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Health The US Health Care Failure.  Throwing the Dice  

Health Care

written by Mike Sterling for Canadian Community News

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The United States again seems mired in unending health care woes.  Donald Trump is bent upon abolishing what is known as Obama Care.  But, danger lurks.  He does not understand the broad spectrum of the health care dilemma.

Some time ago I wrote an  article comparing US and Canadian Healthcare costs. (See Read More)  It's an interesting story.

Canada's costs with single provider status are less than 1/3 of the US cost with better expectations on average for Canadians They were equal in cost as late as 1970.  What's happened?  Is Canada's single payer system responsible?

US Presidents from Teddy Roosevelt to Barack Obama have attempted reform and to make universal coverage possible.  Big stepping stones came with FDR and Social Security, Lyndon Johnson with Medicare and George Bush Junior with Medicare Part D.

The  recent attempt is called the Affordable Health Care Act or 'Obama Care'.  It now insures over 20 million citizens, who cannot afford other health care options.  It also insures people with a pre-existing condition, who could not get health care otherwise.  It also took life time limits away as end of life was taking entire families down the no insurance drain.

It was thought that Obama Care would be enhanced, refined and made cost effective as any normal product would, but Republicans have blocked any changes and improvements. They have put forward many bills to abolish it altogether to be replaced by what they call the 'free market'.  The real plan is not defined.  They have set a time bomb.  Ironically, Obama Care was modeled after a Massachusetts plan of Republican Mitt Romney.

US citizens receive their health care insurance in a number of ways including:

  1. From their employer and their own contribution to a payroll plan.  This is hurting small business. 
  2. A small proportion of wealthy Americans buy golden plans for themselves for high $$. 
  3. Millions get Medicare and Medicaid for the elderly and those who cannot afford market driven insurance premiums.
  4. Some have special plans that enhance options like Medicare.  These in general are called med-a-gap plans.  They cover any gap between Medicare and total coverage like OHIP in Canada.

The US has very good health care for retirees 65 and over.  There is basic coverage and a ton of special add-on plans.  Looking at them closely, the final result is much like OHIP.  You go to a doctor/hospital and show your health care card and the system responds from individual doctors to hospitals and specialists.

I was talking to a US couple, newly retired, that were totally at a loss about their own Health Care. 

Click the orange arrow to read the second column

They were paying outlandish medical and drug bills, when they had no need to do so.  

Why? They just didn't know the available plans and options. There are just so many plans and too many providers.   They got their own issues totally confused with Obama Care.  They did not have a clue as to their options and blamed "the system" for their woes.  One of them was burdened with a $1600/month drug bill.

All this is much more complicated than I've described.  People are lost in the maze of options and costs go up because of the complexity.

Many states have a plethora of agent/experts who, strangely enough, can really save a US retiree a great deal of money by just pointing out the way.  They run seminar after seminar and the TV screens and Internet ads scream out to the over 65 generation to look up, listen and save.  For once such ads are true!

The key idea is to have a pool of individuals large enough to support the expected costs with premiums paid for by both the government and the insured.

All this has to be much simpler to be effective.  Canada is indeed lucky to have universal health care of high quality with the single payer option.

Now the new administration in Washington is faced with what they promised.  They are bent on abolishment and replacement with an unknown solution. 

Trump vowed to abolish Obama Care in the first hours of his presidency.  He is counting on market pressure and a form of trickle down economics.  Let's see how he does that and what, by the way, will replace it?


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Monday, November 21, 2016