April 24, 2004
A Tale of Two Health Care Plans
It was the best of times. It was the worst of times. The best of times because I still have a job that offers health care benefits and the worst of times because I recently had to use them. A few weeks ago I had my first trip to the hospital and it was an eye opening experience to be sure. I am happy to report that everything turned out well and the overall experience will not have a negative effect on my health or my finances. I received good treatment from the local hospital and I enjoyed the peace of mind that comes from knowing that I was not going to face financial hardships because of it. I am lucky. I wish all Americans could have the same peace of mind when it comes to health care.
Sitting in a hospital bed for about a week gave me a lot of time watch TV and read the news. During my stay the story broke about the kidnapping of Tom Hamill in Iraq. There was a certain amount of irony in watching this story unfold from a hospital bed as it seems that Mr. Hamill was in Iraq driving a truck for Halliburton to help pay his bills after the failure of his dairy business. A good portion of those bills stemmed from a heart condition his wife has that requires surgery. Mr. Hamill is a well liked hard working guy from Macon Mississippi who fell victim of the Bush economy and was forced to put himself in harms way to provide for his family. To say that this story just about broke my heart as I sat safely in the United States with my healthcare taken care of (at least for now!) is an understatement.
Unfortunately Mr. Hamill’s story is not unique. There are about 15,000 contract workers in Iraq helping to rebuild that country and so far 30 of them have been killed. By and large these are ordinary people placing themselves in extraordinary and dangerous situations to provide a better life for themselves and their families. It seems as though all the wonderful statistics proffered up to show Americans how strong the economy is and how it is growing doesn’t mean much when you can’t afford health insurance and are at risk of losing everything you have worked for. I pray for the safe return of Mr. Hamill along with all our contractors and soldiers who are in harm’s way in Iraq and Afghanistan. I pray that we can bring them back to a country where the basic necessities of life are attainable for every American and where the American dream is not held hostage by the greed of the privileged few.
Note: The tax benefits to be realized by Bush and his cabinet from the 2003 tax cuts are estimated to be between $800,000 and $3.2 million. Cheney is the big winner in all this saving somewhere around $300,000 to $800,000. Let’s split the difference and say that Bush and his cabinet are going to see around $2 million extra in their pockets due to the 2003 tax cuts. I did some checking and it seems that if your job does not provide any healthcare benefits you could be looking at about $4,000 per year for healthcare insurance for you and your family. This means that the tax break for Bush and his cabinet could have provided health insurance for about 500 needy families. Which option sounds better to you?
Note: A recent story on the NY Times has noted, “The Equal Employment Opportunity Commission voted Thursday to allow employers to reduce or eliminate health benefits for retirees when they become eligible for Medicare at age 65”. It seems as though once you qualify for Medicare you don’t need your personal health benefits so employers should be free to take it away from you. Isn’t that grand? The government wants to take something away from you that you have worked your entire life for because they have determined you don’t need it. Bully for them. Of course if I pointed out that Bush’s cabinet probably doesn’t need the extra $2 million they are pocketing due to the 2003 tax cuts I could be accused of class warfare.
Posted by William Flynn at April 24, 2004 06:25 PMI think the thing that’s missed in the discussion of universal healthcare is that the burden of providing health insurance to most Americans has now fallen almost exclusively on the backs of businesses. As health insurance rates continue to rise and companies see that line item eat up a greater and greater percentage of their annual expenses, something’s got to give.
What’s happening now is that companies are asking employees to foot more of the bill. That’s a trend I don’t see reversing itself.
I can’t say I know enough about any proposed universal healthcare plan to say whether it’s truly “socialized medicine” or not. I do believe that health care reform is long overdue in this country.
And by the way, did you really mean to say $4,000 a year for a family insurance plan? I’m self-employed and I pay over $900 a month for my family of 4, and that’s on my former company’s COBRA plan. To get the same plan independently, it would cost me well over $1,000 a month.
Posted by: Jerome Guerra at April 24, 2004 09:01 PMMSNBC covered a story about a group of girls and what happened to them in the aftermath of having been hit by a drunk driver. The least injured of the girls, a cut above her eye and 1 night’s stay for observation resulted in her being billed - ready for this - $15,000.00.
The most seriously injured young lady’s bills approached a $200,000.00. She was a college student when the ‘accident’ happened. Turned out the drunk was a petty criminal with a record and had also been arrested for DUI before.
But an insured person going in with a cut over the eye and 1 night stay for observation would resulted in a total billing to the insured and insurance company for the same treatment of about $1,500.00. One tenth of what they billed this uninsured girl.
Broken? Understatement to say the least. Absolutely unfair, discriminating, and bankrupting are apt terms for what our health care system is. Corporations talk about how America offers cutting edge treatment and technologies. What they don’t say is that only the wealthy can afford that cutting edge technology and treatment. While the rest of America has to do without and go broke for the more mainstream medical care.
Single payer, WHICH IS NOT THE SAME AS SOCIALIZED MEDICINE, is way, way overdue.
One final note, Bush pushed a little legal maneuver to let ER’s off the hook for treating patients who have no insurance. Thus, he supports ER’s turning away patients if they don’t have insurance or cash for treatment. Just die or suffer your way to another charity hospitial if you can make it. That is our President. It is time for we charitably sent him home for a long convalescence from his 4 years of incompetence. He desperately needs it. And so do we.
Posted by: David R Remer at April 25, 2004 01:34 AMHey Jerome. I posted a summary of Kerry’s health care plan over in the Democrats column and I just added a summary of Bush’s plan.
Posted by: Lee at April 25, 2004 11:15 AMI think a single payer system is a good idea. It is time to remove the good Ol boy system that exixsts in our health care system.
It probably is unreasonable for a $15,000 bills for an over night stay in the hospital. My guess is that if she had no insurance, she would have been treated and released. The Insurance company is a deep pocket for the medical comunnity and the deep pocket pays. This results in poor economic decisions. However, what would happen if she did not have MRI’s, or Xray’s, or was not observed overnight for signs of concussion? If some problem arose, the first option persued would be a lawsuit. I understand the doctor’s reticence to use his intuition and medical judgment rather than every expensive diagnostic tool available.
Frankly, some form of “socialized medicine” which provides for catastrophic insurance, removes the burden from employers, and protects the medical community from the “sue first methodology” that our current system engenders
Medicine is a social service. The anathema that the word socialism has become to some people is a knee jerk reaction that has been fostered by people who’s primary goal is profit. Profit and the “best” medical care are not always synonomous.
It is exactly the “for profit” drive that is destroying our medical system. Not everyone needs the newest and the best new “toys” of medicine. Only a government body could set up the guidlines and allocation system that is truly needed without being sued out of existance.
Yes, you may have to wait a long time for an elective procedure. Yes, some new technology may not be viable because of a different value system.
Americans it seems want everything without sacrifice. That only exists in Nirvana. Sadly, we’ve come to expect that doctors are always 100% right and take little or no responsibilty for educating ourselves to be better consumers.
Posted by: Greg at April 25, 2004 11:37 AMA couple general thoughts about healthcare:
First, everyone should have it, but not everyone is willing to pay their fair share. I work with a lady who says she cannot afford health insurance, though she makes around $40K, owns an $80 K house and is single. Did I mention she also can afford a motor boat??? She says if she gets sick, her dad will help her out. True, this is anecdotal (still true, though), and as such is not statistically sound, but we whatever systems are implemented, this kind of self indulgent behavior can’t be allowed.
Second, lawsuits just have to be limited in some fashion. Doctors are so afraid to use their judgement because it leaves them open to lawsuits. A “smart” doctor will simply run every possible test on a patient, so that he/she cannot be accused of not having provided the best possible care. This is not to say that some lawsuits are not warranted—-and for negligent, lazy, and uncaring doctors, there should be severe penalties.
There’s a story in the news about medical scissors being left in a patient’s abdomen. Now…she had 10 months of intermittent pain, plus the cost and time of a second surgery to remove the scissors. But….I’m guessing there will be a multi-million dollar lawsuit. And for waht??? there is no long term damage, no more pain etc. Any such suit should cover relevant costs etc, but millions is out of the question.
Posted by: joebagodonuts at April 25, 2004 12:39 PMGreg, I think you misread. The uninsured girl with the cut over her eye and one night stay was billed $15,000.00. Had she been insured, $1,500.00 would have been the total estimated billing. This is the advantage of being insured, the total cost drops about 10 times if you are insured.
This is what makes a single payer system so absolutely necessary with over 40 million uninsured who will be gouged 10 times more for the same treatment as an insured person.
And we need to give up just a bit of the cutting edge R&D in return for quality affordable care for all. R&D is the single largest factor driving inflation of health care costs and insurance premiums as reported by pharmaceutical companies and medical facilities.
I haven’t seen the CBO or OMB do a crunch on pro-rata savings per unit of decrease in R&D yet, but it is safe to say that scaling R&D back just 20 or 40%, would yield significant and large reductions of medical inflationary costs year over year. The great majority of Americans would benefit while a few who might have benefitted from the exorbitantly expensive cutting edge treatments lost by the 20-40% cut back in R&D would not have had their experimental treatment available.
The greatest good for the greatest number of Americans would be achieved by a single payer system - which means the government negotiates and buys insurance for every American citizen and with such huge buying and negotiating power, is able to get competitive pricing from insurance companies, thus lowering the cost of premiums for all Americans wanting to buy into the single payer system. Many more of the currently uninsured would be able to afford insurance, and those who do not want to buy into it, can pay higher premiums elsewhere if they choose.
Posted by: David R. Remer at April 25, 2004 12:40 PMjoe, we agree up to a point regarding lawsuits. I would like to see two things happen. A preliminary health care court which screens health related lawsuits for merit, dismissing those which have neither proximate nor relevant cause of action.
Second requires a little background. About 80,000 patients this year will be misdiagnosed, mistreated, or unnecessarily maimed or killed by health professionals this year alone, and that study was done under the auspices of the AMA if I recall correctly. It is a known and well distributed fact that you do not want to have surgery on Monday, Thursday or Friday as the incidence of malpractice goes up significantly on those days. Does take much to imagine the reasons why. Monday is hangover day, and Thursday and Friday’s are hurry up days to turn wring the last amount of profit out of the week and to get it done in a hurry so one can get out to the golf course or whatever on the weekend.
So malpracitce is a very, very large problem in the U.S. If law suits are to be curtailed, I want to see health care professionals who commit malpractice to lose their health care license, whether it be a nurse, orderly or doctor. I want to see a review board over malpractice that is NOT PEER and which is not associated with profit oriented health care industry in anyway.
If those conditions are met, I would be willing to accept a major limitation on lawsuit awards, limiting them to a cap on pain and suffering and allocating reparation costs.
Under our current system, insurance premiums are the only motivating force curtailing wanton and negligent health care abuses of patients. Some other effective oversight and disciplinary system must be put in place before I would accept any limits on health care law suits.
Posted by: David R. Remer at April 25, 2004 02:16 PMThe challenge of living in a country where everyone has access to decent health care and where the threat of finacial ruin no longer accompanies health problems is indeed a big one and the issues are complex. The basic problem I see is that our current administration has neither the desire or the skill to tackle this problem unless the solution can be tied to another tax cut for the rich. I recently watched a tribute to the comic George Carlin and in one of his routines he had this to say.
” We can’t provide health care for our elderly or educate our young prople but we can sure bomb the (bleep!) out of your country.”
Truer words were never spoken. Is this the America we want to live in? A country that can devastate any country on the planet but can’t take care of it’s own people? The problems facing the average American don’t even register a blip on the Bush radar beyond paying them lip service in an election year. Sending Bush packing in 2004 is the first step towards making health care and the economy a priority in this country.
Posted by: William Flynn at April 25, 2004 06:00 PM
William: Clinton made healthcare a priority in ‘93 and gave us “managed competition.” That didn’t fly with the majority of Americans, and I don’t think a single payer system has much backing either. I just don’t know if there is a good national solution to healthcare (but according to Mr. Carlen we must have a good national policy on defense).
In our current form of government healthcare is mostly a State and local issue, save the Federal government’s delving into the insurance business with Medicare and Medicaid and the healthcare delivery business with the VA’s.
My real gripe is toward the employer based insurance. I wish we could somehow spur the market away from it and head towards more individual insurance solutions. Then I could better tailor my insurance premiums and my coverage similar to what I do for my life, health and auto, and wouldn’t have to worry when I change/lose my job.
I think if the premise of the Kerry plan were truly taken at heart, that an increased level of coverage would decrease per-capita cost, then it should be obvious that a universal system is the most cost-effective of all.
Ultimately, health care costs are like any other costs of living, and I think at a core philosophical level, should be lumped in with food, clothing, shelter, transportation, et al., and factored into a Living Standard Level, below which if you work or have a qualifying reason for not doing so (retired, handicapped, full-time student), you should get a reverse income tax to bring you up to that level (or a portion of the difference if you work part-time). That should be the sum total of any and all public assistance, to replace welfare, social security, medicare, and so on—providing the efficiency of the IRS handling it all, concurrent with that agency’s “don’t MESS with us” approach to fighting fraud.
With regard to particular plans, the excuse given by private HMOs for lower costs than COBRA is that “economies of scale” allow for lower per-participant costs. Well great. Let’s go with the biggest scale imaginable: How ‘bout we say every U.S. citizen is IN THE PLAN. Payment of premium could be called “taxation” (with the IRS as a stern collection agency thereof), and distribution of the funding to the licensed health care providers would also be an IRS function… and gawd HELP the provider that overcharges!
Things could be so much simpler than they are now, and yet there could also be more choices. If a person is, say, a Pagan/Wiccan type and wants to see an herbal healer for an illness rather than go to a slash-and-burn allopathic hospital for it, that should be covered in the plan if for no other reason than—it would be CHEAPER! To enable this will require breaking the stranglehold of the AMA over all things medical. Competition lowers prices, and the AMA is a monopoly. Is there any wonder why care is so expensive?
I think if the premise of the Kerry plan were truly taken at heart, that an increased level of coverage would decrease per-capita cost, then it should be obvious that a universal system is the most cost-effective of all.
Sure, but we got burned by Republican mischaracterization of our plan last time.
Kerry’s new plan is voluntary. It allows people to choose whether they want to join the FEHB program, and it allows other programs to engage in free-market competition for customers. It even borrows some Republican ideas like encouraging modernization of administration and billing systems, and tax credits to make health care more affordable. It’s everything the American people want, couched in terms Republicans can understand.
