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	<title>Comments on: Giuliani&#8217;s health plan</title>
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	<description>medical blog</description>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2007/08/giulianis-health-plan-2.html/comment-page-1#comment-78554</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Fri, 03 Aug 2007 02:38:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/08/giulianis-health-plan-2.html#comment-78554</guid>
		<description>Famalies who make 18000 a year qualify for Medicaid.&lt;br/&gt;&lt;br/&gt;Paying 5000 a year on an income of 45,000 is paying 11% of  your income for health insurance.  The nation is paying about 15% of it&#039;s total gross income for healthcare. So you are getting off cheap. Any system of national healthcare would likely have your paying at least that, probably more.  You couldn&#039;t get a subsidy since your income is near the median.  You are the one who will be doing the subsidizing. I pay about 11,000 a year. &lt;br/&gt;&lt;br/&gt;We should never forget that Medicare was a solution to the crises of old people paying 20% of their income for healthcare.  Now, they pay 19% anyway.  Every solution has unintended consequences.  &lt;br/&gt;&lt;br/&gt;A tax deduction for individually purchased insurance will not help everyone.  But it would likely sweep a couple million more people into the insurance pool, and is just plain fair.  &lt;br/&gt;&lt;br/&gt;There is no universal plan that will actually cover everyone anyway.  What they don&#039;t tell  you is that most of the growth in the pool of uninsured &quot;Americans&quot; is in illegal aliens. Yes, they count them.  But you can&#039;t create a plan that covers people in the country illegally without making even more of a mockery of the border itself.  Not to mention the magnet it would create for &quot;medical immigration&quot;.  A financial disaster and not politically viable.  Yet, without the interface with the immigration issue solved, the uninsured problem can not be solved.&lt;br/&gt;&lt;br/&gt;Most of the rest of the uninsured are not as big a problem as some make it out to be.  Most are uncovered briefly between jobs.  All those young people who should buy insurance but don&#039;t: about half of their medical expenses are covered by other sources as their major expenses are usually accidents and usually some non health policy (workmans comp, auto, homeowners) is covering.  Some are just idiots and we can not idiot proof society without turning it into a totalitarian tyranny.&lt;br/&gt;&lt;br/&gt;The other problem is that of the uninsurable:  those with chronic diseases with predicatable high costs.  Insurance doesn&#039;t work as insurance covers against the unexpected catastrophe, and here the catastrophe is certain.  Homeowners can&#039;t be bought to cover the house already on fire.  When they can&#039;t work, medicare kicks in eventually, but their is more room for the  state to create health coverage for the medically uninsurable who can still work.&lt;br/&gt;&lt;br/&gt;I really believe that the big barrier to making things work better is the compulsion to come up with some kind of global  comprehensive reform.</description>
		<content:encoded><![CDATA[<p>Famalies who make 18000 a year qualify for Medicaid.</p>
<p>Paying 5000 a year on an income of 45,000 is paying 11% of  your income for health insurance.  The nation is paying about 15% of it&#8217;s total gross income for healthcare. So you are getting off cheap. Any system of national healthcare would likely have your paying at least that, probably more.  You couldn&#8217;t get a subsidy since your income is near the median.  You are the one who will be doing the subsidizing. I pay about 11,000 a year. </p>
<p>We should never forget that Medicare was a solution to the crises of old people paying 20% of their income for healthcare.  Now, they pay 19% anyway.  Every solution has unintended consequences.  </p>
<p>A tax deduction for individually purchased insurance will not help everyone.  But it would likely sweep a couple million more people into the insurance pool, and is just plain fair.  </p>
<p>There is no universal plan that will actually cover everyone anyway.  What they don&#8217;t tell  you is that most of the growth in the pool of uninsured &#8220;Americans&#8221; is in illegal aliens. Yes, they count them.  But you can&#8217;t create a plan that covers people in the country illegally without making even more of a mockery of the border itself.  Not to mention the magnet it would create for &#8220;medical immigration&#8221;.  A financial disaster and not politically viable.  Yet, without the interface with the immigration issue solved, the uninsured problem can not be solved.</p>
<p>Most of the rest of the uninsured are not as big a problem as some make it out to be.  Most are uncovered briefly between jobs.  All those young people who should buy insurance but don&#8217;t: about half of their medical expenses are covered by other sources as their major expenses are usually accidents and usually some non health policy (workmans comp, auto, homeowners) is covering.  Some are just idiots and we can not idiot proof society without turning it into a totalitarian tyranny.</p>
<p>The other problem is that of the uninsurable:  those with chronic diseases with predicatable high costs.  Insurance doesn&#8217;t work as insurance covers against the unexpected catastrophe, and here the catastrophe is certain.  Homeowners can&#8217;t be bought to cover the house already on fire.  When they can&#8217;t work, medicare kicks in eventually, but their is more room for the  state to create health coverage for the medically uninsurable who can still work.</p>
<p>I really believe that the big barrier to making things work better is the compulsion to come up with some kind of global  comprehensive reform.</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2007/08/giulianis-health-plan-2.html/comment-page-1#comment-78538</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Thu, 02 Aug 2007 22:20:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/08/giulianis-health-plan-2.html#comment-78538</guid>
		<description>Try to answer how to cover those wiht pre existing conditions with quality care. The problem is one of conflict of interest. Inaruance companies are in business ot make money. Not provide quality care.</description>
		<content:encoded><![CDATA[<p>Try to answer how to cover those wiht pre existing conditions with quality care. The problem is one of conflict of interest. Inaruance companies are in business ot make money. Not provide quality care.</p>
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		<title>By: LeosMama</title>
		<link>http://www.kevinmd.com/blog/2007/08/giulianis-health-plan-2.html/comment-page-1#comment-78521</link>
		<dc:creator>LeosMama</dc:creator>
		<pubDate>Thu, 02 Aug 2007 04:25:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/08/giulianis-health-plan-2.html#comment-78521</guid>
		<description>I&#039;m not sure I understand. &lt;br/&gt;&lt;br/&gt;Does this mean that the government is going to give us $15,000 to pay for health insurance each year? That would take care of our family quite well. We pay $5000/year for our insurance. It hurts! We make about $45,000 gross, take $5,000 out off the top for insurance. &lt;br/&gt;&lt;br/&gt;I know that&#039;s more than many people make, but it&#039;s not a lot of money. If I understand this tax credit idea correctly, we would be all set for health insurance costs.</description>
		<content:encoded><![CDATA[<p>I&#8217;m not sure I understand. </p>
<p>Does this mean that the government is going to give us $15,000 to pay for health insurance each year? That would take care of our family quite well. We pay $5000/year for our insurance. It hurts! We make about $45,000 gross, take $5,000 out off the top for insurance. </p>
<p>I know that&#8217;s more than many people make, but it&#8217;s not a lot of money. If I understand this tax credit idea correctly, we would be all set for health insurance costs.</p>
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		<title>By: masaccio</title>
		<link>http://www.kevinmd.com/blog/2007/08/giulianis-health-plan-2.html/comment-page-1#comment-78509</link>
		<dc:creator>masaccio</dc:creator>
		<pubDate>Wed, 01 Aug 2007 23:00:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/08/giulianis-health-plan-2.html#comment-78509</guid>
		<description>The point is that if we move to single payer, we delete the costs and expenses of insurance.  By many estimates, these run around 30%, between actual costs and profits of insurance companies, and the costs incurred by doctors trying to cope with a dysfunctional system, and costs incurred by patients, and other costs.  Whatever part of that is cut will provide a source of funds to pay for more care, and reduce the burden on the GNP.  I think it is likely to be a large number, perhaps 20%.  That would free up about 3% of the GNP, plenty of money for increased care.</description>
		<content:encoded><![CDATA[<p>The point is that if we move to single payer, we delete the costs and expenses of insurance.  By many estimates, these run around 30%, between actual costs and profits of insurance companies, and the costs incurred by doctors trying to cope with a dysfunctional system, and costs incurred by patients, and other costs.  Whatever part of that is cut will provide a source of funds to pay for more care, and reduce the burden on the GNP.  I think it is likely to be a large number, perhaps 20%.  That would free up about 3% of the GNP, plenty of money for increased care.</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2007/08/giulianis-health-plan-2.html/comment-page-1#comment-78499</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Wed, 01 Aug 2007 15:46:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/08/giulianis-health-plan-2.html#comment-78499</guid>
		<description>There is no free market solution until one addresses the supply side restriction issue.</description>
		<content:encoded><![CDATA[<p>There is no free market solution until one addresses the supply side restriction issue.</p>
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		<title>By: Cathy</title>
		<link>http://www.kevinmd.com/blog/2007/08/giulianis-health-plan-2.html/comment-page-1#comment-78497</link>
		<dc:creator>Cathy</dc:creator>
		<pubDate>Wed, 01 Aug 2007 15:28:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/08/giulianis-health-plan-2.html#comment-78497</guid>
		<description>I agree with Greg p. and anon. People who have money just doesn&#039;t get that this will not work for the majority of people. &lt;br/&gt;&lt;br/&gt;Tax credits will not help all the people in this country who already don&#039;t have health ins. &lt;br/&gt;&lt;br/&gt;This is nothing new, and if this is his plan, he has already lost the election.</description>
		<content:encoded><![CDATA[<p>I agree with Greg p. and anon. People who have money just doesn&#8217;t get that this will not work for the majority of people. </p>
<p>Tax credits will not help all the people in this country who already don&#8217;t have health ins. </p>
<p>This is nothing new, and if this is his plan, he has already lost the election.</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2007/08/giulianis-health-plan-2.html/comment-page-1#comment-78493</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Wed, 01 Aug 2007 14:49:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/08/giulianis-health-plan-2.html#comment-78493</guid>
		<description>I agree. Some families have an income of $18,000 annually.  What&#039;s a $15,000 tax credit going to do for them?</description>
		<content:encoded><![CDATA[<p>I agree. Some families have an income of $18,000 annually.  What&#8217;s a $15,000 tax credit going to do for them?</p>
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		<title>By: Greg P</title>
		<link>http://www.kevinmd.com/blog/2007/08/giulianis-health-plan-2.html/comment-page-1#comment-78492</link>
		<dc:creator>Greg P</dc:creator>
		<pubDate>Wed, 01 Aug 2007 14:23:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2007/08/giulianis-health-plan-2.html#comment-78492</guid>
		<description>Mr. Giuliani&#039;s plan in fact isn&#039;t innovative at all, it&#039;s really the status quo, in which those with plenty of money can&#039;t understand why, if people don&#039;t have health insurance, they don&#039;t just go out and buy it, and set up a health savings account.&lt;br/&gt;So we just stay where we are, with a major part of the population not being able to afford and not having insurance.&lt;br/&gt;&lt;br/&gt;The bullet that everyone needs to bite is that if there is going to be more widespread health care coverage, someone has to pay for it, and the money has to some from those who actually have money.</description>
		<content:encoded><![CDATA[<p>Mr. Giuliani&#8217;s plan in fact isn&#8217;t innovative at all, it&#8217;s really the status quo, in which those with plenty of money can&#8217;t understand why, if people don&#8217;t have health insurance, they don&#8217;t just go out and buy it, and set up a health savings account.<br />So we just stay where we are, with a major part of the population not being able to afford and not having insurance.</p>
<p>The bullet that everyone needs to bite is that if there is going to be more widespread health care coverage, someone has to pay for it, and the money has to some from those who actually have money.</p>
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