http://content.healthaffairs.org/cgi/content/abstract/28/1/103

To be fair to Mass Health. They did improve the percent having health care. However, they clearly underestimated the costs.

Given enough money getting universal coverage is easy. Managing cost is the hard part

I have been an insurance broker in the state of Illinois for the past 13 years and I have seen first hand what happens when an over burdened, tax funded, Government controlled, entitlement program like Medicaid is offered to everyone regardless of income. Several recent Medicaid entitlement “expansion” programs have been enacted in our State by Governor Rod Blagoyevich (Democrat) http://blogs.wsj.com/health/2008/12/18/blagojevich-a-childrens-hospital-and-medicaids-stingy-ways/ In fact, our state was the first to expand these Medicaid entitlement programs to include the “All Kids Covered” plan http://www.allkidscovered.com the “Mom’s & Babies” plan http://www.allkids.com/pregnant.html and the “Family Care” plan http://www.familycareillinois.com/

These entitlement programs not only provide free health insurance coverage to all low income women who are currently pregnant (”Mom’s & Babies”) and all children - here legally or otherwise (”All Kids Covered”) but it also provides free health insurance to all low income mothers of children who are insured under the “All Kids Covered” program (”Family Care”). One does not need an actuarial degree to quickly conclude that these types of entitlement expansion programs simply can not work because the “All Kids Covered” program is available to any child regardless of household income levels (there is a small premium required based on a sliding scale if you are above the poverty level). Therefore, quite literally, “all kids” can enroll.

This is most troubling, because the State of Illinois is currently $1.5 Billion (yes that’s BILLION) behind in payment of claims to medical practitioners who have provided treatment for Medicaid recipients. Furthermore, submitted claims by unpaid practitioners have “accrued a potential liability” of $81 million in interest due to payment delays over the past 8 years! http://www.mysuburbanlife.com/broadview/archive/x1874998363/Illinois-must-fix-Medicaid-woes

Yet, we still hear the Democrats pushing for more expansion of the Federal and State Medicaid entitlement programs. In fact, Illinois was lauded as the “Flagship” state for all others to follow regarding the expansion of the Medicaid entitlement programs. If this is the template for all others to follow, then god help us all, or at least those of us that actually fund the Medicaid system through our hard earned tax dollars. Weighty decisions such as expanding the Medicaid system to all kids regardless of their actual need, simply can not be made based entirely on emotion! Prudent decision makers must weigh the DESIRE to help all mankind against the fiscal REALITY.

There simply is not enough money to provide such irresponsible expansions of the Medicaid program. This is expressly why President Bush vetoed the expansion of the SCHIP program http://www.nytimes.com/2007/10/03/washington/03cnd-veto.html which was pushed irresponsibly forward by the Democratic Party. The Conservative side of the House shares the same concern for those in need. However, this side of the House wishes to help those who are deserving of such entitlements (e.g. legal residents of this country who actually qualify during a legitimate needs assessment).

Expansion of these entitlement programs to anyone else is a well meaning, but a fiscally irresponsible act. One that, in the end, will end up crippling the already over burdened Medicaid system. This will especially be true when the “Baby Boomers” all start entering the assisted living arena without Long Term Care coverage to help shoulder the burden of the ever increasing cost of professional care that will, without a doubt, be needed for this gigantic population of new senior citizens.

This can all be avoided by shifting the risk where it belongs. Namely, the private health insurance industry. This is where the money is, and always has been, to shoulder this burden. But this paradigm shift will require personal responsibility - a concept rarely spoken of during the current Democratic Presidential election. Instead, we here how broken our country is and how the current presumptive Democratic presidential candidate is going to “change” everything for the better.

If changing everything for the better is how his party has handled things here in his home state, then this is a recipe for disaster. One that will not only cripple the current Medicaid entitlement programs, but may very well cripple the future of all other desperately needed entitlement programs that are designed to protect those who are truly deserving of such services.

Those of us who are in need of health insurance have many options to choose from. These options are priced very affordably, most especially so if one takes advantage of the recently expanded tax incentives awarded to those who own HSA qualified HDHP’s http://www.sbisvcs.com/Health%20Insurance%20products.htm Even if one can not qualify for the aforementioned HDHP option due to underwriting restrictions, then there are many other options now available to those who have been rendered “uninsurable” in the individual health insurance market.

These options include the following:

1.) State Insurance Risk Pool Coverage provided under HIPAA http://www.naschip.org/states_pools.htm

2.) Small Group or Employer Sponsored Health Insurance which contains the all important “Guaranteed Insurability” clause.

and

3.) HIPAA certified “Defined Benefit” Health Insurance policies issued on an individual basis to anyone regardless of medical history http://www.sbisvcs.com/guarantee_issue.htm

An integral part of making fiscally sound responsible decisions, means you must explore ALL of your options before leaning on a Medicaid system that is already over burdened by those deserving, and most recently, those who are undeserving.

This is why it is always prudent to consult with a reputable and knowledgeable health insurance broker (not a captive agent who can only offer one company’s products). It does not cost a penny more to buy your health insurance using a broker than to purchase it blindly on the internet. That being said, why not take advantage of the wealth of knowledge accumulated by insurance brokers all over this great country of ours? The majority of them truly have your best interests at heart, and will do their very best to guide you in the right direction to properly secure your financial future.

This is most important now, since one can only assume that the quality of care (e.g. ordering expensive follow up tests to properly diagnose a condition) that a Medicaid recipient receives, must inherently suffer. Simply due to the fact that the practitioner knows in advance that payment for services already rendered is behind, and payment for future services may never come! http://www.mchenrycountyblog.com/labels/Kids%20Care.html

Part of his plan is to expand the role of SCHIP and State Insurance Risk Pools so that those who are rendered “uninsurable” on the individual major medical market have guaranteed insurability through their respective State Risk Pools. Many states already have this option. However states such as Arizona and Florida do not. These states desperately need such Risk Pools. Unfortunately, until now they have not been able to receive enough Federal funding to expand this much needed role. States that do have risk pools are listed here: http://www.naschip.org/states_pools.htm

President Elect Obama wishes to provide more Federal funding to these existing risk pools to drive the premiums down, thereby making this option more affordable for those rendered uninsurable.

One of the reasons that a “nationalized” health care system has never been on Obama’s agenda is most likely due to the terrible failure of such programs in countries such as Canada. A common example used to further the cause of “socialized medicine” in the United States is to point out how well it is working in Canada. However, those living in Canada know full well that their government run health care program is most certainly not working.

As a matter of fact, many Canadian citizens choose to hire high priced brokers to find them quality health care right here in the United States because of the terrible bureaucracy that controls all forms of health care in Canada. For more about what is really going on with the Canadian health care system please watch these short but very informative documentary videos:

http://www.freemarketcure.com/brainsurgery.php
http://www.freemarketcure.com/twowomen.php
http://www.freemarketcure.com/thelemon.php

The number of actual uninsureds in the US has been grossly inflated as well. For the real numbers watch: http://www.freemarketcure.com/uninsuredinamerica.php

The truth of the matter is we already have an enormous amount of entitlement programs available to those who find themselves unable to pay for their health care. Often times these entitlement programs are offered to those who are here legally and illegally as was the case in the State of Illinois: http://www.sbisvcs.com/healthinsuranceblog.htm

Most recently, the State of Hawaii tried to emulate the Medicaid Expansion programs that were enacted in Illinois. It took less than 7 months to render their program bankrupt: http://www.breitbart.com/article.php?id=D93SBEUG0&show_article=1

All things considered, the best way to offset the high cost of health care in the US is to adopt the initiatives set forth over a decade ago by Senator Bill Archer (R) of Texas. The Health Savings Account (commonly referred to as a “Medical IRA”) is a unique option that maintains high quality health insurance coverage for the policy holder whilst also building a tax deductible, tax deferred interest bearing account for the insured to use for future medical expenses. Even if these expenses would not normally be covered by the policy holder’s health insurance plan. For more about the “intelligent health insurance choice” (HSA qualified HDHP’s) please click here: http://www.sbisvcs.com/HSA%20&%20HDHP.html
In the end consumer education and retention of existing Federal entitlement programs (via a legitimate needs assessment test) will go a long way towards not only maintaining our current health care system, but also towards keeping the bulk of our nations risk where it belongs namely, with the private health insurance sector. In light of the recent $7 Trillion “Bail Out” and many other failing corporations coming to the table with their hats in their hands (and their private jets on the tarmac) the last thing our government should do is start cutting more blind “bail out” checks in an effort to “reform” the U.S. health care system.

As noted above, the US murder rate is higher. A majority of those murders are young black males killing other black males. It has nothing to do with health care quality, but it has a major impact on longevity (a small percentage of people dying at 18 has a big negative effect on longevity than a much greater percentage of people dying a few months earlier). Of course, considering how much crime, both violent and non-violent, has increased in Europe, I’d guess that European murder rates will catch up also.

Also, the US treats infant mortality differently. Here in the US we try to save every preemie — and we do succeed with an amazing percentage. But the failures are counted as live births even when they die within a short time period. That hurts our longevity numbers. However, in much of the world, the most extreme preemies have no chance and aren’t counted as live births.

Finally, with national health care systems we are dealing govt. bureaucrats. The first rule of bureaucracy is to CYA. So concealment of bad information is pro forma. And unlike the US, it’s relatively easy for a national system to conceal information. There’s no lawyers to sue or citizens running to the media or their representatives or bloggers to report.

I knew a British girl who was a nanny. She went to Chicago with her nanny girlfriends for New Years Eve. She collapsed/had a seizure when she was leaving a department store and was taken to a hospital for tests and observation.

After returning to her host family, she got a hospital bill for over 100,000.00. Everyone (including me) told her to ignore the bills. She did. Less than a year later, she was back in Britain. She never paid her bills.

Later, I went to visit this girl in Britain. I had a toothache. She told me to go to a dentist and get it checked out. All I could think of was “The Big Book of British Smiles” from The Simpsons. I went anyway.

The dentist filled my tooth. When it was time to pay, the women at reception simply said “National Health”. I was not a citizen or even a resident at the time.

Once back in the States I went to my real dentist and asked her about the work that was done in England. She said, “We don’t use that kind of filling anymore. We use a composite. It’s newer.” However, she never replaced the filling.

True stories. Anybody else got one?

Yes, the U.S. healthcare system is retarded. For once we agree- my wife developed M.S. a few years ago, so I’m tied to this shit job so she can have health insurance.

How can the French do it and we can’t? Are they just smarter than we are? Are you saying Americans are less competent than Frenchmen?

I hate to admit it, but they must be smarter… Rick’s post clearly demonstrates that we can’t seem to implement universal healthcare without increasing the cost, and decreasing the quality.

The French seem happy with their system generally. (No one’s 100% happy about anything, least of all the Fench.) But the French people I know think we are either idiots or crazy on the subject of health care. I tend to agree with them.

Lose your job in France you don’t lose your health care. In this country you do. So we’ve built a system that kicks you when you’re down. Not only do you lose your job, now you can’t get your meds. It’s absurd.

I can’t speak to whether French doctor’s offices are dirtier. When I lived in France as a kid I was under the US military health care system. And while living in Italy recently I didn’t happen to get sick at any point.

But we may be comparing apples and oranges. Since I’m a relatively affluent American I see doctors who typically have very nice offices. (A cost they pass along to me, by the way.) But a poor or working class or unemployed American gets his medical care most often at a clinic or an emergency room. Having been to emergency rooms on occasion, I can tell you they aren’t quite as swank as my kid’s pediatrician’s offices.

We accept as normal all sorts of bizarre issues of American health care. We accept as normal that emergency rooms are overwhelmed by poor people getting non-emergency care. (Poor people often take their kids to emergency rooms that cost thousands of dollars to treat routine ear infections a pediatrician deals with for $50.) We accept as normal that losing your job means your kids can’t see a doctor. We accept as normal that every medical practice in the country has to hire employees whose sole job is negotiating the bureaucracy of private medical insurance. And we accept as normal that the course of a sick person’s treatment is a function of stock dividends at insurance companies. These are not logical or defensible. They are idiocies built into our system.

If it works in France, then by all means, lets copy it. I honestly don’t know. What I do know is that my brother-in-law lives in France, has access to the French healthcare system, and flys back to the U.S. to see doctors or dentists- he says that the doctor’s offices in France are both crowded and dirty. I suppose I could tolerate crowded doctors offices, but dirty?

I admit that I have only that one anecdotal evidentiary point, but it is a real one. Have you had a different experience with healthcare there?