• curmudgeon said on Aug 19, 2009....

  Sure it's great for those who use it, because those who use it don't pay 100% of the costs. The only way Medicare works is if people who don't have access to Medicare help pay for it through their tax dollars. The same thing goes for Medicaid. Every dollar government takes away from me in favor of someone else's health care makes it harder to look out for my own.
  
  And sure, Medicare works great for this generation of aged folks, but once the Baby Boomers retire in a decade or two and there are more retired folks than working, we'll see how well it serves those retirees.
  
  If everyone has access to a Medicare-type program, there won't be anyone left out of the program who is forced to subsidize it. Now we're back to skyrocketing costs or rationing of services or probably both.
  
  If you want a lower premium, just get a high-deductible policy. If you are smart, you will vault the savings on your premium into a health savings account and spend your own money the way you want. A good health savings account would accrue interest or value, thus enabling you to cover your increasing health care costs as you age.
  
  I just don't see why it is so necessary for government to take care of people when there are other ways of enabling people to take care of themselves.
  

• sheltercrow said on Aug 19, 2009....

  Unless we get a public option the bill being looked at will be nothing but another give away to the insurance industry. A public option would mimic what the rest of the industrialized nations have. And they're doing quite well.
  
  The U.S. does not have the best health care system in the world - it has the best emergency care system in the world.
  
  International Comparison of Health Care Systems (pdf)
  
  
  ...health care expenditure in the U.S. vis-a-vis the other industrialized nations.
  
  The United States is ranked lowest under most of the categories of health care system.
  
  
  A side-by-side comparison of the leading comprehensive reform proposals across a number of key characteristics and plan components.
  
  The Medical Money Pit
  
  
  Let me rattle off some numbers.
  
  In 2002, the latest year for which comparable data are available, the United States spent $5,267 on health care for each man, woman and child in the population. Of this, $2,364, or 45 percent, was government spending, mainly on Medicare and Medicaid. Canada spent $2,931 per person, of which $2,048 came from the government. France spent $2,736 per person, of which $2,080 was government spending.
  
  
  I'll let you guess where that additional money went.

• silver_phoenix said on Aug 19, 2009....

  Curmudgeon: If everyone made enough money to have a health savings account that would be nice. Unfortunately, that's not the case. The plan is for the government to make healthcare available to all, which enables people to better take care of themselves. That's why so many argue the Public Option is essential because it does just that. It would also enable people that are employed with companies they hate to quit because there would be affordable health insurance available that wouldn't reject them for preexisting conditions.
  

• curmudgeon said on Aug 19, 2009....

  How do you know that this public option will actually work as advertised? Again - government programs only "work" because there more people who pay into them than those who have access to them. Think of all the childless people who pay into the public education system. Think of all the people who educate their kids privately but are still forced through tax law to support public education.
  
  If everyone has access to public healthcare, who then will make up for the funding shortfalls?
  
  Also, if the goal is for people to take better care of themselves, the information on self-care and healthy living is already out there in abundance, for free. We do not need a public insurance program for that.
  
  Neither do we need a public option to deal with the portability or preexisting condition issues. If legislators want to pass one particular bill banning pre-existing refusals, they can do that tomorrow and probably would not get such strong resistance from anyone but insurance lobbyists.
  
  Again, if you want to maintain your own health insurance apart from your employer, all you have to do is find a high-deductible policy that meets your needs. If government wants to work with insurers to devise ways of lowering the cost of individual insurance, I am all for that.
  
  And why does a new program have to be implemented just to insure everyone? Why not offer tax credits or new deductions to help free up cash to pay for private insurance? Why not offer vouchers or some kind of discount card people can use to purchase private insurance? Why is it that a whole new public infrastructure needs to be created simply to insure 46 million out of 300 million people? Does this not sound just a bit silly?
  
  
  It seems to me that some folks are sold on this public option without even looking under the hood.
  

• sheltercrow said on Aug 19, 2009....

  Re curm: "...who then will make up for the funding shortfalls?"
  
  "If everyone has access to public healthcare" the cost per capita, as the data clearly shows, would be significantly less.
  
  Re curm: "...if the goal is for people to take better care of themselves"
  
  The goal is to provide healthcare for all not "for people to take better care of themselves."
  
  Tax credits, new deductions, vouchers, discount cards, et el will still be government subsidies going straight to the insurance companies.
  
  "...simply to insure 46 million" is "just a bit silly?"
  
  The "public option" is Medicare extended to a larger group. I believe we all know what Medicare is. The Economic Policy Institute:
  
  
  A public plan option would force private insurers to compete on efficiency and quality, rather than on their ability to enroll the lowest-cost workers and firms. Furthermore, a public plan would introduce competition to currently monopolistic or oligopolistic insurer and provider markets—three or fewer insurers account for at least 65% of market share in 36 states.
  
  
  The savings... Economic Policy Institute:
  
  
  Based on the success of other public health insurance plans (such as Medicare) in reducing administrative costs, the independent Lewin Group estimated that a public health insurance plan would have significantly lower operating costs, resulting in windfall savings for employers and enrollees. Moreover, a public plan would not have to earn profits, as most private insurers must do. All told, these savings for employers from an illustrative public plan could total $25.4 billion in the first year of operation. Premiums for potential enrollees would also be 20 to 30% lower than for comparable private plans. [See COST IMPACT ANALYSIS FOR THE “HEALTH CARE FOR AMERICA” PROPOSAL Final Report [pdf]]
  

• sheltercrow said on Aug 19, 2009....

• curmudgeon said on Aug 20, 2009....

  Shelter - take up your "taking better care of themselves" dispute with silver phoenix - SP is the one who made that assertion.
  
  If all this debate is about is expanding medicare and medicaid, this would not be such a huge debate. Whatever the economic policy institute says, creating a huge new federal bureaucracy will cost Americans more taxpayer money - administrative, labor, overhead, communications, everything.
  
  Unlike you, I do not consider my insurance company to be my enemy. If they need more money from me, maybe it is for good reason. I at least have the option of shopping around for other companies if I do not like the way they do business.
  
  If the government demands more money of me - for good reason or bad, whether they work efficiently or not, whether their programs even deliver the product advertised - I must pony up and shut up.
  
  I am currently not eligible for Medicare, yet a significant portion of my income pays for it. How is that in any way fair?
  

• sheltercrow said on Aug 20, 2009....

  Re curm" "creating a huge new federal bureaucracy"
  
  The expansion of Medicare is "creating a huge new federal bureaucracy"? It already exists.
  
  Re curm: "a significant portion of my income pays for it."
  
  
  Social Security Tax consists of two parts. The Old Age, Survivors, and Disability Tax (OASDI) at 6.2% and Medicare Tax at 1.45%. For 2009, the combined rate of 7.65% will apply to earnings up to $106,800. As there is no limit on the Medicare Tax, the 1.45% will be taken on all earnings.
  
  
  If you want health insurance at all, what ever the plan, you "must pony up and shut up."

• silver_phoenix said on Aug 20, 2009....

  Obama has addressed where funding will come from, although I do not recall the exact figures in my head. I see no clear distinction between insuring all with healthcare and "taking better care of themselves." They go hand in hand. With one, comes the other. I do know that Obama is up to hearing other ideas and options. He strongly suggested and hopes for Public Option, however.
  
  We never know what will work until we try it. We can't reject something for that reason. Taxes on public services are certain and required. A major issue is that there needs to be healthcare reform because prices will continue to go up and less and less people will be able to afford it. People as it is now are going broke paying medical bills. That's not right.
  

• sheltercrow said on Aug 20, 2009....

  From the Congressional Budget Office Director’s Blog
  
  
  Preliminary Analysis of the House Democrats’ Health Reform Proposal
  
  Yesterday CBO released a preliminary analysis, conducted with the staff of the Joint Committee on Taxation (JCT), of H.R. 3200, the America’s Affordable Health Choices Act of 2009, as introduced by several House committees on July 14. Earlier this week, CBO released a preliminary report on the health insurance coverage provisions of the bill; this latest report added analysis of the other provisions.
  
  According to CBO’s and JCT’s assessment, enacting H.R. 3200 would result in a net increase in the federal budget deficit of $239 billion over the 2010-2019 period. That estimate reflects a projected 10-year cost of the bill’s insurance coverage provisions of $1,042 billion, partly offset by net spending changes that CBO estimates would save $219 billion over the same period, and by revenue provisions that JCT estimates would increase federal revenues by about $583 billion over those 10 years.
  
  By the end of the 10-year period, in 2019, the coverage provisions would add $202 billion to the federal deficit, CBO and JCT estimate. That increase would be partially offset by net cost savings of $50 billion and additional revenues of $86 billion, resulting in a net increase in the deficit of an estimated $65 billion.
  
  
  Compare that to the "projected national rate of increase for employer-sponsored insurance."
  
  
  ...analysis of federal data finds that if premiums for employer-sponsored insurance grow in each state at the projected national rate of increase, then the average premium for family coverage would rise from $12,298 (the 2008 average) to $23,842 by 2020—a 94 percent increase. [Paying the Price: How Health Insurance Premiums Are Eating Up Middle-Class Incomes--State Health Insurance Premium Trends and the Potential of National Reform | The Commonwealth Fund]
  

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