Health+Insurance+Coverage+In+America

HEALTH INSURANCE COVERAGE IN AMERICA - Charlene Cutler-Floss __ Who: __ "One in six Americans" (apprx. 45 million) lack health insurance coverage today (Wall Street Journal 1/19/07. Lacking insurance, citizens receive too little health care, often too late, and suffer from.poorer health and earlier deaths., __ Costs in lost productivity: __ approximately $130 Billion a year (National Institute of Health at pubmedcentral.nih.gov, an archive of biomedical and life sciences journal literature). Costs quantified in 2004 by Dr. Coleman, co-chair of US Institute of Medicine. __ What: __ Proposals to address this issue from governors, congress and White House. California, with GovAS leading the way, is in forefront of Nat'1 discussion. Plan to take $ from hospitals, doctors and fed gov't, increase eligibility to Medi-Cal (MediCaid in rest of world), and require insurance companies to accept all applicants in state. Vermont already has universal coverage and finances with 3% premium fee on insurance co's. __ How: __ Buy-in from diverse groups with often competing interests. Business, labor, ins. co's etc. GovAS's plan takes something from all and gives something, but not equally. Players: __ Individuals: __ Many, especially self-employed and working poor, can't afford ins. Families forced into bankruptcy in increasing rates, lack of knowledge re: true costs of care leads to over-consumption, straining the system. Current employer-based system provides tax advantages for employers, but not for individuals buying insurance. New plan will require those with 3x national poverty level to purchase, those under that level will receive assistance. Proposal is for catastrophic coverage, with $10,000 deductible. __ Business: __ According to the Medical Expenditure Panel Survey, CA ranks as 6th most expensive state to buy health insurance. Businesses factor that in if they don't "have" to be located here (Microsoft.comsmallbusiness/resources/finance/business). GovAS plan only requires them to provide if employing 10+ people, can pay a smaller amount into state fund if employing less than 10 people. __ Insurance providers: __ Currently making large profits. Can expect to make less money with universal coverage than what they make now. New people could be excluded from some coverage plans but must be offered something. Profits will be ltd. To 15%, 85% of income must be spent on patient care. Companies could be regulated like utilities. __ Municipalities: __ Facing huge costs for retiree health care benefits, many will be unable to meet those costs and are cutting back on benefits.. __ Healthcare Providers: __ Hospitals seeing growing numbers of charity care, don't currently receive full reimbursements for costs from insurance companies. Plan levies new taxes on doctors and hospitals to pay for care for the uninsured, incl. immigrants. Physicians: No reimbursement for charity care and don't get reimbursed for full cost of care (insurance can pay less than cost of providing care) with many insurance plans. Proposal is to pay 80% of what Medicare pays (still below costs).