An Example of Why We Need Health Care Reform

Submitted by Lawrence Rafferty-Guest Blogger


With the recent news of an appeals court decision that struck down the individual mandate portion of the Health Care Reform act, the problems with our Health Care system is on the front page again.  While we hear politicians claim that the market place should decide all health care cost and access issues, millions are without coverage and the costs Americans pay for health insurance is staggering.

When I opened my business last Fall, I was shopping for affordable health care coverage.  My wife teaches in a middle school here in Illinois and we eventually went with her School District’s cheapest family coverage.  We joined a HMO which required us to change the doctors that we had both been going to for 20 years, but the cost concerns were overriding.  Our cost for the coverage is approximately $550.00 per month for the two of us.  Now, imagine my shock when I read that Florida Governor Rick Scott and other State legislators pay $30.00 per month for family coverage!

“Scott is among nearly 32,000 people in state government who pay relatively low health insurance premiums. It’s a perk that is available to high-ranking state officials, including those in top management at all state agencies. Nearly all 160 state legislators are also enrolled in the program that costs just $8.34 a month for individual coverage and $30 a month for family coverage.   Brian Burgess, a spokesman for Scott, confirmed the governor and his wife are enrolled in the state health insurance plan, but refused to discuss why Scott signed up. He called the governor’s health care coverage “private matters.”  The health insurance coverage provided to Scott used to be free for top state officials until 2010. Rank-and-file state workers pay $50 a month for individual coverage and $180 a month for family coverage. Married couples working in state government also pay the same amount as Scott and legislators.”  Miami Herald

As you can see from the Miami Herald quote above, Gov. Scott is paying the same rate that state legislators pay for family coverage.  I have no problem with an employer like the State of Florida paying for a nice health care insurance plan for its employees, but when the politicians on both sides of the aisle piggy back on that system and sometimes pay even less than full-time state employees, and then turn around and vote to deny other people the opportunity to obtain quality care at a reasonable cost, the morality alarm goes off in my head.  (My morality alarm consists of visions of the good Benedictine nuns chasing me down a hallway with a yardstick in hand.)

You may remember that Gov. Scott has made a name for himself by refusing Federal Affordable Health Care Act funds for his state in the past.  First Coast News  Those are funds that would provide health care savings and access to his Florida residents who don’t have coverage, but what is good for the goose, is not good for this politician gander!

After reading the Miami Herald article it seems clear to me that my wife and I need to move to Florida and run for the State legislature and then present a bill to make every Florida citizen an employee of the State and maybe then Florida can get affordable coverage for all of its citizens without that evil individual mandate.

Submitted by Lawrence Rafferty-Guest Blogger.

72 thoughts on “An Example of Why We Need Health Care Reform”

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  2. Mr. Scribe,

    Did I touch a nerve?

    With respect to your question about doing my homework: I did not know I had an assignment, but the blog entry has extensive source documentation linked. And, given that this thread involves a contention that Medicare works and should be extended to cover everyone (in the US), I assumed that (open minded) people would find the referenced post to be of interest and that some of those people would access the PrawfsBlawg.

    As to it being an “opinion,” in my opinion, the vast majority of commentary on blogs is nothing more than opinion; I included that information because the blogger himself made clear he was expressing one.

  3. mahtso, how about doing your homework and finding out if the claim is true before reporting what somebody with an opinion wrote somewhere. Source documentation, baby….

  4. Over at the PrawfsBlawg blog today (8/18) is an interesting opinion piece on Medicare:

    “Are Tea Partiers Actually Correct to Believe that Medicare Isn’t a Governmental Program? “

    I haven’t followed the article’s links, but one of them purports to show that current beneficiaries are receiving much more in payouts than the have paid in. (Not Foxnews so it must be chicken little.)

    Another link purports to show that costs went up 9% per year for 2001 t0 2009.

    The overall thrust of the opinion is to explore whether the providers (i.e., hospitals, doctors and drug cos.) are looting Medicare.

  5. Off Topic–but about Rick Scott:

    Courts: Gov. Scott overstepped his authority
    Case stemmed from a lawsuit filed by a blind Opa-locka woman who charged governor’s action was causing delays.
    Miami Herald

    TALLAHASSEE — The Florida Supreme Court on Tuesday ruled that Gov. Rick Scott “overstepped his constitutional authority and violated the separation of powers” with an executive order freezing all pending rules until he could approve them.

    In a 5-2 opinion, the court concluded that rule-making authority belongs to the Legislature, not the governor.

    “The Legislature retains the sole right to delegate rulemaking authority to agencies,” the majority justices wrote, “and all provisions in [Scott’s executive orders] that operate to suspend rulemaking contrary to the Administrative Procedures Act constitute an encroachment upon a legislative function.”

  6. I did not say that anyone overbilled Medicare. In the articles I read, the reporters thought it suspicious that doctors could be billing that much and they wanted access to the billing records to investigate. But, because those records are private, the reporters could not get them and we don’t know who the doctors are, only that they exist. (It might be of more interest to find that these doctors were collecting millions while staying within the law then to find that they were overbilling.)

    Comparing the situation Elaine references to this one, suggests another area in need of reform: require doctors who accept Medicare payments to publicly disclose their financial records in the same manner that insurance companies must disclose their finances.

    To me, that doctors would like to earn a small percentage of what insurance executives earn is meaningless in light of the prevailing view that insurance execs are grossly overpaid. I didn’t really expect cogent answers to my questions, but who knows, maybe some of those who assert that (part of) the problem is insurance company salaries will surprise me.

  7. Blue Cross CEO’s pay rose 26%
    Salary, bonus totaled $3.5m as insurer’s net income slid 49%
    By Jeffrey Krasner
    Boston Globe / February 28, 2009

    The salary and bonus paid to Cleve L. Killingsworth, chairman and chief executive of Blue Cross and Blue Shield of Massachusetts, increased 26 percent last year, to $3.5 million, even though the health insurer’s membership declined and its net income fell 49 percent.

    Blue Cross CEO got $8.6m in exit deal
    In frugal times, critics see excess
    By Robert Weisman
    Boston Globe
    March 02, 2011

    Cleve L. Killingsworth, who abruptly resigned last March as chief executive of the nonprofit Blue Cross Blue Shield of Massachusetts, collected $8.6 million in compensation from the state’s largest health insurer in 2010.

    The rich package — which included $1.4 million in severance pay, with more money to follow — was detailed in a Blue Cross filing with the state Division of Insurance yesterday. It touched off a volley of criticism at a time when government and business officials, including Blue Cross’s leaders, have been struggling to restrain health care costs.

  8. I think you are looking at the wrong equations….how much should drs. be ‘allowed’ to make? How much should ‘insurance executives’ be ‘allowed’ to make?

    How about, how much physical and time oriented labor can be allowed to be shunted on to those whose labors actually generate the interaction? How much profit can be ‘allowed’ to be culled off the backs of those who do the work? How about, do we ‘have’ to actually pay those whose labor we count on for our profits a living wage with the potential for ‘allowing’ them savings for the future? Do we ‘have’ to consider that those workers may need to further their education, pay for food, housing, taxes, children, healthcare, a reasonable amount of time off for physical recuperation….

    better questions please….maybe the equation really should include percentile increases for education and risk and percentaged caps for earnings that are actually connected to those others whose earnings are also part of the equation.

  9. mahtso: regarding overbilling. There are crooks in every profession, including medicine. My concern is the crooks in the executive suites and in the halls of Congress. Those are the ones who cause the real damage.

    As for crooks in medicine, law enforcement watches for them and Medicare/Medicaid have anti-fraud departments. Their names are not kept secret because you will find them named in indictments, which are public documents. And if convicted, they are to be found on the web pages of state licensing boards when they are disciplined or licenses revoked.

    As for the questions in your last paragraph, every doctor I know would love to be reimbursed at even a small percentage of what a top level insurance executive makes. Those big executive bonuses and salaries come on the backs of health care providers and the little guy who pays the premiums. If you want to talk tax, those excess premiums are actually a kind of tax, but no one wants to call it that.

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