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Americans are deeply unhappy with the country’s health care programs and costs. And rightly so. As one author observed, “A recent survey showed that only 17 percent of respondents in the United States were content with their health-care system . . . Why the discontent? The superficial reasons are simple enough to describe: the system is hugely expensive, very bureaucratic, and extremely patchy. The expenses first: U.S. health care costs a third more, per person, than that of the closest rival, superrich Switzerland, and twice what many European countries spend. The United States government alone spends more per person than the combination of public and private expenditure in Britain, despite the fact that the British government provides free health care for all residents.”

The United States pays more for health care per capita than any other industrialized nation — and even then, Medicare is not a comprehensive, pay-for-everything national health program like those of many nations and United States per capita health care costs continue to escalate rapidly.

Here’s what you need to know about health care costs as you plan for retirement.

Americans age sixty-five and over spend four times more on health care on average than do Americans under the age of sixty-five. At the outset of this decade, the average per capita health-care outlay for a person under the age of sixty-file was about ,800. For people over the age of sixty-five, it was ,089. And for Americans ages eighty-five and older it was ,001. Clearly, health care outlays are likely to get substantially larger as you age. You need to plan for them.

U.S. health care expenses have grown mightily. U.S. health care expenses have dramatically escalated each year as new medications, new treatments, diagnostic tools, and health care innovations have come onto the market.

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For example, the median nationwide cost for a hospital stay — excluding physicians charges — was ,280 in 1997; by 2004 it was almost double at ,455. The average total cost for treating a heart attack climbed 40 percent in just seven years. All in, health care costs have escalated fast and the increases are gaining momentum.

Health care costs are likely to continue to grow unabated. Unlike in other countries, no laws meaningfully curb the continual climb of health care and drug costs in the United States. For example, many Americans continue to import drugs from Canada because Canadian prices are significantly lower. This is true even though the new Medicare Features introduced in 2006 offset the cost of pharmaceuticals for U.S. retirees. To curb the cost of medicines, Canada prohibits drug companies from advertising on its television channels. In the United States, on the other hand, the very legislation that created the new Medicare drug benefit (Part D) expressly prohibits the federal government from attempting to negotiate lower prices with drug companies.

Count on it: medical costs are sky-high and likely to keep climbing unless there is a radical overhaul of the system.

More and more corporations are cutting back on health care benefits as medical costs soar. Recent statistics show companies cutting health care benefits and requiring employees and retirees to pay more for them. As one survey of corporate benefit trends concluded, “[Benefit] reductions have become not just common, but expected, with the only question now being of how much more of a reduction in benefits and or an increase in cost will be directly placed on individuals . . . In the end . . . individuals, either as taxpayers or consumers, will need to pay the bill.

I believe this trend will gain greater momentum over the next decades. It will be part and parcel of the continuing erosion of employment benefits — like the demise of traditional pensions — that is taking place throughout the country. Just like pensions, more and more health-care expense is going to become a do-it-yourself responsibility because heath care insurance costs are simply becoming too great for companies to shoulder competitively.

Taken all together, you can count on: (1) higher and higher health care costs, (2) more health-care-benefit cutbacks by U.S. employers, (3) the need to factor large health-care expenses into your funding plans, and (4) the need to buy supplemental health-care insurance to shield your savings from cost attack.

Of course, these views will not come as a surprise to most folks. Recent polls show that — immediately after the foremost financial concern of having enough money for retirement — the next great concern of most Americans is health care. More than half of adult Americans are “very worried” or “moderately worried” about being able to pay for serious illness or catastrophic health-care expense.

Copyright © 2008 by Jim Schlagheck

The above is an excerpt from the book Cash-Rich Retirement

by Jim Schlagheck

Published by St. Martin’s Press; March 2008;.95US/.00CAN; 978-0-312-37740-3

Copyright © 2008 by Jim Schlagheck

Author

Jim Schlagheck is an author, banker, longtime advisor to the ultrawealthy, and the coproducer of the public television series Retirement Revolution. He has written numerous articles on investing, retirement, and finance, and is also an acclaimed speaker who describes better ways for retirement readiness to audiences of wealth-management professionals and lay investors nationwide.

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How many people do you know who think their Congressperson has the answers to providing health care in America?  Or, their Senator?  George W. Bush?   Barack Obama or  Hillary Clinton?  Or, for that matter, any politician?  Do they really have the answers?

 

If they can’t do it, then how about the politicians in Canada, or Great Britain?  Have they solved the problem in their societies?  Some people believe they have.  However, in England, where the private practice of medicine was outlawed when socialized medicine was first established there, they were eventually forced to reverse their policy and permit the public to go outside the government’s system to obtain health care from private physicians. 

 

In Canada today, the story is much the same.  Many Canadians come to the U.S. for emergent needs, such as bypass surgery, because the waiting time in Canada is interminable, often many months before their citizens can get life-saving treatment when they need it.  

    

State-Run Health Care

All state-run health care systems have one thing in common: rationing.  Not necessarily involving the use of ration cards, but rationing nonetheless.  Rationing of resources.  The cause is a devilishly simple principle that’s present in all nationalized health care programs.  That is, it’s free, or so low cost that it’s almost free.  Basic economics clearly demonstrates that whenever something is free, the demand quickly becomes unlimited.  The lower the price, the greater the demand.  Give something away and you can “sell” everything you have and more.

   

However, the flip side of unlimited demand is a shortage of supply.  And, not having enough doctors, nurses, or expensive equipment, such as CAT Scans and MRIs, eventually leads to rationing.  Without enough health care to go around, rationing becomes a necessity.  That has been the failing with nationalized health care in England, Canada, Germany, Japan, the former USSR, everywhere it has been tried.

    

So, if there are no politicians who really know what should be done to solve our health care problems why do we keep expecting them to come up with the answers?

   

Just exactly what are the problems?  Too many uninsured?  Too high cost?  Poor quality?  Lack of availability?  All of the above?  Do you know or think you know?

    

What have been the government’s (read politicians’) solutions to date?

 

Health Care Policy

National health care (socialized medicine) in one form or another is the primary health care policy that is gradually being adopted in America.  And it is slowly but surely lowering the quality of the health care we are getting.  Talk to any doctor you trust and see if they don’t agree.  They will tell you that they are working much longer hours for far less money, that many physicians are retiring early or converting to “concierge” practices because they are fed up with the government and insurance company bureaucrats telling them how to practice medicine.  Consequently, there is a growing shortage of doctors and nurses.

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But, you may say, we don’t have socialized medicine in America!  Perhaps not yet, but we’ve been moving in that direction for some time, and we seem to be going further down that path as the years progress.  It’s a slippery slope.   For example, consider Medicare. 

   

But, Medicare is not socialized medicine, you may insist.

    

Unfortunately, it is, or is headed that way.  Why?  For one thing, it’s a system that’s based on price controls. 

    

Price Controls

Price controls have never worked, ever, in any society at any time in history.  They were tried as early as 301 A.D. by a Roman emperor, Diocletian (243-316 A.D.) who implemented price controls under penalty of death.  But, even that didn’t work, and it hasn’t worked since.  What price controls do is cause shortages, increased costs and disrupted markets.

    

Look at what has happened to the Medicare program since 1984, the year the government changed its method of paying for hospital services from a “cost plus” to a system called DRGs (Diagnostic Related Groupings).  DRGs are a method of classifying illnesses and assigning a comparative value and a specific authorized payment to each.  At that point, many hospitals began to lose money because the government started dictating the prices that are paid for inpatient care.

 

As much as 70% of many hospitals’ patients are seniors, whose bills are paid by Medicare.  The Federal Health Care Financing Administration (HCFA) determines, in its sole discretion, the prices that can be charged for seniors’ inpatient hospital care, and then pays only 80% of those amounts.  The differences between a hospital’s standard fees for service and the amounts that Medicare pays must be written off.  They cannot be collected from the patient.  That’s price control.

    

Furthermore, because Medicare payments are determined solely by the government, annual cost of living increases are limited, generally to between 1-1/2% and 2-1/2%, in spite of the fact that hospital costs have been rising for years at an annual rate of anywhere from 6% to 14%. 

    

Another little known fact about Medicare is that seniors are prevented from seeking care outside the Medicare system, even if they are willing to pay the bill themselves.  Any doctor who accepts payment directly from a senior who is covered by Medicare is automatically disqualified from providing care to all Medicare patients for a period of two years.  This is especially important in situations where a patient wants a second opinion and would like to see another doctor.  That type of regulation is certainly an element of socialized medicine.

    

Many Hospitals Lose Money

Between health insurance contracts (HMOs) and Medicare limits on their charges, hospitals generally collect only about 50% of their total billings.  The rest is written off.  The result of all this is predictable: many of them are losing money.  About one-third of all hospitals in California are currently operating at a loss.  With a national health care plan, at some point, many hospitals would either be closed or services curtailed.  That’s been the pattern in every country that has nationalized its health care.  Nonetheless, that seems to be where we are headed, in spite of compelling evidence that it doesn’t work. 

    

Like the proverbial frog being cooked in a pot of cold water, Americans are gradually becoming aware that the quality of their health care is declining, even as costs continue to rise.  It just hasn’t sunk in yet.  When it does, they will undoubtedly be led into believing the government has the answers and demand more government control, regulation and oversight.  And, our politicians will be only too willing to oblige. 

    

Nationalized Health Care

Nationalized health care in America is gradually overtaking the free market, and we are all being slowly cooked in the pot of government intervention.   So, don’t be surprised at the type of health care program we get as time progresses.  Whatever your own conclusions, remember one thing: that our politicians won’t have to rely on whatever health care plan they establish for everyone else.  As usual, they will have their own, superior plan.  And, it will not be a part of the nationalized health care system that the rest of us will be required to use.  If you doubt that assertion, just look at the health care plan that our Federal legislators and government employees have now. 

 

In the interest of full disclosure, I’m one of those seniors who has Medicare health insurance coverage and I ran a hospital for about seven years.

 

© 2008 Harris R. Sherline, All Rights Reserved

The socialized system of healthcare delivery and financing, a relic of the British colonial era, still practiced in Sierra Leone has glaringly failed and any efforts at resuscitating it without implementation of major structural and systemic reform will only serve to prolong the inevitable.

Throughout the world, total state control and management of industries, services, markets and the means of production are gradually becoming a relic of the past. This model as practiced in the Sierra Leone healthcare system has empirically been proven to have served only to stifle innovation, growth, productivity and quality output with a resultant decline in overall living and healthcare standards of the citizenry. The current state of the hospitals and health centers glaringly highlights the systemic problems endemic in the entire government owned, managed, financed and operated health care system.

The continued operation of such a decadent and dilapidated delivery and financing system, lacking in even the basics of a modern healthcare infrastructure continues relegating Sierra Leone to the very bottom of the human development index.

The transformation thus of the medical healthcare delivery and financing system into a private insurance or a national insurance based system offers opportunities not only for insurers to develop market-based medical insurance plans and policies but also serves to effectuate the Ministry of Health & Sanitation’s desired policy goals, as espoused in the 2002 National Health Policy Paper.

Both policy and regulatory officials, healthcare providers, the insurance industry and other stakeholders must be engaged to effectuate implementation of fundamental systemic reforms if the country is to avert an even greater catastrophe.

Privatization:

 

Under the proposed privatization plan, the Ministry of Health & Sanitation will be transformed from ownership and management of hospitals, clinics, and employer of last resort for all physicians, nurses and ancillary healthcare providers into a health agency with only policy and regulatory functions.

The goal will be for the health agency to serve as a policy and regulatory watch dog mandated with ensuring that adequate and quality medical care is provided at the various private hospitals, clinics and pharmacies that will inevitably be established with the break-up of the current government owned facilities.

With the break-up and subsequent purchase or leases of these hospitals, clinics, health centers and other facilities, investors and entrepreneurs in an effort to realize maximum returns on investments, will economically be compelled to upgrade quality and standard of care, introduce state of the art equipment and technologies and engender a type of market forces competition which will inure only to the betterment of health consumers in the country.

A much needed infusion of capital into the health care industry by such a privatization plan will clearly spur additional economic activities in ancillary industries, as the dynamic forces of privatization and market mechanism forces of demand and supply will ensure competition for the healthcare pie.

Divestiture of Government Ownership:

The dismantling of the current mammoth and highly inefficient government owned healthcare delivery and financing entity must from a public policy perspective be designed and restructured to ensure governmental ownership and management divestiture from hospitals and other health care facilities.

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Under such a scenario the government’s current enormous but woefully mismanaged capital outlay for health services will be substantially decreased as inefficiencies of corruption, salaries of providers, infrastructure maintenance, costs of medications and diagnostic equipments and other overhead operating costs will no longer be recurrent expenditures from the nation’s depleting coffers.

A system based entirely on a private market-based national health insurance plan with private enterprise and market competition at its core appears the most logical reform policy route to ensure a future sound, efficient and profitable health care infrastructure.

 Health Insurance Plans:

The cog which the proposed new system must revolve around is a nationwide network of affordable health insurance plans creatively designed to ensure a greater pool participation of a majority of the population. In such a system health insurance companies and provider organizations will be established to market various health plans, with minimum services and premiums based on market conditions. The responsibility for monitoring compliance by the various plans would fall under the ambit of both the Ministry of Health and Sanitation and the Sierra Leone Insurance Commission.

Multi-Payer System:

A major plank in this proposed health care delivery and financing privatization hinges on the enactment of health insurance legislation providing for employers to provide health care for their employees and dependants as part of a standard benefits package with concomitant tax incentives and governmental subsidies to ensure compliance. With such legislation the virtual free socialized medical care system, the costs of which have been borne exclusively by the government will now be based on a multi-payer system in which government, employees and employers will all participate.

With the system as currently structured however, only the government has a financial interest and stake and when other programs conflict with the financing of health care, politicians have only been too willing to sacrifice the health of their citizens on he alter of their greed and personal aggrandizement.

It is envisaged that health insurance providers will introduce concepts and plans, such as Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO), through alliances of health providers and insurance companies and marketed to employers, labor unions, governmental ministries and corporations on an annual premium basis.

The competition engendered by such health organizations for the medical insurance pie will subsequently result in competitive rates, coverage, deductibles, co-payments and premiums to make health care costs affordable for all.

The Unemployed:

As unemployment and underemployment are perennial problems in the Sierra Leonean economy, the provision of health care benefits to this category of the population must remain the responsibility of government. Medical services provided to this category of citizens in a private enterprise environment must be reimbursed by the government on a negotiated and pre-determined fee schedule or an insurance mechanism established in which government negotiates with providers and carriers for the provision of services.

As an example a fund established by levying taxes on the private health care providers, envisaged to emerge with such privatization, could be instituted and utilized to pay for these indigent services.

Further, since the hospitals, medical clinics and other medical facilities will be operated as businesses, either for profit or as non-profit organizations, the market forces of demand and supply will certainly ensure that patient quality care, improvements in diagnostic technologies, competent personnel and a general responsiveness to the demands of the clients will drive the new marketplace. The lethargic and inefficient atmosphere witnessed at most government hospitals today with customer service virtually non existent would be a philosophy of the past.

The economic viability of healthcare businesses will depend largely on the clientele they can attract and maintain utilizing the above yardstick. Providers of lousy health care plans and services will inevitably loose business to competitors as every year participants will have an opportunity to change health insurance plans.

Since a large population of Sierra Leone resides in rural areas, the proposed privatization plan will ensure the expansion of health care facilities into areas currently inadequately serviced. This plan will ensure that clinics and doctors put up shop in every part of the country in order to tap into the healthcare services available in these rural areas.

Challenges to Insurance Companies:

Designing an insurance system and plan to cater to the needs of the rural population who often are self employed in farming and mining activities posses a challenge to insurers in Sierra Leone, who in the past have been largely passive and unimaginative in policy design to meet the challenges and risks confronting the nation’s socio-economic landscape.

Proactive and creative underwriting of risks must be undertaking by underwriters, actuaries and marketing specialists to design, tailor and price health insurance coverage to meet the diverse needs of the insuring public. For example, the creation of pools by occupational categories could be one method by which insured’s, engaged in similar trades could be encouraged to form co-operatives for purposes of obtaining health insurance coverage at affordable rates for themselves and dependants. Premium payments through the pooling together of the co-operatives commodities can be an

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Health care is one of the most promising industries in the health and hospitability sector today. Health care relates to the prevention as well as to the treatment of illness. It also implies the overall mental and physical well being of individuals. A health care system refers to the organized functions which are involved in promoting the overall health of the country. The United Kingdom is the only industrialized country that does not offer health care universally. The National Health Service in the United Kingdom deals only with healthcare in the UK.

Overview of The Rising Health Care Sector

The health care industry is an industry that is considered to be one of the most budding among all other recent upcoming industries. Health care deals with delivering quality service towards improving the health of the people residing in a country. In recent years, the health care sector has been witnessing an upward surge. In a developed country, the health care industry contributes to 10% of the country’s gross national product. The professionally trained people serving the health care system ensure that all processes run smoothly.

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In most of the developed countries of the world, the health care sector has undergone a lot of privatization. This ensures that the systems that are developed under it run without any bottlenecks. There are several health care models that have come up in recent times. With the growing popularity of the health care industry, some major public insurance systems have also come forward to ensure the smooth functioning of the systems. There are numerous pay systems that have been developed to guarantee the accurate administration of the health care sector.

The health care industry has witnessed a rapid growth in recent times mainly due to its contribution in maintaining the overall health and hygiene of a country. Today, the governments of different countries invest a huge amount of money in the health care sector to ensure that the sector has the proper support needed to grow. Statistical studies have shown that the profit derived from the health care sector is huge, both from the social, as well as the economic point of view. It is due to these reasons that the health care sector is considered to be one of the most emerging and promising industries today.

The technological development brought forth by science in this 21st century, has been seen in the domain of the health care sector too. Today, there are many trained professionals who work in this sector. The professional touch has been given to the health care sector which goes a long way in delivering quality care and support to those who seek its help. With the increase of demand among the people of various countries, the health care sector is also undergoing various stages of evolution to cater to the changing needs and demands of the people. As a result, health care today, stands as one of the most significant industries of recent times.

Erectile dysfunction has long been a problem for men of all ages around the world. It is one of the most commonly experienced sexual problems by men. Erectile dysfunction is also referred to as impotence. It is a condition which makes it difficult for a man to achieve or sustain an erection long enough for satisfactory sexual intercourse. Men often lose their confidence in bed owing to this condition which adversely affects their sex life. You can treat impotence with the help of mechanical devices such as vacuum pumps or prescription medications available on the market.

One of the most popular and commonly used prescription medications for treating erectile dysfunction is Cialis. It consists of tadalafil as its active ingredient with the help of which it treats erectile problems in men. This pill works by relaxing the corpora cavernosa muscles in your penis. By relaxing the muscles, it leads to an increase in the blood flow in your penis. When the blood flow increases in your penis, you are able to achieve better erections and sustain them for a longer period of time as well.

The Cialis dosage available on the market are 10mg and 20mg, of which you can choose the most suitable for yourself. You are required to take one pill at least 30 to 60 minutes before you engage in a sexual act. The effects of this pill last for up to 36 hours after taking the pill, which is why it is known as ‘the weekend pill’ as well. However, you should avoid using more than one Cialis pill within a span of 24 hours as it can lead to side effects. Some of the Cialis side effects that you can experience include headaches, indigestion and facial flushing.

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Health Care System Needs Reform, Not a Government Takeover 

Believe it or not, America boasts some of the world’s best doctors, the most advanced health care system, and the most technically superior resources in the world, bar none. Those who travel globally and have gotten sick know that their first choice for treatment would be in the U.S. Though heatlh care in America is, more expensive thanany other country, many of the worlds wealthiest come to the U.S for surgical procedures and complex care, because it holds a worldwide reputation for the gold standard in health care.   

To examine the complex health care issue, a small research study was conducted from randomly selected doctors in mdnationwide.org’s best doctors database. We ask 50 top doctors, located in different states and who practice different specialty fields, ” Is a universal health care plan good for America?” Forty-eight of these doctors essentially responded that it was a “bad idea” that would have negative mpacts on the quality of our nation’s health care.   

 
Social Engineering Your Health Care 

One of the greatest mis-conceptions some people have relied on with regard to the health care debate is that, given a universal health care system, every person in the U.S. would receive the highest quality health care – the kind our nation is renowned for and that we currently receive. However, unlike some public amenities, health care is not a collective public service like police and fire protection services, therefore the Government cannot provide the same quality of health care to everyone, because not all physicians are equally good orthopaedic surgeons, internists, neurosurgeons, etc, in the same way that not all individuals in need of health care are equally good patients.  

As an analogy – stay with me – when you design a software program, there are many elements that are coded on the back-end, and used to manipulate certain aspects of the software program, that your average “John Doe” who uses the software(the end user) does not understand or utilize, nor do they care about these elements. Certain aspects of the program are coded, so that when one uses that portion of the program, other elements of the program are manipulated and automatically follow the present or next command.  

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Likewise, once a universal health care plan is implemented in America and its massive infrastructure is shaped, private insurance companies will slowly disappear, and as a result, eventually patients will automatically be forced to utilize the government’s universal health care plan. As part of such a system, patients will be known as numbers rather than patients, because such a massive government program would provide compensation incentive based on care provided, patients would become “numbers,” rather than “patients.”

In addition, for cost savings reasons, every bit of health information, including your own, will be analyzed, and stored by the Government. What are the consequences? If you’re a senior citizen and need a kneereplacement at the age of 70, the government may determine that you’re to old and it’s not worth the investment cost, therefore instead of surgery, you may be given medication for the rest of your life at a substantial cost savings to the government, and at a high quality of life price to you.       

Solutions:   

Fixing the current U.S. health care system might require that we;

1. Encourage prevention and early diagnosis of chronic conditions and management.

2. Completely reform existing government health care programs, including Medicare and Medicaid.

3. Forgive medical school debt for those willing to practice primary care in under-served areas.

4. Improve access to care, provide small businesses and the self-employed with tax credits, not penalties for providing health care.

5. Encourage innovation in medical records management to reduce costs. 

6. Require tort reform in medical malpractice judgments to lower the cost of providing care. 

7. Keep what isn’t broken-research shows 80% of Americans are happy with their current insurance, therefore, why completely dismantle it?

8. Reimburse physicians for their services.

9. Innovate a system in which Medicare fraud is dramatically decreased.  

 Devil In the Details 

Socialized medicine means: 

1. Loss of private practice options, reduced pay for physicians, overwhelming numbers of patients, and increasing burn-out may reduce the number of doctors pursuing the profession.  

2. Patient confidentiality will need to be compromised, since centralized health care information will be maintained by the government and it’s databases.

3. Healthy people who take care of themselves will pay for the burden of those with unhealthy lifestyles, such as those who smoke, are obese, etc.

4. Patients lose the incentive to stay healthy or aren’t likely to take efforts to curb their prescription drug costs because health care is free and the system can easily be abused.   

5. The U.S. Government will need to call the shots about important health decisions dictating what procedures are best for you, rather than those decisions being made by your doctor(s), which will result in poor individualized patient care. 

6. Tax rates will rise substantially-universal health care is not free since citizens are required to pay for it in the form of taxes. 

7. Your freedom of choice will be restricted as to which doctor is best for you and your family. 

8. Like all public programs, government bureaucracy, even in the form of health care, does not promote healthy competition that reduces costs based on demand. What’s more, accountability is limited to the budgetary resources available to police such a system. 

9. Medicare is subsidized by private insurers to the tune of billions of dollars, therefore if you take them out of the equation, add a trillion dollars or more to the current trillion dollar- plus cost estimates.

10. Currently, the government loses an estimated $ 30 billion a year due to Medicare fraud. Therefore, what makes anyone think that this same government will be able to run & operate a universal health care system that is resistant to fraud and save money while doing so?.

Having the best Los Angeles insurance makes the experience of living in this vibrant city even better.  People need safety nets in all aspects of life, so choosing the right insurance policies is essential.  Most people have needs of auto, health, home and life insurance although there are many variations within these policies and the many others for those with more specialized needs.  No matter one’s coverage needs, it is important that he or she shops around and looks at as many quotes as possible to find the best insurance products and rates.

California tends to be one of the healthiest states in the country.  This should make it easier for some to find a good health insurance policy.  One may want a conventional policy that covers doctors’ visits, prescription medications and other forms of regular health care.  However, another may decide that he or she does not need regular visits to the doctor and can afford to pay a higher premium for catastrophic health insurance in case of an accident or incident that requires a long term hospital stay or care.

There are other forms of Los Angeles insurance related to those involved with health.  For instance, the fitness and wellness industry is deeply embedded in L.A. culture, so those with stakes in these endeavors need to protect their investments.  For instance, personal trainers and fitness instructors need both professional and personal liability coverage to protect their business and reputations.  Should an injury come to a client, the instructor or trainer needs to have the means to provide restitution for the error as well as protect his or her reputation as a professional.

Even small businesses can benefit from looking into health insurance policies.  Companies that can offer such incentives have a better chance at attracting quality employees as well as retaining them.  Businesses with health coverage can produce happier and more productive employees.  Small businesses can look into group health insurance policies in order to provide an affordable insurance option for their employees and families.  Those who are self-employed can also find other options such as group affiliations that provide discounted health insurance for their members.

Of course, health insurance is not the only Los Angeles insurance one needs.  However, one can see that health insurance is quite varied.  This is why it is important to find ways to narrow down one’s needs when starting one’s search for quality insurance of any kind.  Using online sites, insurance agents and personal recommendations can help the process.  One needs to get as many quotes and as many options as possible in order to find just the right policy as well as the companies that will offer the best rates on a needed policy.

The Truth About Canadian Health Care
Part 1 of a 3-Part Series

First of all, we don’t euthanize our infirm or elderly.  Most Canadians would cringe at the thought.  Yes, Canadians do have universal access to necessary health care, but this benefit has never led to a push for euthanasia, as the two issues are different concepts.

My wife, who works as a broadcast producer, shared a humorous anecdote with me a few days ago.  Her managing editor, just returned from a family vacation in Virginia.  He said that the locals really wanted to talk with him as soon as they heard that he was a Canadian broadcast executive.  And the topic on everyone’s mind was – you guessed it – health care.  Sadly, a lot of the folks he conversed with were sorely off the mark or, worse yet, perhaps purposely misinformed about the reality of the Canadian health care experience.  The fabricated gem about euthanasia is just one example he shared.

It sure does sound plausible, though.  Think about it.  Canadian taxpayers’ dollars directly and indirectly fund a mammoth and complex system of family practitioners, specialists, surgeons, nurses, clinics, hospitals, lab work, assisted care and convalescent care facilities.  It would reason then (given some well-timed propaganda) that the administrators of this mammoth system would authorize cutting the lifeline, quite literally, of those whose care costs the most, have no hope of getting better and have no likelihood of contributing to the very system that pays for their expensive care.  Sounds believable, but it is not reality.

Many well-publicized court cases underscore Canada’s aversion to any form of assisted suicide or euthanasia.  In 1993, a farmer from Saskatchewan named Robert Latimer, carried-out a mercy killing on his twelve-year-old daughter.  She suffered from severe cerebral palsy, could not walk, talk or feed herself and was in chronic, excruciating pain.   A year later, Latimer was convicted of second-degree murder and sentenced to ten years in prison with no chance of parole.  Further cases have upheld the court’s objection to those who have aided in others’ suicide or active cessation of life.  In other words, Jack Kevorkian could not have gotten away with it in Canada either.

The ‘Canadian Health Care Plan’
So, how does it work?  Canada’s health system is not a federally-administered public health insurance plan.  Instead, what we do have is a fabric of individual provincial plans that mirror a set of national ‘medicare’ principles.  That’s quite different from what is being floated by Washington.

Here’s how it works in a nutshell.  Your average Canadian pays income tax to both the federal and provincial governments, with the federal side taking the lion’s share.  The federal government doles out a portion of total revenue from personal and corporate income taxes, along with other sources of income to fund ‘transfer payments’ back to the ten provinces and three territories.  These transfer payments are earmarked specifically for health care. Each province or territory is individually responsible to administer and deliver health care services.  Some provinces, such as Ontario, levy an additional health care fee on workers’ paychecks to shore-up gaps between available funds and the reality of costs.

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There are differences in the precise ways in which each province or territory administers its own health care system.  However, the federal government has an overall responsibility to set principles and priorities through legislation that each province or territory must mirror.  As such, Canadians living in British Columbia on the west coast, Newfoundland and Labrador on the east coast or anywhere in-between, take advantage of similar coverage and services.

You Never Need to Worry About ‘Coverage’
A friend of mine from Florida got an unsolicited lesson in the limits of health insurance ‘coverage’ about six years ago.  He and his wife, ‘Kate’, never questioned the health insurance that she had through her former employer.  That was until she was diagnosed with a tumor in her neck near the brain stem.  After undergoing many nerve-racking tests, Kate’s health insurance carrier revealed the extent of treatment it would cover and identified the specific hospital in which she would have to receive that treatment.  Fortunately, the couple was able to explore the best options with their own choice of specialist and hospital.  Had it not been for my friend’s persistent badgering and clever negotiation, the carrier’s desired course of action would have prevailed.

My friend’s experience surprised me.  I had made the assumption that personal choice and access were exceptional in a country with the world’s finest medical facilities, practitioners and technology.  The reality of limitation and the decisive power that’s necessary to maintain profitability in a private health care system had not crossed my mind.

Take a look at this scenario.  A Canadian cardiac patient is diagnosed with very severe blockage in at least two aortic arteries.  The cardiologist determines that a stent or angioplasty would solve the problem in the near-term, but recommends a double bypass.  Although far more expensive, it’s most efficacious for that patient’s long-term health.  There is no question that every aspect of the bypass will be covered in full, with no cost to the patient for all necessary tests, consultations, hospital stay, in-hospital medications and the surgery itself.  And it really doesn’t matter whether that same patient is the CEO of a major corporation, a politician, a part-time fast food employee or a stay-at-home parent.  The provincial health plan will cover the bill.

That’s not to say that Canadian patients have access to every type of treatment in every case, such as cutting-edge, experimental or unproven procedures.  However, the average Canadian will not ever be denied generally accepted treatment, surgery or counsel according to his or her medical needs.  That includes organ transplants as necessary and available.

Where you live does matter.  There definitely is a small town – big city gap when it comes to health care options, choice of practitioner and responsiveness to medical treatment.  However, a Canadian patient from ‘Hickville’ can always get subsequent opinions from specialists in a more urban setting.  And when the patient’s condition requires the most advanced technology and prominent specialists such as may be available at a major metropolitan teaching hospital, that patient is routinely transferred in order to receive the required surgery or treatment.

Every story has another side and in this case, it’s not always quite so rosy.  More Canadians live in Ontario than any other province.  Ontario’s Ministry of Health and Long Term Care administers and delivers health care to about 13 million residents.  Ontario has been grappling with a serious doctor shortage; as a result, many Ontarians do not have a family doctor.  In August, 2008 the Ontario College of Family Physicians released results of a poll showing that up to 879,000 Ontarians did not have a family doctor.  Since that time, the province has ramped-up efforts to increase the number of doctors, to implement innovative solutions and to connect those who are without.  Despite the fact that progress has been made, many patients continue to visit clinics or emergency rooms because they still don’t have a family physician.  So, the system is not perfect.

Not perfect, but the benefits of universal health care are immense.  Bottom line – medically necessary consultation, treatment or surgery will never be denied to a Canadian in his or her own province or territory.  A Canadian will never hear the words, “Sorry, but even though there is better treatment available, here’s the extent of what we’ll cover,“  or, “You’ve reached the maximum pay-out for treatment of this condition,” or “Your claim has been denied due to pre-existing conditions.”  That just doesn’t happen here; if you’re Canadian, you’re covered.

In general, we choose our own family physician without having to select from a list of HMO approved physicians.  Canadians never have to worry about having their coverage dropped due to pre-existing health conditions or personal habits.  We never have to ask family or friends for money to pay for a medically necessary operation, because it’s always covered.  Canadians rarely hear or read about fundraisers to help pay for medical treatment, unless it’s to pay for out-of-town lodging expenses for patient’s families or for treatment in the U.S.  Canadians never have to send-in claim forms for doctor visits or hospital stays.  When we lose our jobs, become self-employed or simply can’t become employed, our basic health coverage does not change.  That is what universal health care looks like and most industrialized countries in the world have it.

 

Time to Receive Treatment is another story and Part 2 of this series, “Real Life Stories About Government-Administered Health Care” will explore that issue.  See more content by Stephen Kristof at http://themorethingschange.weebly.com/

The World Health Organization reports that the United States has the 37th best health care system in the world. America’s health care system is fraught with problems and its patient satisfaction is rated among the worst in the world. Even though the America’s health care system is envied by the world, it ranks at the bottom of many health care indicators. In the developed world, the United States is at the bottom of the list for infant mortality and life expectancy.

Health care is not the same as it was fifty years ago. Many things have improved over the last fifty years, but the personal touch of medicine has been lost in the process. Medical science has made tremendous advances in the treatment of heart disease, cancer, infectious disease and diabetes just to name a few – but these advances have come at a cost.

Health care is expensive. Not only in dollars and cents, but also in time. A patient can call for an appointment, be told they can be squeezed into the doctor’s busy schedule tomorrow at 3 PM, and then not be seen until 5 PM the next day.

This problem is likely to get worse as time passes as fewer and fewer doctors are choosing to go into primary care medicine specialties such as pediatrics, family practice, geriatrics and internal medicine. Instead doctors are opting for more lucrative specialties – and why not when many specialties pay over twice the annual salary of a primary care provider.

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The use of mid-level providers, such as the nurse practitioner or the physician assistant, will help ease the shortage. None-the-less it is critical that patients learn to take care of themselves and know when they should go to the doctor and when a trial over the counter medications or other measures can be helpful.

Health care in America is the most expensive in the world. In 2006, the United States spent ,421 in per capita health expenditures, which is over 50 percent more than any other country. Contributing to high health care cost in the United States are cost of medications, top rate medical technologies, the extensive use of diagnostic tests, salaries of doctors and hospital administrators.

The use of the emergency room as a primary care service not only results in poor health care but it is a costly form of care. Emergency room physicians do not know the patients and are more prone to ordering expensive tests and treatments.

The health care system is overburdened, fragmented and as a whole not concerned about your health as much as you are. Each patient must assume responsibility for his or her own health.

Running to the doctor, urgent clinic or emergency room is not necessarily the best option for every situation. Health care providers often do things to appease the patient instead of doing the right thing.

Doctor appointments, in the eyes of many patients, are sub-par. Health care visits are typically about 15 minutes. The health care provider has a lot of work to do in that short visit. The health care provider needs to review the chart, talk to the patient, examine the patient, write in the chart, answer questions, fill out forms and dispense prescriptions. Time limits placed on office visits do not allow the health care provider to spend adequate time with the patient.

Health care consumers need to maximize this short time with the doctor. This includes being knowledgeable, organized and knowing how to communicate with the health care system. Some doctor’s practice under the assumption that doctor knows best and do not feel it is necessary to share all information with their patients.

Health care consumers are ultimately responsible for their health and need to act accordingly. The health care system is in need of many changes and people need to realize that they need to take responsibility for their health. If you do not take an active role in your health care you will waste a lot of time, money and quality of life.

Get educated about how to improve the quality of your care. With improved knowledge you will be better able to care for yourself.

As a health care consumer you need to:

Understand the health care system Understand doctor visits Improve the quality of your health care visit Improve the quality of your health

 

Here’s To Your Wealth!  Comparative Costs of Private and Public Health Systems
Part 3 of a 3-Part Series

 

Everything comes with a cost and health care is no exception.  But which type of health care model costs the most – the universal public type or the for-profit private system?  The answer depends on the source and perhaps what political stripes that source wears.

While President Obama’s camp continues to promote the public option and what they say will be a lower overall cost to consumers, many conservative politicians and talk show hosts have, of course, campaigned hard to make the opposite seem true.  Their take is that industrialized nations with universal public health care pay far more per capita for sub-standard services compared to their US counterpart.

It’s easy to accept without question, this latter position as fact, particularly if you buy-into another popular view that suggests everything and anything the government administers suffers from waste, inefficiency, ineffectiveness and bloated costs.  Let’s face it, you don’t have to look very far to find examples of poor public governance.  (Does anyone remember stories about a certain stars-and-stripes military outfit paying 0 for hammers and hundreds more for toilets?)

Is Public Sector Governance Necessarily Bad?
What some people seem far too eager to ignore is the fact that given proper governance, a publicly administered system providing an essential service has an important advantage.  That advantage is a missing link of sorts.  The ‘chain’ of service provision has many various links that make up the total cost of providing that service.  Consider that the profit link is often one of the biggest links in the chain.  Somewhere along the line, that profit link will necessarily impact the total cost of providing the service as well as the amount of investment that’s diverted back into the system.

Therefore, in operating a for-profit health care system, regardless of whether the gross profit margin is ten or thirty per cent, at some point along the way a markup must occur to generate the extra revenue needed to feed that profit.  A properly managed public health care system need not implement markups.  In theory, then, the taxpayer isn’t overcharged just in order to meet the profit margin goal.  Does it actually work that way?  Just as with other aspects of the public vs. private health care debate, there are both success and horror stories on each side.

Are Canadian Patients Dissatisfied With Their Health Care System?
So much of the chatter we hear today slams the inefficiency and overboard costs of Canada’s health care system.  But consider that for each story from a Canadian patient who experienced mediocre treatment or long delays, there are far more success stories from patients who are sincerely happy with their treatment and who wouldn’t trade their system for the world. 

Take, for instance, the case of a woman from Windsor, Ontario, whose story was revealed this past summer in an article in a Florida newspaper, the St. Petersburg Times.  This Canadian patient was billed a grand total of .95 after having been in hospital for over two months.  Her friend who lives across the river in Michigan spent two or three days in hospital and was billed over ,000.  Those are some real numbers to chew on.

So, what are the rest of the numbers, vis-à-vis the comparative costs of Canadian and American health systems?  More on that in a bit, but first consider the example of education.  Education is one of the untouchables; a cornerstone of most wealthy nations.  It’s one of those essential services.  The quality of a nation’s education determines, to a great extent, that nation’s future prosperity.  Most kids go to public school and most of those parents would never consider scrapping their district’s public system in favor of a for-profit pay-as-you-go private system.

Public Education is in a Shambles, Right?

Education has for long been as politicized as health care has lately become.  Pour the education facts through a political filter and you get a skewed take.  Just as with the health care debate, those on the right champion the superiority of private schools, citing lower costs per student and higher test scores.  They would also have us believe that public education costs are far more expensive per student compared with that of private school.  Both of these ideas are easily challenged.

A widely accepted figure pegs the average cost per student for public education systems nationwide at under ,000.  Comparatively, according to the National Association of Independent Schools, an organization comprised of private schools, the average cost of annual private school tuition per school-aged child is over ,000.  Reports about this seem to be easily overlooked by those wishing to cash-in on the profit potential of the education business.

But isn’t the quality of education better at most of those private schools as compared to the much more heavily attended public schools?  Private schools’ high teacher-to-student ratio and their more selective community are features that are hard to deny.  However we hear little about the fact that public education systems must follow a host of state and federal laws and guidelines; many of which the private schools need not and do not observe.

Further bolstering the argument was a study out of Washington released in October, 2007, confirming that 12th-grade private and parochial school students had matching scores in core academic subjects when compared to their public school counterparts with similar family and income backgrounds.  Other more recent studies by the University of Illinois showed that public school students actually outperformed their private school counterparts in standardized math tests.

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Universal Public Education is a Sacred Cow; Why Isn’t Health Care?

It can therefore be easily argued that a service as essential as education can and is provided both efficiently and effectively by the public sector.  Why, then, are so many opposed to the same idea with health care; another service that’s just as essential?

It’s Not a Free-For-All in Canada
First of all, don’t think that every aspect of health care is included in the package.  The government does not pay for most Canadians’ prescription medicines.  Just like the American experience, most Canadian prescriptions are paid for by way of employment benefits packages or it’s a self-pay deal.  (But the Canadian government does cover prescription costs during in-hospital treatment and for patients in certain income and age brackets.)  Another thing that most Canadians pay for is just about any surgery that is elective and not medically necessary.  So that face-lift, laser scar removal or tummy tuck – well – you’re on your own.  The same applies when it comes to dentistry, orthodontics, optometry and eyewear, chiropractic care, and other medical areas that fall outside traditional physician-provided necessary care; for the most part, Canadian patients or their employer insurance carriers pay for these services and treatments.  These things are generally not coming out of the public purse.

The Canadian medicare system covers, in full and without question, all necessary visits to family physicians and specialists, all necessary medical tests, and all necessary hospital stays.  Quite simply that means no bill and no nasty surprise.

What are the specific costs north of the border?
According a report by the Canadian Institute for Health Spending, in 2008 health care spending in Canada was just over 0 billion.  That covers all aspects of costs and comes out to ,170 per person.  Which nation boasts the highest spending?  Spending in the US is now over ,000 per person annually.  A recent analysis in Memphis Tennessee’s Commercial Appeal newspaper showed that the average American needs to work through the months of January, February and March just to pay for his or her share of the health care bill.

How does the old axiom about statistics go?  Liars figure and figures lie.  Yes, it’s easy to skew the truth with statistics, but it’s hard to argue with bottom-line costs from trusted sources and the real-life experiences of real people.

Regardless of whether you sit on the left, the right or on the fence itself, there’s no denying one more fact.  Since universal medicare was legislated in Canada by Tommy Douglas in 1961, Canadian patients have not had to worry about losing their homes, going bankrupt or plundering their retirement savings as a result of the cost of treating a major illness or disease.

Ask any Canadian and they’ll tell you that knowing they’ll always be covered is peace of mind; which, in itself, is quite therapeutic.

Read Part 1 of this series, The Truth About Canadian Health Care; and Part 2, Real Life Stories About Canadian Health Care.

Visit http://www.themorethingschange.weebly.com for more articles and columns by Stephen J. Kristof.