education faces the death panel, why wouldn’t health care?
By American Girl in Italy on September 8, 2009 at 10:01 AM in Current Affairs, Education, Health Care, Obama Administration, Sara in Italy, Sarah Palin, Universal Health Care
All this talk about Obama speaking to the *shoochildren* got me thinking about the school system. Can’t one look at the education system when pondering what a government run health care program would look like?
Like health care, the US spends more than any other country on education (except Switzerland). And like health care, we are not ranked anywhere near the top. Out of 21 industrialized countries, U.S. 12th graders ranked 19th in math, 16th in science, and last in advanced physics.
According to a 2005 report from the OECD, the United States is tied for first place with Switzerland when it comes to annual spending per student on its public schools, with each of those two countries spending more than $11,000 (in U.S. currency). Despite this high level of funding, according to the OECD, U.S. public schools lag behind the schools of other developed countries in the areas of reading, math, and science.
According to a 2007 article in The Washington Post, the Washington D.C. public school district spends $12,979 per student per year. This is the third highest level of funding per student out of the 100 biggest school districts in the U.S. Despite this high level of funding, the school district has produced outcomes that are lower than the national average. In reading and math, the district’s students score the lowest among 11 major school districts - even when poor children are compared with other poor children. 33% of poor fourth graders in the U.S. lack basic skills in math, but in Washington D.C., it’s 62%.The country has a reading literacy rate at 98% of the population over age 15, while ranking below average in science and mathematics understanding compared to other developed countries. In 2008, there was a 77% graduation rate from high school, below that of most developed countries.
With health care, the plan is to tax the top 1% of the country to pay for health care for others. Some people are already paying taxes for schools they don’t use, and the plan is for them to pay taxes for health care they won’t use, either?
Another issue is that many parents of private school and homeschooled children have taken issue with the idea of paying for an education their children are not receiving. However, tax proponents point out that every person pays property taxes for public education, not just parents of school-age children. Indeed, without it schools would not have enough money to remain open. Still, parents of students who go to private schools want to use this money instead to fund their children’s private education. This is the foundation of the school voucher movement. School voucher programs were proposed by free-market advocates seeking competition in education, led by economist Milton Friedman, but have been criticized for damaging public schools, both in funding and diversity.
The US spends $972 billion annually for schools, covering 76.6 M children. The government is proposing a figure roughly equal, over 10 years, to cover how many American, exactly? They were throwing around the 46 million dollar figure, but Obama said health care reform would NOT cover illegal immigrants, who make up about 10 Million. (and by the way, what is their solution to handle those 10 million?) Also, the figure is bound to change when companies drop coverage or people prefer a cheaper option. So, do we know how many will need to be covered under the public option? And if the Dems get their way, and their reform morphs into single payer universal coverage, we would need to cover 200M people.
Anyway, my point is that if we do end up with a government run health care program, a la single payer, which is where the Administration and Democrats want to go, what will it cost per person for care and treatment? England spends roughly $3000 per person annually in health care. (Refer to my other post the impact of universal health care )
After looking at the budget for the education system, $11,000 annually per child, it made me think about how much it would cost to cover Americans with chronic illness.
In 2005, 133 million people, almost half of all Americans lived with at least one chronic condition.
Chronic diseases account for 70% of all deaths in the United States.
The medical care costs of people with chronic diseases account for more than 75% of the nation’s $2 trillion medical care costs.
Chronic diseases account for one-third of the years of potential life lost before age 65.
Hospitalizations for pregnancy-related complications occurring before delivery account for more than $1 billion annually.
The direct and indirect costs of diabetes is $174 billion a year.
Each year, arthritis results in estimated medical care costs of nearly $81 billion, and estimated total costs (medical care and lost productivity) of $128 billion.
The estimated direct and indirect costs associated with smoking exceed $193 billion annually.
In 2008, the cost of heart disease and stroke in the U.S. is projected to be $448 billion.
The estimated total costs of obesity was nearly $117 billion in 2000.
Cancer costs the nation an estimated $89 billion annually in direct medical costs.
Nearly $98.6 billion is spent on dental services each year.
And from the Coalition for the Advancement of Health Through Behavioral and Social Science Research, more than 45 percent of adults struggle with a chronic health condition that affects their daily activities. From diabetes to asthma, heart disease, depression, obesity, and AIDS, more and more Americans are living with chronic illnesses. More than 90 million Americans live with one or more chronic illness; at least 22 million live with three chronic illnesses.
Could we even afford that, under a universal health care program? Which led me to think about budgets and cost cutting in the health care industry.
Sarah Palin caused a firestorm with her comments:
“And who will suffer the most when they ration care?” Palin asks. “The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,’ whether they are worthy of health care. Such a system is downright evil.”
But, looking at the cuts made in education, for budget reasons, isn’t she right in questioning what would happen with a government run health care program? States budgets are coming up short, and school programs are facing the educational version of death panels.
What cuts are being made? Teachers, healthy lunches, art, music, gym, after school programs, books, supplies, busses, and special education and special needs programs. I don’t know about you, but I don’t find it hard to imagine that when budgets need to be cut in a health care program, certain people may face a type of death panel that Palin was talking about…
California - The Governor has proposed $1.3 billion in cuts to this current school year and another $4 billion in cuts for the next school year. If these cuts are approved in their entirety, they would add to the nearly $12 billion in cuts schools were already forced to sustain with the budget agreement that came about in February….including class-size increases in the South Pasadena Unified School District, which would result in kindergarten through third-grade classes having up to 32 students and fourth and fifth grade classes with as many as 36 children in each class; the cancellation of summer school programs at the Los Angeles Unified School District and the expected laying off of 2,250 teachers; and the recent vote by the Mount Diablo Unified School District board to lay off more than 400 teachers as well as the likely elimination of their sports and most music programs.
The poorest districts will be the hardest hit by the new layoffs, as they have the highest concentration of new teachers. Some school districts in wealthier areas of the state are seeking to compensate declining state funding by increasing local taxes that their residents can afford. About 75 percent of education funding currently comes from the state government.
The Los Angeles Unified School District (LAUSD) recently voted to lay off over 2,000 teachers and over 1,000 educational personnel, though 500 of these layoffs were subsequently rescinded. As teachers are laid off, class sizes are slated to increase and materials will be scarcer as well.
At the end of last month, LAUSD announced that it was canceling most of its summer school programs, forcing many working parents to find alternative means of childcare. In past years the state has enrolled an average of 225,000 students in summer classes. The cancelled classes come as unemployment for youth is soaring.
The district is also planning $17 million in cuts to its school bus program, forcing many students to walk or take longer bus rides. A program to provide special transport for those facing hazardous walking conditions will also be canceled, potentially endangering thousands of students.
Georgia - teachers, who on average earn $48,300 a year, according to teacherportal.com — are facing the prospect of working several days without pay. That’s a not-insignificant sacrifice for teachers, although such pain has already been felt by thousands of people in other jobs.
Maryland - cut funding for a school breakfast pilot program, professional development for principals and educators, health clinics, gifted and talented summer centers, and math and science initiatives. For the coming fiscal year, Maryland’s governor has proposed cutting direct aid to local school districts by $69 million.
Massachusetts - enacted cuts to Head Start, universal pre-kindergarten programs, and early intervention services to help special-need children develop appropriately and be ready for school. Funding for K-12 has also been reduced, including spending for mentoring, teacher training, reimbursements for special education residential schools, services for disabled students, and programs for gifted and talented students.
Nevada - the governor has ordered various cuts to K-12 education, including delaying an all-day kindergarten expansion, cutting per pupil expenditures by $400 in a pilot program, eliminating funds for gifted and talented programs, eliminating funds for a magnet program for students who are deaf or hard of hearing, and making across-the-board cuts. Additionally, young children with developmental delays will lose more than 15,000 hours of needed services.
New York - the Governor proposes nearly $2 billion in cuts in education funding in FY 2010. Reductions in aid to individual school districts would range between 3 percent and 13 percent. In addition, a number of specific programs are eliminated, including supplemental math/science programs and new-teacher mentoring programs.
South Carolina - the Governor proposes suspending funding for textbook purchases in FY 2010.
Washington - the Governor has proposed reducing by one-third the amount the state spends to supplement education funding in property poor school districts. This proposal is likely to widen the gap in education funding between wealthy and poor districts.
New Haven — Children in more than 110 school districts and schools across Connecticut may soon be eating less nutritious school lunches as Governor Rell proposes to cut funding in half for the Healthy Food Program. The $2 million cut will force cash-strapped schools to find funding for the program or eliminate it, and replace fresh fruits and vegetables with less healthy food.
After school programs, and arts programs also suffer in budget cuts.
School budget cuts are wiping out entire departments, with art classes and programs for at-risk students disappearing fastest, the Daily News has learned. Intermediate School 218 in East New York, Brooklyn, is losing one third of its teachers, which will mean axing its music, art and computer programs, teachers said.
“From top to bottom, the school is going to be gutted,” said Chris Schilling, the school’s computer teacher and basketball coach whose position has been cut, he said.
“There’s no paper, no ink in the printers - we can’t even make copies,” he said.
“We’ve been staying here on Saturdays, working for hours after school and we’ve raised our standards, so why would they make such a big cut. Read more.
In the face of today’s gloomy economy, many school districts are facing the sad reality of budget cuts. In fact, the Center on Budget and Policy Priorities predicts that half of all states will face budget shortfalls in fiscal year 2009.
“Every single grade is in desperate need of books,” Jones said, “and we can’t afford it.”
Cuts in teachers, after school programs, art, music, gym, computer classes, lunches, increased class size, supplies and books, busses, sports, special needs and advanced student courses cut, tutoring, counseling, librarians…
What do you think would happen with universal health care? Can we look at the education system, and guess?
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Sorry, but you’re making up comparisons that have little to do with each other. It’s called apples and oranges. To use our collective hatred of our education system and anti-intellectualism as a basis for smacking down “health care for all” makes little sense.
I’m not a philosopher, but your last sentence linking the two seems like an attempt to create something that doesn’t exist. Somehow, because we screwed up our educational system (in your opinion) that means we’ll screw up universal health care. Sorry, but can’t go along with that false assumption.
For one thing, public educations is generally funded by local districts and individual states, with a little loose change coming from the feds. Universal health care would be handled by the feds, based on premiums on individuals and, I suspect, businesses.
And, frankly, in this country, education is the first thing to get docked in a fiscal emergency. You know, let’s nail the teachers; they only work 9 months, anyway. All that kind of baloney.
And you think this is good?
I’m not a philosopher, but I think the point is that the goverment screws up everything it touches.
The United States already uses single-payer systems to cover over 47% of all medical bills through Medicare, Medicaid, the Veterans Administration, the Department of Defense and the Bureau of Indian Affairs.
No one is screaming to get out of Medicare, to the contrary, they say -don’t touch it!
Insurance companies pocket up to 30% in profits and overhead (compared to 4% for Medicare) while their executives take multimillion dollar salaries.
You made my point for me:
.
The US governement screws up everything it touches.
I’m on Medicare. The government doesn’t seem to be screwing it up.
That blanket “don’t trust the government” philosophy is a problem, even though it has been around since 1776. It sometimes keeps us from acting collectively for the common good.
We should always be looking at the specifics and logically analyzing every proposal, not just using a handy slogan. And that goes for both sides.
I’m glad that Medicare is working out for you. This has not been the case with some of my relatives.
I have an autistic brother who lives in a group home. The State of New York does an excellent job taking care of him. I’m not saying all government health care is bad.
Sorry to hear about your relatives, Arabella. Perhaps there is a Seniors advisory group that could help them?
We all need a little help and support from each other. And that will always be true no matter what system we’re in.
“I’m not saying all government health care is bad”
Yes, you did. You replied ‘The US governement screws up everything it touches’ to my comment that the US gov. cover 47% of all medical bills through Medicare, Medicaid, the Veterans Administration, the Department of Defense and the Bureau of Indian Affairs.
I meant to say “the federal governement.” Does that clear it up for you? My family and I don’t have many problems with programs offered by the State of New York, or other local entities.
Really? Do you like the concept of private armies? How about private law enforcement? You know, only for gated communities.
Medicare is basically bankrupt. It is held together with baling string and spit. There are tens of trillions in unfunded liabilities. Bankrupt means broken. Although people who go to their doctor today and get a Medicare-provided service may be happy the product, the Medicare system cannot continue in perpetuity like this.
Well, apples and oranges are both fruits, and if they’re grown in the same orchard by the same farmer, and one crop is mismanaged to the point of failure, that does not bode well for the other crop.
Good suggestive analogy American Girl. Thanks for the painstaking article. Got me thinking.
you rock!
Imagine if all of the private and home-schooled children showed up at the public schools’ doorsteps tomorrow morning demanding an education. School systems across the country would collapse.
great point the comparison is easy to grasp for anyone with half a brain however bots intake of koolaid has taken 90% of their independant thinking.
i didn’t even think about that…
And imagine if all the private schools were required to accept any student who came through their door. All the emotionally disturbed kids, the kids who have special needs, the homeless kids, the kids who don’t speak English very well or at all, the kids who will never be intellectual stars. Those private schools would go out of business today.
Good point Sandi.
I sent my kids to private school even though there was a excellent public one nearby. That was because my husband and had a business and I needed the extended hours that a private school would keep them. They also kept them through the summer.
I don’t begrudge my tax portion going to Public Schools. They need all the help they can get.
They already do accept disturbed students of the wealthy. If you can pay, you’ll get your way.
[...] education faces the death panel, why wouldn't health care? : NO … [...]
Insurance companies take $230 billion a year out of the system in profits and overhead.
The real question is -why have private plans?
What is the value? What are they providing?
The real answer is PROFITS FOR INVESTORS, not health care. Health is not a commodity.
The solution (which Obama has no interest in pushing) is a single-payer system, like Medicare.
Why doesn’t Obama have an interest in pushing a single-payer system?
And just where the Hell do you think this country would be without investors?
Health is not a commodity.
Investors are great for the economy, but not sucking the life out of my health care, along with the insurance companies CEO’s huge bonuses.
What do you think is the best plan for “your” health care?
Single-payer system for ALL Americans.
Private insurance companies out of the equation: they take 30% in profits and overhead (compared to 4% for Medicare) and when their executives take multimillion dollar salaries.
Then I take it that you are dissapointed in Obama for not “pushing single payer” insurance:
Zoom
How can I be ‘dissapointed’ with Obama when I never was an Obama supporter?
I wanted a fighter like Hillary for president, not a guy praising Raygun and trying to be ‘bi-partisan’.
Zoom, you are so wrong in your assumption that a single payer for all Americans is the solution. I lived and worked (contributed) under a single payer system, and it is not the solution.
In those systems, as soon as one can afford it, one goes to private parallel or foreign systems, hence paying twice.
Reality beats up ideology any time. Check your facts.
I have also lived under a single payer system my entire family still does and not one of them would change it. Some of them have supplemental private insurance which is handy for small, elective things, but for anything serious, they go to the NHS. You see the same doctors, use the same hospitals for serious illnesses or surgery.
The problems, such as they are, occur in densely populated areas where there are not enough doctors or facilities.
First, a single payer system will dramatically reduce the quality of our existing healthcare system. That is evident in looking at Canada and the U.K.
Second. I will agree that health insurance companies are making great profits. That should present opportuntities for entrepreneurs and investors to create health insurance companies that would be more competitive in costs and operating at lower margins. They would naturally attract most of the existing customers away from high cost insurers. Do you know why that is not the case? Because of existing government regulation that prevents such competition.
There are case studies where deregulation dramatically reduced costs amd made the industry affordable for most people: airlines and telephone. There are no case studies for successful government run anything. Take a look at the U.S. Post Office or even a simple program like Cash For Clunkers. Medicare and Medicaid are not well run and are filled with corruption. Other countries have a myriad of problems and do not come close to the quality of the U.S. health system.
The answer is to fix the system we have rather than trash it and replace it with a system that has been proven to be a failure. Government run anything should be the very last option after all other means have been exhausted.
‘Evident looking at Canada and the UK’?
How is it evident?
Where are the Canadians and British people clamoring for a change in their health care system? To the contrary, they are satisfied with what they have and quite surprised with all the negative things said here about their health care system.
Medicare and Medicaid need fixing, but are way less expesive and wasteful than the private insurance system we have now.
“First, a single payer system will dramatically reduce the quality of our existing healthcare system”
Not only is that not “obvious”, it’s not true.
Evidently you missed the litany of articles about just how bad the healthcare system in Canada and the UK are under socialized medicine. So here are two for starters:
http://www.examiner.com/x-11804-Health-Care-Examiner~y2009m7d11-Canadas-health-care-system-has-its-problems
http://www.telegraph.co.uk/health/healthnews/6127514/Sentenced-to-death-on-the-NHS.html
Anything that is government run fails: from the U.K. to the U.S.S.R. to our own country. Governments are incapable of running any kind of business:i.e. USPS, Amtrak, Cash-for-Clunkers, Medicaid.
I don’t know where you get your information from but people in Canada do not like their healthcare system which is why they come here for treatment.
The solutions for healthcare reform are evident unless you only believe in socialism, which is the problem right now.
No Canadian I know (including family, friends, and all the people connected with my company in Canada) would trade for the U.S. system.
Rich people from any country can go where ever they want - U.S. hospitals or clinics in Switzerland.
The problem is ordinary working-class people who can’t be so mobile.
What “ordinary working people?”
In Canada you said they love their socialized medicine.
In the U.S. “ordinary working people” are have health insurance through their employer and either pay nothing or relatively little.
I too know people in Canada and in the U.K. and none I know are happy with their healthcare system at all. They can’t see doctors when they want and the costs unsustainable.
I think there are a lot of working class people who are out of work now and therefore have no employer to pay for health care.
In a single payer system you move from job to job and through periods of unemployment and are still covered.
You can see doctors in Canada the same way you see them here. I haven’t noticed any difference in appointment time or waiting time.
The ordinary working people who can’t move around for expensive treatment exist in every country. The difference is whether they are satisfactorily covered where they are and single payer is their safety net. It would be good to have that here.
Whoa, hokma. My husband and I have health insurance through our companies. And we pay. The company contributes to the overall cost. But everyone knows the prices have been going up and the coverage down. To pretend that it’s a free lunch even if you’re working simply isn’t true.
If we go to single payer or public option or any of the creative programs being suggested, we will pay through our taxes.
Will it be cheaper? I suspect not. And one of the stats on the UK system that rocked my socks was that their health bureaucracy was the 3rd largest in the world. And the UK is a fraction our size.
Once we put a system in place it’s going to be impossible to dismantle.
So, it has to be right the first time. I think most people agree that the present system needs reform. But we want to maintain quality, pull in as many people as we can, get rid of the idea that people can be dumped for preexisting conditions and have a portable function so the unemployed are not left to fend for themselves.
But we have to do it without collapsing the country under anymore unsustainable debt.
I don’t know what the answer is. But I’m not convinced the Dems have it. And if it’s half-ass, I’d rather have Congress go back to the drawing boards.
“To pretend that it’s a free lunch even if you’re working simply isn’t true.”
Where did I say that? I never said that. Apparently that is what some people want though - a free lunch.
When they deregulated the airline industry, did prices go up or down?
When they broke up AT&T and opened up the telecommunications industry, did prices go up or down?
When you restrict competition, prices are inflexible and go up. Look at your local energy company or cable company.
All they have to do is take away state mandates and restrictions on interstate competition and by opening that up it will trigger a price war - rates will go down - and those stupid restrictions on coverage will disappear.
I am paying close to $2000 per month. If Democrats get their way that coverage will not go down in costs and will be taxed. In addition, if a government supported public option is put in play then I will lose my coverage and be forced to go with the government plan and lose quality of coverage.
Our government is incapable of running anything except a military. They cannot run Amtrak, the Post Office, financial institutions (Fannie Mae, Freddie Mac), and Medicaid. They even screwed up Cash for Clunkers.
What makes anyone think they can maintain a high quality of healthcare!?
I concur with most of this, except you say “I’m not convinced the Democrats have the answer.” Correct me if I”m wrong, but I don’t recall the Republicans offering any healthcare plan. (Not since Richard Nixon).
I don’t like Obama’s plan, but the perpetual resistance of Republicans to any program that benefits the American people has led directly to the unworkable situation we have today. Billions of dollars for war, not one cent for healthcare of education. Unfortunately, that has been the Republican motto for too long. That and support the corporations at all costs.
Really? I’m Canadian. The only person I have ever known who complains about our health care is a conservative millionaire.
This is the truth about our system:
http://www.youtube.com/watch?v=VQFX32Ed7ZQ
If you believe you have a better system, then please keep it and don’t have any Canadian citizens cross over seeking better qulity care.
Wrong. My costs are rising faster than the rate of inflation. You might want to check where you are getting your information. Capitalism, while the best system, does not work well at all with a captive audience.
I said “relatively little.” It costs about $2000 for a good quality family policy. Do you pay $2,000? I do. Are your rates going up 18% per year? Mine do.
Of course it’s going up fast, but not because of a “capitive audience” - because of no real competition. Half these insurance companies have consolidated so there is little choice. And because of state regulations there is no real competition.
My information is from facts since I have to purchase health insurance for myself and for others and have tried to go across state lines to get cheaper insurance. Where do you get your information from?
you are a clueless, hokma, and probably a paid insurance company shill.
Yeah OK, now take a look at this:
-Real Canadians Talk About their Health Care System:
http://www.youtube.com/watch?v=U7lPc7DEARU
-Canadian Churches Speak Out on U.S. Healthcare Debate
http://rosemarieberger.com/2009/08/28/canadian-churches-speak-out-on-us-healthcare-debate/
If you believe this then move there since they already have the system you want, because in this country the alrge majority of American do not want Obamacare and do not trust the government to run their healthcare.
“a lrge majority of American … do not trust the government to run their healthcare”
Really? FoxNews is not giving you fair and balanced information:
June 2009 NBC/Wall Street Journal poll revealed that 76% of all Americans support a “public option.” http://msnbcmedia.msn.com/i/msnbc/sections/news/090617_NBC-WSJ_poll_Full.pdf
Feb. 2009 New York Times/CBS News poll: 59% say the government should provide national health insurance, including 49% who say such insurance should cover all medical problems.
http://www.cbsnews.com/htdocs/pdf/SunMo_poll_0209.pdf
A Feb. 2009 Grove Insight Opinion Research poll found that 60% of all Americans favor Medicare for All, the single-payer concept embodied in H.R. 676.
http://www.consumerwatchdog.org/resources/PollMemo.pdf
The numbers are dropping. Still in the majority but not 76% anymore.
http://www.politifact.com/truth-o-meter/statements/2009/aug/20/progressive-change-campaign-committee/groups-claim-overwhelming-support-public-option/
That’s right, but still the majority of Americans support a public option. That’s not what you hear from the ‘Liberal Media’, they would make you believe the opposite, but the polls are out there:
• The Kaiser Family Foundation , a health care think tank, polled 1,205 people July 7-14 and found that 59 percent of people questioned would favor “a government-administered public health insurance option similar to Medicare to compete with private health insurance plans” and that 36 percent would oppose the idea.
• A second NBC/Wall Street Journal poll done July 24-27 asked 1,011 people whether they “would favor or oppose creating a public health care plan administered by the federal government that would compete directly with private health insurance companies.” Forty-six percent said they would favor the plan while 44 percent said they opposed the idea. The two news organizations asked the same question to 805 people between Aug. 15-17 and found that 43 percent favor a public option and 47 percent who oppose it. Both statistics fall within the three-point margin of error of the July poll.
• A New York Times/CBS poll of 1,050 people between July 24-28 asked whether they would “favor or oppose the government offering everyone a government administered health insurance plan — something like the Medicare coverage that people 65 and older get — that would compete with private health insurance plans.” Around 66 percent favored the idea and 27 percent opposed it.
• From July 27-Aug. 3, Quinnipiac University asked 2,409 voters whether they “support or oppose giving people the option of being covered by a government health insurance plan that would compete with private plans.” Around 62 percent were in support and 32 percent were opposed. That’s down from a July 1 Qunnipiac survey in which 69 percent supported the public option and 26 percent opposed it.
You are citing old, old news. The newest is June. Try July and August polls.
Well, as far as the U.S. Post Office is concerned, I’ve always been a huge fan. Only once in my entire life have I had a package lost. I should have tracked it but was lazy that day. (And I’m pretty darned old.)
My son and his wife, for instance, don’t even try anymore to send things to her parents in Istanbul. Our service is fine; but when it gets there, it’s a mystery to everyone how to tell what happens. They will often receive the letters or packages, but no one can explain why it took so darned long. That’s just one country, I know. But my point is, I do trust the post office.
I agree. I can’t remember losing anything to them. They do pretty good work considering all the pieces they have to move and at what I consider to be a reasonable rate. In my neighborhood, we still have carriers who walk house-to house and are always very pleasant and courteous.
Yay U.S.Post Office!
And I freely admit that the U.S. Post office is better than Canada’s.
But Canada’s Medicare is better.
They are Broke! Have you read how in debt the US Post Office is and how taxpayers have to keep them afloat? If FedEx or UPS ran their business like the US POst Office they would be out of business. Like I said, the U.S. government is incapable of running a business.
I am a fan of the post office too. The only reason I have ever placed tracking or sent something certified is so that company couldn’t blame the post office for not receiving it.
The post office has never lost a package or letter of mine. However, lots of companies try and blame them for their neglect of a document.
I oppose a single-payer system, which probably puts me in the minority here.
There are numerous problems with the concept in my opinion.
Some of them have been discussed by several groups. I will mention a few.
The size and demands of our health care system will require that we continue to depend on a combination of employers, insurance companies, and the government programs.
Many physicians have already stated that those in their 40s, at the height of their expertise and knowledge, will leave the system. This will leave the newest grads carrying the load for everyone.
Many rural hospitals are already on the brink of closing and can not cut budgets further. The patients they serve may already be an hour or more away. Some of these hospitals have only survived by becoming satelites of larger hospitals.
This is very serious stuff, and should not be a political football!
As I mentioned in the prior comment to yours, I agree.
The fundamentals of our healthcare system are the best in the world: from physicians to hospital facilities to research and analysis. The problem is finance. I will agree that health insurance companies make too much profit but there is no competition to bring that down because of excessive government regulation. Also there is problem of malpractice and the cottage industry of unnecessary lawsuits just to get rich quick. That has forced doctors and hospitals to pay enormous sums for malpractice insurance and to commit to procedures and tests that may be unnecessary but needed to fend off potential lawsuits.
Obama and leftwing leaders talk about reform and the two problems I just mentioned are real and common sense, but you won’t find them anywhere in any Democratic bills.
This is why a large majority of Americans are opposed to the government option and almost anything Democrats are doing now for healthcare reform. They have lost all credibility by being reckless ideologues and will certainly lose their majority if they thumb their nose at the majority of Americans and pass a bill Americans do not want.
Have you noticed that anybody supporting the single payer solution will advance ideological principles,ie. moral duty, civil right, God, but that anybody rejecting it will backup his or her postion by facts and numbers.
This reform is not about improving health care, it ia about advancing an obsolete ideology and power grabbing.
Let’s talk about portability, nationwide open market, abolishing pre-existing conditions and tort reform. Those are the key fronts to reform.
I am supporting a single-payer solution, and I am not advancing any ideological principles.
I’m saying that insurance companies take $230 billion a year out of the system in profits, overhead and multi-million salaries and bonuses for executives, and provide…exactly what to our health care?
Insurance companies pocket 30% in profits and overhead compared to 4% for Medicare.
What you are advancing is left wing propaganda that misleads the facts of the debate.
Do you have a problem with companies making as much profit as they can in this country? If you do then you will be more comfortable in a socialist society.
How many people in a healthcare insurance company make “multi-million dollar salaries?” Three or four very senior executives? At what point is it any of your business how much someone makes? Do you complain how much money Clinton or Obama made on their books? Do you complain how much money Tiger Woods or Lebron James makes? Or how much Sean Penn or Angelina Jolie makes?
I pay close to $2000/month for my healthcare insurance and I would sure like it reduced. But I am smart enough to know your way and Obama’s way is a road that will eliminate my coverage and any quality healthcare. And on the way Obama is going to also tax my existing health insurance.
The government option is the fastest road to ruining our healthcare system. That is something that all republlicans and a large majority of Independents and moderate Democrats, as well as the large majority of physicians do agree on.
actually the amount of money that Obama/Clinton/tiger woods, etc, etc, etc make can in no way be compared to multi-million dollar bonuses and salaries for insurance company execs. you “choose” to buy a book or attend a sporting event. you don’t “choose” cancer, it chooses you. I want my money going to healthcare professionals, not suits who don’t give a rat’s ass about MY health.
“actually the amount of money that Obama/Clinton/tiger woods, etc, etc, etc make can in no way be compared to multi-million dollar bonuses and salaries for insurance company execs.”
You are right. Obama/Clinton/Tiger Woods et all make far more money that even the CEOs of corporations.
In this blog there were first complaints about how much the salaries and bonuses were of car companies, then of banks, and now healthcare insurance companies. I am waiting for you to start complaining about how much physicians make or you local pharmacist.
The only way to bring down profits and costs is to expand competition - not with a government run fiasco like every other government run fiasco.
Stop with the scare tactics “Oooh, socialism!” it’s getting tiring.
In Canada, the UK, Sweden, Denmark, etc. they are not communists, and they have a single payer system for health care that works.
I am all for people making tons of money, but I also make sure I don’t waste mine, and we are wasting our money as a country with the insurance companies.
I do have a problem with having a system that takes away 30% of the money spent in profits and overhead when we have Medicare that takes only 4%. You paying $2000 in health insurance are a good example of what is wrong with the insurance companies.
That is not ‘left wing propaganda’, those are facts.
What is also a FACT is that EVERY single payer system is bankrupt and running on chronic deficits.
Thanks, but no thanks.
hokma: I have a problem with companies making as much profit as they can if it involves damaging consumers and destroying resources that rightfully belong to everyone. You, my friend, are ingesting too much corporate media propaganda. Sometime take a look at how these corporations in the U. S. make their unprecedented profits. It ain’t pretty. They do it by poisoning all of us and using the courts to destroy any competition that produces quality products. Right now they’re after small organic farmers and dairy farmers.
Since laughter is good for what ails you, I have a suggestion.
Obama should appear in an ermine-trimmed lab coat and give every American a Chinese first-aid kit!
France having trouble with health care deficits:
http://www.reuters.com/article/healthNews/idUSTRE5863CN20090907
As long as I can remember (40 years+) the system has been operating on enormous deficits. It is permanently bankrupt. Every gov from all political spectrums has failed to reform it, because the voting block of health care “administrators” (anybody administrating the system) is so huge that their agenda trumps the public welfare and will.
The truth is that as soon as you can you squize out of your monthly budget additional money to pay for private additional insurance or care in private clinic with doctors working out of the system. Therefore you pay twice for your health care. The end bill is enormous.
Otherwise you have delays of weeks, crowed hospitals, reduced nursing staff and on and on.
The cost on the economy is enormous. It is a total drag on growth.
My niece teaches in a Univ. of CA School, and she says that all faculty have had to take an 8% decrease in salary this year. She is thankful, however, that they are not being paid in IOUs, as yet.
Her mother is a long time elementary school teacher, also in CA, and she says her class size is the largest it’s ever been.
Schools are financed by property taxes.
Guess what happens when property values tank?
Yep.
Fine, if people don’t want to sign up for “Medicare for all,” then let them keep paying for their over-priced private insurance, with all its exclusions and very own set of death panel rules. In the meantime, what benefit is gained from preventing the rest of the population from access to decent, affordable health care? Seems like this web site, which I originally thought was relatively liberal in its overall tone, is actually a haven for a clique of right-wing “thinkers” whose basic interest lies with self preservation and damn the rest of us.
I hope you’re all happy with what is coming down the pike: forced signing up for over-priced private insurance for all. And no regulation of the insurance industry. In other words, more big bucks for the insurance industry, which offers NOTHING to the health care process. (Name one thing!) (Check out Max Baucus’s proposed bill.)
BTW: here’s Obama before the industry got to him:
Obama in 2003 - addressing the AFL-CIO:
“I happen to be a proponent of a single payer universal health care program. I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody… everybody in, nobody out.
…A single payer health care plan, a universal health care plan. And that’s what I’d like to see.”
Obama in 2009 - addressing the AFL-CIO:
“I continue to believe that a public option within the basket of insurance choices would help improve quality and bring down costs.”
I know Obama wants single payer - I linked to his videos where he says it.
I don’t think this is necessary:
“Seems like this web site, which I originally thought was relatively liberal in its overall tone, is actually a haven for a clique of right-wing “thinkers” whose basic interest lies with self preservation and damn the rest of us.”
This is a topic to discuss. It occurred to me yesterday. You don’t need to result to attacks. There are liberals, conservatives and independents here.
You might want to read another post of mine: http://www.noquarterusa.net/blog/2009/08/18/lets-have-a-nq-town-hall-on-health-care/
I’m not “attacking.” Just making an observation.
You could have fooled me!
Actually, it wasn’t an attack, it was an opinion.
I have been attacked. That’s when they call you names and insult you personally.
This quote “I hope you’re happy with …” pings my bot radar like posts that contain:
“Listen, people …’
‘Folks, don’t let them pull the wool over your eyes”
“Sad. Just sad.”
You say it’s not an attack and I’ll take your word for it this time but I will quote you below and it sure reads like a negative commentary/insinuation of other’s opinions here.
Yeah, it’s pretty negative, but it doesn’t characterize the “you’re all” personally. If it said “card-carrying Nazis” that would be an attack.
A minor distinction perhaps, but at least more civil.
I agree with Arabella on this one.
As long as there’s no name-calling I’m OK with most things.
Having said that, I don’t like either side to say “You deserve what you get” which just seems mean-spirited.
Hopefully we all want the same health benefits for each other and are just divided on how to achieve that goal.
well, obama’s a shameless liar, so it really doesn’t matter what he says, does it? but i agree that there should be some sort of non-profit public option that people can *choose* to buy into. if some people just love their insurance companies, they can keep them. at least the rest of us would have the option of having a plan that isn’t deliberately robbing us blind and providing no health care in return.
“but Obama said health care reform would NOT cover illegal immigrants, who make up about 10 Million. (and by the way, what is their solution to handle those 10 million?)”
The way to handle 10 million illegals is to make them legal. Next on the agenda, Immigration Reform.
agreed they need to resolve the situation.
Just a question which I need an opinion on - where’s jbjd when I need them?
If a Federal law is passed which enshrines health care as Private with no public option, what happens if one state decides they want a public single payer system in that state and it is voted in?
Does the Federal law keep them from having it?
The only way Federal law trumps State law is in cases of interstate commerce. In the case of healthcare, if Massachusetts wants to keep their single payer option they can, although I hope they don’t come calling on the rest of us to bail them out.
Thanks, Hokma.
If interstate commerce governs Health Insurance companies crossing state borders, would that count?
If they grant interstate access for health insurance companies to be able to sell thier insurance in every state, an individual state could not block that.
BUT it would not affect a state’s public option.
I heard that Health Insurance companies could go across state lines now but they prefer not to because of the different regulations in each state.
I manage a company that has separate Blue Cross in each state but Metlife Dental can go across the whole country.
Anyone know what keeps the Blue Cross companies from doing that now?
Yes. There are state mandates that prevent a company in one state from doing business in an other state. A company like Blue Cross/Blue Shield have separate entities in different states as a result. These mandates create a symbiotic relationship with state governments that do not benefit the people insured and allow for the high prices.
since every dem. defending obamas agenda keeps saying we are spreading lies and untruths about the healthcare proposal, someone needs to bring a copy of it to a town hall meeting and read the parts we object to directly from the bill and then ask them ifs its a lie? most likely they havent even read it.
yesterday obama said “the time for debate about this has passed” WHAT DEBATE? Did i blink or something while the country was “DEBATING ” it? they have tried every thing from calling us vile names and trying to shut the protesters up..so where was the debate?
i just posted a really good reply but my posts never show up. bleh.
The thing that bothers me about all the discussions about new spending, is that all of it comes with new adminstration of said spending. California is not bankrupt from spending too much, although that is where the cuts are being made, it is broke because of the pensions for retired bureaucats. Those numbers grow and grow and they keep pulling dollars out of all levels of government. At some point, we will all be paying taxes for retired politicians and bureaucrats and debt service. The rest of the services will be cut to nothing. Any reform of any system needs to start with goverment reforming itself. Since when do I have to work until I’m 65 for a paltry payback of my social security taxes but a bureaucrat can retire at age 50 with full benefits and sometimes full pay. Have we all gone crazy? We should cut those pensions before we cut our sevices. Let goverment workers retire on social security like the rest of us and see if we can’t afford all that we need in this country. We could probably even cut taxes.
I agree. We don’t need several systems. Let the elected officials and bureaucrats use the SS system like the rest of us. I wonder how long it would be before it was solvent again?
What scares me about this government trying to run a health care system is the way they ran the Cash for Clunkers program.
1. It costs 3 times more than they thought it would.
2. The government was woefully understaffed and only 20% of the payments have been processed.
3. About the CARS program, Jeremy Anwyl, CEO of Edmunds.com says. “The issue is that the regulations that were written were incredibly cumbersome.”
4. If a dealer’s application is rejected by the government for any technicality, they are not allowed to resubmit the paperwork to the government according to Lena Pons of Public Citizen.
5. The “new car owner” is then dunned for the $4500 rebate they thought they qualified for.
Does anyone else see how these same problems would affect the administration of health care and what dire straits we’d be in??
Ahhh.
More proof that Universal care is SOOOO special.
http://www.telegraph.co.uk/health/healthnews/6156076/Daughter-claims-father-wrongly-placed-on-controversial-NHS-end-of-life-scheme.html
AGiI,
Thank you for the thought-provoking post. I’ve been away most of the day doing other things.
The comparison between public schools and a possible public health care system is valid to me in some way.
As an ex public school teacher, I am now very conflicted about our public schools. I started out teaching in ‘70 and was in total support of the idea that EVERYONE in the country should have a right to attend school. It was important to me to have strong public schools for our democracy to remain. After all, the point was that without an educated public we could not have an educated voter.
I know; I know–many will now say that if public education got us the voters we had during the last election, we should totally shut down public schools.
As the system is now, I would not send a child through it, but I do remember a time when the system worked much better, and I still adhere to the idea that we should have a public school system for the sake of our ideals.
I also moved toward wanting a single payor option for health care expenses because, darn it, no one can really learn if he or she is miserable from illness and can’t afford to get medical help. As a child whose parents could not afford insurance as I was growing up, I remember that I often felt like a burden whenever I became ill (no, they did not make me feel that way, I just knew. My parents kept us clean and disciplined and well fed (no garbage) so we didn’t become ill often, but with kids it just happens. So, I am also feeling the need for public health care.
I have often thought that the thing that needs to happen with the schools is that we have to throw out our love of tradition.
Why must our schools close down during two and a half months a year now that we are no longer such an agrarian country? Why waste those buildings those months? Could we stagger so that class sizes are made smaller? Could teachers have different break times a year in order to keep the schools running all year as have been done in many places? Could we do academics during normal school schedules and the other enrichment activities during times when schools are now being wasted? Wouldn’t some of this save in school construction costs and also improve scores?
Why must some small school districts decide NOT to hire the best candidate for the English position and instead hire a person with only a minor in English just so they can meet the Title XI requirements and hire that less qualified person because he/she will agree to coach a girls’ sports program? Wouldn’t academic scores improve if schools could do more about eliminating coaching requirements and expenses by getting their coaches another way–if they must have those programs?
Why must we continue public schools as training grounds for college, rather than look at some of the European systems in which only some of the kids stay in the college bound track, while others go off on more vocational tracks? Couldn’t we allow different graduation requirements based on the tracks? Wouldn’t that open the school day so that many high school kids, at least, could spend only half a day in school and be out mingling with adults in a real world environment doing internships, helping their parents, doing part-time work, attending vocational courses, etc., and getting a wider view of the world? (And teachers could then have more time to plan and grade and improve scores.)
Could some schools schedule school days a different way to serve kids who might learn better with a different schedule? For instance, they might be able to take only English for several weeks, then only science for the next session. Many kids are not Type A multitaskers but are just as bright. Their scores would improve with intensive, uninterrupted study. I’m not sure how it would help costs, but I bet it would if thought out.
Why MUST public schools keep totally disruptive students in classrooms? After all, they cheat the kids who behave out of their learning time. Couldn’t we actually find a way to find alternate placement for those behavior problems (which are often the result of their parents’ bad attitudes)? I don’t know the answer to this one, but there MUST be a way to make parents and children know that the child will lose his or her right to public education if he or she does not behave. It would improve scores and lower class size. But this alternate placement should NOT be the school system’s expense.
There are so many ways to cut costs and improve academic education in our public schools IF WE WOULD EVER AGREE TO CHANGE THE SYSTEM IN MAJOR WAYS.
For example, I have often thought that our public school academic scores would improve dramatically if our schools cut the tie to extracurricular athletics and gave that over to recreation districts or the community at large. Let the parents and people from out of the school system run the programs. Those programs are already widely available anyway. What a cost savings there.
I can’t tell you how many teachers I knew who had no interest in the subject they taught most of the day were teachers simply because they wanted to coach–couldn’t quit “talkin’ about glory days.” I know I would have preferred never having to stand guard duty at the school doors to prevent students from leaving during the pep assemblies—which took more time from the classroom. And I would have preferred never having to go back to a classroom after the cheerleaders did virtually a pole dance at an assembly and have to be asked to explain why it was o.k. that those girls got to wear clothes that didn’t meet the dress code and why they got to do things other kids would have not been allowed to do. (All you have to do is ask the administrators how sports and cheerleading parents can be their worst headaches.)
I could go on and on–But my point is we need a real, in-depth analysis of the schools’ problems and actual expenses and a real effort to think outside of traditional ways to improve our schools and save costs other than by maintaining the organization of the schools as they are now. But it needs to be done with the attitude that learning academics is the major focus of the schools–that curing social ills is not their responsibility.
Now, not being anyone who is at all knowledgeable about medical practices and the needs of the medical profession, I have little advice in the way of specifics. But, my gut tells me that the same principle applies here. There MUST be ways to improve the system in terms of its costs by thinking outside the box, so to speak–by imagining the system in a totally different way and by assigning it a single goal: treating medical problems to maintain a healthy citizenry.
And I just want a real explanation about why, for instance, my son’s one-hour at the emergency room with only 15 minutes of that time being seen by the doctor resulted in a bill for $1,800. He got an antibiotic injection and a bottle of powerful antibiotics for his wound. He had already cleaned the wound, so they had to do little in that regard. He ended up having to pay $1,000 of that bill. There should have been something available so that he could have received that treatment somewhere else: an all-night pharmacy with a nurse on staff, perhaps?
It just bothers me to hear these outrageous costs. I have no problem with most of the medical professionals. I do think we provide great medical help in our country, but I know there has to be a way to cut the costs. Single payor seems a way to do it with our current healthcare establishment. But I also wonder if Congress couldn’t just take time to really look at those costs and ask questions about why certain services are priced the way they are and why they couldn’t be provided in a different—less expensive–environment etc. Fix the system from the inside.
But it would definitely mean questioning the salaries of insurance company officials, hospital administrators (or people on their boards–does the $200,000 raise MO got in Chicago through pork spending of her Senator husband ring a bell?)
It might mean writing laws that go after those young people who think they’re invincible and don’t get the insurance they can afford because they “never get sick” but who skip out on paying emergency room expenses after a bike accident, just refuse to pay.
It might mean making sure that people making really poor choices in their diets have to pay higher taxes on certain types of foods or on the cigarettes they purchase (I don’t care if you call them sin taxes). I might mean higher expenses for procedures that could have been avoided if the patient had followed pre-screening schedules (as my HMO does it), etc. I just don’t know. But it is pretty well accepted that many of the costs of those chronic conditions could have been avoided with different lifestyle choices earlier in life.
It might mean looking at the rules about who can provide certain care. I know there are many times when I would feel totally comfortable letting a nurse treat me but the rules require that my doctor see me to prescribe. I know that for some things even a pharmacist could probably prescribe.
It might mean a different way to purchase and provide the expensive equipment and provide them for use when necessary so they can be widely available at a cheaper cost.
I am nervous that if the Dems pass this “reform” now it will be nothing like real reform at all. Costs will still be too high. I am encouraged by the general debate happening. But I just don’t think we are there yet. We do need a reform, but it must be one that will result in a better system for our country.
I just still smell the stench of Wall Street involved in the system through stock prices, high CEO salaries, and “creative” accounting. The system needs to get itself away from those influences so it can concentrate only on health and not on the bottom line so much.
And that is why I don’t like the idea of keeping this as a free-market system. It needs to be something like the public schools—a system that answers to the interests of the communities and the states, not to the interests of Wall Street. It will still end up with problems, just as the public schools have problems, because the people in the communities and in each state have differing, and warring ideas about how things should be done.
I guess, though, that I still have faith in Americans and their desire to be the best. I think in regard to the schools and the health system, Americans have finally come to the point of wanting changes and it may take some real changes in thinking about the “traditional” organization of those systems before changes for the better and for the good of all do occur.
But one this is for sure—the Democratic Party and the Republican Party should keep out of it entirely. These are two concerns that should never be politicized.
Excellent comment, Diana. The school issues you list are why we pulled our son out of public school in 2nd grade. He is now a happy, accomplished, thriving homeschooler, set to graduate High School a year early, already racking up credits at our very nice jc, and spends every day with other homeschoolers in an amazing variety of classes, field trips and other events. Homeschooling isn’t for everyone, but if you can do it, and do it well, the rewards are tremendous. BTW, my husband works for the 2nd largest school district in the country. He has a good job, he loves it, and works hard for taxpayers he’s working for, but the waste & mismanagement he sees on a daily basis are very frustrating.
excellent comments, and thanks for taking the time to write this all up! your school ideas are quite interesting. I have often thought a longer school year would be better. I would be interested in what schools would say about pulling athletics out. I assume they make money off football and basketball games?
I think out schools should be flooded with money, and we should be giving kids the best education. All schools should be equal, too, but since they are funded by property taxes the more expensive neighborhoods are usually better.
Your comments about cost for your son’s wound - totally agree. Why can’t there be more clinics for that stuff? I went to one once and paid $50. I wrote a post about this, figuring the reasons were medical malpractice insurance and the cost of equipment and drugs. I’m sure there are medical workers who would love to work in *free clinics* in the US, but they probably can’t afford to, because of the insurance and costs associated.
Diane,I couldn’t agree with you more. I may have my doubts about the proposed health care bill; to be sure this does not put me in line with either party.
The self accountability factor you present so well for both education and health is an important part of bringing both of these areas into a clear focus, which would then allow some of the issues to be looked at and hopefully solved.
I never understood the summer vacation, but then again I went to a parochial school, which at the time gave a break during the summer equal to Easter and Christmas.
How about the city/community offer the sports? This may require thinking out of the box for those scouting-they would need to move beyond schools. It is a win-win. The community charges for the season to play, brings the community together for those interested in the sports, and puts the competition in the sports that can do this into a wider avenue.
Also have alternate school schedules: for specific grades that can handle it, and which mirror more what a real day is like in the college and working worlds. It was done with Kindergarden years ago, changing to half days either am or pm. Why not teach the students to prepare in advance for different schedules? Having an end to the day at 5pm-with corresponding instructor schedules.
Introduce first year trade school programs within the last two years of high school; keep the college prep courses which will transfer but also offer a comparable trade set for a variety of trades, which are also seen in the local and surrounding communities. - or off campus apprenticeship that would carry credit toward either college or a trade.
As far as the health issues, there are many nurse practitioners who are allowed to treat in place of a physician, however that depends on which state you live in, and which field of medicine. These practitioners are able to prescribe prescription drugs-however they also bear the burden of malpractice insurance and rarely make the money physicians do in this circumstance as they are often a fill in for smaller rural areas.
Although I agree with you 100% here, I simply do not trust the government not to abuse this particular area of health care.
How a choice will be defined and the events surrounding it will get deep and detailed, with some bureaucrat deciding perhaps an obese person needs to pay more based on their specifics without looking further into the actual problem created by each person; which there simply will never be enough resources to do.
We end up with what are perceived as old fashioned morals and responsibility of the family. At some point in time each person must step up and take some responsibility for themselves and the care of others in their family. I don’t have the answers, or suggestions because I believe until we face our problems with the family itself, we will not be able to solve any of them. The only thing I know at this point is what we as people are doing is not working either.
Thank you Diane I have gained a great deal from your perceptions on this topic. You have given me a lot to think about.
Yes, that is what concerns me also. Like the Cap & Trade plan…supposedly for the common good, but seems to be another scam for Wall Street or Enron type crooks.
AGI: Look at Medicare. It’s a better comparison than public schools. It works fine.
Personally, I would rather see a universal healthcare plan funded by the taxes Americans already pay, than to see people forced to buy insurance (which only fattens the already obscenely wealthy and corrupt insurance companies) and then fined for not having insurance when the reason they don’t have insurance is they can’t afford it. That just seems bizarre to me.
Fining Americans for not having insurance is not about getting better healthcare for people, it’s about getting more policy-holders for insurance companies. Pathetic. Obama is a Republican.
medicare: except that it is going broke.
and a lot of people still carry additional coverage because medicare doesn’t adequately cover expenses.