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Jul 27, 2005


Bill Carroll

This development is filled with both promise and danger. Pray for working people everywhere. One thing is certain, labor will continue to take it on the chin unless unions get out and organize workers. Stern has been doing this. Sweeney has promised to do it. Maybe this division will prompt new efforts in this direction. I am reluctant to see any division of the unions, but the AFL-CIO needs to fight harder for workers. Maybe this is the beginning of something big, not just for SEIU, the Teamsters, UCFW, etc. but for those unions that remain with the AFL-CIO. Who knows?

Reverend Ref

Maybe if teachers hired Drew Rosenhaus to be their agent they would get paid what they deserved.

Phil Snyder

Hi John,

I know very few conservatives who are against paying teachers well or more. What most conservatives that I know are against is paying for more administrators and more administration. These people often make the task of teaching much harder.

On universal health care, we have something close to it today. I did CPE at Parkland Hospital where no one was turned away because of a failure to pay or lack of insurance. They did not recieve speedy care in cases of non-acute symptoms, but they did receive care.

What you are probably after is a single payer system or universal health insurance - where the government pays the bills. Should we include only US citizens and legal residents in our universal coverage or should we also include citizens of Mexico, Central, and South America - as well as Africa and Asia? Why should only the economically advanced countries have good health care? (end of specious argument).

On a more serious note, health care is a scarce commodity. It will be rationed. It is currently rationed on the ability to pay. If you have health insurance or lots of money, you will get good health care in a timely fashion. If you don't you will have to make due with the county hospitals or wait in the ER until they have time to deal with your condition.

Since you seem to be against rationing based on the ability to pay (or making ability to pay meaningless), how do you suggest we ration health care? Who gets to make the decisions on who receives care when?

I agree that we need to reform the delivery of health care and how it is paid for. One problem is that the delivery of care is divorced from the payment. Those recieving care have to pay little or any part of the bill. Imagine if businesses offered "Lunch Insurance" where the employee was responsible for only 10% of the cost of lunch each day. Do you think that most employees would bring their lunch from home or go to McDonalds? I think that they would more likely go to the nicer restraunts for lunch and spend about double or even triple what they pay for lunch now. So a person who averages $8 for lunch would start spending $16 or even $20, because he is only responsible for $1.6 or $2.

If we provided some form of catestrophic insurance (paying everything over say $5000 in a year) and provided some form of savings account so everyone could pay for the rest, then the individuals would have an incentive to check the cost of care. As it is now, I know people who go to the doctor for head colds and other minor ailments.

Phil Snyder

Phil Snyder

John wilkins

Obviously people don't get turned down for health care.

Recently in "thirty days" the documentarian lived on mimimum wage. When he got a sprained arm, and his fiancee got an infection, they had to pay $1200 that they didn't have. This falls well below $5000, but is enough to inhibit any possibility of moving out of poverty.

I think there are several ways to attack the issue. For example, plenty of qualified people who are talented enough to become doctors can't because of the dearth of medical schools. One reason is that with a limited amount of doctors, salaries remain high. There is a monopoly among medical schools.

I think your comparison of lunch to health doesn't quite work. But if that were the case, nurse practitioners could administer many of the more minor problems.

what I think you ignore is the added administrative costs that insurance companies require. Medicare has a 2% average administrative cost. Insurance companies run ten times that.

Instead of the "government" paying the bills, we instead have everyone pay into the system. The consequence is that people individuall would pay much less. what I advocate is that instead of insurance companies rationing and feeding their own salaries, eliminate the middleman.

Obviously there would be some difficult choices. The wealthy smoker who is 80 and wants a brand new heart might have to wait longer than someone who is in their 50's and still working. But should wealth be the deciding factor? Why wealth and not future productivity?

Bill Carroll

Better preventative health care, decisions about rationing made by public health experts and physicians, and extensive public investment in hospitals, non-profit insurance companies, and medical and nursing schools. Expanding the kinds of care that can be offered by RN's and Nurse Practitioners.

The test for a good reform, how it affects the most vulnerable, not how it affects care for those who already have good health care.

Andrew Spark

I think the limited medical access to medical facilities and the bad reliance of the service are mainly responsible for this situation.

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