Archive for the ‘Uninsured’ Category

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Auto Bailout

A column in Tuesday’s New York Times raises an issue not raised by many who opine on the bailout of the auto industry – the relationship between health care financing and the bailout.  David Leonhardt  examines the much discussed wage disparity between the unionized autoworkers and their non-union counterparts employed by foreign manufactures in the US like Toyota and Nissan.

Ezra Klein in his blog picks up the same theme.  Apparently the Republicans in the US Senate missed their helpful analysis – as did most of the talking heads on the news shows.

1210-biz-webleonhardt1

They make two relevant points. Most of the disparity between the wages is in legacy cost, and secondly, wages are not the significant cost driver in the cost of an automobile.  They both agree that Detroit’s troubles are not related to costs, but to their inability to design and build cars that the American public wants.

Personally, I do not think the car makers deserve all of the criticism they received; a lot, just not all of it.  Until a couple of months ago, our family had two American made vehicles in our driveway.  Their combined mileage was almost 350,000.  Our high priced foreign car cost more per year to repair than the other two combined.

But I digress. This graphic reveals yet an another example of how the inequity in health care financing distorts the marketplace.   Continue reading ‘Auto Bailout’

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QMCSO – Say what?

In my last post, I wrote that health care reform proposals need to focus on the patient side of the health care delivery system by designing systems that eliminate the cumbersome, even tortuous routes that patients must travel to enter that increasingly privileged space – a person with health insurance.

An illustrative example is the Qualified Medical Child Support Order (QMCSO).  QMCSOs apply to those children who live with one parent but the court orders the other parent to provide the health insurance.  The parent who has custody of the child is called, logically, the custodial parent.  The other parent is called, can you guess, the non-custodial parent. Continue reading ‘QMCSO – Say what?’

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Administrative Cost Savings Is No Myth

Since November 4th, interest in health reform proposals has understandably intensified.  I like to flatter myself that this blog might make a small contribution.  But I do have a day job and so the horn I blow here only has one note; if we simplify the system we can find the money we need to cover the people without health insurance and increase product satisfaction among all stakeholders.  

I am not a policy wonk who views the health care system wonderfully distilled through the glorious abstraction of statistics; nor am I encumbered by practical politics.   I view the system from the bottom looking up.  I have a stake in the present system, but that stake is poorly represented in these musings.  I am a gatekeeper to the health care maze.  In my ideal world there would be far less need for the work I am doing.

I know from daily encounters just how daunting that maze is for people needing care.  I tend to demonize piece rate physicians who are too quick to deny care rather than trust the maze.

So when I read others who write about health care reform I look for my theme.  On Sunday, November 23, 2008, the Washington Post published an opinion piece by Shannon Brownlee and Ezekiel Emanuel, 5 Myths About Our Ailing Health-Care System.  The authors are right on target with four of the five myths that they debunk.  They drive home the point that we are paying a lot of money for our health care, that we are paying a lot of money for not particularly good health care, that we really are paying the price through premiums, taxes, and lost wages, and that Americans are ready for a change.

I take issue with myth #3 – we would save a lot of money if we could cut the administrative waste of private insurance.  The authors don’t think much of that notion.  Since administrative complexity, and consequently costs, is my central theme, I need to take issue with the authors on this one.   Continue reading ‘Administrative Cost Savings Is No Myth’

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Health Insurance for Small Business

Every health care reform proposal attempts to offer some relief for small businesses.  According to the National Federation of Independent Businesses (NFIB), small businesses create 2/3 of American jobs, yet half of the uninsured are in small businesses.

Look at President-elect Obama’s health care proposal on his campaign’s web site.  The first two items:  

  • Require health insurance companies to cover pre-existing conditions so all Americans regardless of the health status or history can get comprehensive benefits at fair and stable premiums.
  • Create a new Small Business Health Tax Credit to help small businesses provide affordable health insurance to their employees.

What’s remarkable about these proposals is that we are still discussing them. Continue reading ‘Health Insurance for Small Business’

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Ask Jesse the Artist

Instead of focusing on Joe the Plumber and his tax phobia’s, perhaps the presidential candidates should talk to Jesse the Artist and ask him or her about health insurance.  On Sunday, October 19th, I visited the Bethesda Row Arts Festival in Bethesda, Maryland.  I did just that.  In a very unscientific survey, I talked to a number of the artists about their health insurance.  

Why should anyone else be interested in artists?  Because they are small business people.  They are also very creative.  It is this creative entrepreneurship of small businesses that candidates like to support because it is the economic engine  that drives the American economy. Continue reading ‘Ask Jesse the Artist’

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