I think that the health care system will be fixed gradually with the next administration. Perhaps the new president will kick-start health care reform with an action designed to build goodwill toward the process, such as an announcement of federally-subsidized catastrophic coverage or medical debt forgiveness for a small segment of Americans, and build out slowly from that.
If employers no longer need to purchase private health insurance for employees, they might need to pay into a local, state, or national health care plan fund. If the plan (either government-based or private) is structured and administered well, with a reasonable level of services for patients and reasonable reimbursement rates for providers, it can provide better care at a lower cost than the patchwork of plans currently available. The debate about the cost of such a plan is raging in San Francisco now, though, with the city mandating employers to pay into a fund that would cover uninsured adults. The Golden Gate Restaurant Association fought the plan, claiming the mandated costs are higher than restaurant owners can afford.
If employer-provided health care is decreased or goes away completely, I think that there will be some unintended consequences for large companies in particular. Many people hold on to jobs they don't like at larger employers solely for the access they provide to quality health insurance. If other affordable, high-quality options become available, I think that these employees will leave their employers. Some will move to work in different fields, but others will move to competing companies, or start their own businesses to compete with their former employer.
According to the White House, small businesses are the engine of job creation in this economy, providing two out of every three new jobs, although the nonpartisan National Bureau of Economic Research questions these rosy statistics. Small businesses freed from the burden of taking on large health care costs once they reach a certain size, however, are likely to grow rapidly. As some larger businesses lose employees and smaller businesses gain them, will the revenue gap between the two types of businesses decrease? Will that change ultimately decrease the gap between rich and poor, and shore up the middle class again?
Showing posts with label Health Insurance. Show all posts
Showing posts with label Health Insurance. Show all posts
Thursday, February 28, 2008
Thursday, August 30, 2007
Uninsured Rates Creeping Up
Earlier this week, the U.S. Census Bureau released the latest statistics on income, poverty, and health insurance coverage (gathered in 2006). The message: more people had health insurance in 2005 than in 2006.
Although the poverty rate fell .3% from 2005 to 2006, the number of people without health care coverage increased .5% to 47 million in 2006. This may be due to a decline in employment-based health insurance, the type of coverage that most Americans have. The number of people receiving employment-based health insurance fell .5% from 2005 to 2006, while the number receiving government health insurance, such as Medicare and CHAMPVA, fell .3%.
Children and certain minorities are especially likely to be uninsured. The number of uninsured children increased 9%, from 8 million to 8.7 million, between 2005 and 2006. Among the entire population, Hispanics are most likely to be uninsured (34.1%), followed by American Indians/Alaska Natives (31.4%), Native Hawaiians/Other Pacific Islanders (21.7%) and African-Americans (20.5%).
Mark Twain famously wrote that "there are three kinds of lies: lies, damned lies, and statistics" (inaccurately attributing Disraeli as the source of the quote), so these statistics need some context. The Census Bureau notes, for example, that they surveyed previously unrepresented populations in 2006, including prison and college dorm residents, which could skew comparisons between 2005 and 2006 data.
Still, I think that children, the middle class, and the largest minority group in the country (Hispanics), among others, deserve some better health care options. A pediatric ER doctor told me recently that there is a tacit understanding between parents and ER physicians that the ER has, by necessity, replaced primary care for uninsured pediatric patients. These parents know that many of their visits are not medical emergencies, and the physicians understand that the parents have no other option for health care. That is what health care has become for many people: these silent bargains and unspoken apologies.
Although the poverty rate fell .3% from 2005 to 2006, the number of people without health care coverage increased .5% to 47 million in 2006. This may be due to a decline in employment-based health insurance, the type of coverage that most Americans have. The number of people receiving employment-based health insurance fell .5% from 2005 to 2006, while the number receiving government health insurance, such as Medicare and CHAMPVA, fell .3%.
Children and certain minorities are especially likely to be uninsured. The number of uninsured children increased 9%, from 8 million to 8.7 million, between 2005 and 2006. Among the entire population, Hispanics are most likely to be uninsured (34.1%), followed by American Indians/Alaska Natives (31.4%), Native Hawaiians/Other Pacific Islanders (21.7%) and African-Americans (20.5%).
Mark Twain famously wrote that "there are three kinds of lies: lies, damned lies, and statistics" (inaccurately attributing Disraeli as the source of the quote), so these statistics need some context. The Census Bureau notes, for example, that they surveyed previously unrepresented populations in 2006, including prison and college dorm residents, which could skew comparisons between 2005 and 2006 data.
Still, I think that children, the middle class, and the largest minority group in the country (Hispanics), among others, deserve some better health care options. A pediatric ER doctor told me recently that there is a tacit understanding between parents and ER physicians that the ER has, by necessity, replaced primary care for uninsured pediatric patients. These parents know that many of their visits are not medical emergencies, and the physicians understand that the parents have no other option for health care. That is what health care has become for many people: these silent bargains and unspoken apologies.
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