Posted on 01/25/2004 7:17:02 AM PST by Libloather
Why prospects for reforming health care look so dim
Fri Jan 23, 6:27 AM ET
Tucked deep within the promises and policies of his State of the Union address, President Bush uttered three words that speak volumes about Washington's paralysis in addressing the plight of the 41 million Americans who lack health insurance. In between his discourse on Medicare and his support for a low-income health care tax credit, Bush called for something called "association health plans."
These plans allow small businesses to band together into national pools to negotiate discount health insurance rates closer to those available to big corporations. They aren't a radical idea. Nor would they come close to solving all of the nation's health care woes. But they would address an important problem: the steep costs small businesses must pay to offer medical coverage. Because they can't spread their risk throughout a large workforce, they pay higher rates for their insurance. Partly as a result of this limitation, only 49% of small employers offer health insurance, compared with 98% of large companies, according to the U.S. Department of Labor.
Yet even this small, common-sense reform has touched off fierce opposition from powerful groups ranging from Blue Cross and Blue Shield to state health commissioners. They claim it would gut state regulations that consumers need without reducing the ranks of the uninsured.
The controversy raises a vexing question: If one incremental change can set off so many special-interest battles, what hope is there for the broader health care reform the nation needs to extend coverage to all and stem skyrocketing costs for those who have insurance? Currently, one in five individuals lack insurance at some point each year, and premiums have seen double-digit increases for three years in a row.
Bush isn't the only one who believes association health plans hold promise. In June, the House of Representatives overwhelmingly passed legislation allowing such small business pools. Opposition has blocked action in the Senate.
Both sides claim they are willing to compromise or offer alternative proposals. But in the nine years that small employers have been begging for help, Washington hasn't responded. Now, the pop from Bush's Tuesday night speech and a commitment by Senate Majority Leader Bill Frist, R-Tenn., to take up the matter as part of a broader health care package may brighten the outlook.
If so, small businesses, and their employees, could gain numerous new benefits.
Among them:
Lower costs for insurance. The economies of scale that small businesses could get by banding together would allow them to negotiate lower coverage costs. Since 2000, premiums paid by small business employees have risen an average of 13% a year, compared with 11% for those working for large businesses, according to the Kaiser Family Foundation, a non-profit health research group. In 2003, the inability to find affordable insurance surpassed taxes as the single most troubling issue for small business owners in a survey conducted by the National Federation of Independent Business.
Greater leverage for patients. Employees of small businesses could have stronger advocates if they encountered problems with their coverage. A large association representing hundreds or thousands of firms would have considerably more sway over insurers than a single employee or his small-businesses employer.
The Blue Cross and Blue Shield Association argues that such plans would "cherry pick" the healthiest employees and leave the sickest, most expensive patients in existing insurance pools that would have to pay higher rates. It also says associations would be exempt from state regulations, stripping consumers of protections from unscrupulous insurers.
The worries, while valid, could be addressed without killing an otherwise-promising idea. Federal oversight of health insurance does need strengthening. A good place to start would be with a patients' bill of rights that guarantees consumers a more effective avenue of appeal when their claims are denied. That reform also is stalled in the Senate because of opposition from insurers.
Both sides in the association debate have their own interests to protect. Insurers such as Blue Cross and Blue Shield don't want to cede leverage to their customers to negotiate better deals. On the other side, small businesses don't want the hassle and expense of dealing with state health regulations, even those that protect patients. Yet, instead of working to find common ground, both sides have dug in.
Their feuding is a microcosm of the larger problems facing health-reform proposals. Health care is now a $1.5 trillion business and represents 15% of the entire economy. With such enormous sums at issue, the public's needs too often give way to protecting special interests.
Until all sides commit to compromise, change can't occur. A good way to break the logjam is to start modestly: working together to help the small employers that are among the most hard-pressed in the current health care climate. That small success could serve as an important model for addressing bigger health care issues on the horizon.
I'm more worried about the plight of folks who lack car insurance...
Health care will remain unaffordable by everyone until and unless the malpractice crisis is brought under control.
Limitless jury awards, unaffordable malpractice insurance premiums, and the possibility of financial confiscation, all leading to defensive medical practices, amount to a virtually limitless tax that everyone is forced to pay.
Lawyers, of course, reap the greatest rewards. To them, the medical care system is an unlimited cash cow.
Every time a huge award is given to a plaitiff, the tax that you and I pay goes up.
I for one am very tired of being forced to pay this staggering tax so that an army of well paid lawyers will police the system.
But even more, I am very tired of living under the threat of catastrophic health care costs and under a system that no one--including my family and me--can afford, so that lawyers can exploit the system and plaintiffs can receive enormous--even unlimited--awards.
Sounds like you could have been in the Politburo. You certainly do seem to believe in Central Planning rather than individual freedom. Any other groups you want to express your Christian love towards?
They understood nothing about money etc but they knew what thar plaque on the wall said. You cannot be turned away if you have no MONEY. They did'nt, I did and I paid for both.
Health care insurance is available to any individual who chooses to buy it.
Yes, its nice to have a job where the employer shares a part of the cost as a benefit, as an inducement for your services.
Some employees choose to go bare and decline health care even though their employers will subsidize part of the cost. Who knows why, cost, ignorance - they feel they just don't need it ??
Yes, "Group Rates" are less costly -- but, nonetheless, any individual can go buy private health care insurance.
Even if you or a family member have a costly, or deadly condition, most states have laws requiring companies doing business in those states to syndicate the risks of coverage for such individuals.
Regardless of how it is provided, health care is expensive - that's just a fact of life.
Nothing in life is free, Cadillacs cost a lot of money too.
One reason health care is so expensive is because beneficiaries expect it to pay for everything, like flu shots and treating sniffles.
Just as your car insurance does not pay for oil changes or new tires, health care coverage would be cheaper if only catastrophic costs were covered, not routine health maintenance issues.
Irrespective of any other factor, Federal law mandates public hospitals MUST treat sick people regardless of whether they can pay for it or not.
Finally, Federal law mandates NO hospital, public or private, may turn away patients who are in life or death situations.
In this great country, even the indigent are guaranteed free necessary health care.
Are they entitled to private rooms and elective procedures ??
NO, and that is as it should be.
Neither are they entitled to free Cadillacs.
Not yet.
What's the solution ??
When you're young, go to school, get a good education. Then, get a job, work hard - climb the ladder of success, investing lots of sweat equity. Get a better job, earn enough money to pay for health care and health insurance. Eat right, take care of your body.
Be a contributor not only to yourself and your family, but to society as well - do NOT expect your government to provide you womb to the tomb care, do NOT become a leech.
That's what Freedom, Liberty, Free Enterprise and Capitalism are all about.
Do not buy into nor believe all this class envy, class division crap your hear from Democrats and the liberal media.
Or,
VOTE DEMOCRAT - IT BEATS WORKING
"Affordable" is similarly translated when it is used by liberal politicians in conjunction with other plain words such as housing, drugs and daycare.
It all has to do with their attempts to mask their efforts to employ Robin Hood schemes to redistribute the wealth of us working class (taxpayer) Americans.
In a liberal's lexicon, the doublespeak meaning of working class, means Americans (and illegal aliens) who are non-taxpaying beneficiaries of government largesse.
Liberals are hopeful these people continue to vote the straight Democrat ticket.
Voters who do so, are categorized as "Yellow Dog Democrats" by all politicians.
Damn liberal media.
Why don't they say: More than 86% (259 Million) of Americans are covered by Health Care Insurance." ??
Because, they have an agenda, that's why.
Willing patient pays for willing freeloaders. And if you beef, you're a bigot...
Your real problem is not that bill, it's going to be your premiums in another couple of years. Or, your insurance company could go out of business altogether.
It is tottering around on broken legs right now.
I really believe it could be fixed, too, with some courage.
1. Because people expect it to cover EVERYTHING;
2. Because trial lawyers sue at the drop of a hat and win unjustified, outrageous settlements;
3. Because insurers are forced to share the burden of paying some of the costs of those who are not covered;
4. Because rate structures are unfair - there are two rates. Single and with dependants. A single person pays X rate. The with dependant rate is only about 20% more. The with dependant rate may be for a 20-something year old couple with no kids, or it could be a nearly 50 year old couple with 10 minor dependant children.
Rates ought to reflect reality, if you've got 10 kids, you ought to pay some sort of a reasonable marginal premium for every one of them.
In this country, people are free to have all the kids they want - they shouldn't expect the rest of the country to share the cost of raising them.
Still, acknowledging the cost, what's the option - to go bare and throw yourself on the rest of society ??
You think $8K expensive ?? Two or three days in the ICU will blow that, or surgery and a week's hospital stay.
Or we could adopt a universal health care system like Canada, that's what Hillary has in mind.
Of course, everybody knows Canada's system is on the rocks and health care there is abysmal.
We have so many illegal aliens in this county, the ER admission facility ALWAYS has a Spanish speaker available.
Pretty Salvadoran girl at the window next to me, so big I think she was about 11 months pregnant, maybe twins ??
No, she wasn't a legal U.S. citizen; No, she hadn't had any prenatal care; No, she didn't have any insurance; No, she didn't have a job; No, she didn't have any ID to prove who she was; No, she didn't know who the father was (could be any one of 3 or 4 boyfriends); No, she didn't have a regular doctor; No she didn't have a fixed address - just stayed with friends who would put her up; No, her parents/relatives were back in El Salvador; No, she didn't have any money.
My bill was $1,400. I pay premiums for two health plans, one thru my entitlement - the other through my wife's job (we do that because one plan is not very good, but it does provide some coverage the other one doesn't). Between my two providers, they paid 100% of my bill. And, indirectly (along with all the other insurers), they paid for this teenager to deliver an allegedly illegitimate child (maybe two).
The real rub is, when it was all over - she was the mother of a brand new U.S. citizen (or two) that will anchor her here until she too is a citizen. I bet she remembers who the father is by that time too.
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