A View From The Press Box

It is interesting that you claim that those who make $50,000 a year or more can afford to buy insurance. Perhaps you haven't seen what private insurance costs today.

Even more, you can beg the insurance companies to take your money for a catastrophic-only policy and they reject you for sinusitis.

If insurance costs 33 percent of your take-home pay, it is too expensive. Even then, the high deductibles make it too expensive.

We need to be talking about affordable health care, and not enriching the insurance industry.

When will common sense ever prevail?

We do not need universal health care. We already have taxpayer-funded health care. It is called Medicare and Medicaid.

People choose material possessions over health coverage--that is not my problem, and I am not going to pay more taxes so they can have health insurance. Hello! It is called SACRIFICE. Do it or leave our country. GET OUT!

Review Dr. Ben Carson's plan, which was proposed to the President prior to 9/11. He is the Director of Pediatric Neurosurgery at John Hopkins, and an extremely brilliant man.

His plan would save over $300 billion and would not create another government plan. Every disease and every sickness has an IDC 9 code. We need to streamline the industry.

Just one example of the waste: A doctor does a surgery on a 70-year-old man. The claim is submitted to his employers' plan, where he has coverage. They deny it and say it is Medicare's claim. Medicare denies it and says it is employer's carrier. This is just one claim. Now multiply this by millions of claims like this on a yearly basis.

But why try to correct and improve the best health care system in the world, when you can just create another system to add to the pile of garbage? "Gee, I am voting for Hillary or Obama because they are going to give me health care."

Move to England!

SAM RESPONDS:
I removed some name-calling from the end of this post. Let's keep this civil, shall we?

Also, yes, there is Medicare (for the elderly) and Medicaid (for the very poor), but for at least two-thirds of the uninsured, they are neither old enough to sign on for Medicare, or poor enough to qualify for Medicaid, so then what do they do?

Also, are there really "millions" of claims for people who are working at age 70, and thus caught in the "monkey in the middle" game between Medicare and private carriers?

JOHN GETS THE LAST WORD:
I am sorry. I thought I was being civil on a subject that has so much ignorance involved.

It seems by some of the comments, that another government-run program is the answer. I do like the idea, as with auto insurance, you are required to carry a minimum. The challenge is to make it affordable.

Therefore, I challenge everyone to check out Dr. Ben Carson as well as Newt Gingrich's program (www.healthtransformation.net).

Dr. Carson's plan involves no government-run plan, but would save the industry over $300 billion. This savings can then be passed on, thus making health care more affordable for everyone.

And if you include tort reform (like in Mississippi, to name one state), you can really lower costs. Do some research and become informed. It does not have to be complicated.

As for the 70-year old individual's claim, I WAS NOT implying that there are millions of claims EXACTLY like this. I was referring to the paperwork issue. Whether it is with the carrier, doctor, hospital, individual or whomever.

If you want socialism, I say again, leave the USA and go to another country where they provide for you.

There truly is no one without health care in this country. If you go to an emergency room, they have to treat you. When you get the bill and find you can't afford it, many hospitals have payment plans, assistance programs, or can hook patients up with charitable groups that will assist.

Those who can afford insurance but don't buy it are probably considering themselves healthy for the most part, and do willingly pay the higher office visit payment when they visit a doctor, rather than the little co-pay but the huge monthly insurance premium.

People should be free to live like they choose, according to their budget, lifestyle choice or religion, whatever they base their medical coverage decisions on--not having the government mandate yet another burden on the taxpayer (which isn't always the same as the medical care recipient.)

I have seen government-run medical systems. They are not anything I would want forced upon me. Thanks for your misplaced concern, but enough already!

You can lament that there is a crisis--but there isn't, and it is the individual's decision, not yours or the government's.

After reading this, I believe my family would fall under the "free riders" designation, even though we do have health insurance through our empoyers.

We have adopted two special needs children who qualify for Medicaid because of their special needs. In our case, Medicaid is secondary to our regular health insurance.

For the most part, it pays only our co-pays. However, it does come in handy for those instances when the growing list of exclusions to our group health plan pop up.

Several of the specialists we need to see to address our children's needs are outside of our carrier network. Additionally, Medicaid picks up the co-pay on the six prescriptions that my son needs monthly.

Without Medicaid, our children would not have been able to make the wonderful progress they have made.

SAM RESPONDS:
I would not categorize you as a "free rider," since the pre-existing conditions of your kids might indeed make you uninsurable at an affordable rate in the private market. I believe that term applies more to those who have "normal" health risks, yet don't buy coverage, despite having the means to do so.

I was in my doctor's office the other day for a routine checkup. The doctor owns the building, which is a modern facility housing his general practice and his daughter's pediactric practice. He has been our family physician for over 20 years.

When he enters the examining room, he carries with him several manilla folders, each at least four inches thick containing my medical history.

When I asked him why he is not computerized, his answer is that it is too expensive to convert. However, his daughter, with a startup practice, is not computerized, either.

Each time I am directed by him to the individual facilities (the same ones each time) for X-rays or blood work, I complete a new form, as if I never existed before.

On the few occasions that I visited a hospital for minor situations, I was also required to complete forms as if I never existed before. In addition, most of the in-patient record-keeping in this, a supposedly modern hospital, is paper-based.

Repeat this scenario tens of millions of times and you get a sense for the immense inefficiency inherent within the health care system.

Mandatory electronic records, tied to Social Security and other identification, and combined with practice standards, would enable universal health care via a tiered system that accommodates all income levels from indigent to super wealthy, incorporating Medicare, Medicaid, and a combination of employer/employee funding. It being understood that those who can afford to pay, must pay.

Sen. Clinton is on the right track, but as the example of my physician and hospital illustrate, modernization must be mandatory in order to be accomplished.

And, as Sen. Clinton points out, putting a man on the moon could only have happened by first establishing the goal to do it. In fulfilling that goal, many strategies and plans were delveloped and changed and many mistakes were made.

And so it would be with universal health care. But first, as a nation, we must accept our responsibility to care for the less priviledged and establish the goal to do so.

SAM RESPONDS:
Excellent point, Ed! The insurance industry is always lambasted as being backward when it comes to technology, but the health care community is positively in the Middle Ages!!!

I agree with what "For Health" had to say, and a bit of what Mr. Diesel had to say.

My own opinion is that health care as a whole is a coil of snakes, each biting the other's tail.

Unfortunately, the carriers, health care providers, pharmaceutical giants, etc., are not in enough "pain" to be motivated to make any changes to the system. Individuals wanting change do not have the leverage to force all parties to the table.

While the federal/state governments are the largest consumers of health care services, any mention of federal or state intervention brings screams from the "pro-business" party.

Here's what I don't get: Why wouldn't Big Business benefit from reform??? And by the way, aren't small businesses part of the "pro-business" stance??

Does it truly need to be a partisan issue?

I could not resist the opportunity to respond. This posting oversimplifies a very complicated issue.

People know that in order to register a car, they must have the minimum insurance coverage their state requires. This is a mandate--most of our driving public has this coverage because they choose not to break the law.

Why is this coverage mandated? Because at the end of the day, it is good for society as a whole to know that in the event of a car accident, coverage for injury and damage is more or less certain.

Do we really want people without health insurance walking around with things like TB, fevers, infections and other nasty ailments? In the long run, these items, and many more, can come back to hurt even the people fortunate enough to have insurance.

ALSO, let us not forget the traditional provider of health insurance in the U.S. has always been the employer. If a person has no employer, or if the employer chooses to not offer coverage, where does it leave the individual?

Many more employers are electing not to offer coverage, except to select classes, or limit the employment hours to just under the number of hours for an employee to be eligible for group coverage.

Here in New York, individual plans are virtually non-existent, and the ones that do exist are for the most part not affordable.

Our country is faced with a big dilemna. The profits that potentially exist from the provision of health care at all levels is what has made our medical system the highest quality in the world, despite all the criticism leveled at it.

On the other hand, the profit-driven costs of the care make coverage via private insurance prohibitively expensive.

Lawsuits without limit also add to the cost of care.

Perhaps the way to address this issue would be to have two seperate systems--a government system on a sliding scale cost to the individual for those who have limited financial resources or desire for coverage (really trying to make Medicaid user-friendly, in other words ), and private doctors and hospitals for those who have the money or insurance to pay for this care, with presumably a more personal level of care.

Insurance is a business that allows some people, wise enough to purchase it, to spread the risk of loss among many. It is not a right to which all are entitled, as is the right to vote.

If you fail to buy insurance to spread your risk, you are taking all of the risk on yourself. The problem is that a secret tax is imposed on all of us who buy insurance, by government fiat, that requires hospitals to give service for free to anyone who walks in injured.

Tell people that they get no service unless they pay and they will buy the insurance. If they can't afford it, there is Medicaid and charity.

No one says auto or fire insurance is a right. Why do they believe health insurance is a right?

I understand why a 22-year-old lawyer making $160,000 a year has no interest in buying insurance, since he thinks he is immortal and can afford to pay for whatever service he needs.

I don't understand the people who claim they can't afford the insurance but have no problem buying a 52-inch Plasma HD TV.

Associated Press just ran with a story that a couple retiring today needs about $225,000 in savings to cover medical costs. That is pretty daunting.

For the full story, cut and paste the link below

http://news.yahoo.com/s/ap/20080305/ap_on_bi_ge/retiree_health_care

When discussing the issue of health care in this country, one can learn something from the riddle: " What's the difference between recession and depression ? Answer: Recession is what happens when your neighbor loses his job. Depression is when you lose your job."

There are multitudes of reasons why people have no health insurance, and it is not always the case that these people are spending the money in less responsible ways.

Additonally, many of the people in health care complain that managed care is taking a big chunk out of their earnings, while enjoying many luxuries that their patients don't. Insurance companies are hard pressed by stock holders to show profitability. People litigate without considering the impact on our nation at many levels.

In general, our nation has to address the old problem of greed.

Sam, as to your question on "...whether these 'free riders' should be forced to pay premiums or penalized if they show up for care without a policy":

Perhaps we should charge customers at Lowe's or The Home Depot more if they show up to buy a door, but don't have homeowners insurance.

I concur with Barry Zalma, insurance is NOT a right. It is just one method of paying for loss.

Before I came under my wife's health plan, I had no insurance coverage for dental expenses. Instead, I had wallet coverage. That is to say, I PAID FOR IT.

I am certain that actuaries can find cost savings if different billing and claims-processing methods were utilized. That, and the reduction of statutory mandates, might make health insurance more affordable.

Further, I disagree with Mr Kalbaugh. It is as an INDIVIDUAL that I must accept my responsibility to help those less fortunate, not as a NATION.

As David Crockett said so eloquently: "I will not go into an argument to prove that Congress has no power to appropriate this money as an act of charity. Every member upon this floor knows it. We have the right, as individuals, to give away as much of our own money as we please in charity; but as members of Congress we have no right so to appropriate a dollar of the public money."

I do not recall anything in the U.S. Constitution that says health insurance and charity are within the purview of the U.S. government. To do so, slides us more quickly down the slope towards socialism and the end of personal freedom.

A couple of thoughts.

First, floating through Congress right now, presumably on behalf of "the people," is a bill meant to bring "parity" to government payments for mental health benefits. One must assume that includes medications as well.

So, on the one hand we have some of the people complaining about insurance premiums, while at the same time "we" are passing laws adding substantially more benefits to be paid. Which is it?

Second, the private health care "insurance" industry has two motives: One is to be left alone to manage its assumed risk as it sees fit in keeping with competition and regulation; and two, to bring in more income.

They can bring in more income if they don't fight too hard the legislation to raise the number and amounts of benefits eventually payable. That will serve to increase the premium collected right away.

If someone can't afford the insurance, they should write a letter to their state and federal representatives about cutting back on what is "covered."

In the meantime, 911 will still respond, some if not most hospitals still take in the uninsured, and many doctors will see the uninsured anyway.

Anything wrong with this picture?