The public option IS a compromise!

We want Single Payer.
We will settle for a strong public option... for now.
Drop even that, it's no longer a compromise. It's a cave-in.

Our medical system is hemorrhaging. It needs more than a band-aid.

To be honest, I'm not even that fond of public option insurance, but I share your sentiments. Looks like a "cave in" to me.

:dem:

-Laelth

be available to everyone and it must be accepted by all doctors/hospitals, etc.

After The House got through with the "Public Option" (HR 3200)
it is a complete capitulation to the For Profit Health Insurance Industry.

As I understand it, that would put the government in charge of all health care. Is there anything our government is really good at? They can't deliver the mail on time. Why would anyone want them running their health care if there was another option? The public option is fine with me, as long as I can go elsewhere if it turns out to be a crappy plan.

:eyes:

...then explain why. When you have only one entity managing anything, it is almost certain to do a lousy job or at the very least a worse job than multiple entities competing with each other. If you think otherwise, give me some examples.

what does your plan NOT cover, I'm sure it's a long list.

Single payer as done in every civilized country in the world has no exceptions.
Yes it's true that you generally have to justify WHY you need a bigger penis or boobs, or a new nose, but even those can be covered if your psychiatrist says it's needed.

There are no wait times for anything immediate.

Yes you will have to wait if you want to get that boob job.

but when the Doc says you need XyZ, you GET XYZ, NOW!

Oh yeah and in most countries there isn't even a co-pay.

so please explain how this is inferior to the US system.

It's a well run program and one that I would like to see opened to everyone.

I can post a letter before the first pick-up time and it will be delivered the next day to cities that are hours away. How insufficient, how expensive!

T.H. is right... :eyes:

I've had first class mail take a week to be delivered on numerous occasions. I expect NJ to Florida to require three days and I'm rarely disappointed. I don't consider that stellar service.

What do you want for less than 50 cents?

Free Republic is missing your presence.

That makes me a freeper? Have a good night all.

You probably need to hide.

:crazy:

You like having weekends off? Thank the NLRB. You think Morphine should be illegal? Thank the feds. Do you thinking lynching people because of their race is wrong? Thank the feds. Do you live west of Illinois, Kentucky, Tennessee, Mississippi? Thank the feds. Take an airplane anywhere lately? Thank the feds. Not dead of small pox, measles, diptheria, etc.?

Oh by the way, welcome to DU.

:hi:

I fly from Florida to NJ frequently and most of the time, my flight is late because of groundstops (i.e. problems with air traffic control). The FAA runs that. Sure, I got where I was going, but they don't get an "A" when I'm usually late. The interstates? Have you driven I95 or I87 around NYC lately (especially around the GW Bridge)? How about the Pennsylvania Turnpike? Those roads are in terrible shape and I can give you lots of other examples. Look at many of the bridges; the lack of proper maintenance is obvious. How about our military? Do you think they spend our money wisely?

The government has accomplished a lot, but for the most part, the examples you gave represent legislation or some other singular event. When it comes to managing day to day operations, I think the record is unimpressive. I want great health care and I believe the best way to get it is in a competitive environment. If a public option turns out to be the best, then everyone will want it, including me.

Yeah, let's turn it over to private corporations. They're just whiz bang when it comes to quality.

Single-payer puts the govt in charge of paying the bills. That's it. Unlike now, the care you receive will simply be between you and your doctor.

And your experience with the USPS is not representative of most people's. Out of the billions of pieces of mail they process, I've had things gets lost twice in my entire lifetime. You want bad, try Canada Post.

How do costs get controlled? Who makes the call on whether a course of treatment gets done?

I'm going to answer your second question first, because the first question is sort of a separate issue.

"Who makes the call on whether a course of treatment gets done?" Simple answer: the doctor. Unlike now, under a Canadian-style single-payer system, there is no bureaucrat overseeing care. There is no step therapy, there are no referrals, there are no mandatory generics, etc. The doctor prescribes care, and the government pays for it. That's what makes the whole "government-run healthcare" argument so infuriating, since a single-payer system only requires the government to pay the bills, not to get involved in the actual care of a patient. Check wiki for a good overview (and it's not country-wide, there can be differences among provinces): http://en.wikipedia.org/wiki/Medicare_%28Canada%29

"How do costs get controlled?" The cost of care in Canada is substantially cheaper, for a variety of reasons, that it is in the US. The first would be forcing doctor's to accept lower reimbursements, which the US govt currently has no leverage to do, since they allow private insurers to compete alongside them. For this reason, I would actually be in favor of an HMO-type system where referrals to a specialist are required. Hell, even private insurance these days seems to be doing away with that practice, and it's always been an excellent method of gatekeeping and keeping costs down. Of course, this is a whole other line of debate... Also, I'd prohibit direct marketing of prescription drugs, since this encourages people who have no medical training to demand expensive and sometimes unnecessary drugs from their doctors.

Hope that helps.

I read the Wiki article you cited and I'm not impressed with the Canadian system. In fact, I'm more convinced than ever that my original premise (i.e. that governments do a crappy job managing things) is correct. The Wiki article did clear up a misconception I had about single payer. I envisioned some government agency approving whether a given procedure could be performed before it could be done, which is not the case. The Canadian approach is equally bad, maybe worse: They limit the reimbursements of virtually all health care providers and don't allow health care services to be paid for privately. Providers can only be paid by the government (and if they don't like the reimbursement, it's too bad.) and patients have nowhere else to go for healthcare, regardless of how good or bad the care is. The result is a shortage of medical services and long wait times (translated as crappy health care). The Wiki article cited a lot of references that give a good picture of what health care in Canada is like from a patients perspective. Here are some examples:

- For abnormal premenopausal uterine bleeding, 62% of patients wait more than 18 weeks for treatment. Median wait is 164 days
- For bright red rectal bleeding, 43% wait more than 18 weeks. Median wait is 57 days.
- For a screening colonoscopy, 60% wait more than 18 weeks. Median wait is 148 days
- For a hip replacement, 75% wait more than 18 weeks. Median wait is 247 days. For a knee replacement, the statistics are worse.

I could go on, but I'll just give you the link: http://www.waittimealliance.ca/June2009/Report-card-June2009_e.pdf

Here is a link to another article which I scanned, but did not read in detail. My general impression from this one is that Canadians are not enthusiastic about their system. This article confirmed the problem of wait times.

http://www.healthcouncilcanada.ca/docs/rpts/2007/Public%20Perceptions%20-%20English%20Final_Feb-07.pdf

If you have no health care coverage, the Canadian system would certainly be an improvement, but if you have decent coverage already, why would you choose it? A public option, competing with private coverage, would be better. Everyone has access and if you don't like the government plan, you can go elsewhere. Canadians can't do that.

So what gives? Do you really like the Canadian System?

Wait times are more a function of geography than availability (although, just like in the US, there aren't nearly enough specialists to go around). If you live in bumfuck Canada or bumfuck US, you're obviously going to have fewer world-class cancer centers in your immediate area. People will be triaged, so that you always have access to emergency care (keeping in mind the area that you live in), but less urgent care and elective care is obviously knocked to the back. Every single hospital in the world does this. (Just the other day I sat in a waiting room in the US for over an hour and a half because my doctor had to respond to a cardiac arrest.) And there's always going to be a limited number of specialists; it's just common sense. Where I live, in the US, it takes several months to even get an appointment with a neurologist. That's because you have people coming all over the country to see those particular neurologists. I hate comparing the US to Canada in making my argument, but this is not a problem of the government insurance system, it's a problem with not having enough trained specialists to go around.

Wait time statistics are also misleading because they vary by province. Keep in mind that while the federal govt sets uniform standards, the plans themselves are run provincially. I've noticed, anemically, that the worst stories tend to come out of the more conservative provinces, which makes sense since their system is probably underfunded because of the usual bitching on the right about taxes. Nevertheless, there's also been a huge increase in federal funding recently in order to get wait times down by 2010, because of complaints, even though they've been held to certain standards since the plan's inception. Again, I hate comparing the US to Canada is advocating for single-payer, but here's a good article from radical leftist publication Business Weekly: http://www.businessweek.com/technology/content/jun2007/tc20070621_716260.htm

Regarding the prohibition on paying privately: this is an attempt to prevent the two-tiered system that we in the US have today. As I said, a govt plan competing against private insurance is doomed to fail (this is my problem with the so-called "public option.") If doctor's can choose not to accept the govt plan, private insurers can easily undercut the govt plan by simply offering higher reimbursement rates, and people who have a choice (because they're healthy) will gravitate away from the govt plan because fewer doctors accept it. And just like will happen here, the public plan becomes nothing but a dumping ground for the sick, while healthier people pay lower rates for private insurance (and the private companies make money hand over fist, since all their claims have been dumped on the government). For a government plan to work, it needs to be the only game in town. That's what single-payer is by definition, and it's worked quite well in Canada. And there are still numerous private carriers which offer supplemental coverages for drugs not covered on the govt plan, dental, vision, life, disability, etc. It's just that the core services are only to be paid by the government.

And regarding patients having "nowhere else to go," this is simply not true. There are no networks in Canada like we have here under private insurance; patients can see any doctor they want. And if they don't like their specialist, well, you'd have the same problem here. If you can find another one, great, but there just aren't a ton to go around.

But overall, Canadians love their system and consider it as much a part of their identity as americans tend to do their guns. Even the more conservative Canadians I've talked to (funny, they'd be considered Democrats here) would never dream of changing to an American-style system.

I'm at a different computer, so I don't have all my links to actual studies (give me a few hours), but my Canadian wife and her Canadian friends can counter any horror story you can find with stories of being able to get care that would be prohibitively expensive here, and for other things that I as an american would never have gone to the doctor for because of the cost. Anecdotes are meaningless, I know, but I've never met a Canadian that didn't love their system.

Here's a couple for now:
Debunking Canadian Health Care Myths - http://www.denverpost.com/opinion/ci_12523427
Mythbusting Canadian Health Care - Part I - http://www.ourfuture.org/blog-entry/mythbusting-canadian-health-care-part-i
Mythbusting Canadian Health Care - Part II - http://www.ourfuture.org/blog-entry/mythbusting-canadian-healthcare-part-ii-debunking-free-marketeers

So yes, I really like the Canadian system, and I wish that we were advocating for something similar here, as opposed to a "public option" whose failure will simply vindicate the right and doom single-payer in this country for years to come.

And it doesn't seem an especially good compromise.

Take another example from the Canadian health care experience. Canada is presently fighting its own single option versus public option health care insurance battle.

If you have wondered how Senator Mitch McConnell (R-KY) found Shona Holmes, a private citizen from Waterdown, Ontario, with just the right story to illustrate his talking points against any Canadian-style single payer health insurance scheme, here is your answer.

We already know that Shona's "brain tumor" was actually a Rathke's Cleft Cyst on her pituitary gland. The Ottawa Citizen had that story as early as July 12th.

The Ottawa Citizen’s “A reality check on a reality check” by Julie Mason:
http://www.ottawacitizen.com/health/reality+check+reality+check/1783177/story.html

From Ms. Mason’s story we learned that the court case in which Shona is involved was brought for her by the Canadian Constitution Foundation against the government of Ontario.

Googling we soon learn that the Canadian Constitution Foundation is a Calgary-based extreme right-wing legal advocacy organization. One of its goals appears to be removing one tier insurance (single payer insurance) in Canada and replacing it with two-tier insurance (public option & private insurers).

Most Canadians oppose this, suggesting that two-tier insurance (public option & private insurers) will eventually result in eroding what they currently have untill there will be adequate health care for the rich and "two aspirins and a bandaid" for the poor.

Health insurance is the second third rail in Canadian politics, but moneyed interests in Canada wish to get in on all that gravy that they can see their cousins sopping up down south. So, the Canadian Constitution Foundation is trying to force two tier health care insurance on Canada through legal assaults on the Canadian Charter of Rights, and Shona Holmes, it appears, is one of their pawns.

Backgrounder on the Canadian Constitution Foundation:
http://www.web.net/~ohc/privatization/ccf_backgrounder.htm

Finally, just for fun, note the differrence in conservatives as Canadian Senator Hugh Segal (Conservative-Ontario) responds to statements by U.S. Senator Mitch McConnell (Republican-Kentucky) about Canadian Health Care.

http://www.cnn.com/video/#/video/politics/2009/07/05/sot.canada.segal.cnn

and we then obtain single-payer, and that would be after insurance cos are cut down to size. ;)

any candidate (half the DFL is running for governor) or office holder who mentioned their support for single payer received enthusiastic applause accompanied by a variety of approving vocalizations.

Those who said we need access to "affordable healthcare" (and stopped waiting for a reaction) generally received polite applause but it seemed clear that the crowd has figured out that the term "affordable healthcare" means nothing. The candidate would probably have gotten a better reaction by just saying "Puppies are cute." At least we'd know what that meant.

Mention of a public option resulted in a reaction between the other two but it was pretty clear the crowd at this want single payer. Hardly surprising that the people are ahead of the politicians.

I'll eat my hat . . .