Thursday, November 5, 2009

A Wolf In Sheep's Clothing

I've been trying to read the 1990 pages of the Pelosi Health care bill. This thing is next to impossible to read and understand. At times it feels like a road map as you read one page you then have to go to another page just to get a reference for what you read on a previous page. My head is spinning.

I support health care reform. I want health care reform. I'm not in favor though of a complete overhaul. Parts of the system are broken, doesn't work and needs to be fixed and updated. We must address the large number of uninsured and uninsurable. We have to address the high costs of medical insurance and the way health care is delivered. We need to get patients and doctors back to making health care decisions.

I believe the President wants a single payer, "Universal Health Care System." this is why the "government option/public option" whatever you want to call it, is going to be in any plan they pass. Opinion polls show that most people want reform but don't want a complete government take over of health care.

Don't let the "government option/public option" fool you. This is the wolf in sheep's clothing. A government- run health insurance "public option," will eventually lead to a complete government take over of our health care system, sometime down the road.

Over time the private insurance plans will not be able to compete with a government plan. The government sets the rules and sets the prices. As the cost of private health insurance continues to go up and it will under this kind of proposal, more people will trickle into the government run plan. This is just what they want. They know they can't get it all at once.

How do you eat an elephant? One bite at a time.

So lets see now. We'll have a new "health choices commissioner" who will decide for the good of all of us, what is "essential benefits." All insurers will have to offer first dollar coverage. The government is going to give us all kinds of free wellness coverage including, abortion benefits, unless those get taken out of the bill.

Naturally, all this free stuff has got to cost us. The CBO estimates are 1.2 trillion dollars over a decade. Whatever the price tag, one thing we can be sure of is the final cost will exceed the estimates. it always does. Government always finds a way to disguise additional costs with budget gimmicks.

The Congressional Budget office also estimates 17 million Americans would still remain uninsured under the Senate Finance Committee's 10-year, $829 billion health care bill.

This is health care reform? We can do better than this.

To read the House Bill click on this link

Monday, October 5, 2009

Let's Set The Facts Straight About Healh Care

It's frustrating listening to all the misinformation and rhetoric about health care coming from our politicians.

Just recently, Rep. Alan Grayson, D-FLA., warned Americans that "Republicans want you to die quickly" during an after-hours House floor speech Tuesday September 29th. This kind of rhetoric and name-calling serves no purpose and only fuels the frenzy on both sides.

In his prime-time address to Congress President Obama said. "it will be against the law for insurance companies to drop your coverage when you get sick."

Folks, It's already against the law for your health insurance company to drop you just because you filed a claim. It's also against the law for a health insurance company to single you out for a rate increase.

The state insurance commissioners regulate insurance companies on the state level and enforce good-faith execution of insurance contracts and hold insurance companies accountable. They generally do a very food job of this. Our current Health Secretary, Kathleen Sebelius did this as an insurance commissioner for Kansas State for eight years.. She knows how this works.

Let's set the facts straight. Health insurance companies do have the authority to rescind your policy if they find that you lied on the application. This is a tool the insurance companies use to eliminate fraud and abuse. If they didn't do this the only time we would buy insurance is when we become sick.

The insurance company relies on information that is provided by you on the application to access risk and to protect their current policyholders. If insurance companies only insured the sick premiums to policyholders would be that much higher. Insurance companies need premium dollars from healthy people to help offset claims paid on the sick people.

Because insurance companies pay the bills and not policyholders, most Americans have no idea just how much medical procedures cost. A family member of mine was recently released from the hospital. His stay was almost 3 months and just the hospital portion of his medical bills were $200,000.00.

To be fair to the other side, I have occasionally seen health insurance companies over step their bounds and play the game of delay an/or deny benefits. In their quest to weed out fraud and abuse they sometimes go too far.

We need to stop creating villains and start addressing long-term health care costs and how to best guarantee access to medical insurance for all. We need health care reform and the insurance companies need to be a part of the solution. Government should be responsible for regulating and enforcing the rules. Insurance companies should be in the business of underwriting insurance policies and paying the bills.

Let's stop the name calling on both sides and get to work on health care reform that is fair and equitable for all.

Thursday, August 20, 2009

HSA's A part of the Solution

Rush Limbaugh made the statement, “You can’t insure your health.” We can’t insure that we will never get sick or hurt or never have a catastrophic event. But we can insure the medical expenses.

So the purpose of health insurance then is to reduce the costs of medical bills. The idea is that you are still responsible for some medical bills but the larger costs are paid by the insurance company. The larger the deductible (as we take more of the responsibility) the more the insurance company discounts the premium.

I believe in the concept of consumer-directed medical insurance coverage. I laid this out in an earlier blog. A medical insurance policy where patients are involved and more informed and taking on greater responsibility for their health care decision-making. A medical insurance policy that allows patients and doctors to make health care decisions and allows patients to decide how they want to spend their health care dollars.

This simple solution can save many families hundreds of dollars each year in health insurance premiums. I am talking about the “Tax free Health Savings Accounts.” The HSA plans combine a higher deductible and a lower premium with a qualified health savings account.

According to,. Eight million people are covered by plans with low-cost premiums and high deductibles that are designed for large, unexpected medical costs. Nearly a third of new HSA users, according to treasury figures, previously had no insurance or bought coverage on their own.

Money is also set-aside in a savings account to cover the deductibles, and even non-covered eligible medical expenses. Whatever you don’t spend from your savings account can build up tax-free.

We “can’t insure our health” but HSA’s allow you to decide how and where your health care dollars get spent. The HSA money is your money. You decide when to spend it and when to save it. .

You can even use the money to pay for qualified health care expenses that may not be covered on your health insurance plan.

HSA’s are portable. The HSA stays with you and goes wherever you go.

Remember. With an HSA you self ensure the amount of your family deductible. With a 100% co-insurance option, the plan will pay 100% of covered medical expenses once the deductible is met.

For a list of HSA covered expenses click here

Tuesday, August 11, 2009

Health care Solutions #4

Well, the good news is that people are talking about health care. Just look at what is happening at the Town Hall meetings. The bad news is, are people so busy talking that no one is listening?

In my previous blog I spoke of portability. COBRA (consolidated omnibus budget reconciliation act) is not the answer. Who can afford those premiums anyway? Lets focus on the man or woman who has worked a majority of their life and had health insurance through an employer. Then through a chain of events they lose their employer sponsored group medical benefits. A family premium on COBRA can easily run $1,000.00 per month and more.

If this individual has a pre- existing medical condition, he will be hard pressed to find an affordable alternative that will cover the pre- existing medical condition.

So lets expound upon portability and the value of taking your coverage with you.

I've stated before that we all should have individual coverage that is portable. If you can get coverage through the purchasing power of your employer so be it. However, employers and employees need new options for cost containment and individual freedom of choice.

Currently employers have few options to install cost containment practices. Employees have few options as to the benefits purchased. Employees don't have the option to purchase less costly and often times more appropriate benefits for their family.

Health insurance benefits should be a personal choice and portable. Each employee should be free to chose a plan that would remain with that employee even in the event of a job change.

The solution would be for the employer to pay for the policy of each employee who wants coverage and then deduct the premium from the employees wages.

Some major advantages would be;
1. The rising health care costs would no longer be a problem for employers since health insurance premiums would be a substitute for wages.
2. Employees would have opportunities to choose lower cost policies and higher take home pay.
3. Employees would have the opportunity to select insurance benefits tailored to their families needs.
4. Employees retain the tax advantages of the current system but avoid the waste that is inherent in the same exact benefit structure for all.
5. Employees would be able to continue coverage at fair prices even if they quit work or switch jobs.

For additional information on this idea I highly recommend the book, "Patient Power" by, John Goodman

Thursday, August 6, 2009

health care solutions #3

The next compartment or part of the solution to bring down the cost of the health insurance premium deals with the insurance companies themselves. The insurance companies aren't the whole problem. They are a part of the solution.

This is not to say that I don't have some issues with the insurance companies. Premiums are very high and only getting worse. Many health insurance companies play the game of "deny and delay" with your insurance benefits. In my state of Arizona, last year alone, almost 50% of claims denied, which the department of insurance got involved in, were eventually overturned in favor of the insured.

Insurance companies do this to protect themselves from fraudulent insurance claims. Insurance fraud cost us billions of dollars each year. We all pay for this in our insurance premiums to the tune of several hundreds of dollars each year. We must do a better job curtailing fraud. I personally think fraud will only get worse in a government run plan.

Next, we need competition among insurers. In many states we only have a handful of companies competing for our business. We don't want to give insurance companies a monopoly. Competition is good for the consumer and it keeps the prices down and customer service up.

We need to have interstate competition. We have this for almost all other products and services which we purchase. Why not our health insurance? National center for Policy Analysis June 21, 2006 | Author: Devon Herrick. "Lack of Competition Drives Expensive Mandates. Since each state insurance market is protected from interstate competition, legislators can require insurers to cover services that drive up premiums. For example, about one-fourth of states mandate benefit packages that cover acupuncture and marriage counseling. More than half require coverage for social workers and 60 percent for contraceptives. Seven states require coverage for hairpieces and nine, hearing aids."

"When states force insurers to cover providers or benefits that consumers do not want (enough to pay for), both the insurer and the consumer lose. Consumers lose because they are required to pay for amenities they do not want. Insurers lose because mandated benefits and over-zealous insurance regulations drive up the cost and reduce the sales of insurance products."

We also need to fix the problem of portability. COBRA is not the answer. Those premiums are often outrageous in price and it is only a temporary stop gap. I'd like to see people own their own individual insurance policy. A policy that stays with you and goes wherever you go. If you lose your job, become self employed or whatever, you still have your existing policy. It also helps solve the problem of having a pre-existing condition. Because you keep your coverage and you keep your medical providers.

Tax incentives are available to employees whose employer provides insurance benefits. Tax incentives should be made available to all.

Government mandates add a large cost to our health insurance premiums. There should be a federal arm of the government to regulate the health insurance industry. By opening up the competition beyond state lines we won't need a separate agency in each state regulating. Rather each state have a branch to enforce rules for insurance transactions taking place in each given state.

Reduce the government mandates and allow the insurance companies to offer choices with the kinds of benefits that today's consumers want. This allows consumers to better control their premiums because they simply purchae the benefits important to them.

I'll have more on solutions in my next blog.

These are my opinions, I'd like to hear yours.

Monday, August 3, 2009

health care sloutions #2

In my last blog on July 27th I spoke of a sort of paradigm shift as a way to combat chronic disease in in our country. Imagine a reward system that actually rewards the doctor for keeping patients healthy. I suggested using alternative medicine providers and the the primary care physician to fill this roll. IBM and United Health Care Group are actually now testing this idea out in Arizona.

The idea behind this is that if patients can stay healthy we have fewer people landing in emergency rooms and fewer people on the chronic condition list. President Obama has also stressed preventative health measures.

I am old enough to remember when the family doctor oversaw all ones medical. When needing to refer you on to a specialist the family doctor acted as ones advocate. I don't know where it went but we need to bring back this role to the family doctor.

Solution #2. Put health care back in the hands of the consumer. Consumers need to be more involved in health care as they are in all other aspects of their lives, Mike McCallister, president and CEO of Human Health Care told an audience at a recent 2009 Wharton, health care business conference. With regards to health care "you can't get the price and quality information to make smart health care shopping decisions."

Allow consumers to make choices about how they want to spend their health care dollars. Consumers can be very savvy shoppers when they know what things cost. When consumers need have a stake in the game and when we are spending our money we tend to spend more wisely.

We're all going to have to have a little skin in the game. Check back over the next several days as I outline other solutions and reforms in the way insurance companies do their business.

Monday, July 27, 2009

Health care solution #1

Fewer people on prescription drugs, fewer people sick in hospitals, consumers learning how to get healthy and stay healthy. Alternative and Complimentary medicine should be our 1st line of defense in basic health care

80% of our health care expenditure is in treating chronic conditions. We pay doctors to heal us when we’re sick or injured. Imagine the outcome if we rewarded doctors for keeping us healthy.

Click Here : watch this short video with Michael Stern VP Dorsey & Company

Why Health Insurance Cost So Much!
Wake Up America

These are my thoughts; I’d like to hear yours

Friday, July 24, 2009

More Questions Than Answers

After listening to president Obama's news conference on health care I am left with more questions than answers. For example; 1. How are we going to pay for this without getting further into debt? 2. How in the world would private health care ever be able to compete with a government run public plan? Private enterprise must make a profit to exist yet government run plans can just pass the loses to the tax payer. I can't think of one government program that runs efficiently. Why would health care be any different? 4. Why won't the president be honest with the American people and tell us what is really in this plan?

When asked if the president would put himself and his family on this government plan he skirted around the question. Of course as the president he has the best health care with doctors following him everywhere he goes. But what about when he is out of office and what about congressmen who have the best health care money can buy. All paid for by the tax payer.

I think this one statement is very telling. If the plan isn't good enough for them, why is it good enough for us.

And please Mr. President, don't insult the intelligence of the American people by telling us stories about doctors who would perhaps perform un-necessary surgery just to make more money. We all understand there are possibly bad apples in every walk of life. I believe most doctors are ethical and want to do what is right by their patients. Wouldn't a prudent person seek a second medical opinion?

I don't want to be disrespectful of my President. I want him to be successful for the sake of my country. However, this is one proposal I want to fail. We already have the greatest health care in the world. People from other countries who can afford to do so come here for our health care. Many leaders of other nations come to our country when they have serious health issues.

We have the very best doctors, the best medicines and the finest health care technology all readily available to those in need at an instant notice. I don't want a complete overhaul. I want to fine tune and fix the parts that need fixing. This is what our brightest minds should be focusing on.

More government bureaucracy is not the solution. It is the problem.

Check back next week because I am going to begin outlining what I believe are some real solutions.

This is my opinion, I'd like to hear yours.

Wednesday, July 22, 2009

Highlights From The Obama Health Care Bill

Would our politicians put themselves and their loved ones on this health care plan? Health care needs fixing but not an overhaul. There are some good ideas on both sides of the isle. Let's take the time and get this right. Thanks to Fleckman who broke down the bill and posted on his twitter account.
Here are my top 12

1. fleckman: Pg 42 of HC Bill – The Health Choices Commissioner will choose UR HC Benefits 4 you. U have no choice! #p2 Jul 17, 2009 12:36 AM GMT ·

2. fleckman: PG 50 Section 152 in HC bill – HC will be provided 2 ALL non US citizens, illegal or otherwise. #p2 Jul 17, 2009 12:52 AM GMT ·

Can you say amnesty?

3. fleckman: Pg 58HC Bill – Govt will have real-time access 2 individs finances & a National ID Healthcard will b issued! Jul 17, 2009 01:00 AM GMT ·

4. fleckman: Pg 59 HC Bill lines 21-24 Govt will have direct access 2 ur banks accts 4 elect. funds transfer! #p2 Jul 17, 2009 01:04 AM GMT ·

Do you ever feel like you lose more of your freedoms each passing day?

5. fleckman: Pg 72 Lines 8-14 Govt is creating an HC Exchange 2 bring priv HC plans under Govt control Jul 17, 2009 02:37 PM GMT ·
So much for the private health care option.

6. fleckman: PG 85 Line 7 HC Bill – Specs for of Benefit Levels for Plans = The Govt will ration ur Healthcare! Jul 17, 2009 02:56 PM GMT

To the elderly and the very ill, watch out. Based upon your illness, age or diagnosis it may not be worth while to ration care out to you.

7. fleckman: pg 124 lines 24-25 HC No company can sue GOVT on price fixing. No “judicial review” against Govt Monop. #p2 Jul 17, 2009 06:28 PM GMT ·

8. fleckman: pg 127 Lines 1-16 HC Bill – Doctors/ #AMA – The Govt will tell YOU what u can make. Jul 17, 2009 06:41 PM GMT

Sure, this will really create competition among doctors and provide us the highest quality health care.

9. fleckman: Pg 145 Line 15-17 An Employer MUST auto enroll employees into pub opt plan. NO CHOICE. Jul 17, 2009 07:17 PM GMT

10. fleckman: Pg 149 Lines 16-24 ANY Emplyr w payroll 400k & above who does not prov. pub opt. pays 8% tax on all payroll Jul 17, 2009 08:44 PM GMT

11. fleckman: pg 150 Lines 9-13 Biz w payroll btw 251k & 400k who doesnt prov. pub. opt pays 2-6% tax on all payroll Jul 17, 2009 08:49 PM GMT

12. fleckman: Pg 167 Lines 18-23 ANY individual who doesnt have acceptable HC accrdng 2 Govt will be taxed 2.5% of inc Jul 17, 2009 09:58 PM GMT

These are my top 12. Thanks to Peter Fleckenstein who took the time to break these down. Here is a link to the full bill---

Monday, July 20, 2009

Health Care Is A Lot Of Different Systemes Glued Together

In America, heath care is a business. You need to keep this in mind. Hospitals and doctors and insurers have to make money to stay in business. With insurers trying to control costs often times they tie the doctors hands when it comes to deciding what treatments and medications patients can get.

Have you ever heard this scenario? The doctor prescribed a medication or service, only to have the insurance company decide over and above what your doctor determines is medically best. It happens all the time.

To be fair, insurance companies are a business and they need to make a profit. So they are trying to rid excessive use of services and expensive medications when lesser expensive ones will, in their opinion do the job. But there is not always an absolute and it’s the patient who suffers.

If you think this will be any better with government run health care. It will only be worse when it’s the government deciding your course of treatment and what is cost effective.

Mike McAllister, president and CEO of Humana told an audience at a recent 2009 Wharton health care business conference, “We don’t actually have a health care system. We have a lot of different systems that are glued together.”

Folks, we have (HMO’s, PPO’s POS’s, Indemnity, Limited benefit plans, ceilings on various categories of care, limitless out of pocket costs and more.

We have the wrong objectives. The incentives are wrong for everyone, the providers, the payers and the patients.

Consumers need to be involved in health care as they are in all other aspects of the marketplace, McCallister, told the audience. With regards to health care “you can’t get the price and quality information” to make smart health care shopping decisions.
Medical providers are to blame too. Excessive use of services is one of the main elements at the heart of the health care crisis. For example doctors and hospitals making money off of CT, MRI or Pet scans that aren’t always necessary. And then the patient, if they lay down long enough someone will scan them.

Did you know that the number of hospital and doctor visits is up 20% in the past 5 years on a per capita basis? Why?

Want to know why health insurance policies are area factored?

Why does Wyoming have a rate of back surgeries of 9.63% per 1,000 people while the sate of Illinois is only 3.39% surgeries per 1,000 people? Especially when the rate of back problems isn’t that different in the two states.

And why are health insurance policies so filled with loopholes, limits and exclusions?

Disclosure statements about gaps in coverage are weak. It’s difficult for consumers to figure out what a policy covers and doesn’t cover. Why does one health insurance policy have a limit on organ transplant procedures of $250,000 when another covers the same procedure to $1 million?

Decent insurance is supposed to protect you in the event of a catastrophic illness.

Health care is not going to be an easy fix. It didn’t break overnight. It’s not going to be fixed overnight. Keep in mind. Like in the game of dominoes, when one domino falls it affects all the others.

I’d like to see policies streamlined with fewer choices. Get rid of all these loopholes and make policies easier to read. The federal governments role should be in regulating all polices rather than the individual states, so we can have one standard definition of what constitutes health insurance.

Create portability and open up state lines to create more competition. You are able to cross state lines for everything else you buy. Why not health insurance?

Let’s get health care back into the hands of the consumer and the medical providers. When we know what we are paying for we are more likely to be savvy shoppers.

When it comes to health care I urge you to educate yourself so you know what you want and why you want it. Don’t let yourself be led blindly.

The good thing is people are talking about this and thinking about this.

This is my opinion. I’d like to hear yours.