A plan for disaster

The Bacaus health reform plan has some serious flaws. One of the big ones is that it forces everyone to buy insurance. If they do not buy insurance they will pay a fine that is reported to be about $1,000 give or take. Insurance premiums are expected to be $4,000 to $5,000. This does not include other "out of pocket" expenses such as co pays and the like.

The math here does not compute!

Knowing that an insurance company will no longer be able to deny someone health insurance, who in their right mind would pay the $4,000 to $5,000 for insurance when they are not sick?? Why not just pay the $1,000 fine, wait until you are truely sick, then sign up for insurance?  The insurance company cannot deny you! You will save lots of money.

Young people, who think they are indestructible, will no doubt see the difference.
This is where the recently released study from the insurance industry determined that premiums will skyrocket under this plan. Of course those in support of this reform claimed it was false, and that the insurance industry was trying to "scare" people. Yet, on at least this point, the logic in the study seems quite correct.
This is what would be called an "un intended consequence".

Another consequence of this plan, although very intentional, is that in order to stay under the trillion dollar mark and be so called defecit neutral, its revenues are front loaded and its expenses are back loaded.

This means that cuts in medicare reimbursements to providers, new taxes on "cadillac" insurance plans and the other host of revenue generating features will happen right away, yet on the expense side, like expanded insurance coverage are not fully implemented until years later(some nearly a decade), so as to allow the reform to build a surplus making it "appear" to be under a trillion dollars and defecit neutral. This is pure gimickry.

Another point on "cadillac" insurance plans is that the government, to generate revenue, calculates that the use of these plans will continue to increase over time, yet that flies in the face of economics 101. When you increase taxes on something, you get less of it, not more. So this is another area that will likely contribute to the reform plan exceeding planned expenses.

As it is now, many doctors refuse Medicare patients, does anyone think this situation will improve after the government cuts reimbursement rates even further?

I am in favor of reform, but only reform that makes sense. This does not make sense!

Health Care Reform

I have often posted about what I don't think we should do to reform health care in the U.S. I think I should post on what I thinnk we COULD do to reform health care.

First lets define the problem. Roughly 50 million people in the U.S. have no health insurance. But lets first put some context to that number. Lets subtract the following from it:
1. Illegal Aliens--15 million
2. People who could afford(make over $75,000) insurance but choose not to purchase it--10 million
3. People who are eligble for Medicare/Medicaid and do not sign up for it--10 million

That leaves about 10-15 million peopole who, through no fault of their own, cannot get or afford insurance. Some would claim it closer to 5 million.

Tort reform would be on the top of my list. It is easy to do. Estimates run from 3-10% of every dollar spent on health care goes to lawsuits. This does not even include the millions spent on defensive medicine. Remember though that tort reform is to limit puative damages, not compensatory damages. This means that a person injured by malpractice will still be able to sue for millioins of dollars, if that is what is needed to pay forthier medical care. They will only be limited in how much they can get in as punishment from the doctor.

Pre existing conditions are a tougher nut to crack. I know a person who bought a boat, but didn't buy insurance on that boat....until they day he crashed it. You can't wait until you get sick to buy health insurance. Unless of course you want the insurance companies to go out of business. The only way to get rid of pre existing conditions is to require everyone to have insurance. If we would go to this kind of model I think it should be based on people being required to have catastrophic insurance that pays after the first $5,000 or so of medical expenses. The government could subsidize people who could not afford this.
It goes without saying though, that insurance companies should NOT be able to rescind your insurnace when you get seriously ill becuase you forgot to mention on your application that you had acne when you were 20.

Insurance is part of the problem
If you have insurance, you are not the actual customer in the economic sense. You don't care what it costs. If your doctor wants a test every hour on the hour, you have no incentive to even question it. Think if car insurance covered oil changes, and regular maintenance.....how much more would insurance cost?

This is what I like about HSAs and other types of catastrophic insurance.
With High Deductable Health Plans(HDHP) you are put back in the economic equation, yet if you get seriously ill or injured, you are still covered.

Real insurance competition.
In the U.S. there are about 6,000 health insurance companies, yet Americans are severly restricted as to which ones they can choose by the state they live in. Open up the whole country to all of the insurance companies.

Allow insurance tax deduction
Allow insurance to be tax deductible. This will help to lower the costs of insurance.

No Death Council??? I have proof of it!!!

They say there is no death council! But I have pictures of the them meeting.....









I don't like the way they are looking at me! I must be on the list!!!

Another correction

After much protest, Britain will now treat Macular Degeneration before you go blind in one eye.



This is a pretty interesting video. At the end it describes how in Canada it can take a month or more to get an MRI.....unless your a cat or a dog. Pets can usually get them same day or next day!

I'd also like to point out again that the Democrats plan on cutting 400-500 billion from Medicare/Medicaid to come up with some of the savings to pay for this reform.
Also when the Democrats say that you can keep your insurance and your doctor they are not telling the truth. I have an Health Saving Account with Catastrophic Insurance Coverage. This type of plan will no longer be available under the reform plan!!! People with Flexible Savings Accounts(FSA) or Health Reimbursement Arrangement(HRA) will no longer be able to participate in those plans.

Also if you currently have employer provided insurance and lose it, you will be FORCED into the public plan or the public exchange by this new reform.

Health Care Blues

Because I think "health care refom" is so important I want to blog about it again.
I DO realize that health care is an issue in this country.

One often touted fact is that roughly 47 million people in this country lack health insurance. This fact is true. But lets add some context to this. This does NOT mean there are 47 million people in this country who are denied health care. They DO get health care typically provided at emergency rooms and free health clinics and the such. We , as taxpayers, already pay for this in the form of higher costs for proceedures and higher taxes in the form of government payments to hospitals for the treatments of indigents.

So really, we could solve this problem by insuring the 47 million. I'd say insure the 47 million, minus the 10-20 million illegals in this country.

Those of you that support this plan realize it includes illegals! Every dollar spent treating them is a dollar that will not be spent treating you and your family!

The bill also includes reductions in payments to medicare providers and a "government board" to determine what will and will not be paid for!

Britan has N.I.C.E.which is often described as not being very nice! It is the government agency that decides what treatments are available to whom based on things such as sex and age. A board simmilar to NICE will be comming to the U.S.

For example, if you have advanced breast cancer, you get no treatment. Macular Degeneration? No treatment until you go blind in one eye. Then they will treat your remaining eye.

Recently Paul Krugmen was at a "health care" conference. He asked if there were any Canadians in the audiance. 7 people raised thier hands. He asked if any were "un happy with thier health care?" All 7 raised their hands!!!!

A correction

I my post about health care I made a mistake. Union members would NOT be expempt from the "reform". They would be exempt from paying taxes on thier health insurance as is now propsed as part of at least one of the proposals. This correction was brought to you by the person who has been correcting me for 42 years now.....my father.....

I'm on the way to the hospital

to get a blood infusion. I've bitten my tongue so many times I'm low on blood. I try not to make this blog political, people that know me know where I stand, but damn.

First I'll say that I did not vote for Obama yet he is, for better or worse, my President. I had hoped he would campaign from the left(as he did) and lead from the middle somewhere(he is not, at least domestically)



His health care imitative is just un real. Its not really his though, he has turned that job over to Congress.

Only one action would convince me that this "plan" was a good plan.

Only one, very simple action would convince me to fully support this initiative.

And this one action would save the government money.

That action would be for ALL federal employees to be put in the plan also.
From the President down to the lowliest janitor in some long ago forgotten federal agency.

I mean if its so good for the American People, it should be good enough for Federal Employees who are, by definition, our employees. Have you ever worked at a place where the workers had better insurance than the employees? Me neither.....

President Obama was asked this exact question. His response was to try and say he was giving the American People the same thing that Federal Employees have, then he tried to blend this with Medicare saying that its just like Medicare, in fact its just like what federal employees have....government provided health care.

Does anyone really believe that????? If you do, wouldn't it be easier for the government to open up the plans to all Americans? Ain't going to happen!

Itroducing a "Public" option is a horrible idea. It will not be long until the government begins to subsidize this "Public" plan to the dis advantage of every other insurer out there. Soon the "Public" option will be the only one available.

So how do you get more health care for less money? How does that work?
President Obama want us to think we can achieve that through efficiency.
Their is no doubt a ton of money to be saved from efficiency, but not enough to pay for this plan.

And why are unions exempt from this "reform"??? The UAW, SEIU among others...I wonder why? Payback???

And this very complex(1,600 pages or so) "reform" has to be done by August??? Sorry, I'm tired of Congress not reading laws they pass!!!!

Our health care system is far from perfect, but when I look around I don't see anything better.

I do not like "pre existing condition" being excluded but it is a necessary evil. Otherwise people would only get insurance when they were sick. You can't get sick and then go buy insurance just like you can't crash your car and then go buy auto insurance. So the only real way to get rid of "pre existing conditions" is to require everyone to have health insurance.

As long as were on cars and health insurance....
Everyone knows they are at risk of getting sick. Pneumonia, flue, colds etc. These are minor ailments. Sort of like maintenance items much like changing the oil in your car is a maintenance item. Imagine what car insurance would cost if it insured against needing an oil change or a car wash!

Indeed, if the insurance workings of cars and health care were interchanged, this debate would be about the cost of car insurance!

Insurance is to mitigate a risk. How risky is a cold? Or a twisted ankle? or a fever over a short time? The normal, routine illnesses that come from being alive. The risk is infinitesimal.

My health insurance is a Health Savings Account. To me it is perfect. I put money, albeit tax free, away in a savings account every payday.I can go to ANY doctor, anywhere in the world! I have a debit card I use to pay the bill. I use that card to pay for all prescriptions and tests also. I can use it to pay fom many maedical related things that insurance will never pay for, like asprin or bandages. My "out of pocket expenses" are limited to $5,000 per year so if something catastophic or serious occurs I know what my expenses would be, and I've already saved for it towards the $5,000. After $5,000 I pay nothing. the insurance picks up ALL cost from therapy to doctors to prescriptions and hospitals. It is what is called High Deductible Health Plan and it pays for any catastophic event or ilness over $5,000.
So for about $130 a week, Karen and I are totally covered.

Another upside is that I question the doctor now becuase I am the consumer! although I have yet to refuse what a doctor ordered for me, he knows that I will question him. He recently ordered 2 tests for me that checked for the same thing. I aksed him if he really needed both. He said that because of my family history, he would feel better with both. I completed both...and they both came back "ok". But the point is that if I had "regular" insurance I would have never even questioned him about the need for both.

And, if I ever get to retire, if their is any money left in it, I can use it for whatever.

Much like "energy reform", this bill will have many un-intended consequences. Congress knows well about those little buggers!

We know all about "energy conservation" out here in Nevada. They have been preaching that for a long time here. Our local electric company recently began offering "interest free" loans for you to add a solar water heating system to your house. Not a bad idea on the surface. Las vegas, much like Pahrump and most of Nevada, have been trying to conserve electricity for many years.

The problem comes when the power company gets your payment for your lower electricity use. You save $50 on your normally $200 electric bill. You think "Great"! The power company thinks "Wow! I didn't make enough money last month!" and drives right over to the State Utility Commission and asks for an increase to bring your bill back up to $200! This exact scenario has already played out in Las Vegas. The power company will get their money, that's why they are in business!

So if your in it for the "environment" go for it....and that's an ok reason. But don't think the electric company is doing you any favors trying to lower your bills.