BlogHer - Health Care: Understanding the Policy Discussion and What Women Want - Comments

Happy to share your post

Maria Niles — Tue, 11 Mar 2008 17:43:29 -0500

Change will not happen until we all raise our voices and make them heard. Thank you for sharing yours.

thanks for including my post

libelletage — Tue, 04 Mar 2008 17:09:08 -0600

I have so many things I often want to say about universal healthcare....I am glad other people are pointing out the problems with our current system. As a nurse, it's inherent in my beliefs that EVERYONE deserves quality healthcare, and that includes insurance coverage. Thanks for continuing to bring this topic to light.

I'm very happy!

Maria Niles — Mon, 25 Feb 2008 13:00:36 -0600

I'm so glad you've found this useful!

Thank you, Lisa

Maria Niles — Mon, 25 Feb 2008 12:59:58 -0600

Thank you for the kind words. And, Professor Niles - I haven't heard that in a very long time - it makes me smile. Thanks!

This is great ....

PunditMom — Mon, 25 Feb 2008 12:35:45 -0600

... what a great resource! Everyone should read this!

And thanks for the links for MOMocrats and at my place!

Professor Niles, in the house...

Lisa Stone — Sun, 24 Feb 2008 13:22:35 -0600

Maria, nobody breaks down an issue like you do. Brilliant work!

Lisa Stone
BlogHer Co-founder
Surfette

Thank you so much!

Maria Niles — Sat, 23 Feb 2008 23:01:40 -0600

That's quite a compliment, Erin. Thank you!

My hope, too

Maria Niles — Sat, 23 Feb 2008 23:00:58 -0600

I agree, Pundit Mom - I hope we actually make some progress this time. But seeing all the near misses here in California I worry that perhaps I've become too cynical. I just hope that we find some solutions before our broken system explodes.

what a great post maria

Erin Kotecki Vest — Sat, 23 Feb 2008 22:30:23 -0600

I've never had it laid out in front of me so well. I've been struggling with "single payer" and "universal" and I think everyone avoid even saying "socialized" now because Americans tend to recoil at the word.

I'm passing this post on to many members of my family with whom I've discussed the differences.

Politics & News Contributing Editor
Queen of Spain

Thanks!

PunditMom — Sat, 23 Feb 2008 22:21:30 -0600

Thanks for including my post in this discussion of health care. For me, it's one of the most important issues in this campaign. I just hope that when we reach the end of this cycle in November, we;ll be at a place where we don't have to worry about our families quite so much.

The change in business is important...

nelle2nelle — Sat, 23 Feb 2008 21:55:02 -0600

(disclaimer: I am a member of SEIU 1984, but I am no fan of Stern on many things)

Clearing this issue off the backs of employers would be a huge relief for virtually every employing business in this nation. For those who provide coverage, their products and services become more competitive price wise; for small employers who do not provide health insurance, they gain in competing for employees. And employees gain by not having to feel tethered to employment in order to protect their health care.

When we all talk with others on this issue, encourage them to talk, encourage them to think on this, to share solutions they think are worthy of consideration. If we change from getting all huffy to pondering solutions to the issue or elements of the issue, we will really have made an important advance.

nelle

Political Will

Maria Niles — Sat, 23 Feb 2008 21:44:35 -0600

Unfortunately we have not made it clear to our representatives that we have the political will to make that change. It will never happen unless we collectively make it so.

Thanks for your comment.

PopConsumer
Beyond Help

Discussion instead of arguing is key

Maria Niles — Sat, 23 Feb 2008 21:41:00 -0600

Indeed, Nelle

That will be crucial to making any actual progress. I've taken heart that business seems to recognize that the current healthcare system is making it difficult for them to be competitive and to make sure they have access to employees. Although the goals that have come out of this conversation between businesses such as Safeway and the SEIU labor union are, to my mind, not ideal, at least the conversation is happening.

PopConsumer
Beyond Help

The very nature of health care change...

nelle2nelle — Sat, 23 Feb 2008 21:13:39 -0600

involves countless potential elements to build a solution.

When I debate the issue, normally I hold back from advocacy, other than in goals: cover everyone, portability, take it off the backs of employers.

Unfortunately, when the subject comes up, people queue up in fear of socialism, or in exasperation over our unwillingness to go to universal health care.

Things are pretty divisive, and even with my basic goals, it is very difficult to get people talking instead of arguing. Take that up to an opinion pool of 300 million, and the task is formidable.

There are ways the private sector can remain a part of a solution. I could come up with ideas taken from the p&c field, plans which could involve the government more on a reinsurance level, guaranteeing companies they would cover excess over a given amount, individually or on the loss ratio for their entire book of business.

If we are going to get everyone to sign off on a new system, we need to keep basic goals, but be ready to discuss and consider a multitude of different potential solutions.

nelle

Single Payer System

loonybinblog — Sat, 23 Feb 2008 18:39:05 -0600

I do not understand why the democratic candidates continue to discuss the idea of insurance for everyone as opposed to a single payer system. The current insurance system not only leaves millions without coverage but it sucks up 2/3 of every health care dollar spent. It's time to rid the system of the insurance companies.

Health Care: Understanding the Policy Discussion and What Women Want

Maria Niles — Sat, 23 Feb 2008 18:03:29 -0600

In the 2008 presidential election, healthcare is a leading issue for women. Across their blogs, women are making it clear that they know our system to be broken and they want changes and solutions.

Unfortunately, despite a collective desire for a solution, we are offered a bewildering array of complex and confusing policy options which are further obscured by the application of sound-bite labels.

I hope to clarify what some of the healthcare policy options are and on Monday Morra Arrons will bring you a post sharing what the candidates' stances are on these options.

Healthcare vs. Health Insurance

Healthcare refers to the system of delivery whereas Health Insurance is currently the primary method by which healthcare is paid for. Prior to the advent of health insurance around the 1930's, patients paid doctors and hospitals directly for providing care. As medical treatments and technology increased, health insurance developed as a method of paying for higher cost treatment. Payment of health insurance premiums became primarily employer-based as employers offered health insurance as a benefit in lieu of higher wages.

Health Insurance

Health Insurance is a for-profit system by which companies seek to collect more in premiums than they pay out in benefits in order to make a profit. All insurance companies seek to minimize risk which creates an incentive to determine risk and not provide coverage to those who are deemed risky or to charge very high premiums. In the case of health that means those who are more likely to become ill. (Read here for the story of Patsy Bates who was just awarded $9 million to be paid by her health insurance company after they dropped her coverage when she was diagnosed with breast cancer.)

Universal Healthcare

Universal Healthcare refers to the concept of every American having access to the healthcare system regardless of how the system of payment is structured. Universal healthcare is often used as synonymous to "single payer." This is inaccurate as most universal healthcare proposals do not call for a single payer system but rather offer different ways of providing individuals the ability to purchase private health insurance policies.

Single Payer

Single Payer is the term for the notion of all healthcare payments coming from a single source, namely the federal government. Medicare is a form of a single payer healthcare system. Patients are treated by private physicians whose fees are paid by the government. This is the model used in Canada.

Socialized Medicine

This term is loosely used so it is difficult to define. However, the primary negative vision it is designed to conjure up is the idea of government employed bureaucrats delivering patient care. In this scenario doctors would be government employees and hospitals would be run by government employees as is the case with the Veterans Health Administration rather than by various for profit, non profit and charitable groups and organizations (versus the idea of their fees being paid by the government as in Medicare). However, as the term socialized medicine is often used to refer to any form of government involvement in healthcare, it is often used as a critique of the concept of a single payer system (or as it is sometimes called, "Medicare for all" ) and the prospect of a Canadian style system.

The term "Hillarycare" is also loosely used as a catch-all term for any government involvement in the provision of healthcare. It is important to note that the proposals developed by Hillary Clinton in 1993 are not the same policies she now proposes nor did Hillary Clinton ever propose a single payer system. Therefore this term is essentially meaningless as it is used and not pertinent to the current debate.

Additionally, the term socialized medicine is used to paint a picture of government bureaucrats making decisions about what treatments doctors can provide to patients and how courses of care can take shape. Whoever pays has a strong say in these choices so, yes, under Medicare, the government makes decisions about what procedures are covered and how much is paid for them. Under the system of private insurance it is corporate employees who make those same decisions. The only way those decisions would be left entirely to made by the individual in conjunction with their doctor is if everybody paid directly for services and that was the only system of payment for medical care.

Rationing

All healthcare systems require some form of rationing. One common misconception in discussions of healthcare approaches is that only single payer systems such as those in Canada and the UK require rationing. Our current system rations care by limiting care to those who can afford it as is evidenced by the denial of care, unwillingness of insurance companies to cover those with pre-existing conditions, the increasing loss of the provision employer-based insurance and tens of millions of Americans without health insurance. Any changes to our system of healthcare will have to involve a hard but necessary national discussion about how we will limit care whether it be limits on end of life care, expensive treatments or limits on access to elective procedures such as joint replacement. No system of healthcare can promise that every person can have any treatment immediately at any cost.

So what do women want?

BlogHer's Voter Manifesto shows that women want to know how candidates propose to ensure that all Americans have healthcare. Recent polls show that 2/3 of Americans want a single payer universal healthcare system. None of the remaining major candidates are offering that solution therefore it is incumbent upon us as women voters to ensure that they hear our voices and that we demand clear and complete explanations of why they are not offering what we want and why their solution is superior.

Further Reading:

The Logic of the Health Care Debate (a progressive perspective) from The Rockridge Institute
MOMocrats on healthcare
Public Opinion: Health Care and Election '08 a slide show from the Kaiser Family Foundation
Toward Free-Market Health Care by Grace-Marie Turner of the Galen Institute for The Heritage Foundation

And a small sampling of women sharing their healthcare stories - please add your voice in the comments or link to a story you think is important to hear.

Pretty Lady "Fie on 'Health Insurance'! Fie!"

Kyla at The Journey "My daughter's policy is being canceled and she is being denied for private insurance coverage."

PunditMom "Do My Parents Deserve Health Care?"

libelletage "Here Is My Soapbox: A Message On Universal Healthcare"