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February 28, 2010

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To the editor:

Maybe health care reform is not dead after all, thanks to Wellpoint. Wellpoint is a major nationwide health care insurer which recently announced a 39 percent increase in premiums in California and similar massive increases in many other states, providing us an instructive preview of a future without health care reform.

The people of California did not suddenly use 39 percent more services, and the health care providers did not increase their fees by 39 percent. Nor did Wellpoint just decide to quadruple their profits. What really happened is much more scary for those opponents of reform who are not interested in the uninsured because “I’ve got mine.” It relates to a phenomenon called risk pool concentration.

When health insurance premiums become unaffordable, the first individuals and businesses to drop coverage are the healthy, who perceive little need for coverage. (Their unexpected, uninsured catastrophes continue to be covered by the rest of us through cost shifting.) The last to drop are those with large, ongoing expenses which exceed their premium costs. The faster the risk pool concentrates, the more rapidly premiums increase, starting the whole cycle all over again.

If reform does not pass, the “I’ve got mine” crowd can start counting the days until they will no longer have theirs. Such is the lesson of Wellpoint, and it couldn’t have come at a better time.

In a time of economic stress and health care inflation, universal coverage is not a luxury, it is an absolute necessity, lest the system collapse around us all.

Dr. Steven Bruner,

Lawrence

Comments

Richard Heckler 4 years, 10 months ago

Recognizing the hidden costs that U.S. households pay for health care today makes it far easier to see how a universal single-payer system—with all of its obvious advantages—can cost most Americans less than the one we have today.

Medicare must exist in the fragmented world that is American health care—but no matter how creative the opponents of single-payer get, there is no way they can show convincingly how the administrative costs of a single-payer system could come close to the current level.

More on this matter: http://www.dollarsandsense.org/archives/2008/0508harrison.html

Richard Heckler 4 years, 10 months ago

The health insurance industry needs to go bye bye. The industry cannot be trusted,cost too damn much money and interferes with treatment in a big way. The health insurance industry does not provide health care so why pay them just to generate huge profits?

The debate has always been about health insurance. The health care industry could get better int'l ratings if all USA citizens had equal access AND IF the insurance industry were gone thus removing big time interference with health care.

The actual health care industry is private and should remain as such. The only source of government health care is the military and VA.

Wellpoint is corruption at its' finest:

http://www.pbs.org/moyers/journal/blog/2009/10/bill_moyers_michael_winship_in.html#more If you’ve been watching the Senate Finance Committee’s markup sessions, maybe you’ve noticed a woman sitting behind Committee Chairman Max Baucus. Her name is Liz Fowler.

Fowler used to work for WellPoint, the largest health insurer in the country. She was its vice president of public policy. Baucus’ office failed to mention this in the press release announcing her appointment as senior counsel in February 2008, even though it went on at length about her expertise in “health care policy.”

Now she’s working for the very committee with the most power to give her old company and the entire industry exactly what they want – higher profits – and no competition from alternative non-profit coverage that could lower costs and premiums.

http://www.pbs.org/moyers/journal/blog/2009/10/bill_moyers_michael_winship_in.html#more

Brent Garner 4 years, 10 months ago

The good doctor is almost 100% correct in his description of the issue of risk pools. What he did not explain is that each risk pool is state specific. The policies sold by a certain company with a certain time frame within a certain state constitute that risk pool. When increases come the first people to leave are those who can migrate to other policies with other companies. They usually do not simply abandon healthcare coverage but take a less expensive policy with another company. This still concentrates the risk pool. Actuarial math thus drives the probability that the insurance company may have to pay a claim. By law, the company must collect enough premiums to meet those claims plus provide a legally mandated level of reserves. If the company fails to do that there are severe consequences that can involve government take over of the company. Unfortunatley, the math, which I have seen but cannot do, does not produce a straight line graph. It is a "wall climber" type graph where the cost climbs faster than the shrinking of the pool.

For the Obama administration to condemn Wellpoint for raising these rates is disingenuous as the company is actually doing what state law in California requires them to do. The only other option available for Wellpoint is to leave the state which, in most cases, would involve cancelling all existing policies within that state. Such happened here in Kansas in the 90s when several health insurance companies opted to leave the state and did so all in the same year. Sebelius was insurance commissioner then. I wonder if there was a connection between her socialist viewpoints and that action?

BrianR 4 years, 10 months ago

I am amazed that no one has ever flown a small plane into an insurance provider's offices. At least with the IRS, you know you're supposed to pay taxes and you can hire someone to tell you how much. Insurance providers and HMOs, etc., just sentence people to die because there's no one around to stop them.

Richard Heckler 4 years, 10 months ago

Who can afford this over and above the hew hikes?

Thursday, June 25, 2009

Health insurers have forced consumers to pay billions of dollars in medical bills that the insurers themselves should have paid, according to a report released yesterday by the staff of the Senate Commerce Committee.

Insurers make paperwork confusing because "they realize that people will just simply give up and not pursue it" if they think they have been shortchanged, Potter said.

More on this story: http://www.washingtonpost.com/wp-dyn/content/article/2009/06/24/AR2009062401636.html

Flap Doodle 4 years, 10 months ago

If only somebody had made more copy/paste posts about HB 676.......

jaywalker 4 years, 10 months ago

" Such is the lesson of Wellpoint, and it couldn’t have come at a better time"

Hooonk! Thanks for playing Doc, but you're incorrect. Wellpoint and Anthem didn't jack up their rates randomly, and the President didn't swoop in after the latter tried to do it and suggest price controls just to stop the "evil insurers".
Nope, the insurance companies can see the writing on the wall. After watching and listening for the last year, and now with Pelosi saying they're gonna get their way if they have to ram it through by hook or by crook, the insurers know their risk pools are going to be inundated with people that are automatically and enormously upside down from a premium to imminent cost ratio. Not much choice than to raise rates.

Jason Bailey 4 years, 10 months ago

You mean to tell me that the Socialist Republic of California approved a 39% increase? You do know that states must approve these, right? Right? Companies cannot just randomly jack up prices whenever they want. There is an arduous review process by each state Department of Insurance before a rate increase can be implemented. Many times, the states will not approve the requested increase but rather a lower rate.

Bottom line: the insurance company has to demonstrate claims experience to the state DOI before the state will even consider an increase in premiums. Since Wellpoint got a 39% increase, their claims experience must be tremendous.

Richard Heckler 4 years, 10 months ago

There is another choice you bet!

IMPROVED Medicare Health Insurance = Pro Business and Pro Consumer Health insurance! YES!

Here's the deal. IMPROVED Medicare Health Insurance is not a free ride and never will be perhaps with few exceptions.

The fact is IMPROVED Medicare Health Insurance would be paid from the rather substantial tax dollar cookie jars

Since federal, state, and local governments collect trillions in taxes of all kinds—income, sales, property, corporate etc etc this is how medical bills would be paid as it is now.

You see as we speak government tax dollars support the medical insurance industry to the tune of at least $1.2 trillion a year which is quite a gravy train I'd say.

$1.2 trillion is enough to cover the cost of IMPROVED Medicare Insurance for All as we speak

PLUS it is estimated that IMPROVED Medicare Insurance for All will create 2.6 million new jobs.

IMPROVED Medicare Insurance for All restores choice across the board thus eliminating interference from insurance groups

What is covered:

long term care such that cancer demands prescription drugs hospital surgical outpatient services primary and preventive care emergency services dental mental health home health physical therapy rehabilitation (including for substance abuse) vision care hearing services including hearing aids chiropractic durable medical equipment * palliative care

IMPROVED Medicare for all eliminates co-pays and deductibles

rtwngr 4 years, 10 months ago

Nobody is disputing that there is no need for reform in healthcare. What most of the country is saying is that we don't want the government taking it over and administering the health insurance of the nation. There are many things that can be accomplished through regulation. Here is one for you, Dr. Bruner. Why don't you encourage Lawrence Memorial Hospital to charge patients without health insurance the same rates that they charge the insurance companies. Health insurers only pay what is "regular and customary" and the hospitals accept this. However, if someone shows up at their door without insurance their price for services is a whole lot more. What about Health Savings Accounts. Currently the tax hungry dogs of Washington, D.C. will only allow us to save in an HSA for the year and then it all has to be spent by that year. The amount that can be saved in an HSA is limited too. Why not raise the yearly contribution limit and if it goes unused, be allowed to roll it over to subsequent years. This would allow some to virtually self insure after so many years. No, Dr. Bruner, I will not support socialism and that's what this massive takeover of healthcare is.

rtwngr 4 years, 10 months ago

Merrill, you are deluded if you think this will work. You can cut and paste every article that supports your socialist point of view but it still does not wash. I don't want anything like what Canada or Western Europe has in the way of healthcare. Go back to Berkeley, please.

KSManimal 4 years, 10 months ago

Brent Garner say's: "For the Obama administration to condemn Wellpoint for raising these rates is disingenuous as the company is actually doing what state law in California requires them to do. "

I don't believe Obama is condemning Wellpoint, so much as he is using this recent action as an illustration of systemic problems with the entire health care delivery system in the U.S.

KSManimal 4 years, 10 months ago

rtwngr (anonymous) says...

"Nobody is disputing that there is no need for reform in healthcare. What most of the country is saying is that we don't want the government taking it over and administering the health insurance of the nation."

rtwngr - you need to turn off the Glenn Beck show for a while. Nowhere in any of the health insurance legislation thus far proposed is there a government take-over of health care. Saying so over and over won't make it so.

"There are many things that can be accomplished through regulation. Here is one for you, Dr. Bruner. Why don't you encourage Lawrence Memorial Hospital to charge patients without health insurance the same rates that they charge the insurance companies. Health insurers only pay what is "regular and customary" and the hospitals accept this."

Now THAT is a great idea! Case in point, last year we had some bills from LHM. What LMH got paid by us and insurance combined was about $7K. What the actual bills totaled (before the insurance coverage "adjustment") was over $18K. So, this means that the hospital can and does function just fine getting $7K for those services, but a person without insurance would have paid $18K. There oughta be a law......

The insurance "adjustment" is blackmail, plain and simple. Laws that allow/facilitate virtual monopolies for the insurance companies are such that providers must "take it or leave it", and if they choose "leave it" they'll be out of business. How do they make up the difference? Well, as you can see, they take that chunk of meat out of the uninsured. There oughta be a law.....

And there could be a law....except the windbags who keep calling ANY reform "government takeover" and/or "socialism" are obstructing the process.

repaste 4 years, 10 months ago

Oh yes. Tom's insecurity will force him to repeat every year at tax time just how much he must pay. Poor tommy! He just is so wealthy. Darn poor folk just don't understand how hard it is to be him.

KSManimal 4 years, 10 months ago

...and another thing. Why is it that when there is a crisis in public education funding, immediately people begin calling for teacher to take a pay cut. Yet, here we have a health care crisis....

....where are the calls for medical providers to take a pay cut?

Or, rather than cut teacher's pay, we'll just give them more students (=more work) and pay them the same.

....where are the calls for doctors to see more patients, for the same amount of money?

Liberty275 4 years, 10 months ago

You can have my health insurance when you pry it from my cold dead hands. I walk into the doctors office, I wait 5 minutes to see a doctor. I need an MRI, I get it the next business day.

I pay for that service. I think we're gonna get some aflac so we effectively have all our copays paid and make a little money off of being injured or getting sick.

repaste 4 years, 10 months ago

Maybe the family in "From teenager to mother" needs a few less latte's? Teen, epilepsy, infant child, how much does that cost and who pays? What insurer will cover her? Guess she was not born into the right family eh?

hedshrinker 4 years, 10 months ago

I'm appalled by Shewmon's assumptions that those who are overwhelmed by their astronomical health ins premiums are living some lavish, decadent lifestyle. My individual policy has a high deductible, is catastrophic only and runs about $900 per month. I don't smoke or drink, don't have body piercings or drive an SUV (my vehicle is a gas thrifty 8 year old), I don't have satellite TV , drink lattes, use drugs except a limited number of prescribed rx which I have to skip doses to afford, I eat out once every several weeks, cook healthy food at home and take frugal lunches to work every day, I use a light-weight electric lawnmower but arthritis, multiple orthopedic problems and severe allergies limit my capacity to be completely self-reliant on that score. GET REAL!!! Millions of people don't even have the OPTION of insurance coverage b/c they don't work in situations which offer it. Individuals who try to buy coverage on the "open" market are completely shut out by the high cost and any pre-existing conditions such as sinusitis or acne....God forbid they have a REAL chronic health problem.Health Savings Accounts sound great, but they assume that the person has enough disposable income to put several thousand dollars in an account to cover possible expenses in the coming year. BTW, rtwngr, the last I checked, the unused portion in your HSA can be rolled over year to year, unlike your employer sponsored Medical Savings Acct, which is use it or lose it. The insane health insurance industry necessitates that medical providers spend a significant portion of their overhead and time for insurance billing, constant wrangling and begging and trying to negotiate the intricacies of different insurers whose sole goal in life is to deny claims and insure profits for their stockholders. Millions of committed, compassionate health care providers (of which I am one ) in the US are strong advocates of a single payer plan and in the mean time are providing thousands of hours of pro bono care in their practices, free clinics, etc. Look at the numbers of people who stood in lines all night in terrible weather for one-time low cost care medical and dental care they couldn't access otherwise. Makes us look like a third world country, which we are rapidly becoming when it comes to providing accessible universal care. Yes, we do amazing cutting edge research and elaborate , expensive procedures, but not ongoing , affordable routine care for prevention, maintenance and chronic care. Your disparaging dismissing of the need for insurance reform is just unbelievable.

jumpin_catfish 4 years, 10 months ago

Collapse and prolapse are about the same thing.

Liberty275 4 years, 10 months ago

"hedshrinker"

I'm appalled that you can't find a job with health insurance as a benefit. Maybe you should apply at quiktrip.

hedshrinker 4 years, 10 months ago

To KSManimal, insurance has for years thru managed care been eroding the fees they pay providers for direct face-to-face patient care (the important stuff like building a relationship with patient and family, taking time to let the whole story unfold rather than just the current fire that needs to be put out, patient education especially about lifestyle change, not just meds)....this has something to do with the abysmal press to see as many patients as possible a day for as short a time as possible, and perhaps to engage in other more lucrative procedures. This isn't what clinicians went thru years of training for, but by the time they cover their liability ins premiums and billing time and fees, their margin is disappearing. The reimbursement differential between frontline providers such as family practice and internal medicine vs specialty providers is prohibitive....fewer and fewer med students choose low-reimbursement practices these days, which is the public's loss. We have a crying need for advanced practice nurses, physicians assistants, registered nurses, academic detailers and schools can't turn them out fast enough. These clinicians could provide a huge portion of routine medical care and education with great cost savings and perhaps more sensitively.

Richard Heckler 4 years, 10 months ago

East Otis, Mass. - The less some Americans know, the more strident and voluble they become. Take socialism. The wailing about it over healthcare reform proves my proposition.

Shrill critics menacingly brandish "socialism" to terrify the unthinking, forgetting – or willfully ignoring – that while the United States is capitalist, it's also hip deep in various modes of socialism.

Republicans apparently don't know that it was their beloved President Theodore Roosevelt who in 1912 proposed national health insurance for all.

Some American critics of socialized medicine cite nightmarish accounts of bungled medical treatment abroad, boasting that America has the best medical system in the world.

As a foreign correspondent, I lived in Britain, Germany, Israel, and the Soviet Union and did not discover any sapping of a nation's vital essences because the public enjoyed publicly funded national health insurance.

As a US citizen who lived more than two decades abroad, I found socialized national health insurance programs are often more compassionate and charitable than what I have seen with profit-driven, private insurance companies in the United States.

Some years ago my former wife took my sons on a driving tour of Britain and became involved in an accident. My elder son had a badly broken leg and was taken to a hospital for six weeks until his leg healed. Although I didn't live in Britain at the time, the British National Insurance system paid all his hospital and doctor bills. When I offered to reimburse the hospital, the British charitably declined and only charged me $35 for a crutch my son used to hobble aboard a plane home to America.

More to the story: Walter Rodgers is a former senior international correspondent for CNN. He writes a biweekly column for the Monitor's weekly print edition.

http://www.csmonitor.com/2009/0916/p09s02-coop.html

Richard Heckler 4 years, 10 months ago

A decade ago, a federal report shocked the nation by suggesting that our modern medical system was one of the leading causes of death in America. It called for cutting the rates of medical mistakes in half within five years. But it's only gotten worse. Today, preventable medical injuries kill some 200,000 Americans each year.

Where is the statistical evidence that private healthcare outperforms national health insurance programs?

Meanwhile, members of Congress enjoy "cradle to grave" socialist medical and retirement benefits that outstrip those of the old Soviet Central Committee members.

Many thousands of the poorest Americans and illegal aliens already have access to taxpayer-funded socialized medicine and hospitals through existing Medicaid benefits. One physician tells me that Medicaid recipients get free hospital care plus stipends at taxpayers' expense. Yet tens of millions of working Americans whose taxes subsidize Medicaid have no access to any health insurance of their own.

Walter Rodgers is a former senior international correspondent for CNN. He writes a biweekly column for the Monitor's weekly print edition.

http://www.csmonitor.com/2009/0916/p09s02-coop.html

camper 4 years, 10 months ago

I think the writer is correct and BGardner has a good counterpoint.

I believe our Health Care system has some inherent problems that will only worsen as those who are covered shrinks. The effect is an increased hospital and medical overhead that is pushed onto those who are covered via higher premiums (including those on Medicare). Then the cycle will repeat itself and grow each time.......1) more people out 2) higher premiums 3) start again at #1.

Richard Heckler 4 years, 10 months ago

"If nothing passes now, Mr. Butler says he thinks Congress will tackle narrower areas, like insurance regulation, to make it easier for people with pre-existing medical conditions to find coverage, or maybe it will try another expansion of Medicaid or the children’s program.

But President Obama clearly prefers passage of a broader bill. In wrapping up Thursday’s session with lawmakers, he and other Democrats warned that an incremental approach was likely to provide too little relief to the people already feeling the effects of a broken system. “It turns out that baby steps don’t get you to the place that people need to go,” he said.

And even some people without a partisan point to make argue that the series of bills passed in the last 15 years have not made enough of a dent in slowing down medical costs. “We’ve had a lot of incremental reforms already,” said Mr. McArdle, the Hewitt consultant.

And many argue that putting off the inevitable has an additional cost. The Commonwealth Fund estimates that the nation would be spending hundreds of billions of dollars less than it does today if any of the health care legislation proposed by previous administrations had been enacted, assuming that they reduced costs by about 1.5 percentage points.

If President Nixon’s plan had passed, the United States might be spending a trillion dollars a year less than it does now, and President Clinton’s plan would have reduced spending by some $500 billion a year.

“It makes a huge difference over a long period of time,” said Ms. Davis of the Commonwealth Fund."

http://www.nytimes.com/2010/02/28/weekinreview/28abelson.html?ref=politics

l3roy 4 years, 10 months ago

Here's my plan:

Discontinue all health insurance.

Take the money saved and invest in health insurance companies and pharmaceutical companies.

Pay for routine visits and care out of pocket. This amount is often less than the deductible.

For major medical, withdraw necessary funds from health and pharmaceutical investments, fly to Mexico, receive treatment for pennies on the dollar, and recuperate on the beach.

Fred Whitehead Jr. 4 years, 10 months ago

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

kernal 4 years, 10 months ago

Liberty 275, just because an employer offers a group health insurance plan, that does not make it affordable for the employees. If my employer had stayed with the same insurance plan this year, my 50% share of the premium would have been over $9,000 & my employer would have had to pay the other 50%. The difference? The company got a tax deduction for it's share of the employees health insurance premium. If Katherine Sebilius had not got that thru the State Legislature, there would be few group health insurance plans in KS for employees. Since the premiums have been going up every year, I opted out this year and hope to God I don't live to regret it. I cannot pay over $8700 for insurance then my copays & coinsurance as well. I make too much money to qualify for any medical assitance and not enough to afford health insurance. There are thousands more like me.

KSManimal: I think most community owned hospitals do now charge a "self-pay" for uninsured patients, but patients may have to ask for it. Ditto with doctor's offices. Also, most hospitals have "financial aid", for uninsured patients who qualify.

Many of the doctors in this town volunteer time and money to Health Care Access and the dental clinic (is that still up and running?). What someone said about physician reimbursements is true. Young doctors coming out of med school can't afford to be GPs so they are going for the specialities which pay more. Someone in a previous article's comments claimed that with national health care people would have to wait for surgeries, etc. Well, guess what! We now wait longer than many countries that do have national health insurance The situation will only get worse if it remains as is and will eventually collapse.

I don't have any chickens to exchange for a doctor's appointment.

camper 4 years, 10 months ago

Well I was not a huge fan of the latest plan offered up by the Democrats because I felt it was waterered down and much too complicated. But as a supporter of Health Care reform, I now hope that a "Public Option" can become reality. Why?

1) Because it addresses the problem of a shrinking insurance pool 2) Once more people become insured (either public or private), premiums will come down 3) Individuals won't be trapped in their current job for fear of losing benefits 4) Small business will no longer need to be weighed down by insurance costs 5) Increased entreprenuerism will result because of #3 above

If these things are true as I believe them, private insurance will actually be in a position to be more competitive against the big bad government that they fear so much because they can offer more competitive rates. Right now though they realize they have the Golden Goose and do not want to give it up.

james bush 4 years, 10 months ago

Both parties are corrupt at the top.....only Obama assumes the role of Messiah though. Just heard Bob Brinker, the radio financial pundit, talk about Hank Paulson, Bush's Treasury Secretary, and his( Paulson's) $200,000,000 tax saving on the sale of his stock market shares he reaped for committing to 2 years of "public service." Obama merely wants to be the world's savior....at the expense of USA .

Flap Doodle 4 years, 10 months ago

"I think it takes a Minnesota Vikings fan to explain what happened in Washington yesterday. Let me take you back to the 2005 season. The Vikings had traded superstar wide receiver Randy Moss prior to the season, partially with the thought that it was time to let the Vikings become quarterback Daunte Culpepper’s team...." Read the rest at: http://www.northstarnational.com/2010/02/26/barack-obama-delusional-daunte-culpepper-presidents/

George Lippencott 4 years, 10 months ago

Why has this become a negative sum "Game" I have mine. Why should I be willing to give it up so you can have yours?? How about a solution that asks some sacrifice from the really wealth rather than impacting negatively those who have and have paid for insurance??

BigPrune 4 years, 10 months ago

What none of you eggheads seem to realize, that if the nationally mandated healthcare gets passed, there will be layoffs left and right in the private sector. True unemployment now stands at 20%. Add another 20% to that number, then the IRS will come after you if you cannot pay the premium - of course, you will be paying into it for 5 years before you get to use it. This is why Obama and his henchmen are out of touch with reality. Too bad he doesn't have anyone from private industry (only 8%) in his administration.

jumpin_catfish 4 years, 10 months ago

How many wealthy do you people think there are in this country. the money is in the middle class and that is where they are going to come and get the money to pay for the obama plan. additionally, at some point they will strip our current coverage down and make a level field.....everyone gets their own crappy plan.

wolfy 4 years, 10 months ago

If you see the terms "government takeover" or "socialism" used in reference to the Obama plan, you should stop reading. Everyone should know that socialism involves direct public onwership of the means of production. Obama's plan would be entirely privately run. And the "government takeover" meme is ridiculous. It caught on last summer when dems floated the idea of offering a modest public option. The public option is OFF THE TABLE!! This is not a government takeover of healthcare.

Furthermore, all this doomsday nonsense about lost jobs, higher deficits and ballooning premiums has been roundly refuted by the CBO. What we do know, however, is this: If we continue on like ostriches and do nothing, Medicare will be bankrupt in 7 to 8 years and everybody's premiums will double again by 2020. Get real, people! (And, BTW, all the class warfare crap is offensive and childish.)

jumpin_catfish 4 years, 10 months ago

“A government big enough to give you everything you want is big enough to take away everything you have.” Gerry Ford

parrothead8 4 years, 10 months ago

TomShewmon (Tom Shewmon) says... Possibly, just possibly, those who find their premiums have jumped could:

Get rid of:

Cell phones Satellite TV XM/Sirius Stop smoking Stop drinking No more tattoos No more piercings No more drugs Downsize your car from an SUV to a used Hyandai Stop going to the movies every week Stop eating out every day Learn how to cook a cheap yet nutritious meals at home Sell the rider, mow your lawn with a push mower (may make you healthier) No more $6.00 lattes @ morning"

Pretty comprehensive list, Tom. Here's my tally: No satellite TV, no satellite radio, don't smoke, don't drink, don't do drugs, no tattoos or piercings (well, my wife's ears are pierced...is that too extravagant?), we both drive compact cars that get 30+ mpg (one is paid for), we haven't been to the movies since last summer, we eat out 1-2 times per month and eat almost every meal at home, I've never owned a riding mower, and I make my own coffee at home.

I do everything on your list, Tom, except that I have a cell phone (but no land line, so I save on that.) We both work 40-60 hours per week, and can still barely afford our health insurance. Getting rid of our healthy 9-year old dog is not an option, so please hurry and add more to your list so that we know how to live the perfect lives according to you.

notajayhawk 4 years, 10 months ago

Ah, the good Dr. Bruner gets another LTE in the paper. So I'll ask the same rhetorical question I ask on each and every one:

Dr. Bruner, when are YOU taking a pay cut to make your services more affordable/accessible for the poor? Because the truth of the matter is you want 'reform' because it will prop up your lucrative price structure, and it's the COST of health care delivery, not how we pay for it, that's the problem. In other words, Dr. Bruner, YOU are the problem.

Folks - if you don't like what your insurance company charges, drop your policy. It's pretty much that simple. Then you can all go to Dr. Bruner's office - he seems like a nice guy who's genuinely concerned about your plight, and I'm sure he'll treat you for free.

notajayhawk 4 years, 10 months ago

Well, yes, actually, BeO. I can't say I'm well acquainted with him, though, so since you apparently are, perhaps you could answer the question for him? Has he cut his fees to help those who can't afford healthcare?

That's okay, BeO, the answer is on his website:

"Q: I work full time but don’t have health insurance and find it difficult to pay my medical bills. Can you help me?"

"A: The doctors of Lawrence Family Medicine and Obstetrics understand and share the concern of many about declining health insurance coverage for many Americans. Our professional organization, the American Academy of Family Physicians, has worked hard to promote the passage of universal health insurance coverage in our nation for many years. (We urge you to help us by making your needs known to your elected representatives in Washington and Topeka.) Until legislation mandating insurance coverage for all Americans is passed, we will continue to try to help our patients who are not insured or who are underinsured get the care they need. For instance, we offer a 20 percent discount to cash- or credit-card paying patients. And, although we require payment at the time of service, we will work with you to set up payment plans for large medical expenses. If you let your doctor know about your financial constraints, he or she often can reduce your testing and drug costs, such as by prescribing less expensive generic drugs or, if possible, by supplying you with free samples of drugs. In cases of extraordinary or ongoing medical needs, we can refer you to Health Care Access, a clinic manned by volunteer doctors (including our own), which is able to provide markedly reduced-cost medical care."

In other words, if you can't afford my fees, write to the government and get them to make everyone carry insurance so I don't have to lower them. Although he does offer a 20% cash discount - let's see, that should bring it down to just about twice what he gets reimbursed from insurance companies? And if that's still too high, he'll be glad to refer you to HCA.

deec 4 years, 10 months ago

Actually throughout the '80s and '90s the family practice to which Dr. Bruner then belonged was exceptional in working with my family when we did not have insurance. They let us set up a payment plan, gave us pharm. samples, etc. Thanks, Lawrence Family Practice!

notajayhawk 4 years, 10 months ago

Dr. Bruner, would you like to know why insurance is so expensive? Look no farther than your own website. The answer is in the passage I cited above:

"If you let your doctor know about your financial constraints, he or she often can reduce your testing and drug costs, such as by prescribing less expensive generic drugs or, if possible, by supplying you with free samples of drugs."

In other words, the good doctor uses a two-tiered system, one for those with insurance, one for those without. There are only two possibilities (and the two are not mutually exclusive):

1) He is providing substandard care for those without insurance, by prescribing cheaper drugs and fewer tests for those paying out of pocket;

or

2) he's soaking the insurance companies for unnecessary tests and unnecessarily expensive drugs.

Giving Dr. Bruner the benefit of the doubt, that he would not deliver substandard care to those who have "financial constraints", that means a lot of what he's providing/ordering/prescribing for his patients that have health insurance is beyond what's necessary. Um, Doc? Why can't you offer to reduce the testing and drug costs to those with insurance, thereby lowering everyone's costs?

The answer, of course, is that would cut into his practice's bottom line. Dr. Bruner, you see, is one of those who 'got his'. THAT is why insurance is so expensive.

job4mike6 4 years, 10 months ago

Merrill is incorrect: "The only source of government health care is the military and VA." See

url: http://www.hhs.gov/about/whatwedo.html

"THE DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) is the United States government's principal agency for protecting the health of all Americans and <> essential human services...THE DEPARTMENT INCLUDES MORE THAN 300 PROGRAMS... Some highlights include:

* Health and social science research
* Preventing disease, <<including immunization services>>
* Assuring food and drug safety
* Medicare (health insurance for elderly and disabled Americans) and Medicaid (health insurance for low-income people)
* Health information technology
* Financial assistance and services for low-income families
* Improving maternal and infant health
* Head Start (pre-school education and services)
* Faith-based and community initiatives
* Preventing child abuse and domestic violence
* Substance abuse treatment and prevention
* Services for older Americans, including home-delivered meals
<<* Comprehensive health services for Native Americans>>
<<* Medical preparedness for emergencies, including potential terrorism.>>

<>

Also see

http://www.ihs.gov/PublicInfo/PublicAffairs/Welcome_Info/IHSintro.asp

"The Indian Health Service (IHS), an agency within the Department of Health and Human Services, is responsible for providing federal health services to American Indians and Alaska Natives."

Also neglected: "THE U.S. PUBLIC HEALTH SERVICE COMMISSIONED CORPS is a uniformed service of more than 6,000 health professionals" who strive "to serve the Nation by providing direct clinical care"

See http://www.usphs.gov/AboutUs/mission.aspx

"The mission of the U.S. Public Health Service Commissioned Corps is to protect, promote, and advance the health and safety of our Nation."

"As an officer of the Commissioned Corps, you may:

<<* Provide essential public health and health care services to underserved and disadvantaged populations>>
* Prevent and control injury and the spread of disease
* Ensure that the Nation's food supply, drinking water, drugs, medical devices, and environment are safe
* Conduct and support cutting-edge research for the prevention, treatment, and elimination of disease, health disparities, and injury
* Work with other nations and international agencies to address global health challenges
<<* Provide urgently needed public health and clinical expertise in response to large-scale local, regional, and national public health emergencies and disasters">> <<again my emphasis added>>

job4mike6 4 years, 10 months ago

My apologies to all including Mr. Merrill. In my previous post, I attempt to emphasize several instances of federal government provision of health care. However, my method of emphasis instead deleted the specific highlighted html.

Nonetheless, Mr. Merrill's assertion "The only source of government health care is the military and VA." is incorrect. The following federal government agencies have sizable heath care provision missions:

Department of Health and Human Services -- Indian Health Service -- US Public Health Service

Department of Justice -- Federal Bureau of Prisons

Other federal agencies, such as the Department of State, provide limited medical services to their employees at overseas locations where other medical care is not readily available.

job4mike6 4 years, 10 months ago

"attempted" and "health" were misspelled in my immediate prior post

Brent Garner 4 years, 10 months ago

KSManimal:

You claim that the Obama administration isn't condemning Wellpoint but is using them as an example of the systemic failures of our health care delivery system. I wish that were true because if it were then they would be starting with a basic question: "Why isn't supply keeping up with demand?" You see prices only rise when demand outstrips supply. Normally when that happens, someone somewhere will step in and increase supply in order to--bad word coming now--profit from the market opportunity. This has not happened in health care and we should be asking first and foremost why. However, that has not been done by anyone as far as I have been able to determine. I have read an article here and an article there but no firm investigation. There needs to be one, but I don't think the lefties would like the results.

notajayhawk 4 years, 10 months ago

merrill (anonymous) says...

"The less some Americans know, the more strident and voluble they become."

Ah, finally - merrill explains the reason for his incessant cut-and-paste.

George Lippencott 4 years, 10 months ago

job4mike6 (anonymous) says...

Just what is government health care? Both the military and VA use private insurance companies to deliver care as established by the government. Medicare, Medicaid, Schips and so on do the same. Is it only government health care if the doctor works for the government AS AN EMPLOYEE??

George Lippencott 4 years, 10 months ago

wolfy (anonymous) says...

Furthermore, all this doomsday nonsense about lost jobs, higher deficits and ballooning premiums has been roundly refuted by the CBO.

Do you have a reference? The CBO normally does not "score" things other than federal government outlays and it only scores what it gets - for ten years and ten years only!..

For example if a particular bill collects taxes for 10 years and provides benefits for five it scores it as it is - neglecting the actual long term costs of those benefits. If the bill includes a one time savings it scores that as an offset even though the savings will not continue. If the bill requires insurance mandates that cost money in the private sector - those costs are not included. If the bill includes costs to the states those costs are not included.

Be careful, the CBO can be used with A RESULTANT VERY INCORRECT OUTCOME!

George Lippencott 4 years, 10 months ago

jaywalker (anonymous) says... " Such is the lesson of Wellpoint, and it couldn’t have come at a better time"

Absolutely correct. Many insurance companies are increasing rates to avoid a sharp increase after the bill passes. In order to avoid the actual cost of providing all these mandates the administration and their fellow travelers have already started to blame the health care insurers for passing on real costs resulting from new mandates. Somebody has to pay! The insurance companies neither print money nor make obscene profits. Their profits are a matter of public record - has anybody here yelling about those profit actually looked them up or are you just repeating somebody’s talking points????

Everybody has their own little reference and they are presented without pedigree. Naturally advocates of whatever stripe will produce "studies" that support their positions. It is hard work, clearly beyond Merrill's capabilities, to find what approaches facts.

job4mike6 4 years, 10 months ago

Moderate-

Respectfully suggest you direct your question to merrill. I was citing facts about the federal government that refuted his point that only the military and VA provide government health care. I do believe it is important to distinguish between providing clinical service for care, providing the financial capital for care, providing the trained clinical workforce, and writing the laws and policies that impact all of the above. To me, federal government provision of health care is when the medical professional providing the clinical service works for the federal government. One example of this is a physician who is on active duty in the Army. There are many others such as the Indian Health Service and US Public Health Service. But it is not always a simple taxonomy. I used to be active duty in the military. I had a dermatology problem and the active duty doctor treating me was an internist. No military dermatologist was readily available. Following the clinical recommendation of the military internist treating me, the hospital commander allowed me to visit a civilian dermatologist, at military expense, to confirm I did not have a number of very serious conditions including melanoma. While the military did not provide the clinical service for my dermatology condition, they did did pay the bill and coordinate the related clinical services provided by active duty medical personnel.

George Lippencott 4 years, 10 months ago

job4mike6 (anonymous) says...

Yep. Of course you go to a military medical facility and find a contract doctor. If your a dependent you use TRICARE (with some issues) because the military doctors are in the war zone. And so on!

Merrill does not know what he is talking about at least 60% of the time. He just puts out URLs and re-uses talking points - some long since abandoned.

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