An Innovative Approach to America’s Health-Care Crisis

Health-Care Crisis: A novel way to address the nation’s massive uninsured population while keeping the healthcare business private.

One of the country’s most significant issues is the lack of health insurance coverage for nearly 41 million people.

Health-Care

While the majority of elderly Americans are covered by Medicare and about two-thirds of non-elderly Americans are covered by employer-sponsored plans,

many workers and their families remain uninsured either their company does not provide coverage or they cannot afford it.

Medicaid and the State Children’s Health Insurance Program (SCHIP), also known as HAWK-I in Iowa, help low-income children and some of their parents fill up the gaps.

One of the country’s most significant issues is the lack of health insurance coverage for nearly 41 million people.

While the majority of elderly Americans are covered by Medicare and about two-thirds of non-elderly Americans are covered by employer-sponsored plans,

many workers and their families remain uninsured either their company does not provide coverage or they cannot afford it. Health-Care Crisis

Medicaid and the State Children’s Health Insurance Program (SCHIP), also known as HAWK-I in Iowa, help low-income children and some of their parents fill up the gaps.

Many proposals have been tossed around by politicians on both sides of the aisle ranging from socializing health-care comparable to the Canadian system to endorsing health savings accounts and cracking down on frivolous lawsuits against the medical community.

Many of these proposals have good points, but along with whatever good points, they bring they also bring major downfalls. Health-Care Crisis

For instance; a socialized national health-care program would eliminate the need for health insurance altogether and the cost would be taken on by taxes, which in theory doesn’t seem like a bad idea.

However, there will be a shortage of new doctors ready to enter the field as a result of the anticipated reduction in compensation,

while demand will grow due to the lack of personal responsibility. In other words, if individuals didn’t have to worry about deductibles or copays, Health-Care crises

which would ordinarily deter them from seeking medical treatment for minor ailments, they would go to the doctor whenever they felt discomfort or pain.

As a result, we now have long queues for patients with serious health problems because everyone is making an appointment, but we are losing professionals owing to a lack of incentive.

The Bush administration’s current battle cry is to promote HSAs (Health Savings Accounts),

which combines a low-cost high-deductible health-care insurance plan with a tax-deferred savings account that produces a tiny interest on the side that you contribute to along with your monthly premiums.

Any money withdrawn from the savings account for qualified medical expenses is “tax-free,” and unlike a flex spending account,

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which many individuals are familiar with in employer-based plans, any money withdrawn from the savings account for qualified medical expenses is “tax-free.”

The money you put into the account that you don’t utilize isn’t lost.

Basically, if you never utilized any of the money in the savings account, you can withdraw it or roll it over into another vehicle to be used for retirement after you reach the age of 62 1/2.

For some people, this is a viable option, but for others, the premiums for these plans are still too high, and the problem remains that if you require major treatment during the first few years of the policy,

you will not have enough money in your savings account to cover the gaps, leaving you responsible for a large portion of the cost out of pocket.

Now we come to what I believe is one of the most serious issues from the standpoint of a health insurance agent: the inability of people with pre-existing health conditions to obtain coverage.

I’d say that around half of the clients who contact my office looking for health insurance coverage have a health condition that will either cause an insurance carrier to deny their application or result in an amendment rider that basically precludes coverage for any claims linked to that disease.

Hypertension, or high blood pressure, is an example of a problem that I encounter frequently.

If other variables are present, this condition may result in a corporation rejecting an application outright,

but it is more likely to result in an amendment exclusion rider.

You might assume this isn’t a huge concern; after all, blood pressure medication is the only thing they’d have to pay for out of cash.

However, many consumers are unaware that this rider will exclude ANYTHING that may be deemed part of this illness,

including heart attacks, strokes, and aneurysms, all of which would result in a significant out-of-pocket expense. Consider the fact that my father recently underwent double bypass surgery,

which resulted in a bill of roughly $150,000. If he hadn’t had a hypertension rider on his health insurance policy,

he would have had to pay the entire amount out of pocket, not to mention the additional cost of two months off work. On a low income of $40,000 per year, this would have bankrupted him.

So, how do we address this issue? Clearly, the proposals have been problematic from the start, and even if one of these schemes received widespread public support,

it is unlikely to be enacted into law owing to political infighting. One side wants to keep health-care privatized,

while the other wants to socialize it, which has both benefits and drawbacks, as we previously covered.

It appears that we are doomed on this problem, with no meaningful solutions or light at the end of the tunnel, correct?

Maybe not, but let me tell you about a client I had a few years ago in my office.

A young woman came in looking to compare health insurance policies to see if she and her family had any possibilities.

She had several children, was on Title 19 Medicaid, and was attending state-funded college. She had recently graduated from college and had accepted a position with the local school district,

but she was not qualified for health insurance benefits for some reason.

Obviously, she couldn’t afford a plan for $5 or $6 hundred each month, so she returned to the help office and explained her position.

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They eventually collaborated with us to find a suitable private health insurance plan and compensated her for a portion of the cost, something I had no idea was possible!

Consider how many more people would be able to receive coverage if they could be repaid a percentage of the premium based on their income by the government.

Take, for example, a young married couple in their 20s with one child, with a family income of $25,000 and an average premium of $450 for a $500 deductible health insurance plan.

Let’s say the government determines that a three-person family with an annual income of $25,000 will be reimbursed 50% of their premium, bringing the total cost to $225 per month for the family.

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This is now a cost-effective premium that the family can consider.

We get the best of both worlds with this combination of private insurance and government help. Of course,

the next question is about cost: how much more would this cost the American taxpayer, and how much higher would tax be?

I don’t believe it would cost the taxpayers significantly extra, and here’s why: To begin with, we would reduce the number of uninsured persons who are unable to pay for the medical care they get,

lowering the total cost of health-care.

Second, the number of people forced into bankruptcy and obliged to seek Medicaid Title 19 help due to medical expenditures incurred as a result of catastrophic medical conditions for which they do not have insurance coverage would be greatly decreased.

This is important to remember since, once on Medicaid, a person’s health-care is essentially 100 percent funded by the government, Health-Care

thus there is no longer any reason to avoid seeking treatment for minor or non-existing ailments.

On the flip side many conditions that would have not been caught before they became severe because

a person who didn’t seek treatment due to not having insurance coverage would now be caught before they turned into a catastrophic claim.

Finally, if the government allocated a certain amount of money to help cover claims by people that have pre-existing conditions

the private insurance companies could do away with exclusions and declines due to already existing health problems,

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Some states have already done so, including Iowa’s HIPIOWA Iowa Comprehensive Plans, which ensures residents who are unable to find coverage elsewhere.

You could be thinking that this is just wishful thinking and that these ideas will never be implemented,

but they are all being implemented right now.

The problem is that only a few states participate in such programs, and most health insurance agents are unaware that some low-income families may be eligible for premium reimbursement.

If all of these services were standardized and implemented on a nationwide scale with widespread publicity, I believe the uninsured population in our country would plummet.Health-Care

Now, I’m not claiming to know what reimbursement amounts should be for different income levels, but I do know that something is better than nothing, and this is, in my opinion,

the best medium ground we could discover. Health-Care

The socialized portion of the reimbursement would please Democrats, while Republicans should be pleased that health-care remains privatized,

providing this idea a stronger possibility of bipartisan support.

I faxed my concept to multiple senators and congressmen, but I always got the same normal response about how worried they are about health-care

and how hard they are working to find a solution, despite the fact that no one read my letters.

The only way to get these ideas out to the general public is for those of you who read this to spread the word by word of mouth,

email, or by linking to this webpage from your own website.

If enough buzz is generated, these ideas will be given the attention they deserve, and if enough people, like you and me, demand that a solution be found,

politicians will be put under enough pressure to act.

The number of uninsured Americans will continue to rise, and the expense of health-care will continue to rise.

and if nothing is done now, the cost of health insurance premiums will only rise!

Until then, all I can do as a health insurance adviser is assess all of your options and present you with the lesser of all evils, which is far too many cases is the option of going without coverage.