“When Michael Moore’s Sicko movie, which attacked the health insurance industry, came out, the trillion dollar health insurance industry assigned one man to delegitimize the movie’s message– Wendell Potter.

Potter was head of communications for CIGNA, one of the largest health care corporations. It was his job to be the hit-man, destroying the reputation of Sicko.”

Well, Potter was converted from defender of the “sicker care industry” aka commercial and government healthcare financing, to whistleblower. The movie started his conversion but his own company assisted by their denial of a life-saving surgery. The young lady died and then later he witnessed thousands lined up for free health care in a community close to where he grew up and his parents lived. They couldn’t afford care through the “healthcare industry.”

The movie came out five years ago and I’m of the opinion that we are even sicker today.

Education isn’t an inalienable human right either. I do agree that equality and fairness should apply to both education and healthcare which means that everyone get a basic amount of it.

Everyone doesn’t get as much education as they might want, and likewise with healthcare.

Healthcare decisions should be made on “probable outcome” not racial, economic or other discriminatory means.

In economics we know that there are limited resources so as a country, we can’t spend an unlimited amount on healthcare or anything else.

Always in the healthcare debate the issue of rationing comes up. And everyone acts like that is a four-lettered word. First, we need to recognize that we already have rationing of healthcare in this country. The rationing has been done based on your ability to pay. If you have insurance or money in the bank to pay for every last chemo treatment, then you will get it, regardless that your probability of a cure is only .5% Someone else who has cancer but a different set of circumstances that would give them a probability of 75% complete cure, won’t get the treatment because they are uninsured and no other financial means to pay. If you don’t believe that is reality today, then you need to get out of this debate until you have accepted reality.

There were really two main issues that guaranteed that this country would eventually address the “healthcare crisis.” The first was the continuing double digit premium increases that employers were trying to pay as a cost of doing business and providing benefits for their employees. The second issue was the outcry for “universal coverage” from the social watchdogs. I use that term respectfully without any judgement.

During the very early years of this debate – I would compare the possible options. One of those options was to expand government’s role in the healthcare arena which is exactly what Obamacare has done. I would always say that we needed to look at the current government insurance plan (funding) – Medicare which was begun in 1965. By 1995, Medicare had a terrible 30 year cost containment record. And now we are going to expand that.

What is broke about the current system is that it is “FEE FOR SERVICE,” meaning that the healthcare provider is paid for each service provided. Anyone can see the problem here. The more services the healthcare provider provides then more income is produced. And this system does not increase the healthlyness of Americans. Look at our costs compared to other first world nations. Our costs are excessive and the outcomes are less.

You will always get the results based on where the financial incentives are placed. When you are paying a healthcare provider more for you to get sick and stay sick and get sicker, then that is what you will get. The healthcare providers need to be paid a flat amount (someone else can decide what is a reasonable liveable wage for doctors) for their group of patients they are responsible for. They will then want you to stay healthy and their goal will be for you to return to health as soon as possible when you get sick. They will not want you coming back for three or four unnecessary followup visits because there will be no additional revenue to be gained.

Medicare has tried to contain costs by reducing the “allowable fee” for the healthcare providers and it hasn’t worked. Here is an example that I hope is simple enough for those reading this – Let’s say that the healthcare provider wants $75.00 per visit to take care of “grandma” and one 15 min visit per month will provide adequate management of her healthcare needs. Well Medicare comes along and tells the healthcare provider that they are only going to pay $50.00 per visit. So the healthcare provider starts seeing “grandma” for two 7.5 min visits at $50.00 per visit and the revenue has increased to $100 per month. When Medicare budget cuts come around again and it is decided that healthcare providers will only be paid $40 per visit, the provider starts seeing “grandma” for three 5 min visits each month for a total revenue of $120.

Not only has this increased Medicare’s costs, it has reduced productivity in the nation because the son/daughter or grandson/granddaughter have to take “grandma” to the doctors office three times a month now instead of just once.

In recent years, I have come up with an idea that would benefit us all – it would help truly “REFORM the healthcare system” and insure that we would have a very efficient and beneficial system to provide the needed care for all Americans. The answer is to force WAL-MART to provide healthcare (notice I didn’t say insure) for all their employees (regardless of number of hours worked). I won’t venture out to say what it might look like in this short comment – but WAL-MART would get it done in an efficient and at the least costs.

I’m surprised that Mr. Visconti did not answer the question posed above with simple facts: the non-partisan Congressional Budget Office projects that the Affordable Care Act will actually REDUCE the federal budget deficit over the period 2012-2021 (http://cbo.gov/publication/43080).

I fear that too many of us have simply swallowed right-wing propaganda about budget deficits, without doing our homework to find out the truth

Moral arguments can be good. Moral arguments can lift our spirits and give us the resolve to persevere in the face of seemingly unsurmountable opposition. But knowing the facts can be helpful, too.

Secondly- my employer provides me with health care benefits, but the ever-increasing cost of those benefits has been a primary reason why base salary increases have been minimal over the past several years. Until we provide all citizens with health coverage and get health care costs under control, even those of us with employer-provided health care will be paying for people that just ‘show up’ in the emergency room without coverage. If you’re thinking that because you have employer coverage today, this isn’t your problem, you’re just being naive. You are paying for the uninsured through ever-increasing premiums, higher co-pays, longer waiting times in emergency rooms, lack of salary increases from your employer, etc.