What should government health care look like?

As the health-care reform debate advances in Washington, President Obama insists that a public plan makes sense. Industry representatives counter that government-run health care would drive private insurers out of business.

Say the president gets his way. What should government health care look like?

Everyone should have access to the same level of health care that members of congress have. It should be administered in a manner similar to Medicare.

-Rick Reiter, Coon Rapids, MN

Forget private health insurance--if premiums are too high and coverage is poor, insurance is a cruel joke. Instead, focus on medical care for all. VA and Medicare and Medicaid all work for those who have it. Get employers out of the middle of health care. Our insistence on private insurers results in wasted dollars for administration and thousands of "plans" which we do not need. -Bill Jones, St. Paul, MN

I would support a public plan that is a non-profit health plan that is national. I went to a meeting where single payer plan was discussed and would support that plan. I listened to President Obama's health discussion on t.v. and like what he proposed in the public option. We need to deal with our health care crises, offer health care for everyone and focus on health care quality. -Cecelia Newton, Minneapolis, MN

We've got to start somewhere. The health care plan should be as good as that provided to our representatives in DC. All employers should contribute for all employees. It should be less like insurance than a system that ensures that health care is provided as a human right. -Jeanette Leete, White Bear Lake, MN

I believe the debate should be whether or not the government should become involved in health care. I am of the opinion that government run programs are always less efficient and cost far more than programs in the private sector. The government run medicare program is a great example of government failure in the healthcare field. Most states such as Minnesota already had health care programs availabe for lower income individuals. This government grab for power with poorly written proposals and insufficient planning is going to become a nightmare that will be with us for decades and will cost far more than the President and his advisors are telling us. -Ted Stuckmayer, Winona, MN

Provide health care to those who don't have access or to those who are under insured. It should act as a tool for the people to keep the health insurance industry honest and to get as much value as possible from them for every dollar we put in.-Steve Tripp, Minneapolis, MN

I am not smart enough to know, but is should definitely look like something better than this. Lately when asked if I have health insurance, I just laugh and say 'I cant afford health insurance, I'm an American.' -Brian Jesness, Eagan, MN

A government health care plan needs to address the following issues:

Portability: no longer tied to your job

Accessability: available to all citizens

Affordability: negotiate competitive prices with drug companies to bring our prices in line with the rest of the world.

-Garret Narjes, Minneapolis, MN

Federal government should require the states to run the "public option". Some states may have government workers do it. Some may contract for care, some may do something else - coops maybe. I work for the Department of Veterans Affairs and I can tell you the VA model is not the answer.

-Jeff Hall, Wrenshall, MN

Should be low cost optional plan to take care of serious problems only. All medical places should have to burden with their fair share and reimbursed at a lower rate then standard price.

-Timothy Albrecht, Cambridge, MN

I like the idea of a government program competing with the private insurers. If private enterprise is superior to government programs then the insurance companies have nothing to worry about. Meanwhile the government plan would provide a safety net for unemployed or underemployed people. The carping of the insurance companies looks very suspicious. Let's try the public option. It cannot be worse than the current chaotic, expensive system.

-Hamp Smith, St. Paul, MN

There should not be a government program. We have a fine example of what can be done outside of government with the MCHA program for those with medical problems. Government programs of Medicare and MA are bankrupt despite paying providers a mere fraction of the true costs for service. Those unpaid costs are shifted to others driving up private insurance costs. Blue Cross and others are not for profit companies and operate MORE efficiently than any government program. Stick to the areas outlined in the constitution and leave the rest to the private sector!

-Terrance Genelin, Le Sueur MN

Health insurance should not be a 'business'. Government provided health insurance is the only way to really reduce costs. Nobody is willing to put the amount of political capital on the line that would be necessary to pass or even discuss a single payer option. Maybe someday...

-Matthew Reinhart, Elk River, MN

Government health care should look very much like Medicare. Medicare is the same for all, cost effective. The paperwork would be incredibly lessened, saving more money,and coverage would be the same anywhere in America. After how many years of taking advantage of us with their dirty tricks and denials of coverage, the insurance companies have shown clearly that health care in America is a right and not a priveledge, and must be a nonprofit area in order to not be driven by the hypercapitalism that has taken it over.

-Elizabeth Johnson, Pequot Lakes, MN

Government Health Care? You have to be kidding! Just take a look at how Uncle Sam is managing, or more aptly mismanaging healthcare for our Veterans. I feel that the spearhead of efforts should be directed at reforms in the healthcare services system. I agree with others that the government's role should be in providing insurance for the uninsured and under-insured.

-Dominic Tacheny, St. Paul, MN

1. easy to navigate. 2. takes full advantage of technology for the sake of efficiency. 3. focused on preventative care first. 4. retain private ownership/operation of health care providers (clinics, etc.) where it currently exists. 5. allow for expansion of alternative and traditional medicine wherever it can be deemed safe.

-Jeff Boone, Minneapolis, MN

How about modeling it after the system which consistently receives the top rating in the world at half the cost of the US system -- France. Why the fear of replicating a world class system in the US? We already have a well functioning single payer system for millions of Americans which operates with low administrative costs. Why not simply extend medicare to all US residents. There seems to be an inherent conflict of interest in a health care system in which private for profit companies operate between the patient and doctor to decide how they can maximize their profits, not how the doctor can best treat the patient, and without incentive for the doctor to improve health of the patient. -Ralph Pamperin, Chanhassen, MN

We should do something...but Government health care already composes >1/3 of the market (Medicare/Medicaid). Problems with more of it: 1st preventative care: If the government is going to be paying for health care it will eventually be reasonable that they can dictate how healthy you must be. Personal freedom and choice will need to be suppressed because people make unhealthy choices and will continue to without having those choices forcibly taken away (goodbye buttered popcorn). 2nd Economics: By making health care a right the demand will increase and will overwhelm an already stretched supply of health care. This will lead to increased cost of health care.

-Thomas Miller, Blaine, MN

We need a sustainable health care solution, so it has to be affordable. To achieve the side-by-side public/private market that the President has described, we need the government to do 3 things. First, change the payment approach for health care from that Medicare/CMMS currently uses to one that rewards quality results instead of simply doing a lot of procedures. Second, create fairness from a geographic perspective. MN health care providers receive a fraction of payment that providers in FL and some other states do. They are being punished for being efficient. Third, Medicare and any other public plan need to pay at a level sufficient to eliminate the cost-shift to the private market.

-Doug Smith, Stillwater, MN

A big black hole. There aren't enough taxpayers to cover the costs when only 50% of the people living in the US pay taxes. I'm tired of paying for mine and someone else's.-LouAnn Donahue, Eden Prairie, MN

Yes, a public option needs to be included. The best plan would be a 'single payer' plan, which means that health insurance is not linked to employment, that all providers are in 'the network', that there is no such thing as 'pre-existing condition', that medical decisions are made between the patient and the health care provider. No insurance company looking for ways to deny coverage. Affordable rates, no more bankruptcy because of health care costs.

-Deb Staley, Rochester, MN

From conception each citizen would have a health care account that could be a product from private companies or a public fund. This health product is not tied to employment but the individual. Then when one is employed the premium/maintaince cost is prorated to the employer based on a formula (wages, % of fulltime, etc). All employers would pay something. Now if capitalism works & everyone has a premium, health care premiums should come down. Basically, all citizens/residents should have health care from a central pool which then transferred to employors when working.

-John Robertson, Morton, MN

It should look like a right for every American to have good healthcare. It should most definitely NOT look like a profit center for the companies involved.

-Erik Bartz, Toronto, ON

Our health care system has become a leviathon-a beast beyond our control, it seems. Inefficiencies need to be identified and stripped. Standardized claims processes need to be adapted. Technology should make a variety of efficiencies possible and create new jobs as we transition to new streamlined systems. Beyond that, I'm not sure there is a place for government in health care. No one wants to say it, but as long as health care is a for-profit enterprise, we'll see continued exponential growth in costs. The big question should be: How do we transition to a system that is based on the concept that the health and well being of our citizenry is more important than a big profit machine?

-Trish Clancy, Robbinsdale, MN

Fix private health care by eliminating so many cnoices insurance companies offer to employers. There is so much administrative WASTE in the system. Third party expenses would eliminate alot of cost and bring costs down for employers. You must justify costs for a public plan. Doctors don't like Medicare, it only pays 43%, why would they like a public plan? Someone has to pay!

-Susan Fyock, Eden Prairie, MN

I think Medicare is an amazing program, and I'd like universal health care to be based on that model. I'd much rather have my health care decisions be in the hands of my doctors and me than in the hands of an insurance company bureaucrat whose personal bottom line depends on limiting care the patients his company insures receive. If we could put some of the millions of dollars in salary and bonuses that the CEO's of the big private insurance companies receive, we'd make a dent into providing care for a lot of uninsured people. I wonder how much the director of the Medicare program is paid compared to the salaries paid to insurance company executives?

-Bea Larson, Duluth, MN

Since when has the government run anything successfully? If the government runs the health care we should expect incompetency and government officials getting rich at the taxpayers expense. Just another example of how Obama wants the government to run EVERYTHING!!!

-Dean Waldemarsen, Inver Grove Heights, MN

Existing health program like Tricare for veterans and families. Single payment source, nationwide standards and capacity to bargain for both quantity and quality. A family medical emergency in France showed us that great health care, without bells, whistles and profit focused administration is possible at far lower costs. I wish that government were not captive to business interests and would move towards a real single payer system while leaving service delivery in a mix of private and public hands.

-Jay Wilkinson, St. Paul, MN

Current day federally qualified health centers are the ideal facility for what government health care should look like. Call me if you want more information. We are serving the un and under insured every day with better service that most main stream clinics.

-Betsy David, Minneapolis, MN

It should have a public option that is affordable. My family spends so much on healthcare these days, and if one of us loses our job, we will have no care.

-Nell Kauls, St Paul, MN

Universal healthcare is an absolute moral necessity. Single-payer healthcare is in everyone's best interests: think about it -- private insurers have absolutely no interest in actually providing healthcare to anyone. Their financial interest lies solely in the DENIAL of care to as many of their customers as possible! Equality of care ranks high on the desirability list as well; and that includes affordable coverage for all, regardless of any 'pre-existing conditions.'

-Susanna Patterson, Stillwater, MN

Whether people like it or not there needs to be friendly competition in healthcare to keep it competitive. Government and insurance companies need to coexist to keep it competitive. Obviously, it hasn't been working the way it is. Costs continue to rise and will continue to rise if nothhing changes. Government healthcare should be basic and conservative, again with an emphasis on healthier habits and education. There needs to be some accountability and a limit for those that are solely using the government system. A person should be able to purchase more coverage and services for their own personal needs, to be used where government assistance ends.

-Dr. John Pederson, Roseville, MN

It should look like an expanded Medicare. The Federal government become the insurer of last resort, and an available insurer for the public who prefers what it offers. Public insurance needs to be robust enough to cover preventative care and preexisting conditions as well as emergency room visits and standard treatments. Elective surgery would need approval by case workers. 'Government health care' sounds as if the government provides the services. Though the VA system proves that government can provide medical care effectively, any expansion of government health services can be limited to public clinics. Ideally, the government will focus on providing coverage, not health care itself.

-John Fulton, St. Paul, MN

Everyone should have affordable basic health care, and the stakeholder table should be large and bipartisan.

-@markawallace

I believe that access to health care is a right and not a privilege. Our current system is very unfair. My first choice for reform would be for a single-payer government plan that is not tied to employment. All U.S. citizens would be covered by this plan and would have equal access to high quality medical care regardless of income level or age. Ideally, co-pays would be a part of this system in order to reduce waste and ensure that people are investing in their own health. Minimally, though, I think that there should be a public option for health care that would compete with private insurers. Why not open up the plan that the Senators receive to all Americans?

-Siri Erickson, Stillwater, MN

There needs to be a public plan because it will help to make private plans become leaner and more competitive. If only this were not a political football! Medicare is a program that is thrifty and could be deemed successful were it not for the paltry reimbursement rates that are choking hospitals, long term care facilities and clinics. I'm willing to pay taxes or a premium to make this happen! We will all lose if we don't have some public option. -Lisa Peterson, Bemidji, MN

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