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Week of 12.4.09

Pre-existing Conditions

Can your health insurance coverage still leave you uncovered? Gripping stories from America's heartland.

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The Weekly Q
As Congress hammers out legislation that will determine the future of health care in this country, NOW travels to the nation's heartland to see what reform could mean for the middle class.

This week, NOW Senior Correspondent Maria Hinojosa meets two tight-knit Oklahoma families whose problems with private health insurance left them unable to get proper medical care -- and on the brink of financial ruin.

One of those families - the O'Reillys -- grapples with the issue of how to cover needed respiratory therapy treatment for their eight-year-old daughter, Sophie, who was denied coverage for what the insurance company labeled a "pre-existing condition."

"People pretty frequently say, 'Oh, you know, my plan works great for me'," says Sophie's mother Natalie O'Reilly. "And my answer to that is -- insurance works really well until you need it. Until you really, truly need it."

This show was a part of the "PBS Special Report on Health Care Reform", originally broadcast on September 24, 2009.

Related Links:

Autism Speaks

Senator Coburn: Health Care Reform

Issue Clashes
The gloves come off as experts debate the most controversial health care reform issues. Vote for a winner and add your own arguments.

Will There Be Rationing?, Should the Rich Pay More?, Can It Reduce Costs?, What's Best for Seniors?
Health Care Hub
Find news, information, and analysis from America's most trusted and credible media sources. Also, share your opinion and read other viewpoints on the best fix for America's ailing health care system.
In Your State: Insured and In Trouble
Read and watch personal health care stories of Americans across the country whose coverage has fallen short--in some cases with dramatic consequences.
Viewer Comments

Commenter: sharon
Our family income is 40,000 before taxes, we have 1 child, rent our home and have 1 car. When I thought we might be able to purchase insurance I found out it would cost over 900.00 a month for a family of 3. No pre existing conditions because we haven't seen a doctor in 10 years because its not affordable.
We pray the Lord takes care of us everyday. My husband and I are both over 40 with a 10 year old son, my husband works construction and is constantly in back pain. What does this health care reform mean for us?


Commenter: Bleakia Whitten
I am for a single payer system or a bill with public option so gov. can let people buy into Medicare and Medicaid. I think the only way we can make health care affordable is to eliminate the health care system for profit and have a gov. run health care system where everyone pays into it like Social Security and Medicare. We need to look at other nations and correct the flaws than have a mandatory health care system. Health care is a necessity and the only requirement should be if you are sick. There should be limits and everyone should pay into it. Need to have sensible torte reform so Drs. will quit ordering unnecessary test but still protect patients from unskilled doctors. I would suggest we look at the Cleveland Clinic and other hospitals where Drs. are on salary and there is good oversight of their work. I do not favor any bill that increases profit for Insurance Companies. Health Ins. companies should be eliminated from Health care. The Health Reform bill now just enriches the Health Care companies and uses tax- payers money that should go to Health care not Health Insurance.


Commenter: JaneA
Health Care debate is heating up and in my opinion the health care summit going on right now should be an indication how divided two political sides are really are. I want any change I could get, but some regulations should definitely be set in place for health insurance sector by our government. People with pre-existing conditions being turned away is just not acceptable. And having no-cover because you can't pay for it is unacceptable as well. I work as a caregiver and my benefits are non-existent at this moment. Supporting caregivers and following the issue I came upon this blog post-http://tinyurl.com/ylgk8t6 and related to all the comments posted there by fellow caregivers. Everyone deserves a coverage no matter of their job, health condition or other factors.


Commenter: marie rossi
Where is info re pending legislation re aid for caregivers of acutely wounded?


Commenter: Ted in Richmond
I was laid off and had to resort to temporary insurance just in case something catastrophic happened. I was in a car accident (not my fault) and the insurance did a good job with the bills, but when I bought a new temporary policy the accident was no longer covered. My doctor, looking at x-rays to see progress of the shoulder injury I suffered, found a "spot". Fortunately it was non-malignant, but my insurance wouldn't cover it because it was a "pre-existing" condition from the accident. After I requested two investigations (the spot had nothing to do with the accident)they still denied me.

The American medical establishment has ruined my finances twice - and I am healthy!. Al Qaeda has had a much lesser, palpable effect. Pogo was right.


Commenter: Mollie
I was so touched by your coverage of the O'Reilly family and their struggle to get coverage for their daughter, Sophie. This program should be mandatory viewing material as the Senate debates the need for government run healthcare.

Thank you for featuring this issue and my thoughts and prayers go out to their entire family.


Commenter: Warren Daniels Buffalo, NY
We need reform. Corporate America cares nothing about us. Just two days ago Aetna announced that they were cutting Thousands of people from their plans and raising premiums. What we truly need is medicare for all. It is our responsibility to take care of each other. I am willing to pay a little extra in taxes to help have 100% coverage for everyone. My Daughter didn't ask for muscular dystrophy. Private insurance doesn't want her. Like this weeks now program I too had to choose to have lower income because of her pre-existing condition. As far as seniors are concerned we have a responsibility to care for them as they cared for us when we were young. A Single Payer health care system should be the goal for our health care system.


Commenter: imsg
I am glad your program focused on autism. This has unfortunately been neglected from congress on the healthcare bill although it is a medical condition. I am still awaiting my school district to pay me for speech, occupational and physical therapy expenses from September 2007, plus home applied behavior analysis therapy and autism program school tuition from July 2008 while my loans just pile up. My husband and I have stopped going on vacations except for four days in four years and generally avoid going out to eat. At least unlike others, my husband and I are both professionals and somehow we have managed to get the funds together to help our daughter, who at least now can tell us if she is hungry or needs to use a bathroom and she is learning other things to help with functioning that we too often take for granted.


Commenter: lael
I do not think that this episode of NOW was a good one. We all know that there are people who are struggling with their health coverage, however this family is not having as much difficulty as many. After all, their daughter IS covered by Medicaid, paid for by the taxpayers. Had the parents not let their insurance lapse, then they would not be in this situation. Also, medicaid is likely covering the whole family so why are they complaining. The father's self-serving statements that they would be glad to pay for insurance if they could qualify is disingenuous since he probably couldn't afford it if he is now qualifying for Medicaid.

One other point: if you are going to focus a program one one or two examples then you can't draw sweeping claims from that. This is anecdotal and not applicable generally. Someone needs to explain statisticss to you.


Commenter: R. Saunchegrow
3 words UNIVERSAL SINGLE PAYER

I find it ironic that the same politicians that dug us into the nation's biggest deficit are the ones that are sooooo worried about the price of making sure that every man woman and child has access to the possibility of life, one of our basic rights. The truth is that the only thing that these people are interested in spending lots of money on is killing people, whether it is from war or lack of affordable quality health care. Love the fetus hate the child is their mind set.


Commenter: Anton Grambihler
All Health Insurance needs to be provided by NON-PROFIT or NOT-FOR-Profit companies. Why should anyone be allowed to profit from the sick and dying?

Health Insurance Companies must not be allowed to cut special deals with businesses unless people paying cash or by Credit Card get the best deal of any made to a business. My experience indicates that payments in full from insurance companies are 85% of what the uninsured have to pay and the Hospitals/Doctors are willing to wait months for the Insurance Company Payment.


Commenter: Anton Grambihler
All Health Insurance needs to be provided by NON-PROFIT or NOT-FOR-Profit companies. Why should anyone be allowed to profit from the sick and dying?

Health Insurance Companies must not be allowed to cut special deals with businesses unless people paying cash or by Credit Card get the best deal of any made to a business. My experience indicates that payments in full from insurance companies are 85% of what the uninsured have to pay and the Hospials/Doctors are willing to wait months for the Insurance Company Payment.


Commenter: bill Murphy
Health care reform is being delayed by the oil/coal industry so that the global warming legidlation will also be delayed


Commenter: AARON BENEZRA
RE: GRIPPING HEALTHCARE STORIES FROM AMERICA'S HEARTLAND 12-04-09

Your story speaks repeatedly about "pre-existing conditions", but, makes no mention of "policy exclusions". Typically, "pre-existing conditions" are covered at the commencement of the second calendar year of insurance coverage. This is different from a "policy exclusion" which may for example exclude certain types of cancer. The family in the story probably could have covered every family member with a family policy, and while they would have had to pay out of pocket in the first year for the pre-existing condition of the daughter, insurance should have covered her thereafter. In the case of the elderly couple experiencing the policy change that did not cover the wife's cancer remission, it is not clear from the story, whether or not she suffers from a pre-existing condition clause or a "policy exclusion" clause. Both families admitted that their sufferings would not have occurred, had they maintained their original policies or not lapsed in coverage beyond the legal 63 day window for the change to a new policy. Even so, the system should be more humane, especially with respect to the coverage of extraordinary risk, as with chronic illness or possible remission of serious disease such as cancer.

Here are two ideas to add to the medical system reform idea bucket:

(1) legislate that Medicaid be available regardless of income to any member of a family of any size, when that family member is diagnosed to suffer a severe chronic ailment or extraordinary catastrophic ailment.

(2) encourage insurance firms to offer standard health insurance policies with a "paid up" first year option so that 'de jure' the policy commences in it's second year, such that pre-existing conditions may thus be covered. (Premium options could be created to make this "first year paid-up option" more affordable, such as a pro-rated monthly premium to distribute cost over the first year or over a more extended number of years.)


Commenter: Ric
I notice 70% do not favor Obama National Health Care reform plan. I also notice that EU doesn't provide any socialized health care, but rather their individual member States do. Most of the sovereign States making up our US currently provide safety-net health care coverage to citizens. Maybe it's best to keep the federal government out of it and allow our States to do their job.


Commenter: Thor
Safety net health coverage I believe is a State not Federal responsibility under our form of government. If you want the 'public option' ask your State to provide it, most already do. My State offers ACHIA health insurance for residents who are unable to get personal coverage, or are under insured. State insurance pools have been around for decades. Also ask your State to open up inter-state health insurance sales like they do for auto insurance. Ask your State to deal with tort reform. The federal government needs to focus on federal issues and 'public option' is not a federal concern.


Commenter: paul
Reform, is that what this is, on Tv I see a stack of documents. Where do these come from. I hear that the group creating this is composed of lobbiest, is that how all our laws are made. has any one person in congress read the entire bill. I suggest we keep it simple. It's too easy to hide things we don't need, ie earmarks in a 1000 page bill. Start with one thing at a time, don't pass anything that. Decide what americans want most then pass it. I heard it says that insurance companies only make around 2% profit. 2% of how big a number of dollars. How much of the bill we pay for health care goes to pay clerks and executives that do nothing but paper work. I saw on the news there's a docter in Sarasota Fl, who dose not except insurace. he charges $600 a year to patients and they can see him as often as they need to. I think something along the lines of each of us having money set aside for medical, and an insurace for big things.


Commenter: Singh
I vote for a public health care option.


Commenter: travisbaker
thats never gunna happen or do you want it to happen?he wants you so bad


Commenter: Daniel Sanz
This health care reform gives me big concerns. I don't understand why the American people have not be given the facts regarding this huge change, as well these secertive nightly meetings and everything happening on the weekend (another patriot act). I understand heterosexual families concerns about there families, well what about gay comunnity and their families? In this health reform single American will be mandated ,by the law, to get health coverage, if you choose not to get it the government will fined you or even send you to jail. Also single american prices will be much higher than hetero familie and seniors. This will impact the gay community big time as we are NOT ALLOWED TO GET MARRIED... meaning we will be paying more out of pocket to coverage you heterosexual families, WHICH IS NOT FAIR!!!! I do believe we all need better coverage and prices, but the new health plan is makes no senes to mandate extra expensie to Americans in these tough time... and i'm a liberal!


Commenter: Mari in Florida
J Aegeter:
Your comment that government health care is Communist makes my blood boil! So over-reactive and untrue. Just ask Europeans


Commenter: Mark Elam
Watched the show and was very disappointed. I was hoping to see a thorough review and analysis of the various elements of health care reform. The mainstream media has not really provided this. Neither did you. Instead, we saw tear jerker stories that just left us with the conclusion that "Yes, it's broken". Not enough fact based content on exactly what the proposals out there would do. Too bad.


Commenter: James In Atlanta
I was laid off a couple of years ago. My un employment compensation check was 178.00 per week. My COBRA payment was 1289.00 per month. My mortague payment is 1023.00 per mo., plus food and cost of finding gainful employment not to mention child care expences.

Do the math!

My family and I can not afford to get sick.

Our health care system in the USA is broken and it needs reform.

James In Atlanta


Commenter: James In Atlanta
Our present health system is broken. We pay more than any other developed country in the world for health care but rank 37th in quality of care provided!

Solution! Remove the middle men/parisites and insurance extornsists from our national health care system.

Problem: provide quality health care by the people for the people not for corporate profit and stock holders benefits and greed.

Result: The USA will have lower health care cost and be able provide better goods and services at more efficient cost to compete in the global economy.

In the long run the USA will profit by removing extorationalisttic practices by mega corporations that dictate national policy.


Commenter: J. Aegerter
Coburn is right on everything. A federal government plan will be out of control the minute it is legislated. The philosophy of insurance is the many help the few, and a profit is left over. A government program that makes everyone a winner with no losers, is COMMUNISM, which will make everyone "equally miserable". Harkin is a Communist, pure and simple. If there was personal responsibility, tort reform, and more competition, the problems would diminish completely. Since Medacare (and Medacaid), these federal government programs have caused the current situation. Everybody wants a free safety net, and the trial lawyers of which Obama and most of the politicians are who want to preserve the infinite malpractice lawsuits that line their pockets.A health care bill that mandates health insurance coverage is simply un-American and is what Harkin is behind. The Constitution says nothing about "Health Care", and the States (not the Federal Government) should address this issue. The current state of the United States economy and the wild spending of the Bush administration over the past 8 years is bad enough already without Obumma-Care.


Commenter: rev Owen
Why the insurance co are spending so much money to defit the health care reform program.why the senator and congree person have gotten so mush contribution from insurance organizations.


Commenter: Mark
his question is ill-posed. The more relevant question is: "which reform has a better chance of reducing costs â a public option, or a more competitive healthcare marketplace?"
First, I find it absolutely incredible that anyone would think a public option is going to reduce costs, without severe government rationing. Have you not been paying attention to the Medicare, Medicaid, and Social Security deficits? Have you not been following what is happening with rationing and cost over-runs in those countries that have universal government coverage?
The existing healthcare marketplace is dysfunctional. Let's fix it..don't kill it. A few basic regulatory reforms will go a long ways toward fixing the healthcare marketplace:
1. Enforce cost and efficacy transparency upon providers.
2. Reduce all barriers to insurance company
competition.
3. Encourage insurance companies to sell policies that ensure that consumer pays a meaningful fraction of any healthcare service (with the possible exception of preventative services). Consumers must have "skin in the game" in order to reduce costs. You could even imagine scaling the consumer copay with income level.
I fail to understand why our government is pushing us down the path to socialism while those countries that once embraced socialism (China, Russia, India⦠the list goes on) have been increasingly using market mechanisms to create booming economies. I don't think this is the sort of "change" the country had in mind when it last voted.


Commenter: Doctor Teacher
There's plenty of thoughtful remarks one could make about this program. However the comments of "TRUTH MD" are truly frightening. I know there are more insightful, caring, realistic and intelligent young people working toward taking the Hippocratic oath. This person, who had sufficient grades in the sciences to get into medical school, might consider a career away from the bedside. Perhaps pathology to limit the damage that might be done to the living.


Commenter: Afraid of the government
Whenever I hear our politicians say that a comprehensive single-payer plan will bankrupt the country, I can't help thinking that Americans are inadequate and have a low IQ. If other countries can do it (in fact the entire industrialized world), the only reason The USA can't must be because they just don't have the the intellectual muscle. That, or we are a morally corrupt country.


Commenter: Richard Heckler
Sen Coburn offered little in substance not to mention
the fact that he did NOT present any reasonable argument against single payer aka HR 676.

Go To: http://www.healthcare-now.org/hr-676/

Sen Harkin on the other hand presented an intelligent response that could provide points for debate. About 70% of the USA population elected Obama and a majority of democrats to provide the country with Single Payer.

The most expensive medical insurance in the world has had roughly 50 years to get it right. That has not happened.

The repubs have no intention of improving much of anything. They are the party of misrepresentation and obstacles. Not changing will increase the cost as it has done for the past 50 consecutive years.

Sen Harkin made a few points as to how medical insurance cost could be reduced. Sen Harkin allow me to present some points on that:

What will HR 676 and ONLY HR 676 Eliminate?
Go To: http://www.healthcare-now.org/hr-676/
* Eliminates high dollar medical insurance spending on what 2,000 health insurers add to --the actual cost of medical insurance:
-its bureaucracy
-profits
-high corporate salaries
-advertising
* over charges
-sales commissions
-Shareholders ! are the primary clients of for-profit insurance companies, not patients
-Special interest campaign dollars
-Golden parachutes


* Eliminates Politicians as shareholders:
http://www.washingtonpost.com/wp-dyn/content/article/2009/06/12/AR2009061204075.html


* Eliminates Insurers Wrongfully Charging Consumers Billions = BIG TIME CORRUPTION
http://www.washingtonpost.com/wp-dyn/content/article/2009/06/24/AR2009062401636.html

*Eliminates Leading Cause Of Bankruptcy
http://www.consumeraffairs.com/news04/2005/bankruptcy_study.html#ixzz0IQKZLHHh


Commenter: Richard Heckler
After two republican home loan scandals, medicare and social security are a blessing to those who lost their retirement plans in the process.

The problem is not about government insurance or that government insurance would be bad. It's about the high profit insurance business throwing tons of health care dollars at legislators who are influenced with money and plenty of it.

And it's all about legislators as shareholders....yes their personal money making portfolios. They are among those who love to make money off the misfortune of others. There are plenty of those types waging war against smart medical insurance. OH YES the nations shareholders are also a problem even though the reckless spending med insurance industry is screwing them out of big dividend dollars... the romance of Wall Street dumbs them down.

Medicare Insurance For All would be most attractive to small business,large business and familes/individuals. It's the only one that makes dollars and sense. It makes sense and would require much less money to operate because all of it could be done under one umbrella which saves money.

Medicare is in place ready to for all to use. Some fine tuning is all that would be necessary. HR 676 is the key
to fiscally responsible medical insurance for all.

HR 676: Smart Medical Insurance Improves Our Quality of Life And Our Wallets! http://www.healthcare-now.org/


National Health Insurance does not remove competition from the actual health care industry. It will be alive and well. Profits will be based on customer service and clinic performance based on the clients experience. This is my perception of competition.

This is the only insurance program that substantially reduces the cost of medical insurance across the board: http://www.healthcare-now.org/


Commenter: Richard Heckler
Smart medical insurance improves our quality of life and our wallets!

Our city government,small and large business would be money ahead with National Health Insurance/HR 676. Taxpayers would be money ahead.

Shouldn't taxpayers have the choice of Medicare Insurance For All? Absolutely!

National Health Insurance does not remove competition from the actual health care industry. It will be alive and well. Profits would depend on customer service and clinic performance based on the clients experience.

What coverage would Medicare Insurance for ALL offer?
* long term care such that cancer would require
* prescription drugs
* hospital
* surgical
* outpatient services
* primary and preventive care
* emergency services
* dental
* mental health
* home health
* physical therapy
* rehabilitation (including for substance abuse)
* vision care
* hearing services including hearing aids
* chiropractic
* durable medical equipment
⢠palliative care


The nations ability to attract or develop new industry is at stake. We're talking jobs jobs jobs. We're talking about the need for a new strong economy for 8 million or more jobs lost. Perhaps as many as 15 million new jobs that cannot be outsourced.

Is the most expensive medical insurance in the world good for business? No it is anti business.

All legislators protecting the most expensive medical insurance in the world are INCREASING YOUR COST of living.

Why is legislation so hard to pass? Special interest campaign contributions and legislators as industry shareholders.
http://www.washingtonpost.com/wp-dyn/content/article/2009/06/12/AR2009061204075.html


Commenter: simply angry
Senator Harkin stated on this program that health care reform must pass or people will be spending their own money on insurance/health care. Well let me remind the senator that government has nomoney unless they take it from you or me. So no matter what, people are spending their own money. The difference is, with health care reform, choice and freedom are gone...we are forced by rulers rather than representatives to bend to the will of the long arm of a government no longer protecting our liberty, but dictating how we live our lives. It can not get much more unamerican than that.


Commenter: Earlyn Walker
African Americans have long figured out that sometimes marriage is not helpful with the rules of social programs. Fathers are still in the homes. It best that is not known. The lesser of two evils it that they are thought of as dead beat dads even though they are very much present. There is not real healthcare reform. It is insurance care reform. That is reforme that cares for the insurance companies. We will be mandated to buy health insurance. The companies welcome the new income and have no problems with the mandate to cover everyone. What is not being mandated that they cover our medical bills, just cover us enough to collect premiums. This is more of taking from the poor to and giving to the rich.


Commenter: Elayne Pallist
I was disappointed that this program doesn't cover single payer, one of the bills proposed by NY Congressman Weiner. Please cover this efficient, economic option that Congress will not take seriously.

Additionally, I would reiterate Senator Tom Coburn's call to all Oklahomans who are sick and can't afford their medical bills to visit the office of their Senator for free medical training and advice on how to best approach their neighbors in asking them for financial help with their medical bills. I'm sure there are enough wealthy Oklahomans who would be willing to make some charitable donation to this worthy cause, thereby relieving the U.S. Government of the burden of providing affordable healthcare to its citizens.

If this strategy is successful, we will eliminate the need for Social Security and Medicare/Medicaid as well.

And as the local citizenry gets involved in paying for their neighbors' healthcare and retirement, they should also consider repaving their own streets, opening their own libraries, policing their neighborhoods, putting out their own fires and... oh, never mind.


Commenter: johncappola
Your broadcast on NOW focuses upon a vicious characteristic of the health insurance companies. If you are old, you have Medicare. If you have a chronic condition, you have Medicaid. If you are either young or old and have a preexisting condition, you have bankruptcy.
Our quality of life is dictated by these institutions. And then we support them?


Commenter: Jasdeep
The cruel face of In human marketing brains working against humanity.The people sitting on high chairs in Insurance companies who bring these kind of policies denying people of the basic need to understand the pain they cause to families as shown in video just for their swollen pockets.

I hope HC reform sets a milestone for the coming age of civilized America.


Commenter: Ola Nordmann
America you could reorganize your national budget and spell it out for everyone to see where each dollar goes. This is a commonsense approach any family would take to see how much comes in agaist how much goes out.

Education, Health, Innovation, are things worth investing in.

Military expenditures (how much do you spend on it compared to the above by the way?) could be reduced to other productive areas. Remember America Education and Health is a good investment.


Commenter: rhodes
A lot has been said about paying for universal health care .. We are are paying for it now we are doing so in the most inefficient way possible and the largest burden falls on the people that are least able to pay .. As I see it .. when a poor person buys nearly anything a part of what he pays is health care costs that have been passed on by corporations I have heard it quoted that the average new cars price includes 1500 dollars for health care .. Every person that pays taxes is paying for the health care of senators and congressmen as well as other government employees including the military .. Is this fair when a tax payer has to pay for health care that he cant afford ??
If you took out the profits of the insurance companies and the excess profits of the drug companies and redirected all that money we would have enough money to pay for universal health care â¦
There is talk now about forcing everybody to buy health insurance .. As I see it this is the biggest windfall that the insurance companies have ever had ..if you really intend to give everybody coverage what do you need an insurance company for ???


Commenter: big white elephant in the room for all of your reports...
Who did they vote for? Isn't that the point? If you don't have health care and you vote republican then you're on you're own. Don't complain. Who did they vote for and why in 2000, 2004, 2008?

Who they vote for matters. Isn't that the whole point? If not, what is the point?


Commenter: Dan
I love PBS but the reporting on the first segment was really uninformed. The first family your corespondent interviewed said they were offered a group plan through the wife's work place but for some insane reason thought buying an individual plan would be a good idea. When they realized an individual plan wouldn't cover their daughter, they could have just taken the group plan since that kind of plan can't deny someone for a pre-existing condition. Or they could have gone to work at Home Depot or ANY place that offers a group plan and gotten coverage. The husband of the second couple lost his job, but shouldn't have lost insurance since he should be able to go onto COBRA. But the reporter fails to mention this. Overall, the piece was devoid of facts and seemed like it was trying to make a case through an emotional appeal. Given how little Americans know about healthcare, I would think the piece would have been a bit more educational.


Commenter: Kirit Patel
We are worried about $800 billion over 10 years for public option but there is no discussion about more than $6 trillion that the insurance industry will rake in over the same period. Spending $800 billion to eliminate $6 trillion sounds like cost reduction to me. No wonder insurance industry is opposed to the public plan. We need to publicize the trillions of dollars insurance company will charge and still n ot provide protection when needed. Insurance industry is extorting trillions of dollars from American public. Why is this fact not discussed by anyone in the media.


Commenter: Thomas
I watched your presentation and noted how biased your interviewer went after Colburn.
She seems very unprofessional in her biased approach.
If she is not neutral, she is a disgrace to the journalistic community


Commenter: Mary Barnekow
I like your program on the problems with trying to get health care insurance when someone in the family has a "pre-existing" condition. I was appalled that the family in Denver could not get health care and have to rely on Medicaid for their kids.


Commenter: Matt Young
Last night's NOW special truly delivered on an angle all-too often neglected in other media coverage of health care reform. Indeed, showing the absurdity of the Tulsa, Oklahoma family's choice between insurance coverage or Sophie's survival really highlighted how short our system falls in holistic health coverage.

While state-run Medicare-equivalent plans, such as Oklahoma's, do curb otherwise extraneous costs for lower-income families, these are by no means an end-all solution. Where health care is a human right, and any step in the directions towards universal health coverage is considered, why would we want to deny a true "right to life" for our fellow citizens.

As for Sen. Coburn, I appreciate his outlook, especially my canvassing background on the health care issue. Nevertheless, I'd like to ask Sen. Coburn how he would go for comprehensive health care reform without long-term investments in a publi option equivalent plan(?)


Commenter: Mram
Insurance companies should support Public Option for a very simple reason.

If Insurance companies cannot deny coverage for pre existing conditions, they can increase the premium enormously to force the customer to go to Public option. There is nothing in the bills, as far I see, that premium shall be same for healthy individual and one with pre existing condition.

So every one with pre existing condition will go to public option, if the insurance companies increase the premium, and get the tax payer to pay for all the pre existing cases.

Wouldn't it benefit Insurance companies enormously to make huge profits just by covering healthy customers !!!


Commenter: elliott
Thank you Mark and Frank for telling it like it is! The public just doesn't realize that most of the problems we have now are caused by the private sector--not the government. Doctors daily see very sick patients whose treatments are denied by private insurance companies. Even though the doctor thoroughly documents the need for a particular treatment or test, he/she is overruled by someone with little or no medical knowledge following a "one size fits all" list of instructions. People who thought they were paying for good coverage can die because it often is the case that the only "benefits" are to the company selling the insurance and collecting the premiums. I worked at a hospital where it was determined that a teenager was at high risk for suicide. His family's insurance company denied his transfer to a specialized facility where he could get the care he needed. Reason for denial? He hadn't yet attempted suicide. Well, he subsequently tried--and succeeded on the first try! His medical team grieved and his insurance company probably gave collective sigh of relief. As for the physician in training, I can only pray that he changes his field to pathology.


Commenter: Sarah DiAngelo
Voting Results looked VERY SKEWED.

It looks as though many people who are opposed to health care reform voted against an increased tax and voted no Obama's health care reform. Other votes showed large majorities in favor of the more "liberal" version.

Or maybe Americans think they can get everything without paying for it. Very sad commentary.

I'm for single payer; I will accept universal coverage in any meaningful format at this point.


Commenter: Frank
As a practicing physician, I am disappointed by the physician in training comments. In many respects, the comments about "worthlessness" of care for the very sick and elderly indicate the value of life arguments that became the prevailing political thought in Germany in the 30's and 40's.

The physician in training should recognize that a large part of his/her training in medical or osteopathic school is financed by direct and indirect government funding and his position in medical school could be filled with someone with a better understanding of the duties and ethics of a medical education. Many physicians see the problems with the current health delivery system. Sad that this medical student lacks the basic understanding of disease, human suffering and the medical care needs of this society.


Commenter: yolanda
Everyone know we need health care reform....but this congress act like they work for big businesses and not for THE PEOPLE or the small businesses. They seem to believe that it's ok to save AIG and not us. What a joke.


Commenter: Ken Viste
The question of cost is always used to oppose anything. For health care the issue is who pays. What is the cost of having 45 million uninsured. When someone goes bankrupt because of medical costs there is a cost to society because creditors lose. How do you post the cost of the life of a teenage girl that dies because the insurance company denied her life saving treatment? How do you measure the loss of the lives of 25,000 who die each year for lack of medical care? The only cost that seems to matter is the tax that some wealthy congressman will pay.


Commenter: roy norton
I believe the best way to reform health care is within
our current Medicaid program. I believe everyone should
pay some amount for individual or family health care.
Make it optional for low and middle income workers to
have their employer withhold an equal amount for health
care as to what their income tax obligation is. Those
who opt out would not be covered under this plan. But it could be made mandatory for those who are uninsured.
I believe newly graduated Medical Students should be
encouraged to serve in primary care roles for four to
five years before entering private practice or special
services.


Commenter: Malinda
I expected more balanced reporting on this issue. I was very disappointed. The reporter interviewing Senator Coburn had no interest in hearing the economic and financial side of this debate, which centers on the growing deficit. Instead, she wanted to focus on the emotional side of the debate, which centers around the experiences of the uninsured and the underinsured. Both sides of the debate are important and deserve attention. I am not a frequent viewer of PBS programs and will not be inclined to turn to PBS again for informative reporting. You undermine your credibility when you choose to ignore certain facts.


Commenter: Mark
As a physician I am heavy hearted when Iam unable to deliver the care a patient needs because the restriction of insurance bureaucrats whose primary purpose is to save money; not to cover more people but for the sake of profits. In the current debate on healthcare I become baffled by those who suggest that a public plan would be putting the government between the patient and the doctor since it indicates that some may not be aware that the current system with insurance companies.

There are those who indicate the cost of the plan would run the government bank rupt but seem not to be aware that the current system would do the same but much sooner. When an individual visits the ER rather than their primary docotor's office, the bill is passed on to the tax payer.

There needs to be more education injected into the debate but that is tough to do when the people who oppose encourage their constituents to hinder any such attempt.


Commenter: Tom D'Ambrosio
A brief observation regarding Sen. Cobern's assertion that "government funded healthcare would bankrupt this country."

This is where "follow-up questions" are important.

"Government funded healthcare would bankrupt this country?" Why?

The obvious answer is because of skyrocketing medical costs. And why are those costs so high? Because of insurance overhead, bureaucracy, and our for-profit medical industry.

In just about every country with a government funded healthcare system, the solution is to requires all medical services to be NON-PROFIT (or to cap profits).

Before anyone argues that this would limit innovation and hinder research, might I point out that it was only yesterday that Thailand... with its socialized healthcare system... developed the worlds first HIV vaccine?

What was America's most recent breakthrough? A *cosmeceutical* to grow longer eyelashes (I wish I were joking).


Commenter: Sandy
Obama's plan is just an expensive, complicated way to extract our money to support private health racketeers. We need IMPROVED MEDICARE FOR ALL, the all-American plan. Tell your Congresspeople to drop the GOP looneys and corporate bribes and vote for the Weiner Amendment in the House and cosponsor S703 in the Senate. Everybody in, nobody out!


Commenter: Penelope
I was so disappointed in Sen. Coburn's response. He just doesn't seem to "get it" ... sure I would love to help my neighbors, but I'm not a doctor and I wouldn't have the expertise to be able to do much for them. In any case, this would not solve our problems.

The Republicans have become the RepubliCANTS ... all they seem to be able to say is NO .. or "scratch the whole thing and start all over again." I haven't heard one constructive idea from any of them.

Meanwhile people are dying, losing their homes, declaring bankruptcy and generally living in fear. That is the greatest health system in the world? What is this, a third world country?

Shame on them!


Commenter: Pamela Nathe
Thank you for an insightful and well-produced program. You certainly brought many of the important issues to light.

Hopefully this will help our country to achieve a saner and more workable health care system which is affordable and which covers EVERYONE!


Commenter: Kathy
Thank you for a thoughtful program. I get tired of hearing Republicans say that we have "the best healthcare in the world". We don't. Wake Up! 42 countries have better life expectancy than the United States. Many countries, with government healthcare spend less than half of what Americans spend on healthcare.

Other countries care more about their citizens than we do---where so many claim that they are Christian!


Commenter: E. Rivers
Very, very poor program. It was an excellent example of "the elephant in the room". You want to show us how you're exposing the key issues of "Health Care Reform" and you don't even report on the health insurance agencies. Not even an interview with Wendell Pottle. NOW has really gone down hill.


Commenter: kathleen
On your recent Health Care special I was disapointed in the questioning of the republican senator. When he stated that the US has the best health care in the world, Maria should have reminded him that we are actually 19th in patient care and near the top in deaths from medical errors. Why did she let him make this statement without challenge? The US should look at countries that are sucessful in treating their residents, like Japan, France and Italy, countries that are in the top 5 world wide.


Commenter: Roberta
Enjoyed the program but I do have a strange feeling that the editing was done to favor the existing plans being discussed. You did a good job of making Senator Coburn look bad, which I know he is not, and the Senator representing Kennedy's Bill look very favorable. However, so far, your own polling doesn't seem to favor President Obama's plan. We NEED Reform -- no question --- but I don't feel there has been a fair debate on how to get the reform that will be lasting. Instead we are being force fed ideas and solutions that are confusing to most and disturbing to many.


Commenter: Shirley Shaw
I am 70 and not in favor of health care reform as defined by the goverment.In fact I am not in favor of the Obama goverment being in charge of anything.The stimulas is not working even though they would like to spin that it is.They want tax and trade which would raise everyones taxes no matter what they say.Then there is globel warming.A weather man on the Weather station said it is a hoax.We are suppose to beleive the goverment? I don't think so.We need to get rid of tort reform in all states.


Commenter: Flora
I like the combination of angles you took, weaving business and social and political commentary around a single topic, especially one that is so important and misunderstood by many. Doing a better job of the private health insurance industry is key to health care reform, but that doesn't preclude the need for a government-run option as a safety net.


Commenter: Mom of One
Thank you, PBS, for providing a detailed program with both sides of the issue. It is so necessary to get the facts heard and squelch the fear that is being created. Really, does the senator from Oklahoma expect everyone with the problem his constituent had or one of equal complexity to A) turn to a neighbor (who might also likely be in a difficult situation) or B) show up at his office to ask for help? Please, that is so unrealistic and clearly shows he is unaware or unconcerned of the scope of the problem that exists. Many people have health insurance they are happy with, I'm one of them. But the cost yearly of paying steadily increases at least 10% each year per insured, that's if you aren't ill. If there is concern about paying for all of this reform consider where our children and grandchildren might be if they have to file for bankruptcy or lose their home because they had to pay for their medical claims because insurance capped it or denied coverage (if they are lucky enough to have coverage)or make the choice to save any hard earned money(in an effort to save their home or eat) and not get care, risking their lives? I have spent time in the insurance industry as an employee and understand health policy, been denied coverage for a previous cancer at age 28 as an independent seeking insurance outside of an employer health plan and now pay outrageous rates to cover our own small group employees. I've seen many sides to this issue. I believe the misconception is the idea that if you are well you are untouchable. But get ill and you could easily be in the same situation as those you hear struggling desperately now.


Commenter: JOHN
WE NEED REFORM


Commenter: Brooklynn
I appreciated the in-depth healthcare report that was aired tonight, thursday September 24th. Where can I find out more information about the people that were reported on in the story?
Thanks.


Commenter: John Wojakowski
To PBS regarding your one and a half hour program reporting on healthcare reform:

As an informative report this program was a good piece of propaganda for government takeover, beginning with emotionally colored situations and logical fallacies. It also used scare tactics.

Let me document. The opening story which ran one-half was designed to target the heart and not to inform. Centerpiece to this was "that the pre-existing conditions are at the center of the healthcare debate." This is patently untrue, because there is no debate but rather as you later admitted, there is widespread support from Republicans and Democrats to eliminate pre-existing conditions in any healthcare bill. This opening story ran a full half-hour, longer than the time given to both US senators. A strawman was set up in the quote from the mother of the little girl that she thought everything would always be covered, and from her mother that their insurance would cover any medical emergency. Scare tactics were used when a doctor talked about many bad things might happen to anyone. The solution for everything was given as a government program.

No time was spent delving into Sen. Coburn's statement that has proposed government healthcare would bankrupt this country. The GAO has made a compelling case for the coming insolvency of the program, which obviously must provide promised benefits to the large number of bay boomers. Some have likened this country's situation with Medicare to that of General Motors 15 years ago, and we know the outcome of that situation. This problem is the real crisis in health care. It is the big red truck that is bearing down on the economic stability of this nation.

The current Medicare financial problem, though being funded by taxes on workers, is also one of rationing. Currently there is a shortage of doctors willing to accept new Medicare patients. Many have a limited number that they will accept at the first of each year. Additionally Medicare rations benefits to retirees. Medicare will not cover treatment just because it is medically necessary. It must be approved by them. (I know this from personal experience with my wife's condition.) The financial situation of Medicare and its rationing of treatment need to be addressed before adding millions of people to any government health care program, because it is in the national interest. The US government and this country are currently going in debt because of overspending. This is not the way to prosperity that can benefit everyone in the country.

I had caught the program after the first half-hour, and I was afraid from the last hour that I saw that the first 30 minutes would not really delve into the problem and be a bit one-sided. When I did see first 30 minutes of the program I found I had underestimated how much it would miss the main points and be slanted toward the liberal agenda.

All the above leads me to conclude that this is a sham of a report.


Commenter: Steve Osterday
My daughter is a type I diabetic. My job provided wonderful coverage until she turned 23, then we paid for CAL_COBRA for 3 years.

SHE WILL never BE ABLE TO GET HEALTH INSURANCE COVERAGE.

She currently lives and works in San Francisco, Ca whre the county has a public health Program.

The struggling parents of children with chronic illnesses you are interviewing, will have their worst moment when their child is too old for whatever coverage they now have!


Commenter: m elliott
To Senator Coburn: It must be nice living in your world. But here on earth, food pantries and helping hand organizations exist in churches all over the U.S. Most of them are overrun with requests for help. And, by the way, there is nothing wrong with Medicare or Social Security--except that its getting ripped off by the lobbiests who ply the members of congress with financial support and other goodies. Who do you have in mind from the private sector to run our health programs? Perhaps you have some executive friends from Enron, AIG, Lehman Brothers, etc. in mind. At this point, I'm far more afraid of the private sector than of the government.

Since you have such faith in big business, I challenge you to give up your congressional insurance benefits and pay for your own healthcare. You can certainly afford to do so. As a matter of fact, funding healthcare wouldn't be a problem if congress would give up some of its perks and pork.


Commenter: Norm Spier
As a careful, mathematical type (statistician), I've been aware for over 10 years that the risks of financial bankruptcy due to pre-existing conditions for the middle class is very high, even for responsible people who save hard and always try to maintain health insurance.

Last year, I actually went through state-by-state, to assess the danger, for people with very substantial middle-class savings who always responsibly attempt to maintain health insurance, and found even these people have risks of medical bankrupty due to pre-existing conditions gaps in 23 states if they don't ever try to move to another state, and in and 36 if they do try to move between states. (Details, here, if interested: http://www.nastechservices.com/HealthInsuranceUSATable.html ).

I am glad to see the country finally catching up to me in the realization of the risks. I certainly hope the effort to really form the most ridiculous health care system in the industrialized world succeeds.


Commenter: Eugene Simon
Trust the Government to run a heath care system. One only has to look at the track record. A social Security System and Medicare System about to go belly up in a few years is evidence of failure in Govt. management. We as a country can not afford to give away good paying jobs that can support a well managed health care system and at the same time spend billons each month to be the Worlds Policemen.As a start, lets get the Troops out of South Korea. After 50 years on the DMZ, the S. Koreans should be able by now to take care of themselves. The 30 thousand troops could be retrained to fight the Worlds terrorists. Think


Commenter: Jeff
In one of my dreams I dream that every U.S. Senator loses their health insurance and has it replaced with the health insurance that average Americans have, that is if they are lucky enough to have insurance. They need to feel the heat and live the fear that their constituents do. This might knock a bit of sense into some of their thick, stupid, paid off by special interest groups heads.


Commenter: Paulette Grills
I really could not believe what my ears heard Doctor Senator Coburn, R-OK, practicing physician say. I was flabbergasted, shocked, dismayed and then just plain 'ole angry!


Commenter: Billy
I believe that all Americans should have health care and should not go bankrupt because of sudden health problem.

This country ought to put people first and politic should stay out of the way of this necessary reform.


Commenter: Truth MD
Some observational points as a physician in training:

1.) Healthcare dollars are wasted on the elderly. Wasted meaning keeping them alive just to please family members who cannot accept death.

2.) People want other people to hold their hand at all times. Senator Coburn makes a brief point about how a feeding tube requires minimal training. Much care can be transitioned to the home environment as long as the patient and family/friends are willing to take responsibility. A 24/7 nanny for every chronic illness is not possible.

3.) Basic national insurance should cover young able bodied individuals in catastrophic events. If you really support socialism, then you only support the greater good of society a.k.a young healthy people, not those who place burden on the system.

4.) Cancer is not your fault or can be, but it is certainly not the general publics fault. So why should we pay for futile care in many cases when comfort care should be the focus? Is an extra 2 years of poor quality of life worth thousands of dollars? Probably not, but we do provide care because of illogical cultural demands.

5.) Americans want to live fast and hard, but don't want to die hard when it comes time. This is the essence of the problem. Fat, lazy, parasitic people developing chronic illnesses which transform into major complications that inflate healthcare costs. Why are individuals not responsible even it means letting them die? A hard lesson, but apparently necessary.

6.) Physicians don't drive cost. How is it my bosses haven't see a salary raise over 15 years (inflation adjusted) while their administrators with useless business degrees (yes utterly useless) get promotions? All charges have provider and facility costs. The provider portion may only be 1/5th of your bill. The hospital may take the other 4/5th. Look at the breakdown, and see who is really ripping you off.

7.) Tort reform is necessary. If a physician didn't ever have to fear consequences of missing that one test, then we can cut down lab and test costs. It will never stop until that is done. CYA from trial lawyers. It dominates how we talk to people, document, etc. which affects efficient delivery.

I'll add more as I think of it


Commenter: Cranston Smith
27 countries have a lower infant mortality rate than the U. S. 42 countries have a longer life expectancy than the U. S. We spend more per capita and a higher percentage of of GNP than any other country on disease care. We have the best government money can buy but not the best health care. We need to embrace the complimentary and alternative systems, especially homeopathy.


Commenter: diana relke
I know I will be accused of that typical Canadian quirk -- our feeling of "moral superiority" over Americans. Mea culpa. But I just have to say that I cannot understand this American healthcare debate. With so many different healthcare models on this planet, why can't you just pick one fer crissake! Anything would be better than what you've got. You wanna get personal backruptcy under control? You wanna get consumer spending back up? Get healthcare costs off the backs of your consumers. Or would you rather just do another Republican-watered-down expensive stimulus package that will have a short-term impact and add another few billion to your national debt. Your situation really does look ... well ... American from the Canadian perspective.

Yes, there's a problem with our healthcare system -- and it does have to do with government control -- namely, that funding for healthcare can be slashed whenever the NAFTA-obsessed business lobby insists that Canada is going to hell in a handbasket unless we dump our "entitlement" programs and invest more in our corporate welfare programs. That happens whenever the political mindset lurches to the right. But that's a problem for us, the people, to fix -- not a bunch of sleazy health insurance companies. It will mean getting mad, getting off our butts, writing letters, organizing. That's called democracy, and we're as bad at it as you are.

I found this hour-and-a-half excruciatingly painful to watch -- especially the idiot politicians that got interviewed. They don't even have to wear badges announcing which lobbies own their souls. I could not help recalling Michael Moore's *Sicko* -- especially the stories of New Yorkers who volunteered after 9/11 and then got screwed because the toxins they breathed in ruined their health, and they had to pay $100 for an inhaler worth less than a buck. That just makes me wanna cry.

The bottom line is this. The U.S. spends double what Canada spends on healthcare. We should be spending more to bring the system back up to where it was before we signed NAFTA. But we are still all covered and don't have to ask the neighbours to stand in as nurses. YOU SHOULD BE PAYING LESS, even if that means driving some of those heath insurance sheisters out of business. Get civilized!


Commenter: Jim Pfander
Great program. Insightful and frightening all at the same time. Have a question: four things which can be controlled for better health--tobacco, exercise, tress...what was the fourth?


Commenter: Joe Kmoch
I just saw a good portion of the PBS Special Healthcare Reform. I noted at the end that I could purchase it for 24.95 on a DVD. I truly believe as a public service you need to immediately make this freely available on your website as a streaming video as well as the full show on a downloadable file to be able to play on iPods, at least, even just the audio. This was incredible and it needs totally much wider viewing than it will if hidden behind the cost of a DVD, particularly in this electronic age. Thanks for reading and I hope it becomes available very soon.


Commenter: Anne
Your program on healthcare was a 90-minute commercial for the democrat plans. You did not give a fair shake to Tom Coburn, your attitude toward him was quite negative, and you are a cheerleader for Tom Harkin's poition. I wish your program had been more balanced in its presetation of the various options for changes to the structure of health care marketplace and explain the logic and reasoning supporting alternative proposals.


Commenter: Marcela
Watching 13 and stunned: Who is U.S. Senator Dr. Tom Coburn and why is he in the Senate????? He is Oklahoma's SS Dr Menguele... I seriously don't believe what I just heard, even the interviewer's jaw dropped...


Commenter: Gil Neveaux
I am fliping between cspan and PBS tonight.pbs gives me a face to the problem.CSPAN giving hard numbers and policy.It's a tuff choice to see what we need and the reality of what will be.The problem with watching Cspan is a few given power over the many.The problem with PBS is its good on the issue but by watching CSpan fails on what the public should know on the policy and how its being voted on.sorry PBS not only is Cspan informing us but giving us real time updates on how health care reform will be enacted as it moves through congress but,thanks for playing!


Commenter: Douglas
The pre-existing condition concern can be resolved by mandates that prevent PRIVATE insurers from refusing coverage on people with pre-existing conditions. It does NOT require a government run healthcare program.

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