I interrupt the discussion about health care and higher education comparisons, to report another. L&D. closing.
Southeast Baptist Hospital in San Antonio is closing their L&D unit effective January 1, 2010.
(Click here for news article).
A new hospital is scheduled to open (hopefully if there are no delays) .in 2011. Meanwhile, the people in the southeast community will not have an L&D unit for at least two years.
Do you believe that if L&D were a profitable service, they would close the unit?
Alan.
Alan@birthconference.org
Thursday, December 10, 2009
Wednesday, December 9, 2009
Tuesday, December 8, 2009
Comparing Healthcare Financing and Higher Education Financing
Every time there is an election, some candidate accuses the other candidate of wanting to cut higher education spending, and promises that he or she will fight for more money on higher education, and say “Because our young people are the promise for tomorrow” or something similar.
Let's imagine what would happen if in fact, government higher education financing was reduced or removed. No government student loans, No Pell grants, other German grants, etc.
And let's just say that tuition at College X. is $15,000 per year. (Some of you will say that's too cheap, and others will say way too expensive.) And now, there is no government aid.
Do you believe the colleges will all shut their doors? Do you believe that every student that does not have $15,000 at the beginning of the year will be unable to attend? Will they fire every professor? Will the University of Texas and University of Alabama shut down their football programs?
After 9/11, the airlines were facing the equivalent of the government shutting down student aid. "America was afraid to fly." Some airlines filed bankruptcy, others did not. Most kept flying. They cut everybody's pay between 25% and 50%, if not more, and had substantial layoffs. BUT, they kept flying.
What will colleges and universities do?
Offer their own loans? Cut salaries? Lay off staff? Merge and consolidate? Stop offering ridiculous electives? Re-evaluate how many credits are needed for a degree? Go to online classes? Sell some buildings? Reduce services?
The answer is, they will probably do ALL of the above. They will get creative. They may reduce tuition. They will do everything not to close the doors, and still offer quality education and profitable sports programs.
So your next question should be: "If they can do this without student loans and aid, why don't they?"
When you were a kid and your allowance was $2.00, you spent it. When it was raised to $5.00, you spent it. If you got $10, you spent it.
In other words, as long as the money is there, you will find a way of justifying and spending it. It’s the same with colleges and universities.
Do you think health insurance has had any effect on the cost of medical procedures? (answer tomorrow)
Alan.
Alan@birthconference.org
Let's imagine what would happen if in fact, government higher education financing was reduced or removed. No government student loans, No Pell grants, other German grants, etc.
And let's just say that tuition at College X. is $15,000 per year. (Some of you will say that's too cheap, and others will say way too expensive.) And now, there is no government aid.
Do you believe the colleges will all shut their doors? Do you believe that every student that does not have $15,000 at the beginning of the year will be unable to attend? Will they fire every professor? Will the University of Texas and University of Alabama shut down their football programs?
After 9/11, the airlines were facing the equivalent of the government shutting down student aid. "America was afraid to fly." Some airlines filed bankruptcy, others did not. Most kept flying. They cut everybody's pay between 25% and 50%, if not more, and had substantial layoffs. BUT, they kept flying.
What will colleges and universities do?
Offer their own loans? Cut salaries? Lay off staff? Merge and consolidate? Stop offering ridiculous electives? Re-evaluate how many credits are needed for a degree? Go to online classes? Sell some buildings? Reduce services?
The answer is, they will probably do ALL of the above. They will get creative. They may reduce tuition. They will do everything not to close the doors, and still offer quality education and profitable sports programs.
So your next question should be: "If they can do this without student loans and aid, why don't they?"
When you were a kid and your allowance was $2.00, you spent it. When it was raised to $5.00, you spent it. If you got $10, you spent it.
In other words, as long as the money is there, you will find a way of justifying and spending it. It’s the same with colleges and universities.
Do you think health insurance has had any effect on the cost of medical procedures? (answer tomorrow)
Alan.
Alan@birthconference.org
Monday, December 7, 2009
Health Insurance Was Never Intended to Pay for Birth
Why's it so hard to buy maternity coverage?
(Click Here for Article)
As this article in the Colorado Independent points out, it is difficult to buy maternity coverage for individual health insurance, and most the time. It's not worth it.
Why??
The answer is very simple: Do you want to have a car accident? Would like cancer? Do you want your plane to crash? Do you want your house to burn down? Do you want to be sued? Do you want to die?
I'm assuming the answers to the above are, "NO"
Anybody want to have a baby??
For many the answer to having a baby is "YES"
The whole concept of insurance, is to protect against things that might happen, but you don't want to happen. In most cases, maternity coverage protects against something you want to happen.
Insurance actuaries go nuts when asked to calculate desirable risk as opposed to undesirable risk. Had normal maternity coverage never been included in health insurance, then I believe that our entire system of labor and delivery would have evolved differently.
What many of you don't realize is that “complications of pregnancy”, which usually meant needing a cesarean section, was always covered by your policy, EVEN it had no maternity coverage.
I guess times have changed.
Alan.
Alan@birthconference.org
(Click Here for Article)
As this article in the Colorado Independent points out, it is difficult to buy maternity coverage for individual health insurance, and most the time. It's not worth it.
Why??
The answer is very simple: Do you want to have a car accident? Would like cancer? Do you want your plane to crash? Do you want your house to burn down? Do you want to be sued? Do you want to die?
I'm assuming the answers to the above are, "NO"
Anybody want to have a baby??
For many the answer to having a baby is "YES"
The whole concept of insurance, is to protect against things that might happen, but you don't want to happen. In most cases, maternity coverage protects against something you want to happen.
Insurance actuaries go nuts when asked to calculate desirable risk as opposed to undesirable risk. Had normal maternity coverage never been included in health insurance, then I believe that our entire system of labor and delivery would have evolved differently.
What many of you don't realize is that “complications of pregnancy”, which usually meant needing a cesarean section, was always covered by your policy, EVEN it had no maternity coverage.
I guess times have changed.
Alan.
Alan@birthconference.org
Friday, December 4, 2009
Affect of Super Simple Health Plan on Birth
For the past two days, I've written about the super simple two line health plan, which I put forward, not as a proposal, but rather as an example of how a major change could be made without a 2000 page bill.
The super simple plan is:
1) All US citizens and legal residents are automatically enrolled in the Medicaid program and will pay a fee equal to 5% of adjusted gross income, unless exempt by paragraph #2.
2) Persons having proof of health insurance or who have sufficient assets not to need health insurance are exempt from the requirements of paragraph #1.
So now the question is: “How would this plan affect. birth practices?”
The most obvious answer would be that with everyone being covered, less malpractice suits will be filed, since a large number of suits for birth injury are for the purpose of getting medical bills paid for the baby's treatment. Since medical bills a re covered under Medicaid, or insurance, r than alleviates the need for these lawsuits.
As an incentive for people to buy health insurance as opposed to Medicaid, the insurance companies might offer to pay obstetricians and family physicians and midwives a lot more money per birth in the hope that they would then refuse the meager Medicaid reimbursement amounts.
Medicaid might have to increase their payments to birth care providers, so they will continue to accept Medicaid patients.
Insurance companies might embrace concierge birth facilities as a way of keeping insured’s with private insurance from changing to Medicaid.
This is not comprehensive analysis, but then remember, the original proposal is only two paragraphs.
Have a great weekend.
Alan.
Alan@birthconference.org
The super simple plan is:
1) All US citizens and legal residents are automatically enrolled in the Medicaid program and will pay a fee equal to 5% of adjusted gross income, unless exempt by paragraph #2.
2) Persons having proof of health insurance or who have sufficient assets not to need health insurance are exempt from the requirements of paragraph #1.
So now the question is: “How would this plan affect. birth practices?”
The most obvious answer would be that with everyone being covered, less malpractice suits will be filed, since a large number of suits for birth injury are for the purpose of getting medical bills paid for the baby's treatment. Since medical bills a re covered under Medicaid, or insurance, r than alleviates the need for these lawsuits.
As an incentive for people to buy health insurance as opposed to Medicaid, the insurance companies might offer to pay obstetricians and family physicians and midwives a lot more money per birth in the hope that they would then refuse the meager Medicaid reimbursement amounts.
Medicaid might have to increase their payments to birth care providers, so they will continue to accept Medicaid patients.
Insurance companies might embrace concierge birth facilities as a way of keeping insured’s with private insurance from changing to Medicaid.
This is not comprehensive analysis, but then remember, the original proposal is only two paragraphs.
Have a great weekend.
Alan.
Alan@birthconference.org
Thursday, December 3, 2009
Defending the. Two Paragraph Health Reform System
Yesterday, I put forward a super simplified health reform plan:
1) All US citizens and legal residents are automatically enrolled in the Medicaid program and will pay a fee equal to 5% of adjusted gross income, unless exempt by paragraph #2.
2) Persons having proof of health insurance or who have sufficient assets not to need health insurance are exempt from the requirements of paragraph #1.
Although I'm not proposing or supporting it. I've had a number of people ask me questions regarding it. So, I will post some questions and some responses.
1) Q. Won't expending Medicaid cause everyone to drop private insurance and move to the public program?
A. As long as providers and facilities are free to accept or refuse Medicaid patients Medicaid patients, then private insurers will offer plans with richer and better payment structures. Quite simply, their sales pitch is: “your doctor will not accept Medicaid, they will accept our insurance”..
2) Q. Your program is only available to US citizens and legal residents. What about the illegal immigrants?
A. Nothing prohibits private insurers from offering policies to no citizens, and non legal residents. A provision could be added, that if someone other than the US citizen or legal resident is given medical care and they do not pay for it, that could be a deportable offense.
3) Q. There is no exemption for the poor paying the 5% health fee?
A. There is no exemption for the poor to pay sales taxes or property taxes. Since everyone has the benefit of the expanded Medicaid program, why should they not have to pay something? On a $12,000 year income, the premium is $50 per month, regardless of how many children in the family.
4) Q. Why should a rich person have to pay such a high amount? A person earning $1 million / year would have to pay $50,000?
A. Since this program makes healthcare a right, then funding healthcare, becomes an obligation of all Americans. In other words, we now call it what it is “A TAX” and not an insurance premium. The fact is the wealthy pay more in taxes than the poor.
Again, I am not proposing, supporting or endorsing the two paragraph health plan. I am simply pointing out that if we really wanted to solve healthcare, we could do it, and it would be a lot easier than what is going on in Washington today.
Alan.
Alan@birthconference.org
1) All US citizens and legal residents are automatically enrolled in the Medicaid program and will pay a fee equal to 5% of adjusted gross income, unless exempt by paragraph #2.
2) Persons having proof of health insurance or who have sufficient assets not to need health insurance are exempt from the requirements of paragraph #1.
Although I'm not proposing or supporting it. I've had a number of people ask me questions regarding it. So, I will post some questions and some responses.
1) Q. Won't expending Medicaid cause everyone to drop private insurance and move to the public program?
A. As long as providers and facilities are free to accept or refuse Medicaid patients Medicaid patients, then private insurers will offer plans with richer and better payment structures. Quite simply, their sales pitch is: “your doctor will not accept Medicaid, they will accept our insurance”..
2) Q. Your program is only available to US citizens and legal residents. What about the illegal immigrants?
A. Nothing prohibits private insurers from offering policies to no citizens, and non legal residents. A provision could be added, that if someone other than the US citizen or legal resident is given medical care and they do not pay for it, that could be a deportable offense.
3) Q. There is no exemption for the poor paying the 5% health fee?
A. There is no exemption for the poor to pay sales taxes or property taxes. Since everyone has the benefit of the expanded Medicaid program, why should they not have to pay something? On a $12,000 year income, the premium is $50 per month, regardless of how many children in the family.
4) Q. Why should a rich person have to pay such a high amount? A person earning $1 million / year would have to pay $50,000?
A. Since this program makes healthcare a right, then funding healthcare, becomes an obligation of all Americans. In other words, we now call it what it is “A TAX” and not an insurance premium. The fact is the wealthy pay more in taxes than the poor.
Again, I am not proposing, supporting or endorsing the two paragraph health plan. I am simply pointing out that if we really wanted to solve healthcare, we could do it, and it would be a lot easier than what is going on in Washington today.
Alan.
Alan@birthconference.org
Wednesday, December 2, 2009
If You're so Smart, What Would You Propose for Health Reform?
Yesterday, I talked about 60 votes in the Senate being the most important criteria for the 2000+ pages of health care reform.
Someone just asked me how I would tackle it?
Here is my 2 paragraph starting point:
1) All US citizens and legal residents are automatically enrolled in the Medicaid program and will pay a fee equal to 5% of adjusted gross income, unless exempt by paragraph #2.
2) Persons having proof of health insurance or who have sufficient assets not to need health insurance are exempt from the requirements of paragraph #1.
The above can be tweaked, amended and improved, and it should not take more than 50 pages. Perhaps the premium charge is 4% or 7%, the number is irrelevant. Two paragraphs is about concept not specifics.
Providers would be free not to accept Medicaid patients and insurance companies would compete on that basis.
I am not proposing the above as a solution for healthcare, but, if you're really serious about solving the health insurance mess, then my suggestiosn would be a starting point and we work from there.
My analysis of the political parties involved, is that the Republicans are trying to defend an indefensible system, while the Democrats are trying to manage an unmanageable system.
Alan.
Alan@birthconference.org
Someone just asked me how I would tackle it?
Here is my 2 paragraph starting point:
1) All US citizens and legal residents are automatically enrolled in the Medicaid program and will pay a fee equal to 5% of adjusted gross income, unless exempt by paragraph #2.
2) Persons having proof of health insurance or who have sufficient assets not to need health insurance are exempt from the requirements of paragraph #1.
The above can be tweaked, amended and improved, and it should not take more than 50 pages. Perhaps the premium charge is 4% or 7%, the number is irrelevant. Two paragraphs is about concept not specifics.
Providers would be free not to accept Medicaid patients and insurance companies would compete on that basis.
I am not proposing the above as a solution for healthcare, but, if you're really serious about solving the health insurance mess, then my suggestiosn would be a starting point and we work from there.
My analysis of the political parties involved, is that the Republicans are trying to defend an indefensible system, while the Democrats are trying to manage an unmanageable system.
Alan.
Alan@birthconference.org
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