Health Insurance/Health Care – Is reform needed?

Topic – Health Insurance

Summary

All of the current Presidential Candidates have expressed a need to overhaul or reform our health care system. I decided to do some research about the current state of our health care system to see for my self why there might be a need. Here are some statistics that show the current state of insured citizens and the need for health care.

• Insured/Un-insured Percentage 2007 – 85.8% have insurance, Public and Private – 14.2% do not have insurance (Full Report – Department of Health, Center for Disease Control)
• Percent of the Un-insured who had a medical expense 2004 – 55% (Full Report – Department of Health, Medical Expenditure Survey)

Understanding why 14.2% do not have insurance is critical if the goal is to make sure 100% of the population has insurance. I have found no data that explains why this percentage do not have insurance. I believe it could be one or more of the following reasons:

• Not qualified for public assistance such as Medicaid, Medicare or other aid provided state/local governments and charities.
• Unaware of public assistance such as Medicaid, Medicare or other aid provided by state/local governments and charities.
• Have not budgeted for private health insurance.
• Do not want health insurance.

Based on this information it is clear that 14.2% percent of the population do not have health insurance, private or public. Of the 14.2%(2007) un-insured 55% (2004) had a medical expenses. So, the remaining 7% did not have a medical expense.

Having a government managed/mandated health care system or reform is un-necessary based on this information. The population segments that are most highly covered by health insurance private or public is the age groups under 18 and 65 and over. The government provides safety nets in the form of Medicaid and Medicare for those in need. Education on health wellness, health insurance options and health care costs would provide more benefit to the citizens by way of promoting competition in the health care industry and personal responsibility of the citizens.

Analysis

Question – Is Health Insurance reform needed?
Question – Is it necessary for the government to manage Health Care and/or Insurance for the entire population?
Question – Why do 14.2% of the population not carry health insurance.

Health Care or Health Insurance – I think it’s important that the discussion is focused properly. Health care in our country is open and available to everyone. It is my understanding that no one in our country can be refused health care from an emergency room.

Question – Is Health Insurance reform needed? (In my opinion, no.)

From Wikipedia
“The Emergency Medical Treatment and Active Labor Act (42 U.S.C. § 1395dd, EMTALA) is a United States Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act. It requires hospitals and ambulance services to provide care to anyone needing emergency treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions; as a result of the act, patients needing “emergency” treatment can be discharged only under their own informed consent or when their condition requires transfer to a hospital better equipped to administer the treatment.”

Insurance is not required to receive health care. So, this topic isn’t over the quality or availability of health care, but, over the quality and cost of health insurance. Is health care insurance reform needed? Should the government socialize the health care system because a percentage of the population doesn’t carry health insurance?

Let’s look at the current data on the number of insured and uninsured. The following statistics show that 85.8% of the population has insurance while 14.2% do not. Over the last 10 years the percentage appears stable, not getting worse or better.
(Full Report – Department of Health, Center for Disease Control)

Question – Why do 14.2% of the population not carry health insurance. (Unknown but necessary to know to make an informed decision).

Based on the current conversation by politicians and the media I was starting to believe that our country was in a health care insurance coverage crisis, meaning that there was a majority of our population that needed health care insurance but didn’t have it or couldn’t get it. So I decided to research this myself. I found these statistics at the National Center for Health Statistics (from the Department of Health and Human Services, Center for Disease Control) Based on this report (above) there is no crisis. 85% of the population has health insurance. 100% of the population has access to health care (remember, health insurance is not required to receive health care). Also, there is no data suggesting why the uninsured are uninsured. Having that information would be relevant to understanding why 14.2% of the population is not covered by health care insurance. And, we shouldn’t assume that someone who doesn’t have health insurance doesn’t receive needed health care. We should assume they receive health care and have the means to pay for health care when needed.

Total Health Services-Median and Mean Expenses per Person

I found more data that shows the percent of population that had health care expense vs. no health care expense. This is the latest data they had from 2004. There is great data on this site. Here is some pertinent data:

• Percent of Population with expense – 84.7 (Total population 293 million)
• Percent of un-insured with expense – 55.5 (means that approximately 18 million of the 36 million that don’t have health insurance had an expense).

What does this mean? It means that half of the people that didn’t have insurance sought and received medical care. I believe this is solid data that supports insurance isn’t needed to receive health care. So, of the 14.2% of the population that don’t have medical insurance 7% sought and received health care and the other 7% didn’t seek health care.

Question – Is it necessary for the government to manage Health Care and/or Insurance for the entire population? (No).

In my opinion a move to Nationalize, Federalize or Socialize health care because 14.2% of our population are not covered by health insurance (for reasons that are unclear) is un-necessary. I believe the government could serve us better by providing safety net type solutions for the American citizens who reach emergency health situations. The Federal government doesn’t need to or should control the health care system.

If we are unhappy with our current health insurance coverage because of quality or cost we have the following choices:

• Express our concerns with the Insurance company.
• Shop for a different Insurance company.
• Change Insurance plans.
• Drop Insurance coverage.

The American consumer has tremendous power. If we start asking for better coverage that costs less we will get it! We need to start supporting companies and organizations that help you find health insurance coverage by making easy comparisons of the plans by type and price. Some of these exist on the Internet in some forms already. I will be researching this soon and will provide the information at a later date.

So, let’s start asking our health insurance providers to provide more coverage for less cost, more plans to choose from and an easy way to compare the plans by coverage and price! Let’s start asking the politicians to focus on safety nets for emergency health care situations, not socializing health care.

Let me know your thoughts and comments!