Wednesday, July 22, 2009

Are “those people” in a healthcare crisis or a political tug of war?

Those of you that know me, know that I am passionate about access for ALL to health care. Universal insurance is not a new concept but in the United States coverage for all is a long time coming...and the citizens are still waiting. I touched base with some everyday Americans with no political affiliation. (Well except when they express their views every few years in the voting booth.) 
I’ve asked countless people for their opinion on this and sorting through the answers I got everything from sarcasm to reality. “Lets charge people for their health insurance based on body weigh". This obviously indicates that the overweight, in the US, are taking the system down - not true. Move along the spectrum, “Everyone has access to health care just go to the emergency room”. Or, my personal favorite, “Well something needs to be done for ‘those people’, I just shouldn’t have to pay for it”. Relatively healthy people, with insurance, made these comments.

Okay so that’s a comical look at what insurance companies think about us. Let’s face the facts, America does need health care reform. The health care provisions that are in place are limited at best: Medicare for those over 65. Medicaid for the indigent. Veterans Affairs for those that have served the country. Cobra continuing insurance from a former employee, for the jobless. "Health discount cards", which gives a discount to cash payments. Of course if your lucky you'll have a job that provides the benefit of health insurance.
This debate however, gets bogged down with how to pay for it. Meanwhile the cost of health care is going up, up, up and availability is going down, down, down! With the unemployment rate in the US just short of 10% and the systems that are in place on the edge of exploding...what's to come?!
I personally know doctors that are doing their part by volunteering their services to uninsured people in communities in need. This is fantastic for those with the common cold but if you have a major chronic illness such as Cancer, not so much. What do you do then?
Don’t be fooled, even if you have insurance, this issue is about you. It’s not just about the countless unemployed, uninsured or poor. You know, “those people” that you didn’t want to pay for. In some respects you’re more at risk because the hospitals’ and your doctors’ hands are at the mercy of the insurance company. God forbid you find yourself in a catastrophic position, a bunch of strangers looking over your files and deciding if you’re life is valuable enough for them to spend the money on. I have heard countless stories about people who have died while waiting for a decision from the board of random insurance companies.
I’ve heard stories of the over 65, who had their primary insurance replaced by Medicare. The primary then becomes the secondary with diminished coverage. That's right, the insurance companies follow Medicare’s lead. I’ve heard stories of people loosing the homes they paid for because they couldn’t afford the out of pocket health care & medication cost. Some go penny less while others win the lottery and go on Medicaid, food stamps and other services traditionally held for the indigent, further stressing the system. Hmmm..., sounds like you are already paying for, “those people”.
Think of it this way, if you had a massive stroke and had been hospitalized for 30 days (from intensive care to your transport to the nursing home) the cost could be around $2.5M at one of the best stroke hospitals in NY. Think your insurance will cover it all, think again. What’s your out of pocket? Now you’ll move on to a nursing home. Depending on how sick you are and how much cash you’ve stashed, if your not already broke, you’ll slowly become one of “those people”. Well there’s always Medicaid right? Remember, you have to be poor to be on Medicaid!!! This not only means emptying your bank account but it also means getting rid of your assets, which includes that home that you paid off. Most people don’t realize this possibility until they become one of, “those people”. This may seem like extreme examples but I’ve come across at least three people, not poor people, who lost their homes. My hope is that health care reform will help to alleviate some of these issues.
I’m familiar with Chron's disease which is one of those chronic illnesses that leaves you in the ranks of the un-insurable. Without insurance and with a continuum of health issues, insurance is just out of reach. Well after around $60K out of pocket doctor’s services & surgery, my friend was diagnosed with Crohn’s disease. {Thank God for credit cards…I won’t get into the credit card debacle that may be the only way for some to be able to set foot in the door of a hospital.} In a nutshell the maintenance of this disease can be quite expensive and it may eventually lead to colon cancer.
What does that translate to? If you live in the USA and you don’t work for a company that provides health insurance you have to purchase yourself.  If you can't afford to do so you are most likely without coverage. I have yet to meet someone with a chronic illness that is self-insured. My friend was turned down 15 times after losing company coverage. If not for the savior of COBRA he would have been SOL. But what happens when it expires or he can’t afford the $450+/mo/pp bill?
Here are some thought for the capitalist society to consider to provide health care for all “those people”, immediately:

1. - Extend Cobra benefits to expire when the consumer gets a job with a company that extends insurance as a benefit.

3. - Apply regulations to health insurance companies:
A) Allow affordable health care consideration to those that apply
B) Provide policies for those with pre-existing conditions

4. - Allow the general public to buy into the insurance policy that the president &/or any government employee receive.

5. - Replace Medicare tax with 10% flat insurance tax

6. - Federal Sales Tax on discretionary items. {EX: Sales tax on clothes, etc.}

7. - Change HIPAA so that it extends insurance not only to the "new" company you work for but, to any insurance company regardless of pre-existing condition.

8. - Take a good look at what other countries are doing, take the best of it and then do it better! It's not all free!

9. - Consider fixing the option on the table.

10.- Last and certainly not least, have interest bearing HSA with no max that roll over so that those without insurance can always have access to money that they aren't paying taxes on.  (Of course one would have to prove that they had a pre-existing condition.)

Anyone who has had a loved one with a chronic illness knows the last thing you want to be involved in is a hassle with the insurance company. Worse you don’t want one of your doctor’s assistants hovering over you with a receipt book, waiting for you to awaken so that they can get payment. (Sorry I didn’t bring my checkbook into surgery with me!) Yes that really did happen to me once.  You don't want a doctor telling you, I know how to help you but your insurance won't pay. 
No system is perfect, from the Taiwanese to the Americans, but at the end of the day something needs to be done for the countless un-insurable and uninsured Americans. I do think the government has to have some involvement because they seem to be the ones in the center holding the strings.
Catch President Obama tonight, on most stations except FOX, and make your own decision.
Until next time, when we can chit-chat again!

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