July 31st, 2009
11:54 AM ET

Would health care costs under the public plan be too steep?

By Stephanie Smith
CNN Medical Producer

Three words - health care reform - have transformed the national conversation. And with the vigorous debate elicited by those three words - in Congress, on newscasts, on blogs, in opinion pieces, average Americans are coming out of the woodwork to tell their health-care horror stories.

One of those stories came to our health blog from P.J. May of Ohio, who is the primary caregiver to her 87-year-old mother, who suffers from Alzheimer's disease. A few years ago, before taking on that role, May was working full time, and had what could be considered a decent health-care plan through her employer. However, as her mother's health deteriorated, May made the tough decision to cut her hours to part time to help care for her, and with that she lost her health benefits.

Next, May. did what many in her position would do - she shopped around for private health insurance. She found a plan, but for her budget, the payment was going to be steep. You see, working fewer hours, May brings in only $700 a month, and $213 of that goes toward private health insurance.

May’s situation probably sounds familiar to many Americans who purchase private plans. She's paying an exorbitant amount on premiums, and on top of that, out-of-pocket expenses. In her case, premiums alone constitute about one-third of her income.

She, and many other bloggers, viewers and tweeters writing to us want to know: Will a new public health care plan be affordable for me?

"I don't know if Obama's decisions are going to help me or make it worse," May wrote in an e-mail to CNN.

To find out more about the cost of health care under a public plan, we pored over the 1,000-plus-page health care bill currently in the House with policy expert Kenneth Thorpe of the Rollins School of Public Health at Emory University in Atlanta, Georgia.

Thorpe crunched the numbers, and what he found may not match most people’s idea of “cheap.”

The uninsured, along with small business owners, would get first crack at purchasing a public plan, with the government providing subsidies to reduce costs.

Under the House plan, as it is drafted today, May's entire health care bill would be subsidized by the government. She would not pay a dime out of pocket for health insurance. So, for her, the news is good.

As income creeps above the poverty line, the cost of health care would also creep up, on a sliding scale. So an individual making $21,660 a year, according to Thorpe, would pay $1,083 under the House plan, while an individual making $43,320 would spend $4,704 a year, which is $392 a month.

The same goes for a family of four. At the lower end of the spectrum, a family of four with an income just above the poverty line - $44,100 - pays $2,205 under the current House bill, while a middle class family, making $77,175 a year would pay around $77,15, which is about $650 a month.


A caveat, however, is that those figures include co-pays and out-of-pocket costs.

Still, even considering subsidies, the cost of the public plan is concerning to some legislators. They say that the cost burden on the middle class is too high.

But Thorpe says to keep in mind that on average a family of four today pays around $12,700 a year for health care - more than $1,000 a month.

"[The public plan] sounds expensive, but it's thousands less than what the average family of four pays right now," said Thorpe.

What do you think? Does the public option sound too steep for your budget, or is this alternative better than what you're paying now?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

soundoff (49 Responses)
  1. Robert

    Typical top down approach!!!
    As long as the base cost (bottom-up) approach is not used any result will still be unmanageable.( way too many insurance options)
    In Europe they forced the doctors to come clean with real !!!!!! pricing.
    Doctors and hospitals here can use all kind of methods to cash in; There is no oversight whatsoever on billing, Again start at the base!!!!
    My experience in Europe and Canada shows that the U.S. is way behind in any decent care let alone the administration and computerized "uniform" medical administration.
    No country wide "norm's" or uniform regulations etc.
    It is a total mess, asking for corruption.!!!

    July 31, 2009 at 12:25 | Report abuse | Reply
  2. Nick Rouleau

    I applaud President Obama's efforts to make tobacco products the responsibility of the FDA.
    I have a few suggestions:
    Have the FDA and Congress mandate that:
    1. Reduce toxins/additives/nicotine levels in all tobacco products by 10% each year, starting imediately, and
    2. In ten years, the American public would be weaned off of all tobacco products and by reducing the toxins, tobacco-related deaths would be lessened as the toxins are reduced.
    3. Tobacco-use-related medical costs may drop annually at a rate similar to the reductions in toxins/additives.
    4. Reduce government aid to tobacco-producing states at the same annual rate as the toxins/additives/nicotine levels are reduced

    July 31, 2009 at 12:53 | Report abuse | Reply
  3. JD

    I pay nothing for health care now and have not had insurance since I lost my job in December of 2007. But I have spent most of my adult life without health insurance, so what else is new for me. I worked for many years in the food service industry and then as a temporary, so no health insurance there. My last position, was the first to provide any type of health care coverage for me. Once that job was gone, i didn't even try to keep it with COBRA, since I could not afford the payments. Personally, I don't expect to have healthcare again until I hit 65 and get Medicare, assuming that is still around; since I will be right after all the baby boomers have gone on it and most likely bankrupted the program. I may die with never having healthcare again. And should I ever be diagnosed with a serious illness, at this point I will die; becuase I refuse to mortgage the rest of my life for hospital bills that I cannot pay.

    Oh, and despite the talk in DC, I don't think any of the plans will work since our country will have to make a major shift in how we view healthcare. We will have to stop thinking that we need the latest and greatest pill, when an older one would work just fine for us. We will have to stop giving pills for everything and realize that for some things, changing the way we live or learning some coping strategies (for kids with ADHD and ADD) will work just fine. We will also have to realize that not everyone needs surgery, when medication and lifetyle changes will treat the condition just as well. We will also have to realize that doctors can't cure everything and that they do make mistakes. So no more nuisance claims that the malpractice insurance pays that causes the rates to rise for an entire profession and accross the board for everyone else. Until we as a society are able to do this, then anything the government does just changes who pays, it won't reduce costs.

    July 31, 2009 at 14:28 | Report abuse | Reply
  4. Jane

    I go to local sliding fee clinics since I do not have healthcare. I could not afford to pay at all right now as the above projected costs are too much for the current income I earn. A $1,000 is alot for someone earning 20,000 a year as many other living expenses are way too high for this income to be liveable. The idea that the government could penalize us for being too poor to "buy" healthcare really enrages me. We are already too poor so why punish us for that?

    July 31, 2009 at 15:35 | Report abuse | Reply
  5. Sarah

    I am a single 20-something who is a member of the middle class. I work for a medium-sized company. Even with all the reported problems with healthcare and rising costs, I still only pay 40 bucks a month for healthcare. I have a $1,000 deductible that I've only exceeded one year out of the five years I've been employed (thanks to a horseback riding accident). I paid for the accident out of my savings with no trouble. I have a great doctor, and I also take advantage of an HSA. I am very concerned about healthcare reform and the burden it will put on the American people. I don't see how government-managed healthcare will be any better than what we currently have, and I think that there are other, less radical ways to fix problems in our system.

    July 31, 2009 at 15:46 | Report abuse | Reply
  6. Sarah

    The idea that all doctors are greedy or that all insurance companies take advantage of people or that Americans always go for the most expensive care seems a bit too broad and cynical to me. There are plenty of good doctors who start with the least expensive, least invasive procedures/medications first. There are plenty of good cases of insurance companies doing their jobs (even if their paperwork does drive us crazy). There are many Americans trying to take of their own health (look at the boom in health and wellness products and organic food). Even if our current system really is full of evildoers (which I don't think it is), I guess I am confused as to why some Americans think the government is going to be more saintly than the parties currently running the system?

    July 31, 2009 at 16:26 | Report abuse | Reply
  7. Richard Uber

    My wife and myself just exhausted our cobra coverage. We both are uninsurable (I had a full cardiac arrest, and a pituitary adenoma, she has fibromyalgia) since we are both over 60 the high risk insurance pool from the state of California has a monthly premium of $2,883.95 or about 34,000 a year. And for that you get a maximum of 75,000 a year of coverage. So for us Health insurance could rapidly become a distant memory. And based on the news which is incomplete at best, will I be taxed on top of that for a pathetic insurance that costs more than 25,000 a year? It sure does make one wish they were Canadian or European.

    July 31, 2009 at 21:52 | Report abuse | Reply

    every body should see this. Highjacking healthcare by the insurance companies


    July 31, 2009 at 23:58 | Report abuse | Reply
  9. Krista

    It would be helpful to have some data:
    * What percentage of an insurance premium goes to pay the provider?
    * What percentage goes to –
    – Administration
    – Marketing
    – Political contributions and lobbying
    – Financial investments?
    * What percentage of claims –
    – Are refused at least once before being paid
    – In cases in which the company finally agrees to pay, what is the average delay time and what is the average total legal cost?
    – Are denied completely
    * What percentage of claims are denied because the payer claims to have identified a previously unknown "pre-existing condition?"
    What are similar data for Medicare, Medicaid, and the VA?

    August 1, 2009 at 09:10 | Report abuse | Reply
  10. Linda M. Nenn

    Dr. Gupta, I am a 59 yr. old disabled American. In 1992 I suddenly became Ill. The medical diagnosis: inner ear inflection. Take this antibiotic and you'll be fine. I was a full time teacher at this, but on summer break, finally taking a summer off after 5 or 6 yrs. of nights and summers squeezing in additional courses that would add Health Ed. and Adapted Phys. Ed (SDPE) to my credentials and on track to finish a Master's Degree in Special Designed Phy. Ed.

    As the weeks passed and my condition worsened, primarily extreme vertigo, followed by "bone" and mind numbing fatigue, neurological disturbances, short term but frequent memory loss, daily flu like symptions. Again I was told it was inner ear issue and more antibiotics. With my background in the physical sciences, physiology, anatomy, health care services, etc. I fully understood the challenge a host of symptons but no definitive causative diagnosis presented to my primary care physician. But I was covered by a very good insurance policy negotiated by my Union, and every referral to a myriad of specialists was completely covered. Note: The insurance was and still is administered by a HEALTH TRUST My employer paid the bulk of the policy cost with an increasing share picked up by employees.
    By August 1992 I had to let my school district about my still undiagnosed illness. Superintendent treated me wonderfully, a hard thing to do when you are a dept. of One. I had to then pay %100 of my premiums, about $350/mo for single coverage. I was happy to do this.

    One month turned into one year, then another. Long term disability was running out. I had gone to MAYO, twice, still no diagnosis. I didn't even know what LTD was before getting ill. Now I had to apply for SS Disability, citing CFS as diagnosis. When first diagnosed, in 1993, I was ecstaticI Now fix it!! I had heard horror stories, but was approved in less than 2 weeks. I continued to seek out any reputable MDs who thought they could "cure" or help me. I just wanted to return to work, but every time I tried I just got sicker. Bright lights, loud noises, trying to sustain physical or mental "work" triggered every symptoms to get worse. Then" heart" sypmtoms began. Finally one ER MD told me I Panic Attacks and I probaby was causing the attacks to avoid going back to work. I knew that wasn't true. The number of pills I was taking daily was daunting.

    After 3 years my Insurance Trust said I had to apply for Medicare. I was accepted, around age 45. Emotionally it hit me hard, as it felt like the illness was beating me into submission, even defeat. I did not and do not want to be sick, especially with an illness that, I've found, most people, including the medical profession, don't believe really exists as anything other than mental problems. My point:

    In short, I think I've had a forced crash course in no insurance, private insurance, COBRA and then Medicare. I was NEVER denied access to doctors and the medical establishment. PT, OT, Osteopathic medicine, dieticians. Besides living with this enigmatic, frustrating and debilitating disease every day of my life, the hardest challenge was when my Union negotiated "cheaper" plans, for a while, that were PPOs, considered HMO, IPO. But I was so lucky I could buy insurance of any kind.

    Now, on Medicare, I have the best access to medical care I've had, other than possibly when my Primary physician was my neighbor.

    My parents used Medicare and a supplemental plan since turning 65. Dad died last year after fighting cancer, severe osteoporosis, CHF and other medical issues. He was never denied excellent care. Since on Medicare I've had bilateral knee replacement, Cardiac arrest, doulbe bypass and now just diagnosed Chronic Lymphocytic Leukemia. Only one private practice, the Diamond Headache Clinic in Chicago, did not accept Medicare assignment.

    Every time I hear a politician say Medicare is a failure, unsustainable, Government rationing, etc. , I want to smack them. Instead I write yet another letter.

    My brother spent 30 years in the Navy, where his and his family's health care was provided through a government health plan. Now, working for UCSD, in a skilled trade, he is at wits end trying to find his way through the labrinth called private pay group insurance. The docs and facilities he can use seem to change almost weekly. It's crazy!

    My younger sisters have had to avail themselves of Wisconsin medicaid at different points in their lives. One doing fine now. The other can't afford to see a doctor and even had to file for bankruptcy, when her job terminated, then another job and another job. She makes $10/hr now and her job offers health insurance with an approx. $5000 deductible.

    Want an expert on Health Care? We are your family. After 17 years of too, too many doctor and hospital experiences I don't need 1000 plus pages to address our health care crisis.

    1. Medicare reform: US government, Dept. of HHS, I imagine, given legislative ower to negotiate pharmaceutical price caps. Current reimbursement level be standardized country wide. Things like $7 x-ray have to be reevaluated and new price points set, reflecting a reasonable fee for service structure. Then these fees must be indexed for inflation or deflation every 5 years.
    2. MEDICARE PART D: Laws changed to require government negotiated (set) price controls. Five year proprietary protection for branded new drugs. Proposed 12 year plan of action on meds: ridiculous.
    3. Medicare II: those 65 and other. Same plan as Medicare, but premiums based on a reasonable premium schedule. Look at the WEAIT Trust or Kaiser Permanente (sp?) as non profit insurance trusts, not beholding to stockholders. HMOs sadly showed us exactly the face of rationed care where the bottom line dictates who gets past the gatekeeper. I'd much rather have a bureaucrat, also known as medical practitioners, setting standards of care rather than stockholders. Businesses, large or small, a Wisconsin bar keep and his family, a family farmer or IBM could opt in or opt out. If the individual pays their own premiums, premiums would be a non itemized deduction on Fed/state income tax. No income tax states: deduction on property taxes that will be reimbursed to taxing entity. Biggest savings here would be anyone joining would, at max, pay at a group plan cost regardless of pre-existing conditions. Companies that offer plan as fringe benefit would receive tax credits. Same with for profit plans. Companies, individuals, families would have to opt in or out for everyone, as is the case today in large companies. Small businesses would not have to deal with huge costs because of small no. of employees. Medical related expenses greatly reduced as no need to have extra employees just to wade through the varagies of 100's of individual plans.

    Okay, time to rest my brain and take firstt nap of the day.

    Best regards,
    Linda M .Nenn
    1859 Parknoll Lane
    Port Washington, WI 53074

    I used to be one of those wise women that members of Congress seem to hate.

    August 1, 2009 at 11:01 | Report abuse | Reply
  11. Gilda Aitchison

    What the government wants to do with our health care is the have "as many private carriers" join in their plan and in turn, the government will outsource the management of these plans. This has already been done since HMO's came into the picture. Ask a Medicare patient how many contractors (Medicare Advantage Plans) their claims are processed through? Current plan never worked and will not continue to work. There are abuses in the present system allowing providers to receive multiple payments and insurance carriers to pay multiple times for the same claims. (This is why most of us pay those $12,000.00 premiums a year). Reform needs to start at the bottom. Single pay systems or coordination of benefits; honest and thorough oversights with no protection under the ERISA umbrella (so the US Dept. of Labor can do its job)and no
    transparencies. Real numbers on real claims so debits can equal credits. We have been paying those $12,000 premiums, plus $7,000+ out of pocket, plus $500. per prescription. What is this reform going to do for us???????

    August 1, 2009 at 14:35 | Report abuse | Reply
  12. Sylvia

    I agree with Robert. I experienced European, so called "socialized" medicine first hand this year since my father spent 3 weeks in a hospital there. We should demand a single payer system, paid for by citizens' taxes. And we should demand an amendment to Constitution to make it a human right. Single payer system is the only solution to end fraud and corruption and what is a "multibillion dollar milking " of our current sick care system by "sick care" providers.
    Doctors in single payer systems are paid salaries regardless of how many colonoscopies or other procedures they perform. Access to care seems simple, people get their own medical records without even asking for them. Medical information flows freely, doctors educate themselves, share knowledge and consult a lot among themselves. Not so here as doctors have to "guard" their patients in order to bill insurance companies. They would provide much better care under single payer system.
    Americans wake up! Stop believing politicians! Fight for yourself, not for insurance companies. Don't you know that politicians don't care about your poor health, unemployment and poverty and do everything in their power to address big businesses' needs? If they cared, why would we have so many uninsured, unemployed and poor in the richest country in the world? Think about it! SINGLE PAYER universal health care system is THE ANSWER! It will make American families secure and work force more mobile and will save American businesses. It won't cost more than it costs now! How can we agree to pay 30% of all health care costs to insurance companies??? Lets wake up now. This is our only chance!!!

    August 1, 2009 at 17:18 | Report abuse | Reply
  13. Dan

    I am a physician and general surgeon and I am certain that health care costs without the public option will be higher for most individuals and to the federal budget. It is already about 17% of GDP and heading rapidly toward 20%. It boggles the mind to think that many believe the myths being perpetuated by many of the Republicans and the uninformed. These myths include such scare tactics as the risk of government takeover, radical rationing of care, euthanasia, etc.

    The facts are that we have rationing under the current system. Private insurance is already making important health care decisions for those fortunate enough to have coverage when they deny coverage for medical care that has been recommended by a physician. They ration care by denying coverage for pre-existing illnesses, or when they terminate coverage for patients who develop a catastrophic illness or have a major accident. They ration care when they deny convalescent or rehabilitation care. They do this while maintaining between 15 and 20% administrative costs, and paying off stockholders or building up record reserves.

    Private insurers do not control health care costs because they simply pass them off to employers and employees. This results in higher premiums, higher deductibles, higher fringe benefits costs and lower take-home pay for American workers. On the other hand, a public option, like the very popular Medicare, will keep adminstratve costs well below 10% and force competition. This system can also force health care cost savings by moving away from volume based reimbursement to value based, bundled payments to providers for health care. It is almost funny, but in reality sad, that many of those who complain of the possibility of government involvement in health care would never think of ending Medicare, a highly efficient government-run health care system. Nor would they consider ending the Veterans Health care system, also government run and of high quality. It will be a sad commentary on the state of this nation if we continue to treat health care as a commodity and fail to join the rest of the modern free world by reforming a broken system.

    August 1, 2009 at 17:50 | Report abuse | Reply
  14. Walk in my shoes!

    What needs to happen, while congress is enjoying their summer break, is that they need to volunteer in various healthcare settings.

    Walk with me for a week in my ER. It'll open your eyes. Spend a few nights at your local free clinic. Follow a CNA in a nursing home. Shadow a family medicine doctor, watch what they do, listen to them argue with an insurance company.

    Have a town meeting in your state, and ask people to come and share their healthcare stories.

    Go sit with a patient, in their home, who is dying because they couldn't see the doctor soon enough, couldn't afford the chemo, or life saving surgery.

    I challenge our representatives to do this. Go to a large northeast city, and hang out with a diabetic who has no heat because he bought insulin. Speak to the homeless guy who fought in one of your wars, lost it all, and came back to a country that wouldn't give him good mental care.... a country that provides a run down hospital with toxic mold, toxic enviroment, and red tape to 'help' him. See the 24 year old in my ER who is on disability... who has no doctor, lists no medical problems, and wants pain medication for the sunburn she received hanging out at the public pool all day. Watch the nurse in the same ER dying from cancer who won't qualify for disability until long after she has passed on.

    Spend some time in our shoes. Walk with us. Hang out with the autistic kid who can't get therapy that may help them live independantly as an adult. Watch us have to call the VA.... 200 miles away.... to get approval to ship a war hero to a local facility because he's having a heart attack. Please note that it takes over four hours to get someone at the VA to review his case, but our hands are tied because the patient won't agree to being shipped to help save his life because he can't afford the bill if we don't have VA approval. Ride with an ambulance for the weekend. Stay awake for over 24 hours, and risk your life going into bad neighborhoods, ride up mountains covered in ice, bring in the DOA, the drug seeker, the person having an acute heart attck that probably started two days ago but had no-one to help. Watch the paramedic intubate their child's best friend.

    Do this, and then come back to congress in the fall, and fight about healthcare reform. Do this, and think of the people who elected you when the lobbyist spouts off political nonsense to you because his insurance company or pharmacuetical company is hell bent to keep their record-breaking profits.

    Climb down from your ivory tower and realize that people are fighting for their lives, and losing. This is happening in YOUR country, YOUR state, YOUR hometown. Consider seriously what kind of country you will leave to your children, your grandchildren, and the people who voted for you.

    After all this..... see if your can look at yourself in the mirror for a full minute.

    August 1, 2009 at 22:02 | Report abuse | Reply
  15. Kris

    Thanks Mike. Everyone needs to see that.

    I wish more people would talk about Wal Street's most important metric for success of an insurance company. The Medical Loss Ratio is the only thing insurance companies will ever be held accountable for as long as they are privately held companies. On Wal Street they want to see the lowest percentage of revenue possible going towards medicare. 15 years ago the average MLR for insurance companies was over 95%. Now it is around 80%.

    Someone needs to explain this to people. Insurance coverage is just like gambling. You know the casino has got to win over the long run but you want the casino to win as little as possible. That's why gamblers in the know look for a game that pays out 99% or more. The casino will take all the players they can get at an 80% payout. That means the other 20% is going to the casino. Right now we have billions of dollars that should be used for health care going to insurance companies and only 80% of it goes to medical coverage.

    As a comparison, Medicare has an overhead rate of 3% so 97% of the money goes to medical coverage. These are real numbers, not rhetoric.

    August 1, 2009 at 23:29 | Report abuse | Reply
  16. Joyce Ryan

    I am a fan of Dr. Gupta and am watching the US debate on health care from a Canadian perspective, and with great interest. After watching the "Reality Check" on Canadian health care, which mirrors that in many European countries and the rest of the developed world, I am appalled enough to comment. Please check out this article "A Reality Check on a Reality Check" to see the facts of the situation, and then judge for yourself.


    August 2, 2009 at 08:21 | Report abuse | Reply
  17. Scott Trent

    Ok, just saw some stats on CNN about the current Bill that is floating around the House.

    If you are a family of four and you make $100,000.00 a year, your 'public option' health care plan will cost you over $11,000.00 a year.

    If you are a total slacker dweeb who has spent his or her lifetime making 'bad decisions' like staying up all night and doing drugs and not holding a job and you make $14,000.00 a year, your 'public option' health care plan will cost you $0.00 a year...

    My current health care plan costs me about $100.00 a week for my family of four. My 'Obamacare' plan will cost me $1,000.00 a month!

    What is affordable about that?

    Why do Democrats punish achievment and reward slackers?

    These Democrats must be stopped!

    August 2, 2009 at 09:08 | Report abuse | Reply
  18. deanna harner

    The cost of health care today is too high for those of us with company health care plans. My daughter has a rare disorder, PKU, and insurance companies do not cover it. Without treatment at birth, the children will not lead normal, productive lives...but insurance companies get to decide who lives, and who lives well! Disgraceful! UnAmerican! and NonChristian!

    The other side uses "socialized medicine" as a weapon against national reform. My husband (37) already has to wait 3 months to see a specialist for his hip replacement and another 3 months for the procedure! My daughter's medically necessary treatment is excluded in "self-funded" plans because of a federal law loop hole!

    If you have coverage, and it doesn't cover your families serious medical conditions, "socialized medicine" isn't scary.....I only get scared when I think about another 10 years of insurance run health care plans.

    August 2, 2009 at 14:51 | Report abuse | Reply
  19. Tracy Hammond

    If CNN reporters do not start calling members of Congress on untruthful statements they make about healthcare proposals that negligence will harm the US.

    August 2, 2009 at 15:12 | Report abuse | Reply
  20. Diana VanSlyke

    I hope and pray that health care reform passes. I think the current estimated cost for people is actually lower than reality. My husband and I are on the lowest plan available with our insurer and it still costs us over 1300.00 a month , with a 3,000.00 deductible, and we have no serious health issues. We have tried to get coverage with 3 other companies in the last 3 months and have been denied for very minor reasons. Only people who have coverage that is paid for by their employer are against reform.

    August 2, 2009 at 15:18 | Report abuse | Reply
  21. Lauren R. Wheeling, WV

    Dear CNN,

    At first glance, $1,000 seems like a lot for someone making $21,000 a year. It's pushing it, to be sure. But I was paying $124 a month for my Blue Cross coverage, and I only make $290 a week before taxes. And that was for 80-20 coverage. So, I'd be more than happy to switch over, if government insurance covers everything.

    Lastly, we MUST develop a contigency plan for affordable dental care. Heart disease is expensive, yet many health problems are attributable to dental disease. Without dental care, the costs for other, preventable, medical conditions will continue to skyrocket. Can CNN tell us if the government has any plans to include dental insurance in this, beyond pulling teeth, which merely releases billions of germs into the body and does not really help? Thank you.

    August 2, 2009 at 16:27 | Report abuse | Reply
  22. Eileen Hardaker DeVore

    I feel I am one of the fortunate ones. I am ex-military and get most of my medical care from the Veterans Administration hospitals. People complain about the VA but I feel I have been treated good. I say I am fortunate because the cost of insurance is ridiculous. I believe this administration has done more to help the average american then we had in the last 8 years. The problems we are having with our economy is just left over from the last administration. It is refreshing to see that the average worker is finally going to have a break. The republicans (upper 1%) for the most part are the people who have the most money and do not want to help the poor. That is why we are in the shape we are because the wealthy scoffed up large profits off the backs of the every day worker. It is time that everyone gets a fair piece of the pie. Some say that if you work hard, you can have the same but that is not always true. In reality most people are blocked from getting into the upper levels of our US society. Only a few rise with the cream of society. It is, who you know and not what you know that has always counted

    August 2, 2009 at 17:23 | Report abuse | Reply
  23. Phyllis Ryan

    I agree that the goverment has forgotten all of the working class people. All the bigwigs want their big raises, benefits, perks, etc., while the "little" man is forgotten.
    What has happened to our elected officials that forget they work for us, we have made bad decisions as to who we elect. They fly their private planes, all trips (vacations) for the most part are paid by us, the very people who put them in office and now pay for their grandiose life styles.
    Shame on them & no one lives forever. I feel they will pay in the thereafter.
    Unfortunately, that helps no one here and now who is feeling the pain of seeing a loved one suffer because of lack of good health plans, doctors (who seem now to be "specialists" & those too busy to take on patients who can't pay cash or do not have insurance.
    Our country is going to hell in a handbasket because of the uncaring, greedy "docs".

    August 2, 2009 at 23:19 | Report abuse | Reply
  24. Delores Boone, R.N.

    J.D said: "I may die with never having healthcare again. And should I ever be diagnosed with a serious illness, at this point I will die; becuase I refuse to mortgage the rest of my life for hospital bills that I cannot pay. "

    JD, I hate to tell you that if you get really sick you may not have a choice. For instance, hit by car, have stroke, etc., where you cannot control the outcome. To the hospital then to a nursing home for a few months or longer. What happens? No bank account or insurance? No worries. You'll get go on Medicaid if you are under 65 and think that is taken care of. HOWEVER, they only pay so many days a year, same as Medicare. After than your house is attached and when you do die the first portion of the sale of your home goes to the government.

    You are far better off to have a choice of other insurances if you can, because reform is needed and is coming. Once it begins, it can be improved as others know. But the first step is to begin.

    We already have forced government insurance, to some degree, as I have just laid out. It's far better to have reform out in the open and mold it to work better than what is out there now. As an R.N. I have read the just of many plans and President Obama's plan is the most workable I have seen.

    Opponents have told so many lies about it, especially through email forwards. Think of this for a moment: If anyone sends you an email with a Internet address link for you to look at the scary things this plan will do ask yourself this question: Is this link to the actual bill itself on a government site ( xxxx.gov) or does it take you to some other site that is discussing and showing the bill? If it is not the government site then you can bet your sweet bippy that it has been altered ! Otherwise they would have put the actual government link to the bill itself up.

    Beware the trick of shifty politics. Not all Conservatives act like Christians when it comes to getting what they want.

    August 3, 2009 at 01:35 | Report abuse | Reply
  25. Jay

    This entire debate on Health Care Reform truly does not make sense; the rich should not be penalized and expected to pay for the average man's health care. The rich also work hard to provide for their families and do not expect others to pay for their health care; we should not be expected to pay for other's care just because we studied hard in school, worked our butts off and fortunately came out on top. Those people who just sit at home, unemployed ( this is more directed towards those who choose to be unemployed) and living off of welfare do not deserve free care under Obama's plan. I am a strong supporter in Obama but this Health care reform should we rejected. I am truly hoping that this will not be passed through congress because my taxes are high enough. I do not want to pay for other's health care while also paying for mine; its not logical nor is it fair to those who have strove to make themselves in the middle – upper class society. This system will without a doubt be abused and add yet another problem to our government's increasingly long list of dilemmas.

    Instead of giving healthcare to all, medicare and medicaid should be improved. Those are failing programs that hundreds of thousands of people depend on; why introduce something new when there's other things to be fixed? Not to mention social security; as a young member of society, my parents will be without social security by the time they retire; they're still young late 40s and 50, but god forbid what if something happens to them? The government will not be there to help them and unfortunately, I won't either for the next four years. There needs to be reforms and they need to be done now.

    Ah, this is a never ending cycle with our government, its getting too large, too corrupt and too out of hand. What we truly need at the moment is a governmental reform, cut out the extra costs (lobbyists, branches which are minimally productive)

    August 3, 2009 at 10:30 | Report abuse | Reply
  26. Krista Maki

    In response to Jay, who opposes any tax increase on higher earners. Think about what higher are paying today because of the broken system we have before complaining too much about paying taxes no higher than on Reagan.

    Your premium dollars are paying for the uninsured who come to the emergency room- and only when really ill and expensive to treat; damage caused by drug and other treatment errors because of lack of computerized records, lack of computer control of hospital pharmacies, insufficient use of evidence based medicine; and high insurance company costs for administration, marketing, lobbying and profit. And the high earner is just as likely to be denied coverage for pre-existing (or, by a large stretch of the insurance company imagination, pre-existing) condition.

    I have collected too many anecdotes among friends and family about wars with insurance companies, and the cost and physical damage of badly performed (for the reasons mentioned above) medicine to think that, if we are tough and demanding enough – and counter the arguments of the insurance companies and their cronies – we can make something better.

    On a positive note (v.v insurance companies), I did hear a couple of very good presentations by Non-profit BCBS execs from Mass. and Minn., who talked about trials of new payment methods to replace "fee for service" that were reducing costs, improving payment to care providers, and improving care. The new model is a ray of hope!

    August 3, 2009 at 13:53 | Report abuse | Reply
  27. Thomas

    Well, judging by comments all over, it appears that the smear campaign is working.

    The issue is so clouded that no one is sure what's going on. Congress is in the pocket of big pharma.

    Face it, peeps. We have rationing now. And it looks like it will continue. All the scare tactics about "socialized medicine" seem to be carrying the day.

    As long as we have a pay per procedure system, we will have no reform.

    August 3, 2009 at 15:59 | Report abuse | Reply
  28. Margaret H. Souther

    I have read with interest with iterations of the Health care bills. What troubles me is that so much haste is attending this passage. Why not take our time to really try to understand at teh level of detail this udertaking requires, what exactly it will cost average Americans? This strikes me as an effort to hurry up and finish somethng –anything–so that the powers-that-be can say that they accomplished something.

    Like so many Americans, I have learned that when politicians want something "yesterday", you had better hold on tight to your wallet.

    I recommend to all who are interested in doing everything they can to stay healthy and two excellent sites on natural remedies and healthy living; one is called collectivewizdom.com. My sister turned me on to it, after she followed it during her recovery from shingles last year, and I follow it daily. The other site I wholeheartedly recommend is webmd.com.

    August 3, 2009 at 17:37 | Report abuse | Reply
  29. Donna

    What is wrong with people? Our health care system needs a major overhaul! Is not the government that they should be angry with. Instead our communities need to hols the drug companies and the insurance companies accountable for for rising costs. There must be a public health option! I come in contact with many people, each day, that have no medical insurance at all.
    People need to STOP relying on their emotions. They need to educate themselves on the health care policies in Europe and Canada. Ignorance is not bliss. I am so tired of uneducated people fighting for causes that they really know nothing about! The drug companies and the insurance companies should not continue to dictate our health care while they continue to get rich!

    August 4, 2009 at 15:11 | Report abuse | Reply
  30. Kirt Sloan

    What we have is a system crisi not a health care crisis. Insurance companies colect premiums from patients and doctors and then avoid paying claims...that is how they afford all those great TV ads, so doctors are forced to run their businesses off of drug incentives by drug companies who also run very nice TV ads....starting to see the crisis! The media does not a damn thing to uncover this colossal screwing of the doctors and patients, because that may jepardize their income stream, and politicians colect huge campaign contributions from the insurance industry and the drug companies, so nobody does a damn thing. We have a 2 carrot government, they hold one carrot in front of your nose making you believe you will get something and stick the other carrot in your backside ....taxes and fees! Either way we get screwed while big drug and big insurance get rich.

    August 5, 2009 at 15:48 | Report abuse | Reply
  31. Stef

    Sorry America, but this is what happens when our mindset towards helping others out when we can afford it is despicable, and we put way too much value on a decentralized abusive system. In the UK and Canada how this works is you pay through taxes. You pay a solid fee, around $15, for your prescriptions and of course elective surgery you just pay for. I know people with chronic illnesses who live with it and they love it. I don't see what's wrong with it either. But nope, we can't have it. I am a college student and I know what my debt will be, but I know I could afford an extra 1-2% tax once I work to ensure I get coverage, and anyone else who needs it. You know that if you are under the poverty line you don't pay these taxes, right? Students, under-aged people, and seniors don't pay prescription fees either!

    Oh well, you wanted a pay-per-service, and these numbers Dr. Gupta is listing don't seem unreasonable at all. I know what my mom is paying for our good for nothing HMO.

    August 6, 2009 at 12:59 | Report abuse | Reply
  32. Sarah

    There seems to be an assumption that those against government reform are against helping those in need. This is not accurate. The debate here isn't between those who want to help and those who don't. The debate is how it should be done. Is the current proposed plan work-able and fair, and on a broader scale, should the government be this involved in healthcare? Like many who are skeptical of this current plan, I volunteer in the community (am currently filling out paperwork to volunteer at a hospital) and give some of my modest salary to several causes that help those in need. It's worth noting that studies show that Americans who identify themselves as conservatives are every bit as charitable as self-identified liberals with their finances – some studies even show conservatives give significantly more.

    August 6, 2009 at 13:58 | Report abuse | Reply
  33. Krista Maki

    I think the base question is: "Without cudgels, will the for-profit insurance industry change its ways?" I think that history (over decades) tells us the answer is NO.

    Making/keeping you well is very low on the list of priorities of a for profit insurance company. If you are not well, or it will cost to much to make you well, they can just throw you out of the lifeboat and continue making profit. It would cost money to support a wellness program. Their premium dollars, besides profit, go to administration, marketing, lobbying, investments, big executive pay, and so on. If these reduce profits, premiums are just raised.

    Similarly, without a change in the structure of the payment system, hospitals have little incentive to increase quality and reduce overhead. IBM announced the first highly used general purpose computer in 1964. In the more than 4 decades since, few have implemented computerized medical records or pharmacy control. Evidence based diagnosis and medicine is still a new revolutionary standard – after a hundred years of serious medicine!

    It has been shown that delivering higher quality care (fewer errors or hospital borne infections, e.g.) and, when errors occur, sincerely apologizing and offering fair recompense, can greatly reduce the incidence of malpractice suits. But this is a new and revolutionary thought! Most are still thinking it is better to treat the wronged patient like the enemy, stonewalling against paying, and lobbying for tort reform to deny wronged patients a means to find justice.

    The only answer is to change the payment structure from pay for service to pay for results. The for-profit insurance don't need to do this (they can make profits, as said earlier, by throwing the ill out of the lifeboat). They won't do it without being forced to.

    While a single-payer system won't sell here now, the government option can at least provide a competitor in the marketplace that is motivated to reduce costs and help people be healthier.

    People complain about the cost of changing the system. However, looking at the cost trend line of the current system, the cost of not making big systemic changes is Far worse, and puts our economy at risk. We have frittered away the decades during which it would have been cheaper and easier to change our wasteful ways.

    Many conservatives say: You cannot borrow your way out of debt. But they know better. What else is a loan to a business that has a business plan for a product or strategy that can make great profits in the future. This is called INVESTMENT.

    And, everything does not have to be perfect on day one. We will still have smart people in government (at least I hope so!) in five years. If course corrections are needed – we can do it!

    We just know that it is hard to imagine anything worse than the current system.

    P.S. I heard an ex insurance company exec on the Bob Edwards show the other day. He acknowledged that most everything Michael Moore said in "Sicko" was on the money, and acknowledged (internally) by the insurance companies to be so. They were so concerned that they used code in the subject line of memos to each other about how to counteract what he said.

    August 6, 2009 at 16:48 | Report abuse | Reply
  34. Aaron

    Under a reformed healthcare system via a public plan, costs would go up in the short term. However, with the institution of primary care and wellness-disease prevention programs into our healthcare system and culture, healthcare costs will eventually decline. We can look at the healthcare systems of other industrialized countries and their per capita costs as proof of longterm cost reduction.

    August 7, 2009 at 14:17 | Report abuse | Reply
  35. Jim Greenwood

    The issue of health insurance reform is an important and noble cause, creating a preponderance of discussion and interest among all walks of life. It’s hard to predict what the legislation will be in its final form or even if any measure will eventually become law, but what it proposes could mean drastic changes to the way people receive health care services.

    As CEO of Concentra, a national health care organization, I have had the opportunity to meet with certain members of Congress in recent weeks to discuss the objectives of health care reform. The administration has two primary objectives for health care reform: extend health insurance to every American; and slow the growth in rising health care costs. I believe in the overarching goals of health care reform. Like the current administration, I regard health care as a basic human right and should be available to all U.S. citizens.

    A critical bottom line in health care reform is the need for more individual accountability for harmful behaviors. In order to effectively improve patient health and lower health care costs, an important part of any coverage plan needs to include a risk weighting concept that aims to reduce the unhealthy behaviors of employees. Although our elected officials seem to appreciate the importance of increased emphasis on wellness and prevention, how this translates into law is an entirely separate matter. Unfortunately, the current version of the health reform bill being discussed by the U.S. House of Representatives does not appear to provide for the type of price flexibility that can help facilitate and influence better health practices among individuals.

    Reforming the health care system is a long overdue and enormous task. This change needs to happen with care and precise development that won’t limit patients’ ability to get better, and will not cause someone to file for bankruptcy every 30 seconds due to unaffordable medical expenses. Regardless of the shape health care reform takes, primary care holds an important role in the health care reform agenda. As I look ahead to the future of the health care industry, I believe reforming patients’ health will offer the greatest hope for a healthier tomorrow. The time has come to improve the health of America.

    August 7, 2009 at 16:13 | Report abuse | Reply
  36. Krista Maki

    Regarding Jim Greenwood's comment about improving employee health habits: I have heard talk of re-instating some type of R&D investment tax credit - How about one for Employee health investment. Perhaps at different levels depending on employee participation rates and maybe even on results (if a good way to measure could be established). Building or paying use of exercise rooms & classes, etc.

    We need to also include health management in school objectives and funding.

    Perhaps we could make an improvement in the food labeling requirements, making the info easy to understand: Color coded labels based on a "good health index" summarizing the info in the current label. I saw a frozen soup yesterday that had 1120 mg of Sodium per serving! Black label with "Sodium" printed in it. One would hope the maker would improve the recipe to avoid the black label!

    August 10, 2009 at 12:11 | Report abuse | Reply
  37. susan

    I think the public health plan is still too expensive. I am a middle class stay at home mom. We are paying $500/month with my husband's employer health benefits. If the public health plan starts, will we end up paying more then since we need to help the lower income people?

    August 10, 2009 at 13:31 | Report abuse | Reply
  38. Sarah

    In regards to incentives for wellness... my company and insurance company already does this without any government mandate. And in regards to food labeling... you know, it's not that hard to learn to read the labels!!! I have Celiac's disease and must be careful with processed foods. I just turn the package over and read it. If i don't know what it is, I look it up. My family and friends have all learned to read labels to accommodate me (or, if Americans just choose to eat fresh food there is very little label reading involved, period). This shouldn't be the responsibility of the government or the insurance companies to enforce.

    August 10, 2009 at 15:27 | Report abuse | Reply
  39. alex lyrics

    These Republicans are using the same scare tactic, to promote fear in Americans the same way they duped American people into going to war with a country that had nothing to do with 911 terror attacks.

    When are American people going to stop listening to these people? These republicans feed and grow off of these doctors and pharmaceutical companies, and insurance groups who are clearly fighting for their lives.
    American people need to pay attention, a man once told me follow the money trail, and you will see the answer and motivation for stopping this national healthcare.

    Last night I heard some one say, why would people want to stop poor Americans from having basic healthcare?

    The plain fact of the matter is that we have been at war for almost 10 years, and the nation is mad as hell. It shows we have been on a witch-hunt on everyone from congressmen, to corporations, to bankers, to car manufacturers. Perhaps our anger has helped expose our nations corruption, and perhaps this was a good thing, but when we turn to our nations elderly, and poor without healthcare something’s terribly wrong.

    When we say screw those people and only think of ourselves, we are abandoning the great American hope for equality and freedom, and prosperity for all. Every citizen has the right to a dream in this country, and we are leaving our nations low income and poor without healthcare. Who are we? Barbarians?

    This plan could save $170 billion per year and we need that to come out of this recession, or more like depression. It makes me sick to hear just how bias, and self centered we are and have become on this issue. This has all come out of fear, the same republican fear the republican party used to get us into two wars, wars which no doubt caused this entire financial mess. The republicans are responsible for this healthcare mess, the gas hikes, and the electric Enron madness, the Wall Street crumble, and wounded soldiers, and veteran mess we have now to clean up.

    I ask Americans to follow the money trail, and don't listen to these republicans who created this entire mess over fear. "You have nothing to fear but fear itself. "

    We have a system of government where we can legally vote; if this healthcare doesn't work or needs to be modified trust in ourselves as decent Americans to change it.

    August 10, 2009 at 15:52 | Report abuse | Reply
  40. Krista Maki

    Sarah, in response to your response: I didn't say anything about a government mandate on companies and insurance companies to promote health of employees – but perhaps an added tax (reduction) incentive.

    It is wonderful that some companies have been able to see the benefits to the bottom line of keeping employees healthy – but in prior decades, not that many have. The R & D investment tax credit has spurred creativity in the past, and some are thinking it can help again. Why not, at least in the short term, an additional tax incentive(reduction) to get more companies to see an advantage in supporting employee health.

    Also, we have had food labeling for decades. It, as currently (mandated, by the way) done, is not doing the trick. As you could see from my post, I read the labels. Not many do. While building individual responsibility is a great goal, do not lose sight of the other main goal: a healthier population. We have to think about how people actually behave, not how we wish they would behave. Yes, work to convince everyone to behave better, but find solutions based on the way they do today. (Reminds me of the good advice: don't buy clothes now for how thin you will be after the diet you are starting tomorrow.)

    I have a friend with Celiac's disease. It is a pain in the neck – taking a lot of food label reading and waiter questioning – to keep under control. My best to you.

    August 11, 2009 at 11:55 | Report abuse | Reply
  41. William Wallace


    You should look at the Healthcare Group of Arizona; a government sponsored insurance company that provides health insurance for small businesses at a fair cost. It was originally sponsored by state government, but has become self sufficient. Small Businesses in AZ could not provide health insurance for their employees without it.

    Invasive health questionnaires for each employee are required before a commercial insurance company will give a small business a rate quote. They can raise rates if the health status of an employee changes. AZHCG rates premiums based on age only and provides a fair and predictable premium cost.

    Perhaps the AZHCG insurance model would help fight the predatory health insurance industry practices that block access to affordable health insurance. . http://www.hcgaz.com/ is the web site.

    It may also be the answer to the cost issue since it now supported by the small businesses that it serves.

    William Wallace

    August 11, 2009 at 18:25 | Report abuse | Reply
  42. Krista

    Susan, it is true that a Trillion dollars over 10 years (100 billion per year) is a very big number BUT remember:
    * It is less than 1/10 of the amount that CNN reported is WASTED in the current system, according to an accounting company study. The money spent by hospitals to fill out all the different insurance company forms would almost pay the entire bill.
    * It is less than we are spending on the wars in Iraq and Afghanistan
    * It is less than half the defense budget
    * It is less than .1% of GDP
    * At the current growth of health care costs, we will soon be swamped by health bills. Not making drastic changes costs far more than anything proposed.

    It would probably have been cheaper to have done this years ago, but it will certainly be cheaper to do it now than to wait another ten years.

    Not to say we shouldn't work to not waste money during the transition.

    August 12, 2009 at 08:28 | Report abuse | Reply
  43. Sarah

    Krista – it sounds like we are pretty much on the same page here with goals. I like the idea of incentives over mandates. I will say though thta food labeling has improved greatly (and rapidly) with consumer demand. When I was diagnosed with Celiac's 5 years ago, it was tough to read labels. In that time, as awareness and demand for knowledge has greatly increased. I've been overwhelmed with how many companies are now labeling products "gluten free" and how many restaurants now have gluten free menus. (Betty Crocker is the most recent company to jump on board). It's progress without additional gov't intervention (that I'm aware of).

    I also want to comment here on this "We have to think about how people actually behave, not how we wish they would behave." I agree. I just think as a nation we need to be careful to remember that in a free country (which was founded on principles that valued personal responsibility), sometimes people make bad decisions regardless of our efforts to help or educate. We can't (and shouldn't) attempt to control everyone's behavior (I don't think you're saying that... your comment just reminded me that ultimately, freedom means there will always be some who make "bad" choices, regardless of the most well-designed label or program).

    August 13, 2009 at 09:31 | Report abuse | Reply
  44. Ed

    By what authority in our Constitution does the government enter into a non-government activity like health care? Just asking.

    August 13, 2009 at 18:54 | Report abuse | Reply
  45. Ann Seamans

    I am appalled at the old geesers on Medicare showing up for the town hall meetings. Medicare works. They are lucky to have Medicare.

    The Republicans are successfully shifting the blame for 8 years of Bush who got the deficit to 1 trillion for killing young Americans. No one ever objected then but 1 trillion to help Americans with health issues? Now that’s a problem.

    I don’t see much listening at these Town Hall meetings and am afraid that many unsuspecting people there are stooges for the insurance companies and the Republicans who need to start thinking and have original solutions to problems.

    I believe these loudmouth people are selfishly venting about their own lost savings and forgetting that some people without health care are in dire straits.

    August 15, 2009 at 09:13 | Report abuse | Reply
  46. Jack A. Nicolosi Sr.

    How does this new program affect small businesses who currently do not provide health insurance to their employees? Does the government help pay for the insurance? Will the government pay for 80-90 % of these insurance premiums? Some employees cannot afford any premiums except the very minimal amounts. The business owner cannot afford to buy insurance now, how can they afford it with this new health care plan. Will this new health care program be set like medicare, the employee pays mandatory taxes and the business pays the other half?

    August 15, 2009 at 11:42 | Report abuse | Reply
  47. Muibi Olaoye

    I am a nurse of 25 years experience with the last 10 years in long term care.This comment is not a story, it is what happens today, is not an isolated case it is what happens everyday everywhere in our country. I was standing infront of the room of one of my 40 residents' and the Social Worker walked over to me and said."Ms-----will be discharged tomorrow, because the Insurance Company will stop paying after today". and walks away. When I got into Ms--–room. I met her crying and her only request is to give her a box of clinex because according to her she will cry all night. This is a 62years old woman with multiple health problems that needs 24hr care and assistance even to use the bathroom, who has spent all her life working and paying premium to the Insurance coy. I used all my life long experience to bring a smile to her face and her last comment was "I pray that God will give the President and Congress the power to stop the Insurance coy. from discharging patients without consideration/consultation with the doctor, the nurses, and the patients".Under the present system,there is nothing anybody can do to stop the Insurance coy whose headquarters is in California from discharging a patient in Chicago without consultation with the doctor or the nurses who are in best position to know when a patient is best for discharge. Government plan is the best option. Medicare and Medicaid are government run. The hypocrates are now crying about the deficit, they did not cry wheh they were giving blank checks to the former President to start a war in a country that has nothing to do with the people who attacked us on 9/11. Critics are calling a government option a socialist ideology. Our founding fathers knew that no country can survive without some sort of socialism. If Medicare and Medicaid, food stamp, housing projects, section eight housing assistance and so on are not socialist ideologies, what are they? The Insurance companies are the only beneficiary of the current system and they are using all their financial power to maintain the status quo. We voted for change, and change in the health insurance system is one of them. A word for the Democrats who are calling themselves conservatives and teaming up with those whose goal is for the President to fail. We voted for many of you not on your personal merit, but on the hope that you will support the President to effect the changes that we voted for. Now you are teaming up with the same people who led us to where we are today. They are the same people who twarfted the efforts of President Clinton to reform the health care system in the 90s. We are watching you, you are diging your political graves.

    August 18, 2009 at 03:16 | Report abuse | Reply
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