Claudia Chaufan described in a modified nutshell, the Swiss health care system, which is a mix of public and private. Having enjoyed its' benefits while being a "gast arbeiter," I can attest to the peace of mind one gets from the knowledge that your medical needs will get taken care of once you let the medical professionals know what kind of coverage (mine was "Winterthur Privat") you have.
The Swiss system has three kinds of coverage: Private, Semi-Private, & Health Fund. The type of coverage determined what sort of hospital room your insurance would pay for, with Private & Semi-Private used by companies as an employment perk to attract talent, while Health Funds covered everybody else in the country legally. What is important to note is that there was never any awkward questions or insurance billing hassles with the doctor's receptionists, as they knew they would get paid for services provided, & you the patient would get the necessary care to resolve your medical issue.
Of course, the American Medical Insurance industry will loath to adopt anything resembling this model, as it cuts down on their profits and power.

It is highly unlikely that a complete single payer health system could be enacted immediately, so a mixed system may be what we have to start with. As for paying for it, anyone drawing Social Security has paid into that system for at least ten years and possibly 40 or more. Also many are taxed on up to 85% of their benefits and it is still a good program with minor adjustments needed. Also Medicare requires monthly payments taken out of benefits and taxes are paid on total benefits. It is also working, but more adjustments are needed to keep it going. It does not seem that giving people the choice to go with a government health policy or go for the private insurance is such a bad idea to begin with.

"...if one asks the wrong question or misunderstands the nature of a problem, the chances of getting the right answer or solving the problem are slim."

Thank you for challenging the pre-selected "solution" being framed by the way the debate is being managed. I think we also need to demand definition of terms. The discussion is about forced purchase of a defective product: health "insurance."

My dictionary defines insurance as "a system of protection against loss in which a number of individuals agree to pay certain sums for a guarantee that they will be compensated under stipulated conditions for any specified loss by fire, accident, death, etc."

How many people would think that if you paid insurance against loss on your house, but it would only cover a small part part of your loss, and therefore you would still be bankrupted by a fire or a flood, that it would make sense to say the only problem was that a law needed to be passed making buying that insurance mandatory? The product itself is defective. It does not do what it claims to, which is to protect you from financial ruin from the condition it is insuring you for.

Don't bet on this so called REFORM doing much more then making the Obnoxiously wealthy Health Vampires even wealthier. I suspect from what I'm reading the deal to "FORCE" everyone into their ravenous arms has already been cut. You see it's our fault the system doesn't work. If any has any doubts who OWNS our Gov't , you won't after the abortion called Health reform appears out of this. Obama and his crew will sell it like it's a great deal and then disown it when in a few yrs. it fails just as misrerably as the present system. We all know the FIX is already in don't we?

Liberals, you voted for Obama and the Democrats, and yet he (and they) can't (and refuse to) deliver on anything! What message does that deliver to the Far Right? Certainly not the STRENGTH of liberals... Why continue to prop up the Two Party System with your votes?

A good article...however, I see an error in the fifth paragraph. Yes, the bulk of Medicare patients are the elderly, but remember, everyone pays into it. Which is probably why Medicare works as well as it does considering the relatively small amount taken out of our paychecks.

The problem is really at the other end: Because of the small pool of employees where I work, the private health insurance plan keeps raising the premiums and cutting back coverage. My take-home pay is less than it was when I joined the company 3 years ago.

But you know how it is in the United States. A $50-per-month tax is awful, while a $500-per-month private health insurance premium is, well, just a fact of life that you can choose --nobody's forcing you to pay.

As if the threat of consequences does not constitute "force."

"...which means that at any given moment the healthy or least costly majority pays for the medical care of the less healthy and most costly minority."

There's the deal breaker. "less healthy and most costly minority" are supposed to go away and die...That is the CORE of Slave America based on EXCLUSION. No weak, poor, or infirm (or useless elderly) in AmeriKKKa, we put them down, just like you would with a sick dog (it's a mercy for them). That's the genocidal beast that 'owns' the Heart of this Country.

I have read a lot of blogs and seen many programs denigrating single payer national health care systems. They seem to come from people that have no personal experience with such systems or a vested interest in the current system. Numerous studies have established that single payer national health care systems cost about half of our system while providing better health care as measured by outcome such as infant mortality, longevity, hospital mistakes etc. My family has personal experience with health care systems in England, Germany, Norway and USA from living in those countries. I would not hesitate one moment to choose any of their systems over ours (USA). It is difficult to understand why systems demonstrated to be better than ours, no matter which criteria you use to compare them, are not seriously considered here in the USA. Are we that misinformed, brainwashed, uneducated, dogmatically tied to capitalist philosophy (that in this case is failing), not as smart as citizens in other countries, or is it that it was not invented by the self-proclaimed greatest nation on earth. Most likely it is that our politicians are bought off by the corporate beneficiaries of the current system.

A viable health care system must also be decoupled from ones place of work like the rest of the world. This will help make our industry more competitive, and encourage employee mobility into new economic activities to help spawn and expand new businesses.

The bottom line, born out by facts and not emotions or dogma, is that single payer national health care systems work better for more people at lower cost than our for profit system.

When I come to this article not logged onto CD, it shows only one response, but after I log in, nine appear. This keeps happening to me, does the same thing happen to other people?

Anyway, I wanted to share a link for this letter to Pelosi written by Paul Hochfeld, M.D., Emergency Physician.

Ms. Pelosi,

Despite all the talk of change, most of the noise emanating from inside the Beltway suggests that in health care, we are going to get more of the same: employer based care, more cost, and more government subsidies so the insurance industry can continue to profit from an inefficient delivery system.

This means that 7-8 years from now we will be in the same mess and our government will be facing insolvency from yet another direction.

In your zeal to fix the problem of Access by giving everybody “insurance” you are ignoring the real problem: Cost. Only a “single payer”, with both authority and responsibility to control total cost, can do so.

The taxpayer is already footing 60% of the total bill and our insurance premiums are already inflated by 10-15% to cover the cost of the uninsured.

We are all paying for everybody anyway, so why not design a system that reflects this?

...

Worth reading the rest. Continued at singlepayeraction dot org

http://www.singlepayeraction.org/blog/?p=619

Chaufan is right when she points out the frame of the debate as having already misdirected the discussion. HealthCare clients are not liabilities to be minimized, HealthCare is not a commodity.
Pooling risk is what insurance is and I'm not clear on her mechanism for creating this pool, Private or semi? Or is it expanded and de-privatized MediCare? And if so, why not call it that?
And aren't "compulsory financing" and "paid for out of taxes" functionally the same thing? Why dodge the fact that WE are the single payer in the long run?
We pay into MediCare as it is, if it was expanded to cover the people that are currently uncovered and re-structured a bit (so that it could negotiate Drug Prices, frinstance), it would eventually become Universal as the 4Profits will price themselves out of the market.
It's not the fast lane but it does avoid some of the nastier corners that current and past attempts have crashed on.

Why do conservatives get into such high dudgeon over a "death tax," but show no concern over an "illness market"? Could it be that their principles have no correspondence beyond the interests of billionaires?

Re Pitch Fork May 5th, 2009 2:40 pm, who asks,

"When I come to this article not logged onto CD, it shows only one response, but after I log in, nine appear. This keeps happening to me, does the same thing happen to other people?"

You're not hallucinating (at least not about this). This site was slightly buggy before, and now it's buggy in a slightly different way. Sometimes in trying to log out, I've had to click a second time, which results in a frowny face announcing a "problem loading this page." On a one-to-ten scale of annoying, I'll give it a 2 if I'm particularly cranky that day.

Hey, at least it's not owned by Murdoch...

Healthcare for every American citizen will never be a reality until we get the profit motive out of healthcare. Profits are only made by denying care to the individual or pricing the policy so high, that most will not be able to access their benefits or even afford the policy.

As a healthcare professional, I despise the corporate executives and their treatment of caregivers and policyholders; their attitude is that more profit is never enough and they never offer an apology for those they have harmed. Their actions are criminal as far as I am concerned. The vast majority of these executives have never placed their hands on a patient and have no real understanding of what caregivers do on a daily basis. That also goes for the regulators and surveyors.

I can attest to the declining quality as I have endured increasing workloads and longer workdays, fewer resources available for clients, skimmpy raises or none at all, and the constant drumbeat for more money; do more with less. The emapthy and concern has all but been rung out of the system; god forbid we spend 2 minutes more with our patients/clients; might cost some executive his or her new car or whatever it is they want!

The Swiss system would be good; so would be French or any system that takes the worship of the almighty dollar out of first place and puts the patients first is fine by me. I hope to live long enough to actually be able to claim some of the medical benefits I have paid for the current generation of retirees.

The naysayers always talk about how we will have to ration healthcare - well folks, it is already being rationed. No insurance or money, no care and that's rationing. High deductibles which prevent patients from accessing care unless they are extremely ill, is rationing. Denying coverage for covered services is rationing; waiting for the appeals process to move forward on a denial, is rationing. Making a patient jump through the pre-approval or pre-authorization process before accessing the care they need is rationing. Not being able to find an MD taking on new clients or having to wait more than 3 mos for an appointment is rationing. Etc, etc, etc. WE ALREADY HAVE RATIONING in the name of profits and profit-taking by the executives. Everyone, including our duly elected officials need to rethink this private insurance for all attitude as there is nothing sacred about private insurance.

okay kids who among us believes we still love in a democracy. perhaps we now plan a trip to the washington mall
same amount of people or more but for a entirely DIFFERENT set of reasons!

Not only are the uninsured not the problem, they may become part of the solution. Certainly there are risks to the individual, but anyone who buys private insurance feeds the insurance lobbies as they campaign against single payer insurance.

This hear, see and speak no evil approach to healthcare solutions is going to need a TARP bailout before its even passed at this rate. Look at how fast the group of uninsured is growing:

The worst losses have been in recent months. More than 1 million workers lost health care coverage in the first three months of 2009, which is 42 percent of the total losses since December 2007. Approximately, 268,400 more workers lost health care coverage in March 2009 than in March 2008. Month-by-month estimates of the rising number of uninsured demonstrate how the pace of contraction in the labor market has affected the number of people with health insurance.

http://www.americanprogress.org/issues/2009/05/insurance_loss.html

And the figures are mitigated by growth in government employment. In government, 78.3% of workers are covered through employment, compared with 39% in retail, 36.7% in construction and 25.1% in leisure and hospitality. (Figures for 2007)

Senator Joey Lieberman's wife is a lobbyist for Pharma.
Senator Chirs Dodd's wife earns big money working with Pharma.
What chance does the working classes have against a system that is bought and
paid for by Pharma.

Millions to spill innocent blood in Iraq but not one cent for single payer health care at home.

Millions to jail non violent drug users but not one cent to reform the most expensive and poorest quality health care system.

Why do we keep re-electing these idiots who don't represent the interests of the people??

Healthcare you can afford. What a joke! While your Senators and Congressmen and women recieve the very best. We have two systems that could be modified to provide care in this country for everyone right now. They may not be perfect but they could get better. The VA system and Medicare. Medicare has a low administartive rate and the VA pays the lowest prices for drugs due to its buying power.
We've all watched adds telling us to ask our doctor about such and such drug; you think they really care if their helping you. All they care about is creating a profit by scaring you. Anyhow, just listen to all the complications that they could afflict on you and you should think twice about taking anything.
We Americans also need to take responsibility for our health. Excercise, eat right, drink and smoke in moderation (if you do), and stimulate your mind with more than junk.

If you are going to create a public health care system in the USA, don't make the mistake Canada has made with its publicly run health care system. Make sure that all participants within the system are employees of the public system. In Canada, the doctors are excluded and remain in the private sector. True, the payments they receive is based on a formula established by the government run system and paid by same. But in their greed, they run patients through their offices like an assembly line, billing the public system each time, resulting in poor health care and major costs to the system. Doctors need to become employees of the public system with a fixed yearly salary with further "rewards" based on their successes in actually creating better health for their patients. Then there will not be the drive for assembly line health care and more care and attention can be paid to the patient. This would also get rid of the over-prescription of drugs which our doctors also use to increase their incomes, as they remain private actors along with the pharmaceutical companies. The duplication of expenses because each doctor has his/her own private practice can also be eliminated, resulting in a far less costly health care system.

This article states the obvious. The fact that it needs to be spelled out like so is indicative of the mess we are in. As long as insurance companies are paying for representatives' votes and Bozo Media derides common sense as "socialism" and "fascism," the status quo will remain. Taxpayer subsidized insurance (company profits) is the price we'll pay to save the honor of "freemarkets" and "capitalism."