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Posted on Sun, Mar 13, 2011 : 5:50 a.m.

Privatize Medicare? No thanks!

By Guest Column


Dr. James Mitchiner

Well, Karl Rove has done it again. In a recent opinion piece in The Wall Street Journal (“The Politics of Saving ‘Granny,’” Feb. 3), the former Bush presidential adviser sings the praises of replacing traditional Medicare with a federal voucher system.

Under this plan, as proposed by House Budget Committee Chairman Paul Ryan, R-Wis., and former Clinton Budget Director Alice Rivlin, American seniors would receive a federal subsidy to purchase private health insurance policies from competing insurers of their choosing. In other words, Medicare would become privatized, and seniors could select from among hundreds of for-profit commercial or Blue Cross plans across the country, based on their benefit structures, provider networks and premium costs.

Is this a good idea? I think not, for the following three reasons.

The first has to do with the meaning of “choice.” When it comes to choice in health care, I believe that what Americans really want is the ability to choose their own doctors and their own hospitals, rather than their health insurer. In fact, I honestly believe that the average citizen could care less about who their employer’s insurance company is, as long as the ability to pick their own health care providers is preserved.

Under the present system, that is virtually impossible. Most working Americans get their health insurance through their jobs, and their insurance is chosen for them by their employers’ human resources department, generally on the basis of premium cost. And along with that assigned insurer comes a fixed network of providers - doctors, hospitals, outpatient labs, physical therapists, etc. - chosen by their insurer. If a worker chose an out-of-network provider, he/she would have to pay the full cost of seeing that provider, or at least incur a higher co-pay than would be the case if the chosen provider was in-network.

To explore this further, consider how you might currently choose a hospital on the basis of publicly available information. Right now, you can visit the website and, by typing in your zip code, you can compare up to three local hospitals on the quality of medical care they provide to inpatients with pneumonia, heart attack or congestive heart failure. For each hospital, you can find the typical cost and 30-day mortality rate for each of these diseases. You can also check to see how each hospital performs in preventing surgical infections and blood clots. And you can rank each hospital in terms of creature comforts, like noise level, cleanliness, doctors’ communication skills, and treatment of pain.

All of this is obviously of interest to an educated consumer, and it certainly comports with the public’s desire for more transparency in health care. But here’s the catch: What good does it do for you to know if Hospital A is better than Hospital B, if your insurance plan does not cover the costs if you go to Hospital A (or, if it does, you’d have to pay more out-of-pocket than if you went to Hospital B)? If the purpose of insurance is to limit your out-of-pocket costs for the medical care you value, why should you have to pay more to see a higher quality provider? Clearly, cost is a prime factor in personal healthcare decision-making, even more so for individuals and families of limited financial means. As a practical matter, our current system guarantees that their “choice” will be constrained by the cost of care as seen by their insurer.

The second reason is based on the proposed amount of the Medicare vouchers. Mr. Ryan’s plan, as spelled out in his “Roadmap for America’s Future”, is for those who are now under the age of 55 to receive a payment - as they become Medicare-eligible in 10 years or more - of $11,000, with adjustments for income and disease burden. With the current annual family premium for a private insurance policy averaging $14,000 and climbing, it seems obvious the proposed payment is insufficient for the typical middle-class senior to purchase an insurance policy that would provide meaningful coverage at the time of retirement.

And the third reason for opposing Medicare vouchers is the fact that privatizing Medicare would presumably remove the option of continuing the status quo. As has been the case with attempts to privatize Social Security, there are millions of Americans who prefer government financing of social insurance programs over control by profit-oriented Wall Street firms, thank you very much.

Rather than deconstructing Medicare as we know it, perhaps we should try another tack. Let’s work instead to expand and improve the Medicare we have now, so that everyone - not just seniors - would have access to the health care providers of their choice, without the financial barriers that are characteristic of for-profit health plans. Let’s make health care truly universal, for all people and for all conditions, regardless of where they live, who they work for, or how much they earn.

In other words, let’s cut out the middlemen and their inherent inefficiencies, put people before profits, and push for a single-payer health insurance program instead.

Dr. James C. Mitchiner is an Ann Arbor physician and the former president of the Washtenaw County Medical Society.



Mon, Mar 14, 2011 : 11:36 p.m.

The Republican argument against a single payer system is just dumb. Go on the World Health Organization web page---- look at the numbers--- look at the life expectancy of those countries and tell me what's a better deal. We could save up to 50% of what were paying now. The only way the Republicans have to justify their position are just lies and misinformation.


Tue, Mar 15, 2011 : 1:01 p.m.

The US has the highest survival rate in the world for breast and prostate cancer. <a href="" rel='nofollow'></a> Life expectancy is a poor statistic to evaluate the quality of a health care system. The U.S. health care system is the best in the world. Financing it is expensive. Changes need to be made. Obamacare is a disaster unfolding over the next 6 years. Let each state develop and finance a plan that suits their needs instead of dictating a solution devised by the feds.


Mon, Mar 14, 2011 : 6:06 p.m.

@leaguebus: Imagine that, Time magazine using the World Health Organization flawed study as its basis that England's universal healthcare system is better. Hmmm...only the working rich is covered? I am working, but definitely not rich and I am covered by health insurance. But guess what? I pay for 100% of the premium out of my pocket. I don't expect anyone else to pay for it. I choose to pay for it for me and my family. If you would have read the article you would have noticed: &quot;NHS (England's healthcare system) patients wait an average of about 8 weeks for treatments that require admission to a hospital, 4 weeks for outpatient treatments &amp; 2 weeks for diagnostic tests.&quot; Oh, &amp; they can't choose their specialist. Wow, I have to wait 8 weeks before I am admitted into the hospital for service? Nice system England has there. If the health care in England is so great, then why is their government getting rid of 150 governmental entities that dictates what, who, and where a patient can get medical services? Why is the government abolishing the horrendous practice of government set targets of limits on how long patients have to wait for treatments and surgeries? &quot; Don't blame it on a program that has not really started yet.&quot; The program has started already. And Kathleen Sebelius, Secretary of Human and Health Services has stated in September of 2010 because of the new law premiums will go up!


Mon, Mar 14, 2011 : 3:56 p.m.

@maallen look at the URL below, it a Time article on the British HC system <a href=",8599,1916570,00.html" rel='nofollow'>,8599,1916570,00.html</a> Appears that you are a victim of the Republican Anti Health Care Myth. The Brits love to criticize their system, but don't want to get rid of it. They live longer than we do (something must be working over there) and they pay less than half as much as we do, plus they are all covered, not just the working rich like this country. As far as unregulated private anything works better than a government plan, tell the voters that Medicare is going to be scrapped, the Republican War on the Middle class will be gone in seconds. @Macabre, does DARPA count on the list of government failures? The only way the middle class can afford health care now is if they are working. What is the current unemployment rate? I could not afford health insurance now if I my job did not subsidize my healthcare benefits. My ex-wife is 60 and is a very successful Real Estate Agent. She has $5000 deductible so she and her husband can afford to have health insurance. Sorry, the system is bad and getting worse as you have seen in your rate increases? Don't blame it on a program that has not really started yet.


Mon, Mar 14, 2011 : 2:52 p.m.

One only has to look at Kathleen Sebelius, Secretary of Human Health Services, letter back in September of 2010 to know that because of ObamaCare health insurance premiums are going up. In that letter to the insurance association, Ms. Sebelius admitted that the new law ADDS to the premiums and does not reduce it. When President Obama or anyone else says that the new law lowers or will lower our premiums are just lying. Or doesn't understand that when you mandate more benefits to a policy (no lifetime maximums, no pre-existing conditions) you drive the cost up! As far as single payer system goes, in just 20 short years from fully implementing a single payer universal healthcare system in Canada, the country started rationing their health care for their citizens. 1971 is when Canada fully implemented the single payer system. In 1991 the U.S. Government did a study on Canada's system and here's a quote: &quot;The Canadian method of controlling hospital costs has limited the use of expensive, high-technology diagnostic and surgical procedures. As a result, waiting lists or queues have developed for some specialty care services, such as cardiac bypass surgery, lens implants, &amp; MRI's. Emergency cases however, are treated immediately, bypassing waiting lists.&quot; Now 40 years later, Canada is moving away from single payer universal healthcare and going back to private health care. England is now moving away from universal health care because costs have gotten out of control. Currently in England, the system is designed so as the how and the where patients are treated, and by whom is determined by decisions from 150 government entities known as primary care trusts. England has now put forth a plan to abolish this and allow the decisions and choices go to the patients. They are also abolishing their many current government set targets, like limits on how long patients have to wait for treatments and surgeries. Wow what a system universal single payer system is!

John Q

Mon, Mar 14, 2011 : 2:37 p.m.

I wish I had Macabre's health insurance that was free of any increases until Obama took office. Everyone else I know has seen their health insurance costs rise for decades. How was it that Macabre was getting a free ride for that time while the rest of us paid more?


Mon, Mar 14, 2011 : 1:49 p.m.

We're told that Medicare's delivery of health care services is at a very competitive cost, as compared to commerica health care insurance.


Mon, Mar 14, 2011 : 12:12 a.m.

&quot;In fact, I honestly believe that the average citizen could care less about who their employer's insurance company is&quot; If the average citizen could care less about who his or her employer's insurance company is, then the average citizen does care about who his or her employer's insurance company is. Doesn't this go against the rest of your article. Or did you mean to say that the average citizen couldn't care less?


Sun, Mar 13, 2011 : 11:58 p.m.

I strongly support a move to single-payer. Nearly every advanced country has a well-functioning single-payer system that is embraced by its citizens. Yes, that includes Canada--the Canadians will tell you how much they like their national health plan. Advantages of single payer: - Lower administrative costs--Medicare is by far the most efficient &quot;insurer&quot; out there - Easier system for the doctors, who won't have to deal with lot of different insurers, each with their own rules - Separating health care coverage from employment will allow American busineses to be more competitive internationally


Mon, Mar 14, 2011 : 3:08 p.m.

Canada? Really? You do realize that Canada is now moving away from their single payer system right? The provinces of Alberta, British Columbia, and Quebec are now combining both public and private care to help reduce wait times and control public spending. Canada's Supreme Court said this in June of 2005, &quot;The Courts majority found that waiting lists for health care services have resulted in deaths, have increased the length of time that patients have to be in pain and have impaired patients ability to enjoy any real quality of life.&quot; The Court voted to invalidate the prohibition on private insurance. In 2006 Quebec announced it would improve access within the public system for cardiology, radiation oncology, hip &amp; knee replacements, &amp; cataract surgery within 6 months after being diagnosed. If surgery can't be performed at government facility by then, then Quebec will pay for the surgery at a private institution within or outside of Canada. Even England is moving away from single payer. England is making cuts in their healthcare because costs have gotten out of control. They are now decentralizing the system &amp; putting the power back into the hands of patients and doctors instead of some government employees. Currently, their system is designed so as the how &amp; the where patients are treated, &amp; by whom is determined by decisions from 150 government entities known as primary care trusts. England's government has now put forth a plan to abolish this and allow the decision &amp; choices go to the patients. They are also abolishing their many current government set targets, like limits on how long patients have to wait for treatments and surgeries. What a system this single payer system is!


Mon, Mar 14, 2011 : 12:34 p.m.

Larry, Did you know that Center for Medicare Services farms out payment processing, and other adminstrative functions to insurance companies like Aetna. Because they can do it cheaper.


Sun, Mar 13, 2011 : 9:55 p.m.

Employer based health insurance has almost nothing to do with Medicare. Medicare is a government program to provide health insurance for people over 65 or disabled. Medicare enrollees can seek treatment ANYWHERE in the U.S. that accepts Medicare. There is no network. So &quot;lack of choice&quot; is not relevent. Vouchers will not cover 100% of premiums is true. But Medicare does not cover 100% of expenses. Medicare has a deductible and a co-insurance component like many employer based plans. Seniors are free to purchase additional coverage to cover expenses not covered by Medicare. I agree completely that the staus quo is not sustainable. The federal government is $14 trillion dollars in debt and spends more than $1 trillion dollars more than it takes in. The feds do not have the money to finance a single payer system. America is a large diverse country. A top down central planning approach to something as complicated as medical care financing will not serve us well.


Sun, Mar 13, 2011 : 7:02 p.m.

Reform malpractice, open more medical schools, and allow Physician's Assistants and Nurse Practitioners to do more. These 3 changes would do more to reduce medical costs than anything else. As to Medicare and Medicaid, check out the front page of the Detroit Paper today. Great publicity for a government run program. NOT!


Sun, Mar 13, 2011 : 7:26 p.m.

From, October 10, 2009, &quot;Congressional budget analysts [CBO] said Friday that lawmakers could save as much as $54 billion over the next decade by imposing an array of new limits on medical malpractice lawsuits&quot;. That's $54 billion over ten years, about $5.4 billion per year or, $5.4 billion/$2.3 trillion, or about 0.23%.


Sun, Mar 13, 2011 : 6:55 p.m.

Dr. James Mitchiner hit the ball out of the park! His analysis of choice in the for-profit private healthcare insurance industry accurately describes my experience with employer-provided healthcare insurance. My "choice" was limited to the choices of plans offered by my employer. Now I have only one "choice". For-profit health insurance companies have a fundamental conflict of interest: fiduciary responsibility to their shareholders vs. financial obligation to pay claims of their policyholders. From Physicians for a National health Program," Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay." Yes, let's get rid of the middlemen.

Brian Kitchin

Sun, Mar 13, 2011 : 4:07 p.m.

What is the Government doing in the Healthcare business anyways? See, this is what the Left doesn't get. I want the Government out of all this nonsense. We that have paid into it, give us our money back. So I spend my kids inheritence on my health. So what? It's MY responsibility. Not the taxpayers. The Feds don't mind taking 50% of your estate when you die unless you trick them. So who cares. When the Feds provide for you they limit you. How many laws are passed for our BEST INTEREST. Seatbelts, helmets, smoking. Why? because whoever pays the piper calls the tune and we'll all dancing to the Fed's tune.


Mon, Mar 14, 2011 : 12:37 a.m.

Yes, let's definitely keep Big Insurance companies running our health care system. It's been working so well for us. *sarcasm*


Sun, Mar 13, 2011 : 7:05 p.m.

Libertarianism works great to a certain extent, but it is one step short of anarchy. Yes, we give up some freedoms for our collective good. That's collective utilitarianism rather than individual utilitarianism and it is a constant ebb and flow between the two. But the simple adage, &quot;United we stand, divided we fall&quot;, is probably most apt.


Sun, Mar 13, 2011 : 6:17 p.m.

Yes, there are laws to protect the GENERAL welfare of the country over YOU. I guess if you wanted it, we could return to what the founders had. Balcks were 3/5 of a person. Women could not vote. Why should the government care what I do to MY kids. If I beat them so be it. They are MINE. Why should the government care about food safety? Eat at your own risk. Why should the government care if Ford Explorers roll over and kill people. You should have had it analyzed by your scientist before you bought it. If I sell you a house that has asbestos in it. Too bad, so sad for you. If you want to drive, pay a toll on EVERY street. If you want police protection BUY YOUR OWN. Ayn Rand and her philosophy is dead. Join the 21st century.


Sun, Mar 13, 2011 : 2:54 p.m.

TOO MUCH GOVERNMENT involvement in our business. We DO NOT have a RIGHT to health care it is a priviledge.If you let someone pay for your health care then they will tell you how you have to eat, exercise and how you should live your life to reduce costs. The more people say it then they will believe it. We DO NOT have a right to anything but the pursuit of happiness. What is your perception of happiness? It is different for many individuals. Stop incouraging others to pay for someone else way of life. We should help others out of own free will.

Edward R Murrow's Ghost

Mon, Mar 14, 2011 : 10:14 a.m.

For those, like Kelly, who see &quot;rights&quot; as being limited to &quot;life, liberty, and the pursuit of Happiness&quot;: 1) The pursuit of happiness covers a lot of ground 2) They should note the that the actual phrase in the DofI reads: &quot;We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are . . . &quot; Emphasis on AMONG--in other words, there are other rights not enumerated. Finally, I love the silliness of &quot;If you let someone pay for your health care then they will tell you how you have to eat, exercise and how you should live your life to reduce costs.&quot; Do you therefore mean, then, that people should not want health care provided by their employers because, if anyone has incentive to reduce health care costs in the way described, it is employers. Good Night and Good Luck


Sun, Mar 13, 2011 : 7:02 p.m.

No, healthcare is a right. It is essential to the defense of this country that its populace is healthy. Government need not necessarily be the supplier or payer for healthcare but it must insure that access and availability to quality healthcare is present for young and old throughout the U.S.


Sun, Mar 13, 2011 : 6:03 p.m.

Oh, and how do children go about earning the &quot;priviledge&quot; of health care? Or is it too much interference to force our way of life (i.e. getting medical help) onto a baby? If a baby is born with a health condition, I guess we can just hope they'll make it until they're old enough to consent to treatment and work for years to earn enough to pay for it. Unless, of course, the children of the wealthy deserve health care more than do children born into poverty.


Sun, Mar 13, 2011 : 5:27 p.m.

Health care is a privilege? It is fascinating to see the narrative you've constructed to justify inequalities. Do insurance companies dictate how you live? Does the government dictate how people on Medicaid or Medicare live? Do other countries with government-run health care dictate how people live? No. The fact is that everyone, whether they choose to or not, may end up needing health care. If we all pay for each other, then everyone can get quality care when they need it at the lowest cost.


Sun, Mar 13, 2011 : 4:17 p.m.

Actually, we have a right to &quot;life, liberty &amp; the pursuit of happiness&quot;. I believe LIFE comes first in that statement and with things like accidents, illness and chronic medical conditions, not only are people's ability to be happy decreased, but their chances of actually LIVING are, ESPECIALLY if left completely untreated by medical professionals. You can have your Tea Party narrative as much as you'd like, it is your opinion after all, but to say that we &quot;only&quot; have the right to happiness and to completely ignore our right to LIFE is just silly.

Brian Kitchin

Sun, Mar 13, 2011 : 4:07 p.m.

Amen Brother. Preach it.

David Briegel

Sun, Mar 13, 2011 : 2:24 p.m.

The biggest problem with Health Care Reform was the deal that was made with the devil! The excessive waste in the insurance industry who take the premiums from their patients only to deny them the care they thought they had paid for while renting the best gov't money can buy to prevent real reform on behalf of our citizens. We needed single payer and we got the devil's product instead! Has anyone noticed how every &quot;reform&quot; proposed by the new TeaPublicans tend to benefit the wealthy at the expense of the rest of us? How is it that a populist movement of the masses comes to this type of conclusion?


Sun, Mar 13, 2011 : 6:58 p.m.

Thank you, David. I wholeheartedly agree!


Sun, Mar 13, 2011 : 1:48 p.m.

No, no, and no to privatization of medicare. First and foremost, the government must improve the office that they set up over ten years ago to combat against medicare fraud -- most recently another news program related the story that even this &quot;office was set up&quot;, medicare fraud runs rampant. So now we not only have a continuing of medicare fraud, we are supporting an office to stop it. Fortunately, finally, I did see where some action was taken and several doctors were arrested. Keep up this good work and eliminate are tax payers dollars going into the pockets of criminals.


Sun, Mar 13, 2011 : 3:20 p.m.

Fraud and abuse within government programs are most often carried out by people in the private sector - they're the ones billing the government. But the Republican and Tea Party folk want &quot;less government&quot; - just another phrase for &quot;lets get government out of the way so we can even more easily get away with ripping-off the taxpayers&quot;. Before you complain about the government offices that go after fraud and abuse in government, you should find out how many staff they're allowed and how much we're spending to support them, remembering all the time that it's mostly because of the greed in the private sector that they exist in the first place. And now the same political groups are going after government workers as being overpaid. Maybe that's because the private sector was an easier venue for creating an economic crisis to justify taking pay and benefits from the workforce and diverting cost-savings into huge corporate profits and big corporate management bonuses. And now that that the American people are beginning to realize the extent to which they've been snookered, the same people are trying to divert attention by blaming our woes on government workers.


Sun, Mar 13, 2011 : 12:30 p.m.

I guess there's no possibility that the Private Health Care Bureaucracy that includes Insurance Corporations, Big Pharma Corps like Pfizer, Doctors, Hospitals and CEO's decided on their own to raise premiums to increase their profits in the absence of true reform. Instead of repeating unsubstantiated and grossly generalized Republican talking points about &quot;inefficient government&quot;, we'd like to see the substantiation for your claim that rising health care costs are due to President Obama's and the Democrats efforts. I wish someone would explain in detail and without Republican &quot;job killing&quot; hyperbole how will &quot;socialized medicine&quot; will price the middle class out of health care when single payer will provide better coverage for more people and lower the deficit in the long run by broadending the pool and reigning in Private Health Care Bureaucracy costs and profits?


Mon, Mar 14, 2011 : 3:19 p.m.

In September of 2010 Kathleen Sebelius, Secretary of Human and Health Services, (you know, the one that is overseeing this new health care law) admitted in a letter to the Association of health insurers that because of the new law premiums will be going UP. &quot;According to our analysis...any potential premium impact from the new consumer protections and increased quality provisions under the Affordable Care Act will be minimal.&quot; Minimal? Really? And this is the government saying this. Whatever happened to it will REDUCE our premiums? Now they are saying it will increase our premiums, but minimally. Would you rather believe the government or the market place? She goes on to say, &quot;Any premium increases will be moderated by out of pocket savings resulting from the law.&quot; Out of pocket savings? Really, ummm, what are those again?


Sun, Mar 13, 2011 : 8:25 p.m.

Well if Macabre said it, it must be so! (where is his evidence?)


Sun, Mar 13, 2011 : 6:59 p.m.

johnnya2 is absolutely correct: the insurance companies are thieves. The new health care law will limit their ability to profit from insureds to reasonable levels. Rising costs right now are profit taking before the law is enacted in 2014.


Sun, Mar 13, 2011 : 6:13 p.m.

Your increased cost has NOTHING to do with the Health Care Reform law. The main components of it have not taken effect yet. So in fact, leaving things alone is what caused your rates to rise. Insurance companies that took a bath in the financial crisis are making it all back up on the policy holders. It is collusion among these thieves.


Sun, Mar 13, 2011 : 3:03 p.m.

You just had substantial evidence it is the RISING costs happening RIGHT NOW. Macabre said there costs have gone up 50% and my has gone up almost 50% in the last 2 years. THERE'S YOUR EVIDENCE....WAKE UP!


Sun, Mar 13, 2011 : 1:08 p.m.

Republicans have been trying to kill Medicare and Social Security since their inception. They will call it different things, use different guises or emergencies, but ultimately they want the programs destroyed. And where will we be then? The elderly on street corners asking for pennies to pay for the black market drugs and surgery they can't afford. It's shameful. It is the responsibility of the government to protect its populace - especially the elderly and very young. Medicare is a safety net for our elderly and needs to be protected. It is not perfect, but it's the best thing going right now.


Sun, Mar 13, 2011 : 11:48 a.m.

Our health care system is in serious trouble. Privatizing it will only help the rich. Improving Medicare and moving toward single payer is the best choice for the vast majority of us who aren't wealthy.


Sun, Mar 13, 2011 : 11:06 a.m.

Yes, corporate America has been doing such a good job and when they fail.....who bails them out? Thus, they just keep hauling in more and more profit while we keep bailing them out. No thanks, this frightening attempt by the wealthy to take away any public benefit for the sake of corporate profits......stinks.

Macabre Sunset

Sun, Mar 13, 2011 : 10:03 a.m.

Unfortunately, the single-payer plans would either escalate costs or drive doctors out of the practice of medicine. Whenever the government takes over a business, efficiency is no longer valued or even recommended. This leads to extraordinary cost increases. Obamacare is already screwing up medical care. My premiums have risen nearly 50% in the last six months. Unlike all of this doctor's friends, I run a small business, so I don't have the luxury of spending taxpayer money. Socializing medicine will price the middle class out of health care.


Mon, Mar 14, 2011 : 3:39 p.m.

And how can one forget the CLASS ACT that was tucked into the ObamaCare legislation? You know, the government run long term care new entitlement program. In the health care bill, all working adults will get money taken out of their paycheck to pay for a government run long term care program. Sounds a lot like Social Security doesn't it? If you don't want this government run long term care insurance then you have to OPT OUT. Otherwise it is automatically taken out. What did Ms. Kathleen Sebelius, Secretary of Human and health services have to say about this on February 16, 2011? It is &quot;totally unsustainable.&quot; She said &quot;The snapshot in the bill, I would absolutely agree, is totally unsustainable.&quot; This program starts in 2012!


Mon, Mar 14, 2011 : 12:56 a.m.

Of course it's a tax! The young &amp; healthy (and working) subsidize the healthcare of the infirm, elderly, poor, and very young. What's the alternative - letting them die? When we're old, hopefully folks will want to take care of us too! We are the richest country in the world, we should be able to insure folks to the level that no one ever goes bankrupt from healthcare bills. I'm not talking platinum handouts, but there is a reasonable level of care that everyone in the U.S. should expect.

Macabre Sunset

Sun, Mar 13, 2011 : 10 p.m.

From talking to my insurance agent a few months ago, who bids out my contract from time to time, the cost increases come from the unfunded mandates in Obamacare. I have a high-deductible plan. I'm now being forced to pay for things I don't want. Essentially, it is a tax increase on relatively healthy people - and probably the largest tax increase the government has ever passed. A good friend of mine is in upper management in a non-profit health care company. She is actually responsible for packaging elements of plans her company offers to other companies. Since it is a non-profit company, the state oversees the books and requires that the company spends at least a fixed percentage of what it takes in. No golden parachutes for executives. She said their ability to offer sensible high-deductible plans is being eliminated. There are just too many golden perks the new law requires. My experience is hardly unique. The trillions in extra spending in Obamacare is being paid for by younger, relatively healthy people who aren't working in the public sector. That is a tax.


Sun, Mar 13, 2011 : 6:57 p.m.

SonnyDog: There are a lot of reasons that healthcare costs are rising. One reason is that younger, healthier people are opting out of expensive health care plans because they don't need the care. Unfortunately, the remaining people in the health plans pay the difference. Plus, the larger pool of insureds give health plans leverage in negotiating better costs for medications and services. Part of the problem is that insurance companies haven't been sharing that with insureds. But that is another thing &quot;Obamacare&quot; fixes that some people don't like...


Sun, Mar 13, 2011 : 5:20 p.m.

If government-run health care would lead &quot;to extraordinary cost increases,&quot; then why does every country with government-run health care pay less than we do (and get better results)?


Sun, Mar 13, 2011 : 1:55 p.m.

Insurance companies raise their rates and increase their profits precisely because President Obama's attempts at improving health care and lower costs for everyone have been thwarted by Republicans and their Private Health Care Bureaucracy buddies and election donors.


Sun, Mar 13, 2011 : 1:26 p.m.

&quot;Ironically, the part of &quot;Obamacare&quot; that most people rail against - the individual mandate - is the only thing that will really drive down health care premiums.&quot;&quot; Why do you believe that? Have health care premiums gone down in Massachusetts? They also told us that when everyone had car insurance, rates would go down. That hasn't worked. So, why do you believe that forcing young, healthy people to buy insurance (which is just another way to subsidize the care of the unhealthy) will bring rates down?


Sun, Mar 13, 2011 : 1:10 p.m.

Ironically, the part of &quot;Obamacare&quot; that most people rail against - the individual mandate - is the only thing that will really drive down health care premiums.


Sun, Mar 13, 2011 : 1:03 p.m.

Using the word &quot;Obamacare&quot; generally shows one is misinformed. What part of &quot;Obamacare&quot; that has already gone into effect don't you like? The loss of preexisting conditions? The removal of lifetime limits on policies? No, you're mad at insurance companies raising your rates - not &quot;Obamacare&quot;. The insurance companies are ripping us off because they have a product we need and will continue to (over)charge us for it. Sure they have motivation to be efficient, unlike the government, but they have no motivation to give us back premiums.