Traverse City Record-Eagle

Blogs

Healthcare — the numbers game

Troy Keith, The Armchair ConservativeHearing all of the talk about the great uninsured masses lately would lead one to think the bodies must be piling up in the streets by now, but what are the real facts behind so many of these conflicting reports?

According to the Census Bureau, as of 2008, 47 million people or (15.8% of our current population) are currently without health coverage.

An alarming number to say the least, but as we often find with such data, the real truth rests in the details.

Although previously estimating the number of uninsured Americans to be about 31 million, the Congressional Budget Office has recently revised their totals, arriving at a figure of 45 million for 2009.   As you can see in the chart below, the CBO places the number of non-elderly uninsured at 17%, the same as the percentage of people currently on Medicaid.

Source  Data:

According to MIT economist Jonathan Gruber, illegal immigrants make up as much as 13%, or nearly 6 million people, of the total number of the uninsured today.

In addition, a Commonwealth Fund brief places the number of uninsured young people ages 19-29 at 13.2 million in 2007.   The Census Bureau places those numbers for the same year at 17.9 million with the 18-24 year old demographic (often termed the "invincibles") representing 7,991,000 of the uninsured and the 25-34 year old group comprising 10,329,000 of the total.   Young people are often afflicted with incurable cases of good health which may explain why many often choose not to pay for coverage.

Source  Data:

In 2007, 17.6 million of the uninsured had annual incomes of more than $50,000 and 9.1 million earned more than $75,000.   More details here.

James L. Payne of AmConmag writes:

Politicians are also wrong to assume that I am pitiable. Like many Americans, I have significant savings and can afford medical expenses out of pocket. (Census Bureau figures for 2000 show that over 18 million households had assets in excess of $250,000.) Our savings make it possible for my wife and me to decline both private insurance and Medicaid. (We are 68.) Those without savings are in a different situation: they probably need insurance or subsidy or charitable help. My point is that if you can handle your own medical bills through savings and personal responsibility, this is a sound approach. Politicians should encourage this state of self-reliance, not make it a crime.

Putting all of these numbers together we arrive at the following:

6.0 million illegal immigrants
17.9 million young adults and “invincibles”
9.1 million affluent that choose not to purchase insurance
______
33 million

I did not include the 8.5 million making between $50-75,000 per year as health coverage could still represent a significant, albeit not overwhelming, bite of their household budgets.

I'd also like to stress that these numbers are only approximations.   Statistics are easily skewed to represent one particular point of view, but even a generous tally would place us in the neighborhood of 15 million legitimately uninsured citizens or just under 5% of the total population (304,059,724).   Many of those included in the total are often between jobs and will have coverage again in the future so the actual numbers are probably considerably lower.

The arguments against the currently proposed healthcare reform bill notwithstanding, what are we to do with these people?   I've stated previously that I have no problem with providing coverage for those making less than $35,000 per year and a sliding scale for those earning up to $50,000 (maybe we could add that additional 8.5 million back into our total while we’re at it).

Medicaid eligibility and compensation varies from state to state, but perhaps standardizing the qualification limit at 200% above the poverty level would provide some instant relief for those unable to afford coverage.

Real, comprehensive reform of Medicaid would probably do much to cover a large percentage of the legitimately uninsured in this country.   Obvious additional steps would include things such as tort reform.   According to statistics from a Pacific Research Institute report:

Approximately $124 billion dollars is spent annually by the healthcare profession to avoid medical liability.

About $30 billion more is spent on direct liability lawsuit costs.

Malpractice liability cost is 1 percent of GDP and increases the cost of healthcare by approximately 7 percent.   These added costs deny health insurance coverage to between 2.4 and 4.3 million people, according to the Department of Health and Human Services.

Allowing people to select "ala carte insurance coverage" would allow individuals to customize plans for their specific needs — does everyone really need coverage for in vitro fertilization as is required in policies throughout many states?

Converting all medical records to an electronic format and eliminating  waste within the current systems are two obvious steps that could be taken now without creating a new governmental entity.   These are ‘no-brainers' that would have a small but immediate impact.

We should take the necessary steps (for a number of reasons) to curb the flow of illegal immigration into this country.   I'd also like to see an expansion of HSA (Health Savings Accounts) options and a hefty tax credit for doctors and hospitals providing free or reduced fee services.

The contributions of charitable donations and basic human decency should not be underestimated.   On a local level, I recently spoke with several people at Munson Hospital and was astounded to find out how much care is donated to our area's less fortunate residents.

According to their fact sheet, "Munson Medical Center's mission is to care for all who pass through its doors, regardless of their ability to pay."   Munson's cut-off for charity care is currently $20,420 for individuals and $41,300 for a family of four — 200 percent above the poverty level.   In 2008, the hospital's charity care, write-offs and free programs to our community amounted to $30 million.

I presented them with a scenario of a 40-year-old uninsured laborer making $25,000 per year.   This man just found out that he needs a new heart valve or has cancer requiring extensive treatment, what are his options?   I was told that regardless of his condition, credit score or ability to pay, he would be provided full treatment and counseling with their financial aid dept. to work out a payment plan.

This is the type of solution we need.   Obviously this sort of charity needs to be paid for somewhere along the way and all businesses (hospitals included) are in the game to make a profit, but this is a far cry from government mandated solutions and I would venture to guess that we'd find similar mentalities in hospitals throughout the country.   There are also free clinics and local programs for uninsured adults  such as the CHP through Community Mental Health.

To completely abandon our current system in exchange for a government plan that covers an additional 5% (or even 10%) of our population seems irrational given their track record and the long history of arguably failed initiatives such as Medicaid, Social Security, Welfare, the Community Reinvestment Act, Ethanol, The Homestead Act, Prohibition, the DEA and so on.   If you'd like more, a partial list may be found here.

Hawaii recently ended a disastrous attempt at government healthcare known as Keiki care.   Designed to provide affordable coverage to the state's children, the program was quickly abandoned as thousands who previously paid for their family's coverage shifted to the free system ($7/month), wreaking havoc on the state's budget.   According to the Dept. of Human Services, 85% of those enrolled in the state plan had previously been paying for their own coverage.

Hawaii Governor Linda Lingle commented:

I think it should be a cautionary tale to anyone that there can be unintended consequences of these plans, and when you think you’re doing something that’s a good idea and you have good intentions, that’s often not enough.

While many on the left might argue that there are no failed government programs, only "under-funded" ones, I'm uncomfortable adding nationalized healthcare to the list above.   Doing so would be about as effective as  ordering chemotherapy for a headache.

  • Jim

    If you want a good synopsis of the health care debate I recommend going to
    http://politifact.com/truth-o-meter/subjects/health/
    It is a dispassionate appraisal of the various claims of the proponents and opponents of health care reform.

    • Anonymous

      Dispassionate? That’s laughable.

  • Jim

    If you want a good synopsis of the health care debate I recommend going to
    http://politifact.com/truth-o-meter/subjects/he
    It is a dispassionate appraisal of the various claims of the proponents and opponents of health care reform.

  • Anonymous

    There are more facts in this article than I have heard on any TV news program, Town Hall or calls to congress & the senate. You’ve done your homework — good job.

  • dkubus

    There are more facts in this article than I have heard on any TV news program, Town Hall or calls to congress & the senate. You've done your homework — good job.

  • edburley

    Dispassionate? That's laughable.

  • Anonymous

    How dare you list Medicaid and Social Security as “failed” government initiatives along with Prohibition? I was thinking you were pretty reasonable until I read that. They aren’t even the same kind of program as Prohibition.

    My great-grandparents lost their business in the Depression, then a couple generations later my Dad was in a car crash and couldn’t work, and his employer didn’t pay a penny, so if it wasn’t for government assistance we would have been reduced to poverty.

    Maybe you are so rich you don’t need social security, but it is a lifesaver for a lot of older folks like my grandparents.

    • troykeith

      Social Security hasn’t “failed”, but it’s definitely on life support with a terminal diagnosis.. Obviously the program provides life saving relief to millions, but we won’t be able to continue this course for much longer. Some reports say that SS will start paying out more than it receives as early as 2016 – others say we’re fine until 2042. We can’t even begin to address the problem effectively until our “leaders” tackle the tough issues and face the potential rioting masses of the AARP crowd.

      Our current solution seems to be to avoid the problem. It’s like sprinkling a little magic CRA dust around and expecting people to put their mortgage payments on their credit cards once they realize they’re in over their heads. How long can this continue?

      http://www.americanthinker.com/2009/08/why_social_security_will_go_ba.html

      http://www.foxnews.com/politics/2009/05/12/social-security-medicare-seen-failing-faster/

      For a completely different version: http://www.aarpmagazine.org/money/Articles/myths_and_truths_about_social_security.html

      • Anonymous

        The reason SS is in trouble is that too many venal politicians have dipped into the SS funds. If you want to have responsible government you have to rein in the politicians. It didn’t start during the Bush years, but GWB decided to give tax breaks to people. Then to make up for it he raided the SS funds some more. Now Mr. Obama wants to fix things and you call him irresponsible? For shame.

  • faithie

    How dare you list Medicaid and Social Security as “failed” government initiatives along with Prohibition? I was thinking you were pretty reasonable until I read that. They aren't even the same kind of program as Prohibition.

    My great-grandparents lost their business in the Depression, then a couple generations later my Dad was in a car crash and couldn't work, and his employer didn't pay a penny, so if it wasn't for government assistance we would have been reduced to poverty.

    Maybe you are so rich you don't need social security, but it is a lifesaver for a lot of older folks like my grandparents.

  • troykeith

    Social Security hasn’t “failed”, but it’s definitely on life support with a terminal diagnosis.. Obviously the program provides life saving relief to millions, but we won’t be able to continue this course for much longer. Some reports say that SS will start paying out more than it receives as early as 2016 – others say we’re fine until 2042. We can’t even begin to address the problem effectively until our “leaders” tackle the tough issues and face the potential rioting masses of the AARP crowd.

    Our current solution seems to be to avoid the problem. It’s like sprinkling a little magic CRA dust around and expecting people to put their mortgage payments on their credit cards once they realize they’re in over their heads. How long can this continue?

    http://www.americanthinker.com/2009/08/why_soci

    http://www.foxnews.com/politics/2009/05/12/soci

    For a completely different version: http://www.aarpmagazine.org/money/Articles/myth

  • Anonymous

    If you tell my parents living off their social security that it’s a failed initiative my dad might have some strong words for you Troy. Without it they’d starve to death or we’d have to send them away on an iceberg.

    • troykeith

      Jeff & Faithie

      It’s interesting that one, unrelated sentence has struck such a chord. SS is a complicated issue and a post in itself, but the simple reality is that starting in 2008, boomers have been retiring in droves. That number will only increase in the years ahead, particularly given some of the early retirement options in our current economy.

      While a “life saver” for many, it is a forced system of welfare in which our money is taken from us, used/spent by the government and then doled out at a future date – hopefully.

      The boomers did not replace themselves. More will be drawing upon this mythical pile of money (money that’s not there because every year, congress spends more than it earns ) than paying into it. That gap only widens given the massive unemployment we’re currently experiencing.

      We’re unable to address any of these issues because social security has always been the 3rd rail in Washington politics. Even Bush’s plan to allow people to privately invest just 4% of their social security pay-out was seen as trespassing on sacred ground.

      Barring some new miracle, we’re faced with increasing payroll taxes (even on “those making less than $250k”) and cutting SS benefits.

      According to a Washington Post article earlier this year,

      http://www.washingtonpost.com/wp-dyn/content/article/2009/05/12/AR2009051200252.html

      “Yesterday’s report also said the Social Security trust fund will begin to spend more money than it takes in through tax revenue in 2016, one year sooner than predicted a year ago.

      Administration officials said that if Congress were to act immediately, the impending gap could be filled three ways: by raising workers’ Social Security payroll taxes by 2 percentage points, from 12.4 percent to 14.4 percent; by reducing benefits by 13 percent; or a combination of the two approaches. The officials briefed reporters on the condition of anonymity on the technical aspects of the trustees’ findings.”

      • A. Gabriel

        Several hundred citizens assembled and turned in 4,000+ signatures in support of for health care for all to Dave Camps office last Friday! Thank you.

        NYT Editorial today, Sunday 8/20/09- (some portions excerpted- read it all)
        http://www.nytimes.com/2009/08/30/opinion/30sun1.html?_r=1

        Majority Rule on Health Care Reform

        The talk in Washington is that Senate Democrats are preparing to push through health care reforms using parliamentary procedures that will allow a simple majority to prevail in their chamber, as it does in the House, instead of the 60 votes needed to overcome the filibuster that Senate Republicans are sure to mount…

        …Superficially seductive calls to scale down the effort until the recession ends or to take time for further deliberations should be ignored. There has been more than enough debate and the recession will almost certainly be over before the major features of reform kick in several years from now. Those who fear that a trillion-dollar reform will add to the nation’s deficit burden should remember that these changes are intended to be deficit-neutral over the next decade.

        ..Clearly the reconciliation approach is a risky and less desirable way to enact comprehensive health care reforms. The only worse approach would be to retreat to modest gestures in an effort to win Republican acquiescence. It is barely possible that the Senate Finance Committee might pull off a miracle and devise a comprehensive solution that could win broad support, or get one or more Republicans to vote to break a filibuster. If not, the Democrats need to push for as much reform as possible through majority vote.

        • troykeith

          I should be thanking you.. If ever a conservative should have reason to question their beliefs, they have merely to open to the editorial page of the NY Times and have their values immediately reaffirmed.

          The recession will certainly be over and this is clearly a deficit-neutral proposition.. I wonder how the pro-healthcare demonstrators will be treated by the press?

          With the country so divided over this, it will be interesting to see how things play out in the weeks ahead.

  • jeff4

    If you tell my parents living off their social security that it's a failed initiative my dad might have some strong words for you Troy. Without it they'd starve to death or we'd have to send them away on an iceberg.

  • faithie

    The reason SS is in trouble is that too many venal politicians have dipped into the SS funds. If you want to have responsible government you have to rein in the politicians. It didn't start during the Bush years, but GWB decided to give tax breaks to people. Then to make up for it he raided the SS funds some more. Now Mr. Obama wants to fix things and you call him irresponsible? For shame.

  • troykeith

    Jeff & Faithie

    It’s interesting that one, unrelated sentence has struck such a chord. SS is a complicated issue and a post in itself, but the simple reality is that starting in 2008, boomers have been retiring in droves. That number will only increase in the years ahead, particularly given some of the early retirement options in our current economy.

    While a “life saver” for many, it is a forced system of welfare in which our money is taken from us, used/spent by the government and then doled out at a future date.

    The boomers did not replace themselves. More will be drawing upon this mythical pile of money (money that’s not there because every year, congress spends more than it earns <not just GWB>) than paying into it. That gap only widens given the massive unemployment we’re currently experiencing.

    We’re unable to address any of these issues because social security has always been the 3rd rail in Washington politics. Even Bush’s plan to allow people to privately invest just 4% of their social security pay-out was seen as trespassing on sacred ground.

    Barring some new miracle, we’re faced with increasing payroll taxes (even on “those making less than $250k”) and cutting SS benefits.

    According to a Washington Post article earlier this year,

    http://www.washingtonpost.com/wp-dyn/content/ar

    “Yesterday's report also said the Social Security trust fund will begin to spend more money than it takes in through tax revenue in 2016, one year sooner than predicted a year ago.

    Administration officials said that if Congress were to act immediately, the impending gap could be filled three ways: by raising workers' Social Security payroll taxes by 2 percentage points, from 12.4 percent to 14.4 percent; by reducing benefits by 13 percent; or a combination of the two approaches. The officials briefed reporters on the condition of anonymity on the technical aspects of the trustees' findings.”

  • A. Gabriel

    Several hundred citizens assembled and turned in 4,000+ signatures in support of for health care for all to Dave Camps office last Friday! Thank you.

    NYT Editorial today, Sunday 8/20/09- (some portions excerpted- read it all)
    http://www.nytimes.com/2009/08/30/opinion/30sun

    Majority Rule on Health Care Reform

    The talk in Washington is that Senate Democrats are preparing to push through health care reforms using parliamentary procedures that will allow a simple majority to prevail in their chamber, as it does in the House, instead of the 60 votes needed to overcome the filibuster that Senate Republicans are sure to mount…

    …Superficially seductive calls to scale down the effort until the recession ends or to take time for further deliberations should be ignored. There has been more than enough debate and the recession will almost certainly be over before the major features of reform kick in several years from now. Those who fear that a trillion-dollar reform will add to the nation’s deficit burden should remember that these changes are intended to be deficit-neutral over the next decade.

    ..Clearly the reconciliation approach is a risky and less desirable way to enact comprehensive health care reforms. The only worse approach would be to retreat to modest gestures in an effort to win Republican acquiescence. It is barely possible that the Senate Finance Committee might pull off a miracle and devise a comprehensive solution that could win broad support, or get one or more Republicans to vote to break a filibuster. If not, the Democrats need to push for as much reform as possible through majority vote.

  • troykeith

    I should be thanking you.. If ever a conservative should have reason to question their beliefs, they have merely to open to the editorial page of the NY Times and have their values immediately reaffirmed.

    The recession will certainly be over and this is clearly a deficit-neutral proposition.. I wonder how the pro-healthcare demonstrators will be treated by the press?

    With the country so divided over this, it will be interesting to see how things play out in the weeks ahead.

  • Ed Hahnenberg

    Don't think — just do it, right now!
    I’m not a chemistry or biology major, but I thought I understood that when the body ‘burns’ food the end products are mainly water and carbon dioxide, together with some nitrogenous chemicals such as urea. The carbon dioxide enters the bloodstream, is carried to the lungs, and is excreted in the expired air of breathing. Uh huh, six billion people exhaling that awful CO2 non-stop 24/7. The world’s six billion humans breathe out 2.4 billion tons of carbon dioxide each year.What should we do? I know, just eliminate 425 million humans…what an exciting idea. Population control, cooler planet, less wars, fewer abortions, etc.

    The Obama administration warned Congress this week that if it doesn't move to regulate carbon dioxide, the Environmental Protection Agency will take a “command-and-control” role over the process in a way that could hurt business.
    The Environmental Protection Agency said it has determined that planet-warming greenhouse gases pose a danger to public health and welfare. But it leaves unanswered questions about how the agency will go forward and which industries will be most affected.
    The EPA reached the decision last month, and earlier this week the agency’s determination cleared White House review. Today’s announcement, EPA Administrator Lisa Jackson has said, will “trigger the beginnings of regulation of CO2 for this country.”

    Industry groups are wringing their hands about what it will mean to have greenhouse gases regulated under the Clean Air Act, and environmentalists are chomping at the bit for the agency to get to work. While groups across the spectrum would prefer that Congress pass a new climate bill to address the matter, in the absence of that, the EPA is compelled to start regulating with the laws already on books.

    “There’s no time left to waste,” said David Doniger, policy director of the Natural Resources Defense Council’s climate center. “We want the EPA to do what it can under the existing Clean Air Act, because that’s what the law is today … We have a problem ahead of us that we’re long overdue in dealing with.” Glenn Beck, on Dec. 9th, was engrossingly compelling in his monologue about “let’s do it now” regarding healthcare and a host of other issues this administration wants to regulate:

    “We, the people, are thinking when has “just hurry up and do it” ever been the right strategy for something this big? It must be done now… but it won't start for four years?

    “What? Well, wait a minute. Why don't we take our time, do it right — make sure it's right — and then, once we're finished, if we decide to, we could still enact it by 2013?
    “No, instead: Don't think, don't ask, don't wait another second! This plan, drafted in federal prison back in 2006, is a plan that will cost over a trillion dollars but is somehow free. It adds 40 million patients and no doctors, but somehow doesn't ration care. It cuts Medicaid benefits, but no elderly suffer. It adds fees, taxes and bureaucracy, but no one pays.

    “If you believe that, you'll believe we've saved or created 200 million jobs this week alone and that the temperature is so hot right now, the Atlantic Ocean is boiling and despite the fact that we didn't have even one this year, hurricanes are more powerful, intense and frequent than ever before.

    “Don't think about any of this at all — just act now!
    “It only makes sense to people who will tell you to fly to the other side of the Earth for medical care, but then tell you to stop flying in jets because the Earth has a temperature.

    “The same people that believe that terrorists should be understood and tried in New York courtrooms, but Marines should be tried by the military; that terrorists who mutilate, burn bodies and hang them from bridges should be believed over our Navy SEALs.

    “Or that you can print money all you want because hyper-inflation would be good — it would pay off the debt and everyone will have money in their pockets. We have to keep spending our way out of enormous debt?

    “Again, don't think — just do it, right now!”

    Hey, we can all help if we just ration our breathing…shorter breaths…maybe a device to measure our carbon breathprint….

  • Ed Hahnenberg

    Don’t think — just do it, right now!
    I’m not a chemistry or biology major, but I thought I understood that when the body ‘burns’ food the end products are mainly water and carbon dioxide, together with some nitrogenous chemicals such as urea. The carbon dioxide enters the bloodstream, is carried to the lungs, and is excreted in the expired air of breathing. Uh huh, six billion people exhaling that awful CO2 non-stop 24/7. The world’s six billion humans breathe out 2.4 billion tons of carbon dioxide each year.What should we do? I know, just eliminate 425 million humans…what an exciting idea. Population control, cooler planet, less wars, fewer abortions, etc.

    The Obama administration warned Congress this week that if it doesn’t move to regulate carbon dioxide, the Environmental Protection Agency will take a “command-and-control” role over the process in a way that could hurt business.

    The Environmental Protection Agency said it has determined that planet-warming greenhouse gases pose a danger to public health and welfare. But it leaves unanswered questions about how the agency will go forward and which industries will be most affected.

    The EPA reached the decision last month, and earlier this week the agency’s determination cleared White House review. This week’s announcement, EPA Administrator Lisa Jackson has said, will “trigger the beginnings of regulation of CO2 for this country.”

    Industry groups are wringing their hands about what it will mean to have greenhouse gases regulated under the Clean Air Act, and environmentalists are chomping at the bit for the agency to get to work. While groups across the spectrum would prefer that Congress pass a new climate bill to address the matter, in the absence of that, the EPA is compelled to start regulating with the laws already on books.

    “There’s no time left to waste,” said David Doniger, policy director of the Natural Resources Defense Council’s climate center. “We want the EPA to do what it can under the existing Clean Air Act, because that’s what the law is today … We have a problem ahead of us that we’re long overdue in dealing with.” Glenn Beck, on Dec. 9th, was engrossingly compelling in his monologue about “let’s do it now” regarding healthcare and a host of other issues this administration wants to regulate:

    “We, the people, are thinking when has “just hurry up and do it” ever been the right strategy for something this big? It must be done now… but it won’t start for four years?

    “What? Well, wait a minute. Why don’t we take our time, do it right — make sure it’s right — and then, once we’re finished, if we decide to, we could still enact it by 2013?

    “No, instead: Don’t think, don’t ask, don’t wait another second! This plan … is a plan that will cost over a trillion dollars but is somehow free. It adds 40 million patients and no doctors, but somehow doesn’t ration care. It cuts Medicaid benefits, but no elderly suffer. It adds fees, taxes and bureaucracy, but no one pays.

    “If you believe that, you’ll believe we’ve saved or created 200 million jobs this week alone and that the temperature is so hot right now, the Atlantic Ocean is boiling and despite the fact that we didn’t have even one this year, hurricanes are more powerful, intense and frequent than ever before.

    “Don’t think about any of this at all — just act now!
    “It only makes sense to people who will tell you to fly to the other side of the Earth for medical care, but then tell you to stop flying in jets because the Earth has a temperature.

    “The same people that believe that terrorists should be understood and tried in New York courtrooms, but Marines should be tried by the military; that terrorists who mutilate, burn bodies and hang them from bridges should be believed over our Navy SEALs.

    “Or that you can print money all you want because hyper-inflation would be good — it would pay off the debt and everyone will have money in their pockets. We have to keep spending our way out of enormous debt?

    “Again, don’t think — just do it, right now!”

    Hey, we can all help if we just ration our breathing…shorter breaths…maybe a device to measure our carbon breathprint….after all, it’s othe moral thing to do, right?

Record-Eagle Blogs is proudly powered by WordPress
Entries (RSS) and Comments (RSS).