I hope the advocates of a medicare like system will finially realize what a dumb ponzi scheme medicare actually is and how medicare does nothing to control costs other than rob Peter to pay Pauls healthcare, and all without Peters concent.

The cost accounting of the health care/industrial complex is a bag of worms. It resembles the Department of Defense contracts with the pricing of toilet seats and carpenter's hammers!

Salaries of CEO's vrs the salaries of LPN's--hospitals cut LPB's in order to maintain the pay scale of the bean counters and up.

It is unclear whether the 2% is of a two billion dollar cash flow or of a two billion dollar capital investment.

Nor is it clear how a not-for-profit entity does its accounting. What is profit in a not-for-profit corporation?

It seems that Larry Mitchel is the voice for both profit and non-profit institutions across a wide range of entities each with a different mission and bottom-line expectation.

A story: The Medical College of Georgia is one of 33 institutions in the University System of Georgia. Each year each institution must present its budget performance for the past year prior to receiving its State Allocation for the coming year. One year, Georgia Tech gave their presentation in the morning session and the Medical College of Georgia in the Afternoon Session. As the parties sat at the large conference table, there was a dime in the center of the table.
The Chancellor explained that Georgia Tech had 10 cents remaining from the previous years allocation and they had returned the dime. I reached out and took the dime, saying we happened to be 10 cents short.

Cost accounting is a high stakes game, in which "full disclosure" is a mathamatical shell game to hid the truth from the naive.

Nobody would stay in the game at 2% profit if that was the entire story. Tom

Unfortunately, the real issue with medical care in the US is that because of perceived wealth in the US, medical costs here are based on the ability to pay.

With salaries of physicians, nurses, ancillary medical help, along with the expenses of administration, as well as the insurance costs, all ballooning at rates well over inflation, it doesn't take a rocket scientist to realize the root cause of the exploding costs are related to the expectations of the US be it government or private ability to pay for top quality medical care at whatever the costs.

I remember when intraocular lens implants first started for cataract surgery over 30 years ago. The charge for one side was well over $2,000(US) in US dollars value in 1977 dollars. Opthomologists were making huge sums of money left over right. I thought to myself, at some point this gravy train will have to end because this is not sustainable and would bankrupt the country. At that time, health care costs or charges was about 6 or 7% of GDP.

Soon after, friends that were in business administration positions were complaining that health care costs for their employees were becoming one of their largest expenses for their companies. Note, the health care costs based on the perceived ability to pay.

A variety of means to deal with the costs were dealt with by government programs and private industry on health care costs. Unfortunately, these programs merely shifted the reimbursement responsibilities among government, private industry, private insurers, resulting in making the product: health care, increasingly unaffordable for many companies and persons resulting increasing numbers of "uninsured".

Some of the health care institutions associated with Adventist Health Care West were involved with legal actions for charging people with out health care insurance rates that were far in excess of what contracts they had with private insurance and government insurance resulting in a significant legal settlement.

Until the heath care providers realize that the gravy train, meaning the ability to pay, is headed for derailment due to costs, charges, or whatever you want to call the expenses. There are some difficult choices for the health care providers to face: significant reimbusement challenges for the future all the way down the food chain.

Note, what happen to professionals in other countries where the ability to pay has already hit the ceiling and there is no more "give" and what has happened to their standards of living and the way medicine is practiced. They will make a living but it will be adjusted to what society can afford and not what health care providers anticipate.

Recently, the way that this discussion is framed has shifted slightly to represent the reforms needed more accurately. Rather than being Health Care reform, what is needed, and what the current administration is seeking, is Health Care Insurance reform.

Health Care itself seems to be generally healthy (no pun intended). The problem is paying for it. The problem is exacerbated by insurance mega corporations that are always looking at the bottom line. In practical terms, this means that in order to be profitable and to provide the best returns to investors, insurance corporations must look to cut costs wherever they can.

When insurance companies are always looking to cut costs, it is inevitable that they will do so by cutting benefits to the insured. Rejected claims. Rising premiums. Less coverage.

When those paying for Health Care put profit ahead of patients' well-being, it is always going to be the insured who get the short end of the stick. And this is only pertinent to those who can afford the increasing cost of insurance in the first place.

Currently, those who cannot afford insurance and have no public (read not for profit) option available, are often going to the ER for basic care because the ER cannot by law turn people away. Then nobody pays for it. How is that cost effective?

An excellent observation Jared. Thanks. Tom

Thanks for that helpful update, Jared.

Here's President Obama on that very topic.

I find Jareds position to be out of order.

A more rational and factual accounting of the problem does not begin with the insurance companies. As Jared himself says,
"..this is only pertinent to those who can afford the increasing cost of insurance in the first place."
When one looks to insurance companies as the major problem in health care, its as if they believe it is the insurance companies themselves that are constantly escalating the costs of health care. That is of course completely false.
Health care companies are responsible for the agreed upon treatments and dollar expenditures and deductibles by contract, and they have no ability to control the actual costs of health care which are driven up by preventive and redundant measures and the lawsuits they seek to prevent by such measures.
Also, the ever newer and horrendously more expensive machines and tests which regardless of the level of insurance they buy, people think they have the right to no matter the cost or circumstance.
It is missing the mark to say insurance reform is going to enhance the access issues in health care since the hurdles are all ones of cost.
Even the government makes the problem worse when they reimburse medicaid at 85% of cost.
People get their feathers ruffled when insurance companies who are fulfilling their contractual obligations, per their policies, say, you have reached your agreed upon yearly maximum, or your agreed upon maximum per injury amount even when its spelled out in black and white.
Why dont they get their feathers ruffled when the government dumps an extra 15% tax on their insurance payments to cost shift medicare onto their backs?
Still going to blame the insurance companies?

Great clarification, Jared! In fact, this gave me an idea. Instead of referring to a public health care system, why not refer to what it actually will be (notice I'm being positive here by saying "will be") - a not-for-profit health insurance option.

This is not unlike the system the Adventist Church used to use which technically wasn't insurance. It was "risk management." I've heard of a few Christian groups running these cost sharing pools as well, but it's clearly not enough to make sure the most needy get the help they need.

In terms of the business side of things, we (and by we, I mean Congress) just needs to figure out how to pay for it. We can ask hospitals to run at a loss. It has to make sense financially, but we must do it, on moral grounds. How will history judge us, as the only developed nation in the world who lets its sick people die at home because they can't afford the rising cost of insurance. It's just reprehensible.

To quote John Caputo, "I am still looking for the text that supports the idea that 'Christians' means people who should be free to accumulate as much wealth for themselves as they possibly can under the law while letting the needs of the poor be met painlessly by "charity" - by people of means who will voluntarily give of their overflow - so that they do not have to share any more of their wealth than is unavoidable."

One need go no further than the Adventist Health System Sunbelt, a not-for-profit corporation.

Their top CEO made more than the combined salaries and bonuses of the two CEOs of Mayo and John Hopkins combined!

Check: http:www.wherethemoneygoes to find out more.

You know, I've had conversations like this in Sabbath School classes with Adventist folks who feel like the government really has no business "interfering", as they put it, in the welfare of America’s lower income families. They feel as though programs like Welfare and Medi Care or California’s CalWorks program should be eliminated and religious charity organizations should be doing the work of caring for those with need because then it would be purely by choice and a matter of benevolence, not taxation.

My question for people with such convictions is this:

Really? Is the Seventh-day Adventist church and other religious organizations really capable of and willing to provide for the poor among us (as our Sacred Writings compel us to do)? If government-funded programs were to go away next year, would we pick up the slack? Would our Adventist for-profit medical establishments take Scripture seriously enough that we would be willing to attend to the needs of people who cannot afford chemotherapy or organ transplants or vaccinations?

Isn’t the reason that we have government-run programs in the first place that charitable organizations failed to adequately provide for the needs of American citizens with real needs? And when I read some of the comments on this page, I am not optimistic that the church is looking to provide for those needs.

If the church were to step up and really provide what people need to live and thrive, we would have no use for government-funded programs. But until the church steps up, shared sacrifice is absolutely necessary to ensure the well-being of all America’s people (who happen to be God’s children just as we are).

Jared
Discribing the world in terms of government and church as if their are no other options or constructs is incomplete.
You have completely left out family in your ordering of the health care universe. Do you see no part for them to play in this?

"You have completely left out family in your ordering of the health care universe. Do you see no part for them to play in this?"

Would you please describe who is "family" in this context. Is it biological, blood relations, church relations, community, or what.

If "family" is meant to be only biological, then if one's family is dirt poor, how can they be responsible for huge medical bills, or should such people simply quietly go away and die.

Hi Michael,

I guess instead of the Church, I could have been more inclusive and said the private sector. The facts would be the same. The private sector, including the Church (Christianity as a whole and Adventism as an important part) and families (however you want to describe family) have failed to care for the needs of America's people.

I see two reasons for this. First, the need is too great for private organizations and especially individual family units to meet. Secondly, people seem to be essentially selfish, more concerned for their own well-being and the well-being of their own kin. This is both an individual and a corporate reality, which is why free-market capitalism has failed and why the private sector fails to provide adequate health coverage.

"You have completely left out family in your ordering of the health care universe. Do you see no part for them to play in this?"

I have news for you.

Most of the people without insurance that I care for in my ambulance do not have family who can pay for the treatment.

/Bevin

A large % of the healthcare dollar is spent on people during the last few months of their life. Extensive care in
very expensive critical care units, ventilator management, numerous lab tests, non standard medication delivery protocols, consults, and so forth, significantly escalate costs

http://www.news-medical.net/news/2009/03/10/46700.aspx

The solution to rising costs is simple. Develop end of life care protocols that accept the inevitability of death.

Because family members want "everything" done for their elderly loved one, doesn't oblige anyone to do "everything." It often inflicts discomfort on the patient, who should be allowed to die peacefully.

Insurance companies are not the only "bad" guys here. Take a look at the legal profession and beyond that, the laws, which, in theory, reflect the will of the people. The real culprit is the society which allows, even demands, futile, expensive treatment for people who are going to die, regardless of what the treatment is.

Jared, if "nobody pays" for primary care delivered through the ER, how is it that so many physicians, nurses, respiratory therapists, and phlebotomists who work in ERs, are still getting their paycheck every two weeks?

Where does the money come from, if "nobody" is paying?

Hansen, your suggestion is the very bogeyman so many people are using to frighten people away from the government health-care plan. President Obama wants the government to pay for seniors, and others, to discuss living wills - end of life care - with their doctors, and those opposing him call this rationing health care for seniors. I believe most seniors who do have such discussions with their doctors would choose not to have heroic measures taken when they are dying and this would relieve their family from having to make such a decision. But opponents twist Obama's meaning.

I am curious where you say here.
"The private sector, including the Church (Christianity as a whole and Adventism as an important part) and families (however you want to describe family) have failed to care for the needs of America's people."

Has it always been so? Was it true in the 1800's? how about before 1776? Or is it just in comparison to other countries? Or is it always just in comparison to what other countries have currently? Or has the level of care throughout recorded time not measured up to your standards?
If a system was devised that would meet your standards would it meet your standards for all time? Or would it constantly change to meet your ever changing sensibilities that would themselves always change with whatever advancements were available at whatever cost at whatever time?
Since you mix health-care standards and religion how do you account for the good Samaritan leaving the wounded Jew in the company of an innkeeper? Were innkeepers the doctors of the day? Would an innkeeper meet your standards now or even then?

You speak in ethereal terms that are entirely dependant on ones feelings at the time.

You also wrote, "First, the need is too great for private organizations and especially individual family units to meet."
In what country? Do the huichol Indians who live in the mountains outside Guadalajara agree with you? How about the Amazon Indians? Do they sit outside their huts and opine how the industrialized peoples do not take care of them medically to their satisfaction because the cost is too great for them to pay?
I ask because your points of Christian responsibilities do not just apply to our own country. I know some huichol Indians in Mexico more than I know millions of people here in the US.
Therefore your statement makes little sense to me."...(Christianity as a whole and Adventism as an important part) and families (however you want to describe family) have failed to care for the needs of America's people."
Why should Adventism have any greater role to play in America than it does anywhere else in the world? Is it because "..people seem to be essentially selfish, more concerned for their own well-being and the well-being of their own kin."?
Even the way such health-care is discussed above in a religious sense, violate religious principals since they only seem to envision Americans.

Carol, Research has shown that patients who have discussions on end of life treatment do have lower end of life medical costs. Ignorance is a real issue. Rersearch has also shown that blacks and hispanics have higher end of life health care costs than do whites. Why? It has to do with education and/or intelligence and common sense, among other things.

http://abcnews.go.com/Health/wireStory?id=7042764

If I was a RC who expected to fry in purgatory, I might want to postpone that as long as possible. Filipino, Hispanic and certain other ethnic forms of RC are much heavier into the superstitious nonsense than are modern American RC; consequently, people of this bent require a heavier hand, unless they want to pay for care themselves.

Really, the superstitious beliefs of many religions contribute to irrational end of life decisions. SDA's have great news to share with people on this issue. The church is uniquely positioned to take a leadership roll in educating the public regarding these matters.

I suspect it won't.

Incidentally, the intention of my post was not as racist as it might appear at first reading.

Wow, I was surely surprised at the wide range of feelings and opinions taken.

First of all, when Medicare and Medicaid came into existence during the early 60s as part of the Great Society Programs, the government miscalculated the ballooning demand and expenses associated with those programs and sought to control costs. Health care providers who previously provided charity care for the elderly and indigent were only too glad to get paid for new patients who are now "paying" patients. Unfortunately, these patients became a larger and larger percentage of the "paying" patients to the point that health care providers could no longer avoid those "paying" patients by not accepting those patients as they provided a large reason for the health care provider's existence. When any entity private or government has a large market share you can not avoid reimbursement problems. Unfortunately, since government pays the bills, government determines what is "fair" reimbursement according to government's fairness standards and whatever resulting shortfall is the responsibility of the health care provider. Implications for adding the millions of the "uninsured" for healt care coverage in the near or distant future: over promising benefits and underfunding reimbursements are definitely in the cards only this time, governments will be having the vast majority of the market share to the point reimbursement issues will be entirely on the health care providers as the government will be holding the bulk of the reimbursement funding.

Has there been groups or religious people exempt in the past and current situation and the answer is yes. The Amish people are self insured and are not covered with social security or medicare or medical benefits per federal law and mandate.

I don't think that Adventist church in the US will even consider this to be a part of their teaching or doctrine.

Health care insurance and medical care and benefits are worlds apart. The health care insurance is merely a vehicle to "pay" for medical care and benefits. It itself does not provide the health care unless you are like a Kaiser situation where insurance and health care are part and parcel in one company with two parts. In private practice like Adventist Health, cost containment and medical best practices are not necessarily the main focus unless there is a contractual mandate to control costs because of a per capita reimbursement per member up front payment where the health care provider assumes all risks for a set up front reimbursement rate based on each member adjusted for age and sex.

So, the issue in the future will be how to care for the greatest number of people with the limited financial resources available for health care.

This is a difficult and slippery slope to determine as there are some basic moral issues that society will have to determine and people who study ethics for a living will have to help develop.

In the past when renal transplants were new and novel, committees had determine which candidate was the best eligible candidate for that precious and rare kidney? New diagnostic tools such as ultrasounds and CT scans had to go through a bunch of red tape and paper work to justify their use.

Currently, total hip replacements, total knee replacements, cataract lens implant surgery, all types of cardiac surgery, all types of bone marrow, kidney, liver, heart, and multiple organ transplants are available even to facial transplants and total hand transplants. All of these items are very expensive running to multiple hundreds of thousands of dollars. There are also all manner of cancer therapies available for just about any tumors diagnosed. These are very expensive to treat for hundreds of thousands of dollars each case. Then there are the older seniors who are kept alive with feeding tubes, oxygen supplements, wheel chairs manual or powered, walkers of various types, various type of colostomy bags, foley catheters, who are in nursing homes with a variety of ailments, all requiring expensive care.

Then there is the other end, the beginning of life, with complex treatment of the very tiny premature and multiple births, and infertility, and the million dollar babies, and the addicted babies, and the congenital birth defect babies and the birth accident cerebral palsy babies, all requiring huge sums of money just to survive and thrive.

Unfortunately, medical technology has advanced so far rapidly that the costs have skyrocketed to the point that society as a whole will have to make some serious ethical decisions that may be a bit difficult for fundamental Christians to accept. And we have not included the significant political pressure for the addition of adding stem cell therapy to the costs of medical care in the future.

So, really, the question is at what point the American society will push back and state the total health care expense is unaffordable for society. This is where the politicians will have to make serious decisions on health care benefits and reimbursement for health care providers.

Unfortunately, there is the rush to just pass the health care insurance reform and not deal with the sticky implications that have arisen when Medicare and Medicaid was first passed and how those two programs have forced the issues to how some feel those two programs are models of efficiency but conveniently overlook how the poor reimbursement rates of those two government programs affect how unaffordable medical care has gotten in the USA.

"Incidentally, the intention of my post was not as racist as it might appear at first reading."

That's good to hear.

Ernest,

Look up the Wall Street Journal's article on the Amish and their medical problems. It is not as you wrote. The Amish are having hard times due to their ailments caused by "in-marriages" and high cost medical procedures needed for their children because of this fact. They are turning to others for help. Measure twice and saw once as a carpenter said -- or research twice and speak once as a journalist said.

Jody

Yes Jody, I have worked among the Amish. The incidence of clefts of the lip and palate is higher among that rather closed community. They do seek and accept contemporary medicine and surgery. They are a delightful people as patients. Tom

For Christians concerned about better health care in America, here are some helpful resources.

http://www.sojo.net/index.cfm?action=action.display&item=HC09-main

It includes a guide to the health care debate and what folks can do to make a difference, including Bible guidance.

It never ceases to amaze me how easily Christians can be persuaded to embrace socialism. Socialism is morally wrong. No matter how much good you intend to do with the money you take, the taking of the money, whether you use the government as your agent of coercion or a gun, is wrong. The government possesses a legal monopoly in the use of force in executing its duty of seeing that citizens obey the law, and in punishing them if they do not. Thus, the essence of government is coercion.

Every Christian should realize that he does not have the right to perform an act of charity at the forced expense of his neighbors — that he does not have the right to enter another's home and steal property that he intends to use in a charitable venture. But when the act of stealing is impersonalized by authorizing, by way of a vote, an established agency (government) to perform the confiscation for him, he loses a conscious awareness of the immorality of this practice.

Socialism is morally wrong.

Christianity is all about freedom and voluntary participation in doing good. It is not about coercion. In fact, coerced charity is not charity at all. It is, rather, theft.

It is amazing to me that citizens of the country which won the cold war are considering adopting the government characteristics of the loser of that war (socialism.)

Those embracing universal insurance coverage should think a minute about what insurance is. Insurance is collectivism (socialism.) As long as it is voluntary and as long as you can choose your risk pool or opt out, this is not objectionable. But, as soon as it is government mandated, it is defacto socialism.

I think people should take the time to consider what has happened gradually over time in every country which has adopted socialized medicine. The facilities deteriorate. Worn out equipment is not replaced. Health care workers move to another country, or to the cities from rural areas, or simply quit and cannot be replaced. Those workers who remain become overwhelmed and embittered. Rationing is automatic. Nobody can keep up. No doubt the bean counters overseeing all this only add to the burdens of the workers, but just the load itself causes rationing.

If you don't believe me, ask any one of the thousands of expatriat health workers from Canada who live in the US now. I'm in the middle of nowhere in rural Arkansas and we've got them here, so I know they have to be all over the US. Ask them. They'll tell you the Canadian system is no good. It got to where they couldn't practice good medicine.

You might say that they are just greedy people who didn't have the goodness of soul to work themselves to death for the common good, but if you talk to them, you'll find they are good hearted people who truly care about people.

If the healthcare system is so wonderful in the U.S., why are our stats one of the lowest in the world in infant mortality and every citizen's availability to medical care, and yet it is the most costly of all the industrialized countries. We are certainly not getting the most for our buck.

"Every Christian should realize that he does not have the right to perform an act of charity at the forced expense of his neighbors — that he does not have the right to enter another's home and steal property that he intends to use in a charitable venture"

Implicit in your argument is the concept of "MY STUFF". But the land, the water, the air, the roads, the minerals, the ... are NOT YOURS. Society has granted you SOME CONTROL over them, but society has the ultimate control - and will prove it using the army if you want it too.

In exchange for defending your house against the homeless, society is asking you to help provide them with other ways of getting what they need.

This is not theft. This is the contract that you were born into. A contract that includes the use of the political processes and force to change details of the contract.

/Bevin

ps: I know Canadians. The failings of the Canadian healthcare system are being greatly exagerated by the anti-health-care-reform liars.

Huh?

Is this really how the opponents of health insurance reform reason? Socialism! Run for the hills!

Following the logic, our public schools are also immoral as are our libraries, the military (although some extremists want to privatize it) police departments and fire departments and community parks. All socialist.

Just an fyi, America is actually a pretty great country and most other countries as developed as ours also require folks to contribute to the public good. But complaining about taxes going up is not even an issue here unless you and a spouse make more than a million dollars. Everyone else will not see a tax increase and will actually save money through a public option.

The opposition is so ill-informed about President Obama's hopes for this still-forming legislation that they discredit themselves with absurd anecdotes about Canada and bean counters. Yes, because insurance companies don't us actuaries. Huh?

I believe Medicare is socialism. Anyone on it what to give it up? It's called hypocritical selfishness when one doesn't want your fellow citizens to have what you've got.

(I'd love to see more of these so-called anti-socialists pony to pay for their free use of this website.)

Health insurance reform means that more Americans will have freedom to choose from competing plans. That sounds like freedom to me. Period.

That's all. Folks expose their ignorance when they write on and on, with scare tactics, sans sources, when health insurance reform essentially means that we'll have options for health care, sort of like we have with package delivery. Beyond Fed Ex and UPS, remember that we have that socialist invention of the founding fathers, the United States Postal Service. Is the USPS immoral? What about bringing 47 million people into better health?

Instead of flaming me, please attend to polite conversational norms by telling me how your health care proposal is going to address these issues:

Considering what has happened gradually over time in every country which has adopted universal health care, please address how your proposal would save US healthcare from the following list of socialized health care repercussions: The facilities deteriorate and are not repaired. Worn out equipment is not replaced. Health care workers move to another country, or they move to the cities, where they have some backup, from the rural areas where they have none. Healthcare workers who quit cannot be replaced because nobody in his right mind would work that hard for that kind of money. Those workers who do remain become overwhelmed and embittered. Rationing is automatic. Nobody can keep up with demand. The bean counters overseeing all this only add to the burdens of the workers, but just the load itself causes rationing.

In order to avoid the above, your health care proposal must do one of two things. It must 1) increase the supply of services or 2) it must decrease the demand for services.

You cannot accomplish #1 without making it more financially attractive for people to provide services in the health care industry, nor can you do it without providing a lot more facilities for them to do it in. Universal coverage will only INCREASE demand for services. People who used to take care of a sore throat at home with honey and lemon will head for the ER like Medicaid recipients do now.

You cannot accomplish #2 without killing people off.

Unavoidable conclusion: Universal coverage is going to cost more.

A lot more.

The United States of America is already broke and in the hole for inconceivable amounts of money. Exactly where do you think all this money for health care will come from???? The Democrats say we should take it from the rich. Whadayathink? Sound Christian to you?

Don't start up the flame thrower. Just answer the questions. I'm not a rich guy trying to protect a pile of gold. I just know right from wrong and it is wrong to take something from one guy against his will and give it to some other guy just because you feel sorry for him. If you feel sorry for him, you pay his bill yourself or start up a pool of your friends to do so. But you have no right to force Grandma Moses, who managed to make a little something on her paintings, to fork over the cash for somebody else's bills. If she wants to do that, and she probably will, she should do it from her heart. That way, both she and the recipient will benefit.

Alex,
Your appreciation of freedom is great.
Would you stand as boldly for someones freedom to not want Obamas plan AND that persons right to not be taxed for it?
If Obamamites want his plan, and they choose to pool their resources to do it, more power to them! If it turns out to be a bed of roses the rest of us might be inclined to join.

Thats freedom. Not confiscation and redistribution.

The socialism comes in when you cant grasp that particular point.

Hahahahaha! I love the crazed right-wing banter coming from neocons like Michael and Karl Sandberg.

First, our friend Karl:
"The United States of America is already broke and in the hole for inconceivable amounts of money. Exactly where do you think all this money for health care will come from???? The Democrats say we should take it from the rich. Whadayathink? Sound Christian to you?"

Yes, actually, it does. Render to Caesar the things that are Caesar's... or the Fed's... whatever you wanna call them. Oh, and yes, taking some money from really unbelievably rich people sounds like a marvelous plan. Only since you all have been living in a second even MORE gilded age, as so eloquently stated by Paul Krugman here ( http://krugman.blogs.nytimes.com/2009/08/13/even-more-gilded/ ). When the richest 0.01% get 6% of the pie while all others more or less stagnate, yeah, it seems pretty just. And just so you know Karl, Mr. Obama wants to return tax rates for the really wealthy to the levels they were under that arch-socialist Reagan.

And don't worry. Your medical professionals aren't going anywhere. Where are they gonna go to, Germany, England? Ha! Don't make me laugh.

There will be problems when this plan gets underway, only since 47 million extra people demanding care from the same pool of MDs, DOs, RNs, etc means these people will be overstretched. It takes at least 6 years to train family docs, so something should have been done... um... 6 or more years ago. MD etc schools will need to catch up to meet demand. Don't worry, there are a lot of qualified people out there.

Now to Karl:
"Thats freedom. Not confiscation and redistribution."
I suggest you don't pay your taxes. Because clearly, they are socialistic. Or whatever.

Now in general. As a Canadian, I can attest that us socialists up here are healthier, live longer, have less of our kids dying, have better health outcomes, and STILL use 6-7% less of our GDP on health than you. You Americans have been taken, and need to wake up. Are there problems? Yes. For example, why do most med schools only accept people who have scored in the 90th percentile and above on the MCAT? It's a little excessive. Ultimately though, we're in a better place. I have excellent access to health care services, and I never have to worry about it. Oh, and we're actually starting to plan for the future glut of baby-boomers who are really gonna stretch they system to the limit. Maybe you should follow suit.

What most surprises me about the heated rhetoric coming from people like Karl and Michael is this-all the "me, me, me" instead of "we, we, we". No one ever said you will never be able to go to the doctor again, or that you should sacrifice your health for others. If all that you can offer to the debate is "how dare Obama want to help 47 million suffering people", you seriously need to think about who you are as a person. If you didn't get it by now, you are selfish and totally lacking in compassion.

My suggestion-reset your expectations and actually try to help. Tell your congressman/senator that docs need to be sued less by often unscrupulous lawyers so that they don't have to order a CT, MRI, and extensive blood work for a common cold. It will save some money. Tell the Feds to raise taxes on excessively wealthy to pay the health bills so they give MDs, hospitals, and other health care organizations their fair share (ie stop undercutting medicare). Tell insurance companies that they need to start acting humanely, and pay medical bills instead of fighting all the time. Don't go to the local ER unless you actually have an emergent condition. This too saves money. Finally, start saying "we" like us librul socialist Canadian clowns. It's cathartic, and once you realize what it feels like to actually care for your neighbor, the world will be a better place.

-nik out.

The USA today already has universal coverage. Anyone can walk into an ER for any reason and expect to get treated.

Unfortunately ER's and ambulances are an incredibly expensive way to provide medicine.

The proposal is not to do more medicine, it is to do (a) different cheaper medicine - $60 doctor visits rather than $600 ER visits with $500 ambulance rides, and (b) be more rational about how

Yes, the costs will move around - and the Fed will directly pay more. But, guess what, those costs are already being paid today - by large bills the ER send to Medicare, insurance co's, and uninsured but financially able people that include the costs of treating the uninsured.

/Bevin

According to a study in the April 10, 2007, Canadian Medical Assn. Journal, approximately one in nine physicians educated in that country were practicing in the U.S., although the Canadian government has taken steps to increase retention, including upping salaries.

But ha ha ha, they won't have anywhere to go after the US goes socialistic. Then the Canadian and US governments can just pay those stinkin' health care workers whatever they want to and there will be no alternative other than outright quitting.

That's good, right?

Is that the way Christians do things? Force people to do stuff they don't want to do? Trap 'em and then say they aren't Christian if they aren't thankful for the trap they're in?

I pay $1489.00 per month for health insurance for my wife and 2 young kids. Obama can tax me $1000.00 more per month and I would still be better off. Amazing how we travel the world helping others, but will not help our own get health care. Sounds just like Jesus to me too!

Yeah, and computer programmers like me educated in NZ, Australia, India are here. There are more Malawian doctors practising in London than all of Malawi.

Just because we pay the doctors more doesn't mean our system is "better" - it just means we pay more.

See, I don't have any problem with someone willing to pay and wanting to get a more reasonable price. I've got a problem with people who are obviously plotting to victimize others, whether it be health care workers or the rich. (Let's be honest, it will be both.)

I can't see how this can be considered Christian.

Those promoting socialism are offering this as the only viable solution. They look longingly at other places in the world and they want to be like them. EGW tells us our unique form of government in the US was a gift from God. But many living under the blessings of this God-given government want to trash it in order to be like the other nations around them. Sound familiar? Hmmm.

If you take the time to read the Crockett story, two things become very clear. 1) In his day, although the US Treasury was full and overflowing, they operated from principle and avoided public charity. 2) In our day, although the treasury is empty and we are in arrears for trillions of dollars, we want to engage in the absolutely insane policy of obligating ourselves to even more massive debt to provide public charity in an ever-increasing way.

Trillions of dollars.

Let me put it in perspictive. If you made $100 dollars per hour and worked fifty hours per week for fifty weeks per year, you could earn $250,000 per year. At that rate, it would take you FOUR THOUSAND YEARS to save a BILLION dollars if you never spent one red cent of it.

To make a TRILLION dollars would take you FOUR MILLION YEARS.
If you consider that an excessively long career might span fifty years, if would take the lifetime work of EIGHTY THOUSAND very hard-working and long-working people to earn that much money. OF course, most people don't make that much money, so you can see what a collosal theft of people's lives is generated by all this government spending.

KEYWORDS
Nurse migration • nurse shortage • nursing workforce
ABSTRACT
Objective. To synthesize information about nurse migration in and out of Canada and analyze its role as a policy lever to address the Canadian nursing shortage.

Principal Findings. Canada is both a source and a destination country for international nurse migration with an estimated net loss of nurses. The United States is the major beneficiary of Canadian nurse emigration resulting from the reduction of full-time jobs for nurses in Canada due to health system reforms. Canada faces a significant projected shortage of nurses that is too large to be ameliorated by ethical international nurse recruitment and immigration.

Conclusions. The current and projected shortage of nurses in Canada is a product of health care cost containment policies that failed to take into account long-term consequences for nurse workforce adequacy. An aging nurse workforce, exacerbated by layoffs of younger nurses with less seniority, and increasing demand for nurses contribute to a projection of nurse shortage that is too great to be solved ethically through international nurse recruitment. National policies to increase domestic nurse production and retention are recommended in addition to international collaboration among developed countries to move toward greater national nurse workforce self sufficiency.
===================

Nurses trained in Canada migrate to the US in a slightly lower percentage than do physicians. (Ten percent for nurses as opposed to 11 percent for physicians.) Notice the "due to health system reforms" as the cause of this ongoing migration.

I thought "reform" was supposed to make things better????

According to a 2007 survey by the Canadian Fraser Institute, the median wait time in Canada between visiting a general practitioner and receiving specialist treatment was more than 18 weeks --and up to 38 weeks for procedures such as orthopedic surgery.

Large numbers of Canadians come to America to avoid waiting for MRIs or to get time-sensitive treatment that can't wait. Canada is moving toward more privatization -- which was previously illegal in Canada but is now permitted as a result of a successful lawsuit.

Imagine having to sue to get the right to spend your own money in a voluntary transaction between two parties!

Socialism.

Karl, what is the wait in the U.S.? My impression is that it is about the same or even longer in some cases than in Canada. Is that because of corporate socialism here?

Lack of Health Care Coverage almost Cost Me My Life!
Here are the facts:

Too many Americans can't get the affordable care they need when they fall ill. The number of uninsured Americans is growing, premiums are skyrocketing, and more people are being denied coverage every day. A moral imperative by any measure.

Fact: Health insurance premiums has double over the past eight years. More than half of all bankruptcies are due to extraordinary high medical bills. Co pays and deductibles are on the steady increase.

Fact: Many folks that are taking life saving prescription drugs are having to make a financial decision and choose rather to feed their family or purchase medicine. Often they cut in half their medications, against their doctor's advice in order to make dollars stretch.

Which brings me to my point. You see the reason I tried to postpone my heart attack, in the first place (as if one could postpone a heart attack), for at least a couple of weeks, is due to not having any medical insurance. I had only two more weeks to go on my new job before my medical benefits would kick in. I knew that the consequence of having a major hospital stay would be humongous! And it was. The emergency procedures I had underwent to save my life and the 3 day hospital stay, cost over $100,000.00 ( which almost gave me another heart attack) inflated dollars. I say inflated because hospitals charge a higher rate to those who do not have health coverage, so go figure. Therefore this one medical emergency and hospital stay, after the hospital sued me, forced me into bankruptcy.

Some may say it's my fault because I failed to take care of myself. Prior to the beginning of my health problems, I vigorously worked out at the gym at least 3-5 times per week, sometimes more. Both cardiovascular and with weights . How often do you exercise? What if one slips and fall on the side walk or if you fall off a ladder? What if you were diagnosed with lung cancer through no fault of your own because you did not smoke. What if these ailments hit you inconveniently while you were in between jobs in this very unstable economy? What if your child had a medical problem but was forced off your policy because of they became too old? Oh but there is COBRA? You say. That is true. But how many people that are unemployed can afford to pay an additional $700 to $1000 per month or more for family coverage? And even the COBRA benefits don't last for ever. Unfortunately the health care system is becoming more and more out of reach for the average middle class American. It is time for health care reform today, not 8 years from now. It's time for the public option. Anything less will be un Christlike.

We as a nation are being tested, will you past the test? Here are some reminders:

The kingdom of heaven is at hand.Heal the sick, cleanse the lepers, raise the dead, cast out devils: freely ye have received, freely give. Matt 10: 7-9

32And before him shall be gathered all nations: and he shall separate them one from another, as a shepherd divideth his sheep from the goats:

43I was a stranger and you did not welcome Me and entertain Me, I was naked and you did not clothe Me, I was sick and in prison and you did not visit Me [a]with help and ministering care.

44Then they also [in their turn] will answer, Lord, when did we see You hungry or thirsty or a stranger or naked or sick or in prison, and did not minister to You?

45And He will reply to them, Solemnly I declare to you, in so far as you failed to do it for the least [[b]in the estimation of men] of these, you failed to do it for Me.(A)
Matt 25: 43-45 (Amplified Bible)

Take a look at my blog http://lifeistooshort-45.blogspot.com/

This is a response that I received from my congressman. It may address some concerns on this website:

Dear Glenn:

Thank you for contacting me about your support for health care reform. Your support is very important to me during this intense period of debate.

If the proposed bill is passed, none of the changes it would bring will happen overnight, but many positive changes will come. The proposed bill provides a great deal of funding and support for physicians who want to go into primary care. It would provide student loan forgiveness for these doctors and scholarships for doctors who are entering medical school. Similarly, it would provide loan forgiveness and scholarships for nurses who go into certain fields. This should help ensure that every person in our community has access to a primary care physician. The bill as proposed would also prohibit insurance companies from excluding those individuals whom they determine to have a "pre-existing condition". This will allow many more people to purchase insurance and get the care they need to be healthy.

The proposed bill also includes many provisions to increase the efficiency and effectiveness of an individual's care. There is a pilot program to test the effectiveness of medical homes which could increase the quality of care in our country by ensuring that everyone has a primary care physician or other qualified medical professional who can help coordinate their care with all of their doctors, explain how and when to take their medications and help manage chronic illnesses. The proposed bill contains provisions for another pilot program to test a different payment structure for physicians. There would be funding for comparative effectiveness research (research that compares different medications, equipment and methodologies for a given condition in order to see which of these are most effective) so that you and your doctors can make the most informed decisions possible.

Furthermore, the proposed bill will increase affordability in multiple ways. First, it will expand Medicaid to those with a salary of 125% of the Federal Poverty Line. Second, it will provide affordability credits for those who cannot afford to buy insurance at this time. Third, it will encourage employers to provide health insurance for their employees, and make it illegal to cut the employees salaries to pay for this. Fourth, the proposed public health insurance option will create competition in the health insurance market, and help to drive down costs.

This quite comprehensive bill will bring about many positive changes for the health care system in our nation. Again, thank you for sharing your views and your support with me. Please do not hesitate to contact me in the future if I may be of further assistance. Also, I encourage you to visit my website at http://www.house.gov/cleaver, where you can sign up for my electronic newsletter and receive updates on my latest activities as your Representative.

Again, thank you for sharing your views with me. Please do not hesitate to contact me in the future if I may be of further assistance. Also, I encourage you to visit my website at http://www.house.gov/cleaver, where you can sign up for my electronic newsletter and receive updates on my latest activities as your Representative.

Sincerely

Emanuel Cleaver, II

Member of Congress

Glenn Burgess