Tuesday, December 22, 2009
healthcare vs. health insurance
Our legislators have a problem distinguishing health care from health insurance. Health insurance is a financial product that people buy to protect their assets in the event that they have a catastrophic claim. Health care is what people need when they get sick or hurt. People with low or no assets do not need health insurance because they have nothing to protect. They need health care which is provided by hospitals,doctors and clinics. I think we could build quite an infrastructure with controlled cost over the next ten years with the trillions of dollars they are budgeting. After ten years we have more hospitals and clinics and systems to deliver care to the needy. By giving health insurance to those who do not need it the government is gving individuals blank checks for providers to fill out. The needy have no interest in the cost and their is no cost containment. Control the cost of government plans by providing health care and you improve the system, otherwise in ten years we are right where we started with no additional infrastucture or cost containment.
Thursday, December 17, 2009
The Myth of the Uninsured
Common statistics show 46 million Americans are uninsured, and often the reports do not source the information because the reports are quoting "common knowledge" accepted as “fact”. For my first blog, I want to take the uninsured number that is so often stated and source the information and deconstruct the number.
First of all, you will hear the number “46 million uninsured Americans" quite often. The fact is that within that estimate of the uninsured, there are close to ten million illegal immigrants (United States Census Bureau report 2008). Recently some commentators have been using the more accurate estimate of 35 million in order to exclude illegal immigrants.
Next, according to the Congressional Budget Office report , there are 15 million Americans eligible for publically-sponsored free and highly subsidized programs. Interestingly, if a provider or hospital provides service to a person who they can show was eligible for a publically-sponsored program, the provider can collect retroactively for services performed. The Congressional Budget Office reports these individuals as insured.
Subtracting the eligible who are not signed up and the illegal immigrants lowers the quoted number to 21 million, but like the guy hawking products on late night TV, “but wait there’s more!”. Of that 21 million, there are about 10 million who are under the age of 35 and make over $50,000 per year who can afford and qualify for private health insurance and choose to not sign up. In order to better understand this group, we need to break it down. Here are the stats for this demographic. About 80% of the claims from this group are paid in cash at point of service, 10% are paid on time with a credit card, 8% are donated by providers and only 2% go uncollected. So this group of "uninsured" are “self-insured” and does not present a financial burden the system. It would be better if they bought insurance, but these are the facts.
This leaves about 10 million Americans who are uninsured. This is still a large number, but not so great that we should not be able to come up with a reasonable solution towards getting them covered. Rather than reforming 17% of the American Economy, perhaps a simple tax credit or subsidy based on income could find these 10 million people coverage.
The Health Insurance Guy
First of all, you will hear the number “46 million uninsured Americans" quite often. The fact is that within that estimate of the uninsured, there are close to ten million illegal immigrants (United States Census Bureau report 2008). Recently some commentators have been using the more accurate estimate of 35 million in order to exclude illegal immigrants.
Next, according to the Congressional Budget Office report , there are 15 million Americans eligible for publically-sponsored free and highly subsidized programs. Interestingly, if a provider or hospital provides service to a person who they can show was eligible for a publically-sponsored program, the provider can collect retroactively for services performed. The Congressional Budget Office reports these individuals as insured.
Subtracting the eligible who are not signed up and the illegal immigrants lowers the quoted number to 21 million, but like the guy hawking products on late night TV, “but wait there’s more!”. Of that 21 million, there are about 10 million who are under the age of 35 and make over $50,000 per year who can afford and qualify for private health insurance and choose to not sign up. In order to better understand this group, we need to break it down. Here are the stats for this demographic. About 80% of the claims from this group are paid in cash at point of service, 10% are paid on time with a credit card, 8% are donated by providers and only 2% go uncollected. So this group of "uninsured" are “self-insured” and does not present a financial burden the system. It would be better if they bought insurance, but these are the facts.
This leaves about 10 million Americans who are uninsured. This is still a large number, but not so great that we should not be able to come up with a reasonable solution towards getting them covered. Rather than reforming 17% of the American Economy, perhaps a simple tax credit or subsidy based on income could find these 10 million people coverage.
The Health Insurance Guy
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