AIArchitect

Is this a custom word press theme? I would like to have a similar one for my blog…

That is a excellent point to bring up.

amazing stuff thanx.

Anyone who believes that they aren't already paying for those who have no insurance and use the emergency room for their primary health care has their head stuck in the sand. Who determines what is a fair charge for those that can't and those that can. We are all one way or another paying for those that make bad lifestyle choices; i.e. smoking, drinking too much, eating too much, no exercise, abusing drugs, and others too numerous to list.

If you are lucky to have a hospital or clinic in your community, how is there any free market choices for your health care. When I am sick am I going to call and find out who will give me the cheapest best care. There is no way to regulate this in a so-called free market.

As far as choosing insurance coverage how does the free market provide choice. If your insurance is through your employer they make choice simply on what they can afford if they can afford it. It has nothing to do with free market or making better health choices.

What about employees moving from one employer to another. They don't carry their insurance with them. There is usually a waiting period for practical reasons. What happens with the individual in the meantime. Anyone who has been in this situation knows what COBRA costs. In fact COBRA is the only time most of us find out what our employer was paying for our health plan.

Last, those who see a national approach to our health as worst of all options need to think about this I believe. Those who live in countries that have national health care are not leaving them. I lived in Denmark for a year. Cradle to grave for everyone. There are honest appropriate discussions regarding end of life choices on a case by case basis between family and provider. Those who live those countries don't envy our system. They do have options to buy insurance to get greater care than their government provides. You a form of rationing. But the only people don't like these systems are the doctors who see what American doctors make. For me except for my general practitioner at my clinic, all other doctors make well above middle income in the US. Almost every other country doctors make middle incomes. They are the ones emigrating to the US. Look at the last names of the doctors at your hospital and clinic.

I would agree that individuals or families should have the health plan. They could then make their own choices of coverages and who their employer. That is closer to free market than what we have now. Also our country competes in the world market place with every other country that has national healthcare that the manufacturer doesn't have to consider in the price of their goods. How can we ever compete globally with the greatest foreign government subsidy of imports to our country.

Cash Making Opportunities - The Beginning The working life is already tough enough, but the worries of being out of work was even tougher. The unsecured working environment have prompted me to search the internet for an alternative source of extra income so that I could learn how to Make Money Work for me and be Financially Independent. I listed down a number of Free Internet Business Opportunity Ideas while researching ways how people earn money online while working-from-home....... www.onlineuniversalwork.com

Often we forget the little guy, the SMB, in our discussions of the comings and goings of the Internet marketing industry. Sure there are times like this when a report surfaces talking about their issues and concerns but, for the most part, we like to talk about big brands and how they do the Internet marketing thing well or not so well.
www.onlineuniversalwork.com

www.telegraph.co.uk/health/healthnews/6127514/Sentenced-to-death-on-the-NHS.html

Sentenced to death on the NHS
Patients with terminal illnesses are being made to die prematurely under an NHS scheme to help end their lives, leading doctors warn today.

By Kate Devlin, Medical Correspondent
Published: 10:00PM BST 02 Sep 2009

In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death.

Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.

But this approach can also mask the signs that their condition is improving, the experts warn.

As a result the scheme is causing a “national crisis” in patient care, the letter states. It has been signed palliative care experts including Professor Peter Millard, Emeritus Professor of Geriatrics, University of London, Dr Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer centre in Guildford, and four others.

“Forecasting death is an inexact science,”they say. Patients are being diagnosed as being close to death “without regard to the fact that the diagnosis could be wrong.

“As a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients."

The warning comes just a week after a report by the Patients Association estimated that up to one million patients had received poor or cruel care on the NHS.

The scheme, called the Liverpool Care Pathway (LCP), was designed to reduce patient suffering in their final hours.

Developed by Marie Curie, the cancer charity, in a Liverpool hospice it was initially developed for cancer patients but now includes other life threatening conditions.

It was recommended as a model by the National Institute for Health and Clinical Excellence (Nice), the Government’s health scrutiny body, in 2004.

Follow the link and read on...

economists debate...

www.npr.org/templates/transcript/transcript.php?storyId=111173038

The challenge:

'There is a mentality that Health care is cheaper if managed by the private sector. Clearly if the private sector was better at managing our world we would not have the most expensive Health Care System on Earth in this country. '

An excerpted response:

liberty.pacificresearch.org/docLib/20090714_HPPv7n07_0709.pdf

"Nearly 40 years of evidence reveals what has worked and what
hasn’t. By looking only at the costs of Medicaid and Medicare,
and how they have changed over time, and comparing those to
the overall costs of health care apart from Medicaid and Medicare
and how those have changed over time, one can see government-
run health care’s performance for what it truly is. For every
$3 in per-patient cost increases among (predominantly) privately
purchased health care, Medicaid’s and Medicare’s costs have each
increased more than $4. With trillions of dollars at stake in the
debate over a proposed expansion of government-run health care,
Americans cannot afford to neglect such plain facts.
Since 1970, the costs of Medicaid have risen 35 percent more,
and the costs of Medicare have risen 34 percent more, per
patient, than the combined costs of all health care in America
apart from these two flagship government-run programs.
Since 1970, the combined per-patient costs of Medicare and
Medicaid have risen from $344 to $8,955. The per-patient
costs of all other health care in the U.S. have risen from $364
to $7,119. Medicare and Medicaid used to cost $20 less per
patient than other care. Now they cost $1,836 more.
If the costs of Medicare and Medicaid had risen only as much
as the costs of all other health care in America, then, instead
of costing a combined $807 billion last year, they would have
cost a combined $606 billion. That savings of $201 billion
would have amounted to a savings of more than $1,750 per
American household last year alone — and even more in coming
years if the trend across nearly four decades continues.12
To be clear, Medicare and Medicaid don’t cost just $1,750 per
household; they cost $1,750 more per household than they
would if they had controlled costs as well as other care.
Supporters of the president’s proposed “public option” and
proposed Medicaid expansion owe it to the American public
to explain their oft-repeated contention that such expansions
would cut costs, when nearly four decades of evidence shows
that government-run health care has succeeded only in raising
costs. During an economic downturn in which we are
already running the highest inflation-adjusted budget deficits
in our nation’s entire history, wishful thinking and empty
rhetoric should not be allowed to trump empirical evidence.
In truth, there is only one reliable pursuer of value in American
health care: the American consumer. If Congress and the
president are truly serious about improving American health
care, they should end the tax discrimination against the uninsured.
They should issue a tax credit to put the uninsured and
self-insured on the same ground as those with employer-provided
insurance. They should promote a more vibrant private
market with greater competition across state lines, greater
consumer freedom, and greater incentives for consumers to
pursue value. These are the changes we need."

Terry means it...
and he has friends too:

www.breitbart.tv/uncovered-video-obama-explains-how-his-health-care-plan-will-eliminate-private-insurance/

Food, Water, Shelter, Power, Sanitation & Other Utility are all paid for by the labor of the people in our society. One way or another. It's the jobs that pay for everything.

But jobs are not guaranteed. So the entire system is at risk. Every worker in the private sector goes through life dealing with the never ending risk of unemployment. Because jobs are not guaranteed people compete for jobs, because jobs are directly linked to survival. The competition for jobs is always driving wages down.

Air is free but keeping it pollution free is not free.
Nothing in this country is free. So workers must have jobs sufficient to sustain the cost of living and global competition is driving wages towards the breaking point. Clearly Health Care can no longer be sustained at the current private sector cost.

Being free is not free. Clearly unemployment is not free either. We pay for that too.

There is a mentality that Health care is cheaper if managed by the private sector. Clearly if the private sector was better at managing our world we would not have the most expensive Health Care System on Earth in this country.

There is no burden in this nation that is not carried by those who work for a living. There is no profit that does not flow from labor and capital working together.

Working cooperatively we can be self sustaining as a people. But that partnership has to be the intention of labor and capital. We appeal as a people to government whenever the private sector becomes dysfunctional in some critical core capacity, such as health care.

There are always bills to pay. The private sector knows what the cost of living is but compensation for most Americans is falling not rising. Prices for everything listed above are rising, not falling. At a certain point it becomes impossible even for people who work very hard and never suffer job loss to keep paying. It becomes impossible as wages dwindle against the costs of living to save money, build retirements and be prepared to pay for health care in their old age.

Global economic forcing has destroyed the equilibrium of our free enterprise system. This weakens the US as a nation. We are in trouble in every sector of our economy, because our global policy is embracing a flawed philosophy that we will never run out of jobs adequate to support our system.

Huge government is certainly a part of the problem as is the deepening fracture between labor and capital. Clearly we cannot compete globally without optimal efficiency in every sector of our economy. As a people we often engage in blame storming before we engage in brain storming to bring cogent solutions to our problems.

Wages are too low in the context of the status quo. Unemployment is too high and capital is blaming labor and government. labor is blaming capital and government and government is pretending they are not the problem while doing nothing to improve their business processes.

We enjoy a collective failure to manage our business as a people. Heath Care is too costly and now must become the domain of government because we engaged the economic forcing to create that outcome. No shortage of stupidity in the USA.

Bring American jobs and compensation in line with the burdens workers here must carry.

Air is free.
Water is not free, unless you live next to a clear mountain stream.
Food is not free, unless you're really good at hunting and gathering.
People need air, food and water to survive, but no one seriously suggests that the latter two should be provided at no cost to all citizens as a basic right. We each have to earn (or bake) our daily bread. There are places to get free food, but we recognize these places as a humanitarian resource of last resort, not as normative.

My question is, why is health care different than food or water? It's important, yes, but does that make it a basic "right" for all Americans, like, what was that other free thing, oh yeah, air?

If we can agree that health care is more like food, say, than like air, then the question is how should it be paid for?

One approach is that it should be paid for like food: you want some, you buy some. We tend to resist that option because we all know that one trip to the hospital for gallstones can be ruinously expensive.

That leads to the second approach: pooled risk. People form 'mutual assurance societies' into which they pay a small sum every month so that if any one of them has gallstones, they are not ruined financially. But trips to the doctor are still on the food model: you want some, you buy some.

The problem with mutual assurance societies is that not everyone belongs to one, or wants to. These non-joiners are betting that either a) they'll never have gallstones, or b) if they do have gallstones, someone will take pity on them and remove them for free. Either way, they are gaming the system.

What seems to make sense to me is to say to the gamers, "you have to be a part of some mutual assurance society so that the gallstones one of you gamers will inevitably get can be treated equitably." To make that statement, however, is to compel gamers (presumably by the coercive power of the state) to fork over some money. When the government does that, it's usually called a tax. I can't think of another case where the government compels individuals to spend money for something that isn't a tax. (I suppose you could argue that the goverment forces us to give car companies money for seat belts, but let's not go there).

The problem with universal health care is that, depending on your point of view, it's either a tax, which people tend not to like, or it's a big government program, which people tend not to like. Or it's both, which, well, you know.

What it comes down to, I think, is a program not unlike what Massachusetts has put in place (I can hardly believe I'm saying this), where you either have insurance (the mutual assurance society), or you pay into a state fund to cover gamers. There probably needs to be a third, "mountain man" option for people to opt out of the system entirely, but that means you remove your own gallstones. What you can't do is pretend to be a mountain man until you get gallstones, and then come crying to the hospital emergency room. That option is not open.

One troubling thing about this plan is that it imposes a cost of citizenship on everyone who prefers not to be a mountain man. Taxes normally go along with earning or spending (or both), but there aren't many (any?) taxes levied per capita just for living in the U.S. This would be one such tax. "Look, pal, either show me your insurance card or give me $8,000." It's a tough choice, but to me it seems the only fair way to go.

HR3200 schematic:

docs.house.gov/gopleader/House-Democrats-Health-Plan.pdf

Q: As long as creating bigger government is not the objective, is that an acceptable incident cost?

Does the outcome matter as long as the intent is righteous?

Survival IS a right.
Health Care is a mandatory component of my survival.

The United States spent approximately $2.2 trillion on health care in 2007, or $7,421 per person - nearly twice the average of other developed nations! That fact reveals the truth about the free enterprise “profit motivated” health care system. It is not less expensive than the alternatives.

Americans spend more on health care than on housing or food. The cost keeps going up! If rapid health cost growth persists, the Congressional Budget Office estimates that by 2025, one out of every four dollars in our national economy will be tied up in the health system. That is not a rational idea that conservative should be in favor of, that is a failed health care system.

Do not make health care a disposable benefit subject to your company’s profitability. The time for true health care reform is now, and as a supporter of a public option and delivery system reform, I believe that Congress must seize this opportunity for change.

The idea that health care is something that the “good” companies provide their employees, but can scale down anytime they want, is no longer a working strategy. The quality of health care coverage is not improving as the costs rise and companies are shopping around and reducing health care benefits. That is good business, but bad for your health care. Wealthy republicans want to own whether or not you get any health care, by controlling wages at a rate the precludes you access to adequate coverage. Two face evil is obvious.

The quality of your health care benefit is tied to the employers profitability, so employees have no security regarding long term medical care or the quality of that health care program. Getting up everyday and saying today I have health care insurance is good compared to nothing better. Going to bed every night and praying you still have health care next month is bad to unacceptable, because EVERYONE needs health care, health care should not be a negotiable element in the hands of any employer. Here today could be gone tomorrow when you need it most. Unemployed architects often do not have health care.

Let me share with you that health care reform legislation which includes a public health insurance option is on its way to the House Energy and Commerce Committee. Here representative will have the opportunity to participate in the markup of this historic legislation in the near future. Here are our thoughts on what I believe should be our top priorities in health care reform.

First, we must create a health care system that delivers quality patient care and services at an affordable cost. And, we have great examples of this already in our medical system at places like the Everett Clinic in Washington State, and the Mayo Clinic in Minnesota. One cornerstone of a system that provides quality care for all is the creation of a public insurance option that ensures consumer choice and access to care for all Americans. At the same time we must include strong delivery system reforms that improve cost containment in the system.

I support a public health insurance option as part of health care reform because I believe that it will guarantee competition and consumer choice. In 2008 the American Medical Association found that 94 percent of health insurance markets were NOT competitive, and the Kaiser Family Foundation found that wages had grown by 29 percent whereas the average insurance premiums had grown by 120 percent.

Competition in the insurance market is greatly needed. THE PUBLIC OPTION can help provide quality care at a more affordable cost. It also provides another layer of accountability for private insurance companies because they will need to remain competitive by keeping costs down and providing quality services. I believe that my constituents, and all Americans, should be able to choose the health insurance that works best for them and their family, so I support President Obama's approach that if your health insurance works for you, you can keep it. That is until you lose your job...

It is also my belief that we must be much more aggressive in this bill in implementing delivery system reforms to improve the effectiveness of current programs, notably Medicare and Medicaid, and take steps to dramatically bend the cost curve. I advocate amending this bill to address major cost containment issues which significantly affect providers and access to care in states like ours. Medicare currently reimburses based on the quantity, rather than the quality, of patient care, and has also resulted in significant geographic disparity in reimbursements. We are constantly working with colleagues and our congressman, to promote in these reforms, the best way to reward efficiencies instead of penalize them.

This has long been a problem here in Washington State where doctors have found ways to bring down costs. But in turn are not rewarded adequately due to the fee-for-service reimbursement model. The current system embodies serious shortcomings!

As a result, it is possible that the regional inequities that exist in Medicare, could be incorporated into this new health care system. We want to find ways to ameliorate this problem to ensure that Washington state, and your State, is not penalized for a more efficient health care system. Bundling of service payments, using a value or efficiency index, and creating a robust physician peer review program would realign payment policies to promote greater quality and significant cost-savings.

The current draft proposal circulating in the House, offers a tremendous opportunity to reprioritize and streamline the health care industry while also improving quality of care. This is the objective, not creating bigger government, but rather creating better and more secure health care for Americans. You may be pleased to know that the draft health care legislation which is circulating in the House would include in the basic package, preventive services with no cost-sharing, dental and vision for children, mental health services, and it would cap the amount of money a person or family spends on covered services in a year. In addition, it would not only prohibit insurance companies from denying coverage for pre-existing conditions, but also limit the ability of insurance companies to use factors like health status and gender to charge higher rates, or cancel coverage.

We propose a model of minimum health care coverage be a part of this legislation. This proposal also calls for a Health Insurance Exchange program that will help individuals and small employers as they search for the health insurance option that best fits their needs. No American should be without health care. Additionally, the draft includes a public health insurance option that would include sliding scale affordability credits to assist those with low and moderate incomes. It would also create a small business health tax CREDIT to make it easier for small businesses to cover their employees and assist in lowering premium costs for businesses.

The House proposal also seeks to fill the "donut hole" in Medicare Part D by providing an additional $500 in coverage in 2011, and increasing that amount over time in order to eliminate the "donut hole" within 15 years. This proposal also seeks to improve Medicare and Medicaid and prevent waste, fraud and abuse in the programs and would eliminate cost-sharing for preventive services.

Is your health care an option owned by your employer?

Wow, I'm impressed by the passion & relatively high level of understanding of our current failed pseudo-socialistic healthcare/insurance/tax-subsidized/redistribution-of-wealth system works, or doesn't work.

Unfortunately, labeling us dissenters as "republicans" is unfair & irrelevant (I'm a conservative independent, I don't give money to anyone, anymore!).

I agree that AIA has "jumped the shark" by not focusing on its original mission while instead choosing to support increasingly socialist policy agendas including climate change legislation with our membership fees.

If we get universal healthcare it not only adds insult to the injury of our economic meltdown but in addition to "cap & trade" & "card check" legislation will accelerate our demise into 3rd world nation status while failing to resolve global climate change, failing to increase business activity or real private sector jobs, and failing to improve our ability to compete in the global marketplace, yet reducing the quality & availability of high quality healthcare by making mediocre healthcare more available to more people who don't pay into supporting it.

No thanks, I don't want to adopt a European or Canadian system either, keep the "Change". I tend to agree that we should purchase health insurance like we do car insurance, don't force companies to offer it, pay out of pocket for preventive/wellness care, eat less, exercise more, give monetary incentives for people to improve their health, be more intelligent about their lifestyle choices, use the emergency room for true emergencies, etc. Get gov't & insurance companies out of our personal lives so we can get on with life, liberty, & the pursuit of happiness!

By that logic, Mark, the AIA should support the principle contained in the Kelo v. City of New London decision.

The confiscation of private property and its transfer to another private entity, for the purpose of increasing tax revenue, is not a legitimate 'public use.' But it is an unconstitutional approach that would "flood the architectural profession with cash" as well.

The AIA considered, briefly, supporting that misuse of government - unfortunately.

Knuckleheads! The AIA should be supporting Healthcare Reform as it would lead to a boom in the construction industry! WTF Is this blog dominated by Republicans still pushing the failed agenda of the Bush Cheney Regime? If 40 million Americans suddenly were given medical coverage, we'd need more hospitals, clinics, medical schools, medical manufacturing, office buildings to administer insurance programs etc. An expanded medical industry plus future growth due to retiring Baby Boomers could flood the architectural profession with cash, and jobs! End the war, end tax cuts for the rich, get illegals to pay tax...And Nationalized Healthcare will pay for itself.

A description of Norway's tax approach:

www.nationsencyclopedia.com/Europe/Norway-TAXATION.html

Both the central government and the municipal governments levy income and capital taxes. There is also a premium payable to the National Insurance Scheme. For individual taxpayers, income taxes and premiums adhere to the pay-as-you-earn system.

Taxes on corporations are paid in the year following the income year. Corporate income taxes are levied at a flat rate of 28% (a combination of 21.25% national tax, and 6.75% municipal tax). Also, employers contribute up to 16.7% of paid wages to the Social Security Scheme. Companies involved in oil or gas pay a special oil tax of 50% in addition to the standard 28%. All income from capital is taxable at 28%, except dividends, which are taxed at 11%.

Central government personal income taxes are levied at progressive tax rates, which differ for single taxpayers (class one), those with one or more dependents (class two), and for nonresidents (class zero). In 2002, individuals in Class one and Class zero were liable for a municipal tax of 28% on the increment of income above 28,800 Kroner (about $4,000); for Class two taxpayers, the threshold for the 28% tax was twice that amount (57,600 Kroner). The national income tax schedule in 2002 had three brackets. For individuals these were 0% up to 289,000 Kroner (about $40,000); 13.5% on the next increment of income up to 793,000 Kroner (about $109,3000); and 19.5% on the increment of income above this level. The only difference for Class two taxpayers, with dependents, was an increased tax-free base of 342,200 Kroner ($47,160). A number of additional deductions from taxable income are available including allowance for some travel expenses, insurance payments, mortgage interest payments, living allowances, and deductions for contributions to capital investments. A withholding tax on wages can be credited against income taxes. There is also a municipal wealth tax, ranging from 0% to 1.1% and a land tax with rates from 0.2% to0.7%. Gifts and inheritances are taxed according to progressive schedules with a maximum rate of 30%. The premium for the National Insurance Scheme is 7.8% of assessed income for wage earners, 3% for pensioners, and 10.7% for the self-employed.

The main indirect tax is Norway's value-added tax (VAT), with a standard rate that has increased from 20% in 1999 to 24% in 2003. A reduced rate of 12% is applied to basic foodstuffs, and there is an extensive list of VAT-exempt goods and services, including health and social services, education, passenger transport, hotel accommodations, travel agents, government supplies, etc. Stamp duties are charged at a rate of2.5%.

###

??? A National Health Premium of 7.8% or 10.7%...
??? Value added tax of 24%...

www.washingtonpost.com/wp-dyn/content/article/2009/05/26/AR2009052602909.html

"There is a growing awareness of the need for fundamental tax reform," Sen. Kent Conrad (D-N.D.) said in an interview. "I think a VAT and a high-end income tax have got to be on the table."...

Still, Orszag has hired a prominent VAT advocate to advise him on health care: Ezekiel Emanuel, brother of White House chief of staff Rahm Emanuel and author of the 2008 book "Health Care, Guaranteed." Meanwhile, former Federal Reserve chairman Paul A. Volcker, chairman of a task force Obama assigned to study the tax system, has expressed at least tentative support for a VAT. ...

"Everybody who understands our long-term budget problems understands we're going to need a new source of revenue, and a VAT is an obvious candidate," said Leonard Burman, co-director of the Tax Policy Center, a joint project of the Urban Institute and the Brookings Institution, who testified on Capitol Hill this month about his own VAT plan. "It's common to the rest of the world, and we don't have it." ...

###

The administration and its conspirators like the Urban Institute, Brookings Institution and, unfortunately, the AIA have a vision for a radically altered way of life for you and me (think "change"). We should reject it and their leadership as well.

If a Government based system is to be competitive, it needs to take its focus off the insurance. One needs to address and be effective at the source. An average American does not long for a five star treatment in a fancy hotel like hospital. He/she longs for quality based care that saves lives and is available without having to cross hurdles.
I come from India and have 5 medical specialists in my immediate family. They all work in Government funded hospitals. None of them makes any outrageous amount of money. They work in bare minimum luxuries. What keeps them going is the respect and work satisfaction that comes from treating the poorest of the poor.

I understand that it is hard to motivate people to aspire for a higher purpose in life.

But the challenge for Washington should be to create an alternative business model for health care that competes with the private system. They stand a much better chance at controlling the cost. Otherwise the nexus between the insurance and privately operated health care is going to shoot the cost up the roof.

I am working on a jail now and often joke that here we do jails just like we did government hospitals in India. You put concrete and steel everywhere and never come back to it for the next 50 years or so.

But guess what, those hospital are on the national map in the quality of health care !!!

Health insurance needs to move towards a preventative medicine approach. I am healthy but pay the same amount as a non-healthy, non-compliant person. Were is the incentive? Doctors should be paid based on results. Don't pay for an illness were the Doctor just prescribes a pill with no repercussion for the patient for not making lifestyle changes. Money is a powerful incentive.

I just read our constitution (including Amendment 10) and couldn't find the part where it is the government's responsibility (or right) to provide free health care for its citizens. But what does that matter? If it feels good, forget the constitution. It's just the framework for our government and what they specifically can do, and more importantly what they cannot do. Well, I guess it just gets in the way of good intentions.

I am glad to see the AIA has become an activist organization fighting for social justice and enviro-justice instead of defending the proper and legal practices of architecture and the interests of its members. I mean it's not like there are any contractors out there illegally practicing architecture, or code officials weakening our designs by letting the contractors get by with code violations exposing us to risk, or countless other issues weakening the profession. Instead our professional organization is preoccupied with promoting the President's agenda. Every initiative just seems to be picked up by the AIA. It's so transparent it's tragic. The AIA constantly asks us to promote this socialist agenda or that, asking for money, time, or support to promote sustainability issues yet cannot find the time to address actual immediate legal issues concerning our profession today. How many requests from the AIA have we all received asking us to send letters to our legislators promoting socialist and anti-business causes? Too many. This organization needs a serious leadership overhaul and new mission statement.

Yes, insurance is not a right, but getting gouged shouldn't be a right, either. I had a friend whose child had a broken arm - she was refused at the hospital because THE INSURANCE WOULDN'T PAY FOR IT! By the time the nonsense was resolved, the arm had started healing and had to be re-broken. The existing private system is broken, yet despite pledges to improve, there is no improvement. I want what they have in France, or in England, or in Norway. Yes, it's taxes, but my god you can get treatment without having to re-break your arm!

If the above people who wrote those comments actually knew about the excellent level of quality health care available in Norway, they wouldn't have written those comments. The outcomes in nearly all categories--life expectancies, child birth deaths, cancers, heart etc are all very nearly the highest in the world. The USA with the highest costs is about 37th worldwide.
Despite insurance company propaganda, patients in the successful countries, are seen immediately -- there is not the delay (threatened by insurers) while the clinic determines payer protocols as we do in the USA. There is no waiting. People can go to Doctors of their own choice when they choose to -- they do not have an 85 page contract (that I have from Blue Cross) that spells out which PPO or providers are acceptable or not.
Finally the quality is outstanding for everyone, AT ONE HALF THE COST PER PERSON OF THE USA (including the 45 million uninsured). That means taxes and costs of doing business would go down. If GMC figured $1800 per car for health costs, and we had a public system, GMC could have charged $1800 less per car, and just maybe would not have gone under.
By the way this is true in Holland, Belgium, France, Germany, Singapore, Switzerland, Australia, Sweden, Denmark, Canada and many many other countries that have more positive outcomes than our USA level of 37th. Get informed.
A healthy population is a productive, effective, and intelligent population. Why are we letting the insurance world charge a 30% mark-up and profit (nearly $3 trillion), making our system extra complex, ineffective and super costly?

"under a government sponsored system we also would have an obligation to one another to take much better care of OURSELVES, to minimize our impact on any system"

I assume that, in this proposed approach, the governement is the arbiter of each individual's obligation. As such, I expect, the government to have the ability to enforce compliance.
What a proposition to ponder on Independence Day!

But when a long train of abuses and usurpations,

pursuing invariably the same Object evinces a design to reduce them under absolute Despotism,

it is their right,

it is their duty,

to throw off such Government,

and to provide new Guards for their future security.

###
Enumerated Powers Act
HR 450
A BILL
To require Congress to specify the source of authority under the United States Constitution for the enactment of laws

Read it.
###

The question at hand is not a limited one pertaining to the acquisition of health care services.

What happens when a sufficient number of citizens refuse to consent to an ever expanding, consolidated government that is itself unsustainable?

What happens when its legitimacy vanishes?

SIC SEMPER TYRANNIS

Would you support a plan by a man who:

-Is ending the educational voucher program in DC for attending private schools, but refuses to subject his own children to a public DC school?

-Is trying to force his socialist scheme for a govenment-run health care system on Americans, but wouldn't THINK of actually being subjected to it himself?

Any more information needed here?

I recall a perfectly apt quote:
"If you think healthcare is expensive now, wait until the government starts giving it away for free."

I would allow choice: Those who wish to contract with conventional private insurers, and thus enjoy being ripped off, would continue to be able to do so. All others would be served by an alternative single payer system. As it is, insurers and health providers see Americans as a growing annuity. They charge exorbitant rates for just about everything because they can; we have no effective alternative unless eligible for full Medicare coverage. However, it is also true that compared to Europeans, we are fat, overfed, and lazy. Despite all our various magazines, clubs, and government educational programs devoted to diet and exercise, our collective accumulation of lard and arterial plaque continues apace, along with associated health problems. Additionally, without any affordable alternatives, we delay dental work and other medical procedures that are preventative, leading to both more chronic and acute problems down the road. Thus, we have a two-headed problem: overpriced private health services coupled with a population dedicated to bad habits. This is a perfect storm of unsustainable trends that Big Pharma and the entire medical industry see as an endless opportunity for grossly inflated profits. As citizens, we deserve better, but under a government sponsored system we also would have an obligation to one another to take much better care of OURSELVES, to minimize our impact on any system. Otherwise, even a single-payer system will tend to grow more expensive - and less effective - than the very effective ones in Canada and Europe.

First of all Health Care is not a right, neither is Social Security, or Welfare. Second, the term health insurance is not correct. Everyone is going to get sick one day. Insurance is to provide the assistance to pay for the unforseen to happen, like a car wreck or a house fire. The human body will be ill. There is no prevention of that. If anyone were sick in this country, all they have to do is go to a doctor or a hospital. One doesn't need an insurance card. The problem is that you have to pay out of your pocket and because we have so many who feel entitled to suck off the teat of government, they continue to expect others to pay their way. We have a Medicare system now that is rife with criminals pilfering the common man's medical stash. And what does the government do? Continue to fund it and not weed out the corruption. For the Government to pretend that it can run a business by offering cheaper services, is hogwash. Like the current administration, they will continue to print money to fund any plan and put private insurance out of business, no matter how bankrupt it becomes. I think about going to the DMVB to get my drivers license and imagining one of those people rationing out my healthcare. Just like GM and Chrysler, they will never be allowed to fail, no matter how continuing to keep it running is devastating to the economy by putting private enterprise out of business and creating massive unemployment: oh wait that is happening now. That is why I boycotted GM and purchased a car from Japan last week.I will never support a government run program that was confiscated from the private sector. I refuse to join a program that will pay for illegal aliens or "the poor" to suck off my tax dollars that I see wasted on slaves to the government. I have a great health plan and I negotiated for it when I came to work at my current business. I am tired of working so hard and paying so much in taxes only to have the government frit it away on the unproductive in our society. Government is not a business. Governments only reason for existing is to protect us from an alien foe, not give to us all our daily needs. Government doesn't and shouldn't give us anything, the constitution provides our basic rights and the last time I checked welfare wasn't one of them. All these programs should be cut and should not even exist. It is my belief that when you take a handout from the government you become a slave. When you take money from the government they can tell you how to spend it and how to live your life. We have a nation of slaves in this country that only want more off the backs of others. This insurance plan is a nightmare and will put many out of work, and I am seeing the same circumstances that I saw with Jimmy Carter. If our politicians would worry about passing tort reform and de-regulating healthcare, we would see a revolution in competitive pricing. I think it is funny that those who are writing the bill, won't have the same plan as us. Maybe if I could get the same health plan that Congress and the President gets, then maybe I would suppport such a scheme.

David's and Chris' suggestions might work well for those firmly ensconced in the middle class. However, there is an increasing proportion of the US population who cannot benefit from tax credits because they pay so little due to low taxable income or who work outside of the tax structure altogether. Chris also suggests that insurance companies constitute an efficient way to spread risk and cost, which is a point of view harder to justify the more we understand how they now function.

We currently have an indirect socialized medicine system by which the employed and insured and their firms pay inflated medical costs and insurance fees to finance an ad hoc medical care social net system that tries to deliver care to the uninsured. It would be far more efficient to run a public option system than to continue this cobbled-together system that more closely resembles the medical systems of third-world nations than it does that of an industrial superpower.

I prefer none of the above. I think we need:
1. A mandate that all have coverage
2. A law that insurance cannot deny coverages for pre-existing conditions nor drop coverage
3. A government voucher somehow tied to a person's health so that the insurance companies will have an incentive to insure all people
4. Ability for individuals to upgrade their plans for optional coverages

This creates real competition in insurance, provides a safety net for the low income & elderly. Abolishes CMS or repurposes it to the role of #3. See "The Healthcare Fix" by Kotlikoff for better details.

Clearly, any government-run program will end up causing severe health care availability and quality issues. All one has to do is take a look at Medicare, Medicaid and Social Security to see how the corruption, fraud, financial fragility and poor quality of available care amounts to utter failure. The free market must be the main provider of health care, including insurance. Tax credits, tax incentives, and other forms to make insurance affordable is a must. Additionally, tort reform is a major component that must be addressed in order for insurance costs to go down. Another aspect will involve reduction of overly burdensome government regulation, including both Federal and State requirements that artificially inflate insurance costs to cover unneccessary or inappropriate procedures. Portable insurance plans should become available as well. Next, the myth that we have 46 million people without health care needs to be corrected. By simply looking at the data from where that number came from, one easily observes that millions of people within that number are actually illegal aliens and should not be covered. Additionally, millions more were simply in between jobs, so their coverage was only temporarily lost. More millions had only been without insurance for less than a year. Also, millions more had elected NOT to obtain insurance because they didn't want to pay for it, not because they couldn't pay for it. Likewise, more millions did not prioritize health care insurance, even though they made enough money to obtain some form of insurance. While they may not be wealthy, their level of income would have enabled them to purchase some sort of insurance should they have elected to do that. Since this realization of the number of uninsured drastically reduces the number of uninsured, the situation is not near as dire as many claim. By enacting strong tort reform, the costs of insurance would be lowered allowing many more to purchase such insurance. Finally, one only has to look at the multitude of government health care programs both domestic and abroad to realize the severe defeciencies these programs represent. We should NOT rationally even consider such a program, particularly when analyzing the plan that President Obama has promoted. The only result in such a plan would be the crumbling of our healthcare system, that, in spite of its flaws, is the best in the world. We can make it better, but we have to take it in the proper direction, not toward socialized medicine.

I prefer to see employer sponsored health care completely abolished. Public health care would also be abolished. Only private individual (or family) plans would be allowed. Then to provide for the needy, we simply have the IRS admister a tax credit on a sliding scale based on average cost for a PPO insurance plan for your household. This way, everyone gets a private plan they choose themselves regardless of income. Those more fortunate would still benefit and could thus hire more employees with the extra money they save. This would also allow employers to pay their employees roughly $1000 more per month per employee.