talk about the even more expensive disaster of the pre-ACA healthcare system. The way healthcare is organized (or, more accurately, disorganized) in this country is unaffordable both at the national and consumer level.
4
No not Hillary or Billary.
Healthcare got plenty of attention from Bernie Sanders and Jill Klein who were basically excluded from the campaign.Pity isn't it?
158
Time to move on. Hillary is the candidate & she has plenty to say about healthcare. Too bad the media has no time to report on policies. For months they were very busy breathlessly attacking HRC over emails & the Clinton Foundation. Reminding us how she lacks transparency in spite of years of tax returns & public disclosure of Foundation donors & contributions. And then furor over Hillary's health ratcheted up by conspiracy theories promoted by Trump. Finally after months of normalizing Trump in spite of his antics some of the media are actually vetting Trump. As far as Bernie being excluded from the campaign , who is responsible for that? I'd love to see him out vigorously campaigning for Hillary.
2
Sarah: the lefty media -- especially here at the NYT, but elsewhere too -- decided a LONG time ago that they were going to support Hillary, and going to deny ANY attention or coverage to Bernie Sanders (let alone minor candidates from third parties).
This was a concentrated, deliberate effort to destroy the competition, so that The Anointed One could proceed from nomination to coronation without opposition.
Think about it -- the lame GOP could come up with SEVENTEEN different candidates, including different races, ethnicities, genders. But the super-liberal diverse inclusive DEMOCRATIC PARTY could only come up with....one, old, rich white lady who used to be married to another President????
The fix is in.
This was a concentrated, deliberate effort to destroy the competition, so that The Anointed One could proceed from nomination to coronation without opposition.
Think about it -- the lame GOP could come up with SEVENTEEN different candidates, including different races, ethnicities, genders. But the super-liberal diverse inclusive DEMOCRATIC PARTY could only come up with....one, old, rich white lady who used to be married to another President????
The fix is in.
1
She is universally hated for a reason, she did it all to herself by being such a world class sleaze her whole life...she has no one to blame but herself. She has nothing, she has never accomplished a single positive thing...lots of horrible things but never anything good or decent... she has been handed everything like SoS job or had election stolen for her.
She is maybe a hair's breadth better than Trump but she is still useless, she will never help anyone but herself and that is why she can't even beat a loser like Trump. Mickey Mouse would be beating Trump in the polls, a mushroom could beat him but she can't because she is dishonest as they come and THAT is why people hate her.
She is maybe a hair's breadth better than Trump but she is still useless, she will never help anyone but herself and that is why she can't even beat a loser like Trump. Mickey Mouse would be beating Trump in the polls, a mushroom could beat him but she can't because she is dishonest as they come and THAT is why people hate her.
1
I thought that the Affordable Care Act was the magical answer to the problem of health care costs.
Perhaps President Obama and Congresswoman Pelosi could explain what went wrong.
They passed the bill. And now we have found out what was in the bill.
Perhaps President Obama and Congresswoman Pelosi could explain what went wrong.
They passed the bill. And now we have found out what was in the bill.
28
No, nobody ever said that. Nobody ever thought that. No proponent was ever happy with its limits. It was a compromise, Romneycare sabotaged.
33
Obama tried to work with repubs like Grassley until he figured out they were not going to do anything with him. ACA (originally a repub plan) is a less than perfect compromise with Lieberman and friends. But more people are covered. 1st step toward single payer.
11
Yeah, JMBaltimore, I thought President Obama and Congresswoman Pelosi had fixed it, too. President Obama said that the average family would save $2,500/year.
Instead, the costs are skyrocketing.
Clinton is 4 more years of Obama; they've both said that. So, if Clinton is elected just ever more increasing medical costs.
I'm voting for Trump.
Instead, the costs are skyrocketing.
Clinton is 4 more years of Obama; they've both said that. So, if Clinton is elected just ever more increasing medical costs.
I'm voting for Trump.
4
Trump doesn't have a clue so he doesn't say much beyond the standard repeal and replace with tax cuts. Hillary does know what the problems are but does not champion the cause because that would put her at odds with the President. He is campaigning for her so she cannot attack his signature program. She should.
Contrary to how the Times characterizes the ACA, most people hate it. Certainly, those who were previously cast aside due to existing conditions have been greatly helped, but many have been hurt.
For example, once again the Times does not discus the impact the ACA has had on the individual market. This editorial calls out costs for people that are insured by their employers. This is not the population that the ACA was intended to address. The healthy, self employed are getting killed buy it.
We are forced by law to buy policies that pay for nothing until deductibles approaching $7000 are met. What we have now are catastrophic policies at even higher rates than before.
I wish I could buy a low cost catastrophic policy and pay out of pocket for my regular care. That's now against the law. The law was written this way to force the healthy to subsidize the insurance companies to pay for the previously high cost uninsurable.
Hillary knows this. She should speak out and ride this cause to victory. Speak the truth and win. The Bernie people and independents would flock to her if she would champion something. She needs a cause to rally people to her.
Contrary to how the Times characterizes the ACA, most people hate it. Certainly, those who were previously cast aside due to existing conditions have been greatly helped, but many have been hurt.
For example, once again the Times does not discus the impact the ACA has had on the individual market. This editorial calls out costs for people that are insured by their employers. This is not the population that the ACA was intended to address. The healthy, self employed are getting killed buy it.
We are forced by law to buy policies that pay for nothing until deductibles approaching $7000 are met. What we have now are catastrophic policies at even higher rates than before.
I wish I could buy a low cost catastrophic policy and pay out of pocket for my regular care. That's now against the law. The law was written this way to force the healthy to subsidize the insurance companies to pay for the previously high cost uninsurable.
Hillary knows this. She should speak out and ride this cause to victory. Speak the truth and win. The Bernie people and independents would flock to her if she would champion something. She needs a cause to rally people to her.
104
The hate-the-rich claptrap has always done wonders for Democrats but it can't save Obamacare because it directly attacked the middle class and Christian groups.
Barack COULD have gone with a smaller, less-damaging set of new clinics and hospitals scattered everywhere there were poor people not being served.
BUT that would not have damaged the people of the U.S. as much as he always intended to.
Barack COULD have gone with a smaller, less-damaging set of new clinics and hospitals scattered everywhere there were poor people not being served.
BUT that would not have damaged the people of the U.S. as much as he always intended to.
2
Interestingly enough the doctors down here are starting to opt out of medicare and even many insurance policies. Our GP just announced that he is turning to "concierge medicine" where if you want to be a patient, you pay him $3500 up front and then pay for whatever services are provided. But one still has to carry insurance in case of accident or illness requiring surgery or medical tests that will of necessity be provided by someone else. Even now if you go to his office for a wellness exam, you never see the doctor, just the PA who, if you are lucky spends ten minutes going over the results of your blood tests and listens to your heart and lungs. If you have a skin problem, you have to go to a dermatologist, for women you might need a gynecologist, if you have severe joint problems you have to go to an orthopedist. But before you even start you have paid $3500 for the privilege of being on a general practitioners patient list when the most he is likely to do is say you need to see a specialist and thank you for the money!
1
The fairest and most efficiient way to pay for health care is single-payer with premiums set at a percentage of income, like other countries (and Medicare here) do. This being said, the only way a health insurance system can work is if the healthy subsidize the unhealthy. And it works because you don't know when you will be healthy or unhealthy. You can be healthy today and have a serious accident tomorrow. As a French advertising campaign for auto insurance put it: "Insurance seems expensive only before an accident".
3
Nothing serious to Americans is getting attention on mainstream or cable television right now. They would rather "report" on and discuss ad nauseum The Con Don's hate-anger-fear-war-chaos appearances and the hate-anger-fear and chaos he's ramping up in America.
Ms. Hillary Rodham Clinton will improve America's Affordable Health Insurance program when she is President IF we also elect a Senate and House she can work with on November 8 and it is up to US to make sure it happens - because the press will not.
Ms. Hillary Rodham Clinton will improve America's Affordable Health Insurance program when she is President IF we also elect a Senate and House she can work with on November 8 and it is up to US to make sure it happens - because the press will not.
171
Really, you are JUST NOW figuring out "the press is not your friend"? that media care more about outrage and page clicks, and ginning up hysteria -- than reporting factually on the truth?
BTW: that "media" and news is almost entirely hard-left liberal.
BTW: that "media" and news is almost entirely hard-left liberal.
You made the point before I could. Health care, potential judicial appointments (on the Supreme and lower courts), poverty, income inequality, foreign affairs, you name it, no-one covers it and the campaigns barely mention it. We do have a lot of useless information about the candidates though and not nearly enough of the relevant kind.
The media helped turned this contest into a farce. No-one should express surprise if Americans elect a clown.
The media helped turned this contest into a farce. No-one should express surprise if Americans elect a clown.
5
You forget, HRC once tried to "fix" health care with thousands of pages of regulations. And, as a result, voters sent many Democrat congresspersons into a much-needed retirement from "public service." And today, the USA has a God-awful financing mess called "ObamaCare."
She and BHO have no ability to fix anything, because they have never had to work on their own, with their own resources. They think there is a bottomless pit of taxes and money for their loopy, unproven theories. Well, there is not.
Fixing health care requires asking hard questions. Why are so many still smoking? Doing dope? Drinking heavily? Eating too much? So many domestic assaults? Abused children? Broken families?
The old HRC/BHO crowd is incapable of fixing hard problems. Time for a change.
She and BHO have no ability to fix anything, because they have never had to work on their own, with their own resources. They think there is a bottomless pit of taxes and money for their loopy, unproven theories. Well, there is not.
Fixing health care requires asking hard questions. Why are so many still smoking? Doing dope? Drinking heavily? Eating too much? So many domestic assaults? Abused children? Broken families?
The old HRC/BHO crowd is incapable of fixing hard problems. Time for a change.
1
Trump: Repeal and replace the HCA.
Clinton: Enhance the ACA, so the poor can deduct more and the middle class pay for it. Mostly on the backs of single tax payers.
No boldness here; no public option here; no Medicare fro All here. Again, the Clinton "status quo".
And no one addresses the real problem health care costs rising at 10 - 20% a year, with stagnant and dropping wages.
So, both Clinton and Trump are ignoring the "third rail" health care costs, stagnant wages, low paying jobs and exportation of jobs, failing infrastructure, failing education system. The only thing really working is Wall Street and the redistribution of wealth to the 1%.
What we now see with the "Black Lives Movement", may extend to "99% Lives Matter" movement. The Democrat push fro the TPP may light that fuse which has been growing for teh past 8 years.
Clinton: Enhance the ACA, so the poor can deduct more and the middle class pay for it. Mostly on the backs of single tax payers.
No boldness here; no public option here; no Medicare fro All here. Again, the Clinton "status quo".
And no one addresses the real problem health care costs rising at 10 - 20% a year, with stagnant and dropping wages.
So, both Clinton and Trump are ignoring the "third rail" health care costs, stagnant wages, low paying jobs and exportation of jobs, failing infrastructure, failing education system. The only thing really working is Wall Street and the redistribution of wealth to the 1%.
What we now see with the "Black Lives Movement", may extend to "99% Lives Matter" movement. The Democrat push fro the TPP may light that fuse which has been growing for teh past 8 years.
113
You left out the part about Ryan and his buddies plan to privatize medicare. A truly sick person like my husband would be kicked out in a minute or we would be living in our car after paying medical bills because any voucher plan would never cover him.
5
Mrs Clinton is proposing a public option. See the Commonwealth Fund website for analysis.
5
We are in the same boat as Bruce R., paying over $13,000 annually for a high deductible plan. Effectively, that money just goes down the drain, unless something catastrophic happens to one of us. I feel like the problem is further compounded by doctor's offices, hospitals and any other healthcare supporting structure because you can't get a quote for costs. No one seems to know what the costs are until "after the insurance is billed". I just really don't understand this. The cost should be standard. If your insurance company has negotiated better rates for services, this should not blur the issue of what the original cost is. Perhaps the service provider should be able to get on the insurer's website and see a list (or menu) for prices for various procedures. That shouldn't be hard to do. As it is, while in the doctor's office, one can't make a sound decision without all the financial facts. Is that EKG going to cost me $1000 or $100? All in all, we just don't go to the doctor for anything because we have no idea what the costs will be, and I don't want a guilt trip for not following the advice of the doctor when I refuse treatment. So, we just take Aleve and keep slogging along.
2
I wish the various people lying, telling fairy stories, and showing a complete lack of understanding of what the heck they're talking about would take the time to read a few of KFF's excellent primers, surveys, studies and discussions of health insurance, health care, and the PPACA.
However, I do not expect this to happen: much better to make ridiculous stuff up about their $10, 000 a month premiums, Michelle Obama's $350K part-time job, how Jill Stein will fix everything, how great everything was before the PPACA...