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Eshoo shares details of health care proposal

Original post made on Aug 24, 2009

U.S. Rep. Anna Eshoo, D-Palo Alto, talked about the need for health care reform, the status of the current proposals and the legislative process of getting the bills passed during a "Telephone Town Hall" with her constituents Wednesday evening.

Read the full story here Web Link posted Friday, August 21, 2009, 4:03 PM

Comments (42)

Posted by Carol Kornfeld, a resident of Portola Valley: Portola Valley Ranch
on Aug 24, 2009 at 2:21 pm

This was an excellent description of explaining the Health Care proposal. Unfortunately, I didn't sign up in time for the telephone town hall. I agree with everything you support although I would strongly support the SINGLE PAYER SYSTEM. I am retired and can afford to pay for a very good supplemental plan but there are many who cannot. It has always been said that Congress has the best health plan and we should strive for that for everyone.

It is criminal that over 40 million people in this country cannot afford health care. That has to be changed!!


Posted by Scott Oesterling, a resident of Menlo Park: Central Menlo Park
on Aug 25, 2009 at 4:01 am

This is a succint article. I now know the positions that my rep has on the key items in the reform bill.

Ms. Eshoo has decades of healthcare experience. She was on the board of directors of our county hospital many years ago and began the public-private San Mateo Health Foundation.

I was talking with a friend who lives abroad and bemoaning the fact that I can't vote directly for the healthcare bill. Other than call my rep and donate to a PAC, I can't directly affect the process. After reading the article and communicating with her office (who send me a 30 page snap shot of the bill), I think we are fortunate to have a rep who gets it. We need to let her know our views and communicate our support.


Posted by Steve, a resident of Menlo Park: Felton Gables
on Aug 25, 2009 at 1:44 pm

Good summary. I wish I'd attended the teleconference live.

One question that didn't come up is how can we reduce costs if we don't eliminate the profits that the insurance companies make? As TR Reid points out in his book that compares health care systems of the world's other developed countries:
"foreign health insurance plans exist only to pay people's
medical bills, not to make a profit. The United States is
the only developed country that lets insurance companies
profit from basic health coverage."
Do any of the bills address how profits can be redirected back into providing health services and thereby help with cost reduction?


Posted by Harry Turner, a resident of Portola Valley: Ladera
on Aug 25, 2009 at 1:47 pm

Congresswoman Eshoo is overlooking the most important place to start: Government, first reform thyself with these two steps to correct the damage you have caused:
1) Create a single national market in health insurance by eliminating the current 50 isolated state markets. Regulate this national market in a constructive way. A Californian cannot shop in any other state, say Massachusetts, Florida or Nevada, for the best health insurance. With this change a "public option" would be redundant, not needed, and a wasted expense. This change would create intense national competition at NO COST to the taxpayer.
2) Government discriminates egregiously against the unemployed and the self-employed by providing a tax benefit to corporate providers of health insurance. This started during WW II. The system has been burdened by a major injustice for 65 years. Employees cling to their jobs;they fear "losing benefits." Since the cost of the benefit, although part of an employee's compensation, is not taxed to the employee. Thus the benefit if much greater for the high tax bracket employee than for the lesser paid employees. How can Representative Eshoo justify benefiting the rich more than the average citizen with this tax policy? Moving the credit to individuals will eliminate this damaging injustice, create freedom, and it will save money for the higher good.

Harry Turner
Ladera


Posted by Worried Voter, a resident of Menlo Park: Stanford Hills
on Aug 25, 2009 at 10:29 pm

I am not sure why everyone is so enthralled by the single payer system? Are we to model our health system after the UK and Canada - 2 places where it is openly known that the systems are poor. The death rate from Colon cancer in Canada is 10% higher than here. Also, it takes an average of 8 months to get a colonosopy in Canada. In 8 months cancers can spread to the point where it is too late for treatment. Why can't we come up with a better solution than socializing our health care? Why can't we start with regulating the current industry (eg with folks with pre-existing conditions being protected, etc). Also, why can't we simply have some sort of credit for the uninsured so that they can afford health insurance. Sorry, as a person with relatives in the UK and having heard their stories, I cannot in good conscience support a governmental solution. Also, I cannot in good conscience support the 1/2 trillion in cuts to Medicare that the Democrats embrace as a wonderful solution to this problem. The elderly paid into the system all their lives. Now we will cut back their services?? If a private company cut back services to that extent, there would be outrage, investigations, law suits, etc. Oops I forgot...this current Congressional bill legally bars anyone from suing this wonderful "universal health care system".... Problem solved....


Posted by Tom Gerson, a resident of Menlo Park: Downtown
on Aug 25, 2009 at 10:37 pm

Harry and Worried Voter, I completely agree with both of you! Rep. Eshoo, please listen to these folks and have a real Town Hall Meeting where you get to meet folks and hear their thoughts and not just a scripted phone call where we hear your view.


Posted by disgusted, a resident of Menlo Park: Felton Gables
on Aug 26, 2009 at 8:41 am

Worried Voter, you are merely parroting the blatantly false talking points of the demagogues who are determined to kill any real reform of this joke of a health care system we suffer with. These claims are shameful attempts to scare people into opposing reform. Give us sources for your ridiculous claims. I know plenty of Canadians and Brits who laugh at these lies about their countries' health care. I wish I could laugh. But I'm sick to my stomach instead.

For anyone who wants a good, nonpartisan source for reliable information about our health care system, I recommend Kaiser Family Foundation:

Web Link

Meanwhile, to the demagogues who are engaging in fear-mongering and lies, stop. Your children deserve better.


Posted by Conerned Parent, a resident of Menlo Park: The Willows
on Aug 26, 2009 at 9:25 am

Disgusted,

You may disagree with Harry and Worried Voter and it may be that the negatives of the UK or Cancadian systems are overstated in their posts, but that doesn't mean de fact that they are parroting views or that they are patently false.
Keep in mind that as far as cancer treatment is concerned, the UK had to be shamed into covering Herceptin for breast cancer. The last time I checked, there are some 4 new treatments for kidney cancer that are approved (and covered) in the US, that are not covered in the UK. The more extreme statements out of their comparative effectiveness body (NICE) basically said that if a cancer treatment was not curative or for a very rare cancer population, it couldn't be convered. People I know in biotech look at the UK as good place to test new cancer drugs because the patients haven't received too many prior therapies. Does that mean that there aren't some advantages of the UKs system? No. Does that mean that we as a country are ready to radically shift to that system? I'd say no there as well.
The incoming president of the Canadian health system expressed concerns that the system is imploding as well.
So there are documented stories of each of these systems working well in some cases and not well in others. For those staunch defenders of the US system, there appear to be no shortage of stories of denial of covereage, recission, and so on. Steve above alluded to an article listing 5 health care myths. Whether you agree with all the author's contentions or not, I don't think anyone can deny that there is a lot to be learned from looking at how other countrie deal with providing health care to a population. As individuals, you will be better informed in any forum such as this if you have an idea of what you want from a system and then look at the various systems with their pros and cons (there is no perfect system and any system has to fit with a country's culture as well)before you tout any of these solutions as a panacea.


Posted by Steve, a resident of Menlo Park: Felton Gables
on Aug 26, 2009 at 10:28 am

Here's that link to TR Reid's short article on 5 myths about Health Care around the world:
Web Link

To quote from his opening lines: "As Americans search for the cure to what ails our health-care system, we've overlooked an invaluable source of ideas and solutions: the rest of the world. All the other industrialized democracies have faced problems like ours, yet they've found ways to cover everybody -- and still spend far less than we do.

I've traveled the world from Oslo to Osaka to see how other developed democracies provide health care. Instead of dismissing these models as "socialist," we could adapt their solutions to fix our problems."


Posted by Worried Voter, a resident of Menlo Park: Stanford Hills
on Aug 26, 2009 at 12:23 pm

Dear Disgusted,

Do you always try to win disagreements with people by throwing false insults and accusations in their face? Hardly conducive to a healthy and educational debate.... My source of the Canadian FACTS was the NY Times. Or perhaps that newspaper was just "parroting" the view of the "demagogues"? As for the UK stories, I am also assuming that my aunts, uncles, cousins and numerous friends are also telling false tales? You may have friends who tell you one side, but I have facts. I am getting very disappointed and worried by the Obamacare supporters supporting their side by merely accusing us opposing it as "parrots" and folks sent in by the right wing, etc. These is the "blatant false talking point" that is really occurring. We are raising valid issues and problems. You can't silence the truth by pooh-poohing it or brow beating it. If we are going to get true and solid reform that works, we need to see what is broken in the UK and Canada and NOT repeat it. We are supposed to be a country that comes up with the best ideas. Not one that mere copies mediocrity from elsewhere. And certainly NOT one that tells its people that we won't allow the use of life-saving drugs because they are too expensive. I completely agree with Concerned Parent. We need to see how to make a better system by analyzing the flaws of BOTH systems and not just being mindless followers. Tsk, tsk, tsk disgusted. Our country needs better.

AND we need to figure out how to protect our elderly. One of Obama's economist's wrote a very passionate article recently explaining how spending money on the elderly really wasn't a very good use of funds. We are better off spending it on the education of the young. Really?? Is the country we want to be? A country where we have people pay into a system and when they need the help (that they already paid for...), we say too bad - we are giving your funds to someone else? I am not elderly or anywhere near elderly. But I have compassion for the elderly. And I also think that it is unethical to take someone's money and then change the rules.


Posted by Steve, a resident of Menlo Park: Felton Gables
on Aug 26, 2009 at 1:18 pm

Worried Voter -

First, I want to say I completely agree with you that we can make a better system by analyzing both the flaws and the successes of the systems other countries have implemented. Let's get over our NIH (not invented here) attitude, recognize that other systems are superior to ours in a number of areas, and learn from their successes.

Second, if you can find it I'd like the reference to the article by the Obama economist. I find it hard to believe, as you imply, that he was suggesting taking Medicare funds to increase funding to education. That doesn't sound like a good liberal position, let alone a politically astute idea. At least this proposal isn't anywhere in the health care legislation being discussed now so it's kind of a red herring in this debate.

Also, when did your British relatives experience problems with the NHC? I understand that Tony Blair caught holy hell for decling declining services and satisfaction with NHC at the end of the 90's and consequently beefed up funding by billions, built new hospitals, etc.. What surveys I've seen recently show that folks in Britain are once again quite satisfied with their system.


Posted by Ethan, a resident of Menlo Park: University Heights
on Aug 26, 2009 at 1:23 pm


Citing the UK in this debate is a red herring. No current bill comes anywhere close to proposing that paradigm. Still, one thing you can say about the Brits is that 20 cents of every dollar (or rather the pound sterling equivalent) that they pay into their system does not go to a parasitical for-profit entity that has a financial incentive to deny or delay care. I'm referring of course to the insurance companies.

If you want a good example of a government-funded program that works well for really sick people right here in the US, check out Medicare-run hospice. And definitely do not believe anything Alaska Caribou Barbie and her ilk say on the subject of end-of-life care. If they manage to beat THAT particular baby harp seal to death, it would truly be a disservice to us all.



Posted by Worried Voter, a resident of Menlo Park: Stanford Hills
on Aug 26, 2009 at 2:35 pm

Dear Steve,

Unfortunately I don't have the article from the Obama economist. I read it on a business trip to NY. It was a woman economist and her commentary appeared in either Newsweek or Time Magazine. (Perhaps someone else in this string may have read it?) If I can dig it up somehow via the internet, I will post it asap.

I agree - paying for education of the youth is not on the table. However, the same kind of thinking is when it is suggested that the paying for universal care come from Medicare funds. And when I say it is on the table, I do not mean that it is in the Bill. But, as everyone knows, even Pres Obama himself has said that the $1 Trillion needed for Universal Care can be 1/2 paid for by trimming "waste" out if Medicare. What waste?? I have reviewed years of Medicare bills due to having ill parents. And I have seen the cutback in services that have already occurred over the past couple of years. And I am reading about new cutbacks that are now occuring quietly. Medicare service providers (ie, doctors), are not overpaid. They are minimally paid compared to our normal insurance payments. That is a well known fact. If you cut back payments even more, then doctors will drop the elderly and then the elderly will suffer as they search for some clinic that will accept them and their meager Medicare payments. Hence, services to the elderly will be cut in order to pay for the proposed Universal Care. It's not in the Bill, but it will definitely be the result. Also, even Pres Obama has said that we need to re-think spending money on the truly elderly and think about when to simply give them a "painkiller" and counseling (I heard this speach myself several times. I am not "parroting" any demagogues".) I think we need to take off the table the Medicare cutbacks as a means of paying for universal coverage. If we need to raise taxes, so be it. I am willing to pay more taxes to help out. But let us not be a country that decides to pay for one program by pillaging the elderly simply because they are probably to frail to show up at the polls.

As for my UK relatives - unfortunately one was indeed a post Blair case involving cancer treatment (a couple of years ago to be specific). Please read Concerned Parent's posting. He/She speaks the scary truth.

So, I completely support Universal coverage. BUT let's do it through regulating the greedy insurance companies, raising taxes on those who can pay, and looking to other systems for their good ideas. And let's do it after a lot of research. This rushing a plan through Congress in Pres Obama's first year just so that everyone can say it was done in X months is a disaster waiting to happen. Rome wasn't built in a day, nor can a robust, good, FAIR health care plan. I recently saw some articles suggesting doing health care in 2 or 3 phases while more research is done. That seems to be much, much wiser than merely putting the UK and Canada's highly flawed systems on a pedestal. And demonizing private companies is also dangerous, as is the very naive idea that anything government run must be wonderful. Regulating private entities has worked for generations in many different industries. Also opening up competition does wonders to fix problems. As Harry above said - let's open up cross-state competition for these insurance companies. Finally some healthy competition will shape them up asap! (Of course, this would also require us not allowing them to simply merge into one big happy really greedy company....) There are no easy answers. But let us at least be open to more ideas than those pat answers supported by Pres Obama and Barney Frank. We can do this health care reform and we can help people. But let's do it correctly.

One comment to Nathan - I am also not a supporter of Sarah Palin. However, I must admit that I find it offensive that when someone disagrees with a woman, they call her a "Barbie".... Thank God she is not blonde... What would you have said then?! Also, let's try to keep the health care debate above board. Such name calling and mean spirtied attacks will only stop the useful exchange of ideas. I don't wish to see anyone "beat to death".


Posted by Concerned Parent, a resident of Menlo Park: The Willows
on Aug 26, 2009 at 3:13 pm

Steve and Worried,
Thanks for thought provoking comments. I'll add a few others:
1) Any health care plan is going to involve balances. At present, our "plan" separates consumers from payment (so how can we be good consumers) and insurance (Medicare excluded) is attached to employment so again as individuals we can't be rewarded for being good consumers. The fee-for-service model incents health care providers to err on the side of over providing (and medicine is full of jusdgement calls). Being able to move to a system encouraging erring on the side of watching and waiting may be just as good and a lot cheaper, but people need to understand and accept that. I suspect docs can sell that but won't be as easily able to ally with the patient in fighting to get more.

2)None of the other systems are perfect, but they may work well in an individual country (Cuba's works fine in that country but it doesn;t have a lot of the freedoms and flexibility and patient's right we take for granted here). We need to be careful if we thing we can take only the good of all the other systems, but it's certainly worth seeing what aspects are successful and how would/could they be implemented here.

3)As best as I can tell, the UK is not a red herring. If you read some of what Tom Daschle has written, he has several steps in moving the US toward that type of system. First single payer, then guidelines for MDs (established by a national group), then ratchet down costs. He specifically mentions the slowing of technology. So, while what has been bandied about in various bills may not resemble the UK system, people get worried that it sets up a framework for going down that path. I'll also note that there are studies in the British Journal of Cancer describing the more advanced stage and higher death rates from multiple types of cancer in the UK due to delays in the system. These may not weigh heavily in life expectancy stats, but are a real negative of the UK system. The Brits in general do not tend to place such high expectations on their medical system either.

4) Much is made of competition. I'll repeat my preference for opening up the sales of insurance across state lines. One alternative put out there appears to be a federally defined plan (to qualify it must cover a,b,c, and d) and then multiple different companies can administer it. The challenge there is determining what a,b,c,and d are and imagine the lobbying that would go on there. I'd prefer that there be a wide range of plans with different offerings that people can choose from to suit their life setting.

5) End of life care- the challenge here is that (kind of like recessions and recoveries of the economy), this is defined retrospectively. Not knowing in advance what the outcome is going to be, it's hard to know when the last 3-6 months of someone's life is going to occur. An 80-year old can get pneumonia and be given antibiotics yet die or could be intubated with antibiotics at great expense. If they recover and live to 90, the right decision was presumably to make the expensive intervention, but if not, you don't know until after you've spent the money. Yes, there are likely some cases of people who wouldn't want to be kept alive "artificially" that have not made their wishes clear who would be kept comfortable and allowed to die peacefully if they have end of life discussion with their doctors, but I suspect there is less savings there then people would like to think. Unless, of course, one takes away the option of treating the 80 year old man with pneumonia. That's not what the bill as I understand it says (or said), but it does come back to distrust of motivations of the people writing the bills, lack of clarity, and a sense that something is being done quickly because the authors don't want people to have the time to examine it. That's the approach taken by the Bushies with Iraq and it's taking a lot of time, money , and loss of life to undo that. With what I've seen put out there for the health bills, they will cost a fortune and will be near impossible to undo. All the more reason to look closely at exactly what is being proposed. If each of the pieces of a program can't stand up to scrutiny and if it's all or none (as some Demos have said), then it's probably not really a plan worth doing.


Posted by Worried Voter, a resident of Menlo Park: Stanford Hills
on Aug 26, 2009 at 11:00 pm

Dear Concerned Parent,

And many thanks for your thought provoking comments. I learned quite a few things from reading your posts!

I do have a couple more thoughts/comments to add:

Re your # 3 comment - I totally agree. There is nothing in the current Bill to create as socialized medical system as in the UK. However, I watched an interview that Pres Obama gave about a year ago. He clearly said that was his goal and he realized that it needed to be phased in and would take 10 or 15 years to accomplish. He clearly said that the goal was to do away with all private insurance companies. So, I completely agree with you. Raising the problems in the UK is not a "red herring".

As for your # 5 comments above - again, all very valid points. By the way, I know three 80 year olds who lived on to see additional years after live saving treatments (including my father), so I admit that I am a bit biased towards giving them treatment should they want to fight a valent fight. I also have learned that these are indeed very difficult decisions for the patient and the family to make since you never want to see a loved one suffer. And an incorrect decision is one that can never be fixed. These decisions need to stay in the hands of the patient and not any beauracrats. What I have seem in the Bill is the setting up of a government board that would set "standards". Pres Obama has said that the standards need to be uniform and we can't consider the individual's tenacity and will to live. I heard him say this at a recorded town meeting. This brings back memories of the novel 1984....

Again, many, many thanks for your wise, informative and thought provoking comments.


Posted by Mystery Science Theater 2009, a resident of Menlo Park: Suburban Park/Lorelei Manor/Flood Park Triangle
on Aug 27, 2009 at 4:50 pm

People need to stop watching Logan's Run and ask themselves if the current health care situation in America is really that good.

How this debate got turned into a fright-fest over turning geezers into soylent green, I don't know, but it's a red herring. What kind of nut-job wants to kill off senior citizens? And what kind of politician would back such an outrageous proposition? Seniors are the only ones who actually go out and vote on a regular basis.


Posted by Get your head out of the sand, a resident of Menlo Park: Downtown
on Aug 27, 2009 at 9:06 pm

Mystery Science Theater 2009

Nobody is watching Soylent Green. We are watching Obama who has CLEARLY said that $1/2 trillion in cuts need to come from Medicare in order to pay for his bloated government health plan and (2)that government teams will be created in order to set "standards" for treatment which our great leader has said would not take into consideration the individual spirit to live that the elderly or sick might have. Obama said we can't afford to have a system that allowed for such individual standards since it wasted money. Put #1 and #2 together and bingo - you end up with the elderly getting less treatment. Less treatment = earlier death. As to what kind of politician would back such an outrageous proposition?? Obama and the liberal wing of the Democratic Party. Perhaps if you watched the news (regular and cable) you would see Obama and Barney Frank making these comments and you wouldn't be so quick to say that everyone's reasonable concerns are "red herrings". These statements are recorded and being played for anyone who wants to hear the entire story. Out of curiosity, are you under 30??


Posted by disgusted, a resident of Menlo Park: Felton Gables
on Aug 27, 2009 at 9:29 pm

Get your head out of the sand, Please cite your source for "Obama ...has CLEARLY said that $1/2 tillion in cuts need to come from Medicare in order to pay for his bloated government health plan." Don't resort to an out-of-context quote on a partisan site, please. We want to see his CLEAR statement that half a trillion dollars need to be cut from Medicare, in the statement's FULL CONTEXT.

Regarding your #2 interpretation of what Obama is advocating: If you sincerely believe what you wrote, I'm very sorry. Life must be an angst-ridden ordeal when lived in such irrational fear.


Posted by Get your disgusted head out of the sand, a resident of Menlo Park: Downtown
on Aug 27, 2009 at 10:37 pm

Ahh yes, Disgusted has risen up again to insult, yet make no actual cites himself. And again dear Disgusted simply calls his opponents names. It was not a partisan cite - it was on the news. Obama was being interviewed and he made the statement. Maybe you should try watching the news (on major TV channels, not some partisan channel) instead of buying into the Obama governmental rhetoric and merely throwing insults at people who disagree with your ignorant comments. Not once in this post or your previous post have you supplied ANY facts supporting your side. Instead you launch into attack mode. Are you related to Barney Frank or R. Emmanuel? LOL!!


Posted by Disgusted with Disgusted!, a resident of Menlo Park: The Willows
on Aug 27, 2009 at 11:03 pm

[Post removed; same individual posting under multiple names]


Posted by Avid reader, a resident of Menlo Park: Sharon Heights
on Aug 27, 2009 at 11:34 pm

[Post removed; same individual posting under multiple names]


Posted by disgusted, a resident of Menlo Park: Felton Gables
on Aug 28, 2009 at 9:13 am

"Get your disgusted head out of the sand," you write that I've "risen up to again to insult" and "again" call opponents names. My last post contains no such insults or name-calling (though I can understand why opponents may have taken umbrage to a prior post). In my last post, I was addressing "get your head out of the sand" and asking for citations for what he/she was claiming. Hardly an insult or namecalling or "launching into attack mode." I'm still waiting for the citations -- in context, not snippets without context.

Meanwhile, I repeat (from an earlier post): For solid, nonpartisan facts and information about health care reform, see Kaiser Family Foundation's website:

Web Link

Somehow we've got to get purely emotional responses out of this debate. Fear and anger, which is often based in fear, blind people to what's possible for the good of our society. Find good sources for information, like KFF, read up, then form your opinions. If we disagree at that point, well, we just disagree. But at least our opinions will be based on facts, not fiction based on unreasonable fear.


Posted by Get your head out of the sand, a resident of Menlo Park: Downtown
on Aug 28, 2009 at 9:45 am

Dear Disgusted,

It seems to me that the "fear and anger" is on your side. You ignore facts that are well known and calling someone's life "angst-ridden" simply because they know the facts isn't insulting?? Or accusing me of being "irrational" isn't insulting?? Do you own a dictionary??

As for cites, there are tons of them my fearful friend. You really need to check your info before you attack people who are merely supplying truthful facts that you don't want to hear. See:

Web Link

This is from Reuters and it clearly says that Obama wants to cut $1/3 Trillion from Medicare and Medicaid. Other articles talk about bigger cuts, For example, Yahoo news points out that our fearless leader has suggested $622B (ie, $2/3 Trillion...) in Medicare cuts. See:

Web Link

How is that for CLEAR? By the way, neither Reuters or Yahoo have ever been accused of being "talking points" for partisan nonsence. I agree there has been nonsence spouted from BOTH sides of the healthcare debate, but the sacrificing of out elderly is not nonsence. As befitting of a good politician, Obama has given these cuts a nice spin by calling them cutting of "waste". $622BILLION of waste??? Name another govenmental program that could take a $622BILLION cut and not be devasted. Do you know anyone who is elderly? Go ask them if their doctor is overpaid through the Medicare program. Or if they are getting too many unneeded tests. The answer will be a resounding NOOOO!! Anyone who knows an elderly person knows that their doctors already get reimbursed less than our doctors (who are paid by those evil private insurance companies...). That is why everyone knows that some doctors turn away new Medicare patients. You are either not well read on this topic or young. Or you are just reading the headlines and not the full articles, Otherwise you would know these details about the current state of Medicare and Obama's plans for the future. I can get you more cites if you like. There are tons of them on the internet. Or you could shock us all and go find them and read them yourself. But please do keep your emotional attacks to yourself. I do not appreciate being called "angst ridden", "fearful", "irrational", "angry", "blind" etc just because I am more knowledgeable on the topic. Your denials and attacks are proving what I was truly afraid of...the Obamacareheads are either ignorant of the true facts...or heartless. I am not elderly, but I have a heart. We can have universal coverage through raising taxes. BUT not by basically taking all the needed money from the elderly who already paid into the system and have built this county up. And then we can't even be honest and say we are stealing, we just call it "cutting waste"....


Posted by Concerned Parent, a resident of Menlo Park: The Willows
on Aug 28, 2009 at 10:06 am

Disgusted:
I agree that there needs to be a dialogue based on facts. My sense is that there is an attempt to move quickly an avoid the asking of reasonable questions.
People point to polls for support, but they can be fickle. If you ask people a general question: Would you pay more taxes to support universal coverage? Many people will say yes- universal coverage sounds good in theory. If you put more details on a plan, e.g. will you pay $1000, $2000, etc. more in taxes, people start to back away. If you tell people you won't lose anything, everyone will get covered, and someone else will pay for it, people like that, it's just not truthful. In going to war in Iraq, the previous administration was (rightfully) critiqued for getting people to sign up for something that was ill defined and rushed. We should avoid that mistake here. It seems that people who want to rush into a major plan are taking the position that there is a limited opportunity and so I want to do as much as I can before anyone wakes up. It could be that the programs proposed are the best thing, but if so, they should be able to stand up to scrutiny with details transparent to all. The problem with the public and polls in general is the same problem we have with California and the initiative system. We all want the govenrment to do everything but we don't want to pay for it. We all also want to have infinite health care but not pay for it. Here's where leadership and strong defensible positions freom the White House would be useful, but Obama is rather wishy washy and his numbers don't add up.
In terms of Mystery Science Theatre and others who bring up rationing, I would say that while you may not find them articulate and they may be addressing issues that are not explicitly expressed in nay of the current proposed plans, if you read Tom Daschle's book on health care reform and listen to some of the opinions expressed in some of Obama's speeches over the years, it is not an irrational fear. I would also add however, that while nobody wants to talk about rationing, 1)it occurs in some form in our system today, 2) by not examining the health care costs sytematically we have no way of knowing what we might be losing. It may be that spending $1 million on someone in a coma for a month with a dismal prognosis may be better spend on vaccinations for 10,000 kids. As far as medical care, the assumption that doing something is always the best answer is not necessarily true, but if doctors are paid based on doing more, patientes believe doing more will be helpful, and neither need be concerned about costs, the result will more care at more cost, but of questionable benefit in some cases.


Posted by Mystery Science Theater 2009, a resident of Menlo Park: Suburban Park/Lorelei Manor/Flood Park Triangle
on Aug 28, 2009 at 10:27 am

@GYHOOTS: I think it's pretty clear that what you are watching is Fox News, and I find it's almost impossible to have a logical discussion with someone who believes that Fox News is a reliable source of unbiased information.
So go ahead, believe that Obama = Hitler, liberals and progressives all want to kill their grandparents, and that the government isn't capable of running anything (except leave my Medicare alone!), and that for-profit insurance companies are doing a bang-up job of providing adequate, low-cost, non-rationed health care to America.
I know a hopeless case when I see one.


Posted by Concerned Parent, a resident of Menlo Park: The Willows
on Aug 28, 2009 at 10:38 am

Mystery Science Theatre,

Sorry, I referred to you in my previous post and attributed a position to you that was from Get your head out of the sand. I did not mean to imply that you were expressing concerns about rationing. With regard to your comments about Fox, I find that there is no objective source for news and information these days. In channel surfing I'll sometimes go between Fox and MSNBC and figure the truth is somewhere in the middle. When Nancy Pelosi goes on Charlie Rose and claims to be non-partisan and is unchallenged, I have hard time with taking the new-entertainment industry too seriously.


Posted by Get your head out of the sand, a resident of Menlo Park: Downtown
on Aug 28, 2009 at 10:42 am

LOL!! Mystery Science Theater, again with the attacks and absolutely no cites backing you up. This is not an educational debate with you. It is an attack missle experience. I quoted Reuters and Yahoo news. Concerned Parent quoted Daschle, And you quoted....ummmm....yourself. NO ONE even mentioned or cited FOX news. Who watches that junk? EVEN the Kaiser cite that Disgusted keeps bring up admits that $622BILLION in cuts is planned for Medicare under Obama. And as Concerned Parent said, there are few and hazy details actually given. I repeat - name another federal program that could take a $622BILLION cut and not be devestated. If you can do so, then I am definitely listening. But right now, I don't care how Obama or you spin it - the elderly will be sacrificed in the name of this health care plan. As for comment "leave my Medicare alone", I am decades away from Medicare. It is not even remotely a factor in my life at the moment. But I have seen elderly loved ones have to deal with the current system. Even now, if you do not have someone to speak up for you when elderly and sick, Medicare will often leave you in a rut. And the Obamaheads want to cut the waste from Medicare? You are the truly hopeless (and heartless) one. Fortunately all polls indicate that you are in the minority....and shrinking.


Posted by wants reform now, a resident of Menlo Park: Central Menlo Park
on Aug 28, 2009 at 6:01 pm

I am tired of Wall Street being in the middle of healthcare decisions. Yes, it's the profit motive of for-profit health insurance companies that scares me the very most. That's why pre-existing conditions are denied, why recissions occur, why so much money is spent on systems designed to trigger reviews for payment.
Once post-employment COBRA coverage had ended, my family could not get insurance coverage anywhere close to the breadth we'd paid for decades with the same insurance companies at any price! This just has to stop.
How about the Kaiser model -- it's a pre-paid group plan with a not-for-profit insurance company. The doctors make decisions, the systems support patient care and health records. Sure, it's not perfect, but anything involving people and the inexact science of medicine that's the case.
Allowing people an option that allows them to be able to afford such care makes a lot of sense to me. Most of what I see in the above posts is fear mongering. The fact is - the current system doesn't work!


Posted by Get your head out of the sand, a resident of Menlo Park: Downtown
on Aug 28, 2009 at 7:50 pm

Dear Reform Now,

The above is not fear mongering - it is the truth. NONE of the above writers even remotely indicated that they thought the current system worked. While I think that the government takeover of medical insurance and the sucking dry of the Medicare system is a heartless disaster, I also do believe that the health system needs reform NOW. But there are better ways to fix it than the poorly thought out and heartless (re Medicare) Obamacare. For example, we are long over due for the regulation of the medical insurance company industry. Why aren't we focusing on making many changes through regulations? We regulate many other industries. Why not medical insurance companies?? For example, we need rules that allow people with pre-existing conditions to be given coverage, we need rules that protect people from being dropped when they become ill and we need rates that are better regulated so that people can afford insurance as opposed to leading to huge profits. We can regulate profit margins. We have done so in the past. It is not rocket science. And we need to be able to give coverage to those who can't afford anything on their own. I have often said that I am willing to pay more in taxes - yes, even the $2000 that Concerned Parent mentioned. But I am not willing to steal from Medicare or willing to allow the Federal government to run yet another business. Even Obama has said that the Federal govt has trouble running businesses and he mentioned the Post Office as an example. Every major state is on the verge of bankuptcy, so are major cities. And the roots of those financial problems pre-date the current recession. Another example - The Veterans hospitals are constantly being attacked as supplying poor help to our brave men and woman, etc, etc, All I am saying above is that Obama, Pelosi and Barney Frank seem more interested in quickly nationalizing this country than solving the real problems. By the way - why do supporters of Obamacare always immediately call any criticism of the Obama and Democratic Health care plan "fear mongering"? Is there no room for debate in this new "Hopeful" America??? Please stop calling reasonable criticisms fear mongering. It is not. It is a desire to make sure that we come up with solutions that will work best.


Posted by Concerned Parent, a resident of Menlo Park: The Willows
on Aug 28, 2009 at 10:00 pm

GYHOOTS:

Thanks for saying it pretty simply. Having both an interest in the outcome of this discussion and made what I consider to be a pretty good attempt to look into the issues, I also don't support the direction Obama appears to be going. (I put it that way because he appears to want us to pass something before it's defined and frankly, with this much at stake, he and his colleagues have not earned the trust for me to not want to see what we're signing up for before it's too late. Does that make me a fear monger, heartless, and all the other names people have been called? No. Logic 101 will tell you that just because A is a fear monger and doesn't support Obamacare and B doesn't support Obamacare doesn't make B a fearmonger. Nor does it make me a tool of the various interest groups with a big stake in the outcome. Nor does it make me an opponent of health care reform done correctly, I just don't think the way we're doing it is right (from what we've seen).


Posted by wants reform now, a resident of Menlo Park: Central Menlo Park
on Aug 29, 2009 at 6:02 pm

OK I should not have said everyone posting was fear mongering. However, I do believe that the government has done a decent job running the VA system and Medicare. Yes, the regulation some of you recommend for medical insurance is important and I believe it's in what is proposed. Having a public option doesn't mean that any of us has to accept it. It's just an alternative, but it's one that could help push toward better healthcare and service through increasing competition. My family might decide to stick with Kaiser or a for-profit insurer, right?


Posted by Get your head out of the sand, a resident of Menlo Park: Downtown
on Aug 29, 2009 at 6:59 pm

Actually, having seen what my parents and other loved ones have gone through with Medicare, I have to say that it also is not well run. For example, even in Medicare, there are uneducated clerks who reject doctors' recommendations and cause the patient to suffer. One of my parents needed a very important life-saving drug. The clerk said no - instead use a generic drug. Her very highly respected specialist doctor insisted that she needed the actual brand. Result? The clerk insisted he knew better.... Thus, my mother paid a fortune out of her own pocket. Also, many basic things are not covered by Medicare. According to one of my doctors, Medicare has about 2 years ago terribly cut back on the payment of physical therapy, which is seriously needed by the elderly in order to stay as active as possible. And the Medicare reimbursement rate to doctors is so dinky that many doctors won't take on new Medicare patients. (Cite? I have reviewed my parents' medical bills to see the rate reimbursement myself. This is not info supplied by a Fox news or any other source,) Conclusion? Private run AND Government run health insurance entities suck unless they are regulated. That is why I support MAJOR regulation of this very important industry. Some of those regulation ideas are being bounced around Congress, but no one is really pushing them through. Instead everyone is bickering about socialized medicine vs non-socialized medicine.

As for the just being an "alternative" government run entity - unfortunately that will eventually lead to the entire industry being government run. I say this since Obama has said that himself. I am not listening to the crazy theories out there. No, I don't have any cite. I actually witnessed him say that during an interview on the topic that was on TV. He said, and I quote, "it would take 10, maybe 15 years, but the goal is for it all to eventually be governement run". I have also heard Barney Frank say the same thing. So, we are back to the question - do you or don't you want a FULLY nationalized health insurance? It won't be just an "option" in a few years. That is why I am so adamant about regulating the industry (in a major way) AND giving some sort of credits to those who can't afford health insurance so that they too can now buy health insurance. Or perhaps give more tax breaks to non-profits like Kaiser so that they could flourish. I do truly want everyone to be covered and covered properly. And I am willing to even pay higher taxes to do my part to help out. I just don't want govt running something so important.

Hey, look at the bright side. We are at least all looking to attain the same goals. Hopefully that will lead Congress to get their act together and make sure that good solution is indeed created.


Posted by Get your head out of the sand, a resident of Menlo Park: Downtown
on Aug 29, 2009 at 7:14 pm

Oops - apologies, I forgot to also mention another solution that will help the industry in addition to regulation - healthy competition by getting rid of the state line rules that cause health insurance companies to be able to develop basic monopolies in many states. I do believe that healthy competition will do a world of good to help on many issues that currently caise many of us pain. One of the posts a few days ago mentioned this idea.

So, I do sincerely believe that the fillowing would solve all the problems:
1) Regulatins
2) Healthy competition between insurance companies
3) Bigger tax breaks to help the not-for-profits luke Kaiser
4) Some sort of credit system so that the uninsured can get covered.

As for how to pay for the uninsured? For one thing - end the war.... Lot's of money freed up then. And yes, we will need to raise taxes somewhat. And do we really need the space program? Maybe I am wrong on that one. Pleae feel free to tell me that we need the space program. I plead ignorance on the topic. But from my limited knowledge, it doesn't really seem to be the best use of money. What other country even bothers with a space program besides Russia? Just a thought.


Posted by P. Adams, a resident of Portola Valley: Los Trancos Woods/Vista Verde
on Aug 31, 2009 at 4:27 pm

I just don't understand how anyone can talk about the horrors of having the feds dictate medical treatment and ration health care. How is that worse than having greedy, for-profit corporations rationing health care and dictating treatment?
If we can't have single-payer insurance for everyone, then there needs to be a non-for-profit public option. Everyone who's pro-capitalism will have to agree that competition is healthy, right? Well, this country desperately needs some competition that will drive down prices, as well as regulation that will stop the current abusive practices of insurance companies.
The current system doesn't work.


Posted by Concerned Parent, a resident of Menlo Park: The Willows
on Aug 31, 2009 at 5:53 pm

P.Adams:
I think most people (at least judging from the posts on this site) believe the system needs to be improved. Surprisingly, from what I can tell from the polling data I've seen, most people are happy with their care today. I am, however, my concern is not for today, but the fact that the system isnot sustainable Most people appear to want increased competition. However, there is a fair amount of disagreement about how to do that. Many people are not comfortable with the government entering the playiong field when it is also the referee. Several people on this board have called for allowing the sale of health insurance across state lines as a way of instantly increasing competition. THat is a possible solution without the "competition" of government. Keep in mind that the "successful" government program of Medicare operates at a loss and relies on underpaying providers which drives up the cost of care for everyone else. Take a look at Fannie and Freddie as well.


Posted by Get your head out of the sand, a resident of Menlo Park: Downtown
on Sep 1, 2009 at 1:11 am

Dear P Adams,

I would support a federal alternative if you can tell me one federal program that is run properly? Study after study, statistic after statistic show that government run entities always end up much more bloated than their private industry counterparts. The post office, states, cities, etc. And as Concerned Parent points out, Fannie and Freddie Mae and Medicare is also not running properly. It would be better to increase competition either with more private entities or not-for-profits. Not-for-profits also run a lean ship generally. And "horrors" of the feds running this program can also be predicted by how socialized medicine runs in other countries. Several posts above gave a variety of facts on those problems.

More solutions on how to fix the current problems, in addition to the 4 I listed above:
5) Regulate the drug companies. They are the ones with the really outrageous profits
6) Increase govt grant spending for drug research.

By the way, I am not sure why you speak of capitalism as almost equal to evil? Please name one socialist country that provides the same amount of freedoms and opportunities that our capitalistic country does? Also, name one socialist regime that has worked? I distinctly remember East Germany and other Eastern European countries throwing off the yoke of socialism and nationalized economies. And I remember the human rights attrocities of China. I have family and friends who have left (fled) such countries and they also don't comprehend the current love affair that Liberal Democrats have with nationalization of banks, car companies and medical care. It seems to be opposite of what a true liberal would want for his fellow human beings.


Posted by For universal health care, a resident of another community
on Sep 1, 2009 at 8:20 am

GYHOOTS, I support government-run universal healthcare. I know you don't. I am content to respectfully disagree with your position. But what I have a hard time ignoring is the suggestion that the government can't run any program properly. I've never had a single problem dealing with the DMV, the unemployment office, the IRS, my own city's government when I've needed permits, etc. Not a single problem with errors, lack of professionalism -- nothing of the sort.

On the other hand, I get a queasy stomach every time I realize that I have to deal with a mistake made by my credit card company, or my private healthcare insurer, or even my own private-sector employer.

That nausea is the result of experience. I've had to wait on the phone line too many times for too many precious minutes, only to be connected to someone in India, and to get little if any satisfaction. Switch credit card companies or insurers, you say? I have. Same story.

I've had to finally give up on trying to sort out errors made by my employer's business office -- except of course when the error was in my favor (only once, by the way). Then they were able to fix the problem promptly.

Private sector or public sector -- workplaces are all run by human beings. Human beings will at one time or another make errors, and it doesn't matter if the person is employed by a private company or the government.

My experience has been very good with public employees, yours may not have been. But personally, I'd rather deal with an entity that can be held accountable by the public for my health care insurance than a for-profit corporation whose financial interests it's in to NOT provide coverage for care that my doctor says I need.


Posted by Concerned Parent, a resident of Menlo Park: The Willows
on Sep 1, 2009 at 9:11 am

Universal:
My experiences with various public bodies have not been particularly good. Permitting processes for housing remodeling took years with multiple committees. The DMV has improved but if you walk in, prepare to wait. Same thing with the VA and Post Office. There seems to be an attitude of the employees that I'll get around to it in good time. Then there are the schools. I agree there are problems with calling a service line and getting connected to someone in India or elsewhere offshore for hours (though they are usually very pleasant though not too helpful in my experience). One difference is the right to escalate and even sue is there for private companies (even if it is difficult), but not for the government. For a while, competition worked pretty well for credit cards so when one company had a higher rate, you could go to a competitor. If people as individuals, rather than groups of employees could be good consumers (they would need lot of competitors as well as information), I suspect we'd arrive at what the real cost of health care and insurance is. Intorducing the govenrment as a player could set rates, but what would be the basis? If they were too low and require a bail out, I don't see how different that would be from the old monopolies who would undercut competitors for a while, drive them out of business, then raise the prices. The answer is tighter regulation, oversight, and competition, not making the government a player as well.
as far as a payor having an interest counter to your MD's recommendation, keep in mind some of the opinions of Dr. Ezekiel Emmanuel. In summary, he has opined that MDs should not see patients as individuals but keep in mind the entire social context when treating someone, sort of modified Hippocratic oath. I'll be clear and say I've not seen anything in any bill that gets there, but if thats put out there as a goal, it worries me to provide a mechanism that may facilitate that tomorrow, even if it doesn't today.


Posted by Get your head out of the sand, a resident of Menlo Park: Downtown
on Sep 1, 2009 at 12:01 pm

Dear Universal,

I said that the governmental program/entities become "bloated". By that, I meant that they were over-staffed and extremely costly. I wasn't making any comment about their professionalism or politeness. Generally, I too have enjoyed my interaction with government workers. For example, my local post office workers are delightful. However, as Concerned Parent said - be prepared to wait and wait (As is the same case with the call centers in India...). And I must add that unfortunately say that my family has been the recipient of a disgraceful lack of support from Medicare. I agree with you - human beings are fallable. Thus, I honestly don't know why anyone would think that a federal fun health insurance would be run any better than a properly regulated private insurance company. The key to making sure people step up to the plate, is competition. As Concerned Parent said and so did Obama - the government would ultimately run ALL health insurance. Then be prepared for the bloat and much higher taxes to pay for the bloat. Or major cutback in services as we about to see with the post office when they finish closing offices and perhaps cutting Saturday service. Basic Economic Theory says that monopolies are bad. This is taught is all Economic classes. Monopolies lead to higher prices, lower services. So, it is very, very important that we increase the short and long term competition in the health care industry. History has shown us over and over that the best way to do this is to have multiple private industry players. Hence - no government takeover. AND no future mergers of the health insurance companies.

And I agree with you and Concerned Parent on accountability - the only way to truly make sure that human beings shape up is to make it clear to them that they are accountable. That is another worry I have with the government running health care insurance. Due to unions and rules, government workers are almost never fired for mistakes. Combine this with language in the current Congressional bill that has a clause that bars lawsuits, there will be no "accountability". So, when the human being at the new Federal Insurance Company makes that normal human error - too bad. That scares the heck out of me.

Actually, I would even dare say that the private health insurance companies and doctors and hospitals are today held to a too high a standard of accountabily thanks to our current tort system. Lawsuits where people get $1M+ for stupid things like spilling hot coffee on themselves has led to higher costs for all of us normal people just trying to survive and live our lives. One of the above posts suggested that health care would benefit from tort reform. Many of my doctors have told me that they pay fortunes in malpractice insurance due to the outrageous lawsuits and huge lawyer fees that go along with them. They pass those costs down to the patients in higher fees. It becomes a viscious cycle of escalating fees.

As for your comment about not wanting a health insurance entity that does not listen to your doctor, that is a common experience of the federally run Medicare program. Also, Pres Obama and Dr. Ezekiel Emmanuel (brother of R. Emmanuel) have frequently and publicly stated that MDs can not view patients as individuals, but must instead adhere to the new federal standards that will be created through the Fed medical board that Pres Obama and his supporters want to implement as part of medical reform. This Board will look at statistics and set standards. And Pres Obama has said that we cannot look to an individual's will to live, but rather his odds based on statistics. He said that we will have to start making those "hard decisions" to perhaps just supply "painkillers" instead of more medical services. He likened the spending of money on folks who were near the end as an expense we no longer could afford. He doesn't believe in euthanasia and no he is not killing grandma. He just doesn't think we can afford to keep wasting money on treating those who are near the end. I saw and heard all these speeches. I am not just quoting some biased news source. So, how will we be viewed as "individuals" if our doctors are now told to refer to a chart only? I have seen many cases of people who had odds stacked against them who managed to survive. As you say, we are only "human". I don't want a human generated stack of statistics making my or my loved one's decisions on life. I want a doctor who makes the decision with me. I personally know of several people who have FAR outlived the odds given to them. I don't want a system that will force the statistics on those who are willing to fight the valiant fight and often live.

This is all best attained by regulating the insurance companies and drug companies, increasing their short and long term competition, increasing federal grant money for drug research, and tort reform. A government run health insurance company is no more likely to be the magical, kind hearted cure to our current problems than continuing things as they are. Medicare doesn't treat members any better than private insurance companies, so why would this new federal insurance company be better? If Medicare ran better, then I would understand this support for the nationalized health insurance. But having seen the problems with Medicare through family members and friends use, I sincerely don't.


Posted by Ethan, a resident of Menlo Park: University Heights
on Sep 1, 2009 at 1:56 pm


In response to some of the attitudes toward government and government-run programs expressed above, perhaps a little thought experiment is in order. Let's imagine that Steve Ballmer, CEO of Microsoft, steps to the podium at the next company shareholder's meeting and says the following:

Thank you for being here today. Let me get right to the point.

Customers are complaining that our operating system crashes. They start rumors about how the tech support team actually consists of one adenoidal guy in Uttar Predesh. They say that when it comes to effectively conveying information, PowerPoint works about as well as sky writing or a flashing beer sign. And they want to know why Word keeps doing that weird thing with the margins.

We don't have solutions to these problems. In fact, we aren't even working on solutions. And that's good. Because if we attempted to fix things, if we made this a better company, our customers would stop thinking for themselves. They would have no incentive to develop self-reliance, to take responsibility, to write their own software. They would become DEPENDENT on Microsoft.

And, eventually, they would lose their souls.

It is a truth, universally acknowledged, that large businesses are incapable of running efficiently or meeting the expectations of their stakeholders. Such organizations cannot be improved. Nor should they be. For the better a company operates, the more it intrudes into our lives. It's like a car that always starts or a cell phone that never loses reception. Slowly, insidiously, you find that you no longer have the freedom to pay for a tow truck or yell at your kids in person.

That's right, a successful, well-run business infringes upon peoples' rights. It takes away their choices. Worst of all, it calls into question their most cherished beliefs about companies in general. And we can't let that happen.

That's why we're rolling out our new corporate governance structure. And behind that structure is one key precept: "Microsoft is not the solution. Microsoft is the problem."



Posted by Steve, a resident of Portola Valley: other
on Sep 1, 2009 at 6:15 pm

Everyone reading these comments really should consider reading T.R. Reid's superb analysis of US health care compared to other countries:

Web Link [www_washingtonpost_com]

Yes, the U.S. is unique, but we can learn from others, too.


Posted by Get your head out of the sand, a resident of Menlo Park: Downtown
on Sep 1, 2009 at 7:54 pm

I agree. Your article was very interesting. It looks like several developed countries (Germany, Japan, Switzerland) have managed to keep their private insurance companies and private doctors and get the job done quite well. In fact, much better than Canada and the UK's governmental models. Hopefully our Congress will look at these models and get ideas on the best ways to fix our system without turning to nationalization. And I don't want to watch our country make the same mistakes as other countries (eg, Canada and their inexcusable long waits for medical care as your article mentioned). We need to learn from others AND also be creative since we are so unique in size and other ways. It won't be an easy process, but let's begin the steps forward. I just read an article today that predicted that the health care reform process will indeed go slower so as to give Congress a chance to truly study the problems and will start with regulations of the industry. Let's get this right. Too much is at stake.


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