Discussion

• OliveR :

  As I read the Wisconsin plan, it means that as a small, 2-person professional corporation, my spouse and I would now pay almost 15% of our separate gross wages in Social Security withholding and another 15 % for health care coverage. This is 30% of our gross income for insurance and retirement. Take another 9% for sales tax, another 25 % for the IRS, my property tax, my life insurance, my disability insurance, my car insurance (required), and you begin to see why buying stuff that makes the economy grow (cars, homes, appliances and for many people food and gasoline) ends up being done on credit.

  The deduction is also based on Social Security wages, which means a (a) a cap for the wealthiest people who already have insurance and/or the ability to pay for uninsurable health problems, and (b) people who already can't spend what they have are spending a far lower pro rata share for health care than people who can barely put groceries on the table at $7.00 per hour (remember, that 10 percent employer contribution could be paid in wages if it didn't have to be sent to the State).

  Some will argue this is fair and that it is good because it is capitalism and socialism (you know, the theory of economics taught by Jesus) is evil. I don't see it as being consistent with progressive philosophy.

  The missing elephant in Wisconsin's state house is the cost of health care itself, not just the cost of health insurance. Who is going to get the megaholding companies that now own most doctors' offices and hospitals, and the pharmaceutical companies, to control THEIR double digit increases every year? Even doctors now have a sense of entitlement, having gone from distinguished, economically comfortable professionals driving Buicks and Cadillacs and living in nice homes to driving huge Mercedes, BMW 7 series, and buying up the 8,000 square-foot mansions all up and down every coastline and in the most luxurious areas of the cities. These costs are destroying the country.

  Posted on August 1, 2007 8:56 AM

• waltc :

  Who is going to get the megaholding companies that now own most doctors' offices and hospitals, and the pharmaceutical companies, to control THEIR double digit increases every year?

  That is the $64000.00 question. So far I haven't seen squat from the Democrats on how they plan to cost contain these monsters and its vital that we do get the costs under control.

  Posted on August 1, 2007 11:41 AM

• Henry Dubb :

  I do agree with OliveR somewhat. There are certainly aspects of the plan - co pays and indexing it to SS wages - that are regressive.

  Getting costs under control is the rationale for the plan. Here is an article on a plan its based on. I don't think keeping costs down will be the biggest concern. As the article mentions if the bids are too high they are sent back to make it right. I am less concerned about costs rising than what will happen to the tier system over time.

  Posted on August 2, 2007 5:17 AM

• Henry Dubb :

  I also wanted to point out that the bill has no likelihood of passing. It is being put forward as an attempt to appeal to the people. The assembly is controlled by Republicans and the Demopublican governor is about as worthless as any of the Republicans. In fact over half of Governor Doyle's large contribution come from interests fighting universal healthcare.

  The only hope for such a plan is a binding referendum. A non-binding one last year, asking the people if they favored universal health care, passed with over 60% of the vote. Maybe if we let the republicans vote on gay marriage again, they will let a binding referendum on universal health care through.

  Posted on August 2, 2007 8:02 AM

• dchavern :

  A number of these commentators are quite right that cost is a much bigger issue than the source of insurance -- but blaming "big corporations" and doctors is ridiculous.

  For some reason people simply can't get their head wrapped around the idea that good, modern healthcare costs a whole lot of money -- particularly if you have a serious or chronic illness, or significant weight, smoking and other issues. If we want everyone to have access to every possible medical advantage then ALL of us will have to pony up a whole lot more money. Getting more poeple care will be a good thing (see the NYT article below) but absolutely no one should pretend that universal care would be anything but very, very expensive. To do otherwise would be completely dishonest.

  "September 27, 2006 – The New York Times

  Economix
  
  The Choice: A Longer Life or More Stuff
  By DAVID LEONHARDT

  The most authoritative report on the cost of health insurance came out yesterday, and it’s sure to cause some new outrage.

  The average cost of a family insurance plan that Americans get through their jobs has risen another 7.7 percent this year, to $11,500, according to the Kaiser Family Foundation. In only seven years, the cost has doubled, while incomes and company revenue, which pay for health insurance, haven’t risen nearly as much.

  These spiraling costs — a phrase that has virtually become a prefix for the words “health care” — are slowly creating a crisis. Many executives have decided that they cannot afford to keep insuring their workers, and the portion of Americans without coverage has jumped 23 percent since 1987.

  An industry that once defined the American economy, meanwhile, is sinking in large measure because of the cost of caring for its workers and retirees. For every vehicle that General Motors sells, fully $1,500 of the purchase price goes to pay for medical care. “We must all do more to cut costs,” G.M.’s chief executive, Rick Wagoner, said on Capitol Hill this summer while testifying about health care.

  Mr. Wagoner’s argument has become the accepted wisdom about the crisis: the solution lies in restraining costs. Yet it’s wrong. Living in a society that spends a lot of money on medical care creates real problems, but it also has something in common with getting old. It’s better than the alternative.

  To understand why, it helps to look back to a time when Americans didn’t worry much about health care costs. In 1950, the country spent less than $100 a year — or $500 in today’s dollars — on the average person’s medical care, compared with almost $6,000 now, notes David M. Cutler, an economist who wrote a wonderful little book in 2004 titled, “Your Money or Your Life.”

  Most families in the 1950’s paid their medical bills with ease, but they also didn’t expect much in return. After a century of basic health improvements like indoor plumbing and penicillin, many experts thought that human beings were approaching the limits of longevity. “Modern medicine has little to offer for the prevention or treatment of chronic and degenerative diseases,” the biologist René Dubos wrote in the 1960’s.

  But then doctors figured out that high blood pressure and high cholesterol caused heart attacks, and they developed new treatments. Oncologists learned how to attack leukemia, enabling most children who receive a diagnosis of it today to triumph over a disease that was almost inevitably fatal a half-century ago. In the last few years, orphan drugs that combat rare diseases and medical devices like the implantable defibrillator have extended lives. Human longevity still hasn’t hit the wall that was feared 50 years ago.

  Instead, a baby born in the United States this year will live to age 78 on average, a decade longer than the average baby born in 1950. People who have already made it to their 40’s can now expect to reach age 80. These gains are probably bigger than the ones the British experienced in the entire millennium leading up to 1800. If you think about this as the return on the investments in medicine, the payoff has been fabulous: Would you prefer spending an extra $5,500 on health care every year — or losing 10 years off your lifespan?

  Yet we often imagine that the costs and benefits are unrelated, that we can somehow have 2006 health care at 1950 (or even 1999) prices. We think of health care as if it were gasoline, a product whose price and quality have nothing to do with each other.

  There is no question that the American medical system does suffer from a lot of waste, be it insurance industry bureaucracy or expensive procedures that haven’t been proven effective. But the No. 1 cause of the cost increases is still the one you can see at the hospital and in your medicine cabinet — defibrillators, chemotherapy, cholesterol drugs, neonatal care and other treatments that are both expensive and effective.

  Not even most forms of preventive care, like keeping diabetes under control, usually save money, despite what many people think. The care itself has some costs, and, more important, patients then live longer than they otherwise would have and rack up medical bills. “When I make this point, people accuse me of wanting people to die earlier. But it’s exactly the opposite,” Dr. Jay Bhattacharya, a researcher at Stanford Medical School, told me. “If these expenditures are keeping people alive, it’s money well spent.”

  As Dr. Mark R. Chassin of the Mount Sinai School of Medicine in New York says, “You almost always spend money to gain health.” Of course, the opposite is also true: the best way to reduce health care spending is to reduce health care itself.

  Which is exactly what we’re starting to do. The growing number of families without health insurance are, in effect, families who have been kicked off the country’s health care rolls. Many will go without available treatment, will get sicker than they need to get — and will thereby save the rest of us money. They are what now passes for a solution to the health care mess.

  The current situation is indeed unsustainable, a point that the conventional wisdom has right. The cost of health insurance can’t keep doubling every seven years, and wasteful spending — the brand-name drugs that are no better than generics, the treatments that haven’t been proved to extend lives or improve health — does need to be reined in.

  But far too much of the discussion has been centered on this narrow idea. Somehow, going to the mall to buy clothes has come to be seen as a vaguely patriotic way to keep the economy humming, and taking out a risky mortgage is considered to be an investment in one’s future. But medical care? That’s just a cost.

  It’s easy to be against high costs, and it will no doubt be hard to come up with a broad health care solution. But the way to start is by acknowledging that an affluent society should devote an ever-growing share of its resources to the health of its citizens. “We have enough of the basics in life,” Mr. Cutler, the economist and author, points out. “What we really want are the time and the quality of life to enjoy them.”"

  Posted on August 2, 2007 12:06 PM

• butte :

  I had to have surgery earlier this year. The initial bills I received were pretty damn scary they were so high.
  As retired military, I have Tricare Standard. The hospital, and various doctors submitted their bills to Tricare. I waited and watched the Tricare statements as I got them.
  I noticed Tricare didn't pay near what my initial bills were. But I didn't wind up paying the difference. In other words, Tricare told them what the caps were and they took the money. It's almost like the hospitals and doctors are trying to soak the uninsured for as much as they can, because they don't have the power of a major corporation, either HMO or insurance company behind them.
  Uninsured private citizens don't have that luxury. They have to pay through the nose. It's pay or bankruptcy, and the Republicans have pretty much taken bankruptcy out of the picture.
  I wonder how much the stress of financial disaster and dealing with uncaring and often vicious collection agencies adds to people's medical problems and turns recovery into more illness, not to mention the possible choice of either buying meds or having one's paycheck garnisheed.
  Why are the uninsured hit with such high bills if the insurance companies can get lower rates?
  The whole thing has left me with big questions about the whole medical system.

  Posted on August 3, 2007 8:05 AM