Posted on 10/13/2004 2:48:04 AM PDT by Cincinatus' Wife
If the presidential candidates don't convince you tonight that our system for financing health care is broken, consider two local incidents that happened Friday.
Osteopathic Medical Center of Texas announced that it was shutting down after 58 years, primarily because it couldn't win decent-paying contracts from health insurers.
Then Albertsons, a leading grocer, said it will shift thousands of full-time employees to part-time status, because, among other reasons, health insurance has become too expensive.
What's wrong with this picture?
On the same day, one longtime business says it can't get enough health care money to stay afloat, while another has to go to extremes to cut its health care spending.
Not exactly the "win-win" situation that business likes to talk about.
More like lose-lose.
Politicians have tiptoed around the health care issue since then-President Clinton's overhaul attempt was squashed a decade ago. Suggest a single-payer system similar to Canada, and critics immediately portray it as Hillarycare all over again. That usually stops the conversation.
On the campaign trail, President Bush supports a market approach that aims to shift coverage from employers to individuals. It banks on health savings accounts to help reduce costs for workers and employers.
John Kerry sees a bigger role for government, at least in providing coverage for children and the uninsured. He also wants to pool catastrophic insurance to reduce the coverage costs for businesses.
Who knows if either approach would resolve the root of the problem -- double-digit inflation in health care costs. Or whether either could muster public support.
But something needs to happen, either by choice soon or by necessity in a few years. The system is simply cracking in too many places.
Osteopathic, for example, was able to collect an extra 13 percent to 18 percent on its Medicare procedures because it was a teaching hospital. The government wanted to support the training of physicians, said Justin Doheny, interim chief executive.
But health insurers weren't moved by that idea. They could press Osteopathic on reimbursements because it wasn't part of a broader network and didn't have a niche that customers clamored for.
That may be fine for business, but is it good for health care?
It's been a long, long time since health benefits were an afterthought in corporate America. Still, who imagined it would come to this: By 2008, McKinsey & Co. says, the average Fortune 500 company will spend as much on health care as it generates in profits.
Workers, in general, are paying much more than before for coverage, too, and unions have made health benefits a battleground. It's the issue behind the current strike threat at Vought Aircraft Industries in Dallas. And it was the dispute that led to a 41/2-month grocery strike in Southern California this year.
On average, worker health premiums rose three times faster than workers' earnings from 2000 to 2004, with deductibles and co-pays also climbing.
In Texas, where the number of uninsured is the nation's highest, a Lewin Group survey found that 1.2 million workers spent a quarter of their income on health care. That includes premiums, co-pays, deductibles and uncovered services.
How do they pay the rent? Doheny says many working poor end up stiffing hospitals on the co-payments and deductibles, squeezing the companies' results.
Employers aren't required to offer benefits, so it's natural that more are dropping insurance altogether or making it harder to get. Many restrict coverage for family members or end up hiring more part-time workers.
Last year, J.C. Penney increased the number of work hours needed to qualify for company-subsidized health benefits, from 30 to 35 per week. Like Albertsons, Penney said it needed the flexibility to increase staff during busy hours and reduce it during quiet times.
Benefits costs are certainly a part of the equation.
The high costs of benefits are even being cited as a major factor in the slow pace of the economic recovery. Companies have said they're reluctant to hire full-timers and take on the added health care expense.
So it's not surprising that more people are going without insurance. Their numbers have risen by 5 million in the past four years, to an estimated 44.7 million in 2003, according to a Kaiser Family Foundation survey.
The Census Bureau says 25 percent of Texans go without coverage. Other surveys put the number higher.
Blue-collar workers at service companies have the highest uninsured rates, an average of 36 percent nationwide, Kaiser says. The most insured group: white-collar employees in mining and manufacturing, where just 5 percent go without health insurance.
It's easy to blame employers for not providing benefits for more people, but the costs can tilt the playing field. General Motors, for example, outspends Honda on health care by more than 3-to-1.
In 2001, 65 percent of employed workers received health coverage through their jobs; by 2004, that was down to 61 percent, Kaiser says.
Guess what happens if we expect business alone to keep this system working?
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Mitchell Schnurman's column appears Wednesdays and Sundays. (817) 390-7821 schnurman@star-telegram.com
Government has messed health care up royally and now the government must fix it?!
Granted things are wrong with the best medical care system in the world BUT there are always two sides to the story.
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Osteopathic Medical Center of Texas announced that it was shutting down after 58 years, primarily because it couldn't win decent-paying contracts from health insurers.
Osteopathic - massage therapy schools, chiropractic colleges, acupuncture schools, or any school of the natural healing arts***
Then Albertsons, a leading grocer, said it will shift thousands of full-time employees to part-time status, because, among other reasons, health insurance has become too expensive.
ALBERTSON'S March 15, 2002 - Struggling Albertson's to exit market***…Albertson's, which has 43 stores in the Houston area, entered the local market in May 1996. Soon after establishing a presence in the Bayou City, the company was denied a $45 million, 10-year abatement on county taxes for its distribution center in the west part of Harris County.
Albertson's spokeswoman Rhonda Clements says the company saw a huge potential for growth when it first researched the area, but says Houston hasn't lived up to growth expectations or the investments the company has made here.
"Albertson's will only operate in areas where we have significant market share and potential for significant growth," Clements says. "We are currently fifth in the Houston market, vs. Dallas where we are first and have a lot of growth opportunities."
The company announced 10 immediate closures on March 13 and says the remaining 33 stores will be closed as the company determines the best way to divest the real estate. Albertson's owns some of its stores outright and leases others.
Clements says more than 800 Houston-area employees will be affected by the immediate store closures. Those workers will be given a chance to transfer to the stores that are remaining open for the short-term. …..***
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Krogers bought up most of Albertson's stores.
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It looks to me like the FREE MARKET has decided.
Part of the problem with health insurance is lawyers like John Edwards and the frivolous lawsuits he brought up. If you think health insurance costs to benefits are bad look at dental insurance. My premiums for the year are more than what the benefits are. The only plus is two free cleanings a year.
The free market is also deciding in health care. Employers got into providing health care benefits (it is not insurance) when they needed to attract employees. They used the benefits as a recruiting tool in competition with other industries. Old timers still talk about their "hospitalization" plans. When this began, the benefits were much cheaper than they are now. The combination of government health benefit programs such as Medicare and the easy availability of employer plans allowed people to "consume" as much care as they wanted to. It became a great fringe benefit. As time passed, people began to think of it more as an entitlement. Now employers can't afford the same level of benefits and can actually hire people without having to offer them at all in some instances. While people view them as entitlements, business can view them as less than indispensible in recruitment. The market is deciding how much private business will have to do to recruit and retain employees. God help us if we treat health care as an entitlement or a constitutional right and put the government totally in charge. Medicare and Medicaid do not work the way they function now. More of the same is going to be disastrous.
So you can smile like Edwards!
Who is our? I have health care and its costs are going up big time. Do I blame the president? I blame all the politicians and lawyers who have turned the health care system into a political/financial game in which they are using us as the pawns.
The only way I see a compromise, as sickening as it is, is for the government to take on the role of a not for profit insurer in which everyone has the option to escape (and more importantly not pay for) the government plan. Any government plan simply cannot be paid for with general revenues (tax dollars) but instead, with regular premiums that are deducted from the paychecks of those that still want to participate.
It's a disaster.
The "cost" billed to insurance companies is jaw-dropping. But the "agreed upon amt" is much, much lower.
If your insurance allows it, medical providers practice defensive medicine and order every test in the book and then some. While those HMOs that don't cover much, have your doctor practicing a conservative approach to keep costs down for the insurer (a peek at universal/Canadian health care).
Neither approach is good and each one has cost us dearly.
I'd love to leave my job for a better paying position, but with the health care benefits offered by my present employer, it just wouldn't be a rational decision. Our company self-funds our medical, and I don't pay a dime except for a low copay. Wonder how long this will last???
Politicans love to have control because they can hold-up companies for political donations or constituent buying schemes, just by threatening legislation that will hurt their bottom line.
If we can, at least, own our medical dollars and spend them as we want, then we can begin a reversal of this mess.
Bump #9 to you!
"Osteopathic - massage therapy schools, chiropractic colleges, acupuncture schools, or any school of the natural healing arts*** "
If you're implying that osteopathic medical school and osteopathic healthcare facilities are not "real" then you're in for a big surprise. Long gone are the days of spinal manipulation. Osteopathic physicians undergo the same duration of training as those physician that practice allopathy. Most osteopathic physicians do residencies along side of allopathic physicians.
That's the sixty-four thousand dollar question in my mind. Will those companies that drop health care pass that premium on to the worker to allow him to buy his health care or will they keep it and force the workers to pay for health care out of what they are taking home now?
You think premiums for dental insurance are so high partly as a result of frivoulous lawsuits and lawyers like John Edwards?
With your two free cleanings, don't you also get some x-rays?
I paid an average of 355.00 per month for health costs every month for years - from about age 33 to 50, for my husband and myself. A couple of doctors' visits and monthly meds for hypertension, which we both have. We went without insurance, which at 80% would have cost the two of us about $630.00 per month (hypertension brought the cost up). This $630.00 would have provided me the chance to get a doctor I wanted - about the equivalent of PPO coverage.
In 2003, I had an injury that resulted in getting an MRI - it was from a car accident, so Florida PIP was paying the bills for all care related to it. They did the MRI and found a mass in my right lung which led to recs for CT scans, bone scans and a PET Scan. I'm at about $12,000 + for this year alone. Now, I cannot get health insurance except by getting hired by a large company that provides group care - no company that I have found will insure myself and husband with this condition. Doing this -- getting such a job - will require a 90 day waiting period to get coverage for pre-exisiting.
Most likely, it will be suggested that I have surgery to remove the mass then chemo. I do not have that money, even with the providers' "charity" deductions.
The MRI was ordered, imho, due to the practice of "defensive medicine" -- the doctors were aware that I work in the legal field and wanted to cover their behinds just in case my continued complaints of pain in my back were something other than muscle strain/sprains. So, "defensive medicine" isn't always a bad thing.
I think it's great to continue to argue about whose fault it is for rising health care costs, particularly the cost of insurance. But this country has been having this discussion for what - 30, 35 years now? And no one is getting anywhere except worse. I see some people -- those with government benefits like Medicaid -- going to the ER for everything because the ERs are mostly required to pay/provide free care to these folk. We earn way too much to qualify here.
I see no reason that every US citizen should not be afforded the opportunity to buy insurance exactly like what we pay for our Congresspersons. That's an Edwards/Kerry alleged policy.
I would love to see how any Bush policy could help me. And I am one of what - 40 million? Can you think of any other "entitlement" that is as important as providing citizens with basic health care? Do you think the fact that many physicians refuse to provide treatment to people with, for example Blue Cross Blue Shield HMO coverage (cost of $460.00 per month for spouse and me)because their reimbursement from BC/BS is so low has anything to do with their refusal to provide care for these people? I have that HMO coverage now - and I had a real difficult time finding a PCP who accepted it.
What percentage of the cost of health care premiums comes down with Bush's tort reform -- where, what state has proved it works?
I think it's way past time to move the discussion beyond who is at fault for the problem. Bush et. al. are stuck in "tort reform" mode. They and the Republicans need to get over it.
If there's one thing that I've noticed here is that some conservatives - in fact many - just don't trust markets.
"God help us if we treat health care as an entitlement or a constitutional right and put the government totally in charge. Medicare and Medicaid do not work the way they function now. More of the same is going to be disastrous."
I agree with you that Medicare and Medicaid don't work as they function now, at least to some extent. OTOH, they do at least provide some coverage - Medicare more than Medicaid.
What's your solution?
If health care should not be treated as an "entitlement," what should it be treated as? Do you think there are any "entititlements" today? If so, would you give me an example? National security? I think it probably is something we are "entitled to." But what's the point of being somewhat assured of being able to stay alive if you can't get health care to keep you alive?
I really am curious as to what "things" you or anyone else considers legit "entitlements."
Free market.
Now, maybe I'm missing something that you've written in your post, but you know that someone - someone other than yourself - is going to be contributing to the cost of your treatment. You write that you left the coverage of your plan after spending 17 years on it and making all of those premiums. You left you plan that offered the catastrophic benefit that you now need and you wounder why no one will cover you now that you are such a high risk.
Forgive me for asking but why didn't you move to a high deductible plan with the same insurer while you had the chance?
Don't expect to get what our Congress persons get. The PLAN would most likely be modified. Most people in the Senate are millionaires and I'm sure Sen. Kerry seeks the best care he can pay for.
I would love to see how any Bush policy could help me. And I am one of what - 40 million?
Anyone who has lost health insurance, EVEN WHEN THEY GET BACK ON A PLAN, are still counted in that number.
Young adults who have don't want to buy insurance because they have better ways to spend their money, are counted in that number.
People who can apply for free medical care but don't bother to sign up, are counted in that number.
If so much money were not being sucked out of the health care system by frivolous lawsuits and practice of defensive medicine, the dollars we now spend would go considerably farther. If a doctor is paying $250,000 a year in malpractice insurance and is seeing maybe 50-75 patients a day, with up to 10,000 office calls in a year, that amounts to an extra $25 for each office call. This is BESIDES running all the other costs of an office. And doesn't even include hospital rounds or time in an operating theater.
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