Archive for October 2009

Health Care Reform: Government Single Payor System   6 comments

Health Care Finance Reform: Government Single Payor System

 Congress is currently working through the proposals concerning health care reform.   Most republicans are not in favor of a public option of any kind. Some democrats are in agreement with no public option while most democrats are in favor of some kind of government option.   Some don’t want the government to have that much control or power.   Some believe that government is inept or wasteful.   I have addressed much of this in previous posts.   I would prefer that government have the control or power rather than the private health care insurance industry.

 Right now the health care insurance industry is spending millions of dollars in an attempt to thwart the health care reform movement.   These millions of dollars are our health care dollars.   They are our premium dollars.   These are dollars that should be used in providing their clients the health care that they need.

 Some are concerned that any kind of public option would drive the private health insurers out of business.   I understand this concern.   That is not a desirable consequence of health care reform.   However, eventually, I believe that this will be the only way that real reform will ever take place.   There is a basic conflict of interest in the health care insurance industry.   The need for a profit in the private sector is too great. Under the present system too many health care dollars go toward salaries and benefits for thousands of employees, compensation packages including huge bonuses for the top executives, return on investment for stockholders, and profit.   I believe in the capitalistic economy that we live under, but it is not working in health care right now.   I would not want to see a government single payor system initially, but would like to see it phased in over a period of a few years.  That would give private health care insurers time to diversify and adjust.   I know that many will cry about “socialized medicine”, but that’s what we have now with the health care plans that congress , medicaid, medicare and the VA Administration have.   I truly believe that more of our hard earned health care dollars would go toward providing all Americans the health care that they need, rather than to all the above costs.   I heard a statistic that only 4% of the revenue that medicare receives goes toward administrative costs.   That’s a pretty impressive statistic.   Far better, I’m sure, than the private sector.   All Americans should have the same basic health care coverage, from the President of the United States to the homeless.  

Thank you for visiting my blog site.  Your constructive criticism, thoughts and ideas for improvement are welcome.  Blessings –

Posted October 23, 2009 by terryflowersblog in Health Care

Health Care Insurance Reform: Who is Our Enemy?   2 comments

Health Care Insurance Reform: Who is Our Enemy?

 Recently I received a forward email which contained outlandish accusations against Nancy Pelosi.   If these accusations were accurate, I would consider her to be unfit for public service.   The email had a statement in it that this kind of behavior was so bad that it could not be made up…it had to be true.   This statement caused me to be suspicious so I went to www.snopes.com to check it out.   Sure enough, the accusations were misleading at best and mostly false.

 I decided to search other political leaders on the snopes website to see if they had any kind of misleading or slanderous attacks directed toward them. I searched John McCain and Sarah Palin.   Sure enough, they had several entries against them as well.   For John McCain most of the entries I looked at were false or misleading.   However, the entries I looked at on Sarah Palin surprised me.   Many of them were actually true, while some were misleading or false.   However, I only looked at a few and may have missed some of the false or misleading entries.   I would encourage you to investigate this for yourself.   It seems that anyone who devotes themselves to public service is subject to misleading and false accusations.

 Why is this?   Who originates such material?   One would suppose that there are some who would attempt to discredit anyone of a different perspective.   These individuals may or may not be an official part of an organized group or political party…they could be acting independently. Regardless of who would develop such harmful materials or why they would do so, is this the way we want out country to work?   Is it any wonder that there is a great deal of skepticism in our society?   I believe that this type of subversive behavior is detrimental.   We need to work together to address the great challenges that face us as a nation and quit attacking one another personally.   These attacks are a distraction to what really matters…the issues and challenges that we face collectively.   We may continue to disagree on the means and methods of meeting these challenges, but lets work together in a non-confrontational way to find solutions, instead of attacking one anothers’ character or reputation.

 I am reminded of the old Pogo cartoon strip of some 50 years ago…yes, I’m that old.   In one of the weekly Sunday strips Pogo is quoted as saying, “We have met the enemy and it is us”.   Are we our own worse enemy?   Are we more likely to fall as a nation due to our divisiveness and polarization than we are from any outside threat?

 Another thought that came to me as I was considering what I might write about in this blog, is that perhaps these attacks are not from the opposite perspective.   What if…and I have no evidence of this… but what if there is a group or some groups who want to see the US destroyed but do not have the resources to do much about it?  What better way to bring down a superpower than to cause division within it? This may sound far fetched, but upon thinking about it, maybe not.   There are always some who like a conspiracy theory…this is one great one.

 This strategy of discrediting those who we disagree with is currently being used as we debate and struggle with how to reform our nations health care system.   As I watch the ads and promos about the health care reform proposals I hear so many outlandish claims against the political leaders who have a differing position from the one the ad is promoting.   There are also claims and counter claims about how the proposals will affect us as a nation. For more on that you can see my previous posts.   It is my hope that we can end the personal attacks on one another and begin to really and seriously deal with reforming health care for all Americans.   May we seek God’s blessing as we work together to this end.

 

Posted October 13, 2009 by terryflowersblog in Health Care

Health Care: What Are Our Options?   2 comments

Health Care: What are our Options?

 It seems that our nation is divided over how to address the challenges in regard to health care.   For the most part the division is along party lines…democrat vs republican.   There is a fundamental difference between the parties.   As I see it, democrats believe that our social ills are best solved through government regulation and/or intervention while republicans believe that most of our social ills can be solved through the private sector.

 It seems that almost everyone…republicans, democrats, libertarians, etc…agree that our health care system needs to be fixed.   There is no disagreement that health care costs are rising at an alarming rate (and have been for the last 10-20 years).   Health care comprises one-sixth of our nations total GNP, and as health care costs continue to rise, the portion of the GNP may reach one-fifth, one-forth, etc.   Will our economy be able to absorb this continued growth…and for how long?  More and more middle class Americans are losing their health care insurance coverage resulting in more and more bankruptcies.   This has a negative impact on our economy as well.   This is to just name a few of the challenges before us in regard to our health care system.   See my previous postings for more.

Where do we go from here?   Can, or will, the private sector be able or willing to allow change to take place to meet the goals and objectives of providing most, if not all, Americans the health care that they need and deserve?   We live in a capitalistic economy where the priority is profit.   Don’t misunderstand, there is nothing wrong with profit.   Profit provides incentive for development and innovation.   It helps drive the economy for all.   The downside to capitalism comes when profit becomes the beginning and the end…our god.   That which we work for with no thought for those who may be left behind.

 Yes, we all have the same opportunities in life.   Anyone can rise to the top.   Or is this a concept that we believe, but may not be true?   Perhaps it’s true that anyone has the opportunity.   But is it true that everyone has the ability?   Each one of us is unique.   Each one of us has our own giftedness. But we are not created equal in the sense that we can all accomplish the same economic success .   I am reminded about an interview that I heard with Warren Buffet.   I don’t remember the exact words, but the jest of his comments were that while he had the gifts, intuition and environment in which to be successful, he said that if he were born in a different time and place he would not have been able to succeed as he has.   What I got out of this is that there will always be some who will succeed (financially) in any given situation, while there will always be those (probably the majority of us) that will not be so successful.   He felt that having been so blessed in this life, through his fortunate place in history, he needed to pay his fair share to help those who were not so fortunate.   He also said that he was able to shelter his resources from taxes and that was also not fair to those who had less.   He supports health care reform.

 Many presidents…republicans and democrats…over the past several decades have acknowledged the need for reform or have attempted reform, but have failed.   The private sector and their lobbyists are strongly against any regulation from government.   Why?   I think you can answer that.   Why have they been successful in blocking change to this point?   They have a great deal of power and money.   Their influence is sometimes frightening. They capitalize on the fear and distrust of governmental influence in our personal affairs.   They put out ads that perpetrate and exaggerate government ineptness, incompetence and graft.   This supports the republican philosophy of leaving the problem solving of our social ills to the private sector.   This further divides us as a nation.   We are becoming more and more polarized as a people.

 On the other hand, democrats (most of them) don’t believe that the private sector can or will meet the challenges that oppress and cause great harm to individuals and their families.   Is this a dangerous position?   Can government become too large or become too invasive in our lives?   I would say probably.   I would say that if we become more involved in our government individually that we can keep the proper balance.   There are issues in which government has no business getting involved.   It is up to us as voting citizens to decide what those issues are.   I just don’t think that something that touches each of us to the degree that health care does, is one of those issues.   I don’t believe that the private sector can or will meet our nations’ health care challenges.

 So, where does that leave us?   How do we bring these two ideologies together in bringing real reform to the acknowledged challenges with our health care system?   Can there be real reform without government involvement?   I doubt it.   How much government involvement would it require to see real reform?   This is debatable, but there must be real teeth in any legislation if true reform is to take place.   How can our republican friends find a place where their concerns are met while at the same time provide for the needs of lower and middle class families?   I wish I had answers for these questions.   There are a few moderate republicans who are willing to come to the table.   We need more of them.   I would be interested in hearing from anyone who reads this post as to how you think the challenges that we face can be met.

Posted October 10, 2009 by terryflowersblog in Health Care

Health Care Reform Is Now Health Insurance Reform   Leave a comment

As the legislation continues to be worked through it has become more and more clear that nearly all the health care industry is on board with most of the proposals before us except the health care insurance industry.   It is also clear that it is this industry that has the most to lose with reform.   If we look at that industry we can plainly see that millions (if not billions) of dollars each year are funneled through it.   A great deal of that money goes for administration, salaries and huge bonuses for the top executives of each insurance company, as well as to the stock holders of these companies.   That represents a great deal of health care dollars that do not go toward health care for the American people.

 It is also clear that health care provider (hcp) fees are inflated due to the insurance companies.   Let me explain.   Annually hcps negotiate with the insurance company payors (icp) that they will be accepting in net.   The contracts generally include the discount that the icps will receive due to the clout that they have being such large an industry.   Typically discounts of 40-60% are negotiated. Now, hcps have to calculate what their “usual and customary” (uac) fees will be in order to receive enough revenue to remain in business.   Remember, most of the revenue for providers will come through the icps.   This means that the hcp must inflate the uac fees in order to maintain its ability to provide services.   That means that when an uninsured person receives his/her bill it will charge the “uac” fees.   To do otherwise would be a violation of the contract that the hcp has with the icp. Let me give an example.   Suppose a hospital bill comes to $500,000 and the icp has a contract that gives it a 50% discount.   That means the statement sent to the patient would show a fee of $500,000, the amount the icp pays ($250,000) and the amount the patient is responsible for (if there is a copay or a percentage that the patient is obligated to pay).   Suppose the patient has no obligation to pay anything (plans vary).   In this example the hospital receives $250,000 for the fees charged of $500,000.   This, of course, means that the hospital must inflate the uac fees in order to, not only cover its true costs, but to also cover all overhead (salaries – including non-medical staff -, maintenance, utilities, security, equipment, etc, etc).

I believe that most of us would agree that this is extremely unfair to the uninsured who are in the minority (about 15% of the population but steadily rising) who would have to come up with the full $500,000 on their own.

 I just returned from a rally supporting President Obama’s health insurance reform plan.   The presentations that I heard from a panel of seven physicians (three of which practice at Centerpoint Medical Center of Independence), group organizers and a cancer patient have done nothing but reinforce my previous views.

 It is so important that the final version that goes into law contain a provision for a public option.   If this does not occur the bill will be quite weak and much more will need to be done to bring real reform.

 I realize that there are many good people who work for the health insurance companies.   This is why a plan must be phased in as to change too quickly or drastically would put many thousands more out of work.   We must have a plan that will allow for gradual change and for adaption over time.

 There is so much more that I could say.   For those of you who listen to talk radio or to the network or cable news I would say, fine, go ahead and listen. I listen to them so that I can try to balance the two positions.   I would encourage you to also be open to what those supporting reform are saying.   Don’t dismiss out of hand what is being shared.  There is a long way yet to go, but progress is being made.   Let us stand in there for the duration.   Let’s make change happen for the sake and for the good of our country now and long into the future.

 

Posted October 3, 2009 by terryflowersblog in Health Care

Health Care Reform: The Need For Critical Thinking   Leave a comment

Health Care Reform: The Need for Critical Thinking

 

A high school friend has pointed out to me some of the issues that may have an effect on how public opinion may be influenced in regard to government involvement in health care.   I have heard these statements before but had not seriously thought them through critically.   I wish to thank my former high school colleague for bringing these issues back to my consciousness in order that I might think through them more fully.

The statements are:   The United States Postal Service (USPS) is losing money, medicare and medicaid are in the red and in danger of running out of money and, there are some states that are going bankrupt or on the verge of bankruptcy due to their involvement in a state health care system.   The implication of these statements is that government can not and should not become involved in a national health care system.

 Yes, the USPS is losing money and has been for a number of years while private business has been successful.   I will concede that this is a true statement.   Let’s see if we can determine some of the reasons why this may be the case.   The USPS services the entire United States six days a week regardless of “rain, sleet or snow”.   This requires an extremely large work force as it is labor intensive.   As you may know, federal employees are well paid with better than the average benefits including a federal retirement.   This is expensive.   The USPS services those areas that are sparsely populated which is not profitable under any circumstance.   It is inappropriate and unfair to compare the USPS with private delivery services as they are not competing on a level playing field.   The private enterprise is motivated by profit while the USPS is foremost service oriented.   Therefore private business does not and is not required to service unprofitable areas.   If they do deliver to a sparsely populated area, they are not covering the entire area, only the address to which they have a paying customer.

 It is my opinion that the reason that the USPS is losing money is not because of poor management or ineptness, but because they are service oriented, have an extremely large service area and deliver to nearly every home and business six days a week.   Do we wish less service in order to make the USPS more efficient and cost effective?

 Medicare and medicaid are always in the red and will run out of money in the year ….(you can fill in the year).   I will concede that this too is also a true statement.   Let’s analyze why this may be true as well.   It’s no secret that health care costs are rising faster (you have heard how much faster) than the rate of inflation.   When health care costs go up for the private sector, they also go up for the public sector.   Medicare and medicare struggle with rising health care costs the same as the rest of the county.   This is actually a good reason why health care reform is so critical.   In previous blogs I have addressed other points in regard to medicare and medicaid and I would invite you to read those as well.

There are a few states that have a form of a health care system in place and they are struggling to remain solvent.   I would concede that this statement, too, is true.   It is my opinion that 50 individual state health care systems would be extremely inefficient and confusing.   Also, I would guess that there would be some who would move from state to state in order to obtain health care coverage or better coverage if states offer different plans.   It is also probable that for those few states that already have a health care system in place, there have been some citizens move in from other states because they were, for some reason, uninsurable or uninsured.   This would cause strain on any state.   This is another good reason why a national health care system is so important.

 While we hear claims, counter claim, statements and innuendos, it is incumbent upon us as individuals to think through these issues critically.   To take these statements at face value without looking into the reasons as to why they may be true, we are doing ourselves and our nation an injustice .

 I liked some points that Matthew Bolton made in a recent article that was run in the Independence Examiner this past weekend. “…people in the US often say, ‘yeah, well, those countries have to pay higher taxes.’ to a certain extent, this may be true.   But in democratic countries taxes are not money completely lost – we get something in return from them.”   He also quotes figures on how much we pay per capita for health care compared to other nations and how poor value we receive for that cost.   Another quote that I thought quite insightful is, “Certain problems are simply solved better by the public sector than private business.   This is not socialism – just common sense”.   If you are able I would encourage you to find this article and read it. It was published in the weekend edition over September 25-27.

 In the final analysis we need to realize that comparing the private sector to the public sector is like comparing apples to oranges.   They have different goals and objectives.   The private sector is motivated primarily by the bottom line of profits…for themselves and for their shareholders.   The public sector is primarily motivated by the need to serve its people.   I encourage you to think through this and other important issues that face our great nation with critical thinking and a desire to find plausable answers.

 Thank you for visiting my blog and taking the time to read it.   Now, critically think about what I have written and leave a comment…agree or not.   We need ideas from everyone in order to make our great nation even greater.   Blessings –

 

Posted October 2, 2009 by terryflowersblog in Health Care