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.
We already have a system that works extremely well, and much better and more efficient than Medicaid. It is called Medicare.
I personally support a universal Medicare program. The savings in paperwork alone will allow health care providers to cut costs dramatically. Note the figures posted in the thread above.
mahtso:
“I do however, have experience with Medicaid and that experience, coupled with my belief that chicken little is right in that Medicare is unsustainable as currently structured, lead me to conclude going to socialism is a poor choice at this time.”
Good point, maybe when things get better we could start funding health insurance for those who need help paying but can pay. And pass a few laws to let people who are not able to get coverage be able to be covered.
Of course the health care system can be and should be improved. Paraphrasing what I’ve heard attributed to Lyndon Johnson: doing the right thing is easy; it’s figuring out what’s right that’s hard.
culheath touched on the key issue: some people think that implementing a socialist system is the right thing to do, whereas others do not.
Many of us are relying on personal experience in determining what is right. Comments show that people are happy with Medicare, of which I have no direct experience. I do however, have experience with Medicaid and that experience, coupled with my belief that chicken little is right in that Medicare is unsustainable as currently structured, lead me to conclude going to socialism is a poor choice at this time.
Otteray Scribe:
I will agree that is pretty chicken sh….
No Roco, it is the paperwork and clerical time required by insurance companies that takes up so much time and money. These have absolutely nothing to do with government regulations and everything to do with creating so much fine print that it is easy for a practitioner to make a mistake and trigger a denial of claim. Step back and look at the simplest interpretation.
I can give you an example. One third party payer added one or two digits or letters to the practitioner’s ID number. This number goes into the box for the tax ID number. By adding numbers or letters, the printer has to put them outside the box. Then the insurance company denies the claim because their scanner does not read outside the box. We had to reset the computer to default leaving the provider ID number blank, then the secretary would write them in with a ball point pen. At that point the claim was denied because the numbers were handwritten and their optical scanner could not read them. I have no idea if that company still does that or not, because after they screwed me out of more than $15,000 I refused to deal with them any more.
And so it goes. How is that “government regulation?”
Roco,
The different health care insurers all have different forms that have to be filled out. In addition, some insurers don’t always reimburse hospitals for medical claims the first time they are submitted and have to be chased for payment.
*****
from Physicians for a National Health program:
Won’t this just be another bureaucracy?
The United States has the most bureaucratic health care system in the world. Over 31% of every health care dollar goes to paperwork, overhead, CEO salaries, profits, etc. Because the U.S. does not have a unified system that serves everyone, and instead has thousands of different insurance plans, each with its own marketing, paperwork, enrollment, premiums, and rules and regulations, our insurance system is both extremely complex and fragmented.
The Medicare program operates with just 3% overhead, compared to 15% to 25% overhead at a typical HMO. Provincial single-payer plans in Canada have an overhead of about 1%.
It is not necessary to have a huge bureaucracy to decide who gets care and who doesn’t when everyone is covered and has the same comprehensive benefits. With a universal health care system we would be able to cut our bureaucratic burden in half and save over $300 billion annually.
http://www.pnhp.org/facts/single-payer-faq
anon nurse:
I will hazard a guess that the $350 billion per year in paperwork is a result of government mandates similar to what happens with the IRS and taxes.
Maybe we should get government out of health care and save $350 billion dollars per year. that way insurance companies could have money to put toward an uninsured patient pool.
You are still going to have the paper work because it is government and that is what they create, lots of paperwork. Government run health care is not going to be a panacea.
So I think Matt T. is wrong.
Otteray Scribe:
“I have no idea what that is about. I guess when arguments fail, resort to hyperbole.”
Not at all, that was in response to Woostys John Birch Society song.
Health Insurance Industry Whistleblower Wendell Potter (Democracy Now)
Rick Scott Lets His Pals Run a Monopoly on State Employees’ Health Care Coverage
By Matthew Hendley Thu., Aug. 4 2011
http://blogs.browardpalmbeach.com/pulp/2011/08/rick_scott_lets_his_donors_run.php
Excerpt:
Earlier in the week, the state Department of Management Services announced that it was consolidating the number of HMOs offered to state employees to one per county.
In a move the DMS says was “following the governor’s direction,” the department predicts the change will save taxpayers $400 million in two years.
The new HMO provider for 38 counties in the state — including Broward, Palm Beach, and Miami-Dade — also happens to have some close ties to Gov. Rick Scott.
AvMed Health Plans, which won the bid to be the sole HMO provider in the 38 counties, happened to be very friendly to Scott on the campaign trail.
State campaign contribution records don’t provide details of donors’ employment, but Health News Florida reported during Scott’s campaign for governor that he received $5,000 from people associated with AvMed. The company itself also shelled out $10,000 for Scott’s inauguration party.
On the other hand, UnitedHealthcare of Florida — which claims it provided HMO coverage to 66 of the state’s 67 counties before it was butted out of most of them — has no such record of contributions to the governor. In fact, the contribution records show that someone named David Lewis — the same name of UnitedHealthcare’s CEO for Central and North Florida — and claiming to be of the medical profession donated $500 to Alex Sink, Scott’s Democratic challenger.
Incidentally, UnitedHealthcare of Florida has filed a formal protest against the state’s decision to nix its HMO coverage from most counties, claiming that the Department of Management Services rejected its bid to continue the HMO coverage of 47,000 people that would have been cheaper for the state.
This is the stupidest column I’ve read. All of the F*ng money comes from the same place: the People! So F*NG what if he pays $30 out of his gross income, the PEOPLE are paying for it all! Its just like my boss, who is instructed by the US Government, albeit without Constitutional authority, to withhold my income and pay for my healthcare en blanc. Here is a simple NEWS flash: the employer makes $X off the labor if his employees making sandwiches. The government sez you have to pay $Y for their health care –and here is the G*D F*NG point: left over for the employee is X – Y!!!
The employers do NOT pay for the health care, the workers do and I want the G*D right to control my dollars, you commie SOFB!
From an excellent diary by health care reform activist Eve in NYC (nyceve):
“The survey research reveals that physician practices in the United States incur nearly $83,000 in administrative costs per physician each year, nearly four times the amount spent by their Canadian counterparts. The U.S. could save almost $27.6 billion in annual health spending if administrative costs were similar to those in Canada.”
Get the full story here:
http://www.dailykos.com/story/2011/08/04/1003114/-OMG!-Commonwealth-study:-US-MDs-spend-$83,000-(yearly)-on-insurance-administration-costs-?detail=hide
Here is a list of her diaries–there are a lot of them. She is a busy woman.
http://www.dailykos.com/user/nyceve/diaries
The obvious solution is in recognizing that the private for profit insurance companies are the problem and should be eliminated the health care industry equation. Why is the US the last place on earth to recognize this simple fact? The US is killing itself with its socialist-phobia.
OS,
Elaine gets all the credit for finding it… I simply highlighted it…. — it just jumped off the page… 🙂
Leave it to a nurse to find the money quote. Love a nurse, PRN.
“Fully $350 billion a year could be saved on paperwork alone if the U.S. went to a single-payer system — more than enough to pay for the whole goddamned thing, if anyone had the balls to stand up and say so.”
-Matt Taibbi (from Elaine’s previous comment)
Thanks for posting the Taibbi link, Elaine M. The man has a way with words.
I’ve read that lots of hospitals have to use a good portion of their clerical staff to chase after dozens of different medical insurers in oredr to get them to pay patient claims.
Sick and Wrong: How Washington is screwing up health care reform — and why it may take a revolt to fix it
by Matt Taibbi
(September 2009)
http://www.rollingstone.com/politics/news/sick-and-wrong-20100405
Excerpt:
In the real world, nothing except a single-payer system makes any sense. There are currently more than 1,300 private insurers in this country, forcing doctors to fill out different forms and follow different reimbursement procedures for each and every one. This drowns medical facilities in idiotic paperwork and jacks up prices: Nearly a third of all health care costs in America are associated with wasteful administration. Fully $350 billion a year could be saved on paperwork alone if the U.S. went to a single-payer system — more than enough to pay for the whole goddamned thing, if anyone had the balls to stand up and say so.
*****
puzzling,
“Coverage by insurance is not the same as actually being able to get care. Ask anyone in Massachusetts, where half of doctors are now refusing new patients outright. Primary care physicians are changing to practice as specialists, and even with that shift the wait time for specialists is now measured in months in many cases.”
I’m a resident of Massachusetts. Since I’ve never lived anywhere else, I can’t make any comparison with my state to any other in regard to being able to schedule appointments with doctors. To date, I’ve never experienced a problem.
*****
My elderly mother has had no problem scheduling appointments with doctors or having her medical bills paid. She also lives in Massachusetts and has been covered by Medicare and Medex.
I have no idea what that is about. I guess when arguments fail, resort to hyperbole.
http://www.youtube.com/watch?v=bqgvQ88KGLs&playnext=1&list=PL38562F0F12996505
those Germans know how to compose a catchy tune.
the English translation is below
The Song of the Party
She gave us everything.
Sun and wind, unsparingly
Wherever she was, there was life,
Whatever we are, we are through her
She has never abandoned us
When the world froze, we were warm
The mother of the masses protects us
Her powerful arm carries us
*
[Chorus:]
*
Oh The Party, The Party is always right
And comrade, may it ever be so;
For who fights for the right
He is always right
Against lies and exploitation
[women] Whoever insults life
is stupid or bad
Whoever defends humanity
Is always right
Grown from the spirit of Lenin
Welded by Stalin
The party – the party – the party
*
She never flattered us
If our courage sank in the struggle
She only stroked us quietly.
never wavered, and soon we were strong
Will pain and complaints still count
When we’ve achieved the good,
when we enforce freedom and peace
for the poorest of the earth.
*
[Chorus]
*
*
She gave us everything
Bricks to build with and the Great Plan
She said: Master life
Forward, comrade, tackle the day!
If hyenas propagandize for war
Your edifice will break their power
Timber the house and the cradle
Workmen, be on your guard.
*
*
[Chorus]
Roco, there are greedy doctors, just as there are greedy lawyers, accountants and garage mechanics. That is a condition that will plague us until the end of time. My problem is greedy insurance companies and their executives.
I gave you a couple of real world examples that came from personal experience as an “insider.” As I told you, my son quit his private practice of family medicine. All because of having to spend such way too much time arguing with third party payers just trying to get lab tests and brief hospital stays for sick people. He is a good doctor and had five stars on his on-line patient ratings. Thank you insurance industry for helping remove another primary care physician from the system. Tell him to his face how much better the private insurance industry is than a single payer and you might get rapped upside the head.