« Compare and Contrast | Main | Priorities »
October 17, 2007
McCain and Health Care
After looking at the Kaiser comparison of McCain's plan, I wandered over to McCain's site to read it in full, and make sure I wasn't just looking at a bad summary. Luckily, it was short. "Straight Talk on Heath Care," it's called. "John McCain is willing to address the fundamental problem: the rapidly rising cost of U.S. health care," which is quite brave of him. Also, not true.
It's another of these plans to sprinkle magical tax credits all across the land that will incentivize folks to buy less health insurance, but do absolutely nothing for the cost of care. Families get a $5,000 tax credit to help them buy insurance, and they can keep what they don't use, and so the hope is, they'll buy plans with higher deductibles, be unable to afford the deductibles, and will thus buy less care. It's like if I tried to make food cheaper by encouraging you to diet.
There's a bit more pabulum about encouraging price transparency and sound medical research (all good things, none of which are expanded into actual policy ideas on the site), and it does hint at removing the employer deduction for health insurance (which would be good in many ways, but is politically impossible), but at base, this is a big heap of nothing. It doesn't make health care cheaper so families can better afford it. It makes cheap insurance cheaper so families will buy more of that, and thus use less health care.
October 17, 2007 | Permalink
Comments
"Families get a $5,000 tax credit to help them buy insurance, and they can keep what they don't use, and so the hope is, they'll buy plans with higher deductibles, be unable to afford the deductibles, and will thus buy less care. It's like if I tried to make food cheaper by encouraging you to diet."
No, it is like trying to make food cheaper by encouraging you to eat in rather than go to an expensive restaurant. What McCain's plans drive at is placing some of the cost of healthcare choices on the consumer. I fail to see how this is controversial. To give examples, there are about 15 different antidepressants on the market currently, ranging from about $20 a month to $400/mo. If my health insurance pays the full cost of all of them, what incentive does the consumer have to choose to lower priced one? If the patient is paying the full cost and the doc says try this one at $300/mo or this other one at $25/mo, you might choose the lower pill. This would save money on health costs. Now it may be the $25 one doesn't work, but it's just as likely the $300 one doesn't and you'll have to switch. Putting some cost consciousness in there is not a bad idea.
Same thing with acid reflux. You can get zantac or prilosec OTC $20/mo, or nexium and aciphex by prescription for $200/mo. If the cost makes no different (or is sometimes even cheaper than OTC since HI doesn't cover OTC) you will get the nexium or aciphex even though the zantac might work just fine. If that works, you just saved $2000/year.
Does this work for everything? Of course not. But it can work on the margins reducing costs which is the whole point, isn't it?
Posted by: Scott | Oct 17, 2007 10:45:55 AM
Scott, in my experience, health insurance plans have co-pays for drugs that are higher for on-patent than for generic. In the case of anti-depressant and acid-reflux drugs, there are systems in place to incentivize the use of cheaper drugs by consumers.
Certainly I choose generic generic zithromax every time I get prescribed it because a $10 co-pay is much easier to absorb than a $30 co-pay.
Posted by: Tyro | Oct 17, 2007 11:00:17 AM
"What McCain's plans drive at is placing some of the cost of healthcare choices on the consumer. I fail to see how this is controversial."
Its controversial because most people don't want to be forced to make health care choices based upon cost, especially for their children. If you had to choose between private tutors for your children or regular medical checkups, which would you choose? What about "pay for play" sports vs. dental care? Is there any evidence that people are clamoring for a massive delegation of risk? "Yes, let's gamble with our childrens lives. Hooray!"
Aside from that, another theory about this is that, in many situations, people will "choose" to forgo preventative care. If that's the case, overall spending on helth care won't be reduced, it will be redistributed to emergency care/specialist care, because people won't prevent problems before they occur.
Posted by: Michigander | Oct 17, 2007 11:00:52 AM
"If my health insurance pays the full cost of all of them, what incentive does the consumer have to choose to lower priced one?"
Poor analogy. The consumer does not choose what drug is prescribed, the physician does.
Posted by: little green | Oct 17, 2007 11:02:04 AM
Scott,
Nu? then the real question is how those prices end up getting decided in the first place ... if there is no elasticity of demand because people, not spending their own money but spending someone else's, will get the more expensive drugs anyway, what's keeping the prices of some drugs lower?
OTOH, I have a friend who about a year ago had a stay in the ICU. Do you know how expensive that is? About $2000/day at the hospital he was at (a middle of the road quality hospital).
Why so expensive? Well, let's look fundamentally. We too often forget that money is just a measure used as a medium of exchange. The money is required to pay people who labor to provide care, either directly as care givers or indirectly to provide medical products (equipment, medicines, etc) or to repay capitalists who invest to make it all possible.
So what does it mean that health care is un-affordable? To an individual it means that I cannot produce enough with my labor to make up for the labor of those providing me health care. But in the global sense, does the fact that some people are working as ICU nurses, etc., really mean that we as a society no longer have enough food because we don't have those people working as farmers? No. Maybe our consumption is not (e.g., environmentally) sustainable, but we somehow, even with our so-called debts, produce enough that we consume what we do without massive starvation or what not.
So somehow we have the resources to provide health care -- that is we have the resources to keep doctors' medical school bills paid and keep 'em clothed with polo shirts and fed with cheeseburgers (or whatever is sufficiently unhealthy that only a physician would eat it). But I, as an individual, cannot crank out enough academic papers to exchange for money to give to the doctors to buy polo shirts or nurses to buy pasta primavera or whatever ... somehow, the extra resources we know we have our somewhere, but not in individuals (like that song about all the gold in California?).
The question is how to proceed -- seems to me only government has the purchasing power and the ability to stir up stagnent wealth so that way the capacity we have to pay for medical care actually pays for it. If you ask me, single payer makes sense in this regard ...
whether it's politically feasible ... that's another story.
Posted by: DAS | Oct 17, 2007 11:08:42 AM
Poor analogy. The consumer does not choose what drug is prescribed, the physician does. - little green
But the physician is receiving a lot of pressure in making that choice. On the one hand you have the insurance company paying for the drug pressuring the physician to purchase whatever drug is cheapest whether or not it's the best (so indeed the analogy is poor). But on the other hand, you have drug company reps -- and thanks to advertising campaigns, the patients themselves -- pushing for the "best" drug at any cost (since they don't have to pay ... and in the case of the reps, they are paid) whether or not it's really the best (indeed, even with some price transparency, people might still go for the more expensive item as they might be afraid that the cheaper drug doesn't work as well).
Posted by: DAS | Oct 17, 2007 11:11:51 AM
The issue should never be framed as who needs health insurance. The issue is: everyone must have access to the healthcare they need. The only way that will ever happen is in a single payor system, where we all pay for the healthcare we all need. A single payor system also creates power to affect costs if used appropriately.
Any statement to the effect that a corporation, whose primary motivation is production of profit, will aid us all in getting the healthcare we need is intellectually dishonest.
Posted by: little green | Oct 17, 2007 11:13:55 AM
My insurance has a much greater copay for non-generic than generic. The copay for generic is so low that it is sometimes better to get a prescription than OTC. This may not be uneconomic as the insurance company can get very low prices even for non-generic.
But anyway, there are opportunities for cost minimization of medication at all stages of the process, from consumer through doctor and insurance.
A lot of pressure for overspending on medication now comes from advertising for prescription drugs (in addition to the advertising which has always been allowed for non-prescription drugs and snake oil). This is a regulatory issue, where free enterprise is opposed to cost minimization.
Individual choice does not lead to optimization of health care - an enormous amount is spent on remedies which are not only not demonstrably useful, but demonstrably not useful. Individual do not have the knowledge to make medical decisions - this is just not a field where a free market gives the optimum result.
Posted by: skeptonomist | Oct 17, 2007 11:42:34 AM
At a high-level, I like everything McCain says insofar as he seems to be the only one addressing the cost growth issue, which I believe to be the biggest issue we face. Get cost growth managed and you can provide total access affordably. Granted, the devil’s in the details so we’ll see what’s to come.
Posted by: DM | Oct 17, 2007 12:04:08 PM
In MA the pharmacist *must substitute* a generic for a higher priced drug *unless* the doctor signs a special form saying "no substitution." And, of course, my beautiful insurance company doesn't cover some drugs my doctor (with good reason) would like to prescribe so that they are completely uncovered and a month's supply would cost me 100.00 for thirty pills.
I'm not complaining about this, just pointing out that my doctor adn I are forced to make economic decisions *all the time* under Blue Cross/Blue Shield and my state law. Why is something that is *bad* when it might hnappen under a government run system (ohmygod bureaucrats are making medical decisions not your doctor) suddenly miraculously *good* when forcing me to make them on the basis of cost, or merely allowing my insurance company to make them on the basis of their profit margin?
Cost is and always will be a serious component of any health care delivery system but as Ezra has explained over and over again the costs of the kind of phony health insurance scams we all are paying into don't really control health care costs per se but really control the share of my premiums (and those of my insurance pool) that go to my actual healthcare or that go to insurance company profits. Why is this so hard to understand? Health care, good health care, comprehensive health care is *expensive*--rationing it by charging more for it doesn't get you better health care, it just gets you less of it at a very high price.
This, in fact, is what happened when they privatized the water system in bolivia. the peasants responded by drastically cutting their use of water until the whole thing became econmically unviable for the would be privateers. If we start to ration health care for children, for example, we won't pour money into pediatricians and clinics and we will *have less of them*. We'll save money, but we'll have less access to care. We could choose to recognize that a baseline of good care for children, all children, was a good thing and pour money *into* pediatrics and clinics and then we'd *have more of it.* We should be *encouraging people* to use health care assets adn to demand more health care, not less, because the money spent on health care is not money wasted but money going into a very significant economic sector that supplies good jobs to educated people. I'd way rather see my tax money going to pay the salaries of doctors, nurses, and MRI techs than see it go to pay the salaries of insurance company execs.
aimai
Posted by: aimai | Oct 17, 2007 12:25:32 PM
Stop the debate. I agree to have any level of health care that Congress votes for itself. That is, as long as members cannot go out and buy additional healthcare with the raises they vote for themselves.
Posted by: Jody | Oct 17, 2007 12:54:04 PM
If you did succeed in encouraging everyone to diet, you would in fact reduce the price of food -- demand curve shifting to the left and all that.
Posted by: henry evans | Oct 17, 2007 12:58:40 PM
Trouble is - you aren't encouraging people to diet. You are encouraging people not to treat their illnesses. The negative externalities from that are huge.
Posted by: Spike | Oct 17, 2007 1:48:29 PM
Ezra,
Some thoughts on McCain's plan.
First, let's put the policy wonk bias aside, i.e. yes, reading more detail on a plan is more interesting to you and me, but has little to do with the veracity of the claims within the plan. A two-page, bulleted format plan can be as sufficient as the 20 page plans (which have a fair amount of fluff in them anyways). McCain's plan doesn't "hint" at delinking employer coverage but says it pretty clearly and any lingering questions were clarified with his campaign's comments after its release on the issue.
So on the substance. McCain's plan does offer things that other plans don't. Again, these are principles that are less detailed, but doesn't mean they don't merit applaud if they have been offered in good faith by McCain.
Policy proposals he uniquely offers:
-- Delinking employer coverage. A major, major departure from the others. The benefits here are clear and don't need to be elaborated on further.
-- VA care. One of your babies, Ezra, but McCain has focused on something here that is very true: while the system has its advantages there are some clear disadvantages. Providing care to a subset of the population that is geographically dispersed has some significant inefficiencies. If you're not in a major metropolitan city, you may need to travel many hours to a VA facility that has the capability of diagnosing/treating your ailments. McCain offers a sensible solution to this problem. At an individual level, its much more patient friendly-- if you don't believe me, hop onto a VA van and spend a day or two with a vet so he can have a 20 minute appointment with a specialist. (And for those who would say that a single-payer system would offer an even better option-- that's very true on this issue. But no one has offered that plan. So given the incremental approaches offered by the Dems big three, they haven't done anything to improve VA care in the meantime.)
-- The biggest policy difference for McCain: his apparent willingness to take on the physician power structure in reforming the system. Specifically, calling for nurse practitioners to be more involved in directly providing primary care (great idea), use of retail clinics for routine care (a hot topic that state medical societies are aggressively looking to crush) and pushing for greater data transparency on physician outcomes and prices. Obama has offered the last point (I pointed out previously this was an important difference in his plan), but only McCain has put together several policy proposals that directly aim at the physician stronghold in health care.
-- Experimentation with cost control. A quick aside: this is one of my biggest points of contention with Ezra, the big three Dems' approach and single-payer approaches in general. There is no established method that has successfully controlled costs. European systems are doing better than the US on an absolute basis, but on a growth basis they are no better and as a result their systems are looking for new methods of cost control. In other words, adopting their system will not solve our problem, though it would improve it in the short-term with administrative savings. But we will still be on a financially unsustainable path just as they Europeans say about their own systems. Back to McCain: He looks to leverage states' role in health care to provide a 50 state experiment in cost control via Medicaid, regulation of insurance providers and changing supply-demand dynamic via licensure. This would give the US a lot more options in identifying effective ways for controlling costs via government intervention that offer by the Dems. As those who have read my criticisms on single-payer know, I believe this is an extremely important point on cost control. Only McCain has put forth a plan that could push innovation in controlling costs. The big three Dems are all offering their own versions of what is essentially a precursor to NICE. NICE hasn't worked. McCain offers something more here.
--Greater role for consumer in driving competition, quality and cost control in health care. I've written on this issue at length, and others have responded. No real point to discuss this one further here but for those who believe it has value, McCain offers something more here than the others. Please note, he's talking much more than HSAs.
McCain also offers a number of other policy elements that the Dem big three have offered and other Republicans haven't, i.e. health, federal research into clinical effectiveness, promote prevention, etc.
Altogether from a substance perspective, McCain does offer some different choices than the Democrats. If we could take the best of both, we'd actually have a much better plan.
Posted by: wisewon | Oct 17, 2007 2:02:11 PM
FYI-- In case the obvious needs to be said.
Yes, the Dem plans are far better.
But they are far, far from perfect and McCain has looked at the problem much differently and offered a number of things that would be good to have in any plan.
Posted by: wisewon | Oct 17, 2007 2:09:19 PM
Ezra,
One other thought, I find your overall analysis disappointing.
It's another of these plans to sprinkle magical tax credits all across the land that will incentivize folks to buy less health insurance, but do absolutely nothing for the cost of care.
Yes, McCain's plan doesn't offer universal health care. It is fair to provide ample criticism on that point. But to characterize his plan as no different than the other Republicans, isn't a fair characterization. There was much more there than the others, as I wrote above. You decided to give short shrift to the best ideas and dismiss the others. I was hoping for more. From you.
Posted by: wisewon | Oct 17, 2007 2:27:35 PM
I am suprised. No one has mentioned that Krugman gives young Ezra props today on this post.
Posted by: Joe Klein's conscience | Oct 17, 2007 2:28:18 PM
Because I disagree with what you wrote, WW. First, the lack of actual policy proposals, or funding promises, or identifiable mechanisms, is a huge warning flag. I don't take policy ideas seriously until they become policy ideas. How will McCain increase transparency? How will he change chronic disease management? How will he cross-compare treatments, or gather better data? All the Dem plans actually have concrete proposals for how to do this, McCain's doesn't. I'll give him props when he gives me something to evaluate.
On cost control, you well know that I disagree with the experimentation argument. I think we need integration and federal regulation to encourage cost control. Simply letting 50 fractured systems conduct small scale experiments may be useful, but its not up to the task, nor anywhere near it. Given that McCain's plans don't integrate the system at all, I'm totally unimpressed with their capacity for reducing growth.
But the nut of our disagreement is on the employer deduction. I looked at the op-ed McCain "authored" on his plan, and it's never mentioned. I looked at his speech and found no mention of the employer deduction. It's possible you've found newer statements that I haven't. If he's really arguing for an end to the employer deduction, I think he needs to have a better idea of what will replace it, but even so, that's news. As it is, I don't think he's doing that. I think he's created this new credit which will help "even the playing field," creating a smaller deduction for individuals and other orgs, and making them slightly more viable as health insurance providers. But I could be wrong. I just need to see McCain say so.
Posted by: Ezra | Oct 17, 2007 2:44:42 PM
First, the lack of actual policy proposals, or funding promises, or identifiable mechanisms, is a huge warning flag. I don't take policy ideas seriously until they become policy ideas. How will McCain increase transparency? How will he change chronic disease management? How will he cross-compare treatments, or gather better data? All the Dem plans actually have concrete proposals for how to do this, McCain's doesn't. I'll give him props when he gives me something to evaluate.
This is the wonk bias. I just don't see writing off the whole plan because more detail isn't there. McCain doesn't know the answers to those questions. Edwards doesn't and Obama doesn't. (Hillary actually probably does.) They provide the high-level guidance and have some policy folks on the campaign write in the detail. And the level of detail in the 20 page version still pales in comparison to the level actually needed for real policy implementation. So is the 25 bullet-points sufficient to evaluate a presidential candidates health plan? I'd say yes, if made in good faith-- a qualifier I wrote above.
On cost control, you well know that I disagree with the experimentation argument. I think we need integration and federal regulation to encourage cost control. Simply letting 50 fractured systems conduct small scale experiments may be useful, but its not up to the task, nor anywhere near it.
We do disagree here and I still haven't seen a real rebuttal of my primary point. Other countries have the integration and government regulation that you believe is fundamental to cost control. No country (Nordics aside) have accomplished the task of successfully controlling costs. Their country-specific policy proposals today talk about financial unsustainability, need for better cost control, etc. OECD shows that European countries have grown at same rate relative to GDP as the US-- and we're a horrible point of comparison. Where is the evidence that integration and government regulation is key to cost control? As I wrote above-- NICE is presumably your dream scenario, and it hasn't been effective. There is no model of successful cost control that exists. People don't know the answer here, so we need a variety of approaches.
A different but related point here. I've made the point recently about top-down policy wonk bias-- i.e. analyzing everything from the macro-level standpoint. Those get at certain cost-control ideas. McCain's approach has a very different flavor-- it is much more relevant to day-to-day practice of medicine and reflect an "in the field" understanding of some micro-level issues in health care. Its true for the VA (I'd be really surprised if you were aware of the VA point above) and true for cost control.
I think he's created this new credit which will help "even the playing field," creating a smaller deduction for individuals and other orgs, and making them slightly more viable as health insurance providers.
Completely agreed, this is my read of the approach as well. I don't think he's looking to "end" the employer deduction either. But what I read was he was looking to end the link to employer-based coverage. In a more hands-off way than the Wyden legislation. If the tax advantage is neutral, and people have options for choosing health insurance via other organizations at group rates, I think employer benefits consultants would immediately suggest to clients that they offer up the proportionate increase in employee salaries and get out of the health insurance business altogether. Its a huge drain on businesses, hurts their ability to raise people's cash compensation. You underestimate the impact of "leveling the playing field" coupled with the ability to pursue coverage via other organizations.
Posted by: wisewon | Oct 17, 2007 3:24:10 PM
I had the time to go back and look, I knew I had read about the employer deduction when this first came out-- here is the WSJ article that did explicitly say that employers would lose the tax break (I still actually think it means tax "break" in the sense of the playing field being leveled, but the intent is extremely clear).
The existing tax break for employer-sponsored insurance would be eliminated, taking a step away from the work-based model in place for the last half century and toward an individual market.
http://online.wsj.com/public/article/SB119206651378255555-jC_k4Vc_G_SgxniFouXTBWsohoY_20071109.html?mod=tff_main_tff_top
And for kicks-- here is the Democratic party using it as a scare tactic to weaken McCain's proposal:
http://www.democrats.org/a/2007/10/john_mccains_bu.php
FYI-- If you read that, you'll note that they are saying exactly what I did-- that the Post's analysis of Bush's health care tax proposal earlier this year concluded that "leveling the playing field" would effectively de-link employer based coverage. Of course, unlike Bush, McCain also stated that the individual market would need to be improved so people could still get a group rate.
Posted by: wisewon | Oct 17, 2007 7:55:15 PM
PS-- The WSJ article was based on input from McCain "senior advisers." Given that McCain is looking to improve himself in the Republican primary, the WSJ piece is probably more important than others to the campaign, so the excerpt is above has a decent chance of being accurate and merits further follow-up to clarify these ambiguities.
I'm not the one with the day job to actually do such things, but I do think this one is worthy of your investigation (like you did one some of the Dem plans). Because as you said, if he is arguing for the end of employer deduction, that is news.
Posted by: wisewon | Oct 17, 2007 8:23:23 PM
"-- The biggest policy difference for McCain: his apparent willingness to take on the physician power structure in reforming the system. Specifically, calling for nurse practitioners to be more involved in directly providing primary care (great idea), use of retail clinics for routine care (a hot topic that state medical societies are aggressively looking to crush) and pushing for greater data transparency on physician outcomes and prices. Obama has offered the last point (I pointed out previously this was an important difference in his plan), but only McCain has put together several policy proposals that directly aim at the physician stronghold in health care."
this is smokescreen bullshit and McCain doesnt know what the fuck he is talking about.
Please enlighten us as to what McCain wants to do SPECIFICALLY for nurse practitiners. What powers is he going to give them that they dont have already?
This is a dead end of course, becasue NPs can already do everything that a doctor can do. They can open up their own clinic, they can see patients independently, and they can prescribe any drug that a doctor can prescribe.
The only thing NPs CANT do yet is surgery. Is McCain advocating allowing NPs to do surgery now? Because thats the only thing they are legally barred from doing.
So I'd like to hear exactly what McCain is proposing for NPs that they cant do already.
Posted by: joe blow | Oct 18, 2007 1:22:28 AM
Necessity truly is the mother of invention. Edwards, followed by Obama and Clinton posited their health insurance plans early on in the process. After assessing the public reaction the Reps figured out they needed to address the issue, publicly.
I have not personally reviewed the various plans - since I'm retired and on Medicare - but would have to maintain that a 20 or 25 bullet point plan is nigh onto useless unless their is detail behind it. This detail could be explained rather than incorporated at this point but bullet points do not a plan make.
Although retired (this year) I am not far removed from the complex issue of selecting health insurance. There is, in many of the plans proffered, a strong emphasis on forcing the consumer to take on more responsibility for insurance choice. At first blush this seems reasonable; who better? However, I feel this preference fails to understand the nature of the question. I have for years been encumbered with health problems, minor for me, with a heart attack 25 years ago and no problems since, but my wife has Alzheimers and has been in a nursing home for 9 years. She has had Medicare and Medicaid coverage all that time but I felt a responsibility, as long as I could afford it, to provide primary coverage through my employer's plan. My employer's plan segued from HMO to PPO to a form of PPO with in-network doctors and institutions. My main criteria was that our doctors and hospitals of preference were on the lists. My employer offered another plan but with higher deductibles, co-pays, more restrictions but no doctor limitations. It was cheaper but didn't offer, in my mind, better coverage.
I bring this up merely to point out that their can exist a plethora of selection criteria for each individual. In my case it was fairly simple but for many others it can be quite complex, depending on age, health status, family status, etc. A young family, apparently healthy, is likely to opt for the cheapest premium plan. They won't care much about co-pays, deductibles, out of pocket requirements because they will presume they will not need the insurance that often. The logic would seem the reverse of the normal insurance rationale. When a catastrophy occurs it may be too late to change coverages and they will be stuck with significant cash outlays for medical treatment.
God forbid they incur a catastrophy, lose their job and have to COBRA their coverage. Though COBRA is a blessing it is still difficult to pick up the full premium payments when out of a job, in addition to the deductibles, etc. And what if you are still unemployed after COBRA runs out? You generally have a conversion option to a personal policy but guess what happens to the premiums, especially if you have a medical condition. Happened to me and premium would have gone from $3,600/year on COBRA, to $16,000/year for a personal policy (so much for the $5,000 tax credit). This was in 1995.
The point of all this is that a universal single-payer system appears to me the obvious solution. Attempts to create a hybrid system, leaving private insurance in the equation, seems to add more cost to the system and adds a required element to personal health insurance decisions akin to soothsaying. To make a health insurance decision in this proposed environment would beg for genetic tests to attempt to forecast illness possibilities but with that information in your medical history, good luck.
Am confused about all the discussion regarding the employer deductibility. I presume you're talking about the pre-tax treatment of premiums in employer based programs. If that be the case, then the tax credit proposal requires, at least, a more precise calculation of the net effect given that the pre-tax treatment is not only from federal income tax but also from SSI. The other major question I would have is how would the tax credit be implemented: At the end of the year when filing tax returns; built into the tax tables for withholding?
As to employers raising salaries and wages if, and when, they drop coverage, surely some but don't hold your breath for a dollar for dollar pass through.
At this point I'm not enamored with any of the proposed plans from the candidates. They are geared right now to offering a confused answer to a difficult problem that keeps all sides happy. Best guess is that should a Dem win we'll get closer and closer to universal single-payer and rightfully so.
Posted by: Art A Layman | Oct 18, 2007 11:56:52 AM
Oops! Forgot one thing. Believe that cost control is best left as an addition to any plan implemented for providing coverage. Though some ideas can be presented currently, the factors affecting costs in the process are varied and would likely best be handled through separate regulations as an ongoing process.
Posted by: Art A Layman | Oct 18, 2007 12:02:57 PM
The great invisible burden that the Right doesn't want anyone to talk about is the sole source of health care for those without health insurance: the ER. And who pays for that? You and I.
For any of us to be quibbling about copays and whether we should pay for generic vs brand is freaking stupid when we are already paying for the ER.
Posted by: Bugboy | Oct 19, 2007 2:05:46 PM
The comments to this entry are closed.
