Re: 60 Minutes



Jenny,

Great post.

Are you forgetting that the median IQ is 100? And that the median family
income in this country is something like $42,000 (for a family of 4). What
happens when the treatment costs $20,000? Or for that matter, $4000--for a
family that is already paying everything it earns to keep a roof over
their heads?

Actually the typical MSA/HSA deposits money into a checking account with a
Visa Card debit feature. The amount will typically cover most (if not all)
the annual deductible.

You decide if you spend money, but the first dollars come out of that
checking account, rather than the insurance company. The insurance kicks in
afterward, typically anything over $2500 or $5000.

So the money is there. We just aren't paying the insurance company overhead
for them to return our own money to us. Plus, WE are spending the money, so
we presumably will make the judgements about what care is necessary.


A lot of people don't have the intellectual capacity to understand whether
they need a treatment or not.

That would be true regardless of their insurance plan.

IMHO, it is almost always better for a patient to make the decisions about
their medical care, than a night school MBA at an HMO, or a government
bureaucrat.


Even worse, children of people who are financially strapped would not get
treatment for things like ear infections that untreated lead to deafness.
A cost-cutting doctor at Kaiser years ago refused my daughter an
antibiotic and she ended up permanently deaf in one ear. Kaiser made some
money, but at whose expense?

Apparently somebody in your organization chose that HMO in order to save
money. You could have chosen care for your daughter elsewhere, but went to
Kaiser because it cost you less out of pocket. You could have gone to a
private clinic, perhaps even closer by.

Where does the buck stop in this decision? The final decision was still
yours.

Step one should be that Medicare patients, insured patients, and everyone
else be billed the same amount and then putting in some kind of mechanism
so that people who really can't afford the bills get some kind of break.

Government price controls historically have led to only one thing.
Shortages.

With the current Medicare payment rates, I often have to beg specialists to
see my patients. The problem seems the most acute in Neurology, Psychiatry,
and some Orthopedic subspecialists.

We have many docs in our community that won't accept new Medicare (or
Medicaid) patients. Extending those rates to everyone would result in many
doctors offices closing as you couldn't meet your payroll.


As it is, millionaires on Medicare pay almost nothing for treatment after
treatment while kids who earn $13,000 a year can easily find themselves
being socked with $30,000 medical bills after having an accident and
having it ruin their lives.

I can assure you that all Medicare recipients, regardless of their financial
status, feel that they have a right to it. They have been paying into the
system for 45+ years, and they feel that they are owed care now in return.
To change the system now would be viewed as a breach of contract by the
Medicare patients.


That's just plain not right.



Unfortunately, people who have insurance--which covers everyone who makes
policy, have no idea how vicious and unfair this system is for those who
are self-employed or have pre-existing conditions that bar them from
getting insurance.

Hey, I agree totally. We all seem to agree on the problem.

It's agreeing on the solution that will be the hard part.

WCB



--Jenny



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