SPEAKOUT: Health-care plan stresses prevention
By Jared Polis
Published February 13, 2008 at 12:05 a.m.
Rocky Mountain News editorial pages editor Vincent Carroll recently criticized my proposal of a single-payer health-care system ("Polis' rationing plan," On Point, Feb. 1), suggesting it would result in the widespread rationing of care. Let me describe what in fact I am advocating.
First, let us not delude ourselves into thinking that we have anything close to a "free market" in health care. A free market would allow the uninsured to die on the hospital doorstep rather than provide them treatment they cannot pay for. Having made a moral decision not to allow people in our great country to die in this fashion, let us discuss how to more efficiently provide for sensible universal health care.
America does not suffer from lack of total spending in health care.
We spend nearly twice as much per capita on health care as other Western nations, and yet our health outcomes are in the middle of the pack. One of the main drivers of cost are the estimated 50 million uninsured Americans, who are treated in the costliest manner with the worst health outcomes under our current system.
Generally, patients without insurance have little access to preventive care and are treated for everything from acute conditions to the flu in the most expensive way possible - in emergency rooms and hospitals that pass the costs onto insured consumers. It would be less expensive and more successful if patients were diagnosed and treated earlier.
Under my plan, supplemental or "gap" insurance would also exist, just as many Americans on Medicare today also have additional insurance in place. Many companies would offer additional coverage to attract and retain their employees, but, at the very least, every American would have a basic level of portable coverage including preventive care and catastrophic care.
The truth is that under the current health-care system, both Carroll and I have insurance, and under my proposed plan we would both likely continue to have good supplemental insurance, as would many readers of this who are far from "super-rich." The main difference is that there would be a basic level of universal, portable coverage that every American would enjoy and that would save costs.
Would this involve "rationing"? We have rationing within our health-care system today, whether it is private insurance or Medicare. Anyone who has had to fight a claim denial knows that. Any reform that reduces the administrative overhead and duplication in the system and encourages preventive care will free up resources that will result in less rationing, not more. By reducing administrative overhead and aggregating risk into a larger pool, we can achieve more efficiency out of a universal system that can, without magic spells or incantations, actually save money and lead to better health outcomes.
Jared Polis is a Democratic candidate for Congress in the 2nd District.
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February 13, 2008
8:21 a.m.
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vudumom writes:
There are lots of uninsured people who go to the ER for colds and the Flu like Mr.Polis pointed out. If those same people would have spent a small amount of money or taken advantage of free flu shots given out around the area , they wouldn't need the ER.So how are we going to force people to do the responsible thing and get prventative care. If they can't even take the time and effort to get a flu shot?My husband and I have insurance ,but they were giving flu shots away for free around the metro area as part of a epidemic training excersise.We got ours for free instead of paying a $25 co-pay and having our insurance company pay for a shot.Do you think if you give someone something for nothing they are going to be responsible for their health?
Not going to happen.they will also be running to the Dr.'s for every little sniffle.I treat colds at home.Not in the ER or going to the Dr's.I treat my kids at home,instead of running to the Dr's everytime the get a cold.We eat healthy and wash our hands.If people can't even take the time to get free flu shots and instead use the ER as their personal Dr. when they get the flu,Why should we give them insurance?
February 13, 2008
9:09 a.m.
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farmboy writes:
Polis wrote, "A free market would allow the uninsured to die on the hospital doorstep rather than provide them treatment they cannot pay for."
That is such a canard. It's like saying that a free market in food production and distribution means people starving in the streets. On the contrary, because it is market driven, people can get almost any kind of food they want in any quantity they want conveniently at reasonable prices.
But if it was run like Polis' plan for health care, people would have to depend on either getting fed at the equivalent of an Army mess hall or wait in long lines for a loaf of bread.
February 13, 2008
9:16 a.m.
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kathyM writes:
Mr. Polis, rationing requires a monopolistic control of the resource in question. Currently, there is no monopolistic control of healthcare. The mere term "single-payer system" defines your plan as a monopoly.
Administration costs take up 30% of our health care dollar. How exactly will adding MORE bureaucracy reduce that cost?
February 13, 2008
10:51 a.m.
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s.degrees writes:
I have always found a good rule to be that anyone who starts accusing others about being unable to talk about the basics of Econ 101 should probably not talk about economics at all. SASQUATCH says a monopoly will effect the consumer because the consumer will no longer have choice. What choices do consumers have now? No matter what plan you are on health care costs have been rising 20% per year for the last several years with no end in sight, and these plans restrict our choices more and more. My most recent plan offered by my employer, $240 a month with a $2500 yearly deductible. Does it cover chiropractic care? No. Does it cover eye glasses? No, and thank God I don't have a pre-existing condition.
Meanwhile, my Father, now retired and covered under his former companies health care plan, has had several bouts of diverticulitis, which until recently was treated with anti-biotics, although his doctors said surgery was inevitable. Having decided in January that it was now time for surgery, when is the first available surgical date? May 15! This is why I laugh at the clueless Vince Carrol when he complains about wait lists and rationing. There are wait lists and rationing now! As someone who lived overseas for a year and was covered under NHS under an agreement, give me NHS anyway.
As KathyM points out correctly, 30% of our health care costs go towards Administrative costs. That is in the private system by the way. Medicares Administrative costs, 2%. Not bad for a "Monopoly". So yes, I would rather have a health system that is run by the people who "deliver our mail, maintain our bridges and highways, run social security, run the DMV and educate our kids in public". At least there is some accountability when it comes to these people unlike today's health care companies where there is none. The idea that Government is less efficient then the private sector is nonsense and always has been nonsense. Private companies can be run well and poorly. Government can be run well and poorly. Give me the system where there is accountability to the people.
I guess the thing I really do not understand is why this plan is coming from a guy like Jared Polis, of all people. Why is the guy who advocated vouchers and the privatization of the postal service now advocating a government solution? Is he pulling a Mitt Romney?
February 13, 2008
11:10 a.m.
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kathyM writes:
It's easy to have 2% admin. costs when you make everyone else do the work! Medicare users must also buy PRIVATE supplemental insurance. The admin. costs of the healthcare provider increase with the number of parties to which it must submit claims on one patient/treatment. And as someone posted previously, Medicare claims get denied more frequently than private claims. So Medicare's administrative costs are partially shifted to the healthcare provider, the private sector, and the insured.
February 13, 2008
12:07 p.m.
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BrianSchwartz writes:
Jared Polis writes: "A free market would allow the uninsured to die on the hospital doorstep rather than provide them treatment they cannot pay for."
This is a pathetic argument. Is Mr. Polis so heartless that he wouldn't help such a person if the law didn't compel him to do so? Or if he would, does he think that doctors are so heartless? Give me a break, Jared.
In the wake of the French Revolution, French economist Frederic Bastiat wrote that "every time we object to a thing being done by government, the socialists conclude that we object to its being done at all...It is as if the socialists were to accuse us of not wanting persons to eat because we do not want the state to raise grain."
Apparently nothing has changed.
February 13, 2008
11:40 p.m.
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BrianSchwartz writes:
Jared Polis represents the worst in all of us.
At least Polis recognizes that we do not have a free market in health care. The government interference in the free market he’s addressing is EMTALA, the Emergency Medical Treatment and Active Labor Act. As its Wikipedia entry (linked above) summarizes, this law forbids hospital emergency departments from denying care to anyone with an emergency medical condition.
According to Jared Polis, a law is required compel doctors to treat the uninsured in emergency situations. Is Polis saying that doctors are so heartless and cruel that they would not treat someone for free? Is he saying that the electorate as too callous to fund charities to pay such that doctors could treat the uninsured in emergency situations?
Apparently, the answer is “yes.” Polis writes that we have “made a moral decision not to allow people in our great country to die in this fashion.” Not quite. Moral decisions are a matter of choice, not a threat. EMTALA threatens doctors with penalties up to $50,000 for not complying.
So Jared Polis thinks that the citizens of Colorado and Colorado’s physicians must be forced to do the right thing, since they lack the moral fiber to do it themselves. And yet, Jared Polis seeks public office, to represent us, the very people he doesn’t trust to do the right thing. So if the citizens of Colorado’s 2nd District elect Mr. Polis, how can we trust him to do the right thing?
(For an expanded version of this, see my blog post at
<www.wakalix.com/wp/?p=306>)
February 14, 2008
8:59 a.m.
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jay writes:
I'd still like someone from the far right to address the question of why they believe the US incapable of adopting some of the best practices of countries who are doing healthcare cheaper and better than we are...
February 14, 2008
11:36 a.m.
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jgd writes:
***I'd still like someone from the far right to address the question of why they believe the US incapable of adopting some of the best practices of countries who are doing healthcare cheaper and better than we are...***
The US is not incapable of destroying the health care system, they are intelligent enough not to let the government control yet another part of their lives. It is your right to want a socialist society and it is my right to argue against it. "Best practices" is a subjective idea, I happen to believe a free market health care is the "best practice". Does our health care need some modifications? Maybe, but it sure isn't this socialized health care that you are promoting
You liberals can buy your votes with your own money, don't even think of trying to use mine.
February 14, 2008
11:49 a.m.
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mytwosense writes:
BrianSchwartz: "Jarid Polis represents the worst in all of us."
Mr. Schwartz, a significant amount of Americans share Mr. Polis' view that all of us should have access to health care. Telling them that desire represents the worst in humanity is hardly the best way of winning them over to your side.
You also stated: "Is Mr. Polis so heartless that he wouldn't help such a person if the law didn't compel him to do so? Or if he would, does he think that doctors are so heartless? Give me a break, Jared."
That...is one of the most wildly drawn conclusions I've read to date from you. This can't seriously be what you really think he meant. Do you not have the plain common sense to understand that doctors can't maintain their practices by indefinitely treating for free people with diseases that are shockingly expensive to treat? Mr. Polis' advocacy of insurance for all would go a long way in preventing doctors from being put in the terrible position of having to deny someone treatment for such a disease.
A piece of advice to whoever is funding Schwartz to spread your propaganda: Find another hack who is actually compelling and eloquent. At least you'll get more of your money's worth.
February 14, 2008
noon
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mytwosense writes:
SASQUATCH: "Mr. Polis simply can't grasp the basics of Econ 101. Monopolies, even buyer monopolies, are always hostile to the consumer. This is especially true when you separate the consumer from the payer."
The current privatized health industry has proven it doesn't play by your Econ 101 rules. It can't. For one thing, it doesn't directly profit off premiums. Instead, it profits off the investments it makes with those premiums. That is the only way insurers can make enough money to pay out such exorbitant health care costs. And that is also one reason why the huge insurers rely on their size to eke out a living in the health care space. You seem to believe a proliferation of health insurance companies would drive down costs, but I believe the industry couldn't survive with that many companies.
In the case of single payer insurance, the payer and consumer are more "one," than with our current system. The payer - the government - is elected and funded by the consumer. That is a huge bargaining chip.
February 15, 2008
5:39 p.m.
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anderson writes:
KathyM, the whole idea of a single payer system is to have less, not more, bureacracy, by not only eliminating the middle man, but by eliminating the inefficiences of having multiple middle men.
Right now, if you are working, and get health insurance through your employer, the parties involved are typically:
Employer > Insurance Co > You > Doctor > (and sometimes other medical providers you never meet such as a lab);
Under Single-Payer it would be:
Govt > You > Doctor
Obviously if the middle man is in the picture, he has to take his cut. Why are we paying the middle man?
February 15, 2008
5:42 p.m.
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anderson writes:
Mr. Schwartz doesn't need funding for he's got true religion. The market is God. All-knowing, all-seeing, ever beneficent. The government is Satan, always trying to interfere with our relationship with God.
February 15, 2008
5:52 p.m.
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anderson writes:
Oh yes, as Two Cents points out, we all have stock in the government. Most of us don't have stock in insurance cos. Who do you think we'll be more responsive to our needs?
Now Sasquatch, he's apparently offended by the whole concept of "ours", "we", "us", "all together now", and the audacity that "our" government--sorry, I mean "the" government (i.e., in opposition to *me*) would undertake to deliver mail to everyone, or provide a safety net via Social Security, or make us have a license to drive, and do it without great complication or messy competition, is positively evil.
February 17, 2008
11:07 a.m.
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kathyM writes:
Anderson, Have you considered that the government would be taking on BOTH roles, as payer AND middleman? Also, in a single-payer system, the doctors will become employees of the government. So guess who's at the end of the equation?
It will be Govt (taking the payments) > Govt (making the rules) > Doctor (employee of Govt.) > YOU.
Taxpayers might have "stock" in the government, but it's common stock, not preferred stock. That means taxpayers' real power and influence is extremely limited. And taxpayers can't sell their "stock"!
February 18, 2008
1:59 p.m.
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anderson writes:
In response to your first question, no. Your reasoning escapes me.
As for doctors becoming employees, I believe it all depends on how the system is set up. We already have a version of single-payer: Medicare, and doctors are not employees of the gov't. In fact, some don't take Medicare patients.
The gov't "making the rules" and insurance cos. "making the rules" are six of one, half-dozen of another. At least you and I have some say-so in terms of the govt's rules. Never underestimate the power of the common stock holders. The board of directors has to answer to us. We even have the power to call up and talk to the board members.
I was talking to a couple of nurses yesterday. One was making some general complaints about her job (her long-time career) and later I asked her why she thought there was a shortage of nurses. Her theme was generally: they treat us lousy. She said they like to hire new nurses who will accept less pay. She said there are basically three employers of health care professionals in Denver: HealthOne (and two others I don't remember), and they all operate based on the bottom line, i.e. on profit. And I'm thinking: that's a lousy basis for a health care system.
February 19, 2008
7:28 p.m.
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kathyM writes:
And you think the government will be altruistic and fair in its administration of healthcare? It scares me to think of the government denying my father's surgery because he's terminally ill anyway, and that would be a "waste of money." That's what Medicare--our wonderful government-run health insurance program--told him. Fortunately, my stepmother's private insurance (Blue Cross/Blue Shield) paid for his surgery, chemotherapy, several hospitalizations, and hospice care at the end. The final bill was well over $1 million. But my dad lived three more YEARS--of good, quality life watching his grandchildren grow, traveling, enjoying his happy marriage--than he would have if the government decided "what's best" for him (meaning "what's best" for their budget).
Rationing requires monopolistic control of a resource. There already is rationing with the existing government-run healthcare programs. Nationalized health care will be a monopoly, and there WILL be rationing. And the rationing will not just be driven by a budget; it will be driven by political agendas of every stripe.
February 19, 2008
10:32 p.m.
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kathyM writes:
Anderson, "I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind--yet what is it that they expect to depend on, when they lie on the operating table under my hands?" I think you know what I mean.
February 20, 2008
2:07 p.m.
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anderson writes:
You're on the same bandwagon with the other ideologues who claim that gov't rations healthcare but the private sector doesn't. What utter nonsense. And spare me your rhetoric about enslaving doctors. Sounds straight out of Ayn Rand.
February 20, 2008
10:30 p.m.
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kathyM writes:
Glad you remember it, Anderson. It's Dr. Hendricks, one of the "strikers" in Atlas Shrugged. That character's comment was actually inspired by the British "brain drain" in the early 1950s, when doctors fled the UK in droves after the government socialized the medical industry.
I will fight like h*** against the expansion of the government-run healthcare system that declared my father's life not worth saving. I'm not an idealogue nor a fanatic. I'm simply making the point that business owners are motivated by profit, politicians are motivated by power--and neither put our interests before their own.
February 22, 2008
10:45 a.m.
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anderson writes:
Kathy, if I happen to stumble upon Galt's Gulch in one of my hikes in Colorado's mountains, you'll be one of the first persons I'll let know. Meanwhile, we as Americans have to deal with the reality of a healthcare system in need of reform.
February 22, 2008
2:48 p.m.
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kathyM writes:
THIS is the reality you can look forward to: See "Whistleblower: Surgeon breaks cover over NHS beds crisis" in the 7/29/07 issue of The Independent (U.K.). If you suffer severe trauma (like in a car wreck), guess what happens to you in the U.K.? You get put in a regular hospital, YOUR INJURIES UNTREATED, for days or weeks until the NHS Trust (the bureaucrats, NOT the doctors) decides you can be moved to a trauma hospital.
If you can't get immediate treatment for trauma, imagine how long you have to wait for non-trauma medical treatment.
THIS will be our reality if our healthcare system is socialized. I'm not the one denying it--YOU are.
February 22, 2008
3:01 p.m.
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anderson writes:
We can design our healthcare system any way we like. It doesn't have to be England's system or Canada's system. You have this idea that government involvement will mess things up, merely because it's government. I don't see it that way at all. I say we get the government we ask for.
February 23, 2008
8:45 a.m.
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kathyM writes:
No, we get the government we elect. Once the politicians are in office, they are free to represent us any way THEY like.