Thursday, October 10, 2013

MONEY 36 - HEALTH CARE


THIS IS MY 36TH POST ON UNDERSTANDING MONEY TOOLS

There has been so much talk in the past couple of years about health care in the United States.  I am especially referring to the so called “Obama Care”. Out of frustration I thought I would do a blog on it.

First, “Obama Care” and the Affordable Care Act are the same, but many people don’t know this fact.  They hate both, but don’t understand the basics of the Act or why we as a country need to do something about health care.  I can’t say I understand a lot about it myself but will try to say a few things about the facts I do know to help you.  I have heard the entire Act has about 2300 pages to it, and contains a lot of “pork” on both sides of the political isle.

Let’s trace back 50-60 years of health care in this country.  It has come a long way in certain respects, but also continuing on it’s current course will not be financially sustainable.  After WWII a doctor made a modest income and became a doctor because he wanted to help people with their health needs, not necessarily a profession to make a lot of money.  Outside the hospital the doctor made house calls and then you paid him a nominal fee for that service. Today, there are no house calls in the US.  Hospitals such as the Mayo Clinics and other fine hospitals are like staying at the Ritz Hotels.

The whole industry is quite complex.  In the US we spend about 18-20% of our Gross Domestic Product on the industry. 50 years ago this figure was about 5%. The inflation of health care is far greater than our overall inflation rate in other things. We rate overall very poor in the world in health care, about 34th, and yet we spend so much more and have some of the best doctors in the world.  All the world’s top countries have a national health care program except for the US. The top socialized countries in Europe and Scandinavia spend about 10-12% of GDP on health care.

It is conclusive that if it is the Affordable Care Act or something else, drastic changes need to be made. We need to look at all aspects, and cuts will need to be made to general costs, drugs, employment and other areas. It was on 60 Minutes some time ago about robots in the manufacturing/industry and hospitals transporting items, taking the place of humans. The people in the US need to get healthier and in better shape, that is a great portion of our problem. People in other countries are healthier; they walk, they eat less fast food, and they are more physically mobile.  Hypertension, high blood pressure, diabetes, obesity are some of our biggest health problems. A good majority of the people who have these issues need to help themselves with exercise and better diet. About 30% of Americans are obese, and almost 70% are somewhat overweight.  We are killing ourselves and running to the doctors and hospitals for every reason. The ratio between the number of ill people and total costs is alarming. Pretty dysfunctional. 

America is getting older. Medicare and Medicaid account for over 50% of our health care expenditures.

Reality! Drug companies that push through much of their costs for research and development to insurance companies are going to have to cut back, doctors are going to have to take less and will have set payments for procedures, medical staffs will be cut and less qualified individuals will be taking on work that perhaps a physician’s assistant does now. Hospitals will need to figure out how to operate on budgets perhaps 25-30% less than today.

With a national care program we may add 40 million people to insurance of some sort for medical care. There are several good things about a national care program, and that program may have to have several layers; one layer for the wealthy, one for the common man and one for less financially fortunate, as we have Medicaid today. In general here are some benefits:
-       With a pre-existing illness you won’t be excluded from health insurance and care.  In the past, if you switched from one insurance company to another, or didn’t work for a company that provided insurance you might not have been able to get insurance. I had a couple of Basel cell cancers removed year’s back, however no insurance company would take me without a total exemption from all cancers. Today the greatest reason for bankruptcies with older people is medical costs. The costs overall should be lower and more shared equally, in theory.
-       Uninsured people won’t need to run to the emergency rooms for everything as they tend to do now.
-       The corporate games played now to avoid paying for insurance perhaps will be changed. An example of this that I personally know is a friend’s wife who was pregnant would not be employed by a new company until 6 months after giving birth.

On the negative side to a national health care program are:
     -   Total costs are going up because many more people are added.
-   We will sacrifice in places like number of attendants per patient 
and the experience level of professionals.    
-       Will younger people pay and sign up?  The young say, “I’m never    sick, not hurt, I’ll take my chances, and sign up if anything happens”. Costs may be higher per month than anticipated by government. A person may be eligible to sing up at certain dates.
-       The younger people who this Act is counting on for financial support may take the penalty for not signing up instead of signing up.  From what I understand the government will rely on the IRS to hold back overpayment in taxes for this penalty. If a person isn’t owed money back on taxes they won’t pay a penalty. This comes from a financial advisor friend of mine.

Some of the successful European countries that have national health care have commonalities that we don’t have; these being smaller populations, common cultures, common languages, common focus for the good of the country and it’s people.

The Affordable Care Act is far from perfect and needs to be worked on, however it is my feeling that something major needs to be done as an overhaul to the health care industry in this country and this is a first step.

I hope this gives a simple overview of the some aspects of the health care system.


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