NY Times Paul Krugman writes: “Right-wing opponents of reform would have you believe that President Obama is a wild-eyed socialist, attacking the free market. But unregulated markets don’t work for health care — never have, never will. To the extent we have a working health care system at all right now it’s only because the government covers the elderly, while a combination of regulation and tax subsidies makes it possible for many, but not all, nonelderly Americans to get decent private coverage.”

It makes me wonder if those arguing about Health Care take into consideration the massive market that is behind it and dependent on it functioning the way it does. Regulation is good but only to a certain degree. Regulation cannot chain companies to not make profit, otherwise they will close their doors and you will see even more uninsured. Who is going to take on all that cost? The government? Obama?

Just what we need, more jobs lost in a hurting economy, guess its a good way to get people to sign up for the new government plans?

Health care costs have increased significantly over the past year. Way higher than wages. This has caused our current crisis in the Health Care industry. This is not to say that the Real Estate Industry didn’t have anything to do with this, as when house prices start spinning out of control and debt soars high, every other industry takes a hit. So now we are on the cusp of a new decision; HealthCareReform: fix the old system and allow it to survive, changing what needs to be changed, or wipe it out by making pretty much everything government controlled. Obama at the center, the country taking sides even more strongly than before…Kind of scary.

In my opinion one of the problems I have seen related to costs is the cost requested by hospitals and doctors for procedures. It almost doesn’t seem standardized, or if it is, it is appraised at too high of a value. If we could get those costs down, then Health Insurance companies wouldn’t t have to charge so much. Then again, with house prices the way they are, it’s kind of hard to justify lowering the amount made by anyone.

This is such a hard decision and it will affect many. Imagine how many will be unemployed if we get rid of private insurance?

A traditional health insurance plan operates on the system of copayments (copays) and coinsurance. You will pay a monthly premium for the coverage. In addition you will pay a copay for every doctor visit, as well as trips to the hospital and emergency room. The copays are set, and usually increase when you see a specialist or go to the emergency room.

You may also be required to pay coinsurance on certain procedures such as tests or hospital stays. The coinsurance is the percentage of the bill that you are responsible for in addition to the copayment for the procedure. For example is you have 80/20 coinsurance, the insurance company will pay eighty percent of the cost and you will be responsible for the other twenty percent. This coinsurance applies after you have reached any deductible set by your insurance policy.
Many policies have a maximum out of pocket payment limit. Once you reach this limit the coinsurance no longer applies, although you do need to continue to pay your copayments. You will also pay coinsurance on the amount that your insurance has contracted to pay for procedures with the hospital and doctor. For this reason it is important to pay attention to both your doctor’s bills and the insurance statements that you receive outlining the payment amount.

It is important to understand how much a procedure could cost you. For example if you had to undergo surgery and stay overnight, you would have to pay your hospital copayment amount, pay the deductible amount if you have not already met it, and then pay your coinsurance amount on the remaining balance of the bill. You can call and talk to a representative at your insurance agency to learn the estimated costs of the procedures before you have them done. Additionally you should make sure that you get preapproval for most tests and surgeries before you have them done. This is one reason why it is very important to go with a reputable insurance company and not a discount plan.  Most hospitals work with all the of the major insurance companies therefore they will already know what is covered and not covered.

A common thread is emerging in the right wing response to healthcare reform. Its opponents aren’t claiming that public healthcare will be bad. Rather, they are terrified that the new system will be so good that no citizen would buy expensive private insurance–or vote for politicians who wanted to take public insurance away.

The Obama team is sending clear signals that healthcare reform is a core economic issue, and the health insurance industry is becoming increasingly anxious by the future administration’s determination to bring healthcare costs under control. Some Americans are seeing their healthcare premiums rising at four times the rate of inflation, if they have insurance at all. Healthcare reform is a pocketbook issue for all of us, according to the Obama team.

In tough economic times it might be tempting to postpone healthcare reforms, but Obama is adamant that delay would be a false economy.

In the American Prospect, Joanne Kenen and Sarah Axeen support claims about the high cost of doing nothing:

A recent report by the New America Foundation’s health-policy program estimates that the cost of doing nothing about health care, including poor health and shorter lifespan of the uninsured, is well above $200 billion a year and rising. That’s enough to cover the uninsured and still have some left over for other public-health needs.

If healthcare costs continue to rise at their current rates, it will cost $24,000/yr to insure a family of four by 2016, an 84% increase from today. At these rates, half of American households would have to spend at least 45% percent of their income to be insured.

In the Nation, Willa Thompson describes how a bicycle crash made her appreciate the connection between healthcare and politics. Thompson was 21 years old when she suffered major injuries after a collision with a truck. Luckily, she was covered by her parents’ medical insurance until she turned 22. She later realized that if she had been just a few months older when the accident happened, she wouldn’t have been able to pay for her medical care.

We all agree that something needs to be done. Let’s briefly review the options that have been proposed so far. Obama wants to provide healthcare for all by requiring private insurance companies to cover everyone and creating a public health insurance plan to compete with private insurers.

Are you tired of searching for the right health plan, feel overwhelmed or like your going around in circles? Do not give up on insurance, many people feel the same as you do. After receiving the right information, most have been able to make an informative decision for themselves and their families.

To help you understand how the Internet works, if you search for a website and do not provide the correct spelling for the company you wish to find, you may be redirected to their sites offering similar services. Once you provide your personal information to theses sites, you may be exposed to have numerous companies contact you to solicit. Also, remember you can not always buy into what is advertised on TV. Make sure you speak to a “Licensed Insurance Agent” not a “Representative”, you want to discuss your personal information with a professional that can hold themselves accountable and validate their integrity. It will some take effort on your part, but take your time to find the right company to help you. Most Agents work with many insurance carriers and they can find the right plan for you and make it a seamless process to obtain health insurance.

When making a decision for health care many questions come to mind. One of the most important is should you get a HMO or a PPO?

There are similarities but researching the two you will find many differences.

Health Maintenance Organization or HMO you have to select a physician to be your primary care provider. That doctor who is usually part of the insurance carriers network will coordinate all of your medical needs or act as a “gatekeeper”. Any time that you are required to go to a specialist that primary care doctor will refer you to a specialist instead of you picking your own. If you decide to choose a specialist that is not part of the network most of the time you will be required to pay most of the cost. For most employers, selecting a HMO option is least expensive. HMO’s often provide preventive care for a lower copayment or for free in order to keep the insured from developing conditions that would require medical services. In addition, HMO’s have lots of rules that must be followed if you want them to pay your claims. Even if you have to go to the hospital you must have your primary care doctors permission prior to going.

Preferred Provider Organization or PPO is a subscription based medical care arrangement. The actual organization negotiates with providers to set fee schedules, and handle disputes between insurers and the provider. PPO’s are great for people who wish you spend the extra money and want to have more say in their healthcare choices. PPO plans have less restriction but cost more to the patients (insured). The insured has more control over their medical needs and does not need a referral or choose a primary care physician. PPO’s are usually more expensive due the fact that the plan usually covers 80%. Therefore that is usually the reason the copayment is higher. Also, you may have to meet a deductible to meet before coverage starts each year.

Before making any type of healthcare decisions always take a look at all options and make an informed decision. One could work for one that does not work for the other. HMO’s and PPO’s are not perfect. Do the research and pick the one that best suits you and your family.