I guess I am getting cynical in my old age, but “informed electorate” seems like another oxymoron.

Miki, regarding your comment that “It seems that greed, stupidity and politics-as-usual doom fixing the mess. But no surprise there, but I sure hope I’m wrong!” There is always hope.

However, in addition to hope, it depends on an informed electorate and media demanding that our elected representatives, Democrat and Republican, stop telling the voters that $2 + $2 of revenues = $6 and that $2 + 2 of expenses = $1.

In addition, we should demand that ALL earmarks be ended, including those buried in the Administration budget as well as those buried in the Congressional legislation.

However, in addition to hope, it depends on an informed electorate and media demanding that our elected representatives, Democrat and Republican, stop telling the voters that $2 + $2 of revenues = $6 and that $2 = $2 of expenses = $1.

It seems that greed, stupidity and politics-as-usual doom fixing the mess. But no surprise there, but I sure hope I’m wrong!

While the development of healthcare technology and pharmaceuticals provides longer life expectancies for Americans, there are a number of structural impediments to providing efficient healthcare.

Health insurance companies have created bureaucratic nightmares for efficient and cost-effective distribution of healthcare services and administration while optimizing profits.

The industry consistently says it provides the most efficient and cost effective business processes to provide healthcare to millions of Americans. If that is the case, then:

(1) Why do Medicare Advantage providers require a 12% or higher surcharge to provide Medicare Part C coverage than the amount spent by Medicare to provide Medicare Parts A and B coverage?

(2) Medicare beneficiaries in south Florida are offered the choice of Medicare Part A and B which allows the use of any physician or medical facility in the country that accepts Medicare payment.

In contrast, Medicare Advantage offers more than 60 separate healthcare plans that may provide lower monthly Medicare payments, but restrict beneficiaries to specific physicians, medical services providers, and hospitals, and have a relatively complicated set of co-pays.

Medicare Advantage beneficiaries have to check carefully to determine coverage when outside their service area, which may be as small as a county.

It appears that the administration of 60-plus plans must require significantly higher administration, marketing, and overhead costs to service the 10-15% of South Floridians who use these plans in lieu of Medicare Parts A and B.

(2) In a two-year period, the United HealthGroup, Inc. offered their CEO stock options worth 800-Million Dollars followed by an additional $600 Million Dollars in stock options and retirement perks the following year.

The $600 Million Dollar offer was retracted the following year after investigations started by the US Attorney’s office and a civil penalty/fine of $7 Million Dollars. Is this an appropriate of the healthcare premium dollars paid by beneficiaries?

Commentary – As a retiree of a major US Corporation that allocated approximately $3,000/retiree to provide health and dental services, I watched the cost of a benefits-rich nationwide HMO healthcare plan for a husband and wife with $5 Doctor and Rx co-pays, no co-pays or limits on lab, Rx, and hospital services go from $1920 Dollars/year in 1998 to more than $13,000/year by 2006 with 35% co-pays and limits on Rx coverage and 20% co-pays on everything else.

That did not include the $3000/retiree that was still being allocated. I understand that the costs of providing medical care have exceeded the annual rate of inflation. I think that the health insurance costs increases of 677% over an 8-year period for an employer with a very sharp pencil and ability to command competitive prices far exceeded the actual increases in fees received by healthcare providers.

It would appear that marketing, administration; overhead costs, executive benefits and perks, and HMOs being traded back and forth at increased prices on every takeover probably represented a major portion of the 677% increase in premiums paid.