Michael Moore's controversial film SiCKO opens nationwide this weekend. But before the inevitable discussions about the accuracy of the film's portrayal of the U.S. health care system, you can make up your own mind. The summary below includes comparisons of the American health care system relative to other countries and between the states, plus data on the uninsured, rising health care costs, the woes of Medicare and Medicaid and more.

For all the details, see: "SiCKO Required Reading: U.S. Health Care by the Numbers."

You can use a simple bar graph to predict when the US will adopt a single payer system. Bar #1 will show the total congressional and presidential campaign contributions from the insurance and health care industries. Bar #2 will show the total congressional and presidential campaign contributions from the poor and uninsured. As soon as Bar #2 is higher than Bar #1, I expect to see single payer adopted.

In the absence of the above, single payer will be adopted on the day that Hitler and Stalin place first and second in the men's freestyle ice skating competition in hell.

I find myself agreeing w/Kari. I am defintely NOT your grass roots stereptypical 'progressive' this board caters to. He is correct that the employer based health care system in the United States is irretrievably broken. The double digit cost increases over the past decade are breaking companies and leading to less available healthcare.

FSA's, MSA's HDHC and 'consumer driven healthcare are merely re-arranging deck chairs on the Titanic. A true change needs to come about and only highly competant politicians will be able to help usher this change. I am not confident that the government as healthcare provider is the best model. Certainly look to the HIV and HBC scandales of Canada and France; however, I am more than ready to help mold a new system. Certainly what we currently have now isn't working.

When GM spends more annually for healthcare than they do for steel or tires, something is dreadfully wrong.

There's no reason that a universal health insurance mandate couldn't work at least as well as removing half of a malignant cancerous tumor in a major organ would work. Quite similar, actually.

I'm Canadian, and yes, there are mix-ups and scandals in our system. However, some of these observations ring like ab hominem or tu quoque fallacies a bit, in that the discovery of flaws in systems that demonstrably outperform the American system means there is nothing to learn from those systems. I'm sure many of you have noticed this manoever too.

There are some economic binds and double-binds in health care provision.

1) As Moore points out, when someone is sick, we expend resources to help them get better. There is no way to turn that expense into a near-term monetary gain, just like there is no way to regain the time you spend awake by the bedside of a sick child. It's gone. There is thus a contradiction between the act of providing good care and the obligation to profit financially from providing it. Private insurers will always have the structural incentive to withhold services.

Instead of gaining profit from the money stream that heals people, you have to look at the larger value to society of having a happier, healthier (and better-educated??) workforce/citizenry. It's worth spending the money!! Value is not just measured in dollars.

1. Any universal system will face supply problems. You can get rid of supply problems as is done in the US by locking some people out of the system, but then the larger value of public health and the moral duty to help each other go out the window (the strong help the weak knowing no one is strong forever - reciprocal altruism). So there is a quantity/quality tradeoff that needs to be managed. Other countries manage it more cheaply than the US does, but on any budget it has not yet been able to max out both. The US is the richest national economy ever in human history, so perhaps you guys could be the first.

Actually, in an efficient market, the intersection of supply and demand is supposed to produce the greatest value. Contradiction 1 above shows that the insured, the sick, are structurally ill-served by this industry. The industry profits when it does not give them what they paid for. So buyers of insurance cannot be the customers of the health insurance industry. The customers - those who do find satisfaction in supply-demand price points, are investors, shareholders. These are the real customers of the health insurance industry, perhaps (I'm not an economist, obviously...).

If investors are the customers, then the insured are just a resource bed, like a copper mine or mineral claim, mined for money in order to produce financial performance indicators for the corporations, who sell these value-signals to investors on the stock markets... or something like that. It doesn't matter if insurers fail the insured, because they are not the customers.

On another blog somewhere (http://bradhicks.livejournal.com/348604.html) I read someone who said:

<h2>joxn wrote: My point is this, of course: the basic healthcare that everyone needs to stay alive and healthy is not something which an insurance policy is designed to handle. Insurance policies are for rare but statistically definable events. But basic healthcare is not rare -- although it is statistically definable: everyone will have to have it, and in the case of preventive care, they'll have to use it for it to be beneficial.</h2>

So private insurance may be the wrong paradigm, since we are all guaranteed to need to use this shared pool of resources. We are managing things that are something between risks and eventualities... And much too much like eventualities than risks. So this economic consideration also feeds into the economic problem. We have a moral obligation to manage this particular economic problem well too, so we need to pay attention to exactly what the challenge is, and ignore all the static about patriotic jingoism.

Single payer has demonstrated its superiority empirically in medical and economic terms in many places over a long period of time. This is not surprising; only in the U.S.A. is it considered to be a radical idea that people should take care of one another in a way that reflects their fundamental moral and (theoretically, at least) political equality.

Wyden's public-private plan (what I've read of it on here and in the newspapers) seems to me to be only the latest iteration of the late unlamented Hillary-care Rube Goldberg mess.

Medicare for all. This is not a hard question.

I fear that folks on the left are becoming so blinded by the single-payer dogma that they're not willing to accept other solutions to the problem.

It is unlikely that the choice before us will be single-payer versus a public/private universal health care plan. It is much more likely, as it was in 1994, between a public/private plan and the status quo.

(Full disclosure: I run StandTallForAmerica.com, where you can learn about and discuss Senator Wyden's health care plan, but I speak only for myself.)

Kari I am going to take away your ability to speak in such meaningless and ultimately propagandistic terms about this issue here and now: No one I know who is working so hard to pry the fingers of the private health insurance companies from around the neck of our health care system even talks about single-payer in the way you, or even Jeff, does. Everyone I know advocates that our Congress create a public national health insurance plan analogous to Medicare. HR-676 actually should be called "Medicare INSURANCE-For-All", because Medicare is a national health insurance system. Failing that, we advocate that the legislature create a public state health insurance plan analogous to Medicaid. SB27 would have started a discussion that offered us that as one possibility if we wanted it.

Even John Edwards' plan includes a version of this idea by allowing us to buy health insurance from a national health insurance program like Medicare because he knows the costs will be so favorable to working people that private for-profit health insurance companies will be forced out once enough people actually look at the costs and benefits they receive. You can't honestly be for Wyden's plan and for Edward's plan because they represent fundamentally conflicting sets of moral and political values. Are those of you who share Kari's misleading position willing to stand up to the folks who fund the people you like to run with, and tell them you could care less if they are driven out of the business of making money by squeezing the life out of our health care system? (Remember again that SB329 is not a public state health insurance plan, despite efforts of all the groups in "Hope For A Healthy Oregon" from the AARP and AFL-CIO to the Oregon Business Assoc. and Oregon Small Business for Responsible Leadership to imply in various ways that it is.)

The fact is Kari, there is no way that the system you describe in such a meaningless and vague way for your own reasons, a system in which private for-profit health insurance companies play anything but a role of selling supplemental insurance to those who can afford it, can fix the catastrophic structural problems our health care system faces, in a fiscally sustainable and equitable way. Only by cutting out the bloodsucking private for-profit health insurance industry that owns Wyden and the corporate red wing of the Democratic Party will the operating costs of our health care system be reduced low enough, and the pool (all Americans) be made big enough, to possibly cover the costs in an equitable and sustainable way of the baby boom as it moves on to Medicare and the increasing number of working people who have no choice but to go on Medicaid.

At the national level, Ron Wyden and the corporate red wing of the Democratic party he actually represents propose to sell us out to the private health insurance industry by compelling us to buy insurance from private, for-profit health insurance companies with no other options. And don't forget - Wyden was a proponent of the bankruptcy "reform" to stop people who experience financially devastating medical crises from declaring bankruptcy, leaving them in undischargeable debt, potentially for the rest of their life. At the state level, SB329 is a similar step propagandistic and certain step into the abyss. Just as Wyden does in his plan, Merkley, Brown, Hunt, Nolan, Bates, and Westlund (all Democrats, mind you) have shoved a plan down our throat that now requires by law that that we buy insurance from private for-profit health insurance companies if we are not lucky enough to either qualify for a public insurance program like Medicare or Medicaid, or work for an employer that provides health insurance. SB27 would have been the first step on a hard climb out precisely because it was about bringing everyone into the discussion as we need to do to fix our health care system, but it was certain Democrats who chose not to give us that chance.

For the same reason, beware of any Democratic candidate the DSCC endorses here starting with Merkely, Brown, and even Evans to run against Smith next year. And Evans, think carefully before you sell your soul to the DSCC: Come out the first day making it clear you support health care reform that ends the role of private health insurance companies as the means for providing basic health care coverage to all Americans. If you do that in no uncertain terms and the DSCC still supports you, you will be free. If you don't, you will be a big part of the problem rather than part of the solution.

The big message of SickO, based on all the serious commentary I've read, is that this is not only about saving our country, it is about saving the very soul of our Democratic Party from those who are destroying it. We will stand up to those who are selling out our Party and pathetic apologists for them like Kari. We will get health care reform that ends the role of private for-profit health insurance companies as we know it now, bringing us into line with every other industrialized nation.

Here's yet another interesting little example of Google's now infamous "Do No Evil" philosophy in action (Not!):

Does negative press make you Sicko? http://google-health-ads.blogspot.com/2007/06/does-negative-press-make-you-sicko.html

After you read that, and when your blood starts to boil about the abuses of private, for-profit health insurance companies, be fair to facts and remember Bates and Westlund, Merkley, Kate Brown, Nolan, Hunt, the poeple at "Hope for a Healthy Oregon" (AFL-CIO, AARP, AFT-Oregon, SEIU, Oregon Primary Care Association, Coalition for a Healthy Oregon, Oregon Business Council, Oregon Business Assoc., Assoc. of Hospitals & Health Systems, Oregon Nurses Association, Northwest Health Foundation, Oregonians for Health Security, Oregon Health Care Assoc., Oregon Small Business for Responsible Leadership), Democratic party members who were not sponsors of SB27, and all the posters here who have defended and apologized for them so aggressively.

All of these people did their part to get SB329 passed, making us just one of 3 states that now mandate that we have no choice except to do business with the private, for-profit health insurance companies you'll see in the film. Yet they just could not quite find it in themselves to work equally hard or harder for SB27, which would have given us a say in deciding whether we want private, for-profit health insurance companies involved all, including withdrawing support for SB329 if that is what it would have taken. Kari and others even had the gall to call some of us trolls who spoke out in this way.

I grew up in the Air force. 1945-1964 then the USMC 1966-1970. need glasses? get glasses, frames sucked at times but I could see. any thing go wrong. get it fixed. no money to pay. I never thought about who the Dr. was or if I was to see him again. The system was fine and open to all service personal. A single payer system works.

Single payer countries, which means pretty much every other industrialized country, spend somewhere between 8-11 percent of their GDP on health care and cover everyone.

The USA, a richer county than many others, spends 16% ($2 trillion per year in 2005) of its GDP on health care and covers about 80% of its citizens by some form of insurance. Though uncovered persons also get emergency and catastrophic serivce.

The medical industry believes the challenge is to figure out how to continue to collect 16% in a more equitable manner so that everyone can have some coverage for routine care.

But true health care reform would not only cover everyone, but would do so at less cost. Because another major problem with our health care industry is the overall outrageous cost that is doing serious harm to our country, and our future. As long as we pay twice as much as other countries for our health care, we will be at a serious disadvantage competitively, and we will all suffer. You know what, if we adopt the Wyden or Edwards or whoever reform, GM will still be paying twice as much for health care for each car as Toyota.

So while I sympatize wth the urge to achieve universal coverage soon, and understand how difficult, if not impossible, it may be to battle a 2 trillion dollar industry that stands to lose 40% of its revenue, I come down on the side of hanging tough and going for single payer or nothing.

Is Kari actually a corporate red troll? You know "I'm for liberal value here but corporate red talking point here"? He certainly keeps repeating the corporate red talking points without any apparent understanding:

But there's something else: The health insurance industry (which I loathe, to be sure) does manage to employ about a million people - and somewhere north of $12 billion in stock market capitalization.

And all of those workers would be a highly trained work force ready, willing, and available to make a public health insurance system soar just as soon as we are ready to put them to work. As far as the capitalization red herring, the insurance industry ultimately is just an investment business, that kind of money will always finds other places to invest and generate more money for it's private owners. Maybe we can actually set it upt so that they'll be forced to invest in industries without anti-trust exemptions, and with higher tax rates so they'll have to carry their fair share of the load in this country.

Senator Wyden thinks there's still a half-court-shot's chance of getting universal health care in 2008. He's an optimistic fella. More likely, we're talking 2009 under a new Democratic president. The question that lefties will face then: public/private universal health care? or hold out for single-payer?

As already demonstrated, Wyden's plan is not about public/private universal health care. You do the troll thing well though, by never veering from the script. Wyden offers no public health insurance option for those of us who don't already have one. It is a mandatory health insurance purchasing system which forces us to buy insurance from private health insurance companies and yet provides no uniform, universal equitable guarantee of health care beyond what those insurance companies will support politically, or authorize when the time comes. That's precisely why all of those actually in the trenches working for health care reform are supporting a public national or state health insurance alternative.

Jeff inexplicably commented:

Failing that tipping point, trying to get a single-payer plan together is a pipe dream, and I'll follow Wyden to universal insurance.

Since the predicate of his statement is false, as already noted the serious and informed people in this game from Kucinich to Edwards to SB27 advocates are working for some form of public health insurance. The polling shows support is already there for that. There is no tipping point involved and the comparison to "An Inconvenient Truth" is simply invalid. In view of those realities, one has to wonder why Jeff would follow Wyden to universal insurance since that really just means following Wyden into forcing everyone to buy insurance from private health insurance companies, and that in turn simply means making us economic victims of the private health insurance industry while still tipping our health care system over into total collapse?

To anyone who saw Sicko - Did Mr Moore honestly compare the quality of medical care in Cuba to the quality of medical care in the US? Here is my biggest gripe with socialized medicine, yes everyone can get it, but unless you are on death's doorstep, you basically wait until the doctor has time.

Why not have something like a tax credit for med insurance premiums? Med insurance companies seem to do a way better job than govt in managing healt care costs.

IMO, the most formidable opponent that universal health coverage will face is an opponent with even more power than inusrance companies: an overwhelming marketing campaign--the best that money can buy. All the other industrialized countries with universal coverage didn't have to face this foe that has no morals.

Bottom line: Private Health Insurance 20-30% overhead. Medicare overhead: 1%. The answer is 'Medicare for All' and private health plans for those who want the Platinum Plated Rolls Royce I Want it and I want it Right Now Plan. And Steve by the way, Canada and Cuba are rate in the top ten as far as health statistics are concerned: USA 30-something. We spend allot and don't get allot for it.

If we do go toward socialized medicine, I think you need to address the disproportionate risks in the population. Smoking, drug use, obesity, etc, inevitably mean that a certain segment of the population that is less healthy incurs more costs. Do you make vaccinations and such mandatory, regardless of an individuals' personal concerns about safety? The government already says it has the right to experiment on citizens without their knowing. Do you establish mandatory drug testing or body mass standards for public health recipients? If they don't comply, do you dump them? Or do you just write that down as a cost of doing business and spread it among everybody? If so, are you going to raise taxes or just keep printing money and running up the national debt, in which case you pay for through inflation and currency devaluation.

Like the gun control issue and Bowling for Columbine, Moore seems more interested in agitating public opinion than resolving some of these questions. In a time when the government on both sides seems intent on pushing for a sacrifice of privacy and liberty on behalf of the nation-state, once you open up socialized health care, how do you keep the government from using that information in a way that is inappropriate? They already are spying on Americans without probable cause, and the Bush Admin basically says, "tough sh--." Who's going to impeach? Pelosi? Do we want to surrender private information on our health when we can't get either party to stand up against the unconstitutional PATRIOT Act?

The status quo generates billions in salaries and investment returns. All those employees and investors will never give up the gravy train that is the US private health care system, at least until somebody pries it from their "cold dead fingers" (with apologies to my NRA friends). At best, we can expect that SICKO will generate a few hearings and some masterful late night oratory on C Span, after which our elected politicians will resume worshiping at the alter of political donations from the industry.

As far as half-measure proposals go, Wyden's is not too bad. However you do have to admit that passing a law to reduce the number of uninsured people by making it illegal to be uninsured sounds a bit like something out of Alice in Wonderland. If you drive your car without mandatory insurance they suspend your license and if you keep driving, they can (but usually don't) put you in jail. If you get sick without health insurance, what are they going to do? Put you in jail? The good news there might be that they do have free medical care in jail.

To anyone who saw Sicko - Did Mr Moore honestly compare the quality of medical care in Cuba to the quality of medical care in the US? Here is my biggest gripe with socialized medicine, yes everyone can get it, but unless you are on death's doorstep, you basically wait until the doctor has time.

The answer to your question, interpreted as it is framed by your statement, is: No, he most certainly did not. Moore was on CNN's Larry King Live Friday with an encore presentation last night. You can read the transcript here:

http://transcripts.cnn.com/TRANSCRIPTS/0706/29/lkl.02.html

or watch a bunch of clips on YouTube from other appearances here:

http://www.youtube.com/results?search_query=Sicko+Moore&search=

if you really want to know what Moore's talking about before commenting further. People like Steve and Ted really don't even have the slightest idea what is going on in the battle to fix the broken health care system in this country before it collapses for all but the rich. Ah, it would be nice to be young and dumb again, (since I truly prefer to think they are not over 40 and still talking like this).

And Steve by the way, Canada and Cuba are rate in the top ten as far as health statistics are concerned: USA 30-something. We spend allot and don't get allot for it.

WRONG. The World Health Organization puts Cuba at #39. Perfect-in-every-way Canada is at #30, below such glorious paradises as Colombia, Saudi Arabia, and Morocco. The US is #37.

I wouldn't be opposed to some level of government intervention in health care, but I'm not convinced at all that it should be the federal government. I'd much prefer to see state/regional plans. The feds have enough power as it is, and they rarely use it wisely.

We also need to guarantee that the plans cover only American citizens and, perhaps, legal residents. A huge portion of the budget for Washington's recent expansion of their children's health care plan goes to cover illegal aliens. We can barely insure our own people, how on earth can we be expected to cover Mexico's surplus population? It's not our responsibility to insure the world, especially when there are tens of millions of citizens like myself going without any insurance whatsoever.

As for Michael Moore, he's such a polarizing figure that his film will probably set back any movement towards universal health care, especially given his penchant for torturing facts. Progressive ideologues love him because he spouts all the lies you want to hear, but most non-leftists who've heard of him recognize him as the lying, pompous, hypocrite he is.

Of all the health care reforms being proposed, I think John Edwards' has the most potential. His proposal would create regional "health markets" that would offer competing private and public plans. This competition would offer people a real world example of a public plan out performing private plans. In the end these health markets would probably evolve into a near single payer system in which most people buy into a state run plan but private options still exist.

Here's something for the incrementalists to think about, if the problem is the size and power of the private insurers, why does that go away in the incremental approach? How does forced participation in private plans decrease their power? How, short of single payer, do you propose to achieve a situation where the Fed isn't in the position of subsidizing private insurers, increasing their power and influence in health care?

Coyote wrote:

And Steve by the way, Canada and Cuba are rate in the top ten as far as health statistics are concerned: USA 30-something. We spend allot and don't get allot for it. WRONG. The World Health Organization puts Cuba at #39. Perfect-in-every-way Canada is at #30, below such glorious paradises as Colombia, Saudi Arabia, and Morocco. The US is #37.

Typical meaningless drivel. #39, #30, #37 at what? First give a reference, and then make an argument what those numbers are even relevant. Sounds like a junior high classroom.

As for Michael Moore, he's such a polarizing figure that his film will probably set back any movement towards universal health care, especially given his penchant for torturing facts. Progressive ideologues love him because he spouts all the lies you want to hear, but most non-leftists who've heard of him recognize him as the lying, pompous, hypocrite he is.

As already noted above, but when dirtbag, excuse me "coyote", starts lying and stinking up the place with BS, we need to air out the place with facts s:

SiCKO Required Reading: U.S. Health Care by the Numbers http://www.perrspectives.com/blog/archives/000654.htm

Analysis: 'Sicko' numbers mostly accurate; more context needed http://www.cnn.com/2007/HEALTH/06/28/sicko.fact.check/index.html

Sorry Jeff, your "conclusion" doesn't have any connection to your argument before that.

And this is why, unless we've hit a tipping point in public opinion, we are going to have to accept universal insurance.

Paragraph #1: Some scrambled arguments that amount to "an election is going to happen in 2008" and health care reform may or may not play a role in that.

Paragraph #2: Some incomprehensible talk about something Jeff calls "single-payer", that no one active in health care reform would recognize or is even talking about.

Paragraph #3: Anecdotal stories about OHP, which is not the issue here nor speaks to anything about the current state of debate about health care reform.

Bizarre. The only thing a reasonable person can conclude is that Jeff must adhere to that old dictum "If you can't dazzle them with brilliance, baffle them with BS".

Eamon, on the other hand, "gets it". (not that Eamon wants validation from anyone.) Folks would do well to read, re-read, and re-read again his simple three sentences to understand pretty much the uninspired middle ground in the current debate in the real world. The Conyers-Kucinich-Sanders "Medicare Insurance for All" plan being the plan that says why not just get us where will end up anyway if we do adopt Edwards' plan.

The real question is how we get a public national health insurance and/or public state health insurance options up and running quickest. The private health insurance industry and the pols who they own like Wyden, and those SB329 advocates in this state who blocked SB27, are doing everything they can to forestall that day. There is a polar difference between the Edward's/Conyers-Kucinich-Sanders' public health insurance plans, and the Wyden/Bates-Westlund (SB329) "no role for a public national/state health insurance" plans.

The powerful private for-profit health insurance interests know that as soon as the public health insurance option becomes available, people will overwhelmingly flock to that and end the private for-profit health insurance industry as we now know it. Why do you think Medicare --- public national health insurance for people over 63 --- is the "third-rail" of politics no politician attacks directly? (The right-wing and corporate red dirtbags who want to destroy our health care system once and for all leave that up to lying paid flacks.) Pollling shows us that an irresistable majority wants public health insurance options, the debate really is about how to get people talking to each other --- that was what the actual legislation in SB27 was about --- to save as much time and money as possible, so that we get on with the real business of providing health care.

Jeff Alworth . . . if you would respond to the actual argument rather than reach for the ad hominem attack, it would help your position.

The argument here by several folks that single payer is of course preferable but it's not going to happen for structural and political reasons is, in my opinion, emblematic of why the Democrats continue to struggle for any kind of moral high ground in the public imagination.

Americans (again, in my view) want health care at least as good and as fair as other industrialized nations.

Americans don't want to be required to make the richest .01% of the nation even richer in order to do that.

If the Democrats cannot, by virtue of their ties to various corporations, lead in this matter, then they do not deserve to lead at all. Saying that they are "better than the Republicans" doesn't cut it.

I strongly endorse universal health care administered by the government for review and payment of claims to either private insurers or medical care providers directly. Private insurance would remain a viable industry because the National Plan would pick up most of the tab, like medicare, and supplemental or employer provided policies fill the gaps or provide more generous coverage of procedures not included in the National plan.

I think the energy resource industry likewise requires govt. intervention eliminating the incentive for corps. to price gouge by taxing all profits beyond a specified percentage defined as reasonable annual profit. A permanent "windfall" tax. Thus, once the business earned a reasonable profit, all excess would benefit the public, and the incentive to gouge would evaporate. This kind of intervention should only be considered for this scarce resource which is non-renewable with demand driven by public necessity and not the market. The corporations affected would still be profitable, just not obscenely so. Gene

As the one fellow noted, we have two very capable single-payer plans going in the US: Medicare, and the VA. Most of the military care is pretty good too, until they were overwhelmed by Boy George's war and the unexpected survival rate of people who then need huge levels of care. Call it 2.5 functioning single payer systems.

There are zero functioning private insurance systems anymore in the US, period. The ones limping along do so purely by denying needed care, excluding the ones who most need care, and by paying 1/4 of all costs to paper pushers whose only role is to bleed more from the already sick to serve their corporate masters. Any "system" that leaves 50 million people uncovered at any moment (and more than that for intervals) and causes job lock is NOT. WORKING.

Also, can we please stop discussing whether or not to have government intervention in the health care system? It's a nonsense distraction, because the government essentially IS up to its eyeballs in the health care system.

What we are talking about is the FINANCING --- the reason the right and the corporadoes don't want to use that word, and want to keep people from actually understanding what we're talking about, is that once you explain that single-payer replaces faceless, unelected insurance company bureaucrats at 25% overhead rate with government employees at 2% overhead rate, the game is up.

Nobody in their right mind would tolerate the "system" we suffer with today.

And, as I noted above, incrementalism is like trying to cut back on your meth habit a few percent a month, or only removing a bit of a cancerous tumor at a time.

PO'D Democrat @Jun 30, 2007 8:15:02 PM

Apparently the Google ad flap was done on the initiative of a Google employee who was acting on her own personal opinions, and Google itself has no opinion on SiCKO or the issues it raises.

http://google-health-ads.blogspot.com/2007/07/my-opinion-and-googles.html

http://www.boingboing.net/2007/07/01/more_on_google_vs_si.html

The problems of health care costs include two factors that are rarely discussed, but which are major problems in the USA.

1. Malpractice Insurance - Americans have become intoxicated with major litigation and huge settlements, and the unscrupulous file many lawsuits that push of the cost of healthcare for everyone. Until there are reasonable limits, private health care will get more and more expensive.

2. Entry Barriers - The medical establishment makes it very difficult to get licensing to provide health care. Yet much of what people have insurance for can be dealt with by health care workers that are not paying off huge medical school bills, and which care would cost far less. So this is not really a FREE market, but a MONOPOLY - and costs are much higher in a monopoly.

Bring into the discussion these issues before making the fatal move to socialism.

Kari "However, I think it's important that we keep in mind the goal: Put simply, the goal is universal health care."

It's not about the USA having the best health care in the world, it's about covering everyone. don't worry about the lines to get the surgery you need. You're covered - eventually....if you don't die first waiting in line.

Kari "However, I think it's important that we keep in mind the goal: Put simply, the goal is universal health care."

I think the goal should be providing the best health care possible...... Not universal coverage. What good is "unverisal coverage" if you don't have the investiment in state of the art medicine to back it up?

Universal healthcare = superior healthcare for the elite scanitioned democrats who donate lots of $$ to the right folks. Bright, shiny white hospitals that show up in documentaries adovacting universal health care.

Universal healthcare = WAIT IN LINE for everyone else. Like being of a cruise ship where everyone has diarehea. good f'king luck you poor b@stard.

Capitalism-"generally refers to an economic system in which the means of production are mostly privately[1] owned and operated for profit, and in which investments, distribution, income, production and pricing of goods and services are determined through the operation of a free market. It is usually considered to involve the right of individuals and groups of individuals acting as "legal persons" or corporations to trade capital goods, labor, land and money (see finance and credit)."

My friends this is the definition of capitalism, and corporate America (in this case the insurance companies) are taking full advantage of this, America was found on this and even though I understand how and why Universal health coverage through Medicare or other companies such as this could work, it seems incredibly unreasonable for a couple of reasons.

1. If we took insurance companies rights for selling health insurance it would go against every single thing this country was built on, not to mention the lawsuits that would be brought on if taking those rights away from insurance companies ever happened. We would be taking away the American dream altogether. Closing down a company because they make a profit isn't right or constitutional

2. Like brought up before, killing off companies like that would cut a million jobs, Po'd Dem, I completely disagree with what you said earlier, we couldn't reemploy all of those people because we wouldn't need or afford the workforce for medical that wasn't making any profit, the program would go bankrupt if we reemployed everyone and if we didn't and employed half of those people, then still that leaves us with 500,000 people jobless. as for the stock options you cant just tell the investors to "invest somewhere else" either the insurance companies or the feds would have to pay what their stocks are worth and economically insurance companies cant afford that.

3. Look at social security, putting something like health insurance in the feds hands will end in a catastrophe not to mention we have a million deep pool of citizens that know how to do the job and do it right.

So after my little rant what do i propose? I propose that health insurance be private still, but with some certain actions and policies taken...Step one is we cap the amount of profit a company can make on health insurance (this was a quick idea, i haven't put whole lot of thought into it but i am guessing starting by cutting it at the knees would be a good step one), this can stabilize the cost (so far i can recall one person talking about a 200 price increase in the cost of coverage, standard of living hasn't increases a tenth of that, which makes that an insane amount of money)...as for enforcing legislation we coattail this with committees that oversee the health care industry and also lay down heavy fines of companies that break laws like the profit cap.

Now before your fingers start typing away in chipping at all my theories/ideas/rants. Being a seventeen year old I know some of my ideas are broad and will have controversy stapled to every sentence, just like communism I think universal health care for America is a great idea on paper but could not and would not work in real life, due to the incredible amount of opposition and the fact that health insurance is such a huge industry that completely abolishing the private sector of it would start a chain reaction in the public reform of all insurance (auto, life, ect.) and I don't think our country is in a state to do that

(say hello to special interest groups)

So to sum this all up let me restate my idea again, keep health care private, but start to hammer out and enforce strict guidelines that the companies have to fallow.

Thank you for reading my opinion and let me state again that this all my opinion and most facts are coming of this blog. thank you

P.s If someone could point on how to bypass all of what i said and make health care public i am all ears.

I'm not sure making private industry/employers pay for health insurance is such a great idea. Doing that might make businesses try to squeeze their employees even more. Everyone's already trying to cut costs.. I'm pretty sure business owners and any major stock holders would find a way to make this not happen.

let me jump into the thread to address two quick points.

1. Coyote/Jenni - it really doesn't matter where US/Cuba/Canada are ranked in the 30s. Don't overlook the HUGE problem that we spend DOUBLE what every other industrialized country spends on health care...and we have somewhere in the 30s to show for it?

2. Mark - while malpractice insurance is ridiculously expensive for doctors, it is but a fraction of a percentage of health care spending. However, the cost of defensive medicine is at least 10-15% of health care costs. Do we need tort reform? Yes, but it's more complex than you make it out to be.

Sorry Rob, that won't hunt.

Leaving aside whatever makes you think Hilary will get the nomination, she has shown no interest in doing anything for health care other than carrying on Bill's triangulation sidestep, making noises about insuring everyone while raking in cash from insurers.

The more important point is that Hilary' plan had NOTHING to do with single payer -- she cobbled together this hideous monstrosity straight out of the AETNA/Jackson Hole group, designed to give them permanent ownership of all health care financing forever.

THAT's why the little insurers ran the Harry & Louise ads that killed it deader than dead.

That and the fact that it took a nightmarish non-system and made it much worse.

Moreover, one of the uglier things that Hilary health care commission project revealed is that, when the chips are down, she operates in the Cheney mold -- she freezes out dissent (refusing to even consider single payer) and prefers to operate in secret. (It took court cases just to get the damn meetings opened up.)

Common themes made by people who oppose "socialized medicine":

1. Long waits for an appointment, surgery, etc.

People often claim horror stories about long waits in countries with "socialized" medicine. I don't know about you, but unless you have a really expensive plan/doctor at your beck and call, I have to wait a long time just to get my regular check-up. Sure, I might get rushed if I have a life-threatening condition, but wouldn't it make sense to have a system which places emphasis on and incentives for prevention, as ours so obviously does not? Rather than have speedy and expensive surgery, let's have a system which rewards/incentivizes patients, doctors, and the overall system to prevent disease.

2. Government control of your lives I'm not too keen on the frittering away of our civil liberties, especially in the last 6 years. However, call me crazy, but I actually have less faith in the large, private corporations that dole out insurance and medical care than I do in the government. Again, I see no incentive for corporations to do right by you. Think they'll protect your medical records, personal information, etc. on their own? I doubt it, not without gov't oversight.

Besides, I see health care as a human right. I believe it is uncivilized and immoral that we cannot provide basic health care to every citizen (and visitor). You may think me a dreamer or a naive progressive, but if you forget the idealism and remember the facts others have posted about the incredible and growing costs of our current broken system (on businesses, individuals, bankruptcies, etc.), that alone should motivate to do something.

3. Poorer quality

People like to claim that the quality of care would suffer if we were to go with a national plan. That may be true, but I don't believe it. First of all, even if we get a national plan, there will still be the demand for private plans for those people who want it. It's not either-or.

And again, if we focus on and incentivize prevention and healthy living, the need for those expensive organ transplants etc. will be greatly reduced. The fear-mongers will read the above as government mandated morality/choice limitation, but that's not what I mean. If we made it easier and free for everyone to get an annual checkup, we'd save bundles on treatment (and cures) in terms of early detection (diabetes, cancer, etc. etc.).

As to the original question of public or private, I of course would prefer a national health plan. I am skeptical that any plan involving/requiring insurance through private insurers is just putting icing on a cake made of mud.

Unless private insurers have an incentive to:
a. give people care (vs. save money for every rejected claim)
b. cover quality care, not the cheapest or biggest money-making choice
c. are required to be transparent so we can verify they are adhering to the previous two points
I don't think anything that relies on/requires private insurance will help.

Jeff Alworth:

So what do you think--a single-payer system or a universal insurance program?

Bob T:

That's like the "Are you still beating your wife" question. None of the Above.

B. Tiernan

We shouldn't even HAVE health care. The healthy should live, and the unhealthy die. That's the law of nature, and to break it is to bring down the wrath of god to destroy our empire.

Besides, how are we supposed to defeat Iraq if our soldiers are weak, bleeding-heart liberal fufus?

I read folks here say they want a single-payer system or Medicare for all. What makes you think whatever system we do come up with won't be uniquely American?

I don't want "Medicare for all" as was said earlier in this chain. Why? Medicare is broken and outdated? we're about to inherit the baby-boom generation in another few years and by then it'll be too late.

Trade is in the toilet. Uninsured numbers are huge. Health care costs are totally outta control. It'll take our own version of what works for Americans or it'll take a system collapse/trade collapse which is inevitable.

Either way, insurance companies will win in the end and the average person will lose.

How many people on this chain are uninsured or have a pre-existing condition? Other than me.

While I could actually get insurance, for a nasty price, my wife would be obscenely expensive to insure if I could find someone to write her. There is exactly no point in my sacrificing everything other than food and house payment for insurance with that thrown in the mix.

The fault in 'Our Own' analysis is that the private insurers are not going to let loose if they are left in the picture. The idea that they would makes the unlikely assumption that they give a rat's ass what's good for America rather than corporate profits. If you think I exaggerate, look around at where we are today and tell me who (corporate) is.

The goal should be perfect health.

That's right, no one needs to go to the doctor, stay in a hospital, take drugs, etc.

With a health care system designed with the goal of perfect health in mind lots of things would have to change, including the conduct of those who profit by super-sizing us, selling us tobacco, etc.

Right now we don't have a very good idea of how much our lousy health care system is costing us - compared to the cost of a system designed to produce perfect health. Who cares if such a goal is unrealistic, wouldn't a system designed to produce such health be better than the one we have now?

So that's what we should go for, perfect health - for everybody.

Kari writes: Senator Wyden's plan calls for national health care within one year of the passage of his legislation. It's hardly an incremental approach. It would end, overnight, the employer-based system that is crushing our economy, forcing people to stay in hated jobs ("job lock"), and leaving 46 million people without health care.

Kari - please define "hated job."

It's a worthy goal to seek personally rewarding employment, but the reality is that in most cases if we'd do it for free anyway - it wouldn't be called work. To suggest that one argument for government funded healthcare is to allow people to do work they love rather than work that pays their own bills is a slap in the face of generations of Americans on whose backs this country was built. These people - our nations unsung heroes - were too busy providing for their families to have the romantic luxury of deciding whether or not they "hated" their jobs.

Take a walk through the Oregon History Museum and refelect on the faces staring back at you. Do you see anyone with their hand out expecting others to foot the bill for their personal employment gratification?

Chuck Butcher:

The fault in 'Our Own' analysis is that the private insurers are not going to let loose if they are left in the picture....The idea that they would makes the unlikely assumption that they give a rat's ass what's good for America rather than corporate profits.

Bob T:

Do you have a DVD player? Was it built by a company that really cared that you, Chuck Butcher, wanted one?

Anyway, the problems with insurance companies and health care coverage started a long time due to assorted regulations that cause the insurance companies to make decisions that people now think originated with them.

A lot of companies would be happy to offer policies covering major illnesses but not paper cuts, knee scrapes and all that, but the government in its alleged wisdom mandated mega coverage.

We would be better off had the government not encouraged the employmnent-based insurance coverage after WWII, which would not have taken off as it did had the government not fostered the unintended consequence of banning companies from offering more pay to lure workers to their companies, which meant that the workers lured by health benefits instead.

Does anyone think that it would be a good idea to have car insurance thru your employer, in which case when you lose your job you then can't drive to look for other work. Why is it different with health insurance?

Bob Tiernan

Perfect Health - can anybody else conceptualize it?

Bob T writes: Does anyone think that it would be a good idea to have car insurance thru your employer, in which case when you lose your job you then can't drive to look for other work. Why is it different with health insurance?

Bob - If my employer wants to provide me with car insurance and maybe even a company car, that's my employer's business. Either way, it's not my government's business to pay it. I lose my job, I get my own car insurance.

While your example is somewhat tongue in cheek, I won't be at all surprised when the day comes that liberals here at BlueOregon argue that government funded car insurance IS a good idea for job seekers - with the option of selecting an emission-free bicycle instead, of course.

Hi Robert - the problem I have with your perfect health proposition is that it assumes the government has to initiate that goal for the individual. I already have the goal of perfect health, don't you? I don't need the government to step in and prevent me from supersizing or using tobacco. And how I maintain that perfect health as my body ages and begins to fail on its own without seeing a doctor or taking prescription drugs is more than a stretch.

Interesting assumption DJ, that only government can work toward the goal of perfect health for everyone. I'd have to hear more before I will say I agree - and of course it would be interesting to hear the alternative.

Perhaps you're correct.

Kari: Put simply, the goal is universal health care.

The problem with the goal being universal, is it could be universally bad.

Perfect health for everybody - that's the goal!

We have universal health care now, which is why they can go after the LA hospital where a woman died on the emergency room floor. But only a fool would argue it was designed with perfect health for all in mind.