Lynn Abbott: Health care reform

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On Friday, Rob Douglas wrote, "There is nothing wrong with health care in the United States today." We also hear this when newscasters interview protesters at recent town hall meetings: "Our health care is the best in the world!"

By whose standards, I ask? Let me share some statistics:

- The World Health Organization ranks the U.S. 41st in the world in infant mortality, worse than the United Kingdom, Canada, France, Spain, Puerto Rico and even Bosnia/Herzegovina, among others.

- In life expectancy, they rank us 45th in the world.

- For diseases such as bacterial infections, treatable cancers, diabetes, cardiovascular disease, and complications from common surgical procedures, in 2002 (the last year available) we had 109.7 deaths per 100,000. This was 50 percent higher than the rates in France, Japan, Spain, Italy, Canada and Australia.

- Lastly, the Commonwealth Fund ranks the U.S. last in health care outcomes when compared to Australia, Canada, Germany, New Zealand and the United Kingdom - even though we spend twice as much on health care as these countries.

Those who believe that we have the best health care in the world must live in their own little bubble, convinced that they will always be able to pay for insurance premiums that escalate every year. They must believe that they will never lose their jobs - unlike the 250,000 who lost their jobs last month - and therefore probably lose their insurance. They must not be concerned that this "world's best health care" is not affordable to a huge number of our citizens.

But many are likely to discover that, no matter how wealthy they are, their insurance will suddenly become unavailable to them because of a pre-existing condition or a disabling illness. The Harvard Study, funded by the Robert Woods Johnson Foundation, found that in the U.S., "a quarter of insurance firms cancel coverage immediately when an employee suffers a disabling illness; another quarter cancel coverage within a year." These cancellations frequently lead to bankruptcies and loss of homes. Health care reform, if done right, could put a stop to such rate hikes and cancellations. Otherwise, watch out Rob, your policy could be next.

Those who worry about the expense of health care reform neglect to recognize that the health care expense we have now is unsustainable: It will double over the next decade. President Obama has made it clear that health care reform must not increase the deficit over the next decade and must reduce costs over time. By cutting wasteful and fraudulent spending, by streamlining medical records and by emphasizing preventive care, we can reduce much of the current medical costs. It bears mentioning that this is the first administration to plan and budget for the cost of health care. When Medicare Part D was passed, there was no cost planning - except to raise the cost by prohibiting volume pricing for drugs. With health care reform, we can negotiate lower prices for drugs and services.

Those who worry about loss of choice of doctors or medical plans are not listening. Right now, choice is limited only to the healthy, to those who can pay and to those of us lucky enough to be on Medicare. With comprehensive reform, everyone will be able to choose their current insurer and doctor, or another private insurance plan, or a public plan - none of which will be allowed to deny coverage for pre-existing conditions or disabling disease. Now that's choice.

The town hall meetings being held across the country this month are an excellent opportunity to explore this complex issue. Unfortunately, many people have felt compelled to drown out all conversation at these meetings, screaming about euthanasia and other nonsense. There is no truth to this silliness, and the loud rudeness is unproductive. Fortunately, here in Routt County most of us welcome civil discourse about important issues. I look forward to joining our community in such discussions.

In summary, if you are positive that you will always have enough money to pay for your health insurance, no matter how high the premiums go and if you are certain that you will never be diagnosed with cancer or another disabling disease, perhaps the status quo is what you want. On the other hand, if you want our country to join the nations with the highest health ratings, if you want to lower the cost of everyone's health care premiums, and if you want to guarantee that nobody's insurance can be canceled because of disabling illness, ask your legislators to develop deficit-neutral comprehensive health care reform.

Lynn Abbott

Steamboat Springs

Comments

JusWondering 5 years, 1 month ago

"The good news is that the recession is starting to wind down." Do you suppose the current administration will take credit for it?

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Matthew Stoddard 5 years, 1 month ago

Hmmmm...who was the last person to put hands on Medicare/Medicaid, along with the Prescription Drug Plan when it came to overhauling it? Might it be the same person who wanted to privatize Social Security? I'll bet a lot of people are glad their SS wasn't in the market over the last year.

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Martha D Young 5 years, 1 month ago

Thank you, Lynn, for an informed, reasonable and well-balanced response to Rob Douglas' misinformation. When I read Douglas' column I thought of Darwin's "survival of the fittest" as a health care program. It's interesting to note that few people are aware that insurance companies dictate which doctors, procedures and reimbursements will occur. Medical decisions dictated by insurance companies are made by clerks whose job is to keep down costs, and keep up profits for their companies. If you've ever been a provider who's been denied payment for your services, you know what I mean.

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seeuski 5 years, 1 month ago

What a bunch of hooey. Why do foreigners trek to this Country for medical care then? The House Bill HR 3200 is a sham and a political power grab and not a Bill to improve any form of service. Why is tort reform ignored in the Bill? House Bill HR 3400 that has been proposed deals with the real issues of Health Care without a political Government takeover.

But go ahead and put forth lies about bussing people around and Insurance companies paying for the opposition, REALLY? You folks just don't get it that main stream America is not into Socialism and they are awakening to what this Administration is up to.

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Fred Duckels 5 years, 1 month ago

The WHO compares health with factors that distort reality and favor other countries. Babies under a certrain weight are not included in their survival rate, health comparisons factor in fairness and essentially are grading on a curve to promote their propaganda. It is only normal to present a countries health care in the most favorable light. Let's start with tort reform, and forcing insurance companies to compete across state lines, that would be huge but the administration has promised the lawyers their piece of the pie and that is not negotiabale. Looks like a loser unless O divorces his cronies. The insurance companies want no part of competing, that is why they are somewhat cooperative with the administration. Toss out the politicians and do the right thing, I think that this is a start.

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Duke_bets 5 years, 1 month ago

seeuski - You proved my point again. R good, D bad. That's it. Rob's article is the gospel and this article is hooey according to you. I wonder why.

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trump_suit 5 years, 1 month ago

The basic problem as I see it is that the Republican Party has ignored this issue for years and does not see that the big business insurance industry is in fact causing these problems.

"Capitolism has created more wealth than any other system in history" JLM is correct about the marvels of capitalism, however, there are cases where the pure greed of capitalism must be balanced with effective regulation. Health insurance is one of those cases.

While looking for profits, the insurance companies have failed to provide Americans with quality service and health coverage. Those of you that work for large corporations have not seen the problems that individulas and small employers have experienced with denied coverage, cancelled policies and pre-existing conditions.

While I do not support a single payer system, or a gov't funded effort, it is my opinion that several changes are needed to balance out the needs of American citizens with the inherent greed of big business. Some of our conservative posters on these forums have expressed excellent ideas that need to be in the final reform.

  1. Torte reform is required and necessary.

  2. Nurse Practioners are an excellent idea.

  3. The AMA needs more Doctors and should be taken out of their position of control over these choices.

4 Each and every citizen needs to have some "skin" in the game, if medical treatment does not affect your household budget you will not make good economic choices. This needs to be in any reform package.

  1. Get rid of employer groups and allow interstate policy movement. The insurance companies should be forced to offer the same plans/rates and coverages to "ALL" americans regardless of employment of health history. A pre-existing waiver for 30-60 days would be sufficient to cover situations of getting coverage because I got sick situations.

  2. No more out of network denials. The insurance company can refuse to pay for "Cadillac" doctors or treatment but should not be alowed to control who provides that service. A cap of some sort for specified care is necessary to control costs but who provides that care should be left to the choice of the individual.

(Continued)

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JLM 5 years, 1 month ago

When the world needs cutting edge health care and when the wealthiest people in the world get sick and when medical research makes another breaththrough --- where does it happen?

Bosnia/Herzegovina?

Or the Mayo freakin' Clinic?

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trump_suit 5 years, 1 month ago

I do not understand how the conservative right wing of this country has taken a provision about counseling during end of life decisions and turned it into a "scary story" about the gov't trying to euthanize elderly americans. Give me a break........

While I do not fully agree with the plan as currently outlined in regards to the Gov't health company, or in taxing business, these tactics by the far right are damaging any progress towards a real solution. You are not going to get provisions like torte reform and personal responsibility built into this plan if you continue on your current track. We need some cooperation from both sides of the isle, and an acknowledgement fhat there are in fact problems with the current system.

I believe that reform is necessary. We can find common ground in this debate if both sides will back down just a little bit and make some common sense points instead of the screaming match that seems to be taking place. Health reform is coming whether you like it or not, the only real question is how much influence will your argument have.

Make your points with intelligence and some sense and maybe just maybe someone will listen instead of argue.

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Scott Wedel 5 years, 1 month ago

That the US has bad infant mortality numbers is true and is not the result of distorting the numbers. We have way too many pregnant moms not getting health care prior to giving birth.

If you want to see how a whole lot of health care money is wasted then go to a big city neonatal care center. A huge number of the babies are there because mommy did not go to a doctor to deal with health issues before baby was born and thus sick baby was born.

And while people come here to get treatment at our research hospitals, we do not see Canadians and so on coming here in droves. In fact, the Canadians I know keep their citizenship so they can return home to get health care.

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JLM 5 years, 1 month ago

Frankly this is an error of composition of the most basic type. There are lies, damn lies and statistics. What nonsense!

The health of the American people is not a proxy for the level of expertise or the quality of American medicine. As a group, we Americans are pretty damn unhealthy. The best medical practices cannot overcome a lifetime of poor nutrition, inadequate sleep and no exercise.

This is like saying Michael Phelps' doctor must be a wizard --- look at his patient.

Michael Phelps is a world class athlete who exercises just a tad more than the average chap, is careful about what he eats and is under the care of a coach who ensures he gets adequate rest. His only vice appears to be a bong hit or two during the offseason. Well, we all have our flaws, now don't we?

His health is not the result of the expertise of his doctor or the quality of his care --- it is the product of his age, lifestyle, exercise, nutrition. His doctor is almost irrelevant.

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JLM 5 years, 1 month ago

Oh, please, who goes to Canada for medical care? Who? At least argue with some integrity!

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seeuski 5 years, 1 month ago

False Scott. They go home for the healthcare they have already payed into but they come here for life saving treatment that the Canadian plans delay or won't cover. I know Canadians too. And how is the incompetence of the Government going to cure the ills of inner city slum areas? As Obama so eloquently stated yesterday the Government can't even run the Postal service efficiently. I think trumpsuit has a good list in his post as to what is needed and that is being presented to the Congress in the form of HR 3400. JLM is right about rich foreigners coming here I do remember the King of Jordan came here for treatment of his cancer. The former Shaw of Iran and many others. Why not Canada, France or the UK?

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JusWondering 5 years, 1 month ago

My mother in-law works in neonatal and I can absolutely echo some of Scott's comments from the stories she tells me. It is full of three types (in order of who she sees):

  1. drug babies (not sure education will help these or whether the mother would have pre-natal care anyway)
  2. poor pre-natal care babies
  3. medically assisted pregnancies (invitro, fertility treatments, etc).
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seeuski 5 years, 1 month ago

It's Obamacare to the rescue of drug babies. Nonsense.

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Scott Wedel 5 years, 1 month ago

For a young healthy man, health care is almost always irrelevant.

A 55 year old can have a healthy lifestyle and have ongoing health issues that requires regular doctor visits to treat effectively and efficiently. If that person lacks health care and money then that person all too often ends up being treated when the problem becomes severe in a series of emergency room visits.

A pregnant woman can be healthy and taking care of herself and having an unhealthy pregnancy resulting in a baby in a neonatal care center.

It is common to have medical issues that require consistent medical care to remain minor that become expensive if not treated. We have way too many people getting treated for crises that are the result of failing to timely treat medical issues. But emergency rooms have to treat the uninsured.

We already pay quite a bit for health care provided to the uninsured because of treatment provided in emergency rooms. How much that would decrease is hard to quantify and thus not included in budget projections, but our emergency rooms see so many more patients than other countries that either our citizens are far less responsible than the French (for instance) or with intelligent health insurance then we will visit our doctors or see a visiting nurse before we need to go to the emergency rooms.

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Scott Wedel 5 years, 1 month ago

Seesuki, It is very hard to do anything about the drug babies. But other countries also have that issue.

Poor care during pregnancy is a problem unique to the US among industrialized countries.

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JLM 5 years, 1 month ago

What is being missed by many in this debate is that the dialogue has transcended politics and has now become a deadly serious debate about life and the intrusion of government into that life. The abandonment of an economic system --- capitalism --- which has delivered unto us the highest standard of living in the world and has literally lifted millions out of poverty on the strength of their own hard work.

While it is easy to identify the ends of each pole, the debate has now come to the normally placid and uninvolved middle. This is now about prudence and reasonableness. The debate has now subsumed the political junkies and has begun to involve the "normal" folks.

Why? Because everybody has an interest in this subject not just the political junkies and, dare I say, "extremists". I mean that in the nicest possible way.

There is ample evidence of this when you look at the town hall debates and see who is mad. Sure, there are junkies involved but many are just plain folks. Folks with a bit of real life experience, a splash of gray hair, an earthiness of having wrestled with success and failure and a lack of faith in "whiz kids" and politicians.

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JLM 5 years, 1 month ago

(continued, sorry)

The guys who fight our wars, the women who raise our families, the cops who make us safe, the folks who work hard and take pride in their work. Normal, hardworking, solid Americans.

This anger is magnified by the realization that the Obama administration has abandoned, demonized and targeted capitalism as the enemy. Why would Nancy Pelosi characterize the insurance companies as "evil"? What a silly, over the top utterance and what a revealing insight into her psyche.

Camille Paglia --- sometimes an honest voice of reason among the liberal leaning media --- captures a snapshot of the craziness of this debate just about perfect in her recent Salon column. Imagine, me referring to a Salon article? But, she does get it right with equal measure of scorn for both parties.

The perfect storm which delivered the Presidency into the arms of Barack H Obama has now subsided and it appears that he is just an ordinary man. As the hangover subsides, he is revealed in the stark light of dawn not an uber mensch politician but a very ordinary, inexperienced liberal hack who has been gifted with extraordinary personal charm and ability to express himself. He is a Brooks Brothers teleprompter angry elitist given to firing first and aiming second. He is ordinary.

It has been revealed in a million different ways. His playing golf when the country is at war. The unresolved conflict between his utterances to the SEIU re health care and his public statements. His attempt to govern as if the Presidential campaign was non-ending. The awkward comparison between his campaign promises about transparency and his frenzied signing of flawed unread legislation.

The American tiger has been awakened and the American tiger is pissed. The debate is not just about health care, it is about America and the intrusion of government into our lives.

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Clearsky 5 years, 1 month ago

Hey JLM, We are trying to stay healthy but when we try to ride on the road some yahoo makes sure he diesels the runner or biker or some other harassment. I work in Health care field and I want to pay for Medicare or join the federal government coverage program that federal employees get from my tax paying dollars. I am paying for others to get healthcare but I can't afford my own or my families.

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Clearsky 5 years, 1 month ago

Just let the US citizens make the choice of either paying for Medicare; the same coverage our federal employees receive;or private insurance. One of three choices. Then there should be no more arguing.

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JLM 5 years, 1 month ago

Clear, babe, go join the Army and get "free" healthcare! LOL

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Duke_bets 5 years, 1 month ago

seeuski - Your last post is extemely ironic even for you. Here's a question........Do you support abortion? I'm fairly certain of your take on that issue being the single track mind that you display. Yet, you don't support government care to 'drug babies' as you call them.

Did I just prove my R and D point again? You tell me.

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freerider 5 years, 1 month ago

Thanks Lynn for calling Rob on his B.S. Rob is starting to sound like Sarah Palin..the health care system in the U.S.A. sucks...the insurance company's just deny claims as standard operating procedure. That's just on the insurance side of things...so let's talk about the actual care you receive ...over 150 thousand people in the U.S.A. died last year from presciption medicine ...wow !!! death by presciption...the flu shots this year contain squalene and glycol ...people like Rob Douglas and Sarah Palin will be scaring you into getting them..sheep herders leading the flock to slaughter along with the A.M.A and your local neighborhood drug dealing doctor and the usual right wing fear mongering campaign...I asked one of the local doctors how she felt about giving gaurdisil to 10 year old girls...she replied" it's the right thing to do" ...then I asked her if she was aware that guardasil has killed over 100 girls and left other paralized or with a stroke... healthy young girls killed by big pharma...and you idiots out ther have the nerve to say this is the best system in the world...the only thing that I see going on out there are right wingers that are arrogant and ignorant of the facts...they don't like anything OBAMA is doing cuz's he is black so they call him a Socialist...laughable for sure any fool that has his head removed from his backside can cleary see we live under corporatism....money rules this planet, the right wing mantra, screw the poor and greed is good. I'm not affiliated with either party democraps or repukes , both are embarrasing to me as an American

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trump_suit 5 years, 1 month ago

"The American tiger has been awakened and the American tiger is pissed. The debate is not just about health care, it is about America and the intrusion of government into our lives."

JLM, you are wrong about this. The debate is about Health care and the conservative attempts to derail the conversation is what is wrong.

Where was your concern about the intrusion of goverment into out lives when the Bush administration was illegally tapping our internal phone calles and emails? Your outrage rings hollow when you accuse the Obama administration of similar actions. One action is OK in your world and one is not?

Health Insurance has become corrupted by the greed of corporations and we need to reform the requlatory structure. While I do not agree with all of the proposed reform legislation something needs to be done and without some recognition from the Conservative right that reform is in fact needed you will be unable to control the process in any meaningful way.

Example: How the right wing of this country that actually wrote the provision about end of lfe counseling turned it into mass euthanasia for elderly americans. This is a perfect example of the "scary stories" that have been made up about the health care reform process in an attempt to derail the concersation.

Speak clearly articulated thoughts and ideas and you may persuade some changes in opinion. As long as the Republicans choose "scary stories" over facts and ideas you will lose this debate in the long run.

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paulmauro 5 years, 1 month ago

Very good article, Lynn. I enjoyed reading it and I applaud the points you accurately made. I know of one US senator who has also commented the US has the best health care in the world. When I asked by what measure he claims we are the best I got no response. I am amazed how the debate on this issue is either totally non-sensical or totally off the point. Just look at some of the comments to your article. One reader offering a comment goes on about death of capitalism. Huh? Folks, we are debating health care. We already have government run health care, now we are trying to improve it and make it sustainable. It has nothing to do with capitalism. Perhaps that reader thinks Sweden, Switzerland, or Canada are not capitalist societies?? Then there's another reader who deplores all the Moms at a free neonatal care clinic. Duh. The reason they are there is because they can't afford insurance here in America. Nobody goes to a free clinic if they had the choice of a personal physician. Why can't these people focus on the issue at hand instead of throwing up smoke screens?

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Clearsky 5 years, 1 month ago

JLM. It weirds me out that you are referring to me as Babe. Your friends might stand a little further from you in the men's room unless of course you are -----. Which is your choice of course.

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JLM 5 years, 1 month ago

Believe me, clear, babe, nothing could make you weirder than you already are. But I must admit a strange attraction to you, you weird goose you. Don't worry, you're safe, babe. You're not my type. I like smart folks. LOL

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Fred Duckels 5 years, 1 month ago

This subject sure brings out the hate America crew. This has to be the worst country conceivable. If things are this bad I could surely use a little more elbow room.

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JLM 5 years, 1 month ago

Actually the more folks involved the healthier the debate (pun)!

It is interesting to note that the margin of Obama's victory (for that matter all Presidents elected since WWII) is far less than the number of registered voters who simply failed to vote.

Said another way, the majority failed to speak with a unified voice. Now, perhaps, they have found their voices.

Perhaps a good dividend paid by this debate will be that perhaps more folks will participate with increased vigor and interest in determining the nature of our democracy and its leadership in the future. That would be a good thing!

In any event, it is clear that the Obama strategy is to go back into "campaign mode" --- a sophmoric, shallow and cynical strategy when the quality of one's thinking is dwarfed by the nature of the delivery.

The Romans had circuses and the Americans have town halls. In both venues, the lions are roaring and the politicians better take heed. The American lion has been awakened and she is pissed!

The good news is that the recession is starting to wind down.

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Chuck McConnell 5 years, 1 month ago

Those crying for nationalized health care are typical left wing bleeding heart liberals with no concept of reality or national economics.

Here are the realities: Medicare is a national unfunded liability to all of us. Medicare -- the current socialized health care system --is bankrupt. The Federal government's prescription drug plan is bankrupt. I remember the debate and the government promised us it would pay for itself. Not true. Medicade is bankrupt in nearly all states. In some cases, states are forced to cut back on benefits because there is no money to pay for services.

And now you believe the government can mandate adding 47 million people to the system and not bankrupt the entire economy? Come on, if this health care plan is passed all benefits will be cut and taxes will be raised. Why don't liberals go to their elected representatives like conservatives do and demand tort reform and caps on medical liability. This action alone could pay for medical coverage under the current system for millions of citizens.

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JLM 5 years, 1 month ago

"...you will lose this debate in the long run."

That's the thing about it, trumpy, it's not just a debate --- it's an important policy decision which will have a massive impact on our economy and all of our citizens. In their health care and in their pocketbooks.

The issue is to "get it right" not to "get it done".

Obama has wandered off course when he begins to use analogies which compare and contrast FedEx and UPS w/ the US Postal Service.

Free enterprise capitalism v government subsidy --- and still the US Postal Service cannot compete effectively.

It makes the point that is really scaring many thinking Americans. Hmmm, if the government cannot deliver the mail and packages in a cost effective manner in competition with FedEx and UPS --- how the heck are they going to deliver health care and why would anyone in their right mind --- apparently now includng the Obammer himself --- think the government could be effective, efficient or competitive.

If FedEx and UPS were allowed to deliver first class mail --- which they are prohibited from by law --- the US Postal Service would be closed down in about 10 days.

Why, why, why do we subsidize failure? At the US Postal Service, at GM? These are political boondoggles. Government run health care is going to be different? Why? How?

The US Congress is so tone deaf that they cannot see the conflict between chewing the butts of auto executives in their private jets and buying a quarter billion $$$ of Gulfstreams for their own travel --- planes not requested by the Air Force, mind you. This is the quality of the intellects which are wrestling with your health care future.

You have a right to be scared. If you have a brain, you should be scared.

The simple truth of the matter is that governments never compete effectively with capitalism and free enterprise --- more importantly, they should not even try.

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NamVet 5 years, 1 month ago

Lynn great article, it was great to see some facts instead of spin and misinformation about killing our seniors, free abortions, health care for illegals etc. It is great also that Rob, JLM and See have done very well in life and are wealthy enough to pay for any health problems they and their families might have. More power to them and I'm really happy for them, however most people in this country are not as fortunate as them. I know many people who have had their insurance cancelled due to pre-existing conditions or loss of job. This is what I call rationed health care. We are all concerned about the financial future for this country and I'm glad they are now on board when it comes to fiscal responsibility. Unfortunately they must have been out of the country over the past 8 years of which 6 were totally controlled by the most fiscally irresponsible Administration of modern times which they seem to adore. Why not let both the Republican and Democratic plan for health care take effect and let the people decide what they want. All US citizens can chose from the Republican plan which allows them to opt out of ALL gov't health care forever like Medicare, Medicaid etc. and instead receive a $5200 a year tax credit(McCain Plan) to buy the health care they want from the insurance company they choose. This includes all Congressman and Senators who will no longer get a free ride. On the other hand they can choose the Democratic plan that would let them keep their present plan or buy into a gov't option plan. Each plan must not add to the deficit like the Medicare Part D did which was supposed to cost 300 billion over ten years and now is estimated to cost 1 trillion according to the CBO. I think Pres. Bush and the Republican Congress gave us that one along with the "Iraq War would totally be paid for by the Iraqi oil revenues" which was another 1 trillion wasted.

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Matthew Stoddard 5 years, 1 month ago

JLM- The USPS isn't doing well not just because of being a Government entity. The Fax Machine and E-Mail have taken up quite a bit of it's business when it comes to regular mail (which UPS and Fed-Ex don't provide), along with smaller envelope sized overnights, due to electronic signatures. Same thing applies to Holiday/Special Occasion cards- you can email those personalized now, and many times, from free sites. You just can't fax or email larger packages, which Fed-Ex and UPS rely on. Even then, they can suffer the same foibles as USPS for delivery.

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boatgirl 5 years, 1 month ago

JLM, you disgust me. You just sit on your computer all day and spew angry conservative babble on Steamboat Pilot's website. You obviously haven't been afflicted with an everyday condition or a persistent medical problem, because your view on healthcare is so backwards. The right wing strategy of showing up at town hall meetings and screaming their heads off about socialism and "death panels" is pathetic. They are just using health care reform as a platform to vent their anger and fear towards Obama.

So why don't you get off the computer, turn off Glenn Beck, and open your mind a little.

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JLM 5 years, 1 month ago

Boatgirl, you obviously know nothing about me and my views on healthcare. First, I am in favor of universal healthcare and as an employer I have provided healthcare, dental, eyeglasses and life insurance to my employees for over a third of a century. When you were first thinking about it, I was already doing it.

I am in favor of allowing the private sector to solve its own problems in much the same way that FedEx and UPS have beat the pants off the USPS --- or alternatively how Amazon, Costco and Sam's Club have turned retailing on its ear by using technology, affinity groups, purchasing power, entrepreneurial zeal, low cost facilities and reliable service.

I support:

Tort reform --- to dramatically reduce the value of judgments which are not paid to the victims but rather to their contingency attorneys <<< the John Edwards model of jury driven junk science sweepstakes has to stop

Binding arbitration --- just like the entire securities industry and able to be completed at a low cost to maximize the payment to victims

Tax deductibility --- of insurance premiums for both business and individuals thereby levelling the playing field

Uniform contracts --- contracts which are standardized as a means of protecting the public against the vagaries of state law

Purchasing coops --- the ability for individuals and affinity groups to combine purchasing power when buying insurance, medical supplies and pharmaceuticals in much the same way that Costco and Sam's Club purchase in bulk and sell individually

Doctors --- get the AMA out of the business of limiting the supply of medical doctors through their school accredidation programs and create a supply of doctors whose focus is not on becoming rich --- get these doctors into local clinics and make house calls

Nurses --- create a super nurse category which is able to prescribe drugs and provide treatment under the supervison of a doctor as described above --- get these nurses into local clinics and make house calls

Wellness programs --- develop wellness programs which are used to prevent the onset of disease before it happens

National hospice network --- a national network, in conjunction with clinics, where terminally ill folks can be cared for in the last months of their lives with dignity and respect

Portable insurance --- create a portable insurance policy which can be transported from affinity group or purchasing coop to another without regard to geography

You will note, boatbabe, that there is not a political element to anything I support. Why? Cause I have actually been doing it while you have been wrestling w/ inverted cranial rectum syndrome, my pretty!

Get over yourself!

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JLM 5 years, 1 month ago

So, Mattie, your point is exactly what?

The USPS is not making money, has wasted an enormous government subsidy, has not been able to adapt to a changing marketplace for its services and is probably not the exemplar that the President should be holding up for government healthcare?

We seem to agree, no?

Beware --- there are some things in life that the "fake it until you make it" approach of this administration will simply not solve --- the economy, the wars and healthcare.

The rest? Hell, let's have a town hall meeting, Andy Rooney! Yeah! Whee! Oh boy!

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Matthew Stoddard 5 years, 1 month ago

Yes, it was a bad example for him to bring up, but it can't be related. Health Care will always be a tangible, needed (until immortality sets in to all of us) commodity while mail is not. But, if you like, we can have the internet taken over by USPS to make it viable again, making you pay for each email you send on top of what you pay your provider. Or, if you just check your email from places like the Library, you're email provider can start charging you. How capitalistic is that? Very.

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JLM 5 years, 1 month ago

Mattie, your problem is you don't understand capitalism. Capitalism is rooted in the concept that entrepreneurs fulfill a market driven demand in a competitive environment at an attractive price point.

Think about how the cell phone business has evolved until it has become a freakin' utility. Hell, people are now going to have a cell phone number assigned at birth and the landline will be a thing of the past.

Do you remember the first cell phones --- the Motorola "brick" phones you could drive a nail with? Do you remember $1.25/minute calling rates?

Now, through the magic of capitalism, cell phones are cheap and so useful they have begun to converge with the Internet, PDAs, digital cameras and mobile computers. That is capitalism at its best.

The services go up while the cost goes down all because some entrepreneurial wizard had a vision and was driven to give consumers what they wanted at an increasingly cheaper price.

Damn, capitalism is good.

That is what we need with healthcare --- just a nudge in the right direction and turn loose those entrepreneurs to satisfy market driven demands at an increasingly lower price.

And remember, telecom is a highly regulated field but guess what? The government has had the wisdom not to try to do it itself but rather to let the private sector --- subject to appropriate levels of regulation --- go forth and harness the power of capitalism.

We can do the same thing with purchasing coops, digital records, standard health care insurance compacts, tort reform, binding arbitration, portable insurance --- if only the government would harness the power of capitalism.

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Matthew Stoddard 5 years, 1 month ago

Oh, I understand capitalism just fine. Unfortunately, all people NEED health care and it shouldn't be bid upon, unlike mail and cell phones. And that nudge (since private health care hasn't "brought prices down") will be with a public option, forcing the competitors to actually compete. Funny how a far-right conservative is espousing more regulation. No more of the "We had to RAISE our prices so we could compete," chestnuts would be fine with me, but that doesn't happen right now because private industry- no matter what it is- is profit-driven and always will be.

And again- not everyone NEEDS a cell phone...they just want one. That's why it doesn't have to have more government intrusion. A telephone has always been a utility, also. It's just in a different form now. Nothing new there, since AT&T broke up.

Your last paragraph sums it up perfectly: Government will regulate the price point by making them compete...with the Government.

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JLM 5 years, 1 month ago

"Government will regulate the price point by making them compete:with the Government."

LOL Yeah, that's worked out well with the United States Postal Service, right?

Name the single function of government which when in competiton with the public sector has been able to compete effectively, provide a quality service and achieve a competitive pricing point?

Honestly, there is none. Why? Because it is not a legitimate function of government. Governments are not organzied to provide business services to their citizens.

Should we bet 15% of the Nations' GDP on an idea which has no basis in reality, one which is a complete blind experiment and one in which its very sponsors and proponents will NOT even participate?

Parachute riggers at least have to jump with the same chutes they pack. The US Congress will never be subject to the mess they create with healthcare. Never. Ever.

Does that lack of confidence not scare you?

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Chuck McConnell 5 years, 1 month ago

Why do liberals believe health care is an entitlement? I took another look at the constitution and there is nothing there about socialized medicine. Our economy has been successful because of free enterprise -- not government fiat! Liberals, move to Canada and quit trying to bring down our economy.

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Matthew Stoddard 5 years, 1 month ago

chuckmc- Sound familiar? Note that "general Welfare" portion:

"We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America."

A healthy country is a safer country. I guess you don't want to remain safe, then? I sure do. It's why I gave up drinking 18yrs ago and finally cigs 3yrs ago.

Isn't free enterprise, with all it's "competition" what caused the recent collapse of our economy just back in September? (although we'd been in Recession for 1 1/2 yrs prior)

JLM- The USPS was doing just fine competing with packaging, since their tiered rates on Overnight could start out lower priced. Priority is much less than a 2-3 Day Option. (I've also worked for Mail Boxes, Etc., at one time.) The downfall is the 1st Class Mail and 3rd Class Mail. It's already been stated that due to the recession, less companies are sending out that 3rd Class "junk mail" which can be a cash-cow for the USPS when times are good. 1st Class just plain can't compete with "Free" email.

Look up UPS and Fed-Ex and you, yourself, can compare what happened to their sales of Flat Envelope deliveries with the prominence of the fax machine starting in the early '90's and email (with electronic sigs) in the late 90's.

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seeuski 5 years, 1 month ago

"Isn't free enterprise, with all it's "competition" what caused the recent collapse of our economy just back in September? "

How was the crash of the mortgage industry not a Government involved failure? I guess Fannie/Freddie had no role in providing the funding for the liar loans that led to the collapse of the economy. It was exactly the Governments intervention in private underwriting standards that set the whole mess in motion. But I'll say it's day and you'll say it's night. And now one of the big players in the Freddie Mac debacle and their cooked books, Rahmbo Emanuel, is Obama's right hand man and you want people to feel good about the Government running/ruining our personal health care with Socialized medicine? Not a chance.

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Chuck McConnell 5 years, 1 month ago

Wow! General welfare twisted to mean socialized medicine? Now that's one of the longest stretches I have ever seen. The liberals have abused the word "welfare" so far to produce a $1.3 trillion debt that Obama, et. al. are increasing nearly exponentialty in their ongoing budgets -- debt that will never be repaid. You and your cohort are draging the US into a third world failure. If you are not able (or, I'll bet willing) to explode your personal debt beyond your ability to repay why should we collectively as a government?

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Matthew Stoddard 5 years, 1 month ago

chuck- Maybe with lower insurance premiums, due to having to compete with the public plan, we all can have more spending cash for non-necessities- frivolities...which jump-starts the economy again with more tax flow to can help pay down the debt. It might even allow you to save money on top of that.

Seeuski- you're not even worth it any longer. You just go on chasing your tail, running in small circles. You are a partisan to the Nth degree and you're correct: I can never agree with that.

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Chuck McConnell 5 years, 1 month ago

Matt -- with respect, if we have more money in our pockets due to a public option it will be taken out of the other pocket with higher taxes (or much lower medical benefits). Nothing the government does is free. Government intervention will not be free nor will it lower overall costs. We simply cannot add 47 million people to medical care and lower costs. Medicare is broke!

Could we at least agree that if the excessive costs of mal-practice insurance were mitigated by mandated caps on liability of providers we might actually lower costs to all of us and only be a negative to the trial lawyers who make millions on these cases? Or, alternatively, if caps were in place we could actually use the billions in savings to insure a significant number of the currently uninsurred.

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JLM 5 years, 1 month ago

Really, what possible evidence is there that anything provided by the government can possibly be provided at a lower cost than the private sector? Anything?

What current government program gives you confidence that the government can run a business?

Isn't the government running Medicare and the US Postal Service and aren't both of these financial failures whose only reason for still being in business is enormous gov't subsidies?

Educate me, please.

Chicken salad cannot be made from chicken excrement!

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Matthew Stoddard 5 years, 1 month ago

Chuck- I do agree with you on those points, but a lot of money goes into insurers coffers as plain profit. CEO bonuses and the like...you hear about it every day. Didn't someone just get a $100 million dollar bonus payout the other day? Can't remember who, but it was on the news. I agree with paying a bonus...but c'mon...$100 million for a single person payout? That's capitalism gone wrong.

This is why both sides need to work together, but when either side says "Let's work together," they mean, "Let's work on what WE want...together." Compromise on both sides is how you get things done. That's why I'm starting to vote more 3rd party now, just to get someone else in there.

JLM- For the reasons I provided before (are you sure you aren't Hannit-ski when it comes to not actually reading?), the USPS is a money loser for non-governmental reasons. UPS 10yr stock average has been fairly stagnant. Fed-Ex had a great surge in the early to mid 2000's, but has recently leveled to UPS's average. There's no innovation in shipping until someone invents teleportation.

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JLM 5 years, 1 month ago

The US Postal Service is a "loser" because it consumes huge amounts of government subsidy and is unable to turn a profit.

Both FedEx and UPS generate profits, provide jobs and pay taxes. Stock market performance is simply the measure of what an investor values it at at an instant in time.

You may not have noticed but the stock market has been a bit "down" of late. Hell, even Berkshire Hathaway is down 40%.

The intrinisic value of the enterprise as measured by its profits, taxes paid (income, state, sales, payroll, etc.), employment, taxes paid by employees, etc. is huge.

More so because they are doing it with their own money and not with government subsidies.

Any way you look at it, no reasonable person would say --- hey, sure the government has no experience running a profitable business and the only health enterprises we have entrusted them with (Medicare, Medicaid, CHIP, VA) are broke, abysmal failures but what the heck, let's give them 15% of the GDP of the US --- and, have a nice day!

This is reality and sometimes reality is not a pretty thing!

Not to put too fine a point on things but you might want to take another peak at the FDX graph, mattie, as it is pretty spectacular since 1980 and is damn sure not too shabby over the last ten years either. Don't want to confuse you with hard facts though, sorry. I'd take that return in a NY minute.

If your argument is founded on FDX being a bust over the last ten years, you may want to reconsider.

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seeuski 5 years, 1 month ago

"Didn't someone just get a $100 million dollar bonus payout the other day? Can't remember who, but it was on the news."

Read? For what? Stoddard is always right.

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dave mcirvin 5 years, 1 month ago

why not universal health care in the US? it is one of purest forms of unselfishness. we are all only one terrible diagnosis from a family emergency.

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JLM 5 years, 1 month ago

I don't think any right minded person in the US is against universal healthcare, it's just the mechanism of paying for it all that is in contention. And whether it is reasonable to expect the government to run a busness of this magnitude --- 15% of GDP ---given their demonstrated track record on such things as Medicare and the US Post Office. There ARE some things the government cannot do and cannot do well.

I am a pretty conservative person but I have provided health, vision, dental and life insurance to my people for a third of a century. At times I have had as many as 400 employees.

For the first time in my business career, I am contemplating cancelling our policy because of the implications of the current policy direction. I am a long way from making that decision but it has certainly crossed my mind.

Perhaps the fundamental problem is that the folks designing the program (that would be the Administration and the US Congress) are designing a plane they will never fly in --- they don't intend to amend their goldplated coverage.

Unfortunately the current debate seems to be about "free" healthcare rather than universal healthcare with everybody having a bit of skin in the game.

To provide universal healthcare everything has to be on the table including tort reform and the AMA's control of medical school accredidation. There can be no sacred cows in this hamburger.

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Chuck McConnell 5 years, 1 month ago

Matt, I agree with you about the third party issue. I am very strongly considering changing to independent.

I was a CEO of a public company several years ago and am one who believes the excessive salaries and bonuses are a disgrace. In my time in business I never saw anyone worth that kind of money (even me as good as I was, LOL). My belief is that CEO jobs can be done just a well by business leaders making far less. Blame the shareholders who are afraid to speak up and insist on reasonable compensation.

Grand Junction is a model of what can be done to provide health care for everyone -- without government intervention -- with just a little cooperation from the medical community. What if the AMA mandated that every Dr. give just 3 or 4 hours a week to a public clinic?

Looks to me like the polarized sides would rather fight than solve the problem rationally.

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Chuck McConnell 5 years, 1 month ago

seeuski, I hate to burst your bubble but the housing crisis was caused at least in equal part by government. In the late 1970's the Feds. demanded that banks loan money for home purchases to people who could not afford the homes. It was called the "Community Reinvestment Act (CRA)" and was done to stop what the government called "red-lining". It was just another way the fringe left wanted to redistribute wealth. Over the years, billions of $ of loans were made to people who were within banking institution's sphere of business but were unqualified for loans by any standard. Also, Greenspan kept interest rates near zero for years after 9/11 and millions more bad loans were made because now even more unqualified borrowers entered the system. I do not deny the unabated greed on the part of Wall Street and others that exacerbated and ultimately precipitated the crisis, but to deny the hand of our Robin Hood leftist Federal government is to deny the truth.

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Chuck McConnell 5 years, 1 month ago

seeuski,

My bad. The above was intended to support your view not to refute it.

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JLM 5 years, 1 month ago

Corporate governance pre-SOx and the remaining vestiges of those ills are responsible for public company CEOs being over compensated.

The practice of CEOs attracting and nominating their "friends" to serve on highly compensated Boards of Directors and having that Board appoint a "compensation committee" to negotiate the employment agreement w/ the same CEO who was instrumental in attracting them to serve in the first place is nonsense.

CEOs should be compensated based upon a "living wage" --- which granted for a large cap company may be a tidy bit of change to start wtih --- and then based upon the actual value created during their tenure.

Executive comp should have a mix of salary, performance bonus based upon specific performance parameters, incentive compensation (short term, specific objectives, long term) based on stock price, deferred compensation, benefits and ownership. Well run companies provide their CEOs with incentives which align the attainment of those incentives with long term shareholder value.

And, then, even when everything works out just fine, there is a level of compensation which is just obscene whether in its absolute magnitude or in its insensitivity to other real world implications.

Nonetheless there legends of the right CEO creating gobs of shareholder value and thereby rightly deserving extraordinary compensation.

Stock based compensation --- which does, in fact, align managment and shareholder interests --- with appropriate vesting periods is a useful tool, but, alas the sheen has been taken off stock optons with their current accounting treatment.

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Chuck McConnell 5 years, 1 month ago

In no case is a CEO worth $100 million. Shareholders put up their money and risk which enabled the CEO to perform. Besides, how thick a steak can a CEO eat, how fast a car can he or she drive, how big a home is big enough? All of those things can be maximized at a compensation of $5 or $6 million without going to some of the abhorent excesses we see today.

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seeuski 5 years, 1 month ago

chuckmc, I see that you have perfectly described the history of the mortgage crisis which led to the economic meltdown. I would add that the CRA was then taken advantage of by the mafia style bullying tactics of the ACORN gang when they bullhorned at the homes of bankers and rallied into the bankers boardrooms en mass which caused the Congress to further ease the Fannie/Freddie underwriting standards in the late 1990's which caused Clinton, to his credit, to warn the Dems in Congress they were going to far. The worst part of it all is the culprits who are most responsible for this mess were rewarded with election victories in 2006 and 2008 basically putting the cats in charge of the hen house. So it is up to an awakening American populace to stand up against the Socialist agenda that is being shoved down all of our throats.

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seeuski 5 years, 1 month ago

And chuck, I did not name the quoted a few posts ago for sensitivity reasons. Sorry for the temporary confusion.

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Clearsky 5 years, 1 month ago

It really is quite simple, allow US citizens to choose to pay extra for Medicare coverage or choose private insurance. The systems are already in place. A society must take care of its workforce or it will collapse. Personally I'd like the same coverage as federal employees and our elected leaders. We tax payers are already paying for the un and underemployed. Its the working class that needs affordable coverage and the government appears to be the only entity that can deliver.

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seeuski 5 years, 1 month ago

So Clearsky, are you for HR3200 in it's current form? Or are you more inclined to go for proposed House bill HR3400 which deals with what appear to be your concerns?

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JLM 5 years, 1 month ago

Chuck, you do not really understand corporate finance.

Shareholders own the "equity" in a company they do not invest "in" the company. Their money does not go to the company to invest, it goes to the seller of the shares they purchased.

The simple truth of the matter is that sometimes compensation is, in fact, proportional. If a corporate CEO creates $10B of stock market value who cares if he is being paid $110MM --- even as obscene as that number truly is?

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seeuski 5 years, 1 month ago

Boatperson,

Why don't you add some substance to the discussion instead of commentary?

Anyway, here is a factual application of what would work and is working to cure the problems of health care.

http://www.washingtonexaminer.com/opinion/columns/OpEd-Contributor/Tort-reform-must-be-part-of-health-care-reform-8096175.html

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Boatperson 5 years, 1 month ago

Lynn Abbott nice post, thanks.

Wait I thought this blog was about Health Care (Insurance)

A mish-mash of misconbobulated utterances! So you say, she said, he said and this guy's a Doctor. Therefore, my opinion based on bits an pieces of opinions of others has to be absolute and accurate.

Say What?

There are five different bills in the House three of which have moved on to the Senate all of which need to be conjoined, modified before they get to any type of final stage or vote. Any quotes made by individuals in this forum from HR 3200, HR 3400 or any other (H) House of (R) Representatives bills or (H) House (C) Committee bills about the end of Medical Care as we know it are pure conjecture.

SEIU representing the Nurse's of America and initiatives for Medical School Students to become Primary Care Physicians are an Important partner in any Health Care (Insurance) Reform referendum.

There are NO proposed entitlements. There are proposals to modify risk by covering everyone thus reducing cost, Health Care Cost. Not eliminate the Medical Care we have now; the best in the world(?).

P.S. Here are the Buzzkill winners of the blog so far

JLM - Capitalist (only)

seeuski - Speaks (only listens to himself)

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Boatperson 5 years, 1 month ago

Just to clarify a prior quote from the blogdom:

"Perhaps the fundamental problem is that the folks designing the program (that would be the Administration and the US Congress) are designing a plane they will never fly in they don't intend to amend their goldplated coverage."

"Members of Congress receive retirement and health benefits under the same plans available to other federal employees. They become vested after five years of full participation. Members elected since 1984 are covered by the Federal Employees' Retirement System (FERS). Those elected prior to 1984 were covered by the Civil Service Retirement System (CSRS). In 1984 all members were given the option of remaining with CSRS or switching to FERS."

2009 Federal Employees Health Benefits Program

Rates ( Non-Postal Monthly )

Self - Aetna HealthFund -CDHP - $87.71, Aetna HealthFund -HDHP - $67.01

Family - Aetna HealthFund -CDHP - $201.72, Aetna HealthFund -HDHP - $146.75

Rx Mail Order -Supply Size Per Copay - 90 Days Rx Brand $50, Rx Generic $20

Rx Brand Local Pharmacy - $25

Rx Generic Local Pharmacy - $10

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Boatperson 5 years, 1 month ago

seeuski,

You mean why don't I inject some out of topic interest of my own, and then rebut with URL's of that topic? What is it? "The Wise Man Listens While the Fool Chatters"

I digress, I'll do it your way. I'll post a URL:

http://www.pbs.org/wgbh/pages/frontline/video/flv/generic.html?s=wwir0epb30

Please remind yourself not to make any assumptions until after the presentation. The presentation answered my question of why TORT reform was not on the table.

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JLM 5 years, 1 month ago

Boat --- you are about half right as it relates to US Congressmen and their families. Which is a marked improvement in your batting average --- congratulations!

What you fail to mention is that while Congress is in session a full medical team is standing by at all times day and night IN the Capitol solely for the benefit of the Congressmen.

Hell, a Congressman can get an x-ray, an EKG and lab work done right in the damn US Capitol. But no MRI. Yet.

A Congressman can receive a full physical, a checkup and other elective care in the Capitol.

In addition, a Congressman can be treated at Walter Reed (though WR is slated to be shut down soon).

There is a pharmacy in the Capitol and the Congressman can charge his co-pay to his Congressional account --- comes in handy for those Viagra prescriptions.

In addition, the families of Congressmen can also participate in their plan.

So, yes, indeed the poor Congressmen are enrolled in the FEHBP but they get a few extras including no pre-condition limitations!

Bottom line, US Congress is working on a plan for you cause they've already got a pretty damn good plan for them.

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Boatperson 5 years ago

"Wisdom is what's left after we've run out of personal opinions." - Cullen Hightower

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Chuck McConnell 5 years ago

JLM

I think we agree on a lot of issues but the overpayment to CEO's likely is not one of them.

CEO's like Bill Gates and many others deserve anything they get because they started their companies. Professional managers usually do not create much wealth. Most of the time they are simply in the right place at the right time. A CEO of an oil producing company, for example, who receives a huge bonus because profits of his company increase ten fold as a result of the price of crude oil going to $147 through no action on his part is unfairly compensated. Examples like that occure all the time, believe me. On the other hand if a company is failing and losing money and a new CEO comes in and turns the company around that person does deserve large compensation. All too many times the rich payouts are made as a result of circumstances and not real innovation.

And, I do understand corporate finance. I was very successful in running a billion $ company.

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JLM 5 years ago

chuck ---

I don't disagree with you at all as it relates to your example of a commodity like oil driving the profits of an oil company. Chalk that down to luck not management skill. I like lucky while understanding it is often just the product of fortuitous timing. As Napoleon said: "I like lucky generals."

Nonetheless, the increase in share value for a company's shareholders is a true measure of value. Pension funds can more fully cover their obligations, investors can cash in for their own American dream; and, widows and orphans, well, they can become wealthy widows and orphans.

Luck, yes, absolutely! But sometimes, luck is all it takes. Corporate boards have a role to play and corporate governance must play a role in setting CEO compensation. Nonetheless, no shareholer is going to curse a CEO who is lucky and whose presence happens to coincide with a huge run up in their stock portfolio. This is simple human nature.

As to understanding corporate finance, you should now the difference between a company's market capitalization and its balance sheet. To imply that the trading of a share of stock has some direct connection to funding the company's operations is sheer nonsense. Shareholders do not deliver cash to a company which is then managed by the CEO.

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