Rally in Bellingham for health care reform

Some march signs reflected in windows of Bellingham Herald Building as marchers walked up Chestnut Street. A car in the foreground often detracts from a picture. Too many cars, ride your bike.

Many signs said, "put single payer on the table." Yes, that would reduce much of the convoluted complexity of contradicting insurance forms that patients and doctors must wade through now.

I think single payer could be very good, but even if it doesn't happen, something needs to be done.

Sliding scale premiums is what we need. The wealthy should pay more so lower income people can pay less for the same service. With the income gap so wide, in USA, I think sliding scale is the only way we will get universal access to care. Otherwise there will be a lower standard of care for a large chunk of the people.

Death panels? Under the present system, we're already headed that way. People dying due to lack of access to care including preventative care. An estimated 18-20,000 perishing each year in USA due to poor access. Those figures were mentioned in some of the rally speeches. I'm not sure how the numbers were estimated, but for sure this is becoming a problem.

Pull the plug on grandma? Under the present situation, Medicare is expected to go bankrupt in the near future.

Yes we need healthier lifestyles and incentives for healthy living. Under the present system, the incentive is to work like a dog to pay high premiums and then neglect exercise and so forth. No time for healthy living, got to work two jobs to pay for insurance.

Public option? Seems like the discussion we need always gets derailed into some controversy that's almost like a side issue. To me, it doesn't matter a lot if it's public or private as long as the job gets done. Government is most likely the only thing that can tax the wealthy to provide sliding scale access to care for the less wealthy. Aside from that, one can ask, "can government run a plan better than private sector?" A plan being, the paper shuffling (or these days computer shuffling) that makes a health plan. Claim forms, statistics, whatever. Number crunchers.

Here's another problem where a public option may not be any magic answer. If the public plan tries to be more humane than private plans, it can end up falling on its face. Not cutting people off with preexisting conditions means higher plan costs passed along to rate payers, for instance. A public plan could be more compassionate, but in the marketplace it could be more costly as well. That's why none of the plans would work without some sort of sliding scale wealth transfer.

Higher taxes? Yes, probably, but lower premiums if one counts premiums along with taxes. The present system is taxing. Not affordable for large segments of the population.

Can overall health care costs go down? Yes. With healthier people. Better prevention and healthier lifestyles. Also curbing the runaway salaries of insurance company executives.

Would a public plan control executive excesses better than the private marketplace? I'd hope so. Still, be wary. Sometimes the track record of government is not that good at keeping down administrator pay. Look at college president salaries in the public sector. Nearing the million per year mark. Justified because comparable positions in private sector pay even more. The brain drain argument.

Be careful. often the high salaries just lure the most greedy and crooked, rather than the best talent to an organization whether public or private.

The bottom line is, we need a sliding scale and something to promote healthier lifestyles. Whether the entity that does the paperwork is public or private may not be that important.

Then some people say we shouldn't strive for better health. Do healthier people cost more because they live longer? Maybe it's most "cost effective" to be dead. Really, that's capitalism for you.

I still think healthier people cost less. I would guess healthier people don't live that much longer, they just live better. Genetics still plays a big role in the human lifespan. One can live out much of their life in poor health with high medical bills all the way, or one can live healthy for roughly that same span of time. Access to good preventative care and lifestyle coaching (which hopefully doctors do) can reduce longterm health problems and costs.