I'm for the single-payer system. Charge everyone the same rate and give everyone health care. Pattern the hospitals after the Cleveland Clinic and let's "Get 'er Done".

Hi Tony,
I wrote a letter to the president 2 weeks ago. No response of course. I will copy a segment of my letter to the president on my ideas on Health care reform.
Dear Mr. President,
Your argument during the news conference on Tuesday June 23rd regarding healthcare and the public policy was illogical and disingenuous. If the government undercuts insurance companies by capping costs and providing healthcare as they already do with Medicare and Medicaid, the only way the private insurance companies will be able to compete is to eliminate all aspects of profit which is very unlikely, or go insolvent like Medicare/Medicaid. If you say that patients are going to be able to keep their current healthcare plans, you obviously do not realize that employers will offer the public policy option to their employees since it will be cheapest, and physicians will not accept the public policy (i.e. extended Medicaid rates) since no private practice can survive on those rates. So how on earth can you propose that the public will be able to “keep their doctors or health plans if they are happy” if their doctors won’t keep them, and the health plans are dismantled? The idea of health maintenance organizations in the late 1980s was to eliminate waste, provide quality care and make profit. They have succeeded in making profit, and eliminating some waste, but they have become greedy and irresponsible. The HMOs failed with a key obligation of maintaining health and providing quality care. The insurance companies have already squeezed all types of profit from physicians, and the government has made it all but impossible for physicians to provide care to Medicaid and Medicare patients. When physicians treat Medicare or Medicaid patients, they are already doing it for nominal sums. Do you really think that physicians are going to start to pay their patients to treat them?
By creating a public policy option you are creating a second tier or second class health insurance for the majority of Americans who cannot afford the costs of private insurance. You are simply creating a larger Medicare/Medicaid program or perhaps a new “Public Administration Hospital System,” a larger inefficient bureaucracy, with a lot of waste, and extremely poor quality care. Simply go to any Veterans Administration Hospital in the country and see how they are run; they are a prime example of a Government Run Public Policy System. You can ask any doctor or resident who has operated in the VA system, “What do you think of the VA? And they will say, “Oh….. The VA,” and then they will subside with laughter; which means without translation: apathetic staff, lack of incentive to perform, waste, and poor outcome. When you know that you will get a paycheck and great benefits, no matter what you do, where is the incentive to perform? There are very few people in this world who do anything out of pure altruism. I greatly appreciate the veterans and believe they deserve so much better.
I agree that healthcare is too expensive, and I agree that no one should go bankrupt over a hospital bill or be denied health insurance because of a preexisting condition. I agree that the ability of American businesses to compete and prosper is contingent on containing the rising healthcare costs. I agree that the country is broke, and entitlement programs are insolvent. I believe that the changes to Healthcare policy in this country have to be more innovative and unfortunately, more realistic. I know we hate to use the word “ration” but hey, it is an unfortunate and more likely scenario for the future. Not everybody will be able to have everything they want. Just as when you go to the supermarket, you can only afford the food you can pay for. There is no such thing as free health care; there will always be a price, whether in higher taxes, rationed services, longer waiting period, diminished quality and options.
I know you believe medical care is a right and not a benefit, and in my heart I agree. But ask physicians when they cannot afford their malpractice or their office staff; ask them if they have any rights. Ask physicians what happens when they cannot afford to pay their student loans, are they forgiven because they are such “great people healing and caring for the masses?” Will you eliminate their negative ratings on their credit score if they default on a student loan? What happens when their malpractice premiums increase to untenable amounts, will you give them a break or maybe a bailout?
I am a physician and an employer, and a guaranteed future patient; therefore I am as concerned as any other American faced with the consequences of rising costs and lessening benefits. I agree that cost containment is critical to the future of the USA, but here are changes that can be made without destroying the whole system and penalizing the free market system and innovation.
1. Mandate health insurance for all, including illegal immigrants (Huh! Sounds weird)
2. Nobody should be able to enter a hospital without some evidence of health insurance, unless they are physically incapable of providing assurances
3. Mandate that private insurances will not be able to discriminate on the basis of preexisting conditions
4. Mandate the ability to obtain affordable health insurance for all patients including those with preexisting conditions from all private insurance companies ( the government may have provide subsidies or tax rebates for families or individuals dealing with long term chronic debilitating illnesses)
5. Mandate that every private health insurance program should have graded levels of health insurance that cover basic preventive and catastrophic care (just as with car insurance)
6. Private Insurance program have to become more innovative to make a profit, perhaps focus on preventive care for their most vulnerable and high risk population. For example, in order to maintain coverage every child must have a yearly physical, and patients who have preexisting conditions must be on a regimen followed by physicians to prevent deterioration, otherwise their costs will increase.
7. Private health insurance carriers may mandate a complete physical exam for every individual who joins an insurance program, in order to start early preventive care
8. Private health insurance carriers can mandate health care initiatives i.e. cholesterol, blood pressure monitoring, mammography and colonoscopy at the recommended ages in order to keep their health insurance coverage. If clients refuse to follow the recommended guidelines the private insurance carriers may increase their costs or deny coverage.
9. Private health insurance can increase costs on patients who are morbidly obese or smoke if they do not follow a regimen to eliminate their increasing morbidities
10. Mandate a living will for all United States Citizens and residents by the age of 18, which includes what measures to take when a catastrophic event occurs
11. Pharmaceutical Corporations have to lower the costs of drugs and make them more competitive with other countries— The incentive is lower healthcare costs for their employees, and no nationalization of healthcare
12. Medical Devices production corporations have to lower their costs and become more competitive with other countries-The incentive is lower healthcare costs for their employees, and no nationalization of healthcare
13. Hospital may need to downsize, streamline, fast track in order to meet the needs of the 21st century
14. Smaller more efficient “outpatient hospital settings” such as we do with outpatient surgery centers
15. Creation of more geriatric and rehabilitation centers that have the primary focus to eliminate prolonged hospital stays (We often keep the elderly in the hospital longer because there is no place to send them)
16. Increasing outpatient services and monitoring (Much Cheaper)
17. Medicare to start at age 70
18. Overhaul Medicare and Medicaid- Increase guidelines to health care
19. More careful scrutiny and limits to claims of disability
20. Private not for profit cooperative insurance programs aim at reducing overall healthcare costs
21. Overhaul the Veterans Administration Program by streamlining and maintaining incentive by integrating the system with private care.
22. Creation of Outpatient free and preventative care clinics in high risk areas, to be run by university or educational medical institutions for the purpose of teaching and providing quality care to the indigent population, subsidized by the government.
23. Physicians, and medical/pharmaceutical corporations, can participate in these outpatient free care clinics and programs (Tax rebates, partial loan forgiveness, or lower malpractice costs can be used as incentive)
24. Eliminate fraudulent malpractice claims by using an arbitration system of (doctors and lawyers) to review the claims, rather than financially abusing healthcare workers for obvious “sue happy lawyers and patients”
25. Mandate that hospitals create a system to determine a feasible payment schedule for patients with extraordinary costs, in order to eliminate bankruptcies due to medical expenses.
The money is already in the system for affordable, quality healthcare. The funds just have to be reallocated in such a way that everybody benefits, especially the patients and the government, not just the insurance companies, pharmaceutical and medical device corporations. However, if you eliminate incentives for profit, research and innovation, you will likely create a second tier system that while providing supposed health care for the masses, does not enhance quality, save costs nor protect choice. Never forget that the wealthy will always have choice, and be able to partake in a first class system.

I wish the best for you Mr. President and our great country. I know you have the best intentions and a lot of promises to keep, and I am also aware that everybody has a stake and is looking out for their best interest. I do feel that as an American, a woman, a physician, employer and future patient, that I am able to see multiple facets to the problem. I feel that by writing this letter, I am doing my best as a concerned citizen in giving my input to the problem of healthcare.

God Bless You,

On earlier broadcasts it was reported that 30 cents of every dollar paid was profit for the insurance and drug companies. Some of this profit should be used to subsidize. It's criminal that they claim billions in profits annually! It is an obvious solution that is being ignored. Why?

From Liz in Louisville, KY: Oh, cry me a river! The rich are worried that their taxes are going to go back up to the pre-Bush tax cut levels. While the rich where enjoyed years of unprecedented tax breaks and low rates, and lack of regulation and oversight to their financial and business misdeeds, the middle and low wage earners of the country footed the bill for a lot of goofy, unnecessary things, like a war against Iraq. We will all have to pay for fair healthcare for all, as we should. If you'll notice, though, the only ones singing the blues are the ones with a lot of zeroes behind their paychecks!

Why are we so concerned about the cost of Health Care Reform that will save lives but the concern for the cost of sending our troops to kill, be killed, and emotionally and physically destroyed was not an issue?

I will turn 65 this month and go on Medicare. Up until now I have to work to get insurance. I make a little over $10 an hr. After a whopping $14,000 they take $50 of every dollar. I still have to pay income tax, medicare tax, SS taxes etc. Tell me how bad I should feel if the upper income people have to pay a little more. I won't change their standard of living.

If doctors across the u.s would have a standerd rate for an office vist .plusset rates all over on al kinds of things this would help. i hane had insurace here and in england , and thy about the same , you still have to wait on matter here or there, the only thing . england has differ is that insurance pays for it though tTAXES so if you have never lived there dont run it down i t works just as well

No mater what they come up with, If it is not good enough for members of congress, it is not good enough for me and my family!!!!
I am sick and tired of paying for their free ride. They have better health care and better retirements at my expense. If they want to force it on me then they should have it forced on themselves as well!

I come from a Country where we had nationalized medicine, yes, everyone paid for it through taxes. It was not perfecr, but, no one died because they could not afford treatment, or lost everything and had to file bankruptcy because they could not pay.

It is very sad that in this Country people have to choose whether to eat and have a place to live or pay for health care.

I was just watching and was thrilled to see the Presidents suggestion on how to pay for health care.
By all means tax the wealthy!!!!!!!!
Isn't about time the grossly over paid athletes, actors, musicians,oil excutives, bank excutives, Insurance Co's. and so on that make millions from the people. They should be required to give back to the people!!!!!!!!

The answer for the health care cost is simple. The government gave a trillion dollars to the banks this year now they need to collect back the money for the next 10 years and pay for the health care. In retrospect we all need to agree that human health is more important then AIG or couple bankers on wall street.

How can we pass it? Call your congressperson NOW. TV iswonderful but does not "cast the vote". Ann Tubbs, Texas

I voted for Obama and, for the moment, I approve of almost everything he has done and said. However, I start to see the writing on the wall: SOCIALISM! I find many of the things the Republican Party stands for abhorrant but I do believe in fiscal conservatism, in a governement that is not too big and in reasonable taxation. The cure-all Democratic solution seems to be ever more: tax the rich. This is a sure way to make everyone poorer and to lose the next election, thus condemning us to more republican governments.

Health Care Reform? Don't want it.. we are open to lose our selection of choice, doctors and treatment.
Have you ever heard of microchips that are inserted into animals?

these people need compose machines to mulch all there garbage into fertilizer.

The biggest lobbyists (insurance companies/pharmaceutical for starters) in the country have a vested interest in seeing the Healthcare Reform fail. They will do whatever it takes to accomplish this. They also have given lots of money to congress to keep them from voting for the plan. One of Obama's campaign pledges was to reverse the Bush Tax Cuts for those making more than $250,000. He can get 2 campaign pledges completed with this. Reverse the tax cuts and use the money to pay for healthcare. We also must have a Public Option. The competition will bring future healthcare costs down dramatically. The private sector will have to reduce their high premiums to compete.

THE BIGGEST THING STANDING IN THE WAY IS INSURANCE COMPANIES, DRUG COMPANIES, BILL FIRST-STYLE HMOS, CORRUPT CONGRESS MEMBERS LIKE BEN NELSON, LOBBYIST WITH BUCKETS FULL OF CASH (AKA CAMPAIGN CONTRIBUTIONS) AND WALL STREET SUPPORT OF THE CURRENT HEALTH CARE SYSTEM THAT BENEFITS THE COMPANIES THEY TRADE ON THE FL

We should be using the existing Medicare System- It has worked in! It has faults passed onto it by members of Congress like Bill Tauzin. Fix the problems and let them negotiate with the drug companies.

Let the health insurance companies go the way of the dinosaurs. everyone has been comfortable out- sourcing the jobs in America -THEY WILL GET USE TO HAVING THE INSURANCE COMPANIES BILLIONS IN PROFITS GO INTO REAL HEALTH CARE.

THE TACTICS AND OPERATION OF DRUG COMPANIES IS CRIMINAL – INVENTING NEW DISEASES AND THEN DRUGS TO CURE THEM. I'VE NEVER SEEN SO MANY COMMERCIALS FOR DRUGS WITH SO MANY DISCLAIMERS. ARE THE AMERICAN SO DUMB TO BELIEVE THIS.

U.S/ GOVERNMENT SHOULD HAVE A CENTRAL RESEARCH CENTER FOR THE DEVELOPMENT OF PREVENTATIVE HEALTH CARE AND DRUGS TO COMBAT AND CONTROL DISEASE. An offshoot of the CDC.

Insurance companies are in business to make a profit, period. People may care about other people, but corporations only care about profits.
As long as insurance companies have a place between the patient and doctor, we will not have a caring, economical health system.
Our health dollars pay more than 30% for administrative expenses, Canada’s is around 7%. How will this idea of adding some government insurance plan to the existing private insurance plans help reduce these administrative costs? I believe that only a single payer plan will be able to do that. A savings of 23% would go a long way toward paying for the right health plan.
Would a single payer system require more taxes? Duh ! Of course, but would the total out of pocket paid be more than it is now? I doubt it. If every tax payer and every employer paid an equal percentage of wages earned toward a National Health Insurance, I believe the total outlay with the inherent savings in such a system, could be less than it is now.

Tony, we need to reduce the size of these health insurance companies. How much does it cost to pay the thousands of employees who are making our health care decisions for us? They just answer the phones and tell you "sorry but you're not covered for that."

How Do We Pay for Health Care Reform? People forget that we are already paying a tax for health care. We pay it to the insurance companies like Blue Cross/United Health/Etna etc. Plus we often have high deductibles and co-pay. Part of that money could go for higher taxes for health care reform. If we don't have a public option, the insurance companies will have won again.
Marjane in Wyoming

I believe health care reform is necessary, however improving health education in schools is equally as important. In order to ease future Medicare and Medicaid spending, public schools must provide better tools and information on sex education, child care, proper diet, exercise, etc. In order to optimize efficiency, preventing the need for government to provide health care for an individual should be as important as creating health care reform.

Tony,
RE: Healthcare reform...
Let us bury an old dog that's been barking the same lie for centuries. "Keep the rich, rich to provide jobs for the poor!" We don't need the extremely wealthy anymore, who live off the interest of their money while other do the real work. The success of not-for-profit organizations have proven that the corporate system is no longer necessary for society to thrive. People are smarter than we're led to believe. They can, and will survive. I say without hesitation: tax the rich for healthcare reform.
Tyeeyuk

Insurance companies and pharmaceutical companies are to blame. In fact, I think pharmacetutical companies should be charged with a crime and locked up for their outrageous price of drugs. i've had 2 failed back fusions. Just one of my medications for my severe pain 30 days – $3500.00. Yeap. So I have to opt to be in bed most of the day since I only receive $13,000 a year for the rest of my life. I've worked all my life and I've paid taxes, I've supported the people on welfare who are capable to of working. I would NOT feel bad if the rich were taxed. It will NOT change their lifestyle. Limited med mal cases. So many people are sue happy in this country. Put a cap on all med mal cases in all 50 states.

What an excellent article on the trash pickers of Indonesia and what a good reminder for us all that recycling can make a difference no matter at what level. The fact that these trash pickers can make a living and help the environment at the same time is an innovative process and one that we can but hope will catch on worldwide. Thank you, Tony, for bringing these informative articles into our living rooms.

I think as a parent and community we all need to be more concerned about all childrens safty. When a parent is slacking at home there child becomes a target for the streets, and unfortunatly the parents who work effortlessly to protect our youth end up at the mursy of crime because the gangs and youth that are commiting the crimes are bringing it to the schools harming any one that gets in the way. That is why we need better security and better transportation getting our children to and from school safley.

Not much different than recycling. Except with recycling- you can't tell that it was just garbage yesterday. Instead there is a little # on the bottom of the container. But if these people want to go get some kind of disease or illness by picking through garbage, more power to them. Oh, and this idea isn't original... there have been other people doing this sort of thing for years.. caught a program on the travel channel about it years ago.

I am concerned about health reform almost as much as I am concerned about the lack of it. I 've worked and been sucessful for 40 years and paid into the medicare program for most of that time. I had reversals and got sick at the same time. Without good insurance I have either paid to much for too little insurance for most of the last decade and or had none. The medical debt has all but bankrupted me and I am looking forward to Medicare. I am now afraid that the approach that is being taken would have elimintaed the care I have already received and I would have died. Treatments that I have received that have saved my life would have never been allowed under the plate of options pre approved for my doctors and hospitals. in the end what you are doing is giving the hospitals the option to let me die if i don't fit into the paramitors of good treatment according to whom! I am seriously afraid!!

Tony,
As newsman, you have a unique opportunity. Tell Crowley and Gates to get on the phone and talk. Then, request that they meet with the press together, so both can concede where they were wrong and apologize to each other. This meeting should end with a heart-felt hand shake, and a commitment to temperance. That's how you teach a society to evolve!