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Archive for Saturday, February 13, 2010

A day at Lawrence’s Health Care Access clinic reveals need for affordable medical care

Louis Shannon, left,  of Lawrence, gets his temperature and other vitals taken by Jeri Safarik, a registered nurse, on Feb. 9, 2010, at Health Care Access clinic, which serves low-income, uninsured Douglas County residents. Jamie Kessler is seated to the right.

Louis Shannon, left, of Lawrence, gets his temperature and other vitals taken by Jeri Safarik, a registered nurse, on Feb. 9, 2010, at Health Care Access clinic, which serves low-income, uninsured Douglas County residents. Jamie Kessler is seated to the right.

February 13, 2010

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Spend a day at Health Care Access and you quickly see the need for health care reform.

Health Care Access is a Lawrence clinic that provides medical care for low-income Douglas County residents who do not have health insurance.

The need for the clinic’s services continues to grow. It served 1,431 patients last year, a 62 percent increase since serving 886 patients in 1992 when it moved to 1920 Moodie Road.

On Tuesday, the nonprofit clinic will open in a much-needed bigger location at 330 Maine, across the street from Lawrence Memorial Hospital’s emergency room.

Before packing up, the clinic’s staff allowed me to spend a day — Feb. 9 — at the clinic.

Executive Director Nikki King has told me the approximately five appointments left open daily for acute care are filled within 10 minutes. She wasn’t kidding. Two employees handle those calls when the clinic opens its phone lines at 8:30 a.m. They sit at adjacent desks, so they don’t accidentally book the same open slot. Today, six appointments are open.

Maria Kerby is the office manager, and Pam Holden, medication coordinator, is there to help her out. They are among the clinic’s seven full-time and two part-time employees.

8:10 a.m. — The first patient is waiting outside in her vehicle.

8:31 a.m. — Maria answers the phone, “Health Care Access, please hold,” and hits a button. She answers another call, “Health Care Access, please hold,” and hits a button. She answers another call, “Health Care Access, please hold,” and hits a button. Soon, all five lines are lit with a red light.

8:36 a.m. — All of today’s acute appointments are filled.

8:39 a.m. — Maria turns away the first caller seeking acute care. She provides references to five other clinics — all will require a fee unless it is an emergency, unlike Health Care Access. The clinic has a $10 fee, but doesn’t turn anyone away who can’t afford it. On this day, many couldn’t.

I visited with as many patients as possible. Only one declined an interview. Their ages ranged from 26 to 51. They were mothers, grandmothers, daughters and fathers.

I found they had several things in common. They had no health insurance and couldn’t afford insurance. They also were ashamed about accessing the clinic, but were very grateful.

Despite a bitter cold, snowy day, no one misses an appointment.

8:46 a.m. — Three patients are in the waiting room. One is a single, 31-year-old Lawrence woman, who has been unemployed for about a year. She has a follow-up appointment for depression. It took two months to get the first appointment. The high school graduate, who mostly has worked in call centers, hasn’t had health insurance for about four years.

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9:55 a.m. — A 30-year-old single mother, of Lawrence, waits to get test results with her 9-year-old son, who receives health care through the state’s HealthWave program. She works full time at a Lawrence massage business, which doesn’t offer health or dental insurance. She hasn’t had health insurance since May when she worked another job. It took $100 per month out of her paycheck.

“It was tight, but it beat not having it,” she says.

She estimated it would cost $300 a month for insurance and that wouldn’t include co-pays and prescriptions.

“I’ve already cut back on everything else,” she says. “I can’t cut anymore.”

10:10 a.m. — 30-year-old Louis Shannon, an employee at Kansas University, says he hasn’t had health insurance “for years.” He was referred to the clinic from a doctor at Lawrence Memorial Hospital. He was at the clinic for a post-surgical checkup.

10:15 a.m. — Tracy St. Clair, 44, of Lawrence, is in pain and can barely sit straight as she waits to see a nurse. St. Clair initially injured her back 10 years ago, and now has degenerative disc disease. She had an asthma attack last weekend that triggered the pain. She tried to get an acute appointment at 8:34 a.m. Monday, but was too late. She is employed, but can’t afford the insurance her job offers, which doesn’t cover prescriptions she needs. Her husband is unemployed and uninsured. St. Clair has been using Health Care Access about four years.

“I tell everybody about this place because there are a lot of people going without and don’t realize there is a place like this,” she says.

10:40 a.m. — A 53-year-old grandmother, who works two jobs in nursing care, waits to get her foot looked at. She thinks it might be broken and has waited more than a month before seeking care.

“I can’t take it anymore,” she says.

It is her first visit to the clinic because she can’t afford more medical bills elsewhere; she owes about $15,000.

She has pre-existing conditions, which makes health insurance unaffordable. She also is taking care of her grown son, his wife and 13-month-old child.

“I can’t let them go hungry,” she says. “I work every day — seven days a week — and still can’t afford insurance.”

The last time she had health insurance was in 2003.

10:50 a.m. — 46-year-old Lawrence resident William Miller is unemployed and also hurting from back pain.

“Without Health Care Access, I would be laying in bed hurt — big time,” he says.

He doesn’t remember ever having health insurance. Miller has worked at many places that don’t offer insurance. Today, he can’t afford the $10 fee.

“I am sick about it,” he says. “But, they don’t hassle me about it.”

11 a.m. — Gloria Mooney, 35, of Lawrence, is picking up paperwork about her 43-year-old husband’s heart problems. He works, but his employer doesn’t offer health insurance. She’s unemployed. She can only chuckle when I ask, “When was the last time you had health insurance?”

“Oh my gosh,” she says. “It’s been forever. About 13 years.”

Gloria and her husband have been using the clinic since.

“He (her husband) would probably be dead now if it wasn’t for this place,” she says.

They looked into buying insurance, but estimate it would cost $700 a month.

11:10 a.m. — A 44-year-old Eudora resident, who is self-employed, says she hasn’t had health insurance since 1991 when she worked another job. She went years without medical care until her husband lost his job in October, and then she qualified for Health Care Access. Today, she is getting blood work and thyroid medicine. She also has scheduled a mammogram.

The couple looked into insurance, but it would cost about $600 a month.

“I didn’t want to make another house payment,” she says.

To qualify for the clinic’s services, people must live in Douglas County. They can’t have any type of health insurance or resource such as Medicaid or student health services. They can’t have a gross income of more than 185 percent of federal poverty level guidelines. That’s about $20,000 for a single person or about $40,800 for a family of four. Nearly three-quarters of Health Care Access patients are at 100 percent of the poverty level — so they make $10,830 or less. That’s $22,000 for a family of four.

New tenants sought for vacated clinic

The future of the Health Care Access building, 1920 Moodie Road, soon will be up for grabs.

City commissioners on Tuesday are expected to issue a request for proposals on how the city-owned building can be used now that Health Care Access is moving to a new location near Lawrence Memorial Hospital.

City staff members have said the building is not well-suited for city office space, and are recommending that the commission receive proposals from nonprofit agencies that may have a use for the building.

The city could choose to sell the building, but because it was built using federal community development block grant money, the city would have to reimburse the federal program about $75,000.

Commissioners meet at 6:35 p.m. Tuesday at City Hall, Sixth and Massachusetts streets.

12:30 p.m. — Staff members eat lunch at desks scattered in a room, where the nurses work. We chit-chat about the benefits and frustrations of their jobs. Taking part in the conversation are Maria, Pam; Melynda Swoyer, a nurse practitioner student; Jeri Safarik, registered nurse; and Lori Winfrey, clinic manager.

They say they aren’t going to get rich by working at a nonprofit, but the work is rewarding because most patients are appreciative.

But, it’s not easy to provide such services.

They are constantly thinking about costs when trying to get patients the treatment they deserve. They make numerous phone calls to find health professionals who might offer tests, medicine or surgery for free or at a reduced cost. Fortunately, 100 doctors do, and only two do not live in Lawrence.

Last year, the clinic provided about $4 million in care and $450,000 in medication.

1 p.m. — Dr. Marc Scarbrough, a hospitalist at Lawrence Memorial Hospital, arrives to volunteer.

1:25 p.m. — Maria turns away the third walk-in visitor seeking an appointment that day.

1:40 p.m. — A 43-year-old Lawrence woman visits the clinic for the first time. She was referred by a Kansas City hospital. She lost her job in April, but can’t remember the last time she had health insurance. She recently graduated from Fort Scott Community College’s Harley-Davidson Training Center in Pittsburg.

2:20 p.m. — Emily Hanks, 27, of Lawrence, is waiting for test results. Two weeks ago, she became very ill and had a 102 degree temperature.

She has been using the clinic for about five years. She works at two part-time jobs that don’t offer health insurance.

Emily says heat, electricity and food come before health insurance.

“It’s not a priority and I know that worries my parents,” she says.

3:05 p.m. — I have to wait to get back into waiting room because a nurse is weighing a patient next to the door.

The staff is looking forward to its new home because it will be about twice the size. There will be 11 clinic rooms instead of six, although today they are using just four. They aren’t using the “makeshift” clinic rooms that are divided by just curtains. They hope more doctors, like Scarbrough, can volunteer because they will be closer to LMH and medical offices.

3:10 p.m. — Five patients are waiting. It is so quiet that you can hear the clock ticking, which makes it difficult to interview patients about personal matters.

3:25 p.m. — Sally Zogry, development director, goes over plans for the clinic’s biggest fundraiser, a marathon on April 18, with Ryan Robinson, race director. They have 458 people registered for the day’s races — a 5K, half marathon and full marathon.

The clinic’s budget is $479,000 this year. About half of the money comes from city, county, state and United Way of Douglas County. The other half is from grants, fundraisers and donations.

3:40 p.m. — Natalie Hamilton, 46, is self-employed and can’t afford insurance. She has been using the clinic since 1998 — the last time she had insurance.

“Luckily, I don’t get sick,” she says.

Hamilton doesn’t use the clinic unless she has to and says she is apt to “let things go.”

4:10 p.m. — Anthony Carter, 26, is checking out. He is a manager at a fast-food restaurant that doesn’t offer insurance. He has used the clinic for about four years.

“If it wasn’t here, I would be in a bind,” he says.

4:20 p.m. — I visit with Dr. Scarbrough before he leaves. He says it’s difficult when he can’t prescribe the best treatment for a patient.

“I have to think, ‘Is the plan that I would really like to do going to be feasible, affordable, and is it really going to happen? How long does it take?’ For example, if they need a colonoscopy, say for bleeding or chronic diarrhea, and some of the practitioners will donate a colonoscopy, but only do one a month. How long is it going to take? Can we get them in? Those are some of the challenges that we face here.”

4:45 p.m. — Natalie, the last patient of the day, leaves after making a follow-up appointment and paying the $10 fee. Maria follows and locks the door. She organizes the waiting room and shuts off the light.

5:15 p.m. — Two nurses — Jeri and Betsy McCafferty — are calling patients and giving them test results. Jeri informs someone that his or her blood pressure was high.

There's a pause and then, she chuckles.

“Maybe, you should eat fewer homemade cinnamon rolls,” she advises.

The clinic serves 22 patients today and turns away so many that Maria couldn’t keep track.

Comments

edjayhawk 4 years, 2 months ago

People who practice good preventative health should get a tax credit and not have to subsidize the obese, smokers, alcoholics etc...

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edjayhawk 4 years, 2 months ago

Liberty275 (Anonymous) says… Here's an idea: let the federal government fund a minimal amount for these clinics

That is socialism as you define it dumbarse...

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George Lippencott 4 years, 2 months ago

BrianR (Anonymous) says

A very valid comment. That said, where does the money come from?? I have trouble with the notion we can do this without major cost increases (despite advocate studies to the contrary) or care rationing - or both?

The notion that most of the costs of insurance would not be transferred to the government if it ran the system seems naive. Other systems hold down costs by rationing in time and quality while paying doctors a lot less than we do. Cost will only be reduced without those consequences if the whole system is government owned and operated. In that case we frequently overlook the costs of facilities, equipment, training, and so on. So, maybe there will be no savings!

Besides entering into a national health care system when we can not afford the social initiatives we already have is also naive

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Ryan Neuhofel 4 years, 2 months ago

Liberty275, You are correct that "insurance" was originally designed to hedge against unforeseen, expensive events . . .and it operates relatively well as such in other industries - auto, home, etc. And to that extent, insurance does provide a "value" for the consumer. Unfortunately, in health care these third-parties have been morphed into fully dominate managers/middlemen - a la, managed care (HMOs, PPOs). Your description about being "protected" from the high cost 'doctors visits', xrays and eyeglasses via your "insurance" ignores two very large facts in the triangulation of payment . . . 1) Third-party payment system drastically increases the cost of the end-product you need - from the administrative costs of the actual doctor and paying insurance administration. Standard doctor visits wouldn't cost $200 if a simplified direct patient-doctor relationship existed - considering a standard Primary Care practice operates at 70-80% overhead (minus doctors salary), likely much, much less. 2) Third-parties do not ultimately "pay" for anything - assuming they are making profits. If their expenses (payments for health care) rise, they just charge higher premiums of their members.

The short story goes something like this . . . Insurance makes real health care costs higher, Consumers doesn't like high costs of care directly, Consumers buy more insurance to falsely defray costs and on and on. Present day.

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George Lippencott 4 years, 2 months ago

PosseComitatus (Anonymous) says…

That works for any third payer including the government

Others. Not all health care insurance is bought by the individual. Large corporations and some government agencies essentially self-insure. The insurance companies administersan employer approved prgram in to which the employee can participate at will.

I don't know the relarive sharing but I suspect that this model may predominate in value.

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George Lippencott 4 years, 2 months ago

lawrencian (Anonymous) says…

You have to pay for it - as I understand it there is some cost sharing particularly with families. You can elect to not pay.

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Liberty275 4 years, 2 months ago

"They are no-value-added."

Risk assurance is the value they add. Our premiums are ~$400 a month. It pays all but $25 of a typical $200 doctors visit, fully covers xrays and stuff like that. But the real value is in paying for $100,000 bills should I need open heart surgery or a new liver.

Nevermind the dental that just paid for my $2000 root canal/cap or that the vision portion paid for a signifigant portion of the $600 eyeglases I wear.

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Sparko 4 years, 2 months ago

Insurance companies actually don't provide care, but profit on the work done by others. They are no-value-added. That we allow legalized medical extortion in 2010 is sad and unsustainable.

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PosseComitatus 4 years, 2 months ago

Look at this business model for you answer to the health care crisis. As long as there is an insurance product involved in your health care the problem will not be solved. There will never be enough money to make it work. Insurance for routine care raises prices.

Let's look at something that most people are exposed to, ambulance transport. Your tax dollars support the operation of ambulances in the county. It pays for the ambulance, staffing and supplies. Now if you are involved in an accident you will receive a bill for the services that the ambulance provides to a tune of about $800.

Why is that???

Well it boils down to the fact that if you want to get money from an insurance company or medicaid you have to bill the same for these services every time you deliver them. You can't create separate billing policies for cash, or the uninsured. So basically insurance and medicaid have taken something that was paid for by tax dollars and used to be "free" and turned it into a major expense.

This applies to every item or service delivered in the health care industry.

The answer to this problem is not more insurance.

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lawrencian 4 years, 2 months ago

How is it possible for someone to work at KU and not have health insurance?!? As an employee at KU, it is my understanding that you can only opt out of health insurance if you can prove you have it through some other company... Something does not add up here.

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BrianR 4 years, 2 months ago

One thing that is going to keep the U.S. down in the world marketplace is that our industries, who have to bear health care expenses, are competing with companies overseas who do not. Patients are not the only good reason a government-run single payer system is in everyone's best interest. We can either lose in the short run by doing nothing to change our current system or lose in the long run when there are absolutely no jobs remaining on our shores to help us pay for our health care.

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George Lippencott 4 years, 2 months ago

kylechandler (Anonymous) says…

And what have you done for the rest of us. Why do you get to demand that the middle and upper middle pay ever increasing portions of their incomes to bail out the lower middle (the poor already have programs). It is even more distasteful in that you do not demand that the elites (who minipulate these arguments) pay even a fair share. Whoever you are, your shrill demands that others make sacrifices for you raise question as to your reason to be.

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George Lippencott 4 years, 2 months ago

bookemdano (Anonymous) says…

I sure am on Medicare. I planned my life and made decisions that insured I had care and could pay for it. Too many of those you want me to pay for made poor decisions and now want me to bail them out. PS My Medicare is the promised retirement health care for military members as promised by your representatives in securing my services on your behalf!!

Let us talk about TAs at KU. They are not well paid because they are working to improve their condition and secure a satisfying upper middle class life in their future. Now they demonstrate and argue for me to pay for them while complaining over the possibility they may have to pay for me when they make it. Greedy bunch!

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lilchick 4 years, 2 months ago

Thank you Karrey, for clearing the staffing numbers up.

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denak 4 years, 2 months ago

I think it is unfortunate that Karen Britt had to ruin what was a fairly good article by ending it with such an inflammatory statement as: "...Maybe, you should eat fewer homemade cinnamon rolls,” she advises...."

Of all the patients written about, not one of them was at the clinic for an illness directly related to obesity or eating habits. They were there for: depression, test results(two), a post surgical check-up, pain related to degenerative disc disease, a broken foot, back pain, paperwork for spouse's heart problem, blood work and to schedule a mammogram.

And yet, she chooses to end her article with a snippet of a conversation that she didn't hear both sides and so gives the impression....one that many posters obviously jumped on...that the people who use Health Care Access are ones that eat badly and laugh about their health problems.

Dena

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Karrey Britt 4 years, 2 months ago

There were two registered nurses, a nurse practitioner student, and clinic manager, who helped care for patients on the day that I was there. Dr. Scarbrough estimated he took care of six patients in the afternoon. These nurses also answered phone calls, and worked on finding the patients affordable treatment and medications, among other duties. Scarbrough said they saw an assortment of issues — colds, arthritis, back aches, and "odd" cases that were challenging to diagnose.

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notajayhawk 4 years, 2 months ago

merrill (Anonymous) says…

“None of the excuses can explain away the basic reality that insurers make more money when they insure less people."

And yet, somehow, insuring EVERYONE is going to reduce costs, merrill?

Just frikkin' brilliant, as always.

Of course, when you post passages that even admit to being biased, such as "The insurer profit study was prepared by the liberal-leaning group Healthcare for America Now, an organization bankrolled by labor unions, which typically take strong positions in favor of Democratic policies, while historically being highly critical of Republicans."

Why do you bother, merrill?

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lilchick 4 years, 2 months ago

Nine staff. Surely you realize that not all of those staff members are providers....people who can diagnose and write prescriptions. It doesn't say in the article where I could find it, but I would guess that there is one, maybe two providers in this operation full time. And it sounds like a few doctors volunteer time when they can. Most doctor's offices I have been to have billing and scheduling staff and nurses to help out, and I'm just guessing that your father's practice was the same way.

I'm sure people and coworkers thought your father was a great doctor, I just find the 122 number hard to swallow.

As for my personal physician, I am fortunate enough to live in a fairly small community where my doctor's home phone number is public knowledge and he has never hesitated to answer calls or call me back personally in his off hours when I have had health concerns. I am also fortunate enough to never require a home visit, but I do know of cases where he has made house calls.

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Linda Endicott 4 years, 2 months ago

Liberty, you are woefully uninformed about diabetes...

Type 2 diabetes is probably what most people are diagnosed with now...with type 2, your body still produces insulin, but you're considered insulin resistant...type 2 can be controlled by diet and/or oral medications...

Type 1 diabetes is insulin dependent diabetes...with type 1, your pancreas no longer produces insulin, and it has to be replaced with injections...if your body no longer produces insulin, you have no choice but to take insulin injections...

And not everyone is able to use cheaper insulin and still manage their diabetes, neuhofel...some insulins just plain don't work on some people, though doctors don't always know why...

My aunt had type 1 diabetes...she was thin when diagnosed, as most type 1 people are...the most famous one being Mary Tyler Moore...my aunt was also in her 50s when she was diagnosed...she tried many different kinds of insulin to control her diabetes...toward the end of her life she was on three different kinds and it was still not totally under control...and she adhered to the strict diet that the doctor gave her...

Type 1 diabetes cannot be controlled by diet alone...it requires insulin...

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George_Braziller 4 years, 2 months ago

In your dreams Starlight. Last time I went to my doctor I had a massive staph infection in my arm that you could see moving up. The nurse gave me a shot of rocephin in my ass, a prescription for additional antibiotics and sent me out the door. Total time was about 45 minutes. Never did actually see the doctor.

Each patient gets 3 hours and 15 minutes of staff time?

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deec 4 years, 2 months ago

"That's a pretty safe guess given that the socialist ponxi scheme will be insolvent long before most baby-boomers are old enough to qualify. 45 years of premiums paid into medicare will get us exactly what we expect of the government, nothing." Why would you care if Medicare ceases to exist? You don't want the dirty government involved in your medical bidness anyway.
Medicare paid for my grandparents' and parents' health care. Your ancestors' care, too. My kids are paying in to pay for my coverage, which starts in 12 years. I was born in the peak year of 1957, and I am confident coverage will be available.

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Starlight 4 years, 2 months ago

Nine staff, eight hours. 22 patients. Each patient gets 3 hours and 15 minutes of staff time? OK lilchick, I understand the extra effort needed to get these folk help but that seems excessive. My father also saw a lot of people who couldn't pay and others wouldn't treat. I was told there was a day Dad's office was as busy as I said, maybe it was exaggerated in it's telling to me but I know he had a busy practice. I guess I should call one of his former staff and get a more realistic number. As I said in the blotted comment he was considered an exemplary diagnostician by the other physicians in town and they brought him their troublesome cases. He was dedicated to and revered by his patients. He made house calls! Do you get that attention from your Doctor?

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been_there 4 years, 2 months ago

Starlight-uncalled for, if your dad saw patients for 10 hrs a day, he saw 12 or more patients an hour at about 4 minutes each (time is needed to go from room to room or other things). If someone says they prefer a doctor that could spend more time, there is nothing wrong with that. Remember you were the one that came on here criticising the clinic for only seeing 22 patients that day.

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lilchick 4 years, 2 months ago

Wow Starlight......no need to call names. If you aren't willing to have people offer some rebuttal to your comments and debate with you on a topic, maybe you shouldn't post in a public forum. Didn't mean to hurt your feelings, simply wanted to address your concern that HCA is seeing too few people in a day. I note you didn't comment on any of the points I raised to counter your questions of how "few" people they are seeing a day........instead resorted to childish name calling. Nice.

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George_Braziller 4 years, 2 months ago

Nope. If it was only as easy as "not eating carbs." It's way more complex.

Liberty275 (Anonymous) says… re: diabetes. Can that condition not be controlled by not eating carbs? That sounds a lot cheaper (and safer) than injecting oneself with insulin.

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Starlight 4 years, 2 months ago

This comment was removed by the site staff for violation of the usage agreement.

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Ryan Neuhofel 4 years, 2 months ago

merrill says, "Most consumers are under-insured" and then admonishes, "high profit middle man money".

Do you not see the inherent contradiction here? Why is this so difficult for people to understand? Let's walk through it together . . .

1) Managed care companies (aka health insurance) are in business to 'manage' people's health care dollars. 2) More "insurance" requires consumers to prepay more upfront dollars to the third-party. 3) The more "insured" consumers become the more revenues "middle-men" take in and ultimately profits they make (even if their profit margins remain static)

I agree that "middle man money" is unnecessary and ultimately the cause of health care inflation over the past 30 years. The growth in "health insurance corporations" is directly due to our society becoming more-and-more "insured" . . . a la, HMOs, PPOs. Currently 90% of all health care dollars are filtered through a third-party before actually paying for medical care.

If you truly want to "stick it to middle man", STOP prepaying your money to them! Pay for routine, affordable medical care directly to actual health care providers + protect yourself from catastrophic events with a low-premium/high-deductible plan.

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toe 4 years, 2 months ago

Just don't pay for coverage and medical care. Soon the industry will collapse and pricing will normalize. The bloat of health care only exists because of the almost unlimited federal and state funds that support it. It is time to just say no.

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Richard Heckler 4 years, 2 months ago

Top Insurers Post Record Profits While Dropping 2.7M Policyholders

A new report says the nation’s five biggest insurance companies set an all-time record for combined profits last year. According to Health Care for America Now, the companies WellPoint, CIGNA, UnitedHealth Group, Aetna Inc. and Humana posted cumulative profits of $12.2 billion. That marks a $4.4 billion, or 56 percent, increase over 2008 and amounts to an average profit margin of 5.2 percent. CIGNA saw the highest profit jump, with an increase of 346 percent. Health Care for America Now says the insurers’ record year was aided by three factors: dropping customers with costly medical needs; diverting spending from medical care to administrative costs and margins; and a higher enrollment in public programs, like Medicare Advantage, that pay insurers higher fees.

Overall, the insurance companies dropped 2.7 million customers from their rolls last year. The report’s release comes ahead of a day of nationwide rallies next Wednesday organized by Health Care for America Now.

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Liberty275 4 years, 2 months ago

re: diabetes. Can that condition not be controlled by not eating carbs? That sounds a lot cheaper (and safer) than injecting oneself with insulin.

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bookemdano 4 years, 2 months ago

kyle, George won't have to worry about pre-existing conditions--he's on Medicare. Must be nice!

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Kyle Chandler 4 years, 2 months ago

George is really on to something here!

Lets just hope he doesnt lose his job the same time he finds out he has diabetes.

Honestly, I think George should have a 'tea party' benefit.

oh and oneeye

yr post was also despicable,

Join George at Tea Party Cove for drinks

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Richard Heckler 4 years, 2 months ago

If millions of healthy insured dropped their policies in the not only would they save thousands of dollars the insurance industry would faint in disbelief that this many people actually are awake and give a damn.

Paying out of pocket will save thousands of dollars a year.

Set up a health care investment account or annuity that makes YOU money instead of wealthy CEO's. Your health care annuity will NOT cancel out on when the poop hits fan.

Sooner or later another few million would do the same. Suddenly all of america would realize the medical insurance business has been doing nothing but making tons and tons of profit by way of fear mongering.

At that point all would see that america could have insurance at a much much lower rate such as 225 a month for the best coverage in the world that includes an entire family of four.

Makes dollars and sense to me. More money to invest smart instead of supporting high rollin executives and shareholders.

Maybe get on with that home improvement with cash instead of borrowing from the bank.....just maybe.

Maybe go to Jamaica for a few weeks instead of supporting high rollin executives and shareholders.

Most consumers are under-insured = candidate for bankruptcy. Most coverage WILL NOT stick with consumers when the going gets tough = fraud.

What could be done with that high profit middle man money that which DOES NOT provide health care?

  1. Home Improvements = jobs

  2. Invest in a green annuity

  3. Create a college investment account for children

  4. Purchase a fuel efficient auto = money saved and secures jobs in the automotive industry

  5. Buy gifts for a lover which improves ones quality of life and boosts a local economy

  6. Buy a second home in the Rocky Mountains = helps reduce number of homes for sale

  7. Keep an existing vehicle in top running condition = dollars saved and clean air

  8. Landscape a yard to reduce mowing substantially and requires far less water = conservation of natural resources and more money in the wallet

10.Donate to a local zoo or library.

*11. PAY OFF CREDIT CARDS

  1. Improved Medicare Health Insurance for All is far better for America than the public option.
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Richard Heckler 4 years, 2 months ago

February 12, 2010 |

" If no health care overhaul passes Congress, health insurers may be in for a windfall -- and one far larger that most Americans probably realize.

According to a study by a pro-health reform group published Thursday, the nation's largest five health insurance companies posted a 56 percent gain in 2009 profits over 2008. The insurers including Wellpoint, UnitedHealth, Cigna, Aetna and Humana, which cover the majority of Americans with insurance.

The insurers' hefty profit gains came even as 2.7 million more Americans lost their insurance coverage due to the declining economy.

The insurer profit study was prepared by the liberal-leaning group Healthcare for America Now, an organization bankrolled by labor unions, which typically take strong positions in favor of Democratic policies, while historically being highly critical of Republicans.

"Insurers will -- perversely -- try and blame the economy for their record-breaking fortunes, saying employers have been shedding jobs and therefor dropping insurance coverage, leading to a decrease in customers," a press release for Health Care for America Now said. "And they're certainly right in the sense that less jobs equals less employer-based health coverage, but that obscures the fact that employers have been steadily dropping health coverage for more employees for 15 years -- even during good times -- because the insurance industry's prices keep skyrocketing much faster than inflation."

"None of the excuses can explain away the basic reality that insurers make more money when they insure less people. They can pay their CEOs more ('administrative costs' rose this year) when they can charge the healthy exorbitant prices and drop or deny these loyal customers when they become sick and therefore expensive," the release added.

Notably, the study also found that insurers spent less money on medical care as a percentage of their premiums from customers. Salaries, administrative expenses and profits made up more of the insurer's expenses in 2009.

Wellpoint's Anthem Blue Cross California created a stir earlier this week by announcing that it will raise premiums on individuals by 39 percent in 2010. The increase was so high it drew a rebuke from the Obama administration. Wellpoint defended the increase, saying the decline in customers had increased the percentage of sick patients under its care, thus warranting a higher charge to consumers. Wellpoint also pointed out that its California division actually lost money in 2009."

http://www.alternet.org/story/145655/top_five_health_insurers_posted_56_percent_profit_gains_in_2009

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Liberty275 4 years, 2 months ago

"I guess its safe to assume that all those protesting so strenuously to the government's involvement in Health Care will be declining to accept Medicare when the time comes?"

That's a pretty safe guess given that the socialist ponxi scheme will be insolvent long before most baby-boomers are old enough to qualify. 45 years of premiums paid into medicare will get us exactly what we expect of the government, nothing.

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notajayhawk 4 years, 2 months ago

just_another_bozo_on_this_bus (Anonymous) says…

"It's not 1%— at any given time, it's somewhere between 17% and 33%, depending on whether you have insurance at all, or whether your insurance company will deign to provide the coverage they have been paid to provide, or do so without co-pays so large that make it insurance coverage in name only."

Just keep repeating the same lies over and over and hope someone stupider than you actually believes it, right, boohoozo?

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just_another_bozo_on_this_bus 4 years, 2 months ago

" I have seen many posts about insurance companies but reject most of them as ill informed or self serving."

What a time-saving method of argumentation.

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Mariposa 4 years, 2 months ago

You don't qualify for Medicaid because you are poor. "...For Families and Children; Children; Pregnant Women; Families With Children... For Elderly and Persons With Disabilities; Elderly; Adults With Disabilities; Children With Disabilities..." If any of those going to HCA qualified for Medicaid, I am quite certain that the staff would inform them and help them to fill out the forms.

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Ryan Neuhofel 4 years, 2 months ago

Frank R says, "There is no generic for insulin leaving me no options."

There are fairly affordable insulins available - even without insurance coverage. Humalog (and other newer rapid or very long-acting insulins) are very expensive at $100-200 per vial, but usually not necessary for control of diabetes. Regular insulin and NPH insulin (and mix 70/30) are less than $25 per vial at most big box stores. While the newer insulins (Lantus, Humalog/lispro, etc) may offer some advantages, I typically advise an attempt at cheaper insulins for my patients - regardless of their finances.

This situation highlights an important point. Unfortunately, "insured" people view prices as only "co-pays" and falsely pretend a third-party is picking up the rest of the tab . . .which is true . . . .until your astronomical premiums come due! The uninsured figure this shell game out all too quickly when they go to pay inflated "insurance-based" prices.

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George Lippencott 4 years, 2 months ago

I addressed this article and only this article. It is a poor vehicle for the conclusion drawn, however valid the conclusion may or may not be.

I also reject the notion that reform will reduce cost. As curently constituted It will increase costs for many. The only cost reduction for the poor in all this is the massive new entitlement where the government takes money from some and gives to others. The question remains. If these people are poor why are they not on Medicaid???

We can save a lot of money by simply reducing care. Care cost money however delivered. If you want state of the art care, you have to pay for it. I have seen many posts about insurance companies but reject most of them as ill informed or self serving. Some entity must perform the functions they perform. Just how would it be cheaper if the government did it. Pay the clerks less, Do not book the capital costs, Pay the doctors a lot less. Reduce care as in most national health care programs. There is no free lunch here!

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George Lippencott 4 years, 2 months ago

just_another_bozo_on_this_bus (Anonymous) says…

I know that, but this group is addressing only 1% of Douglas County and the questions stand.

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Mariposa 4 years, 2 months ago

Why, oh why, do people assume the very worst about poor people? There is no evidence as to what these patients are spending their money on or where they go after leaving HCA. Change of diet is not the answer for everything. Being obsessed with eating healthy now has a name, othorexia.

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Multidisciplinary 4 years, 2 months ago

Starlight, 122...the river of snappy comebacks this brings to peoples minds, but they might not post. Good entertainment on a foggy Sat. morning.

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bookemdano 4 years, 2 months ago

George, the reason for the headline is because those percentages are getting larger all the time. This isn't a problem that will just remain static over time. Health care costs are EXPLODING. Without reform, more and more people will "fall through the cracks" as they lose their jobs, get denied due to pre-existing conditions, or simply become unable to afford the rising premiums. There are more and more people in such situations who don't qualify for Medicaid.

Your "blame the victim" mentality is precisely what is wrong with the anti-reform mindset. Walk a mile in one of these peoples' shoes before you damn them for "self-selecting" out of the health care system.

By the way, hope you are enjoy your government-provided Medicare.

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oneeye_wilbur 4 years, 2 months ago

$10 fee. Many can't pay it, but did they show up with their cigarettes and cell phone and then leave afterwards to go to Burger King or the bar? If they cannot pay $10, then they should pay something, even if it is $1.00.

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overthemoon 4 years, 2 months ago

George, George,George...

See the big picture. This is just not about the one percent getting care. 1. We all end up paying for this care in the cost of our insurance, our medications, the cost of visiting the doctor and in many other goods and services when this 'small' percentage reach the point of total financial devastation. 2. The burden of health care on our economy grows every year. It jumped to 17% of the GNP last year. We pay far more for insurance and health care than ANY other country. It is crippling the nation economically and will only worsen as the population ages. 3. The insurance companies can at will cancel your policy, raise your rates and deny care even if you've been paying into the system as a productive citizen for 10, 20 or 50 years. 4. We pay a large percentage, nearly 30% in most cases, of our health insurance dollar for non health care expenses of the for profit insurance industry (advertising, legal fees, employee compensation, and shareholder premiums) 5. Containing health care costs will BENEFIT the economy and hold the line on or reduce the national deficit.

In fact, the Health Care Reform is very conservative, fiscally responsible that every d***d republican should love.

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lilchick 4 years, 2 months ago

Starlight, if your father was seeing 122 patients in one day in addition to hospital rounds, he was not providing care I would want from my physician.
Back to the topic at hand..... These folks take time to figure out how to get needed medicine, medical equipment, and the knowledge to use them correctly for people who otherwise would not be able to afford it. They are not just spending the typical 15 minutes with a patient, signing a prescription and sending them out of the door. There is a lot more to this clinic then there is in a typical family practice clinic where the patients have some form of insurance to help them.
Thank you to the doctors who volunteer their time to this wonderful cause, and the other staff who try so hard to help those who need it.

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FrankR 4 years, 2 months ago

There is no such thing as affordable insurance, especially for people with pre-existing conditions. I have a plan with BlueCross BlueShield of Kansas City and pay a 165 premium monthly. Having type I diabetes one prescription I have to take is humalog insulin. It used to be a 35 dollar co-pay. Now at the start of the year they have raised that co-pay to 80 dollars! (I buy at least 2 bottles monthly) I cannot afford that. I go to school full time and work a job too. Our current healthcare is criminal. There is no generic for insulin leaving me no options. I have to find a way to fund my right to live while paying that 165 premium monthly. People aren't percentages we all deserve the right to live. I didn't do anything to become diabetic. I guarantee that 1 percent deserves the same right as anyone reading this. When this topic is discussed people think too lightly of it. It is easy to look at numbers on paper but I challenge anyone to go see the suffering of the uninsured and come back to the same conclusion that healthcare is in good shape or that reform isn’t necessary.

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deec 4 years, 2 months ago

How about you go ahead and sign up for Medicare, stay on until you use up your 1.2 per cent, then drop it? That should take, what, about a year? Incidentally, i, too, have health insurance. My daughter the college student, who is too old to be on my policy, does not. My nephew, who has a life-threatening illness and has been on the liver donor list for years, will lose his coverage when he graduates from college.

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Starlight 4 years, 2 months ago

Only 22 people in a day? My father would attend to 122 patients on some days and do rounds at the hospital morning and night. Something doesn't jibe here. It's great that these folks provide this service but I don't understand how so few are served in a day.

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just_another_bozo_on_this_bus 4 years, 2 months ago

"I do, however, have a problem with the Title. Why should we redo our entire health care system to address 1 % of the population (the caseload)?"

It's not 1%-- at any given time, it's somewhere between 17% and 33%, depending on whether you have insurance at all, or whether your insurance company will deign to provide the coverage they have been paid to provide, or do so without co-pays so large that make it insurance coverage in name only.

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George Lippencott 4 years, 2 months ago

Thank you for a fine article. I am proud that we offer this opportunity to some of our citizens. I do, however, have a problem with the Title. Why should we redo our entire health care system to address 1 % of the population (the caseload)? Why do these people not use Medicaid to pay for their medical care? You know that no matter what we do there will be those who fall through the crack, frequently by self-selection. How many of the people at this clinic have access to medical insurance but choose to use this opportunity because it saves them money or ameliorates the consequences of their own choices? Being compassionate is a good thing. Misrepresentation is not.

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commuter 4 years, 2 months ago

Deec- When would gladly not except Medicare when my time comes as long as I don't have to pay the 1.2% of my wages starting now to pay into the medicare system. Is that fair?? Or do you want people not to accept Medicare and still have to pay into the Medicare trust fund?? Please let me know, you can't have it both ways.

Simple analogy, you want an honest politician - I don't think one exists. Obama, Bush, Pelosi, Clinton, Clinton, Emmanuel, Frank etc,

By the way, I have choosen to sacrifice other things to make sure I have care for my family.

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mom_of_three 4 years, 2 months ago

As I read this comments of staying healthy (or thin), not every person is made up the same way. It takes more for some people to maintain the healthy weight and/or lifestyle.
My sister and I are completely different. She works out a couple of hours a week and drinks much more than I do, as she works at a bar, but she is thinner, although I wouldn't know about healthier. I can work out three times as much as she does, not have those daily drinks, and yet, i will never be as thin as she is. NEVER. It's not in my genes. Not everyone will fit in that cookie cutter mold.

I am glad people without insurance have somewhere to turn. But it shouldn't be this way.

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mom_of_three 4 years, 2 months ago

Insurance at KU for a single person isn't that expensive, but maybe he isn't eligible yet or something.

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Liberty275 4 years, 2 months ago

"Non profit healthcare? Where are the right wingers to explain to us how this will lead to the destruction of the health care delivery system in America."

I'm not a right winger, but I'll give your question a whirl. If you can't afford "for profit" health care, you take what the government is allowed to give you by the people that are paying for it AKA the tax payers. Don't expect fast service or the best care (no disrespect to HCA intended). Think of it in terms of eating: You can pay to eat in the restaurant or you can eat free from the dumpster (once again no disrespect to HCA or any clinic offering such services, it is merely an analogy and not a statement of quality).

Given the choice, most people will eat in the resturaunt for $30 and not eat out of the dumpster for free, just as they will pay $600 a month for insurance instead of waiting in lines and receiving minimal service for whatever sum they can afford.

Now before any of you liberals start ragging on me, I have nothing but the utmost respect and admiration for employees and volunteers that sacrifice part of their lives to help the poor. They are true heros and are providing their skill for the most selfless and noble reasons. If I believed a god existed, I'd say he has a special place in heaven for them. If I was god, I know I would.

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jafs 4 years, 2 months ago

Liberty,

Why not simply remove the exemptions from anti-trust laws for insurance companies to promote more competition?

kernal,

If you're health and don't use the health care system much, you shouldn't be paying $700/month as 1/2 of your health insurance. That would mean that your health insurance costs $1400/month.

You could do much better as an individual buying your own health insurance policy.

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deec 4 years, 2 months ago

I guess its safe to assume that all those protesting so strenuously to the government's involvement in Health Care will be declining to accept Medicare when the time comes?

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overthemoon 4 years, 2 months ago

Scot 3460...it would lead to the destruction of their major campaign donors.

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overthemoon 4 years, 2 months ago

"It's not that hard to eat healthy people! Even on a low income as I have done for decades!"

Funny thing is, its cheaper to eat simple whole foods than the processed, expensive crap most people live on! We spend very little at the grocery store, spend a little bit more time cooking and eat very well.

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Liberty275 4 years, 2 months ago

Here's an idea: let the federal government fund a minimal amount for these clinics and require the patient to pay what he can afford. In trade, give us real tort reform, let people buy insurance from any state and quit trying to shove mandates or socialized medicine down our throats.

I don't want the filthy government involved in any way with my health care. Let them find other ways of finding out my personal information or tracking me.

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scott3460 4 years, 2 months ago

Non profit healthcare? Where are the right wingers to explain to us how this will lead to the destruction of the health care delivery system in America.

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commuter 4 years, 2 months ago

Kernal - you are partially wrong about your comment. If done correctly, health insurance premiums paid by the employee reduced your taxable wages. So if you make 30,000 and you pay premiums that your employer takes out of your paycheck of 2,000, your taxable wages are 28,000.

Why does the person who works at KU have insurance?? That extremely bothers me. Did he choose not to have insurance??

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sourpuss 4 years, 2 months ago

We have to face the reality that in America, human life is not worth a great deal. The greater society is not willing to help those who need it. If you made bad choices or had bad fortune, too bad. Those who have not had to face hardship will turn you away. In America, you have to look out for yourself because anything else is branded "socialism," as if wanting to take care of each other is a sin.

Make sure all the babies are born, then turn them out onto the street.

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kernal 4 years, 2 months ago

How about this. In the State of Kansas, if an employer pays 50% of an employees health insurance premium through the company's health insurance plan, the employer can write off that amount on the company's tax returns. But, can the employee? Noooo. So, if the health coverage plan where you work charges a premium of $8,400 a year plus a $1,000 deductible (or more), you get to pay $700 month for your health insurance plus the deductabile, co-pays and co-insurance with no tax benefit. And, you can only hope Medicare is still there when you turn 66.
Oh, and I am physically fit, don't smoke, very moderate with the wine and beer and do not require medication for anything! I eat right to keep my blood pressure and cholesterol low and all the things we are supposed to be doing and I am not over or under the recommended weight for my height and bone structure. I wonder how much our insurance premiums would drop if the majority of our population weren't fat. It's not that hard to eat healthy people! Even on a low income as I have done for decades!

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Richard Heckler 4 years, 2 months ago

IMPROVED Medicare Health Insurance is an extraordinary deal that would free up more expendable cash to be spent elsewhere thus creating new jobs. Things like birthdays, home improvements, investments,wellness programs or a fuel efficient automobile

Without National Health Insurance, jobs and new industry development will remain in the negative column for years to come.

The USA insured cannot afford to have high CEO salaries,golden parachutes,shareholders, key legislators as shareholders and special interest political campaign contributions attached to the cost of medical insurance.

National Health Insurance does not remove competition from the actual health care industry. It will be alive and well. Profits will be based on customer service and clinic performance based on the clients experience.

Improved Medicare Health Insurance is the fiscally responsible avenue.

Improved Medicare Health Insurance will save tons of tax dollars for taxpayers off the bill of federal,city and state employees .

This is something to never forget. It is the private medical insurance industry that cancels YOUR medical insurance AFTER taking YOUR MONEY for years

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Richard Heckler 4 years, 2 months ago

Health Care NOW is EXPANDED/Guaranteed Medicare Insurance for ALL and does understand that rates and fees need to be tweaked to meet current demands. The private health care system will not go broke no way jose'.

A primary reason the Medicare system was chosen is to save tons of health care tax dollars by NOT reinventing the wheel. It is a program that works therefore why not adopt, improve and tweak where necessary. The health care industry is familiar with Medicare. AND several hundred million "clients" = substantial buying power thus reduction in cost for items such as prescriptions.

Should those who are pleased with their current insurance provider be forced to sign on? Probably not. But all would save money for excellent quality of care from the same health care provider.

Freedom to choose clinics,hospitals,health care providers,dentists anytime is a highlight of Expanded/Guaranteed Medicare For ALL

There are estimates that Expanded/Guaranteed Medicare For ALL Insurance will create 2.6 million jobs in the health care industry alone. The economic impact of this will create more jobs throughout the economy.

IMPROVED Medicare for all eliminates co-pays and deductibles

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