HR 676: Clarification and Definition of Terminology

Congressional Statement Filed Online (11.00 / 4)

here  Bet my congresscritter or his staff never ever read it!

"First, they ignore you. Then they laugh at you. Then they fight you. Then you win." Mahatma Gandhi

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by: Terri Emerick @ Mon Jan 29, 2007 at 16:46:03 PM CST

A comprehensive National Health Care plan is necessary. (0.00 / 0)

However, I have my doubts about a single payer health care system, as it is often cheaper to get group insurance, which should also be an option under a National Health Care plan, imo.

Ahhhh....Life goes on.

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by: independentminded @ Mon Jan 29, 2007 at 19:14:40 PM CST

Something to consider. (9.00 / 3)

What better group would there be to distribute costs across a large population, contain costs of processing, and layers of bureaucracy than a NATION?  Employer-based groups, especially smaller companies, can find their costs rising rapidly when a small number of employers experience a suddenly expensive medical problem.

Here is an NPR story that brings up that specific issue.

"First, they ignore you. Then they laugh at you. Then they fight you. Then you win." Mahatma Gandhi

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by: Terri Emerick @ Mon Jan 29, 2007 at 20:55:55 PM CST

[ Parent ]

Great analysis. (9.00 / 3)

like i said on top....we need to get LOUD about this.

It would not only save lives, but is saleable to the corporate rich...it would level the international playing field on COSTS of business.

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by: Diane W @ Tue Jan 30, 2007 at 08:38:32 AM CST

I agree... (4.00 / 1)

that a single-payer system would be the best way to provide quality health care to all Americans.  But I don't see it happening anytime soon.  This government is far to beholden to its corporate masters to do anything that would affect their bottom line.  So any reform we get is likely to be neutral, or even beneficial, to the insurance industry.

Only solitary men know the full joys of friendship. Others have their family; but to a solitary and an exile, his friends are everything. - Willa Cather

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by: billybush @ Tue Jan 30, 2007 at 10:30:38 AM CST

Another thing to consider. (6.00 / 1)

If HR 676 is NOT enacted, this country will be squandering its most valuable resources:  HUMAN RESOURCES.

"First, they ignore you. Then they laugh at you. Then they fight you. Then you win." Mahatma Gandhi

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by: Terri Emerick @ Tue Jan 30, 2007 at 11:36:58 AM CST

[ Parent ]

I want nationalized health insurance! (0.00 / 0)

Medicare is statistically more efficient that any private insurance and what is saved in overhead by not duplicating backoffice systems would pay for many, many additional people to be covered by it.  We spend as much in this country as some countries with nationalized care, but still have unbelievable numbers without health care insurance.  We are the only modern country NOT providing universal health coverage.

Yet, I do have reservations about saying, as a country, "oh yes, lets get everything we want in healthcare under a single payer plan with cheap drugs too."  We have to be realistic.  Not heart transplants.  No fertility treatments.  No cosmetic surgery.  And no to unnecessary drugs.

My preference is that there be some way for everyone to have their medical needs met, but we get out of the luxury medicine business that the doctors and medical centers love.  I cannot tell you how many cancer centers have opened in my community lately, duplicating each other and spending much money advertising their competitive services!

We need to flip our healthcare priorities and make sure people have basic good health: prenatal and child healtcare, inoculations, preventive medicine, glasses, dental care that is necessary for health maintainence, and treatment for intermittent and chronic diseases, with the grand fabulous things that medical centers like for the publicity and riches, such as heart and lung transplants, done last IF there are any healthcare dollars left over.

The Presidents plan merely diverts current medical dollars from current medical use to a tax break and is not any plan at all!  And I do believe that I heard the president explaining that public hospitals would lose money to the tax break for the purchase of healthcare under his proposal that will get a very few more people covered.  A. Really. Bad. Idea.  (How would you, with your fine rich plan, like to go to a hospital that was shortstaffed and lacking up-to-date equipment because of such a tax cut?  Would not matter if you had a fine health plan would it?)

I started my adult life as a dental hygienist and I remember the very day back in 1966 or so that medicare and medicaid began.  I practiced in a nice suburban location where people had always paid for their dental care without any trouble.  On the day of medicare starting, here were all these ladies lined up in the waiting room to take advantage of the "free" medicare care.  Now, even when they have the money, I have seen friends fail to even consider spending it on their own healthcare.  Most important, I never met even one Canadian citizen who did not like their nationalized plan.  Yet all we hear is bad-mouthing in the U.S. about nationalized being worse than privatized. 

I think there should not be a profit in sickness and illness, except for paying caregiving staff.  If any real capitalism existed in the United States, capitalists would not be looking to get rich running nursing homes or colonoscopy centers.


Vigilance is the price of freedom. That means us citizens, and not our professional military or its industrial complex bleeding us for every dollar they waste protecting corporate hegemony. That is part of what weakens citizens and puts us in danger.

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by: Silverbird @ Tue Jan 30, 2007 at 11:39:53 AM CST

One by one. (9.00 / 1)

There is no such thing as an unnecessary, livesaving drug.

A heart transplant is medically necessary.

Fertility treatments, I agree with you 100%.

Cosmetic surgery  when it is medically necessary.  One example of many:  reconstructive surgery for a  broken nose that did not heal properly and has resulted in other complications.  As I said, things happen that people have no control over.

Cosmetic surgery to look like a supermodel--no way, shape or form.  (No pun intended.)

As you mentioned, dental coverage is medically necessary and can result in other complications.  Namely, if a bad tooth is left untreated, that can cause death.  Also, the side effects of many prescription are dental problems. 

The latter statement is included on the instructions/warnings that one receives when purchasing a presctiption.  Additionally, the same warnings are required by the FDA.  Excluding full dental coverage from a single payer health care plan can NOT be justified.

Again, we agree that optical coverage is also necessary. 

"First, they ignore you. Then they laugh at you. Then they fight you. Then you win." Mahatma Gandhi

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by: Terri Emerick @ Tue Jan 30, 2007 at 13:06:19 PM CST

[ Parent ]

It may be medically necessary to have transplants, (0.00 / 0)

but I would not pay for them until everybody else has basic health care.  Just so you won't think I am totally unfeeling, I have had people in my family receive transplants, but I still would not fund them through national health care unless with the last dollars, as I stated.

You have sort of made my point.  Though I know it is my personal view that transplants are excessive care, just as I view the medications I have refused as excessive (and unnecessary to me).  Death is as natural a part of life as all the days that come before it.  It is basic needs we need to meet first, not the spectacular. 

Vigilance is the price of freedom. That means us citizens, and not our professional military or its industrial complex bleeding us for every dollar they waste protecting corporate hegemony. That is part of what weakens citizens and puts us in danger.

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by: Silverbird @ Tue Jan 30, 2007 at 13:49:49 PM CST

[ Parent ]

Spectacular? (0.00 / 0)

The need for lifesaving medical treatment, as determined by an indiviual's doctor, is basic care that insurance carriers or you do NOT have the right to deny.

"First, they ignore you. Then they laugh at you. Then they fight you. Then you win." Mahatma Gandhi

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by: Terri Emerick @ Tue Jan 30, 2007 at 14:48:57 PM CST

[ Parent ]

If I contribute (0.00 / 0)

toward the coverage, which I will through taxes, why can I not say no to coverage of this?

This is my very point about how hard these decisions are going to be concerning what kind of medical care Americans want and what they can afford.  They want more than they can pay for.  IF the hoped for national health care should become reality, I would not expect it to cover everything that all people get through their insurance, and private payments, now.  Would you?

Good health is not a right.  Healthcare provided by a group (government or something else) is wonderful, but it is not a right eiter.  Good health is the luck of the draw.  Basic care to keep people basically healthy is where we need to start.

Vigilance is the price of freedom. That means us citizens, and not our professional military or its industrial complex bleeding us for every dollar they waste protecting corporate hegemony. That is part of what weakens citizens and puts us in danger.

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by: Silverbird @ Tue Jan 30, 2007 at 15:03:52 PM CST

[ Parent ]

You are making this more difficult than it is. (0.00 / 0)

First, you say that you want National Health Care. 

Second, you say that basic medical care is where we need to start. 

Third, you say that decisions have to be made and people should be denied basic medical care that is needed to keep them healthy. 

Why you insist on confusing the issues or making up difficulties that do not exist?

The fact of the matter is that everything, is included in HR 676.  It is extemely straightforward, and, unlike most info related to health care, very easy to comprehend.


"First, they ignore you. Then they laugh at you. Then they fight you. Then you win." Mahatma Gandhi

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by: Terri Emerick @ Tue Jan 30, 2007 at 18:31:14 PM CST

[ Parent ]

universal means universal (1.00 / 1)

An example is the overuse of the phrase "universal health care."  When defined and applied today, universal health care means nothing more that everyone must purchase health insurance from a private carrier.  Additionally, the private carrier is under NO obligation to cover basic medical care, specifically lifesaving prescriptions written DAW (Dispense As Written) for those who need them, as is the case with Part D.

I think you are not defining the terms correctly... even if none of the bills that claim to be "universal" do this... the idea of universal health care is not, cannot be, as you have said... firstly, EVERYONE has to have care. So when you say people "must buy" a plan, no, everyone must have a plan regardless of their decision to buy it... they may be taxed to buy it... but it will be bought, that's what "universal means".

You're argument that "none" provide for that is rhetorical, e.g. no single health care plan actually provides for it either... insofar as none has been enacted, even the one you are arguing for can be changed during debate so we just don't know... but as a concept, single payer of course DOES ensure universal access, and so would "universal access".

There are arguments against universal access, e.g. "it's just a ruse, they don't really mean universal"... but then they've lied, and "universal healthcare" still means "everyone".

The two systems need to be compared, but you can't compare based on the idea that universal means "not-universal"... you have to argue the difference between having a regulated group of companies doing healthcare paperwork or just one governmental (or quasi-governmental) organization doing it.

Personally, I like a regulated market of such payers with public-sector and not-for-profit participants to help dilute the chances of privateer collusion... and I'd like to debate the differences on those grounds, not on the grounds that actually I don't want universal access at all.

-pyrrho-

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by: pyrrho @ Tue Jan 30, 2007 at 14:16:02 PM CST

Corrections. (0.00 / 0)

A plan was enacted that enabled me to get my anti-convulsants DAW, reliably and affordably.  It was called Medicaid.  I fully described my experiences with Part D, a public/private partnership, such as the one you favor, in my Congressional statement.

Additionally, the Congressional Statement notes that

a single payer health care system, including prescription, dental, and vision/optical coverage is necessary.  This would result in the savings of approximately $286 billion in paperwork alone, according to Physicians for A National Health Program  (PHNP).

Other reasons for not wanting a public/non-profit partnership are explained in Rx for Disaster.

The AARP "was instrumental in passing the Medicare bill, continues to defend it and vigorously sells the United plan, from which it earns commissions." By its sale of the UnitedHealth MedicareRx plan, the AARP can generate tens of millions of dollars. However, AARP continues to have non-profit status as it represents 35 million subscribed seniors and is considered to be one of the most recognized and powerful lobbying groups in the country.

[snip]

Congressman Stark recognized the conflict of interest and claimed,

"They can't have it both ways... It would be like Consumer Reports investing trust fund money in Chrysler and then promoting Chrysler cars. You can't claim to be a disinterested advocate."

Additionally, you are assuming that the market will "dilute the chances of privateer collusion."  If that is the case, under the market model that has been forced on people who need prescription drugs, why has the cost of prescription drugs increased for people who are low income?

A new analysis reveals that in 2006, excluding those members who received Low Income Subsidies, beneficiaries enrolled in Medco YOURx PLAN(TM) are estimated to have achieved an average savings of $1,519 on their prescription medications.

*  First, why aren't people who are low-income saving on the cost of their precriptions?

*  Second, why not completely eliminate "the chances of privateer collusion" by establishing a single payer health care system?

*  Third, a public/private partnership was created by the passage of the Medicare Modernization Act and it failed those who needed it the most.
This was after it was as the it was billed internationally as having better benefits, including prescription drug coverage, similar to the kind now enjoyed by federal employees and members of the Congress when in fact, it does NOT. 

Why create another public/private partnership when the one that was created under the Medicare Modernization Act completely blew it?  The government has a proven history of the complexities of health care under the Medicaid, Medicare, and VA systems, provided that all are fully funded. The funding of a single payer system is fully adressed in HR 676. 

*  Fourth, another international quote by George Bush:

"I will continue working closely with Congress during conference to make improvements and pass meaningful Medicare reform."

*  How is denying people medical treatment reform?  I have seen absolutely nothing about George Bush being willing to work with John Conyers or any of the other co-sponsors of HR 676 on health care reform, despite the previous international claim. 

The fact of the matter is, HR 676 will reform not just Medicare D, but, every aspect of health care.  That is the point of this piece, not a discussion of your market preferences when those it has been proven that those very preferences did not work.

Final question:  Why do you advocate further rewarding partnerships that failed? 

"First, they ignore you. Then they laugh at you. Then they fight you. Then you win." Mahatma Gandhi

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by: Terri Emerick @ Tue Jan 30, 2007 at 17:57:08 PM CST

[ Parent ]

apples and apples (0.00 / 0)

"a single payer health care system, including prescription, dental, and vision/optical coverage is necessary.  This would result in the savings of approximately $286 billion in paperwork alone, according to Physicians for A National Health Program  (PHNP)."

compared to what?  to regulated multipayer or compared to the totally unregulated multipayer we have now... I think you have to be specific.

As for why the Medicare Bill didn't work... well, "bush", but also, it does not represent all types of multipayer system.

By the way, you mischaracterize me seriously... I did not say that "market forces" would dilute privateer collusion, I said that making sure there were public sector payers would help insure that.

And why take the chance when single-payer avoids the possibility all together... well, obviously out of concern as to what single payer introduces... namely public sector collusion with medical providers.

We have a government for hire.  I don't think having the government doling out that money means the private companies that get paid won't buy congressment and bend that single body to their will...

We could have a plan called "single payer" that isn't really a payer, it could be a lie, called "single payer" and that would not discredit the idea of "single payer".

"Universal" is a word that does mean something, it cannot mean, "not universal" without a lie being told, so any universal system would have to cover everyone or it's not really universal.

Both single payer and multipayer can be, "universal", at least, you have not yet shown why it can't be. You might be saying that people ARE lying about "universal"... but not me, and what's to stop them from lying about single payer?  They will.  Watch them call it single payer and still use private insurance companies as "contractors" or some other dodge.


-pyrrho-

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by: pyrrho @ Tue Jan 30, 2007 at 18:18:58 PM CST

[ Parent ]

short version (0.00 / 0)

it occurs to me that what I'm trying to say to you is the real issue is if it's universal or not.

not how many payers.

the real issue is how much the system costs the nation.

not how many payers there are.

if you have an argument that multi-payer can't be universal by some logical necessity, then fine, but what is it?

-pyrrho-

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by: pyrrho @ Tue Jan 30, 2007 at 18:20:15 PM CST

[ Parent ]

My short version. (0.00 / 0)

Years ago, I lived in John Conyers district and I can say with 100% certainty, that John Conyers can be trusted.  If so-called "universal health care" was better for those who needed medical care and more cost effective for the nation than HR 676, John Conyers would be endorsing it.

That's how I know. 
 

"First, they ignore you. Then they laugh at you. Then they fight you. Then you win." Mahatma Gandhi

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by: Terri Emerick @ Tue Jan 30, 2007 at 19:20:55 PM CST

[ Parent ]

It is complicated. (0.00 / 0)

I have thought about all this since 1963.  I watched medicare and medicaide begin.  You agree with me on dental and eye care to maintan health and not for cosmetic reasons.  Why do you not at least allow that I might not be unreasonable in my third opinion of no funds for transplants until ALL the rest of more ordinary and basic services are provided to ALL citizens.  We, us, are the ones who must discuss and make these decisions in a democracy, which I think we want to keep, right.  As with oil, we are going to have to be the deciders as a democracy or it will be decided for us.  It is my contribution to the discussion to say forego transplants, and I feel like I do know what I am talking about.

Even though we disagree on this one understanding, you have written here on a topic we will be considering much more in the future.

 

Vigilance is the price of freedom. That means us citizens, and not our professional military or its industrial complex bleeding us for every dollar they waste protecting corporate hegemony. That is part of what weakens citizens and puts us in danger.

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by: Silverbird @ Wed Jan 31, 2007 at 08:00:17 AM CST

Because you are *COMPLETELY* unreasonable. (0.00 / 0)

A procedure that is livesaving is BASIC care that you do NOT have the right to deny.  Why is that so difficult for you to understand? 

Another thing:  a ruptured appendix can kill a person, if surgery is not performed.  Will you want to deny funding for other lifesaving procedures, such as appendectomies as well?

Third:  after my traumatic brain injury, I was denied treatment/traumatic brain injury rehab and I know the hell a person who is denied medical treatment goes through. 

Fourth:  after all of the writing and research on health care that I have done, I know what I'm talking about.

Finally:  I never, in a million years, thought that I would have a traumatic brain injury and my life would turn out the way it has. If I was able to work, I wouldn't whine about paying taxes.  Quite frankly, I don't understand how some can be so selfish to do so. 

Think about it. 

"First, they ignore you. Then they laugh at you. Then they fight you. Then you win." Mahatma Gandhi

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by: Terri Emerick @ Sun Feb 04, 2007 at 14:25:16 PM CST

[ Parent ]

My take on selfishness. (0.00 / 0)

I think it is selfish to want a transplant when other people have no medical care or only need their diabetes controlled or would be healthier if thay had someting simple like false teeth.  You may disagree with that.  (I appologize for not seeing your reply earlier.)

I would NOT fail to treat a ruptured Appendix; that is "basic" care.  No fail to treat a truamatic brain injury; I view that as "basic" care.  Just not transplants.

I also think we need to have that discussion about when it is appropriate to quit trying to live and start preparing for a good death.  Few people I know of have chosen to go home to die peacefully instead of struggling through those cancer treatments one more time.  Both my parents came home to live their remaining days and die peacefully among our family.  Their doctors were prepared to spend thousands more to maintain them in a state of terminal illness.

Besides, here I am not deciding to deny care.  I am only talking about it. You tell me I cannot discuss this.  It has to be discussed.  Medical care is ALREADY being rationed (as you pointed out concerning your brain injury situation).

Despite your disagreement, I know that I am not selfish.  I have considered the ethics of all this for quite a long time.  We do have do make these decisions if we expect to have workable (and not pit-in-the-sky) national health care.

Vigilance is the price of freedom. That means us citizens, and not our professional military or its industrial complex bleeding us for every dollar they waste protecting corporate hegemony. That is part of what weakens citizens and puts us in danger.

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by: Silverbird @ Tue Feb 06, 2007 at 14:52:16 PM CST

I also know people who went off chemo. (A couple against medical advice.) (0.00 / 0)

And, that was their decision.  I also know of people who had transplants or other surgical procedures and beat the odds.  Again, their decision, which they had a right to make.  You do not have the right to make a decision for another person re:  his or her life.  Any medical decisions made are between the person involved and his or her doctor(s).


"First, they ignore you. Then they laugh at you. Then they fight you. Then you win." Mahatma Gandhi

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by: Terri Emerick @ Tue Feb 06, 2007 at 17:26:48 PM CST

[ Parent ]

Somehow, (0.00 / 0)

we are not talking about exactly the same thing.  I also think medical decisions are to be made by the person involved.

But I was not addressing that.  There are some things we can do that we should not do.  This is the area of medical thinking and ethics I am addressing.  Social Security insurance does not make me rich it just provides a roof and modest sustenance.  Social health insurance, I do not feel, has to try and aford every new gegaw of technology.  It is financial decisions that have to be made.  Basic healthcare would be a wonderful goal to start with paying for.  I am not arguing that anyone else should besides a patient makes meidcal decisions here. 

My main caution is that we already now want more health care than we can provide for ourselves, in part because it comes out of other people's pockets.  Providing national healthcare of some sort requires addressing how to pay the bill and that involves considering what to pay for.

That seems to be our misunderstanding.  Paying the bills vs. rights to decide.  On the right to decide part, I agree with you. 

Vigilance is the price of freedom. That means us citizens, and not our professional military or its industrial complex bleeding us for every dollar they waste protecting corporate hegemony. That is part of what weakens citizens and puts us in danger.

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by: Silverbird @ Wed Feb 07, 2007 at 08:40:14 AM CST

[ Parent ]

As I said earlier, (0.00 / 0)

how to finance single payer health care is addressed in HR 676.  You are making this more difficult than it is. 

"First, they ignore you. Then they laugh at you. Then they fight you. Then you win." Mahatma Gandhi

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by: Terri Emerick @ Wed Feb 07, 2007 at 15:49:38 PM CST

[ Parent ]