The real problem is cost not coverage.

Much of the care in Amereican is not top quality

Much of the care, perhaps nearly 50% is unnecessary or inappropriate

Incentives built into the system encourage overutilization because of income generation and defensive medicine

Individual behavior impacts costs and spending patterns

The aging population will drive costs up no matter what

The problem is not the "insurance companies" - about 80 million Americans with employer based coverage are self-insured and those plans cope with cost just as insured plans do.

Expanding coverage without dealing with the fundamental issue first or at least concurrently in real terms will make matters worse - just ask Mass.

Much of the movement to deal with costs is employer driven because they have the motivation to deal with the problem. Even though many employers would get out of the business, who will care about costs if they do?

Individuals fundamentally believe health care should be "free" They scream at a $5.00 increse in office co-pay, while they spend $5.00 on a frappe, late cappaccino thingamajig. They complain when a routine vaccination is not covered never making the connection that protecting themselves is a personal responsbility. It's not covered? I can't afford that! They yell at a higher deductible for medical benefits and raise their deductible to save money on care insurance, hey, a buck is a buck is a buck.

The recordkeeping and adminstrative systems supporting the provision of health care are 1950's. I can use any ATM in the world with my bank card, but a doctor needs a dozen different forms and software to file claims with health plans.

Now, take all that and fix the health care system!

By the way, a national government run system fixes only one thing - coverage and would shortly be as far out of control on cost as Medicare except that Medicare is less costly than it would otherwise be if it did not have the ability to shift costs to the private sector.

How do I know all this? From 47 years running health benefit programs, hearing claim appeals and being on the boards of health plans.

For more discussion on this topic visit QuinnsCommentary

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For some. For myself and my family, the cost is painful, but acceptable. But once I get done paying those premium, I've only scratched the surface. My premiums cost about $400/mo. My up-front co-pays, deductibles, and other out-of-pocket expenses almost double that. Then come the bills. After insurance, I still get bills from every doctor's visit, every ER visit, everything.

So, in my case, coverage is the problem.

That's kind of vague. I know people who go into a doctor's office with a sore back, and if they don't come out with zero pain, they think it was poor quality service. I have the philosophy that if I walk out physically capable of returning to work, then the doctor did as good a job as Jesus could have. So, for me, the fact that no doctor has killed me yet assures me that the quality is ok.

Amen. Can't honestly argue any of that...I'd really, really like to, but I just can't!

Not sure what you mean here...are you saying that since self-insurance is about the same cost as employer-based insurance, that the insurance companies aren't to blame for it being unaffordable? Or is it about the quality of care being the same under both types?

I don't know Mass...he won't return my calls. But again, I guess I'm the exception, but I'm of the opinion that costs are acceptable, coverage is not. So, I don't see anything that needs to be addressed other than coverage. Don't get me wrong...I'm not saying the same applies to everyone, but I do think that whether your complaints are cost or coverage, there doesn't need to be any Government involvement.

If your problem with Healthcare is the cost, then you have a paycheck issue that is between you and your employer, business, job, etc. There are a billion ways to make money, to change jobs, to petition the boss, etc. If you've exhausted all the things YOU can do to help yourself, then maybe you have a legitimate complaint to bring to the Government to fix (i.e. for my taxes to fix).

If your problem with Healthcare is the coverage, then you have a customer issue that is between you and your provider, or your employer if it's provided through them. And again, there a many, many steps you need to exhaust before it should become Government's problem (i.e. everyone ELSE'S problem).

Again, here I may be the exception instead of the rule, but I don't like employer-based insurance. I don't like ANY benefits. I want straight cash from my employer...if he can afford to kick in for my insurance, then he could just as easily kick that money into my pocket and let ME handle my personal finances. I feel the same about every single job perk, down to the penny. If no other reason, I like transparency. When my employer says he's giving me benefits, it means he's financing my benefits by cutting costs elsewhere...such as my paycheck. Or, he's giving me my benefits because he gets enough kickback that it benefits him. Usually, the truth is somewhere in between. My employer, for example, does finance some of our benefits, but he also gets a huge savings on his other insurance by using a specific company, instead of shopping for the best price. It's just business, I don't blame him. But I'd prefer money up front where I can see exactly what's what.

None that I know of. Plenty of them wish it, of course...who wouldn't? But even here in Redneckville, KY, most people I know understand that NOTHING is free, and if someone says they'll give you something free, DON'T TAKE IT - IT'S TOO EXPENSIVE.

And that's just in general. In specific, who do you know that believes doctors shouldn't get paid? Who do you know that would even WANT treatmen from a doctor who made no money? I'd be too suyspicious to even trust Tylenol from a doctor like that.

Consumerism. That would work if people yelled at the right places, and backed it up by cancelling the offending service or returning the offending product. But yelling at your TV never seems to lower the price of anything...

I'd love to take a crack at that but it would all be opinion...no government anywhere, whether Federal, State, or Local, ought to be able to tell a business how to handle their paperwork.

Fix: Keep health insurance a local issue. I'd gleefully let my city or county handle a Government health care system if:
A) All funds come FROM local taxpayers. No Federal incentives, no State incentives.
B) All funds collected are spent SOLELY on Healthcare and the administration thereof.

Using that method has many, many advantages over a Federally run system:

1) No matter what legislation is passed in another Government (City, State or Federal), the laws that affect MY healthcare can be addressed right here where I live, in person, by myself and like-minded neighbors. What's good for a tiny bible-thumping township may not be good for a large urban city, so why would we even pretend one set of laws will work for them both?

2) Government Healthcare is essentially another form of welfare. In principle, I have no problem with welfare. In practice, I have a problem with MY paycheck being sent to pregnant teens in NY, homeless in CA, unemployed in FL, and disabled in OK. I don't live there. While I do care, to the general abstract degree possible from not knowing any of them, I care MORE for the people I know. The same reason you don't buy groceries for the whole neighborhood with your check...you buy them for your family FIRST. Same principle applies to welfare...let me put it to use where I live, in my community, for my community, and because of my community. Local healthcare would solve all of that.

3) Similar to #2, there would be accountability, because I would know or have access to everyone I was financing. You hear about people abusing Government programs all the time. I have no clue if Disabled in OK is really disabled or faking, and even if I did know, the best I could do is file some paperwork and hope I'd see a $0.000012 savings on my next check. But if the people who wanted my tax money lived in my community, they'd KNOW their neighbors would report fraud in a heartbeat. They'd know they were accountable to their friends, family, and neighbors for every dime they cost us. How long would you pay disability for a neighbor when you saw him out riding his 4 wheeler every day? How long would you provide food stamps for someone you saw out drinking every night and spending $$$ left and right?

4) If I absolutely loathe a Federal program right now, my choices are 1) fight for years to get something done, and die a failure, or 2) move to a country with laws I like better. If the problems were limited to local government, and it was legitimate, it'd take very little to get the law changed. If it was a complaint particular to me and nobody else agreed, it'd be easy enough to move to a nerby city with more compatible laws, and I wouldn't have to expatriate myself just to get satisfaction. Once the taxpayers start moving around, you can bet that whatever problems the Local governments had created to cause it would quickly be fixed. The Federal Gov't has no such concerns...they'll tax you wherever you live, and the chances of you leaving the country over a single law are slim to none. Why should they care what you think when there's no competing alternative?

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Global Warming is my favorite color.

Can anyone give a logical explanation as to why the Bush Administration went to such great lengths in terms of military lives lost (4000+) and innocent citizens killed nearly 1,000,000), to lie us into a war over approximately 3,000 fatalities on 9/11, but shows absolutely no concern that we are losing between 80,000 and 100,000 people EVERY YEAR from MEDICAL MISTAKES?