Hearing from the other side

I have a little help in the “Fair Share” battle.

In my recent post, “The battle is joined” I noted that one of the things on my “to do” list was to call both of my state delegates, Bennett Bozman and Norman Conway. Last Friday, I did so. While I still haven’t heard from Delegate Bozman or his office, I heard quickly from Delegate Conway. He was very polite and listened to the points and arguments I made to help convince him to vote in the right manner.

There were some points that Delegate Conway brought up that I found interesting. Chief among them is that he’s the head of the Appropriations Committee, so I suppose if anyone knows about the state’s budget he would be the guy to know. He told me that the state is facing what he termed a $160 million structural deficit. I looked this up on Maryland’s website and the Spending Affordability Committee report from 2005 does show structural deficits in “out” years (FY 2007 on.) (Note: this is a 105 page .pdf file.) That report shows FY 2007 as a $300 million deficit.

However, since the report came out there has been news of a $600 million surplus from this year’s budget. So I’m a little bit confused about whether these numbers the SAC came up with aren’t too pessimistic. Possibly the $160 million Conway spoke of includes an adjustment for this, but it’s hard to say.

Delegate Conway also cited Wal-Mart’s profitability from last year, noting that floor testimony stated the company made $10 billion and cost the state of Maryland $250 million in Medicare expenses because of gaps in Wal-Mart’s health insurance.

Let’s look at this in two different ways. Assume that both numbers Conway cited are correct. Maryland is almost a perfect “average” state in population, our roughly 5.5 million people is right around 1/50 of the nation’s total. So if every state decided to tax Wal-Mart in a similar way that Fair Share would, suddenly the $10 billion profit is a $2.5 billion loss. Then Wal-Mart would have to lay off workers and close stores, thus putting these people right back on the public dole.

Plus, I saw a report the other day that is cited on the “My feedback” page as I responded to a post on Duvafiles. That report showed that the typical low-wage employee is a $898 drain on the state’s Medicare system. That means it’s not just Wal-Mart – it’s K-Mart, Target, McDonald’s, Burger King, Best Buy – all those employers put a little drain on the system.

I will say one thing about Del. Conway – he did sound surprised about the union-sponsored radio commercials citing his stand on the issue, claiming he didn’t know about them until he heard one himself. And I’ll believe him. I did tell him that he is pursuing a solution in the correct arena, since Medicare truly should be a state issue rather than a federal one.

He does have a good, principled stand – I just happen to think it’s the wrong stand.

But the pro-Wal-Mart side has finally gotten some of their message out. I found this link right on the Sun’s website. Also, the Maryland Chamber of Commerce weighed in with an opinion that “Fair Share” violates portions of the federal ERISA Act.

So it’s going to be an interesting week to come.

Now, since I’m on the subject of health care, I have a bone to pick with the health care industry.

Why is it that I get a bill for $131 from my doctor, but when the health insurer pays the doctor, they give the doctor’s office $77? I understand that the doctor’s office has a good deal of overhead, but is it possible that having to deal with all the red tape creates the majority of it?

My doctor’s office has at least one person who handles solely billings and another person who handles referrals. They have nothing to do with patient care, but the doctor has to pay them and lease that little extra bit of space for them. There’s really something wrong with the health care industry.

And I can tell you right now, just based on experience and observation, that the WORST thing we can do is make it solely a government-run program like “HillaryCare” promised to be. I think something on the order of Medical Savings Accounts would be a good idea. I wouldn’t have to worry about having a chiropractor who is out-of-network. MSA’s also discourage needless trips to the emergency room, at least as I see it.

The more things in the health-care sphere that are directly controlled by the patient, the better the system works. And the less red tape there is (along with a serious tort reform measure to help curb the cost of liability insurance), the easier it is for a doctor to actually practice medicine rather than play defense.

Author: Michael

It's me from my laptop computer.

3 thoughts on “Hearing from the other side”

  1. I can give you lots of information about how a Dr’s office works and what a messed up system THAT is.
    Medicare is SOOO screwed up. Did you know they only pay roughly 65% of what is billed. The providers who accept Medicare have to WRITE OFF 35% of your bill as a contractual adjustment.
    Medicare looks for any reason not to pay, frequently taking money back from the provider.
    If you were told that in order to do business with your customers, you had to “accept assignment”, or accept whatever the customer wants to pay, wouldn’t you have to raise your prices?
    If medical care was reasonably priced, we wouldn’t have to have insurance, because we could feasibly PAY for our regular services.
    $10,600 is a bit much for an appendix removal. Don’t you think?
    I’ll remove it for half that.

  2. Welcome to you, MsAmber. I see you commenting on the blog of my “left wing arch-nemesis” frequently. And your comment here was very welcome and thoughtful.

    I think that information on doctor’s offices would be a nice thing to have. But I suppose the doctors offices play the game as well, purposely overbilling Medicare and insurance companies knowing that they’ll only get 65 to 70 cents on the dollar but making their business work for that price.

    However, I agree wholeheartedly with the comment about medical care being reasonably priced. I know that many health insurers seek to counsel certain higher-risk policyholders to attempt to lessen the chances of a major expenditure…if they can pay a “personal nurse” $30 an hour to sit at a phone and check up with these patients, even at a half-hour each, they see it as a benefit in the long run. If one avoids an ER visit for an asthma attack by the nurse getting this patient to see his/her doctor for an office visit instead, they’ve made their money back and then some.

    I doubt Medicare/Medicaid does the same thing. But they have what’s basically an unlimited supply of money because they’re part of the federal government and those bureaucrats have a vested interest in not solving problems.

    As I alluded to in the post, I think the solution is devolving the Medicare/Medicaid programs to a state level. Some states are more successful at it than others. But 50 different laboratories would likely make a better solution than a giant “one-size-fits-all” like we have now.

    Again, thanks for the thoughtful comment. Sometime in the near future I’m going to do a “comment primer” and (with your permission) yours is an example I’d like to use for a good comment.

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