The Clinton/Obama Health Care Reform Rhetoric

It seems as though the most popular reform ideas…

There are numerous ways to address health care reform. It seems as though the most popular reform ideas stem from supposed Universal Health Care crusades and acknowledgement of the uninsured issue. Senator Clinton feels that health care reform is achievable by mandating universal coverage with no recognizable enforcement of that theme. Senator Obama feels that by mandating child coverage only, the uninsured issue is resolved more effectively. There would be fewer uninsured Americans according to his statistics. I love how these candidates use statistics to manipulate public opinion with out telling the whole story.

Insurance has some basic and simple principles. The law of large numbers creates opportunities to spread risk over a broader spectrum of both the healthy and the sick. Hence, when more Americans have health insurance coverage, there will be a better chance of spreading risk and keeping premiums affordable. Although there is truth in that statement, the real problem is being sidestepped. That problem is cost and we will talk about that more.

At least both Senators recognize that health care costs are out of control

At least both Senators recognize that health care costs are out of control. They want to make health insurance accessible to more Americans. I congratulate both of them for that. What about the problems that insured Americans have? These are issues that affect the majority of Americans who, by the way, are covered by health insurance? Overall, Americans may enjoy a better standard of living when the stress created by this health care crisis is resolved.

Both Senators state that the inefficiencies and error rates in the U.S. Health Care System are extremely high for the World’s most sophisticated economy. Several suggestions from both candidates will have a positive impact. However, significant change will come slowly unless a more constructive Congress is willing to approve necessary regulation and, in some cases, de-regulation in order to bring private markets back on track so useful reform can be accomplished.

…the overall impact of more insured Americans on the U.S. health care system is not yet known

Insurance companies will benefit from insuring more Americans. However, the overall impact of more insured Americans on the U.S. health care system is not yet known. It costs a lot more money to insure Americans in need whether they are children or not. If Americans can not afford health insurance and the next President mandates it, what is the penalty for not having it? What are the new income levels to qualify for this mandated coverage? Although Senator Obama criticized Senator Clinton for this lack of oversight, Obama doesn’t have an answer, either. Americans understand conceptually that if you eliminate medical error and have electronic medical records and create more efficiency with in the health care system, costs can come down. What happens then?

None of the 2008 Presidential candidates talk about the fact that demand for medical services is at an all time high and increasing at an alarming rate, while supply is somewhat limited for many reasons. Costs well exceed the current rate of inflation. For how many years will these proposed changes provide relief, should we accomplish them? America needs to have a long term purpose for reform.

Consumption taxes on goods and services on which we are trying to become less dependent…

Consumption taxes on goods and services on which we are trying to become less dependent, present an excellent opportunity to fund positive change. Gasoline, cigarettes and fast food are excellent places to start. The cost of medical services versus the demand issue for those services will be around for a long time. Contrary to what the pessimists are asserting, when Americans have their health, America will experience resurgence in world leadership. Unfortunately, Americans have taken their health for granted and the stress it has created in our lives is overwhelming.

Americans need a 21st century President, who is a leader with vision and ethics. Take this advice from America’s Voice on Health Care Reform. There has never been a better time in America’s history to revitalize our image in the World. Our long term competitiveness in the scope of the world’s economies depends on it. Will either of these candidates get the job done?

Can you believe that this family had the best health insurance money could buy?

Yes, even though you may be one of the lucky Americans…

When it comes to health insurance, if you don’t know what your rights are, you have no rights. Health insurance companies don’t always make it easy for claimants. Yes, even though you may be one of the lucky Americans with health insurance protection, there are numerous instances when the insurance company refuses to pay a claim.

One of my clients, the President and CEO of accompany with 150 employees had a wonderful spouse who unfortunately was diagnosed with advanced stage ovarian cancer five years ago. She was a fighter, though, and hung on for 5 years of chemo, seeking out every possible treatment to fight her disease. She is now deceased.

How was she covered by her Blue Cross and Blue Shield PPO plan?

What transpired during those five years of her fighting ovarian cancer with Blue Cross was difficult to comprehend. This woman and her family received no support from this Blue Cross insurance company when it came to managing her illness and seeking the best possible path toward recovery. With all of their medical directors and disease and case management programs, this woman and family were left to seek treatments on their own.

One would expect, if you advertise a service, that you actually perform it…

When Americans pay for a health insurance policy, they expect to be financially protected from catastrophic loss. This Blue Cross plan advertised its disease management and other care management programs as superior to that of the competition. One would expect, if you advertise a service, that you actually perform it. This Blue Cross plan’s medical director and nursing staff never reached out to help my client. Too many Americans live close to the edge financially and any change in the delicate balancing act of their budgets has potentially crippling effects. This wonderful woman, mother and spouse went through numerous medical treatments for her ovarian cancer. I negotiated on her behalf with Blue Cross, their medical directors, a pharmaceutical company and a hospital, to get experimental treatments approved for coverage. The Blue Cross Plan covered it, despite the high expense. My client’s family was so thankful.
When she was close to dying, she exceeded her policy limits for hospice care. She had 5 million dollars in medical insurance protection, but her hospice benefit was limited to $7,500. Her Blue Cross policy was a very rich, older PPO benefits plan and it was very expensive, too. But, her policy had this limit on hospice care.

The family, focused on her terminal cancer, never paid attention to this limited hospice benefit…

This sick woman had gone in and out of hospice and back to the hospital at the recommendation of her oncologist numerous times. The family, focused on her terminal cancer, never paid attention to this limited hospice benefit and only shared the situation with me after they had exceeded the plan limits by twelve thousand dollars. Imagine that after paying for hundreds of thousands of dollars in claims, now the insurance company would not pay this last bill. My client, the President of this large company, gave me power of attorney to negotiate on his family’s financial behalf regarding the outstanding bill for $12,000 thousand dollars. This Blue Cross’s incompetence exposed my client to substantial out of pocket expenses. Blue Cross never coached my client or their family even after they paid huge claims to try and help this woman. In the end, no pun intended, it took grievances and appeals and rejection after rejection to finally pursue the matter with this Blue Cross legal department. What an incredible hassle!

After I threatened to go public with the story…

Do insurance companies do this purposely? I negotiated with both the general council at Blue Cross and the hospice center. After I threatened to go public with the story, Blue Cross legal department responded by offering my client $2,500 dollars, though they made it clear that they felt they did not have to. I further negotiated with both the hospice center and Blue Cross. The hospice center lowered the bill to $4,000 dollars and Blue Cross increased their offer to $3000 dollars. Now, my client would only owe one thousand dollars to the hospice center instead of the original twelve thousand dollars. After the hospice center received the three thousand from Blue Cross, they closed the account and my client did not have to have any out of pocket exposure. By the way, this Blue Cross has since filed all of its new plans with an unlimited hospice benefit.
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Do your employee benefits consultant negotiate on your behalf? Would they work this hard for you? Do you have the time and understanding of health insurance, to try to make this happen on your own? Is your health really important to you? What are you getting for all of that money you spend on your health insurance premium, anyway