What’s missing from the health care debate?

The national debate continues over efforts to reform the country’s system of providing and paying for health care. Political leaders, interest groups and care providers are sparring daily in the media and halls of government. What’s missing from the health care debate?

A single payer health care system needs to be discussed in Washington! -Abbie, White Bear Lake, MN

What’s missing from health care debate? Long-term care needs to be addressed! -Phil, Woodbury, MN

What about tort reform? -Andy, Stillwater, MN

Is insurance not tied to employment being addressed? -Jane Fisher, St. Paul, MN

Unnecessary procedures, unnecessary lawsuits, preventive care. -Jessica

What’s missing is tort reform, a huge factor in out-of-control health care costs! -Dawn, Lake Park, MN

Health care is as expensive mostly because of our own unhealthy life styles and nutrition. We need to attack the root causes instead of treating the symptoms. -anonymous text message

What’s missing…focus on real solutions for reducing costs. Examples: addressing malpractice limits, standardized reimbursements, etc. -anonymous text message

Share your reply in the comments: What’s missing from the health care debate?

  • Chad

    I am a college student, who will soon be responsible for paying my for my own health insurance. I find it outrageous that people don’t realize that inaction is truly a referendum in favor of continued extortion from the insurance industry. The industry opposes a public plan because they know it would cut into their profits. If the insurance industry actually had to pay for sick people, and keep costs low, well they wouldn’t make much money. Does that sound fair?

  • Tanner

    Healthcare is not a fundamental right and people need to realize that. If you get sick, go pay for services rendered. Don’t have the money? Too bad, get used to it. Socialism isn’t the answer to our problems. More free markets, more big business, and more special interest.

  • Mike

    We need to have a serious discussion in our society about the extraordinary heroic measures we undertake at the end of life. Often these procedures and treatments offer only short-term relief, and the quality of life at that time is not what most would deem acceptable.

    Rationing isn’t the answer either, if a person wants these extraordinary measures, they should be available, but when given the facts, most people would choose quality over quantity.

  • What’s missing from the health care debate is the media debunking the lies conservatives are propagating about this reform. You can share both sides while still being critical.

  • Al

    All of the plans still being considered by Congress tie health care for many people to an employer. Americans watch as many businesses send jobs overseas to cut costs. A major factor in the cost difference between a US worker and a foreign worker is the price paid by the company for employee and retiree health care. While I like the coverage I have with my current employer, will it still be all that valuable to me when my job is given to a foreign employee who receives government sponsored health care? It’s time to stop calling a single-payer system socialism and realize that our current system engourages companies to send jobs overseas.

  • Bruce

    What’s missing from the debate on health care is an appreciation of why market principals aren’t working. We’ve taken the traditional controlled economy for medicine, where we invest our doctors with total trust for our health as if they were gods, and turned over our lives including our pocket books to them and their medical suppliers. The same is true of Medicare, where government programs are harvested like milk cows by big business. Nothing we do will change this until we introduce the price incentives President Obama asked for in his Health Care speech. This is still missing.

    I know of no way of achieving this unless the US consumer takes back control of their health and learns about each and every illness they have to the point that they are co-doctoring themselves and their families. This isn’t so far from our frontier traditions actually, and with the advantages of the internet and expert systems quite achievable at quite a high level. Medical schools train their students to parrot complicated rules and exceptions to these rules which can be translated to an expert online system. Such a system could also be able to code and chart the health problems of those who use it, for a complete health history and reference by doctors who might be needed at a later time for consultation. This would be a high quality baseline of care that would cost the government almost nothing after its development. But of course the industry would fight such a program, as any guild would.

  • Austin

    All the focus you hear in the news is how to make the Healthcare affordable in terms of subsidizing the cost for the worker, family. There is no examination or focus of reform as to WHY its so expensive. Why not look at the Rx companies, insurance companies, hospitals, and other affiliates within Healthcare that are ringing in the profits. Maybe even the doctor’s wage but that would be last as they are prob paid accordingly to their skills. Bring the cost down by fixing the greed within the middlemen. Then people would be able to afford it.

  • Deb

    Whats missing is strong incentives (ie higher co-insurance) for people to stop harming themselves with too much food, smoke, ect. One need only think of the obesity epidemic and all it’s health related consequences. The medical costs of poor lifestyle choices should not be ignored…literally an ounce of prevention is worth a pound of cure.

    I am generally a liberal’s liberal, but I honestlly resent paying preventable, self-inflicted health care costs.

  • Michelle

    I think there is one key idea missing from the health care reform debate. We need to look at moving away from the existing system where your insurance is tied to your employer is crucial. That system was created for a time when employees stayed with an employer for life. That does not happen anymore. Encouraging and developing a system based on the individual or family needs to be a part of the equation.

  • Clark

    What is missing is the true cost. Whatever the democrats tell you, they are lying liars. I would say, take their estimate and mutiple by 5 so if they say a trillion, it will be 5 trillion. If you question my math, look at the estimate of the cost of medicare and medicade in the late 1960’s I believe they were off by a factor of 10.

  • Juliet

    I think we’re missing the point that Americans are not immortal. There are great technological and medical advancements to save 8 week old fetuses and perform heart transplants on 90 year old people but does that mean we should? It seems that Americans don’t like being told ‘no’ for anything. Over-consumption and a sense of entitlement leave us feeling like we expect the best all the time and that’s just not sustainable. Maybe we need to be told ‘no’ every now and then.

  • Mark

    The right might say that malpractice liability reform — tort reform — isn’t being discussed enough. The left will say single payer. The problem is that we might be able to do elements of both but neither side listens to the other — they dismiss potentially good ideas out of blind loyalty to ideology and party politics. As always, it is more about keeping their jobs than doing it.

  • Robert

    I agree with Mike’s comment about end-of-life care being extremely expensive for the benefits gained.

    In addition, the source of many of these problems is the free market. When insurance companies and health care providers first priority is making a profit rather than providing high quality health care how can you expect anything but increasing prices?

    Another contributing factor of increasing health care costs in the widespread problem of obesity in this country. Again, the elevation of profits above the good of the consumer has a lot to do with this. Food manufacturers and restaurants try to find ways to make the most profit by making foods that encourage people to eat more.

    I believe the free market is good for some things but there are areas where it does not make sense. Health care is one of those places.

  • Joe

    What is missing is consideration of the “life time maximum” benefits paid by health insurance policies — your individual plan or the one at work has one, check it out — and how that fits with the “public plan.”

  • Charlie

    I think the biggest thing we can do at this point is realize that Medicare is already a single-payer system and this country hasn’t slid into the abyss of communism. And guess what else: the insurance companies still have a stake in Medicare.

  • Laure Campbell

    What’s missing is the option of eliminating 3rd party payers altogether.

    So much of what we call “health care expenses” is actually the cost of coding services, billing, denying, appealing, paying people to monitor utilization, etc.

    What would health care cost if a patient paid a provider? What would happen to health care costs if the patient knew what he/she would be charged for an MRI, etc…? I’ll bet costs would decrease.

  • Glenn

    When it was decided to reform health care why did they start by inviting drug companies and insurance companies to the table to recommend the solution. To me that means that it was decided to reform health insurance rather than health care.

    If they were serious about reforming health care they would have told ins. companies and drug companies to stay out of the discussion. If it was decided that they would be part of the solution then they would be invited later.

  • Anita Martinez

    1. Of course, single-payer got taken off the table before talks even started – recall the MDs being escorted out the door when asking to discuss a single-payer proposal.

    2. How can we EMPOWER people (don’t call us patients) who live with the chronic illnesses like diabetes, hypertension, asthma, heart disease, or injuries requiring people to do prescribed exercises, etc. at home? We have to do lots of things on our own each and every day, 24/7, and that’s really tough some days (I’ve had Type 1 diabetes since 1976). We all need to have some “skin in the game” if this is supposed to be about improving quality of life and reducing health care costs.

    3. Why does the media – OK, I’m an MSNBC fan – continually repeat the lies like “elderly will be pressured to end their lives while we’re paying for abortions” Chris Matthews on Hardball, who has sincere Catholic beliefs, keeps repeating this lie about a public option; or “people in Canada are put on waiting lists for months to get procedures, surgeries done” when MPR and PBS and even MSNBC have done investigations and interviews stating the contrary? -, why does this go unchallenged? At HealthPartners, i needed a hand surgery consultation and I told the scheduler to give me the very first appointment available by any of their 10 or so specialists and the first available appointment was approximately five weeks away, and now the surgery is another 6 weeks away from the diagnosis? So why doesn’t anybody talk about how long it takes here with an excellent system using employer-provided insurance?

    These are some of my questions. Thank you for the privelege of allowing me to share them.

    -Anita Martinez


  • Les Everett

    What is usually missing from the debate, and as Massachusetts found to be the most important factor (see http://www.npr.org/templates/story/story.php?storyId=111492444 ) is how medical providers are paid. Costs will continue to rise unless we change our payment structure from “fee for service” to payment for health care. Fee for service provides an incentive for more procedures. Paying for a year of health care provides an incentive to keep the client healthy. So the issue is not so much who pays (individual, employer, or government) but rather what we pay for.

  • Amy

    What’s missing is commentary on insurance and pharmaceutical companies, and some of their practices. Many have already commented on the insurance companies, (the office of one such is characterized by granite, marble and fountains, a far cry from what family physicians’ offices look like!) so let’s take a look at pharmaceutical companies.

    The New York Times today reported on the heinous practice of some companies of hiring ghost writers to write promising review articles, promoting their products, and then managed to place them in professional medical journals, (as well as some less-professional journals.) Shame on the editorial boards far accepting the articles, but further shame on the pharmaceuticals, for promoting a drug as beneficial when it perhaps isn’t, always. This reminds one of the tobacco industry promoting the “healthy” aspects of cigarette smoking!

  • Chad

    Regulation changes. There’s so much talk of how the public is going to pay for changes. I don’t hear any buzz about changing the laws that govern the out-of-control and gluttonous insurance corporations.

  • Laura

    I agree with several other posters that one important thing missing from this debate is the consistent challenge to outright lies by opponents of health care reform. Challenges that can be verified by facts should be repeated each time the lies are told so that the lies don’t gain credence simply by repetition.

    I’m also concerned that I haven’t heard any reporting on the progression of the system we currently have, why its costs consistently increase much faster than inflation and what we can expect if we continue with a same/similar system. This must include costs, both overall to our economy and to consumers, including premiums and copays which are increased without consumer approval even within contract periods for those of us who are still covered through employers. Those of us with contractually obligated coverage also experience unrequested loss of coverage of procedures and such. It also must include any further loss of any coverage at all through job loss, pricing out of affordable coverage, etc. I don’t see how those realities can be seen as anything but rationing. Any thorough discussion MUST include a comparison of what we will have if we don’t vote for meaningful change.

    Also, can we talk about how much profit there is within a system that previously had a lot of non-profit components: perhaps a little history of health care in the US.

  • Laura

    I don’t understand what point Tanner is trying to make with his post: “Healthcare is not a fundamental right and people need to realize that. If you get sick, go pay for services rendered. Don’t have the money? Too bad, get used to it. Socialism isn’t the answer to our problems. More free markets, more big business, and more special interest.”

    Is he saying that what he labels socialism causes or conversely interferes with “More free markets, more big business, and more special interest”?

    Perhaps Tanner will live to see the day when he experiences a reversal of fortunes or chronic, expensive illness. I suspect we’ll hear him loudly whining about what he’s entitled to, paid for by the rest of us. I’ve witnessed the pattern many times.

  • Nate

    two things seem to be left out every time I hear the issue discussed:

    1. Paying for preventative care: it should be easy to get things like PT and massage for certain problems payed for by insurance rather then waiting to go to a doctor that just says to take Ibuprofen.

    2. What about tort reform? Do any other countries allow the same level of litigation against health care providers?

  • Brian

    I don’t hear enough about a full centralized database for medical records which could be assessed for any hospital in the country. Too much time and money is wasted by having patients repeat test every time they see a new specialist, doctor, or change hospitals.

  • Robert

    Single payer is missing from the healthcare debate. The discussion started with Obama’s very moderate, mainstream proposal, and the debate since then has been shaped by opponents on the right who claim that it is too extreme/dramatic/leftist. Getting single payer (an approach which I personally prefer) in the mix would clarify for Republicans exactly what the left extreme really is, and how truly moderate the Obama plan is. The Obama plan merely proposes giving individuals the freedom to choose for themselves and “letting the market decide.”

  • Jan

    Single payer solution is almost not discussed. Of course, the amounts on money thrown on the deciders in Washington is tremendous and, hence, no good reform is possible. In any case, the misleading claims about socialism, etc., should be countered immediately using facts and common sense logic. Let’s not permit the whining of the industry prevent the nation to get reasonable in its own interest. Insurance companies will find their niche in the system anyway.

  • Joni

    2 words I haven’t heard that must be addressed: Tort Reform!

  • James

    If this new plan is so good, then ALL politicians should be on it. If that was the case Real health care reform would happen – fast and beneficial to all.

    Socialized health care is bad… just look at Canada.

    Do some research on the politicians health coverage.

  • Glenn

    In response to James, why not have politicians have the same insurance that is offered to all unemployed constituents of there’s . Then there would be true incentive for reform.

  • Jeanne 513699

    Why health care is so expensive in the US? . Yes, it’s the Rx companies, insurance companies, hospitals, etc. But let’s look closer to home. One of the major factors is the unhealthy lifestyle that the bulk of Americans have settled into. American obesity and our car-centered lifestyle are contributory causes of major chronic, i.e. costly diseases. And the unhealthy diet of so many Americans is encouraged by the US Government through the structure of its farm subsidies. If any agricultural products are going to be subsidized, why not real food, such as fruit and veg.

    Further, I’d like to suggest that this forum be renamed “MEMBERS’ question of the day”. I can’t do anything about freeloaders listening to MPR stations, but I am not happy that my membership dollars give freeloaders a free platform for their opinions. I say, put your money where your mouth is!

  • kennedy

    It may be double dipping, but I’d like to see two things more prominent in the conversation, both mentioned by previous posters.

    1 – Consumer behavior that increases health care costs, such as smoking, obesity. The opposite would be healthy lifestyle such as nutritional diet and excercise.

    2 – Rationing. To some it is a dirty word, but we need to figure out which measures are justified and which are not. Everyone can’t get everything when the budget has a limit.

    Politicians won’t like to talk about these because one puts some responsibility on the voter and the other tells the voter thay can’t have everything. Probably a wise political choice, but not very helpful.

  • James

    Jeanne, I thought this was Minnesota PUBLIC Radio.. Not Minnesota Private Radio??

    How do you know I am not a member?

    All members are not liberals / socialists.

  • Linda

    What’s missing is discussion about quality health information and the role of librarians in contributing to quality health.

    Quality health information underpins all aspects of health care – from helping patients and families understand their health issues and be more informed participants in discussions with their health care professionals, to ensuring that those health care professionals have the information they need to keep up-to-date with evidence-based practice standards.

    Librarians are key partners in health information access and health literacy initiatives, and in training tomorrow’s health care professionals to retrieve, manage and evaluate information effectively.

  • Elizabeth

    I think the main cause of skyrocketing healthcare rates is the ridiculous amount of money drug companies spend on advertising. Restrict advertising and drug costs will become more affordable.

  • Critical issue that is NEVER spoken to is the need for a massive migration across all health care providers to electronic records and digital communications.

    This is where the huge waste is, even more so now that consumers are having to juggle health care plans, HSA’s and cash.

    I know Mark Tierney, Chairman of mPay Gateway, former CEO of EBenEx, here in the Twin Cities has an expert view of the issue, and would be worth screening as a possible interview.

    But please, please focus on the issue of dragging every clinic, doctor, nurse, hospital and insurance company into the 21st century

  • John

    What’s missing? Discussion about people taking responsibility for lifestyle and health care decisions. I also hear little about addressing lack of patient compliance with medication or behavior change to improve their health and reduce costs.

  • Moron

    I want world class care, 24/7, with the latest innovations for free, forever. My Congressman says its possible.

  • Joe Schaedler

    Employer based healthg care packages absolutlely must end.

    We need health care available our whole lives.

    However, we will only have our jobs available for ever shorter periods of time.

    I’m hesitant to even get check ups these days, lest one establish some sort of “pre-existing condition” that will excuse private insurers from providing me coverage down the line.

    I’d imagine health care is a citizen’s right, not merely an employee’s only – that should be publicly expressed more often.

  • Lydia

    All those who promote people researching and treating their own health concerns, I hope you never have a complicated medical problem and you guess wrong. These medical people go to 8+ years of medical training for a good reason. They understand far more than you can figure out from reading the internet.

    The one issue that I believe needs to be addressed more openly is the fact that for-profit insurers, drug companies, etc., will ALWAYS be concerned 1st with making their shareholders happy. MPR recently reported Wall Street disfavor with Aetna’s reduced profit in the last quarter because of increased claim payments. If you don’t understand that they are NOT working for you, the insured, then you must have your eyes closed.

  • Audrey

    We are in a war on healthcare. Healthcare should be non profit. It is a sick country that allows corporations and people to get rich off the sick. Even those who have “good” coverage will soon get to a point that it becomes unaffordable. We all have to bite the bullet , decide that, as in times of war, we have to share the pain and go forward knowing that no one human is worth more than another when it comes to providing basic healthcare and needed medical treatments. The for- profit insurance companies should be phased out in the next three years. Who is really getting rich in the medical world? The top paid managers of the insurance industry and it’s shareholders. Heath “insurance” is the biggest driver in government spending. Our tax money is already paying for millions of citizens healthcare. Obama’s suggestion that a medical board should set the price for common medical procedures from tonsil removal to heart bypass is a good one. Then there would be no hidden cost, no confusing billing, etc. We need brave leaders who will force this country to act on values that it pretends to run on, human rights and Christian ideals known as family values. Those who are the most opposed to a single payer system, which isn’t perfect but is far better than what we have now, are the ones who claim to be the Christian right, the family values party. Start putting your ideas where your mouths are.

  • BWM

    According to http://www.iousathemovie.com/ figures (“may be to the U.S. economy what ‘An Inconvenient Truth’ was to the environment’), we are headed toward a 52-56 trillion dollar meltdown of our overpromised health care and retirement programs. Every discussion that focuses on “Auntie Em’s need for dialysis (sob)” without mentioning the cost is just another pandering politician’s dream … as it lets them focus on the deliverables without having to talk about the costs and in that situation they will promise us all the moon. A cynic once said that our politicians have learned to bribe us with our own money. This is worse, they are bribing us with our children’s money. Talk about taxation without representation! Where is the media outrage at these lies?

  • Lydia

    So, BWM, do you think that some Healthcare executive or shareholder should get richer by refusing to pay for your “Aunt Em’s dialysis (sob)?” I spent 10 years on dialysis and then got a transplant and live a rich and productive life. And to the person who implied that 90 year old people are getting heart transplants, that simply is not true. What is true is that many much younger people are dying each year for lack of a heart transplant.

    All you healthy people who have had little or no exposure to real human suffering that can be helped by decent, available & affordable healthcare, please volunteer at a healthcare facility and talk to people and get the real human stories. I am certainly not promoting useless attempts at extending life, but human life should not be valued simply by how much it will cost to make it better.

  • Richard

    Frequently the main stream media frustrates me because they can’t seem to think outside the box. They seem to exist soley to defend the status quo. Yet today I was thoroughly taken aback by a article in the LA times.

    What’s so great about private health insurance?


    What an aha moment!

    Here we are arguing about how to squeeze in a public health care system into our existing without disrupting the private US Health care and the question is why?

    Why protect such a big expensive,innefficient, cumbersome system that fails over 44 millions American? No other industrialized nation would tolerate this and yet we not only tolerate it we defend it.

    My guess is the initial assumption (America health care is first rate) is a faulty assumption. It MIGHT be first rate for those who can afford first rate health care. Yet most Americans don’t get first rate health care. They get Doc in the boxes, health care rationed by insurance companies, prescription drugs rationed by insurance industry accountants.

    So there is the question . What is so great about private health insurance ?

  • susan

    I think whats missing is a fundamental lack of understanding (buy the people making the decisions) of what its like to live without insurance, and the ability to afford any kind of health care other then the emergency room. I think the discussion would be very different if any of them had experienced what thats like. I lived without insurance for many years, its one of the things I consider myself lucky to have now.

  • Mary Colbenson

    I recently have been hospitalized twice and had numerous doctor’s appointments. One of the reasons costs are so high is that you see one doctor one day and another the next and they re-order the same sets of tests because they refuse to accept the test results from other providers, even though they are in the same health network. (In this case Mayo) Also, each doctor I’ve seen has changed my prescriptions because they prefer a different med. It’s almost a competition with them! I recently had an physical for a procedure and lots of tests and the doctor didn’t review any of the results. He ended up cancelling the procedure when I “reminded” him about my infection. he was unaware of the infection because he hadn’t read any of the test results.

  • Jamie

    What’s missing in the debate is all the myth-debunking the news media should be doing. Insurance company representatives and their friends, the Republicans, have been lying to us in order to maintain something close to the status quo so that their profits keep on growing. There are lots of positive stories to tell about Canadian and European health care systems, too, but we seldom hear about them. The Republicans and the insurance companies are very good at marketing their ideas, and the news media just let them do it, mostly unquestioned.

  • Paul

    Why isn’t a sensible rationing system ever talked about? Because unless you think some business school tweeking, overlooked medical miracle, or elite largesse is going to intervene; we need a discussion on what will be the baseline level of care that everyone will get and everyone will pay for .

  • Bill

    It’s not so much what’s missing, but what needs to go: the profit motive. Health care reform should should make the whole thing just as not-for-profit as public schools are.

    Health care, in fact, should be structured like the public schools:

    1) Health Care Districts, with state funding via property tax, and locally elected Health Boards for local oversight.

    2) Health Care Facilities should be publicly owned, with bond issues needed for new construction/improvements.

    3) Health Care Providers should be state employees, with salaries and benefits negotiated by collective bargaining.

    4) Malpractice lawsuits should be limited in the same way as any other suit against a public entity.

    5) Vendors seeking to supply medical equipment, insurance coverage, drugs, etc. should go through a public bidding process just like any other state contract.

    This would eliminate those who prey on the current system for personal gain.

  • Heidi

    Agreeing with Nate’s comments (way) above: litigation has made our doctors scared and our healthcare expensive. Why isn’t this issue being discussed??

  • droogy

    Litigation may be A problem, but when it comes to the out of control cost of health care, it’s not a major one. That’s just what the numbers say, and probably why it’s not front and center.

    I met someone who works for a health insurance company. He begged us to support the government option and thought it would be good idea to put his company out of business because having seen how they operate and the huge profits they make he’s simply disgusted.

    The insurance industry is putting many millions of dollars in to defeating health care reform, not by trying to convince people they provide better service but by trying to make sure there is no discussion. They are shouting people down, disseminating outright lies and taking over meeting with an agenda to disrupt them.

    A vast majority of bankruptcies are declared because of medical bills. And in case you think these are irresponsible people who just decided not to buy health insurance, here’s a true story.

    I had a friend who killed herself rather than go through battling her breast cancer when it returned, not wanting to once again drain her family’s financial resources. The kicker? SHE HAD HEALTH INSURANCE!

    How is this in any way right?

  • droogy

    Here’s a good analysis of the cost of malpractice lawsuits and the practice of “defensive” medicine by the wonderful Factcheck.org:


  • Dennis

    single payer

  • Jen

    One of the biggest things I think people are missing is the goal of the healthcare industry. I think if we are going to fix the issues of cost we need to change track on the goals. Currently the goal for the industry is to make money – it needs to change to the goal of making and keeping people healthy.

  • Lynne

    1. Single payer – American businesses are losing their global competitive advantage because of a decades old policy dictating that American businesses are responsible for paying for our nation’s health care. It keeps many people stuck in jobs they may despise, reducing productivity, and inhibiting innovation.

    2. The need to reconsider high deductible policies that require people to pay thousands out of pocket for both the insurance AND health care. This is what has created the ranks of the underinsured – people who also put off health care because of unaffordability. It’s quite likely that high deductible policies mean almost pure profit for insurance companies.

    3. the role that complimentary therapies could play in the system for both prevention and treatment;

    4. the corporate bureaucrats who are a) already rationing and limiting patient choices for treatment and doctors (when your company changes providers, you may also have to change your doctors); b) kicking people out of the system when they dare to get sick; c)not allowing in those people with pre-existing conditions who have lost jobs and insurance; and d) putting shareholder profit before patient health.

    It does little good to apply band aids to a system that is broken. A doctor doesn’t apply a band aid to a broken leg, so why on earth do our lawmakers think that band aid solutions will work now?

  • Julianne

    Single payer, Single payer, Single payer!!!

    And I agree with other posters (Anita, Laura, Sarah, droogy) WHY does the media let opponents of reform get away with flat-out lies? Again and again? News outlets need to require those they interview to back up their claims with facts!

  • Denise

    Businesses that have been profiting from selling unhealthy lifestyles such as alcohol and cigarettes should bear the responsibilty and burden on their actions by being mandated to provide a health insurance plan to their customers. It would be the responsibile thing to do -shifting the costs from those who do not engage in this activity to the companies and individuals who choose this risky behavior.

  • Gary

    We need to fundamentally change the incentive structure in this industry. Specifically, doctors should not be paid for services delivered but should be put on salary, as they are in Mayo. The new system should incentivize providers to move away from fee for service to salary. As long as doctors are paid more for more services delivered they will provide unnecessary, or marginally useful, services.

  • Douglas Smith

    We need to question the assumption that insurance should be paid by employers.

    If employers must pay (and get a tax break) for health insurance, then the same should apply to food. We need that, too. And clothing, and housing.

    Employer-based health insurance hides costs, puts small business and start-ups at a great

    disadvantage, and creates a mentality of dependency.

  • Lora

    What is missing in this discussion is what happens WITHIN healthcare, not insurance companies, not pharmaceutical companies, not private or governament payers but what is going on between your doctors, nurses, resp therapists, administrators, etc….. It ain’t all about money.

    Ever hear the saying “do you want to speak to the doctor in charge or the nurse that KNOWS what is going on.” We have NOT HEARD from enough nurses. You might be shocked at what they tell you. Many do not speak because they could, do and have lost their jobs. Let’s hear from the folks on the front line!!!!!!!!

  • Laura

    A couple of people have mentioned tort reform. It’s promoters usually promote capping financial judgements against those found guilty of some kind of bad behavior such as neglecting duties expected of a health care provider.

    I would suggest a different kind of malpractice limit. MN has a very low rate of frivolous law suits because our courts set the bar high BEFORE allowing a case to get to court. This limits cases and possible fines to those who truly are bad actors in the system. Those doctors, insurers or clinics/hospitals who know a patient will likely be harmed by their actions, actions often taken for financial gain (eg. institutions that won’t perform treatments known to be safe and effective but are expensive or not approved by the insurer) or due to personal values lapse (eg. performing surgery while drunk) MUST face financial penalty if they are proven guilty. Those whose behavior is within approved practices and doesn’t meet such standards for penalty MUST NOT operate in fear of unfounded legal action. To be brief, we need a good bouncer at the door of our malpractice courts rather than allowing everyone in then charging all exorbitantly for drinks.

  • Victor Urbanowicz

    The rightist opponents of healthcare reform are correct about one thing: significant reform will hurt the insurance companies and I, for one, will enjoy their dying screams. They are piling up obscene profits and rewarding the physicians on their payrolls for denying care even at the cost of patients’ lives. We finance their prosperity at the cost of a high infant mortality rate, almost the worst in the industrialized world, and lower life expectancy and quality of life than many western nations. It is appalling that more Americans don’t see the situation clearly.

    This all can change if our elected representatives get the word that millions in campaign contributions from the insurance companies will not buy our votes. Big money HAS been defeated in the past.

    We put brewers and distillers out of business with Prohibition. Why not insurance companies?

  • Isaac Muhammad

    The Somali community here in Minnesota and everywhere
    in the world is outraged by the despicable act of terror carried out by the
    criminal Al-Shabaab terrorists at Westgate Mall in Nairobi. As a member of
    Somali intellectuals, I would like to send my condolences to those who died and
    wish the quickest recovery for those injured at this horrible tragedy.
    Al-Shabaab is a color and a religious blind, they will kill anyone who stands
    on their way to terrorize the world and invoke their fundamental ideology.

    Al-Shabaab has been terrorizing the Somalian people
    for the last eight years and now started to spread their act of terror
    throughout the region. We as Somalians
    feel the agony that our sisters and brothers in Kenya are going through and we
    stand by them to defeat Al-Shabaab in any form, shape or means possible. We urge the world to unite the fight against
    these criminals and help African peace keeping forces, Somali federal forces
    and the newly formed Jubbaland forces to defeat and wipe Al-Shabaab out of the

    Thank you,

    Isaac Muhammad