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Diagnosing Proposals for Healthcare Reform

(Photos by Robin Holland)

This week on the JOURNAL, Bill Moyers spoke with two leading healthcare journalists, Trudy Lieberman and Marcia Angell, M.D., seeking their perspectives on the current health reform debate in Washington. Lieberman and Angell each addressed whether the “public option” proposed by President Obama would actually serve to insure all Americans and who in the private health industry stands to benefit from the reforms under discussion.

Trudy Lieberman said that Obama’s proposed “public option,” in which the federal government would set up its own insurance option to compete with private insurance plans, has not been explained in detail and would likely not be effective in containing costs:

“From my vantage point, I don't see that the solutions for controlling costs, that will really control costs the way other countries do, are really in place... We hear about preventive care as saving costs, because intuitively it sounds like it's going to work, but the academic studies show that more preventive care actually raises costs. That doesn't mean it's a bad thing to do, but it's not a good cost saver in the system... [Obama] has been vague right from the very beginning, we have not known exactly what the Obama health plan has been... I see an administration that is trying to keep this playbook going as long as possible, and to commit to as little as possible until the eleventh hour. By then, it’s going to be too late for the American people to know what’s going to await them... As a journalist, that troubles me.”

Marcia Angell argued that the “public option” would not create the change needed in the American healthcare system and that reformers should advocate for a “single payer” system, in which a single federal agency would replace and eliminate the private health insurance industry:

“What [Obama] has essentially advocated is throwing more money into the current system. He's treating the symptom and he's not treating the underlying cause of our problem. Our problem is that we spend two and a half times as much per person on health care as the average of other advanced countries, and we don't get our money's worth. So now he says, ‘Okay, this is a terribly inefficient, wasteful system. Let's throw some money into it...’ Obama said in his press conference [that] the worst thing we can do is nothing, the most costly thing we can do is nothing. I disagree with that – you can throw more money into this system and make it even more costly... I think we have to start all over on this, I really do. I think we have to go for a single payer system.”

In his recent appearance on the JOURNAL, Clinton administration Secretary of Labor Robert Reich agreed that “single payer” is the best idea, but said that it is politically impossible and that the “public option” should be enacted anyway:

“[The public option] means that average members of the public have a choice, if they want it, of either their private-for-profit insurers like they now use or a public not-for-profit insurer. That public insurer would resemble ideally Medicare, [with] low administrative costs and it would have the economies of scale. It would be so large that it could actually negotiate low drug prices and very low premiums. That’s what the private insurers are scared of, because that means that their profits will be squeezed... Unless they are going to be genuinely pressured to reform through a public option, there is nothing that’s going to change them... The single payer system would be the best of all... Unfortunately, we can’t get there from here because the political forces are just too strong against single payer.”

What do you think?

  • If instituted, do you think President Obama’s proposed “public option” for health insurance would be sustainable? Why or why not?

  • Is flawed health reform legislation better than nothing or, as Marcia Angell argues, even worse? Should we start over? Explain.

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    Apparently the call for real healthcare reform is not dead.

    and ask yourself how come these people just don't get it. They just don't accept the inevitable government "solution". They are Americans who are acting as the heroes of democracy.

    Dear Senator or Congress Person ________________

    Everybody knows that YOUR reputation is beyond reproach, but there is this feeling among your constituents that the obvious facts now surrounding us will have little effect in your colleague’s world of souls and favors bought and sold. When my angry friends mention YOUR name, I immediately jump to your defense and explain you are doing the best you can.

    It’s all those other guys.

    Last September when Wall Street discovered that their multi-million dollar Christmas bonuses were in jeopardy, their friends in Washington poured everything we had into Wall Street’s ravenous money machine. Some folks in Washington claimed this shameless mechanism would mediate our problems for the greater good. Unfortunately it‘s an apparatus that has been carefully designed to suck money in and to never send it to where it is needed most.

    You knew better of course, but you still may have shared our deep sense of betrayal when absolutely nothing came out at the bottom of this ruthless device to benefit those in real need.

    We live and learn.

    Let’s not make the same mistake with health care. Our current system was designed by Wall Street with the same goal in mind: Collect as much money as it can and send as little as possible to where it is really needed most. It’s the American Way.

    Sadly, we have at last arrived at place in our imperial history where we can no longer afford to sustain our cherished but juvenile myth of the rugged individual. It is time to choose what the rational world’s experience has shown to be the cheapest, the most equitable and most efficient way out. Please demand and support a robust “public option”.

    Healthcare policy is now a test that goes beyond our shameful lethal numbers. It will define who really owns this government. The essential, enduring bonds between our people and this government are in real danger. What little faith still remains in the virtue of your good offices and what little hope still lingers for a new day in America are about to founder once again on the familiar twin shoals of greed and cowardice.


    FACTS you should mention to your friends family and fellow workers every day:

    1. Our government already spends 10.8 per cent of GDP on health care (40% of the total cost). OUR governments (Federal State and local) ALREADY spend the money on health care that it would take to fully fund a single payer system just like the ones the REST OF THE CIVILIZED WORLD already enjoys. In other words, if we weren't so selfish, frightened, stupid and corrupt we cold have a decent and HUMANE health care system at no additional cost.

    2. We ALREADY spend 70% more on health care per capita than the next most expensive system in the world and 50 million of us aren't even covered. Our health care costs now represent nearly 18% of our GDP while the rational the world experiences a cost between 7 and 10% of GDP

    3. We rank number 37th between Costa Rica and Slovinia in measurable health care outcomes.

    Given these numbers there is only one question left to ask.

    Why are WE so stupid?

    Jory Park -

    Here is HR3200:

    Here is a section by section description of HR3200:

    and here is the PBS Newshour website which you should find helpful.
    Be sure to look around.

    and Im sure youve seen Bill Moyers pieces on healthcare.

    Everyone has something to say about this issue, but it seems like no one has any answers. i've been searching the internet all day trying to find the whole official healthcare reform proposals and haven't found a thing. If they would explain it to people better, and stop trying to push it as soon as possible without giving anyone time to read it, we probably wouldn't be having this discusion now would we?

    Without a national portable insurance policy without
    for all those priced & rescinded out of private insurance - there is no insurance reform, there remains no competition to encourage fair market value.
    50 state co-ops are nothing if not expensive STATE government in bed with private insurance that will be an even better opportunity for graft & waste, no doubt unportable & still unaffordable for the working poor or the rescinded....
    Without insurance & hospital & drug profit reform there will be no savings to pay for those already covered under the GOVERNMENT Medicare, Medicaid, etc..Without
    cleaning up the graft, and making it criminal,the tax payers will continue to fund graft over health care.
    We can not patch the roof again while the foundation crumbles.
    Not doing enough of the right things is worse than doing nothing - but both are unacceptable and unsustainable.
    First people have to want to do the right thing which will serve everyone well .. They need to recognize that their lives & quality of life really depend on getting this right. Most don't get that most of the restrictions they think the medical business machine works under were lowered or removed to allow the run away costs..They don't realize that not for profit hospitals just don't pay taxes on their obscene profits they
    give to their managers.. They really don't understand that private insurance only insures you while you are young & healthy and don't need them....they really think if I THINK I am OK then everybody is OK. I ask where other business & small business are? Why are they not screaming for reform knowing they cannot sustain the group policies under present conditions? Where are all those 56 % who pushed Obama to the forefront of this and then ran away and throws darts with the enemy?

    This show was simply so well put together and informative.

    I think it is hard to grasp what is going on and the extent to how broken our health care system truly is.

    This show should be seen by the entire country!

    "Bill Moyer's Journal" does a great job of rationally talking about what is going on and trying to explain it to the average American.

    I saw an episode of "Bill Maher's Real Time", where Paul Begala, a CNN contributor, talked about the health care industry at these trials and how no one including CNN even covered them. The health care industry basically coming out and saying "No we will not stop dropping people with pre-existing conditions". This should be known by all Americans.

    Well apparently there is "someone" who does care and devotes an entire show to the subject.

    Our corporate news has failed the American people. It is "Bill Moyer's Journal" and a few other shows and journalist out there that believe in journalistic integrity and trying to inform the American people.

    This show deserves tremendous praise.

    Thank you so much.

    Ron Najor

    Present health care reform proposals are like rearranging the deck chairs on the Titanic, as none of them will add even one single doctor to help the many people who so desperately need help. All they can do is change who gets denied service. Meanwhile, more than a million former military medics, medical research personnel, immigrant therapists, and many others with applicable skills are unable to practice because they don't have MD after their name.

    While an MD education may be essential for general practice, a typical scientist working in medical research knows far more than any MD about the particular condition that they are researching. If I had a serious medical condition, I would certainly rather have a competent researcher working on my case than some MD.

    I used to work for the University of Washington Department of Neurological Surgery. There they had a floor full of research labs, but only two MDs in the entire department.

    Now with our present economic problems, many of those researchers are unemployed and presently unemployable as researchers, when they should be working to save the many lives that they could easily save if given half a chance.

    Once we remove the necessity of having broadly skilled MDs doing everything including ordering routine tests, then the choke point will have been removed, costs will drop to reasonable levels, and the worst of health plans will be far better than the best of health plans with the present MD choke point left in place.

    A few years ago California adopted a plan to do this, where anyone could practice so long as it didn't involve surgery or controlled substances. All they had to do is get each patient's signature on a document that described their practitioner's credentials, if any. THAT provides far more "freedom" than any of the present health care plans. Any practitioner can order blood tests, X-rays, etc. Quality improved, availability improved, and costs dropped. Of course insurance doesn't pay for most of these practitioners, but their presence greatly reduced the hazards of being uninsured.

    My alternative insurance "plan" is to deny Federal dollars to states requiring that MDs do jobs that don't require MD skills, and most especially deny Federal dollars to states requiring that MDs do things that they are clearly UNskilled at, like "managing" chronic illnesses, when the only reason that many of these illnesses are "chronic" in the first place is because MDs are either unwilling (because of the time required) or unable to work to individual cures. Once the States fall into line and we put to work everyone who can help, costs will drop enough that most of the present debate will simply evaporate.

    The present debate exists only because both sides have accepted the present horrendous situation where many/most potential practitioners are barred from practicing. In short, both sides are right when they state that the other side is wrong. Let's solve the underlying problem.

    Steve Richfield

    Only the Rich and Famous don't want a single-payer system.

    This is the republicans and the Co-operate people.

    America, take Note.

    I think Bobby Peterson's comment above "If they build it, will you come?" is brilliant. We have free public defenders in court, why not free access to a health care advocate when the insurance company is refusing to cover costs?
    There are a lot of good points here. I hope somebody in government is listening.
    In general, I prefer the idea of having lots of choices, with a public option to help keep the private companies honest. I think having the government control all health care would invade patients' privacy, eliminate free choice, and leave no room for creative innovation.

    I am against a single payer, "Government Controlled" health care system. I watched Mr Moyers interview with Wendell Potter and likened him to someone who lived their whole life a certain way and then one day wakes up and finds Jesus. I didn't need a 43 minute lesson on how capitalism works. He neglected to mention that those 4 insurance companies successfully insure over 200 million people. He also never talked about how to pay for the medical costs associated with caring for all those uninsured. As an employed person with a family of 4, I already pay $4000 per year plus deductibles and co-pays for my families medical insurance, and can not stand any additional government taxes or bureaucracy. I am positive that adding a public option will only drive up my current costs and common sense says that adding all those people at once will decrease the overall quality of the current system.

    Take the best health plan America has ever had for very large group of people and remove the 65 year old limit.

    Medicare !

    Discussion over!


    Re: health care in the United States

    As a voting American citizen living in Canada, I have watched with interest, and some dismay, the unfolding of the present debate on health care in the United States.

    While democracy needs to allow for all views to have voice, it seems inappropriate that ‘attack ads’, broadcasting inaccurate information, be used as means to promote fear in our society. A case in point is the Shona Holmes Ad – Against the Nationalization of Health Care,, a one-minute commercial spot, which appears to have been produced to raise fears about the Canadian health care system, and thus further the lobby against any moves to make health care more universally accessible in the US.

    With the support of others, we have produced a response to the above-mentioned 'anti-public-healthcare ad': Response to Shona Holmes. It would be very much appreciated if you would take the time to look at these two sides of the issue. This should take less than 3 minutes of your time.
    We hope that by putting this out, we can keep the health care debate alive for the benefit of all patients. If you are so moved, perhaps you would consider spreading this message to other US citizens.


    There are people working for the opposition in Every sight.

    These people are paid to say something negative, in order to discourage you.

    Do not believe all you hear, Just be sensible!.

    Your guest is concerned that the public option will become a dumping ground for expensive cases unable to pay.

    Funny, that's exactly what IT SHOULD BE, if anything! It should not be a taxpayer-subsidized unfair competitor to honestly competing, heavily-regulated businesses. That undermines the competitive portion (hopefully, the majority) of the marketplace, where competition (in theory) keeps costs down.

    One enormity with the existing system is that it dishonestly transfers costs from people who can't pay to premium payers and also to service providers (e.g. Medicare, where suppliers operate at a loss and make it up with the payers).

    This corrupts the entire system, via the dishonest regulation that has existed for decades now.

    Meanwhile, a completely nationalized system (i.e. 'single-payer') can only bring down costs by severely rationing the services and products supplied. Your guests should admit this and call a spade a spade, if this is what they are advocating otherwise. Otherwise, they are just as cowardly and dishonest as the politicians and have no right to complain about them.

    If the medical bill is $10,000 & the ins. co. or medicare pays 80% & the patient pays 20% then how much is paid?

    Ins. co or medicare allows only $4,000 & pays 80% or $3,200.

    Does the patient pay 20% of the $10,000 ($2,000) OR 20% of the allowed basis of $4,000 ($800)?

    The questions are based on rough but factual bills & allowances.

    A $100,000 heart attack might cost the patient $20,000 & how many families can handle that?

    WHAT are the Mechanics of the plans proposed?

    Will 2\3s of us still face bankruptcy if there is a major health issue?

    Congress & the Insurance companies are not to be trusted to look out for us.

    Medicare can not be as bad as the insurance companies, unless you can affore $12,000 a year premium & then still it will be as good***unless it has a 'Paulson moment".

    Billy Bob, Florida

    why is no one talking about the elephant in the living room? Members of congress have possibly the best health care on the planet. They and their families are enrolled when they take the oath of office with no waiting period, no problems with pre-existing conditions, and immediate acceptance. The taxpayer pays 75% of the policy premimum. So many of the congressmen and women seem to be against any form of a government insurance for us in which they whole heartly participate. My question is is this the definition of hyoprocy or betrail?

    Bill, is there any way PBS could air Sicko?

    You could air it in the Tuesday NOVA time slot. It is a documentary. Those of us that love Nova wouldn’t mind waiting a week for NOVA to begin again.

    Even better, two weeks in a row, at the same time each week. Announce on your Friday show that PBS will air Sicko Tuesday at 7:00pm central for two weeks. After the first airing, those that missed it could catch it the following week.

    Announcing it days before the airing would give the special interest misinformation propaganda cartel a migraine.

    It would go a long way to counter the misinformation and fear mongering directed at the healthcare systems of other developed nations.

    It would be a huge public service

    In 1992 my husband needed emergency heart by-pass surgery. I sat in his hospital room while his cardiologist--I should note, a renowned cardiologist--sweet-talked a woman from our health insurance into approving the surgery that was going to save his life. Fifteen years later, back in the same hospital, with further heart complications but on Medicare, my husband again had surgery but without having convince anyone that it was necessary.

    I think I would rather put our medical decisions in the hands of a government bureaurcrat over an insurance bureaucrat.

    If there is a new government system, there has to be many changes and trials that the new system would impliment.

    Isn't this, like any other system consistent with the facts.

    There will be trials and tribulations because America is been controlled by the Capitalist system, they still call it a "single PAYER" system. The word being PAYER.

    The rest of the world doesn't have a PAYER system.

    Even till today, if you have a problem and want to see a doctor, you have to wait at least a month.

    Talk about the British system. It will be the same only the british system doesn't put you on a waiting list. You go in the very same day.

    In America you see people, waiting in FOOD Places, like burger king.
    That is how they wait in medical offices in the rest of the world.

    You get service the very same day.

    Congress voted in July that they don't have to participate in their government Healthcare plan. How did Pelosi and Barney Frank vote? I asked, but they didn't respond. If they had to participate in their plan, they might write a better bill. Vote out Pelosi and Frank and start over.

    Thank you endlessly Mr. Moyers for your important work. I think progress is being made, thanks to people who are not afraid to speak up and seek the truth. I'm fortunate to live in Vermont and have Senator Bernie Sanders working on exposing the truth behind the health care industry's monopoloy. He holds many local town meetings on this topic that Vermonters can go to.
    I think one of the best arguements that Wendell Potter made in your interview, was to decontruct one of the opponents talking points about government deciding who gets health care coverage. Now we have corporate executives deciding our health care using a Wall Street model. This is absolutely absurd and I feel if the public understands this comparison, it will respond. This is what Michael Moore does so well with his gifted way of seeing through the mirage of corporate marketing and hype.
    I really believe once the American public gathers the facts, we will bury these profiteers.
    People over Profits! Remember, Jesus was a socialist!

    If they build it, will you come?

    The political debate over health care reform buzzes in the hot summer air. The clash of public plan proponents with private plan advocates divides constituencies and fragments bipartisan support. Yet critical elements important to everyday Americans get lost in the contentious debate. Is anyone truly looking out for patients and the help they need to get coverage and care?

    Looking forward, health care will not become easier to understand. Reform efforts that build on existing structures will not create a seamless system of services that are accessible for all people. The nature of health care and cost containment tools means that the existing procedural and administrative barriers to expensive medical services, technologies, and prescription drugs will continue in a “reformed” system. We cannot naively assume that health care reform will break down monolithic public and private health care bureaucracies. Cost containment pressures and policies will still demand that an entity, entirely separate from a family and its doctor, evaluate whether services are “covered benefits” or “medically necessary.” Most patients, who often have their hands full dealing with their illnesses, cannot clear the thicket of checkpoints and red tape to stage a persuasive argument for needed services before the institutions guarding the money. They need our help!

    Fighting entrenched bureaucracies, be they public or private – and I’ve fought them both – can be intimidating and draining, even for someone with a law degree and years of experience as a patient advocate, let alone an individual struggling with a disability or chronic illness. Any new or modified health care system must include structures to help advocate for people to connect to both the care and coverage they need and deserve.

    Patient advocacy systems pioneered in Wisconsin offer a proven strategy to confront the jargon and bureaucratic inflexibility of most health care payors. Wisconsin’s Senior Benefits Specialist program is a fine example of a system developed to advocate for senior citizens and help them obtain the coverage and benefits they need. This nationally-recognized program offers a model for a statewide system of patient advocacy and support for all people.

    Today more than ever, we must ensure that we help people get the coverage and the services to maintain or improve their health. Our elected officials need to take notice that in health care reform we require more than a “field of dreams.” Sadly, and far too often, the laws created in Washington do not include the consumer protections and enforcement mechanisms to make them work effectively for people in need.

    Our marvelously advanced health care system offers nothing if it lacks support for patients to effectively navigate the system and obtain needed health care coverage and services. We cannot hope to reform health care without also building the individual advocacy support system that links people to the care they need. We need health care that is accessible, accountable and available for all people. Only then, if you build it, yes, we will come.

    Bobby Peterson
    Public Interest Lawyer
    ABC for Health, Inc.

    For the record, I do support a form of single payer, universal health coverage; this being stated, to avoid having this comment go too far off track from the blog topic.

    However, the intent of this post is to address Irene, the nurse practitioner and the point of confusion over professional roles in health care.

    As quoted:
    "Confusion exists (based on turf wars and politics) about physisian assistants and Nurse Practitioners. NP's are professional care givers with independent perspectives and liabilities contributing as colleagues. PA's are merely an extension of the doctor's orders and policies to raise more money for the doctor."

    I do feel I should preface this by saying I speak as a neophyte (in one role anyway) near to the completion of my masters degree program in another role.

    It's a sad state of affairs when said confustion exists amongst the healthcare professionals themselves.
    I am a nurse, who incidentally, is also completing a degree (and hopefully will be employable) as a physician assistant in coming months. I have worked with dedicated nurse practitioners who I can only hope to emulate in their clinical knowledge and skill to the under-served patients of this country. I have worked with doctors (both as a nurse and as a PA student) who you would want taking care of your own grandmother, and others I wouldn't let touch my dog with a bottle of distilled water. Lastly, the PA's I've recently had the honor to be a student of, are truly excellent and compassionate providers, and lay a groundwork of inspiration that I dearly wish to follow in the footsteps of...and I would say, they are most definitely NOT merely "extensions of doctor's orders," nor ancillary, money-raking cash veins.

    Physician assistants are, by-and-large, master's prepared nowadays. They are (as with nurse practitioners) intermediate primary care providers. There are still those, amongst practicing PA's, who are certificate trained, and fewer still, who may be bachelor's prepared; however, this by no means detracts from their capability to take a history, perform a physical exam, order relevant diagnostic/screening work-ups, prescribe medication, refer, or teach and educate patients, etc etc. I say this with the underlying notion that, no matter how much schooling (ask any 1st year resident) one has had, most of medical practice is learning on the job, after you've graduated (nursing proved no different; I can only "anticipate" how being a PA might be). This is done in collaboration with a supervising physician, who (depending on the work setting) may or may not be "physically present" (often not). A PA, like an NP, needs to recognize their scope of practice, and know when consulting with their collaborating/supervising doctor is necessary, and in the best interest of the patient. For most cases one sees in primary care, whether stable chronic illness or acute/non-emergency room patients (remember, we're talking primary care here, though PA's and NP's function in ER's too), physician assistants operate with a great deal of autonomy and store of clinical expertise.

    Please be minded, I would say this about many of the NPs I've worked with as well, in regard to the last statement. I was simply posting this, b/c as Irene said ,"Both medicine and nursing can be responsible for "assistants" to help but don't confuse the roles. Reform should better recognize the collegiality of all health professionals."

    Indeed, if the shortage of family practice/primary care doctors is truly as dire as some reports I've heard, reform is going to HAVE TO RECOGNIZE 'the collegiality of health professionals.' What puzzles me is how this is meant to happen when fellow health professionals themselves, across the entire spectrum of the medical/nursing fields, remain so sadly informed of one anothers' respective roles.

    The most lunatical phrase in America is to imply " Taking care of what you eat or drink".

    This simple example shows that everyone of you Americans, Educated or not to follow a regiment of knowing what they eat or drink. (The land of the free and home of the brave). When most Americans are not capable of not being taken for a ride, by some foreigner telling them that they had won the lottery, but send them $???..., and they would be sent the prize money.

    How,if Americans cannot understand this simple ploy, how will they understand what they should eat or drink, besides, will Americans agree to being controlled in what they should eat or drink.

    I am retired now but, having been a Nurse Practitioner, clinician and responsible for my own patient care, I am surprised that none of the reformists are knowledgeable about the superior care of Nurse Practitioners as colleagues. Empowering patients with education as well as health care practice will vastly improve compliance and health outcomes. NP's are independent professionals with Master's or Doctoral education providing comprehensive understanding integrating studies with pharmacology, physiology, psychology and sociology.
    Confusion exists (based on turf wars and politics) about physisian assistants and Nurse Practitioners. NP's are professional care givers with independent perspectives and liabilities contributing as colleagues. PA's are merely an extension of the doctor's orders and policies to raise more money for the doctor. Both medicine and nursing can be responsible for "assistants" to help but don't confuse the roles. Reform should better recognize the collegiality of all health professionals.

    Single payer sounds better depending on details. Action figures spin "facts" in useful directions confusing "most of the people most of the time"! (Et tu, John Stossel). The truth about Canadian health care, whatever it is, could be very useful!

    A non-profit system? Depends on how they tweak it. If non profit meant more coverage with lower premiums who would buy "for profit"? The Blues are no charity! Some non-profit charities and religions charm generous people out of their shorts! The money goes everywhere but the "profit" column!

    A few days in the hospital costs as much as a house! More insured people are excluded, expelled, and ruined every day. The uninsured can get "stabilized" for a phenomenal fee!

    What will it take, Armageddon? (I need to pace myself)

    Diagnosing proposals for health care reform? What a joke. Rhetoric does not equal proposal. However, I do know the prognosis is bleak because no one on the hill has the sense to concern themselves with the people who actually have to pay for their own insurance. Oh, guess who is really paying for Dodd's surgery?
    Does tax dollars ring a bell? Wake up, it's too late to demand, it's time to revolt. We, everyone in this country must have the same coverage as every senator, every representative, every congress person and every civil servant.


    What does that mean?

    I worked in a non-profit Hospital and what did I get!!.

    Where does the money go, to the CEO, and his croonies that control all management.

    Explain that!!.

    To Ned Smith,

    There is no place in the world for true this and that.

    All so-called societies must compromise, that is where we get a fair deal.

    At least a chance for people to have basic needs met.

    I wrote a comment for the first time I ;got through preview and clicked post but my comment doesn't appear? Do I have to type the words below again?

    ing your Comment
    I am answering the writer who thinks that a single-payer medical plan will be too complicated for us. Where have you been?
    Surely you are aware that US. is the only industrialized nation in our sphere that doesn't have a government operated, single-payer medical program? One reason is that gives the best health care for half the cost. That's of record. That is also the reason that you have to dig to get and spread the truth. Corporations buy the main stream press and, worse yet, they do it with our money, the billions of dollars they impoverish us to get from our pain and suffering. A Government plan doesn't pay CEOs billion- dollar bonuses. The health corporations are buying the media to keep the truth out of the press. If the citizens get even a trickle of this, the pigs haven't a chance of continuing to keep us sick and milking our agony. Wake up. Take a look around you. We are only developed nation that still staggers along with privately paid and administered health care accepting pauperization at our graves. Go to google and download health care in Norway. Just in case you still have doubts, read on: three years ago my son-in law died of cancer. He was young and strong, so it took about eighteen months and when it was over my daughter had nothing. All five of their rentals, the ones upon which she had proudly done every bit of the maintenance, belonged to their bank: ditto all 12 acres of their land five miles from the ocean. Health corporations owned the bank. She now could only go to doctor as an "emergency." That's how they missed the tumor that is squeezing and sucking the life from her brain.
    Readers, do you need more?

    I guess it all depends on you financial priorities as to health care reform but consider what a former President had to say.

    "Every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and not clothed. This world in arms is not spending money alone. It is spending the sweat of its laborers, the genius of its scientists, the hopes of its children. This is not a way of life at all in any true sense. Under the cloud of threatening war, it is humanity hanging from a cross of iron. "

    Dwight D. Eisenhower, April 16, 1954

    President Barak Obama
    The White House
    1600 Pennsylvania Av. NW
    Washington DC 20500

    Dear President Obama.
    You are the best president this country has had in a long time.
    Because I have always supported you I like to share some of my thoughts. They are a product of 40 years in the practice of medicine.
    The surge in health care costs can not be contain unless we stem the origins of this problem
    Medicare and Medicaid have been the victims of fraud by many. We need to place health care providers on a leash. Physicians particularly are prone to depend for their diagnosis on expensive tests rather that on their mental effort and information.
    We must establish a National Medical Protocol that will establish the basis in the first steps of diagnosis and treatment of patients.
    It has been my experience that for the physician it is easier to order a test that to spend several hours of thinking about the patient’s problem.
    Physicians are responsible for 35% of the cost of health care.
    Ordering indiscriminately expensive tests (more than 80% of the results come back normal) and prescribing the most expensive treatments when cheaper and equally effective measures would be just as good or better and less risky is a waste of money and does not require a professional, just a bottom pusher.
    By establishing a Protocol by the National Institute of Health that would establish the first steps in the diagnosis and treatment process we could control costs and protect physician from frivolous suits as well.
    Now if an indiscriminate costly test or an expensive treatment were executed without the indication in the findings of a thorough history and physical examination, the physician and the hospital would be accountable and responsible for that cost.
    My message to physicians in the country should become a national slogan. “Doctor, use your head before you avail yourself of the pen the scope of the scalpel”. “Be a professional and not a technician”.
    I hope that we can put a stop to this bad and expensive practice of medicine.
    Medicine is a calling, a practice and not a business.
    Health care is a human right and not a luxury.

    J.A. Ribelles, MD

    All I know for sure is that I do not trust any politician that has accepted one penny from the insurance or health care industry. I think they should recuse themselves for conflict of interest when it comes time to vote on this Health care Bill.

    That of course is not going to happen so I would insist, as a party to the action, recipient of the plan and principal player that any Representative that received any monies from the insurance or health care industry is not allowed to vote on this Bill.

    Congress is not really a party to this action. They are merely acting as my, let’s say attorney, mouth piece. I pay them a salary, retainer if you will, and I do not have to give them reasons why I want something done. I have never given my representative power of attorney, which means they cannot act on their own but do anyway.

    70% of the country has demanded from their representatives a single payer health care. It is not happening. Why? It is not happening because our representatives are double dipping. They make a little, more like a lot, of extra money on the side from special interest like insurance, health care, and drug companies. Everybody knows this. It is not a secret. I (taxpayer/employer/constitute) pay them $165,000 a year to represent me. But they have not been to keen on getting things done in a timely manner for me. Health care has been on the table for at least 10 years. So, perhaps, they are making more money on the side with all the special interests groups and they don’t feel they need to listen to me.

    As an employer, I think I like the idea of having at-will employees that can be fired on the spot for misbehaving, lying and cheating. At least that would get their attention. But that is another subject. In the meantime I will exercise my right to tell them, “If you take money from them, you can’t vote on this Bill for me.”

    How many Representatives have taken money from the insurance and health care industry? My guess is all but two. Senators Bernie Sanders, and Dennis Kucinich.

    I also know that I trust Senator Dennis Kucinich and Senator Bernie Sanders with my life. And that is what we are talking about here. And whatever they say is good enough for me. Both have proven their worth and courage above and beyond. I have no reason to question their intent.

    Senator Kucinich has an amendment to the Bill that gives the States the power to offer single payer health care. Single payer health care is what we need. It is what we want. Nothing else will do. We must have Kucinich's amendment as written and with no compromises in the Bill.

    To be clear, my rights are not negotiable. No compromise on single payer health care plan.

    Now on an entirely different subject, “How to pay for a single payer health care plan”? That's easy. Tax Wall Street .5% on every transaction. It's pay back time.

    Second, bring all our troops home right now. The military budget is killing us. We are dying here. We need to bring everybody home and get healthy or there will be no home to come home to. And that is all I have to say on the subject.

    You are making a difference Bill. Every show is a step in the right direction. Thank you.

    Most Sincerely,

    Jeanne Zindorf

    ILLUSTRATION for difference between public AND private health insurance:

    Air plains have three classes: first, business, and regular
    All passengers get carried on the SAME airplane, SAME safety standards, to the SAME destination. For an ADDITIONAL fee, business class or first class fares will purchase EXTRA perks, EXTRA comfort...

    The important role of Public healthcare will be that of providing good, safe health services for everyone, the general PUBLIC, with the same safety standards for everyone.
    The role of PRIVATE healthcare will be that of offering ADDITIONAL SERVICES to the patient: e.g.
    During HOSPITALIZATION: providing private rooms with a single bed instead of the REGULAR rooms with several beds in each room; private access to physicians instead of public waiting rooms; brand name medicines instead of generic medicine....

    Simple solution to health care: Make all insurance companies and hospitals to be "NON-PROFIT" corporations.

    Why waste your time on Obama's "beer summit"? It degrades our good President, emphasizes beer, and detracts from pressing issues, such as health care reform.

    The Republicans are delighted to have you fall in their trap of getting derailed from health care reform. The Republican are laughing up their sleeve to think they can wreck the Health Problem.

    Peace and support,
    Joan & Richard Hunt

    My feeling is that the people who are against a national health care system are the ones who have health care provided or have the money to pay for it. Until you don't have health care and can't get the medical attention you need, people don't have a clue. I have been out of work for over a year and have temp insurance 2-3 months at a time. I can't go to the doctor or it would be a pre-existing condition for the next 2-3 months. It works well in other countries, so why not here? Let's take the greed and selfishness out of the health care system and do what's right for the greater good. No one in this country should go without health care, or have to die because they couldn't get it.

    I found the podcast discussion quite interesting and the viewer comments equally interesting. I do not doubt the hearts or sincerity of the "experts" or of the viewers, but I feel I must be living in a different country than they are. I think you need to spend some time with physicians who work on the front line. We would be willing to work with a single payer, and in America we do, which everyone seems to forget. Today is the anniversary of medicare, the single payer universal coverage program for Americans disabled and over 65. I can have a patient who is critically ill, and I will get denial of services from some young lady viewing a computer screen. Although in place all these years, it is not properly funded and has projected deficits larger than those which recently brought down the housing market and wall street. How do we know that since they cannot handle the financial's of Medicare and Medicaid that if we combine them together, add private insurance and add the uninsured which diverts 1.7% of the health care costs that suddenly all the financial pressures will disappear. I do like the idea that I will have guidelines for all that are the same, as I feel bad with the Medicaid bulletin in front of me today seeing that the codes for radioimmunotherapy are limited to one per lifetime. I have also been surprised that no one feels that the American citizen should need to change any of their behaviors. It is not required to wear a motorcycle helmet while the rehab costs for the neurological injuries are great. The leading causes of death in American males from 20-39 are 1. accidents, 2. suicide, 3. homicide. None of these seem to be changeable by any health care financing legislation. Our experts keep telling us we are getting bad care when it is obvious they don't have training in medical statistics. While Japanese men in Japan live longer (mean 78.4 years) than the “average” American man (74.8 years), Asian-American men live still longer (80.9 years). (Bureau of the Census). The fetal mortality rate in the US was 6.22 (per 1000 live births and fetal deaths) as compared to Japan's fetal mortality rate of 30.0. We seem to be myopically focused on the money and not on how we choose to live.

    Just as a people care for their country, so a country should care for its people. What is partisan about this?

    A government should care for the the survival of its people--whether that be from acts of war (Department Of Defense), terrorism (Department Of Homeland Security), food standards (Food And Drug Administration), air and water quality (Environmental Protection Agency), or disease (Department Of Health).

    The government already protects us from illness from bad water, bad air, bad food and bad pharmaceuticals, so why should protection from disease, sickness, and injury be any different?

    Answer: Because there is a massively well-funded, profit-making industry that has ensconced itself in the system and is spending gargantuan amounts of money trying to use scare tactics, personal freedom and partisanship to bury the focus and divide us.

    The health and pharmaceutical industry is a virus, and it doesn't care to be dislodged.


    In our particular system of commerce, private enterprise has been the go-to default for all things, but some basic infrastructural services can't be handled by a for-profit private enterprise because it could not generate profit without depriving some of basic services. Things like water treatment, law enforcement, postal services, fire & emergency services etc. Can you imagine a fire station that only operates during business hours or a police force that only protects you if you have good credit?

    The nay-sayers would have us believe that emergency services, law enforcement, water treatment, food safety, the coast guard, the U.S. military, the community college system, health services, highway and transportation services, children and family services and a long, long list of other long-standing, so-called "government-run" systems are total, unadulterated failures.

    Yes, perhaps government could stand to cut some fat in these lean times, but don't throw the baby out with the bathwater. America is a country of people, not profit opportunities.

    Be careful what your political dispositions lead you to believe.

    If you understand the history of the health care system you would see that every stop gap measure short of a one payer system has created new problems and new irrationality in the system.
    Why would yout think that another stop gap measure would not create a whole new set of irrationalities?
    Take the extreme profits out of health care they have not been a part of the system the whole time. They begin in the 1980's when big insurance business saw not for profit health hospitals care as easy pickens. Take back the system now.

    If only this program reached a wider audience, and if only people were less reliant on denial as a defense against the threat of disease and aging. I am in complete agreement with Dr. Angell regarding Single Payer as the rational (and inevitable) solution to the provision of healthcare in the most efficient, cost-effective fashion.

    I'm indebted to Trudy Lieberman for pointing out the hazard of under-insurance and the inevitable coalescence of rising deductibles and more frequent medical bankruptcies for the unfortunate victims of unexpected and premature illness or accidents.

    In times of national emergency...

    At the onset of World War Two, the federal government moved quickly to sieze control of industry, national resources, and to control costs. They capped compensation and rationed items that were critical to the war effort. The term "war-profiteers" became nearly synonomous with treason. Republican/General Dwight Eisenhower said of then Democratic/Senator Harry Truman that because of his efforts to combat war profiteering, we probabaly fielded two additional divisions to the war effort.

    To our johnny-come-lately credit, most now recognize that the current health care system is "unsustainable." In other words, if we don't get it under control, it threatenss to sink this nation with ever increasing costs on government, business, and individuals alike. It will ballon to a point that it becomes impossible for most Americans to save money while the out of control defecits threaten the value of the dollar and our very abililty to sustain ourselves as a nation.

    Stop calling this problem "unsustainable." It is a national emergency and in times of national emergency, our representatives have a solemn responsibility to act in the best interests of the nation. In protecting 1/6 of this economy, they risk the remaining 5/6. Sieze control of health care, cap compensation, and ration the resources until its under control and we can begin expanding the reach and quality of the system. We need to begin seeing "health-care profiteers" for what they are: an albatross that will bring down this nation and everyone with it.

    I'm thinking that non-profit insurance companies have "costs" including salaries, bonuses and lobbying. Many non-profit charities are not all that charitable!

    Your correspondents kept talking about for-profit health insurance. Blue Cross Blue Shield is nonprofit. BCBS Massachusetts has profit goal of 1-2%, and just broke even last year; they also have 30% of the market. BCBS state companies have 30, 40, 60, even 70% of the market.

    Also they talked about for-profit health providers. Again in Massachusetts all the largest hospital/clinic groups are nonprofit corporations.

    If BCBS and providers are acting in a way injurious to the public, it is not because of their shareholders and profits.

    I have noticed a very comical type of argument being made by those who are opposed to the 'bleeding heart' liberals who advocate a single payer option; it goes something like this: In order to promote innovation and in order to ensure that individuals have the ability to flourish without being oppressed by the tyranny of the masses who want to turn America into a welfare state, we must stay committed to the fundamental principles that a capitalistic society is based upon: Competition. Apparently, the people who have been arguing thus live under rocks, and have no idea that America has 'socialized' Wall Street as well as many other financial institutions--for without 'government intervention' corporations such as AIG, for example, would not exist. While people who make this type of argument against health care reform are most likely the same people who bought into the 'too big to fail' premise--and in reality are probably some of the same people staging 'tea parties' in protest to 'government intervention' in our H.C. system--it is high time Americans realized what this debate boils down to in "reality": Conservatives and 'fiscally responsible' blue-dog democrats who oppose a single payer option are NOT doing thus because such a plan isn't economically feasible; the real reason they are crying like spoiled little children is because they want to keep their filthy, money grubbing hands in control of the health care industry since it is a cash cow that they make a fortune off of by exploiting the American people.
    These people are NOT pro American; all they are is pro profit--no matter what means to such an end is used to do so, even if it means killing Americans to maximize profitability.
    To conclude, I would like to briefly digress from the main point of this post: I would like to address a claim made by someone who I will not name out of my benign indifference to people akin to the author of this ridiculous post who don't deserve to exist; namely, a post which claimed that Obama never advocated a single payer option on the campaign trail: Even if Obama did not advocate such an option--which, consequently, the post being addressed never supported with textual or rather factual evidence, opting to use sledgehammer rhetoric instead--based upon empirical evidence, such as the overwhelming support for a single payer plan is on this message board, he should; it is what a majority the American people want.

    Thanks for your continuing excellent program. The two women discussing health care were right in focus.

    My daughter recently spent six months in a Canadian hospital where she received the very best of care.
    She had choice. Her doctors and nurses were excellent. The necessary hospital equipment and medicine were all provided. At the end of her stay, the cost was covered by the Canadian universal health care system.

    It seems obvious that the misfortune and sickness of a person should not become the opportunity for a Wall Street health insurance broker to profiteer. Calvinists invented capitalism and insurance, but they never meant to mix the two. To profitee on sickness is disaster capitalism at its worst.

    Universal health care for every person is the only way out of this quagmire. Perhaps the cooperative mutural program being suggested would work for Americans, but it must be universal for all. Now is the moment of opportunity to shed the barnacles of corporate profiteering health insurers. Otherwise, it is a lost cause. In Canada we had a fellow named Tommy Douglas who took on the profiteers and eventually won the day. Keep the faith.

    Ethically speaking, health care should be a right. The constant backbiting over profit margins is sickening and another illustration about how this country has lost its way. How can polls now say that Americans don't want health care to change? Are people that cold? Are they that misinformed? The media, for the most part, has once again failed the American public and is focused on profit margins over the safety and health of Americans nationwide.

    Your two women commenting on American health care were absolutely right. The problem is the health insurance industry with its lobbyists. Misfortune and sickness should not be opportunities for profit making—disaster capitalism. My daughter just spent six months in a Canadian hospital with choice, the best of care, medicine. The doctors were the best. At the end of the stay it was all paid for.

    Why is a cooperative mutal health care program like a credit union such a bad idea? Why is a government run program so bad? How in the world did the health insurance industry ever get such a stranglehold on the sick and the suffering?

    A universal system for all is the only way out.

    I agree with Dr. Angel, we need to start over with a single payer system since we've sold out to the managed care, pharma corporations who care only about profits. Our lives are on the line, and we need a better approach that puts health status at the center of the equation!

    Mr. Moyers,

    I appreciate your coverage of this issue because I agree with PNHP (Physicians for a National Health Program) that the media is not doing a thorough job of in-depth coverage and analysis. No surprises there. I, like Jeff, found the PNHP website useful, but I am painfully aware of how few Americans will really take the time to research the issue.

    We should know that the World Health Organization rates France's system as the best (while we rank 37th). I wish for the sake of John Q. Public's education someone would create an "entertaining," objective analysis of the issues, e.g. explanations of alternatives, comparative data from each country, peppered with Studs Terkel-style interviews with individuals from various walks of life in those countries reporting on their experiences within their respective health care systems.

    This link is enlightening:

    Personally, I'm convinced that a single payer system is the answer, but I know there is no chance.


    We may get a few changes in healthcare now with such a large group that has been excluded, hurt or ruined by the current system. There is so much anger over pre-existing conditions that it might get adjusted. We can hope! It seems like the system that has been maintained but not regulated is deliberate injustice by policy makers much like the enabling and tolerance of years of financial misconduct that has hurt or ruined so many people. Did I hear that Blue cross of Michigan wants to raise all premiums by 30-40%??? Great timing! Why would it take a few years to implement any health care changes. The rascal bail-out sure didn't.

    Deja vu all over agin.
    This is the 2003 mini-HC-deform all over again.
    It is going to be an even
    bigger theft than Madoff's
    or AIG's. Please write to
    Obama and underline the fact that the progressives who supported him in 08 will
    abandon him if he turns to
    the Rump Republican Party
    as his new ''blue-hound''
    base of support.
    We simply will not support him if he presides over
    another health care
    bait and switch

    First, I have generally stopped watching Moyers, NOW and the other more liberal programs. I was a "liberal" for years, but now it seems most of the shows come on about three levels beyond the reality or reflected concerns at the average citizen level, in much the same manner as the right neo programs of FOX etc are not reality of the average citizen, but do a better job of spinning themselves as such. I am almost ashamed to say so, but the left has been hijacked by a kind of stand off to one side, a condensending elite that seems to discuss all in third party terms, as if dropping coins into the outstretched hands of beggars while munching on a lobster, kind of like mainstream medias. That said, and hope it does not upset the minders, I had just tuned in to see "well what esoteric will they have this week, stunned at your show on HC, best have seen anywhere. No wonder the "major mainstream media's" never air such, but they (see news-GMA et al, sponsored heavily by drug firms, so no surprise there.
    Great show on HC, wish it would have been longer, but to blame Ins/Drug/HMO etc's is to treat the symptoms and not the deadly virus/diseases.
    Reality is the disease virus is a "representative elected officials" system of government that no longer works, it is broken. Be it HC, or taxes, or bailout, or or or, DC down to most local no longer is of or worse yet, "for" the people. I read where OD fees by banks amount to "3700% ANNUAL interest", we read where banks turn back fed money to increase upper end pay. We find the same incompetent robber barons back at it. We tell workers, "wages are those set by foreign corps, live with it. We allow CH11 to close plants, destroy workers, jobs and enrich lawyers, big investors, and C// levels.
    The discussion was correct, only single payer may save the nations jobs, citizens and future USA. But like all mentioned above, the money that bought DC will not allow it to happen. While a great discussion of truths, the reality is single payer or any other plan that will not enrich, in the final count, Congress.. will not pass. The people have no voice, no say and we did it to ourselves.
    So when "Costs are the issue", I am greatly amused that a dumbed down USA, where 90% or more, cannot do simple compound interest/costs is "worried about the costs". Reality is for all practical purposes, "representative USA gov" is not.. and that genie will not be put back into the bottle, We no longer have "government" at most levels, rather an "for profit industry" that I refer to as the "NE Triangle", a area DC-NYC-Boston, connected by a line 60 miles or so wide into which money and ethics flow, never to be seen again. The triangle is one giant series of revolving doors connecting chosen of government-elite education and finance centers. Anyone, the 95% are considered alien of the Hinder Lands, not worthy of concern, nor capable of understanding the importance of the chosen of the Triangle.
    So other then sending their money 401's, etc,uninformed votes, taxes, labors and kids for wars and being reduced to vassals of the robber barons, indebted corporate serfdom's, be population, real worth or effective tax rates verse reality total incomes, HC really will not change for those outside, nor the vassals inside the NE Triangle.. real HC is not going to happen, our rulers, their owners-keepers of the royal corp treasuries, those elite rulers of the NE Triangle have spoken years back, just have not yet told us. Real HC like rest of world.. not while the NE Triangle rules us.
    I END WITH A PLEADING, WILL ANYONE ON THE MEDIA, POL, HOST,"EXPERT" ETC THAT DISCUSSES HC, BE REQUIRED TO STATE WHO PAYS FOR THEIR-FAMILY HC, IF "SELF" OR "MY LLC" IS IT A TAX DEDUCTIONS (AKA single payer as tax payer picks up bill0. WHAT IS DEDUCTIBLE, WHAT IS COVERED, EYES, HEARING ETC. WHAT IS RETIREMENT HC?Perhaps a better perspective as to HC might be arrived at if this was done EVERY TIME BEFORE discussions????? But no doubt to honest to survive. So single payer or even decent HC.. the NE Triangle has already spoken.. snd of course they are not telling us of their HC.. and soon they will tell us "no real change".. as they know what is best for the Triangle, all others need not apply..

    Why does there have to be this big debate that goes on and on and solves nothing? Other countries (actually everywhere but here) have national health care and they're doing fine.They're not all freaking out about or becoming communist.An aspirin in the hospital costing 25.00 ,listening to ad after ad,filling out mounds of paperwork-among other things..When are we going to stop this nonsense
    and have available health care for everyone?

    Moyers has done it again--right on target with two excellent, articulate guests. Why isn't this being raised with the general media? Keep it up Bill.

    I don't give a damn about Jon & Kate Plus 8, which represents the media's wish to just keep us distracted from real issues.

    I began a career in nursing in 1959; as a critical care nurse in 1968; retired in 2004. Common sense observation throughout these years guides me to firmly believe to enact a single-payer system is the need. However even this will be to no avail unless we recognize not only the corporate mentality as reason for the effect of unjust patient care; but also the cause of; the reason why the ‘corporate mind’ had this effect. To carefully reflect on the human course it may become evident our ascent; our current reverence for our intellectual prowess and accomplishments; was preceded by continuously increasing numbers of people reaching a deeper conscious awareness. The common sense of ‘fairness’; the sense of responsibility for the welfare of another person; that seemed to be moving western civilization toward an eventuality of truth and justice is an indescribable; entirely subjective occurrence; made possible because of an equal property existent in the nature of personal character. My education in the 40’s and 50’s was not only theoretic; surrounded not only concrete rules of ‘right’ behavior; but promoted personal character maturation; moved me toward a deeper conscious awareness; realization of a personal,--but common sense of ‘right’ behavior. The words of the Hippocratic oath are reflections of this entirely subjective common knowledge. When credence was in this oath; when there was proximity of the physician to the person suffering; when the physician was ‘free’ to exercise the art of healing, to express personal talent----this deeper conscious energy of compassion sought truths in order to alleviate the suffering; utilized the knowledge and brought forth marvelous technology and skills; and directed it toward common welfare; and effected a love-trust bond between patient and physician. The insurance industry WAS part of this growing deeper sense of responsibility for each other. It WAS a part of progress; a ‘good’ introduction; fulfilled a need. In all living things energy flows from the inside-out; and so it was in the case of progress; of our conscious growth.
    The source of the corporate mind is obvious; but if the deeper conscious awareness of our ancestors isn’t a subtle indication of their connection to God;---then what else explains the ‘laws of our heart’;--the ideals of equality, truth, freedom, peace, compassion,--of ‘personal worth’; the common sense,--the 'silent understanding among people;--the ‘inner personal mindset’ that has moved our country to greatness?
    A corporation is not a person—has proven it does not hold the ‘God-given’ mind in which our founders expressed credence. A corporation should have no voice in government; and God should never have been dismissed from social affairs;--because most likely has been our navigator.

    I keep watching this debate with great interest. I have a back injury and cannot afford the medical system. I can't afford insurance and don't qualify for anything. The Journal is very informative, but the realities are disturbing. In the words of an old movie, "Oh Roma, quo vadis...wither goest thou?" It's hard to find good movers and shakers where favors abound and the lobbyist dieth not!

    All I can say is, America has got to change its system.

    America doesn't respect its poor, middle class, but the worst part is these same people are not doing anything to fight Capitalism.

    Everybody else just talks, and talks, while the rest of the world passes by and by. Just like the conquerers in evolution, there has to be something real nasty, like the inflation, only twice as bad before America crumbles, and life comes back to normal, where they respect the poor, hungry and the not-cared-for.

    Trudy Lieberman and Marcia Angell have it exactly right. Obama's bill will only end up throwing good money after bad, by pouring more funds into a corrupt, inefficient and unworkable system. They also suggested that Medicare coverage could eventually be offered to the entire country by making it available to people 10 years younger than are now covered, and each subsequent year offering it to the next 'decade' group, thereby phasing out private insurance in 5-6 years.

    The present system saddles all American businesses with huge costs that force them to profitshare most unfairly with the insurance adn drug industries. Single payer healthcare is the only really viable and fair option.

    Obama doesn't understand the Healthcare legislation he is proposing, any more than he understood his bailout or stimulus legislation, and, furthermore he doesn't give a damn. But he wants to be thought of as a great president, and if the polls and voters tell him that single payer is the only path to glory, he might very well fell compelled to take it. But don't hold your breath: his $800 million campaign left him with a lot of paybacks due to lobbyists and big industry, and Obama has always taken care of his heavyweight boosters without consideration to the needs of his constituents.

    The Health Care Reform plan is a hurry up, puffed up, version of the present flawed plan. The rich want H.C. to stay the same. The middle class see the heels of the poor close up, and the poor are certain the miasma of America's Giant Corporate Greed can only be stopped by David and his slingshot and a few smooth stones; in other words, something of Biblical proportions.

    Maybe H.C. shouldn't be attached to employment. If it is made affordable people will buy it in the same way they purchase food, shelter, clothes, transportation, utilities and other goods they deem necessities. No-one wants a $50,000 medical bill looming over his or her head. Employers aren't responsible for our food and shelter, etc., why our medical care? People who are uninsured today just don't make a living wage. Who do you think caused that? The "for profit" Insurance Companies, the Pharmaceuticals, Hospitals and Doctors! How can H.C be based on employment when unemployment is at 10% and expected to rise to 12% or more in the coming years. I'm for a single payment reform health plan, not a puffed up, hurry up, lobby driven, version of what is not working.

    What now? Have a look at:
    and, if you can, get to DC July 30.

    Thanks, Bill Moyers, for supporting democracy.

    Look! Congress is BROKEN! The Congressional (some exceptions apply) Zombies are Asleep at the Wheel & the only reform results will be to silence the majority while fattening the vaults of big business.

    FIX CONGRESS or our 'Democracy' will slip away in the ER waiting for
    lack of skilled nursing!

    If The Mainstreet Party of Can-Do people failes to stop this slide of wealth to the wealthiest, (& I do NOT mean socialism) then Spinessless-Congress will not be able to stand up to its addiction for re-election money!

    Billy Bob, Florida

    PS Write, email, your Spineless Congressmen

    Robin Holland and Marcia Angell,
    It is my opinion that providing health insurance that competes with the present insurance monopoly group of insurance companies is essential to a functional capitalistic system of competive industries. To avoid duplication, Medicare could expand to provide alternative health insurance policies.
    Without competition, capitalism fails its mission.
    There is more to capitalism that just business as usual. It is necessary that capitalism changes to adapt to changing circumstances. There must be sufficient funds to support the demand side of economics so that there is investment and buying power to make capitalism functional. Otherwise, products sit on the shelf and corporations fail, people are out of work and the quality of life suffers.
    We need a positive income tax that redistributes income equitably so that it provides people the necessary money to support quality lifestyles.
    The next requirement is to eliminate lobbyists by providing election costs to prospective candidates who are qualified for the job. Donations to a general fund for candidates would be limited to individuals only; no institutions allowed to participate. Government employees would be elected by the people instead of bought and payed for by the institutions.
    Finally, the government budget would be as approved by the government legislators who would be advised by fiscal experts.
    Instead of economics based on a roll of the dice it will be managed to maintain an efficient balance of supply and demand. The quality of people's life will be the bases of economics. When the people have sufficient funds to pay reasonable health insurance and the health insurance companies are made responsible for people's health care; both capitalism and social systems will work efficiently to maintain an equitable distibution of goods and services.

    Dear Mr. Moyers,

    Thank you for stoking my fire. I sent a letter to the President and Senior Advisor. It follows.

    Dear President Barack Obama and Senior Advisor David Axelrod:

    With regard to your White House emails on health insurance reform…
    You need to reposition your policy on National Healthcare.

    INSURANCE is the wrong process. Insurance is a labyrinthine and costly process that works against the health of most Americans. If it were a Las Vegas game of craps, it would be like betting on the “Don’t Come” line.

    Insurance is a premium paid in advance in hope that an inevitable occurrence does not happen. If the risk does not happen, premiums are spent, lost in administration, or used for other purposes. Insurance focuses your administration and the American people on mitigating the risk and averting the solution – rather than focusing all parties directly on the healthcare needed.

    The current healthcare system in America has been a dismal failure for the American people, but at the same time it has been extremely lucrative for those most prominent in Washington – Lawyers, Politicians, Lobbyists, and Insurance Companies.

    This present system has led to an unequal distribution of healthcare resources in the following ways:

    1. If you live on the east or west coast, you find many healthcare providers. If you live in Middle America, you find few providers. And, if you are in rural America, you are considered lucky if you can find a provider in a nearby town. The distribution of healthcare mimics the distribution of wealth.

    2. Americans face two completely different rates for healthcare. For similar health procedures, an individual’s cost for a procedure is prohibitively more expensive than if an insurance provider paid for it. That price difference is more than the legitimate cost of administration and profit. That price difference has the effect of a monopoly – too few services for too much cost. The difference is a barrier to independent market forces. The goal of American government should be to preserve true and fair competition and to prevent monopolies.

    3. Business employers provide healthcare insurance to “their” employees. Employers are in the business of maximizing return on investment -- I.e., securing the cheapest inputs to sell outputs (products and services) at the highest market price. Consequently, the interest of the business employer is tangential to the needs of most Americans, i.e.:
    a. The interest of the business employer is centered on retaining employees who provide profitable or competitive advantage for that specific employer.
    b. The interest of the business employer is primarily to minimize cost of healthcare not providing good and sustainable healthcare. Moreover, American businesses are in competition with foreign businesses that are not similarly burdened with healthcare insurance. Consequently,the collective business interest is to provide the minimum necessary to comply with the law. In other words, Americans could not find a worse negotiator for their healthcare.
    c. Those Americans that have the aptitude and wherewithal to be leaders, entrepreneurs, and eventually employers themselves, forego those aspirations because they are indentured to employers to maintain healthcare insurance.
    d. Unemployed Americans (those without the benefit of employers, self-employed, and those who choose other endeavors) are without healthcare insurance and, as a result, cannot afford healthcare.

    4. Healthcare providers must serve two masters, insurance providers and patients. Insurance providers control premiums, dictate terms, and control performance.
    Consequently, the contract is unfair. Patients are unrepresented and served ineffectively. Healthcare providers and patientss are mired between policies, exceptions, and obfuscation that undermine and deter simple cost-effective healthcare.

    Consequently, this healthcare insurance policy will remain a dismal failure no matter how much American money your administration wastes on it. Therefore, your healthcare insurance policy has to change to a National Healthcare Process not based on the dictates of third party insurance, pharma, or employers. By doing so, your administration may suffer some initial name-calling, but you will be able to provide meaningful and cost-effective healthcare to Americans in the following ways:

    1. The National Healthcare Process will not inherently include the cost of third party insurance administration, overhead, associated adjustors, bill collectors, and profit.

    2. The National Healthcare Process will not inherently include the cost of contract litigation, and bickering about policies, small print, what is and is not covered.

    3. The National Healthcare Process will be based on when and what is actually needed (preventative healthcare) rather than pre-paid premiums based on over-hyped predictions and catastrophic illnesses.

    4. The National Healthcare Process will provide services to all Americans and their visitors. Denial of services and therefore litigation, will not be a part of the system.

    5. Existing healthcare providers, pharmaceuticals, insurance, and litigators, will change accordingly to survive the initial hardship by serving the American people rather than lobbying Congress to serve them.

    6. Prices and services will change accordingly:
    a. The cost of healthcare will fall. No third parties, no billing, no litigation, no premium.
    b. Healthcare providers will find it just as profitable to set up practices in rural areas.
    c. Urban emergency rooms and healthcare clinics will open again.
    d. American citizens will be able to retain their own healthcare provider and pursue their work aspirations without being indentured to insurance providers.
    e. Businesses will be able to focus on maximizing returns and spend less time on side issues such as healthcare, claims, and worker’s compensation.
    f. Americans will spend less time worrying and litigating over healthcare.
    g. American State and Federal Government will benefit from economies of scale with regard to healthcare and eventual combining of Medicare, disease control, FDA, etc. and the reduction of administration costs.

    We voted for you to change the way Washington works. Pandering to the Wall Street was extremely costly and did not benefit Main Street in any meaningful way. Pandering to insurance, pharmaceuticals, and big business will be similarly costly and meaningless. Please adopt a National Healthcare Process.

    As a first step of transition to the National Healthcare Process… After Iraq and Afghanistan there will be many military medical and support staff that will be returning to find work as civilians in a beleaguered economy. This will be a perfect opportunity to provide those individuals with jobs serving the Nation. Please thank them for their services by offering them opportunities to continue delivering their skills in the National Healthcare Process.

    If you could create this National Healthcare Process with the focus on healthcare, not insurance, it would be a great service to the nation and a firm step toward fulfilling your promise to change the (labyrinthine and dysfunctional) way Washington works. It would be a cost-effective solution. And, it would not require 1,000 pages of explanation.

    Daniel N. Shrader
    Rolling Hills, CA

    If Obama taxed 50 cents on every institutional or stock transaction, he could raise all the money he needed for health care. This is what they do in the UK. But the reps we vote for to serve us, arre so coorupt, that they are willing to sacrifice ten's of millions of lives for their own profit. Medicare for all is the only way to go. If we are always at the mercy of special interests Main St will be left in the dust.

    i've been struggling to find answers which might open our understanding of the players in the health care debate. how long does a congressperson/senator need to serve before their health coverage is covered by the taxpayers? when does it cease? if not, how long does it continue, for which members of their families and is it at taxpayers' expense? if i recall, it was sen.clinton who alluded to the quality but didn't ID the payer. why not ID the 'no change' contingent in congress, cross reference the lobbying $ flowing into these individuals campaign coffers. BUT wait until after the congressional summer recess, after the lobbyists have spent millions more trying to undermine any reform. their business people, and must hate to buy the same politicos again so quickly. besides, i have come to enjoy watching them try to save face(ass)and they probably must spend some of those lobbyists' money. just follow the $ and show where it goes!

    Hear, if you will, the words of John Conyers, who is the chairman of the House Judicial Committee. Mr. Conyers says he has not read, and cannot understand the house bill.

    We have no problem with purchasing health insurance in the US, but our costs has gone up steadily every year by at least 20%. I personally think health care is human right and should be given to everyone who cannot afford it. If the bill passes in its current form not only it does not stop the escalating cost it will also provide a captive market to the insurance companies subsidized by tax payers like me.
    I also agree if the bill passes without the SINGLE PAYER mandate it will have such a profound negative effect on democratic rein in Washington that we won't see them in office for a long time.

    As you constant viewer, I would like to thank you for this series on American healthcare, which I find very interesting, and for this latest episode in particular. Not being an American cit-izen, I am hardly affected by the proposed reform. Nonetheless I consider the current debate very important for people outside the US, especially those who live in countries undergoing a radical transformation of their health care systems. Moreover I find this debate important also because I consider the healthcare reform as a watershed in the US politics which I hope will finally mark the beginning of a new post-Ronald Reagan approach to American state and American public sphere in general. What I miss in the debate, for which you provide such a professional platform, is not just a reference to European and Canadian experience but a serious analysis of the main features of each system, the results each system delivers, and the possibility of implementing some European and Canadian solutions both from political and from healthcare prospective. I take into account a long American tradition of not being interested in the outside of the US system experience, especially in the field of government and public policy. But I think the time has come to look at least north of the Canadian border.

    I thought I would share the effect this program had on me.
    I have been a strong, noisy proponent of health care, gosh knows we need it. But your two women thoroughly depressed me, so that now I am very discouraged and not sure if I care if the whole thing goes down the drain again.
    And I am a 60 year old man with heart problems and no insurance so you bet this matters to me.
    I doubt that was your intent, but that was the effect. The idea that what they might pass is just as screwed up as what we've got was a very dispiriting message.

    Americans who support a " Capitalist" health system , or "Capitalist" banking system , or any " Capitalist" system should remember that TRUE Capitalism only works in the presence of TRUE Competition . Examples are the Appliance Industry, the Computer Industry,the Textile Industry , where a multitude of good quality products are produced at very competitive prices . and are abundantly available. One mis-step by a manufacturer and they will quickly lose ground to a hungry competitor.(ie GM , Chrysler) )
    The Health , Medical , Banking ,Insurance , etc.companies are not TRULY competitive because , through their "Associations" they Collude to control prices and marketing policies. If one bank is charging 25% on credit cards , did you ever ask yourself why another company doesn't seek expansion by charging 10% , or if one hospital is charging $100,000 for a prostate procedure , cannot others gain new business by charging $10,000. Lot's of luck.

    In absence of True Competition large corporations and oligopolies need to be Regulated to serve the best interests of the public overall. The Constitution did not create "shareholders" as a privilaged class whose interests must trump everyone , but a Society , where each member has the right to work and compete on an even playing field.

    Large monopolies and oligopolies are not much different than centrally controlled Communist Regimes who reward party elite with mansions and wealth , while the proletariat are lined up for bread.

    In conclusion , Health Insurance companies are NOT truly capitalist , and need to be Regulated as to Standards of Service and Fees charged .

    I think we need to strip the politics out of this and think about a few key observations. One is, if all the other universal systems are so bad, why aren't the French, Canadians, and everyone else studying the US system, and trying to implement it in their own countries? I suspect it's because they like their systems. We could learn from theirs and match them up to ours for a good "single payer" system.

    Most importantly, as we lose our supply of antibiotics to the evolution of microorganisms, we are finding ourselves in a precarious position, where pandemics can again wreak havoc on our populations, just like before 1918. Treatment resistant TB, swine flu mutations, and other communicable disease illustrates the threat. So, people with health care get good meds and help in following treatment, but those without it do not. It's in these folks that disease can more easily mutate, and once it mutates, all the people getting treatment are susceptible to the new strain. So, your health care or income can't protect you from communicable disease. The best way to deal with the ever-evolving microbes is through getting care to as many as possible.

    This doesn't even consider having a healthier workforce makes us more competitive, helps our kids do better in school, keeps more folks out of jail in the long run, etc.

    We either want to compete and be successful, or we want to allow a small percentage of people to profit off the loss and damage to the bulk of the population.

    I have private health now. I can't choose my docs, only a few docs in a small geographical area. My costs go up each year, and the insurance company covers less and less. I've stopped going to the doctor.

    I think we need to strip the politics out of this and think about a few key observations. One is, if all the other universal systems are so bad, why aren't the French, Canadians, and everyone else studying the US system, and trying to implement it in their own countries? I suspect it's because they like their systems. We could learn from theirs and match them up to ours for a good "single payer" system.

    Most importantly, as we lose our supply of antibiotics to the evolution of microorganisms, we are finding ourselves in a precarious position, where pandemics can again wreak havoc on our populations, just like before 1918. Treatment resistant TB, swine flu mutations, and other communicable disease illustrates the threat. So, people with health care get good meds and help in following treatment, but those without it do not. It's in these folks that disease can more easily mutate, and once it mutates, all the people getting treatment are susceptible to the new strain. So, your health care or income can't protect you from communicable disease. The best way to deal with the ever-evolving microbes is through getting care to as many as possible.

    This doesn't even consider having a healthier workforce makes us more competitive, helps our kids do better in school, keeps more folks out of jail in the long run, etc.

    #1. It's hard to tell if the "Public Opiton" would be effective or not, with what little information we have been given by the Obama administration and the media. It sounds like a gentle way (though expensive) to start trying to implement a national health care system. Mandating that everyone buys insurance really bothers me, however. We are still having to buy into a very flawed for profit system.

    # 2. I think this current insurance based proposal is too flawed. Not everyone can even begin to buy insurance, and if it is to be heavily subsidized, it will be a giant windfall to the insurance companies and a complicated bureaucratic mess. The idea of gradually implementing a medicare system for all, starting with the children and moving up in age over the years appeals to me much more. Congress can work on funding it year by year. We shouldstart over and do the right thing now.

    The main point about your show with the two women was that the Lobbyists are in charge, Why not name them what and who are they bribing in the White House, congress or in the senate.

    We can boycott their companies and bring them to their knees.

    Thanks for this!

    Andrew, my dermatologist charged $145 for about 30 seconds of nitrogen on a skin tag. They make around $700,000 per year, not $200,000. But your points are still valid.

    The medical industrial complex is HUGE. Like everything else about the "economy" in the USA, speculators reap the largest profits, NOT the entrepreneurs.

    Health insurance companies are an artificial construct layered over REAL society. They are also reaping the greatest profits without adding ANY value to the progress of the medical arts.

    At the very least, how much PROFIT is reaped by the paper pushers who thrust themselves into the life maintenance stream of "money" has to be LIMITED.

    You cannot eliminate profit because profit serves to facilitate progress. But HONEST profit needs to be reaped by the people providing mano et mano care and the producing companies - medical devices, labs, medicine, etc. And even then it has to be limited. Otherwise, the question NOT ever brought up for discussion is, "if you can get so rich off of everyone's occasional bout of sickness, what prevents sociopathic "busines" people from creating more sickness every once in a while to boost their profits?"

    The business model of speculators already has a "profit" making equation called the "second derivative" - which is nothing more or less than "unemployment".

    Immediate "cost-cutting" is possible, not because a twenty-something graduate with mucho college debt comes up with reusing tubing. It can happen if you limit the PROFITS that health insurance companies can make.

    The entrepreneurs who advance medicine and surgery are the most vulnerable to the "second derivative" because they do NOT have the "rights" to their intellectual property. As soon as they deliver innovation, they are replaced with "cheaper" labor and progress is frozen, usually for a decade or more.

    And the dysfunction continues because the speculators "cut costs" by cutting people.

    So more sick people = more profits and getting rid of the people who "cure" the sickness also = more profits.

    C'mon, this is "sick".

    Not surprising that "fraud" trickles down, is it?

    Thaank you, Bill, for being one of the few in the mainstream media to give real coverage to REAL healthcare reform issues, particularly the need single-payer legislation. To Phil, the Proud Canadian who posted earlier, thank you for your first- and secondhand testimony, which echoes what I have heard elsewhere (in particlular,
    To the commentor who saw Bill's coverage as biased, when you balance the logical arguements presented by his guests with the coverage by most media, which currently seems to simply track the possibility of getting any legislation passed this year, and debates the feasibility of a "public option", I find refreshing and valuable the discussion of the issues rather than the horse race and quid-pro-quo negotiations that take up so much air time elsewhere.
    As to the specifics of the bill, the "choice" of a public option "for those who don't like their current insurance" has a big catch in the Tri-Committee bill: if you work and if your employer offers insurance, you MUST take it unless it costs more than 11% (House version) or 12.5% (Senate version). These plans are unchanged from current options, with employers free to change coverage type, plan, etc., at will. The public option will be available only to those not offered insurance at work, very small business (gradual inclusion of larger businesses to come), and is expected to cover about 10 million people. "Hardship waivers" allow those who can't afford health insurance to avoid enrolling in a health plan without a fine, giving them "permission" to not purchase something they can't afford. Huh?
    Finally, what I think we all want is affordable access to clinics, doctors, hospitals, home and hopsice care, necessary (not excessive) tests; that is not insurance, at least what insurance means today.
    I think we are in for a long fight for single-payer, but women's sufferage, civil rights, leaving Vietnom, didn't happen overnight either. This (perhaps along with equal education opportunities) IS the civil rights issue of our time.

    great discussion, Bill. I like the idea of gradually reducing Medicare down to younger persons till all are covered. But as a medicare recipient, I still have to pay for the so called med-gap coverage to the tune of 200 a month- add that to my part B and I am still paying $300 a month as a retiree on fixed income!!!!!!!!!, which is a rip off.

    Santurceman I think you missed the part of the show were both guests said that they had not read the bill as it has not been released by the White House.

    This is a deliberate foil by them. This was discussed at length in the show as a lesson learned from the Clinton bill.

    I knew Obama never promised single payer, he did openly support it however during the primaries. He was palying politics.

    bottom line is a mandate based bill will fail, it will only put more Americans into debt or just take money from them after they are fined.

    This country is run by the special interest and until this changes we the people will remain the rubes that we are.

    Thanks for all the truly fair and balanced info on so many serious political and cultural issues. With the loss of Russert and Cronkite I do hope your health is good. Where else but PBS gives all of us what we need whether we agree or not

    Disgusted American:

    I'm against patient-dumping.
    That would be Michelle Obama and her role in creating a patient-dumping scheme for the University of Chicago Medical Center back in March. But hey, don't let that little fact deter you from your delusion.

    Oh, and I'm an Independent. But hey, don't let that factual little morsel deter you from spewing your vomit.

    Maybe it was that organizing America outfit that tried to get me to support it.

    Only up to Fri 9:25 PM with the posts here. I wasn't fully thinking that thought like you, Arlene, but it was trying to come into my conscious awareness (dimly registered on way home listening to ATC IIRC). Anyway, now we know like you said. Wonder if we could wind up getting the mandatory part without the "public" version option??? Man oh man, did moveon try to get me to support this thing?

    Guess I've missed some good ones here, but will have to return later. Didn't read 676 as quoted by Betsy, but I've been thinking about making a bumper sticker ""


    Isn't Medicare a single payer system? Most seniors think that is fine coverage, but isn't there a growing, massive unfunded liability that we're facing ($50 trillion??) with Medicare? What's to prevent this new program that would cover the rest of us from becoming a similar problem? Forgetting Social Security's unfunded liability for a moment, hasn't the government already demonstrated over the last 40 that it has been unable to run an insurance program that is fiscally sound?


    Before I start, what Obama is delivering is what he promised. He did not promise single payer health system so stop arguing about that. Now, is what he said in his campaign in this bill? We don't know. The press sure as hell has not reported in detail about the bill (maybe no one has read it.) Congress has been accused of voting without reading the bill (what a surprise.) And Bill did not ask these ladies if they had read the bill. In my opinion their unspecific comments (or lack thereof of specific ones) about the public plan, the statement that "we know the outskirts" "we know enough" or "we have to start over" these ladies have not read the bill an are not a good source of information. They won't have it any other way than a single payer plan and that makes them unreliable. Again, if they voted for Obama because they wanted him to deliver such a plan, they were not listening.

    Until we work out a way to fix this, couldn't we have preventative and yearly recommended tests (mammogram,colonoscopy,blood tests,pap etc) available at low cost, say $50 or thereabout, so all the uninsured could as least get these done before there is a problem? That would save us millions of dollars. Why wait until there is a problem and then scramble to find the money and insurance that will fix it? Let's make preventative and yearly physicals reasonable and available for all, so we aren't creating more problems before we fix this one. Currently when you are uninsured you can't get a blood test easily or any other test without insurance. What happened to the idea of walk in clinics with a price menu - $25 for basic blood test, $30 for X-ray, $20 for antibiotics - that sort of thing. Americans need reasonable health care, not debates.

    While I understand that most of you who comment against a single payer plan are either insane or think profit is more important than human life, I still find it amazing that you have the nerve to insist 'big insurance' isn't responsible for allowing their subscribers to die in the name of maximizing profit. I would ask all of you how you are able to sleep at night, but chances are the answer would be: "Like a baby with a silk Gucci diaper on".

    This fight must be taken to the pocketbooks of the health insurance industry.

    As a first step I suggest all public employees contact their pension plan administrators and demand they liquidate all stocks postions they have in health care insurance.

    These companies must be driven out of business ANY WAY POSSIBLE.

    Only by their elimination does the long range prosperity of our entire country remain viable.

    The single most salient comment of the interview was made when it was pointed out that many a good system already functioning in countries ranging from Canada to numerous ones in Europe could be used as starting points.
    Raw capitalism as the guiding principal for something as essential as a person's health & wellbeing just doesn't make sense. The Netherlands thrives as a country where capitalism provides access to for high levels of consumer goods fort the majority of it's citizens, rewardingly long vacations are the norm, social liberalism has resulted in a very low level incarceration and healthcare is universal and affordable. And it's all done under the system of capitalism where some of the world's top corporations are based: Royal Dutch Shell, Unilever, Phillips Electronics to name a few.
    The lesson learned there has been that capitalism functions only when it is tamed. When it is still raw and unbridled as many an American politician likes to keep it, will result in disparities that tug on the fabric of society to the degree that it tears it more often then it weaves it into a cloth that clothes us all.
    Let's take the profit incentive out of prisons, out of healthcare, out of education etc. etc....... Let government do what government should and let private industry flourish under it's watchful eye.

    I'm from Canada and often don't pay a lot of attention to our health care plan. It isn't perfect but I'm so thankful I can see a Dr. without EVER having to worry how much it will cost. Regarding the politicians remark about having to wait too long for a mammogram, here in BC we not only have free mammograms we even get a reminder in the mail that reminds you it's time to book your next appointment. Consequently our tumors are diagnosed far earlier. If you do have the misfortune to feel a breast lump in between regular screening, as I was, I saw my family Dr. who squeezed me in to her fully booked appointment schedule and then referred me to the hospital imaging department that same day. Everything turned out fine. I did have to wait in emergency for a long time one day when I broke my wrist, but the triage nurse saw me right away and determined that my injury was not life threatening and I did have to wait. We could certainly improve in that regard, but I wouldn't trade our system for yours.

    The democrats' proposed reform done wrong is worse than no reform at all, but the problem is (we seem to be forgetting) real people are really dieing while we fiddle.

    If another 101,000 innocent Americans die this year (number taken from study published in "Health Affairs" journal and includes both insured and uninsured) due to lack of access to proper health care here, but nobody hears them...are they really dead?

    Elaine the point of the show was that the Public Option wont work. Nothing will work unless the insurance companies are taken out of the game. The pharmaceutical companies have to be told that business as usual is over.

    We, the USA should be negotiating the cost of pharmaceuticals just like any other industrial country.

    Magni - is the typical Ï got mine, too bad for you mentality"..the Perfect post person for the GREEDY Americans of the 21st century. I bet you approve of that Patient dumping on skid row too,dontya? People like you make me embarrassed to be are a disgraceful greedy pig,and most likely GOP!

    The discussion on health care reform was not balanced. The two women are essentially asking that President Obama start from scratch and totally redo healthcare. And why did you not mention the public plan, Bill, until much later. They Are advocating killing the bill and starting over. They know that will set us back for another decade. Thus killing everything Obama has been trying to do. I don't trust these women. Obama is right we need to do what we can right now. I am suspicious of their motives. Please have a more balanced discussion. This was not representative of the fair and balanced discussions you've been known for. I'm really disappointed in this program


    I read with great interest the comments from us viewers on your latest interview with the two health care writers. I agree that Obama and Congress have sold us out to drug and health care corporations whose bottom line is their investors not health care services. It does seem hopeless. The only thing about a corrupt system is that it will destroy itself. Unfortunately it will take down this great nation along with it. Let us stand up and tell them NO Way.

    Magni your ranting. Don't watch his show. I don't watch Bill O'Reilly, or any other of those right wing idiots.

    In case you have not noticed your in the minority. Obama won by a huge majority.

    The view points your putting forth are more in line with totalitarianism which is not a very American ism. Since when do you get to dictate what is American or not? Who are you to tell anyone what is American or what is not?

    People like you make me sick. It's people like you who have this ugly, mean spirited mind set that make this country so screwed up.

    Now I suggest to get back on thoses meds.

    "The problem with President Obama's health care plan isn't socialism, it's capitalism."
    – Bill Maher

    The Fourth Amendment to the Constitution matters more than health care.

    At least one comment below quoted me by name, and seemed to have misunderstood my point. Please let me clarify. The Fourth Amendment to the Constitution is fully compatible with a Tax Supported Single Payer Health Care System. I have taken no firm position on whether a Canadian style system is desirable. The current health care proposal would MANDATE that every individual American purchase PRIVATE health INSURANCE. If we accept individual mandates to be constitutionally valid, there will be no limiting the ability of a political majority to coercively seize and redirect the assets and incomes of minority individuals. The constitutional question has implications far beyond healthcare.

    Does the Fourth Amendment to the Constitution effectively prevent a Political Majority from seizing the legally held after tax assets of individual Americans? Perhaps some absurd examples will clarify my concern. The taxpayers now own a big chunk of General Motors. Would it pass constitutional muster to require every individual American to purchase a Chevrolet? The plan might benefit those Americans who already want to buy a Chevrolet, and might reduce or eliminate layoffs. Some citizens would benefit, and some would lose. If Congress and the President were offering a plan that required the private purchase of a Chevrolet by every individual American, it would never pass.

    Old political campaign promises offered "40 acres and a mule" or "a chicken in every pot". The modern version is simply to require that individual Americans purchase land, mule, chicken and pot. If we accept the power of political majorities to fund their own political and policy goals at the expense of mandates imposed on individual Americans, we are effectively Breaking the Constitution. My concerns are beyond the current health care debate and should be worrisome to conservatives and liberals alike. I am an Independent, and don't fundamentally care whether the Republicans or Democrats are winning the "horse race".

    A current political majority can lawfully and constitutionally impose taxes collected from incomes because the Sixteenth Amendment to the Constitution says that they can. For the same exact reason, any future political majority could reduce those taxes and eliminate any programs supported by the taxes. A tax supported single payer health care system is absolutely possible from a constitutional perspective. There simply needs to be a political majority willing to impose such a plan and then stand on the benefits when seeking reelection. The choice between single payer healthcare and private market driven healthcare is a political decision. That "horse race" is being covered in the media.

    I would love to see someone such as Bill Moyers look seriously at the Constitutional Issues raised by the proposed mandate for individuals to purchase (fill in the blank)within a private market. The current proposal fills in the blank as "private health insurance". Future proposals might include "private investments in stocks and bonds", "housing", "food/nutrition", "education", and etc...

    Right now, the political majority is proposing that every individual American purchase private health insurance. Lurking behind that mandate is the potential to impose mandatory health care treatment. Should it be illegal for an overweight child to drink a sugary soda? Can a political majority force every male over 50 years of age to take maintenance medications related to blood pressure and cholesterol? And here is a thought for every good liberal. If we can force an over 50 white male to take medications, could we also force a 16 year old black female to carry her pregnancy to term? These are Constitutional Questions that are directly related. Do we want them answered by a temporary political majority on behalf of all American individuals?

    Health Care is a vital national question. The Fourth Amendment Constitutional Protections are EVEN MORE VITAL. I do seriously propose and ask that Bill Moyers cover this issue. Call in Constitutional experts and have a discussion. I would love the opinion of some retired Supreme Court Justices, past Attorney Generals, etc...

    Now consider this possible question. IF an individual mandate to purchase private health insurance does violate the Fourth Amendment; then, how did that fact escape the notice of: every congressperson, every senator, the President, the media talking heads, AARP, and the entire lobbying industry? Maybe it did not escape their notice. Maybe the fundamental Constitutional Protections of minority and individual citizens are being gutted. Maybe Health Care is just a Trojan Horse.

    I think that is a question worthy of a significant public discussion. What about it Mr. Moyers? Will you step up and start the discussion?

    In MN, our dictator eliminated the Federally Funded health program for the poorest in the state (GMAC). If a public program is instituted, could this happen again? Happen in other states?
    I work with some of these people-physically or mentally disabled who will no longer be able to afford meds, care, room and board or medical care.
    I pay for my basic needs, there isn't anything left over.
    One of these needs is manditory car insurance(the insurance lobby got that passed several years ago). My employer doesn't offer health insurance-for 8 employees it would be cost prohibitive, for him, and me. What do I give up to procure manditory health insurance? Food? Electric? Heat? Housing? Car insurance (no car, no employment)?
    It is clear to anyone watching this debate, that it is fueled by the insurance industry. Why? Employers hire 3/4 time to avoid having to offer it as a benefit because it is cost prohibitive. Who made it that way? The insurance industry. Who benefits from manditory health insurance? The insurance industry.
    Healthcare reform, as it is being discussed benefits noone except the insurance industry.
    I have been hearing about the evils of socialized medicine since I was a child, have seen ambulances from Canada bring patients across the border for something as routine as a CT scan, because the closest machine was 400 miles away. BUT, its time has come in the United States. Giving more money to the insurance industry is not the fix.


    Your way too far left and delusional for most Americans. Your guests are usually crack-pots, who I call intellectual fools.

    Your out of touch with what most American, and your communist ideas and guests would be better suited in Europe. America isn't Europe nor the Soviet Union, so if you don't like American ways, then move. I for one am sick and tired of your treason.

    And single payer health care? Dream on. Thinking Americans are too smart to buy into that scam too.

    Here in MN our dictator just cut totally the medical insurance for the lowest income persons without children entirely. I work with some of the people, who are losing their insurance, mentally and physically disabled, who will now not be able to afford their meds or care. This program is Federally Funded. If another public program is instituted, would this be allowed to happen again? The frightening thing about the entire situation is that "The dictator" was a serious contender for McCain's VP, and it is being said that he is grooming for a run at the Presidency. My employer doesn't offer insurance, and I can barely pay for my basic needs, including the manditory car insurance the insurance industry got instituted years ago, so I can work. What do I give up to pay for healthcare if mandated?

    None of the proposals deal s with the two largest issues facing American Healthcare; chronic disease has taken its toll on both providers and the insurance industry. According to the CDC “The medical care costs of people with chronic diseases account for more than 75% of the nation’s $2 trillion medical care costs”. These figures are also expected to rise as more Americans are diagnosed with a condition requiring frequent long term care. The second issue it provider reimbursement, Medicare for instance pays almost 30% less than commercial insurances, and state Medicaid payments are even worst.

    We all know these media guys are having lunch at the same place ALL of us can not eat and they ALL send their kids to schools were we can not send our kids to school. People hate people thats the way it is. Yes, it is always nice to hear about the nice things people do , but lets be clear people kill each other, lie to each other, steal from one another and otherwise are a scummy bunch. Except of course my mother and every other female role model in my life. I love my mother and for $50 you can too.

    As an American citizen -in all my 48yrs - IF for some reason I get a windfall of Money $$$...Im getting the Hell out of this country...its NOT the America I learned about growing up,nor espired too....the US of A, should change its name to "The United States of Greed and Selfishness"!!

    So many words and so little time. Now global warming is caused by hot air. What we do is tax the hot air of ALL media commntators and then we use the tax to fund the healthcare system.

    agree with above comment by 'meesto.' This is a constitutional crisis comparable to U.S. Civil War, only the issue is not States Rights, it is our constitution vs. big business, in this case the health insurance and pharmaceutical industries. The legislature, a a third co-equal branch of government representing an all inclusive constituency has been broken by the lack of regulation of political ads on TV and radio. We are the only western demnocracy, so far as I know, that does not limit the timing and quantity of political campaign advertising. The consequence is that Senators and Congressmen are by and large beholden to donors of the $millions required for election via TV rather than to those who vote for them. Not only health care is at stake. The future of the republic hangs in the balance.

    Dr. Marie Angell put forth a health-care plan that slowly would place the American population in Medicare, thus giving the insurance companies a chance pursue other markets. This is the 1st time this ideas has come to my attention. Where is this ideas in the national debate?

    Re your question: "Is flawed health reform legislation better than nothing or, as Marcia Angell argues, even worse? Should we start over? Explain."

    In terms of legislation, do we even have to start over? Isn't there a single payer bill--one H.R. 676--introduced in January by John Conyers and described as "elegant" and only a few pages long? Sounds like a good start to me.

    Marcia Angell substantiated what I suspected about the pitfalls and expenses of some alternative plans. There is a built-in conflict of interest when for-profit corporations insinuate themselves into the delivery of healthcare. A purely not-for-profit plan needs to free up the delivery of healthcare from bureaucratic obstacles, and restore the high standards enjoyed by Americans in the days before the health insurance coup.

    I believe that since a majority of Americans polled want the single payer plan, and it appears to have the best chance at fulfilling our health care goals, we should unite behind it. When the medical community did not unite against the health insurance industry takeover in the late 80s and early 90s, they and we were defeated.

    Re your question: "Is flawed health reform legislation better than nothing or, as Marcia Angell argues, even worse? Should we start over? Explain."

    In terms of legislation, do we even have to start over? Isn't there a single payer bill--one H.R. 676--introduced in January by John Conyers and described as "elegant" and only a few pages long? Sounds like a good start to me.

    Marcia Angell substantiated what I suspected about the pitfalls and expenses of some alternative plans. There is a built-in conflict of interest when for-profit corporations insinuate themselves into the delivery of healthcare. A purely not-for-profit plan needs to free up the delivery of healthcare from bureaucratic obstacles, and restore the high standards enjoyed by Americans in the days before the health insurance coup.

    I believe that since a majority of Americans polled want the single payer plan, and it appears to have the best chance at fulfilling our health care goals, we should unite behind it. When the medical community did not unite against the health insurance industry takeover in the late 80s and early 90s, they and we were defeated.

    Under Obamas "plan" we are going to increase the customer base for the existing healthcare industry by forcing everyone to buy in. Isn't it obvious why the industry is supporting this opportunity to increase premiums?
    Limiting this increase in profits by having to compete with a "public plan" is obviously poison to the health industry lobby.
    Keeping in mind that senator Max Baucus received somewhere near $350,00 from that lobby,you can understand why he votes as he does.
    I do not see any realistic proposal to reduce costs in the whole "plan". Computerizing the administration of health care will not make a big difference.Most of the banks and enterprises that went bankrupt are heavily computerized. By not considering the "single payer" option Obamas non-plan was doomed from the start.If everyone recognizes that other countries can do it 2 1/2 times cheaper, why can't we copy the way they are doing it?

    I'm with Dr. Angell and have been preaching such an approach for a couple of years now. I think the simplest and most cost effective way to expand health care is to start lowering the age of medicare recipients, probably 10 years at a time. What's more, I suspect there's a way to do this via executive order.


    “If you are of the opinion that Washington is a corrupt and incestuous soup of politicians, lobbyists and special interests.” If?

    To run for Congress one must have a lot of money. The “special interests” raise that money. No “special interest” to raise money - no political campaign. Once in office the “special interests” must be serviced (accommodated) because they are out raising money for the next campaign.

    We vote them in. When they get to Washington, those who raise money for their next campaign pull their strings.

    “First: ask yourself why you think it is that way.”

    If the observation is flawed, you are welcome to correct it.

    ”Second: ask yourself what you think is going to happen when we add hundreds of billions more dollars to that crockpot.”

    We the American people spent 2.3 trillion dollars (Senator Tom Harkin) on healthcare last year. We spent 100% more per individual in this country than the number #1 performing healthcare system in the world. For all we spent, our system performed 37th (yeah 37th)in the world.

    It is not billions in the crockpot, it is trillions, and they are already in it.

    Is this Health care Reform crafted by Congress just another Congress/corporate scam? Are the health care insurance and pharmaceutical companies crafting this bill?

    Yes. It's going to be worse.

    Obama was elected in part by broad coalition of progressives, 18 to 25 year old's, and African Americans and Latinos.

    Here's what we have elected: Instead of raining in Bush policies on secrecy he is expanding them. Instead of pulling back on the war in Afghanistan he is expanding it. The Iraq war is shifting to Afghanistan. Instead of reforming and regulation wall street and the banks he has let them call the shots.

    Now on health care he sucks up to the insurance and pharmaceutical corporations giving them everything they want. As this program has clearly pointed out, Obama and the Democrat's have sold us out.

    This is not what I voted for. I did not expect miracles but I expected more than the same old crap. Here's one progressive how is now not vetoing for any Democrat for a very long time.

    It seems to me that we are doomed to this absurd dysfunctional form of governess by which it seems the our elected officials just hope by confusing and making speeches that the American people will remain docile.

    We will not have true democracy in this country until we get rid of the ridiculous costs of campaigns = lobbyist & special interests = politicians being puppets as in this battle for health care reform. Also we should get rid of the antiquated electoral system! We must have one person = one vote - period. Until we change the election system these corporations will rule our country in their own greedy self interests and we the people will always finish last.

    As for all the super angry conservative folks out there, in particular these angry DJ agitators that propagate ignorance and violence - be careful! Our country has a bloody and violent history. 600,000 killed each other up close in the Civil war - more then all our foreign wars combined. This does not include our slaughtering of millions of Native people and the killing and violent treatment of all the black slaves and post slavery and the many conflicts and death for workers rights and the violence of the 1960s anti-war and civil right movement. It is worrisome to me when I read some of these political forum discussions on the internet and read the the complete rage of people who hate the current administration and have such fixed brain washed views of how liberals are all communists who are ruining our country. I am somewhat liberal and a little conservative and I am definitely not a dictatorship communist but I am a Democratic Socialist. The fact is there will always be a shortage of jobs and this is only increasing, getting worse as cheap over sea labor and new technology take more jobs away from America. So we do need a huge safety net to counter balance this fact or we will surely have enough desperate and frustrated people that we will end up in a new civil war where it will be the rich versus the poor. This huge discrepancy between the top greedy 1% that possess all the money and resources and the other 99% of we, the neo-serfs is leading this country down a dangerous path. This deep recession plus all the ultra conservative shock jocks promoting some kind of violent action to millions of listeners and the huge discrepancy between rich and poor is a formula of potential conflict. If (because 50% still do not vote)The last few elections are an indicator that our country is split down the middle between liberals and conservative with a tiny 2-3 % swing vote, then I just do not see how we will ever agree to anything. This is the reality of where our country is at.

    The recent Bill Moyers’ program dealing with health care, with panelist Trudy Lieberman and Dr. Marcia Angel, was outstanding. It clearly articulated the core problems and the potential risks if non-fundamental restructuring takes place.
    As Dr. Angel emphasized, throwing more money into a dysfunctional system makes no sense. I actually looked at the issue of our health care from the systems science point of view (see reference below) and found it operating way out within the zone of chaos. It is for this reason that incomplete changes can have a very destabilizing effect on the current system; just imaging another AIG.
    Janecka IP: Is the U.S. Health Care an Appropriate System? A strategic perspective from systems science. Health Research Policy and Systems 2009, 7:1 (Highly Accessed)

    The recent Bill Moyers’ program dealing with health care, with panelist Trudy Lieberman and Dr. Marcia Angel, was outstanding. It clearly articulated the core problems and the potential risks if non-fundamental restructuring takes place.
    As Dr. Angel emphasized, throwing more money into a dysfunctional system make no sense. I actually looked at the issue of our health care from the systems science point of view (see reference below) and found it operating way out within the zone of chaos. It is for this reason that incomplete changes can have a very destabilizing effect on the current system; just imaging another AIG.
    Janecka IP: Is the U.S. Health Care an Appropriate System? A strategic perspective from systems science. Health Research Policy and Systems 2009, 7:1 (Highly Accessed)

    If you are of the opinion that Washington is a corrupt and incestuous soup of politicians, lobbyists and special interests.

    First: ask yourself why you think it is that way.
    Second: ask yourself what you think is going to happen when we add hundreds of billions more dollars to that crockpot.

    Is this Healthcare Reform crafted by Congress just another Congress/corporate scam? Are the healthcare insurance and pharmaceutical companies crafting this bill?

    I am starting to see healthcare insurance company and the pharmaceutical funded adds promoting what Congress has put together.

    It is obvious that Congress is doing what they are told. The Republicans are disgusting, programmable talking puppets.

    The Public Option is the first place to look. Taxpayers will fund the Public Option. Employment, Income and/or net worth will be used to exclude. It will be limited to the poor, the chronically ill, the medically bankrupt (now the poor) and those that are dropped due to a major medical condition. Those that represent no profit to the healthcare insurance companies will be dumped into the taxpayer funded “Public Option”.

    Yes, I know this seems a bit paranoid. After the, corporate retirement plan, mortgage…etc scams I have taken the guilty until proven innocent view.

    Personally I think we should tell Congress to scrap what they have done. Pass HR676, single payer expansion of Medicare. With one exception, 5 year expansion instead of 15.

    RE: The Shock and Hate Segment:

    For the conservatives who state that the program is biased because OBama associated with Rev Jeramiah Wright and Bill Ayers the Pentagon Bomber. I have two points to make 1) Obama distanced himself from Jeramiah Wright due to his hate filled rhetoric knowing that democratic left America would not tolerate it. 2) There is NO association between Obama and Bill Ayers. Look it up on any "official" website.

    I would also like to comment that I have never heard anyone from liberal radio or television state that they wanted to "kill someone" or that someone was a "whore", "cockroach" or a "sodomite that should choke on a sausage and die". We have removed some shockjocks or comedians for using the "N" word. WHY IS THIS any different?

    I have asked my right wing Christian friends and they refuse to even answer the question: Why do you tolerate someone like this representing YOU? This is what we think all right wing Republicans are like. No kidding. We think you are intolerant and hate filled and hardly CHRISTIAN by any definition. Stand UP and STOP this. You can complain about this. You encourage this kind of rhetoric by listening to it and turning a blind eye.

    RE: The Shock and Hate Segment:

    For the conservatives who state that the program is biased because OBama associated with Rev Jeramiah Wright and Bill Ayers the Pentagon Bomber. I have two points to make 1) Obama distanced himself from Jeramiah Wright due to his hate filled rhetoric knowing that democratic left America would not tolerate it. 2) There is NO association between Obama and Bill Ayers. Look it up on any "official" website.

    I would also like to comment that I have never heard anyone from liberal radio or television state that they wanted to "kill someone" or that someone was a "whore", "cockroach" or a "sodomite that should choke on a sausage and die". We have removed some shockjocks or comedians for using the "N" word. WHY IS THIS any different?

    I have asked my right wing Christian friends and they refuse to even answer the question: Why do you tolerate someone like this representing YOU? This is what we think all right wing Republicans are like. No kidding. We think you are intolerant and hate filled and hardly CHRISTIAN by any definition. Stand UP and STOP this. You can complain about this. You encourage this kind of rhetoric by listening to it and turning a blind eye.

    Here's a graphic representation of the network of connections that have built up over time between a Senator and powerful lobbies (Senator Baucus).

    I'm glad that Bill Moyers is featuring the health care/health insurance reform debate, but this has to have been one of the most depressing shows I've watched recently - and that's saying a lot.

    I think Ms. Lieberman has pinpointed one of the main problems right now - we don't KNOW what the "public option" will turn out to be. Those of us eagerly awaiting a definition are being drowned out by those in opposition who are free to define the term in the most "scary" and distasteful way for their constituents. This is not the way to build consensus.

    As Robert Reich defined it, "public option" would be acceptable to me. As others define it, it would be, as Marcia Angell says, worse than nothing. I opposed Arnold Schwarzenegger's attempt at health reform in CA because I did not trust him, or the California legislature, to come up with a program that would actually benefit anyone but the insurance companies. I thought we stood a better chance with Obama and a Democratic majority in the Federal government. I'm sad to say that what I'm seeing so far is disabusing me of that notion.

    For myself, this is probably irrelevant as I will be within months of eligiblity for Medicare by January 2013 - if I live that long. I have been uninsured for 9 years now. However, I have a 31 year old daughter whose COBRA costs 12% of her income, for herself alone, and expires less than a year from now. She has 3 children who just got on SCHIP, but it's unclear whether they will continue to be covered when the details of the shameful California budget become clear. For THEM, I am broken-hearted.

    I am trying to convince my daughter to try to move to Canada - and take me with her if that's possible. (I thought that sentiment would fade after the 08 elections. I was wrong.) I no longer believe our government is democratic (small "d"). The nation watched the California budget debate with relish. They had fun sneering at our "ungovernable" state. The Federal government has a different problem but it shares much with that of California - self-interested politicians, powerful lobbying groups, and ideologues who are willfully blind to the human effects of what they do.

    The story about hate talk in the media was the icing on the repugnant cake.

    Doctors and nurses spend half their time dealing with insurance companies. Those companies turn over 30% of what we pay them into profit, advertising, and the cost of dealing with doctors and nurses.

    So we could save about 40% just by switching to a single-payer plan. That saved money could cover the uninsured.

    Marcia Angelli (sp??) is wonderful and so is Bill's other guest!

    I haven't been able to pin point why I have been uncomfortable with Health Care Reform. These two very intelligent experts and the sensible dialogue made it clear to me.

    Thank you Bill Moyer - you and your format are the best on TV.

    Marcia Angell was very impressive.

    Obama has gone about this all wrong. He should have used the power of the bullypulpit to join forces with the 90 or so House members that already support the H.R. 676 bill (Medicare For All), and then if necessary fallback upon a compromise position that would extend Medicare coverage to age 50 or 55.

    The problem with this "public option" tactic is that it is very, very limited, and only available to people who are unemployed, or who are self-employed. It therefore cannot possibly reach a large enough segment of the population to create any serious "competition" with the Private Insurance Corporations (who still run the show) or push them to lower their obscene costs. And even this pathetic attempt at "reform" doesn't even begin until the year 2013. This is all just a big smokescreen, and there is no true reform.

    Finally, people who are unemployed and have no income, can't even afford to pay their rent or mortgage, much less spend thousands of dollars on a insurance plan.

    There needs to be far greater education about the single-payer model, and how the only effective resolution will be to extend/enhance Medicare.

    I looked at some big fat round numbers, and I don't see why we can't afford single payer (Medicare for all). We have over 300 million people in the U.S. If only 100 million were old enough to work, and actually had a job, and they paid $100 a month for health care, it would generate one trillion, 200 billion $ per year. Now, that's a lot of money. Most people would be very happy to pay only $100 a month premiums. And I bet there isn't a company in this country that wouldn't be glad to pay it for their employees. I think the Democrats will be very sorry one day if they push a Bill through that fails to do a good job.

    Re: chmoore July 25, 2009 6:23 PM

    Yes, that was meant to be obvious satire. I guess it wasn't so obvious. It's hard to sound over-the-top these days.

    The point is that a single payer system would be as "socialist" as are our highway system, libraries, water, sewer, schools, and on and on.

    I thought the quotes from the US Constitution and the Declaration of Independence would make it clear, but I guess those aren't as well known as they used to be.

    What, you solicit our opinion on a one thousand
    page bill? I looked at
    the table of contents, I think that was only ten pages
    long. As for the general
    concept,of course we need health care reform, we
    need to abolish for-profit
    health-care insurance gangsters.
    That's a no-brainer,
    however, on the
    Western Front:
    >Ah Herr Kapitaen, da sind
    sie wieder, heil und gesund, und siegreich!
    >>Ja, wir haben es doch geschafft, das Reformschiff
    ist versenkt worden!
    Hat uns nur zwei Torpedos gekostet!

    I totally agree with the post by Stephen Sherrill. Finally, the unvarnished truth, spoken clearly and intelligently by Dr. Marcia Angell, M.D., a woman with a deep understanding of the health care system.

    The president and his administration have the full support of 70% of Americans polled, of most physicians, and many organizations for initiating a single payer system. The Democrats have the majority in Congress. They all need to know that a successful single payer healthcare system is easily a more valuable political asset for their re-election than the dollars of the two most powerful lobbies, health insurance and pharmaceuticals.

    And by the way, let's see people like Marcia Angell recruited to contribute to the creation and administration of real reform. Healthcare is not a commodity, and it is also not a political issue. Our expertise in delivering it needs to parallel our country's pre-eminent medical capabilities.

    Thank you for Friday's program re: health reform, especially the reasons for single payer. I hope Lilly Tomlin's performance is replayed again and again on ALL the cable and standard channels. It would be quite a laugh for it to be on Fox, not likely though.

    Thank you for the unflinching advocacy of single payer by Marcia Angell, M.D. The constant drone by vested interests who decry the feasibility of single payer is aimed to hypnotize and stupefy the public into despair over passing this legislation. Remaining a-sheep sustains the so-called all-powerful proponents of the status quo. ENOUGH! If not now, WHEN?

    President Obama in his weekly address today, "I recently heard from a small business owner from New Jersey who wrote that he employs eight people and provides health insurance for all of them. But his policy goes up at least 20 percent each year, and today, it costs almost $1,400 per family per month -- his highest business expense besides his employees' salaries. He's already had to let two of them go, and he may be forced to eliminate health insurance altogether. He wrote, simply: 'I am not looking for free health care, I would just like to get my premiums reduced enough to be able to afford it.' Day after day, I hear from people just like him."

    Read today’s White House Council of Economic Advisers report on the impact of health care reform on small businesses and their employees. It documents the key role that small businesses play in job creation and the difficulties they face in the current health insurance system. Small firms are seriously disadvantaged relative to their larger competitors because of the higher premiums that they must pay to provide health insurance for their workers. Workers in small firms are more likely to be uninsured or, if their employers do provide insurance, to have less generous policies.

    “Small businesses pay significantly higher insurance premiums and, as a result, are far less likely to offer health insurance to their workers. The U.S. health care system imposes a heavy “tax” on small businesses and their employees. Due to high broker fees, fixed administrative costs, and adverse selection, small businesses pay up to 18 percent more per worker than large firms for the same health insurance policy. Some of these higher costs are passed on to small firm employees in the form of lower wages, and some eat into the profits of small businesses that could otherwise be used for research and development and for much-needed investments. This implicit tax disadvantages small firms in both the market for the best workers and the market for their products.”

    “Because of their higher health care costs, small businesses are far less likely to provide health insurance for their workers than larger businesses. Only 49 percent of firms with 3 to 9 workers and 78 percent of firms with 10 to 24 workers offered any type of health insurance to their employees in 2008. In contrast, 99 percent of firms with more than 200 workers offered health insurance. Consistent with this pattern, 29 percent of non-elderly adult workers at firms with fewer than 25 employees were uninsured in 2007. In that same year, just 10 percent of workers in firms with 500 or more employees were uninsured. Workers at small firms that do offer health insurance also tend to have less generous plans than workers at large firms. The fraction of small firms offering health insurance has been declining in recent years. From 2002 to 2008, the fraction of firms with 3 to 9 employees offering health insurance to their workers declined from 58 to 49 percent.”

    Republicans complain that health care reform will hurt small businesses.

    It is clear that the opposite is true. Read the post by Gerry Puhara | July 25, 2009 1:28 PM

    I have also read through the comments and I have a few observations.

    It goes without saying that health care reform is a complex issue that will not be solved overnight. No system has converted to a public single payer system without some birthing pains. This is simply part of the human condition.

    It has been suggested that converting to a single payer system would cause major financial problems for the private insurers. This makes sense and perhaps could be resolved by phasing in the single payer option. This would allow the private insurers to have time to re-access it's market and find a niche that is not dependent on playing with peoples lives and wellness.

    Don Clinkenbeard refers to the 4th amendment right of individual citizens to be secure in their person, houses, papers and effects from unreasonable seizure. As I view the current situation, I cannot see how the introduction of a single payer option would go against a persons 4th amendment rights. It is a firmly established fact that at least 50 % of the bankruptcies in the US can be directly associated with medical bills. Is it not part of the of the governments role to protect it's citizens (whether it be from the HMO's or terrorists)? I believe that a bankruptcy created by corporate greed, IS, an unreasonable seizure of houses, papers and effects and therefore represents a government that is not living up to it's constitutional responsibilities.

    Micheal pointed out that the VA covers all expenses of veterans and allows them to have any medical service without question, up to and including plastic surgery. While I think plastic surgery that is done as a result of an injury (ie facial wounds etc) or illness (ie breast reconstruction for cancer patients) should be covered, I would find it a bit ridiculous to be covering plastic surgeries done for strictly aesthetic reasons (nose job, chin/cheek/breast/butt implants). That being said, I agree 100% that the VA should cover every medical expense of veterans and their families. These citizens have made major sacrifices in defense of their country and I believe they deserve medical coverage in return. If they survived their tour(s) of duty, they, and their immediate families, should never have to worry about these issues/expenses upon their return to the US.

    Mike, comments on the Socialist agenda. I can't decide if he is kidding or not. To compare the road infrastructure with healthcare is comparing apples with oranges.

    Finally, it seems to me that if the uninsured masses do not get proper health care, who will be there to do the work that drives the economy. There is no equity in a system that sees some as expendable because they don't earn enough to pay outrageous premiums. An affordable option is a must to ensure continued prosperity because, quite frankly, the spending of the top earning 1% of the population is not enough to keep the economy afloat forever. Americans are at a disadvantage in the global economy, and when measured against the actual wealth in the nation it just doesn't add up to prosperity but will inevitably lead to a financial collapse that will leave the US as the poor cousin to all other western nations.

    Dr. Angell's thoughts about lowering the age limits for eligibility to medicare (our existing Single Payer) to maybe 55, then in a year or so to 50, 40, 45 and so on until everyone is covered is brilliant. It gives the opportunity to gradually expand our Single Payer program & gives the insurance companies time to gradually find a new line of work! That would actually do it! And it makes sense! We could however, end up in a civil war with the Insurance Companies! But I would be that 99% of the American people would gladly fight for it!

    A reflection on Mike at July 25, 2009 12:06 PM

    "...socialists are everywhere"?

    "socialist highway system"?

    "socialist libraries"?

    Someone help me out here. Is this a put-on? It's hard to tell.

    Or else Mike's need to get back on the meds, shows a greater need for health reform (the actual thread here) more than we thought.

    I am "A PROUD CANADIAN" I grew up in the late 40's 50's and part of the 60's when the for profit insurance companies were pillaging bilking and down right stealing from the Canadian citizians. I can still remember the conversations my parents would have as they tried to pay premiums to Blue Cross. "BLUE CROSS" should be a euphanisium for "BLUE SKIES" Thank God that my Dad worked for the Canadian Pacific Railways, or he could never ever afford the "NEGAR" benifits, they so begrudgingly handed out to us the families of their "LOWLY SERF MINIONS, SUBJECTS TO THESE SELF PROCLAIMED LORDS"! WHO'S ONLY PURPOSE IS TO WORK WORRY AND PAY THEIR KIND OF TAX, CALLED PREMIUMS!
    These companies are holding the American Health system hostage, they have somehow woven themselves in as an integral part of the health care in America. Thus they control EVERYBODIES WELL BEING! How did they HI JACK A VITAL RESOURCE THAT CONTROLS THE LIFE AND DEATH OF EVERY CITIZEN IN AMERICA.
    I live in the USA, and I've had to deal with the promises, the lies, the deceit, and half truths of the health insurance sales people who peddle their wares. Are not held to any kind of moral code or standard, let me know if you can find one, and if it has any teeth to it.
    In Canada I have lots of first hand experiences, friends and relatives who can verify about the 'MYTHICAL SHORTAGES, THE LONG WAITING PERIODS, THE RATIONING OF THE HEALTH CARE IN CANADA". Believe me when I tell you, I've personally never experienced it under the National One Payer System in Canada. Also friends and family all have more than adiquate care at a very, very, very affordable price.
    Recently I was talking to a friend of mine in Vancouver Canada, it was tax time, because I asked him what he was doing at that moment. He said that he was writing a check out for the "CANADIAN HEALTH INSURANCE TAX" for him and his wife. I said oh yeah, do you mine if I ask you how much is it for, he replied $720.00. I said is that a month, he said "NO SILLY THAT IS FOR THE YEAR"! I asked him what was his deductible, and he said 'WHAT'S THAT"? He asked me how much do we pay? I was ashamed to say that my wife and I pay $563.00 per month with a deductible of $5000.00 each, with co-pays, on a lot of somethings, not sure if the "COMPANY WILL PAY ON OTHER THINGS", A 45 PAGE CONTRACT OF LEGALLEEES, IN 4 OR 5 POINT, ON 14 INCH PAPER, THE OPPORTUNITY IF I WANT TO, TO PAY FOR A LAWYER TO DECEIPH IT AND READ IT TO ME, OR DO A SEMISTER AT A LAW SCHOOL TO SEE IF I'M COVERED. Or except the assurances of sales agent, who said not only were covered by the best insurance money could buy, but he also gave me a good deal, by locking us in at a reduced rate for 2 years.

    I favor a single payor plan, and rather than hack it out in a couple months, we should not be in a great hurry; doing it right is the first priority.

    I'm looking at my pay stub right now and doing some quick arithmetic. Below are relative percentages, not of my total pay, but percentages of within just the items listed, rounded off to two digits.

    federal income tax 48%
    ss 19%
    medicare 04%
    CA income tax 16%
    CA disability insurance 03%
    accedental death & disability ins 01%
    dental 01%
    employer medical plan 07%
    vision care 01%

    It seems to me that if we had a single payor plan, I could expect a tax of some amount, but as a single payor plan it would replace what I now contribute to my employer provided plan.

    The bottom line for me as a middle class wage earner, of what the cost of any new government health plan would be, boils down to how it compares to my current contribution to my current employer plan. I believe I can also afford to weight the cost somewhat, with respect to the incalculable advantage of not being denied a procedure I might need in the unforseen future.

    I would expect my cost to be higher than Medicare, because currently, the numbers of contributors (still working) into Medicare far outnumber the recipients (retired folks). But my current employer plan now costs me close to double the witholding amount that Medicare does.

    I'm not a CPA or an economist, but it seems there's some negotiating room in there somewhere for a practical way to afford a single payor system, especially if there were efficiency improvements factored in.

    Please don't tell me a bunch of blabber about the government's inability to be efficient. UPS and FedEx would go out of business if they had to deliver every piece of Post Office mail for a few dimes. Also, LADWP delivers electricity to my house with greater reliability and lower cost than either Edison or PGE does in surrounding areas. So government can be efficient with the right management.

    The true roadblock is insurance company profit. I won't hold my breath because they will spend any amount necessary to defeat anything that gets in the way of their profit.


    The problem is big business controls government. How about a show on alternatives. Here is just one more example-


    The real problem is the control business has over government-

    How about a show on alternatives and how we get there.

    Bill,you told it like it is,and i love you for it.Thanks again for exposing the crooks on wall street,and in the health insurance industry

    !Change is in the air.I'm so tired of republican corruption,filling their pockets with cash at our expense,and may God bless you for your continued,and valued work.

    We need a well-funded public plan.
    Why dont we just have a universal health care payroll/self-employment tax, which is rebated at tax time for those who have private insurance?

    If private insurance fails to fully reimberse the insured people for legitimate necessary claims, and they don't pay the remainder of the bill themselves, the public option plan covers the balance owed to hospitals and doctors. Future tax rebates and insurance premium tax credits/deductions for those individuals are garnished until the public plan is reimbersed for medical expenses that they and/or their insurance companies failed to pay.

    Everyone's covered. Everyone pays according to their means, one way or another.

    My comments are not meant to be vindictive or amusing.

    I think the American people need to stand up and speak up for what they are entitled to receive...the same health insurance coverage as the people they elect to office.

    Health insurance benefits should be immediately dropped for Congress. They can "break" and use the time to look for health care plans. Congress needs to experience individual/family rates without the umbrella of a group plan, exhoribant premiums and deductibles, and pre-existing condition clauses.

    Only in this way will Congress appreciate the urgency of the matter and the plight of the American people.

    We cannot wait any longer for the "perfect system." We need to create a "public option" program immediately and continue working toward a single payer system.

    Marcia Angell's final comment regarding tiering made perfect sense, i.e. drop eligibility to 55 year olds in the Medicare single payer plan; in ten years, include 45 year olds and so on. Let the insurance companies get involved in hurricanes and natural disasters.

    Angell and Lieberman are correct regarding the ambiguity of proposals publicized.

    I have not seen the quality of analysis I would need in order rationally to choose among alternative health care reform plans being debated.

    The foresight I seek is what could be summarized in a spreadsheet or table backed up by the detail from which the summary is derived. In the Description column would be an outline of the criteria of choice: all the significant components of benefit and cost forecasted for next 3, 6, and 9 years. The other columns would state what the alternative plans would offer in terms of that common typology of benefits and costs.

    At this point in the political-economic debate over health care reform, my hypothesis would be that, rather than accepting only the Single Payer solution, the most in that direction the Public Option. However, that would have to be defined to change the fee-for-service from the fee-for-contact to fee or salary for results (outcome effectiveness); open to the same demographics of clientele as the private insurers; and freedom to negotiate service fees to get the best responsible providers of pharmaceuticals and health care services.

    If the Public Option is designed and implemented properly, it would compete with the private insurance models in a way to show its comparative advantages and disadvantages with each other model. That way, each of the models would be easier for the ordinary voter to understand and evaluate comparatively, and the nation could manage public dollars for health care increasingly more effectively and efficiently.

    Ed Hay

    If you aren't sure if we need healthcare reform (a strong public option) just show up at a meeting in your area on healthcare reform listen to the horror stories people are telling about being denied coverage by private insurance companies. Or the stories of folks who paid into the private insurance system thought they were covered only to find out when the got sick they were under insured and lost their home because they couldn't pay the bills. Or the guy whose wife had cancer lost his job and his insurance but can't buy insurance because of his wife having cancer.We need to put more value on the lives and health of the american people then we put on the high high profits and pay of the private insurance companies.

    After watch this show on the health care problems we face and the lack of any real solutions coming from anyone in Washington it is clear we need to start from scratch. The Swiss did.
    So did the Taiwanese in less than five years.

    On the hate speech segment:

    Joseph G. Cope, Phyl and anyone else who thinks that the right wing zealots of radio and TV are not abusing the first amendment well to that makes you just as sick a Glen Beck. These people do nothing of the good of the nation. They spew hatred and degrade people for be something other than them.
    This kind of propaganda is exactly the same kind rhetoric that Hitler used as he and the nazi part ramped up for war in the late 30's.

    If you agree with this kind of ideology, and I don't equate the kind hate speech used by these cowards then your an no better than they are. You need to think about what is it in your warped brain that messed you up as a human being. So much so that one can even listen to this garbage for one minute, let alone agree with any of it.

    It's sick all of these people are sick and demented that they think it's entertaining. To think that this kind of crap passes for entertainment.

    The sheer lack of inelegance is staggering.

    Just in case anyone reading this doesn't think the rich should be hit by more taxes to pay for this, you need to watch the series of videos on youtube by Rick Wolff on our Economic Crisis:

    Also, I just did a look-up of lobbying activity reported in the 2nd Quarter of 2009 for 45 health/pharma lobbying firms. The total spent on lobbying health reform in Congress those 3 months alone was $22,925,000. $22.925 MILLION. That is OUR money they are spending to lobby AGAINST our best interests. This is what we are talking about when we mention that so many of our health care dollars are being spent on this stuff NOT Health Care Delivery! CAN YOU SEE HOW WE CAN COME UP WITH THE MONEY TO COVER EVERYONE FOR EVERYTHING? Next I am going to report on the PROFITS of this industry. Watch for it!

    We may not be able to do anything about the hate that comes out of the mouths of conservative talk show hosts now.But some day they will have to stand in front of their maker and explain themselves. Only then will they get what they deserve I hope they can stand the heat.

    You accuse conservative talk radio of promoting political violence. What a self-righteous hypocrite you are. Where is your indignation over Barack Obama's associations with hate mongers like Rev. Jeremiah Wright and Pentagon bomber William Ayers?

    I am a small business owner. I have employed between 7-12 employees over the past 26 years in Montrose, California and in my warehouse in Altadena, California. Now, I employ 5 employees due to the economy. One thing that has been important to me for many, many years is a commitment to providing health care for my employees despite the nay-sayers who complain that small businesses can't provide health care.

    Initially, I started offering health care after the 1993 legislation in the State of California provided for a small business pool of insurers. It was called the Health Insurance Plan in California, and as a small business owner I was given over 30 different insurance plans from which my employees could choose. By law, I was only required to pay half of the lowest cost plan and withhold half from my employee’s salaries. In the early years I provided health insurance for anyone who worked 20 hours a week or more. The participation formula required that at least 50% of eligible employees must buy into the plan. If they wanted, employees could choose more expensive plans and pay the difference. It was always my choice to offer one of the medium plans as a baseline for which I paid my half.

    In 1999, administration for HIPIC was turned over to a non-profit private agency to administrate. Insurance agents entered the picture although I never did utilize an agent for my business. It wasn’t necessary because the plan was equal for everyone, and all one had to do was provide qualification data for your employees. The new private entity was called Pac Advantage. We still had enough choices to provide a flexible health care choice of plans for employees, even though it was not as varied as the original plan run by the state. Each employee would be sent a simple to understand letter listing all of the plans and the price, along with an easily understood listing of what my business would pay toward each of the plans.

    Two years ago, Pac Advantage went out of business suddenly, leaving 50,000 small businesses without insurance. I am not clear on what caused its demise. I scuffled and found a Blue Cross plan through a broker that works well for us, but now the participation quotient is 75% of eligible employees. As an employer I am being forced to cut back my insurance offerings to only full time employees now since I have a small staff, and if even one person does not want the insurance but is eligible it disqualifies the company because we will have less than 75% participation.

    I want to provide health insurance. It is increasingly more difficult and expensive to do so. I am not afraid to have a requirement for health insurance because I already know I can do it. If the cost could be brought under control, I would love to provide full coverage and not require my employees to pay half. Right now, it costs me $1000 a month for 3 employees. They all have chosen my medium Blue Cross HMO plan and seem happy. I have seen that it can work when the government utilizes its massive amount of participants to negotiate the contracts with the insurance companies. It worked for me, and 50,000 other businesses in California. As the insurance companies pushed back, and took control of the plan, it failed.

    I want to support President Obama on his attempts to provide healthcare for every American through a robust public option. The time has come to stand up for what is right for our citizens. Starting over, I believe, is not an option. Private insurers provided wonderful coverage for my employees under a state negotiated and mandated plan. It can be done.
    I have seen first hand what a difference it makes for my employees to have health care, to be confident that they will not become destitute because they are sick and to take care of themselves in a responsible manner.

    Gerry Puhara

    Just in case anyone reading this doesn't think the rich should be hit by more taxes to pay for this, you need to watch the series of videos on youtube by Rick Wolff on our Economic Crisis:

    Are there any honest people in the U.S. Congress?

    I don't think so.

    Satisfied with you current healthcare coverage? Most Americans apparently are. However, many do not realize insurance premiums cost the average family about $13,000 a year. The actuaries at the Centers for Medicare and Medicaid Services forecast that per capita medical costs are expected to increase 71 percent over the next decade, which will in turn drive premium increases for health insurance. According to David Cutler of the Center for American Progress, without health reform, average family premiums will grow to more than $22,000 by 2019, up from $13,100 today. In some states with higher-than-average premiums, family premiums will exceed $25,000 in 10 years. A family’s total health care costs will be even higher once co-payments and other out-of-pocket expenses are calculated into the total. Unless we take the necessary steps now to reduce the rate of growth in health care costs—health insurance coverage will be of reach for even more individuals than the 52 million Americans who today are uninsured.

    After reading all of the comments here, I feel I must reply to some of them. Marcus, I listen to Air America all the time and I do NOT hear the kind of violent talk that I hear from the likes of Limbaugh, Dobbs, Beck, etc. Maybe you do not really understand English. Craig Bardo and Phylis, did you REALLY watch and listen to this show, because it sounds like you were watching something different? And John Kyle, the url listed shows only one thing, which has been reported, that the per capita cost of health insurance, per person in the US (2007) was $7,400 per year. That is ALL that is shown on this spreadsheet having anything to do with this health care debate. This number is mentioned by everyone currently talking. However, the real numbers of how much people would pay in a single-payer system, using the same money we used in 2007, as given in your spreadsheet, is much, much less than $7400. per person AND it covers everyone in the country AND it covers EVERYTHING NEEDED for comprehensive universal coverage, including prescriptions, vision, dental, and long-term care (not even being mentioned in the health care reform debate today).

    A study by Dean Baker of the Center for Economic Research and Policy concluded that under H.R. 676, a family of four making the median family income of $56,200 per year would pay about $2,700 for all out-of-pocket, health care costs. Today that same family, pays $8,200, on average, out-of-pocket on health care expenses not covered by insurance, or employer. AND THE OBAMA PLAN, MANDATING THE PURCHASE OF HEALTH INSURANCE, WILL COST EVEN MORE THAN THE CURRENT $8200 AND FOR LESS ACTUAL COVERAGE, AND IT WILL STILL LEAVE 38 MILLION AMERICANS UNINSURED. THAT IS WITH THE PUBLIC OPTION AS CURRENTLY OUTLINED.

    Business Will Pay Even Less 
    In 2006, health insurers charged employers an average of $11,500 for a health plan for a family of four.  On average, the employer paid 74% of this premium, or $8,510 per year.  This figure does not include the additional 1.45% payroll tax levied on employers and employees for Medicare.  Under H.R. 676, employers would pay a 4.75% payroll tax for all health care costs.  For an employee making the median family income of $56,200 per year, the employer would pay about $2,700. 

    The Nation Will Pay About the Same, While Covering All Americans 
    Savings from reduced administration, bulk purchasing, and coordination among providers will allow coverage for all Americans while reducing health care inflation in the long term.  Annual savings from enacting H.R. 676 are estimated at $387 billion (Baker). And going to single-payer has been project to create at a minimum 2 Million new, well-paying jobs.
    Proposed Funding For USNHC Program (HR 676)
    ·        Maintain current federal and state funding for existing health care programs
    ·        Establish employer/employee payroll tax of 4.75% (includes present 1.45% Medicare tax)-this is in lieu of premiums, copays, deductibles
    ·        Establish a 5% health tax on the top 5% of income earners, 10% tax on top 1% of wage earners
    ·        ¼ of 1% stock transaction tax
    ·        Close corporate tax loopholes
    ·        Repeal the Bush tax cuts for the highest income earner

    What do you think?

    If instituted, do you think President Obama’s proposed “public option” for health insurance would be sustainable? Why or why not?

    I am concerned that the mentality of this country is not ready for a "public option" for health insurance. We need to change our thinking from making a profit to making a difference (non profit). As long as the motivation is to make money we will never have a system that focuses on physical and emotional health but instead focuses on monetary health of the companies and individuals who provide it.

    Is flawed health reform legislation better than nothing or, as Marcia Angell argues, even worse? Should we start over? Explain.

    I believe we need to do something and perhaps it is better to make a mistake then to do nothing. Until we get a single payer system or at least work toward one it I agree with the two women that it just isn't going to work to cut costs and provide quality care. My hopes are still that we will wake up and get a single payer system and consider health care a right rather then a privilege. So if getting the single payer system is starting over, yes I think we should do that.

    I may be wrong but to me it seems that President Obama's team undershot on every issue. They propose watered down programs, hoping that Congress will agree. Congress views every issue as a cow to be milked, so the public is "sold out." Marcia Angell is correct in asserting that Obama should propose a thorough overhaul instead of more money for a health system that produces profits more efficiently than health.

    With the present system in place( I see no change in Obama's proposals),if everyone must buy a private policy, premiums are going to go through the roof, especially since the insurance companies can now blame the fact that they have to accept patients with preexisting conditions.Thus we will bankrupt the economy further.

    Yep, If CANADA wasn't that cold I would move there there too.

    Bill Moyers: My one great complaint is that you did not get involved in the "Fairness Droctine". It looked like the conversations were flaunting how stupidly funny the other side was, while not concentrating on the main issue of "Single payer system".

    If the truth is not shed on the abusive system America has, people, especially stupid Americans will again be taken for a ride by the Republicans.

    TO: Mike

    You are not capable of understanding between a socialist and Capitalist. So quit the BS.

    Can't you see that the socialists are everywhere?

    It's time to put a stop to our socialist highway system! This isn't a socialist country; this is a capitalist country; and our roads need to be secure. The liberals would allow anyone to use our roads. ANYONE! I've even seen those socialists from the Great RED and White North on our highways. CANADIANS!

    It's time to take our roadways out of government control and return them to the people who paid for them. It's my street. I should be able to decide for myself who can and cannot use my street. This is a country founded to protect freedom, not some socialist fantasy to "promote the general welfare." WE DON'T NEED A WELFARE STATE!

    We are literally giving illegal immigrants a free ride on our roads. I suggest toll booths at every street corner. Those who don't have time to man their tool booths could hire someone to do it. CREATE JOBS! Look at the roads inside corporate parks. Beautiful. Let's let those corporations do the same for our roads.

    Anyone who wants to compare our socialist roads to those run by private enterprise need go no further than our gated communities. Those roads are pristine! Proof that citizens can do better when government is kept out.

    It's time to stand up to those communists who, in their own words, "mutually pledge to each other our lives, our fortunes, and our sacred honor."

    And don't get me started on socialist libraries. GOVERNMENT PROPAGANDA GUARANTEED!

    Just as there is no buggy whip manufacturers ..there should be no more health insurance companies.

    A nation charging for healthcare is like a parent charging their children for becoming sick or injured. A loving parent gives a sick or injured child treatment, empathy and sometimes presents; a loving people would treat its sick and injured likewise.


    I consider myself a moderate, and I watch all types of programming, but I was horrified by your intentionally edited smears on those on the right disgusting and untruthful. It's obvious your trying to incite hate, division and outright lies for some unknown reason. It pains me to see you have to sunk to this low, so I will no longer tune in.

    Another thing - If your so for the "unfairness" doctrine, then why haven't you set the example and have balance and fairness your espousing on your own program and with your guests? Because your a liar - You don't want balance - You want to silence those who don't agree with you. Do us all a favor - stop it with the lies and hate.

    On the Journal on 24 July, your interviewees said the Obama plan would force those without health insurance to enroll in private plans, and there would be no competition. Obama keeps saying he wants a public plan, to complete with the private plans. There seemed to be a total disconnect here. The claim appears to be that Obama wants exactly the opposite of what he says he wants. I hope this can be clarified.

    "The worst sin toward our fellow creatures is not to hate them, but to be indifferent to them: that's the essence of inhumanity."   - George Bernard Shaw

    There is something worse than hate speech and hate crime--the cool, calculating sacrifice of people for corporate profits. Do we have the courage and strength to get rid of this cancer in America?

    Thanks Bill for yet another fabulous program!

    It was disturbing to hear the interview with Trudy Lieberman and Marcia Angell. Rarely have I heard any presentation so unconnected to the real difficulties of improving our current health care system. Their general hostility, blaming everything on lobbyists and other evil people instead of trying to understand the real issues, combined with their ignorance of the economics of health care has affected their ability to understand the situation.

    Just 2 examples to illustrate my complaint, --two of many:

    They talk about the money going to the profits of health insurance companies. But health insurance profits cost less than 1% of the total cost of health care. If one does not consider the way health care is carried out here (the real problem), getting rid of the insurance profits would not do much to help us. They are spending their time finding ogres, not thinking rationally.

    A much more dangerous idea is giving people the impression that we need only to expand Medicare to cover everyone. This is financial nonsense. Medicare is personally wonderful (I am on it), but very expensive as well as wasteful, and cannot be expanded in its present form without destroying the financial base of this country, with particularly devastating effect on the poor. The cost of health care has increased to about 1/6 of the TOTAL output (GDP) of the country, and realistic projections of the increase in cost in the near future indicates that it will reach almost 1/3 of the GDP within the lifetime of most people in the country. Effectively it would lower wages substantially, as dollars are funneled out to deal with health care alone. This has been happening these past years, -- it is clear that the wages of the poorer half of the country have not risen at all recently because increases in productivity, which in the past have permitted increased wages, have now gone towards paying the increase in medical costs.

    (And raising taxes to pay for Medicare, as suggested by some of your bloggers, is only the means of moving dollars from wages to health care, not an answer to the increases in health care costs.)

    No, no, the suggestions of Angell/Lieberman would impoverish the country. Dealing with this problem of ours reqires much more sophistication than is evident in the simplicistic ignorance that these two "experts" present as solutions.

    On a separate PBS program, Charlie Rose interviewed the CEO of the Mayo clinic. His experience running an excellent and efficient health organization, and his opinions and ideas did not blame anyone; they were intelligent and useful. It was a pleasure to hear real knowledge injected into this subject.

    Evelyn Berezin

    If you don't believe Moyers and my conclusion that Single Payer is the only way to fix our problems, then read "Why must health reform be isolationist?" at and then watch PBS's "Sick Around the World." After that, maybe we can get some sanity in the debate.

    Some say ours is the best system in the world. It isn't, we rank 37th in the world.

    Taiwan looked & rejected our system: "American health care is not really a system at all. It's a market. In a market, people with money can buy what they want & many people are left out. So we thought, no, we don't want market-driven health care. We want a real system, something that covers everybody & doesn't depend on how much money you have. "

    Over 50% of bankruptcies & many foreclosures are caused because of health care.

    Art Finley, a West Virginian & TV & radio host living in Vancouver, writes:

    "I'm 82, & in excellent health. It costs me all of $57 a month for health care, & it's excellent. I'm so tired of all the lies & b.s. I hear about the system up here in the U.S. media. I now have 20/20 vision thanks to Canadian eye doctors. & I haven't had to wait for my surgeries, either. I read a Canadian Doctor's Wall Street Journal op-ed that said 'Everyone in Canada is covered by a single payer -- the government. But Canadians wait for practically any procedure or diagnostic test or specialist consultation in the public system.' That's sheer b.s."

    Listen to these two ladies! Reps like King & Gahment are full of it and they have to no idea of the European health system...they are are just scareing people. If American had health care way back in 1948 there wouldn´t be the problems you have now. But health care providers & drug companies have a death grip on the system. The difficulty is that you are way down the river in trying to find something that works is like paddling up the river agains these invested interests. They are only profit movitated!

    You would have the money if the billions that go into the 2 wars and the military establishment expenditures would stop. But no, congressmen are getting rich by their own investments in these private companies.

    Thank you Bill for revealing the truth about what is going on in Washington with Healthcare "reform". I just wish Trudy and Marcia were on Obama's advisory staff regarding this issue. I've been calling my representative Dean Heller repeatedly but he is totally against health care single payer reform. I’ve also called my senators Harry Reid and John Ensign repeatedly as well as members of the committees developing the Healthcare bill asking for a single payer system what will cover everyone because it will save the most money. Harry Reid has not decided on single payer yet and John Ensign is totally against it.

    After watching your show with Trudy and Marcia I must say I was depressed. I did not know the healthcare industry had such a stranglehold on Congress. After finding out that President Harry Truman tried to pass a nationwide healthcare bill back in 1945. I then did a little research and found out we have been trying to get national healthcare since Teddy Roosevelt back in 1906 and many times in between. Here is a link to the history of national healthcare efforts in this country that is very interesting:

    I feel that I've done just about everything I can do to convince my representative and senators to pass a national healthcare single payer bill, now I can only pray that they have the courage to do the right thing and get it done.

    Thanks Bill for shedding some much needed light on what is truly a healthcare proposal that will only fatten the wallets of those already so fat, the medical industries that lobby so much for their own cause. Obama is only a part of this corrupt system, the same system that elected him. For Americans to ever have a chance for a single payer plan, the system of Democracy itself will have to change. And that is the change not only America but the entire world truly needs.



    Seems as though you leftopaths in the Pravda media have met YOUR Waterloo -- your credibility is shot.

    Bill, do you think the mainstream buy into your radical fringe 60's time-warp lunacy? Get real!

    Seriously, don't you ever have anyone NORMAL on your ridiculous program? I thought not.

    Great information as always Bill Moyers.
    Its amazing to me with all the media out there that none of them can explain the healthcare situation or anything of great importance like PBS can. W Could it be corporate media do not want people to know the truth about anything but Michael Jackson..When will America wake up and demand real information from the media?? Thank God for Bill Moyers and PBS!

    Dear Mr. Moyers
    Thank you for unraveling the treads of confusion over the health care debate by highlighting the (2) 2-ton gorillas in the room.


    What struck me the most in your discussion with Trudy and Marcia was the reference to Obama treating the symptom rather than the cause of the Healthcare malaise. When trying to diagnose a problem, you should always try to find the cause. At least that is the theory behind a good diagnosis.

    Therefore if you step back and actually look at the cause of the problem, you see that 67 Senators and 290 Representatives in the House are being paid by big business. Who elects these people who quote rhetoric from the profit taking companies? Juxtapose this issue with your Rwandan Talk Radio shows and you also see big business again manipulating the masses in the background with hate and racism. How does someone get away with saying they would like to kill Michael Moore on these red-neck programs?

    I think the American election system needs to be fixed first if you want a government by the people and for the people. I just watched the movie ‘Recount’ and it revealed obvous corruption and manipulation of the election process. Even Jim Cramer on CNBC keeps saying we have a government for and by the corporations. As Marcia said, it you want to fix a problem you have to find the cause. No one seems to want to go there. If they do, the for-profit corporations get them one way or another. As they say, greed is at the root of all evil.

    All we American people have to understand is what these two women mean by understanding how the Harry and Louise ads have changed. The argument has been based on whether people love Obama or hate Obama. That is a distraction. These two women show us what is happening. Wake up - stop calling one another names. Watch this interview. thank Bill Moyers. Write to Senator Bacus and tell him we have awakened.

    If Canada wasn't so cold, I think I'd move there.

    Sign this petition for single payer

    I just caught part of the show about the right wing talk show hosts inflaming people and causing them to kill people. Are you kidding me! I have heard plenty of hate from the TV show commentators. I have just started to listen to many of the different radio show talk shows and can tell you I have become more informed by their discussions. They have excellent guests and callers from both sides call in and I hear intelligent debate from these hosts not hate mongering. I find your analysis Mr Moyer to be one sided. How can you not comment on this without noting that former talk show host Al Franken, now sadly Senator Franken, also said very inflammatory hateful statements along with others who still blog and debate on shows and have plenty of air time on the main stream TV shows. Have you ever watched Keith Olberman, he has a vile show and manner which he displays daily on MSNBC. He is only one of the many commentators that get paid very well to spew their hate on TV. He is only of the many who state their opinion day and night in a one sided commentory. How can you only comment on one side of the massive media. The radio talk shows are a small portion of all the media outlets. There are many more that take part daily in stating many derogatory and inflammatory statements against conservatives, including the former President. Just because one loon commits a violent act, you cannot lay it at the door of conservative talk shows. If that is true then how about the man who shot and killed the poor soldier who was standing outside a recruiting center just a few months ago. Did the liberal commentors on TV inflame his mind with their bashing of our military. Please stop the nonsense, sick people do sick things for their own sick reasons not because of discussions on the radio or TV.

    Bill Moyers-

    Thank you for another great program...I would rather see our President come out directly for Single Payer and let the chips fall where they may. At least the people would know if their Senators and Congressmen cared about them (in which case, they could be re-elected) or cared only about the money from the lobbiests. If the people knew exactly where their representatives stand, they would not be in office for long. We need term limits and Campaign Finance Reform almost as much as we need Single Payer Healthcare reform.

    Also, regarding the second part of your program, you were too kind in assuming that the shock jocks are not calling upon those of feeble mind to commit murder. Of course, they are inciting murder and the Republican Party says nothing because, I think, they also want this to happen. I think you may be naive in this regard.


    Remember when people ordered so many drugs from Canada until the US Government stepped in and made it illegal, in fact confiscated them at the border so people not only did not receive the drugs they ordered at less than half the US price, they also lost the money.

    WHAT FOR? MAINTAIN PROFITS for investors

    I don't understand why the Administration and Republican Congress don't clarify what Healthcare Reform is:

    Health Care = The medical and mental care you receive at your doctor's. hospital and clinic.

    HEALTHCARE: The program working its way through Congress to pay for Health Care.

    One sees repugs daily scaring people that those nasty Democrats will lower the quality of Health Care

    As long as our politicians depend on donations from the Wealthy to survive, those who are established and providing them with the resources will be taken care of first, as has been done time and time again. THAT IS WHY THESE LOBBIES ARE "SO POWERFULL". We have the best life and government, money can buy. As a 74 year old who raised a familly of six without health insurance, served as peronnel director for a Major Medical School, and having had bypass surgery, I for one have elected to die early rather than support the obscene greed that is our current health system. AN IDEA. IF EVERYONE WAS REQUIRED TO PAY OUT OF THEIR OWN POCKET THE CHARGES MADE BY THIS SYSTEM BUT COULD RECOVER THOSE FUNDS FROM THE CURRENT SUPPLIERS, IT WOULD NOT BE LONG BEFORE THERE WOULD BE A SUPPRESSION OF THESE "COST".

    I worked hard to get Obama elected because he stood for change. In health care reform President Obama has opted for the "feasible" route: more money thrown into the same dysfunctional profit-based health insurance system. I agree with the previous comment that the president's approval rating is declining because he hasn't started from scratch on health care reform. We didn't vote for more of the same.

    As Trudy Lieberman pointed out, the majority of the uninsured would have already bought health insurance if they could afford it. Mandating that everyone who currently can't afford premiums purchase insurance anyway so that the insurance industry has a guaranteed customer base with government-subsidized profits is not the change I worked for. Penalizing the uninsured for not buying a product (that's what insurance companies call their plans!) that they can't afford is heartless and unjust. Yet individual and employer mandates appears to be the only piece of health care reform that enjoys wide bipartisan support.

    I have great insurance now through my employer, who picks up the majority of the tab. However, his generosity is unsustainable with health insurance premiums rising several times faster than wages. The areas for cost cutting proposed by public option proponents or in previous comments are just a drop in the bucket, or already proven unfeasible in the current profit-driven system (e.g., reducing duplication and rate of errors). The big place to cut costs is the 20 to 30 percent of health care dollars that goes to administration and profits (compared to 4 percent to administer Medicare). Reining in those costs by eliminating private health insurance would provide the funds to eliminate co-pays and deductibles while covering every U.S. resident and spending less overall than we do now.

    Marcia Angell is absolutely correct: We have to start all over. We have to enact a national single-payer health program: HR-676.

    Is there any chance the powers that be on Wall Street are trying to kill us off? They have long worried about aging baby boomers retiring. We are no longer required as workers or consumers so why not mandate turning our health care over to the for profit insurance industry. As one friend put it “it’s like the holocaust without the ovens”.

    Nothing can be done, because as Marcia Angell stated, the health-care lobbies are too strong. Their strength comes from the private financing of political campaigns. Eliminating private financing is not constitutional. Conclusion: nothing can be done unless there is a revolution or a catastrophe. I think a catastrophe is more likely. We, Americans, are too stupid to have a revolution.

    The picture becomes clearer if we see actions on Health Care in context.

    Financial Crisis: Provide trillions to bail out banks and non-banks that pose risks to our financial system, instead of breaking them up and directly helping homeowners whom they had defrauded.

    Climate Change: Instead of selling pollution permits, give them away. Throw money at the coal industry.

    Jobs & the Economy: Keep taxes on the wealthy low in hopes they will invest, when what we need is massive public investment in domestic infrastructure, paid for by taxes on the wealthy.

    Health Care: Use mandates to channel hundreds of billions of new money through the health industry.

    President Obama seems to see pouring money through Wall Street as the best available path to our salvation.

    Watching your show tonight, but wow as a Canadian I honestly don't see why you are debating public health care. Why is this an issue?

    Dr. Angell's radical commitment to the perfect as she rejects what many regard as the good reminds me of an argument when I was a neophyte voter. Progressive Texas Democrats didn't like the traditional Democrat chosen during the primary so that they urged people to vote for a young political science professor, John Tower. "We'll knock him off after one term," they said. Tower stayed around for the next thirty years as a bane of every progressive advocate. To reject the involvement of profit making concerns in our medical system strikes me as quixotic, politically naive, and culturally deaf. We can correct what New Yorker writer Gawande called "the culture of treatment" and can reduce costs. We can as a whole society address the questions of how to die without invoking the technological machinery that makes our dying both hideously expensive and often grossly painful and undignified. We can reduce duplication, cut the rate of errors, increase preventative measures for good health, determine appropriate treatment for frequent diagnoses, give the federal government the right to purchase and distribute drugs for Medicare recipients. These and hundreds of other improvements the federal government could make if Congress includes them in its medical reform act. None of them could happen if Dr. Angell had her way.
    Would I prefer a single payer system that rid us of the commercial superstructure that threatens to sink the entire enterprise? I would. But I am grateful to have a non-ideological President who read his history about the Clinton Administration and decided that it would be better to gain some reforms rather than to play dog in the manger and keep our society from any correction of a horrendous situation.

    Very informative program as always, Bill. Wish I could say I found the information it provided encouraging, but as another viewer pointed out, it's better to know the truth upfront than face an even more shocking reality after the fact. Single payer certainly seems to be the way to go, but how to get there at this point is the real $64,000 question. All very depressing, discouraging, and frustrating. Keep up the journalistic excellence we have all come to expect from your programs...they are like a breath of fresh air when compared to cable news channels or the networks.

    In the long run, from what I've read, only single payer will work. The "public option" being contemplated appears to be too small to make any difference.

    I'm concerned though that while we're debating this, every day more people lose their medical insurance. How about if we allow people to buy into Medicaid at cost?

    I have just watched The Journal tonight. I am relieved to hear Ms. Lieberman and Dr. Angell remark that the Obama health plan is vague. Whew! I thought it was just me. I am feeling so validated for the moment. Regarding the misinformation about a "single payer" plan such as in Canada that has been propagandized, all I have to say is look at our lovely (NOT!) HMOs. Talk about not being able to chose your own doctor or even move to a community outside the provider net! HMOs are the culprits which limit all kinds of choices and deny care.

    I am breathless after the second story about the crass and angry "dialog" perpetrated by the shock jocks. The subculture of "talk radio" has really taken hold. It was only after the Clinton victory over Bush Sr when, in attempting to have a civil discussion with a colleague and a sibling, I first encountered a spitting wrath that I was totally unprepared for, as it seems the blusterings of the likes of Limbaugh and others, which I frowned at, had already sunk deep roots into the thinking of many Americans. Thank you for two great news stories tonight.

    Having unfortunately accepted that a single payor is off the table, I have come to view the public option as a viable plan. But it will only work if a number of other reforms come together. It is a vehicle to provide insurance for the currently 49 million uninsured. But that does not mean there will be accessible, affordable health care for everyone unless the public option along with all other federal plans become a platform for payment reform (moving away from fee for service) linked to delivery system reform. Barbara Starfield has demonstrated in multiple countries as well as in counties throughout America, that where primary care is strong, costs are lower and quality is higher. A public option with all federal plans would have enough clout to have real bargaining power to impact pharmaceutical and other costs.
    A public option that operates off of premiums (as President Obama has said it would) and is therefore on an even playing field with other insurance companies would have to manage its administrative costs by not denying coverage for pre-existing conditions, and by not engaging in prior authorization and claims denial. A risk adjusted capitation model with quality incentives accomplishes this goal.
    I think the public plan does not solve the health care crisis alone. Access, cost containment, and improved quality are integrally linked and require payment reform and delivery system reform.
    So I think if you just fix one thing (for example mandating access) then the other things (quality and cost) get much worse. If you just cut reimbursement for Medicaid and Medicare services then access, and quality suffer and probably cost.
    It is a scenario where we have to fix multiple things at once or we will create an even bigger mess than we have now.

    I agree that it is time to stop being bipartisan. Republican statements that they want health care reform to fail disqualifies them from respectful bipartisan negotiation. The failure of health care reform is massively destructive to America. I hope President Obama will bring more clarity and forcefulness to the issue.

    Bill, you and your guests need a little civics lesson.

    You keep thinking that you live in Iraq under Saddam or in Iran under the Supreme Leader, and except with the name being Obama and Obama can just say "I am the law" and that is all that is required.

    If you and your guests want something to pass Congress and be signed by the President Obama, you need to figure out how to get to 60 Senators who are committed to your single payer and to the carbon tax and to whatever, and likewise about 250 Representatives to the House. If you can't do that in the next term, and you have a problem with the Blue Dogs in the Senate, then you should shoot for 67 in the Senate and 295 in the House so it doesn't matter who is President.

    I would point out that the fastest way to get your health care bill enacted has not changed since 1960.

    Since you have all failed to elect the right Senators and Representatives, you need to count on Obama's strategy.

    You solution to go down fighting, and your strategy would absolutely would fail, we would end up going another decade or two before another chance will exist to cover everyone.

    You really should take a look at Switzerland and the strategy they are following. They first covered everyone, and now they are working on reforming the system to focus on prevention and lower costs.

    I can't believe your guests are arguing that all the people between the age of 20 and 50 wait for two or three decades to become entitled to some assurance of health coverage....

    If you believe in something, you need to get 67 Senators and 290 Representatives in the House who believe as you do. Otherwise, the president will need to compromise with the people who you helped elect who won't agree with you.

    The primary reason we do not have a sensible health care package in this country is because we allow private capital to finance public election campaigns. Until the Constitution is amended to do away with campaign fund raising, we will never substantively reform any of our institutions. In the age of billion dollar campaigns, voting is all but an after thought. The reason this latest attempt at health care reform will fail is because elected officials are hopelessly addicted to the cash that the for profit health care industry continues to pour into their campaign war chests.

    We need to reform the electoral process before we can ever hope to reform anything else. Mr. Moyers, the show you need to do is the one on why voters do not count. Since the first television campaign ad was purchsed, we have been moving toward becoming a big business oligarchy, rather than a representative democracy. There is no other reason why members of Congress could feel so comfortable discounting all the polls calling for an effective National health care system, unless they were sure that our voices were irrelevant.

    Long ago, a Democratic Speaker of the California Assembly, Jesse Unruh, said that "money is the mother's milk of politics." He was wrong, for it is now the very lifeblood of all American politicians.

    I am a Canadian, but live in the US.

    I saw an article about some brain surgeon at some hospital in upstate New York who was penalized for refusing to perform an operation. The circumstances were not what struct me. This doctor was earning over $10 million per year.

    Why is it necessary to pay a doctor that much?

    The only reason I can see for this, is when there is competion for access to this doctor. So, who is competing with whom? Hospitals or other groups? And, clearly the people bidding up this doctor's salary can justify it because somehow it is profitable for them to hire and work with the doctor.

    Who win's by bidding up doctors' salaries?

    A closing fact: my daughter is an American. She has no health coverage in Canada. She is well insured in the US under a PPO plan.

    While at home in California, my daughter had a reaction to a food allergy and we had to take her to emergency to have her vital signs monitored for 4 hours. This happened in the U.S. Total co-pay: $770 US.

    A year later while on a vacation in Canada, she ate the something that she shouldn't have. So of to the local emergency to have her vital signs monitored for 3 hours this time. For an out of country patient, we had to pay the full rate: $280 CDN. This included the cost of some prescription medicine.

    Is this the soltion? Save your money. Drive up to Canada and get treated for less than your co-pay at home in the U.S?

    Health care issue:
    Scrap it for now.
    First thing to do is CAMPAIGN REFORM so that the undue influence of the for-profit parties is left out of the equation and real reform can take place. They can talk to Congress on the same footing individual citizens stand.
    Thank you very much for bringing these two journalists' studied viewpoints up front.

    Still, the basic questions have not been answered; or even been asked. Medical care, like religion, falls into two categories, true believers and heritics. What should be the role of homeopathic medicine in prevention? Should holistic medicine be considered, or should it (as in the opinion of the drug manufactures) be dismissed as unscientific? Should drug pushers (pharmecutical companies) be considered unbiased? Should the emerging field of Vibrational Medcine continue to be ignored? There are more questions, of course, but until they are considered, healthcare reform will be no different than re-arranging the deck chairs on the Titantic.

    Obama knows what the right thing to do is -- single payer health care. And, as your one guest said, it can be done! Shore up Medicare, lower the age limit, introduce a sliding-scale payment, etc. It can be done. It just takes some leadership. Sadly, as your guests said, the only leaders are the CEOs of the insurance and pharma companies and their lobbyists. Congress and Obama are not working for us but for them. I would rather seeing nothing done than give these immoral CEOs any more money!

    Tonight's segments on health care and talk shows that advocate violence was disturbing. But keep them coming. We need to hear the hard questions and the hard answers. For too long, we took the easy way out--push human needs under the rug.

    One of your guests some months back said, "There is a class war, and we have lost it." Tonight's program illustrates that. Hate mongers have the money to buy radio time. Oligarchs have the money to buy political power. I don't like that. But I don't want the truth to be hidden. No pain, no gain.

    I was happy to finally hear an expert like Marcia Angell saying what so many of my friends and I have been saying for years. We need to TAKE THE PROFIT OUT OF HEALTH CARE. I don't have a problem with Doctors getting paid for their services, or nurses or administrators or even CEO's, but no one should be making a profit of the pain and suffering of others. The local police departments doesn't make a profit, the local fire department doesn't make a profit. These are services that need to be provided to soceity. So is health care. There is plenty of money to go around. A lot of private business is generated by these public services. The fire department buys fire trucks, hoses, real estate, uniforms, etc from private business. Why can't health care be the same?

    Thank You Bill Moyers for your (actual) fair and balanced reporting.


    The question assumes we know what the President's public option is. I do not. Permit me to lay out three sets of facts it took an arduous week to assemble.

    1. The House bill ("America’s Affordable Health Choices Act of 2009") would delay introduction of the public option until 2013. Till then we would be legally obligated to purchase private insurance. Ostensibly (but implausibly) budget-driven, the delay presents the risk of an all-out industry effort to repeal the option before it ever kicks in. The bill thus resembles the "5-year trigger" floated by Rahm Emanuel, a private insurance test period that, if it failed, would result in a public option. That proposal got him in trouble, but this one differs only in that it shaves a year off and dangles a shiny object at the front end. Where's the rage? Tell me where the awareness is and I'll get back to you.

    2. Two Senate committees are working on healthcare reform. Knowing of no draft bill out of Baucus's committee, I sought out the Kennedy committee's bill ("The Affordable Health Choices Act"). I know how to do this, but I would have failed had a committee staffer not come to my rescue. As she also explained, the Kennedy committee bill renames the public option the "community health insurance option." Its gist is this: States could opt into a public health insurance scheme run through federally monitored entities known as Gateways. The ball would thus land in the states' court. HHS would afford the option to residents of states that were still holding out four years after enactment. Otherwise there'd be no delay. I haven't read the fine print, but I haven't heard one word about the bill, so I'm in no great hurry.

    3. I do not know if President Obama favors one plan or the other, or a third plan, or any at all. I cannot even say if the President has a working concept of what the option is. I can't decipher his pronouncements. He seems to want to skirt the issue for reasons unknown to me.

    Apart from a few blogs, e.g. by Ezra Klein and Jonathan Cohn on the budgetary pretext for the House bill's delay, there is stone silence on all of the above. Even congressional reformers omit to explain it. I am at a loss to describe this particular sort of darkness. I am starting to think our political culture needs as many words for the dark as the Inuit have for snow.

    Now, Bill, if you would be so kind as to rephrase the question in light of the circumstances, I will gladly venture an opinion. I didn't go to all this trouble for nothing.

    Then again ....

    The critique of medical delivery ("healthcare") reform presented here tonight is exactly right. It has been necessary for Obama to lead from the center if he was to get consensus, but the right-wing are destructive beyond redemption; they have refused to work together. Obama should firmly stand for what your expert guests described, or he should chuck the whole deal for this year and lay the blame where it belongs.

    We are in dire straits. The attempt to lead from the center has failed, and another administration of "Centrist" sell-out is going to be the last blow we can withstand. The Great Collapse will proceed unabated. Obama has a few months left to get a grip, or it's all going to devolve into more elitist game-playing. He and his allies must be reminded of this loudly, firmly, and frequently.

    No more "polite" mealy mouth, please, Bill. "Raw" words are appropriate at this juncture.

    David Bockoven, RN

    Obama is showing no leadership even though he KNOWS the only answer is single payer.

    His administration will go down in the ignominy of cowardice.


    I am sorry I voted for him.

    Do you think *any* of these right-wing monsters wished for the actual shooting death of liberals or Dr. Tiller, you asked. "Not for a minute," you said.

    Bill! You chickened out! Some of these people, by all available evidence, did want exactly that. Defend their freedom to speak if you like, but don't pull the wool over your (and your listeners') eyes. They did call for and want killing.

    These two women are the first on the national scene to speak the truth about what is going on. where is the video of their session. All of Congress and the President too ought to watch it and speak to it. Get the video out please!

    I'll say it again.

    I'd be willing to support President Obama's healthcare reform without question if he would order CBS, NBC and ABC to announce the National Threat Level every 30 minutes.

    I haven't heard anyone mention the National Threat Advisory Level in 7 months . . . this tells me there's a serious threat to national security when the propaganda is not being repeated over and over again for the truth to sink in.

    I have to live in fear or I can't live at all.

    Reducing medical cost is crucial.Why does a normal delivery of a baby without complications in a Hospital in Utah cost $8000. Why does my dermatologist charge approximately $400 for squirting a little frozen Nitrogen on my skin in a procedure that lasts less than 15 minutes. That is an hourly rate of $1600 for patient contact time. If he earns the typical $200,000 per year his hourly income should be $100/hr. This means his fringe and overhead is 1500%.I understand that no insurance pays the actual charges. Only self-pay patients have to pay the total amount. My insurance -
    Medicare approves about 50% of his charges and pays 80% of the approved amount or $160. I pay the $40. If I was simply buying the doctors time, the $40 should be his total fee for the 15 minutes of service.
    This transaction will take 2 or 3 month because the approval is contracted to a private firm in North Dakota a thousand miles from Utah where the transaction occurred.
    Hint for reducing cost: Pay doctors a reasonable fixed salary with a reasonable overhead such as negotiated by the government with Universities on grants. I worked that way in a University Rehab department for many years as a Rehabilitation Engineer (I have a PhD in Bioengineering) and never had to charge a patient for my services which cost no more than $60/hr including generous fringe benefits and overhead. My salary was paid by "single payer" - the taxpayer.
    Another hint to cut costs:
    Investigate why there is a shortage of doctors. Thirty years ago when I studied with medical students at the University of Utah Medical School, it admitted 100 students per year. This year the school is planning to admit 80 students even though the Utah population has at least doubled. Is medical education a closely controlled expensive monopoly?

    Far worse - start from scratch. Wage a valiant campaign for HR676, improved and expended Medicare for all. I honestly believe President Obama's approval ratings are falling because he hasn't started from scratch on health care reform or the economy. People didn't vote for more of the same.

    Ms. Angell is correct, we should start over with the healthcare plan. Our policy makers need to consider all of the healthcare programs that they are directly funding, look at the pros/cons and what is right, fair and equitable. This will require time and unbiased analysis. I agree that much of our nation's health care is rationed based on income, but we also provide unlimited, full coverage to segments of our population, at government expense. This is inequitable. For example, one group of Americans receives "universal like" healthcare. The Dept of Defense has over 10 million beneficiaries (the VA has closer to 40 million). DoD offers complete and timely healthcare for military members, families and retirees. They can have "head to toe, birth to death" care by one of their DoD Doctors or choose a non-DoD doctor and the DoD will pay for most, if not all, of it. They have a choice. The complete healthcare offered to these military, retirees and family members isn't even available from an insurance company. DoD members and families do not have to wait months or years to get medical appointments or procedures. They can walk in, get same day appointments, go as frequently as they'd like and never pay a penny. Elective and cosmetic surgeries are even offered. The DoD healthcare system is a 100% paid system that our government chooses to offer, protect and funnel billions of dollars. If things were "equitable" then over 98% of the healthcare for our military and family members would be provided in civilian communities by non-DoD doctors, just like any other American. These military and family members would have to use a "partial-pay" insurer just like other citizens or pay out of pocket.
    The healthcare provided in the "war zone" is a tiny 2% (or less)of all DoD health services and that could be provided by a reserve contingency of doctors. Why is there such a disparity between the full health coverage a military family member gets and any other American? If a child (or spouse) of a military member can have this complete government funded[universal]health care, then every American should have it too.
    Even prisoners receive full health coverage and do not pay.
    All current government funded healthcare programs should be carefully reviewed as part of the reform process.

    I have a serious question that does not sound serious, but I promise you that I am quite serious when I ask it. Is Alex Castellanos related to Paul Castellanos of mafia fame? There are literally thousands of people in the mafia who have slipped through the cracks. The mafia swore to become "legit" which in their lingo means to capture the government for themselves. I think it is quite obvious they have been able to do just that and I was wondering if Alex Castellanos was being groomed to be a Don in the future. He can't be president since he was born in Cuba.

    To John Kyl: Your stats just don't get to the bottom line of most people's experience. They do make the point that the whole darned system is broken when the billions spent on pharmaceuticals represent only 10% of total medical expenditures. Single payer would address it all. I wish you, as a leading and powerful senator, would take this on but I guess that's a vain hope. This just isn't political for us.

    With respect to the proposed individual health insurance mandate, I believe that you and your guests have missed a vital conflict with the Constitutional rights of citizens.

    The Fourth Amendment guarantees individual citizens the right to be secure in their persons, houses, papers and effects free from unreasonable seizure by the Government. That Fourth Amendment guarantee certainly extends to the right of individuals to set priorities relative to the delicate balance between their lawful income and assets on the one hand, and their various obligations and ambitions on the other hand. Most of us resort to priorities that defer one or more expenditures in order to permit more pressing needs to be met. I assert that this personal, non-commercial, setting of financial priorities by individuals and households is a fundamental Constitutional Right protected by the Fourth Amendment.

    The health and welfare of my family is far more complex than a single generic assumption to the effect that having private health insurance is always the highest priority. My family is far better situated while in our home than homeless. We are far better if the roof does not leak. My daughters need to complete college, if at all possible. My family's health and security depend upon the freedom to set individual and household priorities. Mandating health insurance is an unreasonable seizure that harms my family.

    The offer to subsidize low income persons does not alter the fundamental nature of the seizure. My Fourth Amendment right to be secure in my person, home, papers and effects is not subject to review and approval by the government.

    The proposed individual health insurance mandate is not a tax. While a direct income tax supporting health care might be distasteful to many citizens, it could lawfully be imposed by a political majority, as would be the case for a single payer system. In contrast, an individual's Fourth Amendment rights are never forfeited solely to advance the political or policy interests of a political majority.

    The commerce clause allows Congress to regulate commercial entities in interstate commerce, including private health insurance companies. If an individual citizen voluntarily purchases private health insurance, then the commerce clause would permit that private insurance contract to be regulated as commerce. However, no commerce exists until after the citizen purchases private insurance. The proposed mandate inserts itself into the private financial decision process of citizens. The mandate is operative "before" any commerce has been created, for the specific purpose of manipulating the individual's financial priorities. The commerce clause is therefore not logically a reasonable constitutional basis for the mandate itself.

    Before Congress and the President impose an individual health insurance mandate, the citizens deserve an answer to several fundamental constitutional questions.

    Question 1:
    By what Constitutional Authority does Congress and the President presume to mandate the individual purchase of private health insurance? Please be specific.

    Question 2:
    By what legal reasoning does Congress and the President presume to supersede the Fourth Amendment rights of individual citizens to be secure in their persons, houses, papers and effects from unreasonable seizure? Again please be specific.

    The answers will reveal much about the future of public policy. The noblest policy goals are abhorrent when they shred the Constitution. I suggest you do a show about the Constitutional implications of a private health insurance mandate.

    I agree that single payer represents the only real possibility for change for the better in our health care system. I'm mystified by Obama's attitude. We want to trust him, we do admire him - does he think single payer is impossible? Some would have said his being elected was impossible. I'd like to see him apply the same formula to this crisis he used in his campaign. Please, just the support the current "plan" has from the likes of Billy Tauzin, George and Louise is reason to bar the doors, batten down the hatches and hide your valuables. Barack, drop back five and're losing traction and respectability.

    Marilyn Valant, in an earlier post, shares my feelings. A one payer system is the only logical way to go. We are the only developed, wealthy nation that allows its infants to die at the highest rate of others, and that actually denies health care to 47 million people, and makes it really interesting/difficult-beyond-belief for the rest of us who are on some kind of predictably, horrible insurance plan.

    And Women? Trust me, we ALL have pre-existing conditions, 'cause I have yet to meet a lady friend who has not had a bladder infection and we ALL will soon have HPV since men don't get tested for it but spread it like crazy.
    To add to insult we earn only 75 cents to a man's dollar and lose that income in our social security benefits. Plus we live longer. On less...

    WE need health care more than men and those men who want to rant about birth control and Choice in being pregnant need to first become pregnant before they open their mouths.

    Being pregnant is the most dangerous thing a woman will do with her life. It's up to her to take that risk, not any other person's on earth to decide for her. Period.

    Speaking as a woman who nearly died from being pregnant, I know.
    Choice in being pregnant is our right as women. Men have no place to make that decision or even, frankly, to comment. Sorry, no freedom of speech there, boys. Just shut the hell up, or get a womb.

    Bill Moyers, by the way, is the newest Most Trusted Man (person) in The Nation, since the death of Walter Cronkite.

    Thank you Mr. Moyers. You are a gentleman.

    Dear Bill,

    I am a loyal follower of yours, and almost every Friday I walk away feeling tense and unsettled, yet proud that there are people like you and your guests who can think and tell the truth. But tonight I'm terribly depressed.

    Because I trust President Obama I have been trusting Congress to "get it right" -- health care reform.

    I know the public option is a Trojan Horse, but I assumed that we're not going for a single payer system because the economy could not sustain another hit (the demise of the medical insurers) right now. In time the insurers would be regulated... I really thought the public option would be the in-road to a unified single-payer system.

    Tonight's speakers made points that I hadn't realized, and I felt blind-sided. Tonight's show was actually shocking: Congress is going to mandate purchase of medical insurance? People cannot afford to buy food right now!

    Your speakers made it clear that the only way to bring costs down is to eliminate all the ways profits are made in our health care system. We've always known that it's immoral to profit off of illness. Yet I'd forgotten how powerful all that money has made the insurers. Will they really be able to hobble the public option by skewing all the sick people to that option? Will they then privatize Medicare?

    Why doesn't Obama's team know this? How can he let them get away with another hijack?

    Talk about hate crimes... profits are robbing American workers of the ability to work and take care of their children.

    I need to know what I can do besides what I'm doing now, writing to Congress and the White House every day. Is there any hope that this country will do the right thing?

    I think I know how that Minister in Tenn. feels as he looks at the culture that produced the murderer that came into his church. There's so much wrong, and the good guys are turning out to be either deceitful or stupid.

    I am a Canadian citizen who is watching this debate with great interest. I have long wondered how a nation with such great wealth and talent can leave so many of it's citizens without health insurance.

    I am also a cancer patient. I was diagnosed with stage IV Ovarian Cancer in May 05. Watching this debate as someone who has had stelar care under our system I get very upset watching the lambasting our medical system gets in the right wing media. It is simply not true that a system like ours would bankrupt the US.

    There are Canadians that will complain because they don't get what they want when they want it. Speaking as someone who's life depends on this system I can honestly say I wouldn't have it any other way.


    Once again, you are the only voice pointing us to the real issue and the perils in the Health Care debate. Single Payer is the only solution and all those who make money off the status quo are gathering all their resources to squash it like a bug. Only a volcanic eruption of the people from all sides, left and right can get us what we need, Single Payer.

    On the other issue, right wing crazies spouting hate. You are again mostly right. The guy who offered to buy the bullet to kill 9/11 Truth members which would include me and a great many conservatives, was offering to finance a hit and should be in jail today for this crime.

    Like most thinking people, I can not align myself with conservatives or liberals either one completely. On some issues one is correct and on others the other is. On some issues they are both wrong. On others they are both right. In discussion with pro-abortionists and pro-lifers I find that we all want the same things, no dead babies and no dead women from back alley abortions. I propose we work on getting what we all want.
    However, you fail somewhat in fairness, to anti-abortionists, abortion is murder, every abortion includes a dead baby human being.

    I never listen to the shock jocks on the right or the shock jocks on the left but some of the speech I heard tonight is advocating violence to people's physical person and therefore is highly illegal in almost every state. Someone should be prosecuting those who advocate violence against citizens of the United States, unless they are murderers who are going to murder again, soon. That is a big gray area for me where abortion, baby murder, is concerned. After 10 weeks a baby has a heart beat and can hear your voice.
    Like in "Cider House Rules" you kind of understand the need to help a woman who is determined to kill her baby not to kill herself, too. If you can only save one, save one. It is a very thorny issue, not to be trivialized by terms like "pro-choice" and abortion. We need to get real and talk about killing babies because that is what it is. To loose sight of that fact is to deceive yourself, the woman involved and the nation.

    I condemn his actions but I understand the frustration of the man who attacked the Unitarian Church in Knoxville. When I first arrived in Knoxville in 1974, there were 7 huge plush fancy nightclubs for gays to party all night long and not one place for Christian teenage youth to gather. But that was not the fault of people afflicted with homosexuality, it was the fault of the Christian Churches in Knoxville. Homosexuals are just sinners like the rest of us in need of prayer, not bullets. Crazed right wing pseudo Christians advocating hate don't help in the fight for decency and values in America.

    In the end there is no left or right, there is only the People against the Criminal Illuminati Elite Banksters, their Oil/Energy/Insurance/Banking and Propaganda Companies and the Congress they corrupt. They always pit us against each other to defend their profits. We must wise up and see through it.

    Charles Michael Couch

    Thank you SO MUCH for these programs on healthcare and the great summary of right wing hatred and violence. I see the same people who love to hate liberals are commenting on this page. I feel sad to be living in a country with so many people like that. I wonder if I can continue to live in a place full of so many vicious, hostile, cold-blooded people who care nothing for the problems of others, who would insult or kill victims of tragedies like Hurricane Katrina, who feel that those who don't have healthcare deserve to die, I guess. Money is all that matters to these people. It's a sad commentary on the state of the nation that so many people buy into the hate speech of the right wing shock talkers.

    A major part of the cost of health care today is the multiple billing system. Someone said Medicare is a single-payer system. Not true! I receive paperwork from doctors and hospitals, Medicare, medicare supplement insurance, prescription-D coverage, etc. Wouldn't a true single-payer system vastly reduce these red-tape costs? (Much of my paperwork at income-tax time has to do with these multiple medical records!)
    How can I get into the debate the idea of participatory decentralization, coupled with non-profit structures like cooperatives or mutual insurance? I just visited my Senator's office today with this idea, but I doubt if he will take it seriously.
    I grew up in the 1930's, and seem to remember that major programs such as rural electrification were often implemented through local cooperative organizations which provided for councils of local experts and respected local citizens to assure accountability and responsiveness to individuals. I think this would offset the fears many of us have of excessive federal centralization and problems we have seem with VA facilities, etc..
    Would not a public option organized on this basis resolve such fears? And I do mean an option--it's the individual's choice to sign up for it or any other adequate program. But I suspect the competition would eventually work in favor of this public option, because it's non-profit.
    And decentralization would allow for local variations in costs and standards, rather than some iron-bound national system. Sure there would have to be some basic standards, but they would be decided by a process of consultation, not by centralized.
    Why Have I heard nothing about this sort of consideration in the debate so far? How can I get the discussion to go in that direction?

    Conservatives are filled with hate. I have NEVER heard a liberal talk show host (Brian Lehrer, Mill Moyers, Al Franken, Rachel Maddow, Amy Goodman, etc) mention murdering Bush,Limbaugh or Anne Coulter. These right wing conservative talk show hosts ARE exactly like Hitler who rallied his nation by using hate, fearmongering and dehumanizing a minority and scapegoating them.

    Marcus, the poster above who thinks PBS or Moyers are hypocritical, needs to take a hard look at the violence in the words of the right wing media.
    You do not see violence in liberal media. It's not in our blood, as liberals, to incite violence. But trust me, the idea of Limbaugh dead of a heart attack tomorrow is something I almost can pray for. But that would be a waste of my prayers when there are so many more valuable people to pray for their well-being.

    Screw the right wing media, they have no soul and, being a Social Studies teacher, I think they actually hate this country.

    When I first heard Obama speak of his requirement for a "public option", I assumed that, if it were honestly to meet the requirements described by Secretary Reich, it would be intended to gradually supplant private insurers. I still believe that IF it could meet the lofty goals first described for it, and if it were properly managed and controlled, that would likely be the ultimate result. But, like Marcia Angell, I doubt that Washington could ever ensure such a result in the face of political reality (the hand that feeds them).

    Having heard Marcia Angell's suggestion about phasing out private insurance over time, publicly announcing that as the intention and direction and mandating that it be done by a date certain, I much prefer her approach. This, as I understood it from Marcia, would mean cleaning up the management of Medicare and gradually (over time) lowering the eligibility age for this Medicare (or Medicare-like) program (from 65 to 60 to 55 to 50 to 40 to 30...etc) until everyone was covered by this single-payer system. Putting the private insurers on notice that they had deadlines certain by which they would need to get into some other business and effectively shutting down the world's only for-profit, captive-market health provider system in the world designed and built by an industry whose profit interests are diametrically opposed to the interests of its customers.

    I totally get the message that one way or another we HAVE TO get to a single payer system if we EVER hope to get out of the morass that will otherwise almost certainly bankrupt the United States of America.

    It’s about health care. This is totally is NOT about healthcare at all. It is a political battle between the Republicans and President Obama. It is more about sick care not health care. What do you mean we are not starting from scratch....WE HAVE TO START FROM SCRATCH...AND.....START ALL OVER AGAIN....get rid of Insurance Companies and Pharmacutical Companies....Pharma Co, Ltd. and 47 other companies, that are part of Pharma are spending millions and millions of dollars to make sure that they have their way....feed Americans pills and keep us unhealthy and dependent....AND misinformed. This is our last chance to bring the change, the REAL REFORM of the Health Care System....I, myself with many of my friends and yoga students, we, who are healthy, are feeling that the whole thing is so UNFAIR and we are being punished for being healthy and fit and informed. I think the NEW Health Care Program has to give people incentive to be healthy, fit and lose weight (if they are obese). Money have to be spent to educate people about Self-Care Health education on sustainable live style that will prevent millions of people getting ill in the future. Remove process junk food from the Mass Eating sources and give people healthy choice. Make gyms and yoga classes be covered by Insurance. Right now the insurance money is there only for pills and surgeries and no money is spent on prevention and real health. WE HAVE TO GO TO SINGLE PAYER PLAN...!!!! IT IS A MUST! Otherwise we will lose and loose BIG TIME. If Obama is not going to get rid of the Farma lobbyist in Washington and get rid of the private Insurance Companies....the bad guys will win and the bad guys will stay in place....and the American People will get cheated one more time!!
    I think we all should storm Washington and demand to put a stop to this charade .
    Hallochem Pharma Co.Ltd is spending $60 million USD a month to kill President Obama’s Health Care or Anybody’s Healthcare which is aiming at regulating the drug (pills) price or limiting their activity and profits in anyway. Right on their website their advertise, “Based on the motto of 'Don't forget old friends, make new friends ' we are looking forward to cooperating with you and warmly welcome you to our company! An amazing thing happens when you work for Hallochem Pharma Co.,Ltd . You will get the rewarding results”. Check this out…. They have to make their profits not matter what….even if it means at the expense of the lives of American People. That is a disgrace. I am almost 58 years old and I go to the doctor once every 2 years for a check up and a good blood test. I go regularly to a chiropractor and for colonics and acupuncture but none of this is paid for insurance co. I juice, sweat & smile every day. I am vegetarian and I fast regularly. I teach Healthy Life Style wherever I can...whoever wants me to teach. I wish some Health Insurance will pay me my fees, so I can offer my workshops FREE to the public and especially young people. Thank you for reading my remarks. Marilyn Valant
    tel. 845-866-3063

    Why no mention of the vile, malicious, and seditious hatespeak against conservatives coming from such leftist media such as Airhead America? Are only right wingers capable of hate? Hypocrite!

    Trudy Lieberman is so right. The public has no idea what health reform really means and they simply trust Obama. But here is where the credibility gap will come back and bite Obama as Marcia Angell notes. If they pass health reform and it turns out to force people to buy private health insurance and has no cost control for pharmaceuticals or hospitals, the public will feel betrayed by Obama and could very easily cost the Democrats the 2012 election. Marcia is so right. Better to go down fighting for single payer which is the only solution than to compromise so much to the medical industrial complex that it could be even worse. Finally, in a global economy when the rest of the world has figured out the value of single payer, we basically will make it impossible to hire any American since our health benefits are so much higher and it will be so much cheaper to manufacture anything overseas. We are going to sink America with our wasteful health care system.

    Liberals would have us believe people are dying in the streets. We have the highest quality care in the world. Life saving drugs, procedures and therapies are developed as a result of a profit incentive.

    There are two problems with the American system, access and cost and none of the liberal attempts at the destruction of the private economy address either. How do you improve access? Reduce government involvement at every level. Make care portable, give individuals the same tax treatment as businesses and expand health savings accounts - allow more funds to be placed into them and make them tax free instead of tax deferred.

    What will this do? It will put care choices back in the hands of consumers and not the agents of businesses - insurance companies. Higher deductibles with lower premiums will keep people from jumping to the doctor for a cut or bruise or because they sneeze.

    It will give consumers the incentive to shop because what they don't spend they keep. They will shop for everything except emergent or acute care. Quality will improve and costs will go lower. There will be fewer people to cover and if you eliminate illegals . . . .

    Why no mention of the vile, malicious, and seditious hatespeak against conservatives coming from such leftist media such as Airhead America? Are only right wingers capable of hate? Hypocrite!

    Thank you, Mr. Moyers, for another program that is moving in the right direction. Dr. Marcia Angell's last remarks today are, I believe, 100% correct.

    The for-profit insurance industry must be phased out. So-called health insurance has nothing to do with healthcare. Only the providers of healthcare should profit reasonably from the care they provide.

    Purge the profit.

    Thank you.

    Thank you for two great segments tonight.

    Your program, like almost all the programs on the health care issue, lacks one important statistics -- where did all the money go? In 2007, over 70% of the total health care expenditures went to hospital care, professional services and nursing homes. Prescription drugs only accounted for 10% of the total cost and the net cost of health insurance was even lower. That is to say, even if we force all the pharmaceutical companies to provide us free drugs and wipe out all the profit the insurance companies made, we won't get any meaningfully lower cost of health care. If you really want to do a high quality investigational report and responsibly address our health care crisis, just follow the money.

    All these numbers can be easily found from the website of US Department of Health and Human Services:

    Thank you for keeping the health issue on the front burner...your program is so very important to all of us who are feeling people don't matter and insurance is only a big business...this country needs to find it's heart.

    OMG! Just what I was thinking before this programmed aired. More money for the insurance companies. More money for us to pay. Wondered why we weren't hearing what was really in this bill for healthcare. Knew I would find out if I watched Bill!

    From what I know, I think it's doubtful that Obama's public option will be sustainable as it currently is. However, given that Pharma and its members collectively are rich enough to have spent on their lobbying efforts about $40 million in the last three months, I think it is only fair that they spend twice that amount on controlling costs to the health care system. How about paying that money to the public option trust fund?

    Another idea that might work is new legislation regarding corporations involved in healthcare delivery. Just as rules and regulations vary between commercial and investment banks, so should there be separate entities in the health care industry. First and foremost, these divisions should not be publically traded. It is categorically unethical to profit from the delivery of health care. Non-profit? Some other corporate entity?

    If we can't have single-payer, why bother at all?
    The insurance companies have had plenty of opportunity to provide the kind of health care coverage afforded to consumers in other countries, and they put profit before conscience.
    Health is not a commodity, it is a human right.
    Throwing more money into a broken system will satisfy no one and only delay a proper response to the problem. The system is rotten and needs to be reformed from the core.
    As to funding, if we can find a trillion dollars to wage war for oil, we can afford to save the lives of our citizens. Or if we could find the missing trillion dollars that is unaccounted for in Iraq . . .

    Q: "If instituted, do you think President Obama’s proposed “public option” for health insurance would be sustainable? Why or why not?"

    A: If Obama hates to bring it up in public, and congress will not pass it, it looks like the idea is dead. Anyway, it looks like a camel made by a committee.

    Q: Is flawed health reform legislation better than nothing or, as Marcia Angell argues, even worse? Should we start over? Explain.

    A: We should start over and give due consideration to HR676...single-payer, Medicare-for-all. Here is the section of the bill which describes funding:
    SEC. 211. Overview: funding the USNHI Program.

    (a) In general.—The USNHI Program is to be funded as provided in subsection (c)(1).

    (b) USNHI Trust Fund.—There shall be established a USNHI Trust Fund in which funds provided under this section are deposited and from which expenditures under this Act are made.

    (c) Funding.—

    (1) In general.—There are appropriated to the USNHI Trust Fund amounts sufficient to carry out this Act from the following sources:

    (A) Existing sources of Federal government revenues for health care.

    (B) Increasing personal income taxes on the top 5 percent income earners.

    (C) Instituting a modest and progressive excise tax on payroll and self-employment income.

    (D) Instituting a small tax on stock and bond transactions.

    (2) System savings as a source of financing.—Funding otherwise required for the Program is reduced as a result of—

    (A) vastly reducing paperwork; and

    (B) requiring a rational bulk procurement of medications under section 205(a).

    (3) Additional annual appropriations to USNHI program.—Additional sums are authorized to be appropriated annually as needed to maintain maximum quality, efficiency, and access under the Program.

    SEC. 212. Appropriations for existing programs for uninsured and indigent.

    Notwithstanding any other provision of law, there are hereby transferred and appropriated to carry out this Act, amounts equivalent to the amounts the Secretary estimates would have been appropriated and expended for Federal public health care programs for the uninsured and indigent, including funds appropriated under the Medicare program under title XVIII of the Social Security Act, under the Medicaid program under title XIX of such Act, and under the Children’s Health Insurance Program under title XXI of such Act.
    Business needs to be taken out of medical care completely. If people think that private insurance companies will protect their interests, they are misguided.

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