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Conor Friedersdorf

The Holes in Health Reform

BS Top - Friedersdorf Health Care Alex Brandon / AP Photo The legislation just passed by the House builds on a deeply flawed system, rather than fixing it. Conor Friedersdorf on how the Democrats missed the boat—and why the GOP is partly to blame.

Neither Republicans nor Democrats adequately acknowledge that it is deeply weird to tie health insurance to one's job, and even stranger to discuss health-care reform as though it is primarily a matter of getting everyone insured.

These two dysfunctional features are preserved in the legislation just passed by the House. Employer- provided health care distorts labor markets by incentivizing workers to stay put. But voters are risk-averse. They’d prefer to keep the insurance they have. Thus President Obama and Democratic leaders pushed reform that built on the employer-provided health-care system, rather than improving it.

The present pace of inflation in the health-care sector is unsustainable. Bettering the situation requires price pressures driven by consumers. The present legislation doesn't bring us closer to that reality either.

The focus on insurance is even weirder. Voters overwhelmingly agree, for example, that a person who already has cancer—or is very likely to develop it—should get the medical care they need to save their life without being bankrupted or put into lifelong debt. That is certainly my position. But the situation I’ve described isn't one best addressed by insurance, a tool used when outcomes are unknown. If we want to cover folks with pre-existing conditions or those genetically predisposed to certain ailments, let's do so directly, rather than layering that requirement onto insurance companies as if it is part of a coherent scheme of pooling risk.

A final necessary reform: addressing costs. The present pace of inflation in the health-care sector is unsustainable. Bettering the situation requires price pressures driven by consumers. The present legislation doesn't bring us closer to that reality either.

It is increasingly likely that we're going to wind up with a relatively expensive Democratic health-care bill that doesn't fix the fundamental problems with the current system. Blame for this failure is partly the fault of Republicans who've abdicated responsibility for advancing a positive agenda on the calculation that obstructionism is more politically advantageous. The whole ordeal makes me sick.

Conor Friedersdorf, a Daily Beast columnist, also writes for The American Scene and The Atlantic Online's ideas blog.

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November 8, 2009 | 9:19am
Comments ()
Tango121

The Dem.'s put the bill together without any amendments or input from the Repub.'s and all the Repub.'s but one voted against it. Now this writer says the Repub.'s fault it is a pile of stinking garbage. This guy would not know the truth if it bit him on the butt.

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9:53 am, Nov 8, 2009
ittybittykitty

I really wish both sides, particularly the Republicans, had dropped the partisan crap and come up with something that would work better. At least this is a beginning. This thing of insurance being connected to your job is archaic and I cannot believe that it wasn't addressed. In the past I took one job over another that I would have preferred because one was a state job that had good benefits and the other was with a private company that offered very limited benefits and none for my spouse (who did not have benefits because his job didn't have them). When I was laid off from a job there was no way I could afford the COBRA payments that were required to keep my insurance. Fortunately by then my spouse had a job that had benefits. And lastly, my brother was laid off from his job 8 months ago. He is lying in a hospital bed right now with a serious and unexpected medical condition with no insurance. He is middle class, has worked hard his whole life and owns his modest house. I have a feeling that this will ruin him and his family financially. Also, it seems to me that the Republicans did not want any health care reform, so it is kind of hard to get input from a party that just says "no". I have voted Republican in the past, but will never do so again unless they become more progressive, and given what I have seen in the last few years, that is not very likely.

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10:38 am, Nov 8, 2009
AbelMalcolm

The partisan crap ONLY comes from the Republicans, because they NEVER have any ideas that benefit the country. The ONLY ideas that Republicans have is to spread hate and to spread propaganda and lies and to stop any thing good from being done to benefit the American people. Republicans are in the pocket of the health insurance industry, for as long as the corrupt health insurance industry continues to finance the election campaigns of the disgusting and immoral Republican party, the Republican rank and file will continue to support the corrupt health insurance industry. Blame FOX news for Republican stupidity. Because FOX news is part of this propaganda campaign that makes Republicans so stupid. I have NEVER voted for a Republican in my life, and I never will, because I'm not stupid. What does abortion or illegal aliens have anything to do with the proposed health care bill? Nothing, but Republicans keep bringing out those red herrings, lying all the time, just to kill health care reform. This is not an honest political party. Republicans have no credibility, and as far as I'm concerned, have no morals either. At best, they are stupid people.

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11:13 am, Nov 8, 2009
crypto

ittybitty: You brought a thought to mind. I wonder how many voters have decided to switch sides because of this forced healthcare plan. I have not been a good party voter for either side, just take which I believe to be the best at the time. But I gotta tell you after Pelosi I'm done with the democrats for at least awhile. None of us commoners, as she calls us, will know whether we're being blessed or screwed by this thing until the end. Maybe it'll come out right.

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11:24 am, Nov 8, 2009
ThinkAgain

Oh Bunk. The republicans passed a huge prescription drug bill under Bush. It was a big old government spending bill that's the only thing that qualifies as good for you dems. But no, it was passed by the republicans so it doesn't count.

Bush proposed a next step (after the prescription bill passed) but it was "dead on arrival" according the democrats who then had Congress. He hadn't even submitted it so they didn't have a clue what it was but they didn't like it. Hear a little obstructionism in that? No? Maybe those partisan ears are a little deaf.

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11:57 am, Nov 8, 2009
AlanD2

ThinkAgain: The Medicare Part D prescription drug bill denied the government the power to negotiate for the best drug prices, so the pharmaceutical industry (whose lobbyists wrote the bill) made out like bandits.

And, of course, Republicans did not fund this new benefit, which helped lead to huge budget problems.

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4:20 pm, Nov 8, 2009
Granite

Partly to blame? How about mostly to blame.

The repubs did not participated in devising the bill. Unless you consider a smear campaign of name calling and comparisons to Hitler, threatening to filibuster, and Tourettes syndrome-like screaming of "I object."

Very few republican even tried to make this work.

If you aren't part of the solution, you are the problem.


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11:00 am, Nov 8, 2009
ThinkAgain

The whole approach is wrong. You can't make this approach work. It's destined to be a big boondoggle that they'll be fixing (hopefully) for years. That's the problem and you democrats are it.

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11:48 am, Nov 8, 2009
AlanD2

Granite: The Republicans did contribute some amendments to the bills (183 in the first four versions that passed out of committees), but for the most part you are right.

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4:21 pm, Nov 8, 2009
irishlad

Granite, the Reps were constantly locked out from ever devising this bill. What happened to bipartisanship that Obama promised during his campaign. Texas has lowered their health costs by 20% but just passing tort reform. However since the trial lawyers in this country mostly support the Dem party, that piece seems to have been left out of the bill.

Why didnt the Dems listen to the Reps about at least this one issue?

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10:44 pm, Nov 8, 2009
DeaconDrJones

The Republicans did nothing - meaning they cried and dragged their feet the entire way, screaming bloody murder like children in a grocery store who just want their candy. The Democrats should have ignored them and pressed on, like a parent demonstrating that bratty behavior will not be tolerated, but instead they caved and watered down the whole thing. In the end both sides work for the same corrupt influences - big business. Pathetic. Why not represent the people who most need it, working people who are barely keeping their heads above water.
Thank you also for pointing out something that really hit me in the face a year or so ago - the system whereby healthcare is tied to employment is stupid. It seems like just another ridiculous compromise to make sure that nobody who doesn't deserve a free ride doesn't get it, at the expense of everybody in the middle of the rich/poor spectrum - that is, most of us.
If our country actually cared about economic mobility, innovation, and small businesses, we would push for universal healthcare. I was trapped in a dead end job for half a decade because of my pre-existing back problems and a fear of losing my insurance and the insurance that I provided to my whole family. I've been laid of most of this year, and I'm in a position to start my own design business, the health care thing is the chief hurdle. Why did I get laid off even though my sales were higher than ever? My boss's sales were slow and he didn't feel like paying my insurance premiums, so he laid me off and took my clients.
Somebody please tell me, why does everything have to be so stupid? The Republicans will cut off our noses to spite our faces, and the Dems listen to them, for some reason.

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12:04 pm, Nov 8, 2009
wrathofkhan

FTW. Great rebuttal. Your story is EXACTLY why these politicians need to stop fighting and get a real health care bill passed.

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2:30 pm, Nov 8, 2009
Margot707

One of the stipulations of the House bill is policy portability so people like you won't be stuck in dead end jobs, or settling for lower paid jobs for the sake of keeping their insurance. It really does make sense to have health insurance benefits tied to employment. Tax free payroll deductions automatically pay the premiums, and in some cases, the employer picks up a big part, if not all of the tab. That's the motivation behind Social Security and Medicare deductions which force contributions into a government sponsored retirement plan. How many people, if left to their own devices, would really set up their own IRAs or 401(k)s and save for their retirement? This health care reform bill is in effect universal health care. What it isn't is a single payer system that would cut out the insurance industry all together.

It sounds like you are bitter about how your former employer treated you which has nothing to do with how the new bill is designed to work.

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3:32 pm, Nov 8, 2009
Margot707

The GOP has been dead set against any kind of reform from the beginning. Obama, Pelosi and Reid have bent over backwards for months to get any kind of cooperation in the name of bi-partisanship. The GOP's weak attempt at a reform bill is as silly and self-serving as their proposed budget bill which had no numbers. When told by Obama to get bill drafted before the August recess, what did they do? Did the GOP get to work over the summer in the spirit of bi-partisanship ? NO! They delayed and delayed and delayed. Then they put on the disgraceful spectacle of the town hall meetings which were thinly disguised anti-health reform / anti-Obama propaganda, designed and funded by the health insurance companies to scare people into being against any kind reform. The pitiful bill recently and at long last put forward by the GOP was a gift to the health insurance companies. The bill just passed in the House has its flaws, but has a chance of really making a positive difference in the daily lives and well-being of the American public, the last thing, it seems, to be on the minds of the health insurance industry and the GOP and blue dogs who are profiting from their legalized bribes in the form of campaign contributions.

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3:14 pm, Nov 8, 2009
AlanD2

Tango121: Rewriting history, Tango121? In the first four committees (3 in the House and 1 in the Senate) that passed versions of health-care reform, the Democrats accepted a total of 183 GOP amendments. The Baucus bill doubtless had some too.

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4:17 pm, Nov 8, 2009
dcbooknurse

The Republicans made it clear from the beginning that they were not interested in participating in forming the bill. DeMint openly stated that the Republican plan from the start was to torpedo health care reform in order to destroy Obama's presidency.

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9:53 pm, Nov 8, 2009
neverlate

Obama said that health care reform at 16% of the economy is way to high and we need to bend the cost curve. This Bill will ensure health care will be 21% of the economy and cost will go up; yet, Obama declares it a victory. You are the first to call him on this and I congratulate you!

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10:02 am, Nov 8, 2009
ThinkAgain

I disagree. Republicans passed a very large prescription drug bill under Bush and had other proposals, so it's a falsehood that they want to do nothing. They simply want to approach this in a slower more incremental manner.

Let's prioritize and fix each problem one at a time so we don't take on more than we can effectively handle. Let's follow up and get things working before taking on more.

It's the democrats massive confused approach that doesn't even really get to the heart of the problem that they're trying to obstruct. Not healthcare reform.

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11:45 am, Nov 8, 2009
kat387s

The prescription drug bill was a gift to the pharameutical industry. The government was not allowed to negotiate prices for drugs. Part of the endless cycle of pillaging the treasury of this country so CEO's and stockholders can become filthy rich.

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12:12 pm, Nov 8, 2009
Margot707

Bush & Co. also hid what the real cost of the bill would be. It would have made much more sense and cheaper for Medicare to negotiate drug prices directly. Rahm Emanuel said very correctly back in 2005 that the ultimate cost would be twice as much as Bush claimed it would be.
http://www.washingtonpost.com/wp-dyn/articles/A9328-2005Feb8.html

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3:38 pm, Nov 8, 2009
Danbury

No, Republicans want to 1) Defeat Democrats no matter what; 2) protect and enhance the top 1% and big business, no matter how destructive to greater society those two elements are.

The prescription drug bill was nothing more than a gift to the already rapacious pharmaceutical industry.

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12:25 pm, Nov 8, 2009
spotted

TA - I quote, " . . . we don't take on more than we can effectively handle . . ."

If American's acted that way, we'd never have invaded Iraq, passed Medicare and Social Security, or even declared independence from England.

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2:07 pm, Nov 8, 2009
AlanD2

As I mentioned above, ThinkAgain, pharmaceutical companies were the greatest beneficiaries of the prescription drug bill, just like insurance companies would have been the greatest beneficiaries of the recent health care reform bill proposed by Republicans.

Conservatives: Looking out for their corporate masters!

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4:24 pm, Nov 8, 2009
kennyvii

"Blame for this failure is partly the fault of Republicans who've abdicated responsibility for advancing a positive agenda on the calculation that obstructionism is more politically advantageous. The whole ordeal makes me sick."

I echo the TRUE statement of Taongo 121 and ask why later comments ignor this.

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11:51 am, Nov 8, 2009
AlanD2

kennyvii: Conservative posters will have nothing to say, because this is true.

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4:25 pm, Nov 8, 2009
Danbury

As a resident of Mass. which has a plan that the federal reform very much models, I have to say that Conor Friedersdorf has it EXACTLY RIGHT.

Not even in the long run, but very quickly - if this bill is made into law - people will come to realize that they are worse off than they are now, and we're all pretty bad off, except for the very wealthy.

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12:24 pm, Nov 8, 2009
spotted

Danbury - The health insurance industry has been paying big bucks for years (since the 1970's) to fight reform, especially on a federal basis. I think we, as a country, had to go through the process of "working within the system." Once this legislation demonstrates unequivocally how broken the insurance system is, which it quickly will, Americans will then must reject that system and adopt a single-payer Medicare-type system.

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2:22 pm, Nov 8, 2009
Danbury

I've been telling friends for years that what needs to happen is Americans need to drop their insurance plans en masse and send the insurance industry screaming into bankruptcy. That would be taking the Band-Aid off quickly as opposed to slowly.

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4:47 pm, Nov 8, 2009
numonk

Wah, wah. Republicans are liars and Democrats are the problem.

Fuck the both of them. I want another eighteen parties with equal clout in this country, not business running government or business running government running crazy religious gay men.

On that note, the article is at least succinct and logical no matter how you may feel about it.

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12:53 pm, Nov 8, 2009
sophia5

You said it numonk.

Both parties are interested in growing the power of government,
for themselves and their "friends" the lobbyists.

All of them should have been REQUIRED to read
All TWO THOUSAND pages
of the Bill they signed, and then forced to take a test in which they
must pass the test in order for the Bill to actually go through.

The more I see and hear some of these incompetent fools, the more I'm inclined to vote Libertarian.

When government has too much power you have tyranny.
When "The People" have more power you have Liberty.

These fools keep forgetting they work for us.
To be fair . . . we deserve the government we get . . . we're the ones
who " HIRED " them.

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2:57 pm, Nov 8, 2009
AlanD2

Sophia: When "The People" have more power, you have anarchy.

There is a good reason that our founding fathers made us a republic, rather than a true democracy. They feared - rightly so - the unchecked powers of an uninformed (or misled) mob.

The tea party protests show that their fears were well founded.

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4:29 pm, Nov 8, 2009
nevermind

While I am truly for reforming health care I do not wish to reform it by reformers who don't even know what is in the bill! Worse by a populace who really doesn't care what is in the bill because what they care about more is that Obama did it!

Furthermore, this is completely one hundred percent a political issue no matter the costs. (pun intended)
Just remember if this health care bill was rushed through at any and all costs it will not lie on my shoulders.

I have been a life long democrat but I am no longer a democrat do or die! The glory is in the fact there are millions just like me.

What is happening in the rush to push this through smacks of stuff we read about in countries I would never not in a million years wish for this country.

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12:53 pm, Nov 8, 2009
AlanD2

nevermind: This bill was rushed through? After almost a hundred years of trying to get reform passed? And after almost 9 months of countless hearings, CBO reports, town hall meetings, etc.?

Please stop your Fox News talking points and get a life.

There may be millions like you, but there are tens of millions like me, who cheered at 11:08 pm last night when the "yes" vote reached 218 and health care reform passed in the House.

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5:36 pm, Nov 8, 2009
irishlad

Why would you cheer for something that is going to cost you your own health insurance? Employers will only be charged $2500 per employee (cost each employer about $7500 now) to cover you from this bill. Once they transfer you to the government option you will no longer have the ability to switch back to private insurance. The government does not have to show a profit unlike private companies. So what have we accomplished?

I also want to know how it is people have come to the conlusion they have a "right" to insurance. This is a commodity like anything else you buy. Per the costitution the main job of federal government is to protect the people of the US. Any issues such as health care really belongs to each individual state. In the end, this is nothing more than a power grab since 12 million people will still be left uncovered by this bill.

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10:23 pm, Nov 8, 2009
nevermind

Fox News talking points? WTH!
You are a left wing bigot and a narrow minded one at that.
It might behoove you to veer off of your 24/7 feedings because you are sounding exactly the mirror image of those you so disdain.

This is a free society here. Majority rules in the house but on the streets my opinion can and will make or break a politician.

BTW: After nine months, countless hearings, CBO reports and town hall meetings the average congressperson has no idea what lies within the thousands of pages within that bill.

The blind voted for it on the haughtiest of principals....JUST BECAUSE.
And there lies the rub of all rubs!

This is more about politics than curing health care.

Good luck.

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10:34 pm, Nov 8, 2009
JalapenoBob

I would not blame it on either political party, but on the nature of politicians in general and the American public.

First, the politicians: we elect them. They are meticulously packaged entities whose every word is often vetted by committees of staffers whose whole job is to make sure that their politician remains electable. To remain electable and elections are extremely expensive, a politician must not offend the big contributers or deeply upset too much of the voting public. I wish that politicians wore the names of their sponsors on the clothes and cars, just like NASCAR drivers do. Then we would know who, for all intents and purposes, owns their allegiance and often, their vote. You must remember, the big money sponsors like stability and predictability. As recent events shows, sudden and unpredictable financial events can hurt everyone.

Second, the American public: As a nation, we are not engaged in the political process. If asked, most of us could not name the two US Senators from our state, our local member of the House of Representatives or the local members of our state legislature. Yet, these are the people who write our laws and levy taxes. They have more effect on our lives than the President or the state governor. We very seldom hold them accountable for their actions or their votes. The net result is that the laws they pass often benefit their sponsors at the expense of the public at large.

I do not mean to sound cynical, but to quote a long-dead urban politician, "We have the best government [that] money can buy!" If you want to know which companies, organizations and individuals will benefit from the current health care bill, just look at the list of those endorsing it.

And do not forget the news media! They are not highlighting the fact that most of the benefits do not take effect for several years. This gives them an expectations gap to capitalize on for the 2010 and 2012 elections: they can harass the politicians of both parties, asking, "We paid billions for health care reform, where are the benefits?"

The only way to change this, is to become aware of what our politicians are doing, which groups they are kissing up to, and which groups they are screwing. Do not expect the media to help, as they are often cheerleaders for one side or the other and they frequently place entertainment before hard news.

If you want real change from our government at any level, do the following very simple steps:
1) Take some time and learn about the issues that are important to you.
2) Think about how you would like to see the issue resolved.
3) Write a letter or send an email to your state legislators, your Congressperson or your US Senators.
4) Repeat the above three steps for each issue that concerns you. This last step is extremely important!

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1:06 pm, Nov 8, 2009
robjh1

Of course there are holes, but you have to start somewhere. I am sure when Social Security got its start there were holes. Now that the holes are identified let's work for solutions to patch them up.

"and we are not saved..."

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1:08 pm, Nov 8, 2009
flyoverland

This is what happens when you let lawyers reform healthcare

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2:41 pm, Nov 8, 2009
Danbury

No, it's what happens when you let insurance and pharmaceutical industries reform health care along with their sycophants in Congress.

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4:46 pm, Nov 8, 2009
spotted

Danbury - "sycophants" is too kind. Since they've been bought and paid for, they should be called out as the whores that they are.

My Agenda:
1. Healthcare
2. Wars (disengagement)
3. Climate Change
4. Campaign Finance Reform

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5:24 pm, Nov 8, 2009
whipmawhopma

spotted - How about adding...

5. Free vocational training
6. Green energy Manhatten project
7. Energy independence, see # 6
8. Functional but not burdensome regulation of banks, Wall Street, etc

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8:47 pm, Nov 8, 2009
BOKOBOT

This story is a ridiculous, childish criticism of a great bill. It's a good example of how spoilt and self-involved Americans have become. Even when something good comes out of Washington some couch potato critic can always find something he doesn't like in it. BOKO

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5:35 pm, Nov 8, 2009
jomama

It's a valid criticism. The bill isn't very smart. Americans deserve better.

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6:48 pm, Nov 8, 2009
oliverckerr

I am an independent candidate for president. My Health care program does not involve insurance companies or any government bureaucracy. Health Care is an issue that ties up one sixth of our economy! My idea makes way more sense.

We can agree our economy, as heartbeat, is near collapse; the dollar is in the dumpster for months, and could permanently go lower, making us into a permanent secondary lender; one of our prob limbs, the growing rolls who lost their health care insurance along with their jobs.

My Loose Penny Program, presented here, is a capital injection that will instantly begin to repair our economic muscle, by repairing our health care delivery without government intervention, but to create actual jobs, mission critical diplomacy is required.

President Obama needs to get off the fly around health care campaign trail, wipe down the makeup on his eyelids (with cold cream) and summon all our fast foods, supermarket; Target and Wal-Mart CEO's to the White House to ink my proposed infusion solution.

The only thing wrong with this proposal is it's mine. It is my 'out-of-the-box approach, and personally I have an expressed stake in the political process as a candidate for president. Were his advisors only willing to set that issue aside we would all benefit!

Obama went to Cairo and Copenhagen. He can meet with KFC. Your loose pocket change will make the critical health care diff rinse.

Every chain must participate in my Loose Pennies Program, regardless the size of their enterprise. My purpose: an additional two-cents in the cash registers of many thousands of locations nationwide, wherever we fast food eat and shop. For every item registered over the counter we want two pennies extra, added as patriotic gratuity.

This proposal is not for a government mandate. Anyone can refuse to pay the voluntary two cents gratuity. Burger, fries and a drink totals six extra cents, pennies off the pavement. Regardless what we purchase at the market; we are only pitching in some loose change out of pocket. 40 items at the supermarket could easily add up to $150. Does another 80 cents inhibit your generosity?

A worker chosen by the workers to represent them can meet with the managers to approve the total pennies for everything out the door the week before, dividing that total by everyone's hours worked.

Then we include up to $2 dollars extra for every hour in the worker's paychecks. A $5 deduct for a Medical Malpractice Pool is on my planing board, which employers don't have to match, so their sticker prices won't rise from any extra cost of doing business. The chains won't be squeezed from our Medical Assurance pay raise, that, a plus minus spreadsheet wash!

The worker's pay increase doesn't come out of management's pocket, but work place production will grow. When someone quits, the crew might ask the boss to leave them pick up the slack, so they earn more money!

The overage, beyond the $2 dollars hourly extra in every pay, goes to interest bearing Medical Savings Accounts, with the worker's name on his or her portion. Two dollars an hour in a forty hour week is more than $4000 a year. There are other innovative possibilities because the prime issue inspiring our voluntary gratuity is Health Care.

The president can ask everyone on the low end of the economic chain to divide their bounty as follows, at least what I am guaranteed to do as president: The president can order the $2 an hour extra be a take home half in cash, with the balance going to dramatically grow these proposed Medical Savings Accounts, a health care solution for at least ten million uninsured people.

More than ten million of the uninsured people will have their medical care access guaranteed with a Medical Savings account they can share with their spouse, significant other, and off spring. The medical savings account, as a health care solution beats health insurance!

Insurance companies are dedicated to making money, not protecting the sick from financial disaster. When an insurance company cancels your policy because you have an expensive disease, they don't refund your premium. But with a Health Assurance Savings Account, when you quit or get fired from the job, your medical savings account goes with you!

After a year behind the fast food counter, a 40-hour per week worker could have more than two grand in their Health Assurance account. Ten million uninsured people at the bottom of our economic food chain might not have health care insurance but all would carry Health Assurance. In the event they don't feel right they have access to medical care, and a second opinion, because the money to pay is there! When it's your money, unneeded procedures evaporate.

Other companies, besides the fast food chains could have the "public Lev option" of creating Medical Savings Accounts, in lieu of providing an insurance policy for their workers.

A sensible choice solution eliminates the insurance company monopolies. A worker could opt out of his company's insurance policy. The employer's end would go into his paycheck, a raise in take home pay. The half the worker was paying would still be withheld, and go into the worker's Medical Assurance Savings Account.

Small businesses unable to afford insurance coverage for their employees could set up Medical Assurance Accounts.

Is there any government bureaucracy involved in my program? Is my proposal 1500 pages of unreadable language?

This two cents program works for the medical professional, too. You agree to the fee, the doctor swipes your Medical Assurance card and the money is debited from your Health Assurance account. The Dr.'s cost layer represented by his required compliance with the insurance company bureaucrat is out of the mix.

This proposed over-the-counter voluntary two-cent gratuity, $344 dollars monthly doesn't bash government. These out of pocket pennies go to the working not so rich, without intrusion. Government bureaus are by-passed, except to investigate anonymous complaints about businesses that may be cheating their workers.

In all the dry cleaners add a nickel to every shirt pressed, a dime for every dry cleaned piece. In all the family operated dry cleaners, medical savings accounts will replace the worker's share of their family's health insurance.

This 2 cents extra covers 90% of all the minimum and lower wage jobs in USA, juicing the recovery by pumping the bottom of our economic chain, enriching the people most likely to purchase goods with their money!

The fresh dollars these people spend will create jobs. Those in low echelon hourly jobs, working 40 hours a week will have $80 extra weekly in his or her pay envelope, the diff rinse between scraping by and getting ahead; the advantage of $75 after a $5 per week set aside for our Medical Malpractice Pool, $40 in their pay with a minimum $35 earmarked for Health Assurance Savings.

To restate: $2 an hour X 40 hours is $80 fresh dollars a week, $344 a month, more than $4000 fresh dollars a year going to more than ten million UNINSURED working people, based on our voluntary two pennies on every item over the counter in all the fast food chains, WalMart, KMart, Target, and every supermarket chain.

The $80 extra a week is divided in half. $40 for pay envelopes, $40 for Medical Savings Accounts. Then $5 out of the pay raise for a Malpractice Insurance pool, which Dr.'s are invited to join, by putting in $5 per office visit; and $5 from your Medical Savings Account into a Catastrophic Illness Pool.

You are working for five years at Burger King. You are an assistant manager. You started out flipping burgers and stayed with your Medical Assurance Savings. You have kidney failure, need dialysis while waiting for a kidney transplant. That is catastrophic.Your Medical Assurance Account won't be depleted on the spot.

Relative to Malpractice Insurance doctors and dentists, the med professionals are invited to participate with $5 per visit, so they can down the road, cancel their Malpractice insurance. Then we establish a reasonable award for all the different malpractice possibilities, allowing the aggrieved party to get a lawyer in the event there is a disagreement. This lowers the cost of a Doctor being a Doctor and gives us a chance to develop a public access data base that identifies doctors who are repeat malpractitioners.

Millions of uninsured not so rich people building Medical Assurance Accounts will directly benefit from this voluntary deal. We gain from tipping our pennies to working folks, as these millions of uninsured won't be crowding emergency clinics for care, which we all pay for, a tremendous savings for the taxpayer!

Emergency health care cost is infected by the actuarial projections of how many uninsured people might use an emergency room walk-in for care during the course of any year.

Working people in min-wage jobs with Health Assurance accounts pay for their access on a need-to-be seen basis. In addition to medical savings accounts, the two cents gratis could secure a million mortgages near default, a contribution to neighborhood health as deserted house disease is a cancer that devalues the whole street.

For the rest of our uncovered citizenry, doctors and dentists must be allowed the volunteer opportunity to do tax deductible charity, treating them. A charity patient is anyone without insurance. The plan: doctors do $50,000 in charitable medical services and deduct the $50,000 off the top of their federal tax. Then, after all the deductions, the doctors take an additional half off their bottom line; twenty-five thousand or half, whichever is greater.

Medical professionals could perform $100,000 in charity and deduct $50,000 off their tax, and because they only owed $49,000 in taxes, earn a one thousand dollar income tax credit. This health care approach cost effectively makes sense.

Doctors won't be at the mercy of an insurance companies,' take it or leave payment for services rendered. People suffering from unaffordable premiums, with pre-assurance from their physicians, will begin to cancel their overpriced insurance policies.

Every doctor will have a waiting list of patients waiting to be classified as charity. Doctors will have more patients, their work incentive: Freedom of Income Tax.

Isn't this one-line change in our tax code easier to digest than a fifteen hundred page med-reform tax increase stick-it-to-us vaccination, unread even by its authors, our congress? Would insurance company's shills show up at town hall meetings screaming, "It's a communist plot! Down with their two cents for medical savings accounts?"

Every doctor and dentist will have a sign on the door: "No insurance? I'm here."

These ideas will enrich our economy from the bottom up, possibly save a million mortgages, and insure access to health care services for many, if not all the millions of uninsured people, whilst leaving the rip off insurance companies out.

The long-term solution to our health care prob limb is free medical education for doctors, dentists, and all related personal, our goal one hundred thousand doctors graduated every year until we have one family doctor for every thousand people. A national marijuana tax could fund this program, as could a three per cent reduction in military expenditures. Politishinz are good at identifying issues but fold their intestinal fortitude as those who finance their campaigns govern the solutions.

In that light, the above proposed change in our tax code, encouraging doctors and dentists to treat the uninsured as a deductible charity, could not pass either House of our current congress absent a million person public outcry first.

Robert J. Samuelson wrote, in the Monday, September 14, 2009 The Washington Post:

"Americans generally want three things from their health-care system. First, they think that everyone has a moral right to needed care; that suggests universal insurance. Second, they want choice; they want to select their doctors -- and want doctors to determine treatment. Finally, people want costs controlled; health care shouldn't consume all private compensation or taxes."

The above Loose Penny Solution covers all of these issues. On Sixty Minutes, September 13, president Obama repeated, "All Americans will be required to have insurance, but those who can't afford it will get subsidies." Health Assurance Savings accounts are a better idea.

Obama's plan: Subsidizing an insurance policy creates a whole new layer of bureaucracy which is unaffordable and unnecessary.

I am the unknown poet, a long-time candidate for president, roasting in the sun.

Once upon a time our Fourth Estate was independent, standing watch, reporting true. Today's corporate approach to politics locks out the unknowns who seek public office, a primary reason there aren't any candidates. You announce, "I'm a candidate." The editor's don't ask, "What are your ideas?" But, "Show us twenty million dollars." And without access to buckets of ducats, the access to broadcast speech, to present their platforms is also blocked. Blog in the bog, dog.

We need to renew our politics, starting with the reestablishment of our First Amendment Right to televised political speech. Upon this essay, I requested e quill time of our television networks, to give my independents' response to president Obama's health care speech to the congress, which was broadcast by the networks and cable networks aired live, September 9, 2009.

I have to stop posting and prepare my petition for the court. The issue of my First Amendment Right to speak will go to the Supreme Court.

michaelslevinson.com

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9:53 pm, Nov 8, 2009
JCSAtx71

Completely and utterly WRONG.

http://www.healthcarereformmyths.org/HealthcareReformMyths.php?ID=28&Act =Myth

Instead of continually postings that resemble diatribes rather than thoughtfulness, you might begin to appear less like someone whose brain has been warped by too much taking the fallacies of Fox and Co. as the truth.

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11:16 am, Nov 12, 2009
Soonchurcher

The only hole is in Pelosi's head!!!!!

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Reply
10:06 pm, Nov 8, 2009
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The Holes in Health Reform

by Conor Friedersdorf

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