Health Care In America . NOW on PBS

Find news, information, and analysis from America's most trusted and credible media sources.

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

Is Your Daughter Safe at Work?
An unprecedented broadcast investigation of teen sexual harassment in the workplace.

Who's Helping Our Wounded Vets?
America's new wounded warriors—Why are their family caregivers overworked and under-supported?

Nurses Needed
Investigating an urgent health care problem—a critical shortage of nurses.

Surrogacy: Wombs for Rent?
Are babies being bought and sold in the United States?

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?

NOW: Quality of Health Care
How does health care in your state measure up and how much could quality of life be enhanced if your state improved its health care system? Use our map to find out.

PolitiFact's "Truth-O-Meter": Statements on Health
Are death panels real? Will the Dem's proposal let you keep your insurance? How many uninsured are there really? Uncover the truth behind statements from politicians, pundits and the press.

"Reality Check"
The White House offers their perspective on health care reform issues.

Daily Show: Healther Skelter
As the town halls heat up, host Jon Stewart pokes fun at both sides.

Frontline: Sick Around the World
Can the U.S. learn from other countries to improve our own health care system?

NPR: The Language of Reform
How both Democrats and Republicans are using creative language to frame the health care debate.

Religion & Ethics NewsWeekly The Ethics of Health Care Rationing
Is it ethical to 'ration' health care? Doctors talk about some of the painful decisions they're forced to make.

Commenter: Ian MacFarlane
We need a public option, perhaps modeled after that of France or Canada since the full socialism of England's plan would put too many people off and give the nut fringe too much ammunition. However, we must not shy away from the need to raise taxes sufficiently to pay for the plan. We would actually save money by not having to pay the excessive private insurance company costs.

I have never understood why our legislators will not simply insure we pay for the laws they create. You decide what you want and need and pay the going price for the product you eventually purchase. You don't simply turn down what you need and just go for the cheapest option every time. They would not buy a car that way, why run a government that way?

Commenter: june marshall
We need a Public Option. Everyone should be allowed to obtain Medicare. And if you want to keep your private insurance, keep it. It is the insurance companies that don't want a public option. We need health care like Canada and the Scandinavian countries. This health care bill is not going to help the people making low wages. I heard on TV one big part of the bill was to make sure the rich kids can stay on their parents policy while they get their PhD's. How does that help the 19 year old working part time and going to community college. Since he cannot afford to pay and go to school full time, he is not entitled to this benefit, because he has to be going to school full time. This is just another plan to help the big shots, and the little guy will pay more in the end. I am a Democrat but believe me I can flip flop just like these politicians.

Commenter: Jeff Struthers
A C-span interview with the CEO of a major modern urban hospital succinctly revealed the root cause of the inexorable rise of health costs. No, its not fraud, the big, bad insurers, or the single-minded pursuit of profit. Its the competitive pursuit of excellence...the desire to offer us the finest facilities and the latest technology, and to recruit and reward the best medical teams and provide them the finest professional environment. We the consumers are the beneficiaries of all this, and we love it. The problem is, of course, that we can no longer afford it. And we haven't been for some time. The insurers have made it look all too easy; affordable insurance has blinded us for decades to the runaway character of these costs. Now, the sound of popping circuit breakers is becoming a roar too loud to ignore.

Government reportedly currently pays for half of all health costs. Potentially, that gives the collective "us" enormous market power to effect change. Unfortunately, we have been a very passive buyer. Wiser use of our collective power can constraint costs and motivate efficiencies, though the solutions might come best from the providers themselves. We're all riding on the same sinking ship, the providers all know it, and they're the ones with both the motivation and the expertise to fix it. Our job as consumers and taxpayers is to demand incentives for change that are challenging, clear and firm.

The will that is needed is our own, not to ration some "them" or "other" group, but ourselves. No painless solutions, but progress seems certain if we demand changes more in keeping with our demographics, focusing on outcomes, motivating disease prevention, and finding sustainable means of delivering quality chronic care.

The solutions are there, we simply need to let ourselves see them, and to act. If we don't, finding who to blame is as easy as finding the nearest mirror.

Commenter: fritz
fixing america's ailing health system begins with only two changes; Single Policy and Outcome Payment.
Administrating one single plan, common to all americans could not possibly, -possibly-, be more expensive than the current cost of administering hundreds of different plans among dozens of carriers devoting as much effort to avoiding payments as administrating coverage. Paying providers for treatments which are covered, yet inneffective or unecessary is also profitcentric and detrimental to the patient and the effective use of limited resources, as well.
but, perhaps most important of all, is the need for media to parse- with meaningful results -fact from fiction. The old saying "silence is consent" is never more true than when media allow patently false and self-serving statements and assumptions to exist.
If the public is able to understand a well-crafted lie, then certainly they have the ability to understand proof of truth. That the public has overwhelmingly failed to recognize the difference between fact and fiction does more to describe the overwhelming failure of media to fulfill it's primary
function.

Commenter: Dawn
Let an 'average' person write it so that everyone can understand it!

Commenter: Martin Ball
'Health Care for Profit' is an oxymoron!

The Health Insurance Industry is not designed to help patients. The Health Insurance Industry is designed to make profit. Stockholders are the Health Insurance Industry's primary clients; not patients.

Hence; raising premiums, increasing deductibles, increasing co-pays, denying service, and refusing to cover pre-existing conditions are not in the patients' interest. All are practiced to Maximize Profit for Shareholders; the industry's true client.

Example: No negotiation on Medicare prescription cost!
Is that in the patient or stockholder best interest?!?

'Health Care for Profit' is an oxymoron!

Most doctors, nurses and other medical personnel are dedicated professionals, striving to 'do no harm.' For-Profit Health Care System is the culprit. From the patients' point of view, the 'system' is not fair; the 'system' needs reform.

I think the proposed Health Insurance Reform, giving all patients a not-for-profit public option for health care, (where the patient is the primary client) is needed to help offset Health Insurance Industry's profit-centered practices.

What do you think? ...Tell your congressperson:
http://www.usa.gov/Contact/Elected.shtml

'Government That Works'
Martin

Commenter: Ron
Two problems with health care programs including the PBS NOW program is that the people profiled are never asked who they voted for in elections. If they voted for Republicans then maybe they should not get help, that is what they voted for.

The second issue is that only women and children are spotlighted. Everyone is concerned about them but never about men. Women always say the health system is broken for "families and children". Does any politician ever say they met a man who needs health care and we need health care reform for them? What about single people and men?
I have paid for insurance most of my life for myslef, two wives and two kids. Now, I only have a high deductible plan that has no co-pays until the deductable is met and with exclusions. No help for me.

I'm all for national health care and it should be a single payer system which has proven to work in many countries. People who vote Republican really don't deserve care because they oppose any national plan unless they personally have a problem. Medical care must be a service model not a for profit model.

Commenter: Kari Cruze
All this health care debate angers and saddens me. While I and my family have adequate health coverage, it is only because my husband is Active Duty military. If we did not have this coverage we would not be able to afford it and would most likely make too much for medicaid for our children. And even if we did qualify for them, we wouldn't be able to afford any for ourselves. My own sister, who is a single mother, goes without health insurance for herself because 1) her employer doesn't offer it and they are too small to be forced to offer it. 2) She makes too much to qualify for medicaid for herself and she only makes 10.50/hr. If she made less she couldn't support her two girls. 3) There is no way that she can afford insurance herself on what she makes. She recently had a health scare where her doctor suggested she have an MRI done. She couldn't do it. For one she would have had to come up with 10% first, and pay the rest in payments. The cost of the MRI? $6000.00! Luckily for her it turned out to not be serious enough to warrent the MRI. We hope anyway. Hopefully a year or two down the line it won't turn out that if she had had that MRI it might have saved her life. She is basically playing russian roulette with her health. Why can't our Government just come together and find a solution without fighting about it? And why can't we look to other countries and learn what they did right and do it here? I really wish we could settle this soon. For my sister and all others out there whose very lives are in jeopardy each day because they have no health care or it is woefully inadequate.

Commenter: Rebecca Hale
I'm a registered Democrat, age 60. I believe that obesity and its comorbidities is the scariest looming healthcare crisis. I believe in personal responsibility and that obesity is largely a lifestyle choice. I don't want to pay for the consequences of lifestyle choices from smoking, over-eating, over-drinking, drug abuse. Just in the last year there has begun to be a public discussion of obesity--it was un-PC in the past. People my age will bankrupt the healthcare system if there aren't more carrot/stick measures to curtail this problem such as counseling for a time, then expectations that people maintain an acceptable BMI in order to not face a premium increase. Increased taxes on soft drinks and other junk food--this wouldn't punish people who can eat cheaply on a McDonalds hamburger--I understand the problem of low-income parents who don't have the time or energy to cook lentils, rice, and swiss chard after a long day pumping gas or washing dishes! Like cigarette taxes, it would raise revenue to pay for health maintenance. Let's use these revenues to help low-income, working class people with lots of stress in their lives--no breaks for middle-class, privately-insured donut divers! Fitness is patriotic. Fitness is fair. Fitness is generous.

Commenter: William Hall
I am still convinced the only real solution that would solve our health care problems is a single payer system but have little hope that it will ever happen until we change the way we fund election campaigns that give all of the power to the lobbyists that now control too much of what our legislature does.

Commenter: Rod Lynch
I'm a long time fan of your News hour program and pro-American. Can you please get one of your journalists to research the Australian health system and then get your politicians to watch your show. Ours is so simple and costs less per person than in US NOW. 100% health cover for all and no out of pocket payments to doctors in all areas.
Small 1.5% income tax surcharge covers this.
Includes emergency operations.
Yes and it's called MEDICARE
For more and faster services, 33% of Australians who can afford it are members of a private health fund. Our system has been operating for 30 years

Commenter: J.I.M.
The first question is: Do people have a right to health care? The second question is economics.

The U.S. spends twice as much as other industrialized nations on health care, $7,129 per capita. Yet our system performs poorly in comparison and still leaves 45.7 million without health coverage and millions more inadequately covered.

Commenter: OneSolution
Message to Congress:
It's time for 'transparency' promised to every American by our Whitehouse and Congress. I'm not finding open HC debate on C-Span or the actual house and senate HC Bills on the web. Yes, a few folks were so 'embarrassed' or 'ashamed' of their discussions they closed the door to America.
Now to the real issue. Stand tall for your beliefs. Put all taxpayer no-cost items into one HC Bill (inter-State HC availability, HC tort reform, inter-national Rx drug price leveling, etc). Place all taxpayer cost-neutral, and deficit spending items into another HC Bill. Ensure both Bills use only 'precise and concise' language, stating what is required and more important what is 'forbidden' under the Act. Give America two weeks for review of the Bills and to contact their legislators before congressional voting. Let the HC Bills pass or fail 'on their merits'. No more slimy backroom deals. Your job includes fixing the economy, not breaking it with HC enslavement of taxpayers. Remember 99% of domestic issues should be solved by the States. Congress needs to focus on inter-State and inter-national solutions to our HC problems. Government run non-profit HC co-ops (safety net) should be designed and run by each State and overseen by State HC regulatory boards, just like utility rate boards. Congress needs to stay in their lane, before they run our country into the ditch. Stop wasting time debating intra-State HC issues. See you at the polls.
cc: Whitehouse, DNC, RNC, etc.

Commenter: Madison
Maybe the cure is to allow our nation to function as designed. The 'limited powers' of congress should deal with inter-State HC availability, HC tort reform, fair inter-national Rx drug prices, etc. Let 'unlimited powers' of each State deal with non-profit HC pools, safety net HC availability for poor and needy, HC price regulation boards (works for utility rates), etc. Domestic problems are best resolved at the State level. Benefits are States must balance their budget, while federal HC solution will enslave taxpayers for years to come (owing Trillions). Progressive solutions need not always be so regressive.

Commenter: Margo
If the public option is taken from the table then the insurance companies will have no incentive to be competitive. If states can opt out - that's chicken ____. If doctors/hospitals can refuse patients, that is horrible. I've had coverage for 9 years and I am flabbergasted at the control that my insurance company has over the medical field. Why do they have the right to dictate to medical experts what they can treat and how? Too much corruption? Shame on this country (all of us)for allowing greed and unethical practices to become the norm. We can't even overhaul our treatment of our people with a good health care plan. With all the partisan debates we are creating a more complicated system that no one will be able to tolerate. Let's set some caps on extremism: what about percentages put in place for profits of company CEOs (God forbid they should pass on the blessings to the people who actually do the work); what about a percetage of gain for sports professionals and coaches and owners and pass a little savings down so people can actually come and enjoy a game at a reasonable cost; what about a percentage of income tax (10% was good enough for God)that covers improvements to the infrastructure, community helpers, and healthcare. Well, I guess I am answering my own questions, because I'm thinking it has been greed that has swayed us from the American ideology of honesty, bravery, and brotherly love.

Commenter: Students
Will they ever fix the health care system!?

This is an overused question...

Well answer it!

GO OBAMA!!! 2009! :)

Commenter: Concerned New Yorker!
You have to fix what is broken first.
1. The government should first fix the Medicaid and Medicare programs before trying to fix the nations problems. Medicare should cover all retiree health needs. If Medicare were such a good plan, then you would not need to purchase supplemental insurance. Supplemental insurance is only available to those who can afford it. Which causes those who can not to either go without the coverage or apply for Medicaid? Also, why do retiree's have to pay for Part B and D?
2. Raise the income threshold for Medicaid so that families do not have to live in poverty to be eligible. Also the federal government encourages families to not get married or lie about their spouse because then they might not be eligible for the benefits they so desperately need. What happens is that a couple may not legally marry or may file for divorce in order to be eligible. Make Medicaid more accessible to families. Allow small companies who can not afford to purchase private insurance to pay a Medicaid premium for their employees. At least then they will be pooled with a larger group and the risk can be minimized.
3. Eliminate preexisting conditions exclusions.
4. Create and implement the patient history database so that providers can share patient medical history and records more easily. This prevents duplication of services and lowers cost. Government should tax the insurance companies to create this system. The rate should be based on premiums they collect. So the higher the premiums the higher their tax. This can also help to eliminate waste and fraud if built correctly.
5. Provide a government wellness tax credit to companies provide insurance and have established wellness programs.

Commenter: Nancy Coulis
I watched the program regarding US healthcare reform with interest yet sadness. I am Canadian and never have had to worry about healthcare for myself or my family. Additionally, I am a nurse practicing in the Canadian healthcare system. Albiet the Canadian system is not perfect but I have not experienced anyone not receiving care nor financially suffering from receiving care. Another falsehood that is discussed is Canadians waiting for tests or long waits for necessary surgery. I personally have experienced health issues and did not wait for tests or surgeries. Your point re health prevention is well taken and here in Canada there is a large movement to address health wellness. Lastly, I must say that I have difficulty in understanding those who are fearful of government plans or those who knowingly choose to ignore their fellow citizens suffering because they are not. I am trying to understand for I care deeply about your future as you are our neighbour and inevitably we are a global society.

Commenter: jose perez
i believe if other countries can do it we can all people should have access to important medical care it seems to me there is also waste goes on as in other programs in the health care industry.it is rediculous in this country people should give up a home to just take care or an illness how bad is that to be homeless is certainly insult to injury surely something must be done my husband has multiple sclerosis and could not get coverage for me on his health insurance and they eventually dropped him also

Commenter: Kathy Dittmer
Get out of the wars!!!! We need to take care of our own people....not worry about whether or not people get to cast a vote for their chosen candidate in Iraq and rebuilding Afghanistan. What about us? We need to rebuild us here in the states!

The ridiculous measures the family you had featured on tonight's program has to take are ludicrous! So much for the Republican's argument that people who want government health care just want a hand out and are not willing to work for it. Here's a hard working family with ridiculous medical bills

Commenter: bab
I had healthcare until the company I worked for closed. Now I can't get coverage based on pre-existing conditions.

Commenter: Richard Bedell
The 'pre-existing condition' clause should be changed. But the real problem is not insurance, it is the cost. Everyone is saying it, health care costs are high. WHY!? Why is heath care costs so high? Every media coverage, reports, shows, documentaries, etc; all talk about the high cost of heath care and how insurance companies need to change. Insurance is partly to blame. The real issue is why is health care so high? Why does it cost so much to visit the doctor? Why does a X-ray, MRI, ER visit or surgery cost so much?
Part of the blame can go to the legal system for alowing lawsuits to become rampant and ridiculous. Another part of the problem is politicians. For one, they have segregated health card - they have their health care and then there is the rest of the country. Politicians have also deregulated and/or not regulated health care properly.
Drug companies have also played a role is rising costs. Coming out with new drugs to replace older drugs - the catch - the new drugs cost more but are no more affective than the old drug. And why does the drug cost more here than in other contries?
The problem is not just insurance companies. It extends in to the legal system, the drug companies, politicians/politics, and us (US citizens - for allowing things to get this way).

Commenter: Javier Arias
Hello,

I believe, it's time for America to take care of their own, and it is crucial that it gives its citizens an affordable health care option they desperately need.

I would like to tell our congress and senate that at least for this issue, not to give in to Wall Street. To send a strong message to investors in the medical industry to use other avenues to grow their profits, and not to do it at the expense of the lives of the american people.

We middle class want a government run alternative to keep these huge private corporations in check. It should all be about balancing power, and finally listening to what most Americans elected our government to do.

And to PBS, Thank you so much for giving me the opportunity to voice my opinion.

Good Bless

Javier Arias
West New York, NJ

Commenter: Byron Tucker, M.D.
Everybody in/nobody out. Improved and enhanced Medicare for all. It is a simple fix. Thirty pages double spaced. HR676

Commenter: Robert Elliott
As a retired senior with both Medicare and insurance from my previous employer, I support a "Public Option" to help give everyone insurance. I am well under $100K a year but would offer more from my income to help all in need. I don't believe the scare tactics that are commonplace in the media and am not afraid of a government "fix" of the problem. Putting this "Option" on the table will certainly cause the status quo of insurance companies on notice to either compete, or be gone. Too many cases of people being denied coverage for "pre-existing" conditions and other false premises by the insurance companies only give credence for government help.

Commenter: J Baird
Cost More? How could anyone be sold the idea that when you go to a doctor or hospital that you're not already paying for those that don't.
Insurance company efficiency? Then tell me why I get 50 percent off at my doctor's office if I pay him on the spot and don't bother his staff with billing insurance?
All my life health care has been going up at twice the rate of inflation; It was a problem in the 70's and it's a disaster now. Every advanced nation worldwide has come to the same conclusion: single payer- because for-profit insurance is unaffordable. Globally, that's the playing field; we won't compete without it.

Commenter: Bonnie AuBuchon
As a young married couple and being self employed, we paid about $400.00 per month with a $2500.00 deductible. We never made a claim. Maternity was not covered when we had my third son. This occured in the late 80's. My husband and I were sporadically covered over the next 8 years. He lost his job and it was my coverage from my job that paid healthcare. The only problem was that I was paying to work and therefore was bringing in no income. I I slowly became self enployed as my husband did and and created more income. The only problem with being self employed is that health insurance can be as much as a mortgage payment.

Commenter: MotherLodeBeth
When I hear special interest groups claim that 1 out of 150 children now have autism I visualize some insurance company wincing at the thought of covering those kids. Same with the claims that 50% of all kids and adults will have obese related diabetes. People pay for medical insurance and the goal is to have less than 50% of those with coverage, needing it for expensive care. If you have more money going out than coming in, you cannot cover all the people in that 50% group.

Nothing was said about the huge number of Americans who have preventative healthcare needs, which according to some experts, eat up a big chunk of medical dollars. Or the huge bills paid out for preemies who are born to high risk mothers over the age of forty. Or the last six months of life for the elderly. Or couples who have one child with medical needs, yet they have another child.

Commenter: Gayle DeForest
We need universal health care in our country.
Every industrialized (and some not so) in the
world has it...why do we, the richest country
in the world, not take care of our own? Here
is why: we have no philosophy of taking care
of each other. We don't care about each other.
We are selfish and look down on those who do
not have the means to provide for themselves.
We have no compassion.

Commenter: Freedem
Medicare has many issues, mostly put in as a sop to Corporations, not any ability to negotiate, the Donut Hole that throws half the Medicare population "under the bus" if they cannot afford to get across it. It takes pressure off taxpayers and puts it on Doctors, even as it takes some of that pressure by not refusing payment.

But with all that if the total cost per person was decided and offered to anyone who wished to go there for the average annual cost, because most of the population is not as sick as the elderly on Medicare, then Medicare would actually turn enough of a profit to cover any shortages now.

There is nothing complicated about that. The Government would not have to raise one extra dime. Most of the structure already exists. And if the insurance companies are so darn good they will cause very few folk to choose that choice. If not then they will not stay in business but should not stay in business, because what they offer will be much worse.

Making the insurance companies not game the system is tricky, but offering plain medicare to anyone who wants it is not.

Commenter: Jay-Jay
A Simple Plan:

This is a simple idea. This is an idea that fixes our health care problem with no tax money being spent and fixes our funding problem with Medicare and Medicaid and SCHIP.

We have a major problem in this country. Our health providers charge too much. This leads to an increase in annual premiums in our present third-party payer system. We do not know how much we spend in health care annually.

The simple idea is this: Make all third-party health insurance illegal.

This means Blue Cross/Blue Shield, Aetna, Medicare, etc. become illegal in the U.S. The Doctor and the patient become only two parties in a contract for services. There is no third-party, i.e. insurance, in the middle. Cost is then negotiated entirely between the provider and the patient.

Health care costs will come down to a level that everyone can afford it. Then it will be only a personal choice to get health care or not.

There is more to this idea but it is a simple one that will solve all of our problems without taxes, government or another's self-interest in our health ruling the day.

Commenter: jan
Single payer or universal healthcare is the only thing that will fix this.

Mr. Coburn's solution is so badly out of touch with real America that it would be funny if it wasn't so sad and so disastrous for us.

Obama's not much better since he has talked about the possibility of tax credits as well. The public option that he has backed away from wasn't enough of a solution and now it looks like he's not even going to offer that. But. We, apparently, will still get forced to buy insurance, pay a fine or possibly risk jail time if we don't in exchange for a temporary ban on refusal to pay for pre-existing conditions.

I don't expect a solution to this any more. Too many people trying to make a buck one way or another while they kick sick people and their families under the bus.

Commenter: BH
To me, it is a no brainer! Take out "for profit"! Why should anyone profit from illness?!! That is absurd and amoral! America prides itself in high moral values. So: everyone has to be covered, as they are in other "civilized", "free", "democratic" countries (an then some). There is no other way! How to pay for it? It will pay for itself over time. Perhaps some insurance company share holders and CEO are going to be worse off but as far as I am concerned, I think they can shoulder it, i.e. afford it!

Commenter: Josh
Single-Payer is the way to go. Expanding Medicare is not changing the whole system, it's expanding the part of the system that works. We can all have universal health care by expanding those that are covered with Medicare from 65 and up, to 55 and up, 45, and up, gradually, until everyone is covered. We can gradually implement this system starting right now.

Medicare has lower administrative costs so it saves the system $400 Million a year, while covering everyone. The plan is already written up - HR 676 is bill that is coming up for a vote. If Dems Vote Yes on HR676, we will have universal, single-payer health care, by expanding Medicare to All.

Commenter: D Maxey
Where is the compassion that American's are so famous for? Why are the Insurance companies and the big pharma spending millions to kill any bill that might take a small piece of their bottom line? Why are the major players in this healthcare reform effort accepting millions in campaign contributions from the industry they are "claiming" to regulate? Who do these legistlators represent, the American public or the health insurance corporations?

Commenter: L Bradshaw
Single payer is the only way. Everyone insured. Get the insurance companies out of it.

Commenter: EMB
Health Care For All! Support Obama!
Healthcare of Senatorial quality for all!
If we do not get it Allplegislators and public officials should give up their publicly funded healthcare, or have it taken away!
Whaty is good for those governing, is good for the governed!

Commenter: Tony Simone
Keep what we have and make it better! DO NOT THROW OUT THE BEST HEALTH CARE SYSTEM IN THE WORLD AND LET THE GOV. RUN IT. The Dem. on your program repeats talking points, he is not very educated. For example, he said he wants a plan that has prevention(exercise),a physical exam each year,low drug cost,no pre-existing conditions, medical nutrition therapy,(colorectal,mammography,prostate, and cardivascular disease screenings).I and 10.2 million people have all this with Medicare Advantage,and they want to eliminate it! HOW EDUCATED IS THIS????

Commenter: B. Session
Single Payer is the only option that will guarantee health care coverage as a right of citizenship.
See www.pnhp.org

Commenter: Bart Woolery
Every other wealthy country in the world has some form of socially funded healthcare coverage. If we were to examine those countries and find that their health indicators were much poorer than ours, their per capita expenses much greater, and the level of public approval of their systems much lower than ours, then we could rightly stick with our uniquely American approach to healthcare coverage. Unfortunately, all evidence points to the contrary. Ours is a uniquely antiquated system built upon an emerging post-war industrial surge. If not for the publicly funded safety net programs and Medicare, our healthcare system would collapse in an instant. Ideally, we would implement a nationwide single-payer healthcare financing system, since this is the indisputably best way to finance healthcare (even those who oppose it for whatever reason cannot dispute this). Beyond that, improvements in delivery can be financed through the savings realized from the single-payer: standardized electronic record-keeping, chronic disease management, implementation of standardized best practices, and preventive medicine being a few examples (all of which cost more money but are well worth the effort for improving health quality). Overall, the public is woefully uninformed and, lately, misinformed about healthcare policy. I hope programs like yours can serve to remedy this situation.

Commenter: Cece Drazek
Bulls, Bears and Pigs

There is an old adage on Wall Street that directly relates to the special on health care that Now is co-producing for airing on Thursday. "Bulls make money, bears make money and pigs get slaughtered." The following eleven points are solid indicators that for-profit health insurance companies have become the pigs of the health delivery system.
1. Only one or two insurance companies (sometimes with different names) control the vast majority of business in most markets. With monopoly control, there is no choice for either providers (doctors and hospitals) or patients â�� everyone must take what the insurance company dishes out, and premiums skyrocket. The insurance company stands between the doctor's judgment and patient's health.
2. Most large health insurance companies use computer software that is programmed to under-pay doctors and charge patients with more of the costs than in the contract. (The State of New York sued the nation's largest insurers that use Ingenix, which is owned by a UnitedHealth subsidiary.).
3. The founding premise of insurance â�� community rating â�� is simply ignored by today's health insurance companies. Monopoly conditions allow companies to charge premiums that prohibitively high. Small companies and individual payers see their premiums increase hundreds of dollars a year, even without usage.
4. Once diagnosed (and in the computer system), a malady becomes a "pre-existing condition." Replacement insurance is prohibitively expensive and will not cover that condition, or will not be available at all.
5. Insurance companies can and will completely cancel individual and small group coverage if the malady is serious.
6. Individual payers have no recourse when coverage for a condition or incident is wrongly denied, except for lengthy, expensive legal battles.
7. Most personal bankruptcies result from health care expenses. More than Â¾ of these folks have "free market" insurance which has failed them!
8. Most managed care companies have a pre-tax profit ratio of 7% to 12% even after all the lobbying costs and paying an average of $4 million to their CEOs. United Healthcare's ratio was 7% after paying its CEO $1.8 BILLION.
9. Health insurance coverage provided by an employer is cancelled with a job loss. Extending family coverage with COBRA can cost 80% or 90% of one's unemployment benefits!
10. Mandating insurance companies to provide better coverage will result in premiums that are prohibitively high-priced.
11. The only option for seriously ill people who have been abandoned by private health insurance or are out of work is relying on either the state or federal governments' programs.

The health insurance industry is spending millions of dollars on senators and congressmen to scuttle a public insurance plan and, if they get their way, turn all Americans into individual payers, like Massachusetts has done. Their goal is for government to mandate that all Americans purchase insurance from a for-profit company, the heart of Max Baucus' bill. The fact that government will subsidize Americans who cannot afford the egregiously high premiums is another slap at taxpayers, and a recipe for health care costs that spiral out of control (like Massachusetts).

The Baucus bill is yet another government guarantee for giant "free market" companies, just like the big banks. The "free market" certainly costs ordinary citizens a lot of money, and the health insurance industry costs us more than money. It has to stop. The "pigs" of the "free market" have proven that they are not worthy of taxpayer guarantees.

Commenter: Jeff
It would be nice if people would get off their ideological high horses and dealt with the fundamental issues at hand necessary for reform. Obama has accepted that being insured must be mandatory, unlike during the campaign where he was criticized by those who understand health care economics. But the reason he took a different stand in the campaign is that most people don't get what is so basic to policy experts. A responsible media would make it their job to do the kind of explanatory journalism that might allow politicians to craft good policy reform.

Commenter: Paula Brinton
The only way to cover everyone equally is to have government run health care without any interaction with insurance companies. It should be financed by raising the income tax so those who have, give, and those who do not have, still get care. The wealthy have had a free ride too long while the working and nonworking crawl along hoping nothing bad happens to them. Employment is too uncertain to base health care on it. Individual finances are too vokitile for many to use it to buy insurance even Medicare. Medicare is worthless for those close to the financial line. There are deductibles and copays and no pays. I have been fortunate to be able to have what I need, but I can imagine there are many who can't afford care even with Medicare. Medicaid requires forms and approval, often from people who are ill and so unable to focus on them. Poverty should not be a death sentence.

Commenter: xandtrek
If we believe the President that health care will only increase as a percentage of our GDP, and that lowering costs, increasing coverage, and bettering outcomes are the goals, then only single-payer makes sense. If I was a conservative I would be confused: traditional values of less government would conflict with how poorly the market has done health care -- and it seems that only government intervention can lower costs now -- something conservatives should also value.

Commenter: J. Dion
From the basic facts: It still appears that the Lobbyest control what is provided and the insurance companys will still regulate all aspects. Why would I be penalized for not being able to aford premiums? I do not see any coverage for alternative medical avenues. It all looks as though if you are earning a decent wage it will be a benifit otherwise kiss your grocery money goodbye!

Commenter: Bernard Dare
Analyze and adopt the best of the European programs. Since Germany (or Netherlands, or Switzerland) uses private (non-profit) medical insurance companies this might be a good start. The current approach seems half-assed.