Longtime fan and supporter of you and John. I hear you’re considering backing Hillary’s campaign. I would urge you to do so. You know that her domestic policies are much more progressive and inclusive, and less market-reliant, than the alternatives, and this is huge in a year that should be dominated by the economic downturn we’re facing.

Thanks for your refreshing verve and great opinions, keep them coming!

The United States spends almost twice as much on health care per person as Canada, France, and Germany, almost two and a half times as much as Britain–yet our live expectancy is two years below theirs…according to 2004 statistics.

Canadians do wait longer for hip replacements than Americans, but that’s because Medicare, which pays for most American hip replacments, is so efficient. In fact, Medicare spends 2% of its funds on administration, versus 15% spent on administration by U.S. private health insurers.

To”Steinmania”: I would beg to disagree that “crashtx1″ is “trying to discuss with a civil tongue”. Whatever, as to your points, no one is suggesting a “single solution”. While I appreciate your “tiered” solution, and DO think that GP´s should be responsible for primary care and referals to secondary care, I disagree with the idea that people should only have access to care that the GP´s can give and that the GP´s cannot refer to higher levels of care. Everyone should be insured access to higher levels of care as ordered via their GP or via specialists or emergency services. As a psychiatrist who practicises in Denmark, where we have such a system, that works just fine.

The biggest thing I have noticed about all of these blog entries is that everyone seems to expect a single solution. Health Care in this country is too complicated for a single solution.

What about a three for four tier system? The lowest tier being free for all and includes doctor appointments for “family doctor” sorts of ailments. The seccond tier costing a co-pay for a little more care like simple emergency room stuff. The third tier may be paid in cash or credit card or insurance programs, paid for by employers or through families purchasing their own private health insurance. The fourth tier may consist of “catastrophic health insurance.” Heart or lung transplants or devastating disease treatments. The fifth tier could be premier treatments like private rooms, etc.

In this way, all would be covered for some basic free care or cheap simple treatments. Private insurance companies would still be able to sell insurance to groups (companies) or individuals.

This does not answer all the health care questions, but it is a point of view that no one seems to be talking about.

Any feedback on this?

You seem to be under the misconception (right-wing talking point) that litigation is a huge burden on our health care industry. The facts don’t agree with you, however, as litigation costs represent about 0.5% of heathcare costs in our country. MUCH more burdensom is the overhead costs, which are over 30%. This is compared with Medicare, which is about 2%. I won’t even get into the fact that malpractice is a real issue and juries issue verdicts because people actually had their lives destroyed many times by negligence or worse. I also won’t get into the overhead costs for the doctors themselves who have to typically hire a whole staff of people just to push papers for the insurance companies.

There is no argument to defend our current system. Even if you want to argue purely from an economic or efficiancy standpoint, it is a loser. We pay far more out the back end for the uninsured and for our gross lack of preventative care. We also end up paying more in terms of lost jobs and lost wages from companies moving to other countries to avoid healthcare costs, from lost work due to preventable medical problems, etc.

Finally, why would your doctor make less money because his payment check is coming from the gov’t verses coming from Cigna? I bet if you had a real conversation with him/her, you would find that he/she has a hard time getting paid for certain procedures from the private companies, and is have to pay out of pocket for all those support staff to deal with the companies.

There are doctors’ groups who support universal health care. Rationing already occurs, obviously by denying coverage to those with pre-existing conditions.

I am covered by my retirement system but cannot get long-term care insurance because I’ve to a serious of conditions that are not serious for me but for which I get medicated – blood pressure, acid reflux, cholesterol, depression, some bits for arthritis, restless legs….so anyway,this is only because these companies don’t want to take on any risk – long-term healthcare companies that want no risk????? That’s a contradiction in terms!

I know many people, some of them “professional class,” who have to endure jobs they hate just to keep health insurance. I know at least one person who was borne under by family health problems he could not cover because he couldn’t afford health insurance and had to declare bankruptcy. He himself is now very ill but has to work full-time to be covered. He really is disabled but in Ohio it is a two-year wait and I think he would have to not work the whole time, which he can’t afford to do.

It’s a truly brutal and inhumane system.

I agree with the Edwardses that Clinton’s plan is significantly better than Obama’s (as are most of her programs) and I hope and pray that hers are the programs we end up with, even if Obama is elected.

As a Cdn with more than a passing interst in US politics, I have always found this a curious defense for leaving the health debate pretty much where it is mired today in the US. Because this one-liner is quite virtually never challenged by mainstream media, the deafening silence is quiet and implied agreement. The most common excuse for not pursuing this comment with “Explain what you mean by that…” is we are running out of time and I have to throw to a commercial.

Don’t misunderstand me, Canada’s system of healthcare is not without its faults and failings. Healthcare costs and access for all does not get any easier on this side of a border that separates us…what we do know in Canada is that people with pre-exisiting conditions and meagre coverage from “private” work plans are not marginalized and left to suffer and die untreated.

Societally we have concluded in Canada that access to care is one of those areas where gov’t not only can, but must play a role.

America is without a doubt one of mankind’s most successful and intriguing experiments…I refuse to believe that your country lacks the will and creativity to understand that the health of all citizens when attended to intelligently raises the general well-being of every single citizen, wealthy and poor alike.

These crazy far-left smelly hippy big-government “healthcare” policies would deny hard-working ‘murrikans their God-given right to make a personal choice between buying food and paying for healthcare.

What are you? A bunch of communists or something?

Look, we’re living this stuff, so you can keep spouting that simplistic ideology but we’re not buying it anymore. Btw, physicians that I talk to are just about as fed up as we are at the hoops they must jump through to get insurance companies to cover their patients’ treatments. The rationing starts by putting risk, responsibility and accountability back in the health insurance business and going from there.

Any national health care plan that doesn’t deal squarely with the power these companies have attained is doomed to failure. What these companies have been allowed to get away with is a crime.

Insurance would be cheaper if not for men like Mr. Edwards.

Insurance would be cheaper if the risk were spread among the entire population. If we didn’t have to pay for layers of bureaucracy whose prime function is to deny coverage. If we didn’t have companies treat injury and death and health problems such as cancer from toxic products as just a “cost of doing business.” If we didn’t have so many Wall Streeters dipping their beaks into the health care industry as little more than Tony Sopranos.

The perversion of health care is a national disgrace and I, like Elizabeth Edwards and so many whose families are touched by serious pre-existing conditions, will be watching all the candidates…and those who are elected. And demanding better.