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Originally Posted by DanaC
In terms of widening affordable access to healthcare, or in terms of tackling the problems of the ininsured/under insured?
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Keeping my previous response in context, and my 30 plus years in the business of healthcare, I am not at all confident that the government can successfully implement a program of government sponsored insurance or a single payer plan (I fully understand that this is currently not on the table but there is no doubt that this is where Obama and many other liberal democrats want to go in time). Nor any plan which encourages the mass migration of those with private insurance, or employers who provide insurance to employees to a government run plan.
People cannot draw parallels between countries the size of Sweden, France, the UK, or other small economies and populations and extrapolate those plans to a country the size of the US with ease. The US is much more complex in its relationships with business and insurance as we now know it. But given what we have seen about the potential back door deals the Obama administration is making with various special interest groups, I am futher discouraged that implementation of a national coordinated effort to provide insurance to some 30 million people can actually work. I believe that care will continue to be rationed but to a greater degree than it is now with a greater emphasis on cost containment spread over a greater number of people. This form of rationing is slowly creeping into the care of Medicare, Medicaid, and other government programed patients. Various more expensive techniques and procedures are not offered to these patients because the insurance will not pay. A procedure that can cost 1/10th the cost in a free-standing surgical center is passed over for a much more expensive procedure which the insurance company will pay for in a hospital. That is detrimental to the system as a whole increasing costs for the patients and other insured people, not to mention the public whom ultimately is paying for it all. The current government run program is broken and fiscally inefficient. What makes anyone think they can expand it by 1000 fold and do a better job?
The issue of illegal aliens must be addressed to eliminate a weakness and further drain on any national program for the uninsured.
The issues of reimbursement fro providers must be addressed, and they are not.
The issues of payment for catastrophic care must be addressed and they are not.
The issues of chronic expensive care and treatment of rare and complex disease needs to be addressed.
The issue of how all this is going to be paid and by whom has not been exposed to the fullest in any plan and those issues must be on the table with adequate time for debate. I do not believe, as history has shown us in this Congress, that this will happen.
What ever plan is developed, Congress should pledge to enter the same plan as the "government option", including Ted Kennedy, and the same level of care should be given to them as should be given to the homeless person on the street.