Health Care
(Solution)

The described problem with health care is: 1) Availability to all 2) Coverage for Pre-existing conditions 3) Rising Costs.

We cannot eliminate pre-existing condition clauses on policies as long as everyone has the option to be buy coverage or not. It cannot be an option to buy coverage only after a condition arises. That allows people to go without coverage until a major condition arises and that makes the entire system unmanageable. The true problem here is people who have done the right thing all their lives and all of a sudden are without insurance due to retirement, downsizing, company eliminating group coverage (or any variety of reasons) and then the individual is unable to buy an individual policy covering the condition.

Here are the changes that need to be made:

1. Allow for continuity of coverage on individual policies. If people have had continuous coverage they should not be subject to pre-existing condition clauses when forced to go to an individual policy.


2. Promote HSA - An HSA is basically a high deductible plan coupled with an account the individual/family can put tax free money into to pay for any out of pocket medical expenses. Any money not used is kept by the individual and treated as an IRA for their retirement. This makes people more responsible for their health care expenses vs. a 3rd party paying for all their bills. (See examples below)


3. Require doctors, hospitals and all providers to publish their prices. Now, providers over bill the insurance companies to max out the reimbursement or have agreed prices with the insurance companies. If patients can compare prices from difference providers and are responsible for part of the bill (see HSA) then competition is built into the system. Better providers will be able to charge higher prices and others will try to compete with more competitive rates.


4. Allow companies to write coverage across state lines. Their are plenty of health insurance companies in the U.S. but laws prohibit them from writing coverage in other states. More companies = more competition = lower premiums. We do not need the government in the health insurance business in order to have competition.


5. Tort Reform - Part of the problem with medical care costs in the U.S. is the high costs of lawsuits. The providers pay high premiums for their medical malpractice insurance or they run excessive procedures practicing defensive medicine. Any honest attempt to control costs must find a way to control the costs of these lawsuits.


6. Medicare & Medicaid Reform - The government pays such a small percentage of the costs for medicare and medicaid patients that the other patients must make up the costs with higher prices. If the government paid more of their bill the doctors, hospitals and other providers would not have to charge the paying customers as high of prices to make up the difference.
   
7. Immigration Reform - There are estimated 11 million illegal immigrants in the U.S. who can go to most hospitals in the U.S. and receive medical treatment with no ability to pay at a conservative estimated cost of over 10 billion dollars a year. Each time they use the system without paying someone else must make up the difference. True health care reform must deal with the ones illegally in the country using the system yet not paying.


8. Good for the Goose - Make Congress and the rest of the government live by the same system they develope for the rest of the country. Why would they design a plan that they are not even subject to?

Greatest Health Care System in the World - Proponents of the president's health care reform have put some doubt put into the fact that our medical system provides the greatest level of care of any in the world. I think we need to address this.

The World Health Organization ranks the U.S. 37th best health care system of the world. The major criteria used to degrade our system is the number of uninsured. Quality of care is not the primary factor but the number of people who choose to not buy health insurance or cannot afford health insurance. This ranking cannot be used to judge the quality of care of the people who receive treatment.

From top to bottom, America is the richest nation in the world We have all the luxuries and conveniences not afforded poorer nations. These luxuries and conveniences have also made us the laziest nation. We do not need to go the the grocery to buy food to cook, we just go out to eat. We do not even need to get out of our cars. When we do decide to cook at home we can buy prepackaged meals. We don't walk or ride to work, we drive everywhere. Americans have more cars per capita than any other country in the world. Technology has made us very efficient yet is has made less healthy. Just go to the pool or to an amusement park or any public event. America is fat! We have an unhealthy life style, we have an unhealthy diet and it puts an extra strain on our health care system. You cannot compare the statistics of a country where the people are thinner, eat better and have more exertion in their everyday life to the stats of Americans.

We do not need to re-invent a new system when the current system provides the highest level of care of any in the world. The goal of this plan is to be the first step towards a single payer system. I say this because: a) the president said that he prefers a single payer system but it might take 10-15 years, b) The current House Bill makes it illegal to add new individual enrollees after the law takes effect. (If he just wanted competition that clause would not be there.) After a few years he will declare the government plan helped but did not go far enough and will attempt to go further until the government has taken over another aspect of the American economy.

Examples of responsible health care with HSA: (Just my experiences!)

1. I had an incident where I thought I was having a heart attack. The hospital ran some tests and saw no signs of heart attack. Ran another test and thought it was maybe just an anxiety attack but wanted to run another test. After questioning the last test the doctor agreed she wasn't going to learn much more and was comfortable with the diagnosis.

2. I hurt my ankle in a sporting event. The doctor did the x-rays and say no break but wanted to have an MRI for a better look. I told him I have an HSA and it basically was out of my pocket and he said he was going to treat it the same way if he found a fracture of it was just a bad sprain so we did not do the MRI.

3. I had some breathing test done due to some asthma symptoms. The bill included a $20 charge to demonstrate how to use an inhaler. I complained and the office told me they just put that on there and some insurance companies pay it but was happy to take it off.

Health Care II

To accomplish anything politically you must have a villain. Justified or not, you need the American people to hate someone, some group, some company or some industry. Bush had Sadam, Reagan had the federal government and the current democrats have the health insurance industry. (It used to be the oil companies but as prices came down the anger subsided so did that political card.)

Here's some number:

Number of people in the United States - 306 million
Number Americans without health insurance - 47 million
Percentage of uninsured who are illegal - 20% * Do we want to pay for their insurance?
Percentage of uninsured making $50,000+ - 40% * These people are making a value judgement.
Percentage of uninsured eligible for Medicare - 30%

Leaves 10% or roughly 5 million Americans - The President and the democrats want to totally overhaul the entire health care industry to cover the 5 million Americans who don't have and cannot get health insurance. It makes more sense to target these Americans and find a way to provide them the coverage they need.

Some Heath Insurance Myths:

1. Insurance companies cancel policies when claims get excessive - By law, all health insurance policies are guaranteed renewable.

2. Insurance companies reject groups with excessive claims - By law, they cannot reject a group but can "rate up" but the max increase is around 2 times.

3. Insurance companies don't compete - Companies are constantly changing their models and rates to try to take business from other companies

I watched the Sunday news programs and it seems the theme that the proponents of this health insurance bill is "insurance companies discriminate against people with pre-existing condition." Let's set the record straight, the system does not work without excluding pre-existing conditions. Otherwise people could wait until they got sick to buy coverage. That would be like buying insurance after an accident or after your house burns down. In addition, discrimination is what insurance do! They put people in discriminate groups so they can assign the proper rate. Otherwise everyone pays the same rate and their is no incentive to act responsible. If they did not, the person with 3 DUIs pays the same as the perfect driver, the person with a brick home next to a fire hydrant pays the same as the wooden shack in the middle of the woods or the 21 year old healthy man pays the same as the 85 year old diabetic smoker. If that was the case the 21 year old would not buy the coverage and the system does not work. A better solution would be to count both group AND individual health insurance policies towards the continuity of coverage. If someone has maintained coverage then no pre-existing exclusion would apply. If the individual had coverage prior to illness through any policy, the pre-existing condition clause would not apply. This way they could not buy coverage after the illness was present.

If you really want to honestly address the problems in the health care industry you need to look at ALL the problems. I will admit that there are problems but, just as the the mortgage crisis, there is more than one problem and they all need to be addressed. Tort reform must be part of any health care reform in the U.S. Either the medical malpractice rates are driven up or the provider practices defensive medicine and runs excessive tests to cover themselves due to excessive lawsuits. Juries can feel for the loss by the patient, see a big bad insurance company with unlimited funds on the other side and find for the patient regardless of the facts. To ignore this aspect of the problem is protecting the politician's supporters at the cost of all Americans.

When I listened to the President in his prime time press conference the one thing that caught my ear was when he said people "will get the care that works." What bothers me in this statement is who will determine what works for any given situation? Every case is different and doctors and hospitals use every bit of information they have to determine the correct course of action. Is this going to be taken out of the providers hands? Is the government going to say, "No, this is the procedure that needs to be followed"? I don't know about you but I hear the first step to rationing which is an inevitable outcome of this legislation in order to control the spiraling cost.

I am by no means an expert on Health Care reform and even if I read the bill I would not be able to understand everything it says but there are people out there who have read the bill and have interrupted the legal jargon and here is the link to the one such ANALYSIS. Here is also a link to the actual bill if you want to reference the analysis HR 3200. What I am confident of is that the President and democrats do plan on taking over the health care in this country over time. The current bill does not dissolve insurance companies but it does make it illegal to start a new plan from an insurance company after the bill is enacted. The President even stated this goal in an interview. I find this idea quite bold for a government who has never balanced the budget. I just never trust their number. When they originally passed Medicare, the actual costs were 600% higher than estimated. (I cannot confirm this figure)

MISCELLANEOUS ITEMS

(Cash for Clunkers, Congress, N. Korea)

I have been working on the 2nd part of my health care blog but I just had to address some unbelievable issues that has developed.

Cash for clunkers - The ideal has some merit but it also has some problems including showing the ineptness of this current congress. The idea is to give people incentive to trade in old gas guzzlers for new cars which will stimulate the American auto makers. Here's the problems: 1) Why are my tax dollars going to help my neighbor buy a car? (Common problem of liberal politics.) 2) The majority of the cars being sold are foreign. Although many foreign cars are made in the U.S., the U.S. auto makers are the ones who need the boost. 3) The list of the cars available include the Hummer H3 with an average of 16mpg. Not very "Green". 4) If I was in the market for a car I would just go out and buy a junker to trade in. Not really stimulating anything. Finally, the billion dollars budgeted for this program was gone in 2 1/2 weeks. This is the same body of people who want to take over 17% of our economy with health care reform. Makes me nervous.

Congressional Traveling - Times are tough. Everyone is cutting back. I run a business and when income is down I cut back. Not our congress! We have the largest budget deficit in the history of this nation. Individual income tax revenue is down 22% and corporate is down 57%. "This is the worst financial crisis since he depression!" So what does our congress do? They buy 3 Gulfstream Jets to taxi our Congressional leaders around the country and around the world. The order was originally for one but congress recently added another $130 million dollars to the defense budget to purchase two more of these elite aircraft. These are the same leaders who chastised the auto makes for flying corporate jets to Washington to make their case for federal bailout money. The congress thinks spending money is their duty and they will not neglect their duty!

North Korea - Now this item will not get the support of all who read it. To be honest, I have not totally settled this in my mind. Two reporters were recently captured and convicted by the N. Korean government of illegally entering the country and sentenced to 12 years hard labor. President Clinton was asked to make a trip to meet N. Korean leader Kim Jong Il and negotiate for their release. Remember, Kim Jong Il is a part of the "axis of evil" and had been defying the UN and the world with his nuclear ambitions. Also, when Clinton was president he had a deal with the N. Koreans only to have them renege on their end of the deal. So Clinton did not get on a plane unless he already had a deal in place before he left. I know these two American women were released unharmed but we have a policy that we do not negotiate with terrorists because it only promotes more terrorism. The N. Koreans treated these women very well because they were just using them as bargaining tools to get what they wanted and that was world recognition to gain more favor among his people and that is exactly what he got. Just look at his face in the picture with President Clinton. Its great they are now free and hopefully the end cost will be small.