Goodbye to US HealthCare?

[Roughneck]

Re: Goodbye to US HealthCare?

IMHO the government is NOT taking over healthcare, they are actually privatizing the whole damn thing!

Lets say you are a young person not insured. Under penalty of fines and jail you are forced to buy insurance. Who are you going to buy insurance from? The cheapest source which will be a government subsidized plan. The government wants their money because they are healthy and will not use services so they can provide insurance to others.

I do agree the insurance companies are lobbying hard to stay in the game. But the true socialists like Obama and Pelosi see health care as a government entitlement. The reason the government option is crucial is that over time they know that everyone will be forced to migrate to their system. In fact one provision in the house bill reportedly made the issuance of private insurance cease after a certain period of time.Canada in fact made private insurance illegal when they passed their system.

The democrats have already stated they will use the senate rule for budget provisions to bypass a filibuster if necessary.The so called nuclear option.

One should also not under estimate what government control of health care means to true socialists. It is an avenue for them to control every aspect of your life including life itself by deciding what treatment,care you are entitled too.

[grapejelly]

Re: Goodbye to US HealthCare?

this plan will become a government monopoly plan. there is no way around it. There will be so much moral hazard that forces people into the government plan that it will take over. It's a trojan horse for complete one-pay monopoly health care.

[c1ue]

Re: Goodbye to US HealthCare?

Innovation is NOT being promoted by the big drug companies? Alright, I think we're done here. You are demonstrably wrong.

I've put up my numbers and example - why don't you put up yours.

So far all I've seen are a series of statements each of which I've put out specific counterexamples.

You're going to have to do better than just your word.

[Crazyfingers]

Re: Goodbye to US HealthCare?

this plan will become a government monopoly plan. there is no way around it. There will be so much moral hazard that forces people into the government plan that it will take over. It's a trojan horse for complete one-pay monopoly health care.

I respectfully disagree. Who do you think wrote this 2000 page Wooly Mammoth of a bill? A bunch of social commies or the lawyers of the lobbyist? I smell the lawyers of the corporations that pull the puppet strings all over this bill.

The Right always quote Rahm Emanuel saying a crisis cannot go to waste. A socialist commie didnt come up with that!

"Only a crisis -actual or perceived- produces real change. When that crisis occurs, the actions that are taken depend on the ideas that are lying around" Milton Friedman

Washington is oozing of neoliberal economics and the U of Chicago's economics. What industry would not love a bill that makes it mandatory, by law, to buy their products? This health bill is a neoliberals wet dream.

The government social stuff is a smoke screen.

Donald Rumsfeld would be proud.

Either way, the bill stinks.

[grapejelly]

Re: Goodbye to US HealthCare?

http://news.google.com/news/url?sa=t...ce-people.html

The bill proposed by Senate Finance Committee Chairman Max Baucus, D-Mont., imposes a $200 fine on anybody who didn't buy insurance, increasing to $750 by 2018. Other versions would impose a fine of 2.5 percent of family income.


Mr. Feldstein estimates the average cost of a family plan at $13,375 annually and an individual policy at $4,800. Ms. Trautwein goes with the Congressional Budget Office estimate of $5,000 for an individual health insurance policy.


A fine of $200 or $750 is obviously well below these figures. A fine of 2.5 percent of a family with $75,000 in income would be $1,875. For a family or individual with an income of $50,000 it would be $1,250.


The economically rational action for people in such situations who are reasonably healthy and do not expect to need pricey care would be to decide not to have health insurance and pay the fine. The annual savings would be anywhere from $13,175 (for a family, if the fine is $200) to $11,500 (for a family with $75,000 in income paying a 2.5 percent fine).
If they knew that they could purchase health insurance without any penalty for preexisting conditions, plenty of people would decide to go without health insurance until they came down with a malady or condition that seemed likely to demand expensive medical care. But this would mean that the pool of insured people would shrink and would be concentrated among those with serious or expensive conditions. Premiums would have to rise to cover the costs. And it is altogether possible that even more people than today would not have health insurance – and it would be an economically rational decision.


If this unintended consequence developed, it is likely Congress would institute subsidies not just for lower-income but for some middle-income people – or create a "public option" (assuming one is not included in the original legislation) that would have to be heavily subsidized to be affordable.

this is exactly what will happen. And it will lead to a single heavily subsidized public option that everyone is practically forced into, except for the very rich.

[KGW]

Re: Goodbye to US HealthCare?

we may not have a free health care market, but we do have choices. I have a private plan I pay for. I am happy with it. Leave me the $#$#@ alone. Don't screw with it, don't make me participate in *your* plan.

This is all Road to Fascism stuff, accelerating at a faster rate. I hate it.

And, lest you forget, it is being brought to you by the insurance companies, big pharma, and such...

[thriftyandboringinohio]

Re: Goodbye to US HealthCare?

this is exactly what will happen. And it will lead to a single heavily subsidized public option that everyone is practically forced into, except for the very rich.

You say that like it's a bad thing.

[grapejelly]

Re: Goodbye to US HealthCare?

You say that like it's a bad thing.

it's a diminution of choice. Liberty and freedom mean having choices. So yes, it's a bad thing.

[thriftyandboringinohio]

Re: Goodbye to US HealthCare?

it's a diminution of choice. Liberty and freedom mean having choices. So yes, it's a bad thing.

Your point is clearly true, but perhaps overly idealistic.

I see practical factors that balance and offset the natural goodness of unlimited choices. They include the gravity of harm should my choice go wrong, and the effort required to get the choice right. I choose my pizza shop lightly and quickly and I like abundant choice there - what's the worst that could happen? Health insurance is just the opposite -it's literally a life-or-death decision, with a side order of potential personal financial ruin. And for most americans, the individual has little or no choice of insurance companies. Our employer chooses for us, and we can like it or lump it. My last employer selected lousy insurance for me because the agent was an old poker buddy of his - it cost me extra thousands of dollars.

[grapejelly]

Re: Goodbye to US HealthCare?

Your point is clearly true, but perhaps overly idealistic.

I see practical factors that balance and offset the natural goodness of unlimited choices. They include the gravity of harm should my choice go wrong, and the effort required to get the choice right. I choose my pizza shop lightly and quickly and I like abundant choice there - what's the worst that could happen? Health insurance is just the opposite -it's literally a life-or-death decision, with a side order of potential personal financial ruin. And for most americans, the individual has little or no choice of insurance companies. Our employer chooses for us, and we can like it or lump it. My last employer selected lousy insurance for me because the agent was an old poker buddy of his - it cost me extra thousands of dollars.

employer chosen and paid for health insurance is stupid. The consumer should be spending her money, not the employer.

[thriftyandboringinohio]

Re: Goodbye to US HealthCare?

employer chosen and paid for health insurance is stupid. The consumer should be spending her money, not the employer.

I second the motion from Ambassador Grapejelly!

[KGW]

Re: Goodbye to US HealthCare?

Solidarity, Individualism and Public Goods

Obama's Flawed Case Against Single Payer

By ALAN NASSER
The liberal imagination has broadened the scope of what it wants to dismiss as unrealistic, utopian and unpragmatic, i.e. as for all practical purposes impossible. These claims have typically been accompanied by the assurance that “This is not something that Americans would go for – it’s not the American way.” There are countless variations on this theme. Obama’s case against a single payer health care system is a conspicuous case in point. What distinguishes Obama’s position on this issue is not merely the weakness of his “arguments”, but the straight-ahead factual falsehood of the some of the counterclaims he has put forward in order to turn the desirable into the impossible.
The Alleged Impossibility of Universal Health Care
In May and August, 2007 Obama stated his position on single payer:

"If you're starting from scratch, then a single-payer system'-a government-managed system like Canada's, which disconnects health insurance from employment-'would probably make sense. But we've got all these legacy systems in place, and managing the transition, as well as adjusting the culture to a different system, would be difficult to pull off. So we may need a system that's not so disruptive that people feel like suddenly what they've known for most of their lives is thrown by the wayside." (May, 2007)
" [W]hen we had a healthcare forum before I set up my healthcare plan here in Iowa there was a lot of resistance to a single-payer system. So what I believe is we should set up a series of choices....Over time it may be that we end up transitioning to such a system. For now, I just want to make sure every American is covered...I don't want to wait for that perfect system...” (August, 2007, at an Iowa roundtable)

Obama offers 5 reasons for not supporting single payer.
First: “..we’ve got all these legacy systems in place” simply means that our system is not single payer, and we’ve had it for a long time. Obama has turned himself into a bent sort of Burkean conservative: we have been marinating in a tradition which so permeates our way of being in the world that to do away with it would upset social life as we know it. This tradition includes…. insurance-industry-based health care! More mundanely: we haven’t got it, so we can’t have it.
Second: it would be hard to “manage the transition” from a deeply flawed system to a much better one. Harder than it was to effect the transition to Social Security, Medicare, Medicaid, desegregation, etc.? In each of these cases, what many people had “known for most of their lives” [was] “thrown by the wayside”. It belongs to the nature of any move from one way of doing things to a very different one that the transition will take some doing. That fact alone settles nothing. What matters is how urgent is the need for change. The US’s irrationally costly system which leaves millions uninsured, a fate suffered by the citizens of no other developed capitalist country, is surely intolerable. We have been given no reason to think that the cost of a transition to universal coverage is so great as to outweigh the massive benefits of this tried and tested arrangement. Obama’s excuses amount to a cleverly disguised a-priori argument against any consequential transformation of the status quo.
Third: the “difficulty” [i.e. costs] of “adjusting the culture to a different system”, given that there is “a lot of resistance to a single-payer system” , outweigh the benefits of single-payer. But what matters is not what a few selected Iowans are alleged to have felt about universal coverage. The demonstrated preferences of the democratic majority can’t be irrelevant.
On this issue Obama clearly means to imply that “Americans” don’t support single-payer. This is factually false. It’s improbable that Obama is unaware of the results of many surveys on this issue, the most recent, to my knowledge, having been conducted between December 14-20, 2007. The results of this Associated Press-Yahoo poll are worth reproducing as they were reported:
Subjects were asked which of the following 2 views comes closest to their own view:

!. The United States should continue the current health insurance system in which most people get their health insurance from private insurers, but some people have no insurance.
2. The United States should adopt a universal health insurance program in which everyone is covered under a program like Medicare that is run by the government and financed by taxpayers.

A majority of 65% supported 2, 34% supported 1 and 2% did not respond.
Those polled were also asked “Do you consider yourself a supporter of a single-payer health care system, that is a national health plan financed by taxpayers in which all Americans would get their insurance from a single government plan, or not?”
55% answered Yes, 44% No and 2% did not respond. Single-payer still has a majority here, but a smaller one, probably due to the pollsters’ use of (what is to some) the red-flag term ‘single payer’. [View the full poll results at http://news.yahoo.com/]
Taxpayer funded, government-run health care insurance for all is a public, not a private, good, and it is the only political project that most Americans are on record as willing to pay higher taxes to achieve. There is in fact not “a lot of resistance” to a rational health care system. Obama knows this. But the interests of those who have heavily invested (literally) in him carry more weight than do the most pressing interests of the rest.
The Ideology of Individual Choice and the Logic of Solidarity
Fourth: Obama claims that a health care plan based on “a series of choices” is superior to one that leaves no choice but instead saddles everyone with the burden of full and affordable coverage. Pity those poor Europeans, deprived of their right to liberty by forced access to first-rate health care. In the City on the Hill, few things are more important than the right to choose: which health care system gives us the most choice? This way of thinking is saturated with the ideology of individualism and its private goods, and functions to obliterate solidarity, as opposed to self-interest, as a political and moral value. This is especially pernicious since, as we shall see, it is only concerted action motivated by solidarity that can bring about a health care system from which no one is excluded because they can’t afford it.
When Obama contradistinguishes choice from universal coverage he unwittingly underscores the irrelevance of individual, self-interested choice to political goals motivated by a commitment to solidarity. Preoccupation with the choice between one doctor and another, one plan or another, conceals a crucial assumption, namely that the fundamental issue underlying the health care debate is one about choice and liberty. An individualist ontology implies that our collective fate is a function of whether or not each individual member of society is savvy enough to make the free choices most likely to promote his or her self-interest. But are people who worry about access to health care really concerned with choice? What weighs upon them is that they can’t afford health care. No individual can make on her own the choice to turn the US into a country that makes health care affordable, available to all. Such a choice is not a choice by an individual about her own well being. It is not even a choice about the aggregate sum of each and every individual’s well being. It is a choice we make together about the kind of society we want to live in. To worry about health care because one cannot afford it is, on reflection, to lament the non-existence of a public good, universally accessible health care, one that can’t be reduced to the sum of all individual goods. The survey discussed above indicates that most Americans implicitly know this. The majority endorse a universally applicable measure, taxation, as a means to institute a universally available, i.e. public, good, access to health care. A universal tax, as for education, roadways, health care, is not an individual cost; it is a social cost. Correspondingly, universally accessible health care is not an individual good, it is a public good. The majority would prefer to live in the kind of society that features that public good. It’s a different kind of society from the one we’re currently stuck with.
That kind of society, and the public goods it prioritizes, can be achieved only if it is pursued as a goal by people acting in concert. That’s where solidarity is on display: in collective action motivated by the desire to achieve a public good.
The kinds of goals/goods in question typically involve bringing about a certain kind of society. For example: the kind of society that provides all with affordable health care, the kind of society that makes access to the means of life -e.g. a living wage- available to all, the kind of society that makes the meeting of human needs the principal motivator of economic production, the kind of society that assigns sufficient resources to the reduction of pollution and the preservation of nature,… Prattling on about individual choice creates a conceptual space within which considerations of solidarity and public goods cannot arise. Talking about solidarity in the language of individualism is like trying to score a field goal in baseball.
Obama references affordability in spite of himself when he claims (falsely) that he wants to “make sure that every American is covered”. The fundamental virtue of single payer is that it detaches insurance from employment and thereby from one’s level of income, so that everyone can afford health care. The question of choice doesn’t even arise if you can’t afford to keep yourself healthy. And come to think of it, were health care universally available, the question of affordability would not arise. Talk of being able to “afford” access to health care would be as misplaced as talk of being able to afford access to elementary education.
Solidarity As a Familiar Phenomenon
The issue is worth dwelling on. In everyday life we are all familiar with the pursuit of irreducibly social goods. Think of a family with kids. A rare and highly desirable work opportunity, but far from home, arises for spouse #1. Spouse #2 has come upon a comparable golden opportunity, also far from home. The family wants to stay together. A decision based on the good of either individual spouse would break up the family. What to do? It’s not uncommon in such a situation for the adults to look to determine what would be good for the family. And what’s good for the family is not the sum of spouse #1’s good plus spouse #2’s good, plus the goods of each individual child. We cannot commensurate and then sum up these different and sometimes incompatible goods. The good of the family is irreducibly social, just like universally accessible health care. Families and households act in solidarity all the time.
Obama’s repeated insistence on the market as the primary agent in distributing resources precludes consideration of questions of solidarity from the outset. He is the instrument of domestic advisors benighted by preposterous economic theories hailing the efficiency and liberty-promoting virtues of the market. For these wags the pursuit of individual self-interest, plus competition, makes the world go round and secures for us all the freedom we (are allowed to) want. As we have seen above, the restriction of human-welfare-enhancing political choices to the realm of competition and self-interest deprives us of the freedom collectively to choose to live in the kind of society that provides copious public goods. That’s a big freedom lost.
The Political Psychology of Solidarity
A sense of solidarity is far more prevalent in much of Europe than it is in the Land of the Free. In a New York Times article titled “For the French, Solidarity Still Counts” (by Youseff M. Ibrahim, Dec. 20, 1995), the author describes public reaction in France to a three-week strike by public workers supported by “hundreds of thousands of demonstrators who filled the streets of every major city in France.” Workers were protesting then Prime Minister Juppe’s proposal to slash medical, social welfare and benefit payments. According to the Times:
“Polls showed an astonishing amount of sympathy on the part of those who did not participate in the strike and who suffered the paralysis of mass transit and essential services. Many people explained that they supported the strike because the Government’s austerity programs are stripping layer after layer of subsidies that permitted French families of even the most modest means to sample the cultural and culinary treasures that only the rich can afford.”
One recipient of the social wage was a woman receiving the standard subsidy extended to pregnant women. The subsidy will continue, for each child, until the child reaches 18. Said the woman: “This is the foundation of our Republican system… Equality and fraternity are not mere slogans here. For me the engagement by the state is an expression of solidarity that gives us values… I think most French people want France’s values to be decided by this spirit, not by cold, remote, economic summits that speak of deficits and competition. That was the message of the strikes.”
This past March one million demonstrated across France in protest of proposed cutbacks in the wake of the financial crisis. I am currently living in France for a stretch of time and have witnessed frequent strikes and other expressions of resistance to neoliberal austerity measures. A sad and stark contrast to the sitting-duck posture of so many US workers.
The Times article provides an implicit explanation of why it is that in France and other European countries there is no general resentment of social benefits available, for example, to single mothers, while in the US more than a few working people oppose this kind of support. The Times reports that the subsidy offered to the woman quoted above “is extended to every mother in France regardless of economic or marital status.” In France benefits to single mothers are not regarded as “special treatment” denied to the responsible and hard-working. There is neither social nor psychological soil in which to plant the seeds of resentment, since the single mother is the recipient of a public good available to all mothers.
Fifth and finally: “I just want to make sure every American is covered...I don't want to wait for that perfect system...” If the president truly wanted to guarantee universal coverage he would not have taken single-payer off the table before discussions began. Whatever is finally settled upon, government will neither negotiate drug prices nor regulate premiums, so we know now that millions will remain uninsured. Obama has known that all along.
Obama rigs the game by characterizing single-payer as “that perfect system”. One of the major weapons in the party-liners’ arsenal is to portray those who believe in greater possibilities as naïve utopians blind to the truism that a “perfect world” is impossible in what William F. Buckley liked to call “this veil of tears”. The logic is fine: since there are no finite limits to the greater possibilities of goodness, and perfection is conceived, as Anselm reminds us, as that greater than which none can be conceived, it follows that perfection is impossile down here. But whoever introduced mumbo-jumbo about perfection in the first place? Isn’t the elimination of a great deal of unnecessary suffering enough? Last I recall, single-payer advocates claim merely (sic) that it is way better than what we are offered. That’s pretty good.
Obama’s case against single-payer frames health-care priorities in the language of atomic individualism. Hence, the range of possible outcomes is determined for the worse before discussion begins. I am suggesting that a good part of our resistance and organizing should consist in reminders that an alternative way of thinking and acting is already on display in some of our common practices, and in already existing benefits won for other populations by aiming at public goods to be achieved by concerted action in solidarity.
Hope that helps.
Alan Nasser is professor emeritus of Political Economy and Philosophy at The Evergreen State College in Olympia, Washington. He can be reached at nassera@evergreen.edu

[grapejelly]

Re: Goodbye to US HealthCare?

this Dr. Nasser is incoherent and rambling. I can't make head of tail of his thesis.

[KGW]

Re: Goodbye to US HealthCare?

November 16, 2009 What Real Health Reform Looks Like

We Need Health Care, Not Insurance

By CAROL MILLER
A very complex, mandatory private insurance scheme recently passed the U.S. House. The public is being overwhelmed by sound bites on one hand about how great it is, on the other, how terrible. We are hearing few of the details that are actually in the bill. Having read the bill, it is clear now that what started as health reform has emerged from the political process as health "deform," building on the worst, not the best of the current system.

It is still a toss-up as to whether the Senate will pass any bill this year. However, due to intense political pressure, the Senate is likely to pass a bill that will make some House provisions better and others worse. What actually comes out in the final conference-committee bill is anyone's guess at this point — so little time, so many deals still to be made, so many political funders to be appeased.

A careful analysis of the bill shows that it is designed more for political goals than to eliminate financial barriers to health care. For example, the actual coverage doesn't even begin until 2013, opportunistically after the next presidential election, in 2012. Run on having accomplished "historic reform" but before anyone actually experiences how bad it is? How cynical is that?

Yes, there are some good provisions. The best relate to improving existing programs like the Indian Health Service, community health centers, and health professionals education and training; all are important for New Mexico.

But there bad provisions, which comprise most of the 1,990 pages of the bill. Five key reasons this legislation must be stopped:

• If passed, this law will move the U.S. farther from universal health care, making it harder than ever to accomplish health care justice in the future. If Congress does not have the courage to stand up to the private insurance industry now, it will be even more difficult in the future, especially after giving the industry trillions of new dollars through this terrible legislation. Let's call this what it is: another corporate bailout on the backs of working people.

Pay attention to your federal representatives as they carefully talk about "health insurance reform." They aren't talking about health reform any more. Congress could have defended and built up a system based on popular, high-quality government-run health programs like the military and veterans fully socialized health systems or Medicare, a single-payer program. Instead, the president and Congress let the corporations and government-haters take control of the agenda.

• The legislation institutionalizes permanent inequality in health care. Unlike Medicare where all beneficiaries have a single plan, this bill further divides the U.S. system into tiers based on ability to pay. It creates basic, enhanced, premium and premium-plus plans. A basic plan will provide only 70 percent of the coverage of a "reference benefit package," one that includes even fewer services than most insured people have today. The bill doesn't even mention coverage for essential services like vision and adult dental care except in the most costly premium-plus plan.

• Out-of-pocket costs remain sky high. Everyone will be required to pay monthly insurance premiums. Some low-wage workers will receive taxpayer subsidies on a sliding scale. The lowest income people will have full subsidies. But remember, this is not money for care, it is support only to buy insurance.

Almost everyone will have to meet a deductible, capped in the bill at $1,500 a year, higher than most insurance-plan deductibles today. On top of this, insurance companies can charge even more under various "cost sharing" schemes for items like co-pays and co-insurance.

The bill puts a cap on cost sharing, but the total amount is obscene. The cap for an individual is $5,000 a year and for a family it is $10,000 before the plan must cover everything. Well, not exactly everything. Even after paying this huge amount of money, the legislation still allows the corporations to make us pay, billing for non-network providers and, since it is not a comprehensive benefit package, we are still on our own to pay for health care that the plans refuse to cover.

The legislation creates a law to let these corporations increase what they charge people as they get older. In fact, they can be charged up to twice as much as younger people for identical coverage.

• The legislation makes it illegal to not buy health insurance. The penalties are described in a section of the legislation called "Shared Responsibility." This will let the IRS impose a tax of up to 2.5 percent of modified adjusted gross income for not having health insurance. People on the financial edge, people fighting foreclosure to stay in their homes or people who are unemployed all or part of a year will not be able to afford the insurance premiums or the penalties for not having insurance.

• We will all be drowning in paperwork, which will continue to drive up administrative costs. Right now, insurance administrative waste is about 30 percent of every health care dollar— or about $1 billion a day. Adding more people to an insurance-based system will result in even more money going into this bottomless pit.

As if this isn't bad enough, the government will be setting up many new agencies to oversee the whole process including, at the top, the Orwellian Health Choices Administration, headed by the Health Choices Commissioner. This is not an agency to help us make health care choices, but to choose a health insurance company. The IRS will play a very large role in everything from certifying our income for subsidies to monitoring and taxing people who don't buy insurance.

Health Insurance Exchanges will be created across the country with at least one in every state offering both Web sites and telephone assistance. This is where we will go every year to pick our insurance plan in an open enrollment period of at least 30 days between September and November. We can add this unpleasant task to all of our other fall chores.

It is hard to imagine the chaos and wasted resources with the entire country picking insurance plans at the same time, attended by marketing, billboards, advertising and misinformation. We will gamble as we choose a plan, decide which corporation will be the best for us, hoping we pick one that is not dominated by corporate bureaucrats focused on rationing care to maximize their profits. It is not an easy task and if a wrong plan is selected, we are stuck for a year, until the next national open enrollment cycle.

The United States can do better. We can build on a strengthened and well-funded Medicare program. In Medicare, when a person reached the age of eligibility or is determined to qualify because they have a permanent disability, they are in, and there is no re-enrollment.

Imagine real reform, as simple as adding people ages 55 to 65 years old to Medicare in 2010, 35-55 in 2011, and so on until everyone is included by 2013. The bills that promote this kind of reform are under 200 pages, they are simple to implement, cost effective and equitable. Choose a doctor, choose a hospital when needed and let the government pay the bills. Everyone in one system.

That is what real health reform would look like.

Carol Miller is a long-time public health professional and health care advocate. She lives in Ojo Sarco.

[c1ue]

Re: Goodbye to US HealthCare?

Imagine real reform, as simple as adding people ages 55 to 65 years old to Medicare in 2010, 35-55 in 2011, and so on until everyone is included by 2013. The bills that promote this kind of reform are under 200 pages, they are simple to implement, cost effective and equitable. Choose a doctor, choose a hospital when needed and let the government pay the bills. Everyone in one system.

This is a stupid proposal.

Medicare is a gigantic sucking drain on the federal government - in large part because the federal government has no alternate method of providing services.

If other nations can provide care for their seniors as well as for everyone else without a Medicare pyramid insurance monstrosity, it can be done here as well.

To simply reduce eligibility ages for the existing program is to guarantee US government debt default: no addition income but massive additional expenses.

Real medical reform must encompass both provision of medical services such as is already done with the VA hospital network along with a mandated minimum coverage medical safety net.

It is likely that the tax deductibility of health insurance will have to be moved from employer to employee as well.