Tak
when are you going to learn that unless you accept Peach's pronouncements without question you are a dolt, uninformed and probably a capitalist Christian to boot. You cannot have a reasonable discussion with Peach, all you can do is have a Look at her postings with AWE and nod feverently toward the hill country of West BY God Virginia. I think it might even help if you prostrate yourself before your computer screen.

I keep ashes and a sack cloth close by

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There is a lot wrong with this post of yours Soho.

Who gets the generic rights to any drug? ......................Other Pharmaceutical companies is who gets those rights, not the american tax payer.

It would be a interested economic equation to look at the billions spent on drug R&D by tax payers and compare that to those same billions be put to work in other sectors of our economy say in public transit or infrastructure building and see which benefits the economy more? A few jobs at automated Pharmaceutical companies for the workers who watch the machines as they pour out thousands of pills a minute or hundreds of thousands of people working to build mass transit systems and bridges. Wonder which would benefit the economy more?


I never complained about Pharmaceutical companies soho, you must be thinking of somebody else.


My daughter is a pharmacist , Mostly US army trained, there is a place for drugs and research . I would argue that if the US tax payer puts money into that drug then we should get paid back at least part of our investment. And seeing how US pharmaceutical companies manage to peddle their drugs for far less than they cost in America I would think a little negotiation of prices is in order.

QUOTE=TakuanSoho The PHH is fine and all, but it won't be what is passed by our government.

Okay , since when did we become a country when we just lay down and say this is a good thing to do but our government won't allow it to happen? That apathy among the American people is really starting to tick me off.

What happened to insisting politicians do what is right, they work for we the people after all?

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Still waiting Peach.

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Here you go Teak all the answers you asked for are on the web site which you have now proved you didn't bother to read.

So since the answers are lengthy and will not fit all in once post lets take them one at a time. Starting with how its going to be paid for which is always everybodies first concern.




PNHP Proposals
PNHP Research
Single-Payer Resources


Is national health insurance ‘socialized medicine’?
Won’t this raise my taxes?
Isn’t a payroll tax unfair to small businesses?
Won’t this result in rationing like in Canada?
Who will run the health care system?
What about medical research?
Won’t this just be another bureaucracy?
How will we keep costs down if everyone has access to comprehensive health care?
How will we keep doctors from doing too many procedures?
What will happen to physician incomes?
How will we keep drug prices under control?
Why shouldn’t we let people buy better health care if they can afford it?
What will be covered?
What about alternative care, will it be covered?
Can a business keep private insurance if they choose?
What will happen to all of the people who work for insurance companies?
How will we contain costs with the population aging?
What about ERISA? Doesn’t it stand in the way of states implementing universal health care plans?
How will the Health Planning Board operate?
Since we could finance a fairly good system, like the Norwegian, Danish or Swedish system, with the public money we are already spending (60% of health costs), why do we need to raise the additional 40% (from employers and individuals)?
How much of the health care dollar is publicly financed?
Why not MSAs/HSAs?
Why not use tax subsidies to help the uninsured buy health insurance?
Won’t competition be impeded by a universal health care system?
Why not make people who are higher risk pay higher premiums?
Walter Reed Army Medical Center has been in the news lately for poor care and treatment of returning soldiers from Iraq. Won’t national health insurance have similar problems?
What about incremental reform of the health system?
What happens to investor-owned hospitals under national health insurance (NHI)?
What proportion of health spending is for undocumented immigrants?
The insurance industry says that PNHP’s figures on administrative costs are outdated. Is this true?
How much could the states save on administrative waste by adopting a statewide single-payer program?


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Is national health insurance ‘socialized medicine’?
No. Socialized medicine is a system in which doctors and hospitals work for and draw salaries from the government. Doctors in the Veterans Administration and the Armed Services are paid this way. The health systems in Great Britain and Spain are other examples. But in most European countries, Canada, Australia and Japan they have socialized health insurance, not socialized medicine. The government pays for care that is delivered in the private (mostly not-for-profit) sector. This is similar to how Medicare works in this country. Doctors are in private practice and are paid on a fee-for-service basis from government funds. The government does not own or manage medical practices or hospitals.

The term socialized medicine is often used to conjure up images of government bureaucratic interference in medical care. That does not describe what happens in countries with national health insurance where doctors and patients often have more clinical freedom than in the U.S., where bureaucrats attempt to direct care.


Won’t this raise my taxes?
Currently, about 60% of our health care system is financed by public money: federal and state taxes, property taxes and tax subsidies. These funds pay for Medicare, Medicaid, the VA, coverage for public employees (including police and teachers), elected officials, military personnel, etc. There are also hefty tax subsidies to employers to help pay for their employees’ health insurance. About 20% of health care is financed by all of us individually through out-of-pocket payments, such as co-pays, deductibles, the uninsured paying directly for care, people paying privately for premiums, etc. Private employers only pay 21% of health care costs. In all, it is a very “regressive” way to finance health care, in that the poor pay a much higher percentage of their income for health care than higher income individuals do.

A universal public system would be financed in the following way: The public funds already funneled to Medicare and Medicaid would be retained. The difference, or the gap between current public funding and what we would need for a universal health care system, would be financed by a payroll tax on employers (about 7%) and an income tax on individuals (about 2%). The payroll tax would replace all other employer expenses for employees’ health care, which would be eliminated. The income tax would take the place of all current insurance premiums, co-pays, deductibles, and other out-of-pocket payments. For the vast majority of people, a 2% income tax is less than what they now pay for insurance premiums and out-of-pocket payments such as co-pays and deductibles, particularly if a family member has a serious illness. It is also a fair and sustainable contribution.Currently, 47 million people have no insurance and hundreds of thousands of people with insurance are bankrupted when they have an accident or illness. Employers who currently offer no health insurance would pay more, but those who currently offer coverage would, on average, pay less. For most large employers, a payroll tax in the 7% range would mean they would pay slightly less than they currently do (about 8.5%). No employer, moreover, would gain a competitive advantage because he had scrimped on employee health benefits. And health insurance would disappear from the bargaining table between employers and employees.
Of course, the biggest change would be that everyone would have the same comprehensive health coverage, including all medical, hospital, eye care, dental care, long-term care, and mental health services. Currently, many people and businesses are paying huge premiums for insurance so full of gaps like co-payments, deductibles and uncovered services that it would be almost worthless if they were to have a serious illness.


Isn’t a payroll tax unfair to small businesses?
The payroll tax means a cost increase for businesses that are not currently insuring their workers. However, it is much less than they would pay at present for adequate coverage for themselves and their workers. For most small (and large) businesses already providing coverage, the payroll tax will mean substantial savings

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There are not "generic rights", this means that the patent has expired and the knowledge is public domain. So yes, the taxpayers do get it. Of course you need someone to make the drugs, but that is a different issue.

Again, I am as opposed to corporate welfare as I am to public welfare, so no argument from me on that. Said so in my first response.

I agree that you did not complain against pharma, but vast numbers of people calling for UHC do complain against them. We cannot have a discussion about this topic without acknowledging that they exist (and I think I used third person throughout so that you would know that I wasn't speaking of you).

This is an important point, because again while I can see both the benefit of UHC and think of several decent plans to make it work, that really isn't the issue. All government plans are "good ideas". What makes them horrible is that in order to become law you have to have a compromise, and this process in the US Congress usually makes things worse, not better. Now if Congress were to form a small committee of experts and can only vote up or down on their proposal, then we can talk about specific plans. But until then, we have to look at who is screaming the most (as with all laws) and make assumptions about what Congress will turn out. It is that I have no faith with, and which makes me afraid to even start them on the process. I have no faith that things will improve (and historically they haven't. Everytime the government has tried to fix a problem, it has made things worse).

But first things first, remove the politics from the discussion, and then we can talk about the specifics.

Here you go Teak all in the plan which you did not read.

Who will run the health care plan?

There is a myth that with national health insurance the government will make the medical decisions. But in a publicly financed, universal health care system, medical decisions are left to the patient and doctor, as they should be. This is true even in the countries like the U.K. and Spain (or in U.S. systems like the VA) that have socialized medicine.

In a public system, the public has a say in how it’s run. Cost containment measures are publicly managed at the state level by elected and appointed agencies that represent the public. This agency decides on the benefit package and negotiates doctor fees and hospital budgets. It also is responsible for health planning and the distribution of expensive technology. Thus, the total budget for health care is set through a public, democratic process. But clinical decisions remain a private matter between doctor and patient.




Won’t this just be another bureaucracy?
The United States has the most bureaucratic health care system in the world. Over 31% of every health care dollar goes to paperwork, overhead, CEO salaries, profits, etc. Because the U.S. does not have a unified system that serves everyone, and instead has thousands of different insurance plans, each with its own marketing, paperwork, enrollment, premiums, and rules and regulations, our insurance system is both extremely complex and fragmented.

The Medicare program operates with just 3% overhead, compared to 15% to 25% overhead at a typical HMO. Provincial single-payer plans in Canada have an overhead of about 1%.

It is not necessary to have a huge bureaucracy to decide who gets care and who doesn’t when everyone is covered and has the same comprehensive benefits. With a universal health care system we would be able to cut our bureaucratic burden in half and save over $300 billion annually.


How will we keep costs down if everyone has access to comprehensive health care?
People will seek care earlier when chronic diseases such as hypertension and diabetes are more treatable. We know that both the uninsured and many of those with skimpy private coverage delay care because they are afraid of health care bills. This will be eliminated under such a system. Undoubtedly the costs of taking care of the medical needs of people who are currently skimping on care will cost more money in the short run. However, all of these new costs to cover the uninsured and improve coverage for the insured will be fully offset by administrative savings.

In the long run, the best way to control costs is to improve health planning to assure appropriate investments in expensive, high-tech care, to negotiate fees and budgets with doctors, hospital and drug companies, and to set and enforce a generous but finite overall budget.

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What will happen to physician incomes?
On the basis of the Canadian experience under national health insurance, we expect that average physician incomes should change little. However, the income disparity between specialties is likely to shrink.

The increase in patient visits when financial barriers fall under a single-payer system will be offset by resources freed up by a drastic reduction in administrative overhead and physicians’ paperwork. Billing would involve imprinting the patient’s national health program card on a charge slip, checking a box to indicate the complexity of the procedure or service, and sending the slip (or a computer record) to the physician-payment board.

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Sorry Peach, that cut and paste did not answer even one of my six questions.

In case you forgot what they were, here they are again. Answer them if you can. Each one should only take two or three words.

1. Who specifically is going to administer this program?

2. How many people will it take, to administer this program for 300 million plus people?

3. How much is it going to cost to cover a husband, wife, one son 8 years of age, and one daughter 16 years old?

4. How much is it going to cost the American tax payer, to implement this program, and run it for two years?

5. How much will it cost to run and implement this program each year after that, including the retirement packages, for the administrators?

6. How is this program going to provide, the majority of Americans, with BETTER health care?


All those pages you have posted, over and over again, are nothing more than a PROPOSAL, a plan will answer the type of questions I have ask. Now do yor realize the differnce?

When it reaches the plan stage there will be something to discuss.

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Here you go Teak research from the GAO on how much this would cost.

National Studies
June, 1991 General Accounting Office
“If the US were to shift to a system of universal coverage and a single payer, as in Canada, the savings in administrative costs [10 percent of health spending] would be more than enough to offset the expense of universal coverage” (“Canadian Health Insurance: Lessons for the United States,” 10 pgs, ref no: T-HRD-91-35. Full text available online at U.S. Government Accountability Office (U.S. GAO)).

December, 1991 Congressional Budget Office
“If the nation adopted…[a] single-payer system that paid providers at Medicare’s rates, the population that is currently uninsured could be covered without dramatically increasing national spending on health. In fact, all US residents might be covered by health insurance for roughly the current level of spending or even somewhat less, because of savings in administrative costs and lower payment rates for services used by the privately insured. The prospects for con-trolling health care expenditure in future years would also be improved.” (“Universal Health Insurance Coverage Using Medicare’s Payment Rates”)

April, 1993 Congressional Budget Office
“Under a single payer system with co-payments …on average, people would have an additional $54 to spend…more specifically, the increase in taxes… would be about $856 per capita…private-sector costs would decrease by $910 per capita.

The net cost of achieving universal insurance coverage under this single payer system would be negative.”

“Under a single payer system without co-payments people would have $144 a year less to spend than they have now, on average…consumer payments for health would fall by $1,118 per capita, but taxes would have to increase by $1,261 per capita to finance this plan.” (“Single-Payer and All-Payer Health Insurance Systems Using Medicare’s Payment Rates” ref : CBO memorandum, 60 pages)

July, 1993 Congressional Budget Office
“Enactment of H.R. 1300 [Russo’s single payer bill] would raise national health expenditures at first, but reduce spending about 9 percent in 2000. As the program was phased in, the administrative savings from switching to a single-payer system would offset much of the increased demand for health care serv-ices. Later, the cap on the growth of the national health budget would hold the rate of growth of spending below the baseline. The bill contains many of the elements that would make its limit on expenditures reasonably likely to succeed, including a single payment mechanism, uniform reporting by all providers, and global prospective budgets for hospitals and nursing homes.” (“Estimates of Health Care Proposals from the 102nd Congress” ref: CBO paper, July 1993, 57pages)

December, 1993 Congressional Budget Office
S491 (Senator Paul Wellstone’s single payer bill) would raise national health expenditures above baseline by 4.8 percent in the first year after implementation. However, in subsequent years, improved cost containment and the slower growth in spending associated with the new system would reduce the gap between expenditures in the new system and the baseline. By year five (and in subsequent years) the new system would cost less than baseline. (“S.491, American Health Security Act of 1993”)

June, 1998, Economic Policy Institute
“In the model presented in this paper, it is assumed that in the first year after implementing a universal, single-payer plan, total national health expenditures are unchanged from baseline. If expenditures were higher than baseline in the first few years, then additional revenues above those described here would be needed. However, these higher costs would be more than offset by savings which would accrue within the first decade of the program.”

Universal coverage could be financed with a 7 percent payroll tax, a 2 percent income tax, and current federal payments for Medicare, Medicaid, and other state and federal government insurance programs. A 2 percent income tax would offset all other out-of-pocket health spending for individuals. “For the typical, middle income household, taxes would rise by $731 annually. For fully 60% of households, the increase would average about $1,600…costs would be redistributed from the sick to the healthy, from the low and middle-income house-holds to those with higher incomes, and from businesses currently providing health benefits to those that do not.

“Even more important, greater efficiency and improved cost containment would become possible, leading to sizable savings in the future. The impediment to fundamental reform in health care financing is not economic, but political. Political will, not economic expertise, is what will bring about this important change.”

“Universal Coverage: How Do We Pay For It?” — Edie Rasell, M.D. PhD).

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State Studies
November 1994: New Mexico
Single Payer could save $151.8 million and cover all the uninsured

The Lewin consulting group was hired to perform a fiscal study of alternative reform plans for the state of New Mexico. The study looked at single payer, managed competition, and an individual and employer-mandate.

The study concluded that a single-payer system with modest cost-sharing was the only plan that would cover all the uninsured and save over $150 million per year (estimates given for 1998). Such a plan could be financed with a payroll tax of 7.92 percent (employer 80 percent/employee 20 percent) and a 2 percent tax on family income. If patient cost sharing was eliminated, the single payer program would cover all the uninsured for a net increase in costs of $9.1 million.

The group’s estimates of administrative savings were very conservative, about half of what other estimates have found. Thus, it is likely that a single payer program in the state of New Mexico could provide coverage for all the uninsured with no increase in current health resources.
Source “The Financial Impact of Alternative Health Reform plans in New Mexico” by Lewin-VHI, Inc. November 14, 1994.)



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April 1995: Delaware
Single Payer would save money in Delaware

A fiscal study of single payer in Delaware by Solutions for Progress found that Delaware could save $229 million in the first year (1995). In ten years, the cumulative savings would exceed $6 billion, over $8,000 for every person in Delaware. “The benefit package for the single-payer system modeled in the report will cover all medically necessary health services” with “virtually no co-payments nor any out-of-pocket health expenditures for any covered benefit.”

The study’s authors’ note that they used a low estimate for administrative savings while using a high estimate for increased costs for utilization in order to assure a high margin for error and adequate funding.

Source: (“Single-payer financing for Universal Health Care in Delaware: Costs and Savings” prepared for the Delaware Developmental Disabilities Planning Council, April 1995 is 11 pages. Solutions for Progress, 215-972-5558. Two companion papers are also available: “Health Expenditures in Delaware Under Single-Payer Financing” and “Notes for Delaware Health Care Costs and Estimates for the Impact of Single Payer Financing.”)



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February 1995: Minnesota
Single Payer to save Minnesota over $718 million in health costs each year

A March 1995 study conducted by Lewin-VHI for the Minnesota legislature found that single-payer with modest co-pays would insure all Minnesotans and save Minnesota over $718 million health costs each year. The projected savings are conservative since Lewin-VHI global budgets or fee schedules to control costs.

Source: Program Evaluation Divison, Office of the Legislative Auditor, State of Minnesota pg 68. “Health Care Administrative Costs” February 1995.



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December 1998: Massachusetts
Two fiscal studies of single payer for the Massachusetts Medical Society show savings & benefits:

Lewin Group Solutions for Progress/Boston University School of Public Health (SFP/BUSPH)
“In early 1997, the Massachusetts Medical Society retained the services of two consulting teams to independently analyze the relative costs of a Canadian style single-payer system, and the current multi-payer health care system in Massachusetts.”

“While Lewin and SFP/BUSPH reports differed in their orientations and methodologies, they reached similar conclusions. First, a single-payer system would achieve significant administrative savings [between $1.8 and $3.6 billion] over the current multi-payer system. Secondly, these savings are of such a magnitude that the available funds would be sufficient to insure universal coverage in the state and provide comprehensive benefits including outpatient medications and long-term care and eliminate all out-of-pocket payments (co-payments, deductibles).”

“The major difference in the studies findings had to do with the timing of achieving the cost savings. SFP/BUSPH estimated that the savings could be in the first year of implementation of the system. Lewin felt the savings would begin in year six.”

Source: (Massachusetts Medical Society House of Delegates Report 207, A-99 (B).
Full text of the studies are available online at: MASSMED | Home)



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