Sunday, July 12, 2009

A Move in the Right Direction for Health Care

Health care is the big item on the White House agenda as of late. It's the hot topic we knew they were going to tackle ASAP and if they get their way, increases the power and influence of government in all of our lives. In my March 31, 2009 post I discussed a need for health care to move away from the current insurance system. This would take providers developing and alternative to working with insurance companies in much the same way Walmart has lead the way for low prices on generic drugs.

On Tuesday July 7, I found this article on Take some time to read it as it is a great example of where I think health care should go.

Basically it discusses a Seattle Clinic that was started by doctors tired of dealing with insurance companies. The attract new doctors by offering stock options. They offer care to patients from $39-$119 a month depending on age and level of insurance. No one is rejected for preexisting conditions. It also covers round the clock unrestricted care and 30-minute appointments

It doesn't cover catastrophic care, but the article reports that a 30 year old person could expect to pay $133 per month for such coverage. Obviously that goes up with age.

Here's the thing, my employer sponsored premium is $350/month. They cover that but I have to pay deductibles, co-insurance, and co-pays. Every time I go to the doctor I pay $20 or $30 for a specialist. Just think, if my employer didn't have to pay $350 for my insurance and instead gave me a $350 raise to go out and buy my own insurance, the least I could pay anywhere from $172 - $252 a month for coverage. This leaves me an extra $100/month plus any of my copays and coinsurance to cover any medication I might need on occasion, or lab work that I usually have only once a year, or anything else that might not be covered in the services offered by their clinic.

This is a link to the clinic's services that they offer.
And while they don't offer all specialty services, they do offer the basic preventative care and disease management which is what most people are needing. They are an example of how specialty care providers could get together and offer their specialty services refusing to work with insurance. Prenatal and maternity care come to mind. Although I know from a previous job that many doctors and providers already have reduced rates for those paying cash for these services. But people always think they need insurance. Radiology groups could refuse to deal with insurance which greatly reduces the staff they need to run the business office, which reduces the costs to you the patient. I'm sure if they put their heads together they could come up with even more ways to reduce your costs, and to encourage people to use their services every once in awhile to help reduce costs over time.

In reality, insurance is just a method of prepaying for services you will use. But we have become so accustomed to our employers providing us insurance or the government doing these things for us that we don't want the responsibility of saving that $200-$300/month just for health care expenses. Trust me people you don't want the government in charge of your health care. If you want health care bad enough, if it becomes a priority to you, you will pay for it. And if you will pay for it, a doctor will see you and treat you. It just hasn't become a priority for most people and they are spending the money elsewhere and are under the impression that they can't afford quality coverage. The reality is they don't want to pay for it so the next step is to demand the government find a solution so they don't have to pay for it. They are just going to take it out of your check each month before you get paid.

What do you all think of what this clinic is doing? They are saving money on the office staff it would required to bill insurance companies, that also have to employ people to process your claims. The providers and the insurance companies are in the business of making money so who do you think ultimately pays for these 2 sets of people to process your claims? They go into the cost of health care provided to you. You pay for it. Don't kid yourself and say your company pays for it or the government pays for it. You're salary is probably a lot less over time because your benefits fall into your compensation package, and you pay taxes to the government to pay for everyone on government insurance. Unless the government is supporting you.


Anonymous said...

Lola, please give your comments on the responsibility of each individual to take care of themselves in support of not being a burden to the rest of us.

Amlicar said...

It appears that only in the USA,where big corporations are the only managers capable of providing people effective service.

We never want to consider other countries' model of providing efficient lower and middle income health care service. Cuba is not loved by us but many developing countries and the Cuban people will swear by their health care model.

I am sicken by the continuous attack by misguided Americans, that do not ever consider lower income families in their analysis of models of health care service.

There are incomes earned by Americans whose families came to America over a hundred years ago. But are still earning less than $20,000 annually.How many Americans you think earn $25,000, or $30,000 annually that are not considered in many income statistics.
So any insurance payments of $115.00 per month is ludicrous to suggest.
When statistics show average American incomes they misguidedly reflect incomes from upper to middle middle class, but do not talk about lower middle class and working class families .

We leave out a large section of Americans when we fashion programs only for office workers and accuse the lower income earners of being socialists for wanting more social and community programs that's within their income reach.

The USA needs more Cooperatives and Credit Unions to protect lower income families from Big Corporations ruining the potential of Americans lives.

Lola said...

You're wrong. It's about priorities and a sense of personal responsibility to take care of youself rather than to depend on the world to step in and take care of your needs. It's about foregoing wants to cover your needs. But far too often lately wants are being defined as needs. For example cell phones, cable, and highspeed Internet. All of which total $150-$200. As opposed to $20/month for basic phone service only. People wrongly think they are entitled to high quality health care. Well they already have the in the form of the emergency room. But that isn't "high quality" enough because they have to wait. Well if not waiting was more of a priority they could purchase insurance or agree to pay the doctor's price for a check up and schedule and appointment. There are plenty of options for people that make less than poverty level to more ($30,000 as you put it) in the form of clinics and doctors that offer free or low cost care for them as well as the ER as mentioned above. But they may run into the same issue of having to wait several hours to see the doctor. I'm sorry but if you're waiting for care you aren't going to pay for, I'd say it's worth the wait. Again if you don't want the wait, invest in insurance or pay out of your pocket.

You're failing to recognize that people/families making $40,000+ even $75,000+ are choosing not to buy insurance for their families because it's apparently worth the risk to them to just pay cash for preventative care or not to have catastrophic coverage, or not to see the doctor at all.

I just ran across an even more affordable option than listed in my write up. There is an ad in the Readers Digest for Telemedicine services for the whole family. $30/month. They will even write prescriptions for things that people often go to the Emergency Room for. Granted this doesn't cover the need for preventative care, but is cheaper than going to the ER and not ever paying your bill, which gets passed on to those that do take personal responsibility for their lives. I don't think $115/month is asking too much when you have cell phone, cable, and Internet and a $500 car payment.

Think I'm misguided? My mother used to work for the charity program of a hospital. People below the poverty line had $75+ cell phone bills, $120 cable bills, and $300-$500 car payments of cars 5-10 years old. Don't tell me I'm misguided. It's about priorities. People making $10-$15 often have to pay for their insurance premiums through their company. Perhaps if they have a job that doesn't offer a plan to buy into, they ought to take that responsibility on themselves. But many misguided Americans believe my family and other hardworking families should buy insurance for those that choose not to buy it themselves.

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