Most Americans want overhaul of health system

This article is based on a report of dubious value. The report can be found at www.commonwealthfund.org. The information provided by The Commonwealth Fund is highly conclusory; indeed, the actual questions put to the survey respondents are not included in the report. The data does not reflect in what order questions were asked or account for how the survey questions might influence answers to subsequent questions. The data does not state what question was asked to obtain responses suggesting that a majority of Americans say health care system needs fundamental change or complete rebuilding. Moreover, other questions in the survey related to how difficult it is to see a doctor the same or next day, getting advice from the patient's doctor by telephone during regular hours, on weekends and holidays. Additional questions inquired whether after a medical test the patient was written to about the results. Respondents were asked if doctors ordered tests that had already been performed or recommended unnecessary treatment or care. If the respondents were asked about a series of issues and then asked whether the system needed to be changed of course they are going to see a need for improvement. This would not mean that the system is broken nor does it tell us anything about what changes need to be made and at what cost.

Emilli, I experienced the birth of the UK National Health Scheme at the end of WW2. Shortly thereafter other European countries developed their own national health. I lived in Sweden for 25 years and their system is supreme. Later I worked several years in the US before settling for good in Canada.
Now the Europeans have developed the European community and eliminated the need for passports so it is like the United States of Europe.
Of all these countries the USA had the worst health-care system of all and for one reason and one reason only. The super expensive and enormously complicated barrier between the patient and the doctor, the insurance companies.
Health-care should be like it is in Europe and Canada, a birthright. A system where a doctor makes all the decisions about your health, not some incompetent clerk sitting at a desk with a stack of rules and regulations. I am happy with our system and I hope you can manage to get as good a system. Just delete all the insurance companies, get a government issued health card. Put all those insurance people to work in the factories so they do something productive.

The first priority should be that everyone has health insurance. The poor have Medicaid, the old have Medicare. People in between should be able to live their lives without the fear that an unexpected illness will bankrupt them.
A second priority should be to address the outrageous cost of drugs in this country while the same drugs sell for much less in other countries. We shouldn't have to go to Canada to buy the drugs we need.

Why do they call it socialized medicine when we already have it for seniors and it is not socialized at all? What is wrong with Medicare for everyone? As long as we don't include corporate "gifts" in the legislation -- such as the lobbyists wrote in Medicare Part D prohibiting the negotiations for drug price discounts -- we should all be able to accommodate it with our health care needs and affordability.

Politicians are selling national health care on the basis that it will save millions. What they do not tell you is that other countries like the UK and Canada delay and deny care. In the UK, if you are over 60, you are not eligible for dialysis and other treatments. In Canada, you can wait 12 to 18 months for heart by-pass surgery. These are just two examples of numerous practices. If Ted Kennedy was an average citizen in any other country, he would be made comfortable and no effort would have been made to save his life.

Why do we all deserve health care? Everyone says that, but no one ever gives a reason why. I'm really curious why some people believe that we all deserve health care? I'm not saying we don't, I just wish people would finish the "because....." part.

There is one big thing that no one is mentioning in this entire talk about health care, and that is the shortage of primary care physicians. Very few medical students are going into primary care (most specialize), leading to shortages in the country. Even if we guarantee insurance to everyone, or nationalize health care, people still won't be able to see doctors when they need to because there won't be enough. Heck, some parts of the country still don't have access to primary care doctors - you can give them all of the money in the world for health care, but if there isn't anyone around to treat them, what do you think they'll do? Don't believe me? Last I heard, Massachusetts is having a problem with their new health care mandates because there aren't enough doctors there to see everyone.

Or maybe we could all stop suing doctors everytime something unpleasant happens. Maybe then we'd have more people going into OB/GYN, for example.

I've been listening to reports on various health care systems in other countries on NPR radio. Though my own health is good, I'm a senior citizen who is more and more seeing how others in my age group are struggling. For many years I bought into the BS about the free market and how it was going to take care of us, complete with obligatory shaming accusations of parasitism for thinking of nationalized health care and the threats of inferior care if we should adopt it. The fact is that our health care industry is just that - INDUSTRY. The bottom line is money. No, I'm not necessarily talking about your kindly doctor, I'm talking about the big business of "health care" that has turned visits to doctors into an experience as near to a Henry Ford production line as they can make it. I'm talking about a pharmaceutical industry that floods TV with ads pushing their drugs, charging exorbitant prices and gouging the old and infirm. They care far more about stock prices than anything else. Folks cry about the oil companies profits, and the oil companies profit margin is FAR lower than the pharmaceutical industry. I don't know if it would be considered nationalization or not, but I'm of the firm opinion that hospitals and drugs should be treated as a public utility. They should be allowed a reasonable profit margin but it should be regulated by a board of knowledgable, informed citizens. As it is, our health care system is, at best, an agglomeration of avaricious enterprises, at worst, a bunch of greedy drug pushers!

Yes, the US system of health care, including mental health care, does appear to need some serious overhauling. At the very least, there should be a "floor" level of care available and readily accessible by all citizens, probably delivered through some sort of community clinic system similar to the current library system, post office system, or the like. The second thing that appears clearly necessary is some kind of "master" electronic medical record with the appropriate security. Everyone, or at least each taxpayer, currently has a master file with the IRS, and with the Soc. Security ADministration, for example. This doesn't have to be a new, scary thing if we look at the current systems that are working for us and use them to create the basic framework, then adapt and modify as necessary. The market for private insurance can certainly continue, often provided as a perk by employers, for example, or purchased by those individuals who want it. This industry is well-established and profitable and will continue to function well in the free market. Providing a modest level of health care and access thereto for all citizens of a country as wealthy as ours is the right thing to do. Positive outcomes would include more-engaged citizens, lower illness costs to employers, vastly expanded jobs and in particular, research and analytical positions as we would be trying to constantly improve treatment outcomes. This just seems logical and necessary to me!

Nationalized medicine by that or any other name is still socialized medicine. It would be the downfall of quality medical care in the US, a tax burden to those of all ready over taxed (I'm far from "rich") and in all probability will create even more red ink that the US can ill afford.

Universal health care? NO! A one size fits all is not the answer. An income based, subsidized health care plan for low income individuals, families and the elderly, sure. Btw ... illegal aliens also strain the healthcare systems in many communities ... so you might have guessed that I don't want my tax dollars paying for people that should not be here in the first place.

The inefficiencies of allowing insurance companies to dictate the claims administration process is staggering. The federal government long ago dictated that checks clear between banks in a very specific and ordered manner, and at the very least should now mandate that insurance claims be processed between providers and the insurance companies in a standard and consistent process. At least this would wring out some of the cost now involved in the system caused by multiple claims processes.

I am a 43 yr old women who has had health problems my entire life. Luckily I have always had insurance. I am a consultant who earns a good income but don't have any benefits. The flexible work hours allow me to deal with periods of pain and dr. visits.

Last year I got a divorce after 20 yrs of marriage. I have a good insurance plan for the next 24 months. After that my Cobra expires and I will be unisurable. This reality kept me in my marriage until I couldn't take it any more. Now I have to live with the worry of what will happen. I pay taxes. Live a healthy lifestyle. Actively work to treat my health issues through regular and alternative health practices. Maintain a healthy weight and get regular exercise. I am terrified by what will happen when my Cobra insurance is no longer available.

I have started researching moving to Canada since my industry is strong there and I can live without the fear of lack of health care or bankruptcy from a major illness. Shame on you America for allowing productive talent to jump ship for basic needs.

the're a lot of people in all those little towns all over this land who care about this land and if you government fools can't set this straight, then we will forcibly take your places and make it right ...you have been warned....this is not a threat ....only a statement of policy .....heed the warning...we hired you and we can run you out of town.....remember....."we the people"

As a critical care nurse at a public hospital in a moderately sized urban area, I am very conflicted in the debate over the nationalization of health care. On one hand there are so many patients I see, that if they had access to to quality preventative medicine, they would not feel the need to wait until their health is in such poor shape that they require a visit to the ER and a hospital stay. Which is indeed a burden on tax-payers. It is far cheaper to prevent serious illness than to treat it. However, on the other hand there are far too many Americans engaging in such unhealthy habits such as: poor eating habits leading to obesity and all the disease processes that comes along with that, to illicit drug abuse, alcoholism, and smoking. Many of these Americans do have access to quality preventative heath care via their employer, spouse or parents employer, but do not use it. Most tell me they know what the Dr is going to say, ie... need to control weight, stop smoking, drinking, or drug use. And they just don't want to hear it, for many, many complicated reasons (psychological, societal, cultural, etc). Nationalized heath care will not change the habits of these people and they will continue to occupy a large percentage of hospital beds draining money from insurance companies who in turn must raise rates to all customers and/or pay the hospital less. Which then circles back to higher taxes for the general public. The situation then becomes even more complex when you factor in children who are not getting preventative heath care, for whatever reason. Many attitudes, as well as just the way we look at health care, needs to be changed before we can even begin to pretend that our heath care system can be 'fixed'.

The U.S. cannot afford universal healthcare. What in the hell makes anyone think it will work? Social Security, Medicare, and Medicaid, all screwed. Yes, universal healthcare is a great idea.

Oh, and something MSNBC won't tell you...countries with "universal healthcare",the government gets to decide who is worthy of healthcare. If you're elderly, forget it. You're no longer of worth to society, so you get put at the very back of the line. If you die, oh well, less money for the government to have to spend on healthcare.

Until the COST of care is capped, this system will continue in its death spiral. People who don't know the system blame the insurance companies but no one seems to get even more PO'd at how much their provider is charging. Is it acceptable the physical therapist who observed me walking for 12 minutes charged my insurance company $450 to do so? Why is it ok the hospital charged my insurance company $75 to put a warm blanket over me-one I didn't get to keep. Did it really cost the durable medical supply the $850 they're charging my insurance as rent for the icing unit housed inside a cooler? I used it for all of 36 hours, by the way.

Shame on our politicians for allowing their decisions to be swayed by medical industry lobbyists with big bills to fill their pockets. It's the only understandable explanation as to why Congress recently overturned legislation that would cut 26% from Medicare waste, then turned around and "tabled" the issue for 18 months after industry lobbyists came in with over 6.7 million. This blatant abuse and misuse by our politicians is going to continue until the Average Joe American does something about it.

Lets start with kidcare, under utilized in the state of Fl. Parents who complain but are to damn lazy to filll out the form for free medical care for the children that they breed but can not feed. The access is there for well child health care. No its easier to take up a seat in the ER for little Johnnys sniffles. Illegal immigrants, non immigrants all get health care. If you are a Cuban wet foot dry foot you get $10,000, food stamps and medicare. Your tax dollars at work. The working stiff you and I get to worry how to pay the copays and premiums, stretching our PAYCHECKS to support our own family and wouldnt think of reaching out a hand to take something we didnt work for. Universal healthcare just another burden on the back of the middle class isn't it is about time we stood up and said enough.

Let me ask you all this... Hypothetically speaking, if every single person were given unlimited, free access to all the drugs and surgery "needed" would we automatically leap up to number 1 in overall health status according to the WHO? The answer is of course not. What makes the top countries the healthiest is not access to drugs and surgery, but rather the way they live their lives. It's lifestyle that controls health care. America has the greatest "sick" care system in the world, but a universal health care system does not address the underlying cause of our problems, which is clearly poor lifestyle choices. We need to spend money on education, not more drugs and surgery... those are getting us no where.

I am a physician in training (resident) in primary care internal medicine. There is another problem that is often overlooked. As pointed out above, we Americans have become used to getting healthcare for granted.

We dont let out seniors die comfortably and unnecessarily perform futile care. Why? As familes dont want to let go, and the law doesnt let us discontinue care even if the patient as no prognosis. Often dead patients are kept alive for weeks using ventilators, pacemakers, dialysis, often all on one patient.

When we see a 30 year woman with chest pain, we admit her and run her through 7,000 $ worth of tests. Even though we are sure that there is less than a 1 in 100,000 chance of finding something. Why? Who gets sued if you miss? nobody listens to pleas. They court says-you had the tests and you never orered them. no doctor wants to be in that position. So we think, I dont care and I am not paying for this. Lets 'waste' another 7,000$ today to save our selves trouble.

When asked to order an unjustified MRI scan on a patient, I asked-'what is the indication?'. i was told by my supervising doctor -CYA. Later my colleague elaborated - 'Cover your a**'

I think it's ridiculous that some people simply demand universal health care. While it seems like a good idea, it would probably cost each citizen just as much in taxes every year as it would to simply pay for health insurance out of pocket.

I think that before any new government programs, including universal health care, are developed, our government spending needs to be cut enormously. There is so much disgusting waste in our government, which equals higher taxes and less important programs like health care for those who need it. I think the government should be run more like a business, where you try to CUT costs and MAKE money rather than lose it.

Anyway, my point is that rather than treat the government like a never-ending wallet where you can just buy all the amazing programs you want without having to think about the costs, it should be treated like a business and run efficiently and profitably. Perhaps if law makers were threatened to be "fired" if there is even the slightest deficit things would work better...

Families don't want to let go...bull@!$%#....my mom is in a hospice that gets 6 grand per month from medicare and I pay 5 grand to the nursing home. They shove food in her mouth, and every little infection she gets they bang down with anti biotics. She is terminal and for 10 grand a month they dont want to let it go.

Most people don't understand squat about the business.

Until they work for an Insurance carrier, physician's office, or equipment provider, or get that dreaded co-pay invoice in the mail.

Stop fraud and those ER visits for a earache or a cough.

Stop those stupid hundred and one coverage plans that no one understands.

Specially beneficiaries who ask why they are being billed for co-pays and get hot under the collar when told their "plan" calls for a 20% co-pay for In-Network service.

Educate people specially the elderly under Medicare through their physicians.

Then chances are you'll not hear of a Medicare beneficiary who called to accuse a provider of fraud saying this stuff should be given to me for "free" and "you" the provider should not be billing Medicare for it.

I went to an ER with severe flank pain and spent about 5 hours max before I gave up and came home after the attending physician woke me up and told me the bad news about why the pain had occured without my family being around to hear it first hand.

They charged $16K for the visit including $5k for the damn nurse's station. My insurance co eventually paid them just over half. And to think the nurse did not even hold my hand for 5 minutes. Sigh!

A year later I went back to another ER with a broken limb. The attending physician released me after 3 hours and said I had a knee sprain. This time the bill was nominal and it got paid immediately. It should never have gotten paid at all. But who asked my opinion and I was in a bad shape and unable to yell "enough".

Suffice to say I eventually did get admitted to a regular room and had surgery to repair/replace the limb.

My surgeon who spent time repairing the broken limb got peanuts.

The Hospital where I had surgery got chunks of change.

The radiation treatment (4 separate sessions) cost over 100K with just one CT scan costing thousands.

Yet a regular CT scan or Bone Scan is reimbursed at very low levels.

The Rehab place got paid peanuts for 10 days of In-Patient rehab including regular PT/OT, food, and room.

The hospital got paid hundreds of dollars for a few minutes of PT on two different days ------ barely enough for me to say ouch enough times to make the money worthwhile.

Somewhere between all this you'll see a big mess.

Fee Schedules that need serious tweaking.

Here's one from Medicare for example.

People complain about how people get power mobility devices even when not medically necessary.

YET ask around and chances are you'll find you can get a good quality STANDARD weight power mobility device WHOLESALE at less then $2K while Medicare's reimbursement is over twice that.

How can you stop fraud when people see quick profits like this!

On the other hand try getting a power mobility device for a genuinely needy patient who has private insurance. Chances are by the time it all ends you, the pre auth seeker, will be in need of a mobility device yourself.

Why go on.

Its one big mess.

Time for "change".

Like all Americans who can afford health care insurance, I could barely afford insurance until now, August 7, 2008. I was a self employed individual since 2000. Hurricane Katrina smashed my self employment to hell and back in 2005. I have not been able to get unemployment benefits, because I formed an S-Corp to pay me a salary and deduct my federal, state, medicare and social security taxes from my paycheck and then my S-Corp matched my social security and medicare taxes. All in all, I personally paid all of my social security and medicare taxes as the net income (loss) of my S-Corp flowed directly to me personally on my personal income taxes. My S-Corp (me personally) even paid state unemployment benefits over the years on my annual salary. I still could not get unemployment benefits. I had to pay personally my own health insurance. In 2000, I paid Blue Cross/Blue Shield $142.15 a month for a $!,000 deductible policy that covered everything. As of July 15, 2008 since changing insurance with a catastropic $5,000 deductible with United Healthcare, my monthly premiums was $516.95. After a four day stay in a hospital because I had severe bowel problems and having a colonoscopy, two endioscopy I was diagnosed with samonella posioning. I was also diagnosed with a crack in my spine between the 4th and 5th vertebrae with spurs growing out of the crack which was causing severe right leg pain from the toes to the right side of my lower back.

After $5,000 of blood work, $19,000 of colonoscopy and endioscopys, $5,000 in MRI's of my leg and thigh, $3,000 for an MRI of my brain, $5,000 for a CAT scan of my brain and a $35,000 hospital bill I still owe nearly $45,000 as United Health Care decided that I had been overcharged and that the hospital was not in their network.

I spent all of $15,000 of my savings account, cancelled my IRA's knowing that I would have to pay a 10% penalty along with the income taxes, cash in my life insurance just to keep paying the premiums on my health insurance and pay what I can on medical bills besides trying to take care of my elderly parents (80 and 82 years old) and try to keep food to eat for all and pay $4 a gallon for gas to get them and me to the doctors.

I have $298.67 in my checking at this very moment. This has to last until September 1st when my parents get their $800 a month social security check. When United HealthCare debits my checking on Friday the 15th, my insurance will be cancelled as I won't have the $516.95 for my monthly premiums.

I have searched and searched and walked miles and miles, looking for a job, but being hearing impared and over 55 years of age, no one has been willing to talk to me.

So what else in new?? Health care has now forcing me into bankruptcy and still have no insurance. By the way, all the doctors had to do was to take a stool sample to know that I had samonella poisioning instead of charging me along with the hospital $30,000. Also, one MRI that went up the spine to my neck instead of my leg and hip over and over would have saved me another $35,000. Who the hell is behind this madness-insurance companies, doctors or hospitals. Maybe they are all in bed with each other screwing everyone or each other in sight. Where is the government that should oversee these filthy bastards who are destroying everyone that makes $50,000 a year and pay over $6,000 in premiums (by the way I am a single male, 55 year old) or those who are on Medicaid with no help at all.

Where do they come off and say that health insurance has doubled in the last ten years. Remember, in 2000 I paid $142 a month for a much better policy than I have now and now in 2008 I am paying over $516 a month!!!!! That's is not double, that is screwing me royally and every one else.

Is amazing to the ignorance of people, socialized medicine will basically mean that while right now most people get decent and most of the time excellent medical care, with socialized medicine we will all get mediocre care at best. Look at a HMO decisions are made for you, not always based on what you want , or what is best but in what the out-come driven policies indicate. American want all the alternatives possible, every treatment available laid out and explained. In a out-come based medicine that will not be allowed. I just reviewed the statement in England about what to offer a 24 week premature infant and let me tell you it differs greatly from what we do here. recently I believe in one of the Scandinavian countries they have a panel that actually decides when to withdraw treatment, with out the input of the patients family, only based on the possible outcome and "quality of life". Maybe the exalted and enlighten are ready for something like this, but as a physician every time a see a patient I must remember that this person is somebody sister,mother,daughter,son,father, husband or wife. That I must honor those ties and the human condition of the patient, and that I took a oath of "do no harm"

To those of you claiming that national health insurance is socialized medicine- think again. Are YOU going to REFUSE medicare when you become 65 ? I DOUBT IT ! National health insurance involves everyone paying into a system with benefits for all , like medicare , which works very well . Why should congress and the elderly have great coverage and those under 65 have NONE ?

A few of you have great coverage through your employers and think our system is great . Not if you are like me and have chronic lyme disease , or like my best friend who has a congenital heart valve defect. We can not work unfortunately , and those in our shoes ( uninsurable ) have no idea the HELL and anxiety we experience.

And yes , greed is rampant . Every therapy is GROSSLY inflated , often ineffective , and designed to fleece you of your last dollar .

If you do not have coverage through an employer and pay premiums, the insurance companies take $ 300 - 600 monthly and most years you end up paying YOUR OWN BILLS!! This should be illegal.

For those supporting Mccain, his proposals are ANEMIC, and offer no help at all and do not require that insurance companies cover everyone. In other words , more of the same !

I often hear people talking about " getting help " . The reality of this is that any help will kick in from the gov't . only if you are INDIGENT and have exhausted all resources to the health care machine. And yes, this could be you if a chronic illness surprises YOU from out of nowhere .

We are all one illness away from bankruptcy .

Why can we not bring our soldiers home let the sunnis and shiaas duke it out on their own , on their own DIME , and invest in national health insurance? Considering history time and again , our efforts to control the internal mechanics of other gov'ts USUALLY Fails TERRIBLY . Example : the US supported Saddam Hussein ! The same outcome will most likely follow, while health care goes to hell, and our soldiers play policemen to parties who have always hated each other . Iraq is a wealthy nation and we are no longer a great superpower , like it or not .