Asturian-American Migration Forum

As we all know, health insurance is a big cost to every family in the US. The Associated Press came out with some numbers today on the state of health care in West Virginia.


The average annual cost of premiums for a family health plan has gone from $6,844 six years ago to $11,128 today, according to the report, while average earnings have gone from $19,876 to $23,533.

Weat Virginians who have lost health coverage since 2000 ---- 88,000
State residents without health insurance ------322,999
West Virginians who rely on Medicaid ---------367,000

Those are whopping figures, Ron! No wonder so many people are left without health insurance. I believe health care should not be a business, but a basic human right and thus provided by the State, free to all citizens. You should not have to decide between buying a steak for lunch or paying your meds.

You know Spain and all EU countries have free national health care systems, so we don't worry too much about rising costs. If we need a heart transplant, it won't cost us a penny. We only pay a symbolic 10% of the cost of most prescription meds, if at all. Once you retire all meds are free of charge.

But it is true that the health bill for the State has skyrocketed here, too. I guess the new and expensive diagnostic devices that everybody demands (and has a right to) has a lot to do with it, but also our increasing hypochondria caused by constant media-scares that make people run to the doctor even when they only have a common cold.

Medical costs is one of the most important issues facing us in the USA. I agree in principle that everyone should be able to access what they need. But, how do we get to that state? I don't know. One of the many factors affecting insurance rates is the litigation factor. And, WV is one of the most litigious states... but WV is certainly not alone on that score. Turn on daytime television commercials, read the back of the local telephone directory, look at passing billboards to see attorneys advertising how they can "..get you money." The medical community faces rising insurance costs in the nature of malpractice premiums. My local GYN office experienced the loss of a wonderful new physician last year. He simply could not afford Ohio's medical malpractice rates; and he had never had a claim. He returned to his home state of Indiana to practice. I know personally of another similar situation with a local surgeon who retired very early. "Someone" has to pay these costs... and it is "us." We pay and pay and pay in many different ways.
Does Spain experience the malpractice and personal injury lawsuits as we do in the States?

Yes, Betty, lawsuits are starting to be a plague in Spain, too. Most doctors are afraid to even diagnose you right out for fear of making a mistake and being sued.
The medical community is being "criminalized" and sued for each and everything, and the results are quite visible.
For instance, the 17-year-old daughter of a friend of mine, who has had classical migraine headaches for the last few years, was ordered an expensive MRI, just in case, and when no tumor was detected, she was finally prescribed migraine meds. That would have been unheard of a few years back and it probably cost the taxpayers around 6,000 EUR!!!

In other words, the fear of making a mistake is driving doctors to refrain from making a simple headache diagnosis, unless they have a scanned image to back them up. You can imagine that this new situation is causing health care costs to rocket.

To put Ron's figures in perspective, the population of WV was estimated to be 1,816,856 people in 2005.

That means that 18% of West Virginians have no health insurance and about 5% have lost health coverage since 2000.

Another 20% are covered by Medicaid. Medicaid was designed to assist low-income families in providing health care for themselves and their children. Over 16% have incomes below the federally defined poverty level, according to 2003 data.

Over 15% of West Virginians are over 65 years of age, according to 2004 data. So many of them probably have Medicare coverage which is commonly provided for retirees.

So, a very rough estimate would be that only about 47% of West Virginians are covered by private health insurance. If that's true, it indicates that the old private health insurance system no longer serves the needs of the majority of West Virginians!

------------------

Poner las figuras de Ron en perspectiva, la población de WV era estimada ser 1.816.856 personas en 2005.

Eso significa que los 18% de los de Virginia Occidental no tienen ningún seguro médico y que casi 5% han perdido seguro de salud desde 2000.

Otros 20% son cubiertos por Medicaid. Medicaid fue diseñado asistir a las familias de ingreso bajo proveer cuidado médico para sí mismos y sus niños. Más de 16% tener rentas debajo del nivel de pobreza definido por el gobierno federal, según 2003 datos.

Más de 15% de los de Virginia Occidental tienen más de 65 años de la edad, según 2004 datos. Entonces muchos de ellos tienen probablemente cobertura de Medicare, un seguro de enfermedad que se proporcione comúnmente para los jubilados.

Así pues, un cálculo muy aproximado sería que solamente cerca de 47% de Virginia-Occidentalinos están cubierto por seguro médico privado. ¡Si eso es verdad, indica que el viejo sistema privado del seguro médico no responde más a las necesidades de la mayoría de Virginia-Occidentalinos!

Two years ago the West Virginia state legislature passed a bill with the backing of the insurance companies. The bill put a cap on all malpractice litigation (tort reform). A rose by any other name is still a rose. West Virginia, the most litigious state, is not any more.

The lawsuit excuse is a red herring put up to by the AMA, the big insurance companies, and corporate health care providers to cover up the real reason not all Americans have affordable health care: They all make a KILLING off of the current system. The wolves are guarding the hen house in this country.

One solution that would not hurt the consumer of medical care would be to have a single, national medical license that could be revoked on evidence of excessive malpractice, and a single government-sponsored malpractice insurance policy with a good sized copay from the physician based on his or her total assets. A cost savings for the physician (no profit to such insurance), and no limit on malpractice payments to the patient or the family.

That's an interesting set of ideas, Bob.

I like the idea of a single, national medical license. That would make sense in a mobile society like ours.

I wonder if there are a significant number of malpractice-prone doctors or if most claims result from simple human error? I suppose the ability to revoke a license on evidence of excessive malpractice could be helpful, but I would want to be sure that we didn't penalize doctors for taking justified risks, especially with experimental treatments.

It seems to me, though, that it might make sense to define the levels of payments to a family for each class of injury. It isn't rational for juries to be able to award huge amounts to some families and small amounts to other families for the same class of injury. I get the sense that negotiated settlement and jury awards depend on the negotiating skill of your lawyer and the lawyer's ability to pull on a jury's emotional chords. So, I'd like to see standardized levels of awards, maybe pegging them to the rate of inflation.

I'd also like to reduce the expense for families by lowering the cost of hiring lawyers to represent us. To my mind, the lawyers' portion of the awards is ridiculously high. We encourage lawsuits by rewarding lawyers so richly.

Perhaps one way to reduce their fees would be to reduce the role of lawyers in setting the level of the award (as by setting defined levels of payments). Or maybe Bob will have another good idea for how to achieve this goal. I recognize that it will be difficult to change this because lawyers write the laws; we've let the fox rule the hen house.

------------------------

Ése es un grupo de ideas interesantes, Bob.

Me gusta la idea de una sola licencia médica nacional. Eso tendría sentido en una sociedad móvil como la nuestra.

¿Me pregunto si hay un número significativo de doctores propensos a negligencia o si la mayoría de problemas resultan del error simple humano? Supongo que la capacidad de revocar una licencia con evidencia de la negligencia excesiva podría ser provechosa, pero desearía ser seguro que no penalizamos a doctores para tomar riesgos justificados, especialmente con tratamientos experimentales.

Aunque me parece que sea posible que tenga sentido de definir los niveles de pagos a una familia para cada clase de daño. No es racional que los jurados puedan conceder cantidades enormes a algunas familias y cantidades pequeñas a otras familias para la misma clase de daño. Me parece que la resolución extrajudicial negociada y la concesión del jurado dependan de la habilidad de negociación del abogado y de la capacidad del abogado de tirar en los acordes emocionales de un jurado. Así pues, quisiera niveles estandardizados de concesiones, enclavijándolas quizá a la tasa de inflación.

También quisiera reducir el costo para las familias por bajar el coste de emplear a abogados para representarnos. A mi mente, la porción de las concesiones que ganan los abogadoses es ridículamente enorme. Fomentamos los pleitos cuando recompensamos a abogados tan ricamente.

Quizás una modo para reducir sus honorarios sería reducir el papel de abogados en fijar el nivel de la concesión (como fijando niveles definidos de pagos). O quizá Bob tenga otra buena idea sobre cómo alcance esta meta. Reconozco que será difícil cambiar esto porque los abogados escriben los leyes; hemos permitido al zorro gobernar la casa de gallinas.