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Wednesday, December 10, 2008
Carrie Schwab Pomerantz :: Townhall.com Columnist
Taking the Pulse on American Health Care
by Carrie Schwab Pomerantz
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Will the Dems' health care Christmas Present to America be an improvement or detriment to our health care system?


Our country's appetite for change, as evidenced by the recent election, seems to extend to our health care system. After years of rising costs and less accessibility to quality health care for millions of Americans, we finally seem ready to accept reform.

According to the 11th annual Health Confidence Survey conducted by the nonprofit Employee Benefits Research Institute (EBRI), virtually all Americans say that affordable, high quality health care should be at the top of our nation's health care goals. Significantly, more than 80 percent are willing to support tax incentives and other government involvement as a way to make health care more affordable and more available.

Add to these statistics the fact that only 51 percent of respondents are extremely or very confident that they can get the treatments they need, and only 42 percent say they have adequate choice of medical providers -- and the desire for real health care reform seems pretty clear.

Not surprisingly, cost is one of the main health care issues today. I think we're all feeling a bit battered by rising health care costs -- from insurance premiums to prescription drugs -- especially when we're experiencing an economic slowdown.

Interestingly, while 55 percent of Americans with insurance coverage report an increase in costs in the past year, that percentage is actually down from 65 percent in 2007. On the face of it, that seems like a positive. But on the flip side, far fewer are satisfied with the cost of health insurance and with the cost of services not covered by insurance.

Especially troubling to me is that 42 percent of survey respondents are not too or not at all confident about the affordability of healthcare -- an increase from 36 percent last year. And this lack of confidence translates into daily decisions that can impact our health as well as our finances.

Consider that for Americans who have experienced cost increases:

-- 62 percent are more likely to go to the doctor only for more serious conditions or symptoms;

-- 29 percent have decreased their contributions to retirement;

-- 54 percent have decreased their savings;

-- 27 percent have difficulty paying for basic necessities.

When people are at the point of having to choose between their physical health and their financial health, the need for a cure for our health care system becomes more and more apparent.

When it comes to rating the quality of the nation's healthcare system, the percentages are pretty alarming. The majority rates it as fair or poor. Only a small minority rates it excellent (4 percent) or very good (11 percent).

While the good news is that half of the survey respondents remain extremely or very satisfied with the quality of their own health care, even better news is our willingness to help find a cure for our ailing system. As I mentioned at the beginning of this column, I think it's pretty significant that:

-- An overwhelming majority says that providing high-quality health care (93 percent) and making health care more affordable (90 percent) are extremely or very important goals of health care reform.

-- 87 percent support tax incentives to help people purchase their own coverage.

-- Substantial majorities would support letting those without insurance buy into Medicare or buy the same insurance offered to government employees.

No matter what your personal feelings are about the current state (or future) of our health care system, there is little doubt that adequate insurance is an essential part of your overall financial health. If you don't have medical coverage through your employer or another group, consider your options right away. I suggest at least a low-cost, high-deductible policy to cover major expenses.

Don't risk the possibility that a major health issue or a medical emergency could derail your financial future. Make health insurance premiums a part of your budget. And make sure that saving for retirement and your other goals remain in that budget as well. With the right coverage, the right attitude and a little fortitude, I believe we can all manage to take care of both our physical and financial health until the goal of quality affordable health insurance for all Americans is achieved.

For more information on the Employee Benefits Research Institute and its 2008 Health Confidence Survey, go to: http://www.ebri.org/surveys/hcs/2008/.

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About The Author

Carrie Schwab Pomerantz is a Motley Fool contributor.

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Good Article..but another approach is...
is much, much better. Almost everything government becomes involved in, it basically screws up....and this is because of micro-management and agenda pushing. (hacks)...

Let the free market determine health care costs by promoting prevention....as in no macdonald's triple cheeseburgers for fat kids, or no salty fries for folks with high blood pressure, and certainly no shakes or banana splits either.

We need MORE education for fitness and nutrition...after all, they say we are what we eat, and if that's the case, many Americans are walking slabs of trans-fat, waiting to collapse at any moment.

If people eat properly, exercise, and change some habits(such as 40 oz. malt liquors)or smoking cigarettes is stopped, there would be less disease or health issues, thereby lowering health care costs by supply and demand economics...if there is less demand, then prices generally go down.

P.S. One of the biggest contributors to breast cancer is OBESITY.......those burgers, fries, shakes and tacos, sure cause alot of problems....

Silver Lion from OH

Well if your going down the path of micro managing high risk behavior, how about higher premiums for parents of kids who play sports?

How about higher premiums for people who jog, ride bikes, mountain climbing, snow sking? They all are prone to more injuries than the general population.

How about people with hobbies, have pets, have a workshop in the home. Most injuries occur at the home.

Should people with Asthma be forced to move to Arizona? If they live in a temperate zone they are exposed to more pollen.

Should African Americans pay more because high blood pressure is more likely in the black community?

I am all for free market solutions to healthcare. But the path you suggest is dangerous.

I don't want the government or the private sector micro-managing our lives.

The nature of insurance is a shared responsibility of risks. Some of us will do some things well and some things we won't do as well as we could. That is the price of Freedom.

Jeffersonian Constitutionalist Dec 10
Your last two thoughts: "I don't want the government or the private sector micro-managing our lives. The nature of insurance is a shared responsibility of risks. Some of us will do some things well and some things we won't do as well as we could. That is the price of Freedom."

Agree and thank you for your post.

no government interference required
Health insurance should be at the option of the individual. Employers should not be allowed to provide health insurance for their employees. Rather, insurance plans should be along the lines of the Health Savings Accounts with a very high deductible and !00% coverage after that. When one takes into account the differential in cost between the full-coverage premiums and the HSA premiums, a family could fund their deductible out of that difference. Having HSAs is the ultimate in portability. And, if a person is conscientious in his health decisions he will be able to reap the rewards by keeping his savings account and having that to use in the event of a diaster or to pass on to his heirs. Health insurance, as is normally understood in America today, is unsustainable whether funded privately or publicly.

Replies
(1) Healthcare is on the nation's agenda ONLY because there is a Democrat in the White House and a Democratic majority in the Senate and House of Representatives. If we had a President McCain, absolutely nothing would be done regarding the healthcare issue (except, maybe, the McCain proposal to tax the value of employer-provided health insurance). With Democrats in office, healthcare reform will happen, and will happen in 2009.

(2) The problem with Health Care Savings Accounts is that it solves a problem that doesn't exist, and does nothing to solve the problem that does exist. 80% of all healthcare dollars are spent treating about 10% of Americans; these are Americans with diseases given to them by God, things like leukemia, epilepsy, heart murmurs, etc. Whatever the deductible is on a HSA, those in that 10% will meet it, be it $500, $5000, or $10,000 per year. If we have HSA's and conventional plans, the healthier 90% will go to HSA's, and those with God-given diseases will be left in conventional plans, which will then cease to be viable plans.

(3) The solution, as proposed by the Democrats (buy into the Federal Employee Health Insurance System), is more likely to work than the Republican "let the free market work/ abandon hope all ye who contract a serious disease" plan.

Go Obama!

GeorgiaGal
"...The solution, as proposed by the Democrats (buy into the Federal Employee Health Insurance System), is more likely to work than the Republican "let the free market work/ abandon hope all ye who contract a serious disease" plan."

Conservatives just cannot understand that what we are doing now costs far too much and delivers far too poor results. US healthcare is a train wreck that has been dragging down the entire economy. It must be fixed. They can join in with their solutions or they can whine and wail on the sidelines that is their call.

Ms. Pomerantz
I am never stimulated to think,when I read your articles. Fortunately, I don't read them often. How idiotic it is to continue to talk about "Health Care". Those who understand the subject should be in the process of redesigning our system. Thirty years ago, Americans failed to understand the economic dynamics of our industries and Health Care. Today it would appear, our mistaken attempts are being revisited. There are simple "Facts", that we can use to fashion a viable system for our future. Talking about "Change" is not enough,at some point it must manifest. I "Hope" someone starts really thinking in America,the answers are obvious.

What if
the goal of quality affordable health-care is impossible to achieve in this imperfect world? There are a great many variables affecting the cost of healthcare. Our government is not capable of curing and is probably now the leading cause of the inefficiency in the industry. Say no to BIG INEFFICIENT GOVERNMENT.

Affordable healthcare
There is NO SUCH THING as QUALITY OR AFFORDABLE healthcare once government is involved. I rather take a tax credit than having a universal healthcare. People that believed universal healthcare are either drinking Obama cool aid or don't read the news or don't ever bother to ask those who have medicare. Universal healthcare will bankrupt this country. In fact, just look at the massachusettes plan and Hawaii plan (oh..wait they ditch that one..too expensive they say..NO KIDDING!).

Joycey
"Date: Dec 10, 2008 - 9:43 AM EST What if
the goal of quality affordable health-care is impossible to achieve in this imperfect world? "

Much of the world has already achieved it

"...There are a great many variables affecting the cost of healthcare. Our government is not capable of curing and is probably now the leading cause of the inefficiency in the industry. Say no to BIG INEFFICIENT GOVERNMENT."

Hey even I agree with that. But that said I prefer to not throw up my hands but to just settle down and figure out how to do it

Marie
"Date: Dec 10, 2008 - 10:15 AM EST Subject: Affordable healthcare
There is NO SUCH THING as QUALITY OR AFFORDABLE healthcare once government is involved."

Well other nations live longer and spend less on healthcare - fact

"... I rather take a tax credit than having a universal healthcare. People that believed universal healthcare are either drinking Obama cool aid or don't read the news or don't ever bother to ask those who have medicare...."

Hmmm most folks I talk to like medicare and certainly wouldn't trade it for a "tax credit". We cannot Afford NOT having some kind of national healthcare program. Why? the expense is bankrupting us right now

GeorgiaGal
The PROBLEM is that we NEVER had a FREE MARKET ON HEALTHCARE or where have you been? Ever heard of MEDICARE AND MEDICAID? That's right! MEDICAID is draining the system...but since you obviously haven't been around for awhile. Let me explain. MEDICAID is a HUGE entitlement program. I think they call it the taxpayers money. EVER VISIT AN ER before/NICU? We have plenty of people who seem to think that we should be responsible for their medical care. We save MILLION DOLLAR babies and adults even if they will NEVER be off the ventilator. Since the government doesn't pay enough to providers, WE THE PEOPLE WITH PRIVATE INSURANCE GETS TO PAY the difference. AS a RESULT, OUR PREMIUMS go up! That is why we SHOULD LET THE MARKET dictates so we don't have this ever increasing cost. WITH COMPETITION, NOT ONE HEALTHCARE PROVIDER OR PHARMACY CAN CHARGE ANYMORE THAN WHAT THE MARKET DICTATES.

Expense
Of course the expense is bankrupting as now..you think? Because of our expensive entitlement programs...things get expense. Can you tell me of a GOVERNMENT sponsored program that's successful?

btw, i'm not sure who your talking to but medicare members are complaining! Insurance are UNAFFORDABLE because those with private insurance are PAYING THE PRICE of our inefficient and ineffective ENTITLEMENT PROGRAM. It's NOT because of FREE MARKET. WE NEVER had a free market! it's not free market when I am being CHARGE the price for something so that other people can have a service!

Costs Too Much
It's correct to say that we do not have a free market on health care. Currently the federal, state and country governments pay over 50% of the cost of all medical care. At the same time, our health care costs have risen to 17% of our expenditures - whereas the rest of the industrial world sits at 9%.

This represents a singular dilemma. Government controlled central payer systems cost far less than the system we have in the US. We have, in sum, what appears to be increasingly the worst of all worlds - given we have a hybrid system - part market - and part government.

We cannot, as a nation, pay 17% - and it doesn't matter what system we have or want. The greatest problem I see is that the business and insurance community - unlike with Hillary in the early 90's - has now switched and is also advocating health care reform.

The problem is that we will not begin with a clean sheet. We will not, for example, implement "suer pays" legal practices that dictates that if you want to litigate - you better win or you will have to pay the other persons legal costs. This one step would eliminate 90% of the almost $200 billion a year that malpractice insurance and litigation costs the medical profession - and which no other country pays.

We will not, in turn, cancel Medicare, Medicaid, and the Drug Entitlement Act, and instead, provide a direct insurance subsidy based on income to Americans' - leaving them to then obtain insurance on the open market. This would completely remove the government from any involvement in paying, billing, setting rates or the rest. And that would eliminate another huge cost.

And this is why I don't see this reform as solving the core problem - which is that our health care "costs too much".

Marie
"Date: Dec 10, 2008 - 10:23 AM EST GeorgiaGal
...We have plenty of people who seem to think that we should be responsible for their medical care..."

Hmmm true but do we let them just die? Yes or no? Your guy, Bush the torturer, actually told folks to go to ER for medical care

",,,We save MILLION DOLLAR babies and adults even if they will NEVER be off the ventilator..."

Should we stop? My answer is in many cases yes. What is yours?

"...Since the government doesn't pay enough to providers, WE THE PEOPLE WITH PRIVATE INSURANCE GETS TO PAY the difference..."

Actually no you do not those folks who have no insurance and pay out of pocket are the ones really paying are they not?

"... AS a RESULT, OUR PREMIUMS go up! That is why we SHOULD LET THE MARKET dictates so we don't have this ever increasing cost. WITH COMPETITION, NOT ONE HEALTHCARE PROVIDER OR PHARMACY CAN CHARGE ANYMORE THAN WHAT THE MARKET DICTATES..."

LMAO then who pays for the care in rural areas? Give them none? All you say could bee argued for but as a package it crashes and burns. Public health alone (rampant diseases and infections)would make it too expensive by far

Jeffersonian Constitutionalist Reply #2
"Should people with Asthma be forced to move to Arizona? If they live in a temperate zone they are exposed to more pollen."

Yes.

Well, not FORCED...but duh! If a temperate climate causes you breathing problems, then move!

Oh, but that might inconvenience someone, right? I mean, God forbid they should have to take steps to take care of themselves. Nope, it's much better that the government steals my money to pay for them to get inhalers and other treatments, right? I mean, come on! They're the victim! Make the EVIL rich pay for their health care!

Bottom line: people get sick. Deal with it. You can't take other people's money to pay for your problems. Is it sad? Yeah...no one likes getting sick or seeing other's get sick. But it's a fact of life. It happens. Grow up and realize that if you get sick, then YOU are responsible for getting treatment...not me and not Big Brother.

The Historian
Name one democracy that has done well. Democracy is a horrible system of government. It's mob mentality, and "majority rule". They are doomed to fail because the people will start voting themselves all the money.

America is a Republic (at least, we're supposed to be). If you don't know the difference, you have no business going by a title "The Historian" becuase it means you are an ignorant fool.

James
Your comment, "or is supposed to be", is the relevant one. We are a centralized social democracy. We were a republic. The powers that rested in the states under the consitution have been stripped away. We have a few forms of a republic, but the substance is all that of a centralized democracy. I'm surprised, you'd even bring it up anymore. The feds spend $5 for each $1 the states spend. 50 years ago - it was $1 to $1. The states no longer meet any definition of state that you can find in your dictionary. They are not, in sum, states at all, merely administrative appendages of the central government. I realize that children and some adults still use the word - but it no longer applies. Granted, it's as nice myth, and Americans apparently need there myths, but me, I live in the real world - not the dream world represented by what once was, and has been irretreivably lost.

yes, the free market
All the free market posters here must be furious at the Republicans who eliminated Medicare's right to negotiate drug prices with the pharmaceutical companies in the 2003 Medicare Drug Act. That vote was pretty much straight down the isle.

Yes, the free market can help health care in certain areas, but the fact that the entire remainder of the industrialized world enjoys greater health at a lower per capita cost through universal health care should tell us something. Medicare's overhead is about 2%. The most efficient insurance company's is around 12%. The myth of government inefficiency in health care is a lead weight propagated by some that drags us down.

Wasn't at least part of the US government screaming at our auto industry for decades to improve their fuel efficiency? It was the free market that failed. No amount of proven failure will get conservatives to change their ideology.

James - If you hate getting your money "stolen" from you, move to Somalia. There's no government there.

To Jeffersonian Constitutionalist......
This is what YOU said:

"Well if your going down the path of micro managing high risk behavior, how about higher premiums for parents of kids who play sports?"

and this is what I said:

"Almost everything government becomes involved in, it basically screws up....and this is because of micro-management and agenda pushing. (hacks)..."

My point was that generally speaking government screws things up by micro-managing,(health-care in this case) which I am totally AGAINST!

I was NOT encouraging micro-managing by government at all.....

My point was in order to reduce costs...I believe that education, nutrition, fitness, and prevention are part of the overall package for a solution to high costs of health-care!

BTW....cool name...

Hal Donahue and Cam
Obviously, you haven't done your homework. The "rest of the industrialized world" waits on triage lists for years to get "universal" medical care". Those that can afford it come to the US to pay out of pocket for treatment they can't get at home. France, England and Canada all have systems apparently designed to kill people who need medical care.

Example, a friend whose wife is an British citizen was born with a congenital heart defect that required high-risk surgery when he was 10. Without the surgery, he wouldn't have made it past his teens. He's been healthy now for 30 years. Last year, while visiting the UK, he needed to go to a doctor for something and the doctor asked about the scar on his chest. The doctor told my friend that the surgery he had is not available in England because it's considered high risk, so the NHS won't pay for it and, as all doctors in England are NHS doctors, the surgery is simply not available. Those that can afford it go to the US. "It's a good thing you were born in a country where real health care is available," the doctor told Byran. Bryan looked it up on the Internet. The surgery that was experimental when he was 10 is now among the most common heart surgeries for young children in the US, but it's not available in England because all doctors there are NHS employees and are not permitted to do that surgery.

So, yeah, great that you have insurance, but not so great if it doesn't allow the treatment you need and you can't even pay out of pocket to get that treatment.

The real issue with US health care
Health care in this country is expensive for several reasons. Greed of doctors is one. We don't need to argue about that. Most of us have to work five days a week, eight hours a day to pay our bills. How many doctors do you know who really work that many hours? I know a handful at least who work less than 30 hours a week and make way more money than my electrician husband makes working 6-10s.

Another reason is that insurance companies and entitlement programs are telling doctors what is an acceptable amount to be paid rather than their customers telling them what they're willing to be paid. Most the people I know how have insurance never ask "What is the full cost of that treatment/test/med?" They just want to know how much their copayment is, giving everybody a false sense of low prices until they have to pay something out of pocket or the insurance company denies a charge (happening more and more often as insurance companies balk at rising prices).

The biggest reason, however, is that people overuse doctors for minor illnesses. The common cold usually goes away in a week if you drink lots of fluids and get some rest. I have several coworkers who go to the doctor everytime they get the sniffles "just in case it's something worse." They drive up the cost of medical care because they cause a shortage (doctors only have so much time in their reduced schedules to give to patients) and because they charge their insurance when there is nothing wrong with them. There's also a lot of people who would never consider a lower-cost alternative to a MD and a hospital visit. PAs, direct-entry midwives, many other services can be accessed for far less cost than an MD, but we won't even consider it as long as our insurance keeps paying for the higher priced services.

Abolish socialized medicine
The reason health care is so expensive is that government has interfered extensively in medicine. Medicine is half-socialized in this country. If the government would get its hand out of the medical profession, prices would go way down. This is classical economics. We have got to start explaining that to people.

A generation ago, liberals talked about the "right" to health care. Now that they have a "right" to health care, liberals talk about the "right" to health insurance. In other words, liberals don't want to be reminded that they are parasites; they want a formal government program so that they can keep up the pretense of respectability.

But we have to explain to people that while government can guarantee coverage, it cannot guarantee anyone any medical care under that coverage. Only doctors and other health professionals can provide medical care; government doesn't provide anything. People actually die on waiting lists in countries with socialized medicine. It is the government's heavy hand that has resulted in fewer doctors, longer waits, lower quality of care, and more expensive care.

The solution is not HSAs or health vouchers or any other gimmick which will only entrench the notion of socialized medicine and act as a precedent for greater socialization down the road. The solution is to start attacking all government programs and laws that interfere in the private sector.
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