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To: patron_anejo_por_favor who wrote (163176)	11/10/2008 1:03:52 AM
From: Lizzie Tudor	Respond to of 306849

and some network of clinics or something needs to be put together to get routine care out of the emergency rooms before everybody gets covered, too

To: patron_anejo_por_favor who wrote (163176)	11/10/2008 1:11:27 AM
From: Skeeter Bug	Read Replies (1) \| Respond to of 306849

in theory, a national system could work and work well. in theory, the dmv could be efficient and cost effective in terms of time and money. the problem is that there is a big gap between theory and actuality when the self serving interests of government get in the way. imagine paying government doctors 90% of their highest salary as a retirement after 25 years. imagine the doctor lobby lobbying for extra pay. yadda, yadda, yadda. school teachers, nurses and doctors will be the face of some of the fiercest unions the world has ever seen - and they don't care on iota about the tax payer.

To: patron_anejo_por_favor who wrote (163176)	11/10/2008 10:17:41 AM
From: Pogeu Mahone	Read Replies (1) \| Respond to of 306849

Only if they have the balls to move to a single payer system otherwise forgetaboutit health reform is dead. No reforming this system with thousands of insurance companies still duplicating, wasting 40% on administrative costs. ================= Mass isn't working because it's not national and they have too little leverage over providers. A national system won't have that (and it won't have sickees from neighboring states moving in to take advantage of the system). Obviously in the first year or two of coverage you're going to get higher utilization. If it remains a problem you kick copays up if the visits are found to be for generally inappropriate stuff (a little goes a long way with primary care visits) And you either initiate or raise ER copays. The point is, any change to a system like that will require adjustments until equillibrium is reached. That program is what, 16 months old? I'm sure the think tanks are pouring through the records to figure out whether a lot of folks can be seen at alternate levels of care to unclog the system. At least they should be. Don't they have "urgent care" centers in Massachusettes for example? If medical manpower is the issue, maybe the state needs to look at the way they treat doctors. Or subsidize training more.