What’s wrong with America’s Health Care System?
When I first got into sales my boss at the time told me that in order to sell you had to do three things.
1. Tell ‘em what you’re gonna tell ‘em.
2. Tell ‘em.
3. Tell ‘em what you told ‘em.
Here in this first chapter I am going to accomplish step 1. I’m going to tell you what I’m about to tell you. The problem with anything that is this deeply ingrained and a part of our culture is that there is more than just one thing wrong. There are actually about fifteen individual problems all together leading up to a system that doesn’t work. It doesn’t work for employers, health care customers, doctors, hospitals, health insurance companies, drug companies, politicians on either side of the aisle or offices of insurance commissioner.
While it doesn’t work for any of them they all bear responsibility for what’s wrong.
There are four pieces of good news with all of this though.
1. It can be fixed.
2. Government can’t do it.
3. By following a simple path and doing it quickly it will work better and EVERYONE in the process will be better off within a period of months.
4. It can be done one person at a time leading to less overall chaos.
But before the solution makes any sense you’ll first have to understand how we got here, ergo the next two thousand words.
Problem Number One: Health care has been lumped in with health insurance. When you hear the numbers of people in the United States who are without health care those numbers are an out and out lie. Everyone has access to health care in this country. The hard fact is you cannot be turned down. The numbers you hear are the numbers of people who for whatever reason do not have health insurance. For some it’s that they don’t understand the need for insurance. For others it’s that they can’t afford it. And for some it’s that they don’t want to afford it. Health Care an Health Insurance should never be intermingled. Would you ever entangle car care with car insurance? No! Car insurance is there to pay for repairs due to an accident. It’s not there to pay for maintenance, gas or simple repairs. Which leads us to…
Problem Number Two: On the surface this may look like a repeat of number one, but it’s not. Health Insurance should be like other insurance it should be there to cover you in the event of a catastrophic loss. Is a $50.00 Doctor visit a catastrophic loss? No! Yet that is where roughly 90% of the claims that are file go to pay. The part that no one here wants to tell you is that premiums are based on the number and totals of claims paid. And the other part of this equation is that insurance companies need to operate at a profit. That is required by law. If an insurance company does not operate within a certain window of profit the offices of insurance commissioner shut them down. What this means to customers of health insurance is that when you pay your health insurance company to pay for your doctor visits you are paying an inflated price for that doctor visit. Plus if you are typical customer visiting roughly twice a year you are also paying for others in your risk group who use more doctor visits for their additional doctor visits. Which leads to…
Problem Number Three: Because our health insurance system is an employer based system the insured has no ownership in the policy. Ownership begets stewardship. Look for a second at rental cars. Rental cars do not get the car when they are driven that a car that is owned by the driver. The problem with not owning a health insurance policy is that it becomes an entitlement. An entitlement is ALWAYS-expected, over-used and under-appreciated. The supplier of the entitlement is generally abused over the entitlement and the entitlement is always complained about. It is never enough. It is never good enough. And it is always a source of complaint from the entitled. AND because it is called health care and not health insurance it is completely misunderstood. Even though the employee pays for it with lower wages and less choice the entitled never writes a check for the care and therefore it carries with it extra layers of abuse. The employee sees the deduction for the amount the health insurance costs him and resentment builds causing more use. “If I’m paying for it I really should use it.” The employee grumbles as he trots his family into the doctor with a slight grin of satisfaction at having pulled one over on the entitler. While there are some who do appreciate it what we are talking about is the general attitude taken by the entitled. It is generally one of dissatisfaction with the entitlement. Because health care is never paid for and taken for granted health too is taken for granted. Which leads to…
Problem Number Four: When there is no price there is no perception of value. When there is no perception of value there is no interest taken in the item received. People have come to look at their health differently because of employer based health care. Because they have no financial stake in their health care policy they have taken to looking at their poor health as something over which they have no control. The fact is that most of the things for which we take pills are lifestyle issues. Among those are heart disease, high blood pressure, high cholesterol, cancer, diabetes, asthma, arthritis - the list could go on. We have come to look at ourselves as victims of our health. When in reality of the things in our life we really have more control over than almost anything health is at the top of the list. Many of the things on the list can be overcome or avoided with diet and exercise. Others still are a function of our emotions and mindset. But because we have no stake in our health care we take no interest in it. Which leads to…
Problem Number Five: Unnecessary and overused doctor office calls. Stand by for a bit of news insurance premiums are based on payment of claims. Doctors visited because insurance covers it leads to an overuse of claims which leads to excessive health insurance AND health care costs. Too many doctor visits are paid by insurance companies for things that should never walk into a doctor’s office. If you go to the doctor for high blood pressure pills the doctor should tell you that you need to lose weight and exercise, but that would mean the doctor would lose another appointment from you in six months PLUS he would probably lose you across the street to the doctor who would give you what you want which is a quick and easy fix – a pill. Which leads to…
Problem Number Six: Too many medications – both prescribed and available. The drug companies have got so much invested in research and regulatory approval that they must pump out a new drug it appears every week. You cannot turn on the TV without seeing an ad for a drug. (Do we really need the shots of the lurid glances and the symbolic bathtubs overlooking the ocean, accompanied by the disclaimer about erections lasting more than four hours?) It seems that everywhere you look there are drug pushers. Drugs on TV, your doctor and his ever handy prescription pad, even your next door neighbor telling you about her latest prescription. People here is a hint, we all have anxiety. Get used to it. There are some estimates that claim that over 90% of the drugs that are prescribed are unnecessary. Some estimate lower. I have been in the health insurance industry for more than half a decade and I go for the higher number. I’ve seen people that are apparently very healthy at the age of 35 already loading up in the pills. I have met with older people who started out with a high blood pressure medication ten years ago who now carry a pharmacy with them. Here is the most frightening fact about prescription drugs I have ever come across; in order for a drug to get FDA approval it MUST be a toxin! Do you get that folks? In order for a drug to be a drug it must also be a poison! Which leads to…
Problem Number Seven: Doctors get paid so little for what they do that they have to see many more patients every day than they can properly treat. PLUS it’s the health insurance company that is really making the call on your treatment anyway. Doctors treat symptoms only. They don’t offer cures. Go ahead ask your doctor next time to give you a cure rather than pill. See how he answers. Which lead to…
Problem Number Eight: Health care – because treatment is prescribed by the health insurance companies – is inferior. Both HMOs and PPOs tell your doctor how you should be treated. Now the doctor is free to tell you whatever he wants but at that point he is liable for costs should you pursue that option and the health insurance company doesn’t approve of his recommendation. Remember doctors too have a business to run. If it is costing them money to treat you – even though you may believe he really, really, likes you, and you are his favorite patient – he probably will stick with the treatment course for which he knows he will get paid. This is – with the rare exceptions of cancer – always the treatment of symptoms. If your doctor tells you to toughen up and get therapy instead of complaining about your anxiety attacks he won’t get to see you for a meds check and you probably will go to another doctor to get pills anyway. Which leads to…
Problem Number Nine: Doctors get incentive from the drug companies to give you pills. Trips, gifts and sometime even cash go to doctors who prescribe certain pills for their patients. Enough said about that one.
Problem Number Ten: What you are billed and what the insurance company pays are really very different. You want to have the insurance company pay for your doctor visits, because you see the bills from the doctor that says you owe $250.00 for the five actual minutes you had with the doctor. You don’t care that the insurance company only paid $50.00. You’re just glad you didn’t have to fork over $50.00 per minute! Because of what has happened with health care in the U.S. there is no transparency or honesty in billing. The doctor has to bill you $250.00 to get the $50.00 from the insurance company. That is part of their deal! Doctor agrees to bill $250.00 for a certain type of office visit and also agrees to accept $50.00 as payment in full. In reality the visit was worth only $30.00 but with the added costs of billing the insurance company the doctor needs to collect $50.00 just to keep the shingle on the side of the building.
There are more and I will get into them plus all that I’ve just mentioned deeper over the next few chapters. Remember – I just told you what I’m gonna tell you. Next comes me telling you.
Copyright 2009 Dennis Rowley
Wednesday, April 22, 2009
Thursday, April 16, 2009
Can the Government Really Provide Good Health Care?
Can the Government Really Provide Good Health Care?
Let’s put the favorite tool of the liberals – emotion - aside for a few minutes. We’ll get back to that soon – TRUST ME! Emotion aside let’s look logically at health care first. First of all what the government is calling “health care” is really health insurance! Health care is doctor visits and hospitalization.
Here is my first and most important logical point. You can go into the doctor without health insurance. In fact you not only can you should! It will cost you less overall if you do. If you pay for a health insurance policy where there is a low deductible to pay for doctor visits it will cost you more per year than you would ever go for visits. If you don't have the $50 that it takes to visit a doctor many doctors will work with indigent, OR you can go to a county clinic. No one has to go without health care. That’s the logical part.
The emotional part is that the doctor will treat you better. He will have more time to spend with you. You will be treated as a patient – not a number or a customer. For a simple sick visit the doctor will be do the work for around $50.00. For a well visit he will charge a little bit more. The emotional part of this is that you got treated better for a small amount of money.
Logical point number two goes like this. You can go to a hospital without insurance as well. You have two options here. The first is that you can go and make payment arrangements. If you are able to keep up the payment arrangements they will collect on you so it is best to have insurance for hospitalizations – ALWAYS! IF YOU CANNOT PAY HOWEVER – and you know that going in, you can apply for charity care. You will be labeled as indigent – which affects some other things in your credit and such so again so it is best to have insurance for hospitalizations – ALWAYS!
But the point is you don’t need it. Hospitals cannot turn you away.
Now let’s talk logically about government control for a second. How well does the government run ANYTHING? Let’s look at Amtrak – our Vice President’s claim to fame. Has Amtrak ever operated at a profit? How about your local transit system? No millions – or in the case of Amtrak billions – of dollars goes into running it every year. And since we are talking about government run health care lets look at the two three that our Federal Government runs right now – the Veterans Administrations Hospitals system, Medicare and Medicaid. In my experience veterans tell me all the time that the Army will kill you one way or the other. The first is in war the second is in the VA hospital. While they usually smile when they say it there is a deep sadness to their joke. How sad that we treat our returning hero soldiers and sailors like that.
Then let’s go to Medicare. First of all it is going broke. Secondly it does not even begin to cover many of the costs that retired people will accumulate. Those costs must be covered with a secondary policy from a private insurance company – called a supplement. OR the senior can have Medicare make premium payments toward a private health insurance company under a program called Medicare Advantage. This is generally infinitely better coverage but again Medicare cannot afford to pay for all coverage on the top of the line plans and the Medicare recipient must a pay a portion of their premiums AND Medicare is still going broke!
Our last stellar example of Government Health Care is Medicaid. Talk to any proponent about Medicaid and watch them quickly change the subject. The program is going broke at a record breaking pace. The care is woeful and ALL Medicaid patients are treated disgracefully. If you doubt that just go to the ward side of your nearest Nursing Home. What goes on there is deplorable.
So much for the logical part of the government running our health care – now let’s tackle the emotional side. Imagine your child now hit by a car crossing the street. Your child is taken by ambulance. If that is government, how soon will it get there? Plus based on the fact that even our local governments are charging now for ambulance and paramedic services you may still have to pay. (Medicare doesn’t pay 100% for ambulance.) So let’s imagine that your child must lie in the street for even five minutes more than a private ambulance service would offer. How does that make you feel?
Now once he gets to the hospital how long does he have to wait in the E.R? Let’s say that with typical waits for universal health care in other countries he has to wait even another 15 minutes longer than he waits now, how does that feel?
Surgery is needed. Surgical wait times in other universal health care systems averages between days and months. Even in critical cases.
Now go to your nearest Nursing Home and go to the ward side – the Medicaid side - and imagine your child waiting for hours to get a diaper changed, or his pain meds. Imagine your child is now in distress and ringing the nurses bell and no one comes. That is what happens now in our government run health care system now.
How does that make you feel?
Now let's answer the favorite emotional plea of proponents of Universal Health Care. "There are over 50 Million people without health care in the United States!" Remember the first paragraph in this post. I stated that 50 million people do not have health insurance. That is because health insurance is expensive. That however is a free market problem that cannot be legislated out of existence.
There are solutions and those will happen soon.
I started out with a question. I will ask it again. Can the Government Really Provide Good Health Care?
Copyright 2009 Dennis Rowley
Let’s put the favorite tool of the liberals – emotion - aside for a few minutes. We’ll get back to that soon – TRUST ME! Emotion aside let’s look logically at health care first. First of all what the government is calling “health care” is really health insurance! Health care is doctor visits and hospitalization.
Here is my first and most important logical point. You can go into the doctor without health insurance. In fact you not only can you should! It will cost you less overall if you do. If you pay for a health insurance policy where there is a low deductible to pay for doctor visits it will cost you more per year than you would ever go for visits. If you don't have the $50 that it takes to visit a doctor many doctors will work with indigent, OR you can go to a county clinic. No one has to go without health care. That’s the logical part.
The emotional part is that the doctor will treat you better. He will have more time to spend with you. You will be treated as a patient – not a number or a customer. For a simple sick visit the doctor will be do the work for around $50.00. For a well visit he will charge a little bit more. The emotional part of this is that you got treated better for a small amount of money.
Logical point number two goes like this. You can go to a hospital without insurance as well. You have two options here. The first is that you can go and make payment arrangements. If you are able to keep up the payment arrangements they will collect on you so it is best to have insurance for hospitalizations – ALWAYS! IF YOU CANNOT PAY HOWEVER – and you know that going in, you can apply for charity care. You will be labeled as indigent – which affects some other things in your credit and such so again so it is best to have insurance for hospitalizations – ALWAYS!
But the point is you don’t need it. Hospitals cannot turn you away.
Now let’s talk logically about government control for a second. How well does the government run ANYTHING? Let’s look at Amtrak – our Vice President’s claim to fame. Has Amtrak ever operated at a profit? How about your local transit system? No millions – or in the case of Amtrak billions – of dollars goes into running it every year. And since we are talking about government run health care lets look at the two three that our Federal Government runs right now – the Veterans Administrations Hospitals system, Medicare and Medicaid. In my experience veterans tell me all the time that the Army will kill you one way or the other. The first is in war the second is in the VA hospital. While they usually smile when they say it there is a deep sadness to their joke. How sad that we treat our returning hero soldiers and sailors like that.
Then let’s go to Medicare. First of all it is going broke. Secondly it does not even begin to cover many of the costs that retired people will accumulate. Those costs must be covered with a secondary policy from a private insurance company – called a supplement. OR the senior can have Medicare make premium payments toward a private health insurance company under a program called Medicare Advantage. This is generally infinitely better coverage but again Medicare cannot afford to pay for all coverage on the top of the line plans and the Medicare recipient must a pay a portion of their premiums AND Medicare is still going broke!
Our last stellar example of Government Health Care is Medicaid. Talk to any proponent about Medicaid and watch them quickly change the subject. The program is going broke at a record breaking pace. The care is woeful and ALL Medicaid patients are treated disgracefully. If you doubt that just go to the ward side of your nearest Nursing Home. What goes on there is deplorable.
So much for the logical part of the government running our health care – now let’s tackle the emotional side. Imagine your child now hit by a car crossing the street. Your child is taken by ambulance. If that is government, how soon will it get there? Plus based on the fact that even our local governments are charging now for ambulance and paramedic services you may still have to pay. (Medicare doesn’t pay 100% for ambulance.) So let’s imagine that your child must lie in the street for even five minutes more than a private ambulance service would offer. How does that make you feel?
Now once he gets to the hospital how long does he have to wait in the E.R? Let’s say that with typical waits for universal health care in other countries he has to wait even another 15 minutes longer than he waits now, how does that feel?
Surgery is needed. Surgical wait times in other universal health care systems averages between days and months. Even in critical cases.
Now go to your nearest Nursing Home and go to the ward side – the Medicaid side - and imagine your child waiting for hours to get a diaper changed, or his pain meds. Imagine your child is now in distress and ringing the nurses bell and no one comes. That is what happens now in our government run health care system now.
How does that make you feel?
Now let's answer the favorite emotional plea of proponents of Universal Health Care. "There are over 50 Million people without health care in the United States!" Remember the first paragraph in this post. I stated that 50 million people do not have health insurance. That is because health insurance is expensive. That however is a free market problem that cannot be legislated out of existence.
There are solutions and those will happen soon.
I started out with a question. I will ask it again. Can the Government Really Provide Good Health Care?
Copyright 2009 Dennis Rowley
Wednesday, April 15, 2009
(FUTURE) Presidential Address to the Nation
(FUTURE) Presidential Address to the Nation
Date July 25, 2011 (Speech entirely read from teleprompter.)
Good Evening.
As you know three years ago the congress of the United States, under my direction, courageously passed the most comprehensive health care reform bill in our country’s history. In this bill were the tools for the entire country to receive free health care. Now, prior to the passage of this bill almost 56 million American were without health care due to the exorbitant and ever-rising costs.
Since congress passed this bill we have seen access to doctors increase and prescription drug prescriptions rise at levels never seen before. It is apparent from the results that we have seen that Americans truly needed this relief from the rising costs of health care. We have also seen the overpaid doctors and over charging hospitals get their fair due by restricting payments to this obviously overly-rich segment of the population. As a result enrollments in medical schools are down giving us the unexpected happy consequence of lowering costs for our comprehensive college reform program.
This is all good news.
But we have also found that the cost for this program has exceeded our expectations. Simply stated our health insurance program is going broke. Now after a two year study of this we have determined that the cause for this could never be predicted by us because we could never have foreseen the rush to the medical centers for the obviously needed medical treatments the poor, uninsured and underinsured are now receiving. It seems that because of our efforts at health care reform our claims are up at rates never predicted. Simply put we are going to the doctor more and that is costing our health care program more.
So tonight I am announcing our new health care reform reform. Because of the overtaxing of the system we will increase taxes on those who can best afford it. Now first of let me state, that those exempt from this tax will be as follows; the poor, the obese, the infirm, those with high blood pressure and high cholesterol. We will also be offering a health care credit – your checks will becoming soon – to those with diabetes, heart disease and cancer plus debilitating conditions like asthma, multiple sclerosis and lupus, as well as fibromyalgia, ADHD and depression.
Because of the fuel savings and the extra income of those in our population who do not need to take off from work and drive to the doctor’s office because they do not need doctor’s care on a regular basis. We will be getting the much needed money from those who do not need medical care. This only makes sense. Those who have good health should pay for those who, through no fault of their own, do not.
This program is called the Pretty Health Alternative Tax – or our PHAT tax. All healthy American are hereby ordered to visit a health care center within the next 30 days to be tested, weighed and measured to determine the level of taxes you will pay. Now because we already have health records for the infirm through our Drug Czar program you will very soon be receiving a letter informing you of the new accelerated level free care or the health care credit you will receive.
Thank you.
Editor's Note: You think this can't happen. Think again look at what has already happened in less than 100 days. Our current President is serious about this and apparently no one in congress in either party is serious about stopping him.
email me a healthdennis@gmail.com
Date July 25, 2011 (Speech entirely read from teleprompter.)
Good Evening.
As you know three years ago the congress of the United States, under my direction, courageously passed the most comprehensive health care reform bill in our country’s history. In this bill were the tools for the entire country to receive free health care. Now, prior to the passage of this bill almost 56 million American were without health care due to the exorbitant and ever-rising costs.
Since congress passed this bill we have seen access to doctors increase and prescription drug prescriptions rise at levels never seen before. It is apparent from the results that we have seen that Americans truly needed this relief from the rising costs of health care. We have also seen the overpaid doctors and over charging hospitals get their fair due by restricting payments to this obviously overly-rich segment of the population. As a result enrollments in medical schools are down giving us the unexpected happy consequence of lowering costs for our comprehensive college reform program.
This is all good news.
But we have also found that the cost for this program has exceeded our expectations. Simply stated our health insurance program is going broke. Now after a two year study of this we have determined that the cause for this could never be predicted by us because we could never have foreseen the rush to the medical centers for the obviously needed medical treatments the poor, uninsured and underinsured are now receiving. It seems that because of our efforts at health care reform our claims are up at rates never predicted. Simply put we are going to the doctor more and that is costing our health care program more.
So tonight I am announcing our new health care reform reform. Because of the overtaxing of the system we will increase taxes on those who can best afford it. Now first of let me state, that those exempt from this tax will be as follows; the poor, the obese, the infirm, those with high blood pressure and high cholesterol. We will also be offering a health care credit – your checks will becoming soon – to those with diabetes, heart disease and cancer plus debilitating conditions like asthma, multiple sclerosis and lupus, as well as fibromyalgia, ADHD and depression.
Because of the fuel savings and the extra income of those in our population who do not need to take off from work and drive to the doctor’s office because they do not need doctor’s care on a regular basis. We will be getting the much needed money from those who do not need medical care. This only makes sense. Those who have good health should pay for those who, through no fault of their own, do not.
This program is called the Pretty Health Alternative Tax – or our PHAT tax. All healthy American are hereby ordered to visit a health care center within the next 30 days to be tested, weighed and measured to determine the level of taxes you will pay. Now because we already have health records for the infirm through our Drug Czar program you will very soon be receiving a letter informing you of the new accelerated level free care or the health care credit you will receive.
Thank you.
Editor's Note: You think this can't happen. Think again look at what has already happened in less than 100 days. Our current President is serious about this and apparently no one in congress in either party is serious about stopping him.
email me a healthdennis@gmail.com
Tuesday, April 14, 2009
What is Insurance?
What is Insurance?
Insurance has always been a way for you to invest in protection against a catastrophic financial loss.
Here is how pure insurance is set up. Let’s say that you need a policy to protect you against the financial loss from breaking your arm. Let’s call this a broken arm policy. Let’s say now that you want this policy to replace lost income of $10,000.00.
Now the insurance company actuary has determined that broken arms occur twice in every 1000 people every year. (This is made up for the purposes of the example. Don’t quote me on the incidence of broken arms!) Now the actuary can accurately determine through his formulas how many people will break their arms out of 1000, he just doesn’t know who.
Now also through their research they determine that if the policy is priced at a level of $20.00 per year that 2000 people will buy the policy. So the insurance company issues 2000 policies at a cost of $20.00 per year. The total collected is $40,000.00. The insurance company is wagering profit on the fact that only two people will file claims for the $10,000.00 for a total in paid claims of $20,000.00. The other $20,000.00 is for operating costs and cost of sales, etc.
Now the cost of $1.66 per month per individual obviously made it worth the risk for 2000 people. The risk for the insurance company was determined through extensive research and after that research they also felt it worth the risk. In this situation the insurance company actuaries predicted the number of claims perfectly and everyone was happy.
BUT as you can see the business of insurance actuarial tables is truly an art. If the actuary underestimated by even one profit was gone. If he missed by two, the company lost money. So if the company decided that they were going to offer the policy again the next year and their claims totaled $30,000.00 they would have to adjust the premiums.
IMPORTANT POINT: Claims paid determine the premium of policies.
Insurance companies assume a lot of risk. That could be why some insurance companies go out of business ever year.
Let’s now shift gears for a second and talk about what is being sold as “health insurance” right now. Based on current claim data provided by Mutual of Omaha, most insurance claims (around 70%) are for procedures less than $2000.00. with about half of those claims totaling less than $250.00 each.
The point here is that health insurance has become less about protecting against catastrophic financial losses and more about the insurance paying for doctors visits. Now remember in the broken arm policy example the insurance company assumed risks based on their ability to make a profit. What is called “health insurance” now is no different. Your health insurance carrier must also make a profit or next year they will join the insurance companies that go out of business. So what happens is that you pay your health insurance company premiums approximately one and one half times the actual costs of total claims paid for your risk group.
The average person goes to the doctor two and one half times per year. Only 7% of people actually file a claim for costs exceeding $2000.00 for a single claim. That is for a hospital stay with the average hospital stay costing around $20,000.00.
Question 1: Does it make sense to pay your “health insurance” company almost $5000.00 a year to cover doctor visits when they cost less than $250.00 per visit?
Question 2: Would it make more sense to write policies that only covered the cost of hospital expenses?
If you have questions please contact me at healthdennis@gmail.com
Insurance has always been a way for you to invest in protection against a catastrophic financial loss.
Here is how pure insurance is set up. Let’s say that you need a policy to protect you against the financial loss from breaking your arm. Let’s call this a broken arm policy. Let’s say now that you want this policy to replace lost income of $10,000.00.
Now the insurance company actuary has determined that broken arms occur twice in every 1000 people every year. (This is made up for the purposes of the example. Don’t quote me on the incidence of broken arms!) Now the actuary can accurately determine through his formulas how many people will break their arms out of 1000, he just doesn’t know who.
Now also through their research they determine that if the policy is priced at a level of $20.00 per year that 2000 people will buy the policy. So the insurance company issues 2000 policies at a cost of $20.00 per year. The total collected is $40,000.00. The insurance company is wagering profit on the fact that only two people will file claims for the $10,000.00 for a total in paid claims of $20,000.00. The other $20,000.00 is for operating costs and cost of sales, etc.
Now the cost of $1.66 per month per individual obviously made it worth the risk for 2000 people. The risk for the insurance company was determined through extensive research and after that research they also felt it worth the risk. In this situation the insurance company actuaries predicted the number of claims perfectly and everyone was happy.
BUT as you can see the business of insurance actuarial tables is truly an art. If the actuary underestimated by even one profit was gone. If he missed by two, the company lost money. So if the company decided that they were going to offer the policy again the next year and their claims totaled $30,000.00 they would have to adjust the premiums.
IMPORTANT POINT: Claims paid determine the premium of policies.
Insurance companies assume a lot of risk. That could be why some insurance companies go out of business ever year.
Let’s now shift gears for a second and talk about what is being sold as “health insurance” right now. Based on current claim data provided by Mutual of Omaha, most insurance claims (around 70%) are for procedures less than $2000.00. with about half of those claims totaling less than $250.00 each.
The point here is that health insurance has become less about protecting against catastrophic financial losses and more about the insurance paying for doctors visits. Now remember in the broken arm policy example the insurance company assumed risks based on their ability to make a profit. What is called “health insurance” now is no different. Your health insurance carrier must also make a profit or next year they will join the insurance companies that go out of business. So what happens is that you pay your health insurance company premiums approximately one and one half times the actual costs of total claims paid for your risk group.
The average person goes to the doctor two and one half times per year. Only 7% of people actually file a claim for costs exceeding $2000.00 for a single claim. That is for a hospital stay with the average hospital stay costing around $20,000.00.
Question 1: Does it make sense to pay your “health insurance” company almost $5000.00 a year to cover doctor visits when they cost less than $250.00 per visit?
Question 2: Would it make more sense to write policies that only covered the cost of hospital expenses?
If you have questions please contact me at healthdennis@gmail.com
Monday, April 13, 2009
Does it take an Act of Congress?
Does it take an Act of Congress?
How many times have you jokingly said, “What does it take, an act of congress?”
Even though we have all – at one time or another – used that line or a variation of it? These days it appears to be no laughing matter. It seems we are ALL waiting around for congress to make changes. And folks as we can see very clearly that ain’t gonna happen. No, if we want change we will have to make it happen.
Congress – the federal government in general – doesn’t look at things the way we do. We look at our income and decide what we can and cannot do with that money. Congress on the other hand looks at what they want to do and then comes up with tax laws to get more money from us to make those things happen. The difference is that they are not budgeting or spending their own money. They are spending ours.
On top of that when congress sees a problem they have only one way to fix it and that is with a law. It’s called the carpenters law: When the only tool you have is hammer, everything looks like a nail. The only thing congress can do to fix things they see as being wrong is to create regulation making something illegal, then they appropriate our money to fund the fix.
The only thing government has ever created is laws.
So what are we to do? We need to look for free-market solutions to fix the problems created by us and our government.
Look, did congress make a law requiring the invention and production of the automobile?
No!
Did congress create a law that conjured up human flight?
No!
The only thing congress has done for those two pieces of entrepreneurial magic has been to make both of them more expensive. (Think about it!)
No it has been the free market that created those things for a ready, willing and waiting market.
The same can be done with health insurance. I am doing it now. I am meeting with businesses looking to lower the costs of their health insurance and along with the employees I am designing health care plans that are, affordable, portable, easy to access and most importantly they belong to the employees not the company. That way the employee gets to control costs not the group.
Does any of that sound like what government is trying to legislate into existence.
Contact me at healthdennis@gmail.com for more details on what you and or your company can do to do the same.
How many times have you jokingly said, “What does it take, an act of congress?”
Even though we have all – at one time or another – used that line or a variation of it? These days it appears to be no laughing matter. It seems we are ALL waiting around for congress to make changes. And folks as we can see very clearly that ain’t gonna happen. No, if we want change we will have to make it happen.
Congress – the federal government in general – doesn’t look at things the way we do. We look at our income and decide what we can and cannot do with that money. Congress on the other hand looks at what they want to do and then comes up with tax laws to get more money from us to make those things happen. The difference is that they are not budgeting or spending their own money. They are spending ours.
On top of that when congress sees a problem they have only one way to fix it and that is with a law. It’s called the carpenters law: When the only tool you have is hammer, everything looks like a nail. The only thing congress can do to fix things they see as being wrong is to create regulation making something illegal, then they appropriate our money to fund the fix.
The only thing government has ever created is laws.
So what are we to do? We need to look for free-market solutions to fix the problems created by us and our government.
Look, did congress make a law requiring the invention and production of the automobile?
No!
Did congress create a law that conjured up human flight?
No!
The only thing congress has done for those two pieces of entrepreneurial magic has been to make both of them more expensive. (Think about it!)
No it has been the free market that created those things for a ready, willing and waiting market.
The same can be done with health insurance. I am doing it now. I am meeting with businesses looking to lower the costs of their health insurance and along with the employees I am designing health care plans that are, affordable, portable, easy to access and most importantly they belong to the employees not the company. That way the employee gets to control costs not the group.
Does any of that sound like what government is trying to legislate into existence.
Contact me at healthdennis@gmail.com for more details on what you and or your company can do to do the same.
Friday, April 10, 2009
There Is an Answer
There Is an Answer
And that answer is not universal health care.
I have read every proposal out there that I can find and all that I have seen neglect one area of concern or another. My plan addresses all areas of concern.
Some of these are:
Concern 1. What about the uninsurable?
Answer 1. Under my plan doctors and hospitals would be given tax credits for treating those who cannot afford to self-insure and are uninsurable. Because these doctors and hospitals will be making what they want and need to make to provide quality health care, and not the network payments that under contract they have to accept from managed care insurance companies, they could afford to take on a certain level of charity care. But because personal responsibility is the key to my plan people would by default become healthier and require less care and we would have fewer uninsurable.
Concern 1. What about the poor?
Answer 2. See Answer 1 above. The same would work for the poor. The poor would get better care and not free clinic care. They could go see doctors that for now they do not have access to, because the really good doctors can opt out of taking payments from Medicaid.
Concern 3. What about my doctor visits?
Answer 3. There will be a level of self insurance and I guess under the current employer based plan you could consider doctor visits self-insurance. But it is more than that; it is the freedom to choose your treatment by your doctor. It is the freedom to ask for a cure rather than treatment of symptoms. Self-insurance begets personal responsibility – personal responsibility begets stewardship. That is the element that is missing from our current health care system.
Concern 4. This self-insurance would mean that I have to have a certain amount of money. I don’t have that kind of discretionary money lying around.
Answer 4. Because employers would be saving money by giving their employees a health insurance / health care allowance rather than paying exorbitant group rates for things like doctor visis. Some of the savings could be used to help employees with a certain amount of money to help them with steep out of pocket costs for a period of time until the mindset of personal responsibility begins to be more prominent.
From the universal health care proponents there will be many more objections but those objections are really more about not wanting a health care system that works for individuals. These people believe in health care rationing, restricted treatments and overall control.
Those who think they want universal health care and don’t understand the huge downsides only believe from an emotional point of view that health care is a right.
More on emotions next week
And that answer is not universal health care.
I have read every proposal out there that I can find and all that I have seen neglect one area of concern or another. My plan addresses all areas of concern.
Some of these are:
Concern 1. What about the uninsurable?
Answer 1. Under my plan doctors and hospitals would be given tax credits for treating those who cannot afford to self-insure and are uninsurable. Because these doctors and hospitals will be making what they want and need to make to provide quality health care, and not the network payments that under contract they have to accept from managed care insurance companies, they could afford to take on a certain level of charity care. But because personal responsibility is the key to my plan people would by default become healthier and require less care and we would have fewer uninsurable.
Concern 1. What about the poor?
Answer 2. See Answer 1 above. The same would work for the poor. The poor would get better care and not free clinic care. They could go see doctors that for now they do not have access to, because the really good doctors can opt out of taking payments from Medicaid.
Concern 3. What about my doctor visits?
Answer 3. There will be a level of self insurance and I guess under the current employer based plan you could consider doctor visits self-insurance. But it is more than that; it is the freedom to choose your treatment by your doctor. It is the freedom to ask for a cure rather than treatment of symptoms. Self-insurance begets personal responsibility – personal responsibility begets stewardship. That is the element that is missing from our current health care system.
Concern 4. This self-insurance would mean that I have to have a certain amount of money. I don’t have that kind of discretionary money lying around.
Answer 4. Because employers would be saving money by giving their employees a health insurance / health care allowance rather than paying exorbitant group rates for things like doctor visis. Some of the savings could be used to help employees with a certain amount of money to help them with steep out of pocket costs for a period of time until the mindset of personal responsibility begins to be more prominent.
From the universal health care proponents there will be many more objections but those objections are really more about not wanting a health care system that works for individuals. These people believe in health care rationing, restricted treatments and overall control.
Those who think they want universal health care and don’t understand the huge downsides only believe from an emotional point of view that health care is a right.
More on emotions next week
Wednesday, April 8, 2009
OK, I Get That it’s Broken – So What Can I Do?
OK, I Get That it’s Broken – So What Can I Do?
This is a question that be answered simply and completely right now.
Take personal responsibility.
Be responsible and talk to your employer or employees about not accepting the “entitled” health care offered by your company. Employees; see what you can do to get your own health insurance – not health care – actual insurance. There are plans out there in your state you just need to find them. (I can help with that. Email me!) See if some of the savings you get by not taking the health care offered by your employer. Talk to him or her about dropping the company plan and encouraging them to get their own health insurance. (I can help with that too. Email me!)
Employers; have the hard conversation with your employees about health care plans offered by your company. Tell them that it is breaking the company. Tell them the entitlement era is going away nationwide or they will soon lose all control of their health care and health care decisions. (Read Universal Health Care.) And I can help you with that too Mr. and or Ms. Employer.
What you will find is that as you realize that the money for health care – Dr. visits and the like - does actually come from somewhere, that you are more acutely aware of taking care of your own health care. When all it costs is a $15.00 co-pay to go to the doctor and your “health care” is covered by your employer there is no sting, you have no skin in the game. But once you have to fork over the cash yourself, you realize that health care doesn’t grow on trees.
And Mr. and Ms. Employer you will see a drastically different work force. Trust me on this; people who pay nothing for something see no value in it. Once the nickels begin to come out of their pocket you will have a dramatically difference workforce on your hands!
This is a question that be answered simply and completely right now.
Take personal responsibility.
Be responsible and talk to your employer or employees about not accepting the “entitled” health care offered by your company. Employees; see what you can do to get your own health insurance – not health care – actual insurance. There are plans out there in your state you just need to find them. (I can help with that. Email me!) See if some of the savings you get by not taking the health care offered by your employer. Talk to him or her about dropping the company plan and encouraging them to get their own health insurance. (I can help with that too. Email me!)
Employers; have the hard conversation with your employees about health care plans offered by your company. Tell them that it is breaking the company. Tell them the entitlement era is going away nationwide or they will soon lose all control of their health care and health care decisions. (Read Universal Health Care.) And I can help you with that too Mr. and or Ms. Employer.
What you will find is that as you realize that the money for health care – Dr. visits and the like - does actually come from somewhere, that you are more acutely aware of taking care of your own health care. When all it costs is a $15.00 co-pay to go to the doctor and your “health care” is covered by your employer there is no sting, you have no skin in the game. But once you have to fork over the cash yourself, you realize that health care doesn’t grow on trees.
And Mr. and Ms. Employer you will see a drastically different work force. Trust me on this; people who pay nothing for something see no value in it. Once the nickels begin to come out of their pocket you will have a dramatically difference workforce on your hands!
Friday, April 3, 2009
When the Only Tool You Have is a Hammer Every Problem Looks like a Nail
When the Only Tool You Have is a Hammer Every Problem Looks like a Nail
In yesterday’s post I mentioned that government was far too involved in your health care. I said they were more deeply involved than you could ever know. Believe me I have studied health insurance in earnest for nearly six years and after that much time I have yet to figure out how much of the crap that is written into a health insurance policy comes from the government and regulation and how much comes from the health insurance company trying to get around an existing regulation or the threat of a future regulation.
Insurance should be self-policing and the free market should be the first layer of consumer protection after the court system. If an insurance company fails to pay a simple claim the consumer should have the right to sue them. But understand that insurance companies have a vested interest in running clean business and that interest is the continuation of existing policies and the writing of new policies. Any company that makes a contract to deliver on payment for a claim that does not come through with that payment should first have to answer to other insurers and secondly should have the consequence of free market regulation in the form of a lack of sales for non-payment of claims.
But unfortunately what has evolved is s series of cat and mouse games between the government and the insurers. It goes like this: The insurance company writes a new health plan. In that plan things like costs for hospitalization and emergency room visits are paid. The office of the insurance commissioner now receives complaints from a few diabetics that cost of insulin is not covered in that plan. The next year the government – read legislature – writes a law that all insurers must now cover the cost of diabetes medications. So the insurers do that. And because the cost for covering those supplies will raise the costs for the insurance companies, the costs of premiums rise. So the next year the office of the insurance commissioner gets complaints that the costs of the premiums are too high so the legislature gets involved and demands lower premiums, so the insurance company has to institute a level of protection for them in the form of a claims department that looks over claims and disallows the payment of certain costs. SO NOW THE NEXT YEAR the office of the insurance commissioner get complaints from consumers that claims are denied which again kicks in the legislature which now goes back to the insurance company and makes laws about claims so the insurance company then goes to doctors and hospitals and asks them to accept less money for procedures. It is a viscous circle.
What has happened in our health care system is that when we demand more it costs more. When we complain to the government, the legislature has only one tool and that is the hammer of making a law. Laws do not enhance commerce they are meant to restrict commerce, but the government – our elected officials - have one tool and they use it with impunity.
In the movie Minority Report, Tom Cruise plays a police officer assigned with arresting people before they commit a crime. The legislature instead of allowing for free commerce and simply funding enforcement – as the constitution demands – plays the roll of “precog” and makes more laws creating more of a boondoggle for insurers to walk through. The thinking by lawmakers seems to be “Well they found a way to work around that last law so let’s try to figure out how they will wiggle around these laws and then write that into the next set of regulations.
In the meantime insurers (true for all businesses really) have to try to stay one step ahead of the legislature by adapting to the current legal landscape by working within that framework to do what they do, AND still make a profit AND do it legally. The problem seems to come when there is a complaint in the form of, “There oughtta be a law!” That is the mating call of the politician. If someone somewhere has a problem – real or imagined – that they can get to a legislator the lawmaker process begins. What should happen is that single business should be taken to court for the alleged infraction to see if there was a law broken. But it doesn’t end there.
Sometimes people make mistakes. That does not mean that an entire industry should be saddled with regulations to right that single wrong. The answer is to properly enforce the laws on the books, not to make new ones.
But remember that legislators have one tool and that is law creation. When citizens present problems that get to them that becomes their nail and the only thing they can do is get out their hammer.
The REAL answer is that we all need to do or best to live moral, honorable and decent lives. Take personal responsibility in our living choices to maintain our health and be fiscally responsible. When the fault is yours take responsibility for that and make changes. This too applies to businesses. The founders of the constitution debated at great length about our ability to self-govern. Many of the founders of the constitution believed quite openly that we could not. In order for our country to work as it was designed and as it has worked for over 200 years is that we as a people must be a moral people guided by divine law. Without that as our guide we get what we deserve, and that is a form of government very unlike what has created this greatest country ever.
SOLUTIONS:
I suggest that insurance companies make health insurance pure insurance. Get rid of networks, restrictions and exclusions. Design a policy that simply pays you if the insured is hospitalized. Because the average hospitalization is somewhere less than $30,000.00 set up a simple policy that will cover an individual for that amount. Don’t set a limit on the number of policies that an individual can buy.
Make the language simple. State what you as an insurer will pay once the patient enters the hospital and stick to it.
Don’t pay for doctor visits. A $200.00 visit to the doctor does not belong in a pure insurance policy.
As a consumer, pick the number of $30,000.00 policies you want to have and pay your premiums. As your age increases you will probably want to get more. Realize that once you have filed a claim it will be more expensive and maybe even impossible to get more insurance. If you use that amount up in a hospital visit then that policy is gone and you need to buy another.
And last but not least leave the regulatory folks out of it. Legislators set up penalties for violations for non-payment of claims and fraud and let the courts settle those.
Can anyone hear me? Am I making sense?
In yesterday’s post I mentioned that government was far too involved in your health care. I said they were more deeply involved than you could ever know. Believe me I have studied health insurance in earnest for nearly six years and after that much time I have yet to figure out how much of the crap that is written into a health insurance policy comes from the government and regulation and how much comes from the health insurance company trying to get around an existing regulation or the threat of a future regulation.
Insurance should be self-policing and the free market should be the first layer of consumer protection after the court system. If an insurance company fails to pay a simple claim the consumer should have the right to sue them. But understand that insurance companies have a vested interest in running clean business and that interest is the continuation of existing policies and the writing of new policies. Any company that makes a contract to deliver on payment for a claim that does not come through with that payment should first have to answer to other insurers and secondly should have the consequence of free market regulation in the form of a lack of sales for non-payment of claims.
But unfortunately what has evolved is s series of cat and mouse games between the government and the insurers. It goes like this: The insurance company writes a new health plan. In that plan things like costs for hospitalization and emergency room visits are paid. The office of the insurance commissioner now receives complaints from a few diabetics that cost of insulin is not covered in that plan. The next year the government – read legislature – writes a law that all insurers must now cover the cost of diabetes medications. So the insurers do that. And because the cost for covering those supplies will raise the costs for the insurance companies, the costs of premiums rise. So the next year the office of the insurance commissioner gets complaints that the costs of the premiums are too high so the legislature gets involved and demands lower premiums, so the insurance company has to institute a level of protection for them in the form of a claims department that looks over claims and disallows the payment of certain costs. SO NOW THE NEXT YEAR the office of the insurance commissioner get complaints from consumers that claims are denied which again kicks in the legislature which now goes back to the insurance company and makes laws about claims so the insurance company then goes to doctors and hospitals and asks them to accept less money for procedures. It is a viscous circle.
What has happened in our health care system is that when we demand more it costs more. When we complain to the government, the legislature has only one tool and that is the hammer of making a law. Laws do not enhance commerce they are meant to restrict commerce, but the government – our elected officials - have one tool and they use it with impunity.
In the movie Minority Report, Tom Cruise plays a police officer assigned with arresting people before they commit a crime. The legislature instead of allowing for free commerce and simply funding enforcement – as the constitution demands – plays the roll of “precog” and makes more laws creating more of a boondoggle for insurers to walk through. The thinking by lawmakers seems to be “Well they found a way to work around that last law so let’s try to figure out how they will wiggle around these laws and then write that into the next set of regulations.
In the meantime insurers (true for all businesses really) have to try to stay one step ahead of the legislature by adapting to the current legal landscape by working within that framework to do what they do, AND still make a profit AND do it legally. The problem seems to come when there is a complaint in the form of, “There oughtta be a law!” That is the mating call of the politician. If someone somewhere has a problem – real or imagined – that they can get to a legislator the lawmaker process begins. What should happen is that single business should be taken to court for the alleged infraction to see if there was a law broken. But it doesn’t end there.
Sometimes people make mistakes. That does not mean that an entire industry should be saddled with regulations to right that single wrong. The answer is to properly enforce the laws on the books, not to make new ones.
But remember that legislators have one tool and that is law creation. When citizens present problems that get to them that becomes their nail and the only thing they can do is get out their hammer.
The REAL answer is that we all need to do or best to live moral, honorable and decent lives. Take personal responsibility in our living choices to maintain our health and be fiscally responsible. When the fault is yours take responsibility for that and make changes. This too applies to businesses. The founders of the constitution debated at great length about our ability to self-govern. Many of the founders of the constitution believed quite openly that we could not. In order for our country to work as it was designed and as it has worked for over 200 years is that we as a people must be a moral people guided by divine law. Without that as our guide we get what we deserve, and that is a form of government very unlike what has created this greatest country ever.
SOLUTIONS:
I suggest that insurance companies make health insurance pure insurance. Get rid of networks, restrictions and exclusions. Design a policy that simply pays you if the insured is hospitalized. Because the average hospitalization is somewhere less than $30,000.00 set up a simple policy that will cover an individual for that amount. Don’t set a limit on the number of policies that an individual can buy.
Make the language simple. State what you as an insurer will pay once the patient enters the hospital and stick to it.
Don’t pay for doctor visits. A $200.00 visit to the doctor does not belong in a pure insurance policy.
As a consumer, pick the number of $30,000.00 policies you want to have and pay your premiums. As your age increases you will probably want to get more. Realize that once you have filed a claim it will be more expensive and maybe even impossible to get more insurance. If you use that amount up in a hospital visit then that policy is gone and you need to buy another.
And last but not least leave the regulatory folks out of it. Legislators set up penalties for violations for non-payment of claims and fraud and let the courts settle those.
Can anyone hear me? Am I making sense?
Thursday, April 2, 2009
The Talons of the Eagle
The Talons of the Eagle
Many years ago I directed a TV commercial for a local bank. The concept of the commercial called for us to film a real, live bald eagle. The opening shot was to be the eagle sitting on the arm of a birder shot all silhouetted against the backdrop of the sunrise. We were also to get shots of the eagle in flight.
The commercial was written to occur in winter. We traveled up to the mountains outside of a ski resort in the very early morning so that we could catch the sunrise for both the opening and closing “money” shots. The snow was deep and the air was so cold that the inside of our nostrils froze when we breathed.
We arrived in time to get our opening and closing money shots then we got some great close-ups of the eagle in mock flight. We were done except for the shots of the eagle in real flight. Our “Eagle Wrangler” informed us that even though the eagle was a “trained” that eagle’s brains were so small that the only thing he could get the eagle to do was to come back to his arm by offering it food. For that purpose he kept mice in his pocket. The producer, the cinematographer and I all looked at each other with a look that could best be described as confused curiosity.
With that the eagle was released to soar over our head, which he did for only a couple of minutes. After that he found the top of a distant pine tree and settled there. Since the snow was deep we watched as the handler made his was slowly across the high mountain valley. When he got to the tree he tried to coax the eagle to him with mice. He even pulled a live rabbit out of his bag and tried to capture the eagle’s interest with that. (I’m serious! We watched all this through the zoom lens on the camera.) Since the eagle wouldn’t budge the handler started to climb up the pine tree. In short order he was out of sight in the pine boughs.
The three of us stood by meantime and made small talk. After a few minutes we heard what could only be described as a masculine scream of pain – sort of like a warrior wounded in battle. We looked again through the lens. We saw nothing to indicate there was trouble over there.
“Should we go see what’s wrong?” the producer asked. The photographer and I both looked at each other with a look that said, “I ain’t goin’ over there. If the handler can’t handle him I wouldn’t have the first clue.” Instead we both said that maybe the producer should go, and we should stay back to move the gear if we needed. So Mr. Producer started the long slow trek, in the time span of about a minute he had covered some 20 yards.
About that time we heard a repeat of that same manly yell. The producer stopped and looked back at us. We shrugged our shoulders and began to fiddle with the camera like there was something that urgently needed done with it in response to the yelps of pain. The producer seemed as frozen as we were. I was looking through the zoom lens at the tree when I saw the eagle wrangler start to emerge from the pine boughs.
When he got back he told us what had happened. The eagle had gotten scared and refused to move from the tree, so the handler had to climb the tree and knock him out. When he knocked the eagle loose, because it was in the tight branches on the tree, it could not spread it wings and glide to earth so it had to grab on to something. What it grabbed hold of was the handler’s left thigh. The first scream we heard was the talons sinking into his leg. The second scream we heard was him wrenching them free. He said that when they sank into his flesh it hurt so badly that he considered simply falling out of the tree with the eagle still on his thigh. But he said the longer the eagle’s talons were in his leg the tighter he clawed and the more pain he was in. So he had wrenched the talons free.
The reason I tell this story is the parallels between that and what is going on with health care in the U.S. You see, the employer based health care system we have now is socialistic. The reasons I say that are vast and many and would take far more time to explain or read here for now, but let me just say this; health care has become an employee entitlement – and entitlements are socialist concepts. And trust me the government is far more involved in our present system than you can ever know. Once we get the talons of the government and socialism in our leg the pain becomes so intense that we can’t think clearly and believe that it may just be better to fall out of the tree and let the talons remain.
But that’s not the smart move.
The wisest move is to remove the talons – pry them painfully from our leg. Once the talons are removed the pain will more rapidly go away and the wound will heal. Leaving the talons in the leg and waiting for the eagle to free the talons itself, will probably not work.
There will be pain short term while we wrench the talons free. That pain will come in the form of confusion and screams from those who have the greatest stake in seeing universal health care become reality – mostly those in government and those in the public sector who see health care as a right and an entitlement. It will also be painful for those of us who will be paying the bill for health care – you and I. Because the new system will be confusing, (“You mean I have to pay for my own Dr. visit!?)” But under the Personalized Health Care Plan I propose, that pain and confusion will be short-lived once you realize that logically it makes more sense to save money on health care, make more money AND get better health care.
But the biggest pain will be getting used to taking personal responsibility for your health care. You see it’s been a long time since we had to do that but it is the only way to live. Would you let your employer or the government choose the mechanic you use to fix your car? How would it sit with you to have your boss or some flunky at DMV tell that mechanic how your car should be fixed? Wake up America! That’s what you have now in terms of taking care of your health! And it will only get worse once the talons sink deeper. But there is something we can all do now.
Please contact me at 912dennis@gmail.com to see what you can do.
Many years ago I directed a TV commercial for a local bank. The concept of the commercial called for us to film a real, live bald eagle. The opening shot was to be the eagle sitting on the arm of a birder shot all silhouetted against the backdrop of the sunrise. We were also to get shots of the eagle in flight.
The commercial was written to occur in winter. We traveled up to the mountains outside of a ski resort in the very early morning so that we could catch the sunrise for both the opening and closing “money” shots. The snow was deep and the air was so cold that the inside of our nostrils froze when we breathed.
We arrived in time to get our opening and closing money shots then we got some great close-ups of the eagle in mock flight. We were done except for the shots of the eagle in real flight. Our “Eagle Wrangler” informed us that even though the eagle was a “trained” that eagle’s brains were so small that the only thing he could get the eagle to do was to come back to his arm by offering it food. For that purpose he kept mice in his pocket. The producer, the cinematographer and I all looked at each other with a look that could best be described as confused curiosity.
With that the eagle was released to soar over our head, which he did for only a couple of minutes. After that he found the top of a distant pine tree and settled there. Since the snow was deep we watched as the handler made his was slowly across the high mountain valley. When he got to the tree he tried to coax the eagle to him with mice. He even pulled a live rabbit out of his bag and tried to capture the eagle’s interest with that. (I’m serious! We watched all this through the zoom lens on the camera.) Since the eagle wouldn’t budge the handler started to climb up the pine tree. In short order he was out of sight in the pine boughs.
The three of us stood by meantime and made small talk. After a few minutes we heard what could only be described as a masculine scream of pain – sort of like a warrior wounded in battle. We looked again through the lens. We saw nothing to indicate there was trouble over there.
“Should we go see what’s wrong?” the producer asked. The photographer and I both looked at each other with a look that said, “I ain’t goin’ over there. If the handler can’t handle him I wouldn’t have the first clue.” Instead we both said that maybe the producer should go, and we should stay back to move the gear if we needed. So Mr. Producer started the long slow trek, in the time span of about a minute he had covered some 20 yards.
About that time we heard a repeat of that same manly yell. The producer stopped and looked back at us. We shrugged our shoulders and began to fiddle with the camera like there was something that urgently needed done with it in response to the yelps of pain. The producer seemed as frozen as we were. I was looking through the zoom lens at the tree when I saw the eagle wrangler start to emerge from the pine boughs.
When he got back he told us what had happened. The eagle had gotten scared and refused to move from the tree, so the handler had to climb the tree and knock him out. When he knocked the eagle loose, because it was in the tight branches on the tree, it could not spread it wings and glide to earth so it had to grab on to something. What it grabbed hold of was the handler’s left thigh. The first scream we heard was the talons sinking into his leg. The second scream we heard was him wrenching them free. He said that when they sank into his flesh it hurt so badly that he considered simply falling out of the tree with the eagle still on his thigh. But he said the longer the eagle’s talons were in his leg the tighter he clawed and the more pain he was in. So he had wrenched the talons free.
The reason I tell this story is the parallels between that and what is going on with health care in the U.S. You see, the employer based health care system we have now is socialistic. The reasons I say that are vast and many and would take far more time to explain or read here for now, but let me just say this; health care has become an employee entitlement – and entitlements are socialist concepts. And trust me the government is far more involved in our present system than you can ever know. Once we get the talons of the government and socialism in our leg the pain becomes so intense that we can’t think clearly and believe that it may just be better to fall out of the tree and let the talons remain.
But that’s not the smart move.
The wisest move is to remove the talons – pry them painfully from our leg. Once the talons are removed the pain will more rapidly go away and the wound will heal. Leaving the talons in the leg and waiting for the eagle to free the talons itself, will probably not work.
There will be pain short term while we wrench the talons free. That pain will come in the form of confusion and screams from those who have the greatest stake in seeing universal health care become reality – mostly those in government and those in the public sector who see health care as a right and an entitlement. It will also be painful for those of us who will be paying the bill for health care – you and I. Because the new system will be confusing, (“You mean I have to pay for my own Dr. visit!?)” But under the Personalized Health Care Plan I propose, that pain and confusion will be short-lived once you realize that logically it makes more sense to save money on health care, make more money AND get better health care.
But the biggest pain will be getting used to taking personal responsibility for your health care. You see it’s been a long time since we had to do that but it is the only way to live. Would you let your employer or the government choose the mechanic you use to fix your car? How would it sit with you to have your boss or some flunky at DMV tell that mechanic how your car should be fixed? Wake up America! That’s what you have now in terms of taking care of your health! And it will only get worse once the talons sink deeper. But there is something we can all do now.
Please contact me at 912dennis@gmail.com to see what you can do.
Wednesday, April 1, 2009
An Open Letter to President Obama
An Open Letter to President Obama
Dear President Obama,
As a simple American citizen – one of the millions of people you answer to – I have a few questions for you. I believe that a highly educated person such as you should be able to answer these few questions in a matter of moments so this should not take much away from your busy schedule.
Mr. President I did not attend Harvard. I have never been a professor of Constitutional Law as you were Sir and seeing as how I never went to law school, have never had the benefit of attending a class on Constitutional Law. So I am completely ignorant of the wording or even in which article of the constitution an educated man like you finds authority to break legal contracts. It appears you have found constitutional authority to void legal contracts made between AIG and its employees. So please simply point out that section of the constitution me.
Also, I am asking you Mr. President for the benefit of your knowledge as to the language in our country’s foundational document that gives you and members of both parties - from both houses of the legislative branch of government - the right to retroactively tax a group of private citizens. I haven’t been able to find that.
Based on what is going on in our country these days I have only fairly recently developed a ravenous appetite for reading America’s most sacred document. My newness to constitutional studies must explain how I have missed the section that explains where you have the power to fire company executives from a private sector company. I don’t have the benefit of a law degree as do you and many members of the senate and congress, so I just need to be shown.
Sir you are my President, and as such I can only ask that you abide by the oath you took in front of me on January 20th of 2009. In that oath you swore to protect and defend the constitution of the United States. So please tell me what verbiage in our Constitution you found that allows you to prescribe to a private sector company what automobiles they can and cannot build.
And Mr. President while I’m asking questions here I have a few more. Did I miss the stimulus plan amendment? As I read the constitution it does not give you and the congress the right to spend money that is not your money to spend. Sir, to me it looks like that is just what you have all done. Being the constitutionally ignorant person that I am I am simply asking that you put my mind at ease by pointing out to me what might be called the “stimulus package clause” so I can go away and you can go about the very important business of protecting and defending our constitution..
There is a large and ever growing group of my friends who have become increasingly interested in the constitution recently. Try as we might we cant find the paragraph or even the sentence in the United States Constitution that allows my President to sign into law a bill that takes away my rights to determine my treatment if I get cancer or when my parents develop heart disease. You see Mr. President as we interpret it, the constitution restricts the rights of the federal government to those specifically mentioned in the constitution. As we read it all rights begin with us, the individual, and then filter down to the state and then finally to the federal level. As such Mr. President we only need to be shown how we constitutionally undereducated American citizens could have missed what I suppose we could all call the health czar amendment. And search as I might I cannot locate the article and section that takes away our right to pay for own health care from our own pocket. Perhaps there is an amendment we all missed that allows the federal government to get into the medical business. We are confused when we read that the government is primarily responsible for governing and protecting our rights. Did we miss the wording Mr. President that declares a visit to a doctor a right?
Mr. President reading back through the journals and letters of the framers of the constitution it appears that they intentionally designed our representational form of government so that the flow of power starts with us and from there goes to our local governments then to the states and then finally to the federal level. (I found it interesting that these men were so thoughtful and attentive that it took them as many as 60 ballots just to agree on how we should elect our presidents.) My friends and I have as of yet been unable to locate the article giving you Mr. President, the right to reverse the rights of states and force them to take the money you call stimulus – which, by the way, we are again still looking for the section that gives you the right to use our money for things like that in the first place.
I only ask, Mr. President, for these clarifications because to me it looks like you are in violation on the constitution on these and several other points. I only ask Sir because it appears to me that you personally are destroying private citizens and private sector companies. President Obama when you openly declare that American citizens are criminals that to me is something that is reserved for the judicial branch of government. As we understand this document anyone declared guilty of a crime has the right to the due process of a conviction by trial that flows through a jury of their peers. I am confused Sir when you go on television and appoint yourself judge and jury in declaring that these honest employees – who took contractually valid bonuses, are now criminals because you now don’t agree with those bonuses because you feel they are illegal. When the President announces in front of the entire country that the bonuses he personally signed into law are now illegal – that President has without the aid of trial declared himself judge and jury and in so doing has found them guilty. And as an interesting aside, we would like to know Mr. President since you are an attorney, how you would interpret your legal culpability in this - as you signed these bonuses into law. Most of my friends are like me and they are not attorneys or judges so we can’t possibly understand that fine point of the law. In appointing yourself judge and jury and trying these people in the media the sentence you have given these citizens, President Obama, has been illegal harassment by state and federal government, threats and harassment from under-informed citizens and what appears to me to be the threat of a blatantly illegal and punitive retroactive tax. Please Mr. President show me again where those rights are granted to you and the federal government by the U.S. Constitution.
And Mr. President you and your fellow public officials have systematically run major U.S. corporations out of business while they have simply been trying to conduct their business lawfully in this country, all while navigating around restrictive, burdensome and obstructive federal regulations. I would like to have you explain to me, what is the exact passage in the constitution those acts fall under. As an uneducated ordinary citizen it is plain to me that AIG will be very shortly run out of business. I know enough about the insurance business to know that new business in the form of new written policies are the life blood of an insurance company. If no new policies are written, even in the course of normal insurance policy attrition, an insurance company is doomed by its restricted cash flow. That insurance company will very rapidly not have the money to pay everyday claims and when an insurance company cannot pay claims they are out of business.
With all of the attention that you and your fellow elected officials have drawn toward AIG no prudent insurable citizen in the United States will opt to purchase a policy from AIG, and many who have policies with the company will be rushing to cancel their policies before they are informed that the company has cancelled them.
I may not be a brilliant Constitutional Law Professor, but I understand business well enough to know that AIG will not be viable long enough for you and the Congress to unconstitutionally break the contracts for next year’s “big bonuses” that you all seem so intent on doing.
Mr. President I would like to have you explain to me under what constitutional authority you can take over the job of the board of directors and fire the CEO of General Motors. And while you’re at it maybe you can enlighten me as to the exact clause that sustains in you the power to tell that car maker what types of cars they can and cannot build. I know that in this letter I mention several times that I do not have a law degree but I am blessed with common sense. My common sense tells me that if by law or decree a company can no longer make and sell its most popular AND most profitable products it will soon go out of business. Is there an article, section or amendment in our country’s founding document that grants you rights of veto over private sector products? If so I need to have you point to that for me.
Mr. President as far as the constitution goes I may not be as educated as you but I know enough about business to recognize when a company is about to breathe its last breath. AIG and GM, two American institutions and monuments to the capitalistic system set up in our constitution, will soon be declared dead. This will happen on your watch and I will even go so far as to say by your hand. I need to hear from you President Obama what law these companies broke that allows you and Congress to invoke whatever constitutional rights you and your Washington DC cohorts uncovered to do what you have done.
I understand Sir that you are a busy man but it will take but a bit of your time to answer these questions. Being the educated man that you are you should be able to answer these questions certainly much faster than I can write them. But it is incumbent upon you to answer these questions because unless we are all reading the constitution incorrectly - you answer to us – not the other way around.
Sincerely,
Dennis Rowley
United States Citizen
Dear President Obama,
As a simple American citizen – one of the millions of people you answer to – I have a few questions for you. I believe that a highly educated person such as you should be able to answer these few questions in a matter of moments so this should not take much away from your busy schedule.
Mr. President I did not attend Harvard. I have never been a professor of Constitutional Law as you were Sir and seeing as how I never went to law school, have never had the benefit of attending a class on Constitutional Law. So I am completely ignorant of the wording or even in which article of the constitution an educated man like you finds authority to break legal contracts. It appears you have found constitutional authority to void legal contracts made between AIG and its employees. So please simply point out that section of the constitution me.
Also, I am asking you Mr. President for the benefit of your knowledge as to the language in our country’s foundational document that gives you and members of both parties - from both houses of the legislative branch of government - the right to retroactively tax a group of private citizens. I haven’t been able to find that.
Based on what is going on in our country these days I have only fairly recently developed a ravenous appetite for reading America’s most sacred document. My newness to constitutional studies must explain how I have missed the section that explains where you have the power to fire company executives from a private sector company. I don’t have the benefit of a law degree as do you and many members of the senate and congress, so I just need to be shown.
Sir you are my President, and as such I can only ask that you abide by the oath you took in front of me on January 20th of 2009. In that oath you swore to protect and defend the constitution of the United States. So please tell me what verbiage in our Constitution you found that allows you to prescribe to a private sector company what automobiles they can and cannot build.
And Mr. President while I’m asking questions here I have a few more. Did I miss the stimulus plan amendment? As I read the constitution it does not give you and the congress the right to spend money that is not your money to spend. Sir, to me it looks like that is just what you have all done. Being the constitutionally ignorant person that I am I am simply asking that you put my mind at ease by pointing out to me what might be called the “stimulus package clause” so I can go away and you can go about the very important business of protecting and defending our constitution..
There is a large and ever growing group of my friends who have become increasingly interested in the constitution recently. Try as we might we cant find the paragraph or even the sentence in the United States Constitution that allows my President to sign into law a bill that takes away my rights to determine my treatment if I get cancer or when my parents develop heart disease. You see Mr. President as we interpret it, the constitution restricts the rights of the federal government to those specifically mentioned in the constitution. As we read it all rights begin with us, the individual, and then filter down to the state and then finally to the federal level. As such Mr. President we only need to be shown how we constitutionally undereducated American citizens could have missed what I suppose we could all call the health czar amendment. And search as I might I cannot locate the article and section that takes away our right to pay for own health care from our own pocket. Perhaps there is an amendment we all missed that allows the federal government to get into the medical business. We are confused when we read that the government is primarily responsible for governing and protecting our rights. Did we miss the wording Mr. President that declares a visit to a doctor a right?
Mr. President reading back through the journals and letters of the framers of the constitution it appears that they intentionally designed our representational form of government so that the flow of power starts with us and from there goes to our local governments then to the states and then finally to the federal level. (I found it interesting that these men were so thoughtful and attentive that it took them as many as 60 ballots just to agree on how we should elect our presidents.) My friends and I have as of yet been unable to locate the article giving you Mr. President, the right to reverse the rights of states and force them to take the money you call stimulus – which, by the way, we are again still looking for the section that gives you the right to use our money for things like that in the first place.
I only ask, Mr. President, for these clarifications because to me it looks like you are in violation on the constitution on these and several other points. I only ask Sir because it appears to me that you personally are destroying private citizens and private sector companies. President Obama when you openly declare that American citizens are criminals that to me is something that is reserved for the judicial branch of government. As we understand this document anyone declared guilty of a crime has the right to the due process of a conviction by trial that flows through a jury of their peers. I am confused Sir when you go on television and appoint yourself judge and jury in declaring that these honest employees – who took contractually valid bonuses, are now criminals because you now don’t agree with those bonuses because you feel they are illegal. When the President announces in front of the entire country that the bonuses he personally signed into law are now illegal – that President has without the aid of trial declared himself judge and jury and in so doing has found them guilty. And as an interesting aside, we would like to know Mr. President since you are an attorney, how you would interpret your legal culpability in this - as you signed these bonuses into law. Most of my friends are like me and they are not attorneys or judges so we can’t possibly understand that fine point of the law. In appointing yourself judge and jury and trying these people in the media the sentence you have given these citizens, President Obama, has been illegal harassment by state and federal government, threats and harassment from under-informed citizens and what appears to me to be the threat of a blatantly illegal and punitive retroactive tax. Please Mr. President show me again where those rights are granted to you and the federal government by the U.S. Constitution.
And Mr. President you and your fellow public officials have systematically run major U.S. corporations out of business while they have simply been trying to conduct their business lawfully in this country, all while navigating around restrictive, burdensome and obstructive federal regulations. I would like to have you explain to me, what is the exact passage in the constitution those acts fall under. As an uneducated ordinary citizen it is plain to me that AIG will be very shortly run out of business. I know enough about the insurance business to know that new business in the form of new written policies are the life blood of an insurance company. If no new policies are written, even in the course of normal insurance policy attrition, an insurance company is doomed by its restricted cash flow. That insurance company will very rapidly not have the money to pay everyday claims and when an insurance company cannot pay claims they are out of business.
With all of the attention that you and your fellow elected officials have drawn toward AIG no prudent insurable citizen in the United States will opt to purchase a policy from AIG, and many who have policies with the company will be rushing to cancel their policies before they are informed that the company has cancelled them.
I may not be a brilliant Constitutional Law Professor, but I understand business well enough to know that AIG will not be viable long enough for you and the Congress to unconstitutionally break the contracts for next year’s “big bonuses” that you all seem so intent on doing.
Mr. President I would like to have you explain to me under what constitutional authority you can take over the job of the board of directors and fire the CEO of General Motors. And while you’re at it maybe you can enlighten me as to the exact clause that sustains in you the power to tell that car maker what types of cars they can and cannot build. I know that in this letter I mention several times that I do not have a law degree but I am blessed with common sense. My common sense tells me that if by law or decree a company can no longer make and sell its most popular AND most profitable products it will soon go out of business. Is there an article, section or amendment in our country’s founding document that grants you rights of veto over private sector products? If so I need to have you point to that for me.
Mr. President as far as the constitution goes I may not be as educated as you but I know enough about business to recognize when a company is about to breathe its last breath. AIG and GM, two American institutions and monuments to the capitalistic system set up in our constitution, will soon be declared dead. This will happen on your watch and I will even go so far as to say by your hand. I need to hear from you President Obama what law these companies broke that allows you and Congress to invoke whatever constitutional rights you and your Washington DC cohorts uncovered to do what you have done.
I understand Sir that you are a busy man but it will take but a bit of your time to answer these questions. Being the educated man that you are you should be able to answer these questions certainly much faster than I can write them. But it is incumbent upon you to answer these questions because unless we are all reading the constitution incorrectly - you answer to us – not the other way around.
Sincerely,
Dennis Rowley
United States Citizen
Monday, March 30, 2009
Let's Unite Under a Common Cause
As you read through accounts of history, successful revolutions have occurred because people were united under one cause – one agenda. People in groups who all wanted different things have never been able to achieve a single goal. In order to get all we want we must unite under a common goal. I am organizing a campaign to address one issue. We will be organizing write-in campaigns, marches and even a broadcast commercial campaign aimed at getting word to our government that having them control access to our health care is a gross violation of our constitutional rights.
Do you realize that in the first stimulus package that there is a law that allows the U.S. Government to determine who lives and who dies by prescribing treatments to doctors? Universal Health Care was described by Vladmamir Lenin as the archway through which socialism marches.
There are MANY issues we need to address with our congress – each of them equally important. But my area of expertise is Health Insurance. Around that expertise I have designed a plan whereby each person is responsible for their own health care AND health insurance. All details will follow but it allows you to choose your health insurance company. It places the responsibility of choosing your health insurance plan, company and providers on you and takes that away from employers. It allows doctors to treat us again as we need to be treated. And it allows the doctors to make what they need to treat us, free from collections and billing offices. (Does it really make sense to have an insurance company pay for our doctor visits at a profit to them???)
Please don’t get me wrong Glenn has done an amazing job of brining us all together and our numbers are growing. However, he describes himself as riddled with ADD, and he brings up problem after problem it is a distraction completely overwhelming. I agree that the problems are overwhelming but we all MUST focus on one objective in a unified voice. Let’s surround them on health care and stop the tide. Once we have one victory we can have many, many more.
Please email me @ 912dennis@gmail.com so I can build a daily email list and get our country moving again.
Do you realize that in the first stimulus package that there is a law that allows the U.S. Government to determine who lives and who dies by prescribing treatments to doctors? Universal Health Care was described by Vladmamir Lenin as the archway through which socialism marches.
There are MANY issues we need to address with our congress – each of them equally important. But my area of expertise is Health Insurance. Around that expertise I have designed a plan whereby each person is responsible for their own health care AND health insurance. All details will follow but it allows you to choose your health insurance company. It places the responsibility of choosing your health insurance plan, company and providers on you and takes that away from employers. It allows doctors to treat us again as we need to be treated. And it allows the doctors to make what they need to treat us, free from collections and billing offices. (Does it really make sense to have an insurance company pay for our doctor visits at a profit to them???)
Please don’t get me wrong Glenn has done an amazing job of brining us all together and our numbers are growing. However, he describes himself as riddled with ADD, and he brings up problem after problem it is a distraction completely overwhelming. I agree that the problems are overwhelming but we all MUST focus on one objective in a unified voice. Let’s surround them on health care and stop the tide. Once we have one victory we can have many, many more.
Please email me @ 912dennis@gmail.com so I can build a daily email list and get our country moving again.
Monday, March 23, 2009
The Expanded Principles of Health Care and Health Insurance
Principles of Health Insurance and Health Care
1. Health Care and Health Insurance are two separate items. They should never be used as synonyms.
For years – actually since PPOs and HMOs became the norm for health insurance coverage, health care and the high costs of it have been blamed on the high cost of health insurance. When in reality lumping doctor visits (doctor visits) in with coverage for catastrophic illness coverage (health insurance) has been the culprit. Over the past several over 60% of the medical claims filed have been under $1000.00 and nearly 40% of those claims have been for costs under $200.00. When you consider that the cost of a monthly premium averages over $3600.00 a year and most people only go to the doctor five times a year, ($1000.00 average.) you can see that the high cost of health care is joined at the hip with paying for simple procedures and doctor visits. Health care (doctor visits) should not be a part of health insurance. (Catastrophic illness coverage)
2. Health Insurance is insurance and insurance is meant to protect you financially in the event of a catastrophic loss.
Closely connected to Principle #1 is the issue of health insurance. Only about 7% of people ever have to go into the hospital for an overnight stay. The average cost of a hospitalization is roughly $25,000.00 (Now bear in mind that this is the amount billed not the amount paid.) The average amount paid in a hospitalization by the insurance company is roughly 1/3 of that amount or $7500.00. Simple mathematics can be done to come up with the cost for catastrophic care spread over a risk group. Health insurance companies could cover catastrophic medical bills for slightly over $100.00 per month in premium per person. Health insurance has been damaged and decimated by attaching it – politically – to health care. In order for health insurance and health care to be saved they must be treated as separate entities. Health insurance must be extracted from the health care equation and treated as pure insurance – as a policy to cover for financial catastrophic loss.
3. Personal responsibility is the first natural law of health care.
It should be mentioned that one of our primary natural laws is, “Ownership begets stewardship.” Since the HMOs and PPOs cam into prominence over 40 years ago we have all learned (been taught) as consumers of “health care” that we have no responsibility in our care. The number one reason for this is that we do not pay for our health care, our employer does. It is critical for the user of health insurance and health care to have some “skin in the game.” Let’s face it if you are not paying for your doctor visits or your health insurance or your hospital stays you are more willing to stand by and do nothing about making sure you are getting the most for your money. If, on the other hand, you are paying $100 for a doctor visit you are probably going to be more anxious to question the doctor more thoroughly. Research shows that the self-employed, those who do pay for their health care not only visit the doctor less and spend less on health care, but as a group they are healthier.
4. Personal freedom of choice in doctors, treatment and care are the primary and most important factors in health care.
This goes hand in hand with personal responsibility. Most people who are in group, or employer sponsored, health plans are completely unaware that they have signed away their rights to see ANY doctor. Moreover they are completely oblivious to the fact if they are diagnosed with ANYTHING that they have signed away their rights to get all options for treatment. Contractually, they have agreed to accept as treatment ONLY those treatments their health insurance company wants to pay for. This is called managed care. (Type “managed care” into Google and see what you get.) There is a reason that there is a list of doctors for both HMOs and PPOs. The doctors on these lists agree contractually to only prescribe the treatments that the health insurance agrees to pay for, and they agree to be the lowest bidder. (I don’t know about you but when I need open heart surgery, I don’t want my ticker being worked on by the lowest bidder.) All patients should have the option to choose their doctors hospitals and treatments.
5. Fair and free competition among insurers, doctors and hospitals insures the best care and pricing possible.
Some people call it transparency. I call it necessary. You should be able to compare doctors and hospitals and insurance companies based on price and performance. Right now managed care health insurance companies don’t want you to know what a doctor visit really costs, because they have spent years convincing us that we must have health insurance to go to the doctor. Nothing could be further from the truth. Not paying for doctor visit through your insurance company would save as much as 40% on your health insurance costs. However, for all of this to work pricing and experience must be made available to patients.
6. Insurance – all insurance – was created to be a self-policing free market business and should remain as such.
Any guesses on any one entity which is most responsible for the high costs of health insurance. I your guess was government you would be right. Government intrusion into health care coverage and plans has added things into health plans to include some people with illnesses that all of us must pay for. This also allows health insurance companies under the guise of “managed care” to exclude certain things legally under their umbrellas of coverage. The constitution allows for contracts to be freely created between individual and or corporations. Constitutionally the ONLY direction that government should exert is legal execution of those contracts. In other words as it regards health insurance you should be able to sign an insurance policy that covers any treatment or surgery up to monetary limits and have that paid as the contract dictates, if that is not paid then the government should step in to adjudicate that matter. Free market economics should allow you to choose your coverage, limits and pricing. Companies that don’t do what they say should be driven out of business by customers refusing to do business with them.
7. Health Care and Health Insurance are privileges not entitlements.
Nothing screams socialism like entitlements. Employers and health insurance companies and our own apathy and laziness have made us all slaves. We are slaves to complacency. We are salves to employers for our health insurance because of things like pre-existing conditions. But mostly we are slaves to entitlements. If you are reliant on someone else for any of your basic needs that is an entitlement. Entitlements make people lazy and apathetic. Motivated and food stamp recipient are rarely used in the same sentence, but complaining and welfare recipient go hand in hand. Employers who rely on health insurance from their employer are looking at that health insurance as an entitlement. There is no motivation to look at what they can do keep costs low or receive the best treatment. The motivation is to get as much from the “freebie” or to “manipulate the system.” Health insurance must be moved from employers sponsored health care to individual policies to get rid of the entitlement mentality.
1. Health Care and Health Insurance are two separate items. They should never be used as synonyms.
For years – actually since PPOs and HMOs became the norm for health insurance coverage, health care and the high costs of it have been blamed on the high cost of health insurance. When in reality lumping doctor visits (doctor visits) in with coverage for catastrophic illness coverage (health insurance) has been the culprit. Over the past several over 60% of the medical claims filed have been under $1000.00 and nearly 40% of those claims have been for costs under $200.00. When you consider that the cost of a monthly premium averages over $3600.00 a year and most people only go to the doctor five times a year, ($1000.00 average.) you can see that the high cost of health care is joined at the hip with paying for simple procedures and doctor visits. Health care (doctor visits) should not be a part of health insurance. (Catastrophic illness coverage)
2. Health Insurance is insurance and insurance is meant to protect you financially in the event of a catastrophic loss.
Closely connected to Principle #1 is the issue of health insurance. Only about 7% of people ever have to go into the hospital for an overnight stay. The average cost of a hospitalization is roughly $25,000.00 (Now bear in mind that this is the amount billed not the amount paid.) The average amount paid in a hospitalization by the insurance company is roughly 1/3 of that amount or $7500.00. Simple mathematics can be done to come up with the cost for catastrophic care spread over a risk group. Health insurance companies could cover catastrophic medical bills for slightly over $100.00 per month in premium per person. Health insurance has been damaged and decimated by attaching it – politically – to health care. In order for health insurance and health care to be saved they must be treated as separate entities. Health insurance must be extracted from the health care equation and treated as pure insurance – as a policy to cover for financial catastrophic loss.
3. Personal responsibility is the first natural law of health care.
It should be mentioned that one of our primary natural laws is, “Ownership begets stewardship.” Since the HMOs and PPOs cam into prominence over 40 years ago we have all learned (been taught) as consumers of “health care” that we have no responsibility in our care. The number one reason for this is that we do not pay for our health care, our employer does. It is critical for the user of health insurance and health care to have some “skin in the game.” Let’s face it if you are not paying for your doctor visits or your health insurance or your hospital stays you are more willing to stand by and do nothing about making sure you are getting the most for your money. If, on the other hand, you are paying $100 for a doctor visit you are probably going to be more anxious to question the doctor more thoroughly. Research shows that the self-employed, those who do pay for their health care not only visit the doctor less and spend less on health care, but as a group they are healthier.
4. Personal freedom of choice in doctors, treatment and care are the primary and most important factors in health care.
This goes hand in hand with personal responsibility. Most people who are in group, or employer sponsored, health plans are completely unaware that they have signed away their rights to see ANY doctor. Moreover they are completely oblivious to the fact if they are diagnosed with ANYTHING that they have signed away their rights to get all options for treatment. Contractually, they have agreed to accept as treatment ONLY those treatments their health insurance company wants to pay for. This is called managed care. (Type “managed care” into Google and see what you get.) There is a reason that there is a list of doctors for both HMOs and PPOs. The doctors on these lists agree contractually to only prescribe the treatments that the health insurance agrees to pay for, and they agree to be the lowest bidder. (I don’t know about you but when I need open heart surgery, I don’t want my ticker being worked on by the lowest bidder.) All patients should have the option to choose their doctors hospitals and treatments.
5. Fair and free competition among insurers, doctors and hospitals insures the best care and pricing possible.
Some people call it transparency. I call it necessary. You should be able to compare doctors and hospitals and insurance companies based on price and performance. Right now managed care health insurance companies don’t want you to know what a doctor visit really costs, because they have spent years convincing us that we must have health insurance to go to the doctor. Nothing could be further from the truth. Not paying for doctor visit through your insurance company would save as much as 40% on your health insurance costs. However, for all of this to work pricing and experience must be made available to patients.
6. Insurance – all insurance – was created to be a self-policing free market business and should remain as such.
Any guesses on any one entity which is most responsible for the high costs of health insurance. I your guess was government you would be right. Government intrusion into health care coverage and plans has added things into health plans to include some people with illnesses that all of us must pay for. This also allows health insurance companies under the guise of “managed care” to exclude certain things legally under their umbrellas of coverage. The constitution allows for contracts to be freely created between individual and or corporations. Constitutionally the ONLY direction that government should exert is legal execution of those contracts. In other words as it regards health insurance you should be able to sign an insurance policy that covers any treatment or surgery up to monetary limits and have that paid as the contract dictates, if that is not paid then the government should step in to adjudicate that matter. Free market economics should allow you to choose your coverage, limits and pricing. Companies that don’t do what they say should be driven out of business by customers refusing to do business with them.
7. Health Care and Health Insurance are privileges not entitlements.
Nothing screams socialism like entitlements. Employers and health insurance companies and our own apathy and laziness have made us all slaves. We are slaves to complacency. We are salves to employers for our health insurance because of things like pre-existing conditions. But mostly we are slaves to entitlements. If you are reliant on someone else for any of your basic needs that is an entitlement. Entitlements make people lazy and apathetic. Motivated and food stamp recipient are rarely used in the same sentence, but complaining and welfare recipient go hand in hand. Employers who rely on health insurance from their employer are looking at that health insurance as an entitlement. There is no motivation to look at what they can do keep costs low or receive the best treatment. The motivation is to get as much from the “freebie” or to “manipulate the system.” Health insurance must be moved from employers sponsored health care to individual policies to get rid of the entitlement mentality.
Friday, March 20, 2009
Principles of Health Insurance AND Health Care
1. Health Care and Health Insurance are two separate items. They should never be used as synonyms.
2. Health Insurance is insurance and insurance is meant to protect you financially in the event of a catastrophic loss.
3. Personal responsibility is the first natural law of health care.
4. Personal freedom of choice in doctors, treatment and care are the primary and most important factors in health care.
5. Fair and free competition among insurers, doctors and hospitals insures the best care and pricing possible.
6. Insurance – all insurance – was created to be a self-policing business and should remain as such.
7. Health Care and Health Insurance are privileges not entitlements.
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