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August 4th, 2009
01:27 PM ET
soundoff (35 Responses)
  1. Glory Davis

    This in response to Anette Goldstein:
    Your healthcare system is horrible, probably the worst ever. People come from Canada to America to receive better medical attention. Cleary we have different view points but how dare you say republicans do not care about their people... First of all, healthcare has nothing to do with caring about people it has to do with the your medical necessities and needs to keep yourself healthy. Quite frankly with public healthcare you will not receive any sort of medical attention when you need it.

    And by the way how about you focus on your own government rather than another countries. Last time i checked we've had 2 consecutive republican wins up until our last failure, Obama.

    February 2, 2010 at 3:54 am |
  2. Vera Waitress

    Ruth, I'm paying for your medicare benefits, and I say we need health care reform.

    December 26, 2009 at 8:41 pm |
  3. JULIE

    Just how much money has ole corpse Lieberman been paid by insurance groups? BIG REASON for term limits. This ole "has been" will not make past February – He is totally demented.

    This man is one of the most deplorable persons on the planet , along with Bush and Cheney.
    Showing his bipolar money for insurance companies, he says he will block lowering the medicare to 55 and NO to health care option.

    In reality, most people I have met over 40 years in business, had insurance until they got sick, when they could not pay the premiums, in thier time of need they were refused any health care. i WATCHED 100'a of people denied treatment and care.

    SO, tell me. What good are insurance companies in the first place?
    And, if you begine to think any insurance company is on your side. Think again. Only when they are grabbing the money. 100,000 each for every senator to block the health care option.

    December 14, 2009 at 9:31 pm |
  4. OkieDoc

    FP in Wisconsin: very succint, well-written response. I wish I could be as eloquent. Equally as eloquent is Vance Harris, M.D., who gave permission to quote his essay "Thoughts of a Fading Primary Care Physisican". I hope that CNN will allow this to be posted.

    His comments as follows:

    I think that being at the bottom of the food chain allows me a sympathy posting at least occasionally.

    We are our own worst enemies, as we have allowed insurance companies and Medicare to set the value of our services. Clearly those values they impose have nothing to do with our contribution to the health of our patients or the cost savings we bring about.

    Case in point:

    How many dozens of chest pain patients have I seen in the last month who I didn't order an EKG, get a consult, set up nuclear imaging or send for a cath. Only I have the advantage of knowing just how anxious most of these patients are and that they have had the same symptoms time and again over the last 20 years. After a pointed history and exam, I am more than willing to make the call that 27 hours of chest pain is most likely not angina in nature. When I take the responsibility on my shoulders I am saving the system tens of thousands of dollars. Most of these patients present to my office directly and are worked into a busy day pushing me even deeper into that mire of tardiness for which I will be chastised by at least 6 patients before the end of the day. Most of those who scold me are retired and have more free time in a day than I get in a month. My reward for working these people in and making a call that puts me at some risk is at most $75 if I count the less than $25 I get paid for being able to read an EKG without sending it off to be interpreted by a cardiologist. My incentive pay for saving thousands of dollars on each patient for 1-2 days in the hospital, stress treadmill and cardiologist referral is $75. Now there is motivation on a busy day to not send someone to the ER.

    How many times has an anxious patient come in, almost demanding an endoscopy, who I examined, after taking a good history, and then decided to treat for 3-4 weeks before making the referral? Few of these patients are happy with me after the visit, no matter how many times I explain that it is reasonable to treat their reflux symptoms for several weeks before considering endoscopy. This delay in referral has lead to many a tense moment in the last 20 years. Cost savings to the system is again thousands of dollars each and every time I do this. I am willing to make the call and go with the treatment first before getting the scope. My reward is about $55 from Medicare and the Big Blues.

    How many low back pain patients have come to the office in agony knowing that there has to be something serious to cause this kind of pain? Again a good history and a directed exam allows me to reassure the patient that there is nothing we need to operate on and that the risk of missing anything in this setting is low. This takes a lot of time to explain as I teach them why they don't need, and better yet, why they don't want to get an MRI at this point. If someone else ordered the MRI guess who gets to explain the significance of bulging disks and narrowed foramen to an alarmed patient? Setting realistic expectations on recovery and avoiding needless imaging that rarely helps, in the acute setting of a normal exam, saves the system thousands of dollars again. My reward is another $55 if I am lucky.

    How many times does a good shoulder exam allow me not to order an MRI giving the patient time to heal and recover before imaging racks up another couple of thousand dollars followed by ortho referral for a shoulder that doesn't need surgery? Another $55 will shower down on me at the end of the day when I send off the bill for that exam.
    How many basal cell and squamous cell cancers have I discovered while examining some ones shoulder or abdomen or even a sore throat? How many of those was I stupid enough to remove the same day, only to find out that I would be paid for only one procedure and it would always be the least expensive of the two? How many appeals have been successful to Medicare when I performed the service and was denied payment?

    How many diabetics do I struggle with, trying to get them to take better care of themselves? How many hours have I spent with teenage diabetics who will not check their blood sugars and forget half of their insulin doses? I have spent hundreds of hours dealing with them and their families trying to effect changes that will someday allow them to get their disease under control. I do this because the only Endocrinologist in the county will not see pediatric diabetics. I can't say that I blame him as the time spent seems like a total waste. That is, until one day they open their eyes and want to take care of themselves. My reward for years of struggle and years of 30 minute visits trying to get them to take responsibility for their health is a few hundred dollars at best. The savings to society for my hard work and never give up attitude is in the tens of thousands of dollars.

    I continue on in my 22nd year giving advice and services to 30 plus patients each and every day. Having me in the system has resulted in savings in the hundreds of thousands of dollars each and every year. My financial incentive to hang in there and work hard is the following. Twenty years ago I made about $220,000 a year. Fifteen years ago I made about $160,000 and for the last two years I have been lucky to make $120,000. This year I will make less as it seems even more of the claims are being reviewed while payment sits in some one else's account drawing interest.

    This will be my last year working full time if my plans work out. These plans do not involve working as a physician as I have for the last 22 years. I cannot afford to continue working 60-70 hours a week and at the end of the month, not be able to pay my taxes. I do not overstate my case at all as that has been the case most of this last year.

    I have always served my fellowman out of a sense of love and compassion and for those reasons I went into medicine. I have been richly rewarded by my patients over the decades as they appreciate my judgment and skills. Isn't it a shame that after all this time and with skills honed by decades of experience, I can no longer afford to work as a physician? Taxes will be collected, no pass for the working physician, not like the Goldman Sacks guys and their buddies with the 9 billion in bonuses given last year after the 58 billion in funds we gave them.

    My parting words next year will be good luck having PA's provide the safety net with their 2 years of training. Good luck getting foreign trained physicians to take over once they see my salary. Good luck having internists in your community with only 1% of medical students going into Internal Medicine. Good luck recruiting the primary care specialists when you are short 70,000 now and 1/3 plan on retirement within 3 years.

    If there is any irony in this at all it is that I will find myself in the same boat as I struggle to find a doctor to take care of my wife and myself. Now that is ironic. Anyone know who is taking new patients in California?

    Vance Harris, MD

    December 14, 2009 at 1:10 pm |
  5. Family Practice Physician in Wisconsin

    Here are a few issues with medicine today that I have noticed:

    1. No tort reform in this medical bill will cause significant access problems, particularly in primary care. Look at states that have enacted it versus those that haven't, seen where the doctors go? (if they haven't retired already). That is a fact.

    2. The payments for a public option have to meet or exceed those for Medicare and Medicaid to hospitals, or many will be forced to close their doors. How is this bill supposed to be deficit neutral (nothing ever has been in government legislation), WITHOUT cutting payments from Medicare and Medicaid. It's the feed you with one hand, beat you with the other, trick.

    3. Most health care dollars are spent in the last few years of life. The ethical arguments around this are complex, but I guess it depends upon who has the medical problem, your elderly mother or the stranger down the street. Those benefits to the elderly will be capped, for sheer cost savings, there is discussion of that already.

    4. There has to be better focus on primary care, preventative care, and staying "free" of disease. That means, higher premiums for smoking, morbid obesity, illicit drug use, drunk driving, etc. There has to be a point when we start to accept responsibility for our own actions. Governmental social policies have never been very good for that. Meanwhile, we are getting fatter, lazier, meaner.

    5. There has to be transparancy of costs of health care, available in a hospitals billing office. Absolutely. We arent even given that information freely as doctors ordering the tests. Patients should be able to shop around for procedures, but this isnt an al a carte option. It isnt "get a hip replaced and then refuse EKG and bloodwork in a preoperative evaluation". The necessary steps still need to be taken to stay within medical standards.

    6. Enact more policy to attract providers to the medical field, regardless of level. Let us write off a portion of our $300,000 student loans, enact better loan repayment programs, more equity with specialists, etc. As a former Army Dr., make the military health care system more equitable financially with the private sector. It is so far behind in some specialities, there will always be shortages and high attrition rates.

    7. Enact small copays for everyone, regardless of coverage. Why do you think there is a 6 hr wait at the ER- because of the 30 people with colds ahead of you (and the 4 ambulances that came in the backdoor). There has to be something that makes people think twice about coming to the ER for a clearly nonemergent condition. If I am on the public aid and responsible for no cost at all, why even consider making that decision? There is no consequence, such as is with those with private insurance.

    There are too many things wrong (and even more right) with health care today. Clearly changes do have to be made. Just remember, a lawyer is going to be signing these changes into law. Have a Merry Christmas.

    December 12, 2009 at 11:32 am |
  6. brian

    My doctor is retiring because he's making less than he was 20 years ago. My son will graduate from medical school with $100,000 debt after 4 years of college followed by 4 grueling years of medical study. He will then have 3 to 6 more years of minimum salary as a resident. There is a study that auto workers who go to work after high school make more money than doctors until the salaries even up at AGE 59!
    Folks, if you want people to put in the time and effort to become doctors, there better be incentive. They're not going to study that hard and live that poor for that long just to have a moderate living.

    December 9, 2009 at 12:41 pm |
  7. Chris DDS

    I am so tired of the healthcare debate, but I am loath to criticize without offering an alternative. So here's my idea. Let's open up the federal employee insurance plan to open admission. Congress uses the federal employee's health plan. So doing this would actually accomplish President Obama's stated goal of providing healthcare equal to that which Congress enjoys. The plan offers 10 choices for providers and a bunch of plans from all ten providers. Looks like a terrific plan! Under the current plan, the claim that the congress is trying to provide a healthcare plan equivalent to their own does not hold up to scrutiny. Douglas Elmendorf, director of the Congressional Budget Office testimony before the Senate put the cost of the current plan at 1.2 trillion over 5 years. The federal plan costs 15 billion per year for 8.5 million federal employees. If you extend that number to the 46.6 million (The President's number) uninsured, you get a estimated cost of 411.176 billion over the next 5 years. Why, if congress is proposing to recreate this plan, does the proposal cost 3x more? Why re-invent the wheel? I say use the framework that is already in place in the form of the Federal insurance plan.
    The federal insurance plan it is simply a distribution point for private insurance plans with reduced costs due to collective bargaining, so there won't be an issue of putting insurance companies out of business. Add to this that anyone that wants to participate in this or any other plan must pay for their own premiums. To increase coverage, the premium payment should be made from pretax dollars. This allows anyone to who buys health insurance to have a tax break.) The carrot of tax breaks might look better than the stick of fines which is currently being proposed? The pre-tax break should also be extended to anyone who has any other healthcare plan. Best of all, this plan doesn't increase taxes on small businesses, the poor, the wealth, ect., ect., ect.... Any profits realized by the federal employees insurance plan can then be allocated to a slush fund to provide minimal membership in the plan for free to any family below the poverty line on a first come first serve basis. There problem solved. Hmmm maybe I should run for congress?

    November 12, 2009 at 4:50 pm |
  8. jnan

    Has anyone thought of doing a fee for service for lawyers??
    Just as physicians have a medicare mandated fee schedule, perhaps the Bar association or the like could suggest a fee schedule for every type of service that lawyers provide. Based on time spent, and specialty. Fee should not be based on contingency as it is now. I suspect if that is done then frivilous lawsuits would stop. Only the cases with real merit would be persued. This coupled with Tort Reform would automatically reform Healthcare cost.

    November 8, 2009 at 10:11 pm |
  9. jnan

    I am not a legislator or a rocket scientist, but. at this time, Medicare, Medicaid and the VA system are run by the government and they cover the highest health risk people in our society. Infact if you talk to any medicare/va recipient, they do not complain about their healthcare. Commercial insurance covers healthy people with no pre-existing condition. If you talk to any commercially insured person, they...

    Read more … am not a legislator or a rocket scientist, but. at this time, Medicare, Medicaid and the VA system are run by the government and they cover the highest health risk people in our society. Infact if you talk to any medicare/va recipient, they do not complain about their healthcare. Commercial insurance covers healthy people with no pre-existing condition. If you talk to any commercially insured person, they will give you an earfull about things their insurance did not cover. Simple math would tell you that if you pool all medicare, medicaid, va and a lot of healthy people (in a public health plan) then the cost would go down because you would spread the risk over a greater number of people (thats what insurances do). If we could make a public option available for say $ 150 per person and $ 300/= per family of 4 per month, and smart people can do the math. Then this public option would be very attractive to people. So if the public option became viable, then medicare medicaid and VA systems would be grandfathered in to the public option, with current funds that are used for these systems to pay monthly premiums for public option for the people covered by them now. We could do away with Medicare, and so there would be no reason for the working population to pay medicare tax, and that could be used to purchase either the public plan or add more to it and purchase a commercial plan. Companies could eliminate the HR division for Healthcare and concentrate money and resources on their core business.
    This is not a republican or democratic issue, its an NATIONAL issue. Govt. provides for Public School system, does it have problems, absolutely, but the right to basic education is guaranteed by the govt. Healthcare should be too!! Do people go for private schools? Sure, they pay more for it. Should people be allowed to go for commercial insurance, absolutely, they just pay the premium.
    Companies would not have to tag on cost of providing healthcare on to their products, thus making them more competitive in the world market.

    I could go on.. really this is not rocket science..

    November 8, 2009 at 10:04 pm |
  10. AustinMD

    Health care reform is essential and it needs to be revolutionary.
    That being said, part of this country's "problems" is our overgenerous nature. Patients w/ serious medical conditions will oftentimes be referred from their own country to receive care here. This is not just South America, but also Canadians, who when faced w/ multiple problems and delays, will cross the border to receive what is in effect free care.

    Part of the "problem" is that our medical science here has advanced to the point where we can give an extremely preterm infant a chance of survival. In Europe, they would just write of that 24 week infant. Here though, we struggle to keep the kid alive, and sometimes we end up w/ a healthy kid, but sometimes we either spend a lot of $$$ for a kid who eventually succumbs to infection or a kid who survives but with significant chronic medical needs. These burden cost more $$$ to the system.

    Likewise, we're better about keeping people around at the other spectrum of life. Again though, this costs a lot of $$$.

    It may seem cavalier or cruel to focus on cost-cutting measures on these two vulnerable groups, but to put this into focus, when you keep a 90 year cancer ridden body on the vent, you're effectively diverting money/resources to about 60 average healthy people...

    The other system that is poorly thought out is the litigative system. No other country suffers from so many lawyers. At a certain point, they do not produce anything, so their only option is to sue whether there is merit or not.

    October 9, 2009 at 1:21 pm |
  11. OkieDoc

    Yes, I'm sure you have an encyclopedic knowledge of all doctors' incomes. Those incomes are at the expense of time, family, and at high personal risk.

    It has nothing to do with empathy. The doctor has expenses that are not discounted on a sliding scale based on her patients' ability to pay. Does your grocery store or hardware store discount prices based on ability to pay?

    September 29, 2009 at 3:34 pm |
  12. JoesLovelyMother

    @doc

    I hoped that the doc would consider a sliding scale.
    Not enough $ or not fair?
    Consider just how many hours a worker has to work to pay for their professional care, THAT makes me sick. I know, empathy is a bad word right now.

    I well understand the management, operations, and PROFITS of a medical office and practice.
    I have seen a lot of physicians W-2 or 1099, etc.
    I have seen them too for the minimum wage workers
    In this area 50% live 200% below the poverty level
    The next town with specialist services is 1.75 hour drive

    .

    September 29, 2009 at 12:01 am |
  13. OkieDoc

    @ JoesLovelyMother

    "Now there are several doctors in our area who are specialists who will not see anyone with out the cash or insurance up front…"

    Good for them. Doctors need to be paid for the services that they provide. "Without a margin, there is no mission." The doctor has to support the huge overhead of running a medical practice. Doctors are bilked constantly on the services that they provide, which is one of the many reasons the rest of us end up paying such a huge price.

    September 17, 2009 at 2:03 pm |
  14. JoesLovelyMother

    Dr. Gupta
    One more thing
    How come we do not have a sliding scale health care system?

    All services available and pay according to income

    September 17, 2009 at 8:28 am |
  15. JoesLovelyMother

    @ Ruth

    With all due, the only way the Federal Govt should have a hand in Health care is to ensure a level playing field for the citizens.

    NO ONE CAN AVOID HEALTH CARE, there is no way around it, now or later in the golden years.....

    The Federal Government is charged with putting in the rules of road to look out for the many......not pave golden roads for the few.

    So however that is done is what their function is.

    Let's see if they can do it....follow the process of how a bill gets to the Oval Office

    And if the needs of the many are not met and protected like we do through MANDATORY car insurance we are hardly a country who believes in the Christian "Best Practices".

    Obama made empathy a dirty word in some circles....but just imagine the total opposite of what you have that befalls citizens every day in health care issues....or a friend or loved one.

    September 17, 2009 at 8:25 am |
  16. JoesLovelyMother

    @ Ruth

    With all due, the only way the Federal Govt should have a hand in Health care is to ensure a level playing field for the citizens.

    NO ONE CAN AVOID HEALTH CARE, there is no way around it, now or later in the golden years.....

    The Federal Government is charged with putting in the rules of road to look out for the many......not pave golden roads for the few.

    So however that is done is what their function is.

    Let's see if they can do it....follow the process of how a bill gets to the Oval Office

    And if the needs of the many are not met and protected like we do through MANDATORY car insurance we are hardly a country who believes in the Christian "Best Practices".

    Obama made empathy a dirty word in some circles....but just imagine the total opposite of what you have that befalls citizens every day in health care issues....

    September 17, 2009 at 8:24 am |
  17. JoesLovelyMother

    Dr. Gupta,
    Do you see some validity to a comment I overheard one day in a respiratory therapists offce some 15 years ago?

    The speaker, being a boomer:

    "Most Doctors who are going into the medical field today are going in for the money"

    Now there are several doctors in our area who are specialists who will not see anyone with out the cash or insurance up front....
    There are only 25,000 folks in the area.

    The Hippocratic Oath is not in the hearts of most doctors I know of today or we would see more of in their deeds.
    But what do you think on a scale of this overall statement?

    September 17, 2009 at 8:09 am |
  18. PLMD

    I love how the caller says "all doctors charge outrageous fees." This is ridiculous. The cost of doing medicine has become very expensive and charges simply reflect this. People do not realize that a surgeon doing a knee replacement gets ONE fee for the entire case – pre-op evaluation, the surgery, hospital follow-up, dealing with complications, post-op office visits, and of course being liable for all manner or lawsuits. Medicare pays me 20% of what private insurance pays. If a public plan ties their payment rates to Medicare, you will see a wave of physicians quit medicine immediately. You will be left with unqualified physicians and foreign physicians who would otherwise not be able to be a doctor in the USA.

    September 14, 2009 at 2:19 pm |
  19. jay m

    When I was in school we had Politician, anti-drug people, and President speeches, I wonder why all the outrage now. What lie are the parents telling their kids on why they can't hear him speak.

    September 8, 2009 at 11:59 am |
  20. Jane

    To Alex. All Democrats are not all against tort reform. Most doctors, and lawyers are Republicans.
    Only 7% of those making over $250,000 pay any federal taxes at all. They have loop holes investment credit, I met a lawyer once where his entire firm worked for a pharmaceutical company, his job was major investments in future generation of living wills, he was working on at that time 16th generations of children yet unborn. They say that 27% of the rich pay most of the taxes, this is in sales tax from purchases, from property taxes on their 5th and 6th homes. etc. Maybe the not- so- rich could enjoy more benefits of health care or paying of taxes by purchasing things if the wealthy paid their share.

    To Karen,
    Medicare and Medicaid fraud is the drain on Medicare. My mom was charged $16,000 for home therapy after coming from a nursing home. This was a mere 6 visits where this woman from another country, maybe outsourced? She barely spoke English. 1/2 hour of writing, and the other half hour of telling my mother to walk to refigerator and back ten times, standing up and sitting down ten times. Lifting her legs on the bed ten times and other equally stupid exercises that they could have just mailed a little ourline of exercises that would help her and a 42 cent stamp. Who paid for this? Medicare.
    Biggest drain on Medicare and Medicaid is the 3.1 Trillion dollars in billing expenses. Therapy is mostly a huge expensive scam.
    My father had knee surgery, and, had therapy twice a week, He never did get out of a wheel chair.for over 5 years. All paid by Medicare.
    My friend is currently doing therapy, at the cost of over 1,000 per visit, all paid by Medicare. She stands on one leg at a time to practice balance. Then step on some rubber thing the same way. She sees no improvement.

    September 6, 2009 at 5:21 am |
  21. Karen

    Insurance reform would be great, but not totally possible. Why not start with how Medicaid could be reduced: Send back the illegals to their own country and let their country take care of them! Then I know a man and woman who both went to the same Dr to get flu shots. He was on Medicare and was charged $80 his wife was self pay and paid $20 for the exact same shot! This is rediculous!

    September 4, 2009 at 1:28 pm |
  22. alex

    The government already caps fees for doctors and nurses who care for patients who have Medicare and Medicaid. If you have private insurance, most fees are negotiated when the doctor or nurse signs on as a health care provider with that insurer, thereby limiting what the patient can be charged for every particular service. So, the "capping" of charges already exists to some extent for about 88% patients.

    I wonder why the Democrats favor a system where the amount a doctor or nurse receives for a good or excellent outcome is capped, but the amount you receive if you sue (and win) for a bad outcome is not capped and is left up to a jury. This resembles a lottery more than a health court or other tort systems that exist elsewhere in the world. The Dems must want to keep the trial lawyer lobby money more than they want to reduce health care costs related to defensive medicine.

    September 4, 2009 at 1:20 pm |
  23. Sam

    Ruth

    Insurance companies are running your life between you and your doctor. They dictate to the doctor what treatments to order and what to prescribe by using their pocketbook. I guess decade of college, medical school, and residency means nothing to these pencil pushers.

    Reason why doctors order all these unnecessary CTs, X-rays, and various tests is to limit their liability from lawsuits. If you fall from a chair and only get a scratch on the forehead, then go through emergency room to get treated? You will get the whole workup and all the tests/labs. Thats standard protocol. Blame it on the lawyers for the high costs.

    And everyone blaming on costs of uninsured and illegals? Guess what? You are already paying for them through high premiums.

    Now it makes me wonder. Who you think will really get affected negatively by this if we get the healthcare reform eh? I haven't heard a peep from Walmart or McDonald-like corporations. They hire large amount of employees and offer the lowest wages. Its in their best interests to drive this reform to the ground. And because these corporations are too cheap to offer affordable healthcare, their own employees end up using the emergency room as last resort. If you look back at it, they pretty much dumped their obligations to take care of their employee's health on rest of the society in favor of profits.

    So yeah, even though the prices are cheaper, you are still paying more by other means (higher premiums).

    August 19, 2009 at 12:35 pm |
  24. Joy H

    I am very glad my health insurance allows a certain amount the dr or hospital can charge. I get statements saying the hospital or dr has over charged and i dont need to pay that amount,giving me the right amount they allow the dr or hospital to charge for services.

    I think health care insurance plans are fine for those who have it. Why not allow the Medicaid or Medicare to run the health care insurance not the governement. After all we go to state for help when needed not the government. Why not let the state law makers and the County Medicaid programs handle it.

    Why not bring back the state making major decisions for us. Government needs to worry about getting the war settled and the deficit straightened out. New Jobs.Economy back on track. People without jobs,Jobs etc etc.

    Why not just erase everyone debts and let us all start over.

    Give everyone a chance to own a home.Not just pay rent.
    Give first time buyers Automatic Loans & Morgage to buy a home or Start a business. Only guide line we should have on this is. If you have a job be auto approved for business or Mortgage loans Not based on how your credit rating is.

    August 14, 2009 at 12:06 am |
  25. JANE

    Insurance companies are paying the riot groups 90 dollars per person a day to upset the town meetings. Why? Because of 12.9 BBBillion dollars in profits. Just how much health care courl be provided by elimination of all insurance?
    Anyone with a brain goes and Reads the Bill. All these creepy Rush Limbaugh and Sarah Palin followers really have to get a grip on reality.
    If health care goes on the way it is, all health care will be in jeprody. There are no death dictators in this bill to eliminate Palin's monolod son. She is so, so out of touch and sheer space cadet. Just like she used the earnarjs fir sine soccor stadium without even purchasing the land it was on. This woman is sign of the party misgivings.
    We have the worse health care in the world, more third world than adequate given to other civilized countries. Only reliable health care is Mayo Clinic, they are the only shining light..

    August 11, 2009 at 5:03 am |
  26. Mike

    What is so disappointing to me is that the government is going to pass the health care reform, because it doesnt have anything to do with them. The government has the best health care available so they would not be classified with every other American or illegal alien. It also bothers me that the federal government employs the most people in America and yet their employees does not contribute to Medicare, Medicaid, or Social Security. If the government wanted to help out America, why not change those laws. Next time everyone talks about a first for America, just remember what a bang up job this first has done.Thanks Mr.President.

    August 8, 2009 at 10:48 pm |
  27. Carolyn

    A town hall meeting should be held in an adequate sized room for the voters to easily enter and exit. There should be written rules for answering and asking questions.There should be a time to submit written questions. No seats swhould be saved for anyone.No one speaker should monpolize the meeting.It is shame that senators and congress people don't know how to run an organized meeting. It makes you wonder what qualifies them to run healthcare!

    August 7, 2009 at 3:58 pm |
  28. JANE

    Dear Rachel,
    There is nothing in this bill that says you are not allowed to pay for anything yourself. You can keep on paying the insurance companies that have bilked Americans out of tons of money. It is not phasing out insurance companies, but giving the little independent small businesses a chance to provide health insurance for it's workers. Competition is great. Only thing that it will demand is that insurance companies cannot deny insurance claims for pre existing deseases, which they have denied people over and over. Go and read the bill. Don't take the insurance companies propaganda, these guys do not want this bill to go forward, because they will have to pay out money that should have been paid for decades, killing many. This is the problem with insurance companies. They love you as long as they have you paying, but, when you have some catostrophic desease, they can and will increase your premiums so high, you and your company cannot afford to keep you. They also will deny you care with the pre existing desease forum.

    Remember, the key is to pass something, anything, to protect us all from insurance companies, then, amend it later, if things do not work out. They should have been reined in decades ago..

    August 7, 2009 at 2:22 pm |
  29. rachel

    the problem with this bill is it does not allow you to pay for anything yourself if it is denied by the government's option. it also allows for the phase out of the private insurance industry. what will happen to the hundreds of thousands of people who work for insurance companies? i'm not opposed to having a better government option for people who NEED help. however, people should not be required to purchase healthcare or be fined by the IRS, and if the insurance company or public option determines the care is not worth the extra cost, it should be up to the PATIENT to make a personal committment to pay for it if they want it. These are some major problems with this proposal. This is why people like myself are against this proposal. Let's reform the problems we have, not completely change the face of our system.

    August 7, 2009 at 12:40 pm |
  30. gary md

    A major problem is that all too often a new procedure or drug becomes available that is slightly better or perhaps only statiscally better but clinically irrelevant. Yet, this incremental benefit comes at a substantially higher cost. We need some objective body that will evaluate these new technologies and drugs. Those which show clear clinical benefit (including a cost:benefit analysis) should be adopted. Otherwise, insurers should be required to pay for the new drug/technology what they would for the old and the patient should have the option of paying the difference.

    August 7, 2009 at 9:41 am |
  31. david

    Rude and Republican
    Me thinks we got a campaign slogan there.
    ... there is a lot of video of these protester types. If you are a health insurance company you might want to lower your risk by scratching those particular subscribers – they are obviously working on expen$ive medical problems.

    August 6, 2009 at 12:33 pm |
  32. brian

    Hey Ruth, the government wouldn't run your life any more, and likely a lot less, then your insurance company currently does. There's plenty to complain about regarding the government, but as far as providing medical care, it's not doing too bad a job with medicare and the v.a. Especially when you consider what those programs cost. The government also is responsible for the health care provided to it's active military, which is reported to be the best available, anywhere. If you're an extremely wealthy person, I'm sure you could hire a private doctor regardless if there were no longer employer based/private health insurance. But let us who want to get what we pay for to receive it, from a non shareholder-profit-only-minded government...

    August 5, 2009 at 7:44 am |
  33. Anette Goldstein

    I am horrified by the hecklers undermine democratic discussion at health care town meetings. It seems that these hypocritical Republicans take democracy as seriously as they take family values. I am a Canadian who believes that we have the best health care system in the world. Of course it's not perfect, but it is a lot better than yours. Republicans, stop the scare tactics that you used with the WMD's and start caring about the people you represent. Maybe then you'll start winning elections again.

    August 5, 2009 at 6:40 am |
  34. RUTH CANFIELD

    I JUST WANT TO LET YOU KNOW THAT I WANT MY HEALTH INSURANCE LEFT ALONE. I DO NOT WANT THE GOVERMENT RUNNING MY LIFE AS THAT IS FOR ME AND MY DOCTOR TO TALK ABOUT. MY DOCTOR DOES NOT ORDER ANYTHING UNLESS IT IS CALLED FOR. THE GOVERMENT CAN NOT RUN WHAT THEY HAVE GOING ON SO WHY MY HEALTH CARE?

    August 4, 2009 at 9:01 pm |
  35. JANE

    well, I believe, doctors should be equalized payment for certain surgeries. In some parts of the country, they can chargee drastically, while lower in other parts.
    Most people on even health insurance, never involve them selves with charges, because the insurance companies are taking over the bills. Medicare and even Medicaid, usually have set amounts that will be paid by these foundations. Many doctors either will or will not take medicare or medicaid, becasue they may do services not approved by them. Many doctors do not take it because of all the forms they have to fill out, and denial of claims.
    One reason for health care to be monitored, is that some people are not getting the required testing before surgeries. If a doctor does not biopsy certain lumps or such before, they are allowed to perfom surgery anyway. This has happened here more times than I could begine to count. Over medication on clients is another problem. I think all prescription ads should be taken of the media and magazines, people read these things and suddenly doctors allow patients to medicate themselves, before futher researching certain drugs and their success ahead of time.
    I love my friend who lived to be 106, told me that she had outlived 19 doctors, and every one gave her a fist full of precriptions, and, she promptly threw them away.
    We need reform in a lot of areas. And, sorry Texas people, you are of the bush mentality. Rude and Republican, all for insurance drones that have taken over health concerns.

    August 4, 2009 at 3:36 pm |