The real crisis in the healthcare arena is non-payment by the health insurance companies when people get sick.  So this isn't just about getting everyone in America a little healthcare card, it is about that card delivering a return on investment.

Until there is a government plan option that is affordable, there will be no competition for the health insurance companies to incentivize them to keep their premiums low or deliver on their promises of coverage when a customer gets sick.  

His conclusion:

Even so, the basic foundation here -- individual mandate, guaranteed issue, some form of community rating -- is the likeliest foundation for a deal, and the political system knows that full well: That's the Baucus plan, the Wyden plan, the Clinton, plan, the Edwards plan, and probably will be the Obama plan. The insurers are recognizing that, and trying to pull the terms in their favor, dangling an easy deal where they endorse passage but have more control over the rate structure (which is to say, there's less community rating). This is the beginning of the fight, not the end of it.

Our current healthcare policy has been shaped in part by the "moral hazard" theory.  Essentially, it boils down to an assumption that utilization will increase if coverage is provided.  Utilization will be spurreed by several things, among them more risky behaviors, hypochondria (nuisance treatment), etc.  

Part of the solution has been to introduce risk sharing.  In most cases, this takes the form of deductibles and co-pays.  The government and insurance companies assumed thiat his would result in more efficient healthcare delivery and reduce wasteful consumption of medical services.

Obviously, this hasn't worked.  We have more uninsured than ever.  The vast majority of our bankruptcies result from medical expenses.  We are less healthy than other industrialized nations, we lead shorter lives, our infant mortality rate is a disgrace and we perform more late term interventions than other countries.  Why?  Because costs deter people from seeking preventative care, either physician or pharmacological.  Only when the need for care becomes immediate do many seek medical aid, at which point the cost of that aid and the severity of treatment skyrocket.

So, the opponents of universal healthcare and believers in the free market for healthcare need to first disabuse themselves of the quixotic notion that "moral hazard" will create an economically unfeasibile burden on the American public.

At present, the sick pay disproportionately  more than those who are well.  We're conditoned to think that the actuarial model practiced by property/casualty companies is fair.  Perhaps it is, but not in terms of healthcare.  In healthcare, risk sharing is by far the better solution, as it ensures that more people will obtain adequate care and will end up being less of a financial drag on other social welfare systems, because they will remain solvent.

With all that's gone down in the last 15 years Harry and Louise ads would probably fail miserably and they know it.

Their strategy may be to fight against a competing government plan, a Medicare for all option, that would eventually lead to their demise.

This development isn't a big surprise, I think they see the writing on the wall.

I don't advocate that at all.  Frankly, I don't think our program will be administered by the government.  However, We are going to have to make hard choices about how we obtain care, how we will structure fees for coverage, how much rsk sharing will be involved on in individual and pool basis, and what our covered service benchmarks will be.

I am a consultant who;s more than a little conversant.  The poster above seemed to distill a complex issue down to baseless assumptions.  the poster also assumed that data generated by other countries was unreliable; I'm pretty sure they're not depressing their infant mortality rates or inflating their life expectancy rates.  

Further, costs are high not because of complexity, though specialists are reimbursed at higher rates than internists, pediatricians or other primary care practitioners.  Costs are high because of enforced complex billing procedures, unfair fee schedules and cost shifting, all resulting from arbitrary rate setting by insurers.  Add on the necessity of protectionist medicine mandated by the need for excessive liability avoidance, and you've got a whole bunch of non-core costs.  

And, I might add, the government mandates all sorts of insurances...auto, workers' compensation, professional liability...I coould go on.

The current system places an unfair burden oth on providers and on those least able to pay for care.  At the very least, the system needs streamlined processing of claims and to be far more (universally?) inclusive in order to drive down costs for all.  

The idea that those who work hard are going to somehow be disenfranchised by health reform is ludicrous.   So is the idea that the poor get sicker.  The poor are more in need of urgent "lifesaving" procedures because they fail to receive preventative healthcare, which forestalls those occurrences.  

Anyone who examines the overhead costs of a medical practice, insurance company reimbursement rates and gross utilization numbers can confirm what I've written.

as well, it is a matter of national security that every child receives proper nutrition and education, for the reason noted above.

wwII saw a 25% failure rate on pre-induction physicals, most due to poor health care and nutrition, during the formative years. this country can ill afford that loss of manpower.

a universal health care system, based on the european model, is the way to go. increase tax rates by 1% for individuals, and 3% for corporations, to pay for it. the decrease in premium costs will offset the increase in taxes.

if so desired, individuals and companies can still opt for a secondary insurance policy, to cover co-insurance costs.

I would venture to guess that if we enacted a national healthcare system and started making sure that people who needed care got care earlier in life, that people just did simple things like had yearly check ups - we'd find that our overall healthcare costs would go down.

That's what they found in Canada. People don't end up in the emergency room for the flu because they can go to the doctor as soon as they have a sniffle.

A universal system will result in a two tier sytem in this country.   The poor will get the government system the rich will get private care.

I mean really, what makes socialized medicine so bad for us while other countries and their citizens thrive under it. Is it still the insane "Red Scare" thing?