Friday, January 11, 2008
Your health - What matters to you?
by Amy Burkholder
Medical News Producer

Dr. Sanjay Gupta is heading back to his roots -- to his home state of Michigan -- for live coverage of Tuesday's presidential primaries. From growing up, to his years of medical training in Michigan, he's seen the state's economy become decimated, and he believes what's happened has to do with health care:

- health insurance premiums that are too high

- companies that don't want to do business in Michigan because of the cost of covering employees

Health care is weighing on voters' minds this campaign season. But have you heard of a plan that meets your needs?

On Tuesday we'll take an in-depth look at the candidates' health care platforms: What do they propose? What would it cost? And what are you willing to pay to cover you and your family?

Plus, who's seduced by cheesy pizza, who likes turkey sandwiches, who munches on Nicorette and who considers coffee his greatest vice? We're dishing on some the candidates' health habits.

Finally, do you think being president leads to health, wealth and a long life? We're doing the math on life expectancy and the Oval Office.

Dr. Gupta will be live with John Roberts as American Morning spotlights the Michigan primary, putting health care center stage - and we want to hear from you: What health care questions do you have this election season?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.
Why does it always have to be a "plan"? Why does insurance always have to be involved? Why can't you just go to a doctor/hospital and pay them for the service just like everything else, instead of having a near heart attack (literally) from worrying about losing your home because you became ill?
That term "The rising COST of health insurance needs to be changed to the more accurate "The rising GREED of health insurance".
Greed is also the answer to the first questions listed above.
I am 71 years old and a retired teacher. I have Medicare Part D as well as a state prescription insurance plan. I have high blood pressure and cholesterol problems and a little wear & tear arthritis, not unusual for my age. Compared to many retirees I am in pretty good health. No diabetes, no heart trouble, etc.
In 2007, my out-of-pocket expense for medicine was $1300 ! That's pretty bad coverage, I think !
The insurance companies don't want to cover "brand name" medications even when there is no generic substitute. I am thinking particularly of Benicar, which is one of my blood pressure meds.
Isn't the provision of Universal health care most easily achieved by extending the present Medicare system to the entire population regardless of age or health condition ? That would enlarge the pool to the point of stabilizing the finances, and, if accompanied by sound health advice, reduce proportionately the level of claimsupon it. Private companies would still benefit by extending policies designed to cover the "other" 20% of the total cost.
What is the argument against such a measure or at least a version of it ?
I'm concerned with universal healthcare plans. I have problems with the HMO's that were developed to keep costs down, they make finding a good doctor almost impossible. I'm wondering if more HMO like hassels are in store with Univeral Heathcare for this country.
As someone who has recently been accepted to medical school, and is having second thoughts due to the uncertain state of the healthcare system, I would love to know more about the different healthcare plans and how they will affect both patients and physicians.
There should be a single pay, government run program as outlined by Dennis Kucinich.

Americans need to have a good food policy, not a cheap food policy as does Europe. As a result Europeans are growing taller, while Americans are now growing shorter.

We need to put the health of our people first, not the health of our corporations.
It seems that one of the greatest health-related problems in the U.S. today is obesity in both adults and children. Not only is this a critical health issue for those affected, but also for our nation's health care system as it struggles to keep pace with treating obesity-related diseases. What does each candidate propose for tackling this particular problem?
How did one of the most advanced courntries in the world end up with a medical system that is so bad?

The American automotive industry is collapsing due to it. Many industries in the US are under tremendous finiancial pressure due to it.

I conclude that none of this happening by accident. Instead I conclude that many very smart and intelligent people associated with the current system are benefitting greatly from it. The system is working as designed. It produces great wealth for some and death for many others.

CS
Apple Valley, Mn
My more or less specific question about health care for the presidential candidates would be 'What will you do, if elected, to promote mental health research and mental health awareness?' I'm 26 years old, and tentatively still a 1L in law school. I am very proud to be here, but I may not be for long. I was diagnosed with Primarily Inattentive ADD in the middle of my first semester of my first year at school. I was also diagnosed with Generalized Anxiety Disorder 10 years prior. Because of these two neurosis, I've been taking medications, switching them when they don't work or have poor side effects, all while trying to do well in school. The results have not been positive, and much of my focus is on dealing with the illnesses and not on learning. Will any of the candidates focus on pharmaceutical research to get more effective medications, or be more open to exploring further usage of stem cells to treat neurological disorders? Perhaps most importantly, will the candidates endorse any sort of public campaigns (perhaps through NIMH, or AD) to further educate the public that mental illnesses such as depression, GAD, ADD/ADHD, etc. can strike many people in all walks of life,in all ages, and are not something to be ashamed of? Many of us suffer in silence for fear of being labeled 'crazy' or 'off'. Changing societal attitudes would go along way to encouraging people to ask for help when they need it.
My company recently switched from accumlated sick leave to PTO's (paid time off). Since it is the beggining of the year, I really have not accumulated any PTO. I was paid off at 6% the sick leave I had previously accrued and got a check for a whopping $350. Now, I have no sick leave safety net despite working there for 9 years. Yes, the insurance changed too - this year my portion of the premium went up $200 and the co-pay went from $10 to $25. Even with the insurance I had to pay an additional $148 for a yearly physical with standard labs.
I just returned from cross country skiing and had a lousy time. I am terrified I will fall and break my wrist (or some other injury) and incur medical expenses I can't afford even with insurance. Since I wouldn't be able to do my job with a broken wrist I would have to go on short term disability in 7 days (for which I also pay a premium) This would only pay 60% of my income. I previously had enough sick leave to last 6 weeks.
I guess I can't do anything remotely risky anymore and will have to stay home and watch football.
I would like to see more control over the administration of health insurance in this country. some one is making out big time - I know it's not the health care consumer. I don't think it is the doctors, nurses,hospitals etc. I believe it is the insurance companies and their executives.
All eyes should be on Hillary Clinton as Health should be her primary focus in the campaign and after if she wins the office of her quest. Some fundamental questions that need to be asked are:
1) Which country outside the US makes a good model for the next President to follow in crafting a revision to US Health Care?
2) Is it not reasonable to ask the wealthiest beneficiaries of the Health Care system, the Insurers, to carry a fair share of the Health care reform burden too?
One question that I have about national mandated health care is one of privacy. I know that many people are not amused to hear about the Gov't having access to their phone records. It seems to me that the Gov't having access to my heath records is an even bigger threat to my privacy!
health insurance premiums that are too high?

I've been retired for 10 years from Boeing and because my wife is under 65, they deduct 66% of my company check for health insurance (and it goes up every year)I am forced to live on my Social Security check. I must take the company health every year!
The continued prevalence of autism spectrum disorder, now affecting literally millions of Americans including 1:150 children born in the country (1:100 boys) simply must be a topic of national discussion for the next president. It is especially important to focus on making intervention available to parents regardless of their income, which has been shown to be critical prior to age 3 in increasing positive outcomes.
We've heard from most of the candidates about health coverage, which is definitely important, but what about medical research? Since Americans' average age is rising, I'd like to hear from the major candidates what they plan to do to help us find new cures for disease and ways to prevent disease.
I'd like to know what/how the candidates are proposing in their health care reform that would reward those people who watch what they eat, who actively work out, who don't smoke or otherwise participate in activites that would, on average, be detrimental to one's health and cause one to incur a higher cost of health care? Why can't the national health care system be renovated to reward those people who take active measures to be healthy?? Granted, some conditions/diseases are genetic or environmentally-based, or might not have any certain cause (some cancers), but most people bring certain conditions (high blood pressure, high cholesterol, some diabetes) on themselves (high fat diets, little or no exercise, smoking, etc..). Why should my insurance premium pay for people who don't take simple steps to take care of their own health?
It seems we are always hearing about the shortcomings of the Canadian health care system, but what of the other systems employed by the major industrialized nations?

I would like to know what a "universal" health care system similar to the ones employed in France and Germany would cost for the US compared to the current costs for the health care "system" (or lack thereof) we are currently dealing with.

An honest analysis (absent the left or right wing skew) of the stengths and weaknesses of health care systems employed by the other major industrialized nations with estimates of what such systems would cost if employed here would be very useful for the voters to consider.

Lastly, I would like to see a comparison of those estimated costs with what we currently spend per capita on health care that includes what is spent caring for the uninsured as well as for the insured citizens.

As foreign manufacturers are not required to provide health care for their employees. It would seem help businesses in the United States compete globally if they were not required to be the providers of health care for their employees.

I cannot believe that a country such as the United States cannot afford a universal health care system at least for those who are working full time; are children; are disabled or are retired.
Dr,

If you get a chance, how about running "The Sperry Plan" by some of the candidates for comment:

THE SPERRY PLAN

In 1963, The Sperry Plan was hatched by a Dr. Webb (If I remember his name accurately) aboard the USS Sperry AS-12 following a Saturday morning sick call just before the watch was set and the liberty crew was off for the week end. Lemuel Bray, an HM3 at the time, has since tweaked it to avoid the “incentive problems” which, although different, exist both in socialized medicine and fee based medicine.

Some of the corpsmen were complaining because of the “minor things” such as simple colds etc. that members of the crew were bringing to sick call and were saying that there should be a co-payment similar to that which civilian insured had to pay for medical care so the medical department could concentrate on the more serious complaints.

Dr. Webb insisted that the “Navy Medicine” was best and that it should be adapted for a National Health Care system. He said it best met the reasonable goals of medical care by both the right minded health care providers (the ones you would want to take your problem to) and the patient.

Goal 1: The right minded physician doesn’t want to worry about the patient’s ability to afford the care and adjust his diagnostic procedures accordingly.

Goal 2: Both the physician and the patient want the best possible outcome and want to have available whatever advanced diagnostic procedures and equipment is available.

Goal 3: Both the patient and the physician don’t want to worry about the money. The patient whether he can afford it or not and the Dr. who wants the best mental attitude in his patient for the optimum outcome and no paperwork or worry by the Dr. in getting paid for his services. The patient particularly doesn’t want to worry that he is getting an unnecessary operation because the Dr. needs the money.

In his later thinking and focusing on the goals, Lemuel realized the “economic incentives” were the primary impediment to optimum medicine. In socialized medicine, such as “Navy medicine”, HMO’s and other socialized medical programs there is no incentive of reward to the provider for doing his best. (As was exhibited by the complaining of the corpsman on the Sperry) The patient is locked in to the provider to a greater of lesser degree. The provider gets no more or less money based on the quality of service. HMO’s improve their bottom line by denying the patient any test or procedures that may show no pathology—thus often delaying the care of the “cold symptoms” until the problem has gone too far. Also denied are extra days in a hospital bed that may have proved beneficial. The socialized medicine care giver must derive his motivation to give his best care altruistically. At least there is some motivation to control costs and some motivation to control costs by getting the patient healthier from management.

In Fee based medicine the primary impediment to optimum care is profit motive that goes against the patients’ goal of getting healthier. No fees are paid by or on behalf of healthy people. If there is not enough call for your new drug you advertise to drum up new business. Never mind if you flood the physicians’ offices with hypochondria. They won’t mind because they get their fee.

In 1965, while working a part time night shift in a local Catholic hospital in Waukegan, IL near the Great Lakes Naval Hospital, Lemuel overheard a conversation between two physicians in the canteen late at night. They had apparently just finished with an emergency cesarean. One was saying to the other, on that late spring night, that he had seen a boat at a local marine sales that he just had to have, but didn’t have enough for a down payment. “Would you believe it,” he said, “3 hysterectomies walked into my office on Monday.” One must question how many of these were necessary. Certainly the physician believed they were or he wouldn’t have mentioned them. And he didn’t give thought to how it must sound. Still, how much was his judgment colored by his financial need. And would the second, now scowling physician have done them. (More emphasis for the need of the Sperry Plan for Lemuel)

Fee based hospitals mark up things provided to the patient based on item cost. There is no incentive to shop for the cheaper elastic back support because 30% of $70 is more than 30% of $30. And if they can get it cheaper they can still do the markup on the higher cost, as long as they keep some of them, and get away with it. So the elastic back band that you could get off the shelf at a local department store for less than $30 will probably cost you or your insurance company more than $90 if it is provided to you in a hospital emergency room.

And with insured Fee based medicine you have to worry about the catastrophic incidence. If you have an automobile accident with a paralyzing back injury your insurance will be maxed out of benefits. You will have to divest of all your assets and request Medicaid unless you are a multi-millionaire.

When looking at “health care” costs, particularly the runaway costs in the U.S. now, one must consider the total national cost and all elements in it rather than our personal individual portion because we are paying our share of the total one way or another. We pay in higher taxes, higher passed on cost of goods and services, or directly in higher medical and medical insurance costs to make up for those who don’t or can’t pay.

So you say, “I don’t like the HMO medicine, so I know I won’t like socialized medicine. How about the point system, single payer, fee controlled national plans such as Japan and Canada.” They have the best part of fee based medicine for the consumer and I won’t have to worry about affordability. I’ll pay according to means. And I won’t have to worry about divesting my assets that I plan to pass on to my children to cover catastrophic health care costs.

And all HMO’s aren’t so bad. Secure Horizons of CA provides MEDICARE recipients full coverage for the MEDICARE premium under a contract with MEDICARE that allows them to avoid the claims form administration except for out of area care for which there is also a co-payment.

These are better than socialized medicine and the multi--payer runaway plan we have now. The Japanese, for example can choose their physician and hospital for care. But their plan is not the best possible. And they still have the co-payment that causes some to wait too long to go the Dr. The primary problem with the single payer plans is they put the health care providers’ hands in your tax and premium pocket. It doesn’t matter if you are ready to be discharged from the hospital, you’ll be kept as long as the point system allows. And the economic incentives are still not right. If you want better health care for less then the “market” should be structured in that way. The computer I am working on is cheaper and far better than my first computer. That is because the market is competitive in the consumers’ favor.

Purely socialized medicine is deficient because of the quality of bedside manner, long lines and delayed access because of insufficient numbers of care givers and insufficient motivation of care givers to give extra time.

Navy medicine, by not having a co-payment, all small problems that develop into big ones are followed and well documented. The over working of the physician is handled by the corpsman screening and taking care of those they can handle and documenting that “cold” that won’t go away so that when it comes time to look more closely to see if it is really a symptom of a major developing problem there will be no further delay by the physician waiting to see if it would get better on its own.

THE ANSWER

To obtain optimum health care for less we must change the way we buy health care. It is easy to do. All that is necessary is to stop letting the AMA control the market through fear mongering. We are the source of the money and we can decide how we want to give it over to the health care providers and insurance companies. If we decide we wish to change the way we buy health care, the health care providers will have to change the way they sell or get out of the health care business.

Peter Diamond: Institute Professor, Massachusetts Institute of Technology wrote an op-ed for the New York Times in 1992 entitled “Fanny Medic”. His basic premise, we should buy health care based on where we live, is on the right track but the Sperry Plan had it first. Lemuel was hawking the better and more complete Sperry Plan in the Los Angeles area in 1991 as a potential ballot initiative but was unable to have or raise finances sufficient to get it off the ground.




THE SPERRY PLAN

The Sperry Plan buys health instead of sickness. Contracts for health maintenance would be issued by location with the consumer choosing his home zip code, his work zip code, his school zip code, or a neighboring zip code for the location of his health care. The consumer would be able to choose his physician and hospital with in his selected area. Emergency care would be at the nearest available site with fixed day rate transfers between the provider of the care and the patients health maintenance contractor. (This charge would be similar to the fixed charges by military medical facilities for emergency care to those who would not otherwise be qualified for care at military facilities.) A patient who becomes dissatisfied with his contract area’s care should be able to change his area at will.

There would be no co-payments. A physician’s assistant corps would be developed by methods similar to the training of Navy corpsman. The physician’s assistant corps would be reserve military and would be assigned to health maintenance contractors on request with the contractor picking up the costs of pay and benefits for the members of the physician’s assistant corps assigned to them. The physician’s assistant corps is the backbone of the preventive medicine item of no co-pay. Physician’s assistant corps volunteers should be able to receive full scholarships to medical, nursing or medical technical school if they are mentally and physically qualified, including the pay and benefits of military academy cadets and if a slot is available. They would be required to continue to serve the corps as assigned for a minimum of say 2 years for each year of training as a means of payback.

The Sperry Plan has a contract bonus based on morbidity report line items and service satisfaction reports such that the bidder for a contract would see the bonus as the expected profit if a projected performance is met. Endemic health problems for a bid area could be approached by providing increased bonuses on that morbidity report line item. An example of a morbidity line item and its related bonus might be:
.01% for meeting a minimum acceptable rate of live births
.02% for achieving a national average rate of live births
.02% for achieving a locally set goal of live births
.02% for exceeding the locally set goal by 20%, Etc.

The above are picked out of the air. It would be expected that contract administrators would be able to set the bonus items somewhat scientifically on a goal achieving target basis which should be somewhat based on community input. Such items should bring more focus on the less costly preventive medicine methods of health maintenance and benefit us all with a longer life expectancy.

A percentage of the bonuses would be required to be shared with all employees on a pro-rata basis to help improve “bed side manner”.

No type of current medical provider would be blocked out of being a contractor or subcontractor. If an insurance company using fee based medicine could achieve profitable results and meet the morbidity and consumer satisfaction standards they could bid on a contract. The patient however, must be exempt from filling out claim forms other than signing a certification that the care was received. It is unlikely that an insurance company could obtain a completive basis bid contract because of their added costs of claim administration and a requirement that they pay all claims.

Anyone who is satisfied with their present medical plan would be able to continue it. Employers who provide health insurance presently would be required to maintain what they have as long as the employer cost isn’t raised and add The Sperry National plan as an option. Everyone would be required to pay according to their means, and other available coverage; a minimum premium for National Catastrophic incident coverage and would be transferred to The Sperry Plan on exhaustion of all other insurance benefits. In this manner The Sperry Plan would replace MEDICAID. Everyone would be required to be insured or post an adequate bond to assure their ability to pay for their health care out of pocket. The Sperry Plan would take all pre-existing conditions without an additional charge. Any state desiring to add their welfare recipients or other destitute residents to The Sperry Plan could do so by doing the means testing and could elect to pay the premium for such individuals.

Premium collection and issuance of insured cards would be administered by the IRS while the contract auditing and oversight would be by the National Public Health Department. Local area contracts would be administered by contract administrators selected by state publically elected officials and approved by the Surgeon General of the U.S.

Prescription Drugs need to be free. We don’t want anyone to die because they can’t afford or think they have more important choices than their medication. To keep the cost down, military style pharmacies should be at all clinics. How the commercial pharmacies will be compensated for loss of business is a question? Perhaps they could bid as a subcontract for providing pharmaceutical services.
Why are health premiums so high when insurance executives are getting extremely high salaries and benefits?
What will we do for health coverage when laid off by our employer, which is a constant threat in America today?
Why is it that insurance executives are not working together to find a way to provide coverage for all Americans? They are smart people. They know the business--if they do not want government involved, why don't they find a way to provide coverage?
Obesity-related diseases like diabetes and cancer posing as the most costly health care expenses. What do you plan to do to lift this immense burden from citizens?
I have never understood why medical records in the US are the property of the physician and not of the patient. Medical labs hand records over only to medical practitioners unlike in most other countries where they are legally the property of the patient and are handed to him/her. Countries like Malaysia hold patient records in an electronic database that could be instantly accessed by any doctor anywhere in the country by using the patient's national ID, for example, an invaluable aid in case someone has an emergency away from home. Other countries like India hand test results and records in a file to the patient so that a complete set of medical documents is available with them in case they would like a second consultation/opinion for a particular problem.

It does appear to me as if this is one way the medical profession could hide facts in the event of a slip up as the records could be altered. Now, am I being conspiratorial in my suspicions? Or is there a valid reason why a patient's medical records should belong to his/her doctor and not to him/her? Why does this monopolistic situation have to prevail here and encourage a systemic slowness in the treatment of sick people?
Dr Gupta,

Each of the Candidates has a plan to provide health care coverage to people. But this only helps those after something has happened.
I am the father of a six month old daughter diagnosed with a terminal brain tumor. No parent should have to go through this. What are the candidates plans for helping fight the #1 killer of our children--cancer.
Several candidates would like to make insurance manditory. How will they ensure that applicants will not be denied insurance or charged high rates due to pre-conditions?
The most important problem for insured older citizens is CHOOSING YOUR OWN SPECIALIST.

SPECIALISTS RUN THE WORKS.
Dr. Gupta,

I am so disappointed that none of the major candidates will come down 4 square for a single payer health system. They all want to try to tinker the system like Nixon to make the current private insurer system that got us into this mess work. And these are Democrats that want to tinker. The Republicans try to ignore it.

It just seems like simple math to me. If we removed the 30% markup of private insurers, much of it used to deny healthcare, we could supply health care to all for no more, probably less, than what we spend as a nation now. I don't blame the doctors, or even in large part the drug companies for our current messed up system, but the insurers for gradually lobbying a system that insures their profits rather than healthcare.

I'm largely libertarian on most matters but when it comes to the health and welfare, education, and defense of the American People we need to look beyond a profit motive for humane national answers.
I'd love for somebody to ask the candidates which section of the constitution gives the federal government the power to deliver or pay for health care.
Let's have a candidate say that they will ask for sacrifice from everyone, DOCTORS, insurance companies, pharmaceutical companies and taxpayers. We can shoulder higher taxes for health care for everyone (socialized medicine is in every other country) Too many Americans are dying because they lack money!!
Thank you for the opportunity to comment on this excellent question. As an RN, certified in acute psychiatric care for 23 years, I am deeply concerned about our current health care crisis.
Unfortunately, I see the often devastating effects of it daily in my job. All the candidates are talking about what they will do regarding this failing system but I have yet to hear anyone tell me what they will do for and about the HEALTH CARE WORKERS like myself. Many psychiatric and substance abuse facilites are closing (or have already closed) all over the country due to "lack of funding". Nurses and ancillary staff are working mandated OT and many are leaving, or have already left the field, due to the poor pay. We have thousands of our men and women returning from this war with serious and long lasting psychiatric and medical consequences. If there are no nurses or health care workers to care for them, then what? I want to know what our next President will do to ensure that these jobs are not left vacant, that RN's, and others, are paid MORE for the extremely difficult work we do. The nursing shortage is real. If we have none in our hospitals, then what do we do to truly 'care' for all those in need? Even if Universal Health Care comes to fruition, if we have no nurses working it doesn't matter. It will still fail.

Respectfully,
Patricia Hartnett
Manchester, NH
I agree we need to have health decision; ie hospital stays, treatment, medications, screenings, etc, being made by doctors and patients; not insurance companies!

I am very concerned about the universal health care systems proposed by the Democrats. I can see where our health care system is already over burdened and thereby taxing the quality given.

I especially like the talk from Gov. Huckabee about the upside health care system we have. I recently lost 85 lbs. I was able to meet with a dietician from the VA. Had I been given that information a while a go, I would have not had to take some of the medications I use to take before loosing the wieght.

I am in complete agreement for the government to step in to ban or make fast food business give warning labels like on cigarettes for some foods. ie. "The sergeon general has determined that eating foods high in saturated fats can lead to heart disease."

Matt, Rockford, IL
Proposed initiatives to correct the rising costs and diminishing quality of health care:

Initiative 1) Part of the cost of health care is the cost of the interest that doctors pay on their exorbitant amounts of student loans. Pay for medical schooling for doctors who become licensed. This will take the cost of interest on medical school loans out of the health care system, so that patients and insurance companies don’t have to pay for it. The taxes required to do this would be less than the cost of interest paid for medical consumers. This will encourage more students to apply to medical schools, and, with an increase in demand for schooling, increase the number of medical school slots available for students as more schools get into the business, as well as decrease the cost of schooling as competition for students increases between schools. The number of licensed doctors will increase, which will increase competition between doctors for patients, which should both lower prices and improve the quality of care.

Initiative 2) The number of hours per day that truckers can spend on the road is limited by law, because of concerns over the quality of their driving, considering that lives are at stake. The same logic applies to doctors. Limit the number of hours per day that a doctor can spend seeing patients, and require a minimum number of hours per day be spent on patient case research and keeping up with medical research. When combined with initiative 1, above, this would not reduce the availability of doctors. These changes, along with increased competition between rising numbers of doctors associated with the initiative 1, would raise the standards of care and improve quality, reducing the amount of time and cost required for a patient to get a correct diagnosis, and reducing the high occurrence of misdiagnoses and the resulting cost of "rework" and malpractice lawsuits. A reduction in the number of malpractice lawsuits would reduce the cost of malpractice insurance, which would reduce the total cost of healthcare and also encourage more students to pursue a medical profession.
More proposed initiatives to correct the rising costs and diminishing quality of health care (continued from above):

Initiative 3) Hospitals and diagnostic centers should be crown jewels of a community. They provide the tools and infrastructure that are vital for medical care in a community, though it is the doctors themselves that provide the brain trust. Initiatives 1 and 2 reduce costs and improve the quality of the brain trust. We need a way to achieve cost reduction and quality improvement at our hospitals. Require by law that hospitals and diagnostic centers (not the doctors that use/run them) be non-profit, i.e., no private or public owners. This would reduce the costs of this vital infrastructure by eliminating business profits to stockholders and breaking up regional monopolies. The hospitals would be accountable to their local community for costs and quality, rather than to stock holders for profits, which is an inherent conflict of interest when the customers of your business can’t reasonably go elsewhere for service. The local board of directors would be publicly answerable to the community for the salaries and capabilities of the management team. A plan would be required to transition existing hospitals and diagnostic centers to a non-profit status, requiring a buy-out of owners. Perhaps one solution would be to provide free lifetime services at the hospital in return for their loss of ownership.
W/regard to the statement about no part of the US Constitution authorizing health care for citizens: nor is there any part of the Constitution that says the government CAN'T provide health care.
If voters had to choose between social security and medicare, which would they choose?

Candidates.......given the exponential growth of our national debt and trade deficits.....can we afford to have both social security and medicare?

As medical services and standards become globalized, should your health plan cover procedures done outside of this country?

Would voters travel to recieve medical care?

Why does the same medical procedures cost different prices different people? is this really fair?

Are doctors over paid?
An American stem cell researcher (and scientists at UCSF) just recently was able to develop 5lines of embryonic stem cells using a procedure that is often used in IVF clinics called pre-implantation genetic diagnosis. This causes no apparent harm to the embryo, and the technique has been used for nearly 20 years. Would you support federal funding of stem cells derived in this manner, if they were derived during the course of PGD testing and with the full consent of the mother? It seems to me that this would have many benefits, the main one being that the child would have a genetically matched set of embryonic stem cells (his own) for use later in life.
FOOD FREEDOM ????? Why are seven of the nine worlds DEADLIEST CHEMICALS/FERTILIZERS back?
Do your homework. Most people know nothing of Codex and the W.T.O.
Meats ,fish, etc... in less than TWO YEARS unless we act now, WE WILL HAVE NO CHOICE.Please tell me this is not real.
Codex Alimentarius will go into global implementation by December 31, 2009, unless We, the People, avert it. We must act now because right now, with $758 Million spent on declared Congressional lobbying by Big Pharma last year, there are members of Congress who are trying to overturn DSHEA and allow Pharma-friendly free reign for Codex. If protective laws like DSHEA are destroyed, the sanctioning power of the autocratic WTO kicks in, and it will be impossible to get out from under Codex Alimentarius. We can protect our access to high potency nutrients and stave off an adulterated food supply only by putting pressure on Congress.

I bet 50 people that this will never make it up.I hope I lose.
God bless you.
Age 73: From 110/75 (no exercise)to 144/84 (3 miles a week and some aeobics) over eight months. Could it be that losing weight and building some muscle sqeezes the body to do that? And when will I get back to the original? Do I have too much blood now and go for blood donation to drop some?
Age 28 From Phoenix AZ, I have a movement disorder called torsion dystonia. I thought I had coverage for my treatment when my insurance turned around and told me that my treatment was considered experimental even though I had a pre- approval for the Botox. My insurance company paid for around five treatments before they decided that the treatment was experimental. I now owe over 23 thousand dollars to one doctor and since then they have been denying coverage for my general neurologists to take care of me. If it wasn't for him I would be more of a wreck than I am. Because, I also suffer from seizures. So, my general neurologist is currently seeing me even though my insurance isn't paying him. But there is nothing he can do about my movement disorder which is slowly taking its toll. I have to have oxygen because my chest muscles are being squeezed.

Thank you for reading this if it gets posted I would really like to be able to show people what these insurance company's can do to a person and not even care it is like they are so money hungry they don't care. In my opinion it is sad when the insurance industry is in more control over our health than the patient and Doctors trying to do their best to help.

sincerely yours,

Heather
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