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Letters to the Editor

Profit motive

February 25, 2009

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To the editor:

As the health of our economy continues to worsen by the day, the deteriorating health of our citizens is overshadowed by the panic of the moment. As millions of Americans become unemployed — and uninsured — the need for reform is vital. Every year, more than 20,000 uninsured adults die because of delayed or denied health care due to unaffordable premiums or pre-existing conditions.

President Obama has promised to sign health care financing legislation that will ensure access to affordable health care for all Americans. But how will this be accomplished?

Last week, the New York Times reported on a secret panel of health care organizations that has been meeting with senators since last fall. This group proposes achieving universal coverage through individual mandates and promises by the insurance industry to provide coverage for people with pre-existing conditions.

Sadly, these “experts” have excluded the voices of tens of thousands of health care providers and millions of citizens who are calling for justice in health care financing. This would start with the elimination of the profit motive by corporations and their executives who are lavished with multimillion-dollar salaries derived from the premium payments of individuals and business.

The ultimate solution is clearly a single-payer system of financing that would be modeled after Medicare, an American system of publicly financed, privately delivered health care that has served our nation for over 40 years. In our current weakened economy, single-payer financing would save billions of dollars while providing coverage for all Americans.

Dr. David Goering,
Lawrence

Comments

jafs 5 years, 1 month ago

notaj,

I agree that the prices are way too high, and with some of your analysis.

If we want good, affordable health care, though, we need to look at other things as well.

When drug companies are making $25 billion profits/year and not releasing affordable effective drugs because they aren't high enough profit makers, we should be concerned.

Given our profit-driven capitalist model for health care, the drug companies of course have no particular reason to release those drugs.

But if we're looking for good affordable medication, those drugs should be released.

That's why some question the profit-driven system, in a nutshell.

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notajayhawk 5 years, 1 month ago

[continued]

It's a travesty that the topic of cost-effectiveness based on life expectancy is even mentioned - ever! The fact that this is something that there's any need to consider is a travesty. When did we reach a point where ANY medical procedure, as complicated/innovative as could be, that might add five years to a person's life can cost ten years' (or more) of their salary?

THAT is the problem.

It seems ludicrous to complain about not being able to afford healthcare but not complain about the cost. We accept as a matter of course that an emergency room visit can cost $12,000, we just want someone else to pay for it. And as long as someone else is paying, whether private insurers or Uncle Sam, we don't scream about the price. The issue is not - and never has been - who pays.

It's the cost. THAT is the problem.


jafs (Anonymous) says…

"Drug companies do, by the way, and apparently refuse to release effective drugs if they won't make enough of a profit on them. Hmmm."

And they should ... why, again?

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notajayhawk 5 years, 1 month ago

This thread seems to be dying off, but I wanted to get another few things said.

Another poster mentioned that nobody should have to go into debt for an emergency room visit (I'm too tired to scroll up and give credit to that person, sorry). That is true. However, the problem is with the cost, not with who pays. My wife recently spent 10 hours in a nearby ER for 'observation'; that's all they could do, as she was pregnant. They couldn't do x-rays, let alone a CAT scan or something fancy. Her treatment consisted of a couple of standard blood tests and a nurse coming by once an hour or so to ask how she was doing. The cost? Over twelve thousand dollars!

THAT is the problem.

Why is it that the doctor who ordered the x-ray can't read one? Why is it that a trip to the ER involves bills from six different physicians, most of whom the patient never saw? When did medicine become so overspecialized that one physician orders the test, a radiologist has to read the x-rays, a hematologist has to look at the blood workup, a GI has to review the liver enzyme panel? I'm not talking about spending a few days in an outpatient clinic to diagnose some rare tropical disease, I mean when you go to the ER with stomach pains?

THAT is the problem.

I'm in an allied health field (specifically mental health). I have worked in agencies where more than half my time is spent documenting and in other 'administrative' tasks - yes, it takes more time to write down what was done than to do it. This is not a billing issue - most of the agencies I've worked for deal mostly with the indigent and there IS a single-payer system, usually state funding. It's for regulatory compliance. It's to keep the government auditors happy that you actually did what they paid for, that you're employing EVT's, that they aren't continuing to pay for patients who aren't demonstrating sufficient (in their off-site judgment) progress. Yes, there's too much administrative cost built into healthcare, but not as much of it as you think is spent on billing insirance companies. (Dr. Goering, how much time do you actually spend preparing and sending bills to various insurers - really?)

THAT is the problem.

Malpractice insurance in some specialty areas can cost literally thousands of dollars per WEEK.

THAT is the problem.

[continued]

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jafs 5 years, 1 month ago

If doctors/hospitals/pharmacies are making obscene profits, then that's not ok either.

Drug companies do, by the way, and apparently refuse to release effective drugs if they won't make enough of a profit on them. Hmmm.

Satirical, all of your arguments about why the military is more efficient under federal control would seem to apply to health care as well.

As far as "free riders", if tax revenue is used for health care then payment is not "optional" for all who pay taxes.

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notajayhawk 5 years, 1 month ago

akt2 (Anonymous) says…

"Dr. Goering is a Hospitalist. He sees patients in the hospital. He also donates his time to Health Care Access. He sees patients whether they can afford to pay or not."

Does he donate all his time? Does he work for free, akt? He makes his living by providing a service. Attorneys see clients who can't pay, too - it doesn't mean they don't make a living from their practice. I'm not saying he's a bad guy - but the money that paid for his home, his car(s), his vacation to wherever, all came from providing a service to sick people in need of healthcare, and it's a bit duplicitous to vilify the insurance company for doing the same thing. I'm willing to bet if you added up the 'profit' of every physician in the country, threw in all the hospitals and pharmacies etc., the dollar figure would be substantially higher than that of all the insurance companies. How come that's okay?


Newell_Post (Anonymous) says…

"The Post Office charges 42 cents for a service that is fairly similar to one provided by FedEx for $20. I have a choice and I choose the Post Office fairly often and FedEx only when I really need a premium service."

Great. When I need a band-aid worth 42 cents, I'll let the government be in charge. When I need heart surgery, I'll do what you do and use the premium services.

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Newell_Post 5 years, 1 month ago

  1. I used to sit on the board of directors of an insurance company and, if I personally had a problem with coverage for a major medical claim, I would much prefer to argue it with a government bureaucrat than with an insurance executive who isn't pulling his quota.

  2. The Post Office charges 42 cents for a service that is fairly similar to one provided by FedEx for $20. I have a choice and I choose the Post Office fairly often and FedEx only when I really need a premium service. FedEx, UPS, etc. can't come anywhere close to matching USPS's price point for basic service.

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dumbassamerican 5 years, 1 month ago

i think sowshalizmm is a bad ideer. we need to get bak to basiks in this cunntree and stop all this commie talk. we is amurricans! we is gunna win the war. my vote is to get rid of all these commie govermint scum. i kin take care of me self. i is an amurican! i aint no commie! amurika is the best cunntree on irth! we is the best at everthang! commie go back to rusha!!!

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Richard Heckler 5 years, 1 month ago

Obama Vows Economic Recovery, Healthcare Reform

President Obama addressed a joint session of Congress last night to push his response to the economic crisis, promise healthcare reform and vow an end to the Iraq war. In a fifty-two-minute speech, Obama touched on the banking crisis but revealed few details of how he plans to steer banks like Citigroup and Bank of America from collapse.

President Obama: “This plan will require significant resources from the federal government and, yes, probably more than we’ve already set aside. But while the cost of action will be great, I can assure you that the cost of inaction will be far greater, for it could result in an economy that sputters along for not months or years, but perhaps a decade.”

Obama called on Congress to invest in areas like energy, healthcare and education, while stressing the need to reduce the federal deficit. Without offering details, Obama also urged what his administration has called its top fiscal priority: healthcare reform.

President Obama: “I suffer no illusions that this will be an easy process. Once again, it will be hard. But I also know that nearly a century after Teddy Roosevelt first called for reform, the cost of our healthcare has weighed down our economy and our conscience long enough. So let there be no doubt: healthcare reform cannot wait, it must not wait, and it will not wait another year.”

Study: 4 Million Americans Lost Healthcare Under Recession

While speaking of achieving universal healthcare, the Obama administration has refused to endorse the single-payer approach favored by most Americans but opposed by the insurance industry. Obama’s pledge for healthcare reform comes as a new study warns as many as 14,000 people could be losing their health coverage every day. The Center for American Progress says an estimated four million Americans have lost their health insurance since the recession began.

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Satirical 5 years, 1 month ago

Easy_Does_It…. “What is Lipitor or a cancer drug worth?”

Everything is worth what its purchaser pays for it.

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Satirical 5 years, 1 month ago

Logan72…. “It works in the context of the military? Explain”

Having the federal government be responsible for our national safety is more efficient than having each State (or individual) be in charge of its own defense. It also leads to a more organized command structure and resource allocation, both are essential for a military. Whether or not you think the military is efficient doesn’t contradict the argument that it is more efficient than if the federal government didn’t control it. Whether or not you think too much money is allocated to the military also doesn’t contradict whether it is more efficient with the its money than if the federal government weren’t in charge.

Also it is more important for national defense to be controlled by the federal government than for medical care b/c national defense is non-exclusive and non-rivalrous. There is the free rider problem as well. If it was option whether to pay for national defense (as it is medical care) then that person would still have the same benefits but without any of the costs.

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Tony Kisner 5 years, 1 month ago

Bozo & Merrill - What should a Dr. make each year? Use a number. Simple question.

What is Lipitor or a cancer drug worth? - Numbers please. Again simple question.

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Alia Ahmed 5 years, 1 month ago

Satirical (Anonymous) says… More government leading to reduced costs and increased efficiency!?! How often does that work outside the context of the military?

Alia asks....It works in the context of the military? Explain.

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akt2 5 years, 1 month ago

Dr. Goering is a Hospitalist. He sees patients in the hospital. He also donates his time to Health Care Access. He sees patients whether they can afford to pay or not. I am pretty sure that he cares more about the patient's health than the money. These doctors see a lot and they know the system. We should listen to some of what they have to say.

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Satirical 5 years, 1 month ago

More government leading to reduced costs and increased efficiency!?!

How often does that work outside the context of the military?

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jafs 5 years, 1 month ago

notaj,

Switzerland switched, despite lots of opposition from drug companies, etc.

Folks there seem to like the new system better.

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akt2 5 years, 1 month ago

I think that every office, lab and medical facility should have to post the cost of each and every test. And what it costs to have the test interpreted by another specialist. And the cost of supplies that may be used. And any other professional fees that may apply. It's all some big secret up front, and you have no idea what kind of expense may be incurred. Consumers should demand it.

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RedwoodCoast 5 years, 1 month ago

To this day, I still see nothing harmful in making health care a universal part of the pursuit for life, liberty, and happiness. I would bet that the naysayers here have health insurance and don't have to worry about going into debt from a simple ER visit. The health care system is pathetic. It's more like a country club than a health care system.

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Pilgrim2 5 years, 1 month ago

merrill (Anonymous) says…

HR 676 National Health Insurance would make Americans employable and self employable.


HR 676 is dead, Richard. It died last week when the looney left snuck a socialist health care rationing system into the pork producers bill. You can quit with the cut-n-paste now. HR 676 is irrelevant.

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logicsound04 5 years, 1 month ago

No biggie, cthulhu. I have misread a post or 100 in my day as well...

And true, your comparison method is probably the closest to an approximation that is available without performing a long and detailed academic study to try and understand what different types of factors motivate people and by how much.

I just think people tend to forget about all the myriad ways in which a business can be successful in lieu of profit margins. We seem to have an underlying attitude that in order for a business to be successful, it has to be generating revenue well above and beyond the cost to actually run the business.

In theory, a business that generates enough money to cover overhead, pay all employees (including the owner), and continue funding operations is just as successful as the one that generates a surplus of millions annually (in order to pay it's investors/stakeholders).

To be sure, 3rd-party investment is important, as it helps create a link between the people with money but no ideas to the people with ideas with no money. But it can also be dangerous, as it creates detachment between the success of a business and the stakes of the people funding that business. If an owner of a self-sustaining business starts getting hit by the economy, he and his staff are going to buckle down to salvage the business however they can--after all it's their livelihood. However, if a heavily-invested corporation starts getting hit, it's shareholders can jump ship without nearly as much damage to their own finances. That ability to get out quick exacerbates situations like the one we are in now--everyone wants to bail rather than either innovating or stepping up their effort level.

Okay, sorry...rant now over.

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Liberty_One 5 years, 1 month ago

madameX, and in the meantime, life-saving drugs are held up for years while people are dying, thanks to your regulations that are meant to....prevent people from dying.

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cthulhu_4_president 5 years, 1 month ago

Logicsound, you are one of the only forum members who actually uses logic in any way, and I stand corrected. The error of misinterpretation is mine.

2nd paragraph: you are right, but in the absence of any quantitative measurement of motivation (of people or corporate entities) I couldn't think of anything better to illustrate my point. Alas, I think we're both saying the same thing.

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madameX 5 years, 1 month ago

Liberty, drug regulation exists for a reason. I'm sorry, but I do not trust drug companies to do expensive but necessary testing before they put something new on the market if there's not some entity there to make them do it. Or make them tell the truth about side effects. Or make them not sell sugar pills labeled as medicine because it's more profitable. I understand that in theory it would be in their best interest to not do any of that because it in theory it they would then be able to avoid lawsuits, but in actual practice I'm willing to bet they'd just build the likely cost of the settlements into the price of the at best ineffective and at worst potentially deadly drugs and write off the innocent folks who get hurt as the eggs they had to crack to make the omelet.

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Liberty_One 5 years, 1 month ago

Myth: "Despite its higher costs, the World Health Organizations ranking show that the American health care system ranks only number 37 in quality".

Fact: No, it doesn't show that at all. The ranking (http://www.photius.com/rankings/healthranks.html) is actually only to a small extent a ranking of health care quality. If you check its details it measures mostly other things. What is being measured is mostly things like a population's health level and to what extent financing and treatment is in accordance with the WHO:s socialist ideals. That socialist systems are better in accordance with socialist ideals is hardly surprising and is definitely not a valid indicator of health care quality. The only one of their indicators which measures quality is "level of responsiveness" which is based on patient satisfaction (http://www.photius.com/rankings/who_world_health_ranks.html) and how quickly and efficient the system works. And in this category the American health care system is....number one! http://www.photius.com/rankings/world_health_systems.html

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notajayhawk 5 years, 1 month ago

Dr. Goering, out of curiosity, how much of a profit do YOU make from treating the sick?

Oh, and would you mind if the government limited your fee for treating a small wound to $12, like it is in Japan?


jason2007 (Anonymous) says…

"An MD asking for government involvement in his business? That seems so backwards to me —"

You shouldn't be so surprised. Physicians are the ones who stand to benefit most from a nationalized system. It simplifies their job and guarantees payment. And anyone who believes that physicians are altruistic and would pass on any savings to their patients probably believes doctors still make housecalls.


just_another_bozo_on_this_bus (Anonymous) says…

"For the mathematically challenged, under a single-payer plan, the average middle-class taxpayer would not see any increase in their overall expenditures. As a matter of fact, you'd likely see a substantial decrease in your overall expenditures, with improvement in overall availability in healthcare— that's what's happened in every country that has established it."

Name one country that developed over several decades into a system such as we have, that recently changed over to a government-funded one-payer system, boohoozo. It is a complete fantasy to assume that changing over to copy someone else's system would result in similar savings to one that developed that way. Or are you suddenly going to wave the Obamatron's magic wand and cut physician salaries in half, do away with the cost of regulatory compliance, reduce the cost of malpractice insurance, etc., etc., etc.?

And, for approximately the thousandth time, boohoozo, how are you defining 'better' healthcare? You mean waiting times that kill people, such as the Canadian courts have described their own system? Or a national oversight board to decide if it's cost effective for you to receive an expensive treatment based on what's left of your life expectancy, like they have in the U.K.?

"And if people don't want government to screw it up, they need to pay attention, and not turn it over to snake oil salesmen like Bush, Cheney and Rove."

How many pages of the 'stimulus' bill did you read, boohoozo?

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Liberty_One 5 years, 1 month ago

merrill (Anonymous) says…

"Privatized medical insurance and deregulation are absolute failures as we speak."

Oh? And what country are these things practiced in, because it surely isn't the United States.

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Richard Heckler 5 years, 1 month ago

Privatized medical insurance and deregulation are absolute failures as we speak.

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Liberty_One 5 years, 1 month ago

Because a person's health, or lack of it, lies increasingly within his own control, many, if not most health risks, are actually uninsurable. "Insurance" against risks whose likelihood an individual can systematically influence falls within that person's own responsibility.

All insurance, moreover, involves the pooling of individual risks. It implies that insurers pay more to some and less to others. But no one knows in advance, and with certainty, who the "winners" and "losers" will be. "Winners" and "losers" are distributed randomly, and the resulting income redistribution is unsystematic. If "winners" or "losers" could be systematically predicted, "losers" would not want to pool their risk with "winners," but with other "losers," because this would lower their insurance costs. I would not want to pool my personal accident risks with those of professional football players, for instance, but exclusively with those of people in circumstances similar to my own, at lower costs.

Because of legal restrictions on the health insurers' right of refusal--to exclude any individual risk as uninsurable--the present health-insurance system is only partly concerned with insurance. The industry cannot discriminate freely among different groups' risks.

As a result, health insurers cover a multitude of uninnsurable risks, alongside, and pooled with, genuine insurance risks. They do not discriminate among various groups of people which pose significantly different insurance risks. The industry thus runs a system of income redistribution--benefiting irresponsible actors and high-risk groups at the expense of responsible individuals and low risk groups. Accordingly the industry's prices are high and ballooning.

To deregulate the industry means to restore it to unrestricted freedom of contract: to allow a health insurer to offer any contract whatsoever, to include or exclude any risk, and to discriminate among any groups of individuals. Uninsurable risks would lose coverage, the variety of insurance policies for the remaining coverage would increase, and price differentials would reflect genuine insurance risks. On average, prices would drastically fall. And the reform would restore individual responsibility in health care.

  1. Eliminate all subsidies to the sick or unhealthy. Subsidies create more of whatever is being subsidized. Subsidies for the ill and diseased breed illness and disease, and promote carelessness, indigence, and dependency. If we eliminate them, we would strengthen the will to live healthy lives and to work for a living. In the first instance, that means abolishing Medicare and Medicaid.

Only these four steps, although drastic, will restore a fully free market in medical provision. Until they are adopted, the industry will have serious problems, and so will we, its consumers.

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Liberty_One 5 years, 1 month ago

It's true that the U.S. health care system is a mess, but this demonstrates not market but government failure. To cure the problem requires not different or more government regulations and bureaucracies, as self-serving politicians want us to believe, but the elimination of all existing government controls.

It's time to get serious about health care reform. Tax credits, vouchers, and privatization will go a long way toward decentralizing the system and removmg unnecessary burdens from business. But four additional steps must also be taken:

  1. Eliminate all licensing requirements for medical schools, hospitals, pharmacies, and medical doctors and other health care personnel. Their supply would almost instantly increase, prices would fall, and a greater variety of health care services would appear on the market.

Competing voluntary accreditation agencies would take the place of compulsory government licensing--if health care providers believe that such accreditation would enhance their own reputation, and that their consumers care about reputation, and are willing to pay for it.

Because consumers would no longer be duped into believing that there is such a thing as a "national standard" of health care, they will increase their search costs and make more discriminating health care choices.

  1. Eliminate all government restrictions on the production and sale of pharmaceutical products and medical devices. This means no more Food and Drug Administration, which presently hinders innovation and increases costs.

Costs and prices would fall, and a wider variety of better products would reach the market sooner. The market would force consumers to act in accordance with their own--rather than the government's--risk assessment. And competing drug and device manufacturers and sellers, to safeguard against product liability suits as much as to attract customers, would provide increasingly better product descriptions and guarantees.

  1. Deregulate the health insurance industry. Private enterprise can offer insurance against events over whose outcome the insured possesses no control. One cannot insure oneself against suicide or bankruptcy, for example, because it is in one's own hands to bring these events about.
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logicsound04 5 years, 1 month ago

"the ratio of non-profit businesses to for-profit businesses would demonstrate that, actually, profit does indeed motivate a majority of our world population."


I don't believe I claimed otherwise. What I did say is that profit is not the SOLE motivator.

Furthermore, I hardly think a general ratio of for-profit to non-profit businesses is an accurate tool for measuring the comparative levels of motivation created by each.

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just_another_bozo_on_this_bus 5 years, 1 month ago

"bozo, your post is entirely premised on the idea that health care is too expensive! If it's not so expensive, people won't have such trouble paying for it."

Liberty, healthcare will always be relatively expensive simply because it takes a sizable workforce to deliver it, and a substantial percentage of that workforce requires a good deal of training and talent to do what they do. And it requires increasingly more sophisticated technology.

But that doesn't mean every doctor needs to get rock star wages, nor do we need insurance companies that do little more than muck up the works, and take a huge cut off the top for doing it.

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Richard Heckler 5 years, 1 month ago

Insurance companies negotiate all invoices and settlements as it is ...so HR 676...National Health Insurance is only the insurance company.

How does that change anything from current practices?

Medicare is re- designed and covered accordingly.

HR 676 National Health Insurance would cover every person for all necessary medical care including; prescription drugs hospital, surgical outpatient services primary and preventive care emergency services dental mental health home health physical therapy rehabilitation (including for substance abuse) vision care hearing services including hearing aids chiropractic durable medical equipment palliative care long term care

The insurance provider is no longer involved in medical decisions and all patients will be free to move about to whatever clinic and doctor of choice = much less bureauracy. No more booklets dictating choice.

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womanwarrior 5 years, 1 month ago

Maybe, like expected of teachers, doctors should go into the business to help people, not get rich. Maybe if we started paying for teachers and doctor's educations, they also wouldn't feel so pressed to make more money.

There are a lot of jobs not providing insurance anymore, Larry, why are poor people's life worthless to you? Why is anyone's life more valuable than others. Yes, maybe that fat guy should have lost weight, but does he deserve to die? Who is more important, a rich CEO or a janitor. Personally I'd choose the janitor, but I'm sure someone loves the CEO and would like for him to live.

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Tony Kisner 5 years, 1 month ago

coverage for what?

Who decides what is covered?

Smoker with lung cancer - sorry bad choices. Old person - sorry you don't have long to live anyway. Fat guy - sorry your open heart surgery is not covered you should have bought some Nikes.

How much do you pay doctors? Sorry Doc, you make too much money, plus I thought you guys were a little smug in undergrad school while I was studying pre-law. (actually not pre-law I was pre-med but didn't get in so I have a little bit of a chip...)

Here is an idea, open the medical field to anyone who wants to practice, lots of drywallers out there looking for something to do. Supply and demand more supply the lower prices will go.

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Liberty_One 5 years, 1 month ago

merrill (Anonymous) says…

"and making profit off the suffering of others?"

I know it's usually futile to address merrill, but I'll try anyway. Who exactly is going to decide how much money doctors and hospitals should make? How much is fair compensation?

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Richard Heckler 5 years, 1 month ago

Corporate america has been wanting to be rid of paying health care for their employees so they will love HR 676 National Health Insurance and many unions are behind this movement as well.

Why should health insurance be treated like a filet migon or lobster in the high dollar retail meat market? and making profit off the suffering of others?

HR 676 National Health Insurance would cover every person for all necessary medical care including prescription drugs, hospital, surgical, outpatient services, primary and preventive care, emergency services, dental, mental health, home health, physical therapy, rehabilitation (including for substance abuse), vision care, hearing services including hearing aids, chiropractic, durable medical equipment, palliative care, and long term care.

Win Win http://www.healthcare-now.org/campaigns/win-win/

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ArumerZwarteHoop 5 years, 1 month ago

More simply:

Government inflating the prices of housing, education, and health care is a wonderful way to erode the middle class and keep poor people in their place.

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ArumerZwarteHoop 5 years, 1 month ago

Whether we are discussing education, housing, or healthcare we are arguing the same thing: the bubbling of prices.

When we invite government into the market their money bubbles the prices, then these products become unaffordable for many, so the government has to step in again, further bubbling the prices. Those who pay without government assistance are robbed and the poor still cannot afford it.

The government creates a situation where it is the cause of and solution to all of life’s problems. Good job security if you are employed by a government, but a complete waste of resources and energy for the country.

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Liberty_One 5 years, 1 month ago

bozo, your post is entirely premised on the idea that health care is too expensive! If it's not so expensive, people won't have such trouble paying for it.

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cthulhu_4_president 5 years, 1 month ago

logicsound, the ratio of non-profit businesses to for-profit businesses would demonstrate that, actually, profit does indeed motivate a majority of our world population.

More to the point, how many doctors will continue practiciing (or enter the practice at all) once that nice, fat, check goes away?

Sad, but true.

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Larry_The_Moocher 5 years, 1 month ago

Woman warrior... I am not picking a fight... We can play what if all day long... in your example... maybe the father needs to do whatever it is to get a better job, and not place the blame for his problems on society.

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logicsound04 5 years, 1 month ago

"So the solution is the removal of the profit-motive. This would leave what other motive in it's place?"


The generation of revenue to sustain your business/organization.

I am tired of the notion that only profits motivate people. The thousands of non-profit organizations around the country (and world) demonstrate otherwise.

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womanwarrior 5 years, 1 month ago

Larry_The_Moocher (Anonymous) says… Who is going to pay for this…

How much are we paying now? If a father puts off medical care, because his job doesn't offer insurance, and his kids need to be clothed and sent to school, then he dies, we end paying to support his family. Or he becomes disabled, then we are paying him disability. There are many diseases, if treated early, that can be cured or managed, so that the person is functional. But if they put off health care they become a burden on society and probably cost more. And don't tell me that the private sector is more efficient. Their motive is entirely profit. They could care less about your health.

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Godot 5 years, 1 month ago

Medical costs are high only because consumers allow it. Consumers are insulated from the true cost of medical care because of health insurance and government.

I point to the doc-in-a-box concept that is taking hold in Walmarts and Walgreens, CVS, etc. I hope the docs-in-gilt-edged-offices soon feel the pinch of free market competition.

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georgeofwesternkansas 5 years, 1 month ago

Once you have eliminated commercial insurance, medicare and medicade will no longer have anyplace to shift their cost to. Currently they do not pay enough for services to cover the cost, they account for 72%-75% of healthcare charges but only 35% of payments. More than half of their charges are written off, with the cost shifted to commercial insurance in the form of higher charges.

If you think your cost will be reduced by 30% go check out your local hospital financial statements and get back with us.

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cthulhu_4_president 5 years, 1 month ago

So the solution is the removal of the profit-motive. This would leave what other motive in it's place?

A selfless desire to assist those who are less-fortunate? Not likely.

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logicsound04 5 years, 1 month ago

"Since many of you consider insurance to be the culprit in the high cost of health care, why did you use that nebulous number of 43,000,000 uninsured people as the example of what is wrong with health care in the last election? Completely illogical."


It's only illogical to a stupid person, godot.

There are 43,000,000 people who don't have insurance in large part because they can't afford it. Insurance is the reason costs are so high, which is the reason people can't afford coverage, which is the reason, 43 million aren't covered.

But I should add that the idea of health insurance is not the problem. Even a single-payor health system involves the use of insurance, it just does it in a far more efficient way that minimizes overhead and administrative billing costs.

What is illogical is your suggestion of boycotting health insurance. As I just mentioned, the notion of health insurance is not the problem, as medical costs can be very high. Insurance provides a way to cover large isolated charges by paying into a pool over a period of time. The problem we have now is that we either can't afford or aren't eligible (damn pre-existing conditions) for coverage or we are covered and it still doesn't get us quality care.

First, I'd love for you to find me a name of a local doctor who doesn't accept health insurance.

Second, I'd love for you to find a doctor's office that will bend to negotiating a lower price when he can just as easily care for insured patients and get a guaranteed compensation.

People shouldn't HAVE to put up a fight to get basic medical coverage.

Profits, rather than quality care, are the drivers of decisions in the insurance industry, and that results in poor care and overinflated costs.

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ArumerZwarteHoop 5 years, 1 month ago

I know of people, third generation Mexican immigrants who make middle class wages that pretend not speak English every time they go the hospital. They get “free” health care, if only I had brown skin I could be above the law too.

I guess the only thing keeping people honest is a sense of pride, but pride is becoming very expensive.

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Godot 5 years, 1 month ago

Since many of you consider insurance to be the culprit in the high cost of health care, why did you use that nebulous number of 43,000,000 uninsured people as the example of what is wrong with health care in the last election? Completely illogical. The problem is obviously the other 273,000,000 who are trapped in the health insurance quagmire.

Here is my suggestion. You hate health insurance? Boycott it. Demand that your employer pay you what would otherwise be sent to the health insurance company, then save that money. Refuse to see a doctor or hospital that accepts health insurance. Negotiate your own price in advance. Make a deal. Tell your doc you will take a "medical vacation" to another country for your treatment if he or she can't meet your price. If your treatment is an emergency, pay only what you think it is worth, then tell the facility to sue you for the rest. Put up a fight.

And refuse to use a hospital or medical practice that is willing to violoate your privacy by submitting your medical records to a government compiled and controlled data base under the guise of "efficiency."

You are not powerless as a consumer of health care.

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Larry_The_Moocher 5 years, 1 month ago

beawolf (Anonymous) says…

Larry the moocher says: “Bewolf… I am so glad you are the self appointed forum cop”

Larry, you are a complete idiot. I could care less about what, why and when you post. Just pointing out the absurdity and validity of your comments. Please continue making a fool of yourself.

BTW, my apologies to the rest of this forum. I dislike off-topic comments as much as anyone., but Larry's and XD40's nonsense was starting to get to me. I'll say no more.


Then leave.. I dont care what you say either...

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beawolf 5 years, 1 month ago

Larry the moocher says: "Bewolf… I am so glad you are the self appointed forum cop"

Larry, you are a complete idiot. I could care less about what, why and when you post. Just pointing out the absurdity and validity of your comments. Please continue making a fool of yourself.

BTW, my apologies to the rest of this forum. I dislike off-topic comments as much as anyone., but Larry's and XD40's nonsense was starting to get to me. I'll say no more.

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just_another_bozo_on_this_bus 5 years, 1 month ago

For certain aspects of healthcare, pay-as-you go could certainly work, for most people, Liberty. But that probably only describes relatively minor medical issues, and would specifically exclude the poor, the elderly and the disabled. And for nearly everybody, any major medical issues require some sort of pooling of resources, which is what insurance is supposed to be (as opposed to providing the funding source for insurance companies' Wall Street investments, which is what we have.)

With healthcare insurance, the biggest pool available is the best solution, and only government can do that. It's just that simple. And if people don't want government to screw it up, they need to pay attention, and not turn it over to snake oil salesmen like Bush, Cheney and Rove.

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Liberty_One 5 years, 1 month ago

Logan, of course that's what you get with statism. When the government has the power to confiscate wealth and make decisions about who gets what, you'll always have special interest groups that get favored. The best way to cure that ill is to not allow the government to tax and spend for the benefit of any group at all. The government should have a limited role in society: judicial, legislative and executive, not as arbiters of "social justice," because we see that there's no social justice to be had, only plunder and a division of the loot.

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Liberty_One 5 years, 1 month ago

just_another_bozo_on_this_bus (Anonymous) says…

"What about the insurance companies? They control it way more than the government does."

But why do they have so much clout? It is because the government has this crazy idea in it's head that the ideal world is for everyone to have health insurance. You get tax breaks for having health insurance, your place of employment gets tax breaks etc. Who does that benefit? The insurance companies! Nevermind all the regulations that stifle competition.

Everytime a thread about healthcare comes up, inevitably someone brings up the number of people in America that don't have health insurance, as if that's the best way to pay for health care. Then they'll turn around and trash the insurance industry for making profits, and conclude that the government is the solution. Apparantly the premises aren't ever questioned.

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Larry_The_Moocher 5 years, 1 month ago

Bewolf... I am so glad you are the self appointed forum cop. Many people feel the same about you. BTW... how is work release going?

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Alia Ahmed 5 years, 1 month ago

Liberty_one-

During GWB's presidency, Medicare wanted to negotiate with pharmaceutical companies to reduce the costs of prescriptions for our senior citizens, but the pharmaceutical companies' lobbyists fought long and hard to make sure that didn't happen. Congress and the president need to not cave in to special interests groups (insurance and pharmaceutical companies) about not negotiating prices. Unfortunately, physicians and hospitals didn't have as powerful a lobby, and they were often forced to accept reimbursement below the actual cost to provide the care. We need negotiated reimbursement that is reasonable for providers as well as tax-payers. Pharmaceutical companies can set their prices to whatever they want, while insurance companies and Medicare want to reimburse for less the cost of providing the care.

I have a feeling that whatever I say, you'll have a snappy comeback and philosophically people disagree whether affordable health care is something we think all citizens deserve. It appears this discussion, like many others, has to do with political dogma rather than discussing the actual pros and cons of the topic at hand.

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just_another_bozo_on_this_bus 5 years, 1 month ago

"A significant percentage of modern health problems are actually iatrogenic"

iatrogenic |īˌatrəˈjenik| adjective of or relating to illness caused by medical examination or treatment.

Good point, farfle.

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just_another_bozo_on_this_bus 5 years, 1 month ago

"No, they aren't negotiated at all because the people paying the bill, the taxpayers, aren't doing the negotiating."

When you're sick and need treatment, you want and need it as fast as you can get it. You're not going to haggle with the doctor while you're bleeding to death.

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farfle 5 years, 1 month ago

The medical industry puts itself out as the be-all and end-all of health care. In truth, modern medicine is very limited in what it can do. A significant percentage of modern health problems are actually iatrogenic.Combine this with health insurance and we have a situation where demand is artificially high, supply is artificially low and the result is that medical providers are vastly overpaid.

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Liberty_One 5 years, 1 month ago

Logan72 (Alia Ahmed) says…

"That isn't the way a single-payor system works. Reimbursements are negotiated just as they are with insurance companies but the administrative costs are reduced by simplifying the billing process."

No, they aren't negotiated at all because the people paying the bill, the taxpayers, aren't doing the negotiating.

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autie 5 years, 1 month ago

Logan72, your link makes too much sense. The wingnuts would have to find a different reason for the sky to be falling.

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Alia Ahmed 5 years, 1 month ago

Liberty-one says "Of course physicians would support a single payor system. If you aren't paying yourself, why would you shop around for a cheaper price? They can charge what they want because they don't have to compete for your business."

That isn't the way a single-payor system works. Reimbursements are negotiated just as they are with insurance companies but the administrative costs are reduced by simplifying the billing process.

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just_another_bozo_on_this_bus 5 years, 1 month ago

"People used to pay for their care with cash out of pocket, it could be that way again if we got the government out of the industry."

What about the insurance companies? They control it way more than the government does.

At any rate, the profit motive works for many endeavors. Healthcare just ain't one of them.

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Music_Girl 5 years, 1 month ago

Yes, let's send more of our hard earned paychecks to a government who sees fit to screw us over as often as possible and shove more money into their own pockets. Can't I just burn it myself? So much for the "land of opportunity" when the government gets to ration everything.

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Liberty_One 5 years, 1 month ago

Logan72 (Alia Ahmed) says…

"Here's a link to an organization of physicians who support a single payor system."

Of course physicians would support a single payor system. If you aren't paying yourself, why would you shop around for a cheaper price? They can charge what they want because they don't have to compete for your business.

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beawolf 5 years, 1 month ago

Godot,

I'm not sure I agree with your statement "The insurance companies are bleeding almost as badly as the banks are." ....They have the leverage of increasing premiums when profits recede.

And I do have to take issue with "they will focus their jealousy on the last remaining “rich people,” i.e. health care providers."...Health care providers should be compensated according to their value to the system. If that value is perceived high then you may be correct.

That said, this is the most complex issue Obama will have to deal with during his administration. The cost to the public will be substantial, but to do nothing is worse. Private health care has failed. The industry has had years to correct itself, but pharmaceutical companies, insurance companies and even the doctors themselves have continued to abuse and destroy any positive value to our society. Time to try something else.

XD40 and Larry the moocher, Why do even bother to post such drivel? Your comments are ludicrous and add nothing to any conversation you have ever participated in.

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just_another_bozo_on_this_bus 5 years, 1 month ago

"If you like the way the government handled Hurricane Katrina, you'll love socialized medicine."

"If you like the way the government runs the VA, you'll love socialized medicine."

"If you like the way the government ran the war in Iraq, you'll love socialized medicine."

We didn't. That's why the Republicans lost the last two elections so badly.

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Alia Ahmed 5 years, 1 month ago

Here's a link to an organization of physicians who support a single payor system.

http://www.pnhp.org/facts/what_is_single_payer.php

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Liberty_One 5 years, 1 month ago

Kryptenx, in what crazy world do you think that US health care operates in a free market? I took a class on Health Law, and more than half of the students were not JD seekers, but health care professionals who were learning health law because their entire job is compliance! Not only is the industry regulated to death, but the government is constantly pumping money into the system which causes prices to rise. Let's give free markets a chance in health care for a change. People used to pay for their care with cash out of pocket, it could be that way again if we got the government out of the industry.

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Kryptenx 5 years, 1 month ago

World Health Organization's 2000 rankings of health systems (which is the last year they produced the list): http://www.who.int/whr/2000/media_centre/press_release/en/index.html

"The World Health Organization has carried out the first ever analysis of the world's health systems. Using five performance indicators to measure health systems in 191 member states, it finds that France provides the best overall health care followed among major countries by Italy, Spain, Oman, Austria and Japan."

"The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds. The United Kingdom, which spends just six percent of GDP on health services, ranks 18 th ."

We spend the most, yet are ranked behind 36 other countries, and we have people advocating for the status quo? (10 year old) News flash: it doesn't work!

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Larry_The_Moocher 5 years, 1 month ago

No one has mentioned Tort reform. This has to be part of any program.

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autie 5 years, 1 month ago

And just when is health care supposed to get cheaper due to competition in a free market? What part of sky rocketing costs did you all miss? Merrill may be a long winded, cut and paste kind of guy...but he is right. A nationalized system would actually let doctors treat patients and not be directed by cost analyst. Commuter, you say everybody has ACCESS? Just what planet are you living on? The dr. says to the rich guy with the cadillac policy...you have cancer, its advanced. go to MD Anderson in Texas..they'll fix you right up. Same dr. tells poor guy with no insurance..your cancer is advanced beyond help..go home and die...Is that the America we want?

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Alia Ahmed 5 years, 1 month ago

jason2007 (Anonymous) says…

An MD asking for government involvement in his business? That seems so backwards to me — I know of a few guys who were in medical school but transferred out once they got a whiff of the overwhelming bureaucracy involved. The supermajority of a doctor's job today is not patient care but rather paperwork.

And this guy wants more bureaucracy? Amazing.

Jason, I know many physicians who like and would support a single payor system. Instead of creating more bureaucracy, a single payor system would reduce paperwork. Instead of submitting claims to various for-profit insurance companies whose best financial interests are served by denying payment, medical providers would submit claims under one system, with one set of rules and paperwork.

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Kryptenx 5 years, 1 month ago

Wait, it was even you yourself who pointed out that health care costs keep rising! What the hell are you doing arguing for capitalism to solve this? Markets find their equilibrium fairly quickly, if the costs rise year after year for 30 years, how much longer should we wait? When is this magical market going to stop rising? It's not, because the insurance companies will continue to rape everyone for more and more profit, while cutting off as many patients as possible.

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Kryptenx 5 years, 1 month ago

Extensively, Liberty. The only problem with your analogy is that is doesn't follow. If it is so true, why have cell phone prices and plans dropped year after year while health care costs rise year after year? Capitalism is great for a lot of things, but when you put human lives into the picture you need to take the profit out. How great is our current system when if I do not have health insurance for more than 4 months, due to losing a job let's say, I will never get it again because I already had cancer at the age of 17? Fact is, the current system doesn't work and is inhumane. If you want to run a business, run a business. If you want to save lives, save lives. I don't know how much sense it makes to say "if you want to save lives, run a business"

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defenestrator 5 years, 1 month ago

Socialized medicine--OOOOOOOOOHHHHHHH, SCARY! Kind of like socialized retirement, right? Thanks, republicans, for adding the most welfare liability to our government since 1935 (Public Law 108-173 (Medicare Act of 2003)).

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Liberty_One 5 years, 1 month ago

Kryptenx, have you ever researched capitalism? Competition brings prices down. Cell phone companies have a profit motive as well, yet their products are cheaper than ever and they offer better service than ever. Why would you not want cheap, quality health care that a free market can provide?

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Larry_The_Moocher 5 years, 1 month ago

Just wait till you get to watch your mother die, as medical assets are better used on a 25 year old illegal alien because the alien can work and put money into the system.

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Kryptenx 5 years, 1 month ago

Are we back in the cold war? The red scare is in full effect here on the LJW boards. How many people dissing socialism have even researched it?

Look up the profits for major insurance companies. They do not make massive profits by treating patients well, but rather by scrutinizing each and every claim to find every and any reason to reject it. This is not a business model, this is peoples' lives. Furthermore, by eliminating extreme profit from insurance companies, everybody's premiums go down. Empirically proven, but I suspect the majority of you are too closed minded and ignorant accept it if it bit you in the ass.

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XD40 5 years, 1 month ago

Obambi has already taken control of healthcare and its not a good thing:

http://spectator.org/archives/2009/02/25/repeal-health-care-fascism

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salad 5 years, 1 month ago

STRS, for all your blow-hard examples, just replace "government" wish "Bush" and you have your answer to why things are so screwed up. It's gonna take a long time to fix everything YOUR guy ruined.

"I ask again, when has the government done anything efficiently?" I find the following to be WAY more efficient than most private corporations I have to deal with: Post office, DMV, Social Security Admin., CDC (your flu shots), National Parks Service, and more... If you have a problem with the way the PO, DMV, SS works, then yer doin' it wrong. Maybe read the directions first. The letter writer is correct about the profit motive. Bring on the socialized medicine!

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Godot 5 years, 1 month ago

"As the economy continues to spiral downward, your up-is-down whining isn't going to save the economic sinkhole that the insurance companies have foisted on the American people."

The insurance companies are bleeding almost as badly as the banks are.

I agree that the health care delivery system needs to change - I do not agree that government bureaucracy is the answer.

Good doctor, beware what you ask for. There is just an election season or two separating your wish for a private delivery, government funded health care system and a government delivery, government funded system. When the populists have seen that the banks are nationalized, and the insurance companies are driven out of business, they will focus their jealousy on the last remaining "rich people," i.e. health care providers.

If you think HMO's and PPO's are bad, just wait until you have a government bureaucrat telling you how to treat your patients.

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Bowhunter99 5 years, 1 month ago

medicare WORKS so freakin' well... and it's not in the red... and it works wonderfully.. can't wait for this.

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Liberty_One 5 years, 1 month ago

just_another_bozo_on_this_bus (Anonymous) says…

"But the ideological purists want to ignore the elephant in the room— sky-high premiums for the most inefficient healthcare system among all industrialized countries."

Close, just take it one step further: premiums are so high because health care costs so much. So the real issue is why does it cost so darn much? Free market principles have brought down the cost of things like computers and cell phones while simultaneously improving the quality. For example, in inflation adjusted dollars, my parents spent $3000 on a computer in 1989 that is inferior to the $500 laptop I bought last year. Health care, on the other hand, costs more. Procedures are less invasive, hospital stays shorter, diagnostics more accurate, medicines more effective etc., yet health care costs more. Let's try letting the same market forces that bring down the price of computers while increasing the quality work on health care.

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SettingTheRecordStraight 5 years, 1 month ago

If you like the way the government ran the war in Iraq, you'll love socialized medicine.

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SettingTheRecordStraight 5 years, 1 month ago

If you like the way the government runs the VA, you'll love socialized medicine.

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SettingTheRecordStraight 5 years, 1 month ago

If you like the way the government handled Hurricane Katrina, you'll love socialized medicine.

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Richard Heckler 5 years, 1 month ago

60% of health insurance today is covered with tax dollars. Is this socialist?

The overwhelming bureaucracy involved comes from the 1500 insurance companies and their administrative boon doggles which by the way requires one third of each health care dollar.

The government is not paying for this WE are. And having only one medicare card that serves all reduces cost substantially and ELIMINATES health insurance dollars going into special interest campaign cookie jars

Other points that favor HR 676 National Health Insurance: • We’ll all receive identical health insurance coverage • Provides extraordinary leverage against suppliers • Protects families and business alike from being gouged by the health insurance industry • Treatment for serious illness such as cancer will not be cut off because a patient has reached the point insurance companies will pay no more…happens everyday • Citizens will not be forced to lose all of their assets or file bankruptcy due to serious illness as does happen somewhere everyday. • Eliminates health insurance dollars from financing golden parachutes • Veterans receive care immediately for whatever symptoms war has imposed on their physical or mental health. No more waiting on the Dept. of Defense • National Health Insurance eliminates over 1500 different policies thus eliminating tons of wasteful administrative costs. That money could be included towards 100% coverage. It is estimated todays administrative costs runs at 33%…that is a lot of dough.

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just_another_bozo_on_this_bus 5 years, 1 month ago

"My concern who is ultimately going to pay for it? You and your social;ist buddies? Not a lot of it!! I will have to shoulder more the buden and it sucks."

For the mathematically challenged, under a single-payer plan, the average middle-class taxpayer would not see any increase in their overall expenditures. As a matter of fact, you'd likely see a substantial decrease in your overall expenditures, with improvement in overall availability in healthcare-- that's what's happened in every country that has established it.

But the ideological purists want to ignore the elephant in the room-- sky-high premiums for the most inefficient healthcare system among all industrialized countries.

As the economy continues to spiral downward, your up-is-down whining isn't going to save the economic sinkhole that the insurance companies have foisted on the American people.

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Godot 5 years, 1 month ago

The good doctor misses the point. Health insurance is expensive because medical care is expensive.

Physician, heal thyself.

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Jason Bailey 5 years, 1 month ago

An MD asking for government involvement in his business? That seems so backwards to me -- I know of a few guys who were in medical school but transferred out once they got a whiff of the overwhelming bureaucracy involved. The supermajority of a doctor's job today is not patient care but rather paperwork.

And this guy wants more bureaucracy? Amazing.

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Flap Doodle 5 years, 1 month ago

If you like the Post Office, you'll love socialized medicine.

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commuter 5 years, 1 month ago

Merrill:

You sound like a broken record. Everyone has ACCESS to healthcare- just because they do not have insurance doesn't mean they do not have ACCESS to health care. They are more worried about paying for it. I know it would be great if the government paid for more and more.

My concern who is ultimately going to pay for it? You and your social;ist buddies? Not a lot of it!! I will have to shoulder more the buden and it sucks. I am getting taxed to death because too many people are not working or they are living off welfare.

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Richard Heckler 5 years, 1 month ago

Everybody pays. 60% of health insurance today is covered with tax dollars. There is no free ride only a less expensive ride which is what all are looking for. A family of four making the median income of $56,200 would pay about $2,700 in payroll tax for all health care costs annually under HR 676 National Health Insurance

HR 676 National Health Insurance would make Americans employable and self employable.

The USA is the only industrialized country NOT providing medical insurance or care for its’citizens.

HR676 National Health Insurance is the ONLY option being offered NOT connected to corporate american insurance.

Far to many politicians are still concerned for themselves and their election campaigns while you and I pick up the cost of their insurance. Politicians could easily afford to pay their own way. Yet you and I are doing so.

I cannot afford THEIR medical insurance. Why should taxpayers be forced to pay insurance for elected officials? They say paying for mine is not affordable. Then how is theirs affordable? Think about it. How many times are we paying considering the number of politicians in our lives? Government employees?

All taxpayers need coverage, taxpayers need relief and big time reduction in cost.

HR 676 National Health Insurance is the only equitable approach that includes all of us. Petition for H.R. 676, the "Medicare For All" Bill introduced by Rep. John Conyers http://www.democrats.com/single-payer-petition

HR 676 National Health Insurance would cover every person for all necessary medical care including prescription drugs, hospital, surgical, outpatient services, primary and preventive care, emergency services, dental, mental health, home health, physical therapy, rehabilitation (including for substance abuse), vision care, hearing services including hearing aids, chiropractic, durable medical equipment, palliative care, and long term care.

HR 676 National Health Insurance family of four making the median income of $56,200 would pay about $2,700 in payroll tax for all health care costs annually.

HR 676 National Health Insurance ends deductibles and co-payments. HR 676 would save hundreds of billions annually by eliminating the high overhead and profits of the private health insurance industry and HMOs.

Petition for H.R. 676, the "Medicare For All" Bill introduced by Rep. John Conyers : http://www.democrats.com/single-payer-petition

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Larry_The_Moocher 5 years, 1 month ago

Who is going to pay for this... Obama has already spent more money in one month than has been spent in Iraq, Afganistan and on Katrina. Now they want to spend 410 Billion more, 5 Billion of which are earmarks... and still complain about Bush running up debt. If I was a Dem I would be ashamed to place all the payback on our children.

At least we will have the empT to ride to the welfare office and the community health clinic.

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Tom Shewmon 5 years, 1 month ago

Obama said last night, "We're not quitters". Right, BO, Nan and Harry are not quitting until we are a full-blown socialist nation. W got lambasted for saying we were not quitters during a very hard time of war.

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KsTwister 5 years, 1 month ago

Well, perhaps this will save a few trips to other countries to get what should be given here for the same cost.

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Pilgrim2 5 years, 1 month ago

Oops, doc, too late. They already slipped a European-style socialist health care rationing system into the pork producers bill that was signed last week.

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Larry_The_Moocher 5 years, 1 month ago

Single payer... .is that like 1 taxpayer for 4 moochers?

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labmonkey 5 years, 1 month ago

I ask again, when has the government done anything efficiently? All of you asking for a single payer system...be careful what you wish for.

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