Tuesday, November 15, 2011
Wednesday, August 5, 2009
Canadian Health Care is NOT single payer
it seems there is a thriving private insurance industry in Canada
from:
http://www.marketwatch.com/story/balyasny-bets-against-healhcare-reform-2009-08-04#comment2591443
"While the health-care system in Canada ensures that virtually everyone living here has access to medical services in any part of the country, it doesn't cover everything. That's where private, or extended, health insurance comes in – it is meant to pick up where your government plan ends. Private health insurance is not the same as emergency health – or travel medical – insurance that you may consider purchasing when you travel outside Canada. Rather, it covers the day-to-day surgeries and treatments that can add up to big bills."
and from
http://www.insurance-canada.ca/health-products/health-dental/health-dental.php
"Directory of Health and Dental Insurance Providers
A certain amount of health and dental expense will be incurred every year by individuals and families. However, health and dental emergencies can prove quite expensive and personal or family health and/or dental insurance can be a big help in reducing the impact of unexpected costs.
For this reason many people not covered by an employer or group plan will consider their own health and dental insurance."
and, last but not least:
http://www.insurance-canada.ca/health-products/health-quotes/health-quotes.php
"Directory of Online Health Quotes Providers
When you decide to buy health insurance, the sales organization - broker, agent, company - must be licensed to do so in your province. Providers will make product information, coverages, pricing and applications available in numerous ways -- in local offices, through the mail, via telephone and/or on the web over the Internet."
Thursday, July 30, 2009
Compare Health proposals
Sites Compare Proposals
If you want to keep tabs on the major congressional health proposals but are starting to get dizzy, the Henry J. Kaiser Family Foundation has a chart for you.
The chart includes President Obama’s health reform principles, the Senate Finance Committee proposal, the Senate Health, Education, Labor and Pensions Committee proposal, and the House “tri-committee” Affordable Health Choices Act of 2009.
The chart also includes a number of other proposals, such as the Patients’ Choice Act of 2009, which was proposed by Sen. Thomas Coburn, R-Okla., and Rep. Devin Nunes, R-Calif., and the American Health Security Act, which was introduced by Sen. Bernard Sanders, I-Vt.
If you want to keep tabs on the major congressional health proposals but are starting to get dizzy, the Henry J. Kaiser Family Foundation has a chart for you.
The chart includes President Obama’s health reform principles, the Senate Finance Committee proposal, the Senate Health, Education, Labor and Pensions Committee proposal, and the House “tri-committee” Affordable Health Choices Act of 2009.
The chart also includes a number of other proposals, such as the Patients’ Choice Act of 2009, which was proposed by Sen. Thomas Coburn, R-Okla., and Rep. Devin Nunes, R-Calif., and the American Health Security Act, which was introduced by Sen. Bernard Sanders, I-Vt.
Tuesday, June 9, 2009
I want the United States Government to be my source for health care.
I want the United States Government to be my source for health care.
It will provide great care, and all of the services I could ever need, in a timely manner.
The Federal government has demonstrated it’s ability, with a proven record of accomplishment, it’s resume is worthy of consideration for management of any position, and that is demonstrated by:
The war on poverty
The war on illiteracy
The war on drugs
The war on crime
The war on pollution
Eliminating violence
Eliminating discrimination
Eliminating racism
Eliminating sexual harassment
Providing good quality health care for those over 65
Providing above average health care for the American Indian
Providing good quality health care for all who served in the military
The quality of life for those living on government programs is superb
Our seniors living on social security want for nothing
The health care for our former government workers is the best they can find, and they had to contribute nothing towards it
CHIP has made sure all children have health care
Those in prison are well cared for
They do their time with no risk
The Social Security trust fund is solvent
The Medicare trust fund is solvent
The IRS is efficient and collects properly from everyone who owes
There is no financial mismanagement
There is no corruption
The controls the government places on private financial institutions are correct and just
Special interests cannot influence the government
All laws and practices are fair and equal to all
Our government officials always serve the people
Our government officials always put the citizen’s needs first
Our government is the most efficient and productive entity that exists
Our government agencies are a pleasure to do business with
The services the government provides are timely and above average
The immigration process is the best in the world
The safety and security of its people is above any other country’s
The government’s process are transparent and above reproach
The laws apply to all equally
The members of government live under the same laws and benefits they choose for us
The justice system never makes a mistake
The executive branch makes no unjust laws
The financial branch manages monies well
The government can account for every dollar it spends
After reviewing this list, I am sure you can see why the United States Government, by the people and for the people, is the best qualified to decide what and how to provide health care for you and I
Now – to be fair – please reply and list the programs and services that I missed that are worthy of consideration.
Would you retain the services of any company that failed so often, and so magnificently?
If so - why not hire me - because I could exceed your expectations by showing up for work half the time and failing only half the time
People - hope and dreams and wishes do not make it a workable idea
Those other countries have systems that do work better than ours, they have much smaller governments
and the bureaucrats have to live in the system they create
Friday, May 1, 2009
Budget reconciliation process on Health Care affects your health.
Hopefully the plan for health care in the U.S. will be under bi-partisan craftsmanship. The Budget reconciliation process, if used here, will create a plan that will have almost 1/2 of the population left out of the creation process.
This would not be a good situation for a president who campaigned, in part, on his ability to reach across the isle.
It would not be a good for the population, as if it is fast tracked, the overall concerns of "We, the People" will not be fully heard.
Providers will choose alternative channels, since there is no way to force them to accept more patients and give less care for less money. Those with short memories need only look what happened in MD about 10 years ago, or what is happening in Massachusetts and other states, today.
If we've learned anything at all from the last year of Congress, with the Stimulus Bill and TARP, Congress moving quickly spells major expenses and lack of control for us now, and our future generations.
"We, the People" have an obligation, and a right to be heard, and be involved fully in the process. Do not let Congress adversely affect the quality of life just to "do something".
Those who have followed my posts know the risks we have if we allow "any" system to be put in place. A plan like used in most European nations, Canada, or our own VA or Medicare system will leave us with limited access to providers.
Such a system will have more Doctors retiring, more going to limited "boutique" access practices, and less accepting the public limited access and limited fee system.
Massachusetts's is on the leading edge, with several state mandates, and they are experiencing Doctor shortages, lack of care, and major increases in ER use.
Trends showing increased lack of care, denial of care, limited access to medications, denied coverage are well documented in Medicare recipients, as well as in Universal "one payer" (one controller of health care access) systems.
I, for one, with 5 family members as Medical providers, am scared to turn 65, because I loose coverage levels and access I enjoy now.
Please, follow the process, and remain active in the political agenda. Your health depends on it.
Health May Go On Fast Track
Democratic congressional leaders have come out with a 2010 budget resolution conference agreement that includes health reform and estate tax provisions.
Democrats and Republicans have posted separate texts and analyses of the 2010 budget resolution agreement on the Senate Budget Committee website, at http://budget.senate.gov
The conference agreement resolves differences between the Senate version, S. Con. Res. 13, and the House version, H.Con. Res. 85.
Here is a "side by side" comparison posted by the Republican members of the Senate Budget Committee.
Congress has agreed to handle health reform measures through the ordinary legislative process until Oct. 15, officials say. If no legislation passes by that date, Congress may consider health reform through the budget reconciliation process.
Supporters of a bill usually need to get the cooperation of 60 senators to get the bill to the Senate floor. When Congress includes a measure in the budget reconciliation process, supporters need just 51 votes in the Senate.
Robelynn Abadie, president of the Association of Health Insurance Advisors, Falls Church, Va., says she is disappointed that health reform could end up becoming part of the budget reconciliation process but welcomes the decision to let lawmakers try to craft a bipartisan health reform plan through the ordinary legislative process until October:
“A health care bill written entirely by Democrats would almost certainly create a new public health insurance program,” Abadie warned.
Continuing with bipartisan efforts offers the best chance of coming up with “an agreement on health care that will stand the test of time,” says John Greene, a vice president at the National Association of Health Underwriters, Arlington, Va.
“Reconciliation would make it difficult to achieve bipartisan health care reform that addresses the core issues of cost, access, and quality together,” says Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, Washington.
Democratic congressional leaders have come out with a 2010 budget resolution conference agreement that includes health reform and estate tax provisions.
Democrats and Republicans have posted separate texts and analyses of the 2010 budget resolution agreement on the Senate Budget Committee website, at http://budget.senate.gov
The conference agreement resolves differences between the Senate version, S. Con. Res. 13, and the House version, H.Con. Res. 85.
Here is a "side by side" comparison posted by the Republican members of the Senate Budget Committee.
Congress has agreed to handle health reform measures through the ordinary legislative process until Oct. 15, officials say. If no legislation passes by that date, Congress may consider health reform through the budget reconciliation process.
Supporters of a bill usually need to get the cooperation of 60 senators to get the bill to the Senate floor. When Congress includes a measure in the budget reconciliation process, supporters need just 51 votes in the Senate.
Robelynn Abadie, president of the Association of Health Insurance Advisors, Falls Church, Va., says she is disappointed that health reform could end up becoming part of the budget reconciliation process but welcomes the decision to let lawmakers try to craft a bipartisan health reform plan through the ordinary legislative process until October:
“A health care bill written entirely by Democrats would almost certainly create a new public health insurance program,” Abadie warned.
Continuing with bipartisan efforts offers the best chance of coming up with “an agreement on health care that will stand the test of time,” says John Greene, a vice president at the National Association of Health Underwriters, Arlington, Va.
“Reconciliation would make it difficult to achieve bipartisan health care reform that addresses the core issues of cost, access, and quality together,” says Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, Washington.
Wednesday, April 22, 2009
Universal Healthcare already in place is failing
One point it raises, that is not spoken of often, is the issue of "unhealthy" lifestyles. There are many studies and programs going on that screen employees for alcohol, diet and exercise issues and this video implied how that may need to be managed because of the cost impact on all.
In this day's conversation about Health Care coverage, the people should know how well the existing system, which is being offered as the Universal model for the U. S., is working.
Again - those computer savvy should Google "Medicare issues" and "infections in Veteran's Hospitals" and get up to speed on what certain congressmen want us to live under.
In the interest of full disclosure - once that plan is in place, the exodus of people leaving the Universal plan will rival the exodus out of New Orleans pre- Katrina.
Agents like myself stand to make a nice income providing people with plans that do not limit access or care, and allow the affluent access to better care than that offered in the social programs proposed.
The other factor is it will create a class difference and discrimination between those who are on the social program, and those who can afford "real" care.
Having health care providers bid for the right to provide coverage by offering the lowest price per service has it's own issues. This is part of the structure the VA already uses, with the result that Doctors prescribe medication that is not available to patients in the Pharmacy system.
Witnesses: Sam, Heal Yourself
- By ALLISON BELL
Published
If the federal government really wants to reform health care, it should start by fixing Medicare.
Witnesses from the insurance industry made that case today at a Senate Finance Committee hearing on reforming the
Ronald Williams, chairman of Aetna Inc.,
The round table was convened by Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee, and Sen. Charles Grassley, R-Iowa, the highest-ranking Republican member on the committee.
Baucus and Sen. Edward Kennedy, D-Mass., chairman of the Senate Committee on Health, Education, Labor and Pensions, wrote Monday in a letter to President Obama that they want their committees to move quickly on passing broad health reform legislation.
“Right now, all of the incentives in our system encourage health care providers to deliver more care, not better care,” Baucus said today at the hearing. “Today’s conversation is about how to lower costs and improve quality in the system for the millions of hard-working Americans that are tired of seeing their health care costs rise faster than inflation.”
Panelists talked about creating incentives in the Medicare program to eliminate waste, using health information technology to improve provider communications, and conducting more research on the comparative effectiveness of various treatments.
Panelists also talked about ways to reduce fraud and abuse in federally financed health care programs.
Williams spoke at length about the importance of health IT efforts and wellness efforts.
The
“Our seat belt laws and anti-smoking efforts have achieved great results, and we need this same type of commitment in the wellness challenges facing us in the areas of obesity and encouraging healthy behaviors,” he said.
Williams also talked about provider compensation.
“Improving our delivery system starts with reforming our payment system to focus on quality and value,” Williams said. “
Reimbursement changes are especially important for the Medicare and Medicare Advantage programs, Williams said.
The programs must be revised so that the focus of health care services “rests on value and quality rather than volume,” Williams said.
Under Medicare’s current fee-for-service payment structure, providers are paid on the basis of volume rather than value, often with suboptimal results, Williams said.
“Moreover, lower payment rates paid by public programs result in cost shifting to those who are privately insured,” he added.
If Congress wants to reduce the cost of Medicare Advantage as compared to Medicare as part of a down payment for financing a health reform program, Congress also must examine Medicare's operational structure and the Medicare Advantage bidding process, Williams said.
“If we decide to follow a pathway to Competitive Bidding in Medicare Advantage, we should look at the development of a viable structure that includes several guiding principles,” Williams said.
Williams said the principles should include generating meaningful cost savings from the Medicare Advantage program; maintaining access for all beneficiaries and minimizing disruption; and providing incentives to improve quality.
Korn also talked about the importance of wellness and prevention programs, comparative effectiveness research, and health IT.
Like Williams, he called for changes in provider compensation arrangements, especially in the Medicare program.
Korn described a “3-tier” Medicare reform strategy that would start with efforts to pay physicians based on quality, build up to promoting wellness and condition management programs, and eventually work up to encouraging providers to combine to form “virtual” care delivery system.
Eventually, Korn said, Medicare should pay the virtual care delivery groups bundled amounts for treating health care “episodes,” rather than paying individual providers separate fees for each type of service delivered.
Korn criticized the Obama administration proposal to create a new, government-run health insurer that would be open to healthy, working-age
“Private plans in general and Blue plans in particular, have been active innovating in these priority areas,” Korn testified. “Creating a new government plan that would compete with the private sector would undermine the ability of the health care sector to implement meaningful delivery system reforms. The private sector has led the way in developing innovative programs (e.g., chronic care management, wellness programs, and Centers of Excellence) that would not be possible under a government plan due to enormous political pressure.”
Sunday, November 2, 2008
Health Care plan assesment for Nov 4
In the interest of full disclosure, I am an agent in the Mid-Atlantic region.
Further - It is my opinion that if the European plan were offered here, the sale of supplemental and replacement plans will be an economic windfall for health agents, as it has overseas.
I have tried to provide a reasonably unbiased review of the stated and posted plan of each candidate, pulled off of the candidate's own web site, and with nothing else added, with one exception. That exception was in a concern for the tax that has been stated will occur on health insurance offered by businesses.
To evaluate each candidate's promises and the impact, an understanding of what exists is appropriate
Current system
1) Employer provided
- employer pays all or part of the employee premiums, and sometimes pays for the spouse and children as well
- employer cost is usually between 350 - 1100 per month per person
this cost is a tax deductible expense for the employer, and any benefit plan under IRS section 125 offers additional payroll tax reductions. Employer expenses for health plans is usually subtracted from the profit before calculations of corporate taxes
- premium cost is usually a factor of the average age of the organization, and the history of incurred medical costs, called experience rating
- normally 75% or more employee participation is mandatory to have group coverage
- coverage is usually through the provider network of physicians
upside:
- no pre-existing coverage issues, anyone is accepted
- coverage until recently was offered with no deductibles to meet and minor co-pay costs
- no lifetime maximum per individual
downside:
- out of network care costs can go to 100% employee expense
- employers often change insurance companies to reduce premiums, this involves changing the provider network, and can result in having to change established Dr / Patient relationships
- the system encourages age discrimination by the employer, as younger workers reduce the average insurance age
- the employee cost share can become prohibitive, resulting in younger and health employees opting out, and going to individual coverage, leaving increased group costs for older and unwell employees
- unhealthy and older employees are tied to the employer for health care coverage, very much like the last centuries' "being indebted to the company store"
- when the employee is terminated / laid off / otherwise no longer employed, the employee and family usually have the option to accept COBRA - which is the coverage provided by the employer, at the full employer cost plus 4% admin fee
once COBRA ends, or if COBRA is not selected, the employee and family may purchase individual coverage on the open market, in many cases subject to underwriting and pre-existing medical condition exclusions or rate adjustments
2) Self purchased
- insured pays all of the premiums for self, spouse and children.
- cost is usually between 150 - 400 per month for an individual, family coverage cost is between 350 and 1100 per month
- the lesser premium cost is usually coupled with a deductible of some manner
upside:
- this cost is a tax deductible expense along with other medical costs on schedule A
- for the self employed, all medical, dental, LTC ins. and out of pocket expenses are a tax write off on schedule C per IRS Section 105, so it can be subtracted from profit before calculations of corporate taxes, and in the case of a husband and wife sole proprietorship or "C" corporation
- coverage costs are age adjusted, but adjustments for health issues are normally not allowed by state laws
- since this is the individual's coverage, the individual has no ties to an employer for health care coverage, allowing job mobility
- lifetime maximums of 5 to 8 million per person are available, although lesser levels are more commonly selected due to consumer ignorance of implications
- established lifetime Dr / Patient relationships are possible
downside:
- usually medically underwritten, and premiums can be adjusted at issuance based on health issues or coverage can be declined
- policies vary and can be confusing, to the point that some people may find coverage insufficient for their needs, or gaps can exist that do not cover brand name drugs or services
3) Federal, State or Local Government provided
- taxpayer pays all or a large part of the employee premiums, and sometimes pays for the spouse and children as well
- cost is usually between 400 - 1300 per month per person
- premium cost is usually a contractual amount, vaugly a factor of the average age of the organization, and the history of incurred medical costs, called experience rating
- coverage is usually through the provider network of physicians
upside:
- no pre-existing coverage issues, anyone is accepted
- coverage has no deductibles to meet and very minor co-pay costs
- no lifetime maximum per individual
downside:
- out of network costs can be shocking to the insured
- the employee and family have no clear understanding of actual coverage or service costs, resulting in a large financial surprise when they leave the government position
- unhealthy and older employees are tied to the employer for health care coverage, very much like the last centuries' "being indebted to the company store"
- when the employee is terminated / laid off / otherwise no longer employed, the employee and family usually have the option to accept COBRA - which is the coverage provided by the employer, at the full employer cost plus 4% admin fee
once COBRA ends, or if COBRA is not selected, the employee and family may purchase individual coverage on the open market, in many cases subject to underwriting and pre-existing medical condition exclusions or rate adjustments
4) Low income, CHiP and State High Risk Plans
- State pays all or part of the person' premiums, based on household income
- State underwrites the cost of covering the medically unwell
- individual cost is usually between 350 - 1100 per month per person, based on plan choice and deductibles selected
upside:
- no pre-existing coverage issues, anyone is accepted
- coverage until recently was offered with no deductibles to meet and minor co-pay costs
- this cost is a tax deductible expense along with other medical costs on schedule A
- for the self employed, all medical, dental, LTC ins. and out of pocket expenses are a tax write off on schedule C per IRS Section 105, so it can be subtracted from profit before calculations of corporate taxes, and in the case of a husband and wife sole proprietorship or "C" corporation, reduce the self employment tax as well
- coverage costs are age adjusted, but adjustments for health issues are normally not allowed by state laws
- since this is the individual's coverage, the individual has no ties to an employer for health care coverage
downside:
- premium costs are usually higher than a medically underwritten policy
- lifetime coverage level can cap at 1 to 2 million, which can be insufficient for the individual
5) over 65 or severely medically challenged
Medicare part A (paid for by government)
and parts B and D, are usually paid out of the recipient's social security check
medicare advantage programs can combine the systems and provide an inclusive coverage package, forming an 80 /20 cost sharing for the consumer
upside:
- no pre-existing coverage issues, anyone is accepted
- coverage is offered with minor co-pay costs
open enrollment is every Oct 15 thru Dec 31, with an additional plan adjustment period the first months of each year
downside
- the schedule for medical procedure payments is set by the Federal Government, and many qualified physicians decline to treat people with limited payment systems and Medicare
- without assistance, many over 65 do select plans which are insufficient for their needs, or fail to purchase part D, and so are penalized for not having the coverage when they enroll later, or do not have coverage when they need prescriptions
- plans can change every 6 months, so a viable plan can alter to the detriment of the insured
6) Uninsured
there are about 45 million who currently do not have coverage
22 million are here illegally, and they can not purchase coverage
it is estimated that another 10 million have ot been able to find coverage due to medical issues
the balance find the costs unacceptable, and choose to allocate funds for other purposes
European Systems:
Most operate on the same basic principal. Taxpayers fund the government sponsored plan, which pays 70 - 80% of the cost of care inside the plan offered by the country. The resident pays the remaining 20 - 30 % of the care costs. If a person can afford it, and they want a better level of care, they apply for a voucher, opt out of the government plan, and purchase a policy on the open market.
What this does is create a clear class system, much like is occurring with our similar, medicare system. Those who can afford to, opt out, and get better and quicker care, or even come to the US for care.
Obama's proposal
http://www.barackobama.com/issues/healthcare/
- Require insurance companies to cover pre-existing conditions so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums. This exists in some states already, and comparable policy premiums are 10 -15 % higher. Fair and stable premiums artificially established by the Federal Government will require the Federal Government to re-insure the risk - it may be counter productive since the taxpayer becomes the financial entity responsible for covering the major cost of the financial risk. Without any controls in place, you and I will pay for the person who lives an unhealthy lifestyle, and the health risks they take. That also removes any incentive for the company to encourage the individual to adjust their lifestyle to minimize their personal health risks. In effect - the smoker who drinks a quart of booze per day and eats McFat burgers every day is put on the same economic level as someone who acts responsibly about their health
- Create a new Small Business Health Tax Credit to help small businesses provide affordable health insurance to their employees. This will be a reduction in taxes paid in - if it is above and beyond the already existing effect of the Section 125 provisions, it will reduce employer taxes and decrease revenue for the government, a small employer tax cut if you will.
- Lower costs for businesses by covering a portion of the catastrophic health costs they pay in return for lower premiums for employees. This will require the Federal Government to re-insure the risk - it may be counter productive since the taxpayer becomes the financial entity responsible for covering the major cost of the financial risk. Without any controls in place, you and I will pay for the person who lives an unhealthy lifestyle, and the health risks they take. That also removes any incentive for the company to encourage the individual to adjust their lifestyle to minimize their personal health risks.
- Prevent insurers from overcharging doctors for their malpractice insurance and invest in proven strategies to reduce preventable medical errors. This will require tort reform, or caps on victim compensation - Obama did this to the sexual harassment laws in Il, reducing the amount an individual can collect from an employer. Premiums will not drop until the settlement is capped. We saw the impact of this in MD when the labor and Delivery malpractice costs were affecting the ability of Dr's to pay for coverage. Since no one can force an insurance company to cover a Dr, the private insurance companies recourse is to decline to issue coverage, since the stockholders (you and I and our 401K) will see this as an unsound risk. the next step will be that the Federal Government becomes the insurance company, and you and I become the persons accountable for paying the judgments and taking the financial risk
- Make employer contributions more fair by requiring large employers that do not offer coverage or make a meaningful contribution to the cost of quality health coverage for their employees to contribute a percentage of payroll toward the costs of their employees health care. This is the Federal Government telling the business how to run their business. No longer will workforce supply and demand control the benefits offered, now the Government will tell the employer what they can and can not offer. This will ultimately drive more industry off shore, since the costs to provide goods and services will include increased Federally mandated coverage levels. This practice is already in place for Federal and State contracts of all kinds. The costs the Federal and State governments pay for services are considerably higher than for the same service purchased by the private sector, and we, the taxpayer, pay for the coverage levels mandated by the Government in everything the Government purchases.
- Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage. The congressional plan costs the taxpayer about 1200 per month per covered person. Given that most people d not have that level of income, the only way a private individual can afford the plan is with extensive Government subsidies, which the taxpayer will be paying for. Even assuming the average age of this coverage plan drops, and the rates reduce accordingly, covering 20 million plus uninsured and under insured people will still cost the taxpayer about $10,000 of the $12,000 per year premium per person, (this is Obama's own statement of premiums) or $20,000,000,000.00. If the plan is better and cheaper than the existing coverage the individual already has, it is very probable the coverage level will jump to 100 million plus people, which will cost the taxpayers an additional $100,000,000,000.00 per year as they subsidize the costs. (I'd take it as well, since it's better than any plan I can buy or sell) Interestingly enough, the GAO already reports the existing Federal, State and Local health care plans are underfunded and will go deficit spending, BROKE, by 2015 - see page 8 and 13 of http://www.kslegislature.org/postaudit/GAO.pdf
- Ensure everyone who needs it will receive a tax credit for their premiums. This will reduce taxable income, income taxes paid in, and reduce tax revenue to the Government, increasing the deficit.
Reduce Costs and Save a Typical American Family up to $2,500 as reforms phase in:
The average individual family policy I write in MD is less than 6500 per year
- Lower drug costs by allowing the importation of safe medicines from other developed countries, increasing the use of generic drugs in public programs and taking on drug companies that block cheaper generic medicines from the market. To do this, patent laws will need to be changed, so that companies will lose rights to ownership and development. The incentive to create and develop drugs and procedures and technology will disappear, and the US is one of the last countries on the forefront of medical development.
- Require hospitals to collect and report health care cost and quality data. There is an increased risk for identity theft and privacy being compromised. Personal data will be widely available - anyone following the news has seen where laptop and data base files are being breached and compromised. the more data is electronically available, the more data can be and is accessed by individuals who have malicious intent. Google "government laptop losses" for an education on how bad it already is.
- Reduce the costs of catastrophic illnesses for employers and their employees. This will require the Federal Government to re-insure the risk - it may be counter productive since the taxpayer becomes the financial entity responsible for covering the major cost of the financial risk. Without any controls in place, you and I will pay for the person who lives an unhealthy lifestyle, and the health risks they take. That also removes any incentive for the company to encourage the individual to adjust their lifestyle to minimize their personal health risks.
- Reform the insurance market to increase competition by taking on anticompetitive activity that drives up prices without improving quality of care. Interesting idea - except there are currently many companies that compete in the individual and group sectors. MD has 6 major group providers and their offerings are dictated by the consumers, and the state laws and mandates. To do this, other insurance companies will have to be created, state regulatory laws will have to be challenged or removed, and the Government will need to subsidize companies to enter into and compete in a mature market.
The Obama-Biden plan will promote public health. It will require coverage of preventive services, including cancer screenings, and increase state and local preparedness for terrorist attacks and natural disasters. Adding preventative and early detection services will not add to many policy costs, as most are already covering those costs. It is a logical move. What is being missed is that over 50% of the population in this country already has it, thru their Federal, State and Local Government and Learning institution health care package. Also, most major employers have hugely beneficial preventative health focused plans already. individuals with HSA plans even have some, as most HSA plans allow certain early detection and testing without having to meet the deductible.
I am having a math problem with this one, only because there are no incentives in the Obama plan for healthy actions by the individual.
McCain's proposalhttp://www.johnmccain.com/Issues/JobsforAmerica/healthcare.htm
Cheaper Drugs: John McCain will look to bring greater affordability and competition to our drug markets through safe re-importation of drugs and faster introduction of generic drugs. Will require the Federal testing and approval system FDA, to be streamlined.
Chronic Disease: Chronic conditions account for three-quarters of the nation's annual health care bill. By emphasizing prevention, early intervention, healthy habits, new treatment models, new public health infrastructure and the use of information technology, we can significantly reduce these costs. We should dedicate more federal research to treating and curing chronic disease. There will be a financial impact on the taxpayer, to find the research, but there are already existing Federal funding programs in place on many diseases.
Coordinated Care: Coordinated care - with providers collaborating to produce the best health care for the patient - offers better outcomes at lower cost. We should pay a single bill for high-quality care which will make every single provider accountable and responsive to the patients' needs. Accountability and responsibility will have an additional effect, in that malpractice may go down - reducing the multiple bills to a patient eliminates the confusion and double billing. however, the current delivery system has each provider as a separate entity, a separate company so to speak. To have one bill, there would need to be a structure to assimilate all bills into one, much like a general contractor manages sub-contractors.
Greater Access And Convenience: Families place a high value on quickly getting simple care. Government should promote greater access through walk-in clinics in retail outlets. Local care provided by easily accessed providers is a model that existed when we had the general practitioner of old, the town Doctor. This deliver system is one already in use for pharmaceuticals, and seems to work well.
Information Technology: John McCain will promote the rapid deployment of 21st century information systems and technology to improve patient safety, enhance quality and lower costs. Communication of new practices and methods would be enhanced doing this. If it applies to patient records, there is an increased risk for identity theft and privacy being compromised. Personal data will be widely available - anyone following the news has seen where laptop and data base files are being breached and compromised. the more data is electronically available, the more data can be and is accessed by individuals who have malicious intent. Google "government laptop losses" for an education on how bad it already is.
Medicaid And Medicare: John McCain will reform the payment systems in Medicaid and Medicare to compensate providers for diagnosis, prevention and care coordination. Medicaid and Medicare should not pay for preventable medical errors or mismanagement. We also need to implement a zero tolerance policy towards Medicare and Medicaid fraud that is increasingly stripping away resources from the sick and the elderly. A good idea all around - some insurers are already refusing to pay for the results of medical mistakes. An increased focus on prevention will as a minimum keep the costs the same to the taxpayer, but provide early detection and improve quality of life.
Smoking: John McCain will promote the availability of smoking cessation programs. Most smokers would love to quit but find it hard to do so. Working with businesses and insurance companies to promote availability, we can improve lives and reduce associated chronic diseases through smoking cessation programs. The New England Journal of Medicine ran an article after a review of lifetime medical costs for smokers and non-smokers. The overall result was that smokers die sooner and incur less lifetime medical costs than non-smokers. Given that, this may have a negative economic impact on Medicare costs, and a negative impact on programs funded by the tobacco taxes.
Tort Reform: John McCain will lead the fight for medical liability reform that eliminates lawsuits directed at doctors who follow clinical guidelines and adhere to proven safety protocols. Every patient should have access to legal remedies in cases of bad medical practice but that should not be an open invitation to endless, frivolous lawsuits that drive up health care costs for everyone and make the practice of medicine unaffordable for good doctors everywhere. Currently, even though the Doctor can do everything right, he/she can still be sued, and in many cases the settlement is out of court since trial costs are excessive. This process, if done right, will allow peer reviews to determine if the proper procedure was performed. the risk is that the peer review process could be corrupted by professional interests.
Transparency: John McCain believes we must make information on treatment options and doctor records more public, and require greater transparency regarding medical outcomes, quality of care, costs and prices. We must also facilitate the development of national standards for measuring and evaluating treatments and outcomes. Given that most people have no concept of the actual medical costs, the public being aware can affect the amount of frivolous testing occurring. The risk is that new tests, new procedures may take overly long to be approved and accepted.
Making the Tax Subsidy Fair: By making the tax code more equitable and transparent, John McCain will give every family a refundable tax credit - cash towards insurance - of $5,000 (Individuals receive $2,500). Every family in America, regardless of the source of their insurance or how much they make will get the same help. Families will be able to stay with their current plan, or choose the insurance provider that suits them best and have the money sent directly to the insurance provider. This portion is a plus for the consumer as there is no difference for the insured based on employer or employment.
Making Insurance More Portable: Americans need insurance that follows them from job to job. Too many job decisions today are controlled by a fear of losing health care. Americans want insurance that is still there if they retire early and does not change if they take a few years off to raise the children. John McCain will lead the reform for portable insurance. This is a solution to a real problem - if I can not keep my insurance in effect, I am at risk of not being able to acquire a replacement policy due to pre-existing issues.
since there has been much talk about taxes on benefits, I searched also for this, and found Mc;Cain's speech on health care, see:
http://www.johnmccain.com/Informing/News/Speeches/2c3cfa3a-748e-4121-84db-28995cf367da.htm
from that speech:
"Americans need new choices beyond those offered in employment-based coverage. Americans want a system built so that wherever you go and wherever you work, your health plan is goes with you. And there is a very straightforward way to achieve this.
Under current law, the federal government gives a tax benefit when employers provide health-insurance coverage to American workers and their families. This benefit doesn't cover the total cost of the health plan, and in reality each worker and family absorbs the rest of the cost in lower wages and diminished benefits. But it provides essential support for insurance coverage. Many workers are perfectly content with this arrangement, and under my reform plan they would be able to keep that coverage. Their employer-provided health plans would be largely untouched and unchanged. "
Only if this benefit would no longer be a tax reduction for a business would it have the effect of reducing the amount of coverage a business would pay for.
To do that, it would require a change to the tax code (not likely) and such a change would only affect about 25 - 30% of the employed. Here is why:
Since the government pays no taxes to it's self, changing where those benefits fall on the balance sheet would have no impact on government workers. Those that are self employed, and those in the the public service sector, like Public Schools, Police and Fire, State and local municipalities and services, would also not see any changes to coverage. Add to that the 6% unemployed ( just under 30 million), the 45 million uninsured, plus those on Welfare programs, those who are retired or on Medicare and out of 360 million in the US, it's safe to say over 7o% of the population will see no impact of such a change.
"But for every American who wanted it, another option would be available: Every year, they would receive a tax credit directly, with the same cash value of the credits for employees in big companies, in a small business, or self-employed. You simply choose the insurance provider that suits you best. By mail or online, you would then inform the government of your selection. And the money to help pay for your health care would be sent straight to that insurance provider. The health plan you chose would be as good as any that an employer could choose for you. It would be yours and your family's health-care plan, and yours to keep. "
"The value of that credit -- 2,500 dollars for individuals, 5,000 dollars for families -- would also be enhanced by the greater competition this reform would help create among insurance companies. Millions of Americans would be making their own health-care choices again. Insurance companies could no longer take your business for granted, offering narrow plans with escalating costs. It would help change the whole dynamic of the current system, putting individuals and families back in charge, and forcing companies to respond with better service at lower cost.
It would help extend the advantages of staying with doctors and providers of your choice. When Americans speak of "our doctor," it will mean something again, because they won't have to change from one doctor or one network to the next every time they change employers. They'll have a medical "home" again, dealing with doctors who know and care about them.
These reforms will take time, and critics argue that when my proposed tax credit becomes available it would encourage people to purchase health insurance on the current individual market, while significant weaknesses in the market remain. They worry that Americans with pre-existing conditions could still be denied insurance. Congress took the important step of providing some protection against the exclusion of pre-existing conditions in the Health Insurance Portability and Accountability Act in 1996. I supported that legislation, and nothing in my reforms will change the fact that if you remain employed and insured you will build protection against the cost of treating any pre-existing condition.
Even so, those without prior group coverage and those with pre-existing conditions do have the most difficulty on the individual market, and we need to make sure they get the high-quality coverage they need. I will work tirelessly to address the problem. But I won't create another entitlement program that Washington will let get out of control. Nor will I saddle states with another unfunded mandate. The states have been very active in experimenting with ways to cover the "uninsurables." The State of North Carolina, for example, has an agreement with Blue Cross to act as insurer of "last resort." Over thirty states have some form of "high-risk" pool, and over twenty states have plans that limit premiums charged to people suffering an illness and who have been denied insurance."
for another opinion, see:
http://healthpolicyandmarket.blogspot.com/2008/03/detailed-analysis-of-barack-obamas.html