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  • Open Letter on Health Care

    To the President and Congress of the United States
    From Edwin Feulner, Ph.D.
    President, The Heritage Foundation

    Health care reform has been a central goal of The Heritage Foundation since our creation more than three decades ago, so we welcomed President Barack Obama’s call for a common effort to find the right solution to this public policy challenge. We believe that putting families, not the government, in control of the system is the key to success. We want to strengthen our health system based on that principle.

    The trouble has been that, no sooner does the President call for “everybody to pitch in” and engage in the debate, than he vilifies anyone who criticizes his plans. Denigrating different views does nothing to improve the tone of the debate here in Washington, let alone achieve real reform.

    Having a civil national debate will produce more lasting change; accusing opponents of engaging in “scare tactics and fear-mongering” will not.
    And make no mistake: there are legitimate concerns with what the White House has proposed. Americans need to understand the implications of all of the competing proposals, whether from the White House, from Capitol Hill, from industries, from think tanks or from interest groups.

    In his speech to the American Medical Association, the President said, “When you hear the naysayers claim that I’m trying to bring about government-run health care, know this: They’re not telling the truth.” Truth, however, is not a commodity over which the President has a monopoly. We not only believe that we are alerting the nation to potentially catastrophic consequences when we point out pitfalls in his plans, we think that some proposals being made by the White House are advertised on false premises.

    Here are a few examples:

    • If you like your health care package you can keep it: This assertion is difficult to square with the facts. The President says that a “public option”—a government plan—would just be one of many health care plans that Americans could select. In fact, a public plan will lead many employers to drop private health coverage for their workers and dump them into the public plan—just as many employers in the 1990s pushed their workers into cheaper managed care plans. According to independent analyses, as many as 119 million Americans could end up in a public plan. This is hardly letting people keep what they have. And many in Congress are eager to expand a public plan, with tight rules on what your doctor can do and how much he or she will be paid. Congress can do that because it will be both the “umpire” who sets the rules and the “team owner” of the public plan. There will be no “level-playing field.” We believe a public option will toll a death knell for private plans.
    • The end goal is not a single payer system: This is another Washington euphemism that confuses people. Let us all be clear: The “single payer” here is Uncle Sam, using taxpayers’ money, and not just paying the bills but calling the shots and deciding what care every American will get—or not get. The inclusion of a public option is nothing more than a Trojan horse. The architects of the President’s proposals, and the sponsors of his proposals on Capitol Hill, know that once a government plan is in place, private insurance companies will be eventually run out of business. The government already owns a major bank and auto company; we shouldn’t hand over the medical industry as well.
    • The proposals are deficit-neutral: The President also asserts that a government system will be fully financed. This is a stunning untruth. Analysts, including the non-partisan Congressional Budget Office–Congress’s own watchdog–have issued preliminary estimates that the cost could be high as $2 trillion over 10 years, with most of that borrowed money. Even squeezing Medicare payments and adding new tax revenue will not pay for the massive burden this plan would put on American families. And current congressional proposals would still leave millions without insurance. Washington always says that new costs will be paid by savings elsewhere, but these phantom savings never materialize. These new costs will be borne by American families.
    • The quality of your health care will get better: One need only look at current government health programs to test this premise. Medicare has huge gaps in coverage. Medicaid’s quality is notoriously bad. They both offer substandard care compared to most private insurance plans. These persistent deficiencies are routinely overlooked in discussions of a government health plan. Rather than fixing Medicare and Medicaid, what the government proposes is to make these programs the foundations of a universal plan.

    But we know opposing bad ideas is not enough. We need to fix the gaps in our health care system and lower costs for Americans. The system we need must not just protect union bosses, bureaucrats and select cartels, it must empower American families. The nation needs health care reform, not health care micromanaged by the government.

    We are happy the President has joined a cause we have championed since our inception. He has recently been asking audiences across the nation “Where’s the alternative?” We at The Heritage Foundation are ready to discuss our alternative plans and help craft a bipartisan solution to America’s health care problems. That is what the country needs and what the President says he wants.

    Specifically, a plan that would reform health care will need to:

    • Give families control of their health care: We need to let families—not the government—control decisions so they can choose the coverage they want. For this to happen private health insurance needs to be portable—that is, owned by Americans so they can take their package from job to job. The health care system we have today was conceived in the era of World War II, when many Americans worked for the same company all their lives. As we know, that is not the case today. The President has acknowledged this. But we do not need a public plan, or mandates on businesses, to have portability. We need changes in rules and the removal of tax penalties to allow families real choice and ownership.
    • Reform the tax system: For portability to become reality, we need to reform the tax system. Right now, families can get a tax break for their insurance only if they hand over control of their insurance to their boss, and leave their plan behind if they change jobs. That needs to change. We need to provide the same tax relief to families wherever they choose to get their plan. In that world of empowered families, plans would have to compete to satisfy them, not compete to cut costs for employers.
    • Bring on competition: Americans will get quality health care only with the mechanism that has given us quality in all other aspects of life: competition. The way to get quality care in America is to have insurers compete to satisfy families in an insurance market, one that provides transparent information, ease of delivery and quick results, and which is fair to families and their doctors. Members of Congress pick and choose plans in such a market. The rest of America should also have that right.
    • Recognize that states know better than Washington: The challenges of organizing and delivering health care vary greatly across the nation. Rural Mississippi is not the same as Midtown Manhattan. States have always been smarter than Washington at figuring out how to get the job done. To the extent that government must play a role, the states should take the lead in devising the best way to reach our national goals. The last thing we need is one-size-fits-all health care. Congress needs to let states find the best way to achieve value for money in widening coverage while bringing down costs.

    A reckless, expensive and one-sided rush toward “reform” would not only be damaging to our public discourse, but it could fundamentally change our society in ways that have far-reaching consequences.

    Rather than bringing in the failed central-planning approach to health care, with the government controlling who gets what, let’s ensure access to affordable health care for all Americans. Let’s use the tried and tested approach of the empowered consumer in a truly competitive market.

    These are some of our remedies to our nation’s health care system. There are other free market ideas that also warrant consideration. We call on the President and Congress to widen the conversation. Let the debate truly begin.

    Posted in Obamacare [slideshow_deploy]

    113 Responses to Open Letter on Health Care

    1. Ron Yauk says:

      I couldn't agree more with the assertions in the open letter to the President. There are more deceptions and untruths in Obama's description of the public health care plan than there are facts. This plan is a sham on the American people that will just be one more act of the fed getting involved in areas they shouldn't be and adding more taxes on all of us.

    2. Frank Crocker, Washi says:

      I have yet to understand why this new bill is planning to model its new system after Medicare. Medicare is one of the most inefficient programs in our government, costing billions per year for sub par service and health care.

      However, it will be difficult for many Democrats to actually vote for this bill, in my opinion. Many people in Congress are there because they received donations and were backed by large, health care companies. The companies have an extremely large and influential clientèle, and if their delegates abandon them, they will quickly turn to the opposition. There are at least 50 seats in congress that would be lost if they were to vote for this "government plan"

      http://www.axiomatennessee.com

    3. Gary Shelby, Raleigh says:

      Vote "NO" on the Kennedy-Dodd Health Plan.

    4. Geraldine Lewis says:

      My vote is: Ed Feulner for President!

      Thanks for such a great and meaningful letter regarding "American Health Care" Mr. Feulner!

    5. Mary Moise, Forked R says:

      Applause! Applause! Thank you for speaking out for me and millions of Americans.

    6. Diane Preslar says:

      Excellent letter. A phrase out of one of your sentences, "empowered consumer in a truly competitive market." really excited me. I've been following the President on this subject and it scares me how fast things seem to be happening. I just think he needs to slow down because any actions he takes without full consideration will be devastating.

    7. DAG, Round Rock,TX says:

      I desagree with Obama's proposals in general, but playing devil's advocate I must say that under Heritage's proposals millions of americans still won't be covered by health care. Nothing is proposed here in this regard.

      The fact is that currently people which do have insurance are mostly happy with it although it is expensive ( it probably should be expensive in order to be happy with it). But 50 millions have no insurance. Potential improvements, such as bringing small employers together, tax reduction, paperless technology, etc. are cosmetic and won't drastically change the situation.

      No matter how you slice the pie the inevitable conclusion still stands: someone has to pay for those who have nothing and one way or another the society as a whole is already paying for it, although not in a most effective manner.

      Spreading the wealth… this is the direction Obama administartion is moving toward. Although the very rich won't feel it, the working upper-middle and middle class – will.

    8. Milton Humphreys, Th says:

      a good letter but it omits an important point-the supply side.all plans so far contribute to creating an infinite demand for a finite supply and severe rationing.Healthcare insurance is not the same as Healthcare, which is only provided by medical professionals.All that want to preserve the best system in the world should actively support providing the private sector with the necessary resources to improve the supply side.

    9. Michael Henreckson says:

      Wise words indeed. I particularly like the idea of portable private healthcare in this economy where workers may not stay at one job for ten years. The ability to move around and take a quality healthcare plan of their choice would greatly increase their freedom.

    10. John Hoffmeister, Da says:

      The President of the United States must begin to realize that he represents over 300 million people who are protected and guided by the Constitution and Bill of Rights. We have the right to freedom of choice and speech. The debate on the future of healthcare that involves a central point of control must be held openly in order for all alternatives to be carefully considered. This country was built on wide-ranging debate. Our president, by his actions, demonstrates not only a cavalier approach to democracy, but his true statist ideals…ideals that will erode the beauty of our democracy and render us alike to just another "European State". Once the leader of this great nation recognizes his role as a steward of our unalienable rights and not as some third world leader of a regime, we can make progress for the good of all Americans. Perhaps we should all take a deep breath and recognize that his young, talented man does not have the experience to perform the duties of this office.

    11. ragingspear, califor says:

      I would add that there is no reform of the health care system without cost control. How do you get this done? If you think that the proposed public option will control costs, look at how poorly Medicare has done that. Half of the total health care dollars we spend in this country is spent in the last six months of life, and Medicare insures the bulk of the elderly.

      There won't be any significant reduction in cost, (actually holding the line against the rise in health care costs,) until there is real tort reform. Hospitals and doctors cannot reduce intervention on the terminally ill without exposing themselves to liability. If they can't do that, we can't start to reduce overall costs.

      And Democrats, and many Republicans, will not stand up for reforming the tort system because, 1) trial lawyers give them money, 2) the existing contingency system gives "the little guy" access to the legal system, and 3) many of our politicians, particularly senators, and of course the president, are lawyers themselves.

      There are many suggestions out there for tort reform. One easy and simple one is that in order for a plaintiff and his/her attorney to bring a case in court, they must set aside, or post a bond, amounting to enough money to cover the costs of the defendant in the event that they lose their case.

      This idea has been around a long time, and is in effect in many countries around the world, but is rejected here in the USA because it would put a lot of lawyers out of work, and would result in fewer contingency cases going to court. No doubt there would be some famous cases that in the past were contingency based not being filed, but if the cases are good enough, then the lawyers who would bring them, can post the bonds themselves. They stand to make a lot of money if the case is won. Why not have them put their money where their mouths are and take some of the financial risk for the financial benefit if they win?

    12. Shari Berens, Mount says:

      What a great article! A very clear and concise alternative to the Obama health care plan. I am making phone calls to Congress and the White House today!

      Thank you!

    13. Bernie, Scottsdale A says:

      I wish every American would take a minute and read this letter,instead of paying so much attention to President Obama's nonstop television rhetoric. His confidence level is so high, yet he has no proven record of accomplishment since leaving college.

    14. Donald J. Lisa, Mesa says:

      Dear Ed: I have read your open letter to the President and Congress and agree 100%. The analysis by The Lewin Group VP, John Shields, in his testimony to the Ways and Means Committee on 4/29/2009 exposes Obama as a liar with his intentionally deceptive sweet sounding talk. It is crucial that the people be told clearly that the reason the private plans will go out of business if a public plan is offered in competition with them is because the premiums for the public plans will be dramatically lower than the premiums for the private plans based on the facts that (1) the public plans will mandate lower payments to providers for their services performed than the private plans will pay under their "negotiated" rates, so the public plan's payment costs will be dramatically lower, and (2) the public plans will not have to provide for any profit margins, insurance agent or broker commissions and fees which the private plans must provide, thereby further significantly lowering the administrative and operating costs of the public plans. Given this competitive environment, no private individual in his right mind would stay in a more expensive private plan when he could have the same benefits in a much cheaper public plan. Ergo, 119 million people would voluntarily give up their private plan and opt for the public plan, basically putting all of the private insurers out of business and guaranteeing a single payer public system for all Americans, which is what Obama secretly wants. We know such a government run system would be an utter failure. Just look at Social Security, Medicaid, and Medicare. Sincerely yours, Don Lisa.

    15. Donald J. Lisa, Mesa says:

      Dear Ed: I have read your open letter to the President and Congress and agree 100%. The analysis by The Lewin Group VP, John Shields, in his testimony to the Ways and Means Committee on 4/29/2009 exposes the fatal flaw in President Obama's offer of a public plan. It is crucial that the people be told clearly that the reason the private plans will go out of business if a public plan is offered in competition with them is because the premiums for the public plan will be dramatically lower for the same benefits than the premiums for the private plans based on the facts that (1) the public plan will mandate lower payments to providers for their services performed than the private plans will pay under their “negotiated” rates, so the public plan’s payment costs will be dramatically lower, and (2) the public plan will not have to provide for any profit margins, insurance agent or broker commissions and fees which the private plans must provide, thereby further significantly lowering the administrative and operating costs of the public plan. Given this competitive environment, no private individual in his right mind would stay in a more expensive private plan when he could have the same benefits in a much cheaper public plan. Ergo, 119 million people would voluntarily give up their private plans and opt for the public plan, basically putting all of the private insurers out of business and guaranteeing an exclusive single payer public system for all Americans. We know such a government run system would be an utter failure. Just look at Social Security, Medicaid, and Medicare. Sincerely yours, Don Lisa.

    16. GR FOX SOUTHPORT NC says:

      I am 81 years of age; I retired in 1992. In 1993, Clinton & Co. started taxing 85% of my and my spouse's S.S. retirement benefits. Tax starts at $32,000 total retirement income. In 2008 my tax on SS was $6600. Our health insurance was about $5400 (medicare + secondary). We are satisfied with our medical expense coverage. However, I would be much more pleased if our SS benefits were free from income tax. We could then pay for our health insurance and have a little left over.

    17. Carla, Portland says:

      I believe the Heritage foundation needs a new fact checker…..

      "The government already owns a major bank and auto company; we shouldn’t hand over the medical industry as well."

      The government had to step in & save the banking & auto industries because the people running the companies were incompetent & greedy. If the insurance industry doesn't want the government taking over their business, perhaps they shouldn't have been raising their premiums astronomically while cutting benefits in order to pad their own pockets for the last decade.

    18. Ken St Louis says:

      I am 70 years old. I get social security which I paid into, so I think I'm entitled to that! Although I would have preferred to put my earnings in the market, and believe I would be light years ahead of what I'm getting now. As to government run anything. When I tried to sign up for Medicare I was told that I wasn't eligible because I still had private health insuance from my employer.I hadn't had private health insurance for 2 1/2 years! It took me 5 months and untold hours to finally get enrolled in medicare. If you make a claim to medicare you may get a response from and office in Phildelphia one week, and then the mext one will come from and office in Alabama, or heaven only knows where. The federal government couldn't run a lemonade stand without screwing it up!!! Can you even imagine what a nightmare it would be if they had a hand in Healthcare??

    19. Michael Moyer,Royal says:

      I am one who does not have health care and I have three children but I am going to get health care now and I will cost me but I will be able to to chose for my family as I have the rigth to as a american.

    20. Peter, Amherst MA says:

      Beautifully and simply stated. Everyone (including members of congress)should read this letter to help them make an intelligent decision about this issue. Thank you for the honesty!

    21. Russ Hall 14 W.Wab says:

      Good ltr on the Obama plan to take over our health care system in America. He is taking this country down the road toward communism and it must stop. I refer everyone here to the ltr on G. Beck's show yesterday from the grandma in Calif. It outlines all of our concerns against the policies of this community organizer socialist. Please, everyone, read that letter and sign it so it can be forwarded to every politician in Washington.

    22. Andrew Schlessinger, says:

      I would love to see ALL governments get out of the health care regulation businesses, that includes repealing state mandates on what insures must offer. Let the people and the insurers determine what is best for them, including not having coverage at all. We accept risk on much more important issues than health care without government mandates, why not now?

    23. R. Donegan, Springfi says:

      As always, The Heritage Foundation leads and stands on the principles of the Founders. The Obama administration is on a fast track to fundamentally change the nature of the United States and it must stop! While there is plenty of blame to go around when it comes to why this socialist/radical was elected in the first place; it remains for all of us who are true Patriots to work as hard as we can to stop these fools in their tracks. The penalty to individual liberties and our children's futures is far too great to let this socialist/radical succeed. The true Patriots in congress, who still remember that they are there to serve, regardless of party, must take a stand against this madness…

    24. Joanna Campbell says:

      It is difficult to understand how President Obama can justify taking responsibility for healthcare from individual families. I've wondered if the Obama administration has complete distain for the ability of each American to tend their lives. Certainly, individuals make errors, "along the way we all stumble", but most keep trying to be effective in making decisions regarding their lives, most especially decisions that concern something as personal as healthcare. Perhaps, Obama thinks Americans are those who "refuse to begin the journey" [to develop virtue, including self government which mandates personal decisions]. Consequently, if my understanding of Obama's view of Americans to make personal decisions is accurate, any recommendations from that quarter are highly suspect and, indeed, must be debated and decided in the public forum, and not in the White House.

    25. Ann Johnson says:

      Thanks for your info. I'm sending my congressman

      & Senators emails today.

      Ann Johnson

    26. Joanna Campbell says:

      It is difficult to understand how President Obama can justify his position on healthcare. I agree with Heritage, that healthcare should be decided by each family, and to accomplish this it must be debated in the public forum. This exercise would have value on a number of fronts: families would begin clarifying their healthcare objectives, determining personal costs and necessary planning, and begin reclaiming control of their lives. These, among other, values are lost when the debate is decided for them. I also agree with Heritage that changes in healthcare are critical and that changes of such import cannot be done well when rushed. Refusing to rush is not the same as procrastination. On the other hand, Heritage has a ready, well articulated, plan, what is the delay?

    27. Pingback: Sensible Health Care Reform « Justbkuz

    28. Patrick Moran, Honol says:

      Once again, a "Mammoth Plan" in the making, which must be pushed through our House and Senate in the quickest time possible…to SAVE the most taxpayers money possible…is turning out to be another "TRILLION DOLLAR BONANZA" heading the… other direction, and taking the American citizen down the Obama trail of "Imposter FIRST – Lover of Life & Liberty – LAST"!

      Patriots must come to the forefront to rescue our country! I just returned from Western Samoa where people from around the world are searching for relocation, and bringing their funds and pride for liberty and justice with them! It's a Independent Island Nation (a Democratic Republic with a Parliment of the Righteousness of God prevailing from Scripture)and the most common quoted Biblical sourse: "If a man does not work, a man does not get paid, and a man does not eat". It sure solves a lot of problems in so many ways!

      THE BOTTOM LINE: They're SOLVENT, and the people love their neighbors as themselves…like we used to do

    29. william wilcox olath says:

      Thanks for the letter to Obama on health care debate. Obama is too arrogant to listen to the other side. It's sad and unfortunate and I pray that Americans wake up to all that is going on before it is too late. Keep up the work. I continue to contact my Representative and Senators on all these matters

    30. Pingback: babblestatic » Blog Archive » Obama’s Healthcare Plan debunked

    31. Betty Perkowski, CT says:

      One cradle to grave government health insurance/healthcare system already exists . It is Indian Healthcare. Just look and see how that is working out. It's "free" for the recipients and that's about all you can say about it. What are the death rates for various illnesses etc.? ife expectancies? Would nayone want to go to a resrevatioon if they had a catastrophic illness to be treated?

    32. Willam Galivan, Tall says:

      In reference to DAG's comment I feel it should be pointed out that of the 50 million uninsured 9 million or more are illegal aliens; millions of more can afford insurance but choose not to get it, and almost all of those who don't have it and want it are only without insurance for 18 months or less. There is a problem, however, it is blown way out of proportion with the phony 50 million number.

    33. Stephen Kale, San An says:

      Dr. Feulner has written a persuasive letter. Several commenters have made negative comments about Medicare. I disagree strongly with these negative comments. I am 74 and my wife is 73. Medicare and our supplemental insurance have promptly paid for all of our hospital and provider expenses since we turned 65. The providers handle all the paperwork. Medicare pays the providers at rates greatly discounted from their so-called billing rates. Our premiums are less than they were for my last employer's covereage.

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    35. Mike, WV says:

      Is anyone planning to protest in DC related to this and the "Cap & Tax" issue? I want to participate!

    36. Pingback: Ed Feulner on Health Care… « Campfire Blog

    37. D Mooter, Kennard, N says:

      As William from Tallahassee stated, DAG is way off on his 50 million number. Last week it was 40 million. In actuality the number is probably closer to 10 million who really need help. The other 30 to 40 include illegal aliens, people who opt out of employer plans, and people who just don't want to bother. I wonder how far this would get if Senators and Representatives would be forced to take the proposed public option. This thing would be DOA.

      I have been looking at comments on several sites including Fox Nation and ABC News and the people against this takeover outnumber the people for by about 30 to 1.

      If Obamacare should happen to get through the blame should fall on the government run media for the mess that will be created. They are purposely hiding the truth.

      Great letter Ed.

    38. Pingback: Obama care

    39. Linda Sills Oceansid says:

      Great letter to Obama. There is so much wrong with this administration, I do not have enough room to go into it all. This healthcare debacle is just another aspect of this (particular) statist's agenda. It is another way to take control of our lives, put more and more taxes on us, and destroy what little freedoms we have left. This president and all of his cronies are abusing power. Pure and simple. I have faxed, written and voiced my concerns to every Senator and Congressman and the president to no avail. They do not care about us. All they want is their absolute power.

    40. Angela, Dallas says:

      Very well written letter. Maybe I have just not been exposed to them, but where are the AMA and healthcare workers comments on this subject? As one responder noted, the supply side of the supply-demand equation must be taken into consideration in this debate. It would make sense that the suppliers would have something vital to say on the topic. How can Obama and his cronies possibly attempt to duly tackle this situation without hearing from that other necessary category of players?

    41. Roman Melnyk, Califo says:

      Great letter Ed. I have emailed both my senators this past week about this…no response.

      I hope this letter is forwarded to the AARP. Senior health will really take a hit if this happens.

      I do have medicare and happy with what I have.

      R.M.

    42. Pingback: Well said…. « babblestatic

    43. Ruth Lobs, Jacksonvi says:

      Thank you for the excellent letter and clearly stating what health-care reform should look like. To paraphrase a quote I read a little while back, Americans will not accept socialism in its present form, but will accept it in the guise of liberalism. The one thing this President is good at is cloaking his socialist agenda in terms that do appeal to Americans like "free market" and "personal choice." Anybody with a brain knows that a public option will drive private insurers out of the market and all we will be left with is a degraded health care system with long waiting periods for care, rationing, government ineptitude, and at a cost we can't afford. But he stands there and gives us a pretty smile and accuses his critics of fear mongering, and lies through his teeth. The only difference in the Obama health care and Hillary-care is that the new socialist is more patient and willing to wait for the eventual fall of free markets and free choice that will be brought about by the "public option" plan. Wake up America! Has everyone swallowed the kool-aid?

    44. Thomas L. Fournier, says:

      Off the subject a little bit, how do they come up with 47 million Americans uninsured?

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    46. JGNY says:

      Why is there no mention of the mandates that the government forces on the insurance companies causing the premiums to skyrocket. prior to 1980, there were only 32 mandates, now over one hundred. The mandates were a type of forced governmnet control of healthcare. This caused a ripple effect as fewer employers offered healthcare.

    47. JT, SAN DIEGO, CA says:

      As a practitioner in the HEALTH CARE for many years, the "need" to improve Health Care should start with less Government rules and regulation on not only Health Care, but also on SMALL BUSINESS, and include TORT REFORM and the provision that whoever sues and loses is responsible for the cost.

      Thanks, and please keep th INFO coming!

    48. Martha. Gardner, San says:

      I agree 100%, and unfortunately the media by and large will not tell the true story. CAn this letter be attached to an online petition, promoted and then presented to members of Congress and BHO? And mAybe the AP?

    49. M. Degirolamo, MD says:

      Congress needs to address tort reform. The excesses in litigation, due in part to contingency fees and and the glut of lawyers competing for business, has resulted in the increase of the practice of defensive medicine which drives up costs.

    50. Pingback: News You Won’t See In The Mainstream Media Monday, June 22, 2009 — ExposeTheMedia.com

    51. M. Barrie Illinois says:

      After working at the same factory job for the last 38 years,I am dismayed at how little my co-workers are concerned about the healthcare trainwreck our present "leader" has in store for us or for that matter even the rest of the plans he has to destroy our way of life. It reminds me of the story of the frog paddling around happily in the kettle of water on the stove while the burner was being turned up slowly. Thanks,Heritage for putting the truth with the facts out there.

    52. Erin Anderson, TX says:

      An excellent letter, which will no doubt be ignored by Congress, the White House and the media. Both Congress and the media are turning a deaf ear to criticism of the proposed "reforms". Democrats in congress have already stated that, while they would "like" bipartisan support, they don't need it and will push through their plan with or without Republicans. And ABC's unrebutted airing of the President selling his plan will further mislead the public about the true costs & consequences of greater government intervention.

      Any reform of our current system must include returning health care and health insurance to a free market system, where buyers choose and providers compete based on price, quality, and individual needs. Why have health insurance through an employer? I don't buy my car insurance, for example, through my employer – I buy it in the open market, based on the above criteria. If we purchase health care freely as well (which I do as a self-employed person), comparing prices and the quality of providers, we can make better choices and providers will offer more competitive prices.

      What is surprising in this debate is how little we have heard from doctors, insurance companies, even AARP. The time to speak up is NOW! With (by their own admission) just a rough draft on the table at this point, Democrats want to PASS their health care plan by the August break. I believe the best hope for holding them off is to inform the public about the true costs of the current proposals and present better options.

    53. Olive Harrison, Band says:

      I have in the past carried health insurance with

      the company that I worked for. My Husband and I have a small new business and have no insurance. We currently can not afford the cost, but we definitely do not want the government to tell us what we need or can and cannot get. I ap-

      rove of the open letter and plan that is suggested. Why do I and other Americans work and

      struggle to pay our own insurance but also have to pay citizens and non citizen health care who most have the same options to work and pay for their own. But why should they when Democrats and

      Obama tell them that hard working Americans will do it if they do want to do it themselves. Personally, I do not want the government making my

      decisions on anything except for national security

      which I will gladly pay. Mr. Feulner please keep up the excellent work, it certainly is a step in the right direction.

    54. Amanda Gilpin says:

      Finally, someone eloquently challenges the premise that government has all the answers to health care. We already have living proof of the kind of health care our government would provide -Medicare, Medicaid and the Veterans Administration. Am I the only one who sees this? The best answer for health care reform is to dismiss the idea that reform needs to be government controlled, and put the patient and his physician back in control of medical care. There can not practically be a "one size fits all" health care system.

    55. cj, medford, Or says:

      Thanks for the letter to Obama, Congress, et al regarding health care. Of the four points you address outlining what a reform plan will need to do, I believe that giving families control over their health care is a resonable goal; however safeguards need to be addressed for children. It would be nice if private health insurance was portable. I am not sure where you are coming from when you call for "Bring on competition". Competition does exist and it has not brought down prices. The main problem is the shell game the medical establishment and the insurance companies are playing. The cost are out of line and the American people and American business is getting ripped off day in and day out. How would you fix Medicare and Medicaid? The Republican enacted drug program has turned out to be a sham for the drug companies. I do not know what the solution is and do not think government can solve this problem by itself, and I know for sure that the private market based approach will not work either. Why did you not mention Tort reform?

    56. June 23, 2009 Norman says:

      Having read your open letter to the President and Congress,

      I must agree totally. Things need to slow down, have more

      debate and have the President and Congress listen to the

      "people" not their political cronies. The "people" have done

      a great job with this country–we do not need government

      in more of our lives. We need more discussion –not one

      sided conversation and no more scare tatics. Thank you

      Heritage for all you do!

    57. stephen stuntz, colo says:

      edwin,

      thanks for publishing your health care reform letter to the president and congress. i agree with you that the president's plan will result in very expensive single payer system that will provide mediocre (lousy) health care to all. I applaud your efforts!

    58. bob cutting, colorad says:

      It seems that no one wants to talk about it, but tort reform will do more to make health care more affordable than anything else, and it will do it immediately. Your points are all valid – just include tort reform.

    59. R, Widener, S.C. says:

      The more ideas Obama dreams up the more he shows his lack of apprenticeship training on the basics

      of our Constitution as he seems to be ignoring it

      on many issues as he takes us down the road to

      socialism and it must stop.

      Thanks Ed for the great letter. Keep the good work working.

    60. Pingback: Obama Health Care Promise - Expired | Radio Vice Online

    61. SAMUEL says:

      THANK YOU FOR YOUR LETTER. WE IN AMERICA, ARE LIKE THE IRAN'S. WE HAVE NO VOICE IN ANYTHING OUR GOVERNMENT DOES. BAILING OUT THIS BANK AND THIS AUTO COMPANY WAS AND IS A JOKE. ALLOW THEM TO FAIL. ALLOW THE LEADERS TO LEAVE WITH ZERO MONEY AND GIVE UP ALL THEIR OCEAN AND LAKE FRONT HOMES. ALL THEIR MONEY IN FOREIGN BANKS. SERVE TIME IN JAIL LIKE THE REST OF SOCIETY THAT DOES LESS, AND SERVES TIME IN JAIL. WHITE COLLAR CRIME AND GOVERNMENT CRIME IS MAJOR.

      THIS WILL CEASE IF THE CRIMINALS ARE ALL TREATED ALIKE.

      START WITH FANNIE AND FRED LEADERS, THEN ALL BANKS THAT GOT TARP MONIES, THEN GOVERNMENT LEADERS.

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    63. Mark, Arizona says:

      Why not lower the cost of Health Care across the board? Why does Heart Bypass surgery cost 130,000 in the U.S but only 10,000 in India? I can buy a house for the price it cost to get my heart fixed and that is just wrong. I don't care which way you look at it. The cost is overly inflated (another bubble). Lower the cost of Doctor fees, drugs, supplies, medical equipment, hospital stays etc… and the price of your Health Insurance should drop. Get rid of malpractice and hold the doctors crimally responsible. Our system is a good one but it does need a bit of massaging and some cost caps need to be put in place. Everyone should be able to choose the plan they want, but somebody needs to rein in the outragous cost. Set a reasonable price for all medical services provided and then, only then, will ALL legal citizens be able to afford health care. Screw the illegal citizens in our country. It makes me want to puke on our government for paying illegals health care. Grrrrrrr!!!!!! That another story itself.

    64. Scash, Texas says:

      What ever the choose; congress and all goverment officials must be REQUIRED to use the exact same service they devise.

      Also add a mandatory 10 year prison sentence to the provider AND the congress person if its found out they are getting special treatment. (IE line jumping, put to top of list, etc)

    65. Scash, Texas says:

      ..What ever they choose; congress and all goverment officials must be REQUIRED to use the exact same service they devise.

      Also add a mandatory 10 year prison sentence to the provider AND the congress person if its found out they are getting special treatment. (IE line jumping, put to top of list, etc)

    66. SinglePayer4all says:

      Please tell me, whats SO wrong with pushing out the Insurance Co's. The same ones that deny you coverage for certain procedures and raise your rates in 7-12% clicks at a time. Must be the same people who stand up for CEOs that are making 400% more than the average American.

    67. John wilson says:

      If the president agrees to wait in line like the rest of the sheep Ill go along with the plan.

      We could also look at ending retirement plans for congress and the President since they are already millionares. Those savings would pay for the cost right away.

    68. Scott, Maine says:

      A public plan is not a Trojan Horse- it is a much more obvious path to a single payer system.

    69. Alan, Kentucky says:

      Apparently, malpractice litigation reform has dropped off the radar. It seems completely illogical to have a discussion about regulating health care decisions and providers without offering some relief from the ever-increasing cost of malpractice insurance.

    70. Maria Folsom says:

      On those "47 million uninsured" people: we need more definition. Many if not most of these people are uninsured by choice. Most uninsured people I know have new cars, take vacations, buy expensive games and sports equipment for themselves and their children, get expensive haircuts, buy beer and wine . . . you get the point.

      Being uninsured SHOULD be a choice, as it is. In addition, having health insurance does not guarantee having good health. Many behaviors and choices are necessary in achieving the goal of "good health." Forcing some people to pay for the insurance of other people does not achieve this goal.

    71. Tom Grunzinger, St. says:

      True and effective reform of big government programs can only be achieved by allowing those who don't rely on government benefits to pay for better quality services. This applies to health, education, and welfare. Those relying on public funds are not entitled to the same level of quality as those who pay for the service.

      If a decision is made to tax employer-provided health benefits, then it demands capture of the value of all benefits received by those in poverty as determined by earnings below poverty guidelines. To assess virtual wealth, one must add the value of all benefits (earned income credit, food stamps, school and child-care meals, subsidized housing, energy assistance, Medicaid, public education, additional child tax credit, etc.) to earnings. This would reveal that many poor non-taxpayers are wealthier than many middle class taxpayers.

      The Heritage Foundation, along with other conservative organizations, should mount a major offensive to expose the fraudulence of "means testing" based on poverty guidelines using earnings alone.

    72. Ken, California says:

      These comments by and large are wonderful. A testimony to the level of involvement and thinking among our citizens.

      I'm copying and pasting a comment near the top of this list because it's important and might be missed.

      Tort Reform is important for practically ALL our ills. Not just healthcare.

      ragingspear, california writes:

      I would add that there is no reform of the health care system without cost control. How do you get this done? If you think that the proposed public option will control costs, look at how poorly Medicare has done that. Half of the total health care dollars we spend in this country is spent in the last six months of life, and Medicare insures the bulk of the elderly.

      There won’t be any significant reduction in cost, (actually holding the line against the rise in health care costs,) until there is real tort reform. Hospitals and doctors cannot reduce intervention on the terminally ill without exposing themselves to liability. If they can’t do that, we can’t start to reduce overall costs.

      And Democrats, and many Republicans, will not stand up for reforming the tort system because, 1) trial lawyers give them money, 2) the existing contingency system gives “the little guy” access to the legal system, and 3) many of our politicians, particularly senators, and of course the president, are lawyers themselves.

      There are many suggestions out there for tort reform. One easy and simple one is that in order for a plaintiff and his/her attorney to bring a case in court, they must set aside, or post a bond, amounting to enough money to cover the costs of the defendant in the event that they lose their case.

      This idea has been around a long time, and is in effect in many countries around the world, but is rejected here in the USA because it would put a lot of lawyers out of work, and would result in fewer contingency cases going to court. No doubt there would be some famous cases that in the past were contingency based not being filed, but if the cases are good enough, then the lawyers who would bring them, can post the bonds themselves. They stand to make a lot of money if the case is won. Why not have them put their money where their mouths are and take some of the financial risk for the financial benefit if they win?

    73. Jim Atkinson, Texas says:

      Amen! I could not agree more, and just don't understand why those that are for the Presidents plan just don't get why it is so bad, not free comes without cost!

    74. Jim Atkinson, Texas says:

      Amen! I could not agree more, and just don’t understand why those that are for the Presidents plan just don’t get why it is so bad, nothing free comes without cost!

    75. sue, st. clair MI says:

      The last time I checked, health care was a privilege not a right.As an ER nurse, I know ER's get abused. My answer is to increase govt. clinics for routine health care and is hospitalization is needed, make it on referral only from those clinics for people not presently insured. If the congressman and senators will accept our proposed govt. health care instead of the elite program they enjoy, I will think about it also. Let's discontinue their health care and fancy retirements and make them accept social security like the rest of us and that should save the govt. enormous sums of money. Politics has gotten to be nothing more than an elite lifestyle for morons we elect who then spend the rest of their working lives making sure they get re-elected in order to enjoy all the perks they receive. I say take away the perks and maybe we will get people who genuinely care about our democracy and people and not the narcissists we lcurrently have in office. If you do away with the present health care system, you can say goodbye to experimental drugs, new drugs etc. How would you like to look forward to becoming 50 and be told you only have so much to spend per year on your health care? If you need a pacer or defibrillator….too bad…..they are too expensive and you are too old. You die!! I can tell you as a nurse that lots of people when given free medicine, advice on birth control etc simply listen and then go their own way and continue their old habits…and if govt. is paying….all the more reason to abuse the system. At least the abuse now is pretty minimal. Gov't. needs to stay out of free enterprise….this president is way out of line in his involvement in free business and needs to be voted out of office next time. He is ruining our very way of American life and liberty with his radical politics and pass new bills at any cost. Young people, you better wake up—you are the ones who will carry the financial load while the politicians enjoy their retirements in the style to which we have accostomed them.

    76. Brad Worthington M.D says:

      Our neurosurgical specialty hospital provides excellent care for a variety of neurosurgical problems including those patients needing major lumbar spinal decompression and stabilization.Our length of hospital stay is a fraction of the national average,our direct costs to patients and third party payors is significatly lower,our outcomes are superior,and our patient satisfaction is excellent.

      Yet,our facility is paid the same as those facilities we consistantly out perform.We outperform competitors and are not rewarded in any way other than satisfaction for a superior "product".When payers recognize and reward superior results the healthcare system will evolve to the most efficicent and quality first….then cost driven end.

    77. Alan, Kentucky says:

      We need to remember that presently “uninsured” does not mean one doesn’t have health care. Our hospitals and many clinics enjoy tax exempt status because they provide a level of charitable care. Granted, it certainly is not the most efficient method of care (eg., emergency room visists for cold symptoms). But that is an issue to be addressed through the current system; not a reason to do away with what we have. The great majority of Americans are insured. Let’s work on adding to those ranks through tax and other incentives to families and employers.

    78. mesa arizona says:

      Once again another boondoggle on the backs of taxpayers. I really wonder at the thought processes of people who dont have any idea how to pay for it and tell you they have no idea how to fund it with "savings".

      Apparantly they Do think we are all stupid!

    79. Jack, Marietta, GA says:

      As Ayn Rand said, "Check your premise!"

      The premise to which I refer is evident throughout this thread: government has a place in health care. Can anyone indicate where in the U.S. Constitution (Article, Section and clause) that the federal government has ANY place in health care?

    80. Jane, Georgia says:

      You're right, Jack. Feulner is weak. He cedes ground, acknowledging that it is okay for Democrats to meddle in health to some degree; he just wants to quibble over details. He is happy being enslaved as long as the rope is not too tight. He cannot stand up for the right of Americans to be completely free from government interference in medicine. With friends like him, who needs enemies?

    81. Dana, FL says:

      My family and I switched to an HSA/High Deductible Health Plan, and we are saving hundreds of dollars a year. We pay more to go to the doctor for check ups, but still save money compared to former monthly premiums. I think the mindset of what health insurance is for must change. Insurance is for catastrophe. Our home insurance doesn't pay for a plumber to fix a leaky faucet, but it does pay for hurricane damage. Health Insurance should be no different, and this change in mindset would mean real reform. I'd like to hear more about HSA's in the national debate. I love the open letter otherwise.

    82. Gary, OH says:

      We had that debate when Bill/Hillary tried to push their agenda in the 90's. The people spoke and the current administration is afraid they might get the same answer. Dr. Feulner is absolutely correct. Government run health care can not possibly efficiently dispense health care to such a diverse nation and expect uniform results. The current Government program has over $30 trillion in unpaid obligation today…and we want to keep digging the hole deeper??? Local control is best and that locality is the family/individual. The Administration and Congress know what they are doing. They know that a US government health care system is not going to be any better than a Canadian, UK, French or German one. It is about having the electorate dependent on our politicians, which translates to POWER. Sad.

    83. K. Outzen says:

      I am a cancer survivor. I am as against "Obamacare" as anything I have ever been opposed to in my life! I am desperate to get the word out.

      One of my senators, Warner D-VA, replied to my complaint against nationalized health care with a perky read-between-the-lines bill of his own which he plans to introduce. I wrote back with my own translation of his cost-control-via-euthanasia bill and a plea that he NOT push that bill. I have not heard a response.

      I know why United Health (my own insurer) would but why in heaven's name would AARP endorse such a bill???

      How do we get the current congress to shelve this thing for the summer and still save face? If we can get it past this year, next year is an election year & they may not be so eager to ram it down our throats.

      Please, for anyone who has had to navigate the health care industry through a life threatening illness, I beg you, call your Congressperson today, write them a letter both on-line & snail mail! Help family & neighbors get the contact information–whatever you can do to facilitate the outcry necessary to get the powers that be to BACK OFF!

      OBAMACARE IS A CANCER THAT IS INVADING THE BEST HEALTHCARE SYSTEM IN THE WORLD!!!

    84. Dave O, VA says:

      Saying that the federal govt can be an equal team player in the health care business is like staying there will be no politics in a govt ran health plan. No one can compete straight up with the federal govt. Where are the proposals for no federal govt health plan and relying on private firms only; same as life, auto and home insurance?

      Sure there are govt regulations to keep the insurance industry fiscally sound and fair to citizens but there isn’t a govt provider (other than flood insurance for homes which no private insurer wants). Govt regulation fine; govt provider not so fine.

      Right now we pay for health care through our premiums, local, county, state and federal taxes and donations to charities. This is how we pay for all the free clinics and county emergency room visits by the people who have no health insurance, but they do have health care.

      We would probably be better off getting the govt out of the health care business and telling private insurers it’s all on them now. However, the insurers have to cover all low-income folks and seniors at low to no cost. Their tab would be picked up by everyone else paying premiums. The single private insurer premium we would pay would probably be less than the premiums we pay now and all the other associated taxes and donations put together. Not to mention simpler. Think of the amount that could be eliminated from the govt budget.

    85. Dan in Chicago says:

      Just another way the unions are trying to get the underfunded union health care plans paid for the people of the United States. The milked the companies and state governments out of cash and know they want to have us pay for it.

    86. Kristina, Gloucester says:

      When one person gets something for free or reduced, everyone else pays more. As a giving society we are willing to do that for those who are truly in need; but now, as an Obama Society, the category of need has exploded to include everyone but those who can afford it. The real reason behind Obama's plan is two fold, to give those who've been shafted in life more, and to take away from those have given the shaft. Carla from Oregon has pinpointed the sentiment behind all of what Obama is doing – Wealthy people have destroyed Healthcare, the Auto Industry, Wall Street Main Street, and caused the War in Iraq. So, Carla, would this country be better off if the only wealth was in the hands of Government and it's officials? Would we as the citizens be able to work hard, be successful, help others be successful? Wealth is built not by the greedy (you have those) but by the innovative, the diligent and the hardworking. We have too many people who don't believe that.

    87. Dave Kutschinski, La says:

      Since when does a cookie cutter program fit everyone?

      Look what happened to the USSR.

      Look at the condition of Nationalized healthcare throughout the world today and its true cost on the economy of those countries that have it not to mention the delays in care and services because of restrictions on what is allowed under those programs!

    88. Scott Swan, Missoula says:

      Let me state this simply:

      Government is almost always the problem, not the solution to the problem. Colectivist, statist programs, mandates and controls only serve to take away our freedom, our inalienable rights and our hard earned money. THE FEDERAL GOVERNMENT DOES NOT CREATE OR PRODUCE ANYTHING – IT ONLY CONSUMES! In my opinion, the ferderal government has become a cancer upon our society. It must be constrained if not eradicated!

      It is time for real change, not "hope & change" which will leave us with just spare change.

    89. Gregory Johnson says:

      Adding to what you have written about. Our current for profit system only wants to fill hospital beds with expensive drugs and proceedures. There are all natural inexpensive cures for many diseases that do work but which currently aren't recognized. Our present system does not want a healthy society. They want you to continue to go to doctors to prescribe expensive medications and charge you a high premium for profit. This is only adding to your point about competition. There needs to be competition in what kinds of treatment a patient recieves to bring the cost down. Americans spend about 50% more on healthcare than any other nation and our ranked between 35-40 in the world for care.

    90. Gregory Johnson Rifl says:

      Adding to what you have written about, our current for profit system only wants to fill hospital beds with expensive drugs and proceedures. There are all natural inexpensive cures for many diseases that do work but which are currently not recognized. Our present system does not want a healthy society. They want you to continue to go to doctors to prescribe expensive medications and charge you a high premium for profit. This is only adding to your point about competition. There needs to be competition in what kinds of treatment a patient recieves to bring the cost down. Americans spend about 50% more on healthcare than any other nation and are ranked between 35-40 in the world for care.

    91. Patrick, Wisconsin says:

      This discussion about broadening the availability of healthcare and lowering its costs has been going on for over 50 years. Nothing has changed..nothing. Lets discuss the basics. do you believe that the US can afford to continue to spend what it does today on healthcare? can it afford the 8-10% annual inflation in costs? lets add another layer of massive costs coming our way.. the aging of our population. I am going to assume that everyone agrees with the simple premise above. Next..where do you expect the costs to come out? do you expect anyone along the healthcare food chain to self impose an austerity program on themselves? Why would anyone take away the punch bowl? I want to know who you believe will take a pay cut…the doctors? the insurance co's? the drug makers? the medical device makers? the nurses?..see what I mean folks. We cannot get to a sustainable level of healthcare costs in this country without a lot of highly paid people and enterprises take huge hits to their incomes.

    92. Joan Boyd says:

      I have one question:

      Why is the government [including the president, the cabinet and Congress and now probably the recently appointed czars] along with union members exempt from any health plans that are passed? That alone should awaken all of us. America, we must rise up and let the government know that we are the EMPLOYER, not the EMPLOYEE. Our weapon is our vote. Use it wisely.

    93. Kevin, Illinois says:

      Because of the reasons cited by others herein (too many attorneys holding elected office at the federal level), I do not think that we will ever see meaningful "tort reform" regarding medical malpractice. However, I hope that we will someday see, at the state level, "patients' compensation" programs modeled after "workers' compensation" plans.

      About 100 years ago, it was decided that there were advantages to employers and employees alike by enacting these compensation programs and avoiding the burden of the tort process in cases where employees were injured on the job. When "patients' compensation" plans are passed in all 50 states, we will see the high cost of medical malpractice insurance replaced with a more reasonable premium structure with most of the savings passed onto the consumer of healthcare services. We hear TALK about reducing the cost of healthcare, but we never hear anyone talking about attacking costs from this perspective.

      It is time that we eliminate the MILLIONS upon MILLIONS that medical malpractice attorneys add to the cost of practicing medicine. If as a society we agree to put a price on our arm or leg with our employer, why cannot we do so with our doctors? Yes, we won't get rich as a plantiff in a medical malpractice suit, but our doctor will still have plenty of incentive to do a good job as our physician. Just like workers' compensation, his or her patients' compensation premium contribution will be based upon his or her workload and loss experience (claims).

      Until we start to cut unnecessary costs out of the system, it will be impossible to effectively cover more people with affordable insurance while still enjoying the quality of care that we have now.

    94. donna says:

      "A reckless, expensive and one-sided rush toward “reform” would not only be damaging to our public discourse, but it could fundamentally change our society in ways that have far-reaching consequences." Another fox news spin on healthcare. You can fear-monger and predict the future but ignore any of the current facts. #1 all other countries with gov. run healthcare are out living us. #2. 1 million families file bankruptcy each year due to medical needs and doing so the insurance companies are getting paid and we are all footing that bill already anyways. 3# There are too many high end paid specialist and not enough family doctors. 4# If medicare is so BAD then why do 99% of people 65 and older have it, keep it and use it? 5# Im sure if we all took our money away from these insurance companies and gave it to the government there would be more than enough funds so that we could all have healthcare? But there are too many of you private investors in the way protecting your profits to allow that to ever happen? The Truth hurts your wallet so you lie…

    95. Jed Dahl says:

      My Blog: http://www.jeddahl.com

      Donna Wrote: "If medicare is so BAD then why do 99% of people 65 and older have it, keep it and use it?"

      Answer: Because people don't have a choice. When a person turns 65 they are automatically signed up for Medicare Parts A and B. Now, a person can opt out of Medicare Part B if they choose, however, they can NEVER opt out of Medicare Part A. The only exception is members of the Rail Road Retirement Fund, who don't pay FICA tax but pay into the Rail Road Retirement program.

      Even if a person chooses to get Medicare Part C, which is technically a private program, it is still overseen and funded by the Medicare administration. The only reason people opt out of Medicare Part B is because they are still are on a spouse's plan or on their own work plan which covers things like visits to the doctor, but as previously stated, they cannot opt out of Medicare Part A. In the event that a person has a private PPO, HMO, or other plan, and Medicare Part A, Medicare Part A works as the Primary insurance while the PPO or HMO works as the secondary insurance.

      These are all facts that can be found at Medicare.gov.

      Donna wrote: 1 million families file bankruptcy each year due to medical needs and doing so the insurance companies are getting paid and we are all footing that bill already anyways.

      This is a very very VERY old statistic. It is also stated as, 45% of all foreclosures and bankruptcies are due to a critical illness. The thing fact is, no amount of health care coverage will prevent this from happening. I don't care if a plan will cover 100% of a persons medical expenses, if a person suffers from something like cancer, or a heart attack, or any other critical illness, they will not be able to work from a minimum of 3 months, most likely 6 months. Most Americans don't have enough funds saved up to pay all the bills for 3, or 6, or 9 months while they are unable to work due to a critical medical illness. They ultimately get behind on things like the Mortgage, the car payments, etc… Then they have to declare bankruptcy. The medical expenses are added into the bankruptcy, but the cause was not having an income from not being able to work, not from suddenly having an additional bill to pay.

      Donna wrote: all other countries with gov. run healthcare are out living us.

      This just simply isn't true. Some countries who have a government run program out live us, yes. But not all. In the US using the 2005 statistics from the OECD data: From birth a women would live to 80.4 years of age and a man would live to 75.2 years of age. Turkey, which does have a socialized plan, women = 73.8 and men = 68.9. Poland: Women = 79.4; Men= 70.8.

      A more accurate statement would be, on the average, Americas die one to two years before people in other countries with government run programs. The question I would then ask is why? Is it because of the government run program or perhaps because they have better diets? In Spain, women = 83.7; Men = 77, the diet consists of fish and vegetables, things we are encouraged to consume because of their healthy attributes. Is the 3 and 2 year prolonged life a product of how health care is paid for or is it related to the fact that they are more physically active and eat healthier than we do?

      There is no doubt that health care needs to be reformed. The last thing we need to do in this reformation is get overtly staunch in our passions and refuse to listen to anyone else. There is a right and a wrong in this battle. Wrong is the status quo or jumping blindly into a new system that just changes the payer. Right is, everyone gets to voice their opinion, and a reform takes place that actually fixes the problems. You are mostly correct in what you said in your fifth point. I do believe that if we took exactly every dollar paid in health insurance premiums and paid them to a single-payer plan, we'd have enough money to cover the costs, until next year when the cost of health care went up again. Then the taxes will have to go up to cover them.

      In addition, The Health in Transition report on France written by the World Health Organization said that while they were ranked as the number 1 health care system in 2000, however, due to the challenges posed by an aging population, shortages of health care professionals and growing costs, the system’s sustainability remains a source of concern. Yippee, everyone is covered, but the country is bankrupt!

    96. pete murray, france says:

      Jed Dahl wrote in reference to France "…while (France) was ranked as the number 1 health care system in 2000, however, due to the challenges posed by an ageing population, shortages of health care professionals and growing costs, the system's sustainability remains a source of concern. Yippee, everyone is covered, but the country is bankrupt!"

      Well, firstly France isn't bankrupt. Due to some rather precient decision-making (including investing in nuclear power for 80% of its electricity) France is weathering the present down-turn rather well. This news will no doubt dissapoint Mr. Dahl.

      More to the point, France spends less than 2/3rds of what the US pays as a percentage of its national income on health-care. Wouldn't we be so lucky if our system were as "unsustainable" as the French system!. And whatever about the relative health-statistics of countries with socialized medicine, the French live longer, fewer of their infants die, and French medical consumers enjoy some of the best medical technology on the planet – all without waiting-lists or rationing. In plain terms the French medical consumer gets better value.

      Of course, the French don't have a socialist system except for certain groups for which the government effectively acts as insurer of last resort. This is in stark contrast to the soviet-style British NHS with its command-system economics, long waiting-lists, and rationing of new technologies. What the French have is universal insurance which allows everyone deal with the providers of medical services as empowered consumers. The French are free shop around for insurance. However, their insurance model is very different. Most medical insurers are "mutuels", or in US parlance, "co-ops" owned by their members rather than third-party shareholders. This means that they owe their first duty to their policy-holders and use their bargaining power to obtain value and quality for their members. Their annual reports would suggest that they spend less on administration than their US counterparts. One reason, perhaps, is because they don't have large investigative departments devoting large chunks of time and money to evade claims by policy-holders. The joy of "recission" is unknown in France, and because of "community rating", French insurers cannot dump the sick or refuse them cover.

      I am not saying that we should adopt the French system, lock, stock, and barrel. Nor do we need to go down the co-op route (although it would add a bit of spice to the medical-insurance market if a few US "mutuels" were added to the broth!). However, we need to impose a few rules on the insurers so that the market works for the consumer.

      Here's what I suggest: There should be a basic common package of benefits laid down by law which all medical insurers would have to offer. This package would cover in-patient and out-patient hospitalization without exceptions or exclusion. It would also cover a set percentage of GP and prescription costs. Individuals and firms would be free to shop around for the cheapest provider of this package. Premia would be tax-deductable. Insurers could also market packages of optional extras which would have to be separately priced. Medical consumers would be free to buy extras from an insurer other than the provider of their basic plan without penalty. Finally, "community-rating" would apply by law to the basic plan, and insurers would also have to provide the basic plan without discrimination – including those with existing conditions. Subsidies, covering most of the cost of the basic plan, would be available to the poor.

      The bottom line is that the US does provide universal health care. The problem is that it is provided in a manner which is consumer unfriendly, totally inefficient, often financially ruinous to the middle-classes, and where rationing is real, capricious, widespread, and carried out, not by doctors, but by insurance company actuaries and accountants. I say that health-care is universal because the uninsured do usually get treatment eventually. Often it is by way of the most expensive provider of all – the A & E wards. Often it is of poor quality and too late so that it ensures the recipient on discharge will be a permanent burden on the community.

      Lets give the healthcare market back to the consumers. That is what a decent and caring capitalist economy should do.

    97. David Canale, Woodst says:

      Based upon the federal government's track record of never creating an entitlement program that actually costs what they say it will, all Americans should be skeptical of these healthcare proposals. And the mantra of "higher quality care at a lower cost" just makes no sense. It can't be done. Our nation is already broke, and the federal takeover of healthcare will leave us sicker and "broker."

    98. Raymond, GA says:

      I agree on most of your recommendation except "Recognize that states know better than Washington". Why?? because i don't even want state to control. Why give the control to the Families instead. Why should state picks and chooses only the healthcare providers that can operate on their state?

    99. Tim, Australia says:

      The US health care system is already as socialist as the NHS. In the UK, people pay their national insurance and have unlimited access to the public system and the govt decides what treatment they can receive. To control costs the govt simply chooses cheaper treatment for people. There is a small private health sector availiable to the very wealthy. The UK govt accounts for almost 90% of health care spending.

      In the US the employer pays most (if not all) of the premiums and chooses the policy. Insurance pays for everything from doctors visits to prescription drugs. This creates the moral hazard problem. The US govt accounts for 45% of health care spending (almost 60% if indirect costs like tax credits to employers are taken into accoount).

      But not everyone has an employer and the moral hazards of the system lead to higher costs and people get pushed out of the market because it is so expensive (16% of GDP in the US compared to 10% in the UK).

      Firstly, medicare and medicaid should be abolished.

      Employer sponsored health care should be taxed as a fringe benefit. Individuals should receive a 30% health insurance rebate regardless of income. Insurers must have a "base fee" for every policy and can charge a levy of up tp 100% of the base fee to riskier customers and they should not be able to turn anyone away.

      The govt should subsidize health care for everyone regardless of income. There should be a "Schedule" of the types of services the govt subsidizes and what the "appropriate" fee should be for each service. The schedule should not include things like dental, ambulance or chiropractic care. The provider should be able to charge above or below thise fee. The govt should subsidize half of this schedule fee (75% for the elderly).

      Insurance companies would also receive the subsidy but only for hospital services.

      Non-profit hospitals should not be allowed to charge above the schedule fee for uninsured patients. Insurance companies must at least cover the schedule fee. The may cover anything charged above that but that would be up to them.

      Instead of paying for health insurance premiums employers would now contribute 8% of an employees income into an HSA (that's compulsory). HSAs would accrue interest (higher interest rate for low income earners). HSAs can only be spent on health care.

      The govt should also provide catastrophic health insurance to everyone. Once they spend more than a certain amount in out-of-pocket costs on services listed on the schedule (lower threshold for low income earners and the elderly) the govt should subsidize 80% of the costs for the next 12 months.

      The free market is the most efficient way but some people would still be left even then (but mush less than now). The govt should aim to spend less than 50c in every dollar spent on health care as the ABSOLUTE MAXIMUM!

      :)

    100. TURTLE, TUCSON AZ. says:

      APPARENTLY MOST PEOPLE THAT ARE WANTING THE NEW HEALTH CARE BILL TO PASS HAS NO CLUE HOW BAD THE MEDICARE & MEDICAID HEALTH CARE SYSTEM IS SET UP

      EXAMPLE: I HAVE BEEN ON MEDICARE FOR OVER 10 YEARS NOW IN WHICH I PAY INTO EVERY MONTH WETHER I USE IT OR NOT IT IS NOW ALMOST $100 THEN IF I TAKE OUT THE PERSCRIPTION PART D THERE WILL BE ANOTHER MONTHLY DEDUCTION

      ON TOP OF MY DEDUCTABLE EVERY YEAR AND HAVING ANOTHER 20 % TO PAY ON TOP OF ANY MEDICAL TREATMENTS AND ONLY ONE DAY IN HOSPITAL WOULD COST ME ALMOST AS MUCH AS I GET FROM DISABILITY IN A MONTH

      I CAN'T AFFORD TO EVEN USE IT ONE TIME AND THIS IS A GOVERNMENT RUN HEALTH CARE

      SO EVRYONE OUT THERE THINKING THEY WILL HAVE FREE HEALTH CARE IS LIVING IN A DREAM WORLD

    101. Dexter, San Francisc says:

      Tim:

      A few problems stand out in an otherwise well thought out presentation; to wit –

      "In the US the employer pays most (if not all) of the premiums …."

      Not so. It is the worker-taxpayer that pays for everything; the govt is an 'agent' of the taxpayer after all, so … "The US govt accounts for 45% of health care spending (almost 60% if indirect costs like tax credits to employers are taken into account)." is an oblique nod to a basic misunderstanding. It also ignores what that is of the total population, only a selective percentage receive any benefit of governmental largess, also how much of which goes to the political class.

      To frame the thinking as if the real source of funds is other than the workers (less than half the population) or more particularly workers in production facilities rather than service or administrative roles (ignoring the fact that there are fewer people working in industry than there are in government), foregoes examining the major 'moral hazard' that dissolves most proposals. Especially those that emanate from the bowels of government.

      But at bottom, notwithstanding the effort to contrive a viable plan with other poor initial assumptions, the critical point is most significant with this one:

      "The govt should subsidize health care for everyone regardless of income." by diktat, because each person should indeed be the one to decide if what they earn should be bestowed upon anyone, certainly not some fictional entity designated by government, to satisfy some agenda. It is their own personal health and concerns that must be compromised in proportion to their own sense of charity or generosity.

      That is the basis of our society, culture and government — the foundation of a free country, to ask how does this define liberty.

      Individual health, if that is really the target of any agenda, must be just that: individual. With a doctor/patient relationship, anything that gets between those two is simply not going to be of benefit to either one. Insurance can be rationalized for those who can afford it, but becomes quickly fanciful for those who cannot; they cannot afford something that may protect them from expenses that they will never be able to afford.

      Should others be forced to pay for both of these things and many more instead?

      Each step away from reality takes us further into fantasy, clouding that clear image with complex rules turns the fantasy into a nightmare. That is what we have facing us today in America. Promises that defy common sense, coming at a time when all the previous false promises and deceptions are crumbling in plain sight. Medicare, Medicaid, Social Security and VA are a few of the examples that should appear in these abstractions, to provide some glimpse of the realities.

      There is no money to pay for these ongoing things now — so to what purpose do we expand expenditures to the point of signing a blank check? to help our fellow man? to maintain an illusion?

      Perhaps the war on poverty will finally end with this current suicidal surge coming from the top.

      With any luck at all it will not end with a call at the last minute for shoot-on-sight.

      Stay tuned and have a nice day on the fourth of July.

    102. Jim Kinnu, Fountain says:

      Dear Ed: I agree with you 100% as regards the President waanting to start a dialogue re health care and then immediately shutting off any discussion to ideas which are contrary to his plan.

      As regards your suggested ideas, I think they have merit but I also think you should add several other issues that need to be addressed when revising our health care system in the US viz.:

      1. Revision of our Tort Laws in this country to obviate the enormous number of frivolous lawsuits that the medical providers are faced with which increase their cost of operations because of their high insurance costs.

      2. We need to devise a way to eliminate the medical costs that the medecal providers (and/or the state governments) are incurring for providing medical services for illegal immigrants that are here in our Nation and who utilize our Emergency Room's services for their medical care.

      3. We not only need portability for our health insurance when we move from one employer to another, but we need to get the insurance industry to accomodate the capability to expand/reduce/merge our coverage as we get married, have children, grow older and retire without having to pay excessive charges when we and they rewrite the policy's coverage during its life.

      Bottom line, I think the President,Congress, The Insurance Industry, several of the DC "Think Tanks" in DC of various political persuasions, and the AMA should meet as a Presidential Appointed Commission (ala the Grace Commission) to put together "Strawman Plan" with no groundrules but a lot of different ideas and then have to hld information forums around the country to hear comments/critique of their plan from the citizenry and then revise the plan and deliver it to Congress for them to debsate and finally draft legistlation for vote and passage. Throughout the process the President's HHS Secretary or his/her designee would be a member of the Commission and put the President's inputs into the mix. The State Government's should also hae a role in this process. I believe at the same time, the Commission should also address Medicare and Medicade revisions to improve those programs as well!!!! Go for it.

    103. Chris Kitchens - Dul says:

      Ed; I appreciate your letter and agree 100% I think the bottom line is simple; you name me one thing the US government does well, other than our military and NASA. Think about it

      US post office –

      Our tax system

      Medicare

      Medicade

      State and federal DOT

      So the question is – do you really want some bureaucrat in Washington DC making your health care decisions. I dont thinks so. Keep government out of our lives.

      Chris Kitchens

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    106. Robert Reilly Virg says:

      Excellent letter and excellent alternative to socialized medicine. Did not see solutions for those that can not afford insurance or those that have pre-existing ailments pro-hibiting them from obtaining any insurance.

      These area represent over 12 million Americans. Notice I said AMERICANS, this plan should emphasize that ILLEGALS are not to be covered and paid for by TAXPAYERS!

    107. Faye Yates, New Brau says:

      Feel free to modify. There is nothing about me that is moderate.

      Thanks for your Godly representation in polotics.

    108. Katie Chasey, Austin says:

      This is fantastic. I fight for this on a daily basis here in Austin, Texas. I think it is both great and American. Can you have one without the other? Standing ovation from a little liberal city in Texas. We need some light like this here and for our younger generations of which I am a part. Thank you

    109. Charlie, Maitland FL says:

      I consider myself an independent conservative (Reagan Republican) and have been forwarding the following healthcare outline for several months. Several key concepts were discussed on CNBC Special Report (although not by name) and appear in your open letter. Like Heritage, I believe the solution is open competition with care better aligned to patient interests. Most Americans will get it right and the rest will benefit in their wake.

      This is my Johnny Appleseed Healthcare proposal.

      Key Concepts:

      • Everybody pays something for their Care for Life coverage that is not delivered thru employer group plans.

      • Care for Life system includes childhood education, a healthcare insurer for life and giving the consumer choice with the leverage of a Health Care Savings Reserve. The goal is motivating the care receiver and patient to good practices, turn-key healthcare delivery (case management) based on life stage or health events (M Porter Harvard professor), a commitment to privately secured insurance for life (instead of group coverage through employer) and long-term care for senior years.

      • Health insurance care is aligned with the interests of the patient through market competition. (Congressman Ryan) Not govt management.

      • Healthcare Savings Reserves strengthens the Rights and Responsibilities of the patient by encouraging good use of the system and rewarding those who show good judgment with the opportunity to change carriers to one better aligned with their needs. The Reserve goes with the patient (that’s the leverage) if their insurer’s rate or services stray too far from the market or their personal needs. That is how the market/customer takes care of inefficient delivery systems. It is also how coverage is aligned with the patient interests. After transferring a couple big reserve balances to another carrier’s account the losers will almost certainly modify their coverage. Efficiencies may become evident from a balanced cooperation with medical delivery system and insurers without misalignment from patient interests.

      • Coverage initiated at birth with personal option to modify coverage (major medical coverage, HMO, PPS or whole health coverage) with physical to set costs or savings rate for Reserve Fund. Those with significant incomes can purchase the coverage while those who take care of themselves might use Reserve Fund Savings to purchase coverage enhancements.

      • Long-Term Care could also be applied from Savings Reserve, which furthermore encourages good health and smart use of healthcare services.

      • Health education elevated at all levels of curriculum

      • Re-insurance markets would be developed, if they are not already, to spread the risk that comes with major healthcare events from genetics or possibly poor lifestyle choices.

      • Legal (tort) reform is required. In my view the legal industry has transferred a disproportionate amount of the public capital to themselves at society’s cost. I support the right to sue but this spot in the economy has the appearance of being overfished. It would appear negotiated settlements sometimes result from an attorney’s pre-trial or trial skills, not the claim’s merits. Therefore, public system should include, but not be limited to, a grand jury format to discover the merits of a claim before it advances. This is about spreading the benefits to everyone, not just a few who know how to game the system. No one is talking about tort reform except one. Rush mentioned it last night on Fox. Quite the opposite, Trial Lawyers Lobby has submitted amendments to healthcare bill trying to enhance their ability to litigate.

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    112. Kesh says:

      I think it is fair to say that referring to parts of the new HEALTH care Reform as "Death Panels" is fear mongoring, is a scare tactic (since there is absolutely no truth to it), and is sooooooo "1984". Do you what happens at the end of that book? Have you read it?

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