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Aug 19, 2006 02:31 AM

The 663 Million Dollar Question

by HM2VikingRN Staff

Yet another argument for universal access and/or a single payer plan.

Gov. Tim Pawlenty asked an interesting question recently: "How much would it cost to provide health insurance to every Minnesotan?" Last week, he received a ballpark estimate: $663 million a year, funded by the state if the 383,000 uninsured were enrolled in MinnesotaCare.

The first reaction of Cal Ludeman, chairman of Pawlenty's health cabinet, was that the number sounded big. As a mother who wrote college tuition checks for two children last week, my kitchen-table reaction is the same: $663 million is a hefty sum.
But asking "how much?" is the right question. To put our initial sticker shock into perspective, we need to reflect on some additional numbers:
Hospitals and clinics in Minnesota spend more than $250 million every year on uncompensated care. As a state, we don't turn away the truly ill, whether or not they have insurance. Instead we wait until they are just that -- truly ill -- and then treat them in our emergency rooms. Where does that $250 million come from? Largely by building the uncompensated care costs into higher insurance rates the rest of us (or our employers) pay and through government subsidies.
More than half of the 383,000 uninsured Minnesotans already are eligible for public programs such as MinnesotaCare, based on their incomes. They have yet to enroll, but as a state we already have committed to funding their health coverage, when and if they do. It is as if half of the $663 million is on an invoice that the state could receive at any time. • The number of uninsured Minnesotans is increasing. In 2001, 5.7 percent of of the state's residents were uninsured, compared with 7.4 percent three years later. In that three-year period, 94,000 more Minnesotans were without health insurance. Much of the increase is attributable to a decline in the number of employers (particularly small employers) offering health insurance because of increasing costs.


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52 Comments
No. 1
from ZASHAGALKA
Old Aug 19, 2006, 07:30 AM
Updated Aug 19, 2006 at 08:49 AM by ZASHAGALKA

Default Re: The 663 Million Dollar Question
This cost only takes into account the cost of insuring those CURRENTLY uninsured. And then, the law of unintended consequences occurs and significant percentages of both employers and employees stop spending THEIR money on healthcare because the gov't will pick up the tab . . .

Inside of 3 yrs, your 700mn program will be a 5bn dollar program.

And then the State's budget will totally unravel. They'll make up the costs by RAISING taxes, forcing business into bankruptcy or simply leaving.

That increases unemployment which ALSO increases the uninsured. As a result, in 5 yrs, this will be a 6bn dollar program.

The problem with runaway entitlement programs is that the bill will eventually be paid. When medicare collapses, it will be paid in the loss/curtailment of healthcare. When Social Security collapses, it will be paid by returns far more diminished then they already are. Look at Europe: everybody has great benefits, secure jobs, generous leaves and pensions. That is, IF they're not one of the 20% unemployed as a result of paying for those programs. And the immigrant problems France and Britain are having? The results of massive immigration programs to prop up their collapsing social system.

What you are proposing is a pyramid scheme. It works great if you're one of the first into the system. Not so great if you're the one holding the bag. . .Rather then social systems based on 'get rich quick' schemes where effort is unrelated to benefit, our programs should be honest: if you work hard, you can get ahead. Fortunately, this is the rule in America. But, only if you work hard.

~faith,
Timothy.
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No. 2
from HARRN2b
Old Aug 19, 2006, 08:04 AM

Default Re: The 663 Million Dollar Question
What a mess we in the USA are in. I keep thinking "what is the answer?" No one seems to know. Yet, we are spending so much in Iraq. Are we prepared for our own emergency. What if the pandemic flu hits us such as in 1918. How would our govt react. Would it be like Katrina? I ponder these questions.
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No. 3
Old Aug 19, 2006, 09:13 AM

Default Re: The 663 Million Dollar Question
Originally Posted by ZASHAGALKA
This cost only takes into account the cost of insuring those CURRENTLY uninsured. And then, the law of unintended consequences occurs and significant percentages of both employers and employees stop spending THEIR money on healthcare because the gov't will pick up the tab . . .

Inside of 3 yrs, your 700mn program will be a 5bn dollar program.

And then the State's budget will totally unravel. They'll make up the costs by RAISING taxes, forcing business into bankruptcy or simply leaving.

That increases unemployment which ALSO increases the uninsured. As a result, in 5 yrs, this will be a 6bn dollar program.

The problem with runaway entitlement programs is that the bill will eventually be paid. When medicare collapses, it will be paid in the loss/curtailment of healthcare. When Social Security collapses, it will be paid by returns far more diminished then they already are. Look at Europe: everybody has great benefits, secure jobs, generous leaves and pensions. That is, IF they're not one of the 20% unemployed as a result of paying for those programs. And the immigrant problems France and Britain are having? The results of massive immigration programs to prop up their collapsing social system.

What you are proposing is a pyramid scheme. It works great if you're one of the first into the system. Not so great if you're the one holding the bag. . .Rather then social systems based on 'get rich quick' schemes where effort is unrelated to benefit, our programs should be honest: if you work hard, you can get ahead. Fortunately, this is the rule in America. But, only if you work hard.

~faith,
Timothy.
Will this country not have to be doing the same as Britain and France, specifically to prop up the social security system? Is it not similar to a pyramid scheme?

I realize this is off the topic of healthcare, but what you are supposedly paying for are insurance premium benefits (SSE), that you hope someday you will be able to collect, providing there are enough folks paying into it, or what folks there, paying a lot more into it to make up the numbers. I feel sorry for them already. Just a thought.
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No. 4
from azhiker96
Old Aug 19, 2006, 11:25 AM

Default Re: The 663 Million Dollar Question
Originally Posted by indigo girl
Will this country not have to be doing the same as Britain and France, specifically to prop up the social security system? Is it not similar to a pyramid scheme?

I realize this is off the topic of healthcare, but what you are supposedly paying for are insurance premium benefits (SSE), that you hope someday you will be able to collect, providing there are enough folks paying into it, or what folks there, paying a lot more into it to make up the numbers. I feel sorry for them already. Just a thought.
I think the answer to your question is Yes. Social security is most like a Ponzi scam. There is no real investment of funds, just taking money from working people to pay current retirees. It's a political sacred cow that will probably not get fixed until it's truly bankrupt. Politicians who rob Peter to pay Paul can always count of the support of Paul.
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No. 5
Old Aug 19, 2006, 04:42 PM

Default Re: The 663 Million Dollar Question
The net cost of universal access would be approximately 413 million per year. (663-250=413). Having uninsured patients drives the net cost of health care up for everyone is the real point of the article. This article was posted to the MPLS Star Tribune. The real question is how are we going to get to universal coverage for everyone. Part of the solution for the uninsured is to reduce administrative costs and overhead. If you take the cost of 663 million and take 31% off it shows that in effect we would be paying 400 million for health care services (round numbers).

Minnesota, Maine and Wisconsin all have similar programs to try and bring uninsured patients into an insurance program. One way to reduce costs for small business is to allow the businesses to purchase Health care through these state plans instead of buying health care policies 25-50 employees at a time if we can cut Admin costs in half that would yield dramatic savings that can be used to pay down the cost of universal access.
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No. 6
Old Aug 19, 2006, 05:07 PM

Default Re: The 663 Million Dollar Question
I maintain that the ONLY way to provide near-universal access to health care is to get the insurance industry and the federal government out of it. Get rid of this patchwork mess we call a "system"---it isn't a system, it's a nightmare, and we're paying more and more money for fewer and fewer services all the time.

I say leave it up to the states to decide how to craft programs; they know best what the needs are in their individual areas. Get rid of Medicare/Medicaid and put that money back into the pot along with the money that individuals and businesses would otherwise be paying to health insurance companies so their CEOs can enjoy the good life. Appoint a panel of medical people (including nurses!), financial experts, and ordinary citizens to administer the program and decide what services will be covered and which won't. Offer a basic plan to all that provides preventive care, mental health services and all necessary medications and treatments; as always, those who can afford cosmetic surgeries and other 'extras' can buy them if they so choose. Now, how tough is that??
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No. 7
from Roy Fokker
Old Aug 19, 2006, 05:50 PM

Default Re: The 663 Million Dollar Question
Timothy,

Great post.

One doesn't have to look at France or the UK.
Heck, one doesn't even have to look outside the US!

Why?

Just look at how Social Security has been run since it's inception.
Just look at the promises made AT it's inception and look at the results today.

Government "entitlement"? How's is that for a creepy thought!
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No. 8
from ZASHAGALKA
Old Aug 19, 2006, 06:39 PM

Default Re: The 663 Million Dollar Question
Originally Posted by HM2Viking
Part of the solution for the uninsured is to reduce administrative costs and overhead.
That overhead they are talking about is YOUR salary. Once the gov't gets a monopoly on healthcare, there will be a nationwide 'collusion' to control nursing costs by setting the same standard everywhere.

That's why teachers don't get paid squat: the gov't has a virtual monopoly on their salaries.

No thanks.

~faith,
Timothy.
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No. 9
from ZASHAGALKA
Old Aug 19, 2006, 06:50 PM

Default Re: The 663 Million Dollar Question
The author of 'Rich Dad, Poor Dad' says to expect a recession bordering on depression in 2016-2020. Why?

A confluence of factors.

First, that is when medicare is expected to start failing those not into its pyramid scheme early enough.

2nd - 401(k) programs. The shift to defined contribution plans has a little provision in law that is going to bring the whole pyramid scheme down. See, all those 401(k) - you CAN start withdrawing at 59.5 yrs, but you HAVE to start withdrawing by 70.5 yrs, or face a penalty.

When the advance guard of the baby boomers hit 70.5, they will start draining their 401(k) accounts. The result: pulling the financial supports out from under the stock market.

And THAT will cause the gov't to have to spend massively to bail out the entire financial system. Think: FDIC.

And That will merely exacerbate the Social Security program at the EXACT time payouts will start to reach their zenith.

And when is this? 2016-2020. Think, ten yrs from now. If you aren't putting back for the cyclone heading for our economy now, don't be surprised when it sweeps you away.

How is this on topic? Both SS and Medicare were both only programs that would only cost mere fractions of what they ACTUALLY cost. Medicare, within 30 yrs, is TEN TIMES the projected cost it was to be now.

So, when I say 663 million is probably closer to 6 billion, I'm basing that on the way other such programs have ACTUALLY worked.

~faith,
Timothy.
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