[JohnClif]

...and healthcare 'reform' (as opposed to true reform).

Here in the USA we have government-run healthcare programs: Medicare, Medicaid, and the Veterans' Administration (VA) for military and ex-military who are retired. Medicare and Medicaid are going broke. The VA has an unfortunately well-deserved reputation for delivering substandard medical care... and it's going broke, too. The less said about the pathetic government-provided health care on Indian ('native American') reservations, the better.

In short, the government hasn't proved that it can run ANY health care system. Accordingly, many people (like me) are very reluctant to let them control a functional, working (albeit problematic) health care system that does provide excellent health care for the majority of Americans. Congress agrees, and will exempt itself from any health care bill passed.

A second issue is pragmatism. You can either have universal health care, or you can have top-notch health care, but you can't have both. Why not? Because universal top-notch health care is unaffordable. Other countries handle the cost issue by rationing, e.g., the UK. Given the choice between a government bureaucracy deciding who can get treatment, or being able to decide based on ability to pay (the market), I'll go with the market.

As several people have mentioned, the indigent get free health care. The rich and the insured get health care. Those people in the middle, the working class without insurance, face financial disaster if they get a debilitating disease or get severely injured. But even then they get treated. I recently read about a 23-year-old person without insurance who got leukemia. He was treated and cured (remission for more than 5 years), and the hospital waived the bill because they knew he wouldn't be able to pay. This is one reason why health care is so expensive in America; we really do treat everyone and raise the bills on the people who can pay (or their insurance companies) to keep the hospitals solvent. I dated a pharmacist who told me why a single Tylenol tablet is $70... the few tablets that are paid for cover the costs of the numbers that are dispensed for free.

I, and I believe most Americans, would support health care reform that included letting insurance companies compete across state lines (they can't do this currently), include tort reform that caps damages to real damages only (no pain and suffering), and I would even support a subsidized catastrophic health care option for everyone (a policy with $2k deductible, paid for by a $50 per taxpayer per year tax regardless of income, but that covers everything else, so if you get in an accident or get cancer you're covered). This eliminates much of the costs associated with the current health care system... people going to hospital emergency rooms for non-emergency treatment because they don't have insurance... yet covering everyone against the cost of catastrophic illness. I'm sure the insurance companies would step up to fill the gap between 0 and $2k. To me, this is about the best we can hope for. The government also needs to streamline Medicare and Medicaid paperwork because the overhead adds considerably to the price of a patient visit ($30 or more just to process the paperwork per visit).

The reason why I'm against the public option is that the government will price this so low as to kill private insurance even though the government will be losing money... and then private insurance won't be available AND the program will go broke leaving none of us with insurance. We see symptoms of this with Medicare and Medicaid today, where doctors aren't being reimbursed at a high enough amount to cover their costs... and so many doctors have stopped accepting patients covered by these programs.

Many talk about health care and how it should be considered as a right that everyone is entitled to. The problem with this is that, unlike the negative rights that are guaranteed in our Constitution, positive rights like the right to health care and the right to employment put a financial burden on others. Is it right to forcibly confiscate money (which really represents a portion of our lives, the time we spent earning that money) from one person and give its value to another? After all, taxes aren't voluntary. If you don't pay them, the IRS comes to collect, with guns... and they will shoot you if you resist. Sounds more like robbery than charity, doesn't it? And, if health care is a right, then what about food and water? We all MUST have sustenance daily or we will die. Why aren't these free? The answer is, a need does not create a right, and redistributing wealth even for a good cause is unconstitutional. This is the principled reason why many are against government-run health care; the ends do not justify the means.

I hope this gives some insight into the health care debate here in America. There's no bad guy... no evil insurance companies, or hospitals, or greedy doctors. One side sees the good in providing health care to everyone at government expense, the other side wants to know how on Earth we can afford to pay for it.