Cover the Uninsured


PFG, Picture Framing God
Nov 2, 2001
Centennial, CO, USA
This website has been brought o my attention through a friend and commercials on TV. cover the uninsured It seems to be a positive approach to getting the word out to our leaders about our health insurance crisis. I haven't explored it from beginning to end cause I haven't had time. It says to spread the word so, what better place than a forum with self-employed people reading......

If you could take the time to check it out and there is a place to write your congressperson it would be nice if we could all fill those letters out and send this on to others.

Thanks for reading.
I heard on NPR that Massachussets is enacting a statewide healthcare bill in which it is mandatory for all residents to have health insurance. How they intend to keep the insurance companies from price fixing and making an egregious profit will be interesting to see.

This step that Mass is taking may also be a warning to other states to take this matter up. CEOs of Medical Insurance companies and members of AMA are well served by members of congress; maybe the way to address this is on the state level. Maybe write to Gov. Taft. I've found my representive to congress has a staff that is very helpful-esp. in giving who best to address with a specific concern.
No question that healthcare coverage needs improving. Striking down state-by-state restrictions and letting national insurers move in to set up coverage would likely reduce average coverage costs.

The new legislation signed by Gov. Romney in Mass. is interesting. According to Romney, in the research leading up to the bill he signed, it was determined that 40% of the uninsured in Mass. could afford healthcare insurance, but chose not to purchase it.

Not sure government programs that subsidize these folks is a good idea if they have the means but decide to spend their discretionary dollars somewhere else.
I know a lot of hard-working people without health insurance. They can't AFFORD it. They have no extra money, nada , niente.
I remember hearing on NPR that the penalty for not getting coverage will be a $250 per year "tax penalty" in Massachusetts.

I have a friend that is an Electrician. He is self employed just like us. He has always been a very healthy person. He is a little over weight, OK a lot over weight. The only insurance company doing business in NC that will insure him is Blue Cross Blue Shield. The premiums would be $1400 per month.

If they passed a similar law here, he would just be forced to pay a "tax penalty".

Everybody needs to be insured, period. But some of these companies are too strict and many working people just can afford the rates.
This is a scary topic. We have been responsible for paying our own insurance for years and the premiums keep going up and up. But if we didn't have it - the cost for care/prescriptions is out of sight. But to demand people insure themselves and if they don't they will be fined leads down a road I'd rather not walk.

Will seek more information on this subject

Insurance for the self-employed has gone beyond reasonable. When we asked one agent why we got such a large increase, the second one is a year, his response was, "have you heard about inflation?" My DH responded, "28% in less than a year?" To top it off, we had not even used that policy.

If the government mandates we have insurance, what would it cost to give everyone $1000 a year for insurance. DH and I could buy a comfortable policy for that amount. I do not know what the figures are for government paid health costs for children and other welfare recipients. I wouldn't be surprised if this would be a better way to spend tax dollars.
Below is a link to Romney's recent essay in the WSJ on this. Of particular interest to me is that 20% of the uninsured in his state were eligible for Medicaid, but had not applied. Getting them into the existing program cuts uninsured numbers considerably.

In regards to the $250 fee Jerry mentioned, I've read in several places that one way or another it won't be included in this program in the end. I hope that turns out to be the case.

I'm getting hammered with my BC policy since I am self-insured, and it is small consolation that it comes off the bottom line come tax time.

Federal legislation that would allow associations to sponsor group coverage for its members (like PPFA) is key to bringing down insurance costs for small business and individuals. Our representatives of both parties tout the importance of small business in the economy, but seem unable to drag this excellent idea across the finish line.
I just got this email today from the Professional Photographers of America:

To all PPA Members:

There is still time to take action! In a few days, the Senate will vote on S. 1955, legislation to create Small Business Health Plans (formally known as the Health Insurance Marketplace Modernization Act). Now is the time to contact your Senators and ask them to vote "yes" on S. 1955.

Your participation matters – PPA has learned that approximately 16 Senators are “on the fence” regarding this measure – so an e-mail from you could literally mean the difference between our success and failure.

If approved, S. 1955 will allow small business owners to participate in group health insurance on a national basis -- similar to the way large corporations and unions are permitted to offer employees in various states the same coverage. Passing this bill will help significantly decrease premiums and make insurance more affordable for small businesses, including PPA members who currently have no health insurance.

Again, we urge you to contact your Senators and tell them to vote “yes” on S. 1955, The Health Insurance Marketplace Modernization Act.
Romney's veto of the $295 fee that is imposed on businesses that do not "provide" a health insurance plan for their workers is expected to be overridden. The MA House did so Monday and the senate is expected to follow suit.

During debate over the bill, the claim was that individual coverage would be made available for something on the order of $200 per month. After the law was passed, it was admitted that the reality of the situation is going to be more like $330 a month. That's for individual coverage. Family coverage will surely be north of $500 a month.

Supposedly there will be some needs-based subsidization of the premiums.

It's an interesting idea. It's quite obvious that something needs to be done. Whether this is the right approach or not, I can't say, but regardless of my longstanding disagreements with MA politicos, I have to give them credit for making an effort.
Well, I have heard back from 2 out of 3 Senators I contacted yesterday. I'm fairly certain they are dun letters but that is okay. If everybody tells their local leaders that this is on our minds it will make a difference. Nothing is gonna change if we just sit here and ignore it.

Obviously the system is broken. There are a lot more people without health care because they simply can't afford it than those that choose not to have it. I realize I am self employed and that is a choice I made, I never knew I would be uninsured for this long.

I know more and more people who are having their plans taken away by their employers or who's rates are rising so high that they are now having to pay a good portion to keep them.

I'm sick to death of it being brought up at election time and put back in the closet after. They need to put their money where their mouth is.

I hope you guys will take the time to look at the website and contact your legislators, it was quick and easy to do. This is an important issue even if you are lucky enough to have coverage.
I wish that we had some type of enforceable mandatory auto insurance. I think the average Joe, in AZ anyway, has a much greater chance of being hit by someone without auto insurance.

Perhaps we should require employeers to provide that insurance so that their employees can get to work eveyday

Or, that the state should provide auto insurance for those unable to purchase it?

I'm not making light of the problem of health insurance (and I'll match premiums with anybody-sight unseen). Everyone may have health insurance of some kind, but you may have to make some sacrifices.

Two easiest ways: Work for a company that provides it or become an illegal alien.

There are difficult choices, but choices, nonetheless. Kathy, I understand your dilemna, but we all make choices and there are consequences for the choices we make. Sometimes we have to compromise

And, Jerry, I could park an F-40 in my garage for what I pay monthly
Be careful what you wish for - especially if you're wanting the federal government to run the show.

Part D Medicare prescription drug coverage seemed like a terrific idea. (Part A covers inpatient hospital services and part B covers outpatient services and doctors visits but Medicare did not help pay for prescription medications.)

Millions of low-income Medicare members got help from the drug companies in the form of free or reduced-cost prescriptions. Doctors had samples to hand out to patients. People managed (but you have to wonder how.)

Then Medicare signed up most of these people for Part D prescription coverage and the freebees went away. Many of the plans called for a deductible to be met before any benefits would be paid. There are "donut-holes" - gaps in coverage at some point in benefits where the member would pay the entire cost of the medications. The new insurance, in many cases, resulted in higher medication costs for the people least able to afford them.

The new plan was rolled out without sufficient staffing and resources and patients, pharmacists, agents and insurance company employees waded through a maze of confusion, long hold times and clerical nightmares.

There is a health care crisis. Much of it is of our own making. We demand more expensive diagnostics, sometimes without clinical justification. We want the "little purple pill" when we get heartburn 'cause we saw it on TV - even though there are over-the-counter meds that work as well. We expect to be looked after in every aspect of our lives when we should probably be taking more responsibility for our own well-being.

I'm not sure the federal government is the answer. The states, maybe?

One of the things that makes health insurance so complex is the myriad of state mandates. There are no national plans and patients are unable to take advantage of the choices out there. Arizona decides that every group policy written must have chiropractic benefits. Is that because Arizona residents want/need them or because chiropractors in AZ have a strong lobby?) Another state decides that anyone who wants one should get a gastric bypass.

It's too late to not get me started.
I moved to Savannah, Georgia...Essentially gave up framing (Which I loved) and took a job with the largest Environmental Laboratory in the US primarily because of Insurance. Even though I was working for another company they could not AFFORD to continue the health coverage we had. (which by this time REALLY sucked, I had a $1500.00 deductible). When I hurt my back and was on crutches and a wheel chair, I could not AFFORD to not be at A-Work and B-The Frame Shop. The cost, with the $1500.00 deductible, of evaluation and testing (including the surgery reccomendation) was close to 5K. What choice did I have? I now have a bad credit score because of medical bills.

Insuarance and Medical costs have ballooned out of control next to gasoline costs. HOWEVER, the Oil companies and the Insurance companies are making a profit....WHY IS THIS?

It is time that Congress allows large Professional Groups to become one large GROUP as far as Medical Insurance is concerned.

Group Insurance Coverage for.......Photo Marketing Association International....(Which includes PPFA) and KODAK.................

Think about it!
It is time that Congress allows large Professional Groups to become one large GROUP as far as Medical Insurance is concerned.
Groups are the answer, Jerry, but there are no national plans for the national groups for the reasons I already mentioned: state mandates.

Can't blame the feds or the insurance companies for those.
Check for a local MEWA Multiple Employer Welfare Arrangement. Google MEWA for more than you'll ever want to know.

Just make sure to check with the State Insurance Department and others before giving up the first cent. A legitimate and properly organized MEWA can have the same effect as a trade organization acting as a large group.

An illegitimate or improperly funded MEWA can be the cause of serious headache and additional financial liability to the point that you would have been happy to pay Blue Cross premiums at the going rate. Before joining any professional organization group insurance plan, I'll be asking more questions that can be typed here. Burn me once, shame on you. Burn me twice, shame on me.
Group insurance is not "group" in cost to the insurer if every member of the group is not required to participate. If young healthy members if a group can opt out, you then have the same underwriting cost basis that exists in individual plans. There is NO magic bullet.

Pat :D
Paul Krugman has some good ideas.

May 1, 2006
Op-Ed Columnist
Death By Insurance

For lower-income working Americans, lack of health insurance is quickly becoming the new normal. That's the implication of survey results just released by the Commonwealth Fund, a nonpartisan organization that studies health care. The survey found that 41 percent of nonelderly American adults with incomes between $20,000 and $40,000 a year were without health insurance for all or part of 2005. That's up from 28 percent as recently as 2001.

Many of the uninsured reported spending their entire savings on health care and/or that they were having difficulty paying for basic necessities. And most uninsured adults reported cutting corners on medical care to save money — failing to fill prescriptions, skipping medications, going withot preventive care.

Here's the other side of the same coin: health insurers' business is lagging, reports The Wall Street Journal, as "rising premiums and medical costs push more of their traditional-employer customers to shun or curtail company health benefits." And some investors are feeling the pain. Aetna's stock price fell sharply last week, on news that its "medical cost ratio" — a term I'll explain in a minute — rose from 77.9 to 79.4.

Taken together, these stories tell the tale of a health care system that's driving a growing number of Americans into financial ruin, and in many cases kills them through lack of basic care. (The Institute of Medicine, part of the National Academy of Sciences, estimates that lack of health insurance leads to 18,000 unnecessary American deaths — the equivalent of six 9/11's — each year.) Yet this system actually costs more to run than we would spend if we guaranteed health insurance to everyone.

How do we know this? The medical cost ratio is the percentage of insurance premiums paid out to doctors, hospitals and other health care providers. Investors are upset about Aetna's rising ratio, because it leaves less room for profit. But even after the rise in the cost ratio, Aetna spends less than 80 cents of each dollar in health insurance premiums on actually providing medical care. The other 20 cents go into profits, marketing and administrative expenses.

Other private insurers have similar ratios. And here's the thing: most of those 20 cents spent on things other than medical care are unnecessary. Older Americans are covered by Medicare, which doesn't spend large sums on marketing and doesn't devote a lot of resources to screening out people likely to have high medical bills. As a result, Medicare manages to spend about 98 percent of its funds on actual medical care.

What would happen if Medicare was expanded to cover everyone? You might think that the nation would spend more on health care, since this would mean covering 46 million Americans who are currently uninsured. But the uninsured already receive some medical care at public expense — for example, treatment in emergency rooms that would have been both cheaper and more effective if provided in doctors' offices.

And Medicare manages to spend much more of its funds on medicine, as opposed to other things, than private insurers. If you do the math, it becomes clear that covering everyone under Medicare would actually be significantly cheaper than our current system.

And this calculation doesn't even take into account the costs our fragmented system imposes on doctors and hospitals. Benjamin Brewer, a doctor who writes an online column for The Wall Street Journal, recently commented on the excess expenses he incurs trying to deal with 301 different private insurance plans. According to Dr. Brewer, he currently employs two full-time staff members for billing, and his two secretaries spend half their time collecting insurance information. "I suspect," he wrote, "I could go from four people in the paper chase to one with a single-payer system."

Many pundits see red at the words "single-payer system." They think it means low-quality socialized medicine; they start telling horror stories — almost all of them false — about the problems of other countries' health care. Yet there's nothing foreign or exotic about the concept: Medicare is a single-payer system. It's not perfect, it could certainly be improved, but it works.

So here we are. Our current health care system is unraveling. Older Americans are already covered by a national health insurance system; extending that system to cover everyone would save money, reduce financial anxiety and save thousands of American lives every year. Why don't we just do it?

Copyright 2006 The New York Times Company
I don't know how many Grumblers are over 65 and on Medicare - I am a couple of years away. However most of my retired compatriots are and are typically paying $200 to $500 a month for Medicare supplement policies, in addition to Medicare premiums and the taxpayer contribution. It is a long way from a perfect system and will not in itself protect you from financial disaster if you have a major medical problem. If we go to a single payer Government run system, competition dies and rationing will rear its ugly head - be careful what you wish for. The competitive free market is far from perfect, as you who are in business well understand, but please save me from the government taking over the entire system - and from those who believe that they know how better to run our lives than we do.

There is a place for government assistance and regulation, but please don't give them everything.

Pat :D