There are lots of people out there who work hard at their jobs but have no or little health insurance coverage. (In total, 46 million Americans do not have health insurance today.)
With Democrats taking over Congress there’s been, as expected, lots of talk about patching up this nation’s ailing health care system. But what shape will the patches take?
President Bush in his radio address this past weekend talked about giving people tax breaks to help them buy coverage on their own. Tax breaks seem to be Bush’s answer to almost every economic problem but it’s unclear whether that will translate into more people being covered.
People who have their own businesses or work at jobs that offer little or no health coverage constantly complain to me about how expensive it is to buy insurance on the open market, if they can get it at all. One woman told me she and her husband tried to buy insurance after they decided to leave their corporate jobs and start a franchise business, and they were denied because at one point she was diagnosed with high blood pressure, and it also came up that her husband had smoked when he was younger. How did the insurer find out about these problems? Their doctor’s records. (That’s a whole other topic.)
The bottom line is they ended up getting coverage but it costs them nearly $400 a month for a bare bones plan. The couple is contemplating going back to the rat race and working for a major company again because they fear one catastrophic illness will end up putting them in the poor house.
Some Democrats see the answer in a socialized health care system. Hilary Clinton talked about that but was shot down big time during her husband’s tenure as president.
Now everyone realizes the health care problem in this country is nearing a breaking point and everyone’s scrambling to offer their plan. Tax breaks won’t do much to help people who can’t afford costly plans. And socialized medicine would be such a monumental change I can’t imagine how this country would be able to accept it…doctors, hospital administrators, drug company CEOs and health insurance big wigs are probably going to do what ever they can to keep the profit motive alive and well in the nation’s health care system.
So what’s the answer? Does anyone have a plan out there that will work?
February 20th, 2007 at 1:31 am
Part of the ‘illusion’ of virtually every employer that offers a healthplan is the premise of volume discounts offered by one plan over another. In Pittsburgh we have a learning\research mega insurer tied to our University of Pittsburgh Medical School. Recently they had the audacity to report a 52% profit this last fiscal year ending January 31. Yet the school raised it’s tuition for the 60th year in a row. So much for the defunct ties to it’s origins that once offered discounted rates to various companies, and a volume rate for companies that participated in their Dental school programs. Also there is a distinct shortage of Physicians at this mega-insurer’s hospitals that actually were trained at the esteemed college. The adminstrative cost of every health plan is without a doubt the heaviest toll on premiums. The fairest, most fudiciary health plan is still MEDICARE, yes MEDICARE. THe Bush Administration did what the last ten administrations could not phathom and introduced its prescription benefit in a fair and equitable manner. Someone might say I’m nuts. Well go back to the Truman administraton and tell me perhaps they assumed there would no longer be people on this planet in 2007. I was born in 1961, I’ll be Medicare qualified in 2028. Did perhaps the Kennedy administration assume man would be no more in 2028 so no one thought of creating an equitable health care system? Actually it took from 1936 to 1965 to enact the medicare system. Pharmacy benefits were first introduced by Sen. John Kennedy in 1955 and did not become law until 2005. Becoming recently unemployed, I discovered that while employed I paid about $280 per month for an 80\20 plan that my company paid two thirds for. So based on almost 200,000 covered employees, it cost $840 per month to cover myself and family, and this included an 85% prescription benefit. My wife, who is disabled, picked up the Medicare and prescription benefit after I became unemployed. Her premium for herself is $80 per month with a 90% prescription benefit. There are approximately 40 million Americans on Medicare. Her medical benefit is 80\20 and goes to 100% if our out of pocket goes beyond $2500 annually. I’ve noticed that there is an efficiency in that every procedure and doctor visit is sent to our home within days after an event. With the private insurer, we received a statement every 3 months, sometimes within days of receiving a statement from the Doctors office or hospital close to being sent to collections. My wife is only 52 and although she is permanently disabled, I am encouraged by the efficiency of the Medicare system. The problems occur I believe when people, of course because of their age, don’t go online for questioning or changing benefits. I remember in the earky 80’s when my retired Aunt began to recieve Medicare benefits. We were completely confused by every bit of information we recieved and even more so when we conversed by phone. I remember helping to pay for her medications, they cost over $100 per month and they increased every year until she passed away. However she was hospitalized for a long period of time and I remember seeing how she only had to pay $10 per month on her left over bill of around $1500. The Hospital allegedly paid the balance and she was making payments to them. When she passed away, the bill from the hospital was over 3$3000. I asked about that and well, you guessed it, they billed medicare less than her room cost to be paid and tried to recoup the difference. The bill is like gone, disappeared.