This has been a good discussion on health care. I spent 20 years working in retail pharmacy where I was responsible for the insurance billing of all third party payers (Medi-cal, Blue Cross, etc). The practical solution is to have a public option, where those who don't have insurance can have access to it, regardless of their employment status, health status, and so on. But leave those who have insurance alone. I've had to use the CA Public Option for my kids because my small business employer only covers me, so an affordable option is welcome. We have to buy private insurance for my wife. The bottom line is that it is HEALTHY to our way of life for all of us to have choices.

Having said that, one of the biggest problems of the current system is the waste, fraud, and abuse that go on with ALL insurance, whether public or private. Doctors triple book because they get paid per head, pharmacies have to over-bill insurance companies just to get paid at cost, and all of the restrictions add numerous layers of bureaucracy to the billing process. Plus, regardless of what insurance you have, providers, by contract, are paid AT A LOSS. They don't even break even. Drug companies should be able to make money, of course, but at the expense of our health providers?

I know that opens a new can of worms. However, cutting down the greed doesn't mean one can't make a living providing health care. Nor does it mean that NO ONE makes money, either. And, as far as I am concerned, I still want the choice to do what's right and best for my family's health care. It's not the government's job. I would hope though that a healthy, competing, compromise can be reached.

I like the idea of blogs. They give people a place to speak their minds. But then what? After reading these comments I'm left with more questions than answers. How great would it be to have someone actually read the blogs, gather questions left by the bloggers and then do some 'investigative' reporting that would get the answers to all these questions?

Instead of having questions answered by one political party or the other who have an agenda, I would love to get 'just the facts"...not just paraphrasing from speeches, but real answers. For example, Laura M. posed very good questions on September 7. Getting her questions answered would help to clear things up for many others.

It's times like these when I miss Hal Fishman the most. I may not have always agreed with him but I always felt I learned something when he gave his commentaries.

I hope someone at KTLA will actually read this and help us get some answers.

I have cared for patients with end stage AIDS, and the symptom presented are heart rendering, no matter what side of the fence you travel, and I have questions as to their care. Ca does have an end of life resource and it is identified as Hospice. If the guardian, parent, or the person holding a document named Advanced Directive and Durable Power of Attorney for Health Care, decides that Morphine titrated up and Ativan can be given for "comfort" and then they sign off that even if it ends the life,of their charge, that it is lawful and treatment is given. Is this the end of life plan that the Gov't plan would have? Will the most vulnerable be encouraged or persuaded to sign on the dotted line? We need to know the details and who the people are that are writing such things, and what their history is in the area of life is precious or non-viable or when it becomes non viable.

On one of our 6 week summer trips, my husband and I drove up the Ca coast and continued on into Canada. With the change, sometimes, in eating times and habits, on the road, I developed a female problem and finally admitted that , before we went to church I needed to go to the ER/ED. We went to the closet hospital. They took my name and complaint. I took a seat and waited about 5 min. I was ushered into the ER and they took my urine for analysis. A nutrition specialist came to me, introduced himself as he pulled up a chair and sat down, he talked with me about my weight and how it was putting me in jeopardy of, and kindly listed a few of the signs and symptoms of various disease processes. He spoke to me about prevention, not only about my weight, but why I was suffering from a UTI. My admitting doctor then returned to talk to me about the medication he was giving me and an RX to take to the local pharmacy. This all happened before I went back to school for nursing. No one ask me to sign the reams of paper that are usually needed in our ERs. No one asked for payment, but I am a very proud woman, so I asked how much. Not necessary they said, but we insisted and ended up paying $165.00! It was a Sunday morning-ER not busy, it was acute-was seen.
When we finally got to Prince Edwards Island, the rain was pouring buckets. The lush green public campgrounds have large inclosed clean, one room house sized buildings, with fire in fireplace and a large cooking area, where you can escape too to keep warm and dry and eat and make new friends, as in our case. While there we made instant friends with others who came in out of the rain, and we all were talking about this and that. I commented on my ER/ED visit and they filled us in on how the country had voted to have an increase in their sales taxes to 9.5%, one reason was the healthcare system was in dire need of money and to pay off their national debt. I asked if they were mad about it, their response was so adult. They agreed together that it was necessary and once the debt was paid off they would go back to the old tax. Canadians did pay off their national debt, and the tax was reduced to the original amount. I marveled at the logic and grown up demeanor they displayed. That would not be the response of Americans, and we would have all sort of justifications.
This is not a vote for or against the Obama Healthcare Plan. I want to know the details, such as if children are born with multiple birth defects, and/or the suffering patients of HIV/AIDs , and/or the elderly and their infirmities, will the be counseled and encouraged to their plan of end of life morphine and ativan be the RX, AND will this proposed Obama Plan be the straw that broke the financial back of the United States of America? Will they have to cut resources for the military? Our children are "over there", and most of our Military are out of country, where is our protection? Is it going to be the Obama Internal Military Police? Where is PELOSI? Do her constituents in San Francisco have guarantees, in writing from her, about their care, or is she quietly avoiding them? This plan is being rammed through, we are being rolled over-not nice.

Thanks for that post, Frank...Their overall health care rating as compared to the US was very informative. A friend of mine had a similar experience in Italy...She and her husband are among the many Americans who CHOOSE not to have health insurance (and yet they could afford to travel abroad)...That is a problem that concerns me...just like the couple in Eric's story this a.m. who chose not to be insured, but probably eat out on a regular basis. To me that is irresponsible and I'm not sure how to deal with that part of our population...when they end up in the emergency room in our country I believe we all end up paying.
I too stand behind the President and his health plan. I deplore the partisan politics that is getting in the way and making it more defficult to get it done.

Frank, I am so glad that Mrs. Buckley is doing well. You have a beautiful family and your little vacation village in Italy sounds like heaven.

I am worried that our government in charge of universal health care(which I believe a public option will eventually turn into - why would employers not use the government plan if they already have to pay a fee for it whether they use it or not?) will be a program that will be unsustainable, just as we see with Medicare.

How will it be paid for each year? With more and more tax increases and fees? We are already so in debt and printing money as if that will solve all of our problems - as China worries about the U.S. printing more money and as the dollar is devalued more and more. Our government doesn't have a great track record when it comes to being good stewards of the taxpayers money, why will this somehow magically be any different?

I'd be surprised if you received a bill. If you do, it will likely be substantially less than a similar stay, here in the States. I had a college professor who was in Italy working on an archeological dig. Some old stuff fell, he got hit with it, and ended up in the hospital. They took care of his scrapes and cuts, gave him stitches, antibiotics and a sling, and replaced his smashed glasses, but the new glasses were of a higher quality than the ones he'd lost, they also checked his eyes and adjusted his prescription. He never received a bill.

I do want to talk about the "free" vs. "cost" thing. I'm definitely pro-Single Payer, but at no point is it free. Our taxes are used to take care of all of us, and we all share in the cost. I heard a report the other day that insurance companies in California are now denying claims at a rate of 39%. These aren't people who can't get insurance, they're people who have it, and have paid the ever-increasing premiums every month.

This system didn't work well under Nixon, and it's only gotten worse with each progressing administration and generation. We can't afford business as usual, because it's killing Americans. It's also damaging businesses, big and small, who are staggered by the skyrocketing costs, not to maintain a standard of care, but to stem the diminution. The Con side insists there's a better way. What is it? I keep asking for some detail, but they provide none. Is what Obama has presented the best possible? Probably not, but I will support it, as Benjamin Franklin supported the Constitution, because it is the best likely to realised.

We cannot hand over our health care to the government! Does anyone realize how in debt this country is? The government is irresponsible. We have to personally budget our money, but they don't! Please, let's find a better way than handing them the problem!

A bit of Canadian history (yes I know, please stifle your yawns!) an excerpt from www.thecanadianencyclopedia.com:
"In 1959, Premier T.C. DOUGLAS announced his intention to provide medical care insurance, based on pre-payment, universal coverage, quality service and government administration, and through a scheme acceptable to both doctors and patients. The election of 1960 was fought on this issue, the doctors campaigning against it. A commission, established to recommend a plan, reported in Sept 1961. Members of the Saskatchewan College of Physicians and Surgeons met with the government, stating that they could not work with a compulsory, government-controlled scheme.".....
sound a bit familiar? We had a fight in Canada when universal health care was introduced here, but try and take it away and I'm sure most Canadians would not allow it. Sure, it's not perfect and sometimes you have to wait for elective surgery, but the average cost to a couple I think is about 90.00/month - or less if you are from a low income. I don't know how much it is exactly because my employer pays the premium and I also get an 'extended health' through a private company too, paid by my employer. I don't know where all the stories about our system come from that I see on US commercials etc. We choose our own Doctors (although if you want to see a specialist you do need a referral from your GP). I don't know of anyone who has ever been turned down for something or told they had to change Dr etc as I've seen references to. My family has had to use the system for some serious challenges and been pretty glad for it without too many complaints. I'm not suggesting anything one way or another for your decisions you make in the US, but we are often baffled 'up here' about the 'freedom' word/threat being tossed around in your country. I have never felt anything but free in Canada but am also not afraid of thinking socialism has some good points (socialism is not communism) and am glad that no one ever has to go bankrupt if they are ill or be denied care if poor. Would you question whether your tax dollars should pay to protect your buildings and citizens from fire, for your police protection or schools? Isn't that also kind of the same idea as healthcare? Is that socialism?... Now if I could just figure out how the Canadian gov't should pay for us to go somewhere warm in the winter, California here we come......!

I'm so happy to hear Mrs. Buckley is doing well. But I'm also glad this happened in a country where the money is not the issue but the HEALTH of the people is more important.
I hope someday we can have some type of universal health care system here in the U.S.

Hello Frank, Great story. I cannot believe that the richest and most powerful nation on earth still does not have a comprehensive medical plan for all of it's citizens. I am told we are the only developed nation that doesn't have one.

I am self-employed and it would cost my wife and I about $900.00 a month for medical insurance, that's a rent payment in most of the country, and even if I could afford that I can't get insurance because of a prior condition. This is a joke, right?

I was born in the UK and I still have a large family there, I can tell you that no one I know in England would give up their National Health Service for an American style private insurer system. Yes, they have some gripes about the NHS but that's normal. I bet if you took a poll in the UK asking if people would want to abolish the NHS it would be 95% NO. Sixty years ago they decided that everyone was entilted to First-Rate medical treatment no matter how much they earned or their station in life. Shouldn't we be that noble?

We need something to cover the 50 million of us with no insurance snd if there is a government plan that's in the $500 a month range I'm going to take it. If the private insurers cannot compete then tough, they're going to have learn how for once.

Glad to know that Mrs. Buckley is o.k. Of course we need some sort of universal health insurance. This distrust of government programs is totally irrational and is being stoked by divisive politics, not by public necessity.
Anne

For more info regarding the Worlds Health Organization ranking, please take some time and review how the WHO derives their statistics- There are five areas of criteria and the WHO has created a formula based on many factors that differ from country to country. The five areas are-
Health level
Health distribution
Responsiveness
Responsiveness distribution
Financial fairness

There are factors such as life expectancy, poverty levels, income per household, etc.., etc..., each is weighed differently dependent on thw WHO formula. Quality care, long-term care (such as cancer treatment care) and waiting periods are not entirely accounted for.

As with statistics, numbers can be misleading.

I'm 62 years old and work full time. My small company offers a medical plan, but it is far too expensive for me to afford--about $300/month. It goes up every year, since the premium is based on age, and my employer only pays 50% of the total. Employers like mine use the recession as an excuse not to give raises, so I have worked 18 months for the same salary despite a promised raise. (And my bosses gave themselves exhorbitant raises.)

I have four adult children, and only the youngest--still in college--has medical insurance (he's on his dad's plan). One of my kids was laid off months ago, one just graduated from the Ivy League and can't get a job, one works part time. Getting sick is not an option in my family.

I am terrified, literally terrified, that a public option will not go through, and I will be even worse off than before. Two bases for my fears:

One element being considered is that insurance a company provides can cost up to 15% of an employee's salary. The $300/month I can't afford is 9% of my salary, and I still get to the end of the month and cannot afford groceries and sometimes have to ask my 93-year-old mother for money. 15% is a ridculously high cutoff for people making less than $150,000.

The second is a penalty an employee must pay if she refuses the company plan. The law will not increase my income, so I will still not be able to afford my company's plan, and I will end up paying for nothing--and coming up even shorter every month.

Who does this benefit? My company, my bosses. They offer a plan, so they will not be penalized, and they save the amount of money they would pay if I chose to buy into the plan they have. They save $300 a month on me plus what they save on the other employees by offering a plan that not one employee buys into.

I pray everyday that I will not get sick or be injured, and the same for my children. It's not just praying for health, it's praying that I won't be in a situation where one of us has to die because the available care cannot be bought.

Hi Frank,

I am glad everything worked out for your wife! My partner who happens to be a Neurologist for the VA Hospital in Long Beach and works in spinal cord injury and I are in full support of a public option. He is really in support of a single payer system but would settle on supporting a pbulic option. He prefers and enjoys working for the VA System because he can focus on patient care rather than dealing with insurance "bean counters" to decide course of action. If there is any issue regarding tests being performed on a patient, that is decided among physicans NOT again "bean counters"!

NOW about me....Just recently, I have been given a clean bill of health by my primary care physician. I am 47 years old. The good news is that he says I am one of his most healthest patients. Since my physical I had back in April, I have been advised that my lab report most likely miscoded one of my lab test as "depressive disorder" which freaked out Anthem Blue Cross. Right now, they are investigating me having a pre-existing condition and are requesting my entire medical history since birth, yea that's right birth.

Even if I had a depressive disorder, does that give my insurance company the right to deny me coverage or possibly increase my premium? This is why I a favor a government option!

I' am glad you and your family are doing good.My statement is that; I don't think you will see a bill. What this implies to me is what I have always felt, humanity is universal in some parts of the world. I can't believe that America is so uninformed by the healthcare systems of other countries. What shocks me even more is the division in our country over the humanity of the citizenry, the sword of greed and ethnic tension has permeanted the fibre of our society; God may be able to help us: but our morality must be refocused. I know how far to the left some may think this reply might appear to be, but let me assure all who read this that I'm on Medicare and the current concerns of healthcare have no bearing on my situation. As far as my Leftest thinking well, when I look to the right I see Nancy Polosi. 65 and still alive.....

Frank your blog definately has more importance and is more interesting than Sam's. I am one of those who can't afford health insurance on my own and hope beyond hope the public option doesn't go away. I was caught up in the job loss atom bomb that the recession caused. Private health insurance companies are only out for profit. I've worked for Blue Cross and they are very indifferent to member problems/claims. One last thought. Why does it have to be Democrat vs. Republican. Why can't these elected officials, who are supposed to work in the best interests of those who elected them, just be Americans working to make life in America liveable for all. The congressmen and senators are paid by us(the American population) not the special interests like BLUE CROSS, BLUE SHIELD, AETNA, ETC....

I am very happy that your wife is doing better and your family had a great experience. In an emergency things can go differently then office visits and other treatments though.
My husband is retired military served proudly for 20 years. Retired 13 years ago. We have paid for tricare prime health ins this whole time. Made sure where we retired 13yrs ago was a prime area. On the 9th of July we received a letter (it was mailed on the 6th) that was sent to over 190,000 retires. Tricare Prime was enforcing the 30 min rule. Meaning you need to live within 30 min of your PCM. Well last couple of yr's they went through many areas and canceled out contracts in many cities and towns. It put us over 100 miles now from a PCM. Those who live less then 100 miles were given waivers. We live over 100 miles so were not given a waiver. We were told in the letter that we needed to do something by the 20th of July (11 days) or loose our Prime and forced to go standard. So we opted to move after 13 years leave our home family and friends. We moved to 29 Palms. Because it was the quickest and cheapest of the areas to choose from. We have a very sick little 11 yr old. The stress has caused increase seizure activity.
I truly believe we do need some kind of health care reform. But is it going to include telling people where to live? Especially when we lived in our home of 13 years? Some longer they choose to give up their Prime. We don't have other insurance. And we are not old enough for medicare. We did have agreat PCM there. Till the contracs were canceled.
Our service men and woman have fought hard and many have died for our Freedom of choice, speech and our freedom. My concern is will what happen to alot of others in a public option?
Please don't get me wrong their truly needs to be reform. But we also to need to be careful and fully look into everything before rushing into something.

Frank -

First off, good to hear your wife seems to be recovering fairly well. I'm sure this will be a vaction to remember for years to come. Also, thanks for sharing another very insightful perspective on your experiences, which led to a nice thought-provoking post from you.

Now, with regards to our health debate here in America? Sure, we are in desperate need of some kind of reform, but I just can not see how a government ran system would be cheaper or better than what we currently have. Isn't medicare currently ran by the government? And we constantly hear how it will soon be broke. So where is all this money to pay for uninsured citizens going to come from? Would businesses just drop insurance coverage for their employees forcing them to go with the government option?
Though it is just not about the money, it is also about the quality of care. Having listened to several doctor friends and relatives, I am convinced the proposed reforms suggested by Congress will not work for America, because of the costs and concerns of those that would be affected by a change from what people currently have.

I am glad this topic is being debated at all levels from individuals to the people who (supposedly) represent us. I just hope the president listens to the majority of Americans who seem to be opposed to any type of nationalized medical system. When individuals are affected on a personal level we see they become very passionate.

Frank - I would be curious as to what happens with any bill that may be charged to you. But, regardless your wife's health and recovery was worth it! Best of luck on her continued recovery...

-m

Has anyone watched the show on the Discovery Channel call The Colony? It makes you think about a lot of things. One being the little to no health care. Gives you a good idea what our future may be heading.

Frank:

Thank you for another thought-provoking blog.

Our health care system definitely is not working. I'm so tired of paying for the portion of treatment that my health insurance will not cover; but at least I'm covered.

I definitely believe that the U. S. needs to join the other well-developed countries and provide universal health care for EVERYONE!

For long time that I had been working I paid for expensive health coverage month by month and I used it only once a year for a check up, so when I have an emergency they sent to me a big fat bill. I made a claim and they cancelled the bill. But the question is, who will pay us for the time we have to expend for to made a claim, all the phone calls we have to made for contact some one who really care to listen to us or when we didn't receive the answers we want to heard, take our car and goes some times long enough to expend more than an our in a heavy traffic. So now, like I said before in another blog, I found a small clinic that suits for me and my family with really unexpensive cost and the good thing is I don't have to pay monthly for something I will never get. Thank you Frank for share with us something that we should get here too.

"the Italian health care system was ranked second in the world in best overall health care. The United States? We're in 37th. The Italians spend 8.7% of their Gross Domestic Product (GDP) on health care compared to the 16% of GDP spent here in the U.S. Italians do have the option of using private health insurance and private physicians but they cannot opt out of contributing to the public health system."

The key is looking at the bottom line, private companies could care less about someone's health if there is money to be made, so if in denying care they make a profit, there is a tremendous incentive to deny care. A public health system bottom line is NOT money, is the health of its members, even those with pre-existing conditions. Just take a look at what insurance companies are spending in publicity and lobbying to crush the public option, it is outrageous! They know it is an investment to keep their bottom line, not their members, healthy.

My understanding is that although it is true that Italy is #2 in health care. They are able to handle emergency situation as you experienced and you may get a big bill for it.

But they still have problems with long term care. Their hospitals are underfunded and overcrowded. Also, Italy is a smaller less complicated country than the United States.

By no means, is our current system working but handling all of it to the Federal Government is not the right answer. I think part of the solution is somehow providing the uninsured basic low level and emergency care until they can get insured.

WoW!!! the first blog I have read from Frank Buckley and this was A GOOD ONE. thanks 4 sharing Ur personal Xperience and this gives me more 2 consider if I am for or against "Public Option". I do agree, our healthcare system in America needs to be fixed and we all need to be informed on THE COMPLETE TRUTH.

thank U

one of the problem in the cost of health care is the state mandates.. these are the mandates that are paid for in insurance premiums required by the mandates..

How many of these mandates is one paying for that they don't need?

The most common state mandates:
Alcoholism/substance abuse treatment
Breast reconstruction
Diabetic supplies
Emergency services
Mammography
Maternity minimum stay
Mental health parity
Source: Council for Affordable Health Insurance

Unusual mandates:
Athletic trainer
Circumcision
Hair prosthesis
Midwife
Naturopath
Oriental medicine
Pastoral counseling
Port wine stain elimination (birthmark removal)
Residential crisis service
Source: Council for Affordable Health Insurance

From: http://bytestyle.tv/content/state-mandates-health-insurance-find-out-what-youre-paying-and-dont-need

Shelly Roche explains

State mandates on health insurance are a major factor in the high cost of coverage. I did some research to find out what I'm paying for (and don't want or need):

State: Maryland
Cost of Coverage: about $500/month

Here are just a few of the dozens of things I'm paying for:

In-Vitro Fertilization - accounts for 3-5% of my premium
Morbid Obesity Treatment - accounts for 1-3% of my premium
Smoking Cessation - accounts for 1-3% of my premium
Well Child Care - accounts for 1-3% of my premium
Alcoholism/Substance Abuse - accounts for 1-3% of my premium
Hair Prosthesis - accounts for 1% of my premium

I'm not morbidly obese, I don't smoke, I don't have kids (nor am I looking to get pregnant any time soon, sorry mom!), and I'm pretty sure I don't need rehab.

If I tally it up, these items are responsible for up to 18% of my premium. That's almost $100/month I'm paying for coverage I absolutely do not want or need.

I also learned that there are nearly 2,133 mandates like these, which are responsible for group health insurance premium increases of 20 to 50 percent.

Regardless of whether the hospital charges you an exorbitant amount or little to nothing, the fact that when your wife, Elena, was sick she was immediately cared for and operated on in a clean environment is of paramount importance. The money, TV, the food, the towels are gravy. The hospital administration (admitting clerk to surgeon) concentrated on the most important factor - getting Elena well and back on her feet. They didn't worry about your insurance carrier, or if you were an Italian citizen, or how you planned to pay for treatment - the last thing you want to think of when you're away from home and get sick. We Americans need to spread that love at home.

In my household, tho we've never been without health care (knock on wood), we're firm believers that, in the country of abundance (just watch a segment of "How Did You Get So Rich") we need universal health care. Everyone should have access to a doctor, hospital, immunization. Perhaps if we took better care of each other we wouldn't fall victim to contagious diseases, contaminated foods and indigents (people who've lost everything to pay for long-term illness).

Maybe we aren't intended to be our brother's keeper. If not, why does it work in other countries like Sweden where a doctor will make a house call in the middle of the night (as seen on "60 Minutes")?

If we don't focus on health care (and quality education) for all, we might as well consider ourselves a 3rd world country, no longer a world leader, because we are too selfish to care for one another.

United we stand. Divided it's every man for himself.

We, in my house, stand behind the president and universal health care.

Good to know Mrs. Buckley has recovered.