Every single person who abuses the system has gotten us into this mess. For over fifteen years that I know of, we have known that the issue of rationing care needs to be addressed. Howeer,the problems ae systemic in this respect.

People on Medicare and Medicad get the best healthcare around and either don't pay for it or pay little towards it. Now I have audited Medicaid and Medicare reimbursements and claims and can tell you that neither program even covers the actual cost of the care. That diffference is made up by the private insureres. In other words, a portion of the reimbursements to the heathcare provides from self-pay and insurance companies is necessary to cover the differential and is calculated and included in the insuracne premiums. And even with this Medicare is in huge trouble. This is much less about FACTCATS and more about the system and insufficeint funds to carry the burden of these two social programs.

Medicaid is one of the best insurance plans you can get and many of us who have plans with less benefits voer a portion of thier costs. So far our country has refused to address the cold harsh reality that gorenment programs cannot continue to provide suh a rich benefit. It is time for us to address what these individuals should have access to. No one likes the idea, but it is a reality. In addition to much money is wasted on the bricks and mortar. So much money is wasted on the buildingsthemselves. There are lots of ways to reduce costs as well but no one wants to take on the hard issues. It is also time for standards of protocal to be put in place so that when one has an illness, there are standard procedures put in place how to best handle the illness or injury. this could reduce medical errors, shorten lenghts of stay and be a standard to be applied in malpractice cases. We have known about this forever. The laws could be changed so tht if a doctor used the correct protocol, he could be relieved of liaiblity as some bad outcomes occur for non-medical reasonss no fault of the doctor but often are successfully sued or the insuracne companies settle them. this could be best used in obstetrics to improve outcomes, improve the health of baby and mother and reduce insuracne costs and judgment awards.

As far as Obama's plan goes it will do nothing at all to help the situation....nothing. the plan is a joke. McCain's plans do little to nohing as well except perhaps make isnurance more affodable for those who cannot afford it now, but iwll probably not add much.

The other things both have talked about have been ideas that strecth back to Clinton. I dougt either one will do anything about the problem at all in the next four years. Perhaps the states are in best position to address the issues as state insurance agencies could address the problems most prevalent in htat state. While some federal government could asssit in the federal fudning of the programs, the general welfare of people would be best served otherwise by the state and by federalisitic prinicples should be left there.