A Glossary of Health Care Reform Definitions

by Admin on June 13, 2009 · 4 comments

in News, Patients

Single Payer – Not necessarily socialized medicine. Not even necessarily the government. Just means one set of uniform paper work to one entity with common standards. Could be very efficient.Would certainly drive costs down for providers, who wouldn’t have to employ nine clerical workers for one professional, just to bill insurance companies and collect. Could make claims processing faster, too. Would not necessarily change your choice of provider. Remember: the payer is not the provider.

Public Option – A plan run by an entity like Medicare, which could take all the people who couldn’t afford or get into private plans. Not necessarily cheaper, or worse. But a way to guarantee health care for people who can’t afford it. Doesn’t make paperwork more efficient, but gives people with pre-existing conditions or no employer a place to get affordable insurance.

Rationing – What we all think of when we think single payer or public option. But in actuality, what we have now in America, where if you can’t afford or qualify for insurance, you don’t get care. We have more “effective” rationing of health care in America than any other developed country. It’s just not rational rationing. Rational rationing involves letting the sickest go first, or the ones with the best future potential. In America, the old and the rich go first. Also the extremely poor. The middle goes last.

Pre-existing conditions – the way we ration now. Back problems, depression, asthma, epilepsy, diabetes, high blood pressure, arthritis are some of the most common pre-existing conditions. Let’s not even talk about cancer.

By age 50, most Americans have one of them, and many Americans have as many as three. Pre-existing conditions are used by insurance companies to stop people from qualifying for health insurance, or to limit the insurance to exclude pre-existing conditions (a “rider” attached to a policy), or to make the cost of insurance so high that entire families go bare.

Employer-sponsored coverage – this is what we have (had) now, which most uninformed people want to protect. What “low information voters” don’t realize, is that 1) the cost of health insurance is part of what drove GM into bankruptcy, and makes large employers so anxious to lay people off whenever the economy hiccups 2)that’s one thing that makes the cost of American goods more expensive than those produced elsewhere and has forced manufacturing offshore; 3)small employers are trying to duck it like the plague, because the cost of insurance makes hiring too costly for them.

Who likes employer-sponsored coverage? The health insurance industry, because it has found the deepest pockets to shift the costs to. Who doesn’t like it? Any small business. Anyone who works in a small business. Anyone who is laid off. Anyone who works for him/herself.

Now. Armed with this information, imagine yourself laid off, or with a
pre-existing condition and wanting to work for a small company, or
self-employed. What do YOU think you would want?

Sometimes it’s necessary to walk a mile in the other person’s mocassins, folks.

I don’t have a dog in this hunt, because I’m on Medicare, which is single payer. But I know what it’s like to be over 50 in a small business (my own) with employees I cared about and a hip that needed replacing. I never told anyone about it because I didn’t want a pre-existing condition to raise our rates. As a result, I was bone-on-bone in pain when I reached age 65, and collapsed in a heap in the orthopedic surgeon’s office, thanking God for Medicare.

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