This is, first off, not about the non-working poor. People who are on welfare have 100% government paid healthcare through Medicaid. It’s not insurance as affects the rest of the population. They pay nothing for the policy and there are no copayments, etc. That’s fallacy #1. This isn’t about people who don’t work.

The other group who doesn’t work are people on Social Security, through either retirement or disability. They are covered under a government sponsored health insurance to which they contribute called Medicare. This is more like traditional insurance in that they pay a premium and have copays for medical services, prescriptions, etc.

The government is already involved in health insurance through these 2 programs that focus on the non-working in our society.

This is supposed to be aimed at the working poor. It would be insurance of the more traditional type where the government would negotiate a large scale insurance policy (like it did with Medicare) to take advantage of the savings. Individual policies can run to thousands of dollars a month, which most working people can’t afford. Many employers no longer offer healthcare as a benefit or negotiate a contract collectively for their employees to lower the costs somewhat, but then pass the entireity of the policy costs onto the employee making it, many times, cost prohibitive. This is, more and more, going to become the case since there are too many people competing for too few jobs so employers are now in the position of not having to woo personnel. The economy is such that it’s the employer’s market.

So we have the working poor who are living paycheck to paycheck, maybe working more than one job, and still not able to afford health care. What happens when someone gets very ill? They go to the doctors or leave it until it’s really bad, since they don’t have the money, and end up in the hospital with enormous bills. These bills are extra enormous since doctors and hospitals charge out of pocket people substantially higher rates than insured people. Insurance companies negotiate contractual fees with providers in their network and will only pay up to a certain amount for services. In some cases it’s astounding the differences. One practice I worked in had a difference of over $4,000 for insured vs. uninsured.

So you don’t have the money for the doc, no insurance, and now you have a huge medical bill. Bankruptcy has been rewritten so that it’s not really an option anymore (not that it helped the providers substantially anyway as there usually isn’t much to take and divide) so the providers spend a fortune on collections and writing off debt, which they then pass along to the next person in line, ie. you.

Now providers are not uninanimously against this. Many have embraced it because there is a stipulation for mandatory coverage. This means they will be dealing with far less in bad debt and can at least be assured of getting paid the insurance portion. Where the rub for them comes in is those negotiated contractual fees. Looking at Medicare as their example of government negotiated insurance, they are scared. The rates for Medicare are substantially lower than any private insurance. Can they still make a living? Absolutely. They take Medicare because, if they don’t, they will have a smaller pool of patients to take. Some opt out, but if this is national, they will be even harder pressed to turn their noses up at it.

Medical costs are the highest in the country out of the entire world. Medical inflation is rampant and, unlike most things in a free market, you can’t always decide to just not purchase. Medical inflation has consistently outstripped regular inflation every year for the last 20 years. That means that the devices they use and the labor they purchase, the ground and construction of facilities, has not increased enough to justify their increase in price. Pharmaceutical companies stand to make more because most people are opting generics over the name brand prescriptions (some of which are several hundred dollars per treatment or month, for long term meds) and having insurance means that when the new meds come out, before generic are legally allowed (to protect R&D and keep companies encouraged to continue finding new meds) they will be allowed to charge their assinine prices and have people submit because they are paying $60 instead of $20. Much easier than the “it might work” generic at $50 OOP to $400 for the “this is the ticket” name brand.

The scariest part of this whole plan for the working poor is what are these “mandatory” rates going to be? Are they going to be equally unaffordable? Now you are violating the law if you don’t
I understand it’s long. I thought that people who actually care might have been willing to read an actual thorough analysis. I don’t do talking points like “Osama sounds like Obama” or scream one word slogans like “Nazi” at all republicans.

Published: October 9 2008 19:32 | Last updated: October 9 2008 19:32

Blame greedy bankers. Blame Alan Greenspan’s careless stewardship of the US Federal Reserve. Blame feckless homeowners who took out loans they could never expect to repay. Blame politicians and regulators everywhere for closing their eyes to the approaching tempest.

EDITOR’S CHOICE
Comment on this column – Jun-23More from this columnist – Aug-23All of the above are culpable. I am sure there are even more villains lurking out there. Sometimes, though, it is worth looking through the other end of the telescope. The wreckage of the financial system holds up a mirror to the changing geopolitical balance. It offers advice, and a warning, as to what the west should make of the emerging global order.

Until quite recently, the talk was about the humbling of America’s laisser faire capitalism. The US government’s $700bn bail-out was the price to be paid for past hubris. For reasons that still elude me, one or two European politicians seemed to delight in the troubles of an ally that still guarantees their security.

Schadenfreude comes before a fall. Solid, conservative Germany has been among the European nations forced to shore up its banks. Angela Merkel, the chancellor, has been driven to assure German voters publicly that their savings are safe.

Belgium and the Netherlands have rescued Fortis. Ireland and Greece have issued blanket guarantees to bank depositors. Others have done something similar. Most dramatically, Gordon Brown’s British government has part-nationalised all of its leading banks in a desperate bid to crack the ice of the credit freeze.

If the toxic mortgage securities and opaque credit swaps that infected the world’s financial system came with a made-in-the-US stamp, European banks were eager buyers. For the humbling of America, we should substitute the humbling of the west.

Asia, as we have seen in the markets this week, is not immune from the shocks and stresses. Japan, which has only quite recently emerged from the long twilight of its 1990s banking collapse, has now been hit anew by the global storm. China felt compelled this week to follow western central banks in cutting interest rates. So did a host of smaller Asian countries. Recession in the US and Europe will slow the growth of Asia’s rising economies.

Standing back, though, two things mark out this crisis as unique. First, is its sheer ferocity. I am not sure how useful it is to make comparisons with the 1930s. History never travels in a straight line. What is evident is that governments and central banks have had no previous experience of coping with shocks and stresses of the intensity and ubiquity we have seen during the past year.

The second difference is one of geography. For the first time, the epicentre has been in the west. Viewed from Washington, London or Paris, financial crises used to be things that happened to someone else – to Latin America, to Asia, to Russia.

The shock waves would sometimes lap at western shores, usually in the form of demands that the rich nations rescue their own imprudent banks. But these crises drew a line between north and south, between the industrialised and developing world. Emerging nations got into a mess; the west told them sternly what they must do to get out of it.

The instructions came in the form of the aptly-named Washington consensus: the painful prescriptions, including market liberalisation and fiscal consolidation, imposed as the price of financial support from the International Monetary Fund.

This time the crisis started on Wall Street, triggered by the steep decline in US house prices. The emerging nations have been the victims rather than the culprit. And the reason for this reversal of roles? They had supped enough of the west’s medicine.

A decade ago, after the crisis of 1997-98 wrought devastation on some of its most vibrant economies, Asia said never again. There would be no more going cap in hand when the going got rough. To avoid the IMF’s ruinous rules, governments would build their own defences against adversity by accumulating reserves of foreign currency.

Those reserves – more than $4,000bn-worth at the present count – financed credit in the US and Europe. There were other sources of liquidity, of course, notably the Fed and the reserves accumulated by energy producers. It also took financial chicanery to turn reckless mortgage lending in to triple A rated securities. But as a Chinese official told my FT colleague David Pilling the other day: “America drowned itself in Asian liquidity.”

Owning up to the geopolitical implications will be as painful for the rich nations as paying the domestic price for the profligacy. The erosion of the west’s moral authority that began with the Iraq war has been greatly accelerated. The west’s debtors cannot any longer expect their creditors to listen t

Health insurance- you have a $10.00 co pay, paid, but we charge $75.00 but your insurance only pays $25.00 so you owe us $50.00 and they only cover 2 a year so you owe us $425.00

It is things like that I want changed.

I want a national healthcare. Government regulated, not ran. If per incident charges exceed $5000.00 then this policy kicks in and covers. Just like car insurance does. Clear set understandable rules.

And flex savings that don’t go away at years end to pay for glasses, dental and prescriptions, that cost us citizens the same as in Canada or on the Internet.

IT WAS GOVERNMENT THAT GOT US INTO THIS!!! THEY NEED TO GUIDE US OUT!! Employer-based coverage came about during World War II under FDR as a result of the National War Labor Board’s decision to institute wage and price freezes in an attempt to prevent production shortages due to labor unrest or inflation. The freeze was not applied to fringe benefits like health insurance, allowing employers to compete for skilled workers by offering ever-increasing health insurance coverage. Workers grew accustomed to receiving health benefits from their employers; making employer-provided health benefits became an American institution

AND YES THEY SHOULD BE TAXED,

By taxing them they are back to income not a hidden source for the wealthy to play and not pay

And when you check out of the hospital, or leave a doctors office, bill must be presented in full at time of check out or it is no longer owed. No more three-month latter you owe a or that. It wouldn’t fly at a motel or at a restaurant should not be allowed in healthcare