How can Government fix health care?

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Permalink Reply by Amy Stark on December 29, 2008 at 3:47pm

Your post is entitled "How can Government fix health-care?"

I think a better title would be "Should Government fix health-care?"

My ignorance may be showing, but is there an example of ANY Governmental entity doing a better job with their citizen's health-care system? The U.S. health-care system may suck (please forgive my vulgarity), but at least it sucks less than just about every other country on earth.

I like the sounds of "private plan through an insurance-exchange" WAY better than Medicare.

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Permalink Reply by Mark Howard on December 29, 2008 at 3:53pm

well put Amy, a couple of comments. "private plan through an insurance-exchange" sounds great, but what the heck-fire does that mean? My experience with healthcare in the U.S. is that it is GREAT. It is on-demand, high quality, lovely facilities and nearly free to most consumers (the cost is well hidden anyway). The only thing that sucks about it is all of those great things are EXPENSIVE! the only 'fix' is to get rid of those things I have liked, ration healthcare, or just soak the rich to pay for more of it. Most healthcare 'reform' ideas are just old liberal methods of having someone else pay for someone elses wants and needs. With Daschle at the helm, this is all you'll get, with some lipstick on it!

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Permalink Reply by Amy Stark on December 29, 2008 at 4:05pm

I don't know what "private plan through an insurance-exchange" means either, but I will bet it's better than Medicare.

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Permalink Reply by Mark Howard on December 29, 2008 at 4:16pm

Medicare is actually really good for the recipients. It's like $98 a month for Part B, plus $100 a month for a supplement, or you can do 'Medicare Advantage' for $0 per month and that includes Part D! Many people can't retire before age 65 because health insurance issues. The downside of all this for the that it is EXPENSIVE as all heck for the government! It's about $900 a month per recipient now! GADS! and even then, the providers don't get reimbursed enough to run a business on Medicare patients, the cost shortfall is made up by insured folks. I think the mysterious "private plan through an insurance-exchange" sounds to me like a a step to take for people who think the insurance companies are at fault in this mess at worst, or at best the insurance companies are so inefficient that an 'insurance-exchange' would be so much more efficient that it would go a long way towards solving the problem. That of course assumes some non-profit animal is superior because profit motive is evil and inefficient. Which of course is a joke. Insurance companies are in fierce competition to keep expenses down, service up, and compete on price just like anything else. We could get in raging arguements about the goals mentioned here not being met, but let's just compare the private sector versus the government on cost, service, and efficiency. The examples are already right in front of us, no arguement necessary. Fun sharing with you Amy!

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Permalink Reply by Ben McCann on December 29, 2008 at 5:16pm

I posted some comments on the survey that I hope to recapture here.... Bottom Line is that GREED is one of the biggest problems. And $100 per month for a supplement is a price reserved for a few 65 yr olds in certain regions, the average prices is around $120 and up for supplments.

Medicare Advantage Plans actually save the government money, and consumers money in premiums, for many they are good alternatives to the traditional medicare system, however they have created a few extra layers of burdens for providers, who can opt in one minute, opt out the next and also accept the coverage on a line item basis and balance bill the rest to the insureds... BOTH McCain and Obama planned to cut "subsidies to private insurance companies" but this would be foolish since it saves the government about $250 per month per medicare beneficiary.. and it saves the insureds who elect it the cost of a supplement ranging between $100 and $185 per month on average.

If Obama does away with medicare part C aka ADVANTAGE... it will actually cost the government hundreds of millions more, and cost the enrollees thousands more and many will be stuck paying for the GAPS in medicare because they can't afford a supplement.

Other versions of "SOCIAL INSURANCE" like the Veterans Benefits are very controlled and severly limit the options of those wonderful service people who sacrificed life and limb for our nation.

I have hundreds of clients and have presented many seminars and roundtable discussions on this subject... but I think there are 2 diametrically opposed views here:

1. SOCIAL INSURANCE: 2. PRIVATE INSURANCE

there are plusses and minuses to both. The issue is to big for POLITICIANS to play their usual games around this issue... they must come together and work with Businesses, providers, and Citizens to design a solution.

Most doctors are starting to eliminate the amount of medicare patients that they accept because the "assignment" that they are forced to accept in some instances is as low as 10% of the Billed amount and usually ranges between 30% to 50% of the billed amount. They are forced to write off the rest. Doctors can't pay their staff or their bills, let alone try to do research with write offs... they need cash flow to do that.

The other layers to consider are the Billing Codes and the Outsourcing of This to companies who "Layer" charges by billing multiple single item claims instead of a grouped claim that incorporates all of the line item charges into one simplified Claim. Insurance Companies and Medicare are now investing in Software that "Identifies" Layered claims and delays the payment or fights with the provider on reimbursement.

Doctors have so many layers of RED TAPE by the Insurance Companies, Medcare, and thier own Industry Regulations that they don't have time to keep up on new trends in medicine, practices, etc... for Rural Doctors they are on average about 10yrs behind the latest practices and techniques that their urban counterparts are aware of and using.

This leaves education of the doctors to the "Pharmaceutical Reps" who in many cases are doctors themselves or salespeople. I know of Doctors Offices who Stagger their "Lunch - N - Learns" from Pharmaceutical Reps for their Entire office for the month so that they never have to pay for their own lunch or lunch for their staff. The Reps will buy lunch for the office, most of which don't sit in to learn the new "educational" sales pitch. Many Doctors offices portray this as an "Employee Benefit" Free Lunches multiple days a week.

This forces Doctors away from practicing as Physicians and turning them into PILL PUSHERS who are just a little bit better than Street Pharmacists. I have seen people on so many different medicines because "it's covered on your insurance". They become sicker, more addicted to medicine, and worse off being on some medications than if they didn't take anything at all.

Here is an example from a current client of mine :"Well I take this pill for my Rheumatioid Arthritis, and it gives me ulcers to I take this pill for Ulcers, but It gives me Migraines so I take this pill for Migraines and it makes my blood sugar low so I take this pill for that, and the blood sugar pill needs to be taken with a water pill and this one for bloating and etc......"

How about we try diet, execise, spinal manipulations, and if needed as a last resort medication.. instead of a first fix.

Another problem is that in order to prescribe a medication for "symptoms" without running tests, doctors have to "diagnose" you with a condition... once that condition is diagnosed, the MIB gets this on your record and if you don't have that condition, or never did... you cannot get this removed, it would be easier to bring peace in the middle east than to correct your medical records from "diagnosis" that was being done so that the doctor could "try something" to see if it works and then "try something else" if it didn't... that is why that call it PRACTICE... when they finally get it right... they retire. Once Your medical records contain anything that resembles something for a condition, you might want to consider the impact of the doctors "practice" before accepting his "diagnosis" or you may find yourself UN-INSURABLE. and unable to obtain health insurance on your own... This may also severly impact your ability to plan for your ESTATE and Minimize taxations and endowment vehicles such as LIFE INSURANCE. That is why people need to think about these things as soon as possible, parents need to teach their children these things before they get out on their own.

The impact that MEDICARE had on our private healthcare system ruined it. It started the process that allowed Insurance Companies to regulate heatlhcare instead of the medical community. Moreover, the fact that when they rolled out medicare in 67... the average life expectancy was 67yrs old. They literally created medicare Part B over night, and the actuarial soundness of it wasn't even checked for 25 years. moreover, in 1973 when RoeV.Wade was passed, 1/2 of all pregnancies were terminated by the BABY BOOMER generation and those following. That completely threw off the numbers that the actuaries who designed our SOCIAL INSURANCE system were banking on. They expected the BABY BOOMERS to have kids, who would grow up, get jobs, pay taxes, pay into SOCIAL SECURITY (MEDICARE and SOCIAL INSURNACE) but they never did... 1/2 of them are missing.. because they are dead. now starting in 2008 the first wave of those boomers are stepping into the system and pulling out BENEFITS and providing a drain on the system that if not corrected according to ALAN GREENSPAN in 2000 and late 1990's said would "STOP THE ECONOMY IN ITS TRACKS"

GUESS WHAT 2008 is here and we are seeing the beginning of the END of this Country and its existence. One Historical NOTE: every Civilization in HISTORY that have ever been great.. once that civilization and its Leaders commit GENOCIDE or destroy a GENERATION of Babies ( i.e. Pharoah and Moses, Pilate and Jesus, and others ) That COUNTRIES sovereignty and fiancial security is destroyed within 1 GENERATION. Our Baby Boomers pushed a bill through when they were in their 20's and starting to have a "VOTING VOICE" since that time most legislation from the BABY BOOMER generation have been SELF FOCUSED and SELFISH. their GREED has followed them to their CORPORATE LIVES, THEIR FAMILY LIVES, and have IMPACTED our ENTIRE NATION. Our SOCIAL INSURANCE and Healthcare system are but one example of this truth.

The Baby boomers were the ones who progressed our nation the fastest among the 8 STAGES of democracy... the impact is one that has Cultural, Economic, and GLOBAL effects.

About the time our original 13 states adopted their new constitution, in 1787, Alexander Tyler, a Scottish history professor at the University of Edinburgh, had this to say about the fall of the Athenian Republic some 2,000 years prior:
"A democracy is always temporary in nature; it simply cannot exist as a permanent form of government. A democracy will continue to exist up until the time that voters discover that they can vote themselves generous gifts from the public treasury. From that moment on, the majority always votes for the candidates who promise the most benefits from the public treasury, with the result that every democracy will finally collapse due to loose fiscal policy, which is always followed by a dictatorship." (emphasis mine - he continues...)

"The average age of the worlds greatest civilizations from the beginning of history, has been about 200 years. During those 200 years, these
nations always progressed through the following sequence
1. From bondage to spiritual faith;
2. From spiritual faith to great courage;
3. From courage to liberty;
4. From liberty to abundance;
5. From abundance to complacency;
6. From complacency to apathy;
7. From apathy to dependence;
8. From dependence back into bondage "

Professor Joseph Olson of Hamline University School of Law, St. Paul, Minnesota... believes the United States is now somewhere between the "complacency and apathy" phase of Professor Tyler's definition of democracy, with some 40 percent of the nation's population already having reached the "governmental dependency" phase." (end quotation)
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IF that really is so - then the only stage left is #8 - From dependence back into bondage. What might that look like I wonder? Possibly the welfare state becoming openly socialist and increasingly totalitarian - possibly even a dictatorship? One thing is for sure - our civil liberties will become extinct in the name of "the public good" or "safety."
You know, the Founding Fathers saw this coming and cemented our inalienble human rights in the constitution so that all future laws and govt. actions had to keep these in the center of their thinking and rulings. But social progressives constantly want to redefine these rights and the constitution so that it can be "applied" to modern situations. In the end, all that does is make it easy for some dictator(s) to "redefine" our rights and the constitution so that they can "legally" take them away (so much for inalienable).

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Therein Lies some points to ponder that go greater than just our healthcare system, the issue is not just healthcare...even OBAMA recognizes that... and He is one of the most SOCIALIST minded elected officials in HISTORY. I fear that we are in stage 7 and stage 8 is close behind... it is said that a DICTATORSHIP is what follows stage 7... I look forward to those comments on this subject and take a moment to digress.

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Permalink Reply by Mark Howard on December 29, 2008 at 6:11pm

Rock on Ben! Your synopsis is frightening, irrefutable. excellent synopsis, should be required reading. I particularly like your spin on 'greed' being the problem. When I saw that I thought, "oh no, here comes a rant on corporate greed", but the greed is more from the consumer aspect from people who want services and don't want to pay for them. The government dependents have no problem enslaving a taxpayer or healthcare provider (a real person, doctor, nurse etc) to take care of his needs. You can bet Tom Daschle will only 'hear' solutions that lead us down the path to dependency. His tone of voice in the video is such a joke, I have listened to him for years, I know where he is coming from. He has no intention of 'hearing' anything other than what he wants to hear. I would love to hear a good solution, but I have not. Any solution involves more socialism, more cost-shifting etc, or what nobody will tell the truth about, the rationing of healthcare, and a further decrease in quality of care and service. That is how other 'national healthcare plans' are run.

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Permalink Reply by Timothy Maguire on December 29, 2008 at 6:39pm

I am always amazed when I find that I'm not the only one who thinks like I do...great comments Amy, Mark & Ben!

Q: "How can Government fix health-care?"
A: by getting out of it.

And honestly, if we want prices to go down, we also have to get employers to stop paying for insurance, and let competitition drive the market.

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Permalink Reply by Ben McCann on December 29, 2008 at 8:58pm

Amen Timothy..... Amen,

The problem is that we have gone from:
5. From abundance to complacency;
6. From complacency to apathy;
7. From apathy to dependence;

Within ONE generation. Also we have become a nation that is ignorant of HISTORY, and sadly, we are drowning in information but starving for wisdom. If we ignore HISTORY, we are doomed to repeat it.

Now we are a nation of LAZY people who are not engaged in anything other then their own direct interests, who say that "THEY" should do something about it. THEY meaning someone else, "THEY SHOULD FIX IT".

Guess what, we have a government and an economy and a health care system of our own making and we fully deserve what we have, because it is exactly what we deserve for our complacent apathy that has led us to dependence.

We are the only nation in the world whose impoverished are FAT. Our poor are FAT... In other nations, if you were poor, it meant you didn't eat as much as everyone else. you became skinny, and died of malnutrition.

What other society on the face of the earth do "poor kids" die from obesity and juvenile diabetes instead of starvation and malaria... etc...

we have a "gubbment cheez" mentality... and everyone wants their slice, and the slice of the guy next to them as well.

our society as illustrated by our ERISA laws and the newer HEALTHCARE laws that employers are under are taking people from an ENTITLEMENT MINDSET to forcing them into ENGAGEMENT (being involved and educated and taking responsiblity for ones own actions or lack thereof)

unfortunately, we don't want the responsibility that comes with that engagement... it would mean that we would have to be GOOD STEWARDS over our FINANCES, our BODIES, and our TIME... nobody really wants that now do they?

guess what.. I know some people aren't going to agree with the following information, but here it is, see if you can spot the WISDOM here: I am approaching this from a BIBLICAL WORLDVIEW and can see exactly what is happening to our nation. THE FOLLOWING POINTS COME FROM SEMINARS THAT I HAVE BEEN GIVING FOR OVER 3 YEARS ABOUT SOCIAL SECURITY, HEALTHCARE, MARKET DOWNTURNS, AGING POPULATION ( Baby BOOMERS) etc... I hope you enjoy them. They are designed to get people to set appointments with me for PLANNING so I apoligize for that.. but the information is good and worth a read...Let me know what you think.

INTRO:
“The prudent see danger and take refuge, but the simple keep going and suffer for it.”
-Proverbs 27:12

Stewardship: stew·ard   n. 1.One who manages another's property, finances, or other affairs. 2: a complete lifestyle, a life of total accountability and responsibility acknowledging God as Creator and Owner of all.

“Once one chooses to become a disciple of Jesus Christ, stewardship is not an option.” -- Unknown

Biblical Reference: (Mathew 25:14-30) Parable of the Talents... God takes stewardship Seriously!!! In (Proverbs) there are countless scriptures that Deal with Money, Foolishness, Work Ethic, Laziness, Wealth & Prosperity, Diligence & Faithfullness.

TOO BAD OUR CULTURE AND OUR GOVERNMENT HAVE BEEN IGNORING THEM....WE ELECT OFFIFICIALS AND LEADERS AND EXPECT THEM TO BE GOOD STEWARDS... BUT THEY DON"T EVEN KNOW WHAT THAT MEANS.

Wisdom: wis·dom   n. 1: The ability to discern or judge what is true, right, or lasting. 2: A wise outlook, plan, or course of action. 3: the trait or ability to utilize knowledge and experience with understanding, common sense and insight 4: the quality of being prudent and sensible

Biblical Reference:
(PR 21:20)  20 The wise have wealth and luxury, but fools spend whatever they get. – NLT

(PR 14:8) 8 The wisdom of the prudent is to understand his way: but the folly of fools is deceit.—KJV

Prudence: pru·dence   n. 1: Careful management to economy. 3: attentiveness to possible hazard, caution to danger or risk. 5: discretion in practical affairs 6: knowing how to avoid embarrassment or distress
Synonyms: prudence, discretion, foresight, forethought,
These nouns refer to the exercise of good judgment, common sense, and even caution, especially in the conduct of practical matters. Prudence is the most comprehensive: Discretion suggests wise self-restraint, as in resisting a rash impulse Foresight implies the ability to foresee and make provision for what may happen: Forethought suggests advance consideration of future eventualities

Biblical Reference:
(PR 27:12) 12“The prudent see danger and take refuge, but the simple keep going and suffer for it.” -- NKJV
(PR 14:15) 15 Only simpletons believe everything they are told! The prudent carefully consider their steps.-NLT
(PR 14:8) 8 The wisdom of the prudent is to understand his way: but the folly of fools is deceit.—KJV

Understanding: un·der·stand·ing v. tr.
1: To perceive and comprehend the nature and significance of.
2. To know thoroughly by close contact or long experience with
3. To have understanding, knowledge, or comprehension.
4. Characterized by or having comprehension, good sense, or discernment.

Biblical Reference:
(PR 23:23) 23 Buy truth, and do not sell it, Get wisdom & instruction and understanding. –NASB
(PR 3:4-6,9-10) -4 So shalt thou find favour and good understanding in the sight of God and man. 5 Trust in the LORD with all thine heart; and lean not unto thine own understanding. 6 In all thy ways acknowledge him, and he shall direct thy paths …9  Honour the LORD with thy substance, and with the firstfruits of all thine increase: 10 So shall thy barns be filled with plenty, and thy presses shall burst out with new wine. -- KJV

“If a person gets his attitude toward money straight, it will help straighten out almost every other area in his life.”
-Billy Graham

How Important is This?
62% of all seniors retire at or under $10,000 a year income.
50% retire at or below the poverty level
55% of people worry about money “always”
80% of divorced couples report money as the #1 problem leading to divorce

What are the Biggest Problems People Face Today?
1. Longevity
2. Aging Baby Boomer Population
3. Long Term Care
4. Healthcare
5. Market Downturns

1. LONGEVITY: Longevity is the number one risk facing retirees today.
Unfortunately, most people don’t even realize it… It Is A Real Danger.
Social Security is in trouble Pension Plans are draining companies financially.

-- Current Average Life Expectancy in the U.S. has risen to 84-male and 87-female. A 65 yr. old has a 25% chance of living to age 94 or beyond
-- Many people are living longer in retirement than they live working, this issue is the number one factor that affects everything else. People are simply Living Longer than ever before...

2. Aging Baby Boomer Population
-- Approx. 78 million people will begin moving into the Social Security system, beginning in 2008.
Just 3 yrs. from now!
“…Social Security and Medicare face long-term financing gaps that could fuel huge budget deficits and stop the economy in it’s tracks…”-Alan Greenspan
Those 78 million will be forced by the IRS to begin taking RMDs when they turn 70 ½. This applies to those with 401K’s or IRA’s.

*NOTE: I GAVE THIS SEMINAR IN 2005

1986 Erissa Laws changed from Defined Benefit to Defined Contribution.
401K : Many People not saving enough

What is an RMD ?
-- Required Minimum Distribution (RMD)
-- Account Value ÷ Life Expectancy = RMD

Problem:

More Taxes + Higher Tax Rate + SS Tax = UGLY

Many people take RMD + 30% and find that their account depleted by their mid 80’s, this assumes a 5% return many are invested in Stocks and Mutual Funds. A market downturn can make it run out even sooner.

*HELLOOOOO : RECENT ISSUES ARE PROOF I WAS RIGHT

3. LONG TERM CARE:
-- 43% of all people over the age of 65 will need care at some point in their lifetime.
-- The avg. length of a stay in a nursing facility is 2-1/2 yrs.
-- 83% of all people who go into a nursing facility end up at poverty level within
one year.
-- This affects virtually every senior in America, yet few have done anything about it

4. Health Care
Assumption: People can retire comfortably on 70% to 80% of your pre-retirement income.

Reality: Sky-rocketing health care cost means you’ll probably need 100% of your current income. “Out of pocket” expenses are topping $11,000 a year. Large companies are expected to reduce health care benefits by as much as -40%.
Health care costs are rising 14% annually. They need to have saved $163,000 using a 5% medical inflation rate to $702,000 using the current 14% rate (just for medical expenses alone)… … This doesn’t even take into account Long Term Care…

5. MARKET DOWNTURNS:
-- Market downturns at the beginning of retirement (65 – 75) can significantly reduce how long a retiree’s nest egg will last.
-- This fact gets ignored when retirees estimate how long their money will last using an average rate of return.
-- Most people do not first consider the recovery of their principal before investing in vehicles that put their assets at risk.

When does -30+43=0 ?

$100,000 - 30% = $70,000

$70,000 + 30% = $91,000

$70,000 + 42.8572% = $100,000

A 30% downturn at the beginning of retirement requires a 42.8572% return to recover. The average mutual fund return is 4.5% per year over time. There are more funds than companies to invest in. It would take 10 years without another negative market of average returns just to get back to where you started if you suffered this kind of loss... each loss is even tougher to recover.

A 30% downturn at the beginning of retirement requires a 42.8572% return to recover.
Two-Thirds of Brokerage Firms Continued to Recommend Failing Companies
Among the 30 brokerage firms that covered companies filing for bankruptcy between September 1 and December 31, 2002, 66% continued to recommend that investors buy or hold companies right up until the day that company filed for Chapter 11.

What’s Wrong with Mutual Funds? Most people don’t even know what they have invested their money in, let alone have any control over their own money. He says that it comprised of GOOD PEOPLE IN A BAD SYSTEM.
-- Arthur Levitt ( Former SEC Chairman for 17yrs and 17yr Wall Street Broker and Author of " Take On the Street: What Wall Street and Corporate America Don't Want You to Know. What You Can Do to Fight Back."

Warren Buffet: didn't buy 1 stock in the stock market from 1992-2002 He Said “…stocks were too expensive”
Worlds Greatest investor Couldn’t find anything to invest in, yet millions of first-time investors and their advisors did. Nov. -11 ‘02 Fortune

Investing Without Education is Gambling!!!

“The prudent see danger and take refuge, but the simple keep going and suffer for it.”
-Proverbs 27:12

“Listen to counsel and receive instruction, That you may be wise in your latter days.”
- Proverbs 19:20

WHAT CAN YOU DO? DEFENSIVE ASSET PLANNING.

-- People need to make certain they don’t run out of money in retirement, even more important than investment planning.
-- Trillions have been lost in retirement dollars in the bear market. Meanwhile, Wall Street says, “Ride it out, stay focused long term, the market will come back.”
-- Some do not have the time to wait for the stock market to climb back…whenever that might be.

What Should YOU Do?
You need an investment strategy that encompasses three main goals:
1. Protect retirement savings.
2. A contractually guaranteed level of income, regardless of lifespan.
3. Make certain they don’t run out of money while in retirement.

What Does a Doctor Do When You Go To The Emergency Room?
Stabilizes The Bleeding (the losses).
That’s What I Do Financially.

Most Financial Plans Are Not Designed Against Loss.
Most are not constructed so that people never run out of money in retirement.
Most plan designs do not consider the effects of income taxation.
Most people are not absolutely certain of these things, they need to be educated.


WHEN FACING RETIREMENT?

PEOPLE ARE AT A CROSSROADS>>> WHICH ONE TO TAKE?

ARE YOU GONNA MISS THE JUMP....

OR ARE WE GONNA MAKE IT OVER THE GRAND CANYON OF OBSTACLES FACING US.

AS A NATION... WE HAVE SOME OBSTACLES I HOPE WE CAN WORK TOGETHER TO OVERCOME THEM... BUT I THINK THE GREED ON WALL STREET AND LAZINESS OF MAIN STREET TO KEEP THEM IN CHECK IS A VERY BIG HURDLE TO OVERCOME.

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