part one

It has been said that the character of a nation and its people are judged by how they care for the least among them. The inscription that appears on The Statue Of Liberty “Give me your tired, your poor, your huddled masses” that every American once held dear should remind us of our roots- that not so long ago we once did care for each other, not with the idea of gain but out of a moral responsibility and deep concern for our fellow Americans.


We have reached a cross roads in this country, a deepening financial crisis that appears to the average American as a bottomless pit with no end. Many, those in power say that there’s no money for a national health care plan and refuse to look at options that may actually work. I say we CAN’T afford not to. With another 150,000+ jobs lost in America last month and for each successive month that goes by with more jobs lost, more Americans will find themselves not only unemployed but also uninsured. For those newly unemployed they may purchase COBRA, an extension of their current policy for approximately $500-600 monthly or $1200- 1500 for a family. Think they can afford that? If their current health situation depends on that insurance, they become ill or are injured they may soon be looking at medical bankruptcy. Another foreclosed home, another homeless family that will eventually fall under the care of the public. A sickly population with no access to health care is a huge financial drain on a country and it’s resources.


For those of you who think I’m saying the government should pay, and your health care should be free.. think again. What I am talking about is affordable access and renewed focus on preventive care by each and every individual. Want to smoke? It’s a free country, but that cigarette is going to cost you more than just the price of your next carton. 


We are the only civilized country in the world that does not oversee or provide some sort of financially affordable health care for its citizens. What a terrible disgrace. The AMA, the PMA (the Pharmaceutical Manufacturers Association) and the insurance companies have huge lobbies that protect their interests, namely what they see as their money, and until such a time that these interests can be reasonably reined in nothing will change.


I recently had this very discussion with a client that felt nationalization of health care would be a disaster, and if I wanted some proof of that I should take a look at what the state of Massachusetts is doing. I said to her as I will say to you, we have to start somewhere. The longer we wait the worse this intolerable situation will become.


Stay tuned for part two and three as I help you examine some options if you are currently underinsured or uninsured, what Massachusetts is doing and what the two candidates are proposing. Till next time, Rebecca



part two


Forty seven million Americans are uninsured; this is simply not acceptable. This figure does not reflect all those that are under insured. In this part two of ‘A National Disgrace’ I will examine what the two presidential campaigns are suggesting to address this issue.


A brief overview:


The Obama Biden ticket is looking at the two extremes- government run health care with higher taxes or, letting the insurance companies operate without rules which is basically what we have in place now. They do not endorse either.


Here’s what they are saying: first, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year.


Divide the burden of health insurance cost more evenly. Employers that carry their fair share of the cost of insurance for employees could be eligible for tax credits. Those who do not would contribute a percentage of payroll toward the cost of their employees health care. Small businesses would receive a tax credit for providing employee health care.


Address the issue of insurance companies overcharging doctors for their malpractice coverage reducing their overhead and fees.


Require insurance companies to cover pre-existing conditions so premium payments remain stable.  The insurance companies will receive their fair share of help with difficult and costly medical care. This plan is said to cost between $50-65 billion a year and will be funded by rolling back the Bush tax cuts for Americans earning more than $250,00 per year while retaining estate tax at its current level.


The Obama Biden ticket also wants to reduce costs with the use of generic drugs, hospitals’ reporting costs, and reform how the insurance companies do business. Namely increase competition by taking on anticompetitive activity that drives up prices without improving the quality of care.


The Mccain-Palin ticket wants the insurance companies to have more freedom for the market to play itself out. Little or no regulation and little to no change to the existing system with these exceptions; if you are currently uninsured you would receive a $2,500 tax credit yearly, $5000 for a family to purchase health insurance. Opponents say that because of the rising cost of insurance coverage, employers will drop health care coverage as a benefit and the tax credit you receive will not cover the cost of privately purchased insurance. If your employer currently insures you your employer will be adding their cost to insure you to your W2 as taxable income. In other words, if you pay tax on a yearly-earned income of $40,000 your income will now be $52,000 yearly.


They will be asking individual states to take up more responsibility by allowing alternative payment schemes and flexibility to experiment with private pay for Medicaid and Medicare. More power for the state, less for the patient?


They will be asking for quicker release of patented drugs to the generic market, the elimination of lawsuits against physicians that followed safe protocol and more walk in clinics.


They support HSAs or health savings accounts. Having had a health savings account for a brief period I can only say if you want to tie up $2,500 in a passbook account that earns less than 1% return okay. If you need a tax break, it works like an IRA.


Stay tuned for part three where I will examine what the AMA thinks, how the state of Massachusetts is doing and some others that are coming into play. Till next time, Rebecca



part three


Forty seven million Americans uninsured, and counting- in this part three I will take a look at some options if you are currently uninsured, how Massachusetts is doing, being the first state to cover everyone and how physician organizations feel about changing the current system.


If you are uninsured:


1.  Check into volunteer, state and federal programs that may have funds that can help. If you have a debilitating disease such as diabetes, MD, MS or kidney disease you may qualify for help.

2.  Check into temporary insurance programs designed to insure you for 1-6 or as many as 12 months coverage at a very reasonable cost.

3.  Many drug companies offer programs where medications are free to those that cannot afford them. Also, ask your physician for samples.

4.  If you do not qualify for free medication, many meds can be purchased from Canada for half the cost.


How is Massachusetts doing? - Actually quite well. Their organization is called The Insurance Partnership (IP). The program’s focus is on small businesses and their employees. It is not a health insurance program. Rather the Commonwealth of Massachusetts partners with small business by offering tax credits to the employer, the employer pays 50% of the cost, IP pays the employee indirectly by covering 30+ percent of the cost and the rest is paid directly by the employee to the insurance company. You can read more about IP at www.4ip.org. This successful model could be used nationwide.


The American Medical Association (AMA) has had some ads out there voice for the uninsured that are quite compelling. Reading what they had to say, I felt there was little shift from the current system, asking individuals to look to the government, drug companies and disease founded organizations for help. They are asking for legislative reform of the laws that govern insurance carriers.


Another physician based organization Physicians for a National Health Program are calling for a single public plan covering all medically necessary services from acute care to long term care, dental and drugs. They feel strongly that under the current system many patients cannot afford costly tests and therefore opt out until such a time they have no choice, at which point the cost of treatment will be much higher due to long standing disease and possible complications. Liability for the physician is increased as well due to complicated health scenarios and families that are frustrated and angry that they could not afford care before the situation became so dire.


They site the efficient Canadian national health program with overhead costs of only 2-3 percent. They believe the current insurance system to be broken, costly and ineffective with duplication of services and insurers arguing over whom pays how much. Patients would still be required to meet co-pays and insurance would not be free, but affordable. You can read more about this interesting plan in detail at www.pnhp.org.


We can no longer ignore the problem of the uninsured and the under insured. A sick population is a serious drain on a country and its finances. We can do better. We deserve better. Get involved, ask your senators and congress people to address this growing problem. Till next time, Rebecca


10/16,23,30 2008