Lack of insurance coverage for over 41 million Americans is one among the nation’s most pressing problems. While most elderly Americans have coverage through Medicare and nearly two-thirds of non-elderly Americans receive health coverage through employer-sponsored plans, many workers and their families remain uninsured because their employer doesn't offer coverage or they can't afford the value of coverage. Medicaid and therefore the State Children’s insurance Program (SCHIP) or HAWK-I here in Iowa help fill within the gaps for low-income children and a few of their parents, but the reach of these programs is limited. As a result, many Americans without insurance face adverse health consequences due to delayed or foregone health care and increasing coverage to the uninsured has become a national priority. -(Information taken from kff.org)
The number of individuals that are forced to travel without insurance is nothing but a crisis during this country today. We have fallen into a vicious circle over the previous couple of decades during which insurance premiums became too expensive for even a bourgeoisie family to afford. This successively leads to the lack of the uninsured to hide medical costs which frequently times leads to the financial ruins of the family, and successively results in the continuing loss of income by the medical profession , which successively drives the value of medical expenses higher, finally cycling back to the insurance firm which then must drive the premiums of insurance higher to assist cover the rising cost of health care.
Many proposals are tossed around by politicians on each side of the isle starting from socializing health care like the Canadian system, to endorsing health savings accounts and cracking down on frivolous law suits against the medical community. Many of those proposals have good points, but along side whatever good points they carry they also bring major downfalls. For instance; a socialized national health care program would eliminate the necessity for insurance all at once and therefore the cost would be taken on by taxes, which in theory doesn't seem like a bad idea. However, the downfalls to the present system include a deficit in new doctors willing to urge into the sector thanks to the inevitable decline in income while the demand would grow due to no personal responsibility. In short if people did not have to stress about deductibles or copays that might normally keep the person from seeking medical treatment for minor things, they might simply go to the doctor whenever that they had an ache or pain. So now we've waiting lines for people with major health problems since most are scheduling a meeting while at an equivalent time we are loosing doctors thanks to lack of incentive.
The current battle cry by the republican Bush administration is to push HSA's (Health Savings Accounts) which reduce premium by taking a less expensive high deductible health insurance plan with a tax deferred bank account that earns a little interest on the side that you simply contribute to along side your premiums monthly . Any money withdrawn from the bank account for qualified medical expenses are taken "tax-free", and in contrast to a flex spending account like many of us are conversant in in employer based plans, you don't lose the money you put into the account that you don't use. Basically if you never used any of that cash within the bank account you'll withdrawal or roll it over into another vehicle once you switch 62 1/2 penalty free to be used for retirement. This is a viable option for a few people, however for several the premiums for these plans are still too expensive, and therefore the problem remains that if you would like major treatment within the first few years of the policy you'll not have an enormous enough amount within the bank account to assist cover the gaps leaving that author for a large portion of the cost out of pocket.
Now we come to what i think is one among the most important problems from a insurance agent's point of view, which is that the inability for persons with pre-existing health conditions to obtain coverage. From the amount of individuals that contact my office checking out insurance coverage, i might need to say that about half them have a health condition that will either end in an insurance firm declining that persons application, or end in an amendment rider which basically excludes coverage for any claims associated with that condition. An example of a condition that I meet constantly is hypertension or high vital sign . This condition will sometimes end in a corporation declining an application all at once if other factors are involved, but most generally end in an amendment exclusion rider. You may think that this is not that big of a deal, after all, vital sign medicine is about the sole thing they might need to buy out of pocket, but what many of us do not realize is that this rider will exclude ANYTHING that would be considered a part of this condition including heart attacks, strokes, and aneurisms which might all end in an enormous out of pocket claim. Consider the fact that my father had a double by-pass surgery recently that ended up with a final bill of around $150,000. This whole amount would have had to return out of pocket had he had a hypertension rider on his insurance policy, to not mention the added cost of 2 months off of work thrown into the mix. On a modest income of $40,000 per year this would have ruined him financially.
So what how do we fix this problem? Obviously the proposals so far are flawed from the start , and albeit one among these plans gained support from the American people likelihood is that it might never be passed into law simply thanks to political infighting. One side wants to stay health care privatized while the opposite wants to socialize it, which as we discussed before both have upsides and drawbacks . It seems that we are doomed on this issue and there's no real ideas or light at the of the tunnel right? Maybe not, let me tell you a few client I had in my office a few of years ago.
A girl came in eager to compare insurance plans to ascertain if there have been any options for her and her family. She had several children and had been on Title 19 Medicaid and had been getting to college paid by the state. She had recently graduated from college and had gotten employment with the local establishment , however for whatever reason she wasn't eligible for insurance benefits. Obviously she still couldn't afford 5 or 6 hundred dollars per month for an idea so she went back to the help office and explained her situation. They ended up working with us to seek out a suitable private insurance plan and reimbursed her for a percentage of the value which I didn't even know was possible!
This got me thinking, consider how many more people would be able to obtain coverage if they could be reimbursed by the government a percentage of the premium according to their income. For example; take a young married couple in their 20's with one child, let's say that their family income is $25,000 and that the average premium for a $500 deductible health insurance plan for them is $450. Just as an example let's say that the government determined that a three person family with an annual income of $25,000 is reimbursed 50% of their premium taking the actual cost to the family to $225 per month. This is now a reasonable enough premium for the family to think about .
With this merging of personal insurance with government assistance we get the simplest of both worlds. Of course subsequent question goes to cost, what proportion more would this cost the American tax payer and the way much would this raise taxes? I don't think that it would cost the tax payers much more an here's why I think that: First off we would bring down significantly the amount of uninsured people that are unable to buy the medical aid they get successively driving down the entire cost of health care. Secondly the amount of individuals that are forced into chapter 11 and driven to Medicaid Title 19 assistance thanks to medical bills stemming from catastrophic medical conditions that do not have health insurance coverage would be significantly reduced. This is important to stay in mind considering that when someone is on Medicaid they're receiving health care basically 100% covered by the govt so there's no more incentive to not seek treatment for minor or non-existing conditions. On the flip side many conditions that might haven't been caught before they became severe because an individual didn't seek treatment thanks to not having coverage would now be caught before they became a catastrophic claim. Finally, if the govt allocated a particular amount of cash to assist cover claims by folks that have pre-existing conditions the private insurance companies could do away with exclusions and declines thanks to already existing health problems, this is often already done is a few states like the HIPIOWA Iowa Comprehensive Plans which insures Iowa residents which will not obtain coverage elsewhere.
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You may be sitting there thinking that this is often all just illusion which these ideas could never be implemented, but all of those ideas are already being implemented. The problem is that just some states do some programs and not even most insurance agents know that some low income families can get reimbursed for insurance premiums. If these programs were all standardized and put into effect on a national well publicized level i think it might put one hell of a dent within the uninsured population in this country. Now i do not pretend to understand what the reimbursement levels should be for what income levels but I do know that anything is best than nothing, and in my opinion this is the best middle ground we could find. The Democrats would be proud of the socialized aspect of the reimbursement, and therefore the republicans should be happy that health care remains privatized giving this solution a far better chance at a by-partisan backing.
I have faxed this concept to many senators and congressmen but always received an equivalent sort of standard response about how they're concerned with health care which they are working hard to seek out an answer knowing full well that nobody really even read my letters. The only thanks to get these ideas out into the general public is for you that read this to pass it on to others by word of mouth, by email, or by linking your websites to this web page. If enough buzz is made than these ideas would get the consideration that they deserve, and if enough people such as you and that i demanded that an answer be found than perhaps enough stress are often placed on the politicians to urge something done. The number of uninsured Americans is merely getting to go up, the value of health care is merely getting to go up, and therefore the cost of insurance premiums are only going to go up if something isn't done now! Until then the sole thing that I as a insurance agent can do is to match all of the choices out there and present you with the lesser of all of the evils, which in too many cases the option that is chosen is the biggest evil of going without coverage.
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