Well the spit and baling wire did not hold, the health care reform bill has crumbled under its own weight. Since all agree something must be done to control costs and make sure all have access to adequate care, the Congress will, apparently, now extract the parts of the bill that have widespread support and enact these as seperate measures.

I suggested that one way to assure all get adequate care is to extend Medicaid and/or Medicare to those who are too poor to buy health insurance or with pre-exisiting conditions that preclude them from obtaining health insurance. The response here is that this means the government has to pick up the high risk clients while private insurers can limit their exposure to healthier clients. Well Medicare already covers those with end stage renal disease who are not able to obtain insurance, so the government taking on more of those precluded from insurance is not a new idea.

As for those who are too poor to buy insurance, the health care reform bill already addressed this by stating the governnment would subsidize the mandatory purchase of health insurance by those too poor to buy it. Bringing these people into Medicaid or Medicare would simply mean paying that expected subsidy directly to one of there government programs.

Now there are those who do not have health insurance, not because they have pre-existing conditions or who are too poor to buy it. These are the ones who believe they are invincible or who can afford to pay for medical care when they need it. As far as I am concerned there is no need to extend health insurance to these. Let Tthem pay for health care out of their own resources. If they should use publicly financed health care, then make them pay full freight for the service.

There are other measures that the Congress can address individually and it should. Perhaps doing it specific item by item will be more successful than trying to combine all the goals in one bill.