http://www.reuters.com/article/latestCrisis/idUSN31432035

My largest single expense category (after taxes and direct business costs) is health insurance. And that’s just for 2 adults.

Insurance is basically gambling. People who get up in arms about a casino opening, don’t think twice about regulations requiring homeowners to place a bet that their house won’t burn down or float away each year, or that they won’t have a car accident.

When the local city hospital on the edge of the Projects closed last decade because so few patients had any means to pay, the once-flush Washington University/Barnes/Jewish/Children’s hospital complex had to take up the slack.
Their emergency room is now packed with runny noses and coughs of people who get free $500 Emergency care, but can’t afford a $50 office visit. If the uninsured could get free regular doctor visits for ordinary ailments, then the medical industry could save a bundle.
But insurance accountants with their eyes set on the bottom line for the next quarter can’t see the 5 year savings of regular basic care.

btw: The projects have since been razed, and the hospital building is being converted into trendy condos.

This kind of expense can bankrupt many people quickly. Thus the topic of medicaid. There are lots of strategies for spending down your assets if you will be checking into a nursing home for the remainder of your life. But there are also hazards to doing this spend-down legally. If it’s done correctly (this often occurs merely by the person paying the nursing home bill for a year), the middle-class person becomes a poor person and then medicaid kicks in to assist the “poor” person. This becomes especially tricky if the person going into a nursing home is still married and the spouse wants to remain in the family home. If you know anyone who needs to go to a nursing home permanently, I’d advise that you have that person see an attorney that specializes in issues relating to the elderly. See here for some more information: http://www.dhss.mo.gov/NursingHomes/SelectNH.html

In the meantime, any real discussion of national health care should deal with the role that government will play in funding nursing home care.

Medicaid is welfare. It is extremely limited, and is largely state controlled. So where you live can determine whether you qualify or what it covers. In many, many cases, doctors refuse to accept Medicaid patients because (1) the payments from medicaid are much less than the standard fee and (2) the government sometimes makes these health care providers wait many months for reimbursement. A number of years ago, the only doctor in town that could be counted on to accept new medicaid patients had to close his practice and declare bankruptcy because the state had not made a single payment to him in over a year.

I am fortunate enough to be able to make those payments. What’s scary is that there is no possible way for many people to insure their families.

Your comment didn’t raise the following issue, but I need to address it. Many people out there are against “socialized medicine” because they’d rather engage in the blame game. In the minds of many people who oppose government provision of health care, the people who don’t have health care all deserve their plight.

Tens of millions of people have no meaningful access to health care. That’s a fact. It’s important to note that there are many types of people in that class. Yes, many of them have made bad financial decisions–had they made better decisions, they might have had some coverage. But there are also tens of millions of ininsured (I know some of them) who are working hard to eke out a living. If they paid for medical insurance, they wouldn’t be able to afford their modest car or their modest apartment. And consider, what is the price someone should pay, when that person COULD have afforded health insurance, had they worked harder (maybe taken a second job)? Do we let them remain sick and sometimes die? Is that ever in the national interest?

I can’t help thinking about people with broken arms, babies with high fevers, people with horrible pain that they choose to live with even though they are still in that a tiny window of time where their condition is still treatable. I think of people feeling the throb of aching rotting teeth, month after month. A good friend of mine has two adult relatives who are mentally retarded now, because when they were babies, their young poor mothers couldn’t afford the fee to take their babies to the health clinic. Is that ever in the national interest to have people not get basic treatment such as antibiotics? I think not.

Isn’t this basically like saying that I want other people to be denied health care so that I can jump to the head of the line? If there is a waiting list, it must be because people need medical care, and if there’s no list, then that may mean that people who need care aren’t getting it.