All Kids Failing to Match Hype

NCHS - not sure who's argument this supports - looks to me like over 90% of kids have insurance from somewhere now.

Health Insurance Coverage

(Data are for U.S. for year indicated)

Persons under age 65

Number uninsured at the time of interview: 43.3 million (2006)

Percent uninsured at the time of interview: 16.8 (2006)

Percent with private insurance at the time of interview: 66.5 (2006)

Source: Early release of selected estimates from the National Health Interview Survey, tables 1.1-1.2

Children under age 18

Percent uninsured at the time of interview: 9.3 (2006)

Percent with private insurance at the time of interview: 59.7 (2006)

Percent with public health plan coverage at the time of interview: 32.3 (2006)

But they're not paying into the system.

So you are mad at the young working poor for not buying health insurance and paying into the system?  Have you no compassion?  :-)

""Number uninsured at the time of interview: 43.3 million (2006)"How many of these are American citizens, and how many are "undocumented workers"?"

Based on the nature of the source data, I'm not sure that it is possible to know the answer to that question with absolute certainty, but my guess is that few, if any, illegal aliens are included in that estimate.  I say that because the estimates of total numbers were derived by applying the percentages from sample interviews to weighted population totals from the Census Bureau.

The actual question, therefore, is whether illegal aliens were included in the population totals from the Census Bureau that were used.  I'd be surprised if they were, given the inherent uncertainties involved in counting illegal aliens.

"I think it's reasonable to infer there are several million included in the 43.3 uninsured figure."

The NHIS interviews pegged the overall percentage of uninsured at 14.8%.  As far as I can determine so far, the weighting of census data was done solely on the basis of age.  In general then, assuming that illegals have an age distribution similar to the rest of the population, and also assuming that the Census Bureau's 8.7 million figure for illegals was included in the totals used by the NCHS (two very big ifs), then 14.8% of that figure would be roughly one and a quarter million.

There are probably lots of other variables that could make the true answer much more complicated than this simple math would suggest.

"Anyway, I was genuinely interested in seeing if there's an actual number (or even a good guess) out there to back up that "50 million uninsured" claim, and there isn't."

This is as good a guess as any, I think, and probably as good as it gets for questions like this.  It's grounded in statistically based sampling of households across America, and appears to have been consistent with other estimates over the years.

"using All Kids as an example of why universal government-run health insurance is not going to be persuasive for the majority of people who already do have insurance."

I don't suggest using any Blago accomplishment as an argument for change other than perhaps a change in the governor's office itself.

So, for those of us who are satisfied, why should we be forced to switch?

Forced to switch?  I am not sure that is on the table right now.  Should you want to switch to universal coverage so everyone can be covered?  I think you should, but that is a moral issue, not a cost-benefit analysis.

I'd suggest a couple of hours at the Champaign County Christian Health Clinic.  Tuesday nights - they can always use the help.  A lot of uninsured in Champaign County – it is really a crisis.  That might not do much for you, but it's certainly opened my eyes and changed my heart about a lot of things.

But it will always be up to you.  You can fight against coverage for every American for ideological or economic reasons, and you might even be right.  But until you've come face-to-face with having to choose between taking your kid to the doctor or paying the heating bill I am not sure you can understand why this is such an important issue to so many people.

Whether the system is VA, or Medicaid or whatever, people with a choice usually choose the private option.  Why?

I don't know.  Why do people buy brand new cars when they are just throwing money away?  I reckon we don't know the same people, or maybe the people you know don't understand the system very well?  AllKids was a no-brainer for us, a HUGE savings and something that really does allow the wife to stay home.

Because, really, that's the sale that's going to have to be made - convincing people that universal coverage is not only going to be good for the collective, but good for their families, too.

Two years ago I would have agreed with you, but this issue has serious traction and it is possible that it has tipped now to the point where a candidate for the White House in '08 who doesn't have a plan to cover the uninsured is going to look heartless and/or silly.  Most of the Dem proposals I have seen are plans to cover the uninsured, not force happy families to accept Medicaid.  That is the way it will be sold.  Like the environment, the domestic issues have changed a lot.  Most people I know (and polls do back this up) are less interested in tax cuts than they are in solutions to health care, the environment, schools, etc. 

Gentlemen-my favorite subject. 

My first point is that insurance is not health care, it is a piece of paper, a contract.  A contract is illusory if I agree to pay you as much as I want to pay.  Blago has always played the "fair share"  game, but I am afraid that his idea of fair is not what a free market would say is fair. 

His intent is to get support from a group of people that he believes (ala George Ryan's death penalty) will keep his undeserving behind out of prison.  Here is the man that did not fund your pensions.  Here is a man that always proposes programs without ever figuring out how to fund them.  Here is a man who waited till after the last election to  even proposed an adult health care plan.

I was on Topinka's last campaign issues advisory committee and I can tell you that absolutely no proposal he made during that whole time had a funding plan.  His plans were drawn on the back of a cocktail napkin.  Please-no money for him. And I have always been one who believes we can have unlimited health care for all our children without raising taxes or creating a massive government controlled system. This is why I agreed to me Romney's Champaign County Coordinator.  He actually did this in Massacusets.  Call me a cheapskate if you want, but we waste so much money on the way we currently deliver children's health care.   

If you want to start a health care plan for children, you need to build the infrastructure.  The money that you would have spent on this program should be diverted to the school districts to build health clinics linked to the schools.  (Like Urbana District 116)   The funds are administed through public health districts and the community can contribute through contractor donations (as it did for District 116)  Under the law we have a duty to provide every child with a free public and appropriate education.  Does someone want to argue that we should not provide real health care for our children.  An abbreviated version of this was published in the NewsGazette as a Guest Editorial.  I won't go into it in this post, but I have told you how to start.

My son married an immigrant who came to this country.  To come here I had to sign a joint affidavit with my son to insure she would not become a "publc charge" (inelgible for government programs). Because she was of child bearing age, I insisted she be insured and purchased a Health Alliance (Carle) policy.  Had a complicated pregnancy and birth to the tune of about $20,000.  Good move !  The deductible was $1000, but after child was born, Health Alliance opened up a clinic number for unnamed child and added her as a patient and billed $1200 and another $1000 deductible.  They sent a notice out that they were doing this, and I had the option to join during the first 60 days.   I missed the notice that would have saved me $1200.  The additional $1200 or so was on the child's bill due to the complications.  I asked, but  it was too late to get out for just the child deductible ($1000).

As you said, they cannot refuse AllKids if you are a patient.  I think they could have legally done it in  the situation you related,  under the contract that I read, but they could not avoid it under mine since they  made the child a patient.  So I gave them a taste of their own medicine.  I signed her up for AllKids and they ate both the deductible, future premiums, and the other $1200 charge.   When I related this to a person over at Health Alliance she said she would use me if she ever needed an attorney.   

This having been said,  just imagine how much time that both you and I wasted in all these elgibility battles.  Lots.  If you really want to save money and reduce premiums on real insurance policies, we all need to be in the same boat together.  Instead of playing games like we played,  how much we pay should be determined, not by the fair share that Blago thinks, but by the taxes we pay.  If the the parents have kids,  their deductibles and exclusions can be used so that parents, who can afford it, pay toward their kid's coverage.  The only way that government should be involved is to collect the premiums through Illinois Income Tax. 

"Actually I think government healthcare has driven up private healthcare cost because there are no cost controls in Medicare and Medicaid either in the programs or their spending."

"The reimbursements are also not at market value..."

You've contradicted yourself there by admitting that there are cost controls.  The reimbursement rates are carefully calculated to avoid gouging and runaway spending.  I think what you really meant to say when talking about entitlements is that we have no control on how many new people will qualify for the programs, but even that isn't true, and in any event, the number of new people qualifying for government assistance wouldn't raise the cost of private health care in the ways you suggest.

Something that does affect the cost of private health care is the number of people unable to pay at all who receive emergency services anyway, as you also pointed out.  From that perspective, the more people covered by a government safety net, the less the upward pressure on private costs will be.

"The other part is that there seems to be uncontrolled spending in the programs and there are constant stories of abuses and corruption in the systems."

Actually, there are constant stories of people being caught by fraud controls when they attempt to abuse the system.  The fact that you are seeing those stories is an indication that the controls are working, at least in those cases.

"I don't know how many people don't really have any healthcare. Since healthcare is so expense more people make the decision to go without healthcare. I would say that while those numbers are very high some of them are on Medicaid and Medicare."

Yes, some people decide to go without, but that decision is not always reflective of their actual need for health care.  Sometimes it's more like do I pay the rent or eat or have health insurance.  That's a forced choice, not an elective one.

And the survey referenced in the original post specifically counted people on Medicaid and Medicare and other government assistance as a special category of folks who have coverage, so the numbers of people without coverage do not include them, at least in this survey.

"I guess the biggest selling airline ticket in England right now is one taking someone out to get surgery, the same is found in Canada their healthcare doesn't work."

Statistics?  Studies?  Links to any reputable references?  Or just anecdotal hearsay?  As far as I can tell, your allegations are entirely unsupported by the facts.  The Canadian system has its own unique problems, as does any system, but from what I remember seeing, the general level of satisfaction there is much higher than here, and their quantifiable measures of public health are clearly superior to ours.

Yes, there are people in both Canada and England who travel abroad for procedures, just as there are people from the U.S. who travel elsewhere to get procedures not offered here.  I hardly think it is the "biggest selling airline ticket" in either case.

"I think there has been a problem with controlling cost in the system and this will make it worse. Then that cost will sky rocket as they have in the past and we won't be able to afford to maintain the increases."

First you claim that the government doesn't make payments fast enough or at adequate levels of reimbursement, then you claim that the costs are out of control and skyrocketing.  It can't be both, since those two are mutually exclusive on at least a couple of levels.

I've already pointed out (and you have essentially admitted elsewhere) that there are, in fact, controls on costs. Timeliness of payments is less of a problem for the feds than it is for Springfield, but Illinois has it's own unique problems across the board that are unrelated to health care itself.  I doubt that Blago's people could run anything well.

In fact, the principle reason for the increases in the so-called entitlement programs has been the increase in need.  In other words, more people are qualifiying because more people have lost their conventional employer based coverage, or have been priced out of the market.  Either way, the biggest pressures on health care costs are insurance industry profit margins and the fact that we are already paying for the emergency health care of the uninsured in the most inefficient way possible.

Thanks!  I really do appreciate it.  And I reckon my young un will probably not be spending much time at the doctor since she is not exposed to germs at daycare.  Also reckon she less of a chance of ending up in the back of a police car, in prison, or on welfare.  I think we call this an "investment".

Probably the smartest use of your tax dollars EVER.

So ... you're welcome!

I don't understand how this is even an issue. We have an expensive, completely non-effective health care system--the worst in the economically developed world--and we have opportunities to make it cheaper and more effective.

I don't care if those opportunities are perfect or flawed, or whatever. I want something that sucks less than our current system.

And I reckon my young un will probably not be spending much time at the doctor since she is not exposed to germs at daycare.

While at the same time, our gov't is subsidizing daycare with child care credits.

Also reckon she less of a chance of ending up in the back of a police car, in prison, or on welfare.  I think we call this an "investment".

We conservatives call it "parenting".

.....

No, I am not faulting the parenting, I applaud it.  I am disagreeing that the Allkids program is an "investment" that we should all happily make in his kid.

look at it another way - in D Boon's circumstance, exactly how many uninsured people were covered by the program?  Answer:  ZERO.  He has stated that his wife would have worked more to pay for insurance had Allkids not been available.

I think you are not making a distinction between health care and something like a second car.  We don't have a second car, either.  That is also a choice we made because my wife stays home with our child.  It's a hassle - a REAL hassle sometimes, but we make do.

Health insurance just isn't that kind of option – we can't choose to not have insurance.  We actually could choose to NOT have a car at all, never buy new clothes, do our groceries at Aldi, etc.  Our standard of living might be lowered (or not) but these are choices we could live with.

We CANNOT live without health insurance.  It is way too risky.  My baby could (God forbid) fall off a swing at the park, or crack her head open on a sidewalk, etc.  $25,000 of Carle bills later and we'll lose our house.  This is real, and this happens every day.

My point is that health care is unique.  And it is my opinion that providing subsidized health care to people like us helps cut down on bigger problems down the road.  It keeps my family healthier both physically and mentally and in the long run that is not only going to save our society money, it is also going to help us contribute to society in meaningful ways.  In that way, I see AllKids as a great investment.

no, anon, it was gov't that has mandated those coverages.  Take away the state mandates and let's see what kind of coverages would be sold.

no, I am talking about plans that employers are currently allowed to offer

I want to limit this subject to children's insurance.    It is almost incomprehensible to me that we developed a system for elderly before we developed a "system" for young people.  The reason, of course, is because old people vote and young people cannot.  My second request is that we leave our own kids out of it .  Let us start with some simple questions?

(1) Is the fairest way to fund insurance for all children to have them all on one policy that is the same as a policy of insurance for a US Senator's kid?   (Everyone in the boat together)

(2)  Is the fairest, cheapest,  and least regressive way to fund this "hypothetical policy" through the Illinois Income Tax with all children in the State required to be covered by this policy?  (The more you make the more you pay, yet parents contribute through loss of tax deductions)

(3)  Should we first build clinics in every school district in this State so that they are in place before this "insurance" plan is started?  (Should we design the car before we start driving it or are we just talking because there is an election coming?)    This is the problem with Blago-nothing is for real, it is all in his narcisstic mind.   

Thank you John. I agree--this thread is floating around the key questions a lot.

I would add a few things:

1. Should doctors in the employ of insurance companies, who do not actually treat patients be responsible for determining the course of care?

2. Should there be a sword of Damacles hanging over working Americans that they might someday not be profitable to cover with health insurance?

3. Not extraneous tests, not extra drugs, but is adequate preventive medicine for every American EITHER a human right or the most cost effective option for our society, not for insurance companies?

I would like a system that does the following:

1. Encourages Americans to make health care decisions with the wisdom and insight of their physicians that are best for their health and are most cost effective in the context of their health. For nearly every American this means MORE check-ups and referrals and LESS emergency care.

2. Covers every working American, child or retiree, with those terms defined broadly enough so that no one is unjustly excluded.

3. Places these goals: Public health and affordability above corporate profitability.

What I don't give a rat-ass about, so I politely beg you to shut up about:

1. Whether it is a "socialized" or "privatized" or "single-payer" or whatever system. Those are just ways to avoid dealing with the need here. If you come up with a privatized system that doesn't suck as much as the current one and fulfills the needs above, that's awesome! I'll support you.

2. Waiting lists in countries where people can actually get medical care. I don't believe these are remotely necessary. There are many countries that fulfill the needs listed above with far less waiting involved than our joke of the system. So seriously, shut up about this--if you care about public health at all and not just winning an argument there is no logical way to employ this argument.

3. Losing Choice: I have no fricking choice now. When I was in Japan, I could go to any hospital in the country and pay next to nothing except my month paycheck deduction. Don't tell me, "You could quit your job and find a different one with a plan where you have more choice!" or "You could win the lottery and then with money go whereever you want!" That's not "choice"--that's just idiocy.

Let's lose the talking points and fix this system. If my solution is better, support it. If you make up one that's better, I'll support it. Stop employing the same strawman and in some cases, blatent misrepresentations to simply defend this trainwreck of a status quo.

Fine, you don't believe in the Hippocratic oath, and you think that doctors can kill whomever they want if the price is right.

Xian, as somebody who puts on a persona of being a deep thinker and interested in coming up with solutions, you shouldn't be so closed minded.

Yeah, **** you too. *******.

When I was running for office, I made it a point to get permission to speak with health care officials like doctors and nurses, LP and RN’s while also speaking with the administrators and the thoughts were the same from EVERY person. Universal health care for every person at any time would lower the costs of insurance and health care in Illinois.

Hospitals and clinics freely admitted they charged 3.5 to 4 times the normal rate for emergency care. The reason was, they were obligated to treat those who need emergency care and that is where all the uninsured would go. They would go even for simple ailments that would be treated by a doctor in a routine visit, but could not be, because the State was unreliable for making payments. During the time I was running, the average payment wait was 8 months, not the 4-6 you saw in the papers, 8 months and that was from every medical clinic in this area. 8 Months!!!!!! The 3.5 to 4 multiplier was the means they could get enough operating money. Even though the State was tardy in payments, if the payments were 4 times the actual expense, it made the cash flow work.

The sad part is, the State and Government papers are so involved and technical that 45% of the licensed nurses are doing paperwork and not treating patients. Paperwork delayed because of improper completion, delays payment and causes cash flow problems. Medical facilities and nursing homes cannot borrow money at a low interest rate, because banks identify the State of Illinois account receivable as unreliable and a bad risk. Also, if the medical facilities have to borrow money to offset the payment delays, they cannot recover it from the State because the State does not pay interest.

Also, when I spoke with people with the complete range of income, NOT ONE, indicated they would not pay something for health care. Yes that is correct, not one, but they said they could not afford to make the large insurance payments.

When I posed that fact to the medical society, they completely agreed that some participation by all people was the answer. If a person could come in and get a treatment for anything, no deductibles, not Medicaid or Medicare, just get treated and everything was paid for then that freed up all the nurses who were shuffling paper and consequently reduced the costs. The multiplier would not be added to emergency care and costs of actual treatment and administration would drop or be completely eliminated.

When I posed this to the Insurance Company teachers and administrators in this area, they completely agreed. Simply put out a Request for Insurance, 100% coverage, for areas, probably counties, then collect the premiums NOT taxes from all sources, businesses, individuals, state and government.

The solution is NOT government payments for health care, but government collecting the premiums only. Payments would be made in a timely fashion, lowering costs, patients would be able to get check ups when ever they wanted, general health would improve, emergency rooms would be used for emergencies only and everyone would be covered.

ANY PROGRAM WHICH REQUIRED GOVERNMENT TO ACTUALLY PAY THE COST, WILL FAIL, BECAUSE THE POT OF MONEY IS TOO BIG AND WILL BE DIVERTED TO OTHER POLITICAL PORK.

The states that are utilizing this philosophy are tweeking the system and getting results.

And hey, these are not my ideas, they are coming right from those who are directly involved.
To that end, I am, and shall always remain;
Rex Bradfield

I took a lifetime learning course through U of I (OLLI) on healthcare.  The professor asked us for our ideas on policy reform.  This was my submission.

I believe that we should delay passing any adult universal health care plan until we tackle children’s health care. After we have several models to chose from, then we can decide whether we want a medicare model, or a private insurance model. PRINCIPALS OF FREE MARKET UNIVERSAL HEATH CARE FOR CHILDREN

1. If every child is entitled to a free public and appropriate education, then surely one must admit that every child is entitled to free public and appropriate health care.

2. Government runs bad programs. There is no organized decision making structure. Too much politics. No long term planning past the next election. Too expensive and inefficient.

3. Government has a role and that role is the collection of premiums for a State of Illinois wide insurance system for children.

4. The "fair share" that each person should pay toward children’s insurance should be proportional to the taxes or tax credits they pay. Parents should contribute additionally monies based upon the number of their children and should give up some of their "exemptions" or "deductions" based upon the number of their children.

5. Every child in the State should be under one standard policy which covers essentially everything. Alternatively, the insurance policy should be the same as the one that Senators have for their children. If a child is covered under a policy paid for by their company, the company will be required to pay the employee additional wages or to contribute the premium to the State plan since all are covered under only one policy. (We are all in this together.)

6. We should attach children’s heath facilities to every school district in this State. This is the infrastructure we need to develop. See Urbana School District 116's public health facility.

7. Special education services should be funded and paid for through this "system".

8. The "providers" should sell their claims under "ususal and customary" principals to the insurance companies who would in turn be reimbursed by the State collection system. If a dispute arose between the insurance company and the State, these disputes would be resolved by a system of mediation wherein the block granting entity (the feds) would act as the mediator. Best evidence of the correct reimbursement rate would be the average of like kind communities in other States. The disputed amount would be paid and subtracted from the next block grant payment to the State.

9. Because the school districts are municipal corporations with some degree of tort immunity this would encourage doctors who wished smaller malpractice premiums to deliver their services at the school.

10. We would assign data assurance managers whose job it would be to collect data, screen and assess medical records or diversionary services. Any teacher or administrator could refer.

WHY THIS IS NECESSARY (Start with something everyone agrees upon)

We do not want to put the insurance industry out of business. We do not want to put government in charge of anything. We should not put a national health care system in place until we have modeled similar successful systems. We have not built a National Health Care infrastructure. We do not want more voters to be dependent upon government. We need to have people pay for what they get in proportion to their wealth in the least regressive way possible. It does not make sense to keep proposing something that has failed before. There is no exit strategy if it is not successful because our infrastructure will be gone. All attempts by government to impose wage and price controls on free enterprise have failed. Health insurance is not health care. It is not a health insurance "contract" if the government only pays what it wishes to pay.

The sooner we start diversion programs for our children, the more money we save in the long run.

WHY DO IT THIS WAY

Children are more entitled than the elderly. We do not want politics to run health care. The least regressive tax is the income tax. The most efficient premium collection system is one already in place. As between two people with the same income, a parent should pay more if his child receives free health care. One standard "cover all policy" avoids the bait and switch of group rate advertising. It is cheaper for a doctor to go see 30 kids at school than for 30 parents to miss work taking their kid to the doctor. Special education policy is an example of government at its worst in so far as delivering "bang for the buck". Politicians will attempt to shift "provider’s" reimbursements to their priorities (reelection) unless there are some checks and balances put in place. The trial lawyer lobby makes very little off of kids, so they will not buy off their political backers over this. One of the biggest draw backs to care for kids is adequate case management especially in special education area.

CONCLUSION (Doctor-Do no harm!- This should apply to us too.)

I would like the federal government appropriate monies to try models similar to this one in about 5 states through block grants. . Now we can compare a government run entitlement program (medicare) with a free market entitlement program. I know medicare is not what I would want for my National Health Care program. But, if this children’s model works efficiently, I would certainly be willing to revisit this National Health Care debate.

John,

Exactly, that is precisely what the health care industry, insurance industry, businesses and people suggested. Fair Share and everyone is covered. Yep, you got it.

I agreed with you earlier and I agree with you now.

But understand, and make no mistake about it. The Government wants that Pot of money to play with. It has nothing to do with health care, it is a means to get money into the government.

If they don't pay the bills, and people get health care, only the health care industry is and is now burdened with that monetary stress. Not enough votes to make a difference.

BUT if the government is paying premiums, and they don't pay, a voter walks into the hospital and the hospital tells them they are not covered because the government did not pay the premium. How long do you think it would take to vote out the bums?

Don't make government pay the bills, make them pay the premiums and have no deductions. Everything is covered.

When I was in school, Mckinley Health Care was open to any student any time. You could go in there for a broken leg or a wart, made no difference. There was no payment for anything, you were completely covered. In my case, I did go in for treatment of a wart that had been knocked off in a softball game. Turned out, I had blood poisoning, and was in serious trouble. If it was today, I probably would not have gone into the emergency room because a simple visit like that is going to cost my deductable or nearly all of it $3,000.

No nurses are shuffling paper, they are treating patients, the insurance companies don't worry about deductibles only actural numbers for the risk in a particular area. And everyone is healthy and happy. Why does government feel only a select group of people should be covered? The more who are covered, the less the cost because of the volume. Insurance companies invest in the economy and make the economy stronger, government does not.

As you well know, during my campaign, that is exactly what the health care program I offered would have done ( I was the only one who offered a suggestion for health care). Naomi, said All Kids was her solution. Well we got her solution, and it ain't exactly cutting it.

To that end, I am, and shall always remain;
Rex Bradfield

I would vote for you and your plan.

Then I would push to extend it to working adults and retirees.