The senate and house bill passed on party line politics, making this an historical event in healthcare reform not as a nation but a party line victory. For over four decades previous Presidents have tried to make this change and not until this year has this been accomplished. So why are we a divided nation on this issue? Should we not be rejoicing this historic event? Or has this old party line politics become such a standard in how this nation decide any major issue, we are immune to feeling anything regardless of the outcome. Maybe if term limits existed it would make a big difference.
We as a nation are deciding our future based on the old party line politics and no longer with the idea of America first, party second. So as a nation we currently decide issues by the party first and America second. This is clearly demonstrated in the vote by the Senate on Christmas (60-39). So a bitter sweet victory for America and a joyful celebration for the Democrats Senators who voted for the healthcare reform bill.
Now that we know the structure and provisions of the two bills, the process has begun to consolidate the two bills into one. So in this process let’s highlight the key points;
1 Mandate Healthcare for all America
2 Expansion of Medicaid benefits
3 No pre-existing medical conditions
4 No public option
5Government subsidies for premium to insurance companies
6 New taxation and penalties for individual and businesses
I could spend my time in writing and giving detail information, but the fact remains a bill will pass and the latter will prevail. The sad thing is not all American will get the coverage. So what about the working middle class who does not qualify for Medicaid. The small employer who does not offer insurance will now be mandated to do so without a choice
So its time to offer a choice since we understand after its all said and done approximately 17 million working middleclass American will not qualify for Medicaid, or Medicare and be left without help.
The 47MR Community Healthcare Resource Center provides access to healthcare. These centers specialize in treating primary care services, prevention, and wellness. What makes this center unique is that the model changes the perspective of the physician in how he looks at his patient. The physician is paid up front annually for his services, so the focus is in getting his patient healthier. The other difference is the center specializes in treating its own members apart from the government run programs. The major factor is there no claims, therefore no expense for administrative claims processing, and collections.
In summary, we must start viewing ourselves differently and voting as Americans first, hold our Congress accountable and limiting their term in office, and provide new innovative centers that change the way physician, and consumer think about the access and distribution of healthcare.
Saturday, December 26, 2009
Friday, November 27, 2009
My “Day of Thanks” Prayer
Today is a day of reflection, when we look around us as well as inside of us and give thanks for everything that has happen to us. The good as well as the bad experiences since for each carries a lesson we should be thankful for. So I am thankful for our nation, and thankful for having family and friends. I have been blessed in the course of this years to have met so many individuals whom have encouraged me, believed in my cause an have helped me in getting the word out. Those individuals who have volunteered and offer their time to help me, those whom have extended their home and made our visit possible, those whom have prayed for me in my mission and for my safety;
I am thankful for all the new friends I have this year. As I am for those old friends who have been my salvation all these past years, without them I would have never survived.
I am thankful for a family whose unconditional love has never faulted, and prayers who has blessed me in everything I do.
I am thankful for my own, foster, and step children, and the grandchildren they have giving me, for they are the beat of my heart that keeps me living each day.
I am thankful for my children both those who are around me as those whom are far away for each day I am hopeful we will all one day be together again.
I am thankful for living in this great nation, where freedom exists, people can dream, and opportunities are created where we can always start again.
I am thankful for having the corruption in politics, greed in corporation, show me where we are failing as a nation, to have the insight to vote to change this and be more involved each day.
I am thankful to have good health and be able to do what I am doing, for I know the difference of not having the energy to carry on doing.
I am thankful for all of Gods creations who without them we would not have a world to live and enjoy. So I am thankful we as a nation are finally doing something to save our world.
I am thankful for all religions, for their teaching in love and peace, may we all remember to do this before we act and speak.
This special day of thanksgiving is to remind us on how different we all are, as well as we are all alike. To learn to live in harmony and share our good fortune with other, for today we may have and tomorrow may have not. Regardless of whether we have or have not, we all must be thankful for today is the “Day of Thanks”.
George L Soria
I am thankful for all the new friends I have this year. As I am for those old friends who have been my salvation all these past years, without them I would have never survived.
I am thankful for a family whose unconditional love has never faulted, and prayers who has blessed me in everything I do.
I am thankful for my own, foster, and step children, and the grandchildren they have giving me, for they are the beat of my heart that keeps me living each day.
I am thankful for my children both those who are around me as those whom are far away for each day I am hopeful we will all one day be together again.
I am thankful for living in this great nation, where freedom exists, people can dream, and opportunities are created where we can always start again.
I am thankful for having the corruption in politics, greed in corporation, show me where we are failing as a nation, to have the insight to vote to change this and be more involved each day.
I am thankful to have good health and be able to do what I am doing, for I know the difference of not having the energy to carry on doing.
I am thankful for all of Gods creations who without them we would not have a world to live and enjoy. So I am thankful we as a nation are finally doing something to save our world.
I am thankful for all religions, for their teaching in love and peace, may we all remember to do this before we act and speak.
This special day of thanksgiving is to remind us on how different we all are, as well as we are all alike. To learn to live in harmony and share our good fortune with other, for today we may have and tomorrow may have not. Regardless of whether we have or have not, we all must be thankful for today is the “Day of Thanks”.
George L Soria
Saturday, October 24, 2009
The USA is entering a revolution in healthcare reform
The battle is between major insurance corporations and the government. Major insurance industries are spending a record pace. The OFA reports:
“Sure enough, the insurance industry is already stepping up the attack: Reports just leaked from a closed-door meeting where insurance industry lobbyists frantically warned Republican members of Congress that it was not in their interest to "ever vote for this thing" and said supporting reform is like "giving comfort to the enemy." USA Today is reporting that groups opposing reform are lobbying at "a record pace" -- and the Associated Press notes that they've already spent an astounding $32 million on TV ads this year.”
The question is who does the congressman and senator represents “The People” or they themselves are the lobbyists for the insurance industry? Let’s not forget this is an American issue, and both parties have taken substantial campaign contribution from the insurance industry. So it’s no surprise that in an upcoming election year the insurance industry would remind our representatives who has been buttering their bread.
We as American must remind our congressman and senators we are “The People” and will not accept this and vote against any representative that does not protect America, and place us first above party and special interest.
We also must remind the president if he wants all Americans help to making health reform a reality he must consider other options. The health care reform reads as an insurance policy favoring one type of insurance over the others. It’s time to consider a community option and catastrophic policies which cost a fraction of what is proposed and covers everyone.
So we need to send a loud message to those representatives who vow to do the right thing for America, show us. America is tired of empty promises. Every elected official going forward should agree to sign a contract with “The People”, perform or resign and accept no contribution from lobbyist going forward in these coming elections and let get our country back.
“Sure enough, the insurance industry is already stepping up the attack: Reports just leaked from a closed-door meeting where insurance industry lobbyists frantically warned Republican members of Congress that it was not in their interest to "ever vote for this thing" and said supporting reform is like "giving comfort to the enemy." USA Today is reporting that groups opposing reform are lobbying at "a record pace" -- and the Associated Press notes that they've already spent an astounding $32 million on TV ads this year.”
The question is who does the congressman and senator represents “The People” or they themselves are the lobbyists for the insurance industry? Let’s not forget this is an American issue, and both parties have taken substantial campaign contribution from the insurance industry. So it’s no surprise that in an upcoming election year the insurance industry would remind our representatives who has been buttering their bread.
We as American must remind our congressman and senators we are “The People” and will not accept this and vote against any representative that does not protect America, and place us first above party and special interest.
We also must remind the president if he wants all Americans help to making health reform a reality he must consider other options. The health care reform reads as an insurance policy favoring one type of insurance over the others. It’s time to consider a community option and catastrophic policies which cost a fraction of what is proposed and covers everyone.
So we need to send a loud message to those representatives who vow to do the right thing for America, show us. America is tired of empty promises. Every elected official going forward should agree to sign a contract with “The People”, perform or resign and accept no contribution from lobbyist going forward in these coming elections and let get our country back.
Wednesday, October 21, 2009
47MR Amendment to America’s Healthy Future Act of 2009
Title: The 47 Million Reasons Direct Basic Health Service Plan Community Centers (47MR Centers)
Overview: This amendment provides for federally funded community healthcare centers, non-Medicaid, state plan which combines the innovation and quality of private sector providing direct care facilities for basic health services, wellness, prevention, and stand alone catastrophic insurance plans for major illness.
Under this amendment, the federal government would provides funds to the participating states in order to allow such states to provide affordable health care coverage through private community healthcare centers combined with extending the catastrophic coverage of self insured government facilities to include coverage for the members of the 47MR Direct Basic Health Service Plan Community Centers or allowing for a wrap around stand alone catastrophic plan.
People with incomes above the Medicaid eligibility, above 300 percent federal poverty level(FPL) would be eligible for participation in these centers and these wrap-around stand alone catastrophic plans.
This approach takes advantage of an innovative, non Medicaid coverage model that protects the middle-class that can work at a state level for the people of that state. State government would use their share of federal dollars to empower 47MR Centers in local communities to include and negotiate with the healthcare systems for higher-quality, cost effective services for direct basic health services and wrap-around a stand alone catastrophic insurance policy to provide better value to individual and families in their state. Eligible individual and families would have access to several 47MR Centers at pre-negotiated monthly membership rate options paid direct to the centers for basic health services rather than being limited to fee for service distribution healthcare system offered through the Exchange as the only choice.
By using pre-negotiated monthly membership method for basic health care services, wellness, and prevention, we are improving access, eliminating administration cost, and dramatically reducing cost.
Description of Amendment: The Secretary of Health and Human Services would work with participating states to establish state 47 MR Direct Basic Health Services Plan Community Centers.
State 47MR Direct Basic Health Service Plan Funding: For the purpose of this amendment, a state’s 47MR Direct Basis Health Service Plan funding level would be based on the sum of the value of the direct monthly membership fee to the facility and the cost of individual insurance rate for the catastrophic insurance, which would be assumed eligible for the mandated coverage for the middle-class population in the state. Federal funds distributed to the state would be provided to independent state based trusts for innovative state of art community centers that would be used to negotiate for better medical services, supplies, and medical providers services for 47MR Direct Basic Health Services Plan Community Centers and its members.
Eligibility: The 47MR Direct Basic Health Service Plan Community Centers would be available to people with income over 300 percent of FPL. State could enroll the following middle-class person in their 47MR Direct Basic Health Service Plan Community Centers, as of July 1, 2010 upon availability of the centers: persons who (1) are under age 65; (2) are unemployed; (3) are residence of the community and states; (4) have gross income above 300 percent FPL; (5) choose to be a member of 47MR Direct Health Service Plan Community Centers and obtain stand-alone catastrophic policy coverage: (6) have access by participating in employer sponsored benefits program which include 47MR Centers.
Benefit package and tax credits: Minimum benefit package in the 47MR Direct Basic Health Service Plan Community Centers is set based on the levels provided in Marking Coverage Affordable section of the Chairman’s marks concerning wellness, Prevention, eliminating pre-existing condition, etc. The exception is in having these 47MR Centers deal direct with patients for basic health services and prevention without the current distribution insurance system. Rather a membership fee directly to the facility that meets the guidelines set by the state and HHS for middle-class people. Coverage commence for major illness and hospitalization based on a stand-alone catastrophic policy provided by the state or private sector meeting all the levels. The catastrophic insurance wraps around the 47MR Centers without limitations of HSA rules or deductibles. The tax credits to individuals and businesses for eligible population would have access to tax credits as available in the marks.
State would be encouraged to include innovative services in the 47 MR Centers, included but not limited to; triage, care coordination, care management, care maintenance for those with medical conditions, preventive services which includes a comprehensive physical examinations, risk assessment, and establishment of patient/primary care doctor relationship that maximizes patient involvement in healthcare decision making through educational learning of western and eastern philosophy for maintaining good health.
Health care service plan contracting; State will negotiates contract directly with 47MR Centers providers to ensure the guidelines for the state of the art centers meet the innovative services in the direct health service plan for middle-class people over 300 percent FPL.
The state will under the NAIC will regulate the stand-alone catastrophic policies which provide coverage offered to the members of the 47MR Centers, such as negotiations of payment rates, premiums, and in compliance with benefits package that may exceed the minimum requirement outline above. The Secretary of HHS would be required to verify that state 47MR Direct Basic Health Service Plan are operating within the federal cost and eligibility guidelines as stated above.
The state HHS in coordination with the NAIC are to consider and make suitable allowance for qualifying 47MR Centers based on differences in local communities and availability of healthcare providers resources. The HHS would be encouraged to find ways to upgrade and integrate the direct basic service plan negotiations with community hospitals, specialist, other providers to maximize the quality of care and efficiency and improve the continuity of information between all services providers and the patient.
Incentives to the 47MR Centers would be offered based on specific performance measures and standards based on the improvement of the patients risk assessment report, blood lab results, and physical exams and health outcome. Each 47MR Direct Health Service Plan Community Center must report to the HHS on the performance and results of its members. The NAIC will oversee the catastrophic insurance policy offered by state or private sector.
Cost Savings: State will be able through an independent state trust determine and fund to the 47MR Direct Basic Health Service Plan Community Centers. The 47MR Centers would be able to raise funds through membership in each community servicing the middle-class over 300 percent FPL. Medical providers’ services will be contracted by the 47MR Centers. Each community in the state will have state of the art center. The cost of the centers funded by the individuals, small business, and part-time employees will be direct to the facility overseen by the HHS. The state would be able to negotiate lower prices for medical services, supplies, lab work, hospital stays, etc. by directly purchasing and contracting for all the 47MR Direct Basic Health Service Plan Community Centers.
In addition, the catastrophic insurance policy which provides coverage for self-insured state plans as well as private sector stand-alone plans are one sixth of the cost of the comprehensive plan set at the levels in the Making Coverage Affordable section of the Chairman marks. Therefore combined with the 47MR Direct Basic Health Service Community Center facilities, people will pay a membership fees and affordable premium for catastrophic coverage which is one fraction of the cost, and each local community services their own people.
The high deductible associated with the catastrophic plan can be offset by the independent trust as well or philanthropic measures which exist today. This insures the 25 million uninsured middle-class people whom are not included and have no subsidy. This provides choices for them and give access to healthcare.
Overview: This amendment provides for federally funded community healthcare centers, non-Medicaid, state plan which combines the innovation and quality of private sector providing direct care facilities for basic health services, wellness, prevention, and stand alone catastrophic insurance plans for major illness.
Under this amendment, the federal government would provides funds to the participating states in order to allow such states to provide affordable health care coverage through private community healthcare centers combined with extending the catastrophic coverage of self insured government facilities to include coverage for the members of the 47MR Direct Basic Health Service Plan Community Centers or allowing for a wrap around stand alone catastrophic plan.
People with incomes above the Medicaid eligibility, above 300 percent federal poverty level(FPL) would be eligible for participation in these centers and these wrap-around stand alone catastrophic plans.
This approach takes advantage of an innovative, non Medicaid coverage model that protects the middle-class that can work at a state level for the people of that state. State government would use their share of federal dollars to empower 47MR Centers in local communities to include and negotiate with the healthcare systems for higher-quality, cost effective services for direct basic health services and wrap-around a stand alone catastrophic insurance policy to provide better value to individual and families in their state. Eligible individual and families would have access to several 47MR Centers at pre-negotiated monthly membership rate options paid direct to the centers for basic health services rather than being limited to fee for service distribution healthcare system offered through the Exchange as the only choice.
By using pre-negotiated monthly membership method for basic health care services, wellness, and prevention, we are improving access, eliminating administration cost, and dramatically reducing cost.
Description of Amendment: The Secretary of Health and Human Services would work with participating states to establish state 47 MR Direct Basic Health Services Plan Community Centers.
State 47MR Direct Basic Health Service Plan Funding: For the purpose of this amendment, a state’s 47MR Direct Basis Health Service Plan funding level would be based on the sum of the value of the direct monthly membership fee to the facility and the cost of individual insurance rate for the catastrophic insurance, which would be assumed eligible for the mandated coverage for the middle-class population in the state. Federal funds distributed to the state would be provided to independent state based trusts for innovative state of art community centers that would be used to negotiate for better medical services, supplies, and medical providers services for 47MR Direct Basic Health Services Plan Community Centers and its members.
Eligibility: The 47MR Direct Basic Health Service Plan Community Centers would be available to people with income over 300 percent of FPL. State could enroll the following middle-class person in their 47MR Direct Basic Health Service Plan Community Centers, as of July 1, 2010 upon availability of the centers: persons who (1) are under age 65; (2) are unemployed; (3) are residence of the community and states; (4) have gross income above 300 percent FPL; (5) choose to be a member of 47MR Direct Health Service Plan Community Centers and obtain stand-alone catastrophic policy coverage: (6) have access by participating in employer sponsored benefits program which include 47MR Centers.
Benefit package and tax credits: Minimum benefit package in the 47MR Direct Basic Health Service Plan Community Centers is set based on the levels provided in Marking Coverage Affordable section of the Chairman’s marks concerning wellness, Prevention, eliminating pre-existing condition, etc. The exception is in having these 47MR Centers deal direct with patients for basic health services and prevention without the current distribution insurance system. Rather a membership fee directly to the facility that meets the guidelines set by the state and HHS for middle-class people. Coverage commence for major illness and hospitalization based on a stand-alone catastrophic policy provided by the state or private sector meeting all the levels. The catastrophic insurance wraps around the 47MR Centers without limitations of HSA rules or deductibles. The tax credits to individuals and businesses for eligible population would have access to tax credits as available in the marks.
State would be encouraged to include innovative services in the 47 MR Centers, included but not limited to; triage, care coordination, care management, care maintenance for those with medical conditions, preventive services which includes a comprehensive physical examinations, risk assessment, and establishment of patient/primary care doctor relationship that maximizes patient involvement in healthcare decision making through educational learning of western and eastern philosophy for maintaining good health.
Health care service plan contracting; State will negotiates contract directly with 47MR Centers providers to ensure the guidelines for the state of the art centers meet the innovative services in the direct health service plan for middle-class people over 300 percent FPL.
The state will under the NAIC will regulate the stand-alone catastrophic policies which provide coverage offered to the members of the 47MR Centers, such as negotiations of payment rates, premiums, and in compliance with benefits package that may exceed the minimum requirement outline above. The Secretary of HHS would be required to verify that state 47MR Direct Basic Health Service Plan are operating within the federal cost and eligibility guidelines as stated above.
The state HHS in coordination with the NAIC are to consider and make suitable allowance for qualifying 47MR Centers based on differences in local communities and availability of healthcare providers resources. The HHS would be encouraged to find ways to upgrade and integrate the direct basic service plan negotiations with community hospitals, specialist, other providers to maximize the quality of care and efficiency and improve the continuity of information between all services providers and the patient.
Incentives to the 47MR Centers would be offered based on specific performance measures and standards based on the improvement of the patients risk assessment report, blood lab results, and physical exams and health outcome. Each 47MR Direct Health Service Plan Community Center must report to the HHS on the performance and results of its members. The NAIC will oversee the catastrophic insurance policy offered by state or private sector.
Cost Savings: State will be able through an independent state trust determine and fund to the 47MR Direct Basic Health Service Plan Community Centers. The 47MR Centers would be able to raise funds through membership in each community servicing the middle-class over 300 percent FPL. Medical providers’ services will be contracted by the 47MR Centers. Each community in the state will have state of the art center. The cost of the centers funded by the individuals, small business, and part-time employees will be direct to the facility overseen by the HHS. The state would be able to negotiate lower prices for medical services, supplies, lab work, hospital stays, etc. by directly purchasing and contracting for all the 47MR Direct Basic Health Service Plan Community Centers.
In addition, the catastrophic insurance policy which provides coverage for self-insured state plans as well as private sector stand-alone plans are one sixth of the cost of the comprehensive plan set at the levels in the Making Coverage Affordable section of the Chairman marks. Therefore combined with the 47MR Direct Basic Health Service Community Center facilities, people will pay a membership fees and affordable premium for catastrophic coverage which is one fraction of the cost, and each local community services their own people.
The high deductible associated with the catastrophic plan can be offset by the independent trust as well or philanthropic measures which exist today. This insures the 25 million uninsured middle-class people whom are not included and have no subsidy. This provides choices for them and give access to healthcare.
Monday, October 5, 2009
The baseline premium rate is set at $ 3,500 per single coverage for healthcare reform.
In evaluating the bill chairman's markup these last few weeks, the summation is the middle-class Americans loses in the Senates overhaul healthcare reform bill. What Americans wanted was a new system, which can reduce the cost, include all Americans, and have multiple choices. What American is getting is an overhaul of the Medicaid system, expanding a broken system to include up to 300% poverty level, and eliminate help to the middle-class Americans.
In recent articles, it assumes this overhaul plan will resolve most of American issues, and bring down the number of the uninsured, even thought over 10 million Americans may continue to not afford coverage. So the consensus would be most of the problem is resolved. Well if Americans believe in the end justifies the means we perhaps can accept the collateral damage of leaving the middle class behind. However, this is America and we believe in leaving no man behind.
So to accept anything else is not what we do. Congress in both sides and the White House should carefully evaluate the options and choices. I have seen amendments voted down which offers choices. One of the Senators offered catastrophic insurance as an option to all and he was refused. Why? If affordable coverage is what is needed then this should be an option. Especially when the minimum cost of the proposed young person age 25 making 32,500 is fixed at 2200 per year with no subsidy. So the government will be subsidizing everyone else below that income. The price does not change but the government will pay the premiums to the insurance companies. The Kaiser foundation created a calculator to show the premiums you will pay under this overhaul reform.
The average 40 year old male, premium is based at 1.0 baseline rate of $3500 per year. The rate drops and levels off at 0.62 age 25 and below. The rate increase to 2.46 above baseline at age 64
What this means to middle class professional is:
Any young professional age 25 who earns over 32,500 per year pays $2194 to $2633
Any professional age 35 who earns over 32,500 per year pays $3082 to $3698
Any professional age 40 who earns over 35,000 per year pays $3500 to $4200
Any professional age 45 who earns over 36,400 per year pays $4362 to $5235
Any professional age 55 who earns over 44,000 per year pays $6607 to $7928
Any professional age 64 who earns over 44,000 per year pays $8614 to $8614
The whole Healthcare Reform Act is based on paying premiums to the insurance industry with no pressure on the insurance industry to make it affordable. The savings to the consumer is on government subsidies (taxpayer’s money) lowering our own premiums. However, the middle-class receives no subsidies as shown above.
With the baseline rate remaining at 3500 for single adult, there is no break or anything to look forward too. In family coverage the insurance rates are even more shocking.
Age 64 Actual plan premium ranges from $22,207 to 26,649, our government will pay premiums of $19,137 to $23,579
Age 55 actual plan premium ranges from $15,361 to $18,434, our government will pay premiums of $12,291 to $15,364
Age 40 actual plan premium ranges from $9,435 to $11,321, our government will pay premiums of $7,707 to $9,594
So the subsides sound great if you are under 50,000 in income. If both spouses work and earn over 90,000, there is no subsidies and you pay the actual premiums.
How does this help the baby boomers today,who makes up a large portion of the population?
Why must we reward an insurance industry whom failed to lower cost and make healthcare affordable. We ourselves the American people are funding the premiums to make it affordable. All we have accomplished is to make the industries that fail us a stronger monopoly that we will never again be able to defeat and get true reform pass.
Let the middle-class have their own plan, a community option with direct care and a catastrophic policy to cover the major illnesses as an option. Give American a choice to fix their own uninsured problems in their own communities.
Consider what this overhaul healthcare reform plan is doing. Pass the regulation on the industry to change their ways, but do not close the door on creative thinking in healthcare. The design of one plan fits all, with mandates is the wrong medicine and will frustrate all middle-class Americans.
In recent articles, it assumes this overhaul plan will resolve most of American issues, and bring down the number of the uninsured, even thought over 10 million Americans may continue to not afford coverage. So the consensus would be most of the problem is resolved. Well if Americans believe in the end justifies the means we perhaps can accept the collateral damage of leaving the middle class behind. However, this is America and we believe in leaving no man behind.
So to accept anything else is not what we do. Congress in both sides and the White House should carefully evaluate the options and choices. I have seen amendments voted down which offers choices. One of the Senators offered catastrophic insurance as an option to all and he was refused. Why? If affordable coverage is what is needed then this should be an option. Especially when the minimum cost of the proposed young person age 25 making 32,500 is fixed at 2200 per year with no subsidy. So the government will be subsidizing everyone else below that income. The price does not change but the government will pay the premiums to the insurance companies. The Kaiser foundation created a calculator to show the premiums you will pay under this overhaul reform.
The average 40 year old male, premium is based at 1.0 baseline rate of $3500 per year. The rate drops and levels off at 0.62 age 25 and below. The rate increase to 2.46 above baseline at age 64
What this means to middle class professional is:
Any young professional age 25 who earns over 32,500 per year pays $2194 to $2633
Any professional age 35 who earns over 32,500 per year pays $3082 to $3698
Any professional age 40 who earns over 35,000 per year pays $3500 to $4200
Any professional age 45 who earns over 36,400 per year pays $4362 to $5235
Any professional age 55 who earns over 44,000 per year pays $6607 to $7928
Any professional age 64 who earns over 44,000 per year pays $8614 to $8614
The whole Healthcare Reform Act is based on paying premiums to the insurance industry with no pressure on the insurance industry to make it affordable. The savings to the consumer is on government subsidies (taxpayer’s money) lowering our own premiums. However, the middle-class receives no subsidies as shown above.
With the baseline rate remaining at 3500 for single adult, there is no break or anything to look forward too. In family coverage the insurance rates are even more shocking.
Age 64 Actual plan premium ranges from $22,207 to 26,649, our government will pay premiums of $19,137 to $23,579
Age 55 actual plan premium ranges from $15,361 to $18,434, our government will pay premiums of $12,291 to $15,364
Age 40 actual plan premium ranges from $9,435 to $11,321, our government will pay premiums of $7,707 to $9,594
So the subsides sound great if you are under 50,000 in income. If both spouses work and earn over 90,000, there is no subsidies and you pay the actual premiums.
How does this help the baby boomers today,who makes up a large portion of the population?
Why must we reward an insurance industry whom failed to lower cost and make healthcare affordable. We ourselves the American people are funding the premiums to make it affordable. All we have accomplished is to make the industries that fail us a stronger monopoly that we will never again be able to defeat and get true reform pass.
Let the middle-class have their own plan, a community option with direct care and a catastrophic policy to cover the major illnesses as an option. Give American a choice to fix their own uninsured problems in their own communities.
Consider what this overhaul healthcare reform plan is doing. Pass the regulation on the industry to change their ways, but do not close the door on creative thinking in healthcare. The design of one plan fits all, with mandates is the wrong medicine and will frustrate all middle-class Americans.
Wednesday, September 30, 2009
Is the greed and the underline pockets being filled to stop healthcare reform in this country?
The fact is both sides in Congress have their pockets filled, Democrats as well as Republicans. The deal is simply no-preexisting conditions, prevention, unlimited coverage to be included, in exchange for government subsidies, one expensive comprehensive plan design w HSA’s limits, and mandates. The American public will not notice the increase cost due to the subsidies, and the carriers will make the plans look different by color coding it, and make it look patriotic. So the American public can purchase healthcare by having a platinum, gold, silver, or bronze plan. The only difference is in the payout percentile. The carriers will start from 90% and go down to 60%. Oh let’s not forget the young invincible who will now have to buy insurance (the bronze plan modification), for which the carrier will call it catastrophic insurance. All this can now be administered by each state having to have their own exchange (layer of bureaucracy) and overseen by the insurance commissioner (former insurance executive). And finally the carriers will use the same claims administration distribution system for everyone, so they can CONTROL, by collect all the premiums, by charge 22% up to 30% administration, and by discounting the fees paid to physicians, medical facilities, hospital, and providers who do the work. The American consumer should now be thankful for only having to choose one plan, have more bureaucracy and administration, be force to buy insurance, and pay premiums three times. Government subsidies, insurance companies premiums and providers directly whom will not accept this plan. Is there another alternative? I believe there is, a community option.
Friday, September 25, 2009
What insurance has done to our physicians in our country?
When did we stop following the Hippocratic Oath and began looking at human as dollars signs in the world of practicing medicine? If the government focus continues on rewriting the insurance regulations and practices, it better start looking at the medical profession as well. Since the insurance industry has turn the medical professions to be more concerned on how they will be paid rather then treating a six year old girl.
Yes, a family whom has been seeing this medical group known as Pediatric Associates for over two years will treat the other children in the family, but refuse to treat a six year old with the flu symptoms, in a time of H1N1 epidemic, simply because the Medicaid changed the primary doctor at the time of recertification for the six year old, and not the rest of the family.
It is a shame a Pediatric Associate Management Services, a Primary Care Physician office would deny to see a six year old with flu symptoms. When the doctor was approached directly, he only responded “I am sorry due to the insurance, there is nothing he can really do”. Aware of this problem with Medicaid, the doctor’s office refuses to treat their own patients. So a patient health and treatment is determined by the insurance PPO network arbitrary selected at recertification.
So if the insured with Medicaid cannot get access to care due to the inefficiency of the current healthcare distribution system, and a physician would refuse to examine a child who has been a patient for over two years due to insurance payment, during H1N1 flu season, we must wonder what insurance has done to our physicians in our country.
How can a physician refuse coverage to a six year old with flu systems? Makes you wonder if physicians are now just puppets to this healthcare monopoly, called insurance.
Where insurance CONTROLS the behavior of physicians and the oath to serve your patient is ignored.
Yes, a family whom has been seeing this medical group known as Pediatric Associates for over two years will treat the other children in the family, but refuse to treat a six year old with the flu symptoms, in a time of H1N1 epidemic, simply because the Medicaid changed the primary doctor at the time of recertification for the six year old, and not the rest of the family.
It is a shame a Pediatric Associate Management Services, a Primary Care Physician office would deny to see a six year old with flu symptoms. When the doctor was approached directly, he only responded “I am sorry due to the insurance, there is nothing he can really do”. Aware of this problem with Medicaid, the doctor’s office refuses to treat their own patients. So a patient health and treatment is determined by the insurance PPO network arbitrary selected at recertification.
So if the insured with Medicaid cannot get access to care due to the inefficiency of the current healthcare distribution system, and a physician would refuse to examine a child who has been a patient for over two years due to insurance payment, during H1N1 flu season, we must wonder what insurance has done to our physicians in our country.
How can a physician refuse coverage to a six year old with flu systems? Makes you wonder if physicians are now just puppets to this healthcare monopoly, called insurance.
Where insurance CONTROLS the behavior of physicians and the oath to serve your patient is ignored.
Sunday, September 13, 2009
5 Stars to the President on some issues, back to the drawing board on others
In listening to the President the other evening, I can see a person who believes in the American dream. To do everything possible to build a bridge between party lines, and fundamentally reach out to all sides to change this healthcare dilemma which has lasted for over 63 years. He clearly stated “he is not the first president to attempt to change healthcare, but he is determined to be the last”.
As I watched Congress unfold, the divide between the parties was clear, as it has been for the past 8 years. With America’s war over seas, the economic challenges at home, and the millions of unemployed, uninsured, hardworking Americans struggling to stay above water, one would think that a feeling of solidarity might exist. Before I continue with my comments on President Obama’s speech, I would like to invite every American to wake up and see the politicians that they are electing as party-less individuals and thoroughly evaluate what they stand for. We cannot afford to elect politicians who are unwilling to participate in the movement for healthcare reform.
Now concerning Obama speech, his ideas in fixing what is wrong with our current healthcare system is based on the accumulations of all the concerns and cries of the American people. So it is clear he is responding to the needs of those cries. So to ask to balance the playing field and have the insurance industry take responsibility and include everyone, without dropping coverage, applying caps, he gets 5 stars. This is needed and the industry should be held to those high standards, isn’t this why we buy insurance?
The idea of having the healthcare reform not increase the budget deficit, and having a provision in the law to prevent this from ever happening, again he gets 5 stars, if he could do it.
So with all this positive energy there should not be any more objections, you would think? Well, this reform plan still needs adjusting. Here are my concerns over what was stated,
Everyone will have to buy insurance; this is a mandate which was compared to car insurance. The reason given is many American simply refuses to buy health insurance, specifically the young invincible. I understand the reasoning, but would it not be better to offer a community healthcare center option, where those individual can join the center and contribute directly and/or purchase catastrophic insurance. This idea offers those individual a choice of gaining access and/or purchasing insurance at an affordable cost. Otherwise, the consumer will always opt to purchase the most inexpensive insurance plan and will have gained no guaranteed to get healthcare access. Which bring me to the other points?
Having insurance does not guarantee you will have access to see a medical provider. Many providers are opting out of dealing with any insurance carriers all together. Mainly because of the low reimbursement payments offered by insurance, as well as the over burden administration associated with the carriers, and the full time staff needed to handle the collections and billing. Top that off with shortage in primary care physicians, and no incentive given to become a PCP. What good is insurance with no access to doctors?
Now looking at the plan design to include prevention and wellness as the standard in every policy, although it is vital, has this not been added to the policies back in the 80s & 90s?. The results have been low and the carrier simply increased the premium accordingly to cover the cost of the preventive exam and wellness. So by having the carriers include this in the design, we are enhancing the problem of administration and increasing cost. Why do we need a middleman? A community option/ direct care facility can solve this situation, without administration. It can also eliminate many standard treatments that are associated with standard care. So by having community options centers work with carriers in providing most of the primary care functions, we can eliminate most of the administration cost associated with the small claims, which in some instances represents 80% of expenses in healthcare administration.
These centers operate independent of insurance carriers, and can be private, non-profit, and co-operative in the community. It services the need of its citizens and is based on the population of the community. The fact is we do not have to wait four years; these facilities can exist immediately servicing the uninsured by following the 47MR model.
Not only are these centers an options to affordable care, but it also upgrades the quality of care given to the citizen in their community where doctors can be doctors free of protocol treatment. Quality of care is also a serious problem not address in the speech. The “stabilize and release” tactics practice in private hospitals, the waiting weeks for an appointment base on who is your insurance carrier, the “protocol medicine” doctors are force to practice, all are the result of the insurance carrier “controlling the payment” to providers, or the concern of proper coverage and payment.
Again, the system of distribution on how we handle the claims, how we pay the providers, and how the consumer understand the EOB, while administrating the employers enrollments and eligibility is all encumber some and administratively overburden. So if we are to lower cost we must find alternatives which streamlines, optimizes these function. Not just accept the status quo and continue the same pattern.
And finally, the infamous public option of which seems to be the controversy in getting healthcare reformed passed. Well now that we understand the ideology of creating an government insurance carrier to compete with the private carriers, to break the monopoly of the industry by listing them in the exchange, with no subsidy and only for those small business and individual who are looking for affordable care is great, if the community option is whom they insure, which will offer a different and unique plan apart from the status quo of the insurance companies. This way there is no conflict with free enterprise.
So I accept the President invitation to come forward with new and innovative ideas and let’s get this healthcare reform passed this year. The biggest concern is how do you get to the President to discuss these issues.
As I watched Congress unfold, the divide between the parties was clear, as it has been for the past 8 years. With America’s war over seas, the economic challenges at home, and the millions of unemployed, uninsured, hardworking Americans struggling to stay above water, one would think that a feeling of solidarity might exist. Before I continue with my comments on President Obama’s speech, I would like to invite every American to wake up and see the politicians that they are electing as party-less individuals and thoroughly evaluate what they stand for. We cannot afford to elect politicians who are unwilling to participate in the movement for healthcare reform.
Now concerning Obama speech, his ideas in fixing what is wrong with our current healthcare system is based on the accumulations of all the concerns and cries of the American people. So it is clear he is responding to the needs of those cries. So to ask to balance the playing field and have the insurance industry take responsibility and include everyone, without dropping coverage, applying caps, he gets 5 stars. This is needed and the industry should be held to those high standards, isn’t this why we buy insurance?
The idea of having the healthcare reform not increase the budget deficit, and having a provision in the law to prevent this from ever happening, again he gets 5 stars, if he could do it.
So with all this positive energy there should not be any more objections, you would think? Well, this reform plan still needs adjusting. Here are my concerns over what was stated,
Everyone will have to buy insurance; this is a mandate which was compared to car insurance. The reason given is many American simply refuses to buy health insurance, specifically the young invincible. I understand the reasoning, but would it not be better to offer a community healthcare center option, where those individual can join the center and contribute directly and/or purchase catastrophic insurance. This idea offers those individual a choice of gaining access and/or purchasing insurance at an affordable cost. Otherwise, the consumer will always opt to purchase the most inexpensive insurance plan and will have gained no guaranteed to get healthcare access. Which bring me to the other points?
Having insurance does not guarantee you will have access to see a medical provider. Many providers are opting out of dealing with any insurance carriers all together. Mainly because of the low reimbursement payments offered by insurance, as well as the over burden administration associated with the carriers, and the full time staff needed to handle the collections and billing. Top that off with shortage in primary care physicians, and no incentive given to become a PCP. What good is insurance with no access to doctors?
Now looking at the plan design to include prevention and wellness as the standard in every policy, although it is vital, has this not been added to the policies back in the 80s & 90s?. The results have been low and the carrier simply increased the premium accordingly to cover the cost of the preventive exam and wellness. So by having the carriers include this in the design, we are enhancing the problem of administration and increasing cost. Why do we need a middleman? A community option/ direct care facility can solve this situation, without administration. It can also eliminate many standard treatments that are associated with standard care. So by having community options centers work with carriers in providing most of the primary care functions, we can eliminate most of the administration cost associated with the small claims, which in some instances represents 80% of expenses in healthcare administration.
These centers operate independent of insurance carriers, and can be private, non-profit, and co-operative in the community. It services the need of its citizens and is based on the population of the community. The fact is we do not have to wait four years; these facilities can exist immediately servicing the uninsured by following the 47MR model.
Not only are these centers an options to affordable care, but it also upgrades the quality of care given to the citizen in their community where doctors can be doctors free of protocol treatment. Quality of care is also a serious problem not address in the speech. The “stabilize and release” tactics practice in private hospitals, the waiting weeks for an appointment base on who is your insurance carrier, the “protocol medicine” doctors are force to practice, all are the result of the insurance carrier “controlling the payment” to providers, or the concern of proper coverage and payment.
Again, the system of distribution on how we handle the claims, how we pay the providers, and how the consumer understand the EOB, while administrating the employers enrollments and eligibility is all encumber some and administratively overburden. So if we are to lower cost we must find alternatives which streamlines, optimizes these function. Not just accept the status quo and continue the same pattern.
And finally, the infamous public option of which seems to be the controversy in getting healthcare reformed passed. Well now that we understand the ideology of creating an government insurance carrier to compete with the private carriers, to break the monopoly of the industry by listing them in the exchange, with no subsidy and only for those small business and individual who are looking for affordable care is great, if the community option is whom they insure, which will offer a different and unique plan apart from the status quo of the insurance companies. This way there is no conflict with free enterprise.
So I accept the President invitation to come forward with new and innovative ideas and let’s get this healthcare reform passed this year. The biggest concern is how do you get to the President to discuss these issues.
Wednesday, September 9, 2009
H1N1 swine flu approaching, RX Card free to everyone
It is important to understand that by this time next month thousands of people would be infected by H1N1 swine flu. With so many uninsured, the risk becomes even greater in spreading the swine flu here in the USA. The cost for those who are sick and require antibiotics medication may be prohibitive without insurance.
Therefore it would be an injustice if something is not offered. So now all small business, non-profit organization, health providers, unemployed, etc can get a free Rx Cards, which reduces the cost of any prescription medication from 15% up to 60% by just downloading the Rx Card from the website. www.47millionreasons.org.
Organizations could Link to the website and offer it to all their members, part time employees, unions, small business, etc as a preventive measure if vaccines are not available for everyone. Waiting one month makes a big difference in whether you get the flu or the vaccine.
Therefore it would be an injustice if something is not offered. So now all small business, non-profit organization, health providers, unemployed, etc can get a free Rx Cards, which reduces the cost of any prescription medication from 15% up to 60% by just downloading the Rx Card from the website. www.47millionreasons.org.
Organizations could Link to the website and offer it to all their members, part time employees, unions, small business, etc as a preventive measure if vaccines are not available for everyone. Waiting one month makes a big difference in whether you get the flu or the vaccine.
Sunday, September 6, 2009
Is Access vs. Insurance the real issue in healthcare reform.
The American public is confused as to the issue of access vs. insurance. Are we reforming how we access healthcare or just in how we buy insurance? It seems the way we buy insurance is continuing without change. Whether we buy it from an exchange, privately, or the public option we are buying insurance and paying a premium for the coverage. So to argue this point is to no avail. The fact is we will be paying insurance premium to the insurance companies for healthcare coverage period. We are relying on the current insurance distribution system.
Now let’s look at access. Even though we buy insurance does not guaranteed a medical provider will accept the insurance. Many medical providers today are accepting no insurance, whether private or public, only direct cash payments.
So even though we have reform which will mandates insurance there will be no guaranteed you will have access to care. So just having a policy is not enough.
Now the design of policy coverage is also a big question. If reform includes no pre-existing conditions, no limits or caps, no high deductibles, and all plans must include prevention and wellness, the insurance industry will surely increase the premiums.
So by not changing the current insurance distribution system, the insurance companies will continue to control and receive all the money in premiums. So by offering a comprehensive plan which pay for everything, they can freely increase the cost of plan, and with mandate everyone must buy a plan.
Providers in the other hand, does not have to accept the insurance. The fact is, with a 30% administrative cost in the premium, and the excess office administration expense to the provider, it better to offer direct care, direct payment and accept no insurance.
I think the president plan should allow providers to continue to offer care directly, allowing for providers to offer primary care services and accept no insurance.
Americans are looking for access to healthcare, and affordable premium. Providers are looking for direct care and direct payment. It’s time to re-examine the current insurance distribution system.
Why can healthcare reform have this combination of access, direct care, and catastrophic insurance for the back end at an affordable cost? A 47MR model exist can shows how this can work. www.47millionreasons.org
Now let’s look at access. Even though we buy insurance does not guaranteed a medical provider will accept the insurance. Many medical providers today are accepting no insurance, whether private or public, only direct cash payments.
So even though we have reform which will mandates insurance there will be no guaranteed you will have access to care. So just having a policy is not enough.
Now the design of policy coverage is also a big question. If reform includes no pre-existing conditions, no limits or caps, no high deductibles, and all plans must include prevention and wellness, the insurance industry will surely increase the premiums.
So by not changing the current insurance distribution system, the insurance companies will continue to control and receive all the money in premiums. So by offering a comprehensive plan which pay for everything, they can freely increase the cost of plan, and with mandate everyone must buy a plan.
Providers in the other hand, does not have to accept the insurance. The fact is, with a 30% administrative cost in the premium, and the excess office administration expense to the provider, it better to offer direct care, direct payment and accept no insurance.
I think the president plan should allow providers to continue to offer care directly, allowing for providers to offer primary care services and accept no insurance.
Americans are looking for access to healthcare, and affordable premium. Providers are looking for direct care and direct payment. It’s time to re-examine the current insurance distribution system.
Why can healthcare reform have this combination of access, direct care, and catastrophic insurance for the back end at an affordable cost? A 47MR model exist can shows how this can work. www.47millionreasons.org
Thursday, August 27, 2009
The freedom is to choose without MANDATES, without CONTROL.
It is amazing that this issue of socialize Medicine goes back 48 years. The question I have is why the opposition of socialize medicine are not held accountable for their actions after defeating socialize medicine these past 48 years?
In 1993, opposition again defeats the issue of universal healthcare and profits at the expense of the American people leaving 36 million uninsured. We American must carefully view the motives on both sides. If this nation is to resolve this issue on healthcare, and if we have learned anything from the past, we must free ourselves of both government and the insurance industries control.
We must change the way we distribute healthcare and be free from the insurance industry being the nucleus of which everyone revolves. A citizen, a business, a provider, an insurance carrier should be equal. Each one leg of a 4 legged chair. Therefore, a distribution system where provider, citizen and business can work together without insurance involvement on primary acute care, prevention, and wellness is needed.
Where insurance is only available for catastrophic illnesses and government regulates and protects the patient’s bill of rights. Freedom is only preserved when we are free from control of both.
In 1993, opposition again defeats the issue of universal healthcare and profits at the expense of the American people leaving 36 million uninsured. We American must carefully view the motives on both sides. If this nation is to resolve this issue on healthcare, and if we have learned anything from the past, we must free ourselves of both government and the insurance industries control.
We must change the way we distribute healthcare and be free from the insurance industry being the nucleus of which everyone revolves. A citizen, a business, a provider, an insurance carrier should be equal. Each one leg of a 4 legged chair. Therefore, a distribution system where provider, citizen and business can work together without insurance involvement on primary acute care, prevention, and wellness is needed.
Where insurance is only available for catastrophic illnesses and government regulates and protects the patient’s bill of rights. Freedom is only preserved when we are free from control of both.
Tuesday, August 11, 2009
A New Type of Center, A Community Option vs. Insurance?
Obama answers to healthcare reform are listed below. Are we ready to turn over one Trillion dollars in ten years to pay premiums that benefits the insurance industry? Let’s change how primary care is offered to the uninsured with a new system that access healthcare.
What are the benefits of the public option?
Health reform must be built on three fundamental principles: It must lower the skyrocketing cost of health care; guarantee choice of doctors and plans; and assure quality affordable health care for every American. A public option would achieve those goals and give the American people more choices. It would foster greater competition; lower costs; and give consumers a greater variety of affordable choices
What is the insurance exchange?
The health insurance exchange is a marketplace that will offer affordable high-quality health insurance options. It will provide relief to families who have no insurance or do not get adequate insurance at work and cannot afford to buy it in the costly individual or small group market. It is also for small businesses that cannot afford small group health insurance.. It is one-stop shopping that will enable you and your family to find a plan that is right for you.
For workers at big companies with group coverage, you can keep what you have with new protections against unfair insurance regulations that could limit your coverage if you get sick. And if you lose your job, move or decide to leave that company, you will know that there will be high-quality affordable health insurance options available for you on the exchange.
Why should people with insurance pay to cover those who don’t have it?
They are already paying for the uninsured. American families with insurance pay a hidden tax of roughly $1000 for the cost of caring for people without insurance. As more Americans become insured, that hidden tax will begin to disappear. In addition, covering everyone will put downward pressure on costs. Bringing younger, healthier people into the system will spread the risk. As more Americans become covered, insurance companies will compete for their business. That will begin to lower costs. And health insurance reform will create stability and security for everyone. If you lose or change jobs you will have the peace of mind of knowing that you will always be able to find an affordable health insurance option for your family.
If you read carefully, the healthcare reform plan requires premium payments to insurance companies on a promise the insurance premiums will be lower due to competition, one stop shop, and spreading the risk with younger and healthier people. Sounds familiar! The fact is this has been the promised by the industry for 30 years, and all we have is 47 million uninsured. The truth is we have been told this for over 4 decades and the industry has done nothing but collect premiums and profit from it. It is NOW time to start real healthcare reform and offer an alternative exclusive plan where the uninsured problem is solved by each community? These services can be rendered without the current insurance distribution system involvement. We the middleclass working American can go and get quality care for a monthly contribution which encompasses all primary, acute, and preventive care at a 47MR Center. A 47MR Center accepts no insurance carrier, and is supported by the community providers, businesses, and municipalities for the benefit of all their uninsured citizens. Let the money flow to the centers in the community and not the insurance industry for the uninsured. Let the individual and small business have the option of participating into this 47MR Center and the ability to purchase stop loss insurance at a low cost. See the model and learn more.
What are the benefits of the public option?
Health reform must be built on three fundamental principles: It must lower the skyrocketing cost of health care; guarantee choice of doctors and plans; and assure quality affordable health care for every American. A public option would achieve those goals and give the American people more choices. It would foster greater competition; lower costs; and give consumers a greater variety of affordable choices
What is the insurance exchange?
The health insurance exchange is a marketplace that will offer affordable high-quality health insurance options. It will provide relief to families who have no insurance or do not get adequate insurance at work and cannot afford to buy it in the costly individual or small group market. It is also for small businesses that cannot afford small group health insurance.. It is one-stop shopping that will enable you and your family to find a plan that is right for you.
For workers at big companies with group coverage, you can keep what you have with new protections against unfair insurance regulations that could limit your coverage if you get sick. And if you lose your job, move or decide to leave that company, you will know that there will be high-quality affordable health insurance options available for you on the exchange.
Why should people with insurance pay to cover those who don’t have it?
They are already paying for the uninsured. American families with insurance pay a hidden tax of roughly $1000 for the cost of caring for people without insurance. As more Americans become insured, that hidden tax will begin to disappear. In addition, covering everyone will put downward pressure on costs. Bringing younger, healthier people into the system will spread the risk. As more Americans become covered, insurance companies will compete for their business. That will begin to lower costs. And health insurance reform will create stability and security for everyone. If you lose or change jobs you will have the peace of mind of knowing that you will always be able to find an affordable health insurance option for your family.
If you read carefully, the healthcare reform plan requires premium payments to insurance companies on a promise the insurance premiums will be lower due to competition, one stop shop, and spreading the risk with younger and healthier people. Sounds familiar! The fact is this has been the promised by the industry for 30 years, and all we have is 47 million uninsured. The truth is we have been told this for over 4 decades and the industry has done nothing but collect premiums and profit from it. It is NOW time to start real healthcare reform and offer an alternative exclusive plan where the uninsured problem is solved by each community? These services can be rendered without the current insurance distribution system involvement. We the middleclass working American can go and get quality care for a monthly contribution which encompasses all primary, acute, and preventive care at a 47MR Center. A 47MR Center accepts no insurance carrier, and is supported by the community providers, businesses, and municipalities for the benefit of all their uninsured citizens. Let the money flow to the centers in the community and not the insurance industry for the uninsured. Let the individual and small business have the option of participating into this 47MR Center and the ability to purchase stop loss insurance at a low cost. See the model and learn more.
Saturday, August 8, 2009
ARE WE NOT TO BELIEVE IN HOW?
In listening to the President's weekly address today, it all sounds great. Getting the insurance industry to include prevention, mammographies, no pre-existing conditions, accept all the risk with no limitations or caps is a great idea. Yet if we have coverage, we can keep everything as we had before; our plan, our doctor, and our deductibles will even be capped to a maximum out of pocket. WOW why would anyone in their right mind not stand up and support this plan?
Why would any American object to reform? We American have waited over 4 decades to hear this news. We should all be ecstatic to finally see this done?
However, America is not convinced since the HOW is not clearly defined. We hear all the words, but have seen what has happened with the banks. What assurance do we have this is just not another windfall from which the insurance industry benefits? Remember the biggest objection is the public option, not the mandates.
Are we not to believe that the money being raised, a total of one trillion dollars of tax payer money, is not going to the insurance industry?
Are we now to believe that the plan currently offered by the industry will not have to include all the risk and offer a full major medical comprehensive plan to all Americans as the only plan design offering?
Are we to now believe that the insurance will make these comprehensive plans affordable even though the risks increased for the insurance industry?
Are we to believe that the expansion of Medicaid will lower the fraud and abuse experienced by this broken system by now forcing or mandating the uninsured to join the plan?
Are we to believe that Americans are going to pay less when the industry will charge more, or would Americans buy minimum coverage just because it's mandated like car insurance, creating a bigger pool of underinsured?
Are we to believe if the government subsidizes our premium to pay for the insurance we are paying less while insurance charges more, requiring more taxes for Americans to pay?
Are we to believe just having insurance will open the doors to the medical providers who seem to have them close for the Medicaid, underinsured, and the uninsured?
Are we to believe the current distribution system of the insurance industry that has existed for 4 decades is the best system for access to healthcare?
I believe the current health reform needs to answer these questions and show the American people HOW it will work. American is divided in the HOW, not the fact that we need change.
Americans are not convinced and need answers to these questions. Our children's future depends on what we do today. No one is willing to gamble with their children's future without straight answers on HOW.
Why would any American object to reform? We American have waited over 4 decades to hear this news. We should all be ecstatic to finally see this done?
However, America is not convinced since the HOW is not clearly defined. We hear all the words, but have seen what has happened with the banks. What assurance do we have this is just not another windfall from which the insurance industry benefits? Remember the biggest objection is the public option, not the mandates.
Are we not to believe that the money being raised, a total of one trillion dollars of tax payer money, is not going to the insurance industry?
Are we now to believe that the plan currently offered by the industry will not have to include all the risk and offer a full major medical comprehensive plan to all Americans as the only plan design offering?
Are we to now believe that the insurance will make these comprehensive plans affordable even though the risks increased for the insurance industry?
Are we to believe that the expansion of Medicaid will lower the fraud and abuse experienced by this broken system by now forcing or mandating the uninsured to join the plan?
Are we to believe that Americans are going to pay less when the industry will charge more, or would Americans buy minimum coverage just because it's mandated like car insurance, creating a bigger pool of underinsured?
Are we to believe if the government subsidizes our premium to pay for the insurance we are paying less while insurance charges more, requiring more taxes for Americans to pay?
Are we to believe just having insurance will open the doors to the medical providers who seem to have them close for the Medicaid, underinsured, and the uninsured?
Are we to believe the current distribution system of the insurance industry that has existed for 4 decades is the best system for access to healthcare?
I believe the current health reform needs to answer these questions and show the American people HOW it will work. American is divided in the HOW, not the fact that we need change.
Americans are not convinced and need answers to these questions. Our children's future depends on what we do today. No one is willing to gamble with their children's future without straight answers on HOW.
Thursday, July 9, 2009
What exactly is the Public Option?
As I travel the country and ask the question, it is apparent that America has no clear definition of the Public Option policy. It is clear there are still many questions on this Public Option policy. Let’s begin by understanding what does public option mean? Public Option is understood to have the government “own” an insurance company to offer a competitive product in healthcare to compete with the private insurance companies. This option is in a National insurance exchange or a spectrum of policies, so the consumer can choose and pick the policy in order to acquire affordable healthcare. So the consumer has all the insurance choices, federal employee plans, private plans, and the new Public Option plan.
So is this new government insurance policy truly going to lower the cost of healthcare? Many Americans believe it will. By offering the Public Option, the private insurance company will be forced to lower their rate, or leave the business; this is the consensus of many Americans. Many believe the only solution is a single payer system eliminating the insurance industry completely. So they support this Public Option.
What is not known is the following:
1. What those savings will be?
2. What policy design will be offered?
3. Will the current system of distribution, where everything goes thru the insurance companies, really make a difference now that a government insurance plan is available?
4. Where does all the 634 billion dollars go too? Is it all premiums to the insurance companies?
These are the questions we should consider, and I will attempt to objectively answer.
1. The savings projected by lowering administration fee is estimated at 20%, but that is arbitrary and uncertain.
2. The design is in providing a comprehensive major medical plan. Although the administration may be reduced, the cost will continue to rise. Senator Baucus himself projects premium in 2013 to be $6800 for single person and $17,000 for a family before taxing corporations. There are no projected changes occurring in existing catastrophic plans, where the maximum is $10,000. Why?
3. Since the current system will continue as before with the addition of the government Public Option plan with the same inefficiency, fraud, and ineffectiveness, inevitably the result will be No Change.
4. The dollars allocated for reform will be paid to the insurance industry, and increased fees to the providers thru the insurance industry resulting in a windfall, leaving the American consumer frustrated, under insured, and paying more premiums and taxes in the long run.
The unanswered question is the problem. If we are to believe a government plan is truly the answer, then we should demand AIG to provide the plans, since the government owns AIG. Is this not the proposed Public Option to have a government owned insurance company? What about a public option where the current system is not necessary and provides a true option to the public? We should have a public option where communities can participate and offer access to the 47 Million uninsured, a system where the providers and consumers work together without everything going thru the insurance companies.
AIG or a government plan should offer a stop-loss catastrophic policies with a low premium and very high deductibles for all American interested in covering all major illnesses after the high deductibles at 100% to cover their back.
The community public option with the stop-loss catastrophic policy is viable solution for the uninsured, and indeed would offer the public an option.
So is this new government insurance policy truly going to lower the cost of healthcare? Many Americans believe it will. By offering the Public Option, the private insurance company will be forced to lower their rate, or leave the business; this is the consensus of many Americans. Many believe the only solution is a single payer system eliminating the insurance industry completely. So they support this Public Option.
What is not known is the following:
1. What those savings will be?
2. What policy design will be offered?
3. Will the current system of distribution, where everything goes thru the insurance companies, really make a difference now that a government insurance plan is available?
4. Where does all the 634 billion dollars go too? Is it all premiums to the insurance companies?
These are the questions we should consider, and I will attempt to objectively answer.
1. The savings projected by lowering administration fee is estimated at 20%, but that is arbitrary and uncertain.
2. The design is in providing a comprehensive major medical plan. Although the administration may be reduced, the cost will continue to rise. Senator Baucus himself projects premium in 2013 to be $6800 for single person and $17,000 for a family before taxing corporations. There are no projected changes occurring in existing catastrophic plans, where the maximum is $10,000. Why?
3. Since the current system will continue as before with the addition of the government Public Option plan with the same inefficiency, fraud, and ineffectiveness, inevitably the result will be No Change.
4. The dollars allocated for reform will be paid to the insurance industry, and increased fees to the providers thru the insurance industry resulting in a windfall, leaving the American consumer frustrated, under insured, and paying more premiums and taxes in the long run.
The unanswered question is the problem. If we are to believe a government plan is truly the answer, then we should demand AIG to provide the plans, since the government owns AIG. Is this not the proposed Public Option to have a government owned insurance company? What about a public option where the current system is not necessary and provides a true option to the public? We should have a public option where communities can participate and offer access to the 47 Million uninsured, a system where the providers and consumers work together without everything going thru the insurance companies.
AIG or a government plan should offer a stop-loss catastrophic policies with a low premium and very high deductibles for all American interested in covering all major illnesses after the high deductibles at 100% to cover their back.
The community public option with the stop-loss catastrophic policy is viable solution for the uninsured, and indeed would offer the public an option.
Saturday, July 4, 2009
Great News! Free Rx Cards Offered to the Uninsured on Independence Day
In an effort to help the uninsured during these difficult economical times 47 Million Reasons Healthcare Movement, a healthcare reform advocacy group announces today beginning on America’s Independence Day July 4th; they will be offering a FREE Rx Card to reduce the cost of prescription purchased for the uninsured.
Right now Americas 47 million uninsured need help and cannot wait for healthcare reform. The government has complicated the issue, and it seems a long debate will be brewing before healthcare reform ever happens. In the meantime while 47 million Americans await their fate, life goes on and the cost of getting medication can be prohibitive.
Why can the government just address the problem? The opportunity exists for a new plan apart from the current systems specific for the uninsured. 47 Million Americans are willing to pay, but is it necessary to follow the current ways, which is filled with special interest groups, bureaucracy, and control from an industry whom lost the fiduciary responsibility to its policyholders to provide protection to cover the risk?
So we are reaching out to business, associations, co-op’s. charities alike to joins us in our efforts to help the uninsured. We are seeking a community whom would like to be the first to support and implement the first 47MR Center Model in their community. A model which needs no insurance claims administration or bureaucracy: Where the primary concern is health, wellness and fitness, where primary care doctors and specialists work together and can practice medicine free from all the restriction the insurance industry places on them. The insurance companies can offer to cover the individual risk for major illness ONLY, at an affordable rate for the uninsured.
Learn more at http://www.47millionreasons.org/ and download your RX card today and start saving money and join our efforts to create a 47MR Center in your community.
Right now Americas 47 million uninsured need help and cannot wait for healthcare reform. The government has complicated the issue, and it seems a long debate will be brewing before healthcare reform ever happens. In the meantime while 47 million Americans await their fate, life goes on and the cost of getting medication can be prohibitive.
Why can the government just address the problem? The opportunity exists for a new plan apart from the current systems specific for the uninsured. 47 Million Americans are willing to pay, but is it necessary to follow the current ways, which is filled with special interest groups, bureaucracy, and control from an industry whom lost the fiduciary responsibility to its policyholders to provide protection to cover the risk?
So we are reaching out to business, associations, co-op’s. charities alike to joins us in our efforts to help the uninsured. We are seeking a community whom would like to be the first to support and implement the first 47MR Center Model in their community. A model which needs no insurance claims administration or bureaucracy: Where the primary concern is health, wellness and fitness, where primary care doctors and specialists work together and can practice medicine free from all the restriction the insurance industry places on them. The insurance companies can offer to cover the individual risk for major illness ONLY, at an affordable rate for the uninsured.
Learn more at http://www.47millionreasons.org/ and download your RX card today and start saving money and join our efforts to create a 47MR Center in your community.
Friday, June 26, 2009
Who is Benefiting From One Trillion Dollars?
Ask yourself, who will recieve the one trillion dollars? Are we not just being taxed again, after paying for premium to the insurance industry? Is the cost of insurance due to this reform going to cost over $17,000 for family, and $6800 for single by 2013 ? Where is the cost reduction to the taxpayer, premium payer individual trying to make it? Are we just not paying more to the insurance industry and government for healthcare? Is this reform, or are we just being taxed and then forced to pay premium for healthcare coverage? Its OK to make the overhaul reform to healthcare and create the saving from the Medicaid and Medicare system whom has been mismanaged and needed reform. However, do we really need to immediately spend the saving in the same manner? What happen to freedom of choice? An alternative to pay minimum insurance premium and no more taxes, and have the communities business and local providers work together with communities centers and hospitals for their citizens that are uninsured? This is the 47million reasons model and I think we should look real hard at it before we end up paying way more for what we ask to be reduce, the cost of healthcare. Lets not spend one trillion dollars in the name of healthcare reform to only end up wondering where did all the money go with no idea who the recipients are, and what services are we really buying.
Sunday, June 21, 2009
We the People vs. the Lobbyists
In today's Washington Post this article clearly shows the issues, " Health-Care Reform Will Test Obama's Resolve» Links to this article By Dan Balz Sunday, June 21, 2009", and on how lobbyists play a huge role in what will happen in healthcare reform. The issues are: Cost which continues to be the big issue. Then taxation, mandates, bipartisanship, the public option, and the game of politics for compromise with the lobbyists representatives, our Senators for healthcare reform. And when we reach out to Congress with other cost saving options, which do not agree with the lobbyist we are ignored. If the President has the ultimate decision in this healthcare reform, it’s time to open the door to "We the People" without special interest. The cost of insuring 47 millions can be achieved; $250 billion of the $634 billion set aside in 10 years is the catalyst to reality, if anyone cares to listen.
Why must we accept the lobbyists view points or compromise with the private industries whom has had the opportunity to fix the problem 15 years ago, and have lead us down this path of self destruction, and now America is in debt with foreign countries. Have we not learned anything these pass years in which greed has placed us all in this predicament, and above patriotism?
The healthcare system is not the only thing broken in this country. The biggest difference today versus the time of our fore fathers is American has been place second, to party and greed. We are first and foremost Americans. We must fix America's health and stop this political correct nonsense and do what is right for the American people. The questions we should be asking ourselves is:
1. What comes first Country or Party?
2. Do we really need insurance in everything we do in solving this healthcare issue?
3. Can we as citizens work directly with businesses and local medical providers?
4. Would the premium spend on insurance serve us better supporting our own community medical centers and hospitals?
5. What coverage is important to have insurance for, common flu or major illness?
6. Why can the HSA, have an option of an insurance plan that covers high deductibles starting at 25k to 100K which will have a very low cost and cover 100% thereafter for all major illness?
7. What is important: Access or Insurance?
8. Having a community center that provides basic healthcare services, wellness, and education and work with specialist and hospitals, is that possible?
9. Would providers work directly with community centers at special rates?
10. Why can't we have these center specifically for the uninsured, not for Medicaid, Medicare, VA, or those who can afford private insurance?
These questions have answers if everyone focuses on solving the problem. To try to fix the overall system to encompassing everything and everyone is too expensive and too many special interest groups are involved.
We the people of the uninsured, have falling from the system and are not eligible for any program currently offered. So this is the time to create our own model, apart from the broken system. We are a group of 47 Million whom every company in the insurance and healthcare industry wants to do business with. These industries are trying to demand the government to provide coverage at a cost of $1.6 Trillion dollars for them to cover us.
We can do it better. We have a model at a cost of $250 billion of the $634 billion set aside for healthcare reform. Why can't we have this option? It’s time to stand and let Congress know we have a plan we want for the uninsured. We are not interested in leaving a legacy of debt for our children and grandchildren to repay.
America Comes First!
Why must we accept the lobbyists view points or compromise with the private industries whom has had the opportunity to fix the problem 15 years ago, and have lead us down this path of self destruction, and now America is in debt with foreign countries. Have we not learned anything these pass years in which greed has placed us all in this predicament, and above patriotism?
The healthcare system is not the only thing broken in this country. The biggest difference today versus the time of our fore fathers is American has been place second, to party and greed. We are first and foremost Americans. We must fix America's health and stop this political correct nonsense and do what is right for the American people. The questions we should be asking ourselves is:
1. What comes first Country or Party?
2. Do we really need insurance in everything we do in solving this healthcare issue?
3. Can we as citizens work directly with businesses and local medical providers?
4. Would the premium spend on insurance serve us better supporting our own community medical centers and hospitals?
5. What coverage is important to have insurance for, common flu or major illness?
6. Why can the HSA, have an option of an insurance plan that covers high deductibles starting at 25k to 100K which will have a very low cost and cover 100% thereafter for all major illness?
7. What is important: Access or Insurance?
8. Having a community center that provides basic healthcare services, wellness, and education and work with specialist and hospitals, is that possible?
9. Would providers work directly with community centers at special rates?
10. Why can't we have these center specifically for the uninsured, not for Medicaid, Medicare, VA, or those who can afford private insurance?
These questions have answers if everyone focuses on solving the problem. To try to fix the overall system to encompassing everything and everyone is too expensive and too many special interest groups are involved.
We the people of the uninsured, have falling from the system and are not eligible for any program currently offered. So this is the time to create our own model, apart from the broken system. We are a group of 47 Million whom every company in the insurance and healthcare industry wants to do business with. These industries are trying to demand the government to provide coverage at a cost of $1.6 Trillion dollars for them to cover us.
We can do it better. We have a model at a cost of $250 billion of the $634 billion set aside for healthcare reform. Why can't we have this option? It’s time to stand and let Congress know we have a plan we want for the uninsured. We are not interested in leaving a legacy of debt for our children and grandchildren to repay.
America Comes First!
Wednesday, June 17, 2009
Enough is Enough; it’s time to look outside the box for healthcare reform.
Are any of the experts looking outside the box for healthcare reform? In reading the Washington Post article “Will the Health Industry Derail Obama's Reforms?” the basic theme is the American people cannot resolve their own healthcare issues so government, AMA, Insurance Carriers, and special interest must offer a solution for the American people.
Since the government is willing to spend American taxpayers money and give it to these organization for a promise to provide a solution to take care of the 16 million uninsured at a cost of 1trillion dollars by offering a public plan, these organization protesting not about the cost but rather about the restrictions the public plan would impose on them.
The potential loss of private business, the constraints of payout to providers, the control shift from private to public, and the standard of care all become in question with this idea of public government plans. So the battle begins as it did back in 1993.
The government is currently offering three public plans, Medicaid, Medicare, Veterans Administration Healthcare, each with their pros and cons. So it is necessary to fix the problems in these government programs, and creating an efficient system prior to looking to expand or enter into another public plan. We must remember many of these public plans are administrated by private insurance carriers and the overbilling and fraud continues on these carriers watch of taxpayers’ money.
So what can we expect from the government or the healthcare and insurance industry? They have been working together for years and there have been no positive results. Is it because too many compromises are made in Washington, which results in public policy at the expense of the American people? Just the thought of the President considering mandating healthcare to the 47 million uninsured, is a windfall to the insurance industry and clearly demonstrate this point.
Enough is enough in allowing Washington to continue this narrow focus on solving healthcare problem through the taxpayers by paying the insurance industry, and healthcare industry for a broken healthcare system.
The government should be more in touch in what the American people want and need. The reality is clear of the 47 million uninsured, only 16 million will be insured at the cost of 1 trillion dollars. So what about the rest? If the government wants change then fix the problem by making AIG and the rest of the insurance industry offer stop-loss catastrophic policies which cover the major illnesses by placing a stop gap of 25K, 50K, 75K to the American uninsured which is a fraction of the cost of what is offered now. American wants protection of their major assets and wants policies that protect those assets in the event of major medical emergency.
The primary medical services can be provided on a community level. Many Doctors are now not accepting any insurance and offer affordable fees to their community in an effort to provide care for the uninsured. This is simple and provides access to the uninsured.
An expanded model exists of this simple concept, which shows from the grass roots how each community can service their own uninsured. All the government must do is to listen to the professionals whom are making a difference in their community. Listen to the American People whom want to protect their assets and willing to pay for premium that protect their assets if a major illness occurs, listen to insurance professional whom are tired of selling inferior insurance healthcare products that benefits no one but the industry and watch their client lose everything due to being under insured.
A solution exist which addresses the problem of the 47 million uninsured, apart of what already exist. It meets the Presidents requests with minimum government contribution, or insurance industry involvement. Let us have this model be an alternative for the American people in their own communities. Read more at www.47millionreasons.org. Join the 47 Million Reasons Healthcare Movement.
http://apps.facebook.com/causes/286402?m=3124eff7
Since the government is willing to spend American taxpayers money and give it to these organization for a promise to provide a solution to take care of the 16 million uninsured at a cost of 1trillion dollars by offering a public plan, these organization protesting not about the cost but rather about the restrictions the public plan would impose on them.
The potential loss of private business, the constraints of payout to providers, the control shift from private to public, and the standard of care all become in question with this idea of public government plans. So the battle begins as it did back in 1993.
The government is currently offering three public plans, Medicaid, Medicare, Veterans Administration Healthcare, each with their pros and cons. So it is necessary to fix the problems in these government programs, and creating an efficient system prior to looking to expand or enter into another public plan. We must remember many of these public plans are administrated by private insurance carriers and the overbilling and fraud continues on these carriers watch of taxpayers’ money.
So what can we expect from the government or the healthcare and insurance industry? They have been working together for years and there have been no positive results. Is it because too many compromises are made in Washington, which results in public policy at the expense of the American people? Just the thought of the President considering mandating healthcare to the 47 million uninsured, is a windfall to the insurance industry and clearly demonstrate this point.
Enough is enough in allowing Washington to continue this narrow focus on solving healthcare problem through the taxpayers by paying the insurance industry, and healthcare industry for a broken healthcare system.
The government should be more in touch in what the American people want and need. The reality is clear of the 47 million uninsured, only 16 million will be insured at the cost of 1 trillion dollars. So what about the rest? If the government wants change then fix the problem by making AIG and the rest of the insurance industry offer stop-loss catastrophic policies which cover the major illnesses by placing a stop gap of 25K, 50K, 75K to the American uninsured which is a fraction of the cost of what is offered now. American wants protection of their major assets and wants policies that protect those assets in the event of major medical emergency.
The primary medical services can be provided on a community level. Many Doctors are now not accepting any insurance and offer affordable fees to their community in an effort to provide care for the uninsured. This is simple and provides access to the uninsured.
An expanded model exists of this simple concept, which shows from the grass roots how each community can service their own uninsured. All the government must do is to listen to the professionals whom are making a difference in their community. Listen to the American People whom want to protect their assets and willing to pay for premium that protect their assets if a major illness occurs, listen to insurance professional whom are tired of selling inferior insurance healthcare products that benefits no one but the industry and watch their client lose everything due to being under insured.
A solution exist which addresses the problem of the 47 million uninsured, apart of what already exist. It meets the Presidents requests with minimum government contribution, or insurance industry involvement. Let us have this model be an alternative for the American people in their own communities. Read more at www.47millionreasons.org. Join the 47 Million Reasons Healthcare Movement.
http://apps.facebook.com/causes/286402?m=3124eff7
Tuesday, April 21, 2009
Welcome to the 47 Million Reasons Movement Official Blog!
Welcome, welcome fellow Americans! Stay tuned to this Blog for upcoming news about our movement for realizing true health care reform in the USA! Visit us at http://www.47millionreasons.org today and register with us to support a genuine, viable solution for all uninsured Americans.
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