The absurdity must stop!
Thursday October 18, 2007By Howard Caplan in Milwaukee
We have operated a business in Milwaukee for 20 years. It is a staffing agency for nurses and nursing assistants and we serve the Long Term Care Communities (Nursing Homes) of the area.
Back in 1993 we initiated a group policy for our employees. Initially, the plan was relatively inexpensive and obtainable for most of our employees. I don’t know what we were paying back then but every year since we have suffered annual increases from 8% (thank you) to 48%.
Today, very few of our employees can afford their premium share of 50% of the “employee” only coverage. And even fewer can afford to insure their children which would require them to contribute 50% of the employee share and 100% of children or family portion.
So, even if every employee had coverage through us, most of them would not be able to cover their children. And the problems our insured employees have with Humana since we “downgraded” our coverage a few years ago to a deductable plan…
Even though total cost, if the employee reaches all the deductables in a given year, is less then our old “cadillac” plan, people are NOT accustomed to paying out-of-pocket health care costs. Our employer based system is BROKEN.
I did the math on the Wisconsin Senate plan and found that we, as a company, would pay more then we are now. But, 100% of our employees and 100% of our extended “family” would be covered and I would have gladly paid out more in our payroll taxes to achieve this.
When groups like the Small Business associations pretended they spoke for me when they denounced the Senate plan, they were wrong. Dead wrong.
So, the Senate removes the proposal to get a budget passed and today, 101 days since the new budget was due, we still have no budget and no health care on the horizon.
Imagine the recent General Motors labor contract negotiations if in Wisconsin, every citizen was insured through payroll taxes. How many jobs would GM bring to Janesville? How many jobs and how many other employers would flock to Wisconsin? Yet, all we heard was how many people from other states would move here for “free insurance.”
This absurdity must stop!
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The group payer system is broken.
An employer purchases a group plan, with group power. The only way they are able to get the premium rates for their employees is by assuring the group plan that several people will be paying into it with premiums. As premiums continue to go up year after year, many group health plan members are frustrated, because while they may not use their insurance very much, others who do use it are driving up the cost of premiums for them.
I once asked a group of insurance folks why they didn’t offer catastrophic portable coverage as an option. They laughed at me and told me that catastrophic coverage with high deductibles ($5000 annually) don’t exist, anymore, because they need people who don’t use their group coverage to be paying the higher group premiums to make up for the people who are using it. They told me that if they offered catastrophic plans, they couldn’t survive.
I, thankfully, have health insurance, and don’t use it very much at all. However, every year I have to pay for an increase in premiums because many other people are using it to the max. Why should I have to pay more for my coverage, when I don’t use it as much as other people do? I utilize my Flex Spending plan to pay for my yearly incidentals, because I believe that those sorts of things are my responsibility. If people don’t pay anything for their health coverage, they will always take advantage of it, and will continue to drive up the cost.
So I ask you this, why should I have to pay higher taxes into a system that I don’t use? Why should I pay for someone to go to the doctor for every ailment, when they don’t recognize that they have responsibility for their own health? Why should I see the American culture as a ‘go to the doctor for everything’ and come to the conclusion that universal healthcare would be a good idea?
Americans are CONSTANTLY running to the doctor. Most people are on at least one or two kinds of medication for restless legs, or some darn thing or another. Yet, they aren’t willing to do what it takes to be healthy. How will universal health care survive when everyone will be using it, constantly. I’ll tell you… It will be RATIONED. Right now, we at least have the option of getting good care if we can afford to. If universal health care goes through, there’s no way that we will get the same quality of care that is available today. It’s literally impossible. And let me tell you, you’re crazy if you think that this will ‘even the playing field’ for the rich and poor by way of healthcare, because the wealthy will still be able to pay for better care. In fact, you will create an entire ‘medical underground’ of doctors who are hired out by wealthy people.
So what are you gaining with universal health care? Crummy service, rationed care, and will still see the wealthy getting better of both service and care, only the divide will be much more prominent.
Look at it this way… Water is something that we all need to survive. So is food. If we don’t have food and water, we die. So is it the responsibility of the government to give us all food and water?
We need to fix the system, there’s no doubt. We need to get rid of group plans, and allow for a large tax credit for people to go out and purchase their own portable plans, that are not connected with their employers in any way. This will create competition between insurance companies, and will eventually drive down the cost of both coverage and care. Just look at the plastic surgery industry. Why have their costs actually come down over the last ten years? Because of competition. If we generate a market of competition in the medical industry, in both insurance and medical services, the cost will come down enough for everyone to afford it. For those who still can’t afford it, that’s what programs like SCHIP are for.
Let’s not throw the baby out with the bathwater on health care. Trust me, rationed health care in a universal system in America will not be pretty, and we all will suffer. Health coverage is not a right any more than water and food are a right, and it’s high time that America understands that.
— Pheisty · 412 days ago
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I am reluctant to respond to Pheisty’s ignorant rant so the only point I will make is, cost shifting is occuring. When a mother hesitates to take her child to a doctor out of fear of what the bill will be, the child may get sicker to the point that the mother finally takes the child to ER and creates an uncollectable bill which will increase the hospital charges to all, including Humana which Humana turns over to their members which increases my premiums and Pheisty’s premiums.
BTW Pheisty, even if we insured every resident of Wisconsin through a single payer system, you will still have the option to obtain care using your own money.
— Howard Caplan · 412 days ago
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“even if we insured every resident of Wisconsin through a single payer system, you will still have the option to obtain care using your own money.”
Paying for health care with your own money should be the only option. The problem with your logic is that Pheisty would then be paying twice for health care – for herself and for you. Would it be so bad to only force residents to pay for state health insurance if they are going to use it? Logically anybody would say yes, of course, but since logic doesn’t necessarily apply to the entitlement crowd, I’m sure that you feel that if Pheisty can afford to pay for her own health insurance, she should also be paying for yours too.
I am 100% against any sort of universal health care, but I would support a state-run health system that is funded 100% by the people who use it and ONLY the people who use it. Why take that choice away from people? At least people like me are willing to weigh options, while people like you seem to think the only option is to railroad everybody into a single system and then force them to double up payments if they choose to pursue their own options.
Hmm, come to think of it, it’s a whole lot like the public school system, and we all know how well that works.
— Ryan · 412 days ago
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The problem is, though, we are paying for everybody in the state who does not have insurance coverage for health care.
The problem with both Pheisty and Ryan’s comments are they ignore the reality of the situation and instead latch on to the entitlement red herring.
Makes no sense whatsoever.
— Howard Caplan · 412 days ago
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And just what is the reality of the situation? Perhaps you didn’t make that clear.
Here is the reality of the situation as I see it. I don’t think that it is right to saddle the people of Wisconsin with th burden of providing health care for everybody. This isn’t an entitlement red herring, this is a matter of forced altruism – of which most people don’t want to be a part of. Why do you seem to think it is ok to force somebody to pay for state health care for everybody and then pay a second time if they want an alternative?
If the state ran a system where people could buy through the state based on income levels and people who choose to pursue their own means would be free to do so, why would there be a problem with that? Hell, make it a tax credit system for all I care. If you opt out of the state health care system you are credited your contributions for your own use. Why is that idea so abhorrent to you guys?
You see, this is why this concept disgusts me. It is evident that people want the system to be carried on the backs of those who make more money which means that it would be free and available to those who make little or none. It all comes back to the whole “redistribution of wealth” forced altruism thing. If the concern was simply about affordable and available health care, an alternative like I proposed wouldn’t sound like such a bad thing.
— Ryan · 412 days ago
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We are paying for health care for all.
The reality which was defined is called cost shifting. ER visits cost many times more then a doctors’ visit. Most uninsured people get their health care through the ER.
Uncollectable costs are recovered through higher fees passed on to all of us.
The Senate health care plan would have cost us 15 billion annually. Currently, statewide, we are paying 17 billion annually.
That is the reality.
— Howard Caplan · 412 days ago
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What if those that can’t afford to feed the profits of the private healthcare system, don’t collectively make enough money to fund a healthcare system to look after each other? A new (Chinese) plasma TV will make you feel better while knowing your own countryfolk are dying?
One day, that could be any one of us. The day you lose your job, and your healthcare goes with it- Then you join the masses who, at the moment, you dearly hope not to be confronted with, for fear of triggering your altruism…
I live in the UK. I was born for free, I wil die for free, they’ve fixed me for free in between. No, it’s not truly free, it came from my taxes. No, maybe I don’t get out all I put in. Do you get all of your insurance premiums back in treatment?- NO, you’re paying for the (rich) guy who’s sicker than you.
No, our health service is NOT luxury treatment. Yes, you have to wait for apointments.
But my government will NOT leave me to die the way yours will, while spending money, shall we say “freely”?, overseas. The USA is indeed the land of the free- free, to die…
— Tom · 412 days ago
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“But my government will NOT leave me to die the way yours will,”
In no way does our government leave anybody to die. Hospitals cannot turn away a patient in need. Those who do not have insurance because they truly cannot afford it fall under the Medicaid program. Those who do make enough to afford insurance had better have some good reasons why they don’t, but they will not be turned away… Nor is anybody going to take away their house if they cannot afford to pay as there are laws that prevent that.
As for the plasma TV comment… Get real. I can’t afford a plasma TV. I do, however, have health care through my employer and it doesn’t cost me a fortune. i’m not lucky like that, I simply select an employer with good benefits when I look for a job. I would never go out and get a job without benefits. that’s just plain stupid.
Getting back to Howard, I think your numbers are a bit skewed. According to the Kaiser institute, Wisconsin medicaid spending was somewhere around the $4 billion mark. Now factor in uncompensated care, which totaled $34.6 billion nationally, and I hardly thing that Wisconsin alone ate up $11 billion (assuming 4 billion was taken out by medicaid) of that, and I can’t quite put my finger on where you’re coming up with your numbers.
You have your talking points, but they aren’t really backed up with anything substantial. Do we spend a lot on taking care of the uninsured? You bet, but the answer is not to simply force everybody to pay more so the playing field can be leveled. If we were to play by the rules that you are advocating for, people like me would see significant rises in our health care costs. By the numbers put out by the WI plan, my monthly health care cost would nearly double – and all so that other people can take advantage f my contribution. This isn’t the government helping people out, this is the government forcing me to be more charitable and take care of others. But nobody bothers to look at the people like me. I live on a thin line as it is, so doubling my monthly health bill would be devastating blow to my own budget. Is that OK by you? I mean, you are so concerned with the rich getting off easy – after all, they can afford to pay more so that others can enjoy the same benefits, right? – that you don’t realize that somebody like me, Joe Average, will be hurt by this. Who will come in and help me once I’m forced to help everybody else? It just doesn’t work like that.
Your plan aims to harm the roughly 3,614,920 currently insured Wisconsin residents in order to help out 528,980 uninsured. Do yo not see the disparity there?
— Ryan · 412 days ago
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Ryan is right. The number of insured citizens in Wisconsin dwarfs the uninsured, and I happen to believe that the 528,980 is a high number. I happen to work in benefits at my company, and I know that if you make under a certain amount (depending on the size of your family) you can get on Badger Care. What’s wrong with Badger Care?
I have been paying for my own health insurance since I was twenty years old. YES, twenty. I had my son at the age of 19, worked at a job making $6.25 an hour, without receiving child support, and still managed to make it okay.
Why should I be punished (and everyone will be punished, make no mistake) by having to pay for someone else’s health care, when I’m already paying for MY insurance AND Badger Care for others through MY taxes? And then you tell me that I can buy ‘extra’ coverage on my own?? Excuse me? I worked hard in a job I hated (a poultry butcher) for years, just so I could eventually be promoted, which I was. So now I’m going to be punished for doing better for myself? How messed up is that?
As for the British guy, I don’t know if you’ve ever been to America, but Americans have turned into a bunch of hypochondriacs. They’re also fat and don’t take care of themselves. So again, why should I have to pay for a bunch of people who run to the doctor constantly when they DO have health insurance…Can you imagine what Americans will do if health care is FREE?
Everyone knows that when something is free – especially in America – people will abuse it. They won’t think twice about running to the doctor for everything, and that’s when the rationing will come in.
Why do I have employees who are veterans, who have VA care, but refuse to use it and instead sign up for my company’s health insurance? I’ll tell you why… Government never, ever runs anything well, or efficiently. If you can honestly say to me that health care will be better by allowing the government to run it, I think you’d best have your head examined. I don’t mean any disrespect when I say that, either. It’s just common-sense. If the government isn’t properly caring for our veterans, what makes you think it will be any better for the rest of us?
Please correct me if I missed it, but it appears that no one answered my question about food and water. Should we get our food and water from the government, too? Do images of food ration trucks in the USSR bring back any memories for anyone?
— Pheisty · 412 days ago
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Just piping in here to respond to a few of Ryan’s inaccuracies:
**In the state of Wisconsn, your home CAN be taken away from you if you file for bankruptcy (it depends on equity). Many people filing for bankruptcy file because they cannot pay their medical bills. A few states, such as FL and TX, do allow you to keep your home.
**from the WI DHFS website:
You may qualify for Wisconsin Medicaid if you are a citizen of the United States or a qualifying immigrant and meet certain financial eligibility requirements in one of the following categories:
Age 65 or older.
Blind or disabled.
Under age 19.
Pregnant.
A relative caretaker of a child.
——
So, a single person not meeting any of the above qualifications is not eligible. As such, there are many Wisconsin residents completely unable to get health care coverage.
— Lori · 411 days ago
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You are right on the Medicaid bit. I misread the eligibility requirements.
However…
You can only lose your home in bankruptcy if you cannot make the payments since secured debt is protected. Otherwise you have $40k in equity protection. Which brings me to a point of interest here: if you happen to have more then $0k in home equity and don’t have insurance, perhaps it is time to reevaluate priorities and sell your home and get a small apartment so you can afford health care until you get a better job that offers health care.
Of course, that is if you’re so concerned about health care. What’s more important? Health care or your home? Evaluate priorities and realize that you cannot have your cake and eat it too.
— Ryan · 410 days ago
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Ryan
My numbers are for the total Wisconsin spending on health care. Current total cost of health care for all Wisconsinites = $17,000,000,000. This includes, Medicaid, Medicare, company & employee paid premiums and out of pocket, Badger Care, private pay and there may be other catagories.
Cost of Senate proposal to insure ALL Wisconsinites = $15,000,000,000.
Now, I did not do the math on any of this. I am taking the word for those who did do the math.
— Howard Caplan · 409 days ago
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