This Sounds Like A Really Good Plan
The largest government medical insurance program, Medicare, is threatening to nearly bankrupt the federal government with its rising costs that no one in 30 years has figured out how to manage, short of attempts at price controls (controls which are driving doctors out of the business). Treat with extreme skepticism mystery double-secret methodologies that the Obama administration promises will cut costs 30% when no such savings have ever been achieved in Medicare.
The largest government run medical care organization, the VA, apparently provides awful service and is rife with fraud and errors due to poor accountability.
So, despite 89% of Americans reporting themselves satisfied with their medical care (one of the highest approval ratings for ... anything I have seen out of a poll) we are going to replace our current system with one run by the government.
Outstanding.
Postscript: You will often get quoted enormous numbers (often as high as 47 million) for the uninsured. This seems to be the driving force behind the felt need for health care change. But when someone quotes this number to you, ask for the number excluding a) college students; b) people who make over $50,000 a year who could presumably pay for their own coverage; c) illegal immigrants; d) people transitioning between jobs and e) people already eligible for Medicare/Medicaid but don't bother to sign up until they are actually sick. You will get a number a LOT lower, closer to 10-15 million.
If we need to do something more to help 10 million or so poor people, then lets help 10 million or so poor people. Let's not screw up what exists for the other 290 million or so people in this country. As I wrote before
But health care is different. The author above is probably correct that some crappy level of terribly run state health care will probably be an improvement for some of the poor. But what is different about many of the health care proposals on the table is that everyone, not just the poor will get this same crappy level of treatment. It would be like a public housing program where everyone's house is torn down and every single person must move into public housing. That is universal state-run health care. Ten percent of America gets pulled up, 90% of America gets pulled down, possibly way down.
Health care reform by hatchet, axe, and saw*.
Update: From Doug Ross
The Kaiser Family Foundation, a liberal non-profit frequently quoted by the media, puts the number of uninsured Americans who do not qualify for current government programs and make less than $50,000 a year between 13.9 million and 8.2 million. That is a much smaller figure than the media report and is also subject to "the 45% rule", wherein that percentage will transition to new jobs within a four-month time-frame.
Scott:
I was looking at the numbers a few months ago and I didn't see any way to get a real look at those that don't actually have health insurance that need it. The numbers just aren't explanatory enough to break them down that granular. All of the groups were listed individually, but with no distinction as to whether they were completely separate from the other groups or not. So while it says that there are 47 million uninsured, 12 million of those aren't US citizens, 15 million of those are between the ages of 25-34, 8.7 million are children, etc, none of the sub-categories can be differentiated from one of the other categories.
So you can say there are 47 Million uninsured living in the US, 35 of which are US citizens or you can say that there are 39 Million uninsured adults living in the US, but you can't say that their are 26 Million adult US citizens uninsured in the US, b/c no one tells you how many of the 8.7 Million children are, or are not, US citizens, or how many of the 15 million uninsured 25-34 olds are US citizens, or DON'T CURRENTLY HAVE INSURANCE (which leads to my next point).
The whole 47 million number is completely bogus anyway, b/c it counts everyone who had an insurance interruption during the year. So if someone had health insurance for 11 out of the 12 months of the year, they get counted as one of the "millions" of uninsured living in the US (citizens and otherwise).
However, I would not be surprised one bit, if the total number of truly needy uninsured citizens who were not able to get insurance in some manner, was well under 10 million. Which, BTW, is still a large number when viewed by itself, but not a national emergency.
June 23, 2009, 12:40 pmDaveK:
Just remember... Our Congress will be sure to exempt itself from the crappy health care system that they impose on the rest of us. They'll set up a cozy little system so they and their families will continue to get the very best care with virtually no out-of-pocket expenses for themselves.
Of course, that's just because they are so much more worthy than the people who vote for them.
June 23, 2009, 1:18 pmJeffrey Ellis:
Ha! Loved the Rush reference. And the analogy to a public housing project is a good one (but I bet the lefties would do this too, if they could -- all in the name of equality. Hatchet, axe, and saw indeed!)
June 23, 2009, 1:20 pmJohn LeVine:
I disagree with your sentiment. I believe universal healthcare is actually in the interests of Republicans and those who favor small government. Please see my reply to your post here: http://bit.ly/18WDov
June 23, 2009, 1:27 pmsteep:
(1.0 - 0.89) * 306,743,000 = 33,741,730
47,000,000 - 33,741,730 = 13,258,270
13 Million "Uninsured" people are satisfied with their health care.
Strange.
June 23, 2009, 3:03 pmJames H:
Is it possible that some fraction of uninsured make enough money to pay for insurance, but decide not to buy it and instead buy a fancier car or whatever?
June 23, 2009, 3:42 pmDr. T:
The only effective way for the Obama administration to rapidly reduce Medicare costs by 30% is to kill the sickest 20% of patients. I suppose Obama could try an ineffective way, cutting reimbursements to doctors and hospitals, but that would result in many opt-outs (doctors and hospitals refusing to participate in Medicare) and much worse quality of care.
Big governments and cost-effective, high-quality medical care do not go together.
---------------
June 23, 2009, 3:59 pmTo Steep: It's not strange to be happy with your health care while having no health insurance. My family has no health insurance, and we're happy with our medical and dental care. We pick the clinicians we want, and we discuss treatment options including their costs. The clinicians are happy that they get paid without filing claims.
Raven:
I don't understand why people keep ignoring the fact that the private health care system in the US receives huge subsidies via the tax system (i.e. health premiums are not taxable benefits).
This is not a debate about government funded healthcare. This is a debate about whether the government funding should be provided to private healthcare providers or to private insurers. Providing funding directly to the private healthcare providers should, in principal, always be cheaper.
I also think it is a mistake to ignore the fact that employer insurance programs only work because the healthy employees subsidize the less healthy employees (i.e. employer insurance programs are a form of income redistribution).
As for medicare, I think there is a lot of money to be saved if they eliminated the need to test for eligibility. A universal program would eliminate that bureaucracy.
Also, I suspect that most uninsured by choice people are uninsured because they know that laws required that they be treated in a case of emergency and, if they have no assets, they can ignore subsequent bills.
June 23, 2009, 6:53 pmRaven:
I don't understand why people keep ignoring the fact that the private health care system in the US receives huge subsidies via the tax system (i.e. health premiums are not taxable benefits).
This is not a debate about government funded healthcare. This is a debate about whether the government funding should be provided to private healthcare providers or to private insurers. Providing funding directly to the private healthcare providers should, in principal, always be cheaper.
I also think it is a mistake to ignore the fact that employer insurance programs only work because the healthy employees subsidize the less healthy employees (i.e. employer insurance programs are a form of income redistribution).
As for medicare, I think there is a lot of money to be saved if they eliminated the need to test for eligibility. A universal program would eliminate that bureaucracy.
Also, I suspect that most uninsured by choice people are uninsured because they know that laws required that they be treated in a case of emergency and, if they have no assets, they can ignore subsequent bills.
June 24, 2009, 2:50 amOH! You're my new favorite blogger fyi
Russell:
Raven says "I don’t understand why people keep ignoring the fact that the private health care system in the US receives huge subsidies via the tax system (i.e. health premiums are not taxable benefits)."
And with that you betray just how extremely left wing you are. In most things, we don't consider a lack of tax to be a "subsidy". Subsidy is when someone gives you money, NOT when they decide not to take it.
I can understand how a liberal would have trouble understanding the difference between giving someone money and just not taking their money to start with.
June 24, 2009, 5:53 amRick C:
And yet I don't think we'll ever convince everyone that this is bad. I know a guy who suffers from "we must do something. Obamacare is something. Therefore we must implement Obamacare" because he was out of work several years ago and had a heart attack which he had to pay for the treatment of himself. All that he cares about is that "everyone must have healthcare."
June 24, 2009, 7:04 amRaven:
Russell,
Foregone tax revenue is a subsidy when it is applied selectively. In fact, the numerous special exemptions in the US tax code are all attempts by the government to control the economy by favouring certain types of spending (the government uses this approach to funnel money to the wind energy scammers).
If the government did not provide this incentive then people who choose to self insure would have more money in their pockets because the overall tax rates could be lowered while raising the same revenue.
Anyone who believes that the state has no role to play in health care funding should be calling for an end to all special treatment for health care expenses in the tax code with the extra revenue distributed in across the board tax cuts.
Insisting on keeping the private health insurance tax subsidy while criticizing a direct health care subsidy is a bit contradictory.
June 24, 2009, 7:45 amNot Sure:
"Foregone tax revenue is a subsidy..."
Money that's never been taken away from a person is not a subsidy unless you start from the position that everything belongs to the government to begin with.
June 24, 2009, 8:44 amHS:
This is a front to try and save the broken Medicare program, especially for the sick. After three years of treatment, one is driven to the inferior Medicare from COBRA as my dad was. I covered the rest. This small thing is an indication that people on Medicare need more medical attention than those that are not. The government is trying to draw from a larger pool of healthy to subsidize the sick. I did it for my dad but I am not willing to do it for others.
Yes, we need to take care of our seniors and Medicare was ok until the government started borrowing from it. To solve the issue, we need to start by separating health maintenance from actual catastrophic health events (as someone posted on another topic). We should only cover catastrophic events. We need to find a way to increase the competition in hospitals (6.2% inflation) or even price control like they do with funeral homes for these events. Health maintenance type insurance could work like a tax sheltered savings account where profits are tax free. This can be used for office visits, diabetes, mental health issues, etc.
Sadly, because the people who need Medicare are a huge percentage of voting population, I do not see it being fixed for all of us. The best course is for the healthy to stall this and other bills until we go into a “hand to mouth†system and the needed benefit cuts are forced while we eliminate Medicare.
June 24, 2009, 8:50 amDB:
I often read democrats/liberals reference the VA system as a wonderful model for what government health care can be. My evidence is anecdotal for sure, but as a former medical device sales rep, there was no place I felt more uncomfortable in than a VA hospital. Old equipment, beaten-down staff, facilities in dis-repair. I guarantee that anyone that is citing the VA system as a standard that shows the government can do better than private enterprise has never set foot in a VA hospital. I would do anything to not have to go to one.
June 24, 2009, 9:44 amRaven:
Not Sure,
"Money that’s never been taken away from a person is not a subsidy"
Yes it is if tax system discriminates against different types of spending.
The mortgage interest deductibility is a huge subsidy that transfers wealth from people who do not own a home or have paid off their mortgage to people with a mortgage.
IOW, non-mortgage holders pay more taxes than they should. Do you really think this is fair?
The only time your logic applies is when a tax reduction is given no matter what the money is spent on.
DB,
It is important to distinguish between a public provider insurer and public health provider. The VA system is an example of a public health provider and it is something which should be avoided at all costs.
A public insurance provider that pays for private health provider is no different from a mandatory employer health insurance plan except it cuts out the private insurance companies.
June 24, 2009, 10:14 amNot Sure:
Raven-
subsidy:
a grant of money; specif., a) a grant of money from one government to another, as for military aid, b) a government grant to a private enterprise considered of benefit to the public, c) [Historical] in England, money granted by Parliament to the king.
- Webster's New World Dictionary
Words have meanings. Not taxing a person does not equal "a grant of money" from the government.
If you want to use a word to mean something it doesn't or use it in a non-traditional manner, that's entirely up to you. But you should at least let people know that's what you're doing unless you aren't really interested in communicating your point of view.
June 24, 2009, 10:40 amRaven:
Not Sure,
Fine. A tax deduction granted for certain types of spending is *equivalent* to a subsidy for all intents and purposes.
At their core, tax deductions transfer income from one group of people to another based on the ideological preferences of the government that introduced the tax deduction.
For example, is a tax deduction given to companies with union work forces "fairer" than a subsidy given to those same companies?
Is a tax deduction given only to companies who are "carbon neutral" simply a matter of letting them keep what they rightfully earned?
That is why I say it makes no sense to protest transfers of wealth via direct spending while ignoring equally large transfers of wealth made possible with tax deductions.
June 24, 2009, 11:40 amNot Sure:
Raven:
"At their core, tax deductions transfer income from one group of people to another based on the ideological preferences of the government that introduced the tax deduction."
No, not in the sense you're implying, they don't.
Initial condition:
Jim earns $100.
Joe earns $100.
Enter the government:
Jim is taxed $50 and Joe is taxed $25. The government gives $25 apiece to Manny, Moe and Jack.
Manny, Moe and Jack are the recipients of transferred income. Joe is not, although you have been insisting that he is.
June 24, 2009, 12:43 pmRaven:
Total government expenditures: $75
Jim should only need to pay $37.50 but pays $50
Joe should pay $37.50 but only pays $25
Net consequence of the tax policy: $12.50 is taken from Jim and given to Joe.
June 24, 2009, 12:54 pmNot Sure:
Raven:
"Net consequence of the tax policy: $12.50 is taken from Jim and given to Joe."
Looks like we're back at that "meaning of words" thing. Although $25 was *TAKEN* from him by the government, the *FACT* is that *NO* money was *GIVEN* to Joe (Jim's or anyone else's, for that matter).
Unless, of course, you're saying that the government has first right to all $100 of Joe's income, and whatever amount the government deigns to allow him to keep is somehow "given" to him.
Seems to be awfully convoluted definitions for "given" and "subsidy" to me. Makes me wonder why you wouldn't just use the commonly accepted definitions of the words instead of cobbled-together ones, but I guess if you're trying to frame the situation to make it look like Joe's somehow getting away with something because he's not taxed as much as Jim, then it seems to do the job... as long as the person you're talking to doesn't take the time to really think things through, anyway.
June 24, 2009, 2:49 pmPhr3dly:
This is amusing. "Not Sure", are you being deliberately obtuse?
Raven's point, which is completely correct, is that the government is providing incentives for behaviors through differing tax treatments. Call it a "subsidy", "taking", "giving", or whatever. The impact is clear. The market is behaving in ways it would not otherwise behave if health care benefits were taxed equivalently to other benefits.
Is that really so hard to understand?
June 24, 2009, 3:39 pmNot Sure:
Phr3dly-
I'm sorry to see that you think attempting to define the terms of a discussion renders one obtuse.
As far as Raven's point goes- it's not that the government is providing incentives for behaviors through differing tax treatments (nobody has disputed this)- it's that doing so is unfair.
What I find amusing is the idea that the entity which allows for this unfairness to exist (government) is the same entity that people look to to eliminate the unfairness.
June 24, 2009, 8:56 pmBDAABAT:
Folks here seem to be missing the real issue: Health care in the US is fundamentally broken.
Yes, there are surveys of people who say they are satisfied with THEIR healthcare. But there are also surveys saying that healthcare reform is one of the main priorities for many folks. The reality is that surveys don't really tell you much.
So, what do we look at instead of people's perception of healthcare? How about actual data... like dollars spent vs. people covered? The US spends ~ 17% of GDP on healthcare. It's one of the highest percentages in the world, yet many people aren't covered (you can quibble over the numbers, but it's in the 10s of millions... and it doesn't really matter if folks are illegal or not, they get treated if they show up in an ER no matter what... ERs are NOT efficient mechanisms for delivery of health care... the result is that the costs increase for everyone!). Even people that have insurance are not covered the same... how many folks have comprehensive prescription plans? How many have comprehensive dental plans? How many folks end up going broke because of unexpected medical bills? How many people that have insurance choose to NOT take a new job because of things like "pre-existing conditions" clauses? Does this system make sense?
People have to get past the idea of "rationed" health care... it already IS! It's rationed by economics. So, why not admit that the system is broken and that we can get a better bang for the buck?
Other countries have done this. Taiwan implemented universal health care in 1995. Anyone can go see any doctor... no gatekeeper. They get drug benefits, vision care, kidney dialysis, inpatient care, outpatient care... their one payor system produces some of the lowest administrative costs in the world (<2%). Total cost for this comprehensive system: < 9% of GDP... in other words, they spend ~ half of what the US spends as a percentage of GDP and they have a system that covers every single person with COMPLETE health coverage.
So, why stick with the broken and demonstrably more inefficient system that limits health care such as we have in the US right now????
Bruce
June 24, 2009, 9:15 pmRaven:
Not Sure,
I am responding to the people who object to the idea of a public insurer because of that taxes that would need to be raised to pay for it. My point is the current system already requires that additional taxes be raised in order to make up for the revenue lost allowing tax deductions so going to a public insurer is not that big a leap.
As for fairness - that is a concept relative concept and most people come up with a self serving definition for it.
June 25, 2009, 1:55 amElliot Cutler:
Have enjoyed seeing the back and forth very much. I'd like to participate so here goes.
BDAABAT "Health care in the US is fundamentally broken."
Where to start? (like his first phrase this general statement puts Bruce's in a box labeled "Oh not this again".) Big general statements tend to do that. Then a tip of the hat to the fact that surveys have limited use and specify no real direction (not what their for) followed by an emotional if calm appeal to the magnitude of the problem (don't know the real number but it's sure way up there) along with the warning not to dwell on these nonsensical magnitudes (no quibbling). Probably good advice since no source for the number is offerred.
As far as foriegn solutions, the high school students love to play the game of "But it's legal/moral in other countries!" The pressing problem for us and the U.S. is that for all the attempts to specify, fund, organize and eliminate problems our government (which is what we have to start with) has never succeeded (in what could be commonly called success). All the problems it solves become legacies of institutionalized beurocracy. For each case of "We're from the Govt and we're here to help you." there are precious few examples of "Our work here is done."
Economics always kick in and a long line of (only recently) needy individuals And their businesses and interests spring up to feed at the trough.
Rant is over.
Still Bruce's post was refreshing to see as an example of how the left refocuses the debate to "We Got to Do somthing." just when the debate was narrowing down to some interesting distinctions.
E
June 25, 2009, 10:09 amDKH:
I find it not very useful when other countries' health care systems are cited because the person citing those countries almost always ignores the fact that these are open systems -- they don't exist on their own. Thus, Canadians can come to the United States for operations that can't wait. Or Americans can go to Mexico for dental work.
So it's fine to say that other countries have a certain system and spend whatever amount less than we do, but if Taiwan or Canada or wherever is using more cures developed in the United States than the US is using developed there, their system isn't necessarily as effective as ours.
I don't know the answer to the issue I'm raising here; my point is that the discussion isn't useful without some accounting of this.
June 25, 2009, 3:48 pmBDAABAT:
E: So, is your assessment that things in the US are just peachy? That having the highest percentage cost for healthcare while millions go uninsured and millions more are underinsured is a good thing? Does it provide US workers with a competitive advantage compared to other countries? That as a result of all of this spending, we have modest health statistics (like overall longevity [#45], like infant mortality [#29]... especially for poor people who don't have insurance)?
Am just pointing out the obvious... that other countries have dealt with the problem head on and come up with BETTER solutions that turn out to be much more cost effective. Taiwan created a new health care system in 1995 and their system objectively works much better than our system. Everyone is covered. There are no gatekeepers to care. Actual costs for this comprehensive system is <9% GDP. US costs for crappy care for most and no care for many is ~16% GDP. We're not getting much value for the investment.
Am not suggesting that the US just adopt another countries solution for healthcare. I AM suggesting that we're NOT getting good value for what we spend and that it makes sense to look at alternatives. Other countries have started from scratch to create a system to best meet their needs. There's no reason the US can't do this as well.
From my perspective, it makes little sense to pay billions of dollars for healthcare, a BIG part of which is paid for with tax dollars, and NOT get much bang for the buck.
Bruce
June 26, 2009, 4:09 amPaul:
This plan doesn't have anything to do with helping poor people. It's about increasing the power of the state.
June 26, 2009, 7:45 amElliot:
Bruce;
My assesment is that your making claims about having the highest percentage cost for healthcare while millions go uninsured and millions more are underinsured is rather meaningless. You can look elsewhere in this terrific blog to find details of how infant mortality is calculated differently in other countries for myriad reasons. For similar reasons it is meaningless to pine about all who are uninsured when many of them, making their own decisions about health care, spend less on it than "The Great One" thinks they should. One can always copy and paste frightening magnitudes of terrible consequences of thoughtless neglegence into a handy screed and demand that action be taken. Give me a break. We've all heard it and are tired of stepping in it.
Yes we can and must do better, but your rhetoric does nothing to move the subject long. It only ratchets up the intensity and emotional volume.
And as for
"There’s no reason the US can’t do this as well"
That is precisley what we are discussing here. And if you notice there is a great deal of thoughtful doubt that the government can do anything better than real markets.
By the time our heroes out in D.C. are voting for one perpetual motion machine over another the opportunity for analysis has long passed.
Let's calmly bring down your claims and wishes to just one specific thing at a time. This is certainly the only way they can be reasonably addressed.
E
June 26, 2009, 11:01 amElliot:
I should also mention that there is certainly no way the U.S. can start from scratch in the health care debate. It seems no government system no matter how old is ever phased out so they must all be grandfathered in. All solutions must have us start from where we are.
I don't mean to take a disrespectful tone but there is really no way to discuss a point like the actual costs for a comprehensive system as a percentage of a given nation's GDP in any useful way. The sentence exists only to 'gin up the desparation and anxiety. Even if we could all aggree on the sources for such numbers not one of you or me or the rest of us here could give a learned reason for, or prescription for what could be done to improve that number, or how we would notice the improvment.
I'm used to seeing such an emotional pitch used to motivate and sell dramatic solutions that merely satisfy the current itch rather than the underlying cause. The rhetorical (generalized, non-specific, wide ranging) complaints based on surveys of the worst affected will be used to make the sale (commitment to ill-advised, badly thought out solutions). Once the sale is over only the happy customers will be surveyed to show that we did the right thing. And we'll always be reminded that we acted only just in time.
Again, let's see specific problems and various specific means of making them better.
E
June 26, 2009, 12:01 pmBDAABAT:
Elliot: not sure where you got the idea that my tone was emotional or anything other than calm. I'd sincerely appreciate some clarification and education. Show me the data that has you so convinced of your position.
So, there really aren't people (tens of millions) who don't have insurance in the US? Is that what you are suggesting? Or, are you suggesting that there are millions of uninsured folks who COULD really afford health insurance, but choose not to purchase it?
If you don't like %GDP as a comparator, what metric would you suggest? Or, are you suggesting that survey feedback is the metric of choice?
FYI: I've had the opportunity to work in large urban hospitals in the East and West coasts. I've been involved in the care of many, many folks who have not had insurance. I've seen the effects of people who don't have insurance and have let their small health problems blossom into very large and expensive health problems. I've seen people in the emergency room who routinely use the ER as their "clinic" because that's the only care they have access to. They know they can't be turned away if they go to the ER. That's a pretty crappy way to provide "care". It's also an extremely expensive way to provide "care". What's your suggestion to deal with this situation? What would you do to ensure that these folks get better and less expensive care?
I've also been a patient who has had to navigate the health system... and I've done this as someone familiar with the process and who has the luxury of health insurance. It's not a pleasant experience. It's not efficient. It's not well implemented. It's seemingly designed to prevent access to resources... because it is! I've also had folks try to do "wallet biopsies" because I DID have insurance. Some health providers have incentives to order tests, run scans, or order equipment that isn't strictly needed, but they have a financial incentive to do so.
I'm explaining this on purpose... in a calm tone. 🙂
I've got imperfect information, but that information and experience across a broad spectrum of the health care in the US suggests that health care in the US is fundamentally broken.
Am really curious... what options would suggest to deal with the provision of health care in the US?
Bruce
June 26, 2009, 8:00 pmElliot:
Bruce
Now your talking. This may not cover all your points but it's a start.
Glad to know you've experience in hospitals all over. Last word on the subject is the question of how all those/your patients would feel if they knew with total accuracy what % of GDP their health care was costing them vs people in orther countries. Would that change their opinions of there treatment or give them options to better choices?
Aggree that the ER is a bad clinic. Case in Chicago of patient dying just outside the doors of the ER where the doctors were forbidden by strict rules to go out and bring him in. The fact was they did their job just right but no one could tolerate the outcome. Welcome to health care under government rules.
Extra tests are more often run as a precaution against malpractice. This could start its own thread.
I've had similar experience in this collection of health care treatments and options referred to as Our System, with and without insurance.
The problem with health care eventually goes to it's cost and from that to the cost of insurance.
I wish I could say I was the first to say it but I'm not; the reason health care is so expensive is because it's free. This is a compact way of saying that medical expenses have gone up in price partly (or largely) because the people getting it are most often not paying for it, but just the insurance. Once the price became disconnetced from both the provider and the patient it is no longer controlled to any sensible degree. This may sound crackpot I know, but the economics are the same as with any transaction where a third party intercedes.
Now that the prices are way up there the gate keeping is at the insurure's door. If you are middle age or above good luck getting in. If things are nationalized no new money will be created or arrive to bring comfort to us all. We will just all be given equal shares of the current pie and be Equally underserved. But be sure that somone in government will be making money they aren't now. That is their incentive.
The current problem is being addressed at a state level where (some) insurance companies are trying to get states to allow them to issue policies that permit a narrower number of procedures. Opposing this are people who insist on getting reimbursed for accupuncture and other B.S. treatments. Each state is pressured (also by insurance companies and other people) to insist on only wide ranging coverage when pick and choose type policies would be far more economic.
The desparation in tone (not your's but generally) only serves to mask the details and realities and encourage people to agree to a bigger better(?) solution rather than let the people who currently know what they are doing work to solve the problems with the tools at hand.
E
June 29, 2009, 8:51 amElliot:
Hope I did not shut down the discussion.
Did find a recent post that had myriad links in the Comments section.
http://online.wsj.com/article/SB124640626749276595.html#articleTabs%3Darticle
Do check it out.
E
July 1, 2009, 2:57 pm