Archive | 8:00 PM

Damn the experts, full speed ahead!

12 Oct

 

Some of us non-experts, naysayers, pundits, spoilers and the like according to your political position, have been saying from the start that there is nothing in health care reform, health insurance reform or whatever it is called this day that will actually lower costs or manage them in the years ahead.  Even those items that have a chance such as studies to evaluate the care being provided are several years in the future and then apply to the Medicare population with years more before desirable changes can be filtered to the balance of the population. 

Now, additional experts noted in the New York Times seem to agree with the assessment that little is happening to actually change the health care deliver system.

I see a lot of green in your future

I see a lot of green in your future

Couple this position with the questionable assumptions relied on by the CBO and in a few years we will really have a health care crisis in America.  If what we have is unsustainable, how will be what we get be any better if the main thrust for the next ten years is to expand coverage, and make health insurance more expensive in the process?

The real shame is that there are many true experts out there who do know what needs to be done and how to do it, but the problem is that what needs to be done is not politically correct and too many oxes will be gored so we are left with smoke and mirrors and dealing with problems another time.

Of course, there are some cynics who see this as a grand strategy, screw up the system even more than it is, wait for failure and Americans will rush to a government system with their only worry the payroll tax to fund it.

 

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The quest for “affordable” health care

12 Oct

 

As regular readers recall I am on a quest to define “affordable” health care. No politician seems willing to help me. 

This is strating to get serious

This is strating to get serious

Medicare beneficiaries pay on average about 30% of their income on health care costs, that doesn’t sound affordable and yet they seem to be lost in the health care discussion these days.  Employee with good health coverage from their employer pay about 25% of the premium plus out of pocket costs, but that is unlikely to come close to 30% of income in most cases.  Some pending legislation talks about the employer being required to contribute a minimum of 65% of the premium, but for some workers 35% of the premium is still unaffordable.   What to do, what to do?

On occasion there are hints of how others may define affordable. For example, in the German model workers pay 14.9% of pay into the program. Some of this is paid by the employer but indirectly comes from the workers income.  Germans pay virtually nothing out of pocket.  Like nearly all other systems the Germans are facing cost pressure so one has to wonder if a payroll pay system with no out of pocket costs may create an “I pay for it why not use it mentality.”

For a worker earning $60,000 a year 14.9% equals $807 per month and for a salary of $125,000 the tax equals $ 1552.00 per month. I doubt there are many workers in America who pay that kind of premium. On the other hand there are few employers who pay 14.9% of payroll who health benefits.

Add to all this the well known fact that America spends more on health care than other nations, what would our payroll tax be?

Yikes, I still don’t know how to define affordable but I hope it is not 15% of my income (plus some out of pocket costs).

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