We, at The Encumbered believe we can fix our health care system, but first we need to consider a few concerns.
Large group employers are defined as companies with more than 100 employees. The national average of family health insurance coverage for large group employers is approximately $8,000.00 per year. The average cost of family health insurance coverage for small group employers (those with under 100 employees) is significantly higher – more than double in many cases. Most uninsured working Americans are employed by small group employers, which is where we must focus our attention.
Concerns:
- Insurance companies are financial institutions, and like any financial institution, their income is in part based upon the volume of dollars that they manage. To reduce the volume of dollars that flows through their system would result in a decrease in profits, a decrease in dividends, a decrease in executive compensation, and a decrease in employees. To solve our health care crisis is not in the interest of any health insurance company.
- When the cost of any problem is removed from our responsibility, we no longer practice the same thriftiness as we would if the money came out of our own pockets. If you had to pay the $36 charged every time a warm blanket was placed over you in a hospital recovery room, how often would you let the nurse change it?
- Insurance is supposed to spread the financial risk when something out of the ordinary occurs, such as being in a car accident and needing treatment. A routine office visit is not out of the ordinary, it is a common event – making it eligible for insurance reimbursement has tripled the cost.
- Insurance can be a financial incentive to create a lawsuit. People like the concept of “found” or “easy” money and “passing on” or “spreading” the cost. Gratuitous lawsuits drive up the cost of insurance to the point that many people can’t afford the premiums.
About Medical Coverage:
Medical coverage can be extremely confusing. There are many variations of coverage which include:
- hospital expense insurance
- surgical expense insurance
- regular medical insurance
- major medical expense insurance
- comprehensive medical insurance (combining all of the above insurances)
These are the five standard types of health insurance that cover the cost of treatment associated with an illness or an accident.
A national standard of health care does exist: Medicare Part A & B.
We need to accept and use this national standard, not only for retired persons, but for all. If we were to take the time to examine the differences in policies between every state, we would never make any forward progress. Medicare may not be perfect, however our priorities need to be focused on first adopting a standard of coverage and finding a way to make the program affordable!
Medicare Part A generally covers inpatient services – medical care when you’re checked into a hospital or are recovering in a nursing facility. It also covers some short-term home health care, along with hospice care. Most people are enrolled automatically in Part A when they reach age 65 and get it for free.
How much does Medicare Part A cost?
Medicare Part A is free for the vast majority of people over 65. But if you or your spouse worked and paid Medicare taxes for less than 10 years total, you will have to pay a monthly fee of $233 or $423 per month (for 2008). How much you will have to pay depends on how long you or your spouse worked and paid into Medicare
Medicare Part B is medical insurance rather than hospital insurance. It helps pay for:
- physician services
- outpatient hospital services
- emergency room visits when you are treated and released
- outpatient surgery
- diagnostic tests
- clinical lab services
- outpatient physical therapy
- speech therapy
- medical equipment and supplies
- rural health clinic services
- renal dialysis
- other health services and supplies