Monday, March 29, 2010

Insurance Reform ???? WHY?

Why do they blame the big insurance companies. I need to know, do they feel it is the Insurance companies charging $27.50 for a band-aid at the hospital? They are so close yet so far.
The mistake they make is not understanding that the insurance company is the one that is paying the bills, not the ones setting the prices. We should know that every insurance company in every state is only allowed to make a 35% profit on individual plans and a 30% profit margin in group plans and "The Bill" has changed that to 20% and 15% respectively (Sec. 1001, as modified by Sec. 10101)
Now the health care industry on the other hand has no restrictions on what they can charge. I have seen CT scans come with a charge of $400 to $4000 in Minnesota. Health Cost is the problem, as a nation we spend 15.3% of our GDP on health care. Not on insurance, on the cost of the product. Compare that to other nations and you will see the next closest is Germany with 11.1% and the average being 9.34% of all modern nations. (Not third world) The health care industry has been able to run at an inflation rate of an average of 12% per year over the past 35 years. A baby that cost $165 to be born in 1970 now costs around $10000. Why, when the number of days spent in the hospital has gone down from 5 days to 1.5 days, has something so natural inflated so much? Because they could. You see the health care industry learned that it didn't matter what they charged because the people never saw the bill and never asked, and the insurance companies just paid the bill. This continued on for years because the insurance company never promised they would keep your premiums down. As a matter of fact, if anyone bothered to read their health insurance binder, they would see that the insurance company plans to spend $65 of every $100 taken in and if they have to spend more the have the right to raise your rates. So, if they paid too much they raised the rates.
Thus we get to the real problem which gives the pundits half credit for being right. Since the inception of health insurance provided by the work place, people haven’t had to care how much it cost and went to the MD or ER for everything because to them it only cost $20, their co-pay. To emphasize my point, in a Tucson Citizen special report / By Carla McClain –they reported that bees have become more aggressive over the past 35 years. They cited emergency room reports of bee stings as a source. Now call me old fashioned, but if I ever got stung by a bee, my mom told me to put some mud on it, now it deserves an emergency room visit? Why? Twenty bucks that’s why.

By not being responsible and shopping price we have made health care a business that does not need to compete. Now they are telling everyone about the under payments and the HMO’s and PPO’s taking over everything when really, they own most of them. U-Care Minnesota is owned by the MD’s. They are trading but what they are trading for is an automatic paycheck whether they work or not, as long as their client signs up for the plan. The primary clinic gets a portion of the monthly premium for every client they have on the plan.
To blame the people who are paying the bills is absurd. It’s also about people wanting insurance to pay for everything making it cost more, and not checking on how what your doctor charges for a service compares to another doctor is also why it costs more. When you crash your car do you bring it to the first guy to fix and say have at it or do you get a few estimates?
Now the sad part for the United States, is that 161 million of the 303 million people are already on “The Public Option”. Medicare and Medicaid but also VA, TriCare, Military active and their families, and The Federal Employee Insurance.
We all know that America is broke. We have huge deficits, and we cannot afford to pay for half of the US health care bills. In 2003 all types of government insurances provided 46 % of all health care expenditures. It is only worse now. So my 2 cents is simple. Make the MD’s and Hospitals compete and let capitalism work and there would be no crisis.
As long as you want to blame the person paying the bills and avoid the real issues, the crisis will continue until there is a single payer system (which likely will happen as a result of this bill) at which time the problem will be solved because the MD’s and Hospitals will have no other choice than accept the payment.
Finally, in respect to the big bad insurance companies not insuring pre-existing conditions, would you believe it to be fair for a person to call her agent and say I want a million dollars more insurance on my husband, and when asked why is that, she says he’ll be dead in a week. Or perhaps, you could light your home on fire and call your agent and ask him to double your coverage. Do you at all understand how insurance works. We buy insurance in case something happens. Not because something happened. We also buy insurance for that which we cannot replace, not things we can. All of these are factors on what insurance should cost. What person, let alone a company would bet on the loser of a game that has already been played and lost?

What is wrong with the bill, it doesn’t address the problem that created the crisis “Health Care Costs”, and the people have no idea what the real problem is.

I am for healthcare reform, it is just my reform is to make competitive markets for health care, use the model we have in Minnesota for the un-insured and un-insurable (Minnesota Care, and MCHA) in the rest of the US, and to turn all of Medicare and Medicaid into a known expense by handing it over to Private Insurance Companies like they did with Medicare Part C, Advantage Plans.
Ask every American become insured at birth, if they refuse, then charge them a penalty for the years they abused the system when they do decide to get insurance. You may ask why, and again I say, we buy insurance in case…not because. The only way everyone can get insurance at a fair price, is if everyone is accountable for them self and insures that which they cannot replace.