John T. Salazar: Time for health care reform

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In the coming weeks, Congress will be taking action on one of the most important pieces of legislation that will come before us - health care reform.

It is no secret that our current system of delivering and paying for heath care is broken. We all know someone who has lost a job and the health insurance that went with it. Or the cousin who could not get insurance because of a "pre-existing condition." Or a neighbor who is sick but can't afford to go the doctor. Or a friend who has insurance but had a claim denied because the services weren't covered - and they don't know how they will pay the bill.

It simply is unacceptable to have a country as great as ours where millions of people go without health care. It's estimated that nearly 46 million Americans - your friends, neighbors and relatives - have no health insurance. In Colorado alone, more than 800,000 lack coverage.

Earlier this year, we made a small but important dent in the problem when we enacted into law an expansion of the State Children's Health Insurance Program. This law, which I supported, expanded health insurance coverage to thousands of children who previously had gone without health care. This was an important step, and I'm proud to have been a supporter.

But more, much more, needs to be done. It's time for comprehensive health care reform.

The issue isn't whether the system is broken or whether major reforms are necessary. The devil is in the details, and this is where considerable discussion and debate are taking place. What should we do to reform a complicated, complex and expensive system?

Let's start with what's right - many Americans like the private insurance they have, as well as the doctors who treat them. They should be able to continue receiving the care they have become accustomed to.

Many seniors like the care they receive under Medicare - and many veterans like the health care provided under the VA health system. These, too, should continue to meet the needs of these groups.

There may be other aspects of the current system that should not be eliminated or are only slightly in need of some improvements. But that leaves us with the reforms that are necessary to fix the rest of the system.

Proposals include insurance reform - doing away with "pre-existing conditions" clauses that prevent millions of people from getting coverage when they need it the most. Coverage options and prices should be clear to individuals and businesses so they will be able to shop and compare plans to find one that fits their needs and is affordable. And insurance companies must no longer deny payment for claims - in effect, stepping in between the physician and the patient to decide what care is available.

The health care challenges facing rural communities must be addressed, as well. Too many communities are underserved by doctors, hospitals and clinics. We must find ways to attract more providers to communities and shorten the distance between facilities and patients by increasing the use of telemedicine and other creative uses of technology. Reimbursements from Medicare and insurance agencies must reflect the challenges rural providers face in a setting where there are fewer patients, higher costs to deliver prescription drugs and medical equipment. Reimbursements cannot be based on cost of living prices.

There is considerable talk about including some kind of public option to compete with the private plans. I think a public component may very well be necessary as part of any real health care reform.

Finally, there are the costs. I strongly think any reform must be deficit neutral and fiscally responsible. We can find ways to pay for health care reform by eliminating duplication and inefficiencies in the current system, such as promoting the use of electronic medical records and stopping waste, fraud and abuse. Prescription drugs cost too much, so we must find ways to lower those prices for the sick to be treated. Unnecessary testing must be decreased, along with incentives that result in such testing.

None of this will be easy. Many powerful interests have a stake in the way the current system operates, and they won't give in without a fight. But I think we have too much at stake to simply sit and do nothing about the current situation. Too many people have been hurt by a health care system that is supposed to heal. Too many people have been broken by a broken system. Too many people have gone without in a system that is supposed to provide.

It's time to heal our ailing health care system. It's time for real reform.

Congressman John T. Salazar represents Colorado's Third Congressional District in the U.S. House of Representatives.

Comments

BoatNative 5 years, 3 months ago

Congressman Salazar,

I am pleased to hear that you understand the vital need for health care reform and the necessity for it to happen this year. It is hard to count on you to support issues that are in the platform of the party from which you are elected (hint, hint. . . climate change). I appreciate that you are a strong, independent voice in Congress, but you played politics with that vote and you did not need to.

I hope we can count on you to be a leader for our district and help bring health care legislation through the House and to the president's desk by the end of this year.

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Rob Douglas 5 years, 3 months ago

For a more objective view of the so-called health care reform measure the Obama administration and Congressman Salazar are attempting to ram through Congress with consequences that could devastate the American economy especially the small business owners that are the economic engine of Steamboat Springs and America readers may want to read David Broder's piece this morning in the Washington Post. Broder, a left-of-center columnist, is known as the Dean of Washington Pundits both for his seniority and his refusal to suffer fools of the political class lightly.

Here is the link to "Will the Current Proposals Fix Health Care?:

http://www.realclearpolitics.com/articles/2009/07/19/will_the_current_proposals_fix_health_care.html

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seeuski 5 years, 3 months ago

Salazar expresses the talking points very well. Our system is broken, lose a job and lose your coverage. I don't think so Ken. Ever heard of COBRA? what about the current Government assistance which pays 65% of the monthly payment if you lose your job? This fear mongering is a ploy to scare the American public into supporting something that will be run by Congress and boy do they do a good job of running(ruining) stuff. I'll pass on Government health care Ken. Why would anyone support this when you can't even show how it will be funded and it won't cover everyone? The CBO pulls off some of the wool from the true cost estimates. Not too good. Thanks anyway.

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Rob Douglas 5 years, 3 months ago

Another resource that small business owners in Steamboat may want to take a look at is the analysis of the current proposed legislation done by Salazar's Colorado Democratic colleague, Rep. Jared Polis, who has shown the courage to stand up to Speaker Pelosi and President Obama on behalf of Colorado's small business owners.

Here is a PDF copy of the letter Polis and other Democrats (not Salazar) sent to Pelosi this week: http://polis.house.gov/UploadedFiles/Polis_Health_Care_Reform_Surcharge_letter.pdf

Here is Polis' press release about the letter: http://polis.house.gov/News/DocumentSingle.aspx?DocumentID=137963

And, here is a news piece crediting Democrat Polis standing up for small business owners, unlike Salazar. http://voices.washingtonpost.com/health-care-reform/2009/07/health_bill_advances_in_the_ho.html?hpid=topnews

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trump_suit 5 years, 3 months ago

As a small business owner and cancer survivor I can attest first hand that the health care insurance system is broken. What is needed is a way to reform the current insurance system.

A couple of rule changes that could be implemented with almost no cost to the taxpayers are:

  1. There are no more employer "Groups" If you have a social security number you are in the group and can purchase the same plans as Gov't employees or GM employees at the same rates.

  2. Pre-existing conditions no longer exist. If you have insurance on the day you are sick you are covered .

  3. No more "out-of-network" The insurance companies should be allowed to set maximum payouts, but should not be able to control who provides that service.

I would encourage Congressman Salazaar to approach the reform of healthcare insurance and leave the healthcare providers alone now. A fair market place to purchase insurance would level the playing field for all and a more affordable healthcare system would be the end result.

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Fred Duckels 5 years, 3 months ago

I hear complaints about the private health insurers being too insistent on cost containment. On the other hand that is never the problem with the fraud riddled medicare. This government system is failing because it is riddled with fraud and is essentially a candy store. It will be impossible for the private sector insurers to compete with a complete giveaway. If everyone had free health care it would be very difficult to get a doctors appointment. Insure 47M more and where are the doctors coming from? Let the government fix medicare before it starts spreading its wings, then they will have earned the right to further the spread of socialism.

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JLM 5 years, 3 months ago

Lies, damn lies and statistics! And, now add, politicians!

First, some basic facts:

In a nation of 300MM, we only have 45MM who do not have healthcare coverage. That is only 15%! Crisis? Hmmm, maybe not so much.

Private employers (not including the government at any level) directly insure the health of over 110MM of the 255MM who have health insurance. So this business about "taxing" healthcare benefits is a very, very big deal. It is a huge tax increase for over 110MM workers in the US.

This is an act of war against the small business employers of America and a huge tax increase for the employees. This is one of the mechanisms through which the administration is going to force folks to cancel their private insurance and join the government program.

We have the best healthcare system in the world and yes, it's the world's most expensive but not for the reasons that the Democrats want you to believe --- it is because the cost category "healthcare" also includes all medical research in which the US leads the world by a factor of 3.

The US spends more than 3 times the amount that Western Europe spends on medical research and the healthcare dweebs incude this in the cost of healthcare when accounting for the costs.

Interestingly enough, the government funds less than 35% of the cost of medical research in the US with most of the money coming from private funding sources --- your contributions to the American Cancer Society as an example. Oh, yeah, Obama wants to dramatically reduce or eliminate the charitable contribution deduction for everybody but in particular for the wealthiest Americans who are funding medical research with their contributions. Not too smart, O-man.

This is why the most expensive and exotic and desperate healthcare procedures and treatments can only be found in the US which attributes to the arithmetic cost of healthcare on a per capita basis.

Under an Obama healthcare plan, exotic and desperate life saving measures will be rationed regardless of whether you can afford to pay for them yourself or not. Why? Because the O-man does not want to provide such a procedure for a 85 year old man but rather for a 30 year old man based upon the patient's remaining useful life (taxpaying potential?).

The healthcare system is not the crisis that the administration would make it out to be.

Did you know that the Stimulus plan included a feature to pay 65% of the COBRA payments (the insurance continuation law for any employee who loses his job voluntarily or otherwise) of an employee --- by making the employer pay for it and then giving the employer a "tax credit" against other payroll tax payments. Of course, that implies you are still in business or still have enough employees that you are still paying payroll taxes against which to apply the credit. Just another way that the Obama administration is making war against the entrepreneurial and job creating class in America.

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seeuski 5 years, 3 months ago

Gee, that is what Bush wanted and the Democrats hated it then. No, I think they want the power that our collected taxes brings with it.

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howard_roark 5 years, 3 months ago

The current legislation, which Rep. Salazar supports, only furthers the misconception about and major problem with health insurance it is not insurance. Insurance is something you buy to protect yourself against major issues, not to pay for the routine. Do you bill your car insurance for an oil change or tune-up? Of course not!

The same should be true for health insurance. If individuals paid for routine procedures out of pocket, said procedures would be much less expensive. Why are people so afraid to ask about cost in the doctor's office? The nation that created and supported Wal-Mart will not shop around for a physical exam, it blows my mind. Inject a little consumerism into health care and prices will drop. One only need look at Lasik surgery, which has decreased in price and increased in quality over the years. Lasik is an elective, out-of-pocket procedure; people expect value for their own dollar.

That leaves insurance to do what it is supposed to do, protect against catastrophe.

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JLM 5 years, 3 months ago

Speaking of W-Mart. Have you heard the ads by WMart in support of the healthcare legislation?

Rumor has it that WalMart and Costco are both going to get into the health insurance business --- after all they both have pharmacies and opthamologists in their stores already.

Your comments in regard to simple purchasing disciplines pertaining to healthcare is right on the money. I needed an MRI for a rotator cuff problem and the price was $400 @ 3:00 AM or $1800 @ 4:00 PM. I got it at 3:00 AM --- no wait, undivided attention and no problem finding a parking space.

I had health insurance which would have paid for either time.

Health insurance requires everybody to have "skin in the game" in order to have folks focus on the real cost. If you never see a bill, then you really do think it is free!

And nothing is really free!

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seeuski 5 years, 3 months ago

Tort reform limiting lawsuits and awards is one of the major factors in healthcare costs and it is getting no mention anywhere. The Sawaya law firm, as an example, runs adds on TV all day ambulance chasing. Multiply them by the tens of thousands and you can see where so much cost comes from. Just ask ex Presidential candidate and cheater, John Edwards, he made millions suing Doctors. Doctors are paying about a $100k a year for medical malpractice insurance. In order to cover their behinds they are ordering extra tests on patients before endorsing surgeries which adds to the costs.

This is the area that needs reform. And don't allow the Dems to cut the Medicare coverage of Americas seniors, they earned it unlike the 20 million illegals who will benefit from the Dems proposed Government plan.

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seeuski 5 years, 3 months ago

Oh, and I love how the Dems scared the Seniors last year into voting for Obama by warning them the Republicans were going to do what the Dems are now proposing. Thanks Sarah Silverman for the schlep for Obama. What a hoax.

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Rob Douglas 5 years, 3 months ago

White House Putting Off Budget Update:

"The White House is being forced to acknowledge the wide gap between its once-upbeat predictions about the economy and today's bleak landscape.

The administration's annual midsummer budget update is sure to show higher deficits and unemployment and slower growth than projected in President Barack Obama's budget in February and update in May, and that could complicate his efforts to get his signature health care and global-warming proposals through Congress.

The release of the update-usually scheduled for mid-July-has been put off until the middle of next month, giving rise to speculation the White House is delaying the bad news at least until Congress leaves town Aug. 7 on its summer recess.

The administration is pressing for votes before then on its $1 trillion health care initiative, which lawmakers are arguing over how to finance."

http://www.breitbart.com/article.php?id=D99I8E485&show_article=1

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aichempty 5 years, 3 months ago

Medical costs can be controlled through a number of measures that will not impact the quality of care.

First, make all licensed medical facilities operate as not-for-profit organizations. That takes away the extra tax burden.

Reduce redundant paperwork that requires 2 or 3 people in the typical one-doctor facility to handle. The admin burden imposed by our system and by health insurors is ridiculous.

Reduce tort claims. Instead, prosecute doctors who commit fraud (there are plenty of them around), pull licenses and privileges for those who negligently harm partients, and limit cash payments to the cost of lost income and the cost of care required due to injury by a physician.

Put a 10% cap on attorney fees paid from court awards.

One of the big reasons we have high costs is because our system has created them. Attack the cost-driving rice bowls and get back to patient care for valid diseases and injuries.

Colorado has a "skier responsibility law." The United States should have a "patient responsibility law," that says, "we inform you of the risks of care, and you either agree to them or you don't get care." Even if our society owes a lifelong burden of care to those who are injured in health care facilities, we don't owe them billions of dollars in 'pain and suffering' compensation too. Income replacement and cost of care for a person making $100,000 a year is, after taxes, about $100,000 a year for anything less than 24/7 attendance by nurses in a hospital.

We've got to get past a system that piles on cost to eliminate legal liability in the 99.9% of cases that would go right without all the extra testing. Being injured has been turned into winning the lottery, and fair or not, I shouldn't be paying $300 a month on top of the $300-$400 my employer pays so that someone else can get a free ride from a mistake made by a third person. We can't handle the overhead anymore.

If the airline industry had the same liability burden as the medical industry, nobody would be able to afford to fly. It would be a lot cheaper to have two doctors on every case (like there are two pilots on every airliner) to back each other up than to continue with our current system.

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seeuski 5 years, 3 months ago

If the Government care Bill is passed into law would that eliminate any chance for people to sue for malpractice being that the Government is immune from lawsuits? That would suck, especially since a soldier just had both legs amputated after a military Doctor accidentally cut an artery while doing a simple gallbladder operation and he has no recourse. I am for tort reform but that would be the extreme.

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Robert Huron 5 years, 3 months ago

Health care is not a Republican or Democrat problem it is an American problem that needs to be fixed after decades of neglect. The US spends 19% of GDP on health care when other western countries spend less than 12% and they cover all their citizens and we cover 85%. From my personal experience I can attest that the present system of employer based health coverage sucks unless you work for a Fortune 500 company or you are a Senator of Congressman. This is why 100% of our Congresman choose the Government option over private insurance. Private insurance is increasing in cost by 9% a year so in a few years those that have a good employer based health care may lose it or have their costs and deductables increase dramatically. A government option not mandate may be the way to insure most of the uninsured providing the costs can be made reasonable. Some say this will cost 1 trillion dollars over 10 years which may be true. However this happens to be the same amount of money the government wasted in Iraq in 6 years which so called conservatives never complained about. If you lose your job you lose your insurance. Cobra may be an option but not in all cases like mine. My company went out of business in 2002 and all 2000 employees were denied Cobra. On top of that if you had a claim that had not been processed and paid it was now your responsibility at the non insured rate. In my case the insurance company would have paid $900 but now I had to pay $2500. One of our employees who had a heart attack was left with a $50000 bill. In another case I took my Father who was a disabled Vet to an emergency room in the Houston area at 9am. He was finally seen at 5pm and died a few days later because of internal bleeding. It took so long to be seen beacaue the emergency room was packed with the uninsured. Private health insurance has a 30% administive cost and a government plan would have only 3% cost. The difference is executive bonuses, advertising and whole departments whose jobs are to find ways to deny claims. Also insurance companies are spending 1 1/2 million dollars a day on lobblyists to try and stop a government option which should tell you they are afraid of any competition. I don't know what is the best solution but one thing I do know is the present system stinks.

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JLM 5 years, 3 months ago

Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires the insurance company to provide a continuation of the insurance program. It is not an election by the employer --- unless the employer has less than 20 employees or terminates the plan prior to conducting a layoff.

The government just paid $1.50/lbs for a million pounds of pork which is readily available at less than $0.75/lbs in two pound tins. This is how they are spending the Stimulus money.

The government is not going to buy anything better than Costco or WalMart. Get over that idea. You want these clowns buying something complicated like health care? Huh? They can't even buy pork competitively!

How the heck do Costco and Sams and WalMart do it? They are capitalists and are trying to make a buck. That is a good thing. Kill the capitalists and smother the entrepreneurial spirit and you will get $10/lbs pork!

The government? Not so good at things like that.

My condolences on your Dad. The presence in the Emergency Room of emergency treatment patients is not going to be materially reduced if the 15% of Americans who are not currently insured are suddenly insured because you cannot schedule a heart attack, a car accident or a gunshot wound --- even if you do have insurance.

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Robert Huron 5 years, 3 months ago

COBRA is not guaranteed if your company ceases operations and goes out of business. That happened to all 2000+ of us so I should know because I got stuck with the bills like many of us. Most uninsured people use the emergency room for their primary care which is the cause of overcrowding not heart attacks etc. This is not a problem in Steamboat but go to any major city and you will see what I mean. If they had health coverage they would not be there. That is a fact, talk to any ER physician in a major city and he will tell you that. What is better no health coverage or some kind of coverage government or something else?

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seeuski 5 years, 3 months ago

The argument as presented is as if everyone, or the majority of Americans, are having terrible times with their health insurance and that must not be true Mr. Huron as the polls don't bare out the evidence of it. More than 50% of Americans don't want what Obama is peddling. Don't forget that you are talking to people with their own experiences with health care and who can seek out the plan being pushed along with the history of Government run programs and Socialist health care performances in foreign countries. I for one don't want anything to do with an IRS or Medicare type program as my provider of health care. We can address many of the issues hurting the current programs if Congress would work for the people instead of seeking more power by installing a nanny state program.

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Robert Huron 5 years, 3 months ago

I don't know if a gov't run program is the way to go or not. But what I can tell you in just a few years most corporations will not be able to afford the health insurance they provide today. Most polls I read say that 72% of the American people want health care fixed. You may have a great health plan but ask any Steamboat teacher about their's and they will tell you it sucks. If this country can throw away 1 trillion dollars in Iraq why can't it do something for the American people. I don't know one Iraqi who pays taxes in the US and they hate us on top of that.

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theKid 5 years, 3 months ago

It would be helpful if the opposition could come up with something more meaningful than Reagan saying "Government is the problem".

Those of you (Hi, Rob) sooo concerned about what this will/could cost might ask yourselves:

"What is the actual cost to America of leaving in place the system we have now?"

theKid

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seeuski 5 years, 3 months ago

I would hope you would stick with the issue at hand and not do what the Obama administration is constantly doing, blame Bush. Saddam Hussein is gone and I think you are wrong about the Iraqi people hating us for liberating them from the butcher. As someone who had several family members liberated by the US from the Nazis and personally witnessed the gratitude of people who were liberated from Communist tyranny under Russian rule at Reagan's funeral I can assure you I am steadfast in my belief it was right to end the Hussein terrorist money train. I would start worrying about the 4 trillion Obama is taking from us if I were you. And please, the scare tactics of your statement "But what I can tell you in just a few years most corporations will not be able to afford the health insurance they provide today." Please prove that one. As if the Government will all of a sudden learn how to manage something without it being in the red.

Lets start with a simple fix first like tort reform. Then take step two, three etc. But keep the politicians out of the Doctors office.

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seeuski 5 years, 3 months ago

The kid, What is the actual cost of the Government taking charge of your health care? The current system has been working for years and the goo goo for Obamacare crowd is ready to sign up for a program that has not even been presented in total yet. The CBO has warned of the increased costs of the new Obamacare plan. Welcome aboard and buckle your seat belts.

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howard_roark 5 years, 3 months ago

If you are under the age of 30 the only logical choice is a Health Savings Account. Wonder if the federal government will be offering those?

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OnceLivedHere 5 years, 3 months ago

How quickly one can become a reliable Washington Hack, complete with unsubstantiated party talking points. Next election maybe people will think before they vote and demand that the person who represents them live under the same rules they promulgate. Has anyone ask the congressman if he plans to give up his Health Care and join the rest of us in the proposed government run plan? Small business would not survive this atrocity.

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JLM 5 years, 3 months ago

Government healthcare? Sounds like a great idea to me.

But then I think --- what is the best government program currently in existence which could compete effectively with Costco, Sam's Club or WalMart?

Costco and Sam's are brand new delivery systems for retail which were created and fueled by entrepreneurial capitalistic zeal and have been huge successes. This is the approach we need to healthcare --- encourage the marketplace to reform the inequities.

Government healthcare? Sounds like the freakin' IRS to me.

Of a population of 300MM, only 45MM are not currently covered by healthcare insurance. Private employers provide 110MM Americans with healthcare as a condition of their employment.

Of the 45MM who are not covered almost half have "opted out" many times from an employer's program.

Why are we junking a system that works for 85% of Americans?

Let's make some meaningful but simple reforms first --- electronic health care records, portability of insurance, tort reform, binding arbitration dispute resolution and an increase in the number of doctors produced by medical schools.

If you don't like the paint color of your house, do you tear it down?

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JLM 5 years, 3 months ago

Rob't H ---

While I certainly respect your experience, I would say that your generalization as it relates to the use of ERs for routine care is not the norm. Major cities and most major hospitals have separate health clinics which provide similar services on a drop in basis. Many are publicly funded and many are privately funded. I can assure you that the illegal aliens know exactly where they can get healthcare and not be exposed to the ICE. It is not the ER.

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seeuski 5 years, 3 months ago

The head of the CBO, Doug Elmendorf, is now under direct pressure from Obama and was called in to the Principals office. Why is this President not working through his own Budget office instead of using strong arm tactics against those that provide factual data on his Obamacare plans? I can see a Walpin style firing in the works. And Obama couldn't or wouldn't answer a bloggers question on section 102 of the Obamacare bill. That section sets rules for the elimination of personal health care and forces us into the Government run program. The Obama BS Hour tonight won't change the facts.

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David Wilson 5 years, 3 months ago

Rather than debate Obamacare in the abstract, it is more useful to focus on the details of the 1000 page House Bill. Here is a link that provides short bullet points on the contents of the first 700 pages of the bill: http://www.saveourcountrynow.net/forums/viewtopic.php?f=107&t=1460.

You can read it in five minutes or less.

Orwell himself could not have imagined a bureaucracy as perverse or nighmarish. Congressman Salazar, please vote no on this disaster.

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housepoor 5 years, 3 months ago

Not sure what approach is neede but health care cost are a serious problem. Even people with insurance face bankruptcy if the have a catosrophic health issue. My employer has seen cost rise 20% a year for 10 years straight and that is with a decease in benefits. I don't see anyone else even attempting to find a solution? They only offer an alternative plan when faced with actually making a decision.

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seeuski 5 years, 3 months ago

house, If you understood where the costs are accelerating you may then put 2+2 together. Tort reform is number one and illegal immigrants number two. Then allowing people to have individual policy accounts instead of groups connected to employers. These and more have been brought forth by the Republicans but denied by the Dems. Gee, I wonder why?

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JLM 5 years, 3 months ago

There are some very obvious improvements which will dramatically reduce costs and which can be made immediately --- tort reform, binding arbitration dispute resolution, portability of insurance, expansion of COBRA, increasing the production of doctors from existing medical schools, electronic record keeping and Internet based medical records of all lab tests.

Every single one of these ideas is currently being used by some industry in America. The securities industry has binding arbitration as the sole means of dispute resolution. VISA keeps all of your records on file electronically. The entire auto industry keeps all information about every car running on the Internet. These are simple things.

Insurance --- e.g. auto insurance --- does not pay for routine maintenance but rather catastrophic events. The problem we are really having is that Obamacare is not "insurance" it is intended to be "free insurance". Everybody has to have some skin in the game.

In his press conference tonight Obama wants you to believe we all get free insurance and nobody has to pay anything --- well except for those making $1MM. We can get the rich guys to pay for everything!

Not bloody likely!

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seeuski 5 years, 3 months ago

I finally get the idea of the plan as Obama explained last night. Nothing changes except some millionaire will pay for my insurance and I will take a blue pill instead of a red pill. Why does the Government takeover need to happen? Who swallows this crud? Suckers do. Why, when Obama was a Senator, did he vote down all the proposals from the Republicans that dealt with tort reform and Portability etc? Power and politics. Don't be the sheep people.

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