I believe that a vast majority of MDs have their patients' best interest in mind. And, I do see a conflict of interest as well w.r.t. a survey of MDs. Ask a bunch of MDs what their biggest gripe is about their profession and most, if not all, will say dealing the bleeping insurance companies (malpractice insurance costs coming in second, believe it or not...from my experience, except for the OB-GYNs though).

IMO, health insurance reform should be the first step to take before any universal healthcare is adopted.

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I am an American. That's the way most of us put it, just matter of factly. They are plain words, those four: you could write them on your thumbnail, or sweep them clear across this bright autumn sky. But remember too, that they are more than just words. They are a way of life. So whenever you speak them; speak them firmly, speak them proudly, speak them gratefully. I am an American. ...a tradition

It seems like a noble enough sentiment, but I wonder where it ends. Certainly you don't advocate that I should pay for somebody's boob job, but what about where the line blurs a bit? Smokers or drug users who consciously make unhealthy choices or people who are hypochondriacs come to mind - these people willfully cost "the system" (and therefore all of us) more money. Of course, they're entitled to your "right", but they abuse it. And, when I'm financing a 75 year old smoker's right to bypass surgery or a neurotic man's 15th checkup this year, how do I know if I'm just helping out my fellow man, or if I'm being screwed by enabling systemic abuse?

Two solutions come to mind: increased nanny-state legislation or differentiated premiums. I'm loathe to adopt the first one, and the second one can be tricked/abused (and also seems to be fairly similar to the first one if we're all forced to pay premiums) and it would also create an enormous bureaucracy determining what your "health tax index" would be. I'm envisioning something like a 1040 that we all fill out every year. How would you handle these things (if you are, in fact, advocating a government controlled universal policy)?

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"Government big enough to supply everything you need is big enough to take everything you have... The course of history shows that as a government grows, liberty decreases."

-Thomas Jefferson

Very valid question.

At the risk of sounding too circumspect, let me say that I beleive that certain things are too important to society/the costs of failure are too great, to be subjected to the whims and inconstancies of the private market. (Bear in mind, I am not some commie doofus, who wants to unprivatize everything...)

Education and heathcare are two things that I consider core responsibilities of the government (public/society). If we don;t havw an educated, healthy society, not much else is going to matter. And, there are things that are simply more efficient if done collectively, as opposed to individualistically, like national defense, or roads, say.

I understand the arguments about "why should I have to pay for anyone else?" Let me submit that, done correctly (!) costs would theoretically go DOWN. If more people are paying in than taking out...well, you know the basic argument.

I just think that the people have a vested interest in not allowing others to slip through the cracks, and selfishly think it won't affect them. It sure does. And, since we could agree that preventative maintenance is pennies on the dollar as opposed to when most people bother to go get checkups, I should think that, overall, this makes more sense.

I tend to think of both education and health care as the public's investment in itself. And that's really the whole point of what government SHOULD be doing. A person's health simply should not be subject to one's ability to pay, nor some insurance company's actuarial table. In essence, the people insure their own health.

We already pay for all sorts of things collectively, anyway. Hell, I'll happily trade a few soon-to-be-mothballed jet fighter in exchange for local clinics and free checkups for everyone twice a year. We have to start thinking more as a nation instead of a collection of 350 million individuals. Surely we haven't gotten so pathetically selfish and self-centered as to begrudge other people good health? Doesn't that benefit us all?

All that said, I haven't a clue HOW to accomplish this, honestly.

I should think that we could LEARN from other nation's mistakes and create a stellar system. We have smart people here, I can;t believe we can't figure this out. I don't buy that it's automatically doomed to failure. When did Americans become so defeatist? Besides, with costs already ridiculously out of control, and a fifth of the nation uninsured, we clearly can't limp along much longer as it stands.

Screw Iraq. Think of what we could have accomplished HERE, for what we've spent over there. You know...for AMERICANS!

I am open to all sorts of ideas, and am not terrified of change. It's just disgraceful we haven't been able to figure this out. The richest nation on Earth can't even ensure its own health? What the hell is government FOR, if not that?

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"My opinions may have changed, but not the fact that I am right." - Ashleigh Brilliant(?)
(Voting for None Of The Above, so far...)

I've no doubt that they do have the best interests of their patients in mind, though not necessarily their best financial interests. That is, I'd imagine that my doctor, as a doctor and a human, wants to see me healthy. He might not care if being healthy costs me $50 or $5000 per year.

I'm inclined to agree with this. And, if "universal" health care were enacted and run by the government, I would strongly prefer to be able to opt out of it in favor of something private, as I would with social security or any other program that is going to cost me far, far more than it will help me, if it helps me at all.

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"Government big enough to supply everything you need is big enough to take everything you have... The course of history shows that as a government grows, liberty decreases."

-Thomas Jefferson

Yeah, you do raise good points. Cigarettes? Tax them at such a rate to make up the costs that they create for the system (anticipated and current). Alcohol the same.

Are there going to be those who abuse the system? Absolutely. But, they're already there. I can't tell you how many times I've run lights-and-sirens across town to a call that basically ended up being "I'm old and I'm lonely." System abuse already exists, and it costs us dearly. Every study I've ever seen shows that the savings to the system by creating true universal preventive care would allow the system to pay for itself. Me, I'm not really worried about that small set of abusers. They can't really do any more harm than they already are.

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When they come a wull staun ma groon
Staun ma groon al nae be afraid
Thoughts awe hame tak awa ma fear
Sweat an bluid hide ma veil awe tears

The weakness, of course, with this is that you can't be SURE that you're paying more into Social Security than you're going to get out of it. You could be diagnosed with MS tomorrow and be unable to work in 6 months. Think your company's going to support you for the rest of your life?

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When they come a wull staun ma groon
Staun ma groon al nae be afraid
Thoughts awe hame tak awa ma fear
Sweat an bluid hide ma veil awe tears

Ah, the "slippery slope" argument...

Well, I would think that those things would be taken into account, being elective surgeries, etc. I don't know what we should do about smokers, but I do know that care AFTER the fact is way more expensive than early detection, in general.

I don't think anyone ever devised any system that is immune to "abuse". However, I see health as something we just can;t get anough of! (Oh no, he got four checkups for free! How horrible! )

I'd be pretty happy if eveyone at least got two checkups a year and immunizations. That, alone would be incredible savings.

All I am asking people is to be open to a change, not to immediately freak out. We need pilot programs, data, analysis, time to work this out. Health care costs are, I believe, the number one cause of bankruptcy. Something's GOT to give.

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"My opinions may have changed, but not the fact that I am right." - Ashleigh Brilliant(?)
(Voting for None Of The Above, so far...)

To the first part, I see your point. Perhaps both financial indifference to the patient and insurance hassles influence the survey.

To the second part, if universal care does come to pass, then the opt out needs to be there for me to give it even an iota of support, too.

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I am an American. That's the way most of us put it, just matter of factly. They are plain words, those four: you could write them on your thumbnail, or sweep them clear across this bright autumn sky. But remember too, that they are more than just words. They are a way of life. So whenever you speak them; speak them firmly, speak them proudly, speak them gratefully. I am an American. ...a tradition

That's fine, just don't demand any sort of tax break for your decision. Everyone pays in, but if you want to pay extra for going it alone, that's your business.

Ultimately, your health IS my business. It affects the economy, and much else. It is in my best interest to ensure you are healthy and productive. Therefore, it is part of my duty as a citizen to make my government ensure this on my behalf.

(That's my biggest problem with our individualism. In most cases it's great, but god damn, can we be selfish at times!)

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"My opinions may have changed, but not the fact that I am right." - Ashleigh Brilliant(?)
(Voting for None Of The Above, so far...)

I have to take issue with this. It defeats one of the main purposes. We're not going to leave people without any care whatsoever if they opt-out and get sick. This would leave people in the same position that they are now - not paying in and abusing the system when they get sick.

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When they come a wull staun ma groon
Staun ma groon al nae be afraid
Thoughts awe hame tak awa ma fear
Sweat an bluid hide ma veil awe tears

How about if they opt out yet demonstrate they can handle it themselves? (Financial situation, private insurance, etc.)

__________________
I am an American. That's the way most of us put it, just matter of factly. They are plain words, those four: you could write them on your thumbnail, or sweep them clear across this bright autumn sky. But remember too, that they are more than just words. They are a way of life. So whenever you speak them; speak them firmly, speak them proudly, speak them gratefully. I am an American. ...a tradition

Financial situation? No. Being rich does not excuse you from your duty to your fellow human being.

Private insurance? Depends on the coverage. If it provided lifetime care and couldn't be cancelled? Maybe. Otherwise, no.

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When they come a wull staun ma groon
Staun ma groon al nae be afraid
Thoughts awe hame tak awa ma fear
Sweat an bluid hide ma veil awe tears

But since the wealthy folks are in the minority of the population, wouldn't there be plenty of revenue available for the ones who cannot opt out (assuming the reform is done effectively). On demonstrating proof of coverage, if it is cancelled, what if you are not eligible to opt out until you again show proof of private coverage?

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I am an American. That's the way most of us put it, just matter of factly. They are plain words, those four: you could write them on your thumbnail, or sweep them clear across this bright autumn sky. But remember too, that they are more than just words. They are a way of life. So whenever you speak them; speak them firmly, speak them proudly, speak them gratefully. I am an American. ...a tradition

The system doesn't work if we're not all contributing. It's not just about dollar flow, it's about stakeholding. To allow people temporary outs of the system, especially with the knowledge that they'd still be covered by it in the worst cases would only undercut such a system.

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When they come a wull staun ma groon
Staun ma groon al nae be afraid
Thoughts awe hame tak awa ma fear
Sweat an bluid hide ma veil awe tears

I disagree that it won't work unless all contribute. I'm not getting your reference to stakeholding, so could you expand on that? (I'm not too money savvy and maybe that's why I don't see it not working). For the folks that took the opt out yet still lost their insurance, I don't think they should be allowed to get a free ride. They made the choice (or gamble) to opt out, their insurance gets cancelled, and they are responsible for paying for that choice (budget down their lifestyle, assume debt, get bad credit, etc.) until the next year. Then they can decline opting out or show another proof of coverage to opt out.

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I am an American. That's the way most of us put it, just matter of factly. They are plain words, those four: you could write them on your thumbnail, or sweep them clear across this bright autumn sky. But remember too, that they are more than just words. They are a way of life. So whenever you speak them; speak them firmly, speak them proudly, speak them gratefully. I am an American. ...a tradition