Question for everyone, that for me is at the center of any discussion on changing the system:

Can you get effective reform (either lower costs for those who have coverage or more people covered for the same cost) with the for-profit insurance industry as the gatekeeper for healthcare?

Cuba has a better health care system, with no money. Granted, boob jobs may require a wait.

Privatizers will pay mucho dineiro to so-called experts to ‘splain this crap, but that sure as hell won’t make it true. Check out recidivism rates from the Erlichman school of free enterprise Christian prison reform. Why are there more contractors than soldiers in Iraq? Somebody’s making a pile and nobody’s getting a bang for the bucks.

With regard to healthcare, seems to me it’s everybody’s duty as a human being. Commonweal. That’s why we agree to pay taxes, and Grover Norquist should die a painful death in an ER waiting room. But no. He’s got the best coverage rich asshole’s money can buy.

Just finishing White Fang; Call of the Wild was last week. It’s when you see that one she-wolf, larger than the others and with the reddish tint; the one that sashays.….THAT’s when you have to worry! (well, and when you see the reflections of the packs’ eyes, as they work themselves closer and closer in to your camp fire, in the middle of the night)

Of course, people have a greater need for medical care as they age, and the guaranteed coverage ensured by Medicare increases demand for services. But there is a national conversation to be had about how do we, as a society, want to distribute our health care dollars. Does grandma have to go out in the ICU after heart surgery at 83 while kids lack basic preventive serives? Before anyone writes “But why do we have to chose?” Because we do. Because allocation of resources is a basic function of families, businesses, and governments. It’s called reality. So let’s talk.

Personally, the Alice in Wonderland aspect of the health care industry made me nuts. I got a masters in finance and changed careers.

Also, all anybody seems to talk about is how to meet the costs. Is anybody looking at what the costs truly are? At why the costs are skyrocketing? There must be something other than profiteering on the part of the industry. They wouldn’t pad costs would they? So what has caused costs to increase so dramatically? What can be done to hold them within reason? Has anybody even taken a casual look at the health care mega corps and their cost structure? The politicians couldn’t be . . . No, even such a cynic as moi couldn’t believe that. I mean, look at the wonderful, classically simple drug bill that the Bush administration has given us. It cuts out the insurance companies while creating a mechanism to allow negotiating the most favorable prices from the drug companies. Doesn’t it?

I’m very skeptical about a single-payor system (read gov’t) because I just don’t like the idea of creating a huge new bureaucracy.

I think health care should be mandatory, like car insurance, with mandated minimum amounts of coverage. I like the idea of my insurance being portable and not dependent upon having a job. I also like the idea of being able to choose a plan that fits my and my family’s needs and having the option of choosing just a catastrophic type policy if I can afford it. If I don’t like the plan I’ve chosen or find the service inferior, I want to be able to switch to a new plan as easily as I change car insurance.

I do think the gov’t (state or federal) should mandate certain features, such as no refusal for pre-existing conditions, payment for experimental procedures, annual rate reviews by state gov’ts, mandatory health savings plans for all Americans, and mandatory contribution to the cost of your personal health care with a minimum and maximum. I know health care is expensive, but there are a lot of people who don’t know the real cost because their employer is picking up the majority of the tab.

Finally, on a federal or state level there should be subsidies for the truly needy.

I’d like to see a top-notch commission comprised of an equal number of doctors, health care administrators, nurses, pharmaceutical experts and ordinary citizens with a modicum of intelligence set up to really study the issue, and look at what other countries are doing better than we are and make real, substantial, thoughtful recommendations or even propose a new system that can be discussed rationally.

This country needs a real conversation and debate about this, as well as other important issues. All we seem to be getting from politicians from both sides are empty promises and platitudes.

Two caveats. One, this is my understanding. Two, even if these ideas are implemented, the crisis is not over.

We solved the problem by eloping six months before our scheduled wedding so he could get on my health insurance. (We’ve now been married for a little over a month.) But it sucks that a 23-year-old had to choose between losing his life savings now by taking COBRA and losing his life savings later if the insurance company refuses to pay for medical treatments. Thank goodness we had a third option, but he would have been in huge trouble had we not been together and already planning to get married. The whole ordeal has been horribly frustrating.