Healthcare Insurance Reform

The folks at dailykos.com are talking about the need to do away with private sector healthcare insurance and have a single payer system. I assume this means a publicly funded insurance program something like Medicare.

It appears that many people have no healthcare insurance and many cannot afford their part of the premiums offered by their employer. Many are also underinsured, having what some called junk insurance.

I think that if employers did not have to provide healthcare insurance to its employees they could be more competitive with foreign companies and the small companies could better compete with major employers who do offer some sort of healthcare insurance. What the folks at dailykos.com forgot to explain is that there is not free lunch, not even
in employee funded insurance. The cost is merely passed on to the customers.

My wife and I both have Medicare parts A and B but she kept her medigap or supplemental insurance that is offered by her 3M retirement plan. It is Blue Cross/Blue Shield and the premiums are 155 a month for the two of us. That apparently compares favorably with the cost of other private sector insurance and is quite a bit cheaper than our combined Medicare premium. I think that at the present time our Medicare Part B coverage is on the order of 96 dollars a month each.

Medicare Parts A and B do not cover prescription drugs but our BC/BS does, so they work well together. If I remember correctly the Medicare coverage for hospital stays and procedures has its limits too.

I am in favor of a single payer system if that means less overhead for the providers who have to now file claims for both Medicare and the supplemental insurance, that is for seniors. However, I haven't seen the cost of everybody being on a single payer or publicly funded system. Frankly I find it ingenuous to label socialized insurance as single payer but that is what it is all about. The fact that the proponents don't go into the costs of such a system makes me a bit skeptical of it.

I sometimes think there needs to be a separate prescription drug coverage and a separate coverage for doctor visits, hospital stays and procedures, and the like. Older people like me have medical problems such as high blood pressure and high cholestoral that require little attention from a doctor other than a routine visit with lab every six months once the medication rate has been established. All of the high blood pressure medicine I use is very cheap and I get it via Caremark, which is a mail order pharmacy that 3M wants us to use. The GERD medicince, which is Nexium for me, is expensive, and the cholestoral medicine, which is Lipitor for me is also expensive, but there are generic substitutes that are also cheap like the blood pressure meds. For example, a 90 day supply for the cheap meds can run as little as 1.85 and up to 8.00 or so. That would be my 20% copay.

However, nor every one can tolerate the same sort of medication. For example, the statins such as Nocor are supposed to work as well as Lipitor and are relatively inexpensive but the stuff leaves me sore all over with
muscle pain. Omeprazole, which is a generic Prilosec, works about as well as Nexium and I dont' have problems with taking it. It is also relatively cheap.

Routine follow ups and lab work need not be seen by an MD as a PA or a nurse practitioner would suffice for these matters. That approach should help hold down the cost of healthcare. That is what the VA system is doing. It isn't the best care around but it beats not having any at all.

In the various proposals I have seen there are few if any ideas on how to actually reduce the cost of care, just ways to spread the cost over the entire patient base, which is what insurance does. Access to healthcare for the some 46 million who have no insurance is also an issue but once again it doesn't decrease the cost of the system appreciably
by covering these people.

It can be argued that a lot of the uinsured go the the ER for their non-emergency are needs, and I can see that tending to raise the cost of healthcare for the system. I think the minor emergency care clinics could be of help in this respect. I went to one once and saw a licensed MD, and I was impressed with him. In fact I could have continued to see him as his regular patient but did not do so because his office was 25 miles from my hometown.

At one other time I used a minor emergency clinic for a sinus infection and it was a good move. I was given a regimen of cortisone rather than an antibiotic, and although it caused me to gain weight, which I later lost, it worked ok. I think the doc was an osteopath or a chiropractor who tried such alternate ways of treating problems.