Expanded Health Care Coverage: Blessing or Curse

Have you heard? Under the economic stimulus package, expaned health care coverage is on the way.  Question is, for how long? Is it hard to believe that 4 million children in the United States have no type of health coverage at all.  Well it brings me some comfort to know that at least half of 4 million children will receive coverage under the SCHIP (State Children Health Insurance Program). Under the two-year economic stimulus package released last week by House Democrats, recently laid-off workers could receive health coverage assistance through an $8.6 billion expansion in medicaid or $30 billion in federal COBRA subsidies. 

House leaders said that under the proposal, the federal government would pay in full all benefits and administrative costs for all unemployed medicaid beneficiaries through 2010.  My question is after 2010 when this coverage has run its course, what type of plan or program is to take place of this one?  The proposal would allow states to choose whether to extend medicaid coverage to unemployed residents, and it would allow states to determine who whould qualify for the program.  States would have the option of expanding medicaid benefits to people using or who have exhausted unemployment benefits, no matter what their income is; unemployed people who qualify for food stamps, which in many states are available to residents whose incomes are too high to qualify for medicaid and people who have been laid off and have incomes up to 200% of the federal poverty level who otherwise would not qualify for medicaid.  

We know most private practices and specialist in the health care profession would not even bother to look at a person that has medicaid.  Let's not even talk about charity care.  That's another blog writting in itself.  Getting back to the issue at hand, House leaders said that under the COBRA proposal, health insurance premiums would be subsidized.  Let's examine this closely shall we.  COBRA subsidize their health insurance premiums?  Are they SERIOUS!  Seven out of ten Americans are filing bankrupcy every year on account of high medical expenses.  The COBRA proposal is this, health insurance premiums would be subsidized up to 65% for one year for recently laid off workers.  According to legislative sources, the level of assistance could change depending on the results of congressional budget analyses.  I wonder if the folks on Capital Hill ever thought about what would happen after the funds run out and the aid of this expanded health care coverage program ended in 2010?

Conservative health care policy experts are critical of expanding an entitlement and are predicting that states would have a hard time shutting the spigot of help once the federal money stopped.  It's almost like putting a band aid on a bullet wound.   It will be like trying to rinse soap out of your eyes only to find out that there is no more running water.  "Nina Owcharenko, an analyst at the Heritage Foundation's Center for Health Policy Studies, said that states will feel mounting pressure to maintain the Medicaid expansion when the federal funds run out in two years otherwise, it's seen as kicking people off the program. If  that happens, where is the cushion to break the fall?

Doctors Going South

Has the issue of health care really gone too far?  A critical element for enabling all of these reforms to provide real relief and to help all Americans get access to better and more affordable health care is curbing excessive litigation.  

Most of us are feeling the effects of the down spiraling economy.  We see it every where, in the news, on the internet.  More importantly, we feel it in our wallet.  Have you ever stop and wonder about how those who are in the professional field of health care such as doctors, dentists are feeling?  Many have had to leave their profession doing something else other than what they started out doing in the beginning.  

We now face another litigation crisis that has made insurance premiums unaffordable or even unavailable for many doctors, through no fault of their own.  This is making it more difficult for many Americans to find care and threatening access for many more.   Nevada is facing unprecedented problems in assuring quick access to urgently needed care.  The University of Nevada Medical Center closed its trauma center in Las Vegas for ten days last year.  Its surgeons had quit because they could no longer afford malpractice insurance.  Their premiums had increased sharply, some from $40,000 to $200,000.  The trauma center was able to re-open only because some of the surgeons agreed to become county government employees for a limited time, which capped their liability for non-economic damages if they were sued. 

Overall, more than 10% of all doctors in Las Vegas are expected to retire or relocate their practices by mid year.  There was a female doctor, age 41 who closed her decade-old obstetrics and gynecology practice in Las Vegas because her insurance premium jumped from $40,000 to $150,000 a year.   Other states are facing the same problem.  A doctor in a small town in North Carolina decided to take early retirement when his premiums went through the roof from $7,500 to $38,000 per year.  His partner, unable to afford the practice expenses by himself may now be forced to close the practice and work at a teaching hospital.  

Many physicians in Ohio saw their malpractice premiums triple in 2001, and some are leaving their practice as a result.  An Akron Urologist decided to retire.  Had this Urologist continued to practice, he would have spent seven months of his yearly income to cover the $85,000 premium. In New Jersey, 65% of the hospitals report that physicians are leaving because of increased premiums  (over 250% over the last three years). 

Litigation system does not accurately judge whether an error was committed in the course of medical care, physicians adjust their behavior to avoid being sued.  A recent survey of physicians revealed that one-third shied away from going into a particular specialty because they feared it would subject them to greater liability exposure. 

The Future of Health Care

Most of us that have jobs would normally have some kind of health care coverage right?  You would think so especially those who have large families.  What about those who don't?  As health cost increase, employers that offer health coverage are finding it harder to compete with companies in countries that have universal coverage and with non-union employers here in America that don't offer benefits.  

Here is something you should know.  Premium costs are rising three times faster than wages or inflation.  The average premium for family health insurance coverage today is more than $12,000 and its expected to double by 2016 unless we do something.  Are you aware that every 30 seconds, someone files for medical bankruptcy?  As costs rise, more people are uninsured.  With the number of corporations large and small finding it more difficult to stay afloat,  the effect of the economy has proven to be disastrous. Unemployment is at it's highest in the last 14 to 17 years.  

Today, 47 million people living in our country have no health coverage.  If you think that's shocking, think about 8.7 million children and these numbers are going up.  In the next four years, if we don't change things, 56 million of us will be uninsured.  Retirees especially are losing employer sponsored health care as well.  Only half the employers who provided retiree health coverage in 2000 are still providing it today.  There has been 50% drop in 7 years.  The United States spends much more on health care than other countries.  U.S. health care spending totaled 2 trillion in 2005, representing 16% of U.S. gross domestic product (GDP).  Health care spending accounted for 11.6% of the GDP in Switzerland, 10.7% in Germany, 9.8% in Canada and 11.1% in France.  (Kaiser Family Foundation Organization for Economic Cooperation and Development).   

Do you know health care costs contributes to an estimated 25% of housing problems.  Unless there is a health care system in place that is proven to be effective, than we must be careful about the choices we make when choosing a health care plan that would be beneficial to you and your family.