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This is What Democracy Looks Like
Friday-Sunday, April 7-9, 2006
I know, I know... nothing on immigration in this issue. There are many who are contributing to Madman on that subject and I will address it in Monday Madman (unless the Madness of King George and his scandals rears its ugly head and offers us something else). -NG
A Kerry Quote in the Lead
"The Bush administration is wondering when Iraq will have a functioning government. I want to know when we're going to have a functioning government,"
-Senator John Kerry (D-MA)
When Dumb-Ya is gone would be a start.
Against the Mass Health Care Plan
I think the plan
is perfectly horrid. I would not live in that state over my dead body, which is
what it would be if I was a resident there already. Health insurance can cost up
to $600 per month--sometimes $1,000! And when they do means testing, they have
these really unrealistic levels for poverty. I mean, NOBODY in NY can live on
less than a minimum of $36,000 a year--at least not independently! I for one
would not want to live with my husband in one room of an apartment shared with 3
other couples in order to survive. Our mortgage and maintenance alone is $1,600
a month and that's low by NY standards. And we sure don't want to live in a
broom closet in a crack-infested neighborhood either. That's not exactly
And if I HAD to buy insurance, I would have to buy one of those stripped down plans which would not cover the multiple disabilities in my family. And THEN I would be saddled with those prescription drug bills too.
I am part of the movement for a single-payor system that does not blame the victims. This plan does. It squeezes the middle class like hell. It is murder on working poor or middle class people with disabilities. As it is I am paying double taxes because I am self-employed!
And I think it's terrible that businesses have to cough up so little and the governor wants to cut that slap on the wrist out.
According to Liz Kowalczyk, a staff writer for the Boston Globe, writing on April 6, 2006: "On its website, Blue Cross and Blue Shield of Massachusetts, for example, lists two basic plans for a single person in his or her 40s living in Boston, both of which cost in the $400-a-month range. Neither includes coverage for prescription drugs, however." She also said: " The legislation does not allow health plans to charge deductibles to individuals and families who are below 300 percent of the poverty level. For people with incomes above 300 percent, it does allow plans with deductibles similar to those currently on the market, a maximum of $2,100 for individuals and $4,000 for families enrolled in HM0s."
So, what this would do to my family, if we had it in New York, was cause us to pay approximately $1,200 per month for a plan in which we would received almost nothing for doctors and testing until we spent down $4,000 per year for an HMO which isn't half as good as a PPO. AND, we would ALSO pay $500 per month for prescription drugs all year long. Because, for sure, for sure, the employers would be delighted to drop the coverage we have now in order to pay such a small tax assessment, which I have read would be $325 per employee. What is not clear to me is whether this is a monthly fee or a yearly fee--two different articles I read differed on this. Even so, they may get off scott free because Gov. Romney says he will use his line-item veto to scratch that out.
It will come to New York over my dead body. Literally! If I already said that before, I repeat it here again. It's worth repeating. This thing is a killer for working disabled people. It's worse than the rotten system we have now.
-Billie M. Spaight
The Mass Health Care Controversy
(Please note the lack of colors here. It's intentional due to the issue at hand.)
There has been some debate as to the new Massachusetts Health Insurance Plan. Personally, I am for any plan that will cover every American, but I understand that income levels of those who are near poverty have to be taken into account. Of course I believe that the best plan is a national health care plan that covers everyone. Period. I consider the Mass plan a good start into a "what to do in the meantime" plan. Here is the Mass Plan in a nutshell:
-An adult earning
under $9,500 per year will receive Health Insurance without having to pay
premiums or deductibles
-Every employer would pay $295 per employee of they don't offer health care coverage (companies with less than 10 employees are excluded)
-Those at up to 300 percent of the national poverty level ($48,000 for a family of three) would be able to pay on a sliding scale, with no no deductibles
-Every individual who can afford, but refuses to pay for Health Insurance will have to pay a fine of $1,000 per year
-Insurance companies will b allowed to offer stripped-downed versions of their health care policies
-Lower cost, basic plans will be available for those adults ages 19-26 (young adults will be eligible to stay on their parent's plan for 2 years after their independence)
-The connector (the device "to connect individuals and small businesses with health care" "permits more than one employer to contribute to an employee’s health insurance premium." -From Section A: Commonwealth Health Insurance Connector
-"The bill merges the non- and small-group markets in July 2007, a provision that will produce an estimated drop of 24% in non-group premium costs. An actuarial study of the merging of the two insurance markets will be completed before the merger to assist insurers in planning for the transition." -From Section B: Insurance Market Reforms
-The plans are offered on a pre-tax basis and include other programs like day care ("cafeteria plans")
(Please note: "cafeteria plans" are legal everywhere today. It isn't a new idea supplied by this plan. "Cafeteria Plans" allow an individual to purchase health care before withholding taxes are taken out of their salaries.)
Of course, the Mass Republicans are all for the individual fines and personal finance of the plan while the Democrats realize the necessity of making businesses, at least, partially responsible. By the way, $295 per year averaged out to $5.67 per week; $1.13 per day; or about 14 cents per hour.
Of course, the devil
will be in the details and it is my personal opinion to take a look at the
"sliding scale", what is included in it and what is sorely lacking. Knowing that
Single Payer Universal Health Care or a regulated system of Universal health
care that covers every person in America, regardless of income is the only true,
real and permanent solution makes this Mass plan look like a temporary measure
that might be in the right direction. But remember, although it claims to cover
95 percent of the state's uninsured, that still leaves about 30,000 persons in
the Bay State in need of health care.
Also remember that a plan without details, and this one is sorely lacking, is only a dream. If this plan, as is mentioned above, contributes to higher poverty levels, lost jobs and poorer health care to individuals who now have good health care, then it will be a failure right out of the box. So far, the Mass health care insurance companies have been eerily silent. Either they are still gauging their responses, waiting for those "devilish details", or they already know and are licking their chops. The PDF file is available at http://www.mass.gov/legis/summary.pdf . The Massachusetts State website only offers a summary (see link) and the Blue Cross Blue Shield of Massachusetts website, www.bluecrossma.com, mentions nothing.
Needless to say,
anything that takes advantage of, or merely mentions HCA's (Health Care Savings
Accounts) scares me a whole lot. Does this mean that we, as parents are going to
have to save for college AND health care for our children as they grow up? What
does the plan mean? It is unclear at its inception.
We'll need to stay tuned in the coming months for the actuaries report to see what the future of health care in Massachusetts holds. It might hold the future of our nation's health care as well.
Below are three different plans I have proposed here in Note from a Madman in the past. I feel it would be a good idea to address them again:
A Health Insurance Idea
There has to be a way to cover those who are at most risk of not seeing a doctor when they are sick. One might think that those most at risk are the very poor, and they are at risk. But what is more alarming is the middle class’ risk factor. There are 45 million Americans without health insurance, and over the last four years some 83 million Americans did without health care coverage. No one should have to go bankrupt to see a doctor.
Below is a simple plan. It’s an opt-in plan, with a backup. If you have good health insurance now, then keep it. If not, then this is a plan for you:
Every family, not presently covered by private health insurance would pay 10% of the family’s total yearly income, capped at $80,000, or $8,000 per year, per family. This premium will then be assigned to a health care company drawn from a pool of health care providers in their state (this is similar to being put in an assigned risk pool for auto insurance). Included in the fee will be a full physical examination for each family member once a year. Sick visits will have a co-pay of $25.
Generic drugs will have a co-pay of $15 per prescription; name brand drugs will have a co-pay of $30 per prescription; new drugs, as defined by the Federal Drug Administration will be priced on a drug-by-drug basis.
Weekly incomes would include salary, stock dividends, rental properties and various other sources of income
No income tax will be paid on the medical insurance premium In other words, the premiums would be subtracted before taxes.
The weekly salary will be configured on a 52 week average, or estimates, if necessary
Unemployment insurance will not be exempt
Adjustments will be made at year’s end for any discrepancies, payable quarterly the following year
If a family has health insurance that surpasses the above-mentioned coverage, no fee will be deducted from their wages
Medicare and Medicaid will be unaffected
Since this is an opt-on plan, no one would be forced to join. If a person becomes sick, they would have to pay 10 percent of their salary to pay for their health care. No one should go bankrupt to pay for catastrophic health coverage, even if they don’t take advantage of this plan.
Imagine, if you will, the main wage-earner of a family loses his job, and as a result, the whole family’s health insurance. If there were some sort of national health care plan:
That person might be able to look for a better job rather than just settling in order to keep active his health care
That person might start his own, home-based business
Imagine that home-based business picking up, and that person hiring other people
Imagine the feelings of self-confidence if we were to truly make this an ownership society
A Medicare Idea
According to my rather remedial calculations, there are some 4.2 million working people in New Jersey (US census estimates). Medicare insurance collected by the federal government (as a part of payroll taxes) is taxed at 1.45 percent of your total income from the first dollar you ear to the last. Your employer's share is an additional 1.45 percent. That adds up to 2.9 percent. The average New Jersey income is about $45,000 per year (The median income is about $80,000 - I guess I'm not living up to my end of the bargain).
If the federal government were to transfer the Medicare funds it receives to their respective states, I wonder what New jersey could do with their share?
The following chart shows how much money would be raised by New Jersey if the working uninsured paid a little extra for their own health care, based on a small percentage of their income, for basic health care and New Jersey was allowed to keep the money its workers paid into the existing Medicare system.
People in the NJ workforce
US Census Bureau
US Department of Labor
Total earned by NJ residents
workforce times income
2.9 percent paid into Medicare
Medicare paid by NJ residents
uninsured in NJ
Associated Press by the US Census Bureau
Percentage of NJ Population in workforce
US Census Bureau
Estimated working uninsured in NJ
uninsured times percentage in workforce
additional charge to uninsured for state Medicare
Additional money raised by State Funded NJ Medicare
income times working uninsured times additional charge times
Total Medicare Fund in NJ
Original 2.9 percent plus uninsured's additional 2.9 percent
The question is, could New Jersey insure its uninsured for basic, minimum health care if it were to collect and keep over $7.1 billion this year?
Maybe it IS time for an ownership society. maybe those states with large populations, such as New Jersey, should take OWNership of its OWN Medicare dollars and help its OWN citizens.
Physician, Train Thyself
Good medical care comes from good doctors. Good legal representation comes from good lawyers. One might ask the question, "What's the difference between the two?" The answer is simple and could make a newcomer to the land of liberty and freedom shake their head in bewilderment: If you are accused of a crime, you have the right to be represented by a lawyer, but if you are in sick you do NOT have a right to see a doctor.
We go as far as to require attorneys to perform Pro-bono work (charitable work) but make no such requirements of doctors. Perhaps there is something to that. After all, lawyers don't have to serve an apprenticeship the way doctors do in order to start a successful practice. And let's not forget that, even though law school is an expense, it pales in comparison to the costs of a good medical school education. Look at it this way: A college graduate could actually earn their law degree on line. That graduate could then pass a state's bar exam. They could represent you in a civil matter or prepare your will, or do any number of other tasks that one requires an attorney to do. You might not want them to represent you if you were accused of a capital offense, but for a speeding ticket, you might take a chance.
As far as I know, there are no on-line medical schools, but imagine if there were. Would you trust a prescription written by a "correspondence school doctor"? How about risking a hernia operation by a graduate of EMed-U (I made that one up)? I wouldn't trust my dog to a veterinarian who didn't graduate from a real veterinarian school, so you know I wouldn't trust a doctor from a "fake" medical school.
Here are other questions you need to ask yourself: Are the best people: A) Getting into medical school and; B) Are they even applying to medical school in the first place due to their limited finances? Do we want the best doctors or the best doctors that can afford medical school tuition? What if the next great neurosurgeon is now digging ditches on the Gowanas Expressway in Brooklyn, NY because he wanted to get married to his High school sweetheart and start a family instead of asking her to wait until they are 30 years old or so?
Where am I going with all of this, you may ask? (Go on.... ask.)
I recommend a new system be put in place in the United States that recognizes talent in the science field as early as High School. I recommend a system that would keep tabs on young and talented students with an eye on allowing them a way to go to college, then medical school.
Let's say that student "A" graduates from high school in a poor district of an inner city with high grades. Student "A" attends a public college, mostly on scholarships and financial aid and graduates with honors. Student "A" wishes to become a doctor, but the financial burden would be too great. Student "A" instead heads out into the work force. Even of the student makes it in the business world, we should have wondered what might have been.
Now, let's say we have a plan that allows us to send Student "A" to medical school on the public dollar. No loans. No part time jobs. The student is just that... a full-time medical student who may become the next great research doctor, or heart surgeon, or emergency room doctor, etc. What if, in return for the years of school this doctor has received at public expense, this doctor gives four years of his life, after residency, internship, and whatever else doctors have to go through, at a minimum, but livable wage. Maybe, instead of working in an urban clinic for four years, this doctor might want to repay his debt as an Army surgeon or a doctor on a Naval vessel in 2 or 3 years.
Maybe if we identified the best young people who want to be doctors, we can have the best doctors. Maybe then we can cut the cost of health care by staffing clinics with young, supervised physicians instead of hoping that some good-hearted doctor will help out the poor and indigent when he gets a chance.
Don't just stand up and say, "It'll never work'" or, "the guys in office will never go for it," or, "the medical establishment wouldn't stand for it."
Maybe this is an idea that needs a lot of work, but you have to start somewhere. Why not here and why not now?
Here are questions that should always be asked when confronted with your ideas: If not now, then when? If not me, then who?
On Other Subjects:
Some Thoughts from Casey
YEAH FOR SENATOR RON WYDEN
UP OR DOWN VOTE ON STAYING IN IRAQ
On Friday as Senators rush to leave the Hill for ANOTHER vacation (2 weeks this time I think, the last one was just a few weeks ago around St. Paty’s day) Sen. Wyden (D-Oregon) proudly stood up and boldly said that Congress needs to VOTE UP OR DOWN (the phrase so often robotly uttered by Sen. Frist) on whether the U.S. should stay in Iraq for the next 3 years which Bush recently pledged would happen just because he says so.
“Let the President come to Congress and describe his plan…the vote I call for today will not be about cutting and running from Iraq…the vote will allow the Congress to be a co-equal with the President as provided in the Constitution.”
YEAH for senator Ron Wyden. Sen. Byrd, referring to Sen. Wyden, endorsed what Sen. Wyden proposed and pointed out that it needed to be said.
Frist is throwing a shindig for his PAC in Nashville on April 21-23 and to help position himself as President (does anyone outside Tennessee even know this Pinocchio?). Interestingly, his invitation was a most intriguing card of a cowboy and in order to read the particulars you had to unbuckle the cowboy’s pants and look inside. It promises golf, biking, tours, receptions, etc. and the typical things you would expect. The other point of note is that on the back of the car it shows the cowboy from behind with a red flowered handkerchief sticking out of his right pocket. And for those who don’t know – it’s unclear whether Frist did or not – this is part of a universal code in the gay community to let other gay people know about sexual preferences. Frist will be appalled to learn the meaning of this.
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