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  1. Matthew wrote, //Mind you I’ve always thought that Florida should be towed off into the Caribbean and left there without any air-conditioning like the Banana Republic it is.//
    My youngest son and his friends are in air conditioning. Last night I went to a party because they all got raises. My adopted son (kinda) got a call from his mother in England. She said, “You could see the sun today for the first time in a month.” The boy said, “Mom, how would you like to see the sun every day?”
    Sue is right. Both Republicans and Democrats have contributed to our current mess in health care. I don’t say too much about good Republicans except the Bush brothers. Jeb Bush is a good arguement for cloning. If all states had a Governor Jeb Bush, economic prosperity would soar and national unemployment would plummet.
    We did see a 7 foot gator swim by us last night. In my neighborhood the county removed a much bigger one, 2 days ago. I had to kill a 45 inch Cotton Mouth, four days ago, hiding next to our front door. The eagles soar above my house trying to get a look at our 8 lb little dog. But we are also in the flight path of woodpeckers as big as chickens. So you take the good with the bad, like anywhere.

  2. The thing that bothers me most is that I don’t see very many politicians at all that I feel good about voting for. Personally, I believe that as a country we are facing some critical economic policy challenges related to globalization philosopies, workforce structure, education and healthcare delivery and our politicians are so locked in partisan squabbles that no good solutions are getting put on the table. In my opinion, Republicans and and Democrats have both contributed problems in these areas through lack of good policy initiatives. When voters mindlessly follow a party label they contribute further to the problem. I’d love to see someone who isn’t a professional politician shake up the field the way Perot did with his informercials and get the electorate focused on real issues instead of emotional appeals.

  3. I cant believe that anyone’s lies can amount to those of Katherine Harris….she after all is the one who put us in this mess and was caught with her knickers down by Greg Palast. See http://www.gregpalast.com/detail.cfm?artid=122&row=1
    Mind you I’ve always thought that Florida should be towed off into the Caribbean and left there without any air-conditioning like the Banana Republic it is.

  4. Jeb Bush is a good guy.
    I was a little afraid because Governor Jeb Bush refuses to run for President in ’08. I thought it was important to have a proven vote getter in Florida to take the Presidency. Yesterday, it was reported in the Saint Peterburg Times that Governor Jeb Bush has passed $14 billion in tax cuts since taking office in 1999.
    Also they reported that the Tampa Bay unemployment is down to 3.8%. Governor Jeb Bush at yesterdays tax cut siging said, “I wish I could lower taxes even more. Government doesn’t create jobs but it can produce an environment that lets businesses grow.”
    Now that the IRS has siezed the Florida Democratic Party’s bank accounts and the guy in charge of the fraud is the Democrat’s canidate for Governor in ’06, any Republican running for President in ’08 will win.
    This has got to hurt Senator Nelsen (D-FL) because he is up for re-election in ’06 too, against Republican Kathleen Harris, the strict constitutionalist. Senator Nelsen said a bunch of lies about the HSA right after it was passed. He used to be the state’s insurance commissioner so you would think he would be better informed. If Nelson loses the Republicans will pick up another Senate seat.
    Maybe Jeb Bush is just saying he is not running just to trick the Democrats like Karl Rove does all the time. He sure seems sincere though.

  5. Well said, Sue.
    Someone I have a great deal of respect for (and who reads and occasionally posts here, so I hope he’ll recognize himself) once said in a nutshell:
    “…most right wing extremists [are] only interested in saving the unborn and the nearly dead, and couldn’t care less about the living and merely sick.”
    He was referring to Jeb Bush =)

  6. We actually need an intelligent bi-partisan effort focused on healthcare. You should read John McCain’s discussion of his beliefs in sound fiscal policy in Goldwater/Reagan Republicanism vs. the current Bush philosophy of cut taxes and increase spending. The Republican Party needs to put their house in order. Consider the current Republican health care activism re: Terry Schiavo.
    Woman with eating disorder has potassium imbalance that triggers heart attack and brain death.
    Husband sues for malpractice and wins settlement to pay for extended care. (I guess malpractice suits are okay when “right to life” is involved).
    After trying a range of therapies with minimal results, husband seeks to give her death with dignity.
    Her family enlists Republican conservatives in right to life battle. Conservative Republicans waste tons of tax dollars, legislative time and use questionable legal methods to fight to prolong her life support.
    Courts save the day and allow life support to be removed. Schiavo is slowly starved to death because family prevented her death years earlier when an infection could have killed her faster and our current laws don’t allow mercy killing.
    Autopsy shows Schiavo has been beyond help for years.
    Meanwhile millions go without health coverage because of the inefficiencies in our health care system. It doesn’t add up to me. I’d like to see Democrats and Republicans start to focus on solving real problems. By the way, Ron, I’m a Republican, not a Democrat. But, I’m thinking very hard about that right now. Matthew is right–I’m one of the middle-of-the-road Republicans who may cross the road and join the Democrats if my party’s politicians don’t start doing their jobs and addressing real issues instead of Karl Rove’s PR-spin agenda.

  7. The real problem for Socialized Medicine is that the Democratic Party is totally lost. You need the Democratic Party if we do indeed want a government takeover of health care and they are in ruin. Here in Florida it is really bad. Senator Nelsen is up for re-election along with the Governor. You know I think the St. Petersburg Times is just a propaganda outlet for the Democratic Party. So the St. Pete’s Times didn’t run this story on the front page but hid it in the back pages. Florida’s Democratic Party has been busted by the IRS and is about to implode unless we can get some money in their hands to preserve the 2 party system here in the Sunshine State. Anything you can send them will be appreciated greatly.http://www.tcpalm.com/tcp/wptv/article/0,2547,TCP_1213_3874206,00.html
    Please pray for the Democratic Party of Florida.

  8. Can’t have a big deductible like $20K with an HSA under federal law.
    Most families get a $5,200 combined family deductible that pays 100% thereafter, including Rx. If the employer fully funds the HSA that’s still only $433 a month. But always remember it is against the law for HSA deposits to go up double digit like insurance. Employers never get a notice saying their HSA deposits are going up, unlike those horrible insurance rate increase letters. You can tell where the owner opens the letter because there is a dent in the ceiling.
    Only the $166 monthly premium is subject to medical inflation instead of the current $1,100 per month, per employee. It’s basically an IQ test for those who pay their own health insurance. Heck, these employees could switch to HSA health insurance and save enough money to purchase 2 new SUVs per family, it’s so insane.

  9. I don’t disagree that HSAs represent one creative option to provide affordable premium options, but without controls on the cost of health care they are simply a short-term solution. The real problem we have is that we have a market that is extremely inefficient economically. In markets that are truely consumer-driven increases in price beyond what consumers feel are affordable triggers drops in demand which triggers cost reduction strategies in producers and retailers that lower price. That’s why you can buy a DVD player at Wal-Mart for under $100. Right now, the drop in demand is happening at the insurance level with employers and individuals choosing to drop or restrict their coverage to reduce premium payments. While that reduces today’s out-of-pocket cost, it may be opening the door to a total default on future healthcare costs because the vicious cycle of fewer and fewer people actually paying their way in our healthcare system continues and the “deficit” is being tacked on to the costs of those who do pay their way. Insurance companies offering HSAs will face the same cost challenges that everyone else does and ultimately their consumers will have to share in that cost increase through higher premiums or reductions in services provided (and keep in mind consumers can be motivated to further reduce coverage by premium cost options). The HSA option assumes consumers will be financially responsible and save for their share of outrageous healthcare costs. But, if consumers keep choosing to decrease premiums by restricting coverage on the “bet” that they won’t need those services it is more likely that even good savers will get unfortunate cost surprises as hospital costs increase. That drives more malpractice claims and consumer payment defaults which increases healthcare costs and insurance premiums. There isn’t a single cost driver (it is a lot of things) in this scenario and as a result there won’t be an easy solution.

  10. Ron,
    I think you’re comparing apples to oranges. For it to be avalid comparison, you need to have the employer pay the cost of th HDHIP AND fully fund (or at least 80% fund) the HSA.
    So If the annual deductible is $5,000, then the employer ought to put in $4,000 or $4,500 into the HSA too. That comes out to about $375 per month (and really you need to put that in at the beginning of the period, because a nnew employee might get hit by a truck. So the cost is $544 per month. Though it’s not as bad as $1,100, it’s nearly half-way there, and if teh deductible is higher, say $20k for a family of 4, then the savings are entireky illusory, because the effective monthky rate would be $1666.

  11. Matthew,
    I have never heard anybody explain why we have inflation in health care quite like that. I think it’s much to complex for those people, even though you did work in some stuff they might like to think about. Read their comments. I like to use real numbers when I explain it. For example, when I talk to an employer who is spending $1,100 a month for family health insurance on employees, I like for them to use a calculator. I have them put in the cost of a 30 year old couple and 2 children on HSA health insurance, say $166 a month. Then I make them tell me how much is saved just on one employee. Then I pretend I can’t hear them so they say the number louder. I find that this type of participation helps those who maybe arn’t so good with numbers to fully understand. Then I say multiply that by 12 and how much do you save each year on just one employee. Then if they have 50 employees with family coverage I make them multiply the yearly annual savings by 50 and say, “How many commas are in your 5 year savings, just on the families?”
    These guys know about health insurance inflation because their bills keep going up. I tell them it can’t be stopped, exactly like my wife’s age. With double digit inflation in only a few years your $1,100 premium per month is going to double. Then I ask them, “Would you rather have $166 double or $1,100 double?” That seems to work pretty good.
    Now I can get a lot more creative after 8/1/05 because of new HSA options that allow the consumer (that’s what we call employees) the option to reduce the family premium even more by restricting certain plan coverages. The $166 family coverage can now be reduced 40% by restricting covered expenses for even more consumer choices with HSAs. Of course they still get their HSA tax dodge. We have this thing that if they don’t hit the HSA base family deductable their renewal premium is reduced by 10% to help fight the burden of inflation. We do that for a maximum of 36 months, so that’s nice even if it’s so complicated other insurers will never figure it out. That’s what happens when you are 9 years ahead of the competition.
    The HSA is even better now. I told you I figured out how to give them a mutual fund option and still make the HSA free. Still no fees with a mutual fund option makes these consumers set up and take notice. That’s the way the government should treat tax payers. Start calling them consumers and give them a little more options, choices and freedoms. I could be wrong.
    My Mom showed me a bill from 1972 and the Mayo Clinic was only $50 a day in the hospital. Here in Florida it was reported that a uninsured guy was charged $13,000 a day for his hospital stay. When we started selling health insurance in 1913 a normal vaginal birth was only 2 chickens and today it’s a lot more because of inflation. Imagine how much a $300,000 cancer will cost in the next 30 years when the baby boomers are droppin’ like flies.

  12. That was an excellent piece and it catches the real crux of the issue. There isn’t one single villian that is driving costs–it is a combination of factors which includes consumers with great insurance who have an entitlement mentality and expect Cadillac care with minimum cost sharing, healthcare providers who want higher than world market compensation packages, insurance companies and hospitals unwilling to look at true cost reduction strategies related to sharing of high-dollar equipment or streamlining of admin processes, insurance companies who only want to insure the healthy, malpractice lawyers helping consumers play legal lotto, compassionate conservatives who want to ensure the brain dead are maintained through old age and a host of folks who can’t afford health insurance who expect to get care regardless of their ability to pay. My guess is we will keep running down this road until the number of uninsured/no pays reaches the point where it is bankrupting hospitals. We almost hit that point here, but then the for profits starting billing the county hospital for indigent care services and the county hospital increased our property taxes to pay for it. As long as we keep finding ways to shift the burden of healthcare costs to taxpayers instead of finding a way to cap costs and share them across all patients we are going to be headed toward a crisis. And high deductible/co-pays still don’t address the issue of uncontrolled costs, inefficient systems and overtreatment.