I do not even know how to talk to these people. Do they understand what they will be giving up? No. Do they care? Not yet. By the time they do, if they have their way, there will be no fixing it.

On some people, I am quits politically. They simply cannot or will not understand. I am sure, however, you understand having been on that side (and more recently than I). Can’t make a horse drink, though shooting it might be sorely tempting at times. *grimace* I almost wish I was morally half as politically sociapathic as they seem to be.

Our daughter is self employed. She has been able to obtain good health insurance with a $2500 deductible at a reasonable cost. If most people had $2500-$5000 deductible it would bring costs way down. When people pay the first dollars out of pocket, they do not seek treartment for a simple ailments, and they usually try to do some preventive activities by eating right and exercising.

I don’t think most people know what it means when the dems say they are going to cut $500 billion out of Medicare Advantage. Medicare Advantage is a program offered by HMOs and PPOs that combije Medicare and Medigap into one seamless policy. It’s a good deal for those who hcan afford it. For another $3000 – $8000/year a Medicare patient gets medical, hospitalization, drug and preventive care all wrapped together. If a Medicare recipient buys a separate Medigap policy it entails dealing with two different entities in getting claims taken care of. When the government cuts $500 billion in payments to Medicare Advantage, those Medicare recipients are going to have to cough up more money to keep their same level of benefits. So, is it any wonder that Medicare Advantage recipients are up in arms about this? If they aren’t they just don’t understand what’s going on.

Several things were different back then, he says: there were many more competitors, and you had to really stay lean and mean to underbid your competitors. Second, the policies were for MAJOR medical expenses, like catastrophic illnesses and accidents. Everyone paid for their routine health care out of pocket. Ergo, policies were a lot cheaper. And no one expected to buy insurance to cover hangnail treatments, for heaven’s sake.

Finally, he said that, because of competition and (for most of the men he worked with, anyway) a sense of honor and ethical dealing meant that you didn’t try to cheat your customers. And you sure as hell didn’t make cheating them part of your business plan. If a claim was due, it was paid, with very few exceptions.

He’s been bewildered and infuriated by Blue Cross’s perfidious behavior in our sister’s hospice case: they claim that, because she awoke out of a coma, she didn’t need hospice after all (never mind that she died just five weeks later). These bastards stuck my elderly father with the bill — and he’s paying for nursing care for our mother, who’s ill with pancreatic cancer, as well.

THAT kind of behavior is what makes people hate the insurance companies. And it’s commonplace these days. My own owes me $600 from two years ago, even though every customer “service” rep tells me they do, in fact and under contract, owe me the damn money.

Socialized medicine will suck worse, though, because there isn’t even the feeble incentive of competition and an outside authority to kick its behind. If they stiff you, you’re truly stuck.

I’m seriously thinking of getting a major medical policy. They’re so much cheaper, and the money that I’m shoveling across the table monthly can go into my own health savings account and pay for the checkups and so on.

We have a bottom line now. It is called the ER. No hospital ER can turn away someone who wants (not needs) healthcare. One night I accompanied a friend to our hospital ER. (He was having a heart attack – from which, thankfully, he recovered.) I sat with his wife in the ER all night. Quite an education! There were many people who were indigent (and appeared might be illegal as well) who came in and were given care for everything from sick baby care, colds, and other non-threatening illnesses to fractures, gun shot wounds, etc. (This was a city with a lot of crime and a high number of immigrants.) Most of this care is done pro-bono and the hospitals make it up by overcharging those with insurance or who have resources to pay cash.

If you have no insurance but you have a job and you end up in the hospital, you will be expected to pay. The hospitals go after those types of patients quite relentlessly. When people talk about medical bills and bankruptcy that is usually what they’re talking about. It’s very hard to payoff a $150,000 hospital bill on a salary of $40,000/year. It isn’t a good system and needs to be fixed. But not with socialized medicine.

One way to put a stop to it would be to allow ERs to refuse to treat patients with no insurance. Then people would be more motivated to buy insurance – at least catastrophic coverage. What about the indigent? That is where store front, walk-in clinics could become a lower cost way to serve this group. They could be run on a non-profit, Medicaid style plan. Walmart wants to start clinics like that to serve their customers and if they could write off the pro-bono work, or get some Medicaid cash, they think they could make them work. Life- threatening cases could still be handled by ERs and the hospitals could write these off against their taxes as charity or use charitable programs (like church run hospitals do) to help defray the costs.

The real problem we have is the model of employer paid health insurance. That was a good plan back in the 40s and 50s when it got started. In those days people worked for the same company for 30 years and had some healthcare coverage in their retirement plan too. Today, very few people are staying at the same company for a full career and the lion’s share of employers are small businesses that can’t afford the good plans that the big corporations provide. The result is that people lose coverage when they lose their job. Or the coverage they have with their small employer is not that good. Result: Many more uninsured or underinsured people. The solution: Encourage employers to give their employees a Healthcare Reimbursement Account (HRA). That way the employee could use the money to buy his/her own policy tailored to his/her needs that is portable. Another piece to the puzzle for personal health insurance is to allow individuals to deduct the full value of their policy premiums from their taxes. Finally, if companies could compete across state lines it would increase competition and lower costs overall.

It would take time, but in a few years it would be just like auto insurance. Individuals would buy it when they first needed it and keep it all the way to Medicare. (Assuming Medicare survives!)

However, the dems want to punish the insurance companies. (Huge profits you know. Can’t have that!) Many, I assume, want to punish them until they just drop out of the business and the “government option” becomes the only game in town. That is why Obama’s pronouncements on healthcare reform never quite meet the common sense test.

He won’t. We will suffer because of it.

October 16th, 2009 at 12:49 pm
According to the writer, “As matters stand now, if the Baucus bill were to become law, in a couple of years Congress would be forced to take up the issue again to clean up the mess the bill will have created.”

No need, the public option will be there pick up any slack!

Well start listening Obama. Learn economics. We can all prosper then.