30 Issues: Big Health

Thursday, October 11, 2012

30 Issues in 30 Days is our election year series on the important issues facing the country this election year. Today: The relationship between the federal government and the health care industry. Visit the 30 Issue home page for all the conversations.

Open Prep: Questions, Articles, and Links to Get You Started

Key Questions

  • Can Medicare and Medicaid ever be made affordable?
  • What comes next nationally for Obamacare?
  • Should New Jersey opt into expanded Medicaid?
  • Does the federal government do enough to encourage personal responsibility for health, or is it a "nanny state?"
  • How great a burden are medical costs, and do they contribute to economic inequality?

What are your key questions on this topic? Post them below and get the conversation going!


Got a Follow Up?

Each Friday we'll be following up on one of that week's issues. Got a particular follow-up question from this conversation? Comment below or tweet us. Tweet to @brianlehrer

Comments [34]

jf from ny

Health care in america is ransom.It is free in England free in Canada. American food products have arsenic in them and cause cancer. American cleaning products are banned in Europe and cause cancer. Diesel causes cancer and asthma, car emissions cause cancer and hurricanes. Dental fillings have mercury. Plastic is filling the ocean and breaking down to be digested by fish and eaten by us. Oil spills fill the ocean. Marijuana cures cancer. Cannabis oil shrinks tumors. Why do we still pretend that no one has found a cure for cancer? Medical profiteering. Prison profiteering. Alcohol causes cancer, and is one of the most destructive addictive drugs in existence and guess what? it's legal. I know the self censorship that goes on and stories that put it all together will just get killed, my mom works for public radio and told me. Rent is insane. Wages are embarrassing.
This is a dystopia.

Nov. 16 2012 10:42 PM

The Obama campaign should find all the people in this comment section who are going to benefit from his health care plan and how Romney's plan will be difficult for them.

Oct. 11 2012 11:57 AM
Linda from NY Metro

Re pre-existing conditions:
Some years ago, my sister suffered a massive seizure. After many tests, she had a biopsy and the resulting diagnosis was central nervous system lymphoma. Without immediate treatment she would have died within several months. After the diagnosis, her health insurer would not cover her for any procedures or treatment related to the diagnosis (even though without the surgery, there wouldn't be a diagnosis). The insurer's reason was that she had a pre-existing condition. The reason they could deny her based on a pre-existing condition was based on the fact that -- although she had very good private coverage at the time of her diagnosis -- a year before, she had a lapse in coverage for several months (due to financial problems). Although she appealed the decision, they would not cover her. Under ObamaCare, she would have been covered.

Oct. 11 2012 11:51 AM

ELIMINATE the CORRUPT health "insurance" industry!!

We DO NOT need CRAP "insurance products, WE NEED HEALTHCARE!!!

Oct. 11 2012 11:47 AM
Ann-Marie from Astoria

I had Leukemia when I was two and have been healthy since, I'm now 25. This would be a Pre-existing condition even though it hasn't affected me for all of my adult life. Without Obamacare after I'm off my parent's insurance I would be out of luck.

Oct. 11 2012 11:43 AM
Donna Walsh

Your speaker does not get it. Privatized health insurance has destroyed my family's ability to have health insurance because there is not an affordable option. We have not had insurance for 4 years. Thus our coverage has not been continuous. Is it truly fair and humane to deny us coverage moving forward if we do develop a "preexisting" condition because we could not afford care for the past 4 years.Where is the humanity in the insurance industry and in Romney's position?

When the Supreme Court approved Obamacare I wept. This is profoundly life changing legislation for me and my family.Finally, someone in power cared.

Oct. 11 2012 11:43 AM

So basically Romney said in that clip to Leno that a 45-yo sick man should have been insured when he was well, but doesn't want to require coverage for each person, well or sick. Does that make any sense? Obamacare does work. It is the next step in healthcare evolution for this country.

Oct. 11 2012 11:42 AM
Sunshine Hernandez from Brooklyn

I have RA, and when I attempted to shop around for a better price than $500 a month which when I had a job that helped pay for half. I was currently working part time and could barely pay that amount without and when shopping around I was out right refused or my premium would be $1200. And was informed that even after Obama's acts kicks in, yes they would take me but the cost would be the same.Which is deeply disappointing, since I was paying all those years before I was sick.

Oct. 11 2012 11:42 AM

Can any republican give me a good reason why Americans shouldn't have the option of a single-payer government plan? Other than "private insurers wouldn't be able to compete?"

Oct. 11 2012 11:39 AM
John A from The WC

I support continual review, governance, Yes.
I know this wasn't Direct cause and effect, but I reviewed a hospital bill I had decades ago and found $3K in services unreceived (yet, billed). A couple of years later the hospital in question added a grand piano (locked) to its lobby. Stop the luxuries* on my dime - that's always the issue.
*: Trump Golf outings, Mercedes AMG's, Wraparound corner offices, Safaris in Africa. A short list of the luxuries seen flowing for doctors in Westchester.

Oct. 11 2012 11:38 AM

I work for a health insurer. The only way how insurance companies will cover people with pre-existing conditions is through increased enrollment. The individual mandate in "Obamacare" will generate enough revenue for insurers to cover high risk members.

Oct. 11 2012 11:37 AM
Dee from Montclair, NJ

I was unemployed last year and could not afford insurance. I broke my leg and when the ambulance arrived they asked if I owned my home. When I said yes, they told me not to go to the hospital because I would lose my house. They were right. There was no charity care available for people like me. Fortunately, Obamacare went into effect last year and I met the I had not had insurance for six months and had a pre-existing condition. I qualified and 5 months after I broke my leg I was able to get surgery. Without that, I would certainly have been handi-capped for life.

Oct. 11 2012 11:37 AM

It is just ethically WRONG for insurance carriers to be for-profit.... making a profit on the health of people.... Does that sound right to you? Market competition of insurance companies NEVER drive down costs of policies! This is the biggest BS argument ever! It is ethically wrong to deny someone for being sick... it's like sentencing someone to death!

Oct. 11 2012 11:37 AM
Janet from Manhattan

To be clear,when people have coverage through their employer, yes, they can go on Cobra if they lose or leave their jobs. However, their monthly premium goes up considerably (problem when you have no job), and it is time-limited. After that period of time (I think 18 months), the coverage is likely to go up astronomically.

Oct. 11 2012 11:37 AM
Nancy from NYC

Romney is for "continuous coverage" to help his friends in the insurance industry.

If he's so in favor of individual responsibility, why doesn't he favor the individual mandate (which was in his own health care plan in MA)? Because he's a fibbing-flip-flopper, that's why!

Oct. 11 2012 11:36 AM
Karen from NYC

What happened to my friend, who has since died:

She was diagnosed with 4th stage colon cancer. After 90 days at home, receiving chemo, she was moved by my employer to disability. She lost her health coverage. Fortunately, my employer paid her COBRA.

After COBRA had run out, however, she'd have been on her own, with a pre-existing condition -- cancer -- that would have barred her from obtaining insurance. Her disability payments, while low, were high enough to bar her from Medicaid.

"Fortunately" she died before that happened? Is that what we want for Americans?

Oct. 11 2012 11:35 AM
John A from The WC

I support continual review, governance, Yes.
I know this wasn't Direct cause and effect, but I reviewed a hospital bill I had decades ago and found $3K in services unreceived (yet, billed). A couple of years later the hospital in question added a grand piano (locked) to its lobby. Stop the luxuries* on my dime - that's always the issue.
*: Trump Golf outings, Mercedes AMG's, Wraparound corner offices, Safaris in Africa. A short list of the luxuries seen flowing for doctors in Westchester.

Oct. 11 2012 11:35 AM
Xtina from E. Village

Thanks a million Romney, you're going to repeal Obamacare and then 'put in place' back all the good things you like from it. A.) it's not for YOU, it's for US, and B) if we already have it - what do we need you for?

Oct. 11 2012 11:35 AM
Xtina from E. Village

Thanks a million Romney, you're going to repeal Obamacare and then 'put in place' back all the good things you like from it. A.) it's not for YOU, it's for US, and B) if we already have it - what do we need you for?

Oct. 11 2012 11:32 AM
Karen from NYC

Romney's plan does not help people who lose their jobs and, when their COBRA is up, or they can't pay for COBRA, lose their health insurance. It also doesn't help people who get too sick to work for 90 days, are placed on long term disability, and lose their health care. Once you are uncovered for a period of time - I think it's 3 months -- you are no longer guaranteed that you can obtain any coverage, let alone coverage for pre-existing conditions.

Romney would leave millions more uninsured.

Oct. 11 2012 11:32 AM
Amy from Manhattan

States would cut waste, fraud, & abuse? The Obama administration is already cracking down on these & has saved us more money on this than any previous administration.

Oct. 11 2012 11:28 AM

Evidently, Robert Doar's principle skill is expressing no opinion that might annoy any possible future politician-patron — Democratic or Republican.

Oct. 11 2012 11:24 AM

MASSIVE COST SHIPTING may be affecting how many people are on Medicaid.

I am currently going through the hell of working with a Big For-Profit Health Insurance company. A friend for whom I am the health proxy and power of attorny had a stroke just over a month ago. He spent 11 days in an acute care hospital, then was transferred to an extremely well regarded rehab hospital.

He was in the rehab facility for 17 days when his insurance company declared he was doing too well to be given intensive therapy and acute care, but, if the good rehab facility designated him "sub-acute" and contineued to treat him, the next step would be to send the patient home -- with whatever level of care he could afford on his own.Therefore, I was told, it would benefit my friend to have him go to a skilled nursing facility with rehab therapists. Which was done.

After one week as the rehab facility, the insurance company declared that since he could walk X number of feet, he would be cut off for benefits in two days. This for a person which who was still learning how to swallow. Yes, to swallow, often considered a necessary ability to feed oneself. of course, with his short term memory loss he cannot prepare his own food, nor can he be left along as he is ambulatory enough to get himself into dangerous situations when, for example, searching for the bathroom.

His vision is limited due to tunnel vision caused by the stroke, and he still has muscle weakness on the side affected by the stroke.

He lives alone. He needs 24 hour care. He cannot remember conversations, except recently he recalls small tidbits of conversations. I have to be with him at his meals to give him the reminders to eat slowly, swallow carefully and twice after any solid food. He was just moved up to thin liquids such as water. Before this everything had to thickened, initially at thick honey thickness, then to nectar thickness. If he does not position head head in the right position for swallowing, he aspirates food or liquids into his lungs....

This is considered good to go by the for-profit insurance company.

I was initially told that he had 120 days for therapy; I was not told he would not be permitted to use those days for rebabilitation.

Now, after scaring the hell out of both my friend and myself, telling him to pay $13,000 a month to stay at the nursing facility, suddenly the facility realized it could use his Medicare to pay for his stay.


Oct. 11 2012 11:20 AM

Who calls this in "nanny state"? - The GOP. Don't they also call this a country founded on Christianity? & Didn't Christ tell us to "Care for the least of these"? (& Not just individuals or the "churches")
Well, GOP, which part of your bible do you use to justify letting millions of low "Christ's Poor" have no health care or pay more?

It Can be & is affordable & reliable, as other countries have done. 1) Preventative care is key. 2) Spend less on administrative / office costs & more on physician care (time). Gov't does that better now, than when left in the hands of "Private & For Profit" hands as the Ryan bill calls for. As a Catholic, he should be ashamed of his plan. Spending: The drug & "medical equipment" Companies are gouging us with their pricing.

- FYI The ONLY countries without Health care for all, are those Third World ones we look down upon.

Why do the GOP continue to lie about the "ills" of Universal Health Care? Do they so hate their people of little means, they would jeopardize our national health (= national security) ? Canada and every European country has UHC. Countries from Sweden to Switzerland, England to Greece, & Canada pay Far Less on medical costs than we do - YET theirs are much better results - Their workforce is not denied proper medical care, and they are much healthier & happier because of it.

- FYI, according to numerous studies, Sweden, the country with the high taxes that pays for the most expansive FREE: healthcare, daycare, education, etc. has been noted as THE Country with the happiest population for years!

My brother moved to Canada, our daughter married a Frenchman - neither understands the lies told in this "debate" about their respective countries health care system. The US system of "who can pay for" Insurance, preventative care, drugs, & other treatments is medieval at the best, and shows our bigotry.

Obama-care(s) is only the first step for the US to get out of our 3rd world view of our citizens.

Oct. 11 2012 11:19 AM

Doar is simply lying when he claims that studies are "conclusive" regarding managed care. Costs in the US continue to soar compared to every other industrialized nation — not one of which has a medical system even remotely comparable to that of the US.

Furthermore, New York State does _not_ compare well with the rest of the country.

We do have records the rate of complaints against insurers and managed care programs. New York has among the highest complaint rates in the US.

Moreover, the two key factors in costs are pharmaceuticals and insurance inefficiency.

Doar should go back to the Hudson Valley Times or wherever it is he learned to grovel for politicians.

Oct. 11 2012 11:16 AM

Rising insurance coverage doesn't tell us about the _quality_ of the insurance. New York does very poorly compared to states with which New York would like to compare itself — Massachusetts, California, Oregon, Washington, etc.

The state is extraordinarily lax in its oversight of insurers. New York's leading insurers consistently get some of the poorest ratings in the country.

Oct. 11 2012 11:09 AM
Listener from Queens

Brian, can you ask about state health plans? I was just diagnosed with HIV- currently unemployed, just graduated with a masters but without health insurance. NY state has amazing programs- i was enrolled in a temporary program called ADAP to get care and meds until i find a job with Healthcare. can you ask the guest about the fate of programs like those under a romney ryan plan? or are they seperate?

Oct. 11 2012 11:05 AM

@Ed from Larchmont

What government take-over of health care are you talking about? Requiring a citizen to buy private health insurance is *not* a government take over. The government taking ownership of every hospital, doctor's office, and med school is a government take over. Implementing a public option -- MediCare for All who opt-in -- is not a take over. It just means that more of my health care premium goes to providing healthcare and less into administrative costs and profit.

I'll re-iterate my idea from yesterday...Let's start the United States Medical Corps, funded out of Defense Department draw downs and their mission will be to train the professionals that will provide basic medical services to ALL CITIZENS. That's a public option that I can get behind.

Oct. 11 2012 10:56 AM
Seth Pickenstiff

CK, obamacare will cover millions more people for the same price. price doesn't go down when you do that, but it's still an incredible savings when so many more are covered.

Oct. 11 2012 10:47 AM
CK from Yorktown

Ed has the right points here: There's nothing lowering costs in Obamacare, just moving the cost from one to another. SO now instead the government can pay for more of the healthcare costs, which means, those of us paying taxes. Though there are good things in the bill (which we had to pass so we could see what was in it), other things are un-addressed or made worse. Great that you can keep your son/daughter on your policy til they're 26. Great to not be able to reject those with existing conditions. But watch how quickly companies (and corporations) dump their employees with a little voucher to go find their own coverage. You don't think so? It'll happen immediately; cheaper to pay a penalty then to pay that healthcare coverage.

Keep some key parts but this thing needs a do-over.

Oct. 11 2012 10:08 AM

Data show that access to "health" care actually decreases overall national health and quality of life. 75% of our 'health' care costs (totaling 2.6 trillion dollars annually in the US) involve chronic, preventable diseases like diabetes, heart disease, stroke, autoimmune diseases and cancer. Never mind the complications arising from infectious illness caused by viruses and microbes (whose impacts are largely due to compromised immunity). These are predominantly lifestyle diseases bourne of lack of education, nutritional inadequacy and the Standard American Diet which is comprised predominantly of processed foods. This fact is overlooked in the general discussion of access to health insurance. Health care and access to the medical industry are NOT equivalent. We must challenge this very assumption if the issue is ever to move forward and if we are to escape the tragic losses besetting us.

Oct. 11 2012 08:35 AM
Louis Sena from Jersey Shore

You asked NJ people this question since Obama care. Private insurance companies operate under different regulations now. This is a big difference which is overlooked by your poll. When I own a small business the Group rate private companies charged were the same for each plan by New Jersey law. So there was no competition?? What change?

Oct. 11 2012 07:49 AM
Ed from Larchmont

What we needed was healthcare reform that lowered costs. What we got was healthcare reform that has government taking over and this part of the economy and religious freedom being denied.

If Obamacare goes into effect as is, Catholic healthcare services will close down. Watch how costs rise, if healthcare is available at all for many, especially the poor.

One big reason to vote against President Obama is to get 'Obamacare' repealed and replaced.

Oct. 11 2012 05:59 AM
Barbara Berney from New York City

We are the only Western industrialized nation without universal health care. And our care, despite (or maybe because of ) not covering everyone is the most expensive by far. (Switzerland is closest in terms of cost/person and they spend 2/3 of what we do.) Our health statistics are worse than any of these countries and our levels of satisfaction with our health care are less as well. So what evidence is there that less than universal coverage or leaving health coverage to the free market either saves money or provides better care?

Oct. 08 2012 12:51 PM

Leave a Comment

Email addresses are required but never displayed.

Get the WNYC Morning Brief in your inbox.
We'll send you our top 5 stories every day, plus breaking news and weather.