Thursday, January 3, 2008

Health Care and 2008

We have a New Year--2008! It promises to be a great one for health care but with challenges. In each new year most American consumers anticipate that they will be healthy with little to no health issues. Some years that is true; and sadly, in some years it is not. The NY Times online had an Op-Ed article published today (1.03.08) that speaks to the case of the uninsured. The editorial makes a case for making insurance available to all Americans. The writer makes a point of telling us that everyone deserves insurance, and that the reason is based upon information disseminated by two recent studies--one by the Harvard Medical School, published by JAMA, and the other by the American Cancer Society.

While it is true that the uninsured receive less medical assistance than those Americans who have insurance, there is a percentage of people who do not want insurance and are very qualified to purchase it, either directly as a consumer or through their employer. The 19-29 age bracket is particularly unwilling to be insured, primarily because the common mindset is one of indestructibility--"I'm going to live forever, and I never get sick!" These young immortals, the Twenty-somethings, have the lowest rates of health insurance coverage in the country according to a survey by the Commonwealth Fund. Yet, when offered insurance on the job over 70% will take it. Also, children and the elderly are eligible for Medicaid and Medicare. However, young people, considered among the healthiest demographic part of our population, are more often ineligible for public programs.

Young adults commonly find themselves without health insurance, in many cases due to ineligibility or poverty. The Commonwealth Fund survey found that over half went without medical care, including doctor's appointments, tests and prescriptions, and had significant trouble paying their medical bills. Another risk of going without health insurance, even for a short time, is the possibility of being unable to resume coverage. Often, young adults are faced with a very difficult decision to make--forcing a choice between staying healthy and being financially solvent.

The NY Times editorial also was quick to recommend moving the uninsured to government sponsored programs including Medicare. Although the studies mentioned do make a case for how much better those on the assistance programs did versus those who are uninsured, by no means should the American public be forced to pay for universal health care. At the current rate of spending, the American Academy of Actuaries points out:"Total Medicare spending was $309 billion in 2004, or 2.6 percent of the nation's Gross Domestic Product (GDP). Medicare spending will likely increase to 3.3 percent of GDP in 2006, and then is expected to double to nearly 7 percent of GDP by 2030, continuing to rise thereafter. If total federal revenues continue at their historical average of about 19 percent of GDP, and if no changes are made to the program, Medicare spending will take up a third of all federal revenues by 2030."

In his State of the Union address in 2005, President Bush said, “One of America's most important institutions -- a symbol of the trust between generations -- is also in need of wise and effective reform. Social Security was a great moral success of the 20th century, and we must honor its great purposes in this new century. The system, however, on its current path, is headed toward bankruptcy. And so we must join together to strengthen and save Social Security.” Amen to that!

This year, there will be a big push toward universal health care both on individual state levels, and at the federal level. Health care has become the Number One hot button only second to the War in Iraq, and in some cases even more of a focus. US News & World Report online has stated in August 2007 that the percentage of Americans without insurance has had a consecutive year of increase to about 47 million people in 2006 according to the US Census Bureau Division of Housing and Household Economic Statistics. Forces are coming to bear pushing for a solution. Groups including the Commonwealth Fund and Families USA feel that this trend will serve as a catalyst for some form of universal health care. Even the Consumers Union is advocating a rededication by Congress and the President to expand health insurance for everyone.

How do we fix this problem and others in the health care arena? The answers will need to be carefully thought out. There is no quick fix. Demanding that the American taxpayers pick up the tab is not a reasonable option, nor is ignoring the facts. Over time, the process of figuring out how to resolve many issues in the health care market, including insurance and other products and services, should be addressed by private industry, government, and consumers in a way that will move us in the right direction. So far, most of what we see and hear to date are proposals that are typically one-sided--usually in favor of the proponent. Let's get our thinking caps on and find a way through to a positive outcome. We want to know that the light at the end of the tunnel is the sun, and not an oncoming train.

Until next time. Let me know what you think.

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