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This should be emailed to every voter in the entire country. Never has change been more important than now.

Pat- a profound issue.
But I question your comment "how much just a flip of a coin can affect the rest of their life".

Your health is very much in your hands.
What you eat, what you think, how many massages you allow yourself, did you take a walk today and breathe deeply, do you look both ways when crossing streets, etc.

I don't want to diminish your point, but you don't have to be a vicitm.

Hi Pat,

Thanks for the excellent points you make in your editorial. I hope it will be widely published.

I agree with El Anonimo that the wording "just a flip of a coin" is not quite right. I think what you mean is that even if we do all the right things (eat healthy food, exercise, reduce stress, etc.) we can still end up with catastropic medical bills due to things over which we have little control, such as all the insults to our health from the moment we are born, exposure to carcinogens, etc.

I think it is important to clarify that our health is not just a matter of luck.

PS Thanks for not making me pay that time I accidentally scratched your car with my bicycle!

PS It is all so ironic. Working long hours to pay for insurance is stressful and wears us out prematurely. What if we spent the money now spent on high premiums on massages, yoga, chiropractic care, cleansing programs, colonics, delicious, nutritious organically grown vegan food and vacations in Hawaii swimming with the dolphins...

El Anon,

Pat isn't being a "victim". While it is true that you have some influence over your health, it is equally true that there are a lot of things that happen to people every single day that are simply beyond our control. What about congenital defects. What about genetic diseases. Epidemics, vector born illnesses like Malaria if you are traveling, being hit by a car on your bike, a piece of the spy satellite hitting you while you're out jogging or doing yoga or eating vegan.

Anyone of us could be hit with an illness or injury at any moment that could end up bankrupting us if you don't have insurance or if your private insurance decides to drop you despite having paid premiums for however many years. Looked at in this light, Pat's statement about flipping a coin seems dead on while your comment comes off as vaguely sanctimonious.

spk-
how many people do you know who have congenital defects, genetic diseases, were felled by epidemics, were hit by a car while on a bike, or hit by a piece of spy satellite while out jogging.

you're a fine comedian, but a poor statistician.
by the way what does "sanctimonious" mean.

i assume you are aware of the recent $9Million judgment against Health Net for dropping the woman with cancer
http://www.reuters.com/article/domesticNews/idUSWNAS215720080222?feedType=RSS&feedName=domesticNews&rpc=22&sp=true

Hmmm, OK, so am I supposed to pay for your health care? Where am I going to get the money to do that?

Pat,
I greatly appreciate your posting. You do not at all come across as a victim to me. The fact is that life is fragile. Even for those of us who eat right, exercise, and look both ways, we are all just a flip of a coin, the switching on of a gene, or some luck of the draw from having our lives altered in some catastrophic way.

Because we do not have single-pay insurance, there seems to be a greater willingness, perhaps need, to make someone else responsible for our ills and then sue. (This is on top of a culture where many lawyers and therapists have convinced us that we are all victims and rarely responsible for ourselves.) Our current health care system is caught in a dark cycle of greed. We certainly have the wherewithal as a country to care for the basic needs of our people, yet we readily spend grossly greater amounts on war and its accoutrements.

My daughter recently had to go to Ojai Emergency to have her finger sutured. She got a bill for $600 because the doctor on duty was not on her health plan list of approved physicians. Thankfully it was only two stitches and not a severed limb.
My wife and I have both lived in countries with single-payer systems and the medical care was remarkable. We have all been so inured to this Kafkaesque system that we see it as almost patriotic to defend it. Yet it is not freedom, it is a sort of slavery. The only thing red-blooded American about it is its preference for the profit of the few over the well being of the millions.

Dagny: while i appreciate that you felt confident enough to leave your name, your reaction is neither new nor defensible.

you, personally, would not be paying for MY (personally) health care. you especially would not be paying for mine ON TOP OF paying for your own, so the "i can't afford to pay for everyone!" argument doesnt hold. as i understand the goal/plan/idea (or at least, as i'd like it to work), we all pay in, and we all get health care. simple, clean, and universal. YES if i'm almost never sick then i'm paying for those who are to get care. and when i DO get sick or injured, they're all paying for my care. for me it's not about putting up walls and isolating ourselves in our pain with this "i take care o' my own" philosophy. for me it's about coming to understand that we're all "our own" and that caring for others IS caring for ourselves. for me it's about understanding that when everyone does better, EVERYONE DOES BETTER.

let me assure you that anyone who thinks life/health is a "flip of a coin" is either a poor gambler, non-spiritual, or a VICTIM.

Dennis- please visit a therapist who supports you in the notion that you DO have a choice, that you ARE responsible.

By the way- our "health care system" sucks and it's the best money can buy

Right on, El Anon. It is my belief that the health crisis in this country is a consequence of poor diet choices and dehydration. Folks have given away their own ability to heal themselves. In fact many people are so far removed from taking response-abilty for their own mental, physical, emotional and spiritual health - that I suspect a profound atrophy has been occurring. It is this kind of lazy, victim/perpetrator kind of thinking which allows the most predatory humans to take the reins of power with smug lickin' arrogance.

El Anon,

You seem to live in a privileged world that I've heard referred to more than once as the "land of the yoga left" or even the "royal left". A land where magical thinking and self consciously alternative spiritualism and a sanctimonious air of superiority(perhaps the usage here will help you understand the word) insulates you from the reality in which most Americans live. The power of positive thinking or The Secret and advice from channeled sages won't help you pay the bills in the hospital if you are hit by a car on your bicycle. You aren't, by chance, one of the what a friend of mine refers to as "Trustafarians" are you.

In answer to your question, I know many people who have all manner of health problems that are beyond their control. For instance, I have a good friend of mine who has been doing yoga every day for years and years and who is a consummate chef who only uses organic foods and who was one of the first people I ever heard of touting the benefits of raw foods. He's also a lawyer who paid for his education by joining the Army as an ROTC student when Bush the 1st decided to invade his (until then ally) Iraq in the first oil war. Well my friend went to war, and like so many of our veterans he came back with an amorphous set of symptoms grouped together and called Iraq War Syndrome. Despite his health habits, he still suffers from a number of maladies to this day.

Another friend of mine, also a paragon of health habits was stricken by Aplastic Anemia .

Aplastic anemia has multiple causes. Some of these causes are idiopathic, meaning they occur sporadically for no known reason. Other causes are secondary, resulting from a previous illness or disorder. Acquired causes, however, may include the following:

history of specific infectious diseases such as hepatitis, Epstein-Barr virus (EBV), cytomegalovirus (CMV), parvovirus B19, or human immunodeficiency virus (HIV)

history of taking certain medications, such as antibiotics and anticonvulsants

exposure to certain toxins, such as heavy metals

exposure to radiation

history of an autoimmune disease, such as lupus

inherited condition

Yet another friend of mine was born without a left hip joint. Luckily this was long before the Nixon Administration advanced the HMO as the best "free market" solution to America's health system so her parents weren't bankrupted by the successful treatment that actually allowed her hip to grow in after birth using, ironically, a yoga pose that she was casted into as an infant. Of course, if she had been born in a less affluent area it is likely that due to the disparity in health care in our country she wouldn't have received the cutting edge treatment that allowed her to have a life unencumbered by that disability.

I could go on. And on. By the way, all of the above people are now are were residents of Ojai.

Dagny, welcome. But if you're going to play in this league on an issue of such great importance you really need to come armed with more than one sentence baseless rhetoric. Please don't run away. Defend your position.

Yes- spk, i live in the land of entitlement, of magical thinking, of superiority, but I have occasionally taken detours as a child of holocaust survivors, living on welfare and food stamps and educating myself wherever possible obtaining a doctors degree, a masters degree in psychology, and hanging out in asia, africa and central america with the natives. You are right- I have somehow managed to insulate from the realities in which most Americans live- hence I am not grossly overweight, in debt up to my eyeballs, nor with a wife nagging at me all the time. I have devoted myself to becoming a FREE MAN, although with injured and deteriorated knees, an arthritic big toe and rather large ears.
My main mission in life is to develop compassion and understanding.
My fondest desire is to become a "Trustafarian" although I can't stand reggae music for more than 5 minutes, and yes I have inhaled.

Sorry if this brief bio detracts from the important issue of health care

All these comments contain important pieces of the health care puzzle! Let's carefully consider all viewpoints...I see grains of truth in each one.

Don't forget: "Laughter is the best medicine!"

We should commend El Anonimo for the fantastic insight. Why didn’t I think of that!
He has solved Americas’ health cost problem so simply. His insight makes it easy to understand why we don’t need a special paid medical program for children, nor do we need Dr’s, nurses, hospitals, prescriptions, medical research, government funded medical programs, or insurance companies. Congratulations El Anonimo for bringing such a simple solution to our attention. Now what do you suggest we do with the bodies?

EA, it isn't a position. I am asking a question. You shouldn't be afraid to answer it. This is a serious situation and the easy answer - single payer - is NOT the answer.

Here is some math - it isn't precise, because trillions of dollars never are precise. But stay with me. The Commonwealth Fund estimated that in among the 30 most industrialized countries in 2002, health care costs in the US equated to $5237 per capita (The per capita health care spending in the US 53% higher than the next highest country, Switzerland - that is a separate issue). That is 1.6 trillion dollars total.

In January of this year there were 138 million people working full-time jobs. Those people will need to fork over an additional $11,500 per year in taxes in order to provide everyones health care. That's on top of Federal Income, Social Security, Medicare and state taxes.

There's one important issue to raise about the numbers above: the costs of health care are rising, and the number of wage-earners are declining.

Here's a personal note. My wife and I pay $9500 per year for health insurance. I had a fairly serious pre-existing condition and just changed companies for a lower rate. This plan does have high deductibles, but our yearly outflows for insurance and the care we pay for is far less than the $23,000 total we would have to pay if the government takes over. And then I have no choice where to go or what to do. Ask an old person or a doctor. Medicare is a mess.

So spk, do you have an additional 12K (24K if you have a spouse and he/she works) to contribute to a good cause? The government will graciously accept your donation anytime.

The people here talking wellness are probably onto the most important part. The rest will take creativity and hard work, not promises from Hilary or Barack.

I'm sorry, the anonymous reply above to spk was from me. And Dagny Taggart is an alias. I'm not surprised that no one here knows who she was. But that's why I'm here...

OK, it's worse than I thought. I kept addressing spk and I really meant El Anonimo. My apologies. It must be these generic drugs my health plan makes me take...

Ah Ha! I knew the name sounded familiar. It's been a long time since I read that book and I didn't particularly like it. So you're an Objectivist.

There's only one problem with your numbers. They are a blatant manipulation of reality. You appear to have used the per capita cost of health care in the US in 2002 of $5237 and simply multiplied it by the population of the US today of roughly 305.5 million people. Then you took the resultant $1.6 trillion and divided that by the number of "full-time workers" and came up with your number of $11,500 in taxes. This is extremely dishonest math, and it's being used here as a scare tactic.

Your analysis, if it can be called that, totally disregards the benefits of economies of scale that could gained from 100% coverage. Of course, that's the least of the benefits you disregard. Let's talk for a moment about the whole notion of for profit health care. The $5,237 per capita cost of health care in 2002 is the number that currently exists under our broken, for profit, health care system. Contrary to the myths of competition and increased efficiency of laissez-faire capitalism, there is a tremendous amount of waste in a for profit system in the form of fraud. The fraud takes the form of extreme profit taking and management salaries, bonuses and benefits, bill padding by doctors and hospitals, collusion between drug companies and insurance companies on pricing and a myriad of other ways. For profit business selling widgets is one thing, let the buyer beware. But health care is fundamental and it should not be left up to the vagaries of the market to determine who lives or dies.

Let's just focus on the profit and CEO compensation end of things for now. According to Forbes in 2005 William W. McGuire, the CEO of UnitedHealth Group, was the 3rd. highest paid CEO in the United States. He was the number one in the health care field. He took home the sum of $124.8 million dollars. That's over $41,000 an hour on a 60 hour work week with only two weeks off. The company itself posted a profit of $4,147,000,000 in 2006. Most of this profit is paid to speculators on Wall Street and used to acquire other HMO's to boost the stock price through consolidation, layoffs and outsourcing(ever sat on the phone with someone in Bangladesh trying to talk about your insurance coverage). Some of the employees that get to retain their jobs here in the US are bean counters tasked with the horrendous duty of kicking people off the insurance rolls for any and every reason they can dream up. Cigna, the oldest publicly traded insurer in the US, pays it's CEO, H. Edward Hanway only $13.1 million. Cigna's profits are in the neighborhood of $1,155,000,000. Yet with all this money, they couldn't see their way clear to paying for a liver transplant for 17 year old Nataline Sarkisyan. The insurance adjuster in charge of her case denied the procedure because it was "experimental". Liver transplants have been performed since 1963. As a direct result of these craven calculations, Nataline died.

Historically health care has always been a losing proposition in terms of profit. That is why it's generally been churches and charities that ran hospitals. There should be no profit motive associated with our health care system. Our health costs per capita are higher than every other country in the world and we don't even have 100% coverage. Your example used Switzerland as the next highest per capita. In actuality, in 2005 Luxembourg was the second highest, but either way--both Switzerland and Luxembourg have universal coverage of their populations so your comparison is false. In fact, most of the countries in Europe have universal coverage: Austria, Belgium, Bosnia, Bulgaria, Croatia, Czech Republic, Denmark, Finland, Estonia, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Malta, the Netherlands, Norway, Liechtenstein, Luxembourg, Poland, Portugal, Romania, Russia, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland and the United Kingdom. If we cut out the corporate profit motive and cut back the administration necessary to deal with the morass of insurance companies and adopted a single payer system like most of the developed nations in the world, our per capita health costs would go down and everyone in this country would be covered and assured of getting life saving treatments based on need rather than the calculations of some bean counter.

Dagney, Ayn Rand was wrong. Are you even really someone who lives in Ojai or are you some troll for the insurance companies. If you're really from hear you'll be able to answer this: What's the name of the now defunct bar across from the old Wheeler Hot Springs?

SPK, do you have a life outside this blog? jeeeez!

My job today consisted of telling various computers and decks to do things and waiting for them so it allowed me to yammer.

SPK
Something I don’t think was considered or mentioned in the math figures, is that today some businesses are paying for medical insurance. So if you want to see how much “incremental” costs would be incurred per person, you might want to subtract what businesses are paying today. I am not suggesting that businesses would continue to pay these if we had a national program (that would be an implementation issue), but just to illustrate what the true incremental cost to may be to insure everyone.

It has always puzzled me why businesses don’t get behind a national health program as their premiums to insure their employees are going up too, and health insurance seems to always be a major point in labor negotiations. If medical coverage were nationalized for everyone, it would be one less thing a business would have to deal with which would allow them more time and possible money to focus on running their business.

http://www.venturacountystar.com/news/2008/feb/26/healthcare-cost-could-top-4-trillion-by-2017/

Healthcare cost could top $4 trillion by 2017

By Kevin Freking
The Associated Press
Tuesday, February 26, 2008

WASHINGTON — By 2017, consumers and taxpayers will spend more than $4 trillion on healthcare, accounting for $1 of every $5 spent, the federal government projects.

The 6.7 percent annual increase in spending — nearly three times the rate of inflation— will be largely driven by higher prices and an increased demand for care, the Centers for Medicare and Medicaid Services said Monday. But other factors in the mix include a growing and aging population. The first wave of baby boomers becomes eligible for Medicare beginning in 2011.

With the aging population, the federal government will be picking up the tab for a growing share of the nation's medical expenses. Overall, federal and state governments accounted for about 46 percent of health expenditures in 2006. That percentage will increase to 49 percent over the next decade.

"Health is projected to consume an expanding share of the economy, which means that policymakers, insurers and the public will face increasingly difficult decisions about the way healthcare is delivered and paid for," economists at Centers for Medicare and Medicaid Services said.

Overall healthcare spending in 2017 was estimated to increase to $4.3 trillion.

In 2006, people and the government spent $2.1 trillion on healthcare, an average of $7,026 a person. In 2017, health spending will cost an estimated $13,101 a person.

Hard decisions

In his budget for next year, President Bush recommended slowing the yearly growth of Medicare from about 7 percent to about 5 percent. The slowdown would occur primarily by freezing reimbursement rates for the next three years to scores of healthcare providers, such as hospitals, nursing homes and home health centers. Bush also proposed requiring wealthier Medicare beneficiaries to pay higher monthly premiums when participating in Medicare's prescription drug coverage plan.

Those recommendations would reduce spending by nearly $178 billion over five years but have little chance of passage in Congress. Health and Human Services Secretary Mike Leavitt has acknowledged the unpopularity of the recommendations, but he said politicians must make some hard decisions. The longer lawmakers wait, the more difficult the decisions will be.

"Medicare, on its current course, is not sustainable," Leavitt testified.

Democratic lawmakers also have proposed ways to slow health spending, primarily by trimming payments to private insurers who oversee health coverage for nearly 9 million Medicare beneficiaries. A growing number of the nation's elderly and disabled are electing to get health coverage through private plans that contract with the federal government, and government economists predicted that trend will continue. Now, about one in six beneficiaries get health benefits through private plans. By 2017, more than one in four beneficiaries will get coverage that way, Medicare officials said.

Health experts tell Congress that Medicare pays much more for each beneficiary who opts for a private plan than it would if he or she stayed in the traditional Medicare program, which reimburses providers at a set fee for a particular service. That difference increases the burden on taxpayers as well as beneficiaries, because participants pay higher monthly Medicare premiums.

'An approaching crisis'

The government economists say it's hardly a new trend that the healthcare sector will grow more quickly than the overall economy. Over the past 30 years, health spending has exceeded growth in the gross domestic product by about 2.7 percentage points each year. Over the coming decade, that difference is expected to narrow slightly. Still, the continued gap is worrisome, said Health and Human Services acting administrator, Kerry Weems. He said consumers, particularly businesses, need more information about the quality and cost of care.

"We have an approaching crisis in this country unless we change the way we do business," Weems said.

Within the health sector, economists project that spending on hospital care will increase at rate of 6.9 percent a year over the coming decade, spending on physician services will rise 5.9 percent annually, and spending on nursing homes will grow 5.2 percent a year.

The economists' report will be published online by the journal Health Affairs.

On the Net:

http://www.healthaffairs.org/

http://www.cms.gov

The crisis has been long in coming. The solution of course is single payer. Here are a couple of truths - not numbers, not statistics - to add to the mix:

- SPK cites the European countries and their universal health care. What Americans need to realize is that universal health care is not a quirk of those liberal Europeans. It is a matter of right in most countries in this modern world, albeit one delivered with varying degrees of success. That is because universal health care is an essential part of the social bargain on which the legitimacy of a government rests. Check it out. Universal health care is a right in the constitutions and charters of not just a quirky few rich countries, but MOST countries that have constitutional/charter forms of government (i.e. democracies). That is why even the destitute third world countries where El Anonimo "lived with the natives," make some effort to provide universal health care. Simply put, governments that do not guarantee universal health care for their people are the exception in modern democracies, not the rule. They are also, I fear, the governments that will be least long for this world.

EA, you value "freedom". Pray tell, if not universal health care, for what are you giving up your freedom and the product of your labors to this government? The Iraq war?

Governments that fail to ensure universal health care inevitably will turn to war, oppression, and force to get their way and exact their tribute. It is that basic. On the other hand, governments committed to universal health care send out "medical missionaries," winning incredible goodwill around the world. Sweden, France, Canada, even Cuba. We, lacking this basic right for our own citizens, send out soldiers. Its a bad deal.

In America, we don't seem to understand as a people how basic the right to universal health care is. But the rest of the world does, and even George Bush does. He has made universal healthcare of right something that the U.S. has promised to bankroll as part of rolling out the new Iraqi government. Did you know that? (Funny how our taxes can go to bring universal health care to Iraqis, but not us...)

- Perhaps the saddest, most troubling consequence of our current system is the debasing of the health professions. In America, people become doctors by and large to get rich (or, more euphemistically, as a path to "financial security"). If anyone doubts me, go down to UCLA or any of our other more illustrious medical schools, and hang with the students. You will quickly see who are the exceptions, and who the rule.

We of course ensure even our idealistic doctors will slave to the dollar first, and secondarily to the health of their patients, by the exhorbitant costs and debt load we pour on anyone who seeks to pursue this profession.

If you still doubt, listen to our doctors themselves. Their worries are business worries, not health worries. Costs are too high; reimbursements too low; malpractice premiums are a killer. Between keeping the patients coming in the door, navigating the co-pays and insurance billing, and lunching with the drug reps, there is precious little time for patients. A typical internal medicine practitioner today will book an entire day back to back with 10 minute appointments, one after the other. Just enough time to check the chart and say hello. Your health is being attended to by a nurse or medical assistant, that's the fact, because the doc only has time to see the short notes put out by the nurse or MA outside the exam room door. Why do you think prescriptions are so quick and so common?

We've put our doctors in a selling business, where they have ten minutes to close you. There is no room in ten minutes to go beyond quick fixes.

Meanwhile, the patients - you - aren't even going to be there unless you have something serious enough to make you go out of pocket - IF you have the money - or have the kind of employer-provided health insurance that covers you whatever happens.

If you do have the money, or the full-pay insurance, the doctor has every incentive in our system to give you as much "care" as your dollars can handle, regardless of whether you need it. Thus, the specialists. Remember the Tenet heart care center in Redding a few years back, run by two preeminent heart surgeons, who were shown to have routinely given people open heart surgery who had no need for it, simply because they had shown up at the door? Their practice was to run anyone who showed up with the money through open heart surgery! They made alot of money, and so did Tenet. Despite the crocodile tears of Tenet and the surgeons when caught, let me suggest that under our system, their practices will always be the rule, not the exception.)

Single payer frees doctors to practice medicine, for people who actually need it. When I see a doctor, I would like to feel my health is the doctor's first concern. In our system, your health is second to the money. That is a poor system. Worse; its perverse. Aren't we smart enough to design something better?

Let's get single payer, if for no other reason than to restore honor and dignity to the medical profession, to let doctors get back in the business of providing health care rather than selling, and attract people to the profession whose primary interest is in attending to people's health, not their wallets.

- I promised no statistics or numbers, but let me submit that for those such as El Anonimo who think its all about healthy lifestyles, it is single payer systems that deliver preventative care, and get involved in promoting healthy lifestyles. The statisticians out there will have no trouble showing that public health outcomes are better in the single payer countries, often even in the third world single payer countries such as Cuba, which outshines us on a number of key public health outcomes.

Anonymous: Excellent commentary! Are you the same Anonymous that was involved in the political threads a while back? (The writing style and incredible ability to sum up "truths" with such ease and agility sounds familiar). Whoever you are - your points above are right on the money, as far as I'm concerned. Keep 'em coming!

Gosh, a lot happened here since yesterday! Some good, some bad.

First of all, I have lived here over thirty years and I am not an Objectivist. I have read "The Communist Manifesto" and "Mein Kampf" also in my lifetime, and I am neither a socialist or a nazi. However in discussing health care, there is an objectivist aspect you ignore at your peril. The people who run the engine might walk away, leaving no one to fix the pieces you broke.

Oh, and before I go any further, somebody said something earlier about health care for children. Gosh darn it, PARENTS are supposed to provide health care for their children, for crying out loud, NOT THE GOVERNMENT!

In the interim spk, your are RUNNING away. From the numbers. There are no economies of scale when the government operates anything. The cost is real and will go up no matter who runs it. That is, today, $12K per year per wage earner. FACT.

In reality, it will be much more that $12K per year for most of us. As it is today, 86% of taxes are paid by the top 25% of wage earners. It will be the same with single payer. "Fine" you say, "let's stick it to the rich SOB's!". But be careful. Do you know where that 25th percentile starts? $67,000. People earning that amount and more will be paying four out of every five dollars of health benefits. That will hit many readers and posters here.

For every so-called success story you dig up about government run health care in another country, I can find you one depicting dissatisfaction and disaster. Read the Medicare post above. I am going through my second experience with a parent on Medicare. No one involved is getting what they were promised.

One can always move to Cuba - I don't think there is much of a line. I'll stay here and pay my own way.

Gosh Dagny, you have hit the nail on the head. What we need is for "the people who run the engine" to walk away. That would be great.

As it stands, we are trying to push, and they are pushing back. Hard.

You ought to have more faith in the American people. The present system is completely broken. We don't need to rehash the statistics, do we?

You say you can produce some complainers from single payer countries. I've seen that trick. Ask them if they wish they had our system, and they say "hell no!".

Its like the "statistics" one of the insurance-company shills I think trotted out once saying that Canadians can't stand their system, their number one complaint is long waits for elective procedures. They produced some kind of survey of Canadians showing that a majority of people thought the waits were too long.

Oops! If memory serves, average waits of between 3 and 6 weeks for various types of elective, nonemergency procedures were what Canadians complained about. Of course, in our system, for the relative few who even have a possibility of getting such procedures, it turns out average waits are much longer. IF they are not denied entirely by the insurer who has taken your thousands of dollars in premiums, but like the LA city attorney has discovered Health Net did here in LA, did so with no intention of actually paying for your health care should you submit a claim.

The sooner the people who defend the present system get out of the way, the sooner people with better ideas, better judgment, better motives and better skills can get in the drivers' seat where they belong.

Anonymous, perfection is unattainable, so we keep trying. Yeah, this is a thorny situation that is hurting people. There are private sector ways to fight the status quo, and it will be a battle. I'll join up with anyone working to alter the behavior of the system. Except the federal government.

And still no one on this post (except me) has shown how this will be paid for.

Good discussion. Dagny is shrugging this topic now...

Dagny - No one has shown how this will be paid for?

You are kidding, right?

The savings of single payer systems are so tremendous, the real question is, what will we be doing with the health care dividend that comes from converting to single payer? We will have mountains of extra money in our pockets. Our businesses will have mountains of extra money to devote to competing in the global marketplace. And our people will be healthier, and thus better able to work and compete.

Converting to single payer in fact would be probably the single greatest policy the feds could adopt to stimulate our economy. And it would not be a one-time stimulus, but one that would keep on giving, benefiting our economy year after year.

Right now, we pay far more, both in real costs and as a percentage of GNP, for poorer outcomes than any single payer countries.

The real question is not how would we pay for a single payer system. The real question is, how can we afford to keep paying for the broken system we have? It is the single largest drag on our economy, dwarfing even the cost of our military adventurism. And it doesn't even work.

Auf Wiedersehen Dagny! You say you're not an acolyte of Ayn Rand, but your dedication to the "private sector" and you apparent utter distrust of the public sphere is right in lock step with objectivisms ideals. It's always so odd to hear people saying the government can't run anything when it comes to health care or education out of one side of their mouths, while championing the military out of the other side of their mouths. If the government can't run anything, why do we trust it to protect us? If you're so worried about your taxes, why don't we just repurpose some of that 1 trillion dollars we're spending on the war and occupation of Iraq.

The numbers you tout for the per capita costs of a universal, single payer health care system here in the US are blatantly wrong and you use them as a scare tactic. You disagree, read what Physicians for a National Health Program have to say on the issue. They say what I have already written, that our per capita cost of health care would drop and we would have 100% coverage.

You still haven't answered my question, so we can't be sure you're not just another troll for the insurance companies. If you're really a 30 year resident of the Ojai Valley, you would know the name of that bar or you would know someone who does.

I can't resist - the government doesn't protect us. The Military does, and it is a bad-ass, kick-ass outfit!

I said I was done with the topic and now I am, but I don't want to torture you further, spk.

There isn't a bar in the valley I haven't had a shot of whiskey in. The Wheel, the Hilltop, even The Hut back when Andy was still alive. Used to fire up a cigar in there, too!

Let's see how long you've been here. What was the name of the bar that used to be in the other end of the building that the American Legion is now? And what was the bar across the Ojai Avenue from that?

ooh, a pissing match! fun!

that's SURE to solve the issue at hand in a relevant way! thanks, Dagny!

(i'll let someone else address your separation of Government and Military)

Dag,

I'm glad to hear you aren't just a troll. The insurance industry and the Republicans actually pay people to look for keywords on blogs all over the country and tout false information to scare people away from issues like this one. I wanted to make sure you weren't one of those. Instead you're just a misinformed free trader which is okay.

The issue isn't really how long I've been here. We've dealt with that one here on the post before. I've been here only 10 years this June. Hard to imagine it's been that long. So I never got to go to the Firebird though I've heard some good stories about it. As to the bar in the opposite end of the building from the American Legion, The Cactus Club, I not sure I'd have been old enough to drink when that was still open.

sorry pat but it"is o620 Pm and i"m going to take a shower i shall read it in lLA MANANA SIGNED dE

Let's see how long you've been here. What was the name of the bar that used to be in the other end of the building that the American Legion is now? And what was the bar across the Ojai Avenue from that?

1) Flaming Duck. (Later the Cactus Cafe)
2) The Firebird Inn

Health care, American style:

Citizen A comes in to see doctor, complaining of chest pains. Doctor checks insurance, and finds Citizen A is fully insured with a good company, and has cash in hand for co-pays. Doctor takes blood pressure, sees that it is high, runs a variety of tests, and sends Citizen A to a specialist for a full heart health checkup.

Specialist runs a battery of tests, and takes a 64-slice CT scan of his heart. Diagnosis? His heart is about to burst. He needs to start taking medication, immediately, to continue for the rest of his life. Citizen A takes his prescription to the pharmacy, and starts the program, which with co-pays, runs him several hundred dollars per month. He feels lucky to have his insurance, and resolves to make damn sure he doesn't lose it.

Feeling heavy pains in his chest, Citizen A's good friend Citizen B goes to see doctor.

Doctor sees that Citizen B lacks health insurance. Citizen B says he is paying cash for the visit. Doc charges Citizen B his standard office rate, the equivalent of ten times what Medicare pays for the same visit, and four times what insurers pay.

Doc takes Citizen B's blood pressure. Its high. He tells Citizen B:

"Try to de-stress. You need to get your blood pressure down."

Citizen B asks: "Doc, shouldn't we do some more tests?"

"We could, but that would be very expensive," says the doc. "I think you're probably fine."

"Probably?" says Citizen B.

"Sure. There are no guarantees," says the doc. "Look, we all have to go sometime. Its normal. Happens to all of us. Go home and get your affairs in order, and enjoy yourself. Don't worry about it."

chest pains?
I'd want to rule out anxiety or GERD.
I got a "A" in differential diagnosis