Wednesday, April 24, 2019

Sid Salter: Public Health Care is State and Federal Government's Most Vexing Challenge

I often wrote over the course of 35 years about public health care finance with a level of personal engagement that reminds me today much of a walk through a really fine zoo. The exhibits were intriguing, yes, but I could certainly lose interest quickly and move on to another topic.

 I’m not proud of that, but it’s the way it was. For a man with health insurance – good health insurance – public health care finance was a societal question, not a personal one. Having good insurance was only part of my ignorance on the topic. There was also the burden of relatively good health.

Until 2017, most of my health issues were self-inflicted. Smoked too much. Ate too much. Played golf with my friends and called it “exercise” – rather than what it was, which was driving the cart and drinking a few beers. Lots of coffee. Not much sleep. Workaholic.

But in 2017, a grenade was thrown into the middle of my life in the form of a rare and aggressive blood and lymph node cancer. I was at Stage 4 before I knew I was sick. God was good to me, I had great medical care from my oncologist and a team of health care professionals. I survived.

In a couple of weeks, I will be at the two-year mark since my cancer diagnosis. I’m still in remission. Outside of my work, my life today remains on a short leash of scans and blood work every three months. You learn to live with it and you learn to thank God for each day.

Surviving cancer cost me and my insurance provider $1.2 million – at least that was the retail price. For example, the hospital would provide a PET scan at a retail price of roughly $12,680. The insurance provider would pay the hospital about $2,600. Once I met my deductible, my co-pays and my out-of-pocket limits, it became a fight between the insurance provider and the health care provider.


 One of the great lessons of cancer, and there are many, is that no matter how badly you feel or how much the chemo or radiation kicks your butt, you are rarely the sickest, most hurting individual in the hospital. Somebody usually always has it worse and that knowledge leads to a lot of empathy and sympathy for those who are in worse shape.
During my journey, I saw so many suffering people who had no health insurance, no support system, no family members, nothing. They were receiving uncompensated care and while the health care providers did absolutely everything in their power to help them and to do so compassionately, there simply is a wide chasm of disparities between the haves and the have-nots in obtaining health care.

According to the Kaiser Family Foundation in 2008, some 45 percent of Mississippians had employer-provided group health insurance. Another five percent had non-group private insurance. Medicaid covered 19 percent while 11 percent received Medicare benefits. Another two percent had other public health care while 18 percent were uninsured.

The same source reported in 2017 that some 42 percent of Mississippians had employer-provided group health insurance. Another six percent had non-group private insurance. Medicaid covered 24 percent while 13 percent received Medicare benefits. Another two percent had other public health care while 12 percent were uninsured.
Mississippi’s sad litany of chronic health problems are now familiar — diabetes, heart disease, obesity and the highest infant mortality rate in the nation — as is the state’s status as the poorest U.S. state.

The solution is more complex than simple Medicaid expansion. Total Medicaid spending in Mississippi (adjusted for inflation) over the period 2000 to 2012 doubled from $2.6 billion in 2000 to $4.6 billion (up 76 percent). For the same period nationally, Medicaid spending in the U.S. grew from $263.7 billion to $429.2 billion (up 63 percent).
Aging Baby Boomers like me are going to significantly well the ranks of the uninsured and underinsured over the next 20 years. In both federal and state politics, there is no more important question for political candidates than this one: “How do you plan to pay for public health care?”

Sid Salter is a syndicated columnist. Contact him at sidsalter@sidsalter.com.


29 comments:

Anonymous said...

Free market capitalism, the poor will weed themselves out.

Anonymous said...

P/10 Ed. Well the ranks= swell the ranks

Our car insurance does not cover tires, gas, oil changes or other routine maintenance; yet, our medical insurance does. All people and families need catastrophic coverage as your example(s) points out. Most people under 35 hardly need coverage outside of catastrophic care. A large percentage of this group’s major crisis health situation o cur in areas already covered- for example comprehensive auto insurance or on the job accident and workers comp. This group is often way over covered with overlapping coverage. Obamacare brutalized this demographic in a way that they shouldered much of the costs of others that typically require much more medical and pharmaceutical care. This was wrong.

Not opening up the free and interstate marketplaces is disastrous and costly. Additionally, it plays into the hands of the major insurance corporations and government regulators (state and national). These barriers must be removed. Market innovation and completion has been stymied when it could be testing and yielding solutions. Many doctors, practices and other collective groups have discovered they can offer concierge services and the like while offering great care and group safety nets and still make a healthy living. These barriers must be removed. Lobbying blocs prohibit the free market from gestating and delivering solutions.

Additionally- we can not afford covering the medical cost of non-citizens. This tips and flips the scales of any approach to medical coverage. If a safety net for people here illegally is required it can only rely upon charitable organizations and otherwise should be billed to their country of origin. Ones receiving US aid need to understand that their citizens care will be deducted and at a premium. The reality of the costs of medical care for non-citizens has to be acknowledged as the crippling force that it is.

Big insurance and pharmaceuticals rolled over and had a cigarette after they finished with Obama, Pelosi and Reid. Plain and simple and their profits and stock prices neuters any argument against this. This group needs a haircut and to be hammered by the free and open marketplace.

A final area that cannot be avoided are personal choices. Bad diets, poor fitness and vices cost all of us dearly. America is fat and unhealthy largely due to Americans abysmal personal choices. These costs make solving healthcare nearly impossible. People who eat well, live cleanly and maintain a level of fitness should not have to cover the obese and slothful masses. It’s shameful to see how people treat and present themselves. Look around - the majority of the people you see are leading an unhealthy lifestyle and likely obese. Self mediocrity is costly to one and all and is inexcusable.

Anonymous said...

Trump care has been an utter failure. Not one good thing has happened to healthcare since those idiots took control.

Anonymous said...

Trump care has been an utter failure. Not one good thing has happened to healthcare since those idiots took control.

Did you lose your mental illness coverage?

Anonymous said...

"Trump care has been an utter failure. Not one good thing has happened to healthcare since those idiots took control."

Yes, the damage to our health care system left by Obamacare is severe. Too bad not enough intelligent people got elected to vote to can it and replace it.

Anonymous said...

We fund disease daily when we allow tax dollars to purchase soda, candy and processed junk foods. A never ending cycle of disease and medical care. STOP funding disease and our healthcare costs will go down. If someone is hungry - beans, cheese and peanut butter will work, not candy bars and potato chips. It's not rocket science.

Anonymous said...

The real question is should everyone that takes care of themselves physically have to pay for those who don't, and thus they create their own medical problems.

Anonymous said...

There's no such thing as 'Trump Care'. All attempts to dislodge Obamacare failed thanks to the rino congress, both houses. If you like your enema kit, you can continue to reuse your enema kit.

Anonymous said...

"People who eat well, live cleanly and maintain a level of fitness should not have to cover the obese and slothful masses."

Why don't you apply that axiom also to the fit who choose to not fiddle with employment?

Anonymous said...

Let me see if I can follow some of the above " reasoning"...

If someone is visiting from a foreign country or a child not born here becomes seriously ill, we should just let them die. No other western nation does that but we should.

If you get sick, it's your fault. Genetics have nothing to do with it. Well, that's just being ignorant or stupid beyond belief. More than a few cancers and too many diseases to list have a strong genetic component.

We can't have those with a genetic predisposition to some diseases or those who had developed a pre-existing condition in childhood in the insurance pool or those who don't have what? gym memberships, aren't vegan, eat desserts in the insurance pool?

How about that an essential service to a society shouldn't be profit driven but value driven? How about CEOs of pharmaceutical companies shouldn't be making %300 higher incomes when their employees are making 30% higher over the last decade? How about removing the " middle men" for equipment and supplies and drugs and letting hospitals and doctors buy direct as they used to be able to do.

How about a national pool of citizens who are insured and pay insurance. Spread the risk nationally. There's no reason for GE employees and Mom and Pop employees pay other than the the same rate simply because the number of employees ( not the health) is a larger number.

How about no advertising for pharma on television.

Y'all need to stop letting the health care industry provide you BS propaganda.

Anonymous said...

Our healthcare system ranks below Third World countries. I am ready for Medicare For All

Anonymous said...

2:39 - stay angry! Your ridiculous summations and half cocked analogies further nothing more than outrage and ignorance. “ just let them die” - really? Typical progressive argument deflection and false reduction crap that does nothing to further the conversation or to derive a solution. Why shouldn’t a company be allowed to pool their resources and offer a health solution for employees? Does any sane person think our government will do anything but screw the management of healthcare? What examples of well run government programs would they base that assumption on? Why would anyone want the government to control their health choices?

Anonymous said...

At 5:46 is another moron who thinks he should have be given something for free. There is nothing wrong with the health care system. I've had insurance for 40 years (two policies, mine and my wife's) In the last 10 years, I haven't had a copay or received a medical bill for any doctors bill or hospital bill. Two years ago, wife received 3rd degree burns on hand. Emergency room visit, then referral to burn clinic for two months treatment and Rx's cost me $00.00........

The system is not broke, I'll take it over anything your universal health care / Medicare for All offers. Under those, need an elective none emergency surgery, get ready to wait two or more years.

All Universal HC represents is a ploy by stupid Dim-O-Krats like "Bernie" to buy votes of the dregs of society and lazy Millennials who feel like they're owed something.....

I'll keep what I have medical, dental and vision that cost me and wife per year what two months of the crappy Odummercare wanted to charge me.

Screw you, "Bernie", Poke-a-huntess and the Dim-o-krats you're fools that need Mental Health coverage.

Anonymous said...

2:39 - Genetics is singular, not plural. I realize the 's' fooled you, but still....

Chickasaw County Bubbas for Jim Hood said...

CBO Report: 1.4 Million Lost Health Insurance Since 2016

The number of uninsured climbed by 1.4 million from 2016 to 2018, according to a report out last week from the Congressional Budget Office.
~~~~~
All of the increase in the uninsured over the past two years — all of it — is the result of the massive rate increases Obamacare’s mandates and regulations caused. According to the Health and Human Services Dept., premiums in the individual insurance market doubled from 2013 to 2017.
~~~~~
But for the millions of middle-class Americans who buy insurance coverage on the individual market and aren’t eligible for Obamacare subsidies, the result has been financially devastating.

Anonymous said...

Republicans do not believe that the poor are entitled to health care. Now, it looks like Sid has had a change of heart, as have Bill Waller and Robert Foster.

Rod Knox said...

Mississippi's Republicans abhor the idea of waiting in the same room as "those people" to see a doctor.

Anonymous said...

What a disgusting thing to say!

Rod Knox said...

And if only it were left unsaid it wouldn't be disgusting?

Anonymous said...

That's bullshit Rod Knox.

I think everybody is entitled to participate in whatever healthcare program they choose to participate in and contribute to. Key words here are participate and contribute. I don't think anybody (other than my family and me) has a right or entitlement to health care solely at MY expense.

I don't care who I sit with in a waiting room as long as I don't have to wait an hour and as long as they're not hollering and blowin' snot-rockets.

Anonymous said...

You’re not worthy of debate, if for no other reason, you do not debate. You just toss out angry invectives and gross blanket stereotypes. You’ve had the same plumber for fifty years and they still haven’t fixed the problem. Consider another plumber.

Rod Knox said...

Just let the poor die, right 9:31. That will lessen your share of the burden, snotty noses and all.

Anonymous said...

Rod - This is exactly where you differ from 70% of the US population. We don't like having to pull the wagon. You've never pulled it so you've go no experience with that. If more people felt like you, your president would not be who you call Orange-Man, now would it? Your Rod's gonna be knockin' for six more years, son.

Rod Knox said...

Don't go betting your pay check on your wild meanderings 4:00. I've filed a good many schedule Cs and paid annual taxes greater than the average state income for many decades. But if it makes you feel good go on day dreaming your poor wishes for me. I'll get by OK.

Anonymous said...

Good for you Rod. And as a democrat, maybe you'll agree to up your charitable contributions this year. Republicans here could use your help.

Your personal income being over the state average, if true, has nothing to do with those of us who pull the wagon being tired of the ever-increasing sloths who choose to ride.

Rod Knox said...

And your pulling the wagon for the undeserving.....IF TRUE, is a matter of opinion and perspective 3:16. And it's a real shame that the average income in the state has been and remains LAST and therefore easily surpassed. And without a grand inheritance or a medical degree I found it necessary to be self employed where I soon recognized that those on the lower end were being screwed by those on the upper end and Mississippi's GOP refusing to enforce e-verify is indicative of the upper crust's success in keeping wages and benefits for workers at and below the poverty level. So for now your party's grand scheme is to gain support for a STARVE THEM INTO SUBMISSION plan to make "those people" as docile, meek and desperate as the newly arrived illegals from south of the border and all the while howling for a WALL. Apparently that plan is working in this state.

Anonymous said...

My God - That dude at 7:33 has gone mad and is bouncing off the walls. He just wrote a sentence with 63 words in it. Somebody please pull a welfare check on him, not to be confused with a first of the month deposit into his account.

Rod Knox said...

Some people might be surprised you could count that high 3:41.

And thanks for the concern, I'm OK considering.

Arthrogenix said...


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Trollfest '09

Trollfest '07 was such a success that Jackson Jambalaya will once again host Trollfest '09. Catch this great event which will leave NE Jackson & Fondren in flames. Othor Cain and his band, The Black Power Structure headline the night while Sonjay Poontang returns for an encore performance. Former Frank Melton bodyguard Marcus Wright makes his premier appearance at Trollfest singing "I'm a Sweet Transvestite" from "The Rocky Horror Picture Show." Kamikaze will sing his new hit, “How I sold out to da Man.” Robbie Bell again performs: “Mamas, don't let your babies grow up to be Bells” and “Any friend of Ed Peters is a friend of mine”. After the show, Ms. Bell will autograph copies of her mug shot photos. In a salute to “Dancing with the Stars”, Ms. Bell and Hinds County District Attorney Robert Smith will dance the Wango Tango.

Wrestling returns, except this time it will be a Battle Royal with Othor Cain, Ben Allen, Kim Wade, Haley Fisackerly, Alan Lange, and “Big Cat” Donna Ladd all in the ring at the same time. The Battle Royal will be in a steel cage, no time limit, no referee, and the losers must leave town. Marshand Crisler will be the honorary referee (as it gives him a title without actually having to do anything).


Meet KIM Waaaaaade at the Entergy Tent. For five pesos, Kim will sell you a chance to win a deed to a crack house on Ridgeway Street stuffed in the Howard Industries pinata. Don't worry if the pinata is beaten to shreds, as Mr. Wade has Jose, Emmanuel, and Carlos, all illegal immigrants, available as replacements for the it. Upon leaving the Entergy tent, fig leaves will be available in case Entergy literally takes everything you have as part of its Trollfest ticket price adjustment charge.

Donna Ladd of The Jackson Free Press will give several classes on learning how to write. Smearing, writing without factchecking, and reporting only one side of a story will be covered. A donation to pay their taxes will be accepted and she will be signing copies of their former federal tax liens. Ms. Ladd will give a dramatic reading of her two award-winning essays (They received The Jackson Free Press "Best Of" awards.) "Why everything is always about me" and "Why I cover murders better than anyone else in Jackson".

In the spirit of helping those who are less fortunate, Trollfest '09 adopts a cause for which a portion of the proceeds and donations will be donated: Keeping Frank Melton in his home. The “Keep Frank Melton From Being Homeless” booth will sell chances for five dollars to pin the tail on the jackass. John Reeves has graciously volunteered to be the jackass for this honorable excursion into saving Frank's ass. What's an ass between two friends after all? If Mr. Reeves is unable to um, perform, Speaker Billy McCoy has also volunteered as when the word “jackass” was mentioned he immediately ran as fast as he could to sign up.


In order to help clean up the legal profession, Adam Kilgore of the Mississippi Bar will be giving away free, round-trip plane tickets to the North Pole where they keep their bar complaint forms (which are NOT available online). If you don't want to go to the North Pole, you can enjoy Brant Brantley's (of the Mississippi Commission on Judicial Performance) free guided tours of the quicksand field over by High Street where all complaints against judges disappear. If for some reason you are unable to control yourself, never fear; Judge Houston Patton will operate his jail where no lawyers are needed or allowed as you just sit there for minutes... hours.... months...years until he decides he is tired of you sitting in his jail. Do not think Judge Patton is a bad judge however as he plans to serve free Mad Dog 20/20 to all inmates.

Trollfest '09 is a pet-friendly event as well. Feel free to bring your dog with you and do not worry if your pet gets hungry, as employees of the Jackson Zoo will be on hand to provide some of their animals as food when it gets to be feeding time for your little loved one.

Relax at the Fox News Tent. Since there are only three blonde reporters in Jackson (being blonde is a requirement for working at Fox News), Megan and Kathryn from WAPT and Wendy from WLBT will be on loan to Fox. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both and a torn-up Obama yard sign will entitle you to free drinks served by Megan, Wendy, and Kathryn. Get your tickets now. Since this is an event for trolls, no ID is required. Just bring the hate. Bring the family, Trollfest '09 is for EVERYONE!!!

This is definitely a Beaver production.


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Trollfest '07

Jackson Jambalaya is the home of Trollfest '07. Catch this great event which promises to leave NE Jackson & Fondren in flames. Sonjay Poontang and his band headline the night with a special steel cage, no time limit "loser must leave town" bout between Alan Lange and "Big Cat"Donna Ladd following afterwards. Kamikaze will perform his new song F*** Bush, he's still a _____. Did I mention there was no referee? Dr. Heddy Matthias and Lori Gregory will face off in the undercard dueling with dangling participles and other um, devices. Robbie Bell will perform Her two latest songs: My Best Friends are in the Media and Mama's, Don't Let Your Babies Grow up to be George Bell. Sid Salter of The Clarion-Ledger will host "Pin the Tail on the Trial Lawyer", sponsored by State Farm.

There will be a hugging booth where in exchange for your young son, Frank Melton will give you a loooong hug. Trollfest will have a dunking booth where Muhammed the terrorist will curse you to Allah as you try to hit a target that will drop him into a vat of pig grease. However, in the true spirit of Separate But Equal, Don Imus and someone from NE Jackson will also sit in the dunking booth for an equal amount of time. Tom Head will give a reading for two hours on why he can't figure out who the hell he is. Cliff Cargill will give lessons with his .80 caliber desert eagle, using Frank Melton photos as targets. Tackleberry will be on hand for an autograph session. KIM Waaaaaade will be passing out free titles and deeds to crackhouses formerly owned by The Wood Street Players.

If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!

This is definitely a Beaver production.

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