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Medicine & Politics

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the candidates According to the 2007 Census Report, over 45 million Americans are without health coverage. The impact of those uninsured is widespread and health care costs continue to climb.

When voters have been asked what issue matters most to them in the upcoming presidential elections, healthcare is always near the top of the list. The Democratic and Republican candidates have acknowledged the system cannot continue as is and have proposals outlining the changes they will make if elected.

What do you think of the candidates’ plans? Where do you stand on healthcare reform?

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Which candidate has the better plan for healthcare reform?

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As a medical professional, are concerns about McCain’s age justified?

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What healthcare issue/reform would you most like to see the new president tackle? 

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Should more states adopt a mandatory health insurance law (and work with plans to offer income-based programs), like Massachusetts? 

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Do you feel more compelled to vote this year compared to past presidential elections?

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In the 2nd presidential debate, the following question was asked of both candidates. Is health care in America a:

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221 Responses

  1. Herminio Cuervo

    Obama wants to radically change this country into a socialist state. The sad truth is that it does not work. Failed states like the ex-soviet republics, N. Korea, Cuba and others have shown that capitalism with its financial incentive to work has no substitute. Healthcare is not a constitutional right (it is not in there anywhere. Look it up). We need to constraint expenses. Not everyone needs a zillion dollar work up for a fainting spell. I see waste, fraud and abuse on a daily basis on the consults I get at the hospitals with the docs CYA in case there is something wrong. We need tort reform. If you think single payer works well: look at Canada. How soon can you get the MRI brain? Obama is a walking disaster. He has never ran any type of business on his own. He smokes and no one criticizes him for the bad example this makes. He would never pass a routine security clearance to work on the White House as a cook.

    If Obama get elected, he will slam us with socialized care. There will be major slow down in work output. Who wants to work for $0.30 of every $1 an hour (rest in taxes). I will cut back my hours and go read or fish. When do you need a consult? Try Canada. Multiply x 10. Try go get a driver’s license in any major city and see how it works. Wake up America!

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  2. Cal Scott, D. O.

    The doctor patient relationship is fundamental to the health care process. Any program of cost control that may interrupt that process, will diminish the delivery of health care proportionally. The cost of health care has rocketed due to the intervention of government and insurance carries. Responsibility for cost containment no longer resides with the consumer or the provider. When the two principles are taken out of the equation, the necessary for control becomes the focus and not the delivery of quality health care. People do as they are incentivized to do when making a decision about all aspects of their lives. This is as true of health care as with decisions we make.
    Society must never forget: if they are capable of giving it to you, they are therefore capable of taking it away. Something given without value is valueless.

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  3. Marcie, FNP Student

    Yes, our healthcare system is broken. I believe mostly because it is run by insurance companies. I see health care providers running from patient to patient in order to make enough money to keep their “business” afloat. Providers in my area are refusing to see Medicare/Medicaid patients because of low reimbursement rates. Medicaid patients visit their Provider more often because it is “free”. Illegals are delivering babies every day at the local hospital and receiving emergency medicaid…we are not even allowed to ask if they are a citizen……..not that I care. I am a full-time NP student with not so great health insurance offered through the school. I have to pay for my asthma medication out of pocket which is approx $200/mo. I did not realize the school insurance did not include medications.
    I can now see the Health Care System from both sides. Before school, I had BC/BS and worried about nothing. I now see how not having good health insurance (or none) prohibits one from seeking preventive care. In 7 months,after I graduate and start working full-time again, I can get a mammogram, a pap smear, cholesterol screen…etc.
    Yes, it is frustrating to take care of patients who ask for a toothbrush, shampoo…etc because they are on medicaid and it is free. I do, however, believe that in a civilized country, basic health care should be provided to all citizens. I also believe that there must be some buy-in from all parties involved. I believe co-pays may help to reduce frivulous use of any system. We also need to encourage preventive care and perhaps reduce copayments for individuals who participate in wellness programs.

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  4. Michael

    please review Bill HR 676 by conyers and kucinich - Universal Health Care - Looks good, cover all with medical, Rx, dental and psych.

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  5. Amy

    We must have more preventive care to avoid healthcare costs to begin with. When we need care, it should be accessible and affordable. I agree that nurses should be allowed to be more involved in care, and insurance companies should pay for our services. Preventive, holistic, and alternative and complementary care should also be covered. Patient education and community outreach programs should increase. Adult daycare centers for our seniors could help keep costs down and keep families together. Such centers could be run by nurses, and incentives for such endeavors could be given by the government in the form of grants, etc. Reducing the amount of acute care and pharmaceutical needs through prevention, education, and family support systems would reduce costs significantly. Well people are not profitable in our current system. Perhaps this is why the sick often just get sicker. The system is in dire need of reform, which should be quite obvious to every caring healthcare professional. I think Obama is much more concerned about these issues than McCain is, although this problem is really bigger than them both. It will take many minds to solve it.

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  6. Laura, RN

    Single payor does not equal socialized medicine. If we ensure that all have equal access to preventative care, we will not have the abuse of the emergency medical system as we now do. One way to stop the misuse of the system is to better utilize the resources we have, especially the NURSES! This is why the American Nurses Association (ANA) of which I am a proud member has endorsed Obama/Biden.

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  7. George Kibler

    Private (capitalist model) costs too much because of profit gouging. Government (communist model) medicine will never work because it costs too much because of inefficieny, and it is too susceptable to politics and special interests. The ONLY thing that will ever work will be a non-profit independent NGO.

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  8. Jo Ann

    If everyone knew how Universal Healthcare worked they would NOT want it. I lived in a Country with Universal Healthcare for 3 years. I was TOLD what Doctor I could go to, what hospital I could go to, etc. The Country had age limits for some disease and some medications. Once you hit this age you either paid for the medication or treatment yourself or laid down and died. Sure they kept costs under control but at whose expense?We have too many entitlements in this country now. It is time to start making everyone responsible for themselves. What ever happened to the Not For Profit insurance companies from years ago? There were two parts to the onsurance at that time. They paid hospital and large expenses and the patient paid for dostors visits and medications, etc. These expenses were then sent in for reimbursement under the Major Medical part of the insurance. There was not such a misuse of benefits as there is now. Obama would have us all live as socialists.

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  9. dag

    Health care will always be a problem until all the players stop treating it like it’s going to a rich person’s party and going home with a gift. My dream is all players will consciously work for the good of the patient. In the end, every person will win.

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  10. Allan

    If we regard health care as a right, the unavoidable conclusion is that we need health care for all. This is not only the ethical thing to do, but the most economically sound solution. Businesses will become competitive again. Waste will be eliminated. And best of all, if we eliminate all the obscene profits made by the insurance industry we can cover all unisured and still have money left over. As an added bonus, with a single payer, malpractice reform is included at no additional cost. The drawback: Sudden severe unemplyment in the insurance industry and the trial lawyer industry.

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  11. Barbara Stephens

    Dear Epocrates,

    I believe that the first pressing medical issue in America is the health issue that undergirds all others: the right to life. I do believe in the right to life, liberty, and the pursuit of happiness. All of the health care reform, reduction of frivolous medical malpractice suites, etc. are built on the inalienable right to life given by our Creator. I’m just quoting from our Constitution. We need get this issue “right” first!

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  12. Drew S. PA-C

    With respect to Dr Wayne Moore, does Obama’s superior acumen include being friends with known terrorists like Bill Ayers and Bernadine Dorn who bombed the Pentagon, Capitol and Police HQ? I and my brothers in arms have been fighting terrorists in Iraq and Afghanistan only to come home and get a terrorist sympathizer elected our Commander-in-Chief?
    Obama has no integrity, will say anything and every promise he makes should be taken with a very small grain of salt.
    McCain’s integrity and selfless service to his nation to the extreme should be more of a sign as to who has the best interests of the American people!!!
    Why would intelligent people that I’m sure most of you are believe a terrorist sympathizer over a decorated hero, or do you all have a high opinion of an elitist or low opinion of the men/women who serve and sacrifice for our nation?
    Who has Obama served besides himself and his patrons?
    His resume is so thin most of us wouldn’t hire him to be our office manager! What do we really know about him that we would entrust him with our healthcare, our careers, our businesses and our country?

    I recall the first rule of medicine is to do no harm.

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  13. MAD

    I’m sorry but I have to say this, the govt needs to stop giving free health care to people that abuse the system. I work in a pediatric office and I am tired of seeing people that cannot afford to have children keep having them. My taxes are paying for them to keep having children and for their healthcare. One child doesn’t seem to be enough, they have five and they are all on medicaid. There has to be a some type of limit on how many children can have free healthcare. I am a hard worker and am irritated that my tax dollars continue to go to these people! I do not support Obama’s plan because with his plan tax payers on going to continue to pay for things like this, which is absurd! Health care is a responsibility, people should not be a burden on other tax payers.

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  14. CE Stewart

    While everyone complains that we can’t have a socialized medical system, what do we have now? Those who do have medical coverage pay large premiums for coverage they often never recieve, while that money is used to support others who either have no coverage, or for expensive procedures for those who complain the loudest, and often have the means to pay anyway. We ration procedures on the basis of who can pay, and in the meantime the insurance companies take the money and either invest it - unwisely?, or build their large offices and have well paid executives. They dictate how patients should be treated, sending letters to family physicians regarding treatments that they (not the DR) decide are not needed, or expensive medications that they (not the Dr) think should be ordered, when lifestyle changes and OTC herbal remedies are more effective. We spend almost nothing for prevention, but millions for high end “definitive treatment” of severe illnesses that could be avoided. I agree the government isn’t always the best at running everything, but looking at the greed that has taken over many of the companies lately - neither are they. We need some type of compromise, and oversight, assuring that everyone gets a fair deal. And I do think health is a right - we have the right to freedom, and being healthy is part of freedom.

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  15. Rosalind D. Leaming, MD

    A socialized healthcare system while noble in goal has not been proven sustainable in other large and inhomogenous countries. Yet, our current system is very broken and Medicare for the baby boomer generation will consume all of our tax dollars. I fear that the solutions put forth by the candidates do not address this last and very fundatmental and looming issue. We cannot pay for Medicare and all the new initiatives as presently set up. I applaud immunization and any solution providing preventative health for all especially the young. However, excessive litigation, inadequate electronic medical records (somewhat addressed), and the excessive cost of medical care at the end of life that is non-palliative must be addressed. It seems both elected and those running for office run from addressing these thorny but absolutely necessary issues.

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  16. JM

    I think this is the right time to make changes about the insurance issues in this country. I am just so aggavated by issues about insurance robbing the american people. As medical practitioners, I don’t even think that working hard for the welfare of our patients is not even paid off by these insurances. Bothe the patients and practiotioners at at the loosing end

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  17. Wayne Moore MD FACEP

    Senator Obama , with his superior acumen and judgement has employed the principles and fundamentals to develop the best health care plan for the people of this nation . Lets take a historical view of how Democrats and Republicans addressed this issue . When Hillary tried to address this problem , she was immediately attacked by the radical republican right (Physicians and politicians) for trying to fixed a broken system . She put a few measures in placed , some of which worked and some that didnt , at least she had the courage to try and did the best that could be done , under a radical republican congress. Later on Bush and the radical republicans , with a senate majority leader , could not and would not do anything !!! I believe a partys ( republican vs democrat) past behavior is the best predictor of their future behavior . On that basis alone , I support Democrats hands down ! I must admit Democrats need to change their tune on tort reform . On the issue of “socialized medicine ” which is buzz word that radical republicans love to use , look at our neighbors to the north Canada and the UK , their system has brought better healthcare to their countries than ours has . Wake up and take your nose out of your wallets !!

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  18. Cheryl

    Unfortunately if McCain is voted into office Healthcare may be non existent to poeple who are now covered. Mc Cain’s tax plan is to give each family a 5000credit but that doesn’t go to you or me. It goes to the insurance company. If your work is self insured (I work for a county government and ours is what they consider to be self insured even though administrated by a “insurance” company.) If you are one of those, not only will you have to pay taxes on what your job pays for your health insurance, but you will also have to pay income tax on any payment that was made to the hospital, doctor, or any bill it pays. So that means that If I am off sick, not only will I not have sufficient sick pay but will be said to have earned that money that they paid even though you’ve never seen a dime of any of it. So say someone has a cancer surgery with chemo and all this bill could easily be 500,000 in a year. So instead of having earned your normal rate which you can barely survive on from check to check. Now you will have to pay taxes in that year for what ever sick pay you earned but you will have increased you “income” to an adidtional 500,000 and will be taxed at having earned over a half a million dollar.

    May I please encourage you to really look at the fine print and remember that how this effects every woman child or man.

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  19. Cheryl

    Unfortunately if McCain is voted into office Healthcare may be non existent to poeple who are now covered. Mc Cain’s tax plan is to give each family a 5000credit but that doesn’t go to you or me. It goes to the insurance company. If your work is self insured (I work for a county government and ours is what they consider to be self insured even though administrated by a “insurance” company.) If you are one of those, not only will you have to pay taxes on what your job pays for your health insurance, but you will also have to pay income tax on any payment that was made to the hospital, doctor, or any bill it pays. So that means that If I am off sick, not only will I not have sufficient sick pay but will be said to have earned that money that they paid even though you’ve never seen a dime of any of it. So say someone has a cancer surgery with chemo and all this bill could easily be 500,000 in a year. So instead of having earned your normal rate which you can barely survive on from check to check. Now you will have to pay taxes in that year for what ever sick pay you earned but you will have increased you “income” to an adidtional 500,000 and will be taxed at having earned over a half a million dollar.

    May I please encourage you to really look at the fine print and remember that how this effects all.

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  20. K Thomas

    I read many fear and believe that those on Medicaid go to the Dr. just to get attention. Sorry guys, your not the fun place to go. The news, your own ads, and those of the Pharmacy companies promote fear that anyting is a symptom of some hidden disease. Recommended tests–needed or a fund raiser? I’ve been to a Doctor’s office after a bout of pneumonia and was told since I had X insurance I could come back in 3 weeks. Did I need to? Should I be in earlier? Or only if I don’t continue to feel better? Years back I had a Doctor, (not a businessman with a MD degree) that taught his patients what you’d need to look for and answered the phone if you had a question..appointment or over the counter med? Health savings accouts will only last while your healthy..one major illness and it’s wiped out and so are your savings and credit. Businesses are cutting out insurance..one company told the union it was negotiating with to “go get the state insurance” not that they provided for their majority “part time” 31 hr/wk workers. If there was a plan that covered all catostrophic illnesses for everybody then the insurance companies could provide insurance at reasonable rates for those things that are expensive (broken bones, pneumonia, appendix, gallbladder etc) but short term,(with smaller deductable) and then regular non- preventitve stuff at a higher deductable. Preventive medical care should have a low deductable. However, If a company requires a doctors note, then they pay. (I don’t need to see a dr. for the flu or a stomach virus but my employer says I do if I’m out more than 1 day.) Also the FDA needs to be returned to its supervisory, independent and disciplinary role of the pharmacy companys rather than their rubber stamp/ investment portfolio/future employers. Deregulation of the medical industry (self -testing by the pharmacy co, insurance companys denying dr. diagnoses, out of wack malpractice insurance etc.) has brought the business side of medicine to the same state as the economy.

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  21. Alan K., DVM

    I see many mistakenly stating Senator Obama’s health care plan. Namely, that his plan will result in socialized medicine. Visit his website and read what his plan is before you assume the worst. In part, he proposes that anyone not satisfied with their insurance or that has no insurance be given the opportunity to enjoy the same health insurance plan that he and McCain have. Subsidies would be necessary to insure the indigent and working poor. I, too, have that same benefit as I am a retired federal employee. I have Federal Blue Cross and Blue Shield (PPO) insurance for myself and my wife. The fact that nearly all federal employees and retirees participate in plans offered through the Federal Employee’s Health Benefit Plan (FEHB) means that we can obtain insurance for more affordable premiums than an individual trying to insure him / herself. I have a choice of several companies through the FEHB and my insurance is provided by BC/BS - not the government. However, my premiums and benefits are superior to those that do not have the benefit of purchasing BC/BS through the FEHB.

    The federal government does not insure me, they provide me with reasonable policy choices under the FEHB program. I don’t believe that qualifies as socialized medicine or government insurance. I believe that Senator Obama’s plan is far superior to Senator McCain’s. Read their plans on their websites before you assume the worst. We have seen how well the “free-market” approach worked with the Savings and Loan institutions and now with banks and other financial institutions. If there is no government oversight on such institutions, the greedy will get rich off of the hard working low and middle class workers who are getting farther and farther behind in their pursuit of the American dream.

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  22. Antonio Carbonell MD

    When the UK is considering returning to a privately funded and paid health care system while we’re rushing headlong into what the UK has found impossible to support and maintain, it seems to me it is time to put the breaks on a single solution to what has become one of the most expensive and complex systems in the world.

    We currently have multiple single payer equivalents, from the health care system for government employees (the old 80/20 indemnity plan), to the HMO/PPO alphabet soup of prepaid plans (paying the providers $0.25 on the dollar), to a fully operationsl Federal (Medicare) and State (Medicaid) system (paying $0.10 and $0.09 on the dollar and planning to drop it another 40% by 2010. I have yet to go to Walmart or Target, tell them I’m a doctor and have them give me a 90% discount on my purchase! I have yet to see any legislation that would allow us to deduct our free care, our non-collectibles and our unallowed charges - because we can’t be trusted to submit honest claims! Yet we are trusted to make life and death decisions 24/7… How does that compute?

    The problem will continue to escalate as long as we continue to ignore a key aspect of health care expenditures - the medical/equipment supply industry. There’s no GAO oversight of this “the sky is the limit” system of charges, specially as the ’sterile’ label is attached. No one knows or has reported on the size of such expenses.. Sometime ago the GAO had discovered $500 toilet seat and $250 hammer overcharges. Today the lowly 4 x 4 cotton gauze that used to come sterile in a package of 4 double ply units 30 yrs ago and sold for $0.50 a piece, sells for $1.50 a piece for one gauze, one ply thickness! To my knowledge, the manufacturing of such simple items hasn’t changed in decades, so why has the quality and price taken a divergent plunge?

    MD used to be a euphemism for ‘More Dough’. Today it could be considered as “Maximally Deceived”. The market driven supply and demand theories seem to be incompatible with health care costs. The greater the demand the higher the price, the lower the demand the higher the price, the greater the use the higher the price, the more ’system upgrades’ the higher the price, the more proprietary the software the higher the price, the more services are required the higher the price, and on and on…

    Are we truly the richest country in the world or the most in debt country in the world, as the recent Wall street Credit Default Swaps (the ultimate of deceptive practices - an insurance program that is not called insurance so it can go on gambling with our future unregulated and wantonly)has shown? We’re struggling to meet government demands that we provide interpreters in our practices - we seem to think all we need is Spanish interpreters when in fact the Chinese language may soon become our national language if China calls in the loans and takes over their stake in our soil! Then we won’t have to worry too much about equipment costs and supplies as acupuncture and meridian therapy become the hallmark of managing and treating disease! Perhaps that will become the answer to our current health care cost woes!

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  23. Ronald Myers

    I feel health insurance should be available to all at an affordable price with no exclusion or “rating” based on pre-exisiting conditions. I feel a single payer might have advantages that the private sector has failed to provide. The recent financial crisis shows what McCain’s un (under)regulated plan would bring to millions of us.

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  24. Drew S. PA-C

    What we need is for people to buy catastrophic insurance coverage to cover major events such as surgery, cancer, traumas, etc., and move to a ‘pay for service’ system for the minor situations like colds and routine care. We have auto insurance that covers collision damage but not oil changes and tune ups.
    A market based approach would by its very nature lead to reduced costs as competition comes in to play. Providers will be free to charge for their services, and even do work for free if they want. Customers can shop around for the cheaper providers, cheaper labs, and cheaper imaging facilities. These companies can also offer discounts to attract customers away from other facilities.
    Everyone would be allowed to have medical savings accounts where they can put money away tax free and earn interest on it.
    Why do most of you continue to think the only solution has to be a Big Government, bureaucratic, top down, socialized approach to everything? We have never tried a pure market based approach to healthcare.
    It will also give everyone the choice as to what kind of care they want. They can choose traditional allopathic medicine or choose naturopathic medicine, go to a witch doctor or faith healer or any combination they like. This is called FREEDOM and is what I and my comrades in uniform have risked our lives defending for over 200 years. It’s why people flock to our county as opposed to going to China, Cuba or Venezuela.

    The government is the WORST possible solution because it saps a large percentage of the money just to keep the bureaucracy functioning.
    It also lends itself to abuse because even though everyone is equal, some will be more equal than others (to quote George Orwell). Be sure that those with connections to the powers that be will get priority for everything. Here in Pennsylvania, former Governor Bob Casey amazingly appeared at the top of the liver transplant list when he needed one, even though many were on that list longer and were much more worthy recipients. Don’t you think Obama’s wife or kids would get priority over yours?

    I find it extremely sad that so many otherwise intelligent people are willing to give up their freedom to make a living in the field they spent many years training for all for some scam cooked up by a junior league politician who has NEVER worked a true job in his very short life. To top it off he’s a middle rate lawyer and we all know what lawyers think about the medical field. They view us as a money tree they can pick at will to fill their pockets. He does not know the feeling of holding a new born, which you just helped deliver. He doesn’t know the fatigue felt after spending 6 hours doing surgery to repair an ailing heart. He does not know what its like to look into a patient’s eyes after you just told them they have inoperable cancer
    No we need to do everything in our power as medical providers to get egotistical, governmental busy bodies like Obama out of medicine as well as business. They know nothing about either and are just pointing fingers, trying to divide us to increase their own power and control over our lives. If they had an ounce of caring or an ounce of intellect they would be in medicine caring for real live human beings rather than acting like some sort of messiah. He never even had the courage to serve his country when it didn’t give him power, prestige and lots of money.

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  25. Ellen Stanbach FNP

    I find that a lot of people who have medicaid tend to abuse it, will this happen if everyone gets health care. I have a lot of patients in there 60’s that have no health insurance. My physician and I see them and only charge them a minimal amount of money. If everyone gets health insurance will there be enough medical people to see them, or will they be lined up at the door. I am already 62 and the Dr. is 56. The physician next door is 68 and still working until 9pm every night he is so busy. The baby boomers are coming this may become a big medical nightmare. The previous writer is correct and what I continually tell my patients. You are responsible for your health, stop smoking, eat right and exercise. In the 1960’s employers only paid hospitalization. I paid for my own Doctors visits and I didn’t go to the doctor for every minor ailment. I took care of my children, when they had croup or a cold or stomach virus. Now everyone wants antibiotics for everything. Don’t give it to them and they are in the ER. Benefits are crippling business, GE for every 100 employees has double that amount who are retired getting benefits. We are paying for them. Drug addiction is rampant, I have lived in several different states but South Carolina is the worst. SC also has the lowest high school graduation rate. We had better wake up and go to school and be responsible for ourselves or places like China will replace us.

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  26. Steve Speidel, ND

    Yes, that’s an “N” as in Naturopathic. Licensed in Washington and several other states, we use lifestyle intervention and less toxic therapies to treat our patients, prescribing drugs and referring when appropriate.
    I read many of the other thoughtful and well written posts. Rather than discussing healthcare, we and the candidates are arguing about payment. My patients, most of whom I admit have insurance coverage for alternative services, care more about the practice of medicine than its costs. They want:
    -to be heard, respected, and educated.
    -to be touched. Many patients come to me having received no physical exam, their other physicians relying only on labs, imaging, and the briefest of histories.
    They do not want drugs or surgery except when necessary.
    They feel our healthcare system dehumanizes them.
    Lest you think I’m preaching, let me say that I often fail them in these salutary wants. I sometimes choose technology over humanity. That’s our culture in American medicine. How to rehumanize medicine? That might save money; it would certainly provide better healthcare. I don’t have a prescription for that ill.
    But one dehumanizing political and economic force is the influence over our government and medical education of the drug cartel. Any universal coverage plan put in place without first reining in these corporations’ power to name their own price and to shape our thinking (that is, a pill for every ill) will only serve their profits rather than our patients.

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  27. Mark Hahn MD

    This presidential election cycle is probably the most pivotal in recent memory. As we are all too aware, the economy is slowing down, our financial institutions here and abroad are in meltdown. Credit and liquidity have come to a an abrupt halt. We’re fighting the,’War on Terror’, everywhere and two ground wars in Iraq and Afghanistan. People are being forclosed on their homes and losing their jobs. Some have had fairly successful businesses, and they too are being adversely affected. I have no doubt that in the next two years of this next presidential administration, the rolls of the under/uninsured will surely rise beyond fifty to sixty million. I think neither candidate’s tax proposals at this time reflect the stark reality of our ever sliding economy. I hope that Senator Obama if elected, seriouslly considers a national sales tax and a single payer system to cover all Americans and yes including legal and illegal aliens. The fact of the matter is, we’re paying for it anyway. Lastly,medical tort reform would in my opinion significantly reduce the cost of care, allowing physicans to USE ther medical judgement without fear of ridiculous financial retribution by our parasitic legal brethern.

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  28. Gene J. Boschee

    Support by both candidates for HR 676–Medicare for all a universal, single payor plan which has been in committee for 4 years. See HR676.org

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  29. Drew

    I wish that the American people, and this includes Healthcare Providers, would stop looking at everything under the sun as another “Right.” Rights are given to us from God, not politicians, and my rights do not interfere with your rights or cost you any money.
    People have no right to expect others to pay for anything for themselves or expect anyone to provide a service to them free of charge. But politicians try to buy your vote by promising to take (re: STEAL) from others and give to them.
    I find it interesting that people like Obama, who has no redeemable skills, is very willing to force us medical providers to provide our skills to those he wants us to and at the price he wants to pay us. And God forbid we don’t give them the results he would like, he’ll have his ambulance chasing buddies suing us into oblivion.

    Don’t get me wrong, I am happy and very willing to serve the needy in the world. I have provided plenty of care to those who cannot afford it and have even paid for patients’ prescriptions out of my own pocket. I prefer to do it on my terms, not for some slick talking shyster who thinks he’s some messiah for mankind.
    Remember, there is NO virtue in giving to the poor under threat of force.

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  30. John Trujillo

    Neither plan addresses health care reform. If someone you loved was in an automobile accident the last two people you’d be asking for are insurance adjusters and ITs.

    Obama’s plan will socialize medicine which in turn will make the poor systems that military, veterans, native americans, prisoners and inner city poor suffer from the standard nationwide.

    We need to end the monopoly on how health care providers are selected, educated, trained and employed. We need to increase providers in every specialty and at all levels.
    We need to stream line the FDA so that American technology gets in the hands of providers. The bureaucracy and corruption of the FDA results in immeasurable costs in human suffering and lives.
    We need immediate Tort reform so that providers no longer have to practice defensive medicine which results in unnecessary tests and delays in crucial decisions. Current Tort laws drive up prices while driving providers out of critical specialties such as OB/GYN. Current Tort laws also deter some of our greatest minds and compassionate hearts from even entering health care fields. Currently excessive and frivilous awards are based on the manipulation of the emotions of ignorant and class envious jurors instead of science or evidence based medicine. Look up the relationship of C-sections and cerebral palsy on your own. Now we have an overuse of dangerous and disfiguring surgical procedure but no change in the incidence of cerebral palsy.
    We need to minimize the authority of licensing and accrediting agencies with their Mafioso like kickback system that controls every aspect of health care delivery in America.

    The free market needs to be set free so that competition drives up quality and accessibility while reducing overall costs.

    If this is too much for you to understand after years and years of Insurance debate then consider this. If Obama and his party believe that there is an “underserved” population in health care then by reason you must logically assume that they also believe there are “exactserved and “overserved” populations. Do you really want someone who’s whole life is marked by ambition and corruption to decide what group you or your family belong in based on race, gender or religion?

    And for all of you that believe that good health is a right, then obviously the opposite of a vibrant life is a death. When our system becomes one of no choice regarding second opinions or treatment options, will your messiah guarantee that no one else will die or get sick. Does that mean no more congenital birth defects? What of all the smokers, alcoholics, overeaters, non-exercisers, drug addicts, and generally just stupid people who bring the most preventable conditions down on themselves? Will your messiah attempt more prohibition, a historically failed system of guarantuan proportions. Cost containment in a socialized system is obtained by limiting and rationing health care options. You know the Democrats will not limit abortions or gender transfers so what will they cut out. Most likely a procedure or treatment that the majority of Americans will actually need in their lifetime.

    Obama’s plan is merely the adopted Hillary/Kaiser plan that will subsidize the insurance industry and we’ll have the same exact problems in health care that we have in the mortgage industry. Don’t be fooled by the promise of “free” health care. Nothing is free. Also why not ask yourself why if Obama was so distraught from his mother dying of cancer did he not instead pursue a career in medicine to find a cure? Instead he chose to become the natural enemy of every health care provider who ever lived…a lawyer.

    I keep waiting for the press to ask Obama how his plan will add one extra doctor, nurse practitioner, RN, Dentist or even a candy striper to what we already have. How will his plan reduce the nonrefundable fees and extensive trial periods, that not only limit who can participate in health science manufacturing sectors, but result in the high cost being passed down to the consumer. Drugs are priced according to how much it took to get it from development to market divided by number of patent protection years and rate of distribution. That is why life enhancing meds that will be used frequently by many people are cheaper than life saving meds that might be used by a few hundred suffers of a rare terminal disease. So you see, in all actuality it is Big Government through the FDA that holds children with rare forms of cancer hostage and not big pharmacy like you’ve all been led to believe.
    Ask Obama how his plan will creat an environment where providers can base their decisions more on patient welfare and evidence based medicine instead of the threat of litigation which leads to financial ruin and destruction of reputations.

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  31. Heather Hart

    Access to care is still an issue in many areas of this country including rural states like Montana. I would like to think thta there are many areas that we need to address for providing a better system,one would be getting Medicare AND MEDICAID TO INCREASE PAYMENT To PRIMARY CARE PROVIDERS, so that we can enlist more providers to stay in primary care. The second is a means of providing insurance companies to be required to offer small businesses ie 1-10 employees, 10-40, 50-100 without prexisting conditions excluded. If their was some legislative action that required businesses to offer insurance in trade for a reduced tax or credit on the business and then require the employee to participate in that plan. We can use the free market to facilitate insurance carriers are accessing businesses and providing a basic preventive care policy on all levels ,we should be able to make a few steps in the right direction. If every family had access to some basic care we might be able to provide some assurance that we won’t being diagnosing diseases only in Er’s and Acute care.

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  32. Gwen Smith MAN CNP CDE

    Neither candidate has an all encompassing plan. I think it is unfortunate that the populus cannot be trusted to make good decisions regarding their healthcare and insurance coverage. If you give people the choice, some will still pick designer purses, playing the lottery, going to a casino, etc. before putting money into purchasing a healthcare plan for themselves and family. In the end, the rest will foot the bill and nothing has changed! It seems that mandates are essential for a universal healthcare plan to work. Dividing states into sections and having 3 -4 insurers in each section would provide some competition among providers —- hopefully leading to better insurance plans.
    We have a long way to go - and I hope the promises made during the campaign do not get left in the dust. gwen smith msncnpcde

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  33. BA Carrrico, RN

    neither candidate has the complete answer to our country’s health care problem. They need to ask the professionals who work in the system, look at countries such as Sweden who’s health care system actually works and ask the American people their experiences.Then using the information they have along with the available funds make a healthcare CHANGE that will work. An Example: I worked ICU for years, then the hospital decided to update the ICU/CCU unit, they asked us our opinion on some of the changes, we happily stated what would work/help to provide better patient care. They then proceeded to do the reconstruction and never used any of the staffs suggestions. The result: many things had to be redone because it was neither functional or safe, then they told the staff there would be no pay raises that year due to the cost of hospital update construction. Some people think they have all the answers but there is power(advice/insight)in numbers. The American people are not stupid, but we are ill informed and not used to the best of our ability. To both candidates, use the resources, us, to help solve some of these issues we face. We, the middle class are the ones who not only provide the health care but also pay for it(for everyone) and use it ourselves(when we can afford it). Don’t you think we might know a little bit more about it than you give us credit for. A familiar saying is, If Nothing Changes, Nothing Changes. We need changes that will help solve problems not cause bigger ones. Our voices need to be heard and experience taken seriously.

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  34. Monica Sanders

    As a nursing student, this subject was debated. One student made a profound statement that you can’t give away what you don’t own. Health care is not a right, nor is owning a home or car. It is your responsibility. I have my own plan to make health care cheaper. Disabled and children are covered, but nothing should be completely “free.” Instead of lawsuits, there would be mandatory arbitration FIRST in every state. There must be appropriate safegards and board member rotation for impartiality. Caps on awards if it gets that far. Then each person has a “health card.” Money from salary goes towards it just like a credit card tax free. Cumulative amounts from $10,000 to $50,000. May only be used for: Doctors, meds, medical related costs.You chose where you spend it. No more staff for approvals. Purchase high deductible catastrophe policy for major medical problems above the deductible amount you set. Discounts for non-smokers, normal weight, non drug users, health prevention. Access without preexisting solutions like assigned risk auto insurance. Standardized understandable verbage on insurance policies. Remember, the federal government has NEVER run anything cheaper than private enterprise. Just look at the IRS.

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  35. Carol Ratko

    This is probably a rather unpopular view but I am so angry at the arrogance of the health insurance companies and the fact that their executives appear to be robbing us. Their employees are often rewarded for denying coverage in some cases causing people to DIE!!
    Now is the time for national healthcare for everyone. No insurance companies to rob the American people. We need single payer insurance and we need it now. It’s the only fair way.
    I’m sure those insurance executives will find other ways to rob us but at least it won’t be on life or death issues by denying coverage for needed medical treatment.
    This is not a communist or socialist idea–it’s only common sense.
    National Health Care NOW.

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  36. Olga Alvarez

    Is time to provide a good universal plan to all citizens,no matter economical class they have, with deductions paid by them in relation with their income.

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  37. Barbara McClintock M.A., M.D., D.D.S.

    The reason people come to America from all over the world for medical care is because our medicine is NOT socialized…
    To socialize medicine will lead to doctors all over America to step down on the quality of care patients will receive…

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  38. Barbara McClintock M.A., M.D., D.D.S.

    Socialized medicine will be a disaster for the American people and the American economy. Socializing medicine will lower the income of Physicians, thereby discouraging those from becoming great physicians or even starting with Medical school. You need a lot of expertise and a lot of time and training in order to be a doctor or dentist, why would you go through all that if you were getting payed minimally? What I see happening in the future if we were to adopt this plan, is that there will either be a decline in those attending medical school, or a decline in the quality of treatment being received from physicians (in order to cover costs you must see much more patients - Quantity vs Quality issue).
    I really fear the Obama proposal and that is why I fear Senator Obama becoming President.

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  39. A. J. Zelada, OD

    Confusing: governments of Japan, Suisse, Norway, Taiwan have healthcare GNP costs near 6-7-8% and Americans spend 16-17% GNP on health care. Those countries cover all citizens for basic healthcare. Americans only cover a percent of their population…something wrong with this picture? z

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  40. Greg Cooper MD

    I am a Canadian physician and proud of our universal healthcare system. Even with some of it’s defiencies, it is something to be proud of. For those Americans who take pride in their ability to get an MRI the same day and access hip replacement surgery in less than a week from consultation, you have to remember that you have 20 other fellow citizens who get either no or financially ruining coverage.

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  41. Mike McCord MD

    The candiadtes are each only partially correct. Medical care is a privelege and a CHOICE- not a right.Contrary to what the scaremongers say,in this country, we always have healthcare available.In an emergency, no one is ever denied care here.In other countries like Guatemala where I have worked that is not the case because in some areas there simply is no doctor or medicine available.

    There is a solution available, but it would be politically difficuilt to pass because it would require the politicians to actually fix several problems at once. First problem is the tendency to “PASS the cost” onto someone else’s shoulders. Businesses try to not provide healthcare coverage for employees, the insurors try to not pay legitimate claims, the government tries to pass the costs onto the doctors and hospitals by underpaying for services, the patients try to pass the costs on to others by making the conscious decision to NOT buy insurance that they could afford and instead buy the latest cell phone plan and premium cable services. etc. Most egregious are the illegal immigrants who overburden our healthcare system and place the burden on US taxpayers.

    The best solution is to REQUIRE basic healthcare insurance of everyone-including LEGAL foreign visitors(who purchase temporary plans before entry) and all US citizens. Anyone who is here illegally without insurance should be immediately deported.(Like driving without a license.)
    Also there needs to be a 2 healthcare system- a public BASIC care system, and a competing private like they have in England.BASIC would have to have limits-like no organ transplants for an 80 year old.

    Anyone who wants more than basic would have to raise their own funds or buy their own PRIVATE Insurance.

    ALL individuals are required to buy into BASIC services as part of Medicaid, but ALL Medicaid funds would have to managed SEPARATELY from the general budget so the politicians can’t waste them.

    All doctor fees would have to be fair to the doctors, or else we would have no future doctors and then we become like Guateamala and the rest of the 3rd world.

    I doubt that any of these will pass, but only ALL of the solutions simultaneously placed can “FIX” the problem.

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  42. Peter Barland, M.D.

    A single payer plan would save billions of dollars that are now wasted by private insurance companies that have large overheads going to their investors and executives and in avoiding having to insure higher risk patients and denying payment for needed diagnostic studies and treatments. We would also save billions more by being able to negotiate discounts from the pharmaceutical corporations. It would make health care a right and obligation of the government just as public safety, national defense and “overseeing” the financial services industry. A single payer system is not “socialized medicine”. It is still fee for service and free choice of physician just as the Medicare system works today for senior citizens but with added benefits. It works because all Americans, even when they are young and healthy, would contribute based on their income to a maximum amount just like Social Security. Doctors would be freed of most of the onerous paperwork encountered when dealing with the multiple insurance companies. They would be able to practice as individuals or in small groups rather than have to join large groups since there would be no need for large “administrative” staffs and business mangers. We could send our patients to Emergency Rooms without dehumanizing them. We have lost our independence a long time ago so we don’t have that to fear. A single payer system would allow American physicians to practice better medicine, would reduce the cost of health care for American industry, would eliminate the stigma of 47 million uninsured receiving substandard care and thousands of deaths a year in the richest country in the world, with the most expensive and best trained and equipped health care system in the world.

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  43. SAM SCHIFFMAN, R.PH.

    President Abraham Lincoln in his Gettysberg Address ended his speech saying, ‘—- and that government of the people, by the people, for the people shall not perish from the earth.”
    .
    The purpose of the government is to do the things that the individual citizen cannot do for themselves. The government is failing the people and the people are perishing. The cost of healthcare is so expensive, middle-class and low income people struggle to make payments. From everything reported in the media, corporation (pharmaceutical and insurance) lobbyists are running the healthcare system. We need the buying power of the government to eliminate the profit layer of insurance companies and the high cost of drugs. The pharmaceutical companies spend $5 Billion a year on direct to consumer ads! How come the government does not accuse drug companies of over-charging?

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  44. Julie Hohmeister

    We are at a critical turning point in this country. Reform is needed immediately by the new administration. This is unlikely to occur if the Mc/Palin duo are elected.I will consider moving out of the country if they are elected!

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  45. Rich Rappaport PA-C, MMSc.

    It is a simple as this: The American people need to take responsibility for themselves; insurance needs to be available to EVERYBODY; insurance needs to return to what it once was - a shared risk for major medical costs (with around a 10-15% loss ratio) and not a cover-all; we need to get rid of the huge healthcare machine of buerocrats and lobbyists chewing up billions of dollars of healthcare money. The way to achieve these goals is not so simple, but it starts with voting for the better candidate for president. We can not afford another 4 years like the 8 we just endured, and that is what a vote for McCain would be. We need change, and we need it now. Vote Obama for president!

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  46. Rich Rappaport PA-C, MMSc.

    It is a simple as this: The American people need to take responsibility for themselves; insurance needs to be available to EVERYBODY; insurance needs to return to what it once was - a shared risk for major medical costs (with around a 10-15% loss ratio) and not a cover-all; we need to get rid of the huge healthcare machine of buerocrats and lobbyists chewing up billions of dollars of healthcare money. The way to achieve these goals is not so simple, but it starts with voting for the better candidate for president. We can not afford another 4 years like the 8 we just endured, and that is what a vote for McCain would be. We need change, and we need it now.

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  47. Alexander Bunatin, M.D

    1. Agree with those who wrote “Responsibility”
    2. As a former Russian physician (now I’m NY State licensed) I know first hand what is socialised/nationalised medicine: disaster for the patients!! For the physians if they will pay us average income (as a salary) in each our specialty, then it is good!! Imagine: you are getting paid bi-weekly no matter how many patiens you see, what tests you ordered/did, you don’t care what level of visit you’ll bill. You just getting paid for sitting in your chair,chatting with nurse, having tea etc. Terrible? You are not interested in patiens! Unless you are Albert Schweicer. So, this kind of scenario is out of question!!
    3. With a group of US physicians as CME activity I’ve visited London, Spain(Sevillle & Madrid), Italy (Venice & Rome),Austria, Hungury. Everywhere nationalised medicine. We met whith local doctors, hospital administrators etc.
    In short - God bless America!! We have, maybe not perfect, but the BEST health care in the world!! Do you know that thre is an age limit for medical procedures in England? Do you know that in the same England there is no coverage for chronic Dialysis? only acute? Do you recall that people from Canada come to US to get treatment and not opposite? OUT OF QUESTION!!!
    3. Do we need a reform? O yes!!
    a. Malpractice!
    b. If you want to compare and give examples of countries with nationalised HC then take what is positive! in England the loosing party in Malpractice suite pays ALL expenses!! And your lawyer too!
    c. Stop medicaid reimbursement for OTC, diapers, incontince pads, panties, diabetic shoes (with same income and eligibility but not diabetic, would they pay for their shoes?) etc. It is also a huge opportunity for supply company for fraud and abuse.
    c. In ER make a law that triage physician can dischage anyone without treatment, test and advise on basis “non emergency”. It is ridiculous when somebody comes to ER with low back pain lasting one month!! Or comes at 2 am with headache for two weeks?! Pregnant woman with spotting for 10 days?! Why she couldn’t go to her GYN in the day time?
    d. And many others
    4. I don’t believe in 47 mln. uninsured. In 300mln country it means every 6-7th person! Where are they? I don’t know any! Except for another available statistics that 12-13 mln are illegal immigrants (remember - 5 mln of the illegals bought houses using fake SS#) 50% have income over 50K’s so can afford to buy insurance, some are eligible for medicaid but didn’t apply and so on, leaving only 2-3 mln of really uninsured(this calculations available on line - I swear I’ve read it myself). So, for the sake of 1% of population they want to make so dramatic changes?
    5. We must have insurance in order to buy/drive a car. Why not health Ins? You have $1-2,000 more than to be eligible for medicaid? Pay this excess and get Medicaid!
    There are solutions,

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  48. Alexander Bunatin, M.D

    1. Agree with those who wrote “Responsibility”
    2. As a former Russian physician (now I’m NY State licensed) I know first hand what is socialised/nationalised medicine: disaster for the patients!! For the physians if they will pay us average income (as a salary) in each our specialty, then it is good!! Imagine: you are getting paid bi-weekly no matter how many patiens you see, what tests you ordered/did, you don’t care what level of visit you’ll bill. You just getting paid for sitting in your chair,chatting with nurse, having tea etc. Terrible? You are not interested in patiens! Unless you are Albert Schweicer. So, this kind of scenario is out of question!!
    3. With a group of US physicians as CME activity I’ve visited London, Spain(Sevillle & Madrid), Italy (Venice & Rome),Austria, Hungury. Everywhere nationalised medicine. We met whith local doctors, hospital administrators etc.
    In short - God bless America!! We have, maybe not perfect, but the BEST health care in the world!! Do you know that thre is an age limit for medical procedures in England? Do you know that in the same England there is no coverage for chronic Dialysis? only acute? Do you recall that people from Canada come to US to get treatment and not opposite? OUT OF QUESTION!!!
    3. Do we need a reform? O yes!!
    a. Malpractice!
    b. If you want to compare and give examples of countries with nationalised HC then take what is positive! in England the loosing party in Malpractice suite pays ALL expenses!! And your lawyer too!
    c. Stop medicaid reimbursement for OTC, diapers, incontince pads, panties, diabetic shoes (with same income and eligibility but not diabetic, would they pay for their shoes?) etc. It is also a huge opportunity for supply company for fraud and abuse.
    c. In ER make a law that triage physician can dischage anyone without treatment, test and advise on basis “non emergency”. It is ridiculous when somebody comes to ER with low back pain lasting one month!! Or comes at 2 am with headache for twoo weeks?! Pregnant woman with spotting for 10 days?! Why she couldn’t go to her GYN in the day time?
    d. And many others
    4. I don’t believe in 47 mln. uninsured. In 300mln country it means every 6-7th person! Where are they? I don’t know any! Except for another available statistics that 12-13 mln are illegal immigrants (remember - 5 mln of the illegals bought houses using fake SS#) 50% have income over 50K’s so can afford to buy insurance, some are eligible for medicaid but didn’t apply and so on, leaving only 2-3 mln of really uninsured(this calculations available on line - I swear I’ve read it myself). So, for the sake of 1% of population they want to make so dramatic changes?
    5. We must have insurance in order to buy/drive a car. Why not health Ins? You have $1-2,000 more than to be eligible for medicaid? Pay this excess and get Medicaid!
    There are solutions,

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  49. Alexander Bunatin, M.D

    1. Agree with those who wrote “Responsibility”
    2. As a former Russian physician (now I’m NY State licensed) I know first hand what is socialised/nationalised medicine: disaster for the patients!! For the physians if they will pay us average income (as a salary) in each our specialty, then it is good!! Imagine: you are getting paid bi-weekly no matter how many patiens you see, what tests you ordered/did, you don’t care what level of visit you’ll bill. You just getting paid for sitting in your chair,chatting with nurse, having tea etc. Terrible? You are not interested in patiens! Unless you are Albert Schweicer. So, this kind of scenario is out of question!!
    3. With a group of US physicians as CME activity I’ve visited London, Spain(Sevillle & Madrid), Italy (Venice & Rome),Austria, Hungury. Everywhere nationalised medicine. We met whith local doctors, hospital administrators etc.
    In short - God bless America!! We have, maybe not perfect, but the BEST health care in the world!! Do you know that thre is an age limit for medical procedures in England? Do you know that in the same England there is no coverage for chronic Dialysis? only acute? Do you recall that people from Canada come to US to get treatment and not opposite? OUT OF QUESTION!!!
    3. Do we need a reform? O yes!!
    a. Malpractice, malpractice, malpractice!
    b. If you want to compare and give examples of countries with nationalised HC then take what is positive! in England the loosing party in Malpractice suite pays ALL expenses!! And your lawyer too!
    c. Stop medicaid reimbursement for OTC, diapers, incontince pads, panties, diabetic shoes (with same income and eligibility but not diabetic, would they pay for their shoes?) etc. It is also a huge opportunity for supply company for fraud and abuse.
    c. In ER make a law that triage physician can dischage anyone without treatment, test and advise on basis “non emergency”. It is ridiculous when somebody comes to ER with low back pain lasting one month!! Or comes at 2 am with headache for twoo weeks?! Pregnant woman with spotting for 10 days?! Why she couldn’t go to her GYN in the day time?
    d. And many others
    4. I don’t believe in 47 mln. uninsured. In 300mln country it means every 6-7th person! Where are they? I don’t know any! Except for another available statistics that 12-13 mln are illegal immigrants (remember - 5 mln of the illegals bought houses using fake SS#) 50% have income over 50K’s so can afford to buy insurance, some are eligible for medicaid but didn’t apply and so on, leaving only 2-3 mln of really uninsured(this calculations available on line - I swear I’ve read it myself). So, for the sake of 1% of population they want to make so dramatic changes?
    5. We must have insurance in order to buy/drive a car. Why not health Ins? You have $1-2,000 more than to be eligible for medicaid? Pay this excess and get Medicaid!
    There are solutions,

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  50. Alexander Bunatin, M.D

    1. Agree with those who wrote “Responsibility”
    2. As a former Russian physician (now I’m NY State licensed) I know first hand what is socialised/nationalised medicine: disaster for the patients!! For the physians if they will pay us average income (as a salary) in each our specialty, then it is good!! Imagine: you are getting paid bi-weekly no matter how many patiens you see, what tests you ordered/did, you don’t care what level of visit you’ll bill. You just getting paid for sitting in your chair,chatting with nurse, having tea etc. Terrible? You are not interested in patiens! Unless you are Albert Schweicer. So, this kind of scenario is out of question!!
    3. With a group of US physicians as CME activity I’ve visited London, Spain(Sevillle & Madrid), Italy (Venice & Rome),Austria, Hungury. Everywhere nationalised medicine. We met whith local doctors, hospital administrators etc.
    In short - God bless America!! We have, maybe not perfect, but the BEST health care in the world!! Do you know that thre is an age limit for medical procedures in England? Do you know that in the same England there is no coverage for chronic Dialysis? only acute? Do you recall that people from Canada come to US to get treatment and not opposite? OUT OF QUESTION!!!
    3. Do we need a reform? O yes!!
    a. Malpractice, malpractice, malpractice!
    b. If you want to compare and give examples of countries with nationalised HC then take what is positive! in England the loosing party in Malpractice suite pays ALL expenses!! And your lawyer too!
    c. Stop medicaid reimbursement for OTC, diapers, incontince pads, panties, diabetic shoes (with same income and eligibility but not diabetic, would they pay for their shoes?) etc. It is also a huge opportunity for supply company for fraud and abuse.
    c. In ER make a law that triage physician can dischage anyone without treatment, test and advise on basis “non emergency”. It is ridiculous when somebody comes to ER with low back pain lasting one month!! Or comes at 2 am with headache for twoo weeks?! Pregnant woman with spotting for 10 days?! Why she couldn’t go to her GYN in the day time?
    d. And many others
    4. I don’t believe in 47 mln. uninsured. In 300mln country it means every 6-7th person! Where are they? I don’t know any! Except for another available statistics that 12-13 mln are illegal immigrants (remember - 5 mln of the illegals bought houses using fake SS#) 50% have income over 50K’s so can afford to buy insurance, some are eligible for medicaid but didn’t apply and so on, leaving only 2-3 mln of really uninsured(this calculations available on line - I swear I’ve read it myself). So, for the sake of 1% of population they want to make so dramatic changes?
    5. We must have insurance in order to buy/drive a car. Why not health Ins? You have $1-2,000 more than to be eligible for medicaid? Pay this excess and get Medicaid!
    There are solutions, but not!!! socialised medicine! NO WAY!!

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  51. Thomas Brown, DO

    Like many presidential elections, this seems to be one that is the “lesser of 2 evils.” Obama is a great orator, and “cheerleader.” This may be an important function of the president–to help the nation feel good about themselves (i.e., Reagan). But Obama doesn’t have a lot of the right kind of experience.He does seem to have ties to organizations that promote voter fraud (Acorn–his campaign reportedly paid them $800,000 to “register voters.”) There were many examples of abuse of registration by Acorn from several major cities recently. Acorn is being raided and investigated by the FBI presently. This does not sound like the kind of experience I admire in the person to be my president (I know–they “all do it”). McCain is experienced and I respect his judgment. I do not agree with all his policies. He hasn’t always been right, but I do sincerely believe he did what he thought best for his constituents and the country. He does seem to be genuinely concerned. I admire concern, more than devious politics. Many will probably enlighten me about underhanded Republican politics.
    I agree with McCain that raising taxes is not a good approach now.
    Both parties have whittled away at physicians’ reimbusement over the years to help balance the budget. This is disingenuous, but no one is interested in hearing that “doctors are being underpaid.” The general population thinks we are all millionaires. So, of course we can’t complain publicly, and the Medicare/ Medicaid budget is balanced on our backs.
    As many of us are “small business owners” that employ others, we should be concerned that Barack Obama said he would raise taxes if the business makes more than $250,000. Most private practices, even solo practitioners, will be above this threshhold, and we will be doubly taxed (increased income taxes, plus decreased Medicare and Medicaid re-imbursement–a type of tax on doctors).
    Concern about health care for the underserved and indigent–these people are all presently able to receive medical care at any hospital by law–they are, in effect, “insured.” We do presently pay for this care through our taxes, and doctors and hospitals compensate for underpayment by increasing rates for insured or “self-pay” patients. As with Medicare and Medicaid, this is not a particularly efficient system–it is run by bureaucrats.
    On the whole, I support McCain. I am not really sure anymore of what difference it makes WHO the president is–most decisions are made by consensus and legislators. As I said before, perhaps the main duty of the president is to be a great cheerleader–and we shouldn’t underestimate this function.
    Ultimately, the US will adopt a “single payer” plan–but I think this is 20-30 years away. It won’t happen until the people are screaming louder than the lobbyists for pharmaceuticals, medical equipment, doctors, hospitals, etc.

    Thomas W. Brown, DO
    Retired OB/GYN

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  52. Russell Sandberg MD

    I second the thoughtful summary of Dr. Gary Wright of Indianapolis. Following the failure of the Clinton proposals, Dr. Koop shared his observations of how we might cautiously (and humbly) modify our present “system” toward healthcare for all. I detect an echo of this in Obama’proposals. In California, we have failed repeatedly to go straight for the target through single party payor. A more circuitous route may move us to higher ground sooner.

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  53. donna dion

    18 Years ago, when my son became ill with leukemia, both my husband and I had to quit our jobs, go on Welfare, to be able to get Medi-Cal, so my my son could get treatment. Our employers insurance wouldn’t cover his needs, but our minimum wage jobs was considered too-much money to be able to apply for MediCal. A far as I know, if that situation were to arise again, we would have to do the same thing, quit working and go on county/state aid. Pretty sad in my eyes.

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  54. Anita NP

    I see it as 2 simple steps:

    1. get rid of the lawyers (in other words: malpractice reform)

    2. get rid of the middle man (the bean counters)

    Both these things are what’s driving up the cost of health care.

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  55. Robert C. Kiser, DO, MSPH

    Recognizing the benefit of universal health insurance does not require that one attempt to twist one’s mind into believing that “health care” is a “right.” I do not see how health care could be defined as a right. In most cases when we talk of health care we are talking about goods and services. Such goods and services require others to supply or create them. I could see a case for a “right to the pursuit of health,” but not a right to have one’s health care supplied by others. By analogy, while every person has an innate right to free speech, no one has an innate right to have free printing presses, free air time, etc. Similarly, while one has a right to “keep and bear” arms, one cannot have a right to demand others to provide one with weapons. A right cannot, as I see it, compel others serve you or provide for you.
    I do think universal coverage of health insurance is a responsibility, and one that government would be well served in undertaking. My reasoning is this:
    *universal coverage reduces the burden of disease on society.
    *universal coverage helps reduce adverse selection and helps pool risk.
    *While the government can be amazingly inefficient at times, it is worth noting that Medicare’s administrative overhead is about 3%, whereas the private insurance companies spend approximately 20% on administration.
    *That governments can administer such coverage is evidenced by the plethora of industrialized nations that have such programs.
    It is also worth considering that a single payer health insurance system, frightening as it may be for many to contemplate, would allow for just one administrative group to which patients and physicians would have to appeal for coverage, changes, and compensation. Would this not be preferable to the multitude of private plans to which one must now appeal and the multitude of means to avoid payment exercised by private insurers?
    Although there is, of course, potential for corruption and mismanagement, I do see much benefit in having a system in which the chief administrators are known and held responsible for their decisions.

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  56. Jim

    Part of the problem with the cost of health care in this country is the already over utellized health care insurance of those insured by the Government(Medicare and Medicaid) Many of these patients I see abuse their privilage to access health care for example bringing in their children for a runny nose after one day, and why not it’s no cost to them. The other problem is if the clinic is busy they will just go to the closest ED. Then when you as a provider bill the government, they decide what to pay you and we typically recover only about 50% of the cost which drives up the cost for other insured or private payors. If you think health care is expensive now, wait until it’s free for all. There won’t be enough health care providers to see the rush.
    Health care is a privilage not a right provided to us in the constitution. If health care is a right then should’nt food be a right? Which is more important? Lets have the government buy our groceries too.

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  57. Milton

    You want to solve the health care problem? Do these!
    1. Stablish a no-fault system of medical malpractice,
    2. Stablish state controlled medical arbitration boards with physician, consumer, goverment, general industry, and health care representatives as members.
    3. Allow income tax reductions at federal and state levels of up to 15% of free or reduced care for physicians, clinics, hospitals, pharmacies.
    4. All providers of free or reduced care [from standarized pre approved fees at local level] shall issue a 1099 to recipients of such care at the end of the year and counted as unearned income.
    5. Follow the lead of Walmart, Target, Walgreen in providing low cost medications. Does anybody in goverment agencies know how they do it?
    6. Prosecute to the extend of the law fraud and abuse. Tens of billions here!
    7. Mandate [FDA] that all medications sold in the USA are produced with 95% purity of ingredients and quantity.[95% global standarization]
    8. Stablish community based rated programs of general health and catastrophic insurance.
    9. Continue the total deduction of insurance premiums up to catastrophic levels

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  58. Craig M. Wax, D.O.

    Health care is not the problem. Office visits at my office for routine matters are $65 for established patients. Insurance companies are the problem. Insurance cost $1,500 per month whether my family uses it or not. The excess goes to the insurance companies. Their CEO’s make between $300,000 and $5,000,000 per year. The cost of the policies are our of reach. Their copays and deductibles rise every year. Their payments to me as a physician do not keep pace with overhead, inflation and the endless insurance company rules and government regulations.

    AS PHYSICIANS WHO DO THE WORK OF HEALTHCARE, WE CAN END THE INSURANCE NIGHTMARE TOMORROW; JUST STOP ACCEPTING INSURANCE AT OUR OFFICES AND THE PROBLEM ENDS JUST THAT SIMPLY.

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  59. Rachel

    As part of living in the wealthiest nation in the world all Americans should have a right to some form of health care.Obamas plan to help reduce the cost only by very little in the long run as healthcare premiums continue to rise and If Obama’s plan is taken to far, with too many mandates we will end with social medicine which does not work.So, take that plan in moderation please.McCain’s plan to make healthcare a commodity where markets regulate the price is going to exclude a lot of people from health insuarance and in the end healthcare cost are not going to reduce to a level where most people can afford it.As part of the health care reform our goal should be to expand the pool with insuarance not reduce it.

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  60. Larry Rues MD

    The focus on universal ACCESS is NOT “healthcare reform”.
    Healthcare reform will only occur when we control COST. Access is poor because it is a symptom of excess COST. And,since 90% of HC cost is in our utilization (Drs, hosp, SNF, drugs,etc), we must decrease Unnecessary Utilization- (estimated to be 20-30%).
    Unfortunately, one man’s inefficiency is another man’s profit. Patients and Drs have become accomustomed to expecting and doing a lot of expensive tests and procedures (especially when cost is hidden to pts and Drs are paid by volume–which really increaseswhen they own the testing/Rx eqip(which I believe none should).
    Ultimately, we must re-allign Phys incentives toward well-measured outcomesand efficiency and away from VOLUME only.Patients too need “skin in the game”to encourage prudent HC utilization and healthier lifestyle choices (choose healthier-or pay more?).
    Whether single-payor or pluralistic,HC needs to be PRIMARY CARE BASED like virtually all other countries with better HC stats and satisfaction than ours.
    With the proper application of the Patient Centered Medical Home and payment reform (not less–different)we can do these incrementally(LESS PAINFUL) and could save enough for near-universal access (the Lewin group).
    Finally, we need malpractice tort reform so if we follow guidelines, test and treat efficiently and safely, we cannot be sued for a bad outcome.
    “Fixing US Healthcare” will be resisted many AND will take a cultural shift and a LOT of political courage and leadership.

    SEE,NOW WON’T ALL THAT BE EASY!
    Larry A Rues MD

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  61. Durand C. Waters

    I am very suspect of the US Census statistic that 46 million Americans are without health care. Actually, they must mean without an health insurance policy.

    Everyone in the USA, even illegal aliens, can walk into a county clinic or hospital and receive any health care that they need. They only cost is their time, which may be considerable. It may not be quick or the best in the country, but it is better than the majority of other nations on this Earth.

    There are some questions I need answered:

    1. How many individuals and families who have health care available from their employers or professional associations choose not to have it? Are these in this number? I do not believe they should be!

    2. How many children in broken families have court required support not being paid causing no health care? Are these in this number? I do not believe they should be!

    3. How many illegal aliens and their family members (even those illegally born in this country and given citizenship) have no health care? Are these in this number? I do not believe they should be!

    4. How many employed individuals and families with companies that do not provide health care could afford to buy it but decided not and use free health care and buy “wants” instead of this “need”? Are these in this number? I do not believe they should be!

    I am sure there are other questions that need to be answered, but until these and they are answered, this statistic should be considered invalid and not be used for any purpose.

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  62. M. Ellen Teeter, AP

    I believe we need a national medical insurance system where those who are not insured can get affordable coverage. There needs to be a balance of encouraging self-reliance and supporting those in need.

    Oriental Medicine offers a great deal in prevention and low cost treatments. Acupuncture and professionally prescribed herbal medicines need to be the first line of treatment BEFORE surgery or costly drugs.

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  63. elmo cloessner

    Our economy absolutely cannot provide every drug or medical proceedure or device that is presently available in our country to every patient who might benefit. This is an absolute certainty being ignored in the debate over health care. Therefore, some system will be necessary to determine who gets what. This is rationing regardless of the name applied. Presently, rationing is accomplished by ability to pay. Under any other health care system rationing will be accomplished through government regulation, but the supply will never meet the demand. Someone will be left out. It won’t be the politicians!!

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  64. Chris

    Reforms that extend the tax benefits to individuals to choose their own plan consistent with their needs and moral values as McCain has proposed is preferable to a mandated single party payor system. This reflects true freedom of choice and diversity in our pluralistic society and puts physicians/providers back to a one on one relationship based on trust, respect and responsibility to the patient who is paying either out of pocket or via their personal choice of an insurance carrier. Now it is corporations that enjoy major tax benefits for providing an insurance providers instead of individuals being able to choose the plan best for them. Many reforms could be implemented that do not move to socialized medicine where the government controls and will limit care because it controls the pursestrings. These include portability of coverage, true flexibility with yearly carry overs of flex spending accounts, expansion of health savings accounts, elimination of government mandates, respect for faith-based insurance coverage which respects the consciences of patients and providers and justice in fee structures and increased competition and choice among plans. Out of pocket fees charged by providers for individuals without insurance should not be more than group rates. If government controls effectively make health care a single party payor system then medical decisions and care from beginning to end of life issues and everything in between will become legislative battles ultimately connected to special interests and money.

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  65. Angie B.RN BSN MSN

    It is going to be a challenge, to say the least, for anyone who gets into office to try to straighten out this mess of a healthcare system. The current system is not working. People are dying. I work with cardiac and pulmonary patients. Some are referred to as”non-compliant” with their meds. When you take time to discuss this with them the issue is not that they do not want to take their medications-many simply can not afford them. They also can not afford the procedures they need. People,on the whole,want to live. They want to comply with medical treatment. Many are struggling just to eat the low fat, low cholesterol diet they have been told hey need to eat. They simply can not afford the healthier foods. Many are middle class so they can not qualify for food stamps.State health insurance for the poor is only offered to children. They can not get medicaid.I have patients with pulmonary hypertension who need to be on constant iv medication. This medication runs $900 a bag! Some of my patients have died because they could not afford the medication. Bottom Line-people are dying-preventable deaths not by their own choice.Lack of resources are the main cause.We are not a third world country.What are WE going to do about it? It’s going to take We the People to solve this problem.

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  66. Donna

    People are going to have to take some responsibility for themselves. Health to some individuals is not a priority until something they get sick. Prevention is the key to good health which is all too often lacking. Many times, things are unavoidable and out of our control; however, food intake, alcohol intake, smoking, drugs…all have to be considered. Until health care becomes priority to the majority of Americans, health care costs are going to keep increasing. Not only will insured Americans have to continue to pay for our own premiums, we will have to fund the government health care system as well. The funds have to come from somewhere…us. Illness prevention and early detection has to be part of the solution.

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  67. DJ Novak

    The strength of America lies in the strength of its citzens. This is why there is military healthcare. However, the infrastructure of the US is maintained by the remainder, as well as by the military when they are not called away.
    Health is the origin of this strength: the strength to contribute to society, to earn a living,the strength to get things done. Even the elderly have much to contribute to the QUALITY of our society, if we would just be willing to facilitate this. You cannot have capitalism without having desperately poor people to take jobs like being a waiter, ditchdigger, etc. In order to justify our lifestyles, we have a responsiblity to take care of everyone. We should not have human beings suffering for want of food, shelter, or healthcare while we sip lattes and watch HD TV. The reason for the financial crisis is not healthcare-it is simply those old monsters gree and gluttony-how boring.
    Yes, capitalism could not exist without socialism-living off the backs of those who are poor. Many ancient philosophers have pondered this question-and yes, we DO have a responsibilty to our fellow human animals.That is what makes us truly human.

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  68. John Balhuizen MD

    A certain % of the population will always be unemployable.
    I feel a better way to address this problem to introduce
    medical care stamps, on the basis of foodstamps.

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  69. Melissa

    As an American, I think our government has got to stop providing everything for it’s people. Americans need to get out and work for a living and pay for their own insurance. There are too many people who are collecting welfare and wanting health insurance while they are not even trying to work. The middle class is paying for these people who refuse to work. The Government should stay out of it. Prior to the welfare system, people who needed help went to churches/neighbors/friends/family and those people helped them GET JOBS! or if they really could not work would help them or take care of them. We need to keep government out of charity. Leave that to the churches/families/friends/neighbors who can actually assess whether the needy really NEED help or not. This goes for health insurance as well as welfare. Why should I (working single parent ) pay for those who choose not to work? HEALTH CARE IS A RESPONSIBILITY NOT A RIGHT! It is each person’s responsibility to provide for themself.

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  70. Ernest Scheerer DDS

    The down side of the Hawaii system is that over the years the burden of insurance costs has shifted more and more to the emplorer and the employee is paying less and less of the shared costs. This is one reason why Hawaii is always high on the list of undesirable places to do business.

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  71. Ronald D. Weddle, MD

    Healthcare can NEVER legitimately be considered a RIGHT unless healthcare providers are to be made SLAVES. No one has a RIGHT to my time and services any more than they have a right to any other product or service. The attitude that the time and services of others are a right is becoming the downfall of our Constitutional republic as we plummet into socialism as the politicians of both parties (Republicans just slower than Democrats) attempt to buy the votes of the electorate with revenue confiscated from those who produce.

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  72. Dr. Gary Wright

    Healthcare reform is public conscience work. We as healthcare professionals know first-hand the disparities which exist. Because health and wellness provide a foundation for human dignity to flourish, everyone has a right to basic healthcare. As a part of the common good,healthcare must take its limited place amongst other basic goods that promote/protect dignity - education, stable economy, environment, jobs, etc.
    Individuals have a duty to promote and protect their health; society has a duty to provide a sustainable healthcare system.
    We should aspire to a healthcare system which is
    1. Health Promoting and Preventitive
    2. Transparent and Accountable
    3. A genuine system, integrated and accountable
    4. Allocates its resources across a baanced continuum of care- prevention,acute,emergency,end-of-life,mental health, long term,etc.
    5.Dedicates health resources to actual care, minimizing spending on administration
    6.Is evidence based
    7.Is financed according to ability to pay
    8.Keeps inflation at a level which is sustainable
    9.Supports those in the healing profession- nurses,physicians ans aliied-healthcare professionals

    Insurance is the wrong moral frame in which to examine and reform the current system. Covering the uninsured is a patchwork repair. While it is a good moral goal, it is a bad moral frame. It emphasizes and reinforces the notion that healthcare is a commodity and not a fundamental human right.

    Dr. Gary R. Wright
    Physician Ethicist
    St. Vincent Health
    Dept. of Anesthesiology
    St. Vincent Hospital
    Indianapolis, Indiana

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  73. Jack Czarlinski M.D.

    I think just as we have a safety net for hunger-food stamps-so we need to have same effective safety net for illness -health insurance.Whether it’s Medicare for all or other all comers must be accepted private insurance remains to be seen.

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  74. Carlos

    All world citizens have the right of healthcare. It is a basic right. Please look at the good examples of european countries. It is possible, just believe it! And you will discover a new way of living…

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  75. Christine Mende RN, Nurse Educator

    I find it truly emblematic of the conservative stance that healthcare would be called a “responsibility” by John McCain.
    There is no doubt that caring for oneself, planning for healthcare, attempting not to burden others with one’s personal needs are fine goals. However, there are far too many whose primary goal has become simply to survive the day, the week, the month without losing shelter and daily sustenance.
    A just, democratic, compassionate, and intelligent (to take in enlightened self defense against spread of disease) society must care for its unfortunates. Health care in all its shapes and forms, from adequate emergency care to preventive, maintenance, and restorative programs to address illnesses caused by stress, aging, and poor nutrition, must be a societal responsibility. The measure of a society has always been how it cares for its unfortunate, underserved populations.

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  76. Mike Warner

    45 million uninsured is pure propaganda. 20 Million are illegals which would/should NOT qualify for government assistance. 10 million are healthy young people age 18-30 who make economic risk benefit decisions and choose not to carry insurance. My own son was one of them. 5 million make over $75K annual salaries and elect not to purchase insurance.
    Changing the law making Health ins. like car ins., purchased as individuals with a tax credit as incentive would solve 40% of the solvable problem. Addition of immigration reform would solve the other 50%. the last 10% is a problem, socialism or capitalism?

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  77. Leon Gary

    We as parents have an obligation to make healthy living a mantra for our children. In this country we have traditionally seen healthcare as something to seek when we get sick, for the most part. Painting a stay healthy/stay happy face on doctors and all other healthcare providers in our children’s minds when they are young is a must, if we are to be successful with the effort to provide health insurance for all U. S. citizens. Insuring the healthy Americans will never get an argument from the insurers of the U.S.
    botmlinetalk@yahoo.com

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  78. Ajith Purush, MD

    Health care should be an individual privilege and a societal responsibility. We all know what needs to be done to fix the health care system while undue profits, greed and abuse of the system have been allowed to exist and even considered okay. Unless there is a national commitment in establishing the problems and their fixes we will continue to muddle while lives will be lost, families will go bankrupt and the nation will suffer. Now if this was the only problem that we face today perhaps we may be able to fix it but then shouldn’t we all at least give it an HONEST effort as a nation and stop bickering about party politics.

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  79. Kim

    I don’t believe either candidate will make any significant impact in our healthcare system. Like our goverment it has become so ponderous and riddled with problems that no one man would be able to address it. As with all things the answer needs to start with a little common sense. An attribute missing from both parties at the moment.

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  80. ES, MD

    I agree to have all underserved and uninsured people to have some sort of state or federal founded insurance so children and old people, or the ones lost the jobs will not be feared and worried not having money to pay for physician service or hospital care, which physicians and hospitals will needs to participate the government insurance plan as obligations. On the other hand, Socialized medicine is scary and dangerous, rather income based program is more realistic and practical. Having basic level of health coverage in this country is a priviledge of US residents.

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  81. Tim E

    Health insurance is NOT a right, it is a service. There are already systems in place for those who cannot afford health care. They may be imperfect, but where I work, nobody is denied care. People already go to the ER on a regular basis, either for free care (that is often not urgent) or even to simply avoid their copay. There is at least as much abuse and misuse of our current system as there is need for better insurance. We have access to the best healthcare in the world, and I’d like for anyone to try and compare what we have to those in a country with government-run health systems. For those who claim that their coverage is “free,” it is never free. If the government provides more services as “rights,” we pay for it one way or the other. What are the tax rates in countries with socialized medicine? Either taxes would be drastically raised (which neither candidate seems to worry too much about, as economists predict both would drastically increase the deficit, Obama somewhat worse than McCain), or the US government goes even further into debt, which also weakens our economy and our dollar. It’s time for people to stop feeling entitled to everything and expecting some federal “allowance,” and take some personal responsibility again.

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  82. David, OD

    In the wealthiest and most powerful country in the world, do we really want to compare health care to car maintenance? It’s easy to say health care is a priviledge, or go get a job. But the reality is, 45 million people are still uninsured. There are also millions, WITH jobs, who are underinsured. Both of those groups’ numbers will only go up. It’s absolutely offensive we can spend $10 billion a month in Iraq while our own citizens can not cover their drug costs, etc. Living in Arizona, I see thousands of patients crossing the border to buy medicine, get glasses or have teeth worked on. Most of those are retirees…people who DID work their entire lives. Furthermore, many of us, even the insured and gainfully employed, are potentially one catastrophic disease or event away from bankruptcy due to the massive health care bills that could come with it. “Socialism”? “Communism”? Stop letting politicians and lobbyists scare you with their words. Stop playing into the extreme partisianship that has paralyzed this country. We need to all move back closer to center and work together. This is the greatest country in the world. We put a man on the moon. A MAN ON THE MOON! We can’t solve health care??

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  83. David Ewing, M.D.

    I am amazed at the number of people who believe that socialized medicine “improves” access to healthcare. Socialized medicine works by restricting access to healthcare. Statistics showing “better” healthcare in the socialized countries are drawn from restricted subsets of data and are not “across the board” improvements. Healthcare in this country does not require a shift in payor or how we obtain healthcare, it requires a change in mindset of the overall population. Until we can stop the Rolls Royce care for free mentality, we are doomed. Very expensive critical care for the obviously dying is just a starting point. Yes, we should improve preventative care, but if a patient chooses not to participate, they should deal with the consequences of their choice. We need to get unneccesary profit points out of medicine. For generations, hospitals and insurance were not for profit, and we had better health care. Now, we are paying dividends to the stockholders in the form of higher prices. We have so many problems that we need to address that no political candidate would ever consider touching that I doubt anything will be tenable. But if you truly believe socialized healthcare is the answer, I invite you to be part of it in Britain or Canada. Its why they have another personal pay system. Those that can afford it get their care elsewhere.

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  84. Carrie RNC MSN FNP-BC

    Many challenges need to be addressed in order to START to reform healthcare. Obama will be a better choice here in that he is more thoughtful about the problem, clever enough to grasp and contemplate the many variables contributing to the problem, and wise enough to know who to ask to help him construct healthcare reform.

    Personally, socialized medicine would be my choice. Canada, Great Britain,and France may not implement it PERFECT, but I surely do not believe the US can’t improve on a good thing.

    Having said that, there has to be a HUGE shift in the way americans think about themselves and their personal responsibility and contribution to the health and welfare of themselves, their families, their communities, their country, and yes, even their world. “To whom much is given, much is expected”. Americans need to stop behaving recklessly (with regards to their health for the purpose of this discussion, but I could assemble a list of many other careless and unmindful behaviors) and then expecting others to fix their problem. Yes there will be guidance and help, but individuals need to bare most of the responsibility!

    And that’s where the healthcare practitioners come in. It has to be shouted from the hill tops-OVER 90% OF ALL DISEASE AND ILLNESS IS PREVENTIBLE!!!!!!!!!!!!!!! Preventitive medicine. That’s a big part of the solution.

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  85. Kathy NP

    I practice in a Community Health Clinic. I am happy when a patient has medicaid and has some coverage for prescriptions. I have seen patients come in to our office after scraping together the $20 office visit min., that they are required to make in order to be seen, only to be given prescriptions that they can not afford and as a provider I am at wits end trying to come up with a solution. I see a lot of pediatrics and one of the things that I like to order is Nasal Saline for sinusitis, but it is not on the list and a lot of my patients do not have the $3.00 that it costs. I believe a one payer system would help costs and accessibility for all. I believe that providers would also have to be responsible for what they order. Maybe even a case management system would be appropriate for monitoring. But sometimes that gets out of hand also.

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  86. Eldon

    No comment

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  87. justine McCarthy-Lenz

    As we watch other countries who have implemented single payor health plans reap the benefits of 1)improving quality of health care (outstripping the US in every major measure), 2)cover ALL citizens, and 3)spend less per capita, it behooves us to take an honest look at how these countries achieve it, AND at our own reticence about it. The major arguments against it are that it’s too expensive (why are other countries able to do more for less?), and that the American people want ‘freedom of choice’ (Managed care has essentially limited that, and for those without insurance, they have 0 choice). Those making these arguments the loudest are NOT the American people, but Insurance company and BigPharma lobbies: those with a vested interest in maintaining the status quo of profiting from seling insurance and brand name drugs, not improving the quality of health care for the people.

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  88. Leslie

    As a Nurse, the thought of healthcare for all sounds great, but as a prior member of the business community I can tell you that it is not only a pipe dream but it would destroy what is left of our economic system. True government wide healthcare would encompass all and perhaps alleviate some problems, but what happens when the healthcare system starts to bankrupt the country? What will happen is the same thing that happens in business you start to make cuts. For those that don’t believe this will happen just look at the current government healthcare system i.e. the VA. Though the doctors and nurses give good care they are rationed. Think of all the veterans that you have heard about fighting for their benefits. The only problem is that you cannot force the government into litigation like you can a insurance company. For anyone who dose not think this is correct just read a few nursing journal articles from the British Nursing Journals about how healthcare managers are in place to prevent the people from accessing healthcare to include lifesaving procedures. What is the answer to the healthcare problem? First of all we have to remember the laws of supply and demand. Second we have to remember that hospitals are businesses and not charities, hospitals are businesses that provide a service the service being an improvement in a health related problem. The only real way to fix the problem is to start at the top and this is not referring to the hospital administration. This is referring to the government. Until the government cut out all the wasteful spending to include subsidies to farmers, tax breaks for all the weird groups and all the strange rebates it gives to large corporation the problem of healthcare will never be solved. In a free society no one should ever be rewarded for non contribution. I keep hearing about increasing taxes on business, corporations and Wall Street to the sound of cheering crowds and I realize that those cheering people have no comprehension or understanding of the government or business. When I was still in business one of the companies divisions was closed and many people lost their jobs because the division wasn’t making enough money. Why because of the taxes over 50% of the companies profit was going to the government in the form of taxes and licensing. Some might say that the company was still left with 50% but the profit made was not worth the exposure risk. Meaning the profit made was not worth the risk of one bad accident or event that might leave the company exposed to litigation. In similar fashion if government organizes a nationalized health system at the point where risk is greater than profit hospital will close, medical people will be out of jobs and supply of work for will increase, then wages will go down, quality of care on the pharmaceutical and technology will go down and the overall healthcare of the American people will suffer. Bottom line anyone telling you they will put in place a nationalized healthcare is either lying to you or does not understand the problem but either way the are dangerous.

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  89. Ted Kunstling

    Our current health care financing is designed to maximize profit for those who control the premium dollar and for the various interests such as pharmaceutical companies, and imaging services. It provides poor value to the American people - we lag behind 30 developed and less developed nations.

    It is neither here nor there wheither health care is a right or a responsibility, but it is in America’s interest to promote a healthy population just as we promote an educated population.

    We should put aside ideology, look at reality, and try to learn from other nations who seem to have figured out a better way to serve all their population and still allow individuals personal choice.

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  90. hhobbs

    If the “free market” could have provided health care for all Americans, it would have by now. Unfortunately, government is going to have to fix this one.

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  91. Susan, RN, BSN

    Health care is a right AND responsibility for everyone. Healthcare is a MESS in the US today. Some of the responsibility for this is the government and some is the fault of the medical community and some is the fault of the insurance companies. In our fee for service system, everyone wanted to make money. The doctors charged too much until it became necessary to cap that system. The government mismanaged Medicare and Medicaid. Everyone wants the latest and greatest treatments, medications etc. But someone has to pay for all the research that goes into that. Yes drug companies charge hugh amounts for their medications but they too want to make a buck and research and development is expensive.
    Socialized medicine should become a reality in the US. This can be accomplished with multi-payers much like state insurance plans can be utilized. Look at the World Health Organizations (WHO) website. The US is the ONLY industrialized country in the world that does not have a form of socialized medicine. One would believe that the US would have better outcomes because healthcare is superior to other countries…..right?
    According to WHO, the US doesn’t even rank in the top 50%. Countries like France and yes Canada have better outcomes… such as lower infant mortality rates, less heart disease, longer living citizens, etc… the list goes on.
    Health care is a right and responsibility.

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  92. Jon Sullivan

    i am an allied health professional who left corporate rehab years ago because the system as it stands is about profit not health. it is a meatgrinder spitting out those who can’t afford treatment, and spitting out profits to huge drug companies selling poison to my patients. Single payor is the only way out. if we can find $700 billion for financial markets (free? markets?) we should be able to spend far less than the current $2 trillion on a new system that works for everyone. Make drug companies pay for the damages they inflict upon our old people and maybe they won’t rush the drugs into the veins of the poor and old.

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  93. Denise Yoder, FNP

    I think most would agree our health care system is broken, and the question about how to repair it is HUGE. Both candidates plans have substantial flaws. Senator McCain’s plan sounds good, especially for those of us who have been paying for our own insurance, separate from an employer, for many years. However, what happens to those who rely on their employer’s insurance. That appears to be where the tax break would be paid for and would put them at risk. Socialized medicine is scary, it does provide health care to everyone, but has large flaws as well. Just ask a Physician friend who works in an ER in London, and states that a patient with a stroke will probably obtain the CT scan while in rehab. Or another friend in Canada, who needed Rotator Cuff surgery, but since it was not deemed an emergency was put off so long she finally decided to go to South Africa, where we have other Physician friends, to have the surgery done. I would like to think there is a way to learn from those flaws, and rather than duplicate a problematic system, take the good and create a better plan.

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  94. Claudio Melloni,Md,PhD

    The USA need a coverage for everybody guaranteed by the state(s) or the federal government and covered by the taxes as it is in most of Europe.Private practice will remain,and flourish,but offered as an extra for people who can and will pay .The system of UK is running smoothly and everybody is happy,patients and doctors who can(are permitted) continue offering their private services out of the hours of duty and remaining in the same institution.It is a time for change and not only in the field of healthcare.

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  95. John F Calabrese, MD, PhD

    Obama’s form of Socialism is not what medicine or this country needs. Especially now, we need less punative government intrusion into private sector medicine and more persoal responsibility. Politicians like Barney Frank need to get out of the business of social programing and stop using tax money and government regulation (Frannie Mae and Freddie Mac)for the creation of trillion dollar welfare programs, that we all are now bailing out. Do these politicians have any more great ideas they can now propose for healthcare? I hope not.

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  96. John C Parker

    Want to share some points:
    + Studies by the Am. Academy of Actuaries show the idea of grouping people together to save money has not proven to be economical or effective.
    + The idea of an individual mandate to buy medical insurance has not worked. Here in Conn there is a mandate to buy auto insurance - we have 12% or more who do not have this coverage yet are driving.
    + Discussions about administrative ways to tackle medical insurance costs do not deal with the fact - 70% of medical treatment expenses are connected to lifestyle choices. [Provided by a medical ins. co. here in Conn.]
    + Many reports on the idea of changing to a refundable tax credit are not correct. For example if a family has a $1,200 a month medical plan and is in say a 30% tax bracket their income tax would be $4,320. They would however receive $5,000 thus no cost to them. BTW - refundable means a person who has 0 tax liability would still receive their $2,500 or $5,000 credit. It also is month by month - not something done at income tax time.

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  97. JACK PADGETT-PHARMACIST

    OVER THE YEARS I HAVE SEEN THE INDIGENT AND POOR GET MORE BENEFITS THAN THOSE THAT ARE WORKING 6 DAYS A WEEK. I AM NOT GETTING INTO THE ARGUMENT THAT THE PEOPLE I REFER TO ARE NOT IN NEED OF MEDICAID BUT ARE THEY MORE DESERVING THAN THE TAXPAYER WHO IS SUPPORTING THEM BUT NOT RECEIVING THE SAME BENEFIT? I WOULD SUGGEST THAT IF WE ARE GOING TO HAVE GOVERNMENT INVOLVEMENT IN THE HEALTH CARE SYSTEM THEN EVERY CITIZEN WOULD START WITH A MINIMUM BENEFIT. IF A PERSON WANTS OR NEEDS BETTER PROCTECTION THEN THEY CAN SEEK IT OUT IN THE FREE MARKET. IT IS JUST WRONG TO MAKE A WORKER PAY TAXES TO SUPPORT FREE HEALTH CARE TO OTHERS WHEN THEY CANNOT AFFORD THE BENEFIT THEMSELVES.

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  98. Joe Haynes, R.Ph.

    It amazes me that we have gotten to the point where the access to healthcare has become a “right” enshrined somewhere in some founding document that until recently we have never seen. Access to healtcare is not a right any more than access to car repairs, clothes, food, housing are rights.
    Healthcare is a system of products and services provided by skilled/licensed practictioners. Those products and services cost money and time.
    All a single payor system will create is a masking of the true cost of those services to the end user so that all thought of economizing or prudently engaging healthcare services no longer exists. If I perceive that I have to pay little or nothing out of pocket, what incentive do I have to not darken the door of any given ER for every little physical triviality? You think hospital ERs are busy now- wait until 45 million more people have their access paid for by the rest of us.
    Health insurance itself is also abused. We have insurance for cars and our houses and our businesses but that insurance is only meant to cover catastrophic incidences. We don’t use our car insurance to pay for gas or routine maintenance. That comes out of pocket. Health insurance is used to pay office visits (gas), maintenance (drugs), as well as the catastrophic occurrences.
    People need to economize by paying for their own routine maintenance. Stop requiring health insurance to cover every possible forseeable thing. If you want fertility treatments or psychiatric help or chiropractic then pay for it yourself and stop running up my premiums by covering things that I will never use.
    Health insurance pricing and coverage options need to be competitve by allowing people to purchase their insurance from any willing provider from any location. Insurance is regulated state by state which means I cannot live in Florida and purchase insurance from Georgia. This is ludicrous. I can go to Georgia and buy a car and then register and drive it in Florida. What is the difference? As long as Georgia ensures the insurance I am buying meets its standards what compelling interest does Florida have in that purchase?
    Healthcare providers, like any other provider of any other product or service, have the right to set prices that the market is willing to pay. We have all but stripped market forces from healthcare provision through Medicaid, Medicare, managed care, HMO’s, etc. Once people are forced to pay for services out of pocket, prices will come down as they seek out cheaper alternatives.

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  99. Asrar Nasir

    It makes me mad that the politician like John Mccain has the health insurance on American tax payers expense. While rest of the 45 Million dont have any.
    Its time to change Washington………………!

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  100. MaryAnne

    I have been a nurse since 1982 and have worked in the health care industry the entire time. My feelings on the healthcare crisis is to stop the waste. We waste more health care dollars than you can imagine. This is what we need to get a handle on. We need to watch the medicaid and medicare waste, and abuse by both the people on these plans, and the health care industry itself. We need a tighter rein on who recieves medicaid and get these people back to work. There should at least be a copay so that people who have medicaid will think twice before running to the ER. Just for one example in my many years, is that I once had to throw away a medication that cost $3000 because it was left out of the refridgerator overnight. Let’s stop wasting health care dollars and use it wisely.

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  101. AJ

    Most americans assume that health insurance for all translates in to access to care. That is simply not true as medicare, medicaid (and tricare prime) recipients will tell you. “Medicare for all” will mean that we all have insurance with low reimbursement rates. As it stands now, most providers limit the number of patients they see with this insurance, or refuse the insurance altogether. Will we have to legislate that all providers must see all patients regardless of insurance. Can we deny providers the right to only see patients on a cash pay basis?

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  102. justine McCarthy-Lenz

    As countries with single payor health plans continue to surpass the US by ever increasing margins with regard to health care statistics, It behooves us to drop our ‘Socialism’ and ‘The American People don’t want it’ defense, and take an honest look at how they’re achieving this. We are a nation of brave people with alot of ingenuity. We will need all of that bravery to confront the major obstacles to making the transformation: Insurance company and Big Pharma lobbies. They are keeping the debate so far away from Single payor solution that the majority of people in the US still believe that it’s not a reasonable solution to the health care crisis, when EVERY neutral, informed source understands that it is.
    Let’s ask some other countries who have succeeded in this and get moving!

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  103. James Lohrberg O.D.

    Senator McCain’s response to the question of right vs. responsibility was tepid. If he truly believes the solution to our healthcare problem lies in privately purchased insurance, he’s going to be surprised. Given any extra cash most Americans and definitely the uninsured are not going to buy health insurance. Especially when our Government is handing out stimulus checks and encouraging people to buy more consumer goods.

    One of the biggest costs to our health care system is the carte blanche check we have for end of life interventions and the extensive support we provide for maintaining the physical, long after a person wants or cares. One of the ways we could encourage realistic approaches to that last 6O days of life would be to send a report to people like their Social security report showing them the taxes and premiums they’ve paid in and the benefits they’ve recieved. Somehow we’ve got to rely on the good will of people to choose not to take more intervention when the cost is so overwhelming. I think a lot of people, in spite of their families will choose to forgo so much intervention on their own in light of the fact that their account balance is way overdrawn.

    Co-pays and deductibles are still not nearly high enough to get people to stop saying “is it covered” and start saying “can I afford it?”

    We have to decide on some basic level of catastrophic coverage to help people avoid bancruptcy and cover the uninsured, universally. This, however, needs to be considered a privilige of US citizenship, not a human right.

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  104. John Hendricks MD

    I believe McCain’s plan is more likely to work in our free market system. You can not have part socialized medicine and not address the malpractice issues as well as have expenses doctors have to pay every day. In other words you can not dictate federal pricing ie Medicare for everyone and not relieve the burden from doctors. Obama plan is socialized medicine without complete reform

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  105. Rich Rappaport PA-C, MMSc.

    The healthcare system is broken, and it has been getting steadily worse. The past 8 years have contributed to this decline more than the previous 50 years. As far as choosing the next president goes, it is as simple as this: Do we want another 4 years following the same course we have been on, or do we want to try to START to fix the problems which have been created. We need to curtail the greed of the large corporate healthcare machine, and we need to re-educate people about what is reasonable healthcare. Insurance companies need to be brought back to what they were initially intended to be; risk-sharers (instead of huge financial corporations trying to make as big of a profit as possible). The public needs to understand that insurance was never intended to pay for every minor office visit, it was intended to INSURE that if expensive medical tests, procedures, hospitalization, or surgery were required, that the patient would not be forced into debt. Unfortunately, as a whole, Americans are spoiled and greedy, and not able to stomach the realities that are facing us!

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  106. Jonathan Kirsch

    Obama’s plan isn’t perfect in that it doesn’t provide coverage for all and doesn’t eliminate insurance company corruption and waste. However, McCain’s plan clearly shows that he is out of touch with reality on this issue. Providing less than 1/2 of the cost of insurance by a taxed tax break is ludicrous. However, this is only one small part of his plan, which he claims to be cost neutral. He pays for this by gutting Medicare and Medicaid, which would lead to the rapid demise of our hospitals, especially those that serve the elderly and the underinsured. This is an extremely reckless and dangerous plan and needs to be exposed for what it truly proposes.

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  107. Rich

    Read the book “Overtreated” by Shannon Brownlee. Brilliant book about the economics of medicine- it discusses how we got into his mess and how to fix it.

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  108. Veronica Hasbrouck CRNA

    I agree that every american CITIZEN should get the healthcare they need, but I do not agree that we give every person living in this country the same options. I have seen hard working people denied care because they do not have health insurance, but people living here illegally get everything provided!

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  109. Chris RPh

    If Senator Obama thinks a National Health Care plan similar to the Federal Retirees plan is such a good idea, I suggest that he and his Democratic colleagues let Walmart be the sole provider of this socialistic system. Maybe they can sign up for a liability suit for Mesothielioma, Rezulin, or Quinine while enjoying a 2 to 3 hr. wait for their presciptions to be filled. You may want to keep an eye on your auto parked outside, for some illegal may be trying to steal your wife’s handbag which she left in site on the front seat! Oh, I should not be so harsh to judge, for they are also covered under the new Govt. Health Plan.

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  110. Marla CNM

    The ONLY solution which can work in our dysfunctional and overpriced health-care system is single payer health care. It is a right for everyone to have access to health care equally, regardless of their current employer or financial status. Single payer as presented in HR676 the Conyer Bill costs less, saves money and gives choice of providers for care. It is good for labor and for business.

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  111. Ross Fichthorn, MS.PA-C

    The health care system is broken. We are not talking about offering the “best” healthcare to everyone….simply basic health services to qualified, legal citizens. I believe tax breaks or refunds as McCain advocates will not acheive anything or control healthcare in any way. Healthcare is not a commodity. It should be a public good as basic education, water, sewer and electric. It must be regulated and deregulation and free market forces do not work. I am truly tired of the scare tactics of words such as socialism and communism injected into a discussion about health care in America. They are distracting scare tactics to acheiving our own system. So lets stay on the same page and refute the “Karl Rove” playbook of politics. Thank you.

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  112. TE

    Health insurance is NOT a right, it is a service. There are already systems in place for those who cannot afford health care. They may be imperfect, but where I work, nobody is denied care. People already go to the ER on a regular basis, either for free care (that is often not urgent) or even to simply avoid their copay. There is every bit as much abuse and misuse of our current system as there is need for better insurance. We have access to the best healthcare in the world, and I’d like for anyone to try and compare what we have to those in a country with government-run health systems. For those who claim that their coverage is “free,” it is never free. If the government provides more services as “rights,” we pay for it one way or the other. What are the tax rates in countries with socialized medicine? Either taxes would be drastically raised (which neither candidate seems to worry too much about, as economists predict both would drastically increase the deficit, Obama somewhat worse than McCain), or the US government goes even further into debt, which also weakens our economy and our dollar. It’s time for people to stop feeling entitled to everything and expecting some federal “allowance,” and take some personal responsibility again.

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  113. Kathy Maddocks

    I believe everyone in our country deserves no matter what their income or status in life to have the best health care available to them. My family is fortunate that we at least have coverage through my husbands employment but we have a 1500 dollar deductible per person plus a 10% copay after and have to pay copays for our medicines. It’s a good plan if your healthy and don’t have any accidents in a year if you do you pay a lot out of pocket. We have one income while I am in nursing school and it is very difficult to make ends meet and then having large health care expenses on top of that makes it worse. I am still fortunate that we have coverage and can see good doctors but I believe everyone should have the same opportunity. I don’t believe we have to go to socialized medicine but everyone deserves access to health care. The middle class are who most often cannot afford health care. The poor are taken care of with medicaid and the rich are rich and can afford it. The middle class working family needs help and we need to elect a president who understands and will fight for us, not give tax breaks to the rich and then tax the health care that we receive.

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  114. Ginny NP

    Healthcare should be a right in this country but is also a responsiblity. People should be rewarded for their efforts to care for themselves and not for poor health eroded by years of poor health practices. McCain’s plan which throws short term $5K money at folks who are uninsured will not solve the problem when insurance can easily cost $12 K per year for an individual or family. One health care crisis can bankrupt a famkily’s life savings. This is unfair and inequitable. Native Americans and blacks die at higher rates and younger ages in this country and that is deporable for such a rich country. We need an effective bipartisan plan. Obama is on the right track. Health care providers should become informed and be at the head of the solution table.

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  115. Marla

    I am a Canadian Citizen, living in the United States, and paying $750 a month for health insurance, for something that is FREE back home. My entire family still lives in Canada, and NOT ONE OF THEM has EVER had any problems with the Canadian System. I am tired of the media portraying a BROKEN Canadian system, which is a complete fabrication. The media seems to flaunt and enjoy showing the rare cases of ‘waiting lists’, to scare Americans into believing that the system is “awful”. On the contrary, the system works. Is it perfect? No, but EVERYONE is insured, no one loses their life savings, no one loses their home due to inability to pay for their medical bills, no one has to live with the stress associated with debt, and EVERYONE can see whoever they want, whenever they want, without any fear of receiving future bills that they cannot afford to pay.
    I would take the Canadian system ANYDAY over having to pay $750 for my personal insurance (I am disabled and Medicare will not cover my necessary medications), $610 for my husband (who is a business owner and has to buy his own insurance) and $610 for my mother (who has advanced Alzheimer’s and is living here and sucking up her life savings in her last years just to be close to her daughter)= $1970 a month. Is that acceptable to Americans??????
    Health insurance should be a basic human RIGHT.

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  116. Brian Bladykas M.D.

    Richard, with all due respect, I see the word “Socialist’ and ‘Communist’ thrown around all too casually. I agree with the previous posters who are asking for a BIPARTISAN effort to try and get a handle on this problem; in short, the economic model we have now is unsustainable.
    While some posters believe the ‘Free Market’ can solve most things, the “free Market’…isnt. As one politician said, the ‘Free Market’ works fine when you are dealing with honest people..and therein lies the problem, hence the Ken Lay’s and Ivan Boesky’s of the world. With regards to the elections..get over it..Obama is basically in. As for those who call the British/Canadian model “awful”, well, I’d like to hear why we compare so poorly in health outcomes if thats the case…

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  117. Dan Stockhammer, MD

    As Somebody who worked under full socialized medicine in a communist country,I can unequivocally state that it simply does not work. Sen. McCain’s plan sounds good. However, it does not address the problem of the uninsurable patients with preexisting conditions and portability.
    Also, any plan should include some co-pay as, at least some, insurance against misuse of the system.
    If you are angry about the rules put out by the insurance companies now, wait for the socialization (read: government) to tell you what to do (and how). Don’t we already have guidances (read: cookbook) medicine now?

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  118. santosh khare

    how will we pay for 45 millon new suscribers
    including 45 million uninsured to get in line for care will effect the system adversely

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  119. Nan

    The government track record in administration of public programs is horrendous: social security, medicare, medicaid, welfare in general. McCain’s proposal makes sense in that EVERYONE will receive a $5K tax credit - not a deduction, rather a credit towards the tax owed. If you owe no tax, you would receive a $5K check. If you have insurance through your employer and are happy with it, you will still be ahead since taxing your insurance benefit (for an insurance benefit worth $10K/year, your withheld tax would increase approx $3K)will be likely less than the $5K you receive towards coverage. If you do not receive insurance through your employer, you will have $5K to help you purchase it.
    I would hope for a caveat in the plan, requiring confirmation of a base amount of insurance to be eligible to receive the $5K in subsequent years. The next step would be to require INSURERS to make a good baseline coverage available for $5K.

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  120. Chris

    I think everyone should be required to get a base plan for medical coverage. I also think that people who show that they live a healthy life (do not drink, smoke and exercise regularly) should be rewarded with lower premiums or some kind of rebate for their efforts (like when you purchase life insurance). I am a nurse and see many people who do not have insurance come into hospitals and expect MORE than people who are insured. Along this line I also do not like to hear that people who are collecting public aide (Welfare) do not have to do anything as a condition of getting this. They “work the system” and are not productive. I think this is a multi-pointed issue and there will not be a quick fix but to continue to do NOTHING is also not an answer.

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  121. Erik Bamberg, PhD student

    There is a reason why this country ranks 37 overall (far behind Britain, Canada, Norway, Australia, Frane, Italy, Denmark, Luxembourg, Cuba….just pick a “socialist” country) in healthcare quality, availability, price, and number of preventable deaths per year. Here the money paid goes to insurance, and then healthcare is denied to those who need it most!

    Despite the mass of wealth that is accumulated in this country it all is filtered through a tiny funnel of the rich elite. We need to say no more to capitalist ideas of competition and deregulation when it comes to social services. Should we all pay for education? Should educators have a financial stranglehold on those who learn and those who do not? It is ridiculous that people have bought into the idea of denying people healthcare, yet still paying for it!

    This problem must be taken in either baby steps or a huge overhaul, but either way the American public needs a paradigm shift in the way they view economics, as well as being educated on who is better off. It is for damn sure not us. Europeans outrank us in education, health care, crime and poverty rates, distribution of wealth, and pretty much quality of life. Stop buying ideas the corporate elite is shoving down your throat and lobbying congress to death with. Remove your American pride of “best” and “most free” and learn to progress for the good of the nation.

    The fact that a child can die because of coverage denial (insured or not) is absolutely appalling, and those responsible, the insurers, the physicians, and the legislatures, should all be prosecuted for crimes against humanity. It is insane. The greed of few cause the deaths of many. It is time to wake up! WAKE UP!

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  122. john

    Mccain is correct when he want a bipartisan commission to evaluate and propos changes. He realizes that the approach now is subject to influence by special interests. We need to put the more responsibility on the individual for their healthcare spending. Now, we receive prescriprion drugs, and never really know the true costs because some third party is paying the tab. We need medical savings accounts that can acrue year over year.

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  123. JOHN BRADY

    I support a national sales tax to fund health care. Every person in the country would be given a voucher by the federal government that could only be used for purchase of health insurance. Every health insurance company would be required to provide a base policy that all citizens and providers have input in formulating, not just the liberal establishment. Physicians are not going to buy into this system if they are low-balled like they have been with Medicare and Medicaid. The government is efficient with tax collection, but lousy running programs, so private insurance carriers should run the program.

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  124. CIM

    What I hear a lot are rants about CEOs of managed health. But CEOs in general enjoy a much higher standard of living in the US than they do in other countries. Look at all these financial companies the government is bailing out and what their severance packages are for the CEOs who got them into the mess - in the millions and billions. NO human being is worth that much money, I don’t care who they are. Those CEOs should get what the rest of us get if we lose our jobs: our vacation and a command to hand in the keys. Not millions.
    Why does this idiosy persist? Because our government exempts taxes on the salaries and ‘perks’ given to CEOs. Stop that tax break - make it more reasonable like they do in Japan - and shift it so that the tax break goes to 2 things: one, more tax breaks, not fewer, for companies that give healthcare policies to employees. Two, form a co-op for small business owners so they can offer their employees the insurance at a discount, and include small farmers. I doubt most rural people don’t want healthcare; they just can’t afford a policy on what the average farmer makes if they’re not part of a conglomerate.
    In the 80s, the National Health in the UK took a third of people’s income in taxes; I hear now it’s closer to half (I lived there back then). Not only do they ration healthcare and have long waiting lists for elective procedures (5 - 10 yr. for joint replacements back then and from what I hear, worse now), didn’t you read about that female “ethicist” over there who said Alzheimer’s patients have a “duty to die” to save money for the National Health? I am wondering when it will get to where elders in the UK are as afraid to see a physician for fear of coming out “feet first” as at one time was occurring in another country with socialized medicine where an otherwise healthy elderly person with pneumonia came out “feet first” if they went in the hospital.
    You have to pay for healthcare one way or the other. It’s just where you want the money coming from and how you want to handle it. Neither candidate has a viable plan or knows how to pay for it. It’s up to us and Congress.
    For those who want to extend Medicare to everyone - PLEASE! You HAVE to be kidding. One of the biggest deniers of care is Medicare (especially for elders over 75).

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  125. Todd Morrow, MD

    I suggest one way to deal with the issue of the uninsured: allow doctors who participate with Medicare the ability to provide uninsured patients the necessary medical care in return for tax credits equal to the Medicare fee schedule. I’m confident the reduced tax revenue would be offset by the savings in costs that come with caring for patients without insurance who drain the system due to care needed for chronic illness.

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  126. James Tryon MD

    Most all reform efforts, including Massachusetts, focus on the finance side of the healthcare equation. the problem, however, resides mainly with the structure of the healthcare system, a siloed group of special interests each defending their own turf…physicians, hospitals, pharmaceutical induistry,insurance companies, etc. there is no overarching governance principle, so each group defends its own “truth”. I strongly recommend pjysicians read “Healthcare, Guaranteed” by Ezekiel Emanuel, MD PhD. for a thoughtful, reasoned explanation of why we need a Governance Structure. this does not mean a Government Bureaucracy, but an independent Authority that can incentivize the system to follow evidence-based practices, broaden the primary care base, regulate the financial structure and study the effects of how we use technology. Healthcare is an orchestra without a conductor. No matter how well we finance the instruments its how well they play together that determines the success of the musicians.

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  127. Mark Berg

    Single payer healthcare (that is, government run medical care) is not the answer to any problem. In speaking with physicians, I am constantly reminded that being able to reason and to think logically are not tied to the number of years of higher education.

    To those physicians who say “Everyone should get the best care available” I say “That’s magnanimous.” To those who say “The government should provide everyone with the best care” I point out how ridiculous that is.

    Medicare is a complete disaster, yet people actually argue for the same type of institution to deliver healthcare to everyone in this country. They vaguely remember something about “economy of scale” from Economics 101, but ignore history and the facts. The government does not function more efficiently than the private sector—quite the opposite. In addition to that, thirty three cents of every tax dollar collected goes to cover the cost of collecting that dollar. Now explain away those two facts and prove that government run healthcare will do anything but make the situation worse. Good luck.

    Taking sides–democrat or republican—on this issue is counterproductive, as it distracts from clear, reasoned thinking about solutions. Politicians on both sides say what they need to say to get elected, and do what they need to do to pay those who helped get them elected or will help them get re-elected. If anyone wants to get involved in a cause that would help solve this healthcare problem and many other problems, read and understand the Fair Tax bill (fairtax.org) and help get that enacted.

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  128. Joanne Mears

    While I see the obvious need for health insurance reform, I feel Obama has a basic flaw in his plan, as I see it. Unless I have misunderstood his program, he would require employers to provide health insurance for employees. That, in and of itself, sounds good on the surface, until you consider the implications to the small business especially. Because of the cost of health insurance, a program such as that could put many small businesses out of business, or a the very least cause considerable downsizing of the workforce, thereby creating more unemployment and putting more people on welfare rolls and a socialist healthcare program. With regard to the Canadian healthcare system, though I do not know the premise of their plan, I can say I know of some people (parents of a friend) who come to the US for their healthcare. I’m not sure how that works exactly, but when faced with serious health issues they said they could not wait for the Canadian system to work them through. They, as Canadians, felt the system had major flaws, mainly the time it takes to get proper care.

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  129. Donna Weiler

    I am not in favor of socialized medicine. It doesn’t work in England, Norway or Canada. Why do you think so many canadians are coming to the US for care! If you truly want to help the uninsured then why not let them go to any VA hospital for their treatment. VA hospitals are shutting down wards in hospitals for lack of patients. A medical card can be issued to the uninsured which allows them free health care at these facilities.

    Also, in some cases people do not want health insurance. In our rural community, we have patients that can afford insurance but choose not to. We need to separate our statistics to reflect the people who are uninsured because of the cost of health care from the ones who are uninsured by choice.

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  130. rh md

    it is absolutely unconscionable that in this country health care is treated as a commodity and access is restricted. health care is absolutely a human right. single payer is a start. the “best health care system in the world” shouldn’t be built on the foundation of denying tens of millions of its citizens the basic security of feeling that their government will not let them suffer just because they do not have either the foresight or the means to protect themselves or their families. and while lectures on personal responsibility may absolve us of some of the feeling of collective responsibility, they do not relieve of us of that responsibility in fact. we are good at rescuing people, but not so goood at doing the things to prevent the necessity for those rescues.

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  131. JB , MD

    UNIVERSAL HEALTH CARE IS THE GOLD STANDARD TO WHICH WE SHOULD STRIVE. STRATIFICATION OF QUALITY BASED ON ECONOMIC CRITERIA IS UNACCEPTABLE.
    INSURANCE INDUSTRY MAKES BIG BUCKS BY PROVIDING RISK MANAGEMENT TO THE HEALTHY AND DENYING COVERAGE TO THOSE WHO MOST NEED IT. TREATING HEALTH CARE AS A COMMODITY IS JUST FOOLISH. WE NEED TO ASSURE A DECENT WAGE FOR PHYSICIANS, COMMENSURATE WITH EDUCATION AND EXPERIENCE AND MAYBE A SIGNIFICANT SALARY INCREMENT FOR THOSE MOST IN DEMAND, SUCH AS PRIMARY CARE PHYSICIANS. PERVERSE INCENTIVES FOR HEALTH CARE SHOULD BE ELIMINATED. FREE MARKET FADS SHOULD NOT BE ALLOWED. THE WHOLE IDEA OF HAVING PHYSICIANS IN CHARGE OF HEALTH CARE IS UNDERMINED BY ABROGATION OF AUTHORITY TO LESS-QUALIFIED PERSONNEL SUCH AS BUREAUCRATS AND INSURORS. WE NEED TO CLOSE THE LOOPHOLES WHICH ALLOW NON-PHYSICIANS TO ENGAGE IN THE DE FACTO PRACTICE OF MEDICINE. WE NEED MORE COOPERATION TO PROMOTE EFFICIENCY. WE NEED TO APPLY THE TECHNOLOGY WE HAVE TO THE GOAL OF EXCELLENT HEALTH CARE FOR ALL PEOPLE.

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  132. Terry

    At some point everyone who is a decision maker will have to come together to make changes. Everyone should be able to get medical care. Also, dental care is needed for much of the population. Prices are out of control. The cost of getting a tooth pulled is an insult to Americans and I think it stinks. Most people are dealing with day to day tough issues thinking that the medical community is on their side and prices have soared due to many thinks like lawsuits that should never have gone to trial. Its complex but solvable. But I believe it will not change till we want it to change. I believe we have become morally soft, right and wrong have gotten lost along the way. You decision makers can make a difference and America wants a change. Thanks for your time.

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  133. Ekins, Pharm.D.

    Our healthcare system needs an overhaul and government should not be running it. I don’t think either Presidential candidate has the healthcare savy to propose a solution. However, they should provide the incentive, remove hurdles and invite the stakeholders to create efficiencies and less costly options. McCain has proposed leveling the payment playing field between those with corporate insurance and private or no insurance. When my wife had a procedure done we were charged nearly $6,000. However, the PPO discount was $4,000. The person with their own insurance (self employed) does not get the PPO discount. Having health care coverage is no more a right that having food. In California, hospitals must provide free healthcare assessment and initial treatment regardless of the willingness or ability of the patient. And, without regard to the financial cost to the hospital. But if that same person is hungry or homeless, no one is required to feed and put them up.
    I’m not sure we are prepared for the serious answer to how to make our system better. Cut out the huge salaries that physician’s make, make drastic changes in tort law and eliminate the majority of lawsuits and all of the jury dictated “pain and suffering” awards. consolidate expensive equipment shared by many, change entire way of managing health and chronic disease, make patient’s responsible for their own health and its impact on everyone else. Give people incentives to loose weight, eat less, exercise more and negative incentives for the opposite. As stated, are we ready for the hard cuts?

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  134. Randy

    This is a problem. I do not wish to adopt Canada’s health care system. We already gripe about higher taxes & don’t need to increase it even more. There will be upcoming issues that will increase our taxes on top of this. We have illegal imigrants who are seriously ill crossing our borders and getting free healthcare in this country. The question is, do we have a budget for them too. Whose tax would pay for them. Are taxes paid for citizens of this country only? If the answer is no, then, would other countries pay for medical expenses for our seriously ill US citizen that do not have a health coverage of that country? Why do we pay expenses for illegal immigrants that come to this country and yet if we go to other countries for medical help, we have to pay cash or just get ill.

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  135. Terry Raya Hoffman RN FNP STUDENT

    As a RN who has been practicing in CALIFORNIA for 20 years I AM Fed UP
    I believe doctors deserve more than BALL POINT PENS,MD’s go to school for 10-20 years and deserve Respect not BALL POINT PENS. As a HCP we are working with slim pickings and we beg the insurance company for authorization and we spend hours filling out forms. CEO’s SHOULD NOT MAKE MILLIONS OFF of SICK PEOPLE!
    LAWYERS MUST STOP The nonsense lawsuits, it is a CRIME, a CRIME! THE cost of
    Mal practice insurance is alot and drives up costs and reduces the salary of hard working health care providers.
    If illegal aliens can receive health care insurance I believe people with preexsiting condition should be able to purchase health insurance at a reasonable cost.

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  136. Lee Anderson, J.D.

    Life, liberty, and the pursuit of happiness. Those are our most fundamental rights. Each of those rights, however, is conditioned upon access to health care. Our nation is on the brink of cycling to the next stage of evolutionary consciousness where communal cooperation and preserving the rights of future generations trump individualism and self-gratification. We are all going to have to give up many things we may have taken for granted and make sacrifices for the greater good, but we should never sacrifice quality affordable health care. If the largest insurer in the world can afford to use taxpayer bail-out money to pedicure the consciences of their executives, then nobody should be short-changed by insurance companies in either providing or receiving health care intended to preserve and save lives. I am gratified to read the poll results thus far.

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  137. Richard Belena

    Why would we want government to run our health care system? It is a failure everywhere and substandard. Take a look at the Canadian/British model - awful. McCain has the only reasonable plan. What we need to do is allow everyone to get affordable insurance if they want and eliminate pre-existing conditions. I for one don’t want to degrade the options availble. Obama is a socialist and a single payer program is just one more step to the age of BIG government which only limits the freedom of individuals.

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  138. Gideon

    Open accsess health care is in our grasp. We need to divert founds from other areas, make a tax based insurance (the more you earn the more you pay), and cap the sum health care facility can charge for treatments. The health system will earn 45 million new paying customers and will be sure of their income as this will be given by the tax money no matter what the patients financial situation is. We also need to cut drasiclly the unreal amount of money people get in claimes. It is not hard to do and it will heal the system of its indifference to the poor and hard working American.

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  139. Saul Toobert, Ph.D.

    I am tired of hearing negative criticisms of Canada’s health plan, particularly the notion that Canadian citizens come to the USA for treatment as they do not wish to wait. In Canada, if you have a serious illness, you will be seen right away. If the problem is not serious you may have to wait a bit.

    The people who come to the USA are similar to people in the USA who run off to the Mayo Clinic for treatment.

    I wish we had Canada’s Health Plan.

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  140. Amanda Pulisciano

    There is not going to be a quick fix to the health care problems for America. Canada has people coming to the United States for medical care as they don’t wish to wait. This could be a reality here in the United States too.

    Also a major problem is prescription costs. Does the USA support other countries too? Europe and Canada have system which helps control prices but many fear a socialistic control when it interferes with free enterprise but when it is at the expense of people then ethics must be considered and a moral obligation.

    Also while many companies are not investigating biomedicine as a more serious areas where are things like $40.00 of marijuana that does what $1,900 of prescription drugs do but with less side effects and many times much better and quicker effect.

    I don’t believe in marijuana just be legalized but regulated and controlled so the people with ongoing suffering can safely obtain it at a pharmacy or license depensary. I know people with cancer, glaucoma, AIDS, MS, migraines and other ailments who benefit and have sidestepped the drug companies.

    Anyhow back to insurance and doctors. Doctors right now are in debt after medical school many times and for many years and we are approaching a point where we have a shortage. Doctors need to survive and should be able to live an affluent lifestyle with everything they put into their education and careers. Tax incentives and educational grants should be given to doctors. In terms of insurance many times doctors go without the copay due to the patients inability to pay but they continue to treat the patient. It is very necessary to just have a universal health care system with of course a parity for mental health. Many times mental health issues can simply be controlled with medication but instead is treated with hospitalization due to medicines not being affordable. The primary thing which needs to be addressed is definitly a health insurance system where there is not a profit being made by the insurance companies or the regulatory system involved. Medicare runs at less then 4% overhead while many insurance companies operate with a much higher overhead due to advertising, promotion and lobbying.

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  141. Robert Larson RN

    Those that believe we need competition in healthcare to insure quality has not thought this through. With competition, someone loses. Is that what we need in healthcare? We have universal coverage in police, fire departments, library systems, etc. Who would want to have to choose their fire department and pay premiums for it. Healthcare is no different. We also don’t have to take any other countries model as is. We are smart enough to make a universal hybrid model that works for us. Healthcare is a right. The overhead paid in administrative fees to insurance companies on claims, rejections, appeals, billing, etc. would pay for universal coverage. It’s the only way to stop the spiraling cost.

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  142. Mary Ellen King D.O.

    I think it’s disgusting that so many Americans go without any health coverage, while CEO’s of managed care companies can make HUNDREDS of MILLIONS of dollars. These dollars are made on the backs of hard-working Americans–by turning them down based on pre-existing conditions, denying claims when they’re too sick to debate the issue, cutting off their coverage after people have paid hundreds of thousands of dollars in premiums over their working years.

    This is a national embarassment. If their wages were re-directed, it could provide millions of people with quality care. Clearly only a chosen few can prosper here, and then rest can fend for themselves and collect the scraps.

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  143. Christine Newsom M.D

    A single payer system–Medicare for all–in some form or another is going to have to be implemented. There’s just no getting around the fact that the 35% cut that the insurance companies take out of every dollar for overhead, (vs the 3% that Medicare uses), is breaking our collective backs. The profit motive has no place in the financing of health care.

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  144. Eric Levin MD

    Neither candidate seems to understand indepth the frustrations of daily medical practice. We will save billions of dollars by cutting out all the duplicate mid-level “Know nothing” watch-dog-gate-keepers” who might have a college education
    reading from a computerized “protocol”. Cook Book medicine doesnot and never will be cost-efficient. Nobody is satisfied with the lack of quality of care that is driven by conveyerbelt medicine. Medicine should be truly non-profit for those who profess to be the guardians of cost effective quality health care delivery. Albeit another issue total legal reform is intimately linked to healthcare reform. I need not expound upon what everyone knows what I am referring. I am referring now to the corruption on a community level,the police,the district justices, the judges,lawyers…their is no effective accountability for bad apples. Also, can anyone really afford Legal care?
    All it takes is one bogis law suit and health problems for all will surly follow. Maybe we need a professional jury system where hopefully decisions will
    not only render decisions but actual justice for a change. Why is it that I have
    never heard a presidential candidate suggest that it may be time for an updated
    constitutional convention? We no longer live in 1776! I guess this sacred cow
    is truly such. Also, it should be clear by now that a two party system is insufficient for our complex society and issues. Maybe a coalition type system
    like in many other countries should atleast be in the discussion.
    Yes it is time for change,but much more dramatic that what either party has
    the guts to even put on the table for thought.
    Eric Levin MD

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  145. Dave V

    Oh yeah, to all those parents out there, what happens to something you give your kids for free? What do they do with the same thing that they had to work for and be responsible for? Yeah I thought so, so guess what would happen to ‘free’ health care for all, we would break it, just like a 5 year old and his new free toy.

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  146. Dave V

    I read the answers as I voted and was appalled that the field I am going in has so many big government socialist wanna-bes. Government control will do nothing but burden our already stressed out system. I am a Nursing Student who currently used a Medical Card from the state, the kind for the poor, not the old, and the coverage is rotten, I have more rules and restrictions and wait times than I ever did before when my wife had her nice job before she got laid off. Despite seeing the poll numbers on this site, it seems a lot of the posters seem to think that Health Coverage is a RESPONSIBILITY and not a right or a privilege. And to Obama when he says he wants to give us his government health plan that all the senators enjoy, yeah that might be nice, but it isn’t a government run plan, it is just government paid for like any other employer plan. From someone who has state run care, it is not a good thing, free market and less governmental control would be a much better solution.

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  147. Miles Weinberger MD

    A single payer system with everyone in, nobody out, can eliminate the high percentage of healthcare dollars that don’t go for health care but instead are utilized by the bureacracies created by the multiple insurers and the medical care facilities that must utilize extensive resources to collect from various 3rd party payers, each with their own multiple contracts. My own institution has to deal with 200 different contracts and has progressively increased staff in the attempt to collect fees for service. With everybody in and nobody out, the cost is distibuted among the whole population, most of whom are healthy at any given time. However, all, including the young and healthy, expect the health care system to be there when they need it, just as we expect the police and fire department to be there when we need them, even if they don’t have burglery or fire insurance. That’s why we pay taxes for such service. Should schools be available only to those who have purchased educational insurance? Why then should medical care be available only to those who can purchase insurance excluding those who are sick and self-excluding those who are young and healthy? Health insurance works best when most pay to receive it so that it’s there when and if they need it but only some will need to collect. That works best when all are insured, and a single payer system would provide the greatest efficiency.

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  148. Manuel Bello

    i think peoples health is not an topic that should be about money, if the US can Spend Trillions of dollars in a War, it can also spend what ever is necessary to ensure the health of a nation. im pretty sure that if it was the Presidents Daughter who was sick, she would have the best care money has to offer. Thats how we have to see the issue, you never know what could happend in the future.

    if u see the health system in Canada, people dont have to worry about ensurance or medical issues, they just go to the hospital and get checked out for free, and all the medical studies are free too. In France, they have the same policy. in England they have the same policy!…

    So, are this countrys richer or better than the United States?… maybe, because they value life more than money. you might say, weel its just that you dont understand the money implications, and ill say, well its just that you dont understand the value of life…

    Future Presidents, Eliminate Health Ensurance, and simply give free medical care to your citizines like it was once before about 60 years ago. you got 45 million people who are your childrens, friends, or simply a bum, they are people and decirve just as much care as any rich buissness man.

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  149. VAN, MD

    First and foremost people need to take responsibility for themselves. Those who continue to smoke, eat poorly and don’t exercise expect the rest of America to pay for it. The amount of time and effort I spend working with my patients to make these lifestlye changes is enourmous and yet they still refuse to change. However, when they get sick and can’t afford their care, they become increasly “entitled”. Why should I or anyone else for that matter, have to pay for people who make poor choices even after being warned? What about those who are non compliant with medication or treatment plans? The government is not the answer. Americans taking personal responsibility for their choices is the answer for many things…including our current economic state. We need to quit blaming the government for everything. They can’t fix it..look at medicare and medicaid. I see many medicaid patients who honestly want to milk the system. They want desperately for me to fill out disability paperwork, they have chronic pain and want narcotics while refusing to quit smoking or stop unhealthy behavior. If the government is in charge, there will just be more misuse of physicians time and taxpayers money.

    As for Canada and British government run programs….they are not state of the art. There are many Canadians that “winter” in Florida who also get all of their healthcare done in the the US. Why? Because Americans have the latest and greatest with regard to medicine– and they can get in to see a specialist within a respectable amount of time. Why do we have the latest and greatest? Because it is a free market, that is why. This is not true for Canada. Anyone who tells you differently has not truly been sick in Canada and needed surgical care for cancer removal.

    The only people who should be funded by the goverment are the handicapped, truly disabled (not those with chronic pain) and our veterans. The rest of us, should grow up, go to work, and make healthcare a priority and start making some sacrifices. We don’t need 2 cars, 2 computers, 4 TV’s, cellphones, manicures, pedicures, gold jewelry, etc, etc, etc.

    Oh, and for those who seem to think that doctors are rich and we don’t know the reality of the system, you are incorrect. I grew up in the mid to lower class. My father was ill and my mother worked as a nursing aid and supported 6 children..without any government help. I worked my way through college and med school without government interference. So for all of you with the boo-woo stories, grow up, get a job and make healthcare more important than your next cigarette. Take responsibility America and quit blaming the other guy!

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  150. Darel A. Nelson, DDS

    I work in a rural community in Montana. The largest Hospital in Montana is located in Billings, MT. It is considered a Rural Hospital. The demand for professional health care provideres far out weigh the number available. In the community in which I live the local hostipal control virtually all of the Physicians. The “private practice” is becoming obsolete because of “Big Business”. The more Federal Control such as EHR’s the greater the difficulty of Providers to question a colleague as per diagnosis. Insurance Companies need to be made to accept without picking and choosing those who are in the best of health. Regulating the Insurance Companies is, in my mind, the way to make Insurance Affordable. I see the same problem with CEO’s and “Fat Cats” in the Insurance Companies as in the AIG Executives.

    My wife is a nurse. Compaired to other States she has worked in she would be asked to enter the work market without he help of a nurses aid and receive the same wage she was earning in the State of Utah in 1980.

    Her employer’s Insurance Package excluded benefits which someone our age would most likely need. Supplemental Insurance offers required the use of Contracted Hospital’s outside the State of Montana. Following a year long search for adequate coverage we had to conclude that there was not an Insurance Program that would meet our real needs.

    To date I feel that AARP offers the best Package for the dollar but is still not adequate.

    Insurance Companies and Pharmasutical Companies need greater regulation. The Health care Industry is dominated by Insurance Companies and Pharmasutical Companies. This includes marketing products on TV. People seem to be manipulated by what they see on TV. The Federal Government needs to focus on the Insurance Fiasco and set controlls on the cost of “new” miracle drugs that turn out to be less effective or ineffective compared to older Medications.

    Generic Drugs are “NOT” equivalent to the “Name Brand” but there seems to be a
    tendency to try to sell that falshood to the younger professionals. In some cases it is true “but” for those of use who have been writing prescriptions for 30 plus years I believe that there are most know generic “is not” a straight across substitute. It is “fraud” in my mind to tell a patient that any generic will provide the same theraputicresult. Fillers and binders affect the release of the active ingrediants in very dramatic ways in many medications.

    I believe we will see people reduced to the failing system that existis in Canada which is only a few miles away. Mens hearts have grown cold. The trauma this Country is suffering is a result of Corrupt Government. There is not a Presidential Candidate who can solve the crisis we are in. It will come to communitys and neighberhoods solving their own problems. Simple principles.
    Care enough to do somethig without expecting to get rewarded with the all mighty devalued dollar.

    I have over the years treated patients because I know they had no money. Perhaps that is why Insurance” is expensive in my middle class tax bracket.
    I feel good about what I have contributed, best about what I freely gave

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  151. Tony Carbone, RN Oklahoma

    Health insurance should not be the governments responsibility any more than auto or home insurance. We absolutely must pay our own way. Insurance is so expensive because it is abused. Going to the ER for routine medical care, than expecting insurance to cover the charge is wrong. Insurance should be used for catastrophic illness only, not routine visits.

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  152. John Purdie

    I live in Canada but have American cousins. I would rather deal with a person I could vote out off office then the insurance HMOs over who I have no power.

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  153. H reems

    up here in socialized canada we cant help but look at 45 million uninsured as a blight on the great American dream, why you americans cant get your shit together on this is incomprehensible, im sure it has everything to do with money

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  154. Andrew

    Health care is not a right & the government is not obligated to providing it.
    If you want to see just how health care controlled by the Government might be just imagine it being run like any motor vehicle department. Frankly I don’t want those people being in control of how my health care is doled out. I also don’t feel the need for the Government knowing that much about me.
    I personally have had my fill of the nanny state.

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  155. Carl Steele D.O.

    There is no perfect solution. We as Americans, seem to think we can abuse ourselves and someone else will pay to put us back together.Money and health are both commodities. They both become more valuable when in limited supply. Our money is running short ,and the demands of longer lives and more technology accelerate the disparity. There is no easy way out, but the solution must contain elements of the following:
    1. Some people do not make responsible lifestyle choices,therefore some motivation needs to added to shape behavior i.e. sin taxes on tobacco products that reflects the true damage they inflict. Rating the insurance products to reflect the choices people make (play you pay). Limiting the scope services that are available to people who knowingly abuse themselves.
    2. Prevention is always better than disease management. Our present system should be called “Disease Care” not “Health Care”.
    3. Bad things happen to good people … the system must have a reinsurance for catastrophic injuries that is shared by all intities seling insurance.
    4.Tax credits or LIMITED government subsidy to provide private insurance that individuals may purchase. The individual needs to know the cost, risk , and potential benefits of any procedure or test.
    5. No inappropriate duplication of tests …. all care should be coordinated and shared through an accessible conduit
    6. Cost of information technology to meet these requirements by physians should be offset by a tax credit.(if we did this the rate of implementation would be amazing)
    7.Immunizations must be a mandated portion of any health care plan.
    8.There are more … but I have no more time or energy.

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  156. Thomas Hubbell MD

    How much longer are we going to be the only industrial country (and the most prosperous country) that does not provide health care for every person? This is an embarrassment. For those who object to “socialized” - we’re not talking socialized as in government owned (England), we’re talking universal, as in everyone gets it (Canada, Germany, France). Don’t worry, doctors will still make a whole lot of money. TH

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  157. Lewis Rose

    Imagine a health care system where every doctor was well paid every month with almost no hassle, where every patient had basic adequate health insurance, where the patient could see any doctor who had an open appointment, where changes of job or changes of insurance did not force a change of doctor, where there were enough primary physicians to provide continuity and urgent care to their patients so that specialists could devote themselves exclusively to their specialties, where the doctor only had to follow one set of rules, instead of one for each insurance company, where the doctors were as well trained as in the US, where the patients were almost entirely happy with the their health care, where longevity and mortality were better, and that cost much less than the infinitely complex and inadequate unsystem that sadly or laughably is called a “health care system” the United States.

    I worked in such a system in Canada, and in a different but good system in Britain. There are good models in almost all the advanced nations of the world.
    They don’t call them “Socialized” there. It is a meaningless epithet. They are no more “Socialized” than Medicare or Medicaid. They just call them “good”, and work to improve them.
    None of them are perfect. Almost all doctors would like to be better paid than they are, (just as they do here.) Patients would like to be seen without long waits (just like here). They would like new technology sooner, even though it would improve health outcomes for very few.

    Without the cost savings of a good system, attempts to make private health insurance universal will break the federal budget and the budgets of the states.
    Employer paid insurance prices many of our products out of the market, (consider the sad state of General Motors,) and makes many people who could work unemployable.

    Let us learn the best features of others, and save our health and our money.

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  158. jer

    The health care problem is multifaceted. I will list several things that I feel should be tackled in order to come to a solution. 1) Somehow the medical insurance industry has to be designed to allow all people to obtain insurance with reasonable premiums i.e. no ratings and shared risk for all, because if you have an illness and you truly want to try to treat it in order to stay as healthy as you can, you can’t afford it or you cannot even get a policy. 2) Tied in with the above is the cost of medicines. IF you can’t afford the medicines to treat your illness, what good are they? 3) I don’t mind that CEO’s make a reasonable income but lets not be obscene where they reap enormous profits at the expense of people not being able to afford either health insurance or medications. 4) The medical liability issue is either driving doctors out of practice or encouraging them to find novel ways to create income, even to the point of ordering unnecessary tests in order to gain more revenue. You may not want to believe this but I know it first hand. Many claim that they order more testin in order to protect themselves from liability claims and I am sure many do, but others use it as an excuse to order more test to earn more money. Whichever way you look at it, it increases the cost of care which then goes to increase insurance premiums. 5) In my own state of Illinois there is rampant abuse of the medicaid system and there apparently are not enough government employees to police it. More money gets poured into the system and yes, it does provide care to more people, but it is not always for the people that truly need it. More state taxes means less expendable money for individuals to purchase their own policies. 6) The public needs to stop treating the medical tort system as a lottery. Again, all this serves to do is increase medical spending on defensive medicine and increase the cost for medical insurance premiums. This, of course, leads to more uninsured. 7)Lastly, liability lawyers need to curtail filing unfounded lawsuits that increase the liability premiums for doctors just for the fact of having to work on a defense even if the case never gets to court. As said many times earlier, all this serves to eventually end in increased health insurance premiums because the reflex effect is that it pushes many doctors to practice defensive medicine and order more unneeded testing.

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  159. CE, Florida

    In the same manner the government has analyzed the banking crisis, they should also recognize that fraud and greed has also killed healthcare in America. Insurance companies and their overpaid CEOs and lobbyist have full control over physician practices and heavy influence on government policy makers.
    To think that most doctors come out of medical school with a heavy debt burden then have what we do now be perceived as a God given right or privilege without adequate compensation to the doctors is hypocrisy.

    We are forced to practice defensive medicine to limit our medicolegal liability while accepting a pittance which barely cover our ever rising overhead, including skyrocketing malpractice premiums. How is it possible to render quality care when you are forced to see 30+ patients each day just to keep your practice afloat?

    How do we encourage young men and women to enter a career of medicine, or Primary care, knowing that their thanks will come in the form of debt, paperwork overload, and oppressive insurance tactics strong enough to crush the strongest spirit?
    If the general public thinks that there is a health crisis now, they clearly do not understand it’s depth or how it is likely to worsen if the only issue that is addressed is physician access without addressing insurance company and malpractice liability issues.

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  160. CE, Florida

    In the same manner the government has analyzed the banking crisis, they should also recognize that fraud and greed has also killed healthcare in America. Insurance companies and their overpaid CEOs and lobbyist have full control over physician practices and heavy influence on government policy makers.

    To think that most doctors come out of medical school with a heavy debt burden then have what we do now be perceived as a God given right or privilege without adequate compensation to the doctors is hypocrisy.

    We are forced to practice defensive medicine to limit our medicolegal liability while accepting a pittance which barely cover our ever rising overhead, including skyrocketing malpractice premiums. How is it possible to render quality care when you are forced to see 30+ patients each day just to keep your practice afloat?

    How do we encourage young men and women to enter a career of medicine, or Primary care, knowing that their thanks will come in the form of debt, paperwork overload, and oppressive insurance tactics strong enough to crush the strongest spirit?

    If the general public thinks that there is a health crisis now, they clearly do not understand it’s depth or how it is likely to worsen if the only issue that is addressed is physician access without addressing insurance company and malpractice liability issues.

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  161. Kim Josen

    Providing healthcare to all is the patriotic thing to do for our fellow Americans. As Americans, we should reach out and help those who are in need. In the end, we all stand to benefit from having a healthier, less stressed society.

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  162. Richard Baker FNP

    I agree with much of what I have read above but feel that health care has no business being a government run institution. I do not remember reading anywhere in the constitution that health care was the responsibility of the government. The way to make health care affordable for all is to eliminate frivolous lawsuits so that prices would represent the true cost of medicine instead of this over inflated and cost adjusted version that is required due to the enormous number of lawsuits. Look at the wording of “Socialized Medicine”. First word is Socialism. Never thought America would even consider becoming Socialists. The polls show 50% of them are for it though.

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  163. A. Tseggai

    It’s mind boggling why USA, the world’s richest country, would not have a system in place that would provide affordable, if not free, health services to its citizens. Having a healthy society is an asset to any nation and implementation of a healthcare system in which every citizen receives adequate medical care in times of illness without worrying of the financial burden associated with it should be every government’s priority, whether Democrats or Republicans.

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  164. Robert Emery DDS

    Healthcare is a responsibility to those who can manage their own lives and affairs. For those less fortunate; the infirmed, handicapped or economically deprived, basic healthcare should be a right. This approach protects the weak and enpowers the less fortunate to move forward and take responsibility should their lives change. The devil is in the details. The details would define the “economically deprived.”

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  165. RN

    I have the opportunity to visit many doctors with catastrophically injured workers. I have also worked in a preauthorization department with a general surgeon reviewer who also had a PhD in anatomy.

    My observations:
    1. Some doctors don’t take a history and some doctors don’t do physicals. Many times we have left a doctor’s office without a diagnosis or options.

    2. Most doctors practice from insurance coverage rather than taking a history and doing a physical. If they have coverage for imaging, it is presribed, without any objective findings on exam. Some doctors come into the room and complain about the insurance industry…and waste 5 minutes when they could be taking a history and doing an exam. Doctors rarely offer options for patients and maybe that is one reason patients feel no responsibility for their health.

    3. My MD-PhD preauth reviewer would read the medical records from doctors and KNOW the diagnosis was wrong. So, we often requested specific tests and he was never once wrong. Of course, I’m sure he was complained about at the doctor’s office…maybe long enough that a history could have been taken or a physical exam done. And therapy, which most often should be daily and under the physician’s supervision, is ordered according to what can get approved and done at some pitiful therapy office in the network. Doctor’s don’t fight for their patients…I know there is no time…but there is no inclination either.

    4. Insurance companies will take every discount they can squeeze out of the healthcare provider. They will deny care, when appropriate and timely care might stop all future care. But the decision makers are high school graduates in front of a computer…or possibly a nurse that has to show a savings to the customer.

    5. Third parties have a conflict-of-interest: they are supposed to apply benefits, but how they are judged is completely separate from their assigned responsibility. With the networks, it just becomes more ingrown and there is so much duplication of jobs. Insurance companies use them to reduce overhead and to reduce liability (hold-harmless clauses).

    6. Then there are patients that think someone is supposed to take care of them. They are given no responsibility. I rarely hear a surgeon tell a patient that the operation is the doctor’s responsibility but the recovery is the patient’s responsibility. Then you have a failed surgery…not a failed operation, but a failed surgery.

    In workers compensation, many companies that manage their own claims, save tons of money. One reason is that there is someone that is interested in this person getting better, providing interest in the injured person and closely monitoring the patient’s compliance to their common goal: return to work.

    I do not know the answer to how to fix the situation, but healthcare is a responsibility. To have insurance, it may take not having cable TV, not going out to breakfast, lunch and dinner, and maybe wearing the same clothes year after year. Families can get insurance, but it may not be $20 co-pays and $0 deductables. Sometimes the cost of seeing a doctor (or going to the ER) can help people to stop and think whether they really need to go for care, or maybe they could go to their pharmacist and ask what OTC to take. In Dallas county, our county hospital provides more care for illegal aliens than poor citizens.

    I have a grandmother that is 100 years old and lives by herself with very little help…she goes to the SR Citizen center for lunch and her main meal. But every day she walks the halls of her apartment. She does crossword puzzles and watches the game show channel to keep her mind sharp. She takes care of her old teeth. She still plays Bingo at the Moose Lodge twice per week. She has never lived in a home that she owned. She lives on the $600+/mo social security check and has several CDs in the bank. The point is she takes responsibility for herself. She doesn’t allow others to not give her options…her doctor tried to convince her she needed a colonoscopy for a bout of diarrhea. She said no.

    Count me in on trying to find the answer. I’m sure Obama’s socialistic approach is not affordable nor responsible.

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  166. Luis Irizarry

    KISS (Keep It Simple Sony).

    1. Same premium for everyone (Individual, or business level). Although I prefer no health insurance companies at all (Free market).
    2. Created a Health Insurance Security Commission to regulate upper level insurance officers, reduce excessive spending, increase reimbursement, and provide more coverage for patients.
    3. Burst the hyper inflated pharmaceuticals cost. Government really can do this.
    4. Reduce medical lawsuits by means of:
    a. Federal Tort Claims Reform
    b. State Tort Claims Reform
    State and Federal Government will really put an end to frivolous medical lawsuit when their coffers begin to go down due to excessive spending.
    State Medical Board still has a role in policing medical standard of care and serves as a liaison for patient rights.
    5. Make all medical cost 100% tax deductible.
    6. Personal Health Savings account, 100% tax deductible. Taxable and with penalties if used for non-medical purposes.

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  167. JOHN STULTZ

    I WOULD OFFER THE MEDICARE PROGRAM TO ALL AMERICANS FOR THE SAME PRICE AS THOSE PRESENTLY ENROLLED PAY. IF SOMEONE CANNOT PAY FOR IT THE GOVERNMENT SHOULD PAY FOR THEM. NON-INVASIVE PHYSICANS SHOULD BE PAID 20% MORE FOR MEDICARE PATIENTS THEY TREAT. THIS INCREASE WOULD BE BORNE BY PAYING PROVIDERS OF INVASIVE PROCEDURES OR SURGERY 20% LESS.

    NON PROFIT HOSPITALS SHOULD PAY TAXES AS DO FOR-PROFIT HOSPITALS. EVEN NON PROFITS HUNT DOWN PATIENTS TO GET THEIR LAST PENNEY. THIRTY YEARS AGO THEY WOULD WRITE ALL IF NOT MOST OFF. HOSPITALS SHOULD NOT BE ALLOWED TO OWN MEDICAL PRACTICES. DOCTORS SHOULD NOT BE ABLE TO OWN LABS,HOSPITALS OR ANY FACILITY WHERE THEY WOULD REAP PROFITS.

    HOSPITALS COULD USE AGENCY NURSES ONLY BECAUSE OF EMERGENCY REASONS.

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  168. Adam Fierer

    Obviously this is a divisive and difficult issue to both address and solve. There are many causes for our poorly affordable health care and for the rapidly growing expense of healthcare. I’m not an advocate of socialized medicine, but I am a strong advocate for basic health insurance for all. One of the big reasons people can’t afford health insurance are the runaway premiums. There is not enough (or really any) competition among the plans to keep premiums down. It is another failure of deregulation and market place economics because insurance companies won’t really care if people don’t buy insurance until it hurts their pocketbook, and that, clearly is not happening. We also spend far too much on unnecessary tests (both for defensive purposes and because “the public” demands it) rather than making clinical decisions. We spend too much on end of life care because we can’t and don’t plan well for this eventuality. We are a very demanding society, where we’re used to getting whatever we want. Well, when the question was asked last night what sacrifices O’Bama or McCain would ask of the people, this is one that I would advocate. There’s also no question that providing indigent care costs the system terribly, and this is a very good reason to provide basic care to all, and if one wishes to pay for additional benefits, then that should be our right as well. Poor preventative care, the epidemic of obesity, and the costs of smoking are all problems we need to deal with much more urgently and forcefully. The American Public needs to start taking responsibility for their choices and not expect to receive everything and anything they want regardless of their choices. TIME FOR SOME SACRIFICES!!! As far as Medicaire goes, I think there should be a needs assessment, and if you are in an upper income bracket, you should have to pay for your insurance so that others can continue to get theirs. Sorry if this offends people, but those of us who have done well should be expected to help society as a whole. If we do not do this, our system will eventually implode as it is clearly not sustainable at the rate it is going. I’m sure I’ve forgotton a thing or two, but that is plenty for now.

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  169. Jesus Pichardo.MD

    May be either candidates are out of focus and out of touch with the real word.
    1 People need pay a fee for health
    2 Cut the high cost for administrative services
    3 New concept concerning malpractice low
    4 Every one most be responsible for her or his life style choises

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  170. Dr Makram Samaan

    If Social Security is a Single Payer project so successfull to keep Millions of Americans above the Poverty Line, Why Not Health Care to be a SINGLE paypor too. If the Congress members on a Single Payor Health Care, Isn’t the People who vote them in Deserve better or the same, to say the Least
    Viva Obama
    Single Payor means KEEP what is our right out of the Profit making business and it is not a Commodity for sale and puchase.
    Further, We should TRANSFORM our “Sick treatment” Practice to PREVENTION Practice. PREVENTION is more effective , less expensive and Keep people Healthier longer

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  171. LJB

    First priority has to be to find a myriad of ways to work on the health care funding problems. Medicare costs cannot continue to go up. Sadly, to freeze the growth rates, many things will have to be reduced. I fear that physician fee freezes will make many docs go bankrupt. Freezing innovation is not attractive either. Rationing highly expensive transplants and end-of-life care is not palatable. Clearly, “competition” is NOT going to reduce costs. Clearly, tax manipulation as per McCain is NOT going to be a game changer. Clearly, subsidized insurance ala Obama will be much more expensive than he projects and we do not have the tax revenues for it. Clearly, raising taxes on all making over $250 grand won’t provide enough money. EHR proliferation will not in the near term reduce ANY expense.
    Clearly, in our experience, adding EHRs does NOT reduce expense. It decreases productivity and increases expense per pt seen. It may improve patient safety and that is important.
    A universal payer system is a no-go unless a way were found to maintain the enormous stockholder value held in insurance companies. And, if a single payer did employ 3rd parties like Medicare does, that will devalue stockholder value, perhaps a price worth suffering. What universal payer means is quite simply budget based rationed health care. The notion that enormous fat can be squeezed out of health care expenses without bankrupting many practices and hospitals is naive. And, projections already state that we do not have enough physicians and nurse practitioners.
    We are in a terrible bind, but I do think tinkering with the system can work. I would add Federally Funded Clinics to what is currently available and have them hire/train physicians/re-train physicians for primary care. The Clinics would bill on a sliding scale.
    Health insurance similar to what Obama proposes with a shared expense plan would have to be able to work. If such is to work, though, the patient’s share has to be banked, rather than requested at time of service. The latter costs too much to chase.
    Data management needs to be and can be streamlined. All persons should have insurance cards with all demographic data up to date at kiosks in providers’ offices. The kiosks should be an internet based two way data system which is secured, perhaps with fingerprints, or similar. Demographic data change could be updated on the fly. The data would enter the physician-practice management system seamlessly. Insurer authorizations should ALL be online, including test authorizations. Peer-to-peer should be online as a chat system or email equivalent. EHRs should have online data-type readability meaning that the kinds of data collected which justify charges should be assured as present, online without necessarily having a person read the medical record. Bill paying by insurers should be at time of service. The administrative costs of medicine need desperately to be ratcheted down.
    The perceived need for testing needs a broad look. Now, so many tests can be ordered and the rational basis for testing is actually much broader than is utilized. We need computerized ways to winnow diagnosis and test selections to a narrower and more heirarchical method which integrates the lab in the cascade of test choices. For example, if a normal sed rate makes certain other tests unnecessary, then there should be a way to abort test pathways or activate test pathways much more efficiently.
    In other words, although EHRs are in themselves not very cost effective, by integrating EHRs in a continuous choice process so that a branching decision tree is protocol driven as data comes in, EHRs may make diagnosis and management more efficient. I am not sure that means less expensive.
    We thus have multiple issues: accessibility, affordability, efficiency, and rational rationing to work on. Such is a massive job, extremely hard to grapple with.

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  172. Judy Johnson, FNP-C

    Higher taxes and government control will not help anyone. Prevention will. Getting off of our collective rear ends will. Ending the pharmaceutical companies’stranglehold on drug patents and pricing will. I agree that if we elect Obama we are in for big trouble as he is a Communist and a crook, and we know that Communism is a failed system.
    What would ACTUALLY work is if we got rid of the IRS, the Federal Reserve, instituted the Fair Tax (read Neil Bortz, colleagues!) and went to the Gold Standard and our grandparents philosophy “unless you have the cash, don’t buy it”. We need to simplify our lives (voluntarily, not forced) and return to the founding prinicples of America’s Constitution, which emphasized PERSONAL FREEDOM WITH PERSONAL RESPONSIBILITY. I know this is shocking to people who live on handouts and don’t want to work for a living (most of our patients) but that is actually what made our country great! People who are responsible adults know that they have responsibility for their health, and they must pay for it. Also we providers should (and most of us do) have a covenant that we will provide health care. I like the comment someone made…we don’t have lack of access to health care. Everyone can get health care in America. Just not everybody PAYS for it. Thats the ticket. People don’t seem to realize that government money comes from the PRODUCTIVE people in our society.

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  173. Jean Aycock, M.D.

    Having just completed the survey, I feel embarrassed by the choices of nearly a majority of respondents. Given options for the next President to tackle as a first health care priority including underinsured/uninsured populations and preventive care, which choices did the largest group of us elect? Liability reform (I’m assuming that what you have in mind is greater LIMITATION of your liability), electronic medical records (a liability issue for the most part), and a single payer system (in part a reimbursement issue). Was the version of the oath you took on receiving your medical degrees totally different from the one I took? I promised to make preventive care my highest priority, along with the greatest good for my patients, which would certainly include helping them to be better able to afford adequate heath care. This isn’t a political issue. It’s a greed issue. Let’s get our heads in the MEDICAL ballgame, folks.

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  174. Nowarat

    Medical savings account for people will
    1. cut down the 3rd person (insurance)
    2. people more responsible for there health spend on preventive
    3. cut down the price of the medication, no 3rd party payement
    4. cut down medical bill as it is a direct payement no billing require
    5. stop disability for patient who cannot afford to pay medical bill.

    Fail safe for the 20% of the chronic and serious disease is tohave government support for the extra pay of the medical bill as the savings account start every year they can start payement by themselves again if they can continue working their tax will pay for their own care

    6 if person died transfer left over to the children if no children can donate to a fund to a sick people eventually in 50 years the health care system will be liberate from insurance company.people and doctor same will be more discrete about the health care that both recieve or deliver no body dictate anything except the patients themselves.
    7. the employer can put money in forthe medical savings account and prevent the rate height every year.
    8. the Medical savings account can be in the CD with interest with government garantee or insure
    9.Doctor nurses pay more attention of care to the patients than paper work to maximized the payement from insurance company

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  175. Dr. Ruth

    McCain’s plan would be chaotic from a business perspective and would likely leave people thinking they had coverage until they tried to use it. Obama’s plan tries to address better access to insurance but doesn’t do much to change why access is so expensive now. There probably isn’t money or national will to do the hard work it would take to really make substantive changes, although the money already being spent would probably be enough were it spent smarter. We need basic coverage for primary care, immunizations, lifestyle education, and treatment for chronic disease and acute illness and injury with some of the payment coming from patients so they will use it appropriately. We need to make community decisions on how much we can afford of the portions of healthcare that are enormously expensive and not life sustaining or what we should spend on the last year(s) of life if that diminishes what we can do for our children. Then those who can afford “Cadillac care” should be able to have it without guilt. We should be leaders in this discussion and not be afraid to offer prescriptions for improving healthcare since we know more about it than any other group.

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  176. Gerald A. Filardi, M.D.

    This is a question to which I have not heard the answer: How many of the alleged 45 million uninsured people are in that position by choice? I have not seen a breakdown in terms of age, socioeconomic status, etc. Does anyone out there know?

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  177. Herbert Rubin, M.D.

    I go to my dentist and pay him directly from my wallet. Relatively cheap. Maybe medical care melt down relates to the money going to Washington and to insurance companies before it gets down to the doctor and patient.

    Taxes and tax policy have to change. Thats where the problem is. Thats why there is no freedom for patients or doctors. Free markets mean freedom. Cash payment will allow competition to bring down prices and open access.

    Everything else is doomed. Anyone trusting their health to government or insurance companies is an idiot and a fool. Wake up, children!

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  178. Kristin Wohlschlagel

    There is so much waste going on. I work as an emergency room nurse in a rural area. I would guess that at least 75% of our ambulance transports are not medically justified. Of these, most are used to transport Medicaid or Medicare patients. Then, once in the ER we end up giving inconsistent care to patients — calling it the art of medicine or doing this because of expediency… or lack of time for caregivers to fully assess the patient.

    I am glad that we have the freedom to utilize CT scans, MRI and other technologies quickly and without waiting for insurance company approval — especially for trauma cases or newly discovered possible malignancy, etcetera.

    However, we get so many cases of obese, diabetic, coronary cases that I can’t help but believe we need to identify these patients and require them to be in a managed care environment. Perhaps a Case Manager who checks on them weekly, in the home, to educate them, check med compliance and more. It is hard to imagine but I know we can’t keep managing this way any longer.

    I read over the information about the Massachusetts plan and think it SHOULD NOT BE THE MODEL for us to follow. I think we need to look abroad and consider socialized medicine. Or, investigate Kaiser Permanente’s management practice and consider modeling after them. No easy choices available.

    While recently caring for a Medicaid/Medicare patient who had skipped dialysis and finally dialed 911 to come to the ER, I was trying to encourage her to be more responsible for her own care. She said “Oh well they can do my dialysis while I’m in the hospital — they did it before.” I pointed out that it costs a lot more and her answer was “So what, I don’t have to pay the bill.”

    This kind of ignorant, selfish and lazy mentality is rampant. Somehow, we need to change it. When I worked on an ambulance, we used to comment that if it cost someone $5, at least 50% of our “patients” would never choose an ambulance to get to the hospital. These are the people with menstrual cramps, constipation, a boil on a buttock or hyperventilating hysterical or drama queens/kings trying to make someone feel sorry for them.

    I am very interested to read others suggestions and comments.

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  179. Richard H. Bernstein, M.D.

    Despite the complicated plans of both candidates, health care reform distills down to three words: Medicare Covers Everybody.

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  180. Franklin

    There needs to be some big changes in the entire system. This profit based system pushed by many of the insurance companies needs to change. Patient interest is being lost in the mix. I feel that Physician’s all around are the ones getting the wrong end of the stick. It’s us who are losing out at the expense of the insurance companies dictating rates, and also patient care. It seems that no one is looking out for our, or our patients inerests and that needs to change. The insurance companies have lobbyists, and drug companies got lobbyists, and who do we have representing us in congress? To be a family practitioner is ridiculous amounts of paperwork, and the overhead is tremendous. The rules of treatment handed down from HMO’s, not enough preventative care, it’s almost like my hands are tied. They need to have more input for physicians in this process. A voice not only for ourselves, but for our patients. Until that happens, i don’t think much will change. It’ll just be trading one inefficiency for another. It’s time for a revolution in the way medicine is done in this country.

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  181. David

    We need to focus on reduction of health care cost. We need health care reform and mandated primary care. If we do not reduce the cost of providing medical care and stabilize the overhead of the providers we can not save the leaning tower of medicare/medicaid from falling. Billions of dollars for defensive medicine are weighing down the entire system. The second point is if we do not find initialtive to produce primary care providers and mandate establishment of patients with these providers we will continue to have overwelmed specialists with primary care issues on their doorstep. The ED will continue to run at capacity with non-established patients with primary care problems. The problem with tort reform is we will never convince the lawyers in congress this is the right choice for America. The problem with getting more primary care doctors is that tort reform has not been accomplished and the work burdens are increasing as cost go up. Break the circle, save the system.

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  182. sharfuddin

    only solution for health care is socialised medicine and NO law suits

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  183. Dan

    Well, you have fallen for the “No health coverage” lie, and are helping to propogate it. It is No health Insurance! This number also includes 10-13 million illeagals. Everyone gets treated if needed. It is againt the law not to.

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  184. Ray MD

    Medical care for an uninsured individual is a “right” when said individual goes to a county/city ER or a public clinic. These are usually taxpayer funded.
    Medical care in a private office is a privilege- as my office is not subsidized by the government. I suppose that under the former premise I should be able to walk in to a restaurant, order the largest steak, and then say that the taxpayer will be billed.
    One way to MARKEDLY reduce healthcare cost is strict Tort reform- that will reduce the billions of dollars squandered on unnecessary testing.
    McCain wants to leave medical decisions to doctors and patients- unlike Obama who desires government control a la Karl Marx. Socialized medicine would lead to unlimited demand for a limited supply of medical goods and services. The result would be the dirtiest, most vile word in the medical lexicon-RATIONING.
    Obama’s Robin Hood tax policies would ruin healthcare as it would all facets of the economy. This man’s policies are socialistic, naive, but most of all dangerous. If we are to preserve our profession, we cannot allow Obama to be the next president.

    If any colleagues out there have an urge to vote Obama, please see YOUR doctor, have a CT of the brain and a drug screen before Nov. 4

    In today’s world, some may find this offensive, since too many people have the fortitude of Tiffany glass. It is time to stand up for our profession and our patients !

    No Socialized Medicine
    No Obama
    NO Problem !!!

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  185. Cindi G

    As a nurse who also has type 1 diabetes, I had to get married to have insurance benefits when I was living in Louisiana. I was going to get married anyway, but we had to do it earlier than intended to make sure I had health benefits. Louisiana does have state insurance, but you have to get 3 rejections from 3 major companies before you can even apply, a process that could take months. After Katrina & Rita, my husband & I moved to MA, as this is where I am from. BCBS of LA informed us if we kept submitting claims from MA to them, they would be denied. Luckily, my employer has great health benefits, our plan covers not only allopathic medicine but also acupuncture and chiropractic.

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  186. Harley Rubens, M.D.

    If McCain’s plan goes through, only healthy individuals and families will be able to even afford insurance. Currently and with Obama, companies pay an actuaralized fee for all employees and their families. This will be eliminated if McCain were in office, in which more sick patients would not be covered. I suspect we will be obligated to treat regardlessly. The big companies will not have to provide insurance and we physicians will be working on an emnergency basis for nothing. As a psychiatrist I think the McCain plan is only representing large industry, not the population’s safety. I can Not believe who cannot see through this.

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  187. Steve M

    I work at the main office of company which is owned by its members, It is a cooperative system. In my humble opinion the Health Care system should be setup similar to a cooperative system.

    A company should be owned by it’s members (The American People) the sole purpose of this company is not to turn a profit but to provide affordable insurance to it’s members. The people at this company don’t get paid an extravagant salary but they make a decent living, no big salaries for the CEO etc. The company is not run by the government, there are no middle men (Health Insurance Companies) just direct negotiations between the Doctors and the cooperative system. Every body that has a job could be part of this system and those people will have to pay into the system to receive health insurance.

    For the people who do not work then I guess their insurance would be covered by the government or some type of tax to offset. This would be other government funded programs such as medicaid etc.

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  188. jrileeanp-c

    Medicare and medicaid are dying and dictating physician practice. We need to stay focused on preventative care and getting the American people back up and exercising. Our modern day, fast life, self serve attitudes need to change and the change has got to come from the individual first before the larger entities will agree to such change. We all need to dig deep into our own souls and perspectives and touch that which is most important to our independent, healthy living and make ourselves a light to others. Only then can we even begin to think that this Nation will change. Lawyers and politicians are not going to do it for us. We need to do it ourselves. Stand up for what you believe in and remember all those who have protected us and our freedoms. Let’s offer them comfort and care in all that they do or have done for us.

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  189. Fred Bomonti

    The idea that we are somehow entitled to health care, whether through insurance, single payor, or state government usually does not acknowledge the individuals responsibility in maintaining their own health. Close to half of those without insurance are without insurance because they choose to not have insurance, the 19-30 YO. HSA or MSA types of programs self insuring for the everyday and umbrella insurance for the catastrophic events would promote responsibility for our own health and build savings plus it would be a step toward removing the sense of entitlement. Nauturally, more oversight of the insurance industry to better manage health promotion incentives and to regulate profit like a utility would be required.

    Obama has touched on the ideals of youth and built castles in the clouds with simple solutions without foundations. McCain to some extent has a more pragmatic approach with an appreciation for what it will take to start resolving our nations challenges. None of it will change, until we as a people are willing to change. We are a spoiled, over indulgent society and I have been as guilty as most.

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  190. Dave Carr

    Yeah, that’s what America needs socialized medicine! Obama is preaching the same stuff Hillary did.
    I like McCain’s idea, not perfect but it’s better than socialized medicine!

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  191. Michael C, PA-C

    I agree with Ken about insuring US citizen children…they can’t help it if their parents don’t provide, work, etc. But the entitlement programs are already out of control. Nationalized health care may be the thing that makes me quit medicine!

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  192. Yara

    So let me try to get this straight, we are the medical community that goes through 12 to even 15 years of training and schooling, with huge loans after we are done and we have to pay higher taxes!!!! Taxes that will pay for the medical expenses, social security, Medicaid and who knows what else for our own patients that don’t work and sit on their asses waiting for the “government” to pay for their care. And yes, on top of that our kids don’t exercise, they are all overweight and with more comorbidities that an 80 year old. Yes I definitely agree with paying higher taxes when all I have been doing is studying most of my life to have a better lifestyle and to not end like our patients (overweight, smoking over a pack a day and then telling the doctors that they cannot breath, that is a no brainer). Their knees hurt but they don’t realize that they are overweight. Preventaive medicine should be part of this country.

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  193. Gary

    I have personally experienced the very real fact that health care is really not affordable unless you happen to be one of the very few and fortunate wealthy. This does not, however, absolve people of some personal responsibility for life choices. Everyone, including the poor (the majority of whom are poor because of personal life choices), should pay a portion of the cost for care received. Those who choose risky life styles e.g. overeating, tobacco use etc. should pay considerably higher co-pays for these choices. Much of the over- and mis- utilization of health care services e.g. the E.D. would be eliminated if co-pays applied to EVERYONE. Although, I believe in the free market system, entirely too much of the health care “pie” goes into the pockets of insurance companies and investors. That leaves often marginal revenues for those “in the trenches” actually delivering the care.

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  194. Michael C, PA-C

    I currently work in a socialized medicine type environment…the US Military. Let me tell you this, people will not be happy if that’s what we end up with. To begin with…I don’t feel that it is my responsibility to pay upwards of 40% taxes to fund yet another entitlement program. I take that back…those who do not care to work will be happy, those of us paying that amount will not. The level of availability to see your primary care provider will drop dramatically, because there is no incentive in that environment to work hard. In the emergency department where I work we are inundated with people who come in because they are told they cannot get an appointment with their PCP for 4+ weeks. When I was moonlighting in San Antonio I did urgent care at night at a place that was an IM/FP clinic by day. The IM MD there was a friend of mine, he was able to see 35-40 IM patients a day. Anyone who has been in San Antonio knows there are a great deal of diabetics with significant comorbidities. So the question is this…if he was able to see 35-40 IM patients a day, why can military FPs not see more than 28 a day. Never, at any institution I have worked at in 20 years in the military have I seen a military FP be scheduled for more than 28 a day. The answer is this, there is no incentive under a socialized medicine system to see as many patients as you can. The difference under our current system is the monetary benefit of going the extra mile to see more patients. Access will suffer under socialized medicine…I just hope we are all prepared for that.

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  195. Rachel Winters M.D.

    1. EMR’s would likely save a lot of money if they could be interfaced.
    2. Medicare beneficiaries need to be mandated to make out “Living Will” type things and have them signed by a closest relative so we don’t spend so much money at end of life.
    3. Reading online about Biden raising $2M at an “intimate” gathering of trial lawyers in a home is very troubling. No way could you get $2M from and intimate gathering of doctors. We just do have that much. What are they buying w/ it that we can’t get? On the other hand I think Obama is more in tune with the “little guy”.

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  196. Robin Stevenson

    Each individual has the responsibility for his or her own life. Choices are made by everyone. Some good. Some bad. It should not fall on the shoulders of everyone else if an individual makes bad choices in life. I feel for people who are uninsured, but this is their choice; we should not be held hostage to the bad choices of these people

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  197. Leslie Batten

    I would like to see our country’s health care focused on prevention rather than acute/chronic care. There’s so much we can do as primary care physicians to help the citizens of this country to eat right, exercise, and take charge of their health. Our government has done much to harm our health rather than help; our public schools have not offered mandatory physical education for many years. The FDA will soon agree to label high fructose corn syrup as natural, a substance which is added to nearly all packaged food in this country. We have our work cut out for us. Educating our patients is our biggest challenge. Neither presidential candidate has really addressed health care from the prevention perspective, which is terribly short-sighted.

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  198. Beth Pack,RN, MPH, NP student

    The problems in providing health care in America include:
    1. The high cost of administrative services. These may easily add upwards to 30% to the overall bill. Health insurance substantially adds to this cost.
    2. Ofter, the larger the institution where the services are provided, the more expensive the bill for services - in contrast to an expected “economy of scale”.
    3. National/state insurer are focused on cost (understandably). Hoever, the short term fix is to reduce “reimbursement” to providers for services provided or limit coverage for specific procedures, drugs, & therapies. So, reimbursement provded through insurance is even more rule driven which results in more administrative costs and less payment for direct patient services.
    4. We need serious malpractice tort reform. Much of the reams of documentation is done solely to satisfy a reviewer, and may actually negatively impact on patient care by reducing substantive time with the patient as well as being distracting for the provider. Further, some “standards of care” are applied as though there are “standard patients” - which reflects a manufacturing model rather than a human services model.
    5. Public policy is remarkably silent about the role of personal responsibility in patient health care needs and outcomes.

    It’s time to have realistic discussions of the practical provision of, expectations from and payment for health care. Neither presidential candidate appears to have a realistic grasp of the situation.

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  199. Ken

    This is a very difficult problem. Government run? - Scary and inefficient. Manditory? Yes for the children. Also only if you are a US citizen. Can we afford it? Not now with the down turn in the economy brought on by a War and out of control spending by the Government, but look at the bright side, when health care goes belly up and gets bailed out by the government (tax payers) when can go on a $400,000.00 vacation like the big boys at AIG.

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  200. James Linkin

    Obama’s plan would marginally address the uninsured while not addressing the underlying ills of the system: huge administration and bureaucracy costs from private insurance; and rapacious pharmaceuticals who skew the entire healthcare system for their own benefit.

    McCain’s plan would make everything much worse. With their benefits taxed, businesses would be forced to drop insurance for their employees altogether, who would then be forced into the individual marketplace where no one can afford care. On top of that, all the insurance companies would relocate to the state with the loosest regulations; if you think it’s hard to get reimbursed now, wait until McCain becomes president.

    We already have two enormously successful single-payer systems in the US: Medicare and the VA. VA care is the best in the Western Hemisphere, and nearly as good as the national systems in Europe’s wealthiest countries, like Germany, Sweden, and Netherlands. Healthcare professionals in most of these systems are well paid, have less stress, and are protected against liability. What’s not to like?

    The only reason we haven’t adopted such a system here is the insurers and pharmas. Which is more important, their profits or our health?

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  201. Christian Warren

    Medicare/Medicaid and Social Security are a $100 trillion dollar debt bomb about to detonate. These three programs alone threaten to absorb all future federal tax revenues. Government health care has failed us. We need a market solution, such as medical savings accounts that could be sheltered from taxation. Spending the money in India is a low-cost alternative to US health care. Entrepreneurs need to step forward with creative solutions before we get saddled with a single-payer system.

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  202. Mike

    Taxing employer health insurance is not the answer. McCain is way off track. I’m not the biggest fan of Obama’s plan either, but it is far superior to the patchwork tax incentive plan of McCain’s, which most people know will not work for the underprivileged.

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  203. Dan Rudd

    I could never vote for a person that supports abortion. Its also ridiculous to believe that universal type health insurance will do anything, but lower the overall quality of care and result in only the rich having truly excellent care.

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  204. Tami Borneman

    I very much agree with Jonathan’s comments above. I also think Obama offers nothing more than Socialism and we know how well healthcare does in that kind of a system. For all the negatives we can expose about our healthcare system, it is still the best around.

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  205. Bill DeMedio

    We need a bare knuckles health plan that will cover basic needs. The focus needs to be on primary preventive care. There can be an authorized formulary with pre approvals. This should be available to anyone who wants it on a sliding fee scale. Previously diagnosed conditions should be covered. It can be funded from the excess costs of defensive medicine and futile care. Malpractice insurance and suits should be eliminated. As state licensed professionals already heavily regulated by the state cases of negligence should go to tribunals of our peers for disposition, sanction and punishment much like the uniform code of military justice and court martials. This should keep all parties happy.

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  206. Christina Smith

    I appreciate the fact that I still have a right in this Country to receive whatever type of health care I choose. Mandatory health insurance would be practically useless to me unless it covered complimentary medicine. What if I only prefer to be treated by Allopathic Doctors in an emergency? This is not a one size fits all problem and neither will be the solution!

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  207. Jonathan

    No way Obama will touch tort reform. His biggest contributor is the trial attorney association. Health care is a privilege and should be treated as such. Americans do not take care of their bodies and they expect someone else to pay for it. The Democratic party wants to encourage a sense of entitlement and dependancy. This is being propagated by the media and elite socialists in DC and in Hollywood.

    McCain needs to be the maverick that we know he can be and buck the system and drag America back to the values and small government that made us great in our first 2 centuries. People need to stop whining and pull themselves up. America was built by people with enterprise not handouts –THIS IS WHAT MAKES AMERICA GREAT! When that stops America ceases to be great and becomes just what we left — the rest of the world.

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  208. James Finney

    The Feds will only make the health care system worse They can’t get anything right.

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  209. J Yanoschik

    This topic like most issues is a matter of choices. A vast majority of diseases are self inflicted. Most american make bad choices and then do not take responsibility for their actions. For example, smokers wonder why they have so many health problems. Morbid obesity is rampant and these people wonder why their joints hurt. I hear that a lot of Americans cannot afford health insurance. I will bet that these same Americans all have cell phones and are paying anywhere from $40 to $90 per month on calling plans. Americans choose to be connected rather than insured.

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  210. Leigh

    The government should NOT be required to cover the costs of healthcare for individuals. Yes, we have a number of uninsured/underinsured in America, but how many of those individuals are illegals? How many of those individuals sit at home and wait for the government to serve them? I believe that American already has a “universal” healthcare in place - it’s called Medicare and it is available to the elderly and disabled citizens of America. Establishing a universal health care will cause a substantial decrease in quality and quantity of physicians servicing patients.
    Individuals who are “rich” (in Obama’s eyes that is anyone who makes over $250K/yr) should NOT be required to pick up the tab for others “less fortunate.” Placing extra taxes on America’s small business owners is a sure way to crush small business and eliminate competition in the market place (whether it is healthcare or any other field).
    Let the silent majority rise up and be heard… vote McCain/Palin.

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  211. Nancy

    Many good suggestions-unfortunately neither of the candidates appear to have taken the suggestions of those who actually deliver excellent health care day in and day out. What about Tort reform? McCain does mention it, Obama doesn’t. Without tort reform, and the ability of us to be able to do our best without fear, little improvement will occur.

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  212. Trina Moss, MSN, RN, CNN

    I to believe that the burden of ininsured individuals places an increased burden on our total healthcare resources. This is one of the main reasons we have seen healthcare costs skyrocket in the last decade. Those of us who are insured are paying more because so many uninsured/underinsured use U.S. EDs as their primary care visit. Our country has been well known for all the wonderful advances in technology and innovation. Unfortunately, we don’t do as well when it comes to placing dollars in preventative care. As a Certified Nephrology Nurse, I see all too often, patients who end up with Chronic Kidney Disease, Stage V (ESRD) because they don’t understand the importance of preventing the comorbidities or can’t afford the insurance/medication necessary to slow the progression of the comorbidities. Based on the constitution, every American has the right to life, liberty, and the pursuit of happiness. It is very difficult to attain either of these without adequate health and quality of life. I feel that Obama offers the better solution of the two. I believe that we need to make mandates. If there are no mandates, people typically don’t choose health insurance (or any kind of insurance for that matter) as a priority. We need to take a strong look at what is important as Americans. It is very humanitarian to help other countries but if our citizens are dying at disproportionate rates due to lack of healthcare coverage and preventive treatment, are we taking care of “our own back yard?” As far as government reform/intervention, it is definitely needed. What we don’t need is a continuation of insurance execs receiving millions for denial claims and insurance lobbyist whose voice is louder (by virtue of money talks and everything else walks)than the average American citizen.

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  213. David Denman

    Obama is a willing sponsor for the death of over 1 million of our citizens yearly. This is the greatest healthcare crisis in america. This overshadows all other healthcare issues and this crisis will not be solved by a willing legal participant in this holocaust.

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  214. Catherine Veilleux

    I think Obama has the average everyday American in mind when he talks about healthcare reform, and is interested is eliminating prejudicial and unfair practices of insurance companies. Most American politicians (Republicans) always see this in black and white either government run or insurance run. Why can’t we be more creative and open minded and solve the problem as they do in Switzerland or Germany? Everyone is covered but the working people have a choice, it is a blend of both. If you lose your job medical care does not go away. We need to become a more compassionate caring country- let’s take care of 100% of Americans, not just a select few.

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  215. Scott Moon

    Third parties picking up the tab reliably escalates costs. There must be a move towards putting power/responsiblity back into the patient’s hands when it comes to their health care, like personal savings accounts. If a faceless/nameless third party is picking up the tab, I’ll take the filet mignon and lobster every time. If I or someone I know is paying, maybe a hamburger steak will suffice.

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  216. Clem Hallmann

    We already have a government sponsored health plan that works…..Medicare. They farm out their administration for about 5 to 6% to a private company and use the remainder for health care expenditures. We don’t need to involve a myriad of private insurers just increase the number of Americans covered under the present Medicare system and we instantly have a national health plan that we know by experience will work and will be economically run with no private insurance involvement…..shareholders…CEO’s…..Wall Street…..profit growth….share price etc…all of which have no place in the cost effective care of our sick!

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  217. Karl Harnish DO

    I don’t think either candidate answered the question about health care as a “commodity,” which I feel is a big issue. How much of our health care / insurance dollars are going to the brokers of this “commodity” rather than to the providers of the commodity?

    Since the patients do not see the costs involved, they can not be smart shoppers in the medical field. At the grocery store, they have to decide whether to buy steak or hamburger tonight; maybe if they saw the costs involved they would be more content with a good history and physical exam than expect a CT or MRI for every ache and pain.

    If we, as the medical community, could extract ourselves from the insurance industry, I feel we could deliver good medicine at a reduced rate. We should expect the patients to pay us for our services, then let them seek reimbursement from whatever broker they chose to deal with. Word will get out quickly which brokers have the patients welfare in mind and which ones want our money for their executive’ yachts!

    When a tree comes down on my roof, I pay the carpenters and roofers, I don’t expect the insurance company to pay them. I pay the body shop when they work on my car, I don’t expect the insurance company to pay them. In both cases, I decide (with consultation with the experts) what needs to be done and who I want to do it. If I want “the best that money can buy,” that is what I get, realizing that I’ll probably have to pay quite a bit more than my insurance will cover.

    Why have we given this up in medicine?

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  218. Sylvia Ingerson, PMH-NP

    I believe that those who make the most over `$150,000 a year should be paying the biggest percent of the taxes as well as sports and celebrities should contribute to healthcare. Their should be incentives for individuals that work in healthcare so that we do not lose healthcare providers. Individuals who do not work should be carefully investigated. Criminals and ex-criminals should have fewer options if they harm others or have harmed others. They should have to earn their medical benefits.

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  219. Michael Rupp

    Healthcare reform is needed, but anytime the federal government gets involved things become 2 or 3 times m-re expensive than they need to be because a large bureaucracy is ushered in with every new program. Americans pay enough taxes already without supporting new bureaucracy. Reforms in healthcare should be a partnership with private industry and taxes penalties for no insurance or credits for people or businesses who have/provide healthcare. We cannot afford to pay more and more taxes for more and more programs when our national debt already soras over 10 trillion dollars and people can’t make their house payments.

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  220. Maria Ciferni

    I agree with Obama. The more Americans that are uninsured increase the burden on this country; more illness, loss of jobs, decrease in productivity, etc.. I see too many Americans choose between cars, houses and health insurance. They don’t choose health insurance. They seek out medical care too late, don’t practice preventative care. When they finally show up for health care it is with a list of morbidities.

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  221. mike radu

    one payer would increase my bottom line and we should stop playing games everything is according to medicare and medicaid

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