Medicare is going broke. There are people in this country with serious illnesses who cannot afford health insurance. There are unethical people defrauding the system and providing care that is substandard.

Our health care system has some serious flaws. This President, as others before him, has challenged Congress to fix the problem. Unfortunately the media and members of Congress have made this a contest of winning or losing. Headlines and political rhetoric lead you to believe that the outcome of health care reform will be a victory or a loss for the President or for a particular political party. The reality is that health care reform will be a victory or failure for the American people. For our elected officials to view it in any other manner is negligent and a violation of the trust we gave them when electing them to office.

Passing a flawed bill is not a victory. Nor is it victory to stubbornly oppose any form of reform to a system that needs improvement. We deserve better from those we have elected to represent us.

Any “solution” to the health care challenge must be realistic in terms of cost. We cannot create another government program that will ultimately be in the same financial crisis that Social Security and Medicare currently face. While the government has the ability to print money, it cannot fabricate value. At some point the deficits and artificial cash pumped into the system will collapse, much as the mortgage failures brought about the crisis for many financial institutions in the past year. If government does not start to exercise fiscal prudency, this country will face a financial crisis that no bail-out can save.

The current house reform bill will require insurance companies to accept all patients regardless of preexisting conditions and will prohibit them from placing caps on benefits. The insurance companies cannot charge higher premiums for these individuals than they do for others in the plan.

True health care reform must address health and the issues that impact health. Poor diet, smoking, obesity, drug use, lack of exercise and poor prenatal care are big components of the cost of health care in the United States. Improving quality and reducing cost are not done by making sure everyone has health insurance. They are accomplished by improving the overall health of our population. This issue is not being addressed.

Many Medicare and Medi-Cal/Medicaid patients are finding it difficult to get a primary care doctor or get an appointment with certain specialists. This is because physicians cannot afford to see too many of these patients without risking financial ruin.

Patients who are insured through a commercial health insurance subsidize the federal programs by paying more than their fair share. Physicians therefore give priority to insured patients and commercial insurance is condemned for having high premiums.

Despite this fact, the House bill does not contain an outline to fix this problem. A separate bill does away with the existing payment formula that has physicians facing a 21% cut in 2010, but a long term solution is not included in either bill. Political promises seem to buy votes, but they seldom produce results.

Under such circumstances, how many bright young people will choose medicine as a career? A surgical specialist is in school and training until they are between 32-35 years old. Most will have spent well over $200,000 in tuition and fees. They will have put off establishing a home for themselves and their families.

The Pelosi bill is a bad bill. It does not go far enough in some areas and goes too far in others. It does not address the root causes of our health care challenge nor does it strengthen our health care system. It changes our health care system, but there is little hope that it is the change we need.

Recently, Hibernian Aviva increased its premia by 12% and VHI will,also up its rates in the new year.

Quinn Health care said its newly-announced increase was a result of the Government’s health insurance levy which was introduced aimed at making health insurance affordable for older people by decreasing the risk differentials for health insurers between old and young customers.

This followed the risk equalization scheme being annulled by the courts last year.

With private bed charges in public hospitals likely to be increased substantially in the December 9 Budget, further major increases in health insurance costs can be expected later in 2009.

Health insurance, along with other healthcare charges, are one of thefew areas of the economy to have increased in cost over the past year, according to the Consumer Price Index.

If your boss offers a good plan and pays the bulk of the cost, give him or her a kiss. This stuff is expensive.

The average cost of family coverage is $13,375 this year, with employees paying on average $3,515 of that, according to a new survey by the Kaiser Family Foundation.

Costs went up 5 percent in 2009, and we’re in for another boost next year. The New York Times last month reported that small businesses are getting hit with 15 percent price hikes from health insurance companies. Large firms, which pay medical claims with their own cash, are seeing smaller increases.

This year, about one in five employers shoved their higher costs on to employees, either by cutting coverage or boosting the worker’s share of the premiums. If the boss does that to you, give him a dirty look.

Don’t ignore open enrollment. At some employers, workers who fail to pick an insurance plan get no coverage at all, notes Larry Poger of Poger and O’Connor, a benefits consulting and brokerage form in Clayton.

Given the dollars involved, it pays to take a close look at the choices, says Sam Gibbs, vice president at eHealthinsurance.com, “It’s not unheard of for an employee to be paying $600 or $700 a month toward the premium,” he notes.

Workers at big companies usually have several health insurance options — some with low premiums and big deductible and co-pays, and others with high premiums and low deductible and co-pays.

The deductible is what you have to pay out of pocket for care before insurance kicks in. Co-pays and co-insurance are the portion of the health care bill that you have to pay even after you’ve paid the deductible. .
So, the first question is: Could you afford to pay a big deductible if you had to? If not, choose a low-deductible plan. Still, Poger finds that only one out of four workers actually runs through the deductible in a given year.

Check the plan’s maximum annual out-of-pocket expense. Many people who think they have good insurance find out otherwise when they see the portion of a hospital bill that they’re expected to pay. It’s important to have a reasonable maximum on what you can be charged.

Generally speaking, young healthy people without children will probably do better with high-deductible plans, says Dennis Nilges, benefit consultant with Wolfe Nilges & Nohorski in Des Peres. If they become sick, they’ll be stuck with bigger bills, but only for a year. They can switch to lower deductible plans when the next open enrollment period comes around, and their pre-existing condition will still be covered.

On the other hand, people with chronic illnesses, sniffly kids, or contemplating pregnancy, should probably grab low-deductible plans.

More employers these days are offering very-high deductible plans — at least $1,150 per person and $2,300 for a family — coupled with health savings accounts. A big benefit of health savings accounts is that money going in isn’t taxed, and you can withdraw money for health expenses without paying taxes. Take it out for any other reason and you’ll pay taxes plus a 10 percent penalty, unless you’re 65 years old or disabled.

You can take the account with you when you leave the company. Eventually, it becomes the equivalent of a retirement account.

Generally speaking, such plans are best for people both healthy and wealthy, who will have no problem paying a big deductible if they have to.

Most plans will charge you less to use a doctor and hospital in their network, and more if you stray outside. So, you’ll want a plan that covers your doctor, and the hospitals you prefer. Better check the list. If you do a lot of traveling, or have a kid away at college, look for a plan with a national network of doctors and hospitals.

Plans come with varying restrictions. HMOs are generally less expensive than other plans, often having no deductible. But they are more restrictive, trying to limit your care to network doctors and hospitals except in emergencies

Yeah I had to pay cash. But it was okay because I saved money assuming I was going to need new tires and/or brakes. Even if I did need these items, GEICO would not have covered anything. In fact, the only thing it will cover is collision and liability. You know, it covers the areas that I may not be able to afford if shit hits the fan.

So my question is: Why can’t my health insurance be like this? Does my health insurance need to cover my yearly physical? Does my health insurance need to be billed when I spend five minutes with my doctor for a stuffy nose and she tells me what I already know that I have a sinus infection. Does my health insurance need to cover the antibiotics? I know my car insurance doesn’t cover synthetic oil.

I take good care of my car because I don’t want to lose it prematurely. I don’t want to pay for something that could have been prevented. I have an incentive to keep my car healthy. Yet, I have no incentive other than a longer life to keep my body healthy because I know health insurance will cover anything. I can eat donuts every day and when I get a heart attack, they’ll pay for the surgery and the Lipitor after. No wonder why this country is so fat and unhealthy.

In a perfect world, we wouldn’t have any health insurance. But I understand this is not heaven. But why can’t we treat health insurance like car insurance:

• Mandate coverage for everyone (Increase the pool to decrease the cost).
• Require yearly physicals and other preventative measures.
• Don’t cover every little service and instead cover us when shit hits the fan such as cancer.
• Offer rewards to people for getting healthy the way car insurance takes 10% off for taking a class.
• And because I have a heart and realize we are more important than a car, assist those who can’t afford a physical.

Maybe health care costs have gone up because we use insurance too much. We expect health insurance to cover our bad behaviors but something tells me GEICO isn’t covering a repeat drunk driver. Instead of taking Lipitor, people should eat less cholesterol. If we had to buy our own medication we would probably take the generic cholesterol medication over Lipitor. Maybe this would make health care cheaper, easier, and oh yeah… maybe we’d be healthier. Because part of me is sickened by those in Congress that care more about government role and cost over how can we be healthier so that we can extend our life, liberty and happiness.