Health Care

I am not sure how much people just don’t know how screwed up our country’s health care system is. First and foremost, rich millionaire/billionaires are making more money on the sick and injured which to me seems so un-Christian to say nothing of being immoral. Drug companies charge 300%-400% more than the cost of producing a drug; hospital charge patients without insurance $5,000 for an MRI but only charge the insurance company $2,000; or a hospital charges $17,000 simply to have an Medivac Helicopter land on its helipad. One faith based hospital has made over a billion dollars in profit in just one calendar year! They in fact have so much cash, they have created their own insurance company for their employees and Medicare patients. PLUS their executives get 6 and 7 figure salaries.

Now ObamaCare or the Affordable Care Act was not perfect. It had it issues, but people need to understand that addressing a single issue in healthcare does NOT resolve the problem. To bring healthcare cost in line you need to address insurance company premiums, health care costs, and tort reform. Healthcare since the beginning has been based on a “cost shifting” principle of cost and charges for services. Essentially, the cost of healthcare includes the cost of providing the service plus losses due to bad debt (those that don’t pay) PLUS the losses due to what insurance companies do not cover PLUS cost of administrative/executive salaries and parachutes PLUS a profit margin. Those costs are then offset by premiums, investment incomes, or reduction of payments to providers. Now, if cost increase, then premiums go up – we’ve all seen that; but what if healthcare cost decrease? Well, in over 40 years I have NEVER seen premiums go down – NEVER. If one element of healthcare cost decrease, they just increase the profit margin or executive salaries to justify the premiums OR negotiate the payments to healthcare providers to decrease their payments and increase their profits.

Now granted, some healthcare providers over charge – by a LOT – but other healthcare providers are just barely able to make ends meet. So much so that as reimbursement from insurance companies decrease, the level of services (and therefore cost) on the part of the provider are decreased. Maybe staff is cut; or that old xray machine goes unrepaired; or hours are changed; or the provider simply drops patients that have certain insurance coverages and patients are forced to find new physicians.

Now the GOP has come along to try to put their own spin on HealthCare calling it the American HealthCare Plan. It does NOT address many of the problems with the AHC Act but compounds it and makes it worst. Now granted the current proposal is going to be changed, but here are some facts about the GOP plan as presented:

The “Cadilac tax” – the tax that is charged to individuals for having a comprehensive health care plan – remains;

The Top 1% who earn more than $774,000 would average a $33,000 tax cut according to the Tax Policy Center; the top 0.1% would get an average tax cut of $197,000.

You can contribute more to a health savings account (HSA) but you have to have the money to invest into the HSA. If you don’t have the money to begin with you cannot contribute to the HSA. The proposed HSA contribution has gone from $3,400 to $6,550 per year for a single person.

Under the current plan, an individual making more than $47,500 is not eligible for a subsidy but under the GOP plan, if an individual make up to $75,000 they can claim the full tax credit. The tax credit will not be based on income but the age of the insured and ranges from $2,000 to $14,000/year with the higher tax credits going to those around 27 years old and making the maximum of $75,000; and those with the lowest tax credits being individuals around 60 years old and making less $50,000.

There will be no mandate for insurance coverage. What this means is that the public tax dollars will subsidize younger users of the healthcare system (yea, taxpayers will end up paying either way). For example, the young driver of an automobile involved in a serious auto accident with no health insurance, could easily rake up cost of over $250 thousand dollars. Auto insurance may pay $10,000 leaving the balance of $240,000 un-paid and in most cases coming out of tax payer coffers under increase taxes to subsidize hospital services or increased state taxes to cover Medicaid costs.

What the politicians failed to recognize in their development of the AHA was that people are going to pay as little as they have to if they are mandated to get insurance. Think about – you are in your twenties, you make around $25,000 a year and you are mandated to get health insurance. Your choice is a silver plan that has a maximum out of pocket of $2,300 but you pay $100 per month in premium and the government subsidies the remaining $350/month; OR, you choose the bronze plan that has maximum out of pocket of $6,000 but your monthly premiums are only $5.00 per month.  It would seem to be a no brainer… pay $1200 a year or $60 a year out of your $25,000?…you’re young, nothing is going to happen to you, beside you really don’t need insurance but the government says you have to have it. You will go with the least expensive insurance policy. And then BAM!!!!! Something happens, you have appendicitis and you now have a $33,000 hospital bill. Under the bronze plan, your maximum out of pocket is $6,000 but that is $6,000 you don’t have so you are now $6,000 in debt and you curse the day you got the health insurance because it didn’t cover your health care needs. It didn’t cover your health care not because of the system, but because you were being short sighted and wanted to save that money.

Now what if there was no mandates. Well I have seen it time and time again, particularly with motorcycle accidents.  The motorcycle rider is not wearing a helmet, loses control, slams against the tree and is knock unconscious. Upon waking up in the hospital, they are paralyzed from the neck down.  They have no PIP coverage on a motorcycle, no medical benefits, no health insurance, but is now faced with millions of dollars of lifetime care. So what happens, the patient ends up on Medicaid to cover their health care costs and guess who pays for Medicaid – you and I – the taxpayer.

Even the pre-AHA was not perfect. I know of a patient that is on Medicaid that has racked up over $85,000 in ambulance bills. She gets transported to the hospital every two-three days and Florida Medicaid pays a portion of that bill each time. Why hasn’t someone recognized that there is a problem here? This is over use and abuse of the Medicaid program all at the expense of the taxpayer. But government turns a blind eye to the problem and they want to know why people are so pissed about the state of Health Care in the United States. This patient cannot be held financially responsible for their overuse of the service so there is no disincentive for the patient to stop the abuse. They will continue to take advantage of free rides to the hospital as long as government allows it to happen.