By John Gavin
DID I EVER TELL YOU I WAS IN AN OPERA?
I know, odd right? But it’s true. I was in a real live opera, at the Kennedy Center, in Washington, D.C. in 1985.
It was called “Le fille du regiment” (“The Daughter of the Regiment”) and it was a French opera written by an Italian composer named Donizetti. Donizetti lived in Paris when he wrote it, which is, I suppose, why an Italian would write an opera in French. It’s about an orphaned girl who was adopted by a regiment of the French Army. Yes, I know, a little disconcerting — but it was the 1800s so who am I to judge?
The only reason I know much of this is because I looked it up on Wikipedia. The parts I actually remember about my foray into opera have mostly to do with trying to remember where I was supposed to be standing on stage, and the cast party after the last performance (where I was introduced to a drink called Ouzo, which I now blame for being able to recall the first half of the party but not the second).
The only thing I knew about opera in general at the time was that it wasn’t over “till the fat lady sings.” Which by the way led to great confusion on my part when the first show ended, ostensibly, without so much as a verse by a portly woman.
So how did my theatrical debut even happen, you ask? Well, it went something like this:
I was stationed at Bolling Air Force Base at the time (that’s in our nation’s capital too) and was a 20-year-old kid who knew as much about opera as he did about the mystifying minutiae of government policy — which would be not very much.
What I did know about was working and playing and having myself a good time — and the guys I did that with mostly were Chris Berler, Troy Fifer and Mike Prawley. They were in my unit, and we were tight.
The guys and I were hanging out at the squadron building one day when a call came in from the Washington National Opera Company, of all things. They said they were putting on a show that featured a military unit and wanted to know if they could borrow some real GIs to lend an authentic feel to their production.
And oh, by the way, the job paid a hundred bucks a week. Which was all we needed to hear.
We volunteered and, before long, were at the Kennedy Center rehearsing alongside internationally known opera stars. Or so we were told — honestly I wouldn’t have known any of them from Adam, but they were all pretty good-natured and seemed OK with the fact they’d be performing alongside rank amateurs. Except, coincidentally, for the lady who played the villain (or at least I think she was the villain. Operas, it turns out, are complex and hard to follow). She didn’t seem too impressed with the situation. But we stayed out of her way, she did her best to ignore our very existence, and all was well.
The guys and I played French soldiers who were either trying to prevent or not prevent (was hard to tell which) the leading man from marrying “the daughter of the regiment.” At a point toward the end of the performance we were scripted to escort him off stage as though he were going to the stockade — or vacation (again, not sure which).
The fellas and I had been hustling the leading man off stage for weeks, and it was getting a little stale. So for the last performance we decided to mix it up a bit. Rather than walk the lead guy off like we were supposed to, we decided to pick him up and carry him off — you know, just to make it kind of fun.
But I guess we overdid it a bit. The guy was a little chubby, and so the four of us put our backs into it when we hoisted him up. But it turned out that while he looked kind of fat, he wasn’t really all that heavy, and instead of just picking him up we sort of launched him into the air — which pretty well scared the hell out of him, and worried us just a little too until we caught him on his way back down.
It turned out he was a good guy — by the time we exited stage right he was laughing out loud. He still had a smile on his face when we put him down, and he even slapped me on the back and told us what a great plan we’d devised.
I thought it funny that, as bewildering as I’d found the whole opera thing, taking charge of part of it and making it look how we wanted helped me make sense of it. All of a sudden, in that moment, opera seemed fun. It wasn’t complicated any more — it was (mildly) entertaining.
I’m up against another complicated thing right now that I’d love to simplify, but I haven’t yet figured out how: Obamacare.
Can someone please explain to me what all the ruckus is about? So far I can barely get my head around the name of the thing, which is “The Patient Protection and Affordable Care Act” (which is probably why we’re calling it Obamacare). When I Wikipedia it I get about as far as “… aims to increase the quality and affordability of health insurance, lower the uninsured rate by expanding public and private insurance coverage, and reduce the costs of health care for individuals and the government,” before I feel a nap coming on.
I mean, I know health care reform is a good idea, and long overdue — but is Obamacare the way to go about it? And if it’s not, what is?
Here’s why I know our current system is broken:
Right now the average American spends more tax money, per capita, on health care than the average citizen of Germany, England, Australia or Canada.
Another way to look at that is this: I have a cousin who lives in England (her name is Colette) and I spend more on health care-related taxes, on average, than she does.
And why is that a big deal?
For this reason: To have medical insurance I have to go out and buy a private policy, spending over and above what I already pay in health care-related taxes. Colette gets her coverage courtesy of her government — with no additional private expenditure from her.
Wait, that can’t be right — can it? Hate to say it, but it is.
So something needs to be done — clearly. But is Obamacare the something that needs doing?
First, to understand, I want someone smart to explain it to me. I asked a guy in a parking lot the other day, figuring that, since he had a prominently displayed bumper sticker concerning the topic, he must know something about it.
His bumper sticker said “No Obamacare” or “Defund” it or something like that, so I asked him to please explain the pros and cons as he understood them. By about the third time he mentioned Benghazi I started to excuse myself from the conversation. As I walked off he took one last parting shot, yelling that Obama’s not to be trusted “because he’s for socialized medicine!”
But wait a minute, I thought to myself — isn’t socialized medicine what gets my cousin Colette her care for less than what I’m paying to not get care?
I mean, if socialized medicine could bring me coverage for the taxes I’m already paying, is that such a bad thing?
What if “socialized medicine” is like “Obamacare” in that most of the people who think it’s a bad thing don’t actually understand why they think it’s bad?
I used to think opera was weird — but then one day I figured out it was just a bunch of people trying to make a living by doing what they enjoyed. And yeah, OK, I still think it’s a little weird, but I’m no longer befuddled by it.
So now would someone please explain to me why we’re devoting all this drama to Obamacare? Maybe what we ought to do is not drag our feet, but rather hoist ourselves up to a system that works in so many other countries.
And hopefully we get there soon — I think I hear a fat lady starting to sing.
Benicia resident John P. Gavin is the author of “Online Dating Sucks… but it’s how I fell in love.” You can find it at onlinedatingsucksbook.com or at amazon.com/dp/B009ZYYDVE.
Eliza O'Malley says
As an opera singer, and a fan of this column, it thrills me to see you making a pitch for healthcare via opera!
John P. Gavin - Author says
Hi Eliza,
Glad you like it – and thanks for reading,
John
Tom says
John –
My father-in-law accepted an assignment in England as a plant manager for a packaging company. During his first week there he was approached by a member of his staff requesting an immediate decision. It seems that one of the factory workers had a heart condition that required immediate surgery. What’s the problem, you may ask? The typical timeline for approval of the procedure exceeded his remaining lifespan without the operation. Why were they approaching the new plant manager? They were requesting that the company purchase a supplemental insurance policy for the employee that would provide the life saving operation in a timely fashion. A policy that few could afford on their own. My father-in-law approved the expenditure and the person received the operation.
Could you ask your cousin to comment on that situation?
People don’t want the government making decisions about their health care because the government does not make timely decisions. The government often makes poor decisions.
Do you really want the government making decisions about your health care? Read the Affordable Care Act for youself and decide. If you did you would be miles ahead of most of the Congressmen who did not read the bill but passed it to find out what was in it. If you actually understand what’s in the bill perhaps you could return to DC and author some of the regulations required to actually implement this monstrosity of a law.
What’s the real problem with our current system? The Medical Doctors that I speak to tell me that the problems center around malpractice insurance. Perhaps the government should start cost control activities by attempting to reign in malpractice insurance costs. What might that look like? Lower malpractice premiums for health care providers due to fewer frivolous law suits and smaller settlements.
Could you imagine a Congress full of lawyers standing up to the legal profession and reducing the income stream to personal injury lawyers? Can you imagine politicians standing in a town hall explaining to all of us ordinary folks how we all should be thankful for doctors and hospitals and how we should not despise them simply because the doctors make more money than we do and that it’s actually necessary for hospitals to be profitable? Those fat ladies will never sing. Those starring roles will never be filled.
John, please talk to some doctors and ask them how many of their classmates still practice medicine. Ask them why people leave this profession that they sacrificed so hard to enter.
jeanius says
Tom … For-profit insurance companies will continue to make decisions about your health care after 1/1/2014, just like they do today.
DDL says
For-profit insurance companies will continue to make decisions about your health care after 1/1/2014
Of course they will, but for how long?
The buggy whip manufacturer’s did not shut down over night.
jeanius says
For how long? However long is necessary.
jeanius says
We don’t seem to have much need for buggy whips these days, do we?
DDL says
Nor will we have need for private health care plans under the true goal of single payer.
jeanius says
That’s not necessarily true. Private health care plans are available in countries with single payer healthcare.
Tom says
jeanius –
I and my doctors make my health care decisions. I periodically need pre approval from my insurance company. Sometimes I have to fight with my insurance company for reimbursement. But I am very happy with my health care. I do not want to lose it.
People are already being pushed from employer provided health care onto the exchanges against their will. The Obama administration has been providing waivers from this law since its inception. The administration is now delaying implementation of entire sections of the law. This is a train wreck.
jeanius says
“People are already being pushed from employer provided health care onto the exchanges against their will.”
Tom, how do you know this?
Tom says
News reports of employers canceling employer provided benefits. The statistics regarding the increase in part time employment that avoids the requirements associated with Obamacare compliance.
jeanius says
The increase in part-time employment was being noted well before Obamacare became law.
The “news reports” of employers canceling employer-provided health benefits are out there. I think Fox & the Washington Times have noted such instances. But are employers canceling health benefits at a greater rate currently versus a year ago? 2, 3, 4, 5 years ago?
Tom says
jeanius –
You can disagree with news reports and statistics to whateverextent that you want. Here are a few more: Obamacare makes the cost per employee greater. Unemployment is stubbornly high under PresidentObama. Reductions in the unemployment rate are not due to an increase in jobs but due to people giving up their search for work, thereby no longer being considered as unemployed.
Getting back to John’s point. Would you really rather live under the British health care system? What experiences do you have with UK healthcare?
jeanius says
Tom, the benefits of Obamacare have already been happening. Parent(s) are allowed to insure their under-26 year-old children. Insurance companies are no longer allowed to not decline insurance on the basis of “pre-existing conditions.” Millions of previously uninsured citizens will be able to receive health insurance through the market-based exchanges.
John’s point was not about whether or not we are choosing to live “under the British health care system”.
Quoting John, his point was: “So now would someone please explain to me why we’re devoting all this drama to Obamacare? Maybe what we ought to do is not drag our feet, but rather hoist ourselves up to a system that works in so many other countries.”
DDL says
I note you avoided an answer Tom’s reasonable question.
jeanius says
Tom’s questions are not reasonable. Obamacare will not, by any stretch of the imagination, create a medical system that looks anything like the UK healthcare system.
John P. Gavin - Author says
Hi Tom,
Thanks for the well thought out response.
Your father in law sounds like a good man. But I’d tell you anecdotal evidence is available for both sides of the discussion to illustrate why government involvement is good/bad.
You say your doctor friends tell you malpractice insurance is the real problem with our current medical system. While it’s the problem that I’m sure affects them, personally, most noticeably – it’s not the whole problem (though it’s certainly part of the problem).
The whole problem includes malpractice insurance, and our rising obesity rates, and the fact that people who do pay for their health care end up picking up the bill for those who do not – and other factors, among the most important of which is our lack of negotiating power with health care providers.
Here’s an example: A hip replacement in Belgium costs about $13,000. The same procedure here in the US often costs over $100,000 (trust me on that one, I opened the bill for Mom’s hip replacement).
So why the big disparity?
Belgium (who, by the way, does not have single payer but rather a hybrid type of healthcare much like what’s suggested in comments below) negotiates on behalf of their health care consumers far better than the US does.
The US does a very poor job, comparatively, of negotiating with health care providers, drug manufacturers, medical device (like hip joint) makers, etc. which is among the biggest reason why we are paying so much for so little. And that’s where single payer systems really show their muscle – they have huge negotiating power with the providers. As a result , those providers have to be extremely competitive in order to get the (huge) chunk of business the single payer system can dangle if front of them.
That just doesn’t happen here…
If we want to use life expectancy as a guide we see that, even though your father in law experienced a trying situation in the UK, the UK’s life expectancy is longer than our. As is Belgium’s.
And about thirty other countries (I think we rank 33rd).
And just about everyone of those countries – wait, make that EVERY one of those countries, spends less per capita than we do on health care.
And among all the reasons that is untenable (not the least of which is patriotism) I also have to say I find it, well, embarrassing.
Thanks for reading Tom,
John
Hank Harrison says
http://www.nytimes.com/2013/09/21/opinion/blow-kamikaze-congress.html
John P. Gavin - Author says
Hi Hank,
While I agree with the opinion in the link you posted – I’d also be interested in reading your opinion…
Thanks for reading,
John
Hank Harrison says
Allow me to correct that oversight …
http://www.washingtonpost.com/opinions/eugene-robinson-obamacare-the-gop-nightmare/2013/09/23/fd29187a-246a-11e3-b75d-5b7f66349852_story.html
Greg Maroussi says
http://thinkprogress.org/health/2013/09/25/2675821/95-of-uninsured-will-pay-less-than-expected-for-obamacare-coverage/
Robert Livesay says
The term lower than expected tells it all. HEAVELY SUSIDIZED
Hank Harrison says
Duh
John P. Gavin - Author says
Hi Greg,
Maybe they’ll have enough left over to do some much needed spending in this still sluggish economy?
Thanks for reading,
John
John P. Gavin - Author says
Nice correction Hank…
John
Robert M. Shelby says
Obamacare will ultimately prove to have been elaborate foreplay prior to the nation coming to its senses and enacting Single Payer Health Care, such as I have advocated for twenty years or more.
Robert M. Shelby says
P.S.: Nice article, John.
John P. Gavin - Author says
Thank you Robert,
I have to say though, I don’t think we’ll get to Single Payer anytime soon.
That said, there is a chance we’ll get to a hybrid between it and what we have now that will work way better than our current system.
And I do think the ACA is a step in that direction – and is the step that was possible given the current climate in Washington DC.
Thanks for reading,
John
DDL says
RMS: Obamacare will ultimately prove to have been elaborate foreplay Agree. That is the plan, 0Care will fail, it was designed to do so.
prior to the nation coming to its Knees
enacting Single Payer Health Care Like in the UK?
such as I have advocated for twenty years or more. Robert, Renaissance man, one ahead of his time, with the wisdom and knowledge to assure health and care for all. Just like in the UK:
Deaths, lies and the NHS: Shocking new healthcare scandals emerge in UK
We are witnessing the future of America, when we look at UK Healthcare.
jeanius says
DDL, no health care system is perfect. You fear that single payer health care system will result in the same kinds of deaths, lies, and scandals as reported by the Russia Today article that you linked to in your comment.
On the other hand, the pre-Obamacare health care system precluded about 45 million people from having access to basic health care services. Today, in the US, people will lose access to health care if they lose their jobs. They can pay out-of-pocket for COBRA for up to 6 months – but, COBRA can be prohibitively expensive for a jobless person to afford.
A study was published in the American Journal of Public Health in 2009 that determined uninsured working-age Americans have a 40% higher risk of death than their privately insured counterparts. (see http://www.pnhp.org/news/2009/september/harvard_study_finds_.php)
But, why should employers be stuck with providing health care benefits to their employees? And should those employer-paid premiums be taxed as income earned by the employee?
Obamacare is trying to extend the greater good to the greatest number of people. Everyone in the US should have access to basic health care services.
DDL says
Jeanius,
Thanks for the comments, I do appreciate a reasonable discussion with a reasonable person. Let’s take a closer look at the 45 Million number, if we could:
This was carried in the Herald at the time the bill was under consideration:
Just who is not covered? – During the campaign the number “45 million Americans” was used as the number of those lacking insurance. Then it was changed to 45 million “people”, it was changed once again to 30 million “Americans”. Even Nancy Pelosi added to the confusion when she said that the health Care reform would cover 95% of Americans, leaving 15 million still without coverage.– D. Lund Jan 10, 2010
Here is what the President said:
“all it takes is one stroke of bad luck — an accident or an illness, a divorce, a lost job — to become one of the nearly 46 million uninsured…”
The actual number is 45.7 Million, he rounded up, most rounded down, either way though the number is big. But here is what is included in that figure, which comes from a 2007 report from the census bureau:
1) 9.7 million of the uninsured are not citizens of the United States
2) Census Bureau reports “health insurance coverage is likely to be underreported”.
3) about 14 million of the uninsured were eligible for Medicaid and SCHIP.
4) In 2007, 17.6 million of the uninsured had annual incomes of more than $50,000 and 9.1 million earned more than $75,000.
5) those making more than $75,000 per year are part of the fastest growing segment of the uninsured population.
6) 18.3 million of the uninsured were under 34. Some who have simply determined that they are young and healthy and thus can do without coverage.
Additional point: a 2003 BlueCross BlueShield study showed that 8.2 million Americans are actually without coverage because they are too poor to buy health care
I still contend that finding a way to insure those 8 Million was a very solvable problem and did not require the radical overhaul that is Obamacare
jeanius says
DDL, you’re entitled to your contention. My contention is that Obamacare is far from a radical overhaul,
We needed to start somewhere.
John P. Gavin - Author says
Hi Jeanius,
Well put…
And thanks again for reading,
John
beniciamom says
I have a niece in the UK that has just gone through a nightmare trying to get a routine surgery. My husbands family lives in Canada and I’ve heard all their healthcare nightmares. Why on earth would I support government involvement in healthcare when it has already proven to be a nightmare everywhere it is enacted? Get the government out of healthcare!
Karen LaRiviere says
It’s really unfortunate that the right wing talking points have completely distorted the whole ACA issue. It is NOT a government takeover of healthcare. The government is not going to be making decisions as to who gets treatment and who doesn’t. Insurance companies have been doing that for years. How many people have had their doctor prescribe a medication only to have the insurance company balk because it’s too expensive? How many people have been turned down from getting health insurance because you had a hangnail when you were in college? How many people have lost their job and then couldn’t afford the COBRA coverage because it’s 3 times as expensive?
The government is telling insurance companies that they can no longer discriminate against people with pre-existing conditions, that they cannot impose lifetime caps on people with major illnesses, that it cannot charge women more than men for coverage and that preventative care should be covered at 100% because it’s WAAAY cheaper to vaccinate someone than to treat them for whatever ailment they were vaccinated against – like Kaiser has always done. No government telling them what to do, they saw the cost benefit analysis of doing it for years.
The template for the ACA was taken from the right-wing, conservative think tank, Heritage Foundation and they also consulted with a number of people who developed the Massachusetts plan or Romneycare. The main thing about the ACA that opponents despise is that everyone must buy insurance coverage. A totally conservative and righteous thing to do. Take personal responsibility for your healthcare. How many people complaining about having to have health insurance wouldn’t dream of not carrying auto insurance? Or better yet, get pretty pissed when they get hit by some yutz who doesn’t have insurance?
Most people working in the service industry do not have employer provided healthcare and on minimum wage, cannot afford the ridiculous rates. Now, rather than going to the emergency room, they should be able to get coverage that takes care of their healthcare needs. With all the people out of work, there is no chance for “employer provided healthcare” and then there are those of us who are self-employed. Health insurance is not available if you have a pre-existing condition. Sorry. There used to be a thing called “Association Coverage” where Chambers of Commerce acted as the employer for group coverage so all members who were sole proprietors could join as if they were part of the group. Yea, the insurance companies stopped that because they weren’t making any money off it so if you are working for yourself, good luck.
I find it incredibly irresponsible that the Koch Brothers would produce ads that basically tell young Americans to “Opt Out of Obamacare.” These kids are already saddled with outrageous student loans and now we’re telling them NOT to get health insurance. God forbid they break a leg, get in a car crash or come down with a serious disease. Who is going to pay for their coverage? Are mom and dad going to mortgage their home so that Johnny can get his chemo? That’s what this whole thing is supposed to prevent!!
And as for the Canadian healthcare system, my in-laws are quite happy with the fact that EVERYONE is covered. We have grown accustomed to “want it now” immediacy with everything which is why our healthcare is the most expensive in the world. Not everything is an emergency and the Canadian system prioritizes. However, if you are like most Americans and “want it now” you can purchase a supplemental insurance policy in Canada, similar to Medicare Advantage.
The ACA or Obamacare is NOT a government takeover of healthcare. Medicare has much more government involvement in healthcare. It’s funny that a whole lot of people on Medicare are the same ones railing against Obamacare, yet I haven’t heard a single one of them say that they would forfeit their Medicare! Their truly government involved healthcare plan.
DDL says
The government is not going to be making decisions as to who gets treatment and who doesn’t.
Kathleen Sebelius won’t intervene in girl’s lung transplant case
The family of 10-year-old Sarah Murnaghan might disagree with that assessment. Sarah would likely now be dead if a Judge had not intervened and over ruled Sebelius.
Karen LaRiviere says
As far as I know, the Organ Transplant Registry has nothing to do with the government and they were trying to follow their protocols (right or wrong). HHS has never gotten involved in situations like this before. What about the teenager in LA who required a transplant but Aetna wouldn’t pay for it? By the time Aetna was shamed into paying, the poor girl died. Or the young boy who Blue Cross denied treatment too because giving him the treatment (that might have saved his life) was hugely expensive (i.e. experimental per BC) and they didn’t want to set a precedent. Kathleen Sebelius didn’t intervene because she had no authority to do so.
Robert Livesay says
Wrong. She could have. There are some good parts to Obamacare that should be retained. But overall it should go. The Government has no need to be in utilization. If it is so good why do doctors not like it? If it is so good why do the house, Senate and their employees have it. Simple they do not like it.
Hank Harrison says
Too bad. It’s the law of the land. People will come to like it when they see the benefit in not going bankrupt when serious illness strikes. Among myriad other benefits.
Like Social Security, like Medicare, ACA is here to stay.
Robert Livesay says
Hank the folks that have healthcare now were and are in no danger of going bankrupt. Have you every heard of the health plans that cover that. The poor also had no danger. So just who are you talking about? Could it be the folks that took a chance and did not cover themselves with very low cost plans to cover major issues. I have always believed that we must take care of the needy and help them get on to a better life. Not a way of life. That is what Conservatives do.
Karen LaRiviere says
Bob, really?? Did you not read what I wrote? If you have a pre-existing condition and no job or are self-employed you CANNOT get coverage. You can go into a high-risk pool that can cost 3 times a mortgage payment for little or no coverage and then there are all those minimum wage workers who do not have access to employer sponsored health insurance – none of them have any pre-existing conditions? They can’t get insurance and even if they could, the cost is so outrageous that they take their chances and cost all the rest of us because they go to the emergency rooms. If they are diagnosed with cancer, oh well, sorry for you, but not everyone qualifies for “poor people” coverage and it varies from state to state which is why Texas has the highest rate of uninsured in the country. They won’t expand their Medicaid roles (and are closing clinics that cater to women’s health). The ACA is not perfect by a long shot, but it’s a hell of a lot better than what many have available now which is nothing.
Robert Livesay says
Karen try catastophic insurance. It is available at a small cost. There also many be low cost health plans with high deductibles also available. If the poor need help there is medicade. The poor elderly can have medicaid and medicare its called medi/medi. Also available is MIA which would cost the recipient zero. I do think that Obamcare has two good things. Pre-existing and 26 years of age for single chuikldren. B I do believe we must take care of the needy and the unemployed with assistysance if they cannot get a job. Obamacare is not the answer. eyond that forget it.r
Robert Livesay says
sorry for the typos, you got my message
Karen LaRiviere says
Bob, we have a high deductible plan that still costs $1066 per month. Not many people, especially minimum wage workers, can afford that, on top of the $2700/$5600 deductibles and then the $9000 out of pocket maximum each year. Catastrophic insurance is a joke.
Robert Livesay says
Karen try a trade association. Look around.
Hank Harrison says
Karen try the ACA. Numbers out today look pretty good.
Hank Harrison says
So-called conservatives have two options: They can work to fix the flaws in the ACA, or they can do nothing and let the law proceed. They will not succeed in getting rid of this law and they are wasting taxpayer dollars trying.
Robert Livesay says
Hank they look good if you get subsides. Not so good it you do not. The subsidized plans are no better than the plans at present which are medicaid. As I said medicaid is the answer run like medicare with set premiums and a payroll deduction to pay for it. That could work and make everyone happy. The only problem is the young. They wanty no part of it.
Hank Harrison says
That last statement of yours is pure conjecture. I say the young will sign up in sufficient numbers initially, and those numbers will grow with time.
Robert Livesay says
Explain what changed to make them sign up. Hope is what you are saying.
Hank Harrison says
Explain what evidence you have that they won’t. Hope is what you are saying.
Robert Livesay says
I do not need evidence. Obamacare was designed to punish the young that did not sign up. Got it. Obamacare is the evidence or they would not have put it in. Very simple. The youn have never participated and will not now. Obamacare is all the evidence that is needed.
Hank Harrison says
Thank you. I rest my case.
Hank Harrison says
Everybody read this.
http://www.slate.com/blogs/moneybox/2013/09/25/obamacare_premiums_will_be_cheaper_than_the_cbo_projected.html
Robert Livesay says
Hank ,it is not new and also not true.
Hank Harrison says
Gonna need to do better Bob. Why not true?
DDL says
Karen stated:As far as I know, the Organ Transplant Registry has nothing to do with the government and they were trying to follow their protocols (right or wrong). HHS has never gotten involved in situations like this before.
Karen, I would urge you to look at the website linked for more information on HHS and their transplant network.
US Department of Health and Human Services
Quoting from the HHS website:
“Uniting people and information to help save lives”
“The Organ Procurement and Transplantation Network (OPTN) maintains the only national patient waiting list and features the most comprehensive data available in any single field of medicine.”
Following are titles of links, at the site, for more information:
Waiting list candidates 119,807 as of today 8:05pm
Active waiting list candidates 76,733 as of today 8:05pm
Transplants January – June 2013 14,105 as of 09/20/2013
Donors January – June 2013 6,961 as of 09/20/2013
John P. Gavin - Author says
Oh my Karen,
What an eloquent, concise and thoughtfully written response.
Do you mind if I just refer all subsequent responses to you?
The only downside to reading it are the COBRA flashbacks I’m now having. That thing seems more like a bad joke than a healthcare option…
Thanks for reading Karen,
John
John P. Gavin - Author says
Hi BeniciaMom,
First off: Thanks so much for contributing.
I really like the conversation my little column has led to.
I would say this though, when we use emotionally charged terms like ‘nightmare’ and generalities like ‘everywhere’ our points can be misconstrued by their readers who often think, because of the tone of the language, we’re speaking from a place of anger rather than a place of objectivity.
Okay, climbing back down from my soapbox now…
Thanks for reading,
John
Robert Livesay says
The direction of healthcare is going in the Kaiser Staff Model direction. Obamacare has a few very good things that will remain regardless of what the final outcome is. I suggest all of you take a month off and read the whole healthcare bill. You will not understsand it… Far too confusing. If the young people in Ametrica do not sign up for Obamacare it will be a financial disaster like you have never expierenced. Medical decisions must be made by the medical folks. You know utilization. review Kaiser and you will see that their plan is very well excepted and has wide approval by the folks enrolled. People do not like GHMO”s because they do not understand them. They want their doctor for no good reason at all. Changing Doctors is not a big thing. In fact your health might just get better and you could be using less meds. Think about it and do not fall in love with Doctor Feel Good.
Robert Livesay says
Sorry for the typos= should be HMO’s
John P. Gavin - Author says
Thanks for the input Bob,
John
Robert Livesay says
Thanks for reading my comments John. I know you do not agree with them. As I said there are two things in Obamacare that are very good. Both can be put to practice along with the young and healthy that do not want to be part of healthcare. There have always been policys for those also at low premiums and high deductibles, meaning the young and healthy. Mainly to cap the costs of any unseen issues. Also Disability after two years at any age under 65 you can go to Merdicare. Medicare has no pre-existing issues. So the disabled and the elderly already are covered for pre-existing conditions. Now we fix the pre-existing for all others and the singles under 26 who can go on parents plans. Now as you see that is why I say there are two things that are good about Obamcare. As far as the needy we have always had medicare, yes better in some states than others. That also can be fixed along with the folks on unemployment. We also should do everything we can to shorten the time from disabled to medicare. There are very reasonable solutions to all of this. It could have been thought and you could of had a very solid plan supported by both party’s. It is not Obamacare. Thanks for reading John. I would like your comment.
John P. Gavin - Author says
I think the piece of knowledge that best justified my college tuition was this:
You don’t have to know everything, you just have to know where to find it.
That being said maybe I’ll defer to Karen here – she’s pretty sharp.
I will say this though – I like that you, and most here, are thinking your way through the process and trying to arrive at something reasonable that actually works for those who need and deserve it.
Because that’s how we’ll get there…
John
Robert Livesay says
Sorry John wrong. I was in this industry and thought my through long ago. Should have referred everyone to me.
Karen LaRiviere says
Thanks for your kind comments John. I really enjoy your columns. I have tried to look at this issue from all sides and I keep coming back to the fact that this was a Republican, Heritage Foundation proposal modeled on the Massachusetts plan, implemented by Republican Mitt Romney. If you read the book, Deadly Spin, by Wendell Potter, you will find all the exact talking points that have been used to try to destroy this law simply to make a point. It’s a great book by a former Aetna executive.
The individual mandate is a totally Republican, personal responsibility, issue. So, the only thing I can conclude is, the Republicans have demagogued this whole issue to death to try and keep Obama from any possible success, at the expense of their constituents. They have convinced themselves of the lies that they have repeated over and over, but if you look back to the 1930s, their arguments against the ACA are almost exactly the same as those against Social Security and FDR.
Robert Livesay says
They were right based on cost.S/S is not the same as it was intended. By the way Karen unless you qualify for subsides your high deductible plan at present will more than likely be the same under Obamacare. As I said join a trade group it could help. Obamacare is not the answer only for the ones that were already being helped and two very good editions. Thats it. Karen will Obamacare give you and your family a better plan? I have a better idea Karen run for city council or any other elected job. Benefits are included. Remember the school board member who got hammetred because he wanted benefite rerstored. Not bad now for those members.
Kate says
I only want what all of our lawmakers, congressmen, senators, etc. get, in terms of healthcare. Otherwise, cancel theirs and let them see what it’s like to go shopping for coverage, making decisions about their families’ health and budgets. Or can’t we all have Medi-care? I’m suspicious that these half-measures will be problematic and cause people to take a dim view of moving toward universal healthcare. Also, in an aside, malpractice insurance is an old bogeyman; some places, notably Texas, passed stiff malpractice suit limits and I don’t hear any wonderful stories of cheaper insurance rates as a result.
jeanius says
It’s unfortunate that the passage of Obamacare was a process of throwing together half-measures. Instead of repealing or defunding Obamacare, why not fix it?
I think a Medicare-for-all option should be included in our health care system. But, the powers that be (health industry lobbyists) don’t want that. However, our country’s health care system makes sure that adults receive Medicare when they turn 65. Why not add the under-18 population to Medicare? Every child in this country should have access to basic health care from the time s/he is born.
DDL says
Jeanius stated: It’s unfortunate that the passage of Obamacare was a process of throwing together half-measures. Instead of repealing or defunding Obamacare, why not fix it?
A fair position to take.
But let’s back up and using the above reasonable logic consider this option:
It’s unfortunate that the passage of Obamacare was a process of throwing together half-measures. Instead of the passing Obamacare, as was done, why not fix the flaws in our Healthcare system as it originally existed?
jeanius says
“Instead of the passing Obamacare, as was done, why not fix the flaws in our Healthcare system as it originally existed?”
DDL, Obamacare was passed to fix the flaws in our health care system.
John P. Gavin - Author says
Great points Karen.
Thanks for reading,
John
John P. Gavin - Author says
Hi Everyone,
I just want to thank all of you for taking the time to add the generally well thought out and cogent comments.
I have to say that some of the comments herein are better written and more informative than the column they were written in response to!
This topic is one that requires thought and care – and I have to say that most of your input reflects how important the issue is.
And as always, thanks to all for reading…
John
jeanius says
You wrote a good column, John. You drew us in with your opening line! Well, maybe you drew ME in with the title of the column.
John P. Gavin - Author says
Oh, and if anyone’s interested, I came across a great little video (by a smart guy) that helped explain the healthcare issue to me.
You can find it here:
http://www.youtube.com/watch?v=qSjGouBmo0M
environmentalpro says
This is great! Watched it last week. Spot on!
John P. Gavin - Author says
Thanks EP,
John
Robert Livesay says
i am depressed John I never get thanks from you. Just the usual responce. I am devastated.
John P. Gavin - Author says
Allow me to correct that oversight!
I do appreciate your comments and the fact that you read me – which you do not have to do.
So thank you for that.
John
Robert Livesay says
Accepted. I would appreciate it even more if you understood what I am talking about. My cure for healthcare is very simple. As I said I will elaborate latter in the day.
John P. Gavin - Author says
You are a gentleman and a scholar.
And later in the day I may even drink to that…
Thomas Petersen says
You’re welcome John.
Robert Livesay says
I watched. Nothing new and more important no solution. Later in the day I will comment on by points that we need to fix healthcare. It is very simple and again I must say Obamacare is not the answer.
John P. Gavin - Author says
You already knew all that stuff?
The part that floored me when I heard it was that the Brits spend less to get care than we spend to not get it.
I had just always assumed (probably like a lot of others) that they were taxed through their teeth for the care they were getting…
John
jeanius says
Thanks for sharing! I had not seen this. Anyone interested in more information re: Vlogbrothers, go to http://en.wikipedia.org/wiki/VlogBrothers.
Will Gregory says
From the article below a key passage for the community to consider…
Obamacare Premiums Look Good, But Medicare-For-All Would Be Better
As many healthcare industry experts have long understood, most of what ails the nations’s crisis of healthcare is the profit-based model of coverage that Obamacare does more to bolster than upend.
And according to advocates of a single-payer system or Medicare-for-All program, the implementation of Obamacare may help more people afford private insurance, but it will do too little to end a paradigm in which some people receive access to advanced forms of care and coverage while others languish uninsured and untreated.
“Contrary to many people’s expectations, the number of unprotected Americans will drop by only half when Obamacare is fully implemented,” said Dr. David Himmelstein, representing Physicians for National Health Program, in a recent statement. “Even if all the as yet undecided states were to opt-in to the law’s Medicaid expansion,” he said, approximately 24,000 people can be expected to needlessly die every year because they will continue to lack access to timely and appropriate care.
And Baker adds, “Private insurers are the sole providers of insurance [under Obamacare]. Not only are we not getting universal Medicare, we did not even get a public option, the right to purchase a Medicare-type plan that would compete with private insurers.”
“The drug companies and medical equipment suppliers both end up as winners under Obamacare,” he continues. “They will be able to secure even greater profits from their government-provided patent monopolies since the ACA does little to rein in costs.”
Despite what seems like good news from HHS, progressive critics of Obamacare will still be urging a move to a single-payer, improved-Medicare-for-all program.
“Such a program would assure truly universal, comprehensive, high-quality coverage for everyone while simultaneously ridding us of the scourge of insurance-company-related waste, bureaucracy and profiteering,” said Himmelstein. “It would thereby save both lives and money.”
http://www.commondreams.org/headline/2013/09/25-1
John P. Gavin - Author says
Hi Will,
You know, when I first read the details of the ACA what occurred to me was that it drove just about everyone to buy private insurance, thereby guaranteeing revenue for the private insurance companies.
A ‘public option’ would have been nice.
But I have a feeling it wouldn’t have made it through Congress.
Insurance providers, drug and medical device manufacturers, et al., spend a ton of money in Washington and, as a result, hold a lot of sway.
I think the legislation we have so far is pretty much what’s achievable so far.
Thanks for reading,
John
Will Gregory says
More healthcare news our community can use…
“Obamacare Premiums Look Good, But Medicare-For-All Would Be Better”
“On July 30, in Washington, D.C., longtime single-payer advocates Sen. Bernie Sanders, Rep. John Conyers (chief sponsor of HR 676, the Expanded and Improved Medicare for All Act), and others will speak at a rally for Medicare’s 50th anniversary …”
“The theme of all the events is to Protect, Improve, and Expand Medicare –”
“Protect it, because many in Congress would like to place our best-yet health care program on the chopping block and privatize it. ”
“Improve it, because despite its valuable contributions, Medicare falls short on dental and drugs and leaves some people still unable to afford care. ”
“Expand it – to the entire population – allowing us to end the waste of $400 billion annually that is currently spent on the needless bureaucracy and paperwork associated with the private health insurance industry.” .
“I believe our nation has a compassionate heart and a deep national desire for universal care. What better time to make these yearnings manifest – and to demand that they be realized – than Medicare’s golden anniversary? Tell your lawmakers: we want an improved Medicare for All.”
Key question: Is rep. Mike Thompson an advocate for Medicare -for- all?
http://www.commondreams.org/views/2015/07/29/celebrate-medicares-50th-birthday-expanding-it-all 8
Robert Livesay says
By now I do believe everyone understands I am not a fan of Obamacare. For one reason only. Healthcare in the USA needed to be fixed not demolished. If you need a new roof on the house you do not demolish the house. So what needed to be fixed. #1-Pre-existing conditions; #2- Single under 26 years old; #3- The needy and certain income brackets; #4-The unemployed who lost their job and insurance; #5-Afforable healthcare insurance for those that do not get it at work; #6-Medicaid. #7-Healthy young people who do not buy insurance. Now Obamacare did address many of these. #1 pre-existimg conditions was very good; #2-26 and under year olds was good; #3- The needy and certain income brackets were already eligible for medicaid {Medcicaid see that fix}; #4-The unemployed. Should be moved into the Medicaid group until back to work with insurance if no insurance provided a pay level set by income and need in medicaid. #5-Afforable healthcare insurance. This could be a large group and again should be moved to Medicaid {Many are already in it} and premiums on a set scale. Some employee and employer contribution regardless of number of employees. All business that do or do not provide healthcare insurance regardless of size should contibute a set amount per employee. The employee then can search for the best deal to suit their needs. That is called responsibility. Some will chose medicaid.#6-Medicaid needs a big fix. Benefits should be the same in every state with options to add other benefits. Obamacare is moving far too many folks to medicaid at a very expensive cost. Medicaid was originally for the needy and low income. It now should become the primary healthcare for folks that are not offered healthcare at work. Also the needy and low income. Premiums set on ability to pay. As you see some could get it free others would pay as if they worked for a company that offered healthcare. There should also be a payroll dedution added for medicaid because it is going to became the primary healthcare provider for many. Medicaid can be made into a very good program similar to medicare. Many offering like medicare. HMO’s, suppliments etc. #7- This is the big one. Young folks that think they do not need healthcare. This group or anyone that does not want to buy healthcare insurance should be mandatory to buy a catastrophic insurance. That way they will not be burdened with a huge cloud over their head if a big health bill happened to them. It would be capped. A big problem with medicaid is the fact that you could be made to pay it back as it stands nowe if all of a sudden you get rich. That party must be eliminated Does this sound simple? It is and Obamacare has covered many of these issues. They big problem with Obamacare is that it was not at all thought all the way through. Obamacare in many cases places the burden on the tax payer and the hope that the young will be apart of it. They will not be a part of it. Never have and see no reason to be now unless it is free. There is one of your big problems. Free it what many think Obamacare is and in many cases it is. We have free healthcare for the needy and low income now. What Obamacare did un-necassarily so was expand that group. We now need a payroll dedution for medicaid with matching employer contributions. So as you see the employee and the employer all contribute. The low income will get premium breaks and the employer will only be burden with a set amount of contribution. It will work. Parts of this will happen AS THE rest needs to be reviewed. There are solutions to Obamacatfre.Free market could also exist as it does now. It must be a bi-partisan discussion and not just the way of the Dems..
John P. Gavin - Author says
Yes, there’s that extensive analysis.
Or this slightly more concise one (where this news organization nails it):
http://www.theonion.com/articles/dad-explains-obamacare,33961/
jeanius says
🙂