On Feb 23, 5:28*pm, Larry L wrote:

He and his wife have tried for years to find decent, affordable health
care insurance but to no avail, because of 'pre-existing" conditions.

Sorry to hear about your friend Larry. As a democrat and social
liberal I understand your frustation with the Republican side of the
isle and their inflexible and childish governing style. Unfortunately
the Democrats in Congress are not being entirely truthful as some of
the back alley deals have to indicate. Furthermore this thing is not
so much a healthcare reform bill as some would have you believe though
it would, or more appropriately state "should" offer immediate
financial assistance to your friend's plight, but it does very little
to correct the real or precieved issues in our healthcare processes.

If you want to email me, I might be able to help your friends get
access to some assistance depending where in Idaho they reside and the
actual health issue.

But rather than responding to each specific posts that I think needs a
reponse, other than the three I've already responded to, I'm going to
try to lump a few comments to various posts in here. I apologize in
advance for the length.

For the conservative sounding types, let me point out that you already
subsidize the poor, under insured, and those on Medicare, Medicaid,
VA, and Tricare (Champus). You subsidize them through the costs you
pay now for private insurance or other healthcare services you
purchase out of pocket since the government programs have not
increased their payments in line with the costs of doing business. In
fact that we already have a universal health access program. It's
called the hospital emergency room and by law we have to treat and
stablize any patient regardless of their financial situation. The
issue that needs to be discussed is not what is going to come out of
our pockets in terms of taxes but how does the financial transfers to
the government actually lessen the burden carried by private industry
and individuals? We have already established a de facto right to
healthcare via the emergency process listed above, what we have not
established is who has to pay for it. Like it or not, it is the
privately insured and more specifically the employers who provide the
insurance that are paying subsidizing it. That means we are all paying
for it though various methods, either directly in higher premiums or
in higher prices for the goods and services we purchase.

For Oz and others, it is good that you were able to obtain private
coverage. I am working with a recently widowed friend of the family
here in Indiana who is what most people would consider middle class
but in that no-man's land between the end of her Cobra coverage and
the start of Medicare. We can get her insured, but at $6000 more per
year then her total income. Each state and situation is different and
not everyone can afford it, you were luckier than most. Even within
the same state there are actually two different classes of commercial
health insurance with differing rules. The state regulated plans and
the employer supplied, often self funded plans which are governed
under the Federal statues via the ERISA retirement act.

At the same time, Larry, there is a law which provides a mechanism for
someone who has lost their insurance or had Cobra run out to obtain
other insurance inspite of pre-existing conditions but there is no
provision to govern how much that coverage costs. Hence the issue with
the family friend here. Oz is right in that regard, most anyone can
obtain insurance. What he neglects and other point out is that often
that cost is significant and it forces people to choose between
housing, food, or insurance. And unfortunately are right too when they
bring up the choices people make via livestyle like cell phones, cable
TV, eating out etc instead of buying insurance but that IMO, is a big
social economic issue unrelated to the issue at hand.

For those who mentioned gold standard health care, you need to define
that and really think about what it is you're talking about. A
PetScanner used to detect minute cancers has a seven figure price tag
while the instruments used to provide radiation therapy costs a
multiple of that in many cases. But more specifically, the treatment
of heart attacks has been altered by very expenisive metal rods called
stents. Now many patients can go through a stenting procedure and get
immediate relief and return to a "normal productive" lifestyle in days
instead of months associate with the post op recovery open heart
surgery requires. Those stents are not cheap. Is that a gold standard?
Pin point radiation delivery without damaging as much surrounding
tissue, is that the gold standard? New expensive drugs which reduce or
eliminate certain viruses or tumors? It goes on and before someone
comes back and says they don't want extreme end of life measures, how
can you assume you won't feel that way should it happen to you
tomorrow instead of when you're "old and feeble"?

I could go on and on, there is significant mis information and
misconceptions on both sides out there. Bottom line is the USA has one
of the most expensive health and a significant portion of our
population does not have either ready access to care, the ability to
pay for that care, or both. Costs are high because too many people
can't or won't pay for their services now and that cost gets tacked on
to the already high costs of care for the technology. The present
reform bill does nothing serious to actually reform a payment system
that is weighted heavily towards doing a procedure vis a vis actually
treating the whole patient from a wellness standpoint nor does it do a
thing to address the myriad individual rules and regulations we have
to satisfy to get patients treated and claims adjudicated. I'm all for
reform even if it ends up being a single payor system and ends my
career, but this thing that is out there right now concerns me about
the potential for some very severe unintended consequences.

Enough ramblings, If people sincerly want to discuss this mess further
we can go to email.