A New Idea To The Health Insurance Crisis In America
One of the most critical issues facing the United States now is that more than 41 million of its citizens do not have health insurance. Many workers and their families do not have health insurance, either because their employer does not provide coverage or because they are unable to afford the cost of coverage.
This is despite the fact that the majority of elderly Americans have coverage through Medicare and that nearly two-thirds of non-elderly Americans receive health coverage through employer-sponsored plans. Medicaid and the State Children’s Health Insurance Program (SCHIP) or HAWK-I here in Iowa assist fill in the gaps for low-income children and some of their parents, although the scope of both programs is restricted.
These programs help fill in the gaps for low-income children and some of their parents. As a consequence of this, millions of people in the United States who do not have health insurance are at risk of experiencing negative health effects as a result of delaying or forgoing necessary medical treatment, which is why providing coverage to the uninsured has become a top national concern. – (The information was obtained from the kff.org website.)
The current situation in our nation, with a significant number of people being compelled to go without health insurance, is nothing less than a catastrophe. Over the course of the last several decades, we have been sucked into a vicious cycle in which health insurance premiums have gotten so exorbitant that even families in the middle class are unable to pay them.
This, in turn, leads to the inability of the uninsured to cover medical costs, which frequently leads to the financial ruin of the family, which, in turn, leads to the continuing loss of income by the medical community, which, in turn, drives the cost of medical expenses higher, which, finally, cycles back to the insurance company, which then needs to drive the premiums of health insurance higher in order to help cover the rising cost of health care.
Politicians on both sides of the aisle have put up a variety of ideas, including socializing health care in a manner that is analogous to the system in Canada, promoting health savings accounts, and clamping down on frivolous court claims brought against the medical industry. There are some compelling arguments to be made for several of these propositions; yet, in addition to any compelling arguments that they advance, these ideas often have significant drawbacks.
For instance, a socialized national health care program would do away with the need for health insurance all entirely, and the expense would be taken on by taxpayers, which, in principle, doesn’t sound like such a horrible notion of a concept. However, one of the drawbacks of this system is that there will be a shortage of new physicians who are eager to enter the profession owing to the inevitable reduction in salary, but at the same time there will be an increase in demand because of the lack of personal responsibility.
If individuals didn’t have to worry about things like deductibles or copays, which would ordinarily prevent them from getting medical care for small problems, then those people would just go to the doctor whenever they experienced an ache or discomfort. Since everyone is arranging an appointment, we now have waiting lines for patients who have serious health concerns. At the same time, though, we are losing physicians since there isn’t enough motivation for them to practice here.
The current battle cry of the Republican Bush administration is to push HSAs (Health Savings Accounts), which reduce premiums by taking a less expensive high deductible health insurance plan with a tax deferred savings account that earns a small interest on the side and to which you contribute along with your premiums each month.
This plan reduces the amount of money you have to pay each month for health insurance. Any money that is taken out of the savings account to pay for qualified medical expenses can be done so “tax-free.” Additionally, in contrast to flex spending accounts, which are common in employer-based plans and are familiar to many people, you don’t lose the money that you put into the account but don’t spend if you have one of these accounts.
If you never spent any of the money in the savings account, you will be able to withdraw it or roll it over into another vehicle after you reach the age of 62 and a half without incurring any penalties in order to spend it for your retirement.
The premiums for these plans are still too expensive for many people, and the problem remains that if you need major treatment within the first few years of the policy, you will not have a large enough amount in the savings account to help cover the gaps, leaving that person responsible for paying a large portion of the cost out of pocket. This is an option that is viable for some people, but not for many. For many, the premiums for these plans are still too expensive.
We have now arrived at the topic that I consider to be one of the most significant issues from the perspective of a health insurance agent, and that is the inability of individuals with pre-existing health conditions to receive coverage.
I would have to say that approximately half of the people who contact my office in search of health insurance coverage have a health condition that will either result in an insurance company declining that person’s application or result in an amendment rider that basically excludes coverage for any claims that are related to that condition. This conclusion is based on the number of people who contact my office in search of health insurance coverage.
Hypertension, often known as high blood pressure, is one example of a problem that I come into contact with very frequently. The most common outcome of this condition is the addition of an amendment exclusion rider to the policy, although in certain cases it might lead to the firm rejecting the application entirely if there are further issues involved.
You may believe that this isn’t that big of a deal, after all, blood pressure medicine is about the only thing that they would have to pay for out of pocket. However, what many people don’t realize is that this rider will exclude ANYTHING that could be considered part of this condition, including heart attacks, strokes, and aneurysms, which would all result in a huge claim that they would have to pay out of pocket.
This is something that you may think isn’t that big of considering the fact that not so long ago, my father had a procedure called a double bypass, which resulted in a total cost of almost $150,000.
Should He Have Had a Hypertension Rider on His Health Insurance Policy? If he had a hypertension rider on his health insurance policy, he would not have had to pay this whole sum out of pocket, but he also would have had to pay the additional expense of missing work for two months. This would have been catastrophic for his finances given that his annual salary was just 40,000 dollars.
The question now is, how can we find a solution to this issue? Even if one of these plans won the support of the American people, there is a good chance that it would never be enacted into law due to the constant political bickering that takes place in the United States. It is obvious that the proposals that have been presented up to this point have been flawed from the very beginning.
Both the privatization of health care and the socialization of health care, which we just went over, have their advantages and disadvantages, but one side wants to keep it private while the other side wants to socialize it.
Regarding this matter, it would seem that we are destined to fail, and there are neither any viable solutions nor a glimmer of hope in sight, is that correct? Perhaps not; before I answer that question, let me tell you about a customer who visited my office around two years ago.
A young lady came in with the intention of comparing different health insurance policies in order to see whether or not there were any alternatives available for her and her family. She was enrolled in Medicaid under Title 19 since she had multiple children, and the state also paid for her education at the university level. She had just finished up her studies at the university and found a position in the local school district.
Despite this, for some reason, she was not qualified to get the health insurance benefits that her employer offered. She realized that she was still unable to pay the five or six hundred dollars in monthly premiums for a plan, so she returned to the help office and provided an explanation of her circumstances.
They ended up working with us to locate a private health insurance plan that was appropriate, and they compensated her for a part of the cost, which was something I had no idea was even a possibility!
This started me wondering about how many more individuals would be able to receive coverage if they could be paid by the government for a portion of the premium according to their income. Consider how many more people would be able to obtain coverage.
For illustration’s sake, let’s pretend that a young married couple in their twenties with one kid has a family income of $25,000 and that the typical premium for a health insurance plan with a $500 deductible costs $450 for them. This scenario illustrates a common scenario.
For the sake of illustration, let’s assume that the government has decided that a family of three with an annual income of $25,000 is eligible for a reimbursement of 50 percent of their premium, bringing the total amount that the family is responsible for paying to $225 a month. This is now a premium that is reasonable enough for the family to contemplate purchasing.
By combining the benefits of private insurance with those of public aid, we may enjoy the advantages of both systems.
The issue that naturally follows is one of expense: how much more would this cost the American taxpayer, and how much would it increase taxes? I do not believe that there would be a significant increase in the amount that it would cost the taxpayers,
and here is why I believe so: To begin, we would substantially reduce the number of uninsured individuals who are unable to pay for medical services they get, which would have the knock-on effect of lowering the overall cost of health care.
Second, the number of people who don’t have health insurance coverage but end up filing for bankruptcy or qualifying for assistance under Title 19 of the Medicaid program as a result of the enormous medical bills they rack up as a result of catastrophic medical conditions would drop by a sizeable amount.
It is important that you keep this in mind since, once someone is enrolled in Medicaid, their health care is essentially paid for in its whole by the government. As a result, there is no longer any reason for them to avoid seeking treatment for non-existent or minor ailments.
On the other hand, many conditions that previously would not have been detected before they became severe because a person did not seek treatment due to not having insurance coverage will now be detected before they turn into a catastrophic claim. This is because people are more likely to seek treatment when they have insurance coverage.
Finally, if the government were to set aside a certain sum of money to assist in covering claims made by people who have pre-existing conditions, private insurance companies would be able to eliminate exclusions and declines in coverage due to pre-existing health problems. This practice is already in place in some states, such as Iowa, where the HIPIOWA Iowa Comprehensive Plans insures residents who are unable to obtain coverage anywhere else.
It’s possible that you’re sitting there thinking that this is all just wishful thinking and that these ideas could never be put into practice, but the truth is that all of these concepts are already being put into practice.
The difficulty is that only some states participate in certain programs, and even the majority of health insurance brokers are unaware that certain low-income families may be eligible to receive reimbursement for their health insurance costs.
My opinion is that if all of these initiatives were standardized and implemented on a national basis with widespread publicity, it would make a significant difference in the number of people in our country who do not have health insurance.
Now, I don’t pretend to know what the reimbursement levels should be for what income levels, but I do know that anything is better than nothing, and in my opinion, this is the best middle ground we could find. Now, I don’t pretend to know what the reimbursement levels should be for what income levels.
But I do know that anything is better than nothing. The socialized portion of the reimbursement would make the Democrats happy, and the republicans should be glad that health care would continue to be private, as this will provide this idea a higher chance of receiving support from both sides of the political aisle.
I have faxed this proposal to a number of senators and congressmen, but I always get the same sort of usual answer about how concerned they are with health care and how hard they are trying to find a solution, despite the fact that I am well aware that no one actually ever reads my letters.
The only way for these concepts to become widely known is for those of you who are reading this to share it with others, either verbally, by email, or by connecting your own websites to the page that contains these thoughts.
If there is sufficient interest generated, then these suggestions will be given the consideration that they merit. Furthermore, if sufficient numbers of people, including you and me, demanded that a solution be found, then perhaps there will be sufficient pressure placed on the politicians to get something done.
If something isn’t done right now, the percentage of uninsured Americans, the cost of medical treatment, and the cost of health insurance premiums are all going to continue to rise in the coming years. If something isn’t done right now, these trends will only continue.
As a health insurance agent, the only thing I can do until then evaluates all of the available choices and present you with the one that I believe offers the least amount of risk. Unfortunately, in far too many instances, the option that is selected is the riskiest one, which is to forego health insurance coverage altogether.
