Comments Posted By C. Steven Tucker
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Medicaid Expansion Programs Buckle Under Stress of "Open Enrollment"

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) In fact, our state was the first to expand these Medicaid entitlement programs to include the "All Kids Covered" plan the "Mom's & Babies" plan and the "Family Care" plan

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!

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 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 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

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


3.) HIPAA certified "Defined Benefit" Health Insurance policies issued on an individual basis to anyone regardless of medical history

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!

Comment Posted By C. Steven Tucker On 14.01.2009 @ 09:19

"Socialized Medicine" is primarily an ideology championed by the Democrats. However, contrary to popular belief, a nationalized health care system for all American's has never actually been on the agenda for President Elect Obama His agenda instead has always been to assist those who are rendered uninsurable and or are in need of assistance in obtaining health care coverage due to low income.

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:

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:

The number of actual uninsureds in the US has been grossly inflated as well. For the real numbers watch:

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:

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:

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:
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.

Comment Posted By C. Steven Tucker On 13.01.2009 @ 20:29

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