I don't think anyone can argue against your critique of these myths without willful distortion. But it seems to me that the approach that the administration took allowed those myths to grow into abominable boogie men that were destined to derail an honest debate. The starting-from-the-middle, bipartisan, concilliatory compromise and deal-cutting with the health industry left a dark vacuum for myths to grow instead of accomplishing the naive mission of enlisting the health industry corporations to support reform.

The question about HC that no one in DC dares to ask is: Is basic health care an inherent right? If not, is it not still incumbent upon government to ensure it in the interest of security for its people? If we conclude that everyone is entitled to capable health care (and both sides of this debate begin with universal coverage) then we are saying that it is a right.

The administration had a choice in how to present reform. With the greatest economic collapse since the Great Depression, HC reform could have been introduced as part of the restructuring of government and society necessary to economic recovery and security in the future. A stimulus package was thrown together and passed using the real threat of economic meltdown from runaway financial markets. After that, attention was turned to convincing the American people that economic recovery was well underway, and with the $trillions meted out to the banks, the economy was or is or will soon be hunky-dory.

The Republicans screamed that intervention in the financial markets with a $trillion taxpayer bailout was socialism and their screams went unheard; didn't even slow things down. But if the administration had leveled with the country about the depth of the banking fraud and the insolvency of the "too big to fail" people would be much more inclined towards overhauling the entire economic system including health care. Instead, Obama has all but retreated from the idea of real reform in any arena and only mildly supports a (nonessential) public option that is like the Postal Service, "I mean, if you think about it, UPS and FedEx are doing just fine, right? No, they are. It's the post office that's always having problems."

FDR (1934): But, in addition to these immediate tasks of relief and of recovery we have properly, necessarily and with overwhelming approval determined to safeguard these tasks by rebuilding many of the structures of our economic life and reorganizing it in order to prevent a recurrence of collapse.
It is childish to speak of recovery first and reconstruction afterward. In the very nature of the processes of recovery we must avoid the destructive influences of the past. We have shown the world that democracy has within it the elements necessary to its own salvation.
Less hopeful countries where the ways of democracy are very new may revert to the autocracy of yesterday. The American people can be trusted to decide wisely upon the measures taken by the Government to eliminate the abuses of the past and to proceed in the direction of the greater good for the greater number.
Our task of reconstruction does not require the creation of new and strange values. It is rather the finding of the way once more to known, but to some degree forgotten, ideals and values. If the means and details are in some instances new, the objectives are as permanent as human nature.
Among our objectives I place the security of the men, women and children of the Nation first.
This security for the individual and for the family concerns itself primarily with three factors. People want decent homes to live in; they want to locate them where they can engage in productive work; and they want some safeguard against misfortunes which cannot be wholly eliminated in this man-made world of ours.

You are really barking up the wrong tree here.

First, socialism is the bugaboo of our parents' or grandparents' generation (and I ain't no spring chicken). It is pointless to address this issue, it only "motivates the base" of hardcore Republicans who wrote this program off last November.

Second, the "limits" and "rationing" issues are best dealt with by communicating actual concrete human stories about how the real death panels, aka, private insurance companies, have actually been rationed for years and how that has led to human tragedy including financial disaster and death. It is really silly to talk about someone else setting limits when the folks financing the anti-reform movement are, themselves, the imperious bureaucratic rationers.

Third, anyone who thinks the public option will drive up costs is so far out of it that no deliberative communication will return him or her to earth. Why address this portion of the nutter population? They aren't who you have to convince.

In fact, you don't have to convince the population. Poll after poll shows strong public support for health finance reform with a strong public program. Unlike top officials who are someone insulated, we have experienced the decline in access to health care due to the decline in quality of insurance over the past 3 decades.

We already know that continuing down the same path is intolerable. The reason is not, as top officials seem to think, that this path leads to national bankruptcy or even that it continues to leave 15% of the population uninsured and 10% underinsured. The reason is most of the remaining 75% are one step from underinsured and the health insurance industry seems insatiably determined to make sure they are underinsured in the near future.

Stop defending a good program from demonization by the devils themselves. Turn the lights on the health insurance companies and keep it there. Let's see the roaches scatter.

I think it's a myth that we're gonna save money through any system that allows for-profit insurers to cherry pick the healthy and wealthy and dumps the less wealthy and the sick on the government.

We need SINGLE PAYER; or, if not single payer, then NOT-FOR-PROFIT health insurance. Take the incentive away from denying people care!

Theme : 6 Main Lies Have Nothing To Do With This Promising Reform.

Of young adults ages 19 to 29, 13.2 million, or 29 percent, lacked coverage in 2007, and that implies the total of this promising reform will be cheaper than expected, I guess.

1. The contents of savings (below) in this reform 'have nothing to do with' limit to medical access, rationing, tax raise, and deficit etc.

Rather, without wiping out these wastes and roots of bankruptcy for middle class, all fronts are sure to face larger financial ruin than this recession, which leads to more limit to medical access, more rationing, more tax raise, and more deficit etc than today.

$1.042trillion (cost of reform) + $245bn (cost to reflect annual pay raise of docs) = $1.287bn (actual cost of reform).

$583bn (the revenue package) + $80bn (so-called doughnut hole) + $155bn (savings from hospitals) + $167bn (ending the unnecessary subsidies for insurers) + 129bn(mandate-related fine based on shared responsibility) + $277bn (ending medical fraud, a minimum of 3% , the combined Medicare and Medicaid cost of $923.5bn per year, as of July,) = $1.391trillion + the reduced cost of ER visits (Medicare covers some 40% of the total) + the tax code on the wealthiest more reduced than originally proposed = why not ? (except for a magic pill, an outcome-based payment reform & IT effects and so forth).

As lawmakers debate how to pay for an overhaul of the nation's health care system, a new report from The Commonwealth Fund claims that including both private and public insurance choices in a new insurance exchange would save the United States as much as $265 billion in administrative costs from 2010 to 2020.

"Health reform can help pay for itself, but both private and public insurance choices are critically important," said Commonwealth Fund President Karen Davis, who coauthored the new report. "A public insurance plan can help drive new efficiencies in the system that will produce large cost reductions. Without a public plan, much of those potential savings will be lost."

Unlike high fuel price and mortgage rate in recent years as the roots of great recession and bankruptcy of middle class, the severity in the high cost of health premiums has come to light lately. Similarly, in an attempt to hide these deficit-driven corruptions and wastes, the greed allies struggle to turn the savings via removing these wastes into limit to medical access, rationing, tax raise, and deficit etc.

In contrast, not to mention a wide range of consumer protection, options across state lines, this promising reform takes initiatives in more primary care docs and improved long-term care. Unnecessarily, hope should not be replaced with all forms of malign lies, fear, just like people don't have to fear quitting drug.


2. Greedy insurers with no competitors by consolidation have nothing to do with the law of price, demand & supply.

Under the free market theory and the premise that the public health is also one of commodity like a house, if the demand decreases on a large scale, accordingly the price tends to reflect it, as in the case of house price, and it never happens for the price to spiral up. One step forward, in case the price is spiraling up, to be sure, the remaining clients should withdraw the contract or choose the other options. In practice, runaway premiums with no competitors by consolidation drive the enrollees out, and 4C + 2R (canceling, capping, cherry-picking, cash for special lobby, rationing, rapid premium hike) guarantee multiple times as much profit. Sadly, no way-out other than the prohibitive ER is allowed in America. Therefore, the victims today and tomorrow deserve long overdue protection from non-profit Government.

3. The plans to stem inflation in the House have nothing to do with crowd-out.
With the heartbreaking tears in mind (In no other industrialized country do 20,000 people die each year because they can’t afford to see doctor. Nearly 11 Million Cancer Patients Without Health Insurance), private market also needs changes and should join together to complete this reform , as promised, otherwise, the runaway premium only has itself to blame while new firms are filling the void with competitive deals.
And It can be said that fair competition starts with a fair, sustainable market value.

However, the plan in the House is designed to keep people in an employer-based health insurance system, and the public option would be offered to those for whom employer-provided insurance is not available. And job-based coverage (indirect payment), some mandate code, ample capital, the reduced exorbitant ER costs, IT base to streamline the administrative processes and trim the costs might be favorable to the private market. Over time, supposedly, the public plan will concentrate more on basic, primary cares, and the private insurers will provide their clients with differentiated services. And focus should be on the uninsured, the underinsured.

-- Except For The Underinsured, The Uninsured Alone Outnumber The Entire Population In Canada --

In an attempt to avert innovation, moderation, and social responsibility, accusing essential affordability, citing take-over, will be a dirty play.

4. Profit-driven markets have nothing to do with affordable, sustainable public health.

When the public health is also one of commodity like a house, we come to a tragic and unthinkable conclusion : As to for-profit business, the more and longer ill patients get, the more profits they make, and it will debilitate the overall economy involving education for the future (Of young adults ages 19 to 29, 13.2 million, or 29 percent, lacked coverage in 2007).

Under the most wasteful structure on the planet like no coordinated preventive care program waiting until people get ill, about 50% of idle world's best practices, a pay for each and every service reimbursement and frequent readmissions, no e-medical record and deaths, crushing litigations and the more profits via the unnecessary, risk-carrying procedures, and the most inefficient paper billing systems imaginable, overpriced pharmaceuticals, bloated insurance companies, incredible medial fraud, exorbitant costs by the tragic ER visits etc, it might be no wonder with the comprehensive, systematic reform in the pipeline, just one attitude of patient-oriented value in 10 regions has attained 16% of savings in Medicare while their quality scores are well above average.

Aside from the already allocated $583 billion and the savings of this reform package, 16% of $923.5bn (the combined Medicare and Medicaid cost per year, as of July) is around $147.76bn per year and 1.4776trillion over the next decade, and this patient-oriented value alone could be enough to meet the goal.

Please be 'sure' to visit http://www.nytimes.com/2009/08/13/opinion/13gawande.html?hp for credible evidences !

Today, another innovative, fundamental change in payment system, or patient's outcome based payment reform that is able to turn the profit-oriented malpractices and volume into the patient-oriented value and quality is waiting for a final decision.

5. Inflation-driven greedy allies backed by the insurers have nothing to do with deficit-neutral.

When some part of our body is ailing seriously, we are going to lose competitiveness, equally, when some part of a nation is ailing servery, it is going to loose competitiveness, too. In case somebody in the house gets ill, health will be put over house, in practice.

6. The analyses of CBO have nothing to do with common sense and practice.

Costs of Preventable Chronic Disease account for around 75% of the nation’s $2.4 trillion medical care costs. U.S. health care spending is also expected to double in the next 10 years. and they are largely preventable -- 80 percent of the risk factors are behavior-related.

Unlike the analyses of CBO, world-wide outstanding public programs put heavier emphasis on preventive program equally, and preventable swine flu pandemic is expected to cost about $2trillion dollars world-wide for the lack of prepared vaccines. (Genes included in the new swine flu have been circulating undetected in pigs for at least a decade, according to a team led by Rebecca Garten of the federal Centers for Disease Control and Prevention who have sequenced the genomes of more than 50 samples of the virus).

If CBO asks the profit-driven interests about why they have hindered the budget request for preventive program in Medicare and Medicaid, they will say, " just look at the health Catrina special lobbying has made, we are professional, and we are obstructing this reform right now, too " .

7. Conclusion : The public health is a fundamental human right.

As I said above, patient-oriented value alone could be enough to meet the goal, and another innovative, fundamental change in payment system, or patient's outcome based payment reform that is able to turn the profit-oriented malpractices and volume into the patient-oriented value and quality is waiting for a final decision.

If At least, some media pay attention to this flower of reform, people will feel empty as the past and current discussion has been time-consuming for sure.

Thank You !

Dr. Dean: I want to know why Dems allowed "myths" to take root and flourish like kudzu in the first place. Thanks.

I don't understand why the democratic party doesn't declare the compromise legislation emerging from finance a resounding success, pass it with bipartisan support and move on to Medicare reform as a way of addressing the public option that is needed.

Seems to me an easy sell for most Americans who like Medicare and want to see it stabilized. It only makes good fiscal sense to add paying customers who are young and healthy and uninsured to the rolls based on a percentage of income. I would be willing to still pay my nominal monthly deduction, even if I had private insurance, if it meant keeping the system stable and available as a last resort.

This reform effort was never going to be as simple as passing HR 676 with resounding support from the masses and delivering it to Obama's desk before the end of summer. Artificial deadlines and unrealistic expectations for this first round of legislation is where the conversation has really gone off the rails. The legislation taking shape is actually a pretty good compromise, I believe, that can be the first in a string of progressive successes that completely reform our medical system over the next few years.

Combine that with new food subsidy policies and we may actually start getting somewhere with containing health care costs in this country. If we continue to ignore our fat epidemic, no health insurance reform - with or without a public option - will be sufficient to keep our medical system from collapsing under the weight of all those chronic diseases.

This topic would have been more readable had there been a twit filter.