Today's Question Category Archive: Health

Should a public hospital have to treat anyone who comes in?

Posted at 6:00 AM on November 23, 2009 by Eric Ringham (19 Comments)
Filed under: Economy, Health

Hennepin County Medical Center has announced that, due to budget cuts, it will stop treating uninsured people from outside the county except in emergencies. Should a public hospital have to treat anyone who comes in?

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What do you think of the new guidelines discouraging mammograms for women under 50?

Posted at 6:00 AM on November 18, 2009 by Eric Ringham (27 Comments)
Filed under: Health

A new government study has recommended that most women not get mammograms until they reach age 50. It also suggests that women stop doing breast self-exams. What do you think of the new guidelines discouraging mammograms for women under 50?

Responses texted to MPR:

I am a 16 year old girl, and if my mom had not had her routine mammogram when she was 41, she would be dead now. I don't know how i could live without her. -Michelle, Minneapolis, MN

The age and frequency of mammograms should be decided by the patient and their doctor based on medical and family history. Also with higher rates of cancer every year it seems dangerous to recommend less screening when it has been proved early detection saves lives. -Sarah Fahey, Eagan, MN

Responses from the Public Insight Network:

Despite being low risk, I had a base mammogram at age 35 and yearly mammograms starting at age 40 as recommended by my doctor. This year my mammogram results appeared irregular and I went in for more tests. The end result was that at age 43 I was diagnosed with breast cancer. I underwent a mastectomy a short time later. Where would I be at age 50 without having had a mammogram? Quite likely six feet under. Is it not worth others to undergo a bit of discomfort and/or the possibility of a false positive so that lives like my own can be saved? -Jennifer Hartman, Los Angeles, CA

I was sent for one, but because I don't have health insurance (I'm a part-time community college instructor), I couldn't afford it. Frankly, I'm relieved the age limit has been moved upward. Now I can coast for 5 more years. -Jennifer Rueda, Hillsboro, OR

Recommendations for maintaining health are dubious at best--witness how Vitamin E, hormone replacement therapy, and calcium supplements were first vigorously recommended and now have been debunked by rigorous studies. It is always difficult to determine what to do as an individual. I recently read that colonoscopies, which are strongly recommended, miss about a third of colon and colorectal cancers. People must make the best decisions they can with the information they have--information that is almost always incomplete. -Carol Henderson, Minneapolis, MN

Agree totally. I am a physician. I have spent last few years discussing with friends the lack of data showing the benefit in women 40 to 50 with no family history, and ample evidence of harm in increased procedures. Ditto BSE. Because of official guidelines, none listened. Three of five required ultrasounds and one required biopsy, all normal. -Te Pazdral, Cambridge, MA

My sister-in-law discovered stage 1 Breast Cancer because of her yearly mammo - she was 45 and had no family history and none of the risk factors - she is thin and athletic and eats an extremely healthy, low fat diet and never smoked. The mammo saved her life. Even one life is worth saving. -Alice Potter, Westminster, CO

I understand the reasoning behind the new recommendations - that the benefit to a few is less than the harm of misdiagnosis of many. But I wouldn't want to be that one in whatever that does develop cancer in her 40's (like my sister). -Christine Hopkins, Oceanside, CA

If there is real evidence that mammograms in 40-year-olds don't find that many tumors, then it makes sense. However, I know of 2 women who had breast cancer before they were 50, one of whom who died of the disease. -Lynn Hoenke, Grand Rapids, MI

I think it is irresponsible. One of the reasons they are giving for reduction in number of mammograms is that biopsies are stressful. I have had one and it was very stressful, although it turned out negative. But how much more stressful would it be if you found out you had cancer that had gone on for a long time undetected? -Nancy Snyder, Muskegon, MI

I concur with the guidelines. Some people forget that irradiation itself is a cancer risk & should be balanced against other factors. Sex-related organs have less protection against cancer because of their generative functions; breasts are primarily fatty tissue which tends to collect toxins from the body. Put all this together and x-ray it every year for several years & the process may very well be more risky than the prospect of cancer. Doctors don't like to come right out & say that irradiation itself bears a certain risk because that would frighten women off, but it's true. YMMV: testing depends on one's personal profile. -Susan Williams, Lakewood, CO

I'm disgusted and outraged. It's another strike against womens' health care. Literally overnight, decades of teaching women the importance of breast care awareness was deemed irrelevant. It's a huge disservice to women who may have been on the fence about having this exam, and for families who have a history with breast cancer. -Susan Sheridan Tucker, Edina, MN

This is a paternalistic attempt to save the insurance companies money. Regardless of the protestations of the committee you can bet that the insurance industry will site these recommendation as a reason to stop paying for mammograms. Also I don't think GP physicians will recommend before 50 mammograms because they are not trained enough in the disease. -Janice Farringer, Chapel Hill, NC

Because I have "lumpy" breasts, i had my first ultrasound at 28 and my baseline mammogram at 36. I started annual screenings at 40, but am thinking about changing that schedule to every two years. I value my drs' opinion so that decision will hinge a lot on what they recommend. There is no history of breast cancer in my family so I'm not too worried. This will also help me to be more faithful with monthly self exams. -Tracey Dissel, Durham, NC

This amazes me (in a bad way)! As I understood the news program I heard, the study found there weren't enough cancers found to justify the mammograms starting at 40 and breast self-exams. Any woman in those categories who has been diagnosed early and treated isn't going to think it wasn't justified. I personally find it reassuring to have had the mammograms and to have done the self-exams. -Terry Wagner, Aloha, OR

My grandmother died of breast cancer at the age of 56. My best friend died of breast cancer at the age of 43, she was diagnosed at 36 and it was already too late. My major concern is not so much the mammogram recommendation as the recommendations regarding self exams. Apparently I will have too much anxiety if I do self exams. Given the history - I will have much more anxiety if I don't. I think it is dangerous to suggest that self exams are not important. -Angela Speck, Columbia, MO

I think it is absolutely the worst idea I have heard in a long time. I have a 47 year old friend diagnosed with breast cancer a few months ago. When they found the cancer it was stage 4 and in the lymph nodes. Now it has spead to other organs with a dismal prognosis. Why in the world would these guidelines change now? ...after finally educating women on breast health. The is not good news for women. There is a trust factor here. If what we were told for 15 years is not good advice, shouldn't it have surfaced sooner or at least be questioned? -Brenda Vaughan, San Antonio, TX

I find this confusing and problematic. The new guidelines do not recommend mammograms or even self-exams. Are our ob/gyn doctors exams supposed to be the means of discovery for women under 40.? The doctor interviewed on All Things Considered discussion yesterday was speaking from statistics -- collectively we're all at lower risk between 40 and 50, collectively there are 2 times as many biopsies given after home exams. How is that aggregated picture balanced against individual histories of people who are at risk? -Sarah Herr, Tucson, AZ

I think that each woman should have a personal treatment plan based on her history. However I have come to believe that for women with fibrocystic disease annual mammograms cause repeated tissue damage that may actually aid in the development of cancer. So I would agree that reducing the frequency would be beneficial if and only if MRI is available in the off years. -Adelle Popolo, Orlando, FL

In the 1990s. a physician wrote an article in Atlantic Monthly in which he was highly critical of routine mammogram practices. Although not a physician, I am a scientist. His viewpoint was compelling to me. When I began taking HRT, however, a yearly mammogram was a price I was forced to pay in return for HRT prescriptions. The new guidelines liberate me by allowing me to do what I have wanted to do for years--treat routine mammograms as a "less is more" procedure. -Jennifer Clark, Washington, D.C.

I am 38 years old, and I went for my annual check-up yesterday. While there my doctor brought up this report, and suggested that I go ahead and get my first mammogram now because she is worried that by the time I am 40 insurance companies may not be willing to pay for them. -Leigh Robbins, Charlotte, NC

I think you have to use your head. If you have a history of cancer in your family or engage in risk-taking behaviors like too much caffeine and smoking, then you should get a mammogram once a year. If you do a self-examination once a month or so and have no hereditary risks or behavioral risks, you should decide for yourself. People don't take enough responsibility for their health; they blame it on the other guy--or McDonalds. I decide for myself what's right for me and you should, too. -Susan Kirkland, Burnsville, NC

I've been fine so far. In fact, I asked my Dr. last year if I could start getting them every other year and she said that at my age, it's more important than ever to get them every year. I'm 67. But I'm wondering about the insurance aspects for those women under 50 who wish to get a mammogram regardless of the guidelines. -Ann Swaney, Traverse City, MI

I am 61 years old. When I was in my 40's, one "baseline" mammogram was recommended; annual screenings were not recommended until 50. I started getting regular mammograms at 50, every year at first, then every other year. My doctor has been OK with every other year. I have not had any issues after my screenings, however, last time I was called back to have a sonogram. -Mary Sanada, Carson City, NV

My mother died at 62 of breast cancer which had metastasized. One sister had breast cancer in each breast and had removal and reconstruction. Her daughter had cancer in one breast and had a mastectomy and elected to have the other breast removed. A second sister does not have breast cancer issues but her daughter just had a mastectomy and also elected to have the second breast removed. All of us had breast cancer before fifty. It seems to me that the recommendations of the federal health panel do not have those women with the breast cancer gene in mind. Those with the gene, typically develop breast cancer well before fifty years of age. -Clara Alexander, Denver, NC

While I understand the reasoning at a macro level, individual women will die as a result. Are the lives of those women less important than the overall cost? I know how I'd feel if I or my loved ones were one of the women who'd die. -Barbara Skoglund, North St. Paul, MN

Share your reply in the comments: What do you think of the new guidelines discouraging mammograms for women under 50?

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If you could sign up for Medicare right now, would you?

Posted at 6:00 AM on October 30, 2009 by Eric Ringham (26 Comments)
Filed under: Health, Politics/Government

Health care reform legislation in both the House and the Senate offers the option of a government-run insurance plan similar in some ways to Medicare, the program that covers Americans over 65. If you could sign up for Medicare right now, would you?

Comment texted to MPR:

Fo sho! Cheaper health care is where it's at. -Mike, Savage, MN

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How has the spread of H1N1 affected your workplace?

Posted at 6:00 AM on October 27, 2009 by Eric Ringham (6 Comments)
Filed under: Health

Citing the "rapid increase in illness," President Obama has declared a national emergency to help officials deal with H1N1 flu. How has the spread of H1N1 affected your workplace?

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Does the current health insurance system keep you from doing something you would otherwise do?

Posted at 6:00 AM on October 15, 2009 by Eric Ringham (25 Comments)
Filed under: Economy, Health

The difficulty of finding affordable health coverage may be keeping people in jobs or marriages they would like to leave. It may also inhibit potential entrepreneurs from striking out to start businesses of their own. Does the current health insurance system keep you from doing something you would otherwise do?

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Will you and your family get the H1N1 vaccine?

Posted at 6:00 AM on October 12, 2009 by Eric Ringham (48 Comments)
Filed under: Health, Science/Technology

A recent poll reported that more than a third of parents would decline to have their children immunized against the H1N1 flu. Their reasons included a fear of side effects and skepticism about the flu's severity. Will you and your family get the H1N1 vaccine?

Comments texted to MPR:

I'll get vaccinated when vaccine makers are made legally responsible for the deaths they cause. -A. Kimball, Fergus Falls, MN

We will all be vaccinated as it is the right thing to do. -Lindsey

Been getting seasonal flu shots for 13 yrs; my kids for the last 5. Only got sick the years I didn't get a shot, so I plan on getting both. -Jeremy, Shakopee, MN

As a nurse midwife, i feel that it is my responsibility to be vaccinated in order to protect my patients, my family and myself. I am also a temporary single mom due to my husband currently being deployed to Iraq; i will vaccinate my daughter largely out of work absentee concerns. If she is ill, i am the only person to take care of her. That trickles down and impacts everything at my workplace. -Jen, St. Cloud, MN

I will not. Every year people get flu vaccinations. Every year a new flu virus appears. The one year i was vaccinated, because it was free, i got the flu. -Tammy, Minneapolis, MN

My partner and I do not get vaccines unless required to for travel. We boost our immunities by eating well and taking dietary supplements. -Andy, Minneapolis, MN

Yes we will get the flue shot. We will get all the flu shots. -Tim Brandon, Minneapolis, MN

I'll be happy to get an H1N1 shot if the pandemic hasn't killed me by the time the vaccine becomes available. -anonymous text message

Share your reply in the comments: Will you and your family get the H1N1 vaccine?

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What part of your life has the greatest impact on your health?

Posted at 6:00 AM on October 7, 2009 by Eric Ringham (14 Comments)
Filed under: Environment/Energy, Health, Science/Technology

A series concluding today on All Things Considered examines the "social determinants" that affect health - factors like income, neighborhood and education. What part of your life has the greatest impact on your health?

My jobs in personal training, massage therapy, and yoga instruction. If i didn't do these daily for work, i wouldn't do them on my own, likely. So my work, and the knowledge that comes with them, keeps me going! -Julie, Howard Lake, MN

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How has fear of the flu changed the way you interact with people?

Posted at 6:00 AM on October 6, 2009 by Eric Ringham (24 Comments)
Filed under: Health

In schools, businesses and houses of worship, concerns about H1N1 flu have prompted warnings about close contact and confined spaces. How has fear of the flu changed the way you interact with people?

The flu hasn't changed how i interact with others. I think the flu is just a boogie man. -Peter, St. Paul, MN

Rather than shake hands I give the Star Trek Vulcan "Live long and prosper" greeting. -Mark C.

Swine flu isn't as big of a deal as everyone thinks it is. The regular flu kills more people every year. We need to stop being afraid of interaction with others and get on with our lives. -anonymous text message

I wash my hands more often than normal and carry around anti-bacterial hand wash. If someone is sick I don't shake their hand. Working at Best Buy, I try to avoid touching people that are sick, and try to restrain from touching my face and eyes. -Adolph Hernick, Minneapolis, MN

I am not changing how I interact with people. I think everyone should get the h1n1 strain of the flu so that our population can build up immunity. -Chris

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Can you afford to take five to seven days off work because of the flu?

Posted at 6:00 AM on September 18, 2009 by Eric Ringham (29 Comments)
Filed under: Economy, Health

Now that Minnesota is classified as a state where flu is "widespread," officials are recommending that children age 5 and younger be kept home from school or daycare for seven days after symptoms first appear. Guidelines urge that students stay home for 24 hours after a fever subsides, and that adults stay home from work if they are sick. Can you afford to take five to seven days off work because of the flu?

Fortunately, I'm a nanny, and work through an agency that has advised that we call in sick with flu symptoms so that the families we work with can use an on-call nanny provided by the agency for lesser inconvenience. We're also told we can call to discuss refusal to care for ill children. -Chelsea Chase, River Falls, WI

No kids here, but no paid time off left either. Sick kids and parents, too, need to stay home. Our company is assuming lots of telecommuting will happen. -Kathleen, St. Louis Park, MN

We have minimum wage jobs and a daughter on the way. Most of my girlfriend's check is burned up paying for health insurance and mine barely pays for food and other bills. 5 to 7 days off is impossible. -Dave, Minneapolis, MN

I will certainly stay home, even though self-employment means no pay, nobody else deserves getting ill because of my selfish greed. -Roger, Cambridge, MN

Share your reply in the comments: Can you afford to take five to seven days off work because of the flu?

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What's your experience with school counselors, social workers and psychologists?

Posted at 6:00 AM on September 16, 2009 by Eric Ringham (51 Comments)
Filed under: Education, Health

Sen. Al Franken is cosponsoring legislation to help provide more counselors, psychologists and social workers in schools. Minnesota lags behind most other states in its ratio of counselors to students. What's your experience with school counselors, social workers and psychologists?

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Setting aside the problem of how to pay for it, what would you change about the health care experience?

Posted at 6:00 AM on September 15, 2009 by Eric Ringham (17 Comments)
Filed under: Health

Much of the debate over health care reform concerns finances - how to cover more people and how to pay the costs of their coverage. Setting aside the problem of how to pay for it, what would you change about the health care experience?

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Should parents be held responsible if guests of their kids drink?

Posted at 6:00 AM on September 14, 2009 by Eric Ringham (15 Comments)
Filed under: Culture, Health

The St. Paul City Council is considering an ordinance that would hold you responsible if underage drinking occurs in your home or rental property, regardless of whether you supply the liquor. Similar ordinances are in effect in other cities, including Chaska. Should parents be held responsible if guests of their kids drink?

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How did President Obama's speech affect your view of health care reform?

Posted at 6:00 AM on September 10, 2009 by Eric Ringham (38 Comments)
Filed under: Health, Politics/Government

In his address Wednesday evening before Congress and the country, President Obama sought to build support for his health care reform effort. How did his speech affect your view of health care reform?

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What do you need to hear from the president's health care speech tonight?

Posted at 6:00 AM on September 9, 2009 by Eric Ringham (37 Comments)
Filed under: Health, Politics/Government

Congress and the public appear sharply divided on the issue of health care reform. Tonight, President Obama will address a joint session of Congress in an effort to rally Americans in support of his plan. What do you need to hear from the president's health care speech tonight?

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Where does your health care debate take place?

Posted at 6:00 AM on August 21, 2009 by Eric Ringham (12 Comments)
Filed under: Health, Politics/Government

Health care reform is the subject of town hall meetings, congressional negotiations and presidential news conferences. But the debate is happening in locations that never make the news. We want to know what conversations you're having about health care. Where does your health care debate take place?

I do not debate health care with my friends and family because we agree. My health care debate happens at work with my coworkers. -Erik, Minneapolis, MN

Share your reply in the comments: Where does your health care debate take place?

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Would a member-owned co-op work for health care?

Posted at 6:00 AM on August 19, 2009 by Eric Ringham (32 Comments)
Filed under: Health, Politics/Government

Republicans and some Democrats in Congress are resisting the public option being proposed as part of health-care reform. One alternative under discussion is the member-owned cooperative, along the lines of those used by dairy farmers. Based on your experience with other cooperatives, would a member-owned co-op work for health care?

My employer recently switched FROM HealthPartners to a for profit insurer due to HIGHER cost at HP. So, are co-ops less expensive as a rule? Apparently not. -Dan, St. Paul, MN

Coop health care will be no different than non-profit. More substantial change is needed. -Jerry Olson, Red Wing, MN

A Co-op solution will solve nothing. Universal public insurance is our only option to globally compete for high levels of national health! -John Laughlin, Stillwater, MN

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What's missing from the health care debate?

Posted at 6:00 AM on August 5, 2009 by Eric Ringham (62 Comments)
Filed under: Health, Politics/Government

The national debate continues over efforts to reform the country's system of providing and paying for health care. Political leaders, interest groups and care providers are sparring daily in the media and halls of government. What's missing from the health care debate?

A single payer health care system needs to be discussed in Washington! -Abbie, White Bear Lake, MN

What's missing from health care debate? Long-term care needs to be addressed! -Phil, Woodbury, MN

What about tort reform? -Andy, Stillwater, MN

Is insurance not tied to employment being addressed? -Jane Fisher, St. Paul, MN

Unnecessary procedures, unnecessary lawsuits, preventive care. -Jessica

What's missing is tort reform, a huge factor in out-of-control health care costs! -Dawn, Lake Park, MN

Health care is as expensive mostly because of our own unhealthy life styles and nutrition. We need to attack the root causes instead of treating the symptoms. -anonymous text message

What's missing...focus on real solutions for reducing costs. Examples: addressing malpractice limits, standardized reimbursements, etc. -anonymous text message

Share your reply in the comments: What's missing from the health care debate?

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Should parents be held legally responsible when their kids are severely overweight?

Posted at 6:00 AM on July 24, 2009 by Eric Ringham (20 Comments)
Filed under: Health, Religion/Ethics

Several states have begun holding parents responsible for dangerous levels of obesity among children. In one recent case, a mother in South Carolina whose 14-year-old son weighs 555 pounds has been arrested and charged with neglect. Should parents be held legally responsible when their kids are severely overweight?

I would say you have to be very carefull and make sure neglect is the cause and not family genetics. -Brandon Carriere, Le Sueur, MN

Obesity is a psychological disease just like anorexia. We are not punishing parents for this disease so we should not do so for obesity! -Diana, Bloomington, MN

Definitely parents should be responsible. Maybe putting the pressure on parents now will be the first step in emphasizing prevention in our health care system. -Kerry, Northfield, MN

Yes parents should be held responsible for their children's obesity. Whether a child is overweight or underweight it poses health risks. I think it should be considered neglect when it is obvious that the parents are not making any efforts to promote general health. This would be apparent through consultations with healthcare providers and actions taken...or lack there of. -Tauna Hudson, Bovey, MN

Ultimately it is the fault of the parents; the idea that since a meal has been fixed for them they must eat it is still very much alive. A child will not starve herself just because she does not want to eat when you want her to. There is also the factor of sugar in the diet. My oldest children were never given sugared foods and to this day have no sweet tooth, no weight issues, and also have never had cavities (they are in their 30's). The younger ones did have access to sugar and now fight with weight issues and dental ones as well. -anonymous text message

No, not until the govt cracks down on junk food marketers. -anonymous text message

Yes! As a young child parents provide the foundation of food habits. -anonymous text message

Parents are held responsible if their children are underweight and/or malnourished so I think parents should be held responsible if their children are extremely overweight. Both extreme overweight and extreme underweight are equally negligent and damaging to the child. -Lynn, Elk River, Mn

Yes parents should b held responsible they can say no. -anonymous text message

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How might your life be different if you didn't have to worry about health care?

Posted at 6:00 AM on July 17, 2009 by Eric Ringham (18 Comments)
Filed under: Health

For many Americans, access to health care depends on having an employer who offers it as part of a benefits package. Others may depend upon a spouse's coverage. Does a fear of losing health care affect your decisions? How might your life be different if you didn't have to worry about health care?

I wouldn't have to decide between groceries or the doctor. -Ben, Minneapolis

Not having to worry about health care comes at such a price I'm not willing to pay. There are no fee lunches. -Charlie, MN

I'd feel free to make bolder career choices, and able to change career paths if I didn't have to be concerned about health care for me and my husband. -anonymous text message

If i didn't have to worry about health care i could quit the job i hate and start doing what i love. -anonymous text message

I stayed with a company who offered excellent benefits for 25 years because of serious health issues, even though the job was not well suited to my skills or temperament. It is hard to know how my life may have been different if I had the freedom to get health care benefits that were not dependent on my employer. -Linda Swaggert, St. Paul, MN

I never would have married my first wife if we had some other way to come up with health care for her and our expectant baby while I was in the military. In addition, even though I held a Master's Degree, I took a job in corrections working for 20 years at something that only required a high school education so that my family would have health care. -Bryan Emmel, Moorhead, MN

I think its wise for me to worry a little about health care because it motivates me to live healthier. Fortunately, I have pretty good health care coverage now and am well. Although I believe there will be some form of health care when I ready to retire in 20 years, I am planning to pay a lot more out of pocket than what today's health care consumers pay, especially for conditions caused by my behaviors (as opposed to accidents and genetic markers). So, I'm tying to save a little more and keep my weight under control. But, there are enough worries for today. Let tomorrow worry about itself. -William Knutson, New Brighton, MN

People will always worry about health care, until there is no more sickness or death. Either we'll worry about the cost, or we'll worry about access, or we'll worry about rationing, or we'll worry about waiting lists. Nothing in life is free, especially things subsidized by the government. Farm animals don't worry about health care. It is provided them at no cost by their owner. Their owner also makes all the decisions, based upon cost effectiveness. Americans are more than just the government's beasts. We are a free people, with the right to worry about whatever we wish, even health care. -Kevin Masrud, Chaska, MN

This question treats health care as if it is something that can magically fall out of the sky and bestow its blessings on lucky recipients. How might your life be different if you didn't have to worry about food? How might your life be different if you didn't have to worry about retirement? How might your life be different if you didn't have to worry about your children? Health care is a personal responsibility, just like food, retirement, children, and all the other things that life so cruelly makes us provide for. If you can't afford your own health care, seek help from charities. Don't extract it anonymously and forcibly from my paycheck. -Jonathan Kovaciny, Mankato, MN

Share your reply in the comments.

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What should government health care look like?

Posted at 7:00 PM on June 24, 2009 by Eric Ringham (23 Comments)
Filed under: Health

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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