Do you know anyone on Medicare?

If you know someone on Medicare, or you yourself are on Medicare, then you know that Medicare is not the golden ticket of health insurance that many people believe it is. Until you have to go on Medicare, you might think that Medicare covers prescriptions, nursing home stays, etc.

One reason we need health care reform is because of the high cost of Medicare to seniors who need coverage yet are living on a fixed income. Not every grandma and grandpa on Medicare is rich and can afford $600 month supplemental insurance. Not everyone on Medicare can even get supplemental health insurance once they are diagnosed with a disabling disease.

Take for example, Mr. A. He has End Stage Renal Disease (his kidneys don't work and he goes to dialysis 3 times a week). Mr. A. is on Medicare, part A and part B.

Mr. A was in the nursing home for 110 days.

Mr. A worked his whole life. He is very, very sick. His Medicare doesn't cover his prescriptions or rides to dialysis. He can't get supplemental health insurance because he has end stage renal disease.

Mr. A owes more than $10,000 to the nursing home for days 90-110 because Medicare only pays for days 1-89. If you are on Medicare, you are not allowed to be in a nursing home past 89 days or you will have to pay out of pocket. Hurry the hell up and get better or you will pay at the rate of $300 a day.

Mr. A also owes thousands in chair car charges to get to dialysis, thousands in co-payments to doctors and is behind on his mortgage because of all of his medical bills.

Why isn't Mr. A covered completely by Medicare? Why are our sickest people denied quality care because of money? He has health insurance yet he has thousands in medical bills.

I have a suggestion to health care reform.

Put all members of congress and their families on Medicare only. They can't buy supplemental coverage and they can only go to Medicare approved physicians. Give them no other options. Don't pay for their prescriptions, eyeglasses,or hearing aids.

We will have a solution to our health care crisis in less than a week, with both sides in agreement.

Disability insurance is often overlooked by the young, healthy adult. It often doesn't make sense to invest in a disability policy when a budget is already stretched to the limit. Unfortunately, disability insurance can only be purchased if a person is in good health and not when they are fighting a potentially disabling disease.

Private disability insurance payments do not affect social security disability payments.

If a private disability policy is purchased and in effect when a person becomes disabled, private disability payments will be paid in addition to any social security disability benefits that the disabled person may be entitled to.

This is significant because social security disability payments will be pretty low and many people will find that a huge change in standard of living will occur. Some private disability policies will pay the insured double SSDI amounts, giving the disabled a total payment that they can comfortably live on.

Disability insurance is not often available to those with certain pre-existing conditions.

Insurance companies are a for profit business and it is smart business not to insure people who are at risk of getting sick in the near future. People with potential pre-existing conditions should consider applying for disability insurance before it is too late. Although it may stretch a budget, purchasing disability insurance when young and healthy is a wise investment for the future.

Federal and state programs will pay slightly more than half the tab for health care purchased in the United States by 2012, says a report by Medicare number crunchers released Thursday.

WASHINGTON -- For all the hue and cry over a government takeover of health care, it's happening anyway.

Federal and state programs will pay slightly more than half the tab for health care purchased in the United States by 2012, says a report by Medicare number crunchers released Thursday. Read more from FOX NEWS HERE.

I am not a politically active person. I am learning about health care reform after being inspired by a family friend who has become critically ill and is struggling with health insurance issues. I do not understand why people are so against the government "taking over" and providing a government sponsored health insurance option.

Why are so many Americans upset that the government is trying to establish a public health insurance option? Can someone please explain it to me?

Health coverage right now is up to the individual unless they meet federal poverty guidelines or have certain disabilities. We are already paying a big portion of our incomes to health insurance and health related costs, why not have these costs regulated?

Maybe I'm in the minority and this is the reason health care reform is having such a hard time getting off the ground. Ask any wealthy but critically ill person and they will tell you that money means nothing if you don't have health. Why aren't we investing more into our national health care system?

Unemployment is reaching historical highs. With an unemployment rate of close to 10% in many state, the lack of jobs in the United States continues to perpetuate the recession.

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Unemployment Does Not Cover Health Insurance

If you are on unemployment, you do not automatically qualify for health insurance discounts. In fact, if you receive more unemployment than 133% of the federal poverty level, you don't qualify at all. Where does this leave you, the newly unemployed?

Unemployed and Uninsured

Unless you can afford monthly COBRA payments, you will find yourself quickly uninsured. If you live in Massachusetts, where health insurance is mandatory, you will have to find a way to make your COBRA payments or face a significant tax penalty.

Reduced COBRA Payments are Available

If you meet certain criteria, you may qualify for reduced COBRA payments. Under the ARRA, or the American Recovery and Reinvestment act of 2009, individuals are eligible for a reduced COBRA payment if they are involuntarily terminated from their job. This would result in a payment of 35% of the COBRA premium instead of 100%. Only people fired between September 1, 2008 and February 28, 2010 qualify for this reduced COBRA payment. The reduction can last for a period up to 15 months, but may require extensive paperwork to be approved.

Do you pay health insurance premiums that you really can't afford?

Have you decreased your plan coverage, taking the chance with high deductables if you become hospitalized?

Are you prepared if you lose your job and need to continue with COBRA payments?

President Obama had created a reduced COBRA plan that allowed families to pay for 35% of their COBRA while the former employer covered the other 65% for a period of nine months, but this reduced COBRA plan has now expired.

What would you do if you were faced with a $1,000 month bill to have health insurance for you and your family and you became unemployed?

What if your unemployment was enough so that your family earned just above 133% of the federal poverty level ($2,800) for a family of five and you didn't qualify for any state health insurance reduced/free program?

If you receive $2,801 or more from unemployment and you are a family of 5 (the amount is even less for smaller families), you must pay for health insurance premiums on your own.

Is really the best we can come up with in this country?

http://www.healthreform.gov/reports/statehealthreform/massachusetts.html

The costs of health care in the United States will continue to rise if changes are not made. On both the state and federal levels, health care costs take up a significant percentage of budget allowances. It is estimated that the United States spends almost $8,000 per person a year on health care costs, or in total, 2.2 trillion dollars. This is only expected to rise if changes are not made.

Revamping and Creating a Modern Healthcare system.

Americans spend a good portion of their hard earned money on the high cost of health care each year. Many families are only an accident or health debilitating illness away from financial despair.

Consider this: the health insurance premiums employers pay directly reduces the amount of take-home pay for the employee.

The Obama Administration has been trying to make changes, but has been met with opposition for many reasons. Change is hard and it's not possible for any one person to have the answer. The Obama Administration instituted a temporary provision that allows Americans who have been terminated from employment to pay COBRA at a reduced rate of 35% of the traditional cost. While effective for those that were terminated between September 1, 2008 and February 28, 2010, this legislation is only temporary and will not be available to workers terminated after February 28, 2010 if it is not extended.

The Obama Administration is also pushing for the computerization of America's health records within a five year period. Paper records are more prone to error and more difficult to reproduce. With computerized record keeping, medical records will be available more readily and help streamline information sharing, reducing both waste and costs.

Investing in Wellness

Wellness is not given for many Americans. Poor diets, lack of exercise and smoking lead to many chronic, debilitating illnesses that could be prevented with quality wellness care. As Americans, we need to take responsibility for our actions and we lose the right to complain if we do not take action against the things that hurt us.

Although good health should be reward enough for healthy living, the Obama Administration has devoted one billion dollars in the Recovery Act in order to provide Americans with prevention and wellness support.

Author Don Potter

The subject of health care reform has been a big issue in Washington and the news media for the past year. Citizens jumped into the fray, for the most part uninvited, when it became apparent that our elected representatives were botching the process. Town hall meetings, rallies and protest marches sent a message to legislators that they were out of step, if not out of touch with mainstream Americans. Recent election results from Massachusetts indicates the will of the people is something politicians shouldn't ignore.

Democrats cannot write bills behind closed doors and try to jam legislation through based on their current power in Washington. By the same token, Republican have got to stop hiding in the weeds and taking shots at everything the opposing party does. Rather, it's time to go back to the peoples' business. This means agreeing that the health care system needs to undergo significant change over an extended period of time but in a common-sense, fiscally-responsible, bi-partisan manner. Otherwise, the finger pointing and bickering in Washington will spell the end of the careers for many politicians.

It's not rocket science. Health insurance costs continue to climb. Too many Americans are without coverage. Waste, fraud and abuse abounds within the system. The problems can't be addressed or fixed all at once. So, let's agree that health care is going to be studied immediately and adjusted over time with the goal being coverage we can afford and quality of care second to none. We can figure out how to make this work, but do the politicians, the insurance companies and the medical organizations must come together, forget their own agendas and start considering what's best for the citizens of this country?

As part of the pre-boomer generation (those born between 1930 and 1945), I remember how people from all walks of life came together and fought our enemies in World War II. Folks forgot about labels. We weren't Democrats or Republicans we were Americans pulling together in a common cause. If addressed honestly, health care can be something that unites rather than divides us.

Remember, health care accounts for about a sixth of our economy. This is a real concern when combined with a deficit beyond belief, out-of-control government spending and a double-digit unemployment rate that just won't go day. On top of this, there are more spending plans waiting to be introduced in Congress. The only thing to do is to stop Washington from doing what it's been doing or we're going to keep getting what we've been getting. Translated, this means no new spending. Prioritize the country's need. And re-evaluate where our money is going now and where it needs to go in the future.

At the same time, businesses around the country need to join in the fight to keep America afloat and bring it back to the land of opportunity. This requires the best minds we have focusing on what they know best to get the job done. By applying this same kind of discipline to health care reform, we will undoubtedly end up with something that meets the needs of each individual American. And, that's good for all of us.

Don Potter, a Philadelphia native, was born in 1936 and is a 50 year veteran of the advertising agency business. Now living in Los Angeles, he has written two novels in retirement, frequently writes on marketing issues, and has a blog dedicated to pre-boomers (those born between 1930 and 1945).

Read more articles for and about pre-boomers with thoughts, comments and opinions designed to spark thinking, foster discussion, and stimulate debate by logging on to http://www.pre-boomermusings.com

Article Source: http://EzineArticles.com/?expert=Don_Potter

Health care and health insurance reform have been in the national spotlight. Unfortunately, it seems, no one really knows the solution to our health care crisis.

Why is health insurance so expensive?

Photo by: Monique Discawicz

Why does a family of three have to pay $1,000 a month for coverage, just because they are self-employed?

In Massachusetts, it is mandatory to have health insurance yet if you are self-employed, you must pay out of pocket. A high deductable, high co-pay plan will cost a family of three in the neighborhood of $1,000 a month.

Who can really afford to be insured in Massachusetts?

What about if you get laid off from work?

If your unemployment is more than the federal poverty level guidelines, you must either purchase your own private insurance or enter the COBRA system. Rest assured that you will be paying much more for health insurance than you ever thought possible.

Would President Obama's plan work if it was ever passed through legislation?

I don't know.

Is there an answer to our health care need?

I don't know that either.

Does anyone out there have a solution?

A family of five is facing financial ruin because their father is sick. In 2004, he was diagnosed with a malignant brain tumor. After surgical removal of the tumor, radiation and chemotherapy, the father returned to work.

The father knew that this tumor might return someday, but he hoped for the best and hoped he'd be one of the 5% of people who never have their tumor return. After six years, he began to have hope that his brain tumor would remain in remission. He went back to work in 2004, taking periodic breaks when his health would decline, but always maintaining his employee status at work.

On January 12, 2010, he began experiencing odd sensations and he knew that something was wrong. He called his doctors and who recommended an emergency MRI. His health insurance was cancelled and the hospital would not perform an MRI without proof of coverage.

How did this happen?

The father learned on this day, after calling his employer repeatedly, that he had been terminated five days prior. In order to have health insurance he had to pay COBRA payments. He was quoted $1400 for his family of five. Most families on disability can't pay for COBRA at this rate.

Despite numerous phone calls, his wife is not clear who is covering their health insurance right now, but she is sure of one thing: her husband is getting a recurrent brain tumor removed, regardless of the cost.

The last thing any family needs to worry about is how their medical needs will be covered if a crisis hits. They had coverage as far as they knew and were not told about the layoff until after the father called about his lack of insurance for his MRI.

Maybe this family could have prepared better for the return of the father's brain tumor. They might have decreased their living expenses to a degree, but as anyone that has ever lived on disability payments will tell you, you can't exactly save money living on disability.

We need change in our healthcare system. There is no better proof than this family.

Why can't an average, working person get Masshealth when they discover a brain tumor has returned?

I looked into the guidelines and did a pre-qualification test based on my own personal financial information.

In order for a family of five to qualify for Masshealth, they must not have income of more than $2,800 a month, or 133% the federal poverty level. Masshealth recognizes the disability, but you must meet income guidelines to qualify.

Medicare, the federally funded health insurance for people over 65 or those with certain disabilities is also very confusing. If you are disabled, you must meet certain criteria before you qualify for coverage.

First, if you have end stage renal disease, you qualify right away. If you have a different disability, you must be out of work and collecting SSDI for at least 24 months before you qualify.

This scenario leaves those with some ability and desire to work stuck in the middle. What if you work part time, collect from your private disability insurance and only periodically collect SSDI?

I would think there are special circumstances where the government would approve Medicare health coverage, despite not having collected SSDI for two years, but I wouldn't count on it.

COBRA does offer reduced payments if you are under financial hardship or disabled, but for a certain period of time. Although reduced payments are more than welcome, a person with a diagnosed malignant brain tumor should not have to pay for health care costs.

There is still a gap between COBRA coverage and Medicare, even when you get approved. COBRA lasts for 18 months (as far as I am aware) and Medicare coverage doesn't start until you have collected SSDI for 24 months.

When you are approved for Medicare, this is still not the end all be all we would think it is. Ask an older relative who is on Medicare and they will tell you that Medicare doesn't pay for medications unless, again, you meet federal poverty level guidelines and apply for certain programs.