Health Care Today 3-25-17

Our healthcare coverage is the best in the world and it is the most expensive in the industrialized world. Until Medicare, healthcare was unaffordable to most seniors. People were healthy until they died. When they got sick they died. Until comprehensive healthcare plans, with groups, only people working for firms had health care coverage for hospitalization. Medicare and company-sponsored healthcare coverage made doctors wealthy and care did not deteriorate as threatened by the American Medical Association.  

1)      Medicare is a Single Payer system for seniors, funded through the payroll tax of 1.45% on unlimited income.

2)      Every industrialized country in the world has a Single Payer system for all their citizens

3)      Healthcare insurance has always been expensive and it is expensive today for employer and employee.

4)      There are 267 million non-elderly Americans

a)      56% are covered through their employers and that coverage could range from $16,000 to $30,000 (est) per family. The majority of those covered pay a co-premium of 25% and many have high deductibles. This coverage is not inexpensive and premiums continue to increase

b)      18% are not insured

c)       21% receive coverage through Medicaid and other public programs

d)      6% have individual or family plans, not in groups

5)      The ACA/ Obamacare has made coverage available to millions who cannot afford coverage

6)      The ACA eliminated many so-called “cheaper” plans that had caps on coverage, exclusions for certain care and tests, and excluded people with pre-existing conditions. Many of the replaced plans were “inadequate” plans with fine print exclusions, of which, many policy owners were totally unaware of the contract limitations and the consequences.

7)      Before the ACA, health care insurance premiums were going up at 2-3 times inflation each year. Since the ACA, health care costs experienced the lowest increase in 50 years since the passage of Medicare and Medicaid (1965).

8)      Blue Cross and Blue Shield developed from 1929 through the 1940s. It covered Medical and Doctor related costs in a hospital.  These group plans faced bankruptcy when in the 1980s, when they were left with covering the most vulnerable citizens. Individuals were always able to buy Blue Cross/Shield catastrophic care. The emergence of HMOs and PPOs doomed the old Blue Cross coverage options.

9)      There was never coverage under Blue Cross for receiving a doctor at home or at his/her office

10)   In the 1980’s comprehensive group plans became offered which covered Doctor’s within a certain designated plan-(HMOs, PPOs Oxford, Aetna, Humana, etc.) drug prescriptions and co-pays were added. One could also see a Doctor outside “network” and eventually, co-premiums for these company-sponsored plans were instituted to share the burden of coast from employer to employee. Also, as costs continue to rise for health care and health insurance, deductibles were offered. Many people have high deductibles (basically self-insuring up to a certain dollar amount) to keep the premium as low as possible. These plans caused the re-structuring of all the Blue Cross plans.

What is happening today:

A.      The ACA or Obamacare provided health insurance for over 23 million Americans

B.      Health care expenses are the single greatest cause of bankruptcy in America and in the industrialized world, where a Single Payer system (Medicare for all) exists in Japan, Israel, Canada and Western Europe, there are no healthcare caused bankruptcies. There have been many estimates on bankruptcies caused by medical expenses. One figure published is 643,000 in 2013. That number has declined because of the ACA and this figure has been basically justified by SNOPES.

C.      The above number is broken down in the following age groups:

1.       Below 25  2.3%

2.       26-34       18.7%

3.       34-44       29%

4.       45-54       26%

5.       55-64       15.8%

6.       Over 65     8%  (On Medicare)

What are the Options:

A.      Continue with the ACA, make sure it is properly funded, and force the 19 Red States with Republican governors to have Medicaid recipients have access to the plans, creating a larger pool of younger people. Put pressure or incentives on insurance companies to remain I states where there is one carrier.

B.      Have an alternate plan like the one just defeated in the House of Representatives, which was not properly funded, eliminated many benefits, would cause the loss of insurance to initially 14 million people, created tax incentives for folks who barely paid taxes and favored the well-off.  Basically it went back to the period before the passage of the ACA. But with its provisions to limit pre-natal care along with other services, its passage would have definitely threatened the benefits currently offered in company sponsored health insurance plans, now serving 56% of the population.

C.      Single Payer (Medicare for all).  This plan would have to be first funded by the government and initially supplemented by a period of taxation on every American before it could be instituted. Unlike Medicare, which is funded by payroll taxes on every working America above the age of 18 until age 65, the government would have to create a “pool of money” to service people immediately when it came into service, replacing one’s current form of health insurance.

The Consequences of the Single Payer:

A.      The health insurance company premiums would disappear. Employers would no longer have to offer insurance to their employees and pay 75% of the costs of between $16K and $30K (est) for each employee. This would save the employers hundreds of billions of dollars and make them more competitive with foreign companies and corporations. Employees could possibly benefit from not costing their employer between $12K and $22.5K (est) per year, and receive increased compensation.

B.      The employee would not pay the co-premium of $4-$7.5K (est.) each year with a deductible ($200-$2,000 est.) The employee would be paying an increased payroll tax for each member of his/her family. It would increase when each child is added to a family. In most cases the costs for the employee would be much lower than the current combination of payroll taxes and co-premiums.  Today a person pays a payroll tax of 1.45% of their gross income. An individual pays $725 on $50,000 and a family with a household income of $150,000 would pay $2,175 plus a $4000 co-premium with a $1,000 deductible. Therefore the average family pays out over $7,000 before they even see a doctor.

C.      Therefore the payroll tax would go up significantly and people could also buy a “private” supplemental plan, in the same way people buy a Medicare supplemental plan, for Doctors who wish to be outside of the Single Payer system.

D.      There are Doctors who do not except any private insurance plan or Medicare. The patient can seek re-imbursement (pre-waiver) from their private or group plan and in certain circumstances a person on Medicare, needing healthcare services from a provider that doesn’t accept Medicare, can get permission for a re-imbursement.

E.       Doctor’s office would save considerable money regarding billing- one reimbursement like Medicare.  

F.       The bottom line is that health care expenses would be flattened, corporate expenses would be drastically lowered, health care would be for all Americans, healthcare costs for the average American would be the same, the pool of insured would expand greatly, especially with young adults who don’t need much care. There would be a need for more health care professionals: Doctors, Nurses, and PAs. There would be the end of healthcare insurance companies, their profits and overhead, unemployment would increase with these workers, but more Doctor’s office would open up and many of these people would be employed in that part of the private sector. People would pay a lot less over their working lifetime – 18 through 65.     

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A lifelong New Yorker, who now lives full-time in Palm Beach County, Richard was raised in Mount Vernon, New York and he was educated in the Mount Vernon public schools He graduated from Boston University with a BA in American History. After spending a year on Wall Street as a research analyst with Bache & Co., he joined a manufacturing and importing firm, where over the next twenty-five years he rose to the position of chief operating officer. After the sale of that business, Richard entered into the financial services field with Metropolitan Life and is a Registered Representative, who has been associated with Acorn Financial Services which is affiliated with John Hancock Life Insurance Company of Boston, Ma. Today, he is a retired broker who had specialized in long-term care insurance and financial planning. One of Richard’s recent activities was to advise and encourage communities to seek ways to incorporate “sustainability and resiliency” into their future infrastructure planning. After a lifetime in politics, with many years working as a district leader, which involved party organizational work, campaign chair activity and numerous other political tasks, Richard has been involved with numerous civic and social causes. In recent years, Richard served in 2005 as the campaign coordinator of the Re-Elect Paul Feiner Campaign in Greenburgh, NY and he again chaired Supervisor Feiner’s successful landslide victory in 2007. Over the next few years, he advised a number of political candidates. He has served as an appointed Deputy Supervisor of the Town of Greenburgh, with responsibilities regarding the town’s “liaison program.” He was a member of the Parks and Recreation Advisory Board of the Town of Greenburgh, NY. Richard has lectured on FDR, The New Deal and 20th century American history in the Mount Vernon schools, at the Westchester Council of Social Studies annual conference in White Plains, and at many senior citizen groups, which include appearances at the Old Guard of White Plains, the Rotary Clubs of Elmsford and White Plains, and various synagogue groups around Westchester. In the winter of 2006 Richard was the leader of the VOCAL forum, sponsored by the Westchester County Office of Aging, which addresses the concerns of Westchester County’s Intergenerational Advocacy Educational Speak-out forums for senior citizens. Richard has given lectures for the Active Retirement Project, which is co-sponsored by the Jewish Community Center on the Hudson, the Greenburgh Hebrew Center, and other groups around Westchester County. Richard also is the founder and Chairperson of the Jon Breen Memorial Fund, that judges and grants annual prizes to students at Mount Vernon High School who submit essays on public policy themes. He also sponsors the Henry M. Littlefield History Prize for the leading MVHS history student. Richard serves on the Student College Scholarship Committee of Mount Vernon High School. In past years Richard chaired and moderated the Jon Breen Fund Award’s cablecast program with the Mayor and local and school officials. Richard has been a member of Blythedale Children’s Hospital’s Planned Giving Professional Advisory Board, and was a founding member of the committee to re-new the FDR Birthday Balls of the 1930’s and 1940’s with the March of Dimes’ effort to eliminate birth defects. Their renewal dinner was held at Hyde Park on January 30, 2003. Richard is currently an active contributor to the Roosevelt Institute, which is involved in many pursuits which included the opening of the Henry A. Wallace Center at Hyde Park, and the Eleanor Roosevelt – Val-Kill Foundation. In 2007, he proposed to the City of Mount Vernon an effort to develop an arts, educational, and cultural center as part of a downtown re-development effort. Richard was a team partner with the Infrastructure & Energy Solutions Group. IEFG which has developed innovative strategies for the 21st Century. Richard hosted a weekly program on WVOX-1460 AM radio, called “The Advocates,” which was concerned with “public policy” issues. The show, which was aired from 2007 until May 15, 2013, has had amongst its guests; Representative Charles Rangel, Chairperson of the House Ways and Means Committee, Mr. Jonathan Alter of Newsweek, along with hundreds of others. All the 300 shows are archived at Richard currently gives lectures on Franklin and Eleanor Roosevelt, FDR and the Jewish Community, The New Deal, FDR and Douglas MacArthur, 20th Century American Foreign Policy Resulting in Conflict, and Israel’s Right to Exist. Richard lives in Boynton Beach, Fl, with his wife Linda of 44 years. They have two married children. Their daughter Dana is a Rutgers College graduate, with a MS from Boston University, and is the Assistant Director of Recruitment at Harvard’s Kennedy School of Government. Their son Jon is an electrical engineering graduate of Princeton University and a senior software architect at NY/Mellon Bank in NYC. Richard J. Garfunkel Recent Appearances: KTI Synagogue, Rye Brook, NY- Long Term Care & Estate Conservation- Anshe Shalom Synagogue, New Rochelle, NY- Long Term Care- American Legion Post, Valhalla, NY- Long Term Care and Asset Protection- Doyle Senior Ctr, New Rochelle, NY-Long Term Care and Asset Protection- AME Methodist Ministers, New Rochelle, NY, LTC and Charitable Giving- Profession Women in Construction, Elmsford, NY, LTC and Business Benefits- Kol Ami Synagogue- White Plains, NY, Long Term Care and Disability - Beth El Men's Club-New Rochelle, NY-Long Term Care-Is it Necessary- Greater NY Dental Meeting Javits Ctr, NY, NY- LTC and Disability- IBEW Local #3 , White Plains, NY, Long Term Care and Asset Protection, Health Fair -Bethel Synagogue, New Rochelle, NY-LTC and Disability, Heath Fair- Riverdale Mens Club CSAIR- Riverdale, NY- LTC- Life Weight Watchers of Westchester and the Bronx-LTC and Tax Implications Sunrise Assisted Living of Fleetwood, Mount Vernon, NY-LTC Sprain Brook Manor of Scarsdale-LTC- November 15, 2001 Sunrise Assisted Living of Stamford, Connecticut, February 2002 Kol Ami Synagogue, White Plains, NY, February, 2002 The Old Guard Society of White Plains, NY, April, 2002 The Westchester Meadows, Valhalla, NY August, 2002 Kol Ami Synagogue, White Plains, NY, October, 2002 JCC of Scarsdale, Scarsdale, NY, November, 2002 The Westchester Meadows, Valhalla, NY, January, 2003 The Rotary Club of White Plains, NY January, 2003 The Westchester Meadows, Valhalla, NY April, 2003 Westchester Reform Temple, Scarsdale, NY January, 2004 Mount Vernon High School, Mount Vernon, NY March 2004 Kol Ami/JCC of White Plains, NY November, 2004 The Westchester Reform Temple, Scarsdale, January 2005 The Sunrise of Fleetwood, Mount Vernon, April, 2005 The Woodlands of Ardsley, assisted living, November, 2005 The Woodlands of Ardsley, assisted living, December, 2005 The Woodlands of Ardsley, assisted living, January, 2005 Rotary Club of Elmsford, April, 2006 Kiwanis Club of Yonkers, June, 2006 Greenburgh Jewish Center, November, 2006 Temple Kol Ami, White Plains, February, 2007 Hebrew Institute, White Plains, March, 2007 Temple Kol Ami, White Plains, NY, April, 2007 Westchester Meadows. Valhalla, November, 2007 Hebrew Institute. White Plains, November, 2007 Art Zuckerman Radio Show- January, 2008 JCC of the Hudson, Tarrytown, February, 2008 Matt O’Shaughnessy Radio Show, March, 2008 WVOX –Election Night Coverage, November, 2008 WVOX – Inaugural Coverage, January 20, 2009 The Advocates-host of the WVOX Radio Show, 2007- 2010 Rotary Club of Pleasantville, February, 2009 Hebrew Institute of White Plains, May, 2009 JCC Hudson, Tarrytown, December, 2009-10-11-12 Brandeis Club, Yonkers, March 25, 2010

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