Maybe not that, but currently, a patient that feels slighted in some way can complain to his doc, then the group or IPA by virtue of formal appeal. More times than not, you will get reconsideration. If that doesn't help, then states have an HMO assistance hotline that will get involved. Worst case scenario, while you can't sue your HMO (thank you Knox-Keene Act), you can go after your doc(s) for malpractice, assuming there are damages to be worthy of that adventure (the ole "me and my attorney really think I need that MRI" routine). But you won't be getting any Christmas cards from your doc anymore!

If the Feds run health care, it will be their rules and if you feel slighted in some way, TOUGH! No reconsideration, no appeals, no treatment, period!

Keep in mind this bill is not eliminating private insurers, infact its working through the private insurers. No single payer in the bill. You could argue that altimately a single payer will be introduced. But looking through the years it has all been a patch work affair creating high risk pools the whole way. Altimately that is a failier, it can not be sustainable over time.

What I would like to have seen is the fed remove the anti-trust exemption from health insurers and remove the "50 state health insurance regulators" and allow cross border business creating large groups. Go easy on Tort reform just to keep everone honest. If a particular insuance company didn't like that let them insure inanimate objects such as cars.

I absolutely 100% agree. Let the free market drive prices down with cross-border competition! But where is that in the "proposed" legistlation? Needs to be there...

Don't worry about the thought of tort reform so much. In California, tort reform has been in effect for a little while now ($250,000 cap on pain and suffering - no cap on economic damages) and these inactments have dropped malpractice rates by greater than 30-50%. On numerous fronts, this drops the cost of medical care quite substantially...

One thing I realize is the division folks find themselves pertaining to the delivery of healthcare. Everyone finds themselves in their own box, those with medicare, VA, corporate or government employment coverage. I have no insurance, can not acquire insurance for my wife in my State. So, I'm desperate for this bill to pass, unfortunately so, the pre-existing condition is pulled.

Forgive me for jumping in here so late, I’ve been away for the past few weeks and just returned and felt that I needed to add my thoughts to this conversation.

I think there are numerous reasons why doctors burn out and become unsatisfied with their work. I’m sure much of it is due to onerous regulations (both political and/or corporate related) affecting their remuneration no matter where a physician is practicing. Considering that many doctors need to see patients every 10 to 15 minutes just to pay the overhead bills especially the outrageously expensive malpractice insurance costs in the US its no wonder so few would consider recommending their career to others. I have family members who are primary health care providers in different countries so I have a unique insight into their worlds. It is a very deeply committed profession, most are not in it just for the profit or the pay as some would suggest.

As a patient I’m frequently frustrated here in Canada too but from where I sit it seems that it is the insurance companies have the upper hand over the government, doctors and patients in the USA. No body ever seems to complain about the fact that the health insurance companies are making too much money. Why do people always dump on the doctors just because they make a higher salary than the average? It's no wonder they get frustrated.

Putting aside any rhetoric for or against universal health care I've had the opportunity to see how medical care is delivered in a few countries and I can’t say that universal or private care is any better than the other. They each have their pros and cons but ultimately it all boils down to who is going to pay for the health care doesn’t it. Personally I trust my government more than insurance companies.

I spend a lot of time in Europe and I like Switzerland’s model of health care best. It’s a completely consumer driven medicine system. By their laws everyone there has to buy insurance and all patients are considered “private”. Anyone who has a lower income and couldn’t afford the insurance premiums would qualify for assistance. Not really much of a problem for the Swiss since it is a very affluent society, but so is America isn’t it. The Swiss government provides guidelines that the insurance companies must abide by and this ensures that the patients have many very competitive choices allowing them to select the health care coverage that suits them the best. Physicians, hospitals and clinics have rate guides that need to be followed too regarding their compensation levels and as I understand it they are very fairly compensated, as they should be. As a result the Swiss are able to attract many of the worlds best doctors, everyone is covered, the insurance companies all have good business and their health outcomes are some of the best in the world. It’s a win win situation for all involved.

I’m sure this is a very challenging time for doctors, patients, corporations and governments in America. I have no doubt that with the strength of will and innovation America is so well known for a solution will be found. Perhaps it won’t come in one quick sweeping legislative change as is being pushed but with time and perseverance it will become be the right solution that fits American best.

It's nice to be back to such interesting conversations here.

Warm wishes to you all.

MsL

Thanks for the input Mslday! Yes, there are systems I like, the swiss, German even Taiwan. I'm not in favor of the UK's system at all. Canada seems fine but I do hear many complaints from folks I know there. Most seem trivial, however. I've also been told the different provinces invest different amounts on healthcare to its citizens.

I do hear many complain about doctor and hospital income and I personnally do not have an issue with someone making an upper middle class income whats so ever especially when they're doing a good job. Hospitals have other burdens such as treating tons of non emergency people who have no insurance at all.

I think its about time the fed regulate health insurance companies, currently the 50 States regulate in 50 different ways. If a insurance company does not like certain laws in any particular State that restricts the greed, the lack of payout, the canceling of patient coverage, denial of care, the insurance company packs up and moves its racket to a different State.
This causes quasi monopolies in most States. They blab this isn't true because there are 1500 health insurance companies. But, what they don't tell you is 85% of all health insurance transactions are done by 5 major carriers and it is these five that dominate most States.

Also, health insurance companies enjoy the anti-trust exemption. What this is it allows insurance carriers to collude and altimately fix prices. They enjoy this because of the fact that 50 States regulate instead of the fed. Because of this, insurance companies explain they need to collude with others in many States to gauge their business decisions.

Thanks for your comments.

I agree that something has to be done about health insurance. The insurance companies are indeed the bad guys. Oligopolies usually do tend to collude on pricing.

I wish I shared your optimism that the politicians will solve this problem best.

No way do I believe that they will fix it in the best interest of Americans. By the time this bill is passed there is going to be a TON of pork buried in it. Its just a total bummer. I don't believe anything that I hear the Democrats say any more. (And if the GOP were writing it, I'd say the same thing, I'm technically an independant).

I do like a few of the amendments that thrown in that will be phased in immediately - the elimination of pre-existing conditions, caps on insurance coverage, and extension of insurance coverage to children until the age of 26. But those were last minute additions. The "insurance" part won't be effective for a while.

How many have read the bill?

Obviously a very polarizing issue, swayed by your own experience as either an insured, non-insured, provider, etc.

Based on my 25+ years of experience in navigating the current mess, IMHO the proposed bill will serve to only complicate matters more and ultimately decrease the amount, type and quality of care that all will get.

Whatever happens, I just hope and pray that patient care at the end of the day, is not sacrificed. On that, I think we can all agree!

I am wondering though if the pre existing condition is taken out if the insurance companies will charge so much extra that for many they are not going to be able to afford it.

I understood this morning on Fox News and another channel that the pre-existing clause hasn't been taken out of it.

I do feel like a lot of the Drs. do deserve what they get to take care of patients, sometimes more and sometimes they deserve less or nothing for a visit. They do pay a high malpractice insurance and have large overhead on their offices because they have to be kept up so nice.

As far as people on Medicare and Medicaid, yes it does bother them that they want to take away from it. I'm sure all of you have Mothers, Dads, Grandparents, kids, brothers, and sisters on it that need medical care also.

I also don't feel like people who make decent money should pay 45% taxes to take care of people who aren't making good money. That's a modern day Robin Hood attitude. I don't feel like my kids should have to support my medical care.

My hope is that people don't have such short memories that come election time they forget this past year.

I will be interested to see how many people will be able to get insurance after this goes through.

Ada