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The hope of real healthcare reform is gone. The public option is out. This may well have been our last opportunity to get healthcare reform done right. I don’t believe the idea that we just need to pass any kind of healthcare bill now, and then down the road, healthcare can be fixed or improved. I find it hard to believe because the Democrats already lost the Massachusetts Senate seat and will likely lose additional House and Senate seats in the upcoming elections in 2010 and probably in 2012 as well. The presidency may as well be in jeopardy if the economy doesn’t turn around very soon. With fewer Democrats in both houses, I don’t see how the healthcare system can be improved in the near future.

The insurance industry has won and the American citizen has lost. It seems we are going to be forced to purchase insurance from the same companies that have no true concern for their customers. Their only concern is the bottom line: how much have we made this year. Sure there may be some types of provisions stating that the insurance companies can’t drop customers or can’t refuse to cover someone with a pre-existing condition, but Congress is rewarding these insurance companies by giving them new customers without really having to put any skin in the game. In the Senate’s bill, insurance companies will be able to charge older citizens as much as three times as young adults. They are still exempt from antitrust laws. Only those who don’t have insurance are allowed to purchase insurance through an exchange. Those who have insurance but don’t like their coverage are stuck with what they have. There is no choice for them. For those who can’t afford insurance, the government is going to help subsidize them, meaning giving money to the insurance companies. The depressing thing about it is that between 18 and 23 million people still will be uninsured, and healthcare costs really haven’t been contained.

I support a Medicare for all health bill. We should eliminate the insurance industry as a whole. I say this because I know how well universal helathcare works. I live in South Korea, and I have had government run healthcare for over four years. I will truly miss it when I return to the U.S. next year.

Although South Korea’s healthcare system is not a single payer system, like Medicare, it is very inexpensive. I pay less than $60 US dollars a month (2.77% of my monthly salary) for health coverage for my wife, who is Korean, and myself. The university where I work pays the same amount to the government. In return, I can visit any doctor I want without having to get a referral. Alternative medicine, such as acupuncture and chiropractic care, is covered by the government plan. There is no paperwork to fill out when I arrive at the doctor’s office, and there is no deductible. After seeing the physician, I give the receptionist my healthcare card or my Alien Registration card (Korean green card) and then pay my bill.

Here are my experiences with healthcare in South Korea:

Acupuncture treatment costs less than $5. Chiropractic care was less than $15 a visit.

A visit to an international medical clinic located in a hospital for pharyngitis was less than $30, and the medication was less than $25. In all, my total cost was less than $60.

I recently went to a doctor to see if I broke a toe. I didn’t have an appointment. My wait time was about an hour. The doctor’s fee was $5, and the X-rays were $8.

My mother-in-law was diagnosed with ovarian cancer last year. Her total out of pocket expense for a complete hysterectomy, chemotherapy, and hospitalization was less than $6,000. The cost would have been less than $4,000, but she had to stay in the hospital for an additional two weeks because there were some complications to her surgery. She is doing well now.

My co-worker had his gall bladder removed. His total cost for the hospital stay (3 days), surgery, and doctor visits was less than $1,400.

I would like to note that the South Korean government recently announced it would cover 95% of the medical costs for people who have cancer.

South Koreans don’t subsidize government insurance through taxes. Personal income tax rates in Korea are less than the US. My tax rate is 3.3%. My brother-in-law who makes around $70,000 pays 7-8% in taxes. The Korean corporate tax rate is also less than the US corporate tax rate. The reason why healthcare is so inexpensive here is that the Korean government negotiates with the drug companies as well as the doctors and hospitals in how much they can charge. There are private insurance companies in Korea. They provide additional coverage for diseases, such as cancer, which will act like supplemental insurance. The monthly premium is relatively inexpensive.

There are some items (tests or exams) that neither the private insurance companies or the government plan will cover. For example, a MRI is not covered by insurance. The patient would have to pay around $600. However, if you take in consideration that most Americans pay around $500 – $600 a month or more just for insurance premiums, it’s not that expensive.

What I find frustrating when returning to America is all the misinformation and lies about how government run healthcare is terrible, that it rations coverage to its citizens, and that you have to wait a long time to see a physician. In South Korea, I haven’t found this to be the case. For acupuncture care, I can get in to see the physician that day. To see an English speaking doctor, if I can’t see them that day, I will see them within a day or two. To make an appointment to see a specialist, such as an oncologist or an orthopedic surgeon doesn’t take weeks or months. I was able to see an orthopedic surgeon within a day or two of making the appointment. In the US, some people have to wait up to a month or more to visit their physician (optometrist, family doctor, dermatologist, etc.) depending on where they live. Finally, there are no death panels.

Without real reform, healthcare costs are going to rise to the point that sooner or later, our health system will bankrupt us. Having a public option would help reduce the costs of those who have insurance and give those who currently don’t have insurance the opportunity to purchase insurance at a more affordable cost. Apparently, there are people who don’t understand this.

Since the Senate and House have given up on the public option, why can’t Americans come together and create our own universal healthcare organization that would offer affordable health insurance for anyone, regardless of age or health condition, who doesn’t have health coverage as well as those who are insured but don’t like what they have? In other words, Medicare for all, except it would not be run by the government.

I look at USAA, www.usaa.com, as an example. USAA is a privately held company that provides insurance (auto, home, life, and Medicare supplement) and financial services at a competitive price to its members, who are military personnel. The company was created in 1922 by a group of military officers who couldn’t get auto insurance because they were considered to be a high-risk group. Starting with only 25 members, the company now has over 7.2 million members. Why can’t there be a company like this for people who need health insurance?

If we could get the estimated 37 million Americans without health insurance and those who have insurance but don’t like their coverage and want another provider into a Medicare-like program, we would have a huge pool that would have enough bargaining power to negotiate prices with hospitals, doctors, and drug companies. For people like Senator Conrad, who complain that rural hospitals are receiving only half the Medicare reimbursement urban facilities get, we could reimburse the hospitals at a higher rate (7 -10%).

In regards to monthly premiums, we could have two different ways to pay. First, we could have a single payer system, which wouldn’t cost that much for each person. For example, if everyone in the pool paid $50 a month, and there were 50 million people (the 37 million uninsured plus 13 million who don’t like their coverage although I am sure there would be more people willing to come aboard), that would be $2.5 billion in monthly premiums. Multiply that figure by 12 months, and the annual premiums for this pool would be $30 billion. I would think that would be enough to cover the medical expenses for everyone during the year. If not, we could have everyone pay $100 a month. The annual premiums would be $60 billion.

The second way to pay for monthly premiums is to have the employee and employer split the cost of the employee’s monthly premium. The cost would be based on a percentage of the employee’s salary just like we do with Social Security and Medicare and how it is done here in South Korea. We could set it up where the monthly premium for a family of five or more would be maxed at $400 (just throwing out numbers). I would like to point out that my brother-in-law has seven people covered under his insurance plan: his wife, two children, mother, father-in-law, mother-in-law, and himself. His monthly insurance premium is less than $170.

By allowing anyone and everyone regardless of age or health condition into the system, we could offset the high costs of premiums and care. I believe this would be less expensive to consumers than the House or Senate bill. The key is to get costs under control. As I mentioned before, with a large pool, we would have the power to negotiate drug prices and doctor and hospital fees. Wal-Mart as well as the large drug store chains are able to offer $4 Prescriptions Programs because of their buying power.

The question is why should we wait for Congress? Why not create our own public option? Why can’t we get doctors like Governor Dean, other medical professionals, and former insurance executives like Wendell Potter together to create this new entity, with low overhead costs, that would provide affordable healthcare for its customers and put a big financial squeeze on the insurance companies? I may be naive when it comes to the ins and outs of the healthcare system, but I do know that having insurance companies drop customers, deny benefits, and increase rates to maximize profits while paying millions of dollars to their executives is immoral. I for one am not going to be forced by our government to get health insurance from these unconscionable cartels.

Originally posted to scubadiver on Tue Jan 26, 2010 at 05:23 AM PST.

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