Health insurance revisited

I read an article on CNN online and they had an estimate for the money wasted on processing claims.  Keep in mind that at least when you get an unnecessary test you at least get a test.  Claims processing produces nothing!

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Health Care, What’s Broke? (Besides me I mean)

We are in the midst of what some call a health care crisis in this country.  The insurance companies say the medical costs are rising too fast.  The employers say the insurance costs are rising too fast.  We just see the cost of our health care rising, in many cases, out of reach.  We seem to pay more and more for less and less.

Is there anything in the system that we can fix?  Hmmm, well let’s take a stroll through the system and see if we can see what’s broke.

We take our child to the doctor, the doctor looks at him and prescribes some treatment.  If we are lucky, it works and our child gets better.  Seems like that part of the system works ok, even though sometimes with a serious illness a doctor is only about one step removed from shaking a rattle.  Still there is an honest effort to make the patient better.  A service is provided

Now in most every doctors office there is a person behind a desk whose whole function is to figure out how to get paid by the patient’s health insurance company.  They submit the bill and sometimes the insurance company pays it.  Or sometimes the insurance company pays some of it, or rejects it.  Then it’s this person’s job to bill you for the balance of the bill, SURPRISE!

In your mailbox you get a bill from the doctor that tells you how much the insurance company paid and how much you need to pay, only wait, this was a covered expense and you already paid the copay so what’s up with this.  So you pick up the phone and call the insurance company, maybe for an hour or more, at work!  Finally you think you have resolution, only to find out someone has dropped the ball and you get another bill, this one overdue.  So on the phone again, at work!

This has gotten so bad that there are companies whose whole function is to deal with your insurance company for you.  Yup, you or maybe if you’re lucky, your company (who is probably tired of all that time on the phone) pays someone to make the insurance company do what you pay them to do.  Kind of like hiring someone to watch the kid you hired to mow your lawn, hey kid you missed a spot.

So let’s see, we have a doctor who provides a service and you who, in a roundabout way, pay for it.  You pay for it with your premium, and with the portion you employer pays, which is really just another form of your wages.  So don’t let anyone say you don’t pay your own health care.  The only advantage you get by having it through your employer is he gets a better deal per person than you can ever get by insuring the whole company.

History Lesson, insurance was invented to spread risk.  If 100 ships go out to sea and in a year 10 are lost, all 100 owners will put a small amount into a fund and whoever happens to own the 10 lost ships splits the fund.  Next year you do it all over again.  If a trusted company holds these funds and invests them or loans them they can make a profit with the money, until they have to pay the owners of the lost ships.  It used to be that way for health insurance until some smart guy realized that if we only insure healthy people, or only insure cheap stuff, we get to keep all the money not just the return on the investment.

Today we have an insurance company who wants to maximize profits.  They collect all your premiums in the form of money deducted from your wages and the wages you never see in the form of EMPLOYER CONTRIBUTION.  Then their goal is to keep as much of this money as possible.

Wait, wait, the doctor performed the service, you got the service, why should the insurance company get to keep all that money, what did they do?  On top of that they are difficult enough to deal with that the doctor has to hire a specialist.  They are difficult enough to deal with that you have to hire a specialist, and for what?  In the end, doctors get paid by all of us.  Sometimes I pay for your child’s ear infection, sometimes you pay for my wife’s heart attack, but WE pay for EVERYTHING!  Insurance companies just skim off all they can and then pass through what they have to.  Insurance companies could evaporate tomorrow and if it was done right, we wouldn’t even know they were gone.

So why does it seem like we so intent on keeping this bloated parasite of an industry intact?  Well, of course there is the obvious answer that they have bought considerable interest in our government but that isn’t the only answer.  Take a look at your retirement fund, I bet it’s pretty heavily invested in health care industry.  HMO’s and insurance companies own a good portion of your retirement, and of grandma’s as well.  If we dismantle the insurance industry we hurt a lot of people in fixed income.

They are kind of like the parasitic worm that causes river blindness, if we leave it alone it destroys our eyes, but if you kill it, it can drive you mad.  So we leave it in place, root hairs wrapped tightly around some of the most economically vulnerable, and in the mean time the industry subverts our government with millions of dollars and pays the high level insiders even more millions in annual salary.

You know what?  I think I’d rather be mad than blind.

Capt’n Randy

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Every since I was a kid watching Flipper, I’ve always wanted to ride in on of those air boats in the everglades. Last week, while visiting my brother in Ft. Lauderdale, six of us went out into the everglades with Capt’n Randy. We drove out to a landing in the everglades and met him beside the water. This was a guy that would be hard not to like, friendly, funny and we found out he knew a lot about the ‘glades.

The first thing he says to me is, “you look just like a friend of mine, JD Gator. I sure hope you’re a lot smarter’n him though.”

We loaded up, the six of us and the capt’n. My dad was up in the highest seat beside the Capt’n. These things really fly, and it doesn’t necessarily need any water either. Mud or grass will do just fine. With a Corvette big block and a composite four blade prop this tourist boat (a little bigger than you would use for fishing or hunting) could do 50mph with virtually no wake.

p2080119We saw a lot of wildlife, mostly gators and birds. The gators didn’t care about us but most of the birds we saw from behind. Capt’n Randy told us about his Grandfather who, in the ‘60s, was changed from an alligator hunter to an alligator poacher. Well, I’ll testify to the fact that there is no shortage of gators out there. They are everywhere. I’d say there are more gators in the everglades than there are deer here in West Virginia where I live.

He showed us some of the camps that have been in the everglades for generations. You can almost hear the parties that some of them must have had, there were very few railings so you know someone got wet.

Randy told us about going out at night. He says the moon is enough light to ride with only your nav lights on. He did say that you needed goggles and a bandanna over your mouth to keep from getting “redneck drive through,” a euphemism for a bug lunch, but he says it’s beautiful, and in the summertime, it’s cool after the heat of the hot Florida sun.p2080127

p2080133On the way back my dad got a turn at driving this beautiful machine. It had dual steering controls; you push the lever down to go one way and pull it up to go the other. He’s good with machines and he did really well. Then my brother took a turn and even though he started out in a narrow little channel he got the hang of it quick. Unfortunately we got back to the landing before any of the rest of us had a chance to drive but I guarantee I’m going back, I gotta get me one of those things.

Slacker Beavers

beaver-damI sure everyone has heard the expression “busy as a beaver.” Well I’m here to tell you that there is a slacker subculture in the beaver community.

I have some beavers in the creek behind my house and they aren’t busy at all. They started building a dam and I was fascinated by how they were going about it. First they pushed up a pile of rocks across the creak. Then the started with the sticks. First I thought there was going to be some interesting instinctual plan but it started to look like they just put their trash on top of their pitiful pile of rocks. Beavers eat the bark off of branches leaving a branch of stripped wood. That stripped wood was piled on top of the rocks all willy nilly like in the yard of the shiftless bunch I’m sure you all have somewhere in your town. Well in spite of this leaky lame dam it did collect a small pool behind it. I kept expecting them to work more and make something larger but they didn’t. They seemed satisfied with the little “one pond shack” they had constructed.

Well then it rained and the water can get up pretty high in my creek, and it’s fast. The next day the beaver’s dam was gone. I expected to see some real action now. I had heard about beavers repairing dam damage over night. I waited, nothin’. Every day I’d go back and look, nuthin’. Now I don’t know if they were waiting for their insurance adjuster or FEMA but it was like 2 weeks before they got around to even starting. I dunno, maybe they were in loss counciling or something. Anyway they have finally started building again, but they are slow. I plan on getting out to see them at night if it freezes so I can get across the creek at night, and I fully expect to see them with their little beaver skateboards or one of the other slacker pastimes whiling away the night when they should be building.

Savings, America’s Capital Depreciation Fund

Peter Peterson, the founder of the Blackstone group is lamenting the lack of personal savings in the US. He says this is a bigger problem than the current recession. He may be right when he says that since there is no domestic savings, foreign countries holding our debt can hold our economy hostage.
Unfortunately he blames our attitude of “want it now” for out lack of savings. Here he is dead wrong. If you go and open a savings account these days you will find out two things.

1) You will likely pay a fee for having a savings account.

2) The interest rate you receive on your savings will likely be well below inflation.

Bottom line, when you save, YOU LOSE MONEY.

I don’t know about you but I can’t see why the interest rate on savings shouldn’t be some percentage of the loan rate, AND it should always be better than inflation. The banks are jerking us around, charging fees everywhere they can, keeping savings interest rates low, and now using our tax dollars to pay exec salaries and bonuses. Mr. Peterson has a lotta sand to sit in his fancy suit and talk to us about how bad we are for not saving.

Maybe in our little way by not saving we are telling the MARKET that we want change. But why should they change, if we don’t give them enough at the teller window, they’ll get it from our tax bill.

http://money.cnn.com/video/ft/#/video/fortune/2008/12/02/fortune.500.peterson.saving.fortune

Consumer Confidence

gift_boxSo today the government decided to try to improve consumer spending by investing in the consumer debt market. Treasure Secretary Paulson thinks that by freeing up personal credit we consumers can go on with Christmas as usual. Come on guys, only a moron would go out on a buying spree in this climate. We are cutting Christmas to the bone. The companies we are bailing out are continuiong to increase fees and premiums while holding posh seminars on our dollars.

Now if you really wanted to boost consumer confidence, instead of investing in companies that have already sucked all we can afford out of the economy, why don’t we put a couple of billion into…education.

Yup, if you want to boost MY consumer confidence you could help me be confident of the college education of my kids. With one in college, one starting next year, and the last the year after, if a couple of billion were spent so every child with say a B average gets a free college education, it would go a long way to improve my confidence. I am a firm believer that education improves society so what’s to lose. Sure we need to make sure it’s not just a party, but the VA and most existing scholarships already do this. Instead of keeping some fat cat in his fine house, lets send our kids to school.

If you did this Mr. Paulson, I’d make my Christmas gift list much longer, I’d even send you something nice.