Slashdot Mirror

I would suggest that Oregon's attempt at universal health care never got off the ground because major portions of it were blocked by the Republican-controlled legislature.

Yes, because of the obvious problems in PAYING for it. That the legislature blocked it is a good thing: universal health care does no one any good if everyone is broke. The proposed system was literally incapable of sustaining itself.

I think that experience underscores the need for us to address health care reform at a national level. The path our health care system is on is clearly unsustainable, with exploding costs and declining coverage. I think there are several comprehensive plans out there to ensure everyone has affordable health care, while tackling the cost of care.

None I've seen. All of them only discussed more regulation, and direct cost controls, to control costs, which either wouldn't work, or would only work in the short term, increasing costs and decreasing care in the long term (which always happens when you remove competition).

Here's a fuller explanation of what I think that will take and several measures we need to take to control costs.

I see several problems. First, Medicare negotiating lower drug prices causes INCREASED prices for those not on Medicare. This will be a big hit to middle class and poor families. I agree with this in principle, but see no way around it harming others. The middle class especially is already subsidizing drugs to Canada and other countries; now they would be subsidizing drugs to Medicare recipients.

This does not actually reduce national costs, it just shifts them, from the taxpayer to the drug consumer, which seems to me to be the wrong direction that most Democrats who favor universal health care want to go.

I also absolutely disagree with federal school lunch standards. The federal government has no business of any kind in the local public schools. Period, end of story.

As to hospitals, similar story: the federal government should not be paying for this equipment, or restricting its purchase.

However, I ABSOLUTELY agree that we need to reform the drug patent system. Thanks for highlighting that. I don't believe government should be in the business of handing out monopolies JUST FOR THE SAKE of handing out monopolies. The Constitution is clear: the point of a patent is to encourage innovation. It is only worthwhile to the extent it does that, and patent terms should be tailored to provide the MINIMUM rights necessary to accomplish that goal.

Further, I agree that taxpayers should not be subsidizing drug companies' ads. Indeed, we should not be subsidizing drug companies at all, including money for research. This ties into the patent issue because we pay them to do research and then give them a patent, too! Any research we DO subsidize should be public domain.

Which brings me to farm subsidies: no, we should cut all of them. We do not need them. Yes, the cost of food may rise, but our taxes will be significantly less (assuming the government doesn't spend that money on something else ... ha!), and individual states can increase food aid to needy families if necessary.

But all this put together will only begin to address the cost problems. The real big problem (other than tort reform, which is not a big issue for some, but a huge issue for others) is the lack of competition and choice that allows all kinds of health care providers -- from drugs to machines to hospitals -- to jack up the cost of health care. It's very similar to the patent issue. That is what government should be working on: finding ways to introduce more competition.

Providing insurance to everyone is not the answer. Reducing the cost of health care is the answer. And while you have some good ideas, it is only barely a start. Frankly, I think many people -- not sure if this inclu

I would suggest that Oregon's attempt at universal health care never got off the ground because major portions of it were blocked by the Republican-controlled legislature.

Yes, because of the obvious problems in PAYING for it. That the legislature blocked it is a good thing: universal health care does no one any good if everyone is broke. The proposed system was literally incapable of sustaining itself.

I think that experience underscores the need for us to address health care reform at a national level. The path our health care system is on is clearly unsustainable, with exploding costs and declining coverage. I think there are several comprehensive plans out there to ensure everyone has affordable health care, while tackling the cost of care.

None I've seen. All of them only discussed more regulation, and direct cost controls, to control costs, which either wouldn't work, or would only work in the short term, increasing costs and decreasing care in the long term (which always happens when you remove competition).

Here's a fuller explanation of what I think that will take and several measures we need to take to control costs.

I see several problems. First, Medicare negotiating lower drug prices causes INCREASED prices for those not on Medicare. This will be a big hit to middle class and poor families. I agree with this in principle, but see no way around it harming others. The middle class especially is already subsidizing drugs to Canada and other countries; now they would be subsidizing drugs to Medicare recipients.

This does not actually reduce national costs, it just shifts them, from the taxpayer to the drug consumer, which seems to me to be the wrong direction that most Democrats who favor universal health care want to go.

I also absolutely disagree with federal school lunch standards. The federal government has no business of any kind in the local public schools. Period, end of story.

As to hospitals, similar story: the federal government should not be paying for this equipment, or restricting its purchase.

However, I ABSOLUTELY agree that we need to reform the drug patent system. Thanks for highlighting that. I don't believe government should be in the business of handing out monopolies JUST FOR THE SAKE of handing out monopolies. The Constitution is clear: the point of a patent is to encourage innovation. It is only worthwhile to the extent it does that, and patent terms should be tailored to provide the MINIMUM rights necessary to accomplish that goal.

Further, I agree that taxpayers should not be subsidizing drug companies' ads. Indeed, we should not be subsidizing drug companies at all, including money for research. This ties into the patent issue because we pay them to do research and then give them a patent, too! Any research we DO subsidize should be public domain.

Which brings me to farm subsidies: no, we should cut all of them. We do not need them. Yes, the cost of food may rise, but our taxes will be significantly less (assuming the government doesn't spend that money on something else ... ha!), and individual states can increase food aid to needy families if necessary.

But all this put together will only begin to address the cost problems. The real big problem (other than tort reform, which is not a big issue for some, but a huge issue for others) is the lack of competition and choice that allows all kinds of health care providers -- from drugs to machines to hospitals -- to jack up the cost of health care. It's very similar to the patent issue. That is what government should be working on: finding ways to introduce more competition.

Providing insurance to everyone is not the answer. Reducing the cost of health care is the answer. And while you have some good ideas, it is only barely a start. Frankly, I think many people -- not sure if this includes

I would suggest that Oregon's attempt at universal health care never got off the ground because major portions of it were blocked by the Republican-controlled legislature. I think that experience underscores the need for us to address health care reform at a national level. The path our health care system is on is clearly unsustainable, with exploding costs and declining coverage. I think there are several comprehensive plans out there to ensure everyone has affordable health care, while tackling the cost of care. Here's a fuller explanation of what I think that will take and several measures we need to take to control costs.

With the current path we are on, we will need to raise taxes or slash benefits to cover the cost of Medicare when baby boomers retire. Neither of those are good options. That is why we must reform our system now, before it is too late and we are faced with unacceptable options.

The first step on the path to fiscal responsibility is help the American public understand where their tax dollars go. In terms of federal spending, roughly 20 percent goes to defense, 20 percent to Medicare & Medicaid, 20 percent to Social Security, 8 percent to interest on the debt, and everything else is a relatively small portion for things like transportation, education and the environment. Even the earmarks that have been recently decried are only about 1 percent of the budget. Of course those earmarks include obvious pork like the "Bridge to Nowhere," but getting our fiscal house in order is going to take more than cracking down on appropriations.

Part of what I would propose are moves towards tax fairness, like repealing the Bush tax cuts for the wealthy, or the capital gains and Social Security tax reforms I mentioned in a previous reply. But we also need to spend our taxes more wisely. I do think there are some programs - like the V-22 Osprey or the International Space Station - that are not a great investment of our tax dollars. I also think we can give federal agencies more of an incentive to save by rewarding them if they come in under budget.

You can read a bunch more about this and my record of working to educate the public on budget and tax policy, as well as fighting waste in the Oregon State Lottery.

Thanks for the question. Environmental action has been one of the centerpieces of my record of public service. I spent over eight years at the U.S. Justice Department, suing polluters for violations of the Clean Air and Clean Water Act and I was a board member of the Oregon Environmental Council for the past decade.

Your question does raise a challenge of transitioning to sustainable practices. In some instances, like Superfund cleanup, there are steps we could take right now to reduce the burden on average taxpayers by restoring the polluter pays principles that originally paid for toxic waste cleanup.

But in other instances, like making the investment in renewable energy or expanding mass transit and other conservation initiatives, it will cost some money. That is why in this campaign I have been advocating several moves towards better fairness in our tax code like requiring people who make their money buying and selling stock to pay the same rate as what people pay on regular income. Or that people making a million dollars pay Social Security tax on all of their income, not just the first $100,000. In the long run, reducing our energy consumption, using it more efficiently and reducing the massive cost of global warming and pollution to our economy, health care system and communities will save money. But you are absolutely right that it will take some money up front. I'm committed to telling folks the truth about that and how we are going to pay for it.