Has to be public option

Another issue not discussed here is the abysmally deficient job that's being done to oversee provider fraud. I spent some years as a "benefit integrity" (ie: fraud) investigator with Medicare; too often we find providers who bill insane fees for questionable care and items. A great example is the Florida company currently in the spotlight for billing hundreds of dollars to Medicare and third party payors for "arthritis packs", which consist of a heating pad and some instructions. Without a greater ability to enforce practices, we can legislate ad infinitum and costs will not go down for the consumer. It is not entirely the fault of Medicare, which is actually run by regional fiscal intermediaries working on contract to Medicare. There needs to be a much larger focus on enforcement, with the funding, staff, and tools to do the job. this also includes judges to back them up; the "slap on the wrist" mentality exists everywhere...

When Blue Cross/Blue Shield first began, it was a non profit entity. the novel, and sensible, concept of "Insurance" was the pooling of risks, thereby creating an equitable and affordable premium for all. There were young an healthy in the pool, as well as older and more health compromised. In time, the younger would age and become more fragile, the new youth in the group would continue to balance the risk at both ends of the spectrum. It was not driven by stockholders and high paying executive salaries. Now the companies, to encourage higher profits, seek to hand pick the insured by ruling out those in more fragile health (which we need to remember, can be any of us in a heartbeat), or charging them unaffordably high premiums and copays. We no longer have "Insurance", we have a lucrative investment.

I think it is certainly true that no meangingful change in the way we fund healthcare can happen, if there is no public option. There is no chance, however, that we will will not have a public option of some kind. The US government already controls Medicare, Medicaid and the VA system. These will NOT be dismantled until the government itself is torn down.
None of these are run well, since the government is too big and cumbersome to run anything well.
Part of the solution is to fix Medicare, Medicaid and the VA system, and to cause more competition in private insurance. Fraud and waste are at unnacceptable high levels in every branch of the government, including these healthcare divisions. Private insurers require oversight, as well. They cannot be trusted to not screw over their clients or their competition.
Plus, too many lawyers are cashing in on medical mistake lawsuits, and too many people are suing doctors, hospitals, manufacturers etc for errors. Judgements are too high to be meangful when honest mistakes happen. Carelessness and incompetence, are, of course, different matters. Tort reform must be part of the package.
Healthcare reform is a ginormous agenda, if it is to be done right. I am afrid it will not happen until politicians no longer are owned by special interest groups (like lawyers, the insurance industy, etc.) If anything meaningful is to happen, the concerns of the patients MUST be the top priority, and nothing yet convinces me that this will happen.

Ask any person on "public option" insurance medicare or medicaid and they will tell you this is not the solution and conservative members of congress are absolutely correct. Going with a public option would bankrupt this country for the same reason that so many people can not afford insurance, the greed beyond anything you could imagine of providers. Let me give you true example of what happens to someone with insurance that requires prior authorization from a primary care physician the same as the public options do. This is a real life, factual case. Tracy (ficticious name) developed an alegic reaction rash over much of her body. It looked a lot like poison ivy but she had not been anywhere to pick up poison ivy, had been in long pants, long sleeves and it was definitely the wrong time of year. She had not changed laundry detergents, fabric softener, bleach, body wash, soap, shampoo... you get the idea and the itching was making her crazy. She applied calamine lotion, took benedryl and tried for about a month to figure it out herself not wanting to go to the doctor. Finally, after more than a month, she had to give in and go to her pimary care who diagnosed a contact dematitis (contact allergy) which she already figured out, and prescribed prednisone which she really was not happy about. Tracy wanted to know what she was allergic to so she could get it out of her life, let her body recover naturally, and not have the reaction to that thing again since knowing what it was she could avoid it. Intead, she got dangerous drugs. She paid her co-pay at the desk and her insurance paid $316.

When she took the prescription to the pharmacy, the pharmacist did not want to fill the prescription. He told her the dosage was dangerously high and called the doctor who insisted that was what they wanted. Tracy paid her co-pay, the insurance paid the rest, she went home, followed the instructions exactly, gained twenty pounds in 10 days, was absolutely miserable with side-effects and the rash was uneffected she was still constantly being exposed to whatever. She suffered another week in frustration and called the doctors office and they insisted she come back in. The doctor insisted she use a steroid cream! Her response was, if high doses of oral steroids had no effect do you really think a cream is going to do anything? Doctor insisted of course and she got to pay another co-pay to the primary care the insurance company paid another $316 and she filled the prescription paying the co-pay for the cream which came in little tiny tubes for a rash that covers most of her arms and legs. This stuff was to be applied twice a day and a tube lasted 5 applications being very careful covering that much area. The prescription allowed for 4 tubes which meant in about 10 days that was done, but the rash was not.

She was madder than ever because she was out the co-pays for two doctors appointments and all those prescriptions, had gained 20 lbs had was still miserable and very very angry. She waits another week and in total frustration and now scratching herself blooding heads for the emergency room hoping for releif. The doctor is very nice diagnoses contact dermatitis and says he can not believe she was not immediately sent to a dermatologist or allergist. He tells her to take claritin instead of benedryl which did not make a difference and that he is faxing her doctor that she needs to see a dermatologist or allergist immediately. He even has her stand there watching him send the fax so she knows it was sent. Of course there is a big bill to her insurance for the emergency room visit.

Two days later not having heard from her doctor's office, she calls them to find out what is going on. When she asks about the fax, the nit-wit says "oh, so you want to make sure we put it in your file," ah, no I want an appointment with an allergist or a dermatologist. Of couse they had to look for the fax and would get back to her, which they did not. Two days later she calls again, they had not found it, her response, are you going to call the hospital to get it or do I need to call and have them send it again, I know they sent it the first time, I was standing there when it was sent. We will call. Two more days nothing and she calls again. Oh, yes we got the fax, and you wanted what again, we will have to send the file back to the doctor. Two more days and a her adult daughter had an appointment with the doctor for a fever, runny nose, cough, and tightness in her chest, and she attends college, (swine flu come to mind) not for the doctor its a pulled muscled, daughter left in disgusted but not before she mentioned her mother is still waiting for that referal which the doctor had no clue about and the daugher dutifully paid her co-pay and the insurance company forked over $316 then the daughter went home crawled into bed and missed a week of classes. Tracy called the doctor's office again to remind them she was still waiting for that referal which by then was about two weeks after the hospital trip.

Two days later the doctor's office calls and the doctor wants her to come back in so they can ook at the rash again and give a better description to the doctor they will refer her too. Well contact dermatitis, is contact dermatitis is contact dermatitis. And she was not about to fork over another co-pay to this greedy.....and have her insurance pay another $316 for nothing she called her insurance and changed primary care providers.

He took one look at her and immediately referred her to an allegist.

She has been calling everyone she can think of to complain about the first doctor, insuance company, medical board, et cetera, no one cares, it isn't their area et cetera. Her insurance told her she should just change doctors. She said that fixes it for me, but what about everyone else you insure that uses that doctor and my premiums are effected because you are getting took with every paitient on your plans that they see. It should have been one office visit of $316 plus co-pay to the primary then the allergist of about $500 with the tesing and all done instead this is going to cost you folks/me over $5000. $816 vs $5000+ it is not hard to see where the problem lies in the United States in providing medical care and public option will just encouage more $5000+

Typical experience for far too many. The problem is not due to laws and regulations, but to the unfettered desire of insurance companies to gouge every cent they can out of you and then to deny your claims when you actually need care. Insurance companies are criminal enterprises, much the same way Wall St. banks are. The only reason for their continued existence is the power afforded them due to their money. A public option will crush them by forcing them to actually provide service for premiums, and if they can't, the government will step in and do their job for them at a fraction of the cost.

Any problem that can't be solved with taxcuts, republicans pretend doesn't exist.

there are 1700 companies that offer heatlh care plans but only 6 are allowed to sell in this state. open it up to all and the cost will come down. If we limit the pay to doctors it will not reduce the cost it will just mean we are refusing to pay. that is quite a difference. With the public option there is no health care.

Mr. Russell, what you speak of is the fault of this state laws. They have put in place laws that prevent competition. I suggest to you that maybe you should research this to see for yourself. Also Mr Russell maybe you should research how much profit insurance companies make, it may surprise you.