Comments on: Share Your Thoughts on Health Care Coverage Reform http://blog.iowahospital.org/2009/05/20/share-your-thoughts-on-health-care-coverage-reform/ A place for relevant news and insights about Iowa hospitals Thu, 09 Feb 2012 18:38:42 +0000 hourly 1 http://wordpress.org/?v=3.2.1 By: Jim Carle http://blog.iowahospital.org/2009/05/20/share-your-thoughts-on-health-care-coverage-reform/#comment-1071 Jim Carle Tue, 25 Aug 2009 21:24:24 +0000 http://blog.iowahospital.org/?p=325#comment-1071 So far this whole debate has focused on trying to fix a perceived problem from the back side. What needs to happen is to evaluate all of those things that have contributed to arriving at this point. We need to start with the entitlement mentality and scrap the idea that healthcare is a right. There is no constitutional authority for spending tax revenue on healthcare of any kind. We need to look at the reams of regulations that govern our daily lives and ask the question; "Does this provide value to the delivery of health care?" We need to look at TORT reform and patent laws and frivolous law suits and FDA rules and OSHA mandates. All of these things that politicians have done have created the environment for sky high health care costs. We also need to hold people accountable through the use of high deductibles/co-pays etc. If ALL people are required to pony up some of their hard-earned money to pay for their over-utilization, they will think twice about abusing the system. If we insist on an entitlement, then needs test it. Why should we pay 3/4 of the medicare premiums for the Vanderbilts or Kennedys? They can afford to purchase private insurance. Finally, in regard to the single payer system, this government has proven that it cannot efficiently administer a 3 billion dollar "cash for clunkers" program and we want to trust them to efficiently administer a sytem in charge of more than a trillion dollars?? Ludicrous to say the least. So far this whole debate has focused on trying to fix a perceived problem from the back side. What needs to happen is to evaluate all of those things that have contributed to arriving at this point. We need to start with the entitlement mentality and scrap the idea that healthcare is a right. There is no constitutional authority for spending tax revenue on healthcare of any kind. We need to look at the reams of regulations that govern our daily lives and ask the question; “Does this provide value to the delivery of health care?” We need to look at TORT reform and patent laws and frivolous law suits and FDA rules and OSHA mandates. All of these things that politicians have done have created the environment for sky high health care costs. We also need to hold people accountable through the use of high deductibles/co-pays etc. If ALL people are required to pony up some of their hard-earned money to pay for their over-utilization, they will think twice about abusing the system. If we insist on an entitlement, then needs test it. Why should we pay 3/4 of the medicare premiums for the Vanderbilts or Kennedys? They can afford to purchase private insurance. Finally, in regard to the single payer system, this government has proven that it cannot efficiently administer a 3 billion dollar “cash for clunkers” program and we want to trust them to efficiently administer a sytem in charge of more than a trillion dollars?? Ludicrous to say the least.

]]> By: James E-J http://blog.iowahospital.org/2009/05/20/share-your-thoughts-on-health-care-coverage-reform/#comment-146 James E-J Tue, 09 Jun 2009 21:07:01 +0000 http://blog.iowahospital.org/?p=325#comment-146 First, we need to consider whether Medicare is fair to Iowans. The answer is no. Iowans receive less per patient benefits. So, for Iowa, expanded Medicare is NOT the right answer. Everyone needs to be covered, but people should not be forced into coverage they do not want. Whatever happens, consumer-driven healthcare plans should be a part of the mix. First, we need to consider whether Medicare is fair to Iowans. The answer is no. Iowans receive less per patient benefits. So, for Iowa, expanded Medicare is NOT the right answer.

Everyone needs to be covered, but people should not be forced into coverage they do not want. Whatever happens, consumer-driven healthcare plans should be a part of the mix.

]]> By: Elise Kukuzke http://blog.iowahospital.org/2009/05/20/share-your-thoughts-on-health-care-coverage-reform/#comment-124 Elise Kukuzke Fri, 05 Jun 2009 13:13:32 +0000 http://blog.iowahospital.org/?p=325#comment-124 I have not heard any comments about commercial insurance. I think they are part of the problem with health care issues. The contract with a hospital for reimbursement at a certain percentage so the hospital raises rates to make reimbursement more. Meanwhile the patient is paying 20% of the whole amount and insurance is paying only a percentage of the 80% they will reimburse for. Then the uninsured is paying higher prices for medical care. (The same goes for Medicare) There should be some control over the commercial insurance companies. You pay a good premium and the coverage is always less and less and the deductables (which are foolish anyway) are more and more. I am worried about government controlled health care because the regulations are made by people who are not out with the working class citizens. It is easy for someone with an income of $1 million dollars to make regulations for incomes less than $100,000. And how many senators and representatives are aware that there are providers that will not see Medicare or Title 19 patients. Sincerely, Elise Kukuzke Imaging Manager Marengo Memorial Hospital Marengo, Iowa 52301 I have not heard any comments about commercial insurance. I think they are part of the problem with health care issues. The contract with a hospital for reimbursement at a certain percentage so the hospital raises rates to make reimbursement more. Meanwhile the patient is paying 20% of the whole amount and insurance is paying only a percentage of the 80% they will reimburse for. Then the uninsured is paying higher prices for medical care. (The same goes for Medicare) There should be some control over the commercial insurance companies. You pay a good premium and the coverage is always less and less and the deductables (which are foolish anyway) are more and more.

I am worried about government controlled health care because the regulations are made by people who are not out with the working class citizens. It is easy for someone with an income of $1 million dollars to make regulations for incomes less than $100,000.

And how many senators and representatives are aware that there are providers that will not see Medicare or Title 19 patients.

Sincerely,

Elise Kukuzke
Imaging Manager
Marengo Memorial Hospital
Marengo, Iowa 52301

]]> By: Mariannette Miller-Meeks http://blog.iowahospital.org/2009/05/20/share-your-thoughts-on-health-care-coverage-reform/#comment-120 Mariannette Miller-Meeks Thu, 04 Jun 2009 21:49:35 +0000 http://blog.iowahospital.org/?p=325#comment-120 The true cost of Medicare is not reflected in the off-quoted 3% administration fee. Further, all provider types and hospitals, clinics, ASC's etc have been the method of holding down costs while politicians gin up the benefits to get re-elected. It is true that health care costs are too high, but the current administration's proposal will not lower costs. Further, statistics do not accurately reflect reality. For instance, where does 50 million Americans without health insurance come from. This figure includes illegal immigrants, and so it would be more appropriate to state the number of individuals rather than citizenship status. Additionally, another 50% have health insurance sometime, i.e. they are in between jobs and so lack health insurance for 2-6 months. Perhaps longer now in the current economic climate. The infant mortality rate was mentioned but other countries do not count all premature births as an infant, and therefore skew the prevalence. The U.S. also has one of the highest rates of teen pregnancy which is often associated with an increased infant mortality. If true comparisons are reviewed, health care outcomes are not more positive in other countries, but we pay a great deal more because of our access and utilization of PREMIUM health care. For instance, the U.K. recently closed 19 NHS hospitals because of lack of funding, and the major oncology service merged with a private cancer hospital. They are trying to keep up with the U.S. and outcomes will decline when the U.S. no longer drives progress. So if one presumes health care costs are too high because providers are charging too much, then punish the providers by reducing payment (reimbursement). The Medicare system has already attempted to do this, but while politicians increase benefits and seniors increase utilization even as the number of seniors increase, the cost has never been constrained. Further pediatricians, internists, family practicioners, nurses and other providers are finding it increasingly difficult to have reimbursement which doesn't keep up with the cost of running an office and paying employees. Thus rural medicine areas with minimal or no diversity of payors (only have Medicare) cannot continue to remain in small or solo practices or provide call. Health insurance could cost significantly less is it was utilized as INSURANCE (which is intended to cover rare or infrequent occurrences), not every provider's visits. Numerous non-partisan health studies have proven unequivocally that with an individual does not pay part of the cost of care, access is greatly increased, i.e. over-utilization. The government has a tremendous role in what it does best--prevent fraud, insure the poor are receiving care, and provide transparency. Consumer protection should be enhanced, individuals should be able to purchase health insurance across state lines and the mandated state benefits that drive up premiums eliminated. If individuals were given tax preferential treatment, with tax credits for low income, we could gradually phase out employer sponsored health insurance which would allow it to be PORTABLE and then you could "fire" your health insurance company rather than asking for your employer to appeal to the company, which it is unlikely to do. The issue is very complex and I do not type fast enough to address all the facets. I will say however, that my participation in the health care system in the military, as a nurse and a physician both in academia and private practice, affords me an inside viewpoint most people don't have. With a sister living in the U.K and friends in Canada, I know that our country can come up with a better system rather than emulating the failed policies of these single-payor countries. We have all the talent and ability to have a system that is accessible to everyone, affordable, portable and encourages personal responsibility for wellness through premium reductions and other "carrots"and will still let us innovate and develop technology and cures that we have not even begun to dream. The true cost of Medicare is not reflected in the off-quoted 3% administration fee. Further, all provider types and hospitals, clinics, ASC’s etc have been the method of holding down costs while politicians gin up the benefits to get re-elected. It is true that health care costs are too high, but the current administration’s proposal will not lower costs. Further, statistics do not accurately reflect reality. For instance, where does 50 million Americans without health insurance come from. This figure includes illegal immigrants, and so it would be more appropriate to state the number of individuals rather than citizenship status. Additionally, another 50% have health insurance sometime, i.e. they are in between jobs and so lack health insurance for 2-6 months. Perhaps longer now in the current economic climate.

The infant mortality rate was mentioned but other countries do not count all premature births as an infant, and therefore skew the prevalence. The U.S. also has one of the highest rates of teen pregnancy which is often associated with an increased infant mortality. If true comparisons are reviewed, health care outcomes are not more positive in other countries, but we pay a great deal more because of our access and utilization of PREMIUM health care. For instance, the U.K. recently closed 19 NHS hospitals because of lack of funding, and the major oncology service merged with a private cancer hospital. They are trying to keep up with the U.S. and outcomes will decline when the U.S. no longer drives progress.

So if one presumes health care costs are too high because providers are charging too much, then punish the providers by reducing payment (reimbursement). The Medicare system has already attempted to do this, but while politicians increase benefits and seniors increase utilization even as the number of seniors increase, the cost has never been constrained. Further pediatricians, internists, family practicioners, nurses and other providers are finding it increasingly difficult to have reimbursement which doesn’t keep up with the cost of running an office and paying employees. Thus rural medicine areas with minimal or no diversity of payors (only have Medicare) cannot continue to remain in small or solo practices or provide call.

Health insurance could cost significantly less is it was utilized as INSURANCE (which is intended to cover rare or infrequent occurrences), not every provider’s visits. Numerous non-partisan health studies have proven unequivocally that with an individual does not pay part of the cost of care, access is greatly increased, i.e. over-utilization.

The government has a tremendous role in what it does best–prevent fraud, insure the poor are receiving care, and provide transparency. Consumer protection should be enhanced, individuals should be able to purchase health insurance across state lines and the mandated state benefits that drive up premiums eliminated. If individuals were given tax preferential treatment, with tax credits for low income, we could gradually phase out employer sponsored health insurance which would allow it to be PORTABLE and then you could “fire” your health insurance company rather than asking for your employer to appeal to the company, which it is unlikely to do.

The issue is very complex and I do not type fast enough to address all the facets. I will say however, that my participation in the health care system in the military, as a nurse and a physician both in academia and private practice, affords me an inside viewpoint most people don’t have. With a sister living in the U.K and friends in Canada, I know that our country can come up with a better system rather than emulating the failed policies of these single-payor countries. We have all the talent and ability to have a system that is accessible to everyone, affordable, portable and encourages personal responsibility for wellness through premium reductions and other “carrots”and will still let us innovate and develop technology and cures that we have not even begun to dream.

]]> By: Sandi Wynja, RN http://blog.iowahospital.org/2009/05/20/share-your-thoughts-on-health-care-coverage-reform/#comment-117 Sandi Wynja, RN Thu, 04 Jun 2009 16:00:28 +0000 http://blog.iowahospital.org/?p=325#comment-117 Before we go to a single payer - I'd suggest everyone talk to individuals from Canada who are unable to get in for elective hip surgery for very extended periods, or are unable to start chemotherapy for months, and can not get a colonoscopy in a timely fashion to make a prompt diagnosis in order to receive prompt care. Health care in Canada has a lot to be desired. Before we go to a single payer – I’d suggest everyone talk to individuals from Canada who are unable to get in for elective hip surgery for very extended periods, or are unable to start chemotherapy for months, and can not get a colonoscopy in a timely fashion to make a prompt diagnosis in order to receive prompt care. Health care in Canada has a lot to be desired.

]]> By: Lucia Dryanski http://blog.iowahospital.org/2009/05/20/share-your-thoughts-on-health-care-coverage-reform/#comment-108 Lucia Dryanski Mon, 01 Jun 2009 23:51:34 +0000 http://blog.iowahospital.org/?p=325#comment-108 Health Care should be a right and not a priviledge...and health care dollars should NOT go into the pockets of insurance companies and their shareholders. Currently health care providers are spending significant amounts of money for staff who are responsible for dealing with the specific hoops each insurance company requires them to jump through. Single payer is the only way to make significant change. Will some individuals (those few with excellent insurance) have less access than they do now? Of course. But other developed nations with single payer have more positive health outcomes in general (ie., lower infant mortality rates), and as a country we need to look at what's best for our population in general. Health Care should be a right and not a priviledge…and health care dollars should NOT go into the pockets of insurance companies and their shareholders. Currently health care providers are spending significant amounts of money for staff who are responsible for dealing with the specific hoops each insurance company requires them to jump through. Single payer is the only way to make significant change. Will some individuals (those few with excellent insurance) have less access than they do now? Of course. But other developed nations with single payer have more positive health outcomes in general (ie., lower infant mortality rates), and as a country we need to look at what’s best for our population in general.

]]> By: Jamey http://blog.iowahospital.org/2009/05/20/share-your-thoughts-on-health-care-coverage-reform/#comment-65 Jamey Fri, 22 May 2009 00:20:13 +0000 http://blog.iowahospital.org/?p=325#comment-65 Great analogy! It is absolutely true that one of the reasons for rising health care costs is the failure of many people to assume responsibility for their own health. I am as guilty as the next person of wanting to go out to eat, not wanting to exercise, etc. But we have to do those things in order to stay healthy, and the unhappy fact of the matter is that there are no magic pills to fix things. We have made many advances in pharmacologic therapies, but any medication has potential side effects, and even if it helps to manage a problem, rarely is it "fixed". Great analogy! It is absolutely true that one of the reasons for rising health care costs is the failure of many people to assume responsibility for their own health. I am as guilty as the next person of wanting to go out to eat, not wanting to exercise, etc. But we have to do those things in order to stay healthy, and the unhappy fact of the matter is that there are no magic pills to fix things. We have made many advances in pharmacologic therapies, but any medication has potential side effects, and even if it helps to manage a problem, rarely is it “fixed”.

]]> By: Brian http://blog.iowahospital.org/2009/05/20/share-your-thoughts-on-health-care-coverage-reform/#comment-64 Brian Thu, 21 May 2009 20:02:41 +0000 http://blog.iowahospital.org/?p=325#comment-64 As a health care benefits specialist with over 15 years of experience assisting individuals and employers select and enroll in the best coverage, I support smart reform that will lower costs and improve access. That means, for example, providing tax credits for individuals who need to purchase their own coverage, thus reducing the overall cost and reducing the number of uninsureds. I also support tax credits for employers who wisely choose to implement wellness programs for their employees, so we can deal with the demand side of the equation. Regardless of which path reform leads us, we must preserve the role of the number one consumer advocates we have--the health care benefits experts who help their members both before and after a sale! A website or--God forbid--the government, could never replace their expertise. BTW, no state will be hurt worse than Iowa by a public plan based on Medicare reimbursements. Medicare is what is killing the priviate sector today--because providers (especially in Iowa) do not get reimbursed enough to cover costs for Medicare patients--so they shift costs to private payers. Most reliable estimates suggest that every person with private innsurance pays an additional $1,500 per year just to cover Medicare shortfalls. And if a public option is based on Medicare, most rural hospitals would have to close...not a future we want. As a health care benefits specialist with over 15 years of experience assisting individuals and employers select and enroll in the best coverage, I support smart reform that will lower costs and improve access. That means, for example, providing tax credits for individuals who need to purchase their own coverage, thus reducing the overall cost and reducing the number of uninsureds. I also support tax credits for employers who wisely choose to implement wellness programs for their employees, so we can deal with the demand side of the equation.

Regardless of which path reform leads us, we must preserve the role of the number one consumer advocates we have–the health care benefits experts who help their members both before and after a sale! A website or–God forbid–the government, could never replace their expertise.

BTW, no state will be hurt worse than Iowa by a public plan based on Medicare reimbursements. Medicare is what is killing the priviate sector today–because providers (especially in Iowa) do not get reimbursed enough to cover costs for Medicare patients–so they shift costs to private payers. Most reliable estimates suggest that every person with private innsurance pays an additional $1,500 per year just to cover Medicare shortfalls. And if a public option is based on Medicare, most rural hospitals would have to close…not a future we want.

]]> By: Baxter http://blog.iowahospital.org/2009/05/20/share-your-thoughts-on-health-care-coverage-reform/#comment-63 Baxter Thu, 21 May 2009 16:59:32 +0000 http://blog.iowahospital.org/?p=325#comment-63 When considering options, let's take a look at people/consumers complaints. 1. Premiums are too high. a. Use it like insurance. When you apply for auto insurance they look at your background and can choose what to charge you and whether or not to cover you. Companies can't choose what to charge you based on your usage, but if they did I bet you would think twice before you ran to the Dr. for something. If you are on a group plan they have no choice but to accept you reagrdless of your choices. I think everyone should have access to coverage, but if they could base your price on your health/usage I feel that people would make some different choices. 2. There are loop holes in the coverage a. Know what you are getting into. Speak with someone you can trust. Use someone to obtain your insurance (individual) that has access to multiple carriers. Many plans are just as good or better than that offered by an employer, and once you are accepted you can't be turned away because your health deteriorates, contrary to what many people think. Once again educate yourself. When insurance is provided to everyone at the same price through the same plan and is less expensive than it is currently, where will they get the money for that program. Directly from working legal citizens of the USA. What about the people who don't pay taxes or don't work? Yeah we pay for theirs too. We are currently paying into a system that won't be around for younger people to utilize, what will happen when the same people get a hold of this system? We must think long term for our children/grandchildren's sake. Address the problem, we have a weak unstable economy what will happen when citizens who want the most technolgically advanced healthcare can't get it because we don't have the money to fund the new studies? Doctors move and change professions because they are getting paid the Medicare going rate, and can't keep their offices open? What about the insurance companies, brokers etc go out of business in the insurance capital of the world? (Des Moines, IA) Who will people contact with claims issues, the government, I'm sure that will be easy to get through to, when everyone in the nation is calling. The only benefit would be that they will be hiring for people to answer the phones, which is good, considering all of the people who will be out of work. When considering options, let’s take a look at people/consumers complaints.

1. Premiums are too high.
a. Use it like insurance. When you apply for auto insurance they look at your background and can choose what to charge you and whether or not to cover you. Companies can’t choose what to charge you based on your usage, but if they did I bet you would think twice before you ran to the Dr. for something. If you are on a group plan they have no choice but to accept you reagrdless of your choices. I think everyone should have access to coverage, but if they could base your price on your health/usage I feel that people would make some different choices.

2. There are loop holes in the coverage
a. Know what you are getting into. Speak with someone you can trust. Use someone to obtain your insurance (individual) that has access to multiple carriers. Many plans are just as good or better than that offered by an employer, and once you are accepted you can’t be turned away because your health deteriorates, contrary to what many people think. Once again educate yourself.

When insurance is provided to everyone at the same price through the same plan and is less expensive than it is currently, where will they get the money for that program. Directly from working legal citizens of the USA. What about the people who don’t pay taxes or don’t work? Yeah we pay for theirs too. We are currently paying into a system that won’t be around for younger people to utilize, what will happen when the same people get a hold of this system? We must think long term for our children/grandchildren’s sake. Address the problem, we have a weak unstable economy what will happen when citizens who want the most technolgically advanced healthcare can’t get it because we don’t have the money to fund the new studies? Doctors move and change professions because they are getting paid the Medicare going rate, and can’t keep their offices open? What about the insurance companies, brokers etc go out of business in the insurance capital of the world? (Des Moines, IA) Who will people contact with claims issues, the government, I’m sure that will be easy to get through to, when everyone in the nation is calling. The only benefit would be that they will be hiring for people to answer the phones, which is good, considering all of the people who will be out of work.

]]> By: Baxter http://blog.iowahospital.org/2009/05/20/share-your-thoughts-on-health-care-coverage-reform/#comment-62 Baxter Thu, 21 May 2009 16:37:27 +0000 http://blog.iowahospital.org/?p=325#comment-62 I think we should first (to rule out a state run program) take a look at how Massachusetts plan is working for them and what the outlook is? It is not good thus far. All of the other one's involve government run programs. I think enough history is provided in the article alone to show how that system is working. I think things could stay the same with some education of comsumers. Why do we treat health "insurance" different than auto or home "insurance." Well we don't make claims on our auto or home unless it is necessary because our premium will go up. So what do we do (should we do) instead, we obey traffic laws and try to avoid making a claim. Homeowners insurance the same thing, can we fix it instead of making a claim. What do we do with health insurance "oh I have health insurance so I will go to the Dr. for the sniffles, or I can eat and drink whatever I want because my Dr can give me a magic pill to lower my HBP or Cholesterol." We over utilize a system and complain because our premiums continue to rise. Why don't we instead take some "self responsibility" and take care of our bodies, teach good eating habits, excersice etc and try to avoid running to the Dr. all the time. Does it remove it all together, no but it keeps costs down. Why do we have so many type II diabetics, it's not a hereditary problem it is an overweight problem. We are trying to control the syptoms rather than attack the problem. With the nations philosophy on healthcare applied to the auto insurance world, we would essentially be driving around trying to get in accidents to be sure we are utilizing above and beyond our premium dollars. I think we should attempt to educate people about the importance of wellness and the understanding of insurance. Don't replace something because the consumer abuses it, educate the consumer. I think we should first (to rule out a state run program) take a look at how Massachusetts plan is working for them and what the outlook is? It is not good thus far. All of the other one’s involve government run programs. I think enough history is provided in the article alone to show how that system is working. I think things could stay the same with some education of comsumers. Why do we treat health “insurance” different than auto or home “insurance.” Well we don’t make claims on our auto or home unless it is necessary because our premium will go up. So what do we do (should we do) instead, we obey traffic laws and try to avoid making a claim. Homeowners insurance the same thing, can we fix it instead of making a claim. What do we do with health insurance “oh I have health insurance so I will go to the Dr. for the sniffles, or I can eat and drink whatever I want because my Dr can give me a magic pill to lower my HBP or Cholesterol.” We over utilize a system and complain because our premiums continue to rise. Why don’t we instead take some “self responsibility” and take care of our bodies, teach good eating habits, excersice etc and try to avoid running to the Dr. all the time. Does it remove it all together, no but it keeps costs down. Why do we have so many type II diabetics, it’s not a hereditary problem it is an overweight problem. We are trying to control the syptoms rather than attack the problem. With the nations philosophy on healthcare applied to the auto insurance world, we would essentially be driving around trying to get in accidents to be sure we are utilizing above and beyond our premium dollars. I think we should attempt to educate people about the importance of wellness and the understanding of insurance. Don’t replace something because the consumer abuses it, educate the consumer.

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