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By The Commonwealtlh Fund

Most Americans see the need for fundamental changes in the nation's health care system, according to new survey findings released today by The Commonwealth Fund Commission on a High Performance Health System.

The results, reported in Public Views on Shaping the Future of the U.S. Health Care System, by Fund staff Cathy Schoen, Sabrina How, and colleagues, indicate that change is desired in nearly every aspect of health care. Forty-two percent of respondents said they had recently received poorly coordinated, inefficient, or unsafe care. The survey also reveals strong public support for efforts to improve care coordination, as well as a shared belief that expanded use of information technology could improve care.

Additionally, paying for care is a major concern: about half of adults in middle- and low-income families reported they have experienced serious problems paying for health care and health insurance. Not surprisingly, expanding affordable coverage and controlling costs, they said, should be top priorities for federal action.

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Aug 22, 2006 2:43:14 PM
Penny Roth says

I used to be opposed to the idea of national health care. I believed it would take away all the options americans have come to expect. We all want to get the best treatment medical science has to offer right. Now I say bring it on, National Health Care for all. Certainly when it is implemented we will have to ration care. There will be waiting lists for surgery. If you need a hip replacement you will have to wait; weeks maybe months. Need quadruple bypass we will try cardiac rehab first. Need a bone marrow transplant and your 70 years old too bad. So if it is a right for every american to have free health care, believe me someone will pay somehow. When we ration health care. What will americans do then? Have something new to complain about.

Aug 23, 2006 4:00:47 PM
samantha says


I have lived in several countries where the national health plan is in place. It does not serve the people very well at all.
I believe that people need to learn to be more responsible.Period. I do feel badly for the mother with 3 children, a minimum wage job and no insurance, guess what? Nobody forced her to make the bad decisions that led her there. Why is it anybody elses responsability?

Also, when do we say 'when" on lifesaving procedures? We have to spend our money more wisely. just because it CAN be done, does not mean that everybody should have a right to all procedures, or life extending care...we need to get real, real fast!

Aug 26, 2006 12:31:01 PM
alheider says

I used to feel just like Samantha - the "pull yourself up by the bootstraps approach". You created the problem - you solve it. However, there are several problems with that line of thinking - and they are problems for all of us.

1. The innocent children will not have health care unless their caretaker does "pull themselves up", a chance we should not be willing to take.

2. The woman, should she actually require emergent care, will have the care and we will end up paying for it.

3. The woman may not receive preventive care (for example a pap smear which could prevent her from getting cervical cancer, dying, and again costing us lots of money (medical expenses and childcare)).

4. The woman and her children will congest the medical system, receive inefficient care, and lead to great frustration on the behalf of her providers, who will often care for her despite nonpayment. That doctor just may see any one of us next and their frustration does affect our care.

5. Because the woman is marginalized and in financial desperation, she may be more likely to sue. Medical malpractice drives up the cost of care, affects care for everyone through the practice of defensive medicine, and, again, drives doctors crazy.

6. All of this will result in a less qualified application pool for medical schools and erode the quality of health care you receive.

The list goes on...I am sure I have forgotten something.

Just the same, I do believe in personal responsibility and think that entitlement programs often erode the self-esteem of those they are meant to help. I get angry when people end up getting free care, because they are unwilling to pay for insurance. Especially, since many of those people could pay something, if they really had to.

That is why I am in favor of universal health care with the ability to opt our for "botique care" for those who wish to do so. We can then pay for some of the goods and services we would like to have, but don't strictly need (like maybe a luxury labor and deliver suite and one-on-one nursing). However, we will all get what we do need (like prenatal care).

I think we should pay for health care through a consumption tax. We will all be contributing then, through the goods we buy. We all pay and we all get quality care. If we have more money and but more things, we contribute more, but we still all contribute.

For those of us who still feel a little uneasy about the handout, we have the benefits to consider.

1. No insurance premiums to pay.

2. No added cost to the things we buy (like cars) due to the need for the company to pay insurance premiums.

3. Nobody with an insurance company telling us what care we can and cannot receive.

4. Ultimately, in my opinion, better quality of care and happier,thus better, physicians.

I am sure these points will be disputed...but I would love to hear what others have to say.

Aug 29, 2006 10:54:56 AM
Kathleen says

Alheider: Take a look at the Archimedes website...former governor John Kitzhaber, MD, talks about the public school model as applicable to a concept for universal health care insurance: a defined benefit created with public funds -- every one gets the defined benefit, when state funds are low, the benefit may decline but no one is cut from the program, people can use private dollars to increase their benefits and send their kids to private schools or get tutors (the equivalent of boutique health care) but they still contribute via taxes to the public health care system.

Aug 29, 2006 12:58:32 PM
Angela Heider says

I like the public school system as a model for health care. One of my favorite things about it is that people often bring it up as an example of government gone wrong. "Why would we let the government control health care?" they say. "They have fouled up everything else, like the public school system." Then I like to ask them what they think would happen without the public school system. It seems to me, we would have probably about 40 million children with no means to attend school. Many more would be without college funds in the abscence of government support.

So...I think we are better off with public schools - even if they are imperfect. The same can be applied to health care.

I agree with you about the beauty of a system that allows us to set our limits for health care spending. We can elect to continue to spend 16+% of the GDP and probably get comprehensive services. We could elect to spend less and have less coverage. The key is that we would all have the same level of adequate coverage. As in the public school system, we would have to be wary of the rich moving away from the public system and then underfunding it. I think we would need an ethical board to ensure that the system was indeed providing good health care for all of those covered.

Oct 3, 2006 3:25:22 PM
Evan says

Another unreported benefit to universal health care would be upward mobility. My insurance covers myself, my wife and two young children. It has been my dream to go back to school to receive my bachelors degree and eventually my MBA. However, I cannot reduce my work schedule because we need the insurance, not the money. I have several other late 20's friends who are in the same situation. I'd be happy to be a waitlist to see my doctor once a year, if it would help me gain the means to afford the boutique care.

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