As I have traveled around the country, it seems everyone is concerned about health care. More people than not think the system needs a major overhaul. An estimated 47 million Americans have no insurance. For others, it’s an enormous financial burden. Families USA, a non-profit focused on affordable health care, predicts 18 million Americans under 65 will spend more than a quarter of their family income on health care this year — and that’s before taxes. And for some, the costs of medical care are catastrophic. It’s the Number One cause of personal bankruptcy in the United States.
So what are the candidates proposing to do about health care?
Democratic candidates Hillary Clinton and Barack Obama each promise they’ll provide access to health care for everyone. They would do this by expanding coverage for children and Medicaid for the poor. Also, they’d require most companies to offer insurance to their workers.
The big difference: Clinton would require everyone who wasn’t covered by work or the government to buy their own insurance. Obama says that’s unfair because buying your own insurance is so expensive. As a result, Clinton claims Obama’s plan would leave out 15 million Americans. Both agree: they do not want a government run system like Canada or several European countries.
In the interest of full disclosure, I was a White House Fellow, a non-partisan appointment, in Hillary Clinton’s office in 1997 and 1998 - three to four years after her health care initiative had been defeated.
Republican candidates (Watch Video) say the Clinton and Obama plans are too expensive and would add red tape to already-large bureaucracies. They’re proposing a different approach. They want to increase competition among insurance companies to bring down the price of health care insurance. They also want to give individuals who buy their own health insurance tax breaks. In short, they want to use the power of the marketplace to make health care more affordable.
The challenge for the Republicans, of course, is what to do with people who still aren’t covered?
So, which do you think will work? Using the free market and enterprise or expanding existing programs to cover everyone?

| Cindy |
January 31st, 2008 3:31 pm ET Sanjay, It seems to me that these so called plans are just a way to placate us for our votes and then when and if they win they will just do whatever they want. Don’t they all do that anyway!? Cynthia, Covington, Ga. |
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| Sylvie Grace |
January 31st, 2008 3:38 pm ET It is quite a problem and quite a task to cover all Americans with their health care. As said, in all the scenario’s listed, millions of people will be left out. This will not help the health care crisis. |
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| Arachnae |
January 31st, 2008 3:56 pm ET “Both (Dems) agree: they do not want a government run system like Canada or several European countries.” Taking this off the table is their first mistake and a sad sign that the GOP still controls this debate. Private individual healthcare costs 300-500 dollars a month. You can mandate all you want, but if people are barely making enough to cover the rent and groceries, they’re NOT going to magically find 300-500 dollars for insurance. “They (GOP) want to increase competition among insurance companies to bring down the price of health care insurance.” Yeah, competition sure works to keep the price of gasoline down. Something has to be done to break the hold the insurance companies have on healthcare, but unfortunately, no one running has the guts to take it on. |
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| Stacy |
January 31st, 2008 4:08 pm ET Insurance companies are for profit and therefore their number one priority is to make money. Why are we letting our healthcare be controlled by companies only out to make money? It doesn’t take a brain surgeon (or a Sanjay Gupta, if you will) to see the problem here. A government run system should never be off the table. |
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| Lisa |
January 31st, 2008 4:11 pm ET I vote to have the same plan as Congress. Afterall, if it’s good enough for them, it’s good enough for us. And … we do pay for it. However, since that is not an option, I propose this … Congress gets the same options we do … catastrophic, PPOs, HMOs. Then let’s see how quickly reform happens when they are denied a procedure or have to file bankruptcy because of the costs of a procedure. When the realities do not effect or affect one, one doesn’t really think about it or get what the problems are. Only when someone in a position to affect change is directly effected, only then will change come about. In the meantime, it is all about profit (for the various medical insurance companies) and playing the percentages game. |
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| Arachnae |
January 31st, 2008 4:15 pm ET By the way, we are buying into the insurance companies frame by calling the Canadian model ‘government-run healthcare’ rather than ‘publically financed healthcare’. Healthcare should be part of the ‘infrastructure’ like roads and utilities. |
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| Kat R. |
January 31st, 2008 4:18 pm ET Health care is quite expensive, even if you have good insurance. If you can’t afford the coverage, then medical expenses are at least four times higher, so your only option is to not get sick. I agree that those who can afford insurance should get it, but without some form of government involvement, the people who can’t afford it will still go uninsured. There is no quick fix to the health care problem, and I think that the candidates really need to look at this from all angles, not just from the top down. |
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| Hartman in KC |
January 31st, 2008 4:18 pm ET Cindy, |
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| Barbara in Culver City, CA |
January 31st, 2008 4:34 pm ET For a more detailed explanation of Sen. Clinton’s health care proposals, check out her website: http://www.hillaryclinton.com/feature/healthcareplan/summary.aspx She is proposing tax credits to individuals and businesses to make insurance more affordable. Her plan makes sense to me. I haven’t yet read the details of Sen. Obama’s plan, but without reading up on both, it isn’t really fair to make a comparison. |
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| Linzy |
January 31st, 2008 4:43 pm ET Dr. Gupta, If America really wanted Universal Health Care all it would have to do is get every executive on Insurance Row in Connecticut to come to Washington for a month. Individualized health insurance policies are offered by some carriers just get every carrier on Insurance Row to build those policies into their offerings and everyone who can afford health care can have it. It won’t be cheap but it will be available. One more question: how can health care be paid for if all of our jobs are being shipped overseas (even those of employees who work on Insurance Row). That is even more important than healthcare. No jobs no insurance. |
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| Bill, So.CA |
January 31st, 2008 4:53 pm ET Having insurance doesn’t seem to mean you’re covered anymore. |
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| Holly |
January 31st, 2008 5:11 pm ET I was ticked off at Romney’s description last night that 1/2 of the uninsured “don’t want to buy healthcare”. I do not believe that for a minute. I can’t qualify for it at work because they’ve decided that cutting people to just under 32 hours frees them from having to pay insurance for most of the workers at my company, which is a very common thing now. So, we are left up to our own to get insurance. With a cut back in hours I don’t have enough to buy private health insurance. Even if I did, they wouldn’t insure me as I have a pre existing condition that precludes me from most plans. So, I’d LOVE to buy health insurance if it were possible as would most people that I know would, but they can’t afford. It’s not because they just don’t want to. Who wants to go wait 12 hours in an ER for medical treatment instead of going to a doctor’s office? I don’t know many people like that. Apparently, Mr. Romney has never had to sit hours and hours waiting for care. I’m not sure what the answer is but at least the Dems are trying for an answer that makes sense. More and more people I know don’t have health insurance and they are living in fear that they will get a serious illness and have no where to go. In the end, if you are really sick and aren’t insured most people in the government and the medical field could care less if you live or die. I know it’s true because I went through it. |
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| Tammy |
January 31st, 2008 5:36 pm ET The priorities of the whole country are screwed up. When professional athletes, college football coaches, business execs, actors, and news anchors pull off multi-million dollar salaries, but teachers and other public servants qualify for food stamps in some states and can’t afford to insure their kids, something is really messed up with the system. This healthcare issue isn’t just about who can pay for what. It’s about how much people are paid to begin with, what a human life is worth (I loved Mike Huckabee’s response last night that all life at all stages is sacred, and if a person doesn’t believe that, then he or she is in serious trouble trying to help humankind as the president of this country), and how taking care of our fellow human beings should not be a for profit billion dollar a year industry. I’m a public high school teacher. I’m paid a salary financed by taxes. I work to help kids grow into productive citizens who are compassionate about their world (I hope). I don’t expect to make millions. I expect to pay my bills, save for retirement, have insurance (that I help pay out of my salary), and have a little play money to boot each month (and I do). I am not in a for-profit industry (at least not in my corner of the world), and yet we make a positive difference helping to improve people’s lives every day. You all want to change healthcare? Change the priorities of this nation. Change what a human life is worth at all stages to everyone. Change healthcare to a non-profit service industry. Change to a nation that gives instead of takes. And change to a nation that pays everyone relatively equally and fairly so that they can afford healthcare (quality care at that). It’s not about democrats or republicans. It’s about respect for all humanity. |
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| Cleo Murphy |
January 31st, 2008 5:37 pm ET I am one of those 47 million who do not have health insurance, I am a college student, part of the group that no one cares doesn’t have health insurance. It’s usually always about getting health insurance for the kids. I can barely afford to feed myself, let alone buy health insurance which requires me to take off from my minumum wage job(lose money) to check up on myself. It funny how Hilary did not want a health care system like the Canadians or Europeans because she modeled her health care system exactly like theres before it was defeated and she never spoke about it ever. I don’t think that America is ready for a health care system like the Canadians or Europeans because we are too consumed with greed in our health care system. Its not about caring for the sick, its about caring for the sick who can pay. It is a privilege to receive health care not a right — who cares you have cancer, you can’t pay, go die. Oops, you have back pain…here’s two asprin, you are on your way. What you want me to care that your sick! Pay me for my time. Health Insurance company do not care even if you open the market it because they will skim packages eliminate benefits and leave you worse off financially and physically from before when you didn’t have health insurance. |
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| aj |
January 31st, 2008 6:20 pm ET Lisa I think you’re right. If the people in Washington had to pay for their |
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| Ayanna |
January 31st, 2008 6:31 pm ET The United States is the only wealthy, industrialized nation that does not provide universal health care. “The Definition of Universal Health Care, is the result of government programs intended to ensure that all citizens, and sometimes permanent residents, of a governmental region have free or subsidized access to most types of health care. Patients may pay for some portion of their care directly, but most care is subsidized by taxpayers and/or by compulsory health insurance. Universal health care is a type of publicly-funded health care. In 1984, the Canada Health Act was passed, which prohibited extra billing by doctors on patients whilst at the same time billing the public insurance system. In 1999, the prime minister and most premiers reaffirmed in the Social Union Framework Agreement that they are committed to health care that has “comprehensiveness, universality, portability, public administration and accessibility.” Hillary wants manditory health care weather you can afford it or not. That sounds more like a universal health SCARE. She’s of the same thought as Otto Von Bismark who initiated the mandatory health care system in Germany in 1880. He also held conservative monarchial views. Obama wants a public insurance system more similar to Canada. “Allows individuals to choose between the new public insurance program or from among private insurance plans that meet certain coverage standards.” It’s closer to getting health care in the right direction. America should have gotten started on this years ago and she would not be in the mess that she’s in right now. |
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| Jan from Wood Dale, IL |
January 31st, 2008 7:43 pm ET There are some people who might be able to afford individual health care insurance, but due to a pre-existing condition the insurance companies will not accept them. Not all businesses qualify for group insurance plans, and with the rising cost of insurance, many companies can’t afford to provide those benefits for their employees. Yet the insurance companies continue to reap huge annual profits. Some system! |
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| Cindy |
January 31st, 2008 7:43 pm ET Hartman, Cynthia, Covington, Ga. |
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| xtina chicago IL |
January 31st, 2008 8:43 pm ET Lots of things are to blame for high health care costs. One is the increasing # of illegal aliens using our hospitals without paying. Another is frivolous lawsuits against the medical profession. Another is unions using the Washington lobby to buy politicians. All three of these problems can be alleviated by a new conservative President. |
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| Chris, Ohio |
January 31st, 2008 9:33 pm ET I agree that undocumented individuals utilizing our hospital systems is increasing the cost of healthcare, but they are not totally to blame. We have all seen people in the ER with relatively minor problems that can be handled at their physicians office, except that they don’t want to wait for an appointment. Don’t forget about the individuals who have no insurance or physician to visit, they wait until they are very ill before coming to the ER and it requires more time and services to treat their problem. I was a ER volunteer for many years and cannot begin to count the number parents of young children who came in on Friday nights even though their child had been ill all week and now they didn’t want to spend their weekends caring for a sick child. There is no “quick fix” to this problem but until Congress and the Senate are required to use the same system the rest of us do, nothing will change. |
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| Annie Kate |
January 31st, 2008 10:07 pm ET By not considering national health care insurance they have ruled out the only thing that will cover everyone. The insurance companies if they will insure you because of pre-existing conditions will charge an arm and a leg - after you pay the premium, the co-pays, and the deductible you have nothing left for feeding yourself and your family or for rentn/house payment/etc. I don’t see why Americans are so afraid to consider a system like France or Canada has. Yes, you have to wait on elective procedures, but these systems among the people it covers have a 80 percent approval rating. Their infant mortality rate is much lower than ours. But we have been convinced by the insurance companies here and by our doctors - both groups who would not profit as much from a system like this - that the national systems are no good - scare tactics instead of facts and figures. I don’t think any of the candidates have a plan that will cover everyone. And mandating people to have health insurance just puts the poor and struggling middle class in an even worse situation than they are already dealing with. Get real and find something that will work - we’re suppose to be the top nation in the world yet on this issue we act more like a dveloping country than a developed one. Annie Kate |
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| Robert - Jakarta |
January 31st, 2008 11:11 pm ET On the one hand, we have proposals to have government subsidized healthcare insurance and the other offers “encouraged competition” between health insurance providers. As for a requirement basis, what is the problem? Don’t we already require all drivers to carry automobile liability insurance? What’s the difference? This requirement is necessary for the public’s protection. We are incensed by the idea that anyone on the road would be so thoughtless not to carry it. Why do we not have this same sense of disappointment with regards to medical coverage? There are numerous and many advantages to a health insurance requirement, none less significant than limiting the public’s liability for unpaid medical treatments and, perhaps the most significant, providing access to medications and treatments to prevent the spread of disease. As for the GOP proposal to “encourage competition” between health insurers. How would they do that? Aren’t there already many health insurance providers already? Even with these multiple large carriers, there were huge profits between each of them. What would encourage them to lower their premiums and cut into their profit margins? The GOP use populist sentiments but no clear solution. The government cannot “encourage” anyone to do anything… except perhaps to spend more money (raise our taxes or send us checks). Their solution is merely semantics: leave them alone or “freemarket will”. Let’s say that they could come forward with a solution to get insurers to lower their premiums, say by providing larger tax loopholes or by sending them hundreds of millions if not billions of dollars in “incentives”. What next? If they actually lowered their premiums, would their new premiums reach the threshold where a majority of those 47million uninsured would actually pay for coverage? Probably not. Even still, say that these people magically had the money to pay for these new premiums, at the time they need coverage would the health insurer actually pay their fees? What would their co-pays be? Do you think that the incremental costs, when you consider co-pays would be within the budgets of these 47million people? It seems only logical that if we were to take adequate care of the people who do the majority of service and manufacturing work in the US while simultaneously preventing the spread of disease then we must first have a requirement for healthcare coverage that will eventually lead to universal healthcare coverage. To manage healthcare coverage adequately, we must first place caps on healthcare costs at the clinical, hospital, equipment, and pharmaceutical levels. Health insurers complain that costs of treatment are too high, drug prices are too high, equipment is too expensive, or diagnosis is too expensive. We can no longer operate within the public interest by allowing a public good such as healthcare be dictated by for-profit concerns. I live in Jakarta, Indonesia where, like back home in the US, healthcare is a for-profit business. Like in the US, the working class and poor do not have health insurance and as a result do not seek competent medical care for injuries or illnesses. This socio-economic reality has led Indonesia to nearly out of control disease epidemics and a public burden caused by disease and unpaid or untreated medical complications. Preventable or potentially mitigated diseases such as tuberculosis, hepatitis, typhoid, polio, and measles are epidemic here. Is this what we want for America? If you don’t believe me, make a visit to Indonesia some time. Robert |
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| Robert - Jakarta |
January 31st, 2008 11:29 pm ET I’d also like to point out that national statistics that tell us that 47million are uninsured are just approximations. The number, just as the actual number of unemployed, is very likely much larger. Has anyone ever called you on the phone and asked you about your healthcare coverage? Did the Census taker ask you about your healthcare coverage? Probably not. When you really listen to what the GOP are offering, you’ll find nothing. Just listen to Mitt Romney say things like “we need to support our children and bust up the unions…” (post Florida primary rally). “Bust up the unions”? This will help us how? The unions, who represent en masse individuals who have children, spouses, homes, yards, dogs, bills to pay, food to buy, medical check-ups to pay for… this is their solution. Dissolve our collective ability to make sure we have recourse when our employer decides to not provide us with affordable health insurance? That’s their fix, folks. We really need to get past our fear of “paying for it” when it is in our own best interest to pay for it while we are young and/or healthy and collectively as a nation for each other before we singularly need it and it bankrupts us. I find it very self-serving for the GOP to claim that universal coverage is going to cost us more money and that we should not have to pay for it. Well, I’ve got some bad news for you, and them: you will get sick. It’s going to happen, just ask any doctor. If you happen to be in that median household income range of $48,000 per year, ask yourself if you could afford that $100,000 in dialysis or that $300,000 kidney transplant. Got that stashed away in your bank account? Hidden under the bed? If you are Mitt Romney, no problem-o. Me or you… no way-o. We just have to hope we stay healthy and if the time comes that our insurer, who we’ve paid $300 per month for 18 years (and our employer has paid an additional $600 a month for the same 18 years) will actually cough up the money. Make sure you’ve dotted all your “i”s on that insurance questionnaire. I would like to see Dr. Gupta’s program, allowing that CNN International shows it, but I hope he speaks with doctors about the necessity of preventative care. If you start to see how doctors feel about national health coupled with stories about families not being able to receive let alone pay for necessary medical treatments… well, the idea of universal coverage starts sounding a little more affordable. Robert |
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| Sabrina in Los Angeles |
February 1st, 2008 12:58 am ET Just having watched this show, you have made me realize which candidate to back. I have been in that position of having a pre-existing condition and NOT able to get insurance regardless of cost. Seems intestinal issues nix you out completely, even if you had perfect health for years before hand. I had to get coverage through a group plan where they can’t deny you. One company was willing to cover me after 6 months of being insured but the cost would have been so staggering, I would not be able to afford it at all. Natural remedies finally healed me. Bedridden ill and no Idea what I picked up in Puerto Rico. Roommate that year went home because she was violently ill. I was without a job, without health insurance and medi-cal wouldn’t cover me….they kept trying to kick me out of their system. I had a negative account balance and no job yet they didn’t care. Prevention is worth a pound of cure. My sister is more tragic with this “system”. She was born with club foot due to Benedictine (morning sickness tablets my mother took that the government gave her while my father was in the service.). They now know that this medicine causes birth defects at an alarming rate. My sister was born with a pre-existing condition and NO ONE will cover her. She is an ER nurse and can’t get coverage herself!!! She got injured on the job helping a patient and State Fund failed her along with her employer who let her go and didn’t report it to State Fund for months!! She wants to work but she received a fractured hip, broken rib that splintered backward and tore muscle, and has a shoulder that needs surgery now….all due to the workers comp injury. She can’t get help to heal because the employer let her go, State Fund won’t rightly cover their responsibility and she can’t get insurance on her own (she has tried). Cobra ended and she has tried charities for help. State Fund doctor keep hiding when she tries to get the help she needs. This is how we treat our medical workers who try to heal us?! She got cleared to work in a limited fashion, but that is hard in the ER. She is the one making the house payment right now as well. Good thing they can’t do anything for 90 days. The “system” failed her miserably and there has to be some way of fixing it permanently. EVERYONE should be covered and not to be told that they HAVE to have insurance. Honestly, if it could be afforded, people would have it. Going without is not a choose but a sad reality that ends don’t meet and that is too much to add to it. I get my wealth back, I am going to start the charity I worked on while bedridden ill. A charity to assist single moms with health care. Corporate greed wants us to provide our own insurance so they don’t have that on them but people can’t afford it or get covered if they have pre-existing conditions. We need true reform. I hope these candidates will pull through for us. Namaste, Peace. |
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| Robert - Jakarta |
February 1st, 2008 2:08 am ET In order to achieve “universal” healthcare, you must first require compulsory coverage. This may sound as though it places the burden on the individual but it does not have to. This requirement should work both ways. On the one hand, the individual will be required to obtain health insurance for themselves and their uninsured dependents. On the other, insurance companies must be required to drop pre-existing exclusions and be prevented from pro-rating premiums based upon pre-existing conditions. Both of the latter are primary vehicles for creating this massive pool of uninsured. Coverage must be required to provide 100% of preventative costs as well as a larger percentage of surgical costs (much higher than the standard 80% now). The individual requirement must come with tax incentives for the individual to offset premiums as well as insurer incentives to offset their burden for taking on these new clients. The financial incentives must be tied to performance and should be pro-rated on that company’s P/E or profits. The next critical step will be for federal and state governments to purchase more equipment for hospitals, specifically diagnostic equipment. They must also extend funding to medical schools in order to increase seats and matriculation at these schools. There must be an increase in government-sponsored scholarships for medical schools. Additionally, there must be a government standard for math and sciences in the US in order to qualify more students into medical programs. Caps will eventually need to be placed on drug and equipment manufacture. A method for doing this may be achieved through gov’t purchasing or stipends for medical equipment and drugs (supply and demand) thereby leveraging lower costs through higher production. System-wide privatization of our medical system is not entirely necessary but by the same token, private, for-profit healthcare runs counter to the very tenants of medicine. This is a public concern and therefore should be directed at public interests with profits removed. Sounds lovely but it’s true. Patients cannot be considered based upon their income-generating potential but instead based upon the best recommended course of care as directed by her physician. The gov’t has a role in ensuring that this happens. It isn’t free, will p.o. a lot of really wealthy people but will ultimately put a lot more people to work, help prevent the spread of disease, and offset publicly funded costs for non-paid treatments. Just watch. It will happen some day. Robert |
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| Ruth |
February 2nd, 2008 10:15 am ET As an American who has lived half my life in Canada and half in the United States and someone who has both parents that are a doctor and a nurse in the U.S. let me say something about the government health care in Canada. It’s CHEAPER than the private insurance people are now paying in the U.S. and no one is left out of coverage. I used to think that government health care was a big no no until I lived in Canada for a while. Does anyone think that perhaps it’s been made into a huge phantom bugga boo in the U.S. for a reason? Every other democratic industrialized nation has it and I haven’t yet seen the free will of the people being taken over in Europe or in Canada all because people got government health care plans. Those plans actually take care of people! You need an operation or your child does? You go get that operation and you walk out of the hospital with no great big bill that you will lose your home over. Now then let’s talk about wait lists since that is often touted in the states as the reason why it would just be too awful. Most of the time the wait lists are not longer than they are in the U.S…they have them at times but, not nearly to the extent it is talked about in the U.S. Someone doesn’t WANT the American people to want government health care plans. Could that be the insurance companies? I’ve looked at both candidates plans. Hillary Clinton’s plan makes the most sense over all and she does not say it will cost more without saying she is going aggressively cut cost. She will put a cap on what you can be charged. She will also gear the payments to income *as she has said quite a few times but, that wasn’t included in this report* she will not mandate her plan *which it has to be mandated or it will end up MORE EXPENSIVE if you don’t!* without making sure it’s affordable and geared to income. Not only will Obama’s plan leave out that many people but, it will end up costing more. Comparing the two plans the most humane and affordable on is Hillary Clinton’s. However, I do wish American’s would stop buying into the bill of goods they’ve been sold on really universal government run health care. It’s been working around the world for ages and ages. |
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