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<blockquote><blockquote><blockquote><blockquote><blockquote>mandatory insurance is necessary if you can't be denied for pre-existing conditions. If it is mandatory, you can't just wait until you get sick, get into a car accident, etc to buy into the system. </blockquote>Still, the penalty for not buying into the system has to be sufficiently high or many people WILL wait until they are sick to buy insurance. </blockquote> This is going to become a pretty key issue. The penalty for not buying in doesn't seem sufficiently high to force people to do so. I think people (not necessarily here, but the public at large) are mistakenly assuming this fixes health care. It doesn't. This tries at least to make sure that more people have access to coverage but the trying to tamp down the costs of health care are an entire beast altogether. Forget the obese - people need to raise questions about excessive testing and if we really want to get down to it, we also need to ask how much end of life care is really justifiable. Bring back the death panels! </blockquote> I agree the end-of-life thing, however uncomfortable a conversation, is pretty serious. Not sure about the testing thing; more often than not I've had to talk my doctors into running tests that they would just as soon have preferred to defer. But you're wrong to ignore the obesity thing. I don't have to give you the US obesity numbers, nor do I have to remind you that obesity is a risk factor for, like, *all* medical ailments. </blockquote> I think that the AMA even addressed the issue of excessive testing and it's out of control costs recently. The problem originates with the astronomical malpractice settlements and the need for doctors to cover their ass. Years ago I had a problem with my right inner ear and there was basically a one-in-a-million chance it was caused by a tumor. My doctor ordered a CAT scan of my head. An hour before getting the scan I talked to another doctor who was the world's leading authority on my condition. He said that he would not have ordered the scan but that I might as well go through with it (I would have been charged either way). He also pointed out that if there was even the slightest abnormality of any kind, the faintest shadow etc, that they would want to operate (on my brain) to check it out. He sited this as a undesired side-effect of excessive testing and one reason he would not have ordered the test. The obesity issue is a major factor in the cost of health care in the U.S., one I fear will only get worse now that this has passed. Years ago I ended up talking to one of the top health insurance execs in an airport bar and he said that this country would have had had public health care years ago if it wasn't for the out of control obesity here. He said the type 2 diabetes cost alone has pushed the overall cost of health care beyond a level that can be spread around affordably. I guess we'll find out in a few years. </blockquote> I wonder about the CYA excuse. After all, they get paid more for running more tests, it's not like they're doing them for free. I also have seen stats that say 5% of the doctors are responsible for 95% of malpractice cases. Maybe the medical profession isn't doing enough to get rid of bad doctors. Health insurance execs seem like as reliable a source for honest opinions about public health care as tobacco execs are about the effects of tobacco. I've been to Germany and the US is not the only country with tons of fat people. Oops I said tons. Plus most fat Americans already have health care. I've been to Chamber of Commerce meetings and half those boys are bigguns.

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