March Political Madness

For the first time in more than a decade, the debate over how to provide health care for the uninsured is moving back to center stage in Washington and many state capitals. After languishing as a major issue since President Clinton's health care plan failed in 1994, health reform is back on the agenda — from President Bush's State of the Union speech to stump speeches from presidential candidates.

And you can expect a laundry list of folks who want their story to be told.

Let's look at a few.

When Trenton was born, the family did not have medical insurance. "We took out a loan from the bank," Lela says, "because the hospital wanted a down payment. We paid the rest off a few years after that."

She says the Medicaid program needs to be more flexible to accept families with higher incomes.

Most programs accept applicants up to 200% of the FPL (federal poverty level . . . about $19k for a family of 4). How high do these plans need to go? 300%? 400%?

Where does personal responsibility begin and taxpayer subsidy end?

Kendra Pitts, 28, gets coverage though her job for herself at a cost of $60 a month. But to add her 5-year-old daughter, A'Nya, would cost an additional $300 a month, money Pitts says she doesn't have

I have several clients who insure their children separately, outside of the employer plan. Usually the premium is less than $100 per month. In some cases it is as little as $60.

There is no reason for paying $300/month to insure a child that is usually healthy. Alternatives do exist.

She looked into a private plan for A'Nya, but it was about $150 a month, with a $200 sign-up fee

$200 sign up fee?!!!

How much you want to bet this was not insurance, but a discount plan? I have never seen an INSURED plan with a $200 sign up fee.

For a while I had a policy and was paying $400 a month," says Stewart, who is relatively healthy but takes a thyroid medication and drugs for blood pressure and cholesterol. "I paid them more than they paid back in benefits."

So . . . you should only take out a policy if you believe you will get back more than you pay in? Someone has no clue what insurance is all about.

Cesa says his businesses netted him less than $4,000 in 2005, after he paid his expenses, including the $3,000 in medical bills from his finger injury. He's hoping the numbers for 2006 come in better, but he's certain it will be less than $15,000. There's just no wiggle room to buy insurance, he says.

"What am I supposed to do? Sell my house to pay for insurance for my employees and me?

Seems like there are more issues here than just a lack of health insurance. A net profit of $4,000 for 12 months of work? Perhaps a reality check is in order here.

And of course his answer is . . .

There should be a basic (health insurance) system where coverage is provided for everyone."

How "basic" does one get? Maybe 2 doctor visits per year + immunizations? Is that basic enough?

She pays $200 a month for a "discount card," one of many sold around the country by a variety of companies, which promises discounts on doctors and prescriptions.

Why would anyone pay $200/month for a discount card that can be had for less than $25?

On top of that, she pays about $300 a month for the seven medications she takes and the test strips she needs to monitor her blood sugar levels.

Doesn't sound like there is much of a discount to that card. Wonder how much her meds would cost if she stopped paying the $200 for the overpriced discount card?

"I was trying to set up payment plans, but they (hospitals and doctors) weren't willing to work with the amount of money I was able to send them," she says.

Hospitals are like that. Folks seem to think they can run up a $100k bill and offer to pay the hospital $10 per month and everything will be all right.

Not so.

Some of the uninsured simply choose not to buy coverage.

Quite a few actually. On average, about 40% can afford health insurance and can qualify. They choose to spend their money on other things.

Particularly those who are young and healthy — the very group that insurance companies want to attract — tend to see health insurance as an expense with little payback, rather than a hedge against financial disaster. So they don't buy it.

And guess which group has more accidents than anyone else?

The young & healthy.

About 33% of those ages 19 to 24 are uninsured, and about 27% of those ages 25 to 34 are uninsured, according to a Kaiser analysis of Census Bureau data.

So how much does insurance cost for these folks?

Generally less than $100 per month . . . about the cost of a latte' per day.

One of his co-workers, a man in his 20s, buys insurance on the private market, a move Wurtzbacher says doesn't make much sense.

"There's nothing wrong with him, and he's paying for health insurance," Wurtzbacher says.

Right on, dude. He should save his money and only buy health insurance after he needs it.

What planet do these people come from?