In our world today we are seeing a clash and many see if about whether or not the GOP will ever be OK with it and move on. I'm here to tell you they never will and to move on. But what the American people and politicians need to wake up and smell the coffee they are drinking. They need to pause and think about what is really going on, what is happening and what reality really is. Note, I do not go in depth of the ACA in an effort to remain politically neutral.
Here is the reality.
1) Whose responsibility is it to take care of you? If you haven't already come to the conclusion that it is your own responsibility then you need to go to your local bookstore, app or ebook supplier and download some self help books! It is our jobs to take care of ourselves and our families. Yes, we do need to help take care of the poor and needy ultimately they have their own responsibility to take care of themselves.
Please don't misunderstand me. There are times we all need help. There are times we all cannot take care of our own selves and/or families. I have been there. Many have been and are there. Yes, we can help them in many different ways. These ways can and should be down without the government. Many corporations, non-profits, good people and other organizations give money to hospitals, facilities, doctors and other programs to pay for healthcare for those who cannot afford it.
2) Every American has access to healthcare. They cannot be turned away from a hospital if they need care. It is against the law. Bottom line. We have programs for kids, poor and needy. Many offices around the country offer healthcare on reduction plans to even free. Just turn on your tv, radio or look at your Internet ads and you can see the reality of this.
Number two the access to healthcare never was an issue. It was turned into an issue when the the words "healthcare reform" were sensationalized. Ask yourself, do we have a good healthcare system, do we have adequate hospitals and doctor, dentist, eye doctor facilities? Your answer should be YES! If not, then you need to smell your coffee again and stop and think again.
3) Given the proceeding two points what are we left with? We are left with insurance. Insurance is a lot like immigration. Not a whole lot of beneficial law in the books for it. It is a well proven and recognized fact that many people cannot get covered by insurance. I myself have been there. It is hard and costly.
Hopefully the smell of your coffee and your clear thinking with the previous points has gotten you to realize that the problem really is insurance. We need insurance reform. The Affordable Healthcare Act (ACA) does give some insurance reform. We will have pre-existing conditions removed (after Jan 1, 2014) and other good provisions. This is what we need.
Can you see our healthcare in itself is fine. Insurance is the problem. ACA vs. Insurance Reform.
Perhaps your faculties are buzzed enough now you can begin to develop in your mind all the ways insurance goes wrong and here are many. Yes it is designed for those who are healthy. Yes, it is a business and relies on monthly premiums. But there are ways to fix it.
4) What are the problems with insurance? There are really only 3 problems I see currently. These are Coverage, Cost, Claims
It is very difficult to get insurance for many people. Currently when you apply for insurance you are asked questions about your medical history. A profile is built. Your profile is put into a pot of 5-7 individuals who also fit your profile. These individuals are fairly local to your area. Then a point system is applied. One point for every medication, condition and treatment. The average number of points incurred by the group of 5-7 individuals is consider the target. If the points your profile incurs is greater than the average you are denied coverage.
There is a case to make for maintaining health for the majority of folks. But in the end this system can be approved. So how can this be reformed
4a) Coverage - make insurance nationalized like car insurance. Currently insurers only operate in smaller geographical areas with in a state. Allow them to go national and the base of customers paying into the pot is larger. Then the group size could be widened on a regional or national size. This would allow individuals to incur more points on their profile thus allowing more people to be approved for insurance. Then you have solved your coverage problem. No person involved with politics has ever spoken of this, that I know of.
4b) Cost - it is a well known fact that the monthly premiums for a insurance policy are far beyond what many can affordably pay. Well given that we just recommended to nationalize insurers, this creates more subscribers and profit for the company. This can drive down their costs. This could stabilize and reduces monthly premiums for customers, thus reducing the cost of insurance and ultimately the cost of healthcare for every American. This would also reduce the "shared cost" from the insurer to customer meaning lower co-pays and lower deductibles.
Another way to drive down costs is tort reform. Tort reform is limiting what someone can sue a healthcare professional or facility for. Tort reform does not remove the ability to sue, it just put the burden of proof of negligence onto the the plaintiff. In tort reform you can allow for the cost of legal expense to be covered, if the plaintiff wins. Let's look at one example, Mississippi. At the time had 80% of its insured people under one provider. After 1 year of tort reform in that state monthly premiums reduced 40%. If your policy was $500 a month that is $200 a month savings, or $2400 a year. That amount is bigger than the stimulus checks that came out under Bush and Obama for the majority of Americans.
Just imagine a reduction of cost due to nationalized insurance and then a reduction due to tort reform. Imagine the affordability now. Imagine the amount of people now whose issue with coverage was solved. Now I hope you can smell the scent of money in addition to your coffee!
4c) Claims - currently every ensurer has a board/panel of "doctors" who can review all claims, but typically review only the costly or the ones, new/experimental procedures etc. There are a lot of issues with people getting denied on claims due to this.
Let me first just point out. that the Affordable Healthcare Act sets up the same board appointed by the President who does the very same things. Thus the same problems can occur in this law.
New reform regarding what can be covered even if it is experimental, new procedure, "elective" or otherwise needs to be added into laws. Folks need things covered and got health insurance for a reason. While there are procedures/treatments that are too experimental to consider be considered standard care that dont need to be covered, new reform can bring more definitions surrounding this which can reduce the cost of healthcare to consumers by more coverage of things that previously might have been denied.
The Affordable Care Act does give good things to us like no preexisting conditions, insurance to children and no max limits on claims to an insurance. These need to stay. Some additional things on to change on insurance. Currently insurers are only required to justify that a certain percentage of their profits go to pay out claims if they are going to increase monthly premiums to customers/subscribers. This is followed up on by state attorneys and auditors, many of which dont have the time to follow up on this. New laws need to be passed surround the justification of raising monthly premiums in order to help reduce costs.
The last points I want to make are actually Healthcare Reform. But this reform is strictly related cost of healthcare. Currently in a state such as Utah or Idaho you can pay anywhere from $75- a few hunderd dollars for an ultrasound. But in a state like Washington you are paying anywhere from $1500-$2200. This is not do to an increase of tax in other states. We dont even see that big of a price jump with gas in many different states. There needs to be some kind of regulation on prices. Maybe even a price index of recommended amounts to charge. This could be just like the recommended interest rates the Fed gives to banks and then they charge their rates from there. This will help keep costs to lower for the actual care itself.
Last, I have been the recipient of very late billing and fees for obscure things. For example, when my second son was born he had a small procedure that was preformed in what was a janitorial/first aid closet that is kept clean and sterile. There was a fee for using that room of $1600. That my friends is outrageous and un-necessary. With the birth of that same son we went to an OB appointment for a routine ultrasound. they charged us for the ultrasound and then charged us $300 for the facility use. Are you serious? We were already there for a standard visit. These fees need to be made illegal. There is no basis or reason for them. fair billing needs to be the law. Many I know have received hospital bills 6-9 or more months past their treatment/procedure(s). This cannot be allowed. If they require timely payment the customer needs to be able to have timely and accurate billing.
These are simple ideas that could do everything thing the Affordable Care Act will do. It does it without government entering the market place, without subsidies or tax credits, it does it with limited increase in size or cost to the government. It allows people to provide for themselves, increases coverage, decreases cost and increases covered claims!
I hope you found this thought provoking and ultimately changes how you view the current needs of the country. I hope you understand the issues of the day are really insurance reform rather than "healthcare".
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