Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts
Monday, March 12, 2018
And the poll says......
Have you ever been part of a Gallup Poll or maybe a Quinnipiac University Poll? (Is that a real school? Do they play football? What conference are they in?) According to the above poll of pollsters (haha!) they're in the believable category. Political party polls and news media polls, not so much.
I'm always hearing about how the American people are in favor of or against blah blah blah, but if you look at how Americans say they feel about contemporary issues, and then look at how Congress is representing us with their votes, you'll see a definite disconnect.
We say we want immigration reform, and our politicians nod and agree, and then passively do nothing, or worse, the exact opposite.
We say we don't want trade tariffs, and our politicians nod and agree, and then just sit on their thumbs.
We have opinions on various gun control measures, ditto.
We tell them how we feel about taxes, and health care, and they tippy toe around them and do nothing.
Here's a typical day for a Washington politician: They meet for breakfast with a lobbyist who says his client wants X, then meets with a trade group from "back home" who says they do not want X. He poses for pictures with his constituents, passes out ceremonial Congressional paper weights, thanks them for their opinion, promises to keep in touch, then goes out and votes for X, which is slyly buried in a bill promising to end puppy mills, 'cause, you know, everyone wants to end puppy mills, right?
Then two months later he's the speaker at an event back home, and they treat him as if he was royalty! People are scared to speak up and hold his feet to the fire, or throw him in the fire, because....I have no idea why.
What's the point of public opinion polls if our public servants (wow....there's an oxymoron!) pay us no attention?
S
Wednesday, September 20, 2017
Is "socialist" the most feared word in America?
Damn socialists!
Truth is, Americans have benefited from many programs some would call "socialist", like SOCIAL Security and Medicare. I'll concede, some Americans probably don't like Social Security or Medicare, as they will never in a million years ever need to rely on either. They can just cut a check for whatever they want.
But what about public schools? Isn't that a social program, paid for by all, for the benefit of all? How about interstate highways, paid for by all, for the benefit of all?
How about fire departments? Modern professional fire departments are a fairly recent development. Battling fires used to be something neighbors did for each other on a volunteer basis, with abysmal results. Now we have highly professional, highly effective municipal fire departments, paid for by all, for the benefit of all. Ditto for law enforcement....paid for by all, for the benefit of all.
When I was in school, way back in the last century, we were taught in civics class that government existed to do for people what they couldn't do for themselves. At the time of the writing of our Constitution that meant things like maintaining a postal system and maintaining a strong military, paid for by all, for the benefit of all. It was a pretty simple time.
Now, in this century, it seems reasonable to empower a Securities and Exchange Commission to look out for us, as "financial services" are much too sophisticated for the average person to comprehend, which leads to many of us getting ripped off. We need an SEC to protect us, paid for by all, for the benefit of all.
How about a Food and Drug Administration, paid for by all, for the benefit of all? Would you know how to tell if a drug is effective and safe, or just worthless snake oil, or worse?
We're now on the cusp of comprehensive health care falling into the category of things we probably can't do on our own. If a national health plan similar to that practiced in the UK is too radical for us, maybe we could look elsewhere, such as in my friend's native Germany, for a health care system that works, that is insurance based, and is universal. But to just whack what we have now, without a better replacement, just to please those who will never have to worry about paying for anything, is just wrong!
My point is, benefiting from some social programs does not make us socialists, and is something to be embraced, not feared. We've had them for years, whether we've realized it or not, and they've served us well.
S
Wednesday, January 18, 2017
Think outside the box? I can't even FIND the box!
You're born, you go to school, you go on to a job doing _____, you get married, have kids, and you climb the career ladder, making more $$$ at every step. You have a house, 2 cars, a retirement plan for later on, and finally you hang it up and relax to a nice life bouncing grand-kids on your knee and traveling the country in your RV. Oh, and you'll never get sick. SWEET!
Except you forgot to figure in "reality".
Here's the more likely scenario: You're born (so far, so good)....then the wheels come off. Too often kids find themselves without two-parent influence. The cost of higher education means many kids/parents can't afford it, except with massive student loans that can take decades to pay off. Jobs seldom have the security of lifetime employment like they did 50 years ago. Changing technology means you'll constantly have to reinvent / retrain yourself and start over again, which likely means a pay cut. Which in turn means you'd better think twice before buying that big house with the 30 year mortgage. It's hard enough seeing 2 years into the future, much less 30.
More and more, new jobs are being created by small companies, as opposed to the big Fortune 500 companies, and small companies often can't afford all the perks such as family health care and retirement / 401K plans that were common not long ago. Statistically we're having smaller families since, for one thing, it costs so much to raise kids today....about $250K to raise one child to the age of 18 they say. Ouch! And if that big house is questionable, an RV is even more of a dream.
And the odds are great you WILL eventually get sick. I was healthy as a horse until my innards decided to rebel at age 64. (Maybe I should come back in my next life as a horse?) Luckily I had good health insurance. Many of us, however, find ourselves having to pay more for our health insurance than we do for our house payment. Will it soon be an either/or proposition? Copays and deductibles are up, yet the percentage insurance pays is often down.
Our personal "plans" are increasingly diverging from what life is actually dealing us. The trend lines are moving in opposite directions.
The status quo isn't working for us. Day after day, year after year, we're losing ground. This isn't meant as a doom and gloom post. It's just a wake up call. We CAN turn things around IF we put aside the idea that "we've always done it this way" is the only way.
We're at a crossroads. Are we going to stick with our "plan", or face reality and consider things that don't fit our stereotypical boxes?
S
Friday, January 13, 2017
Now you see it, now you....just kidding. You're NEVER gonna see it.
A few years ago we did a fairly sizeable home remodel for a client. In conversation I learned that the Mrs was a now-retired hospital CFO. (Her hospital was absorbed into another even larger system, and she took her bonus/payout and retired.) I shared with her my frustration trying to figure out hospital and doctor statements, and she just chuckled and said, "Of course you're frustrated. That's by design."
She told me how hospitals had a MSRP Blue Book (my term, as I can't remember what she actually called it) which listed their charges for everything you could possibly imagine. "Appendectomy $19,300; double heart bypass $94,000; set broken arm $12,600, aspirin $10", etc (I can't remember her actual numbers).
But then she told me their dirty little secret: ALL their numbers were totally made up! They bore no resemblance at all to their actual costs. There is no industry standard. And every other hospital had their own Blue Book, too, with their own totally made up prices, and they often differed widely. That's why you'll hear TV investigative reporters tell of how one hospital charges $300 for a mammogram, while another across town charges $2,700.
Of course insurance companies have contract pricing where they pay MUCH less, but if you have to pay yourself, this is what they bill you. Some pay, some walk it entirely, but some come back to negotiate (and the hospitals allow themselves LOTS of room to negotiate). It's a giant shell game!
Some doctors do something similar. You call a doctor and ask if they take your brand of insurance and are told yes, so you make an appointment. A few weeks later you find out from your insurance company that the doctor charged more than the "usual and customary" fee, and that the balance is up to you. Gee, thanks for telling me up front, doc.
Ditto for prescription drugs from your insurance plan or Medicare drug supplement. They cover what is on their "formulary" list only. Their what? If it isn't on their list, you're SOL. (Shit Out of Luck) And they list page after page of things like hydrothialomicizinetine trididodickyluckypucky. WTH? What happened to "Lyrica" or "Crestor"? Sadly this is the way our world works today....you're led to believe one thing, only to find out later the fine print screwed you over.
We little guys don't stand a chance!
So now they're going to REPEAL AND REPLACE Obamacare. OK, great, by all accounts it needed to be overhauled. But please tell me how they're going to get all those various interests, each with their own proprietary fine print, to agree to a viable replacement? Each will be maneuvering to throw the other under the bus first. (No honor among thieves, you know.) And it will eventually have to be voted on by Congress....yes, bought-and-paid-for Congress. *bend over folks*
There's fine print everywhere....buried in that 8 page credit card agreement, that 75 page mortgage document, your homeowners/renters/auto/life insurance policies, your auto loan agreement, that investment prospectus....everywhere!
Here's the deal: most businesses today don't WANT you to know how they operate. They LOVE doing business in the shadows. Transparency is the LAST thing they want.
Ever hear of the Consumer Financial Protection Bureau? It was an outgrowth of the financial meltdown back in '08. Its supporters will tell you it exists to slap down businesses that take advantage of unsuspecting consumers (ie: non-lawyers who can't understand all that legalese/fine print). Detractors, such as the Big Banks, the US Chamber of Commerce, and I'm sad to say the Republican establishment, will tell you it "interferes with their ability to conduct business as they feel they need to", and besides, regulations are JUST DOWNRIGHT UN-AMERICAN!! *saluting flag*
Seems to me if the Big Banks, the US Chamber of Commerce, and the Republican establishment (and probably more than a few Democrats, too) would behave the way their mamas taught them, there wouldn't be a need for a Consumer Financial Protection Bureau.
What you DON'T know WILL hurt you, or at least COST you. Caveat Emptor now more than ever, my friends.
S
Wednesday, April 23, 2014
This is NOT a "feel good" post
I just read in the news that Canada now has a more affluent middle class than the United States. So do several other countries.
On the ever-popular topic of health care, the United States ranked 40th in the world on accessibility of quality health care, behind #1 France, as well as Singapore, Portugal, and Chile, among others.
We've been reading for years about the sad state of our educational system here in the US. Finland ranks first in the world followed by others like South Korea, Hong Kong, Latvia, and Slovenia.
Our economy statistically is bouncing back from recession at a world-leading pace, but those jobs are by-and-large not the high paying jobs we need.
Now many are questioning the wisdom of borrowing heavily for a college education. They say the debt students are straddled with when they graduate is way out of line with the modest-paying jobs they're likely to get. They'll be in debt forever.
Many of our cities are decaying, our roads and bridges are in sad shape, and we're afraid to smile at anyone for fear we'll be called in for "sensitivity training." Political correctness rules.
When something goes wrong, it's always that elusive "someone else's" fault, never our own. Lie, cheat or steal if you have to, just "show me the money".
We universally think we're the best at everything, when we are increasingly just average at everything....nothing more.
This is not meant to be a "beat up on the US" post. Quite the opposite; this is meant to be a "WAKE UP AMERICA" post.
IMO, and I think my position is probably now a majority opinion, our system is simply broken. Class warfare is raging. "I've got mine. You go get your own". Tea Party members don't play well with others, nor do their extreme liberal counterparts. We are our own worst enemies.
We MUST break this. Our political system is a joke. The wrong people / special interests get breaks at the expense of the rest of us, which ultimately weakens us all.
Yet we still strut around yelling "WE'RE NUMBER 1". We're talking the talk, but we're sure not walking the walk. How long do you have to be in denial before you hit bottom?
There's nothing we can't do, but a lot of us are going to have to change the way we think before that will happen.
Does anyone give a shit anymore?
Happy hump day. :)
S
Thursday, November 15, 2012
The Grand Conundrum
The headline read: "Romney blames loss on Obama's 'gifts' to minorities and young voters".
In a conference call with many of his big-money supporters Mitt Romney told them that it was Obamacare (calling it a gift to lower-income Americans, perceived to be primarily minorities), the Dream Act (which prohibited deportation of young illegal immigrants who were brought here by their parents when they were very young), and the forgiveness of a considerable amount of the interest incurred by students (who are relying on student loans to get their education) that was responsible for his defeat. He said these "gifts" to targeted groups bought Obama enough votes to put him over the top.
Or to put it another way, the status quo didn't work for the Republicans. This needs to be their wake-up call. They need to find a way to embrace these groups and broaden their base of supporters. Making the recent election an "us vs them" affair is no way for Republicans to turn their fortunes around.
Here's the conundrum: Yes, we need to cut our budget deficit. We can't go on indefinitely running up a trillion dollars a year in red ink. But at the same time, we DO need to expand health care. Where a decade ago 65% of companies provided health insurance to their employees, today it's roughly 55%. You see the trend? An unhealthy, broke workforce is not what we need to compete economically with the rest of the world.
And we DO need a highly trained workforce, which obviously requires a highly educated workforce. The days of getting a high school diploma and then spending the next 40 years working at the sawmill are over. Education costs lots of money, money most families don't have. Government does, except it's all borrowed money.
And we DO need immigrants. While many developed countries actually have a shrinking population, ours is still growing, thanks to births to recent immigrants. Without them working and paying in to "the system" we won't be able to honor our commitments to our baby boomers now at or nearing retirement. We need to find a way to expeditiously, responsibly admit new immigrants. And legitimize many (but not all) of those here now.
It seems we need to do lots of things to stay on top in the world, but they all cost money. Money we don't have. What to do?
S
Tuesday, August 14, 2012
A couple of questions....
It's obvious that Social Security and especially Medicare are going to be the hot button issues of the upcoming presidential election. It's all about cutting the deficit, and these two things will bear the brunt of any budget reforms.
My questions are:
Are you reasonably happy with Medicare as it exists now, or are you just comfortable with it because it is a known quantity?
Do you just accept Medicare with all it's flaws because you are afraid of the alternative?
Are you afraid a voucher-type senior health care program will force seniors to pay money out of pocket (that they may or may not have) in order to get comparable coverage to what Medicare offers now? In other words, in your mind, is a voucher-type system a step backwards?
My questions are:
Are you reasonably happy with Medicare as it exists now, or are you just comfortable with it because it is a known quantity?
Do you just accept Medicare with all it's flaws because you are afraid of the alternative?
Are you afraid a voucher-type senior health care program will force seniors to pay money out of pocket (that they may or may not have) in order to get comparable coverage to what Medicare offers now? In other words, in your mind, is a voucher-type system a step backwards?
Tuesday, June 26, 2012
Healthcare talk
Any day now the U S Supreme Court will hand down their decision declaring all or parts of "Obamacare" to be unconstitutional or allowing it to stand as-is. Regardless of the ruling, about 1/2 of the people are going to be unhappy. Me?....I'm somewhere right in the middle. I don't think the system we have now is working well enough to remain unchallenged, but I don't have an alternative to offer, either. If you don't have insurance or can't get it, you know how dire the situation is. If you're one of the lucky few who have insurance AND deep enough pockets that would enable you to absorb any after-insurance expenses, you obviously don't see the problem, but you should never forget.....things can change in a hurry.
I have a friend who at age 61 had double-bypass surgery. He had insurance and could easily handle the co-pay, but the next year he was laid off his upper management job of 25+ years, with his termination package giving him just one more year of company insurance after that. (His deep suspicion was his company wanted him gone due to his health liability.) With his medical and family history he couldn't buy health insurance on the open market. He bought into a state "last-resort" policy, but that soon proved unaffordable so he went "naked" until Medicare kicked in at age 65. Every ache and pain sent him into panic mode. He never thought he'd find himself in that position.
On the other hand I don't have confidence in our government to manage much of anything efficiently. The Obamacare bill is...what...2,700 pages long? Can anyone really, REALLY understand it? I know the UK, Canada, Australia, and some others have universal government-run programs that seem to have a lot of good points, but they also have some well-documented problems, too, such as the fact they're breaking the bank.
Then there's the matter of the Emergency Medical Treatment and Active Labor Act of 1986. This law requires almost all hospitals to treat anyone walking in seeking medical attention. It was meant to cover true emergencies, but now is being used to treat colds, the flu, etc. Hospitals and doctors have billions of dollars in un-collectable write-offs. Did you know that >60% of bankruptcies are due to medical bills people can't pay? And that 78% of those are by people who had insurance but couldn't pay for all those things not covered by their insurance? And besides the obvious hit to doctors and hospitals, bankruptcy is a drain on our economy in a bigger sense, too. Those who have gone through it find it difficult or impossible to buy a house, a car....pretty much anything that requires credit. These are potential big-ticket consumers who will NOT be helping grow our economy.
Just some thoughts for you to consider. IMO, regardless of what the Supreme Court decides, SOMETHING needs to be done about healthcare in America. I wish there was a simple answer.
S
I have a friend who at age 61 had double-bypass surgery. He had insurance and could easily handle the co-pay, but the next year he was laid off his upper management job of 25+ years, with his termination package giving him just one more year of company insurance after that. (His deep suspicion was his company wanted him gone due to his health liability.) With his medical and family history he couldn't buy health insurance on the open market. He bought into a state "last-resort" policy, but that soon proved unaffordable so he went "naked" until Medicare kicked in at age 65. Every ache and pain sent him into panic mode. He never thought he'd find himself in that position.
On the other hand I don't have confidence in our government to manage much of anything efficiently. The Obamacare bill is...what...2,700 pages long? Can anyone really, REALLY understand it? I know the UK, Canada, Australia, and some others have universal government-run programs that seem to have a lot of good points, but they also have some well-documented problems, too, such as the fact they're breaking the bank.
Then there's the matter of the Emergency Medical Treatment and Active Labor Act of 1986. This law requires almost all hospitals to treat anyone walking in seeking medical attention. It was meant to cover true emergencies, but now is being used to treat colds, the flu, etc. Hospitals and doctors have billions of dollars in un-collectable write-offs. Did you know that >60% of bankruptcies are due to medical bills people can't pay? And that 78% of those are by people who had insurance but couldn't pay for all those things not covered by their insurance? And besides the obvious hit to doctors and hospitals, bankruptcy is a drain on our economy in a bigger sense, too. Those who have gone through it find it difficult or impossible to buy a house, a car....pretty much anything that requires credit. These are potential big-ticket consumers who will NOT be helping grow our economy.
Just some thoughts for you to consider. IMO, regardless of what the Supreme Court decides, SOMETHING needs to be done about healthcare in America. I wish there was a simple answer.
S
Monday, April 16, 2012
Taxes....the good, the bad, and the ugly
This week it's all about taxes. First the good: April 17th is Tax Freedom Day. The average American has essentially paid all the money he's earned so far this year to Uncle Sam to satisfy his tax bill. After tomorrow he'll be working to put money in his pocket. YEA!!
Now the bad: Your taxes are due today. Pay up. BOO!!
Finally, the ugly: IMO most Americans wouldn't mind paying their taxes IF we felt our government was being run efficiently and fairly. I've heard it said that most Europeans don't mind paying much higher taxes than we do because they feel like their government is run efficiently (?) and they're getting something for their money. A college education is inexpensive or even free for most, child care is free or heavily subsidized, unemployment and job re-training is much more generous, etc. We won't even go into health care.
Yes, those things cost a lot of money, and Europeans are taxed through the nose to pay for it (except the Italians and Greeks apparently), but at least they get something for their tax dollars...er...euros. And yes, since the end of WWII NATO (read: the USA) has covered much of the cost of their national security, leaving them more money for their social programs, but still.... (European readers, if this is not true please feel free to correct me.)
By contrast, here in the US we have a system that taxes one group and generally gives the benefits to another group, fomenting class conflict. For example, I had to pay 100% of the cost to have braces on my kid's teeth. I didn't qualify for any type of government help. (Here in Texas kids on Medicaid can get them for free.) College....100% on me. We made too much to qualify for any grants. Child care....no government assistance for us. I know some will say, "But Scott, you could afford to pay for those things for yourself." I disagree. It was a HUGE struggle for us at the time. We had to go without a lot, but my tax bill still came due on April 15th. Imagine paying for car insurance, then having an accident and being told you didn't qualify for a repair because you made too much money. Same principle. You can imagine how such treatment might lead to "tax resentment".
Yes, of course, the rich pay LOTS in taxes, but they also get LOTS of special treatment / tax breaks, etc. And corporations....somebody 'splain to me again why we give BILLIONS of dollars in subsidies to highly profitable companies like ExxonMobil, ChevronTexaco, ConAgra, and others?
Here's my point: I'm not necessarily suggesting we should adopt Europe's social programs. We can't afford what we have now, I contend because our government is run so inefficiently it's criminal. What I am suggesting is that we need to spread the payment of taxes and the benefits they bring more evenly.
OK, rip me.
S
Now the bad: Your taxes are due today. Pay up. BOO!!
Finally, the ugly: IMO most Americans wouldn't mind paying their taxes IF we felt our government was being run efficiently and fairly. I've heard it said that most Europeans don't mind paying much higher taxes than we do because they feel like their government is run efficiently (?) and they're getting something for their money. A college education is inexpensive or even free for most, child care is free or heavily subsidized, unemployment and job re-training is much more generous, etc. We won't even go into health care.
Yes, those things cost a lot of money, and Europeans are taxed through the nose to pay for it (except the Italians and Greeks apparently), but at least they get something for their tax dollars...er...euros. And yes, since the end of WWII NATO (read: the USA) has covered much of the cost of their national security, leaving them more money for their social programs, but still.... (European readers, if this is not true please feel free to correct me.)
By contrast, here in the US we have a system that taxes one group and generally gives the benefits to another group, fomenting class conflict. For example, I had to pay 100% of the cost to have braces on my kid's teeth. I didn't qualify for any type of government help. (Here in Texas kids on Medicaid can get them for free.) College....100% on me. We made too much to qualify for any grants. Child care....no government assistance for us. I know some will say, "But Scott, you could afford to pay for those things for yourself." I disagree. It was a HUGE struggle for us at the time. We had to go without a lot, but my tax bill still came due on April 15th. Imagine paying for car insurance, then having an accident and being told you didn't qualify for a repair because you made too much money. Same principle. You can imagine how such treatment might lead to "tax resentment".
Yes, of course, the rich pay LOTS in taxes, but they also get LOTS of special treatment / tax breaks, etc. And corporations....somebody 'splain to me again why we give BILLIONS of dollars in subsidies to highly profitable companies like ExxonMobil, ChevronTexaco, ConAgra, and others?
Here's my point: I'm not necessarily suggesting we should adopt Europe's social programs. We can't afford what we have now, I contend because our government is run so inefficiently it's criminal. What I am suggesting is that we need to spread the payment of taxes and the benefits they bring more evenly.
OK, rip me.
S
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