Moyers, at times in his life, was truly a voice in the wilderness. Always worried about the powerless, the trod upon. A real hero of mine. I try never to miss him and we get to see him twice up here in this market.

Thank you for this!!!

The best healthcare reform plan of all those I have read is in a small paperback: 
Healthcare, Guaranteed, by Dr. Ezekiel Emanuel (formerly of the NIH) 
It is the best of public oversight and private delivery. His Guaranteed Healthcare Access Plan:



1) guarantees coverage for 100% of Americans at the level of the insurance currently provided to members of Congress



2) gives everyone a choice of insurers, hospitals and doctors



3) changes the fee-for-service paradigm and focuses on high-quality, co-ordinated healthcare with emphasis on outcome; information flow in both directions is vital 



4) pays for itself from a dedicated fund that cannot be raided for other government programs



5) encompasses the framework for reasonable and timely dispute resolution



6) separates health insurance from employment, getting that function off the backs of businesses and eliminating the primary cause of labor disputes



7) ) achieves cost controls through eliminating redundant bureaucracies, fraud and excessive administrative costs



You can watch Dr. Emanuel outline his plan on PBS here:



http://www.pbs.org/now/news/315.html



The plan is simple and comprehensive. I recommend it to anyone interested in true healthcare reform. This is the moment - let's be bold and get it right.

Cville Dem, I don't know where you're getting your ideas about Zeke Emmanuel's plan, but it's not from his book. For example:

Your first point, that govt. would pay insurance companies more for a patient who is sick / has a pre-existing condition. What you leave out is that the insurance company may NOT turn down any patient who chooses it. So not only can an insurer not cherry-pick patients, it has no incentive to because it is fairly compensated for the services delivered.

Your second point - yes, Medicare and Medicaid are rolled into the new healthcare plan, not "discontinued" as you present. And that applies only to new enrollees.

You complain that insurers don't pay 100% when they say they're going to now. We agree. But in Emanuel's plan, the patient is out of the payment loop, so your point doesn't event compute. Payment rates are set annually by the Regional Health Boards and they pay the insurers directly.

As for your discussion of point #7, insurance companies can waste all the money they want on things you list. But their compensation is set by the Regional Health Board - in other words, their income is limited. If they want to blow their profits on wasteful spending, they will not long be in business. They can't choose patients who need less care nor can they raise their rate of compensation by denying coverage, so the income side is limited. They'll have to learn to live within their income or go out of business.

I really suggest that you read Dr. Emmanuel's book, CVille Dem. His plan is far superior to that in England or Canada.

http://www.amazon.com/Healthcare-Guaranteed-Simple-Solution-America/dp/1586486624/

This is something that I suggest you look at:

http://tpmcafe.talkingpointsmemo.com/talk/blogs/cville_dem/2009/01/forget-single-payer-orthe-obam.php

And here is Zeke, in his own words:

http://www.peoplespharmacy.com/audio/extended_interview_with_dr_ezekiel_emanuel.mp3

You (and Zeke) and I have a fundamental difference of opinion on this. There is no system in the world that provides care better or at better value when money is siphoned off for profits and all the other things I have listed untold times.

I agree that with Zeke's plan insurance companies cannot refuse to cover people regardless of pre-existing conditions. Under Zeke's plan the government would subsidize those companies so that they could continue to make profits and reward their stockholders.

Under MY program, ALL people: young and healthy, old and sick, or even well, but needing preventive care; would be in the pool. They would all contribute and therefore it would be affordable for all -- risk would be shared. The young and healthy would not get back all they contributed -- UNTIL they got older or sick. It works in every other single developed country, and it is less expensive than the way we do it here. I am so sick of repeating myself, but wake up and smell the coffee! Our health care is far more expensive than anything else in the world, and with outcomes that suck!

I have heard Zeke personally -- I have read what he wrote -- I think he is wrong, and I think you are wrong.

Do you think our police, fire departments and schools would be better and less expensive if there was an agency in between us and them collecting money and then passing off to them what the agency thought they deserved, pocketing the rest?

Thanks for posting this.

During the primary campaign, I remember Obama explaining his current rejection of "single payer" with, (to paraphrase):

"If we were starting from scratch, 'single payer' would be the way to go."

What confuses me is... our healthcare system is so completely broken down, how can anyone think we are in a position to do anything but "start from scratch"?

Even Robert Reich's most recent plan seems like he's "robbing Peter to rearrange deck chairs on the Titanic."

(Sorry for that... I'm trying to avoid metaphors that include cosmetics and barnyard animals.)

As always, Bill Moyers brings more perspective to the discussion.

You've changed the posting date on this - from yesterday to today. And that's not really fair to others who have blogs up. If you want to restart the clock today, you can post another blog. But it's not fair to repost the very same blog, as if it had been published today.

great post!

While single payer is nice, and I would be happy with it, it is not the only route to universal quality coverage. Germany, for instance, doesn't have single payer but has excellent health care. Why does Germany's system work so well? Becuase of strict regulation and pricing controls, and a big public role.

The key criteria for any system are:

* A public plan to compete with private plans, that anyone can join regardless of health status
* Strict regulation of pricing and practices of private companies

A public plan could eventually lead to single payer, if the private plans don't and can't compete. People would flock to the plan with the best service and pricing.

I believe the public plan option is absolutely necessary to keep the system honest.