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I have stayed out of this Health care debate pretty successfully until now. I’m not a doctor, insurance agent, or a politician. I have no special interest in this at all…except that I am again uninsured (unemployed again…geez, that sounds horrible, but a 5-hour commute to work every day would not have been possible)…but this is a debate that is completely full of ugliness and b.s. being slung from both sides. I don’t completely agree with any side vs. the other in any way, but I do have a few ideas that might be of interest.
Here’s what my primitive, 28-year-old brain came up with. A major part of this is raising taxes. YES…simply plan to raise taxes in the area of Medicare/Medicaid and Social Security. Tell the truth about it!! They are payroll taxes anyway, and at my basic calculations we will need approximately $420 billion to get this thing started.
- Employ parts of the Whole Foods method. If you haven’t heard about this, read here, but understand that I do deviate quite a bit:
- Create health savings accounts (HSAs) for each individual American. I think a good number here would be $1500 (hence, the $420 billion for the 280 million of us that are currently here).
- Every American with a Social Security Number will be assigned this account on January 1 of their first year of life. Parents can opt-out at birth for religious or other objections.
- Annual contributions to the HSA will make it at least equal to, but no more than the prescribed minimum, here $1500. So, if someone only uses $150 of their HSA, the Fed will only add back $150 on the following Jan 1st.
- The amount of the HSA will increase over time, because it will accrue interest. Safe investing should cover this. If an individual opts not to use any of the funds, the government will not need to add anything to it, nor will it hurt the economy if the money sits and accrues interest (ok, except that it won’t be in the process of being spent at Best Buy).
- Turn the much talked about “public option” into a High Deductible Insurance plan that is federally funded.
- The federal government, businesses and individuals should put funds in reserve that people could use without private insurance or demonstrate need. For my purposes, we’ll call it Federal High Deductible Insurance (FHDI).
- Set the deductible before insurance pays at a reasonable, but attention-getting level above the HSA level. So, if there is $1500 in an individual’s HSA and the deductible is set at $2000, once an individual has exhausted their savings acct they must pay $500 out-of-pocket before any public option kicks in.
- If individuals opt to not purchase any form of insurance, they will pay into the FDHI fund as part of their federal taxes. They won’t have to pay any extra if their income level causes their HSA to be dormant, unless they have no private insurance and have to use the FDHI.
- If businesses don’t directly insure their employees, they will have to pay into this fund annually based on their number of employees.
- Create health savings accounts (HSAs) for each individual American. I think a good number here would be $1500 (hence, the $420 billion for the 280 million of us that are currently here).
- Costs could possibly be contained in the existing insurance companies if we do this first step in setting up HSAs for U.S. citizens. Reasons why:
- Citizens can choose to either spend all HSA funds first before allowing insurance or other coverage to kick in OR can use the HSA to cover costs private insurance does not cover (i.e. if insurance pays 70% of a procedure the HSA funds can cover the other 30%).
- Only once the HSA is exhausted might a person go to their private insurance or a publicly-funded option, and may even elect to choose less expensive insurance.
- If individuals have private insurance they must use this instead of the FDHI, but could use the public option if their insurance company refused to pay for a procedure.
- I too think it is a.)ridiculous to forceinsurance companies to cover random people with pre-existing conditions that have never had insurance and b.) ridiculous to define pre-existing conditions as being pregnant while switching from one insurance provider with similar coverage to another. I can understand reluctance to cover persons with pre-existing conditions who have not previously had any coverage…for this reason I believe the FHDI would be the best and only option. For those who are switching between companies with similar coverage and benefits, we absolutely should force insurance companies to treat them as lifelong customers.
- One other enhancement that might help the above situation would be to standardize the benefits among all insurance companies and at least have similar levels of coverage for approximate costs…not carbon copies, but this would not only give companies a space to compete but a way to judge similar coverage from another company. Also there may be a place for a mandatory, basic plan that exists with the same benefits and at the same price point with all companies.
- Insurance companies should be allowed to compete across state lines, since the FDHI ideally would operate on a national level.
- Some other important points about the HSA that might make it work
- Anyone can refuse to use their HSA, but just like the payroll taxes we pay for medicare/social security, it would still be funded by every American. This is a necessary evil, because the public option is “insurance for when insurance fails”.
- Any citizen’s HSA will become dormant or inactive when they begin to make over $250,000 per year. It can become active again if their income falls below this amount.
- It might still be okay to allow the individuals described above to use the high deductible public option if they choose not to purchase private insurance. They would simply have to pay the $2000 out-of-pocket first.
- When an individual either reaches the age or otherwise becomes eligible for medicare or medicaid, their HSA will rollover into this general fund. This, of course, means we have to fix these programs.
- End-of-life counseling is a great idea. Providing the funds for it is also a great idea, so when the funds rollover, there might be a portion set aside for this purpose.
- All employers must either offer some form of coverage or pay into the national HSA fund and the FHDI fund.
- This has been a talking point that has angered many Americans–to force the small business owners to offer insurance at much higher rates than large businesses. A Health Cooperative might be the best plan here.
- Small businesses can band together in what is recently being referred to as a marketplace or exchange, since the difference between them and large companies is numbers.
- The more small businesses (and individuals who for whatever reason need to buy their own) that band together in a state, a region, a profession, etc., can get more competitive rates.
- These co-ops may need to operate across state lines, to take advantage of the greatest numbers possible
- These co-ops might be of interest to fragmented organizations, where they might find the most competitive rates if they band together in larger numbers.
- In order to get into the co-op, a small businesses might pay a one-time fee (per corporate entity) to the FDHI, a reasonable amount that would not only bolster the FDHI, but allow the business access to the cooperative network, then set this up as a deducted benefit to their employees.
- For the sake of being fair, large businesses (with whatever criteria will classify them as large) will not be allowed to put employees into the co-op systems.
- If they opt not to insure employees directly, they can either:
- Pay a fee anually to the FDHI through their business taxes, or
- Set up their access on the network, but set it up so individual employees can choose their own coverage, but still work within the discounted co-op structure with whatever network fees that might entail being covered by the employer.
- This has been a talking point that has angered many Americans–to force the small business owners to offer insurance at much higher rates than large businesses. A Health Cooperative might be the best plan here.
- The other cost-cutting measures would be to fix the issues in the medical profession itself. Currently, medicine is advancing quickly, but malpractice issues–that drive up cost–are in need of overhaul. I don’t know enough to wax poetic, but I’m willing to pay for the innovation, not so much the litigation. There is the problem within the insurance and government way of thinking that they will bargain for the average cost of a service and pay only what they deem is the “fair” price. Let’s investigate if this is really fair to the physicians that take care of us
I feel that this might be an idea–a rough draft–of a direction we could go. We’re slated to spend $900 billion on this anyway…These ideas give choice; they allow for competition; they cover those who are not otherwise covered; these ideas give an idea of the source of funding, and how they go back to medicare in the long run; they should appeal on some level to all Americans.
In conjunction with whatever health plan that is chosen, there will need to also be a huge effort and focus on better health choices and prevention through lifestyle changes.
Surely we can agree on some comprehensive reform where everyone on every side wins something. There is no place for any more ugliness in a civilized, adult problem-solving process.
On the phone with one of my friends who is teaching in the state, I heard something disturbing. He told me that, this month, in Alabama, the state department of education DOES NOT HAVE ENOUGH MONEY TO PAY 100% OF OCTOBER PAYCHECKS. What??!!?? If nothing else in the business is, I thought, “Surely, the meager paycheck a teacher earns for empowering a generation of students every day for 180 days out of a year is SECURE.”
Apparently, not so much. On Tuesday, state Superintendent, Joseph Morton, sent a memo to all school boards in Alabama stating:
To date, the Education Trust Fund has enough tax receipts to pay 75% of the October allocation for the FY 2009 education budget. Since it appears certain that 100% cannot be paid by Thursday evening in order to get you the state allocation in time to meet October payroll obligations on Friday, October 31, please prepare a 75% payment for October.
Morton said that the remaining 25% should be expected by November 7. But in the same breath, he said if local school boards needed to take money out of their local “Rainy Day Funds”, to do so immediately. If they needed to borrow money from their designated banking institutions, they should begin that process immediately, as well.
So, the culprit here is the Alabama Education Trust Fund, which earns money off of oil and gas revenue in Alabama? The assumption can only be that disruptions in oil production this summer (hurricanes, etc.) has hurt us. But that assumption comes WAAAY too close to advocating “drill, baby, drill,” since the trust fund is only a “rainy day” account. Or…as was stated on the Mobile NBC station’s website, perhaps it is the fact that in this weak economy and tough times for homeowners, people have elected not to pay their property taxes early–which has created an education budget shortfall. But more likely is the fact that, back in early summer, when the Alabama education budget didn’t originally pass, the state department of education scrambled to pass something. the version that did eventually pass came through with projected shortfalls.
Maybe I’m overreacting, and this is not a big deal. So far, it seems that all Alabama school systems have been able to come up with the remaining 25% for teacher, administration, and support staff paychecks without much issue–but how have we allowed this to happen in the first place? The original sin, of course, is due to the inability of past and present governors and legislators to find real, substantial, and stable ways to fund education in the state. But, since they have not yet been able to–or won’t–we’ve come to depend upon the Education Trust Fund, to borrow our shortfall for the year.
Ironically (or not, depending on your ability to concoct conspiracy theories), the major amendment on the Alabama ballot this year is “Amendment One”, concerning the above mentioned Education Trust Fund. Not exactly the hot-button Proposition 8 of California, but no less important to Alabama’s youth. According to the UAH Government Relations Department:
Alabama currently has a constitutionally established ‘rainy day fund’ for education that was designed in 2002 to address budget shortfalls. The language in the 2002 constitutional amendment was “flawed” in that it placed a fixed cap on the rainy day fund based on 2002 appropriation levels. Amendment 1 basically changes the wording in the constitution to allow the rainy day fund cap to increase as the education budget grows over the years.
Think about it this way. Suppose in 2002 you had set aside enough money to purchase a full tank of gasoline for your automobile in case of an emergency. But an emergency did not occur until 2009. And when you pulled up to the pump in 2009 you discovered the amount of money you set aside in 2002 was not enough to purchase a full tank of gasoline now. That situation is analogous to what has happened to the education budget. We are faced with addressing a 2009 funding shortfall with a rainy day fund capped at a 2002 level.
This rainy day fund is built upon a larger Alabama Trust Fund (from the same oil/gas taxes) that, last summer, was quite healthy, with about $3.3 billion. Currently the cap on the education trust fund is set at 6% of the 2002 education budget, which in no way relfects the rising costs in Alabama and across the United States. From what I understand, this is due to the poor wording of the original measure. If the amendment passes, it will not cost us, the taxpayers, one red cent–it will just allow education to tap into more of the larger trust fund.
And now, my official statement.
TODAY, IN ALABAMA, TEACHERS CAME CLOSE TO LOSING 25% OF THEIR PAY. WE SHOULD NEVER BE THAT CLOSE, FOR THE SAKE OF THOSE WHO DEDICATE THEIR LIVES TO EDUCATING OUR FUTURE. NEVER.
Please vote wisely. Vote yes on Amendment One, Tuesday, November 4.
Our entire economy is in danger.
Those were the words of President Bush in an address last night. I couldn’t help but feel oddly reminiscent…he went on to say:
We’re in the midst of a serious financial crisis, and the federal government is responding with decisive actions…I’m a strong believer in free enterprise, so my natural instinct is to oppose government intervention…these are not normal circumstances. The market is not functioning properly. There has been a widespread loss of confidence…Without immediate action by Congress, America can slip into a major panic.
I know I’ve heard this rhetoric before. Change a few of the 5 W’s–who, what, where, when, why–and this is another call to war. Not saying that he doesn’t have every right to be concerned about the state of our economy, since I and many other Americans are too. But we have also been urged in this manner before…rushed, appealed to, given the “something bad is gonna happen” speech. Right now everyone needs to be considering whether the newest economic bailout is the wisest option, the only option. If economists have their doubts–usually, well-versed in their field–then why shouldn’t the rest of America?
No, we don’t need another “fuzzy” war. We haven’t yet achieved victory the first one. Or the second one. Ha…I can hear it now…”We’ll wage this ‘War on Economy’,” which will quickly receive one of those catchy acronyms–W.O.E.
Let’s just hope that we’re not woefully misguided.
As far as days in the stock market go, today was nearly as bad as it gets. The Associated Press said:
In a vote that shook the government, Wall Street and markets around the world, the House on Monday defeated a $700 billion emergency rescue for the nation’s financial system, leaving both parties and the Bush administration struggling to pick up the pieces. The Dow Jones industrials plunged nearly 800 points, the most ever for a single day.
This news blurb certainly caught my attention. After analysis, it looks like $1.2 trillion in market value is gone because of the plan’s rejection. Those most concerned are left scratching their heads, mainly becuase another solution is without precedent (even though, I suppose the $700 billion bailout was too).
Apparently investors are not simply walking away from unknowns–they are moving at break-neck speeds. Although it probably was best for the U.S. to move away from this gigantic risk, you have to wonder what else is coming in this wildly growing financial crisis.
My mind comes back to some new information I’ve been given access to…economist Chris Martensen’s “Three Beliefs“. Watch all of the little mini-lessons, and you’ll start to see that most of world’s economic woes come from need, not so much greed. There are too many of us, and we all need the same resources. It makes me wonder what event or events will ease the pressure. World-wide tragedy? Perhaps, breakthough technology or a spiritual enlightenment? Bernanke has a lot to think about, but so do the rest of us.





