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08/14/2009

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Do you think that the government should be the insurance provider for anyone?

I think that my question above isn't at all where I was trying to go. You have done an amazing job of covering the politics of the health care debate. In the past you wrote about how you like the choice that you have in health care for your family. I think you wrote that it was costing you about $700 a month. It seemed to me you may have thought that it was a little expensive but, having choice was worth it. What I don't remember you expounding on is how you believe the overall, national health-care system should be set up.

You know that we often disagree on things. That doesn't mean I don't think you are smart. Wicked smart even. You seem to have an ability to think through complex subjects and develop a strongly held opinion. I am much less thinking and way more likely to react to emotion. Why not fix health care in our country right here? I'm not being facitious or flip. I mean lay out a plan. I think your big picture vision may have merit.

I don't want a debate. I suck at it. I'm looking for a (dialog?). Here is where we stand as I see it:

Health insurance from corporate insurers - Most people get it at work. They pay some or none themselves with the companies picking up the majority. Some people who don't/can't get it at work pay out of pocket(your family and mine)to corporations for their coverage.

Medicare - strictly for older people who must enroll or loose some or all of there social security benefits. Administered by the federal government and pays health care providers directly.

Medicaid - basically pays for poor people who don't have insurance. Some people register for it and get regular benefits like having corporate coverage except it is administered by the states. The revenues come from the federal government and state taxes(I think that is accurate...).

Self insured - some people through choice or they can't get insurance pay out of pocket for all their care.

I think that covers all the options. Please add to or correct me. Now to the problems, real or perceived, with this set-up:

Corporate insurance - They don't cover pre-existing conditions. Most of the time those conditions are covered after a year of coverage. Sometimes they are not. Often they prevent getting any insurance at all.
You can be dropped from an insurer at any time, at their discretion. This can end up with people not qualifying for any corporate coverage. If the family's income is to high they won't qualify for medicaid leaving them without coverage.
Costs are increasing. The average family of 4 averages a little over $12,000 per year.(we are at $13,333.32 per year without vision,dental or maternity.bought on the open market,no group but no major health problems either). Many families don't make enough to afford that and can't get it at work.
Denial of service. It seems you hear a fair number of complaints about claims being denied as well as reports that that is a standard practice by insurers to hold down costs.

Medicare - Coverage seems pretty good. I know an 87 year old woman who just got her shoulder replaced because the one she was born with bothered her. Medicare paid for it all. Re-imbursements to providers is less than corporate insurance in most cases. Some cite rampant fraud. The program has run in the red and will only get worse, much worse in the future.

Medicaid - Everyone cites rampant fraud and waste with this one. Often the poor seem to over-use the emergency room for care that probably would have been prevented or better handled before it got there. Same problem as Medicare in the indebtedness situation. Not only is the program under water, it threatens to drag down the economy with it.

I hope I haven't rambled too much, or abused spelling and grammer to the painful point. What do you think the ideal program should look like? Is there a place for government sponsored health insurance? Should the obvious problems with private/government insurance even be addressed? How? Should we do anything about the people who can't afford,get or quaify for corporate/government insurance?

I hope you respond to this Jim. It seems like you are spending alot of your time on the He said/She said of this problem instead of the larger and much more pressing issue. I think I am challenging you to speak to what "Health-care in America Should BE". Maybe a manifesto kind of thing...

Say Hi to the wife and kid for me. Amelia just started kindergarten today. It's pretty cool.

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About 24thState

  • 24th State is named for Missouri, the nation's political bellwether which has the honor of being the 24th state admitted to the union.

    From Springfield to Kirksville, from Kansas City to St Louis, we cover the state's news, views, politics, rumors, and elections.

    The site is a group blog, run by average citizens from across Missouri with a desire to get involved in the political process. The Editorial Board is a mix of Tea Party members writing collectively.