Why Don’t We Need Health Care Reform?



Lately there has been a very loud and unhealthy discussion about health insurance in this country. I say unhealthy because the discussion very rarely focuses on the facts and no one walks away from the fight feeling good about it. In my discussion on the subject I would like to remove the political component:

  1. Forget about what side of the aisle the people that you voted for sit – chances are they don’t have any of your interests at heart anyway
  2. Forget about the color of our President and whether or not he has all the qualities of the antichrist as stated in the Bible – that’s just the arrogance of every generation thinking that we are so important that the world will end on our watch and in our lifetime
  3. Forget about what you have heard on TV the radio or from newspaper articles and editorials – it’s all spin since everyone has an angle on this thing and anyway for the most part those guys have good insurance that they can afford

Instead let’s talk about you and me and our experience with the health care system. If you currently:

  • pay less than $100 per month for insurance or have in the past
  • and have never paid more than $10-$40 out of pocket for medical, dental, vision, prescription or a visit to the chiropractor
  • and this is not Medicare or Medicaid

I would understand if you  drop out of the discussion at this point as it is probably difficult, if not impossible for you to understand what all the fuss is about.  But I suggest you stick around so that you can understand what others have experienced or are experiencing.

If you are on Medicaid or Medicare, or have a child enrolled in a federal or state run health plan,  then I definitely want you to stay and give us some insight on what a “government run” health care system is like. For example:

  1. What does it cost you monthly?
  2. How much do you pay for prescriptions?
  3. Have you ever been denied care because you are on “the dole” so to speak?
  4. Do you feel that you receive inferior care because you are on Medicaid or Medicare?

For those of us who fit into none of the above . Those of us who pay anywhere from $200 to $600 plus per month for health insurance. Those of us who have paid additional  health care bills of  anywhere from  $300 to $300K  over and above what we paid for health insurance. I have to ask, what are we doing? Why are we fighting each other? What are we seriously fighting for ?

Last year I wrote an article about consumer driven health care and I told the story of a woman who paid over $300 per month to insure herself and her teenaged child. She required dental surgery that would take several iterations, but was not able to finish the process because she could not pay the $3000.00 bill.  So the world turned and a year later she finds herself working for this very same insurance company, and guess what? She only pays $20 a month for her coverage.  There is a saying that came to mind when I heard about that “somebody is buying you wholesale and selling you retail”.  I mean seriously people, if the insurance company employees can pay only $20 per month for coverage, why are you and I paying upwards of $300.00? What the heck are we paying for exactly?

I’ve had a discount plan for almost three years now (read why here), even though I work full time and my job offers benefits I declined them – do you want to know why? Because my discount plan costs $360 per year, I pay a discounted fee at the doctor, the dentist, the drug store, and even when I get glasses – and I am still spending less than the $10,000 plus  per year that I invested back when I had employer sponsored health care.

When I had insurance I had to get an HSA to cover those extras that my insurance did not cover. I breezed through a $2000 HSA easily. Why is that? Why do we pay so much for something that does not do the job? And why are we letting the insurance companies spend our money on lobbyists and bad advertising? Why aren’t we mad about this? Talk to me, I’m listening…

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My Thoughts on Universal Health Care and Michael Moore’s “Sicko”

Blood testing in a medical facility in Ethiopia.
Image via Wikipedia

The election cycle of the past two years saw health care plans being proposed by both the  Democrats and the Republicans, but now that politicians actually (once again) have a chance to vote on changes that could benefit all Americans we find the bill being used in a dodge ball fight between the have, the have not, and the don’t have a clue crowds.

I watched Michael Moore’s movie “Sicko” this week and I was moved to do something that I usually try to avoid – weigh in on an issue that is highly political. You see , sometimes even  those of us who stand on the sidelines and keep our own counsel, may find that we have to stand for something if it will keep just one person from falling for whatever the talking heads throw at them.

I was not surprised by the fact that 9/11 heroes cannot get help right here , nor was I surprised that there are people who lose everything due to the high cost of being sick. Heck, I wasn’t even surprised that the insurance companies have entire departments devoted to denying claims (c’mon didn’t you guys see “The Incredibles”? ) or that doctors are rewarded for doing the same.

I am surprised that the American people keep falling for the (as my son puts it) oski woski. Namely, that universal health care would raise taxes and make us nothing more than a communist country, that we would have sub par facilities, that the care given to us by our doctors would be dictated by the government and therefore ” less than”, that our doctors would be underpaid and we would therefore lose some of our doctors (after all who wants to study medicine for 12 years if they aren’t guaranteed a country club membership and million dollar income?), and blah blah blah.

As I was reviewing some tax documents for the IRS, it occurred to me that maybe one small  part of  the problem is that the rhetoric is targeted towards people who don’t actually make enough money to pay a lot of taxes. I pay a lot of taxes,  and then at the end of the year I get to pay a little more, and  I therefore  wonder where my money goes.  However, for many years I was a single parent of two, was able to file “head of household” and looked forward to tax time because it meant a nice fat check to be used for something I probably should have saved up for.

Never in a million years would it have occurred to me to forego the refund so that I wouldn’t have to pay $200 a month for health insurance, $500 for a root canal, and be able to get the hearing aid that I never got because no insurance that I’ve ever had fully covered hearing aids (so yeah I go around saying “huh?” and “eh?”  quite a bit).

Since I’ve come into all of this money that the IRS feels entitled to, it occurs to me that it sure would be nice to pay what I owe and still be able to get sick in peace.  I think so highly of our current health care system that I declined the health insurance coverage offered to me by my employer . Why?  Because I did the math and found that I could buy a new car at the end of the year if I banked the money instead and used my discount benefits plan for my health care needs.Not to mention that my plan provides discounts on things that help to prevent illness like stop smoking programs, diet and nutrition programs, diagnostic tests and yes even hearing aids.

I am not done with the subject of our broken health insurance system but don’t want to keep you too long Dear Reader. Next up : “Dear overpaid politicians, stop debating the pros and cons and start doing something about health care reform ” or maybe I’ll tell you why the US ranks behind many third world countries when it comes to our health care.

What do you think about the current debate on health care reform?

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Barack Obama’s Inauguration Speech

Inaugural Address

Tuesday, January 20, 2009

Washington, D.C.

My fellow citizens:

I stand here today humbled by the task before us, grateful for the trust you have bestowed, mindful of the sacrifices borne by our ancestors. I thank President Bush for his service to our nation, as well as the generosity and cooperation he has shown throughout this transition.

Forty-four Americans have now taken the presidential oath. The words have been spoken during rising tides of prosperity and the still waters of peace. Yet, every so often the oath is taken amidst gathering clouds and raging storms. At these moments, America has carried on not simply because of the skill or vision of those in high office, but because We the People have remained faithful to the ideals of our forbearers, and true to our founding documents.

So it has been. So it must be with this generation of Americans.

That we are in the midst of crisis is now well understood. Our nation is at war, against a far-reaching network of violence and hatred. Our economy is badly weakened, a consequence of greed and irresponsibility on the part of some, but also our collective failure to make hard choices and prepare the nation for a new age. Homes have been lost; jobs shed; businesses shuttered. Our health care is too costly; our schools fail too many; and each day brings further evidence that the ways we use energy strengthen our adversaries and threaten our planet.

These are the indicators of crisis, subject to data and statistics. Less measurable but no less profound is a sapping of confidence across our land – a nagging fear that America’s decline is inevitable, and that the next generation must lower its sights.

Today I say to you that the challenges we face are real. They are serious and they are many. They will not be met easily or in a short span of time. But know this, America – they will be met.

On this day, we gather because we have chosen hope over fear, unity of purpose over conflict and discord.

On this day, we come to proclaim an end to the petty grievances and false promises, the recriminations and worn out dogmas, that for far too long have strangled our politics.

We remain a young nation, but in the words of Scripture, the time has come to set aside childish things. The time has come to reaffirm our enduring spirit; to choose our better history; to carry forward that precious gift, that noble idea, passed on from generation to generation: the God-given promise that all are equal, all are free, and all deserve a chance to pursue their full measure of happiness.

In reaffirming the greatness of our nation, we understand that greatness is never a given. It must be earned. Our journey has never been one of short-cuts or settling for less. It has not been the path for the faint-hearted – for those who prefer leisure over work, or seek only the pleasures of riches and fame. Rather, it has been the risk-takers, the doers, the makers of things – some celebrated but more often men and women obscure in their labor, who have carried us up the long, rugged path towards prosperity and freedom.

For us, they packed up their few worldly possessions and traveled across oceans in search of a new life.

For us, they toiled in sweatshops and settled the West; endured the lash of the whip and plowed the hard earth.

For us, they fought and died, in places like Concord and Gettysburg; Normandy and Khe Sahn.

Time and again these men and women struggled and sacrificed and worked till their hands were raw so that we might live a better life. They saw America as bigger than the sum of our individual ambitions; greater than all the differences of birth or wealth or faction.

This is the journey we continue today. We remain the most prosperous, powerful nation on Earth. Our workers are no less productive than when this crisis began. Our minds are no less inventive, our goods and services no less needed than they were last week or last month or last year. Our capacity remains undiminished. But our time of standing pat, of protecting narrow interests and putting off unpleasant decisions – that time has surely passed. Starting today, we must pick ourselves up, dust ourselves off, and begin again the work of remaking America.

For everywhere we look, there is work to be done. The state of the economy calls for action, bold and swift, and we will act – not only to create new jobs, but to lay a new foundation for growth. We will build the roads and bridges, the electric grids and digital lines that feed our commerce and bind us together. We will restore science to its rightful place, and wield technology’s wonders to raise health care’s quality and lower its cost. We will harness the sun and the winds and the soil to fuel our cars and run our factories. And we will transform our schools and colleges and universities to meet the demands of a new age. All this we can do. And all this we will do.

Now, there are some who question the scale of our ambitions – who suggest that our system cannot tolerate too many big plans. Their memories are short. For they have forgotten what this country has already done; what free men and women can achieve when imagination is joined to common purpose, and necessity to courage.

What the cynics fail to understand is that the ground has shifted beneath them – that the stale political arguments that have consumed us for so long no longer apply. The question we ask today is not whether our government is too big or too small, but whether it works – whether it helps families find jobs at a decent wage, care they can afford, a retirement that is dignified. Where the answer is yes, we intend to move forward. Where the answer is no, programs will end. And those of us who manage the public’s dollars will be held to account – to spend wisely, reform bad habits, and do our business in the light of day – because only then can we restore the vital trust between a people and their government.

Nor is the question before us whether the market is a force for good or ill. Its power to generate wealth and expand freedom is unmatched, but this crisis has reminded us that without a watchful eye, the market can spin out of control – and that a nation cannot prosper long when it favors only the prosperous. The success of our economy has always depended not just on the size of our Gross Domestic Product, but on the reach of our prosperity; on our ability to extend opportunity to every willing heart – not out of charity, but because it is the surest route to our common good.

As for our common defense, we reject as false the choice between our safety and our ideals. Our Founding Fathers, faced with perils we can scarcely imagine, drafted a charter to assure the rule of law and the rights of man, a charter expanded by the blood of generations. Those ideals still light the world, and we will not give them up for expedience’s sake. And so to all other peoples and governments who are watching today, from the grandest capitals to the small village where my father was born: know that America is a friend of each nation and every man, woman, and child who seeks a future of peace and dignity, and that we are ready to lead once more.

Recall that earlier generations faced down fascism and communism not just with missiles and tanks, but with sturdy alliances and enduring convictions. They understood that our power alone cannot protect us, nor does it entitle us to do as we please. Instead, they knew that our power grows through its prudent use; our security emanates from the justness of our cause, the force of our example, the tempering qualities of humility and restraint.

We are the keepers of this legacy. Guided by these principles once more, we can meet those new threats that demand even greater effort – even greater cooperation and understanding between nations. We will begin to responsibly leave Iraq to its people, and forge a hard-earned peace in Afghanistan. With old friends and former foes, we will work tirelessly to lessen the nuclear threat, and roll back the specter of a warming planet. We will not apologize for our way of life, nor will we waver in its defense, and for those who seek to advance their aims by inducing terror and slaughtering innocents, we say to you now that our spirit is stronger and cannot be broken; you cannot outlast us, and we will defeat you.

For we know that our patchwork heritage is a strength, not a weakness. We are a nation of Christians and Muslims, Jews and Hindus – and non-believers. We are shaped by every language and culture, drawn from every end of this Earth; and because we have tasted the bitter swill of civil war and segregation, and emerged from that dark chapter stronger and more united, we cannot help but believe that the old hatreds shall someday pass; that the lines of tribe shall soon dissolve; that as the world grows smaller, our common humanity shall reveal itself; and that America must play its role in ushering in a new era of peace.

To the Muslim world, we seek a new way forward, based on mutual interest and mutual respect. To those leaders around the globe who seek to sow conflict, or blame their society’s ills on the West – know that your people will judge you on what you can build, not what you destroy. To those who cling to power through corruption and deceit and the silencing of dissent, know that you are on the wrong side of history; but that we will extend a hand if you are willing to unclench your fist.

To the people of poor nations, we pledge to work alongside you to make your farms flourish and let clean waters flow; to nourish starved bodies and feed hungry minds. And to those nations like ours that enjoy relative plenty, we say we can no longer afford indifference to suffering outside our borders; nor can we consume the world’s resources without regard to effect. For the world has changed, and we must change with it.

As we consider the road that unfolds before us, we remember with humble gratitude those brave Americans who, at this very hour, patrol far-off deserts and distant mountains. They have something to tell us today, just as the fallen heroes who lie in Arlington whisper through the ages. We honor them not only because they are guardians of our liberty, but because they embody the spirit of service; a willingness to find meaning in something greater than themselves. And yet, at this moment – a moment that will define a generation – it is precisely this spirit that must inhabit us all.

For as much as government can do and must do, it is ultimately the faith and determination of the American people upon which this nation relies. It is the kindness to take in a stranger when the levees break, the selflessness of workers who would rather cut their hours than see a friend lose their job which sees us through our darkest hours. It is the firefighter’s courage to storm a stairway filled with smoke, but also a parent’s willingness to nurture a child, that finally decides our fate.

Our challenges may be new. The instruments with which we meet them may be new. But those values upon which our success depends – hard work and honesty, courage and fair play, tolerance and curiosity, loyalty and patriotism – these things are old. These things are true. They have been the quiet force of progress throughout our history. What is demanded then is a return to these truths. What is required of us now is a new era of responsibility – a recognition, on the part of every American, that we have duties to ourselves, our nation, and the world, duties that we do not grudgingly accept but rather seize gladly, firm in the knowledge that there is nothing so satisfying to the spirit, so defining of our character, than giving our all to a difficult task.

This is the price and the promise of citizenship.

This is the source of our confidence – the knowledge that God calls on us to shape an uncertain destiny.

This is the meaning of our liberty and our creed – why men and women and children of every race and every faith can join in celebration across this magnificent mall, and why a man whose father less than sixty years ago might not have been served at a local restaurant can now stand before you to take a most sacred oath.

So let us mark this day with remembrance, of who we are and how far we have traveled. In the year of America’s birth, in the coldest of months, a small band of patriots huddled by dying campfires on the shores of an icy river. The capital was abandoned. The enemy was advancing. The snow was stained with blood. At a moment when the outcome of our revolution was most in doubt, the father of our nation ordered these words be read to the people:

“Let it be told to the future world…that in the depth of winter, when nothing but hope and virtue could survive…that the city and the country, alarmed at one common danger, came forth to meet [it].”

America. In the face of our common dangers, in this winter of our hardship, let us remember these timeless words. With hope and virtue, let us brave once more the icy currents, and endure what storms may come. Let it be said by our children’s children that when we were tested we refused to let this journey end, that we did not turn back nor did we falter; and with eyes fixed on the horizon and God’s grace upon us, we carried forth that great gift of freedom and delivered it safely to future generations.

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Consumer Driven Healthcare – My Experience

My health care package as a corporate worker included an HSA or Health Savings Plan. This is a plan where you pay in x amount of dollars per month with a yearly maximum. You are then able to be reimbursed for non-prescription medical items, co-pays at the doctor or dentist and services that your insurance may not cover. The cost of the HSA is in addition to whatever you are paying for insurance and is considered pre-tax dollars (or is that post-tax?) which means it isn’t taxed as income.

Bottom line is that you pay a little more but are able to be reimbursed for cough syrup, your glasses and visits to the chiropractor. The downside is that you have to send in receipts and they can question your charges and not reimburse them, once you run out of money you’re on your own, and if you don’t use it all you lose it (your own money, gone).

As an entrepreneur I could have chosen a similar package, but I just could not afford to pay for something I could potentially lose. My search for a plan for my family led me to a discount plan which cost $150 per month and came with a couple of discounts for different items like vacations, tires etc. But it was marketed to me as insurance and when I got the package and read through it, I was pissed because it required a lot of out of pocket , and I couldn’t see paying over $100 per month and then having to still pay a fee once I got to a provider!

I cancelled that plan and my search then led me to a discount plan which cost only 49.95 per month and covered everything – dental, vision, prescription, chiropractic, medical, lasik, hearing aids ( you know I have that tinnitus thing and really need to get that taken care of), and cosmetic surgery (dental and medical).

Next Up: Find out how a discount plan saved me 50% on my hospitalization costs!

What is Consumer Driven Health Care?

I started really taking a hard look at health insurance when I became self-employed (OK I was laid off and couldn’t afford COBRA). The cheapest thing that I could find was a $250.00 per month plan with a $10,000 deductible. If I wanted dental, vision, prescription and all that jazz I would have had to pay extra for an addition to that plan or a separate plan altogether.

I also considered an HSA, you know that tax free thing that you can use to buy aspirin, but God forbid you should lose the receipt? The HSA would have been in addition to the $250 insurance plan and I would have used it to pay for dental, vision, prescription drugs, and doctor visits.

Long story short, I could not afford to pay that much per month for what amounted to simple assurance that if something really, really bad happened we would be covered. I have a young and healthy family , and we only go to the doctor and dentist for our once a year check ups. Therefore, it made no sense for me to pay $250+ per month for something that doesn’t cost $250 for a year.

The insurance model that I was looking at (low cost, high deductible plan with a Health Savings account) is one part of what is called Consumer Driven Health Care. There are 3 levels to a CDHC type plan –

  1. The tax exempt HSA account to be used as stated above
  2. The out of pocket payments that you will make when you have run out of HSA money, but haven’t met your deductible yet
  3. And of course the high deductible insurance policy

Consumer Driven Health Care should be a way for consumers to have choices as far as how much to pay for health care and when to pay it.

For example – since I rarely go to the dentist, I should be able to make a (very) small monthly payment, and when I do visit the dentist I could then pay a reasonable out-of-pocket expense for the services I receive.