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senseandsensibility Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:33 PM
Original message
Who's not impressed by ANY of the Dem healthcare plans?
Something is really starting to bother me, and it is originating from all three top Democratic candidates. On this issue, I'll be an equal opportunity basher. Of course Kucinich is not included in this criticism.

Why are Clinton, Obama, and Edwards compelling Americans to purchase healthcare out of their own pocket? This is not universal healthcare, as is provided in every other developed country. Not even close.

Haven't any of these candidates seen Sicko? Universal healthcare, in places where it has been successfully implemented, does not cost anything out of pocket. NO ONE PAYS PREMIUMS.

To me, this sounds like a nightmare. Successful programs like Social Security and medicare succeed because everyone benefits from them. These proposals, as I understand them, do not cover anyone making over one hundred thousand a year. That is not "rich" in many parts of the country. It's what a family of two teachers would make, for example.

Once middle class Americans figure out that they will not benefit from these plans, we will be in trouble. The repugs will use this to divide and conquer.

But then again, I may be missing something. If I am, please clue me in.
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NC_Nurse Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:37 PM
Response to Original message
1. Universal healthcare comes out of your pocket too.
In the form of taxes. I don't understand why people don't realize that they will pay for it one way or another....

Do they feel better paying a tax for it? Whatever.
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senseandsensibility Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:38 PM
Response to Reply #1
2. It depends how the tax is applied
Edited on Mon Dec-31-07 01:39 PM by senseandsensibility
I believe the rich should pay more. And by rich, I mean really rich, not this one hundred thousand B.S. So yeah, whatever.
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NC_Nurse Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:46 PM
Response to Reply #2
10. I assume it would be progressive. The programs that the candidates
have put forward would also have subsidies for those who need them.
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ayeshahaqqiqa Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 02:09 PM
Response to Reply #10
21. You miss the point
I don't want some insurance company bean counter deciding what treatment I can and cannot be allowed.

I've used alternative medicine for years, and have always paid my own way because insurance companies won't pay for them. Only Kucinich has said he'd make sure that alternative medicine will be included in any health care system.
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NC_Nurse Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 02:25 PM
Response to Reply #21
25. I understand you point. I'm not sure that he can guarantee that
even single-payer would pay for those treatments considered "alternative". Medicare and Medicaid do not currently cover them.
Some private insurers cover them partially. I don't know of any that pay for them completely.
I'm not saying that I don't understand your complaint about the current system, I do. I don't think it's going to fix everything to go to
totally government funded programs either. Mainly, I'm confused by the whole mandatory vs. single-payer thing. Aren't they both mandatory?

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ayeshahaqqiqa Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 04:14 PM
Response to Reply #25
38. As I understand it,
the point is that single payer means the insurance companies aren't a part of it. And that's what I want.

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Orangepeel Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 05:20 PM
Response to Reply #38
44. some bean counter will still decide. It's just that he/she will work for the govt.
Health care practitioners will still need to submit claims for reimbursement, so, in an attempt to reduce fraud, somebody will need to decide if the practitioner is authorized and/or if the treatment is "valid."

That's the way medicare works now.

I have nothing against alternative treatments in principle, but I don't want snake oil salesman bilking the government anymore than I want Halliburton bilking the government.
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ayeshahaqqiqa Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 05:33 PM
Response to Reply #44
46. As long as the bean counters aren't the first in line
like they were in the case of the girl who needed a liver transplant and was denied.

As for snake oil salesmen--they can come in all forms, including aleopaths. I've had my share of them nearly killing me twice. That's when I found reliable folks who have made me healthy.
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Orangepeel Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 06:09 PM
Response to Reply #46
48. I don't disagree with you...
but I do think that you are expecting too much from single payer. Medicare has and does deny and refuse to reimburse for treatment that is considered experimental or "not medically necessary".
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sandnsea Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 04:15 PM
Response to Reply #10
39. Obama has subsidies, others have tax credits
They aren't the same.
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NC_Nurse Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 06:19 PM
Response to Reply #39
49. I am not including Repubs in the my assessment. I think they
are the ones talking about tax credits, which are not the same - I agree.
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sandnsea Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 08:10 PM
Response to Reply #49
51. Hillary and Edwards have tax credits
I don't know about the others.

And check this out, after all Krugman's bluster about mandates, Edwards doesn't require a mandate right off the bat either.

"Once these steps have been taken, requiring all American residents to get insurance."
http://www.johnedwards.com/issues/health-care/
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Marrah_G Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:41 PM
Response to Reply #1
4. It's not only about how its paid for
It's about making sure everyone has access and that doctors make the decisions and not some guy behind a desk who's job it is to deny coverage.

As long as healthcare is run by private insurance companies we will see the system abuse horribly.
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NC_Nurse Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:48 PM
Response to Reply #4
12. Right. All the candidates proposals are about making sure
everyone has access, aren't they? They may approach it differently, but the goal is the same.
I doubt that the insurance companies will be eliminated overnight.

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Marrah_G Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:58 PM
Response to Reply #12
17. Access is good- but only if they are relieable.
I buy into my states health care on a sliding scale determined by my income. It is far superior to any other health care plan available. I don't have to worry about some jerk denying me coverage on something because it means a better bonus for him.

Yes I know...baby steps...I just hope we see the day where we have a system like Europe and Canada.
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NC_Nurse Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 02:04 PM
Response to Reply #17
19. That's great. I don't think you can buy in here.
That sounds like a good option as well.
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Bright Eyes Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:42 PM
Response to Reply #1
6. If it'll help the poor, then yes.
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NC_Nurse Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:49 PM
Response to Reply #6
13. As I understand them, most of the proposals are designed to do just that.
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ayeshahaqqiqa Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:43 PM
Response to Reply #1
7. Yes, and I'll tell you why
I'm sick and tired of insurance companies deciding what treatment a doctor can give a patient. The poor girl who died because CIGNA wouldn't allow a liver transplant is the most blatant example, but there are numerous others that are not so dramatic. If an MD who has practiced over 30 decides that a certain prescription is best for a patient, based on that patient's history and the other medications he is taking, NO insurance company should have the right to say they won't pay for it because another drug is cheaper(even though that drug would negatively interact with other medications the patient is taking). This happens, and doctors get angry.

Another thing is that insurance companies will not cover alternative therapies and cutting edge treatments. In fact, anything they don't want to pay for suddenly becomes "experimental".
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NC_Nurse Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:52 PM
Response to Reply #7
14. I agree. I think that one way or another this will change. I know Edward's plan
allows people to choose a government plan OR a private insurer. I guess you can choose based on who you trust more, both have their problems.
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AlphaCentauri Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:44 PM
Response to Reply #1
9. Tax based health insurance would not give you 80% coverage
I think a tax based health system would eliminate the insurance policy to who or what gets to be cover under certain terms.
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NC_Nurse Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:53 PM
Response to Reply #9
15. Maybe.
Medicaid and Medicare have limits and restrictions too.
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goddess40 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:48 PM
Response to Reply #1
11. It would get rid of the obscene profits that are being made off the sick
and provide care for all. That is a real health care option, not just more of the same crap that Clinton and others are offering.
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NC_Nurse Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:54 PM
Response to Reply #11
16. Maybe. The military is completely funded by the government and
Halliburton and KBR have made obscene profits anyway.
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goddess40 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 02:19 PM
Response to Reply #16
23. Two oilman in the White House will do that
Once it's in place the CEO's won't be around to run the White House to jack up their profits.
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NC_Nurse Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 02:26 PM
Response to Reply #23
26. Not the insurance CEO's , but the medical equipment, tech and pharma
CEO's will still be around.
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goddess40 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 03:50 PM
Response to Reply #26
34. Sad but true - if our Dem politicians would only do their jobs
which will only happen if we have campaign finance reform that stops businesses from buying, oops I mean donating to, politicians.
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focusfan Donating Member (884 posts) Send PM | Profile | Ignore Mon Dec-31-07 04:12 PM
Response to Reply #1
36. I know we will have to pay for it in taxes.The main thing is to get rid of the Insurance companies
If they are allowed to continue rates will always go up.We don`t need insurance they are EVIL,crooked,thieving companies who`s only intrest is robbing hard working people.
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undeterred Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:40 PM
Response to Original message
3. I'll be impressed when the insurance companies stop taking a profit
out of it. They make their money by not providing care. That goes against the interest of the patient.
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bluerum Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:42 PM
Response to Original message
5. My question has always been - what about the ♠poor who will simply
not be able to pay 3-$400 or more for insurance? Federal subsidies? Conservative corpo whores will complain that is welfare.

If the insurance is employer mandated I am a little less skeptical. But small businesses that cannot afford this will be hurt.

The administrative burdens of running a program like this are going to hurt everyone. The mega-corpo insurance companies will love it though - they will be able quadruple staff and increase rates ten times. Mandated car insurance and health insurance. Meal tickets for the mega-corpos all around - hooray!
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backscatter712 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 01:43 PM
Response to Original message
8. The only one I like is Kucinich's
Edited on Mon Dec-31-07 01:48 PM by backscatter712
He's the only one who proposes to do it right - extend Medicare to cover everyone, add some taxes to pay for it. It's the simplest, most humane, and most economically efficient way of handling health care in this country - true single-payer.

The other plans might improve things a bit, but they won't solve the problem. Mandatory insurance only works if it's possible to afford it. If we are going to go with a mandatory insurance program, it'll have to be combined with subsidies for the poor (and middle class who are increasingly shut out as well,) subsidies for those with medical conditions, and a lot of regulation on insurance companies - they should be completely forbidden from refusing to insure those with preexisting conditions, or from jacking up their premiums - the guy who needs a heart transplant should pay exactly the same as the healthy. Throw in some price caps as well so insurance can't be priced in the stratosphere, say 3% of median U.S. income for a single person with no dependents? Also throw in some strict minimum standards of coverage - no more deny/delay/deceive/defraud practices - it should be spelled out clearly what is covered, which should be pretty damned comprehensive. While we're at it, require all employers, and I mean all of them, including sole proprietorships with a single employee, to provide insurance to all their employees and families. No exceptions. That will keep employers from competing on who can cut more corners by screwing their employees, if all employers have the same requirement to insure their employees.

After all, I think it's only fair to ask that of insurance companies if the law's going to be changed to require us to buy health insurance from them. Mandatory insurance does address (in a messy and dangerous way) the problem of adverse selection.
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NC_Nurse Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 02:00 PM
Response to Reply #8
18. You are right that the industry would have to be overhauled. But the
reason it has to be mandatory for everyone is that there needs to be a leveling of risk. If all the young, healthy people were required to buy insurance, then the risk of taking on the chronically ill would be offset. That's why any plan has to have mandatory coverage. If the plan is Medicare for everyone, it would be mandatory...payroll taxes are not optional. I don't understand why people have such a problem with that. If the government subsidizes or pays for the poor then what's wrong with mandatory insurance? That's what social security and medicare are.
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backscatter712 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 02:50 PM
Response to Reply #18
28. Very true.
Edited on Mon Dec-31-07 02:51 PM by backscatter712
It's insurance economics. I brought up adverse selection in my previous post - that's the phenomenon where smokers are more likely than non-smokers to buy health insurance and to make a claim. That's why insurance companies do things like refusing to cover preexisting conditions, and jacking up the premiums of smokers.

That's also why mandatory insurance is proposed, and why I prefer Kucinich's plan - it addresses adverse selection. Another reason why I like Kucinich's plan is because it has another economic advantage - it increases the size of the risk pool - the number of people covered. The bigger the number covered by a risk pool, the more predictable the behavior of the pool is, which makes it more efficient to administer it - rather than having to have a large amount of oh-shit money ready, you can calculate the likely number of claims to a higher percentage, and keep the overhead down. With the Kucinich Medicare-for-all plan, the risk pool is the entire population of the United States, maximizing efficiency.

The point I was trying to make is that either with mandatory insurance, or Medicare-for-all, we increase the size of the risk pool, and we block adverse selection by making sure all the healthy people are paying in. Thus, the usual insurance tactics such as jacking up premiums to insane levels, or denying people coverage because of preexisting conditions, and so on, which are usually designed to stop adverse selection, are no longer necessary. Furthermore, these tactics are just plain fucking cruel, so they should be abolished.

That's the price for implementing mandatory insurance - I consider this to be non-negotiable. No more denying coverage because of preexisting conditions, no more jacking up premiums, no more denial of care for various complicated excuses. You pay in, you're covered. When you're sick, your doctor is free to take whatever measures that are best for the patient, in his professional opinion, and the insurance company is required to pay for it.
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WillowTree Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 10:19 PM
Response to Reply #28
52. If coverage for everyone is mandatory
then there won't BE any pre-existing conditions anymore. That would solve that problem right there.
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aquart Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 02:08 PM
Response to Original message
20. Moi. Sadly.
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Turbineguy Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 02:12 PM
Response to Original message
22. Considering we have evolved
Edited on Mon Dec-31-07 02:13 PM by Turbineguy
into our current mess, solving the health care question will also be a long term project. At the end of the day the only real savings the system can realize is what is lost to inefficiency (including the inefficiencies of not having coverage), goes to profits and bonuses, advertising and sales commissions. It's probably sizable.

I think however the biggest impediment lies in our attitude toward medical insurance (meaning who pays). It seems most people want the care but want somebody else to pay. Therefore who ever tells me that I pay nothing and all you fools pay my costs has the best plan, as far as I am concerned.

Given the size of the system, the importance to the overall US economy and the numbers of people employed, making radical changes will result in disaster.

Another problem is that people seem to want some guarantees for success that cannot be given. When it come to health, we are all a lot like used cars. A Doctor who looks at you and tries to determine what ails you has no definitive way of knowing where you've been, what you've been eating, drinking and breathing and how you've been leading your live thus far. Medicine is as much of a crap-shoot as buying a used car is.

My view is a good start would be non-profit foundations (like co-ops) would provide health care coverage. This would slowly devolve for-profit companies from the field. A parallel government system should exist. By allowing providers to control their beneficiary cohort, imbalances will continue.

There are no easy answers.

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NC_Nurse Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 02:33 PM
Response to Reply #22
27. Exactly. I am tired of the "this plan will fix everything" BS.
Our healthcare system is a HUGE clusterfuck.
All of the Dems have plans to BEGIN to address it. That's the best
we can do IMO. It's going to be a long overhaul.
And once it's fixed, that STILL won't guarantee anyone's health. Medicine is not an exact science and
people are not always cooperative in living in accordance with what's best for themselves.
I'm tired of hearing that the magic cure is out there. It isn't.
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Milo_Bloom Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 02:23 PM
Response to Original message
24. The plans are actually a step BACKWARDS.
Since they take the real problem off the table, which is the poor care you get from "for profit middleman" system we have now.

Right now health care is a central issue because so many people are unisured. IF you enact any of these plans, you will reduce the number of "uninsured", wind up with more people receiving far less than adequate health care, but the "problem" will go away.

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Ravy Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 04:24 PM
Response to Reply #24
40. Insuring the poor and less fortunate should never be looked upon
as a step backwards.
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Milo_Bloom Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 04:39 PM
Response to Reply #40
41. Except when it actually is.
I could go through a 1000 examples, but I will just say it this way.

Sometimes giving someone something that is far less than sufficient is far worse in the long run than not giving them anything at all.
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dsc Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 02:52 PM
Response to Original message
29. that is totally untrue
France, as Moore has repeatedly acknowledged, does require some premiums. So does Canada.
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LWolf Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 02:55 PM
Response to Original message
30. I am not impressed with any of the other plans,
because HR 676 is obviously better, cheaper, and makes more sense.

DK was still a Democrat last time I checked, whether his party wants to acknowledge that or not. ;)
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senseandsensibility Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 05:37 PM
Response to Reply #30
47. I exempted DK from this criticism in my OP
Go Dennis! I will vote for him the primary.
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fascisthunter Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 02:56 PM
Response to Original message
31. Take Profit OUT of the Equation
and you get service without a motive to deny health services. Those who do not want to chip in or lose that profit motive, are the ones against Universal Healthcare.
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napi21 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 03:21 PM
Response to Original message
32. Check this info I found on the Canadian HC system.
I find it quite interesting that THEY are also haveing cogoing agruments about THEIR system. They have the opposite problem to ours. THEIR RW is trying to privatize theirs!!! Anyway, it's a fairly long article, but I thought it was worth reading. I learned how their system operates, what limitations they have, and the average cost to their citizens.

User premiums
Currently in Ontario, people who earn salaries above $20,000 must pay an annual health care premium ranging from $300-$900. Funding for medicare in Ontario also comes in part from a dedicated Employer Health Tax (EHT) that ranges from 0.98%-1.95% of employer payroll. Eligible employers are exempted from EHT on the first $400,000 of payroll. British Columbia, Quebec, and Alberta charge similar premiums. Alberta charges $44 a month or $88 per family, though as Alberta approaches debt-free status, there has been talk of removing them.



http://en.wikipedia.org/wiki/Medicare_(Canada)

I noticed some things, like the use of mid-wives that I'm not sure people in the US would be willing to accept.

Check it out and see what YOU think.

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senseandsensibility Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 05:04 PM
Response to Reply #32
42. I have been hearing that those who earn one hundred thousand
or above would not be subsidized at all. So far from paying two or three hundred a year or a few dollars a month, these people would be paying nine hundred a month or more. That's a BIG difference.
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napi21 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 05:10 PM
Response to Reply #42
43. Are you alking about the Canadian System? I haven't found anything
to indicate that in all the searches I've done. I wonder if you heard about the option to purchase private ins? As I understand it, the Canadian system has some base mandates that are covered by your annual payment. After that, there are some taxes at the Province level. If someone can afford it and they want to buy private ins. to cover things like same day appointments for anything, or no waiting for elective surgeries, they can do so, and I would think, the more elaborate the plan, the more expensive it is.
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debbierlus Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 03:31 PM
Response to Original message
33. The profit has to be taken out of it. Period.

Until then....we will be raped by the insurance companies. As long as health is secondary to profit, it won't work.

The problem is that our current government reps are bought & paid for the the corporate powers that be....

It will change only when the care the majority is effected. First, we will get universal health insurance. Then, when that doesn't work, we will get universal health care. About ten years for the cycle to complete. Until then, don't get sick.
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Franc_Lee Donating Member (287 posts) Send PM | Profile | Ignore Mon Dec-31-07 04:09 PM
Response to Original message
35. Haven't any of these candidates seen Sicko? ->exactly, why does it work anywhere BUT, the US???
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sandnsea Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 04:13 PM
Response to Original message
37. They PAY TAXES
Hello???? Why do people differentiate a monthly premium from a tax? They both come out of your income.

And some countries do have their people pay premiums AND taxes.
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senseandsensibility Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 05:22 PM
Response to Reply #37
45. I don't recall saying in my OP that they don't pay taxes
And again, it's all in the distribution.
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Mike03 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-31-07 06:23 PM
Response to Original message
50. I don't understand
Edwards has been so consistent on this issue of Universal Health care, and even in France, Canada and other nations they of course DO pay for it--it is paid for by taxes, but it costs a TON less than we pay individually or spend on horseshit like wars and defense.

The insurance industry soaks up trillions of money that would be better spent on health care.

We would pay A FRACTION of the cost we spend on health care if we eliminated the insurance industry.
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