July 17th, 2017

Pack your bags – we’re goin’ on a trip around the health care delivery system!

The Insurance Mom mentioned in last week’s post that there seems to be a huge misunderstanding of how America’s health care delivery system compares to those of other countries.   The divine Michael Lujan, shares his expertise:

The UK Model – In this mostly single-payer model, healthcare is provided and financed by the government through taxes. Except for small co-pays for prescriptions, there are no co-pays or deductibles as health care is delivered as a public service, like fire and police. With Britain’s National Health Service, most doctors and hospitals are owned by the government and patient wait times can vary by region or treatment type. As the sole payer, the government controls what doctors can do, and what they can charge. Our Veterans (VA) system is a close example. They also have private insurance options.

The Canadian Model – With this “National Health Insurance model”, the providers are private but the payer is a government-run insurance plan everyone pays into. Our Medicare system is a close example of this model. The private insurance plans are non-profit and manage their costs by limiting or delaying care.  Canada’s decentralized health system (coincidentally called “Medicare”) is technically a multi-payer system with slight differences for each of their ten provinces and three territories; some provinces/territories have co-pays at the point of care and others don’t.

The German Model – In this multi-payer system, providers and payers are private and largely funded through employer-based payroll deductions. Patients have co-pays at the point of care. The world’s first national health system (established around 1883) offers citizens 135+ private insurance plans called “sickness funds”. These private insurers negotiate prices with private hospitals and providers. Patient wait times are shorter than U.S. patients typically experience. This is the health care delivery system most familiar to …

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July 7th, 2017

Is Health Care A Right or a Privilege? (more brilliant comments from the amazing Michael Lujan)

A topic about universal health coverage (UHC) Inspired by the great Michael Lujan and his post on LinkedIn.

At the center of the debate is this simple but loaded question. Every other developed nation has answered the question and enacted some form of universal health coverage (UHC). Proponents of the bill often make comparisons to the Canadian or the UK health systems. These comparisons are inaccurate, deliberately misleading, or possibly uninformed. The term “single-payer” refers to the financial arrangement; meaning one entity (the government) collects the funds (usually in the form of taxes) and this “single payer” also pays the providers. In a single-payer model, the providers can be private or government-owned. The government replaces the insurance company role and instead of paying premiums, Californians would pay for health care systems through higher taxes.

“When you look at all the different health care systems around the world… They are not all single-payer… and most are less socialized than America’s.” – T.R. Reid

Visit us next week when The Insurance Mom shares a comparison of four health care models around the world.

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June 30th, 2017

What a difference a week makes! SB 562 Update

Thanks for tuning in for our series on single payer!  What a difference a week makes; big update on SB 562.

On Friday, 6/23/17, CA Assembly Speaker Anthony Rendon (D-Lakewood) shelved the proposal saying it is “woefully incomplete” and has postponed any further legislative action until January 2018.

“If you think health care is expensive now, wait until you see what it costs when it’s free.”  – P.J. O’Rourke

The Insurance Mom’s colleague, Michael Lujan (one of CA’s best-known expert insurance legislative analysts) offers this in his amazing post on LinkedIn:

Single Payer (SP) would:

  • Replace all forms of private and public health insurance in California with a state government-run health system.
  • Would eliminate an estimated half million insurance, health care administration and related jobs, tripling our current unemployment rate. And without payroll contributions going into the system, there will be no money to pay unemployment benefits.
  • Could make California a health care destination for anyone seeking “free healthcare” as neither citizenship, nor permanent residency is required to use the SP system.
  • Requires massive tax increases. The additional 15% payroll tax would make California the highest taxed state in the country.

If enacted, The Healthy California Act (SB 562) would be the largest tax increase in California’s history. The entire state general fund is $183 billion. As proposed, the bill would cost an estimated $400 billion for the initial year and unknown costs for subsequent years. While that may seem like a deal-killer, the bill moved forward to the State Assembly and should not be ignored (when it resurfaces in 2018).

While this bill may be dead in the water, single payer / universal healthcare / socialized medicine / Medicare-for-all have been floating around the brains of the public.  The Insurance Mom wants her kiddies well-informed about …

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June 23rd, 2017

What’s going on with healthcare today!?

Are YOU confused about healthcare?  We all are!  There are some VERY big things being discussed right now regarding healthcare insurance.  But we read all the articles and boil it down into an easily digestible stew.  Here’s the inside scoop from The Insurance Mom!

While a lot is happening in Washington, there’s even more urgent things happening here at home in CA.

SB 562 — The Healthy California Act — is working its way through Sacramento right now.   You probably won’t get to vote on it.

State Senators Ricardo Lara (D-Bell Gardens) and Sen. Toni Atkins ((D-San Diego) say they know what’s best for their constituents.   They say… “all Californians will have one plan, more choice.”  Huh?  What does that mean??

Welcome to Our Blog Series

The Insurance Mom wants her insurance family to be informed, insured, and inspired to engage in the future of health care.  That’s why I’ve written a blog series about Single Payer Health Care.  Tune in next week for some truly EYE-OPENING info on our insights of these concepts.

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June 22nd, 2017

Tax Credits

Part of the Affordable Care Act (Obamacare),  people get a tax credit to help them pay for their insurance premium.  Tax credit eligibility is determined by the FPL guidelines (your annual household income).…

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June 22nd, 2017

Socialized medicine

Aka universal health coverage, a government-run insurance system combined with private insurance policies.…

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June 22nd, 2017

POS Plans (Point of Service)

No, not THAT POS abbreviation 🙂   Point-Of-Service network model which combines the HMO and PPO models in one plan.…

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June 22nd, 2017

Medi-caid / Medi-Cal

A government program for folks with lower incomes to help them pay for medical care.  In CA, this program is called Medi-Cal.…

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June 22nd, 2017

HDHP / High Deductible Health Plan

An HSA-compatible plan with a high deductible.…

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June 22nd, 2017

FSA / Flexible Spending Account

If your employer offers this, an account in which to put tax-free money to pay for medical expenses, but you can only contribute a certain amount determined by the feds every year.…

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