Tougher Times For Health Plans

Larry Price
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Wednesday - April 02, 2008
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Last week, trustees for the government’s two biggest benefits programs warned that Social Security and Medicare are facing “enormous challenges,” with threats to Medicare’s solvency far more severe. The trustees issued their once-a year analysis, predicting Social Security funds will be depleted by 2041 and that the Medicare trust fund that pays hospital benefits is predicted to be wiped out by 2019. It’s not a pretty picture for patients or the medical profession.

It’s a good month to praise your doctor before he moves to the Mainland or runs for higher ground. The baby boomers are coming, and workers and employers better do what they can to survive.

Almost all employers today - nearly 99 percent - offer some type of medical benefit or health care coverage. Depending on whom you work for, medical benefits could include coverages such as vision and eye care, dental, prescription drugs, and basic hospitalization and surgical coverages.


Each year the cost of these benefits escalates. Many employers now want employees to foot part or all of the bill. With rising costs, the different medical laws and the large number of baby boomers retiring, many employers are now seeking other means of cutting down on healthcare costs by implementing healthy alternatives in the workplace.

With the development of health savings accounts, individuals now have the opportunity to pick and choose what type of coverage they would like and expect to benefit their families. It is going to be up to the employee, as opposed to the employer and the government, to choose what type of coverage they may need and, more importantly, what he or she is willing to pay for or can afford.

And with U.S. health expenditures rising past 16 percent of the country’s total economic output, a level that’s nearly 50 percent higher than any other country, politicians and business executives are scrambling to stay away from bills that pertain to America’s complicated mix of public and private health systems. Opinion polls indicate that health care bills are now of greater concern to the U.S. public than terrorism, illegal immigration or the rapidly rising cost of fuel.

Besides the cost factors of medical benefits for both employers and employees, there are also labor laws that both entities must take into account. There are about 45 million uninsured, who have little more than emergency access to healthcare, hoping for change. The increasing cost of medical benefits today makes it very hard for many to even afford coverage for themselves, let alone their families.

Many people are just hoping and praying for the government to rescue them with legislation. Sometimes it does, as with the Family and Medical Leave Act (FMLA), the Health Insurance Portability and Accountability Act (HIPAA), and the Comprehensive Omnibus Budget Reconciliation Act (COBRA), just to name a few. It’s possible that many people have never heard of these acts or what they mean to a patient’s welfare. It’s essential for employers and employees to be educated and aware of their rights and protections under each act so that benefits are not denied to someone who is eligible under the law, and for employers to protect themselves from a lawsuit.

Retirement benefits are another important issue related to medical benefits because those who are of retirement age rely heavily on the company they worked for to pay for the medical package after retirement. Many elderly Americans depend on both Medicare benefits and company retirement medical benefits because, in many cases, company benefits either are canceled or do not increase as the cost of medical care goes up.


So, here we are in Hawaii, one of the most isolated places in the world, with Turtle Bay Resort filing for bankruptcy along with Aloha Airlines, and Molokai Ranch phasing out its operation on the entire island. What will all these people do? Does the law, as currently written, protect any of them? It’s a kind of silly question, because our legislators can’t even offer modest protection for medical professionals from predatory attorneys. It’s a good bet that if our legislators won’t lift a finger to help medical professionals, why would they lift a finger to protect workers? The message is clear: You are on your own.

As time progresses, health care benefits will probably turn into a pension plan, where the ultimate decision and choice of paying for the benefits and choosing the right plan will be up to the individual.

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