A major challenge is that a significant chunk of Americans have really good health insurance and access to great care. These folks are the mostly republican affluent and mostly democratic union members. Both politically active and powerful groups. So health care reform needs to find a way to expand coverage while not making the coverage/care of those who already have it good, worse or more expensive. This is a non-trivial challenge.

Perfectly analogous to what many of us have observed in our careers: Too often people get promoted to managerial rank not because they are good at the central task of the business, but rather because they are good at office politics. Apply this to gov’t and you have put your finger on a MAJOR flaw in American society.

when will americans wake up to that reality

the demos only pretend to be for the middle class

they will fold they have to fold for the lobbyist money

in a republic we deserve our politicans

best kept secret in america

mega profits off the sick and needy what more needs to be said about american values????????

selfish, self righteous, greedy, and arrogant

and of course love their wars for profits

and they want to dominate the world

700 military bases around the world is imperialism defined

trillion dollar military budget that is war mongering defined

two unwinable wars makes mega profits for the industrial military complex

yes we have met the enemy and it is the middle class or former middle class fast becoming lower class status

keep blaming snowe while the wealthy rob you blind

she is only doing what the rich are telling her to do

give credit where credit is due, she is doing her job well very well

In other news today, the NYT Editors *finally* came out for a robust Medicare-like public option!!!

The public option is on the march, baby…

… isn’t that our Congresscritters are bribed into supporting bad policies. It’s that they have to be so good at fund-raising to survive and thrive in this environment, that they don’t have the time and energy to devote to things that don’t contribute to their re-election, things like understanding the policy issues.

What I see in this statement of Snowe’s, and in everything a Baucus or a Conrad says on the subject, is not mainly the hand of their industry paymasters (though, Lord knows, that’s there). The most striking thing about what these “centrists” have to say on the subject is its utter assininity. They’re just dumb shits, at least on this issue, not even smart enough about the issues to come up with clever rationalizations for doing the industry’s bidding. I’m sure they’re utter geniuses at fund-raising. Too bad that’s not what we need them to understand…

What a great description of what we will probably end up with.

Your reference to ‘first dollar’ insuarnce is dated. That is 1960s and 1970s stuff. The move towards higher deductable and co-pays, and away from first dollar coverage has been going on for over twenty years and it has not fixed anything.

Further, if you will look at international statistics, the US does not have high rates of primary care utilization for people seeing the doctor for trivial reasons, or preventive care, or check-ups, or anything else. It has one of the very lowest rates. It does have high rates of utilization for advanced expensive procedures for very sick people.

I hope that reform does make access to primary care easier for selected preventive care services and check-ups than is currently the case. Most other high income countries with lower healthcare costs and better popualtion health do it that way. Simply proposing more indiscriminate slashing of affordable access to primary healthcare (more of what has been tried and has failed for the last 20 years) will not work.

And by the way, I am willing to pay quite a bit for a public option. My rates for a private policy are sky rocketing with more and more cuts in benefits. At least with a public option I would have more promise of honest delivery of service and some say through my representatives in policy design.