Its About Health Care For All – Stupid !!! !!!

All this talk about Health Insurance For All is ZYCZ)(*&%? Health care financing reform isn’t about who has what health insurance, its about ACCESS TO HEALTH CARE SERVICES.

Here’s the deal: The health insurance industry and their minions want to LIMIT ACCESS to health care services and their attitude toward the public is to hell with the sick and dying – let them eat cake. The Obama Administration with its Public Plan Option and health care financing reform efforts want to INCREASE ACCESS TO HEALTH CARE SERVICES.

The Bush Administration allowed the private health insurers into a public social health insurance plan – Medicare by allowing for Medicare Advantage Plans. Now it is time for a social health insurance program like a Public Plan Option to be introduced into the private health insurance market.

You do not have to be Einstein to understand these simple facts.

Our politicians need to make the right decisions on health care financing reform because ALL our lives both physical and financial depend on it.

http://www.nytimes.com/2009/06/21/health/policy/21poll.html?th&emc=th

In Poll, Wide Support for Government-Run Health

By KEVIN SACK and MARJORIE CONNELLY
NY Times Published: June 20, 2009

Americans overwhelmingly support substantial changes to the health care system and are strongly behind one of the most contentious proposals Congress is considering, a government-run insurance plan to compete with private insurers, according to the latest New York Times/CBS News poll.

The poll found that most Americans would be willing to pay higher taxes so everyone could have health insurance and that they said the government could do a better job of holding down health-care costs than the private sector.

Yet the survey also revealed considerable unease about the impact of heightened government involvement, on both the economy and the quality of the respondents’ own medical care. While 85 percent of respondents said the health care system needed to be fundamentally changed or completely rebuilt, 77 percent said they were very or somewhat satisfied with the quality of their own care.

That paradox was skillfully exploited by opponents of the last failed attempt at overhauling the health system, during former President Bill Clinton’s first term. Sixteen years later, it underscores the tricky task facing lawmakers and President Obama as they try to address the health system’s substantial problems without igniting fears that people could lose what they like.

Across a number of questions, the poll detected substantial support for a greater government role in health care, a position generally identified with the Democratic Party. When asked which party was more likely to improve health care, only 18 percent of respondents said the Republicans, compared with 57 percent who picked the Democrats. Even one of four Republicans said the Democrats would do better.

The national telephone survey, which was conducted from June 12 to 16, found that 72 percent of those questioned supported a government-administered insurance plan — something like Medicare for those under 65 — that would compete for customers with private insurers. Twenty percent said they were opposed.

Republicans in Congress have fiercely criticized the proposal as an unneeded expansion of government that might evolve into a system of nationalized health coverage and lead to the rationing of care.

But in the poll, the proposal received broad bipartisan backing, with half of those who call themselves Republicans saying they would support a public plan, along with nearly three-fourths of independents and almost nine in 10 Democrats.

The poll, of 895 adults, has a margin of sampling error of plus or minus three percentage points.

Mr. Obama and many Democrats have argued that a public plan would be essential, in the president’s words, to “keep insurance companies honest.” But Mr. Obama has also signaled a willingness to compromise for Republican support, perhaps by establishing member-owned insurance cooperatives instead.

It is not clear how fully the public understands the complexities of the government plan proposal, and the poll results indicate that those who said they were following the debate were somewhat less supportive.

But they clearly indicate growing confidence in the government’s ability to manage health care. Half of those questioned said they thought government would be better at providing medical coverage than private insurers, up from 30 percent in polls conducted in 2007. Nearly 60 percent said Washington would have more success in holding down costs, up from 47 percent.

Sixty-four percent said they thought the federal government should guarantee coverage, a figure that has stayed steady all decade. Nearly 6 in 10 said they would be willing to pay higher taxes to make sure that all were insured, with 4 in 10 willing to pay as much as $500 more a year.

And a plurality, 48 percent, said they supported a requirement that all Americans have health insurance so long as public subsidies were offered to those who could not afford it. Thirty-eight percent said they were opposed.

In a follow-up interview, Matt Flurkey, 56, a public plan supporter from Plymouth, Minn., said he could accept that the quality of his care might diminish if coverage was universal. “Even though it might not be quite as good as what we get now,” he said, “I think the government should run health care. Far too many people are being denied now, and costs would be lower.”

While the survey results depict a nation desperate for change, it also reveals a deep wariness of the possible consequences. Half to two-thirds of respondents said they worried that if the government guaranteed health coverage, they would see declines in the quality of their own care and in their ability to choose doctors and get needed treatment.

“It is the responsibility of the government to guarantee insurance for all,” said Juanita Lomaz, a 65-year-old office worker from Bakersfield, Calif. “But my care will get worse because they’ll have to limit care in order to cover everyone.”

When asked their opinion of specific changes being considered in Washington, three-fourths of those surveyed said they favored requiring health insurers to cover anyone, regardless of pre-existing medical conditions. Only a fifth supported taxing employer-provided health benefits to help pay the cost of coverage for the uninsured. And there was deep uncertainty about whether employers should be required to either help insure their workers or pay into a fund for covering the uninsured.

Three of four people questioned said unnecessary medical tests and treatments had become a serious problem, suggesting that they would support calls by health researchers for a payment system that would better reward appropriate care. But an even higher number, 87 percent, said the inability of people to have the needed tests and treatments was a serious problem. One in four said that in the last 12 months they or someone in their household had cut back on medications because of the expense, and one in five said someone had skipped a recommended test or treatment.

The poll found that Americans were far less satisfied with the cost of health care than with the quality of it. Mr. Obama, who has emphasized the need to reduce costs, has found an audience for his argument that health care legislation is vital to economic recovery. Eighty-six percent of those polled said rising costs posed a serious economic threat.

Yet only a fifth of those with insurance said the cost of their own medical care posed a hardship. And only a fourth said that keeping health costs down was a more urgent need than providing coverage for the country’s nearly 50 million uninsured. That was a notable change from a Times/CBS poll taken in early April, when 40 percent said that controlling costs was more pressing.

Marina Stefan and Dalia Sussman contributed reporting.

Editorial

A Public Health Plan

http://www.nytimes.com/2009/06/21/opinion/21sun1.html?pagewanted=1&_r=1&th&emc=th&adxnnlx=1245762007-7VOwj7ZxngBMa2a1YXCWSA

NY Times Published: June 20, 2009

As the debate on health care reform unfolds, no issue has caused such partisan rancor — and spawned such misleading rhetoric — as whether to create a new public insurance plan to compete with private plans.

The nation already has several huge public plans, including Medicare for the elderly (once reviled by conservatives, it is now only short of the flag in its popularity) and Medicaid for the poor.

Now the issue is whether to establish a new public plan to encourage more competition among health insurers and provide Americans with an alternative.

Most Democrats and some Republicans have already accepted the need to create one or more health insurance exchanges where individuals without group coverage and possibly small businesses could buy insurance policies. Some proponents hope that big businesses could enroll their workers as well.

An exchange would give the government (federal or state) a lot more power over insurers that choose to participate in order to tap a vast new market of previously uninsured people. It would determine the range of benefits that all participating plans would have to offer. It would presumably require those plans to accept all applicants, regardless of “pre-existing conditions.”

What Republicans are adamantly opposed to is the idea of adding a public plan to that exchange. They portray it as a “government takeover” of the health care system, or even as socialized medicine. Those are egregious mischaracterizations.

There is no serious consideration in Congress of a single-payer governmental program that would enroll virtually everyone. Nor is there any talk of extending the veterans health care system, a stellar example of “socialized medicine,” to the general public.

The debate is really over whether to open the door a crack for a new public plan to compete with the private plans. Most Democrats see this as an important element in any health care reform, and so do we.

A public plan would have lower administrative expenses than private plans, no need to generate big profits, and stronger bargaining power to obtain discounts from providers. That should enable it to charge lower premiums than many private plans.

It would also provide an alternative for individuals who either can’t get adequate insurance from private insurers or don’t trust the private insurance industry to treat them fairly. And it could serve as a yardstick for comparing the performance of private plans and for testing innovative coverage schemes.

Unfortunately, many Senate Democrats are so desperate to find a political compromise with Republicans — or so bullied by the rhetoric — that they are in danger of gravely weakening a public plan, or eliminating it entirely. That would be a mistake.

Here is a look at the main proposals now under consideration:

THE MOST ROBUST This approach, favored by many analysts, would allow the new public plan to piggy-back on the rate-setting powers of Medicare. As a result, it is the one most feared by Republicans, the insurance industry and doctors and hospitals. Any doctors who wanted to participate in Medicare, as virtually all do, would also have to participate in this plan and would have to accept the same payment rates as Medicare provides.

With lower costs, it would be cheaper for consumers, charging its members premiums as much as 20 to 30 percent lower than premiums for comparable private coverage, a boon to hard-pressed families.

It would also shave hundreds of billions of dollars from the amount needed to cover the uninsured — a crucial advantage as Congress scrambles to finance the reform effort.

The risk is that if this plan, given its power, were too stingy, it might drive some financially stressed hospitals into bankruptcy. The hope is that the downward pressure on reimbursements might force them to innovate and find big savings.

Republicans and private insurers fear, with some reason, that such an inexpensive public plan would entice or drive tens of millions of Americans away from private insurance, especially if big employers were allowed to enroll their workers in an exchange. The challenge is to craft rules to discourage employers from simply dropping their own subsidies entirely.

The prospect of competing with a government plan terrifies the private insurers. But in our judgment, if that many Americans were to decide that such a plan is a better deal for them and their families, that would be a good thing. Innovative private plans that already deliver better services at lower costs would survive. Inefficient private plans would wither.

In an effort to address some of these fears, Senator Jay Rockefeller has introduced a bill that would use Medicare provider payment rates for only the first two years and let doctors opt out after three years while remaining in Medicare. That would get the new public plan off to a good start, after which it would compete on its own.

LIGHTER VERSIONS Other proposals are circulating that would level the playing field with private plans. They would require the public plan to hold the same reserves as private plans and sustain itself from premium income without drawing on the federal treasury. It would probably pay providers higher rates than Medicare but lower rates than most private plans. Its administrative costs would be far lower, allowing it to offer lower premiums. These more modest versions could be worth having, but they would save individuals and the health care system far less money.

STATE-BASED PLANS A bipartisan group, led by three former Senate leaders — Republicans Bob Dole and Howard Baker and Democrat Tom Daschle — has proposed leaving it to states to create public plans if they wish. The federal government would be able to step in after five years if a state has failed to establish an exchange with affordable insurance options. That looks like a formula for delay and inaction.

COOPERATIVES Propelled by a belief that no public plan could survive a Republican filibuster, Senator Kent Conrad, Democrat of North Dakota, has proposed instead setting up private nonprofit cooperatives — run for the benefit of their members rather than stockholders — to compete with profit making insurance plans.

The presumed advantage of this approach is that cooperatives might be able to charge lower premiums because they would not have to earn large profits. Their performance, too, would be a yardstick against which to measure whether profit making plans are charging fair premiums.

Health care cooperatives have existed at the local or regional level for decades in this country. Many have gone belly up. A few still provide high quality care at reasonable prices. Given sufficient size, seed money and negotiating power, a cooperative organization could help transform the health care system. But Republicans seem unlikely to accept a strong national organization, so creation of cooperatives is apt to be local and spotty. They would be unlikely to deliver as much savings as a large public plan.

TIGHT REGULATION Right from the start of the debate, some experts have suggested that much tighter regulation of the new insurance exchange could achieve many of the goals of a public plan.

Regulators could insist that insurers not exclude people with pre-existing conditions or charge them higher premiums. The exchange could offer customers a menu of private plans and be modeled on the federal program that serves Congress and other government personnel. Several European countries, including Germany, provide better health care at lower cost than the United States without relying on a public plan. And the near-universal coverage in Massachusetts was achieved without a public plan option.

We continue to believe that a public plan would be desirable. Surveys by the Commonwealth Fund have found that Medicare beneficiaries report fewer problems obtaining medical care, less financial hardship due to medical bills, and higher satisfaction with their coverage than do workers insured by private employers.

If Senate Republicans block a public plan, much tighter regulation will be essential to guarantee affordable private coverage for millions of Americans.