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Government Bureaucracy

Regarding Health Care

Examples of items that are part of the complexities of U.S. health care financing.

  • Medicaid programs in all 50 states
  • COBRA The U.S. Department of Labor’s management of the program resulting from the Consolidated Omnibus Budget Reconciliation Act (COBRA)
  • The medical component of:
    • Workers compensation programs in all 50 states
    • Auto insurance health insurance component: seen as “coordinated medical benefits”; this does not apply to all states
  • Government cash incentives to health insurance companies
    • Just a few examples so far for this list:
      • Medicare Advantage Plans — this is a huge issue of the spending of our tax dollars that has been in the news a lot. It’s payments of our tax dollars to for-profit health insurance companies. It’s costing us a fortune, as part of the Medicare Modernization Act of 2003.
      • The Medicare Modernization Act of 2003 included a guarantee for the initial period of the Drug Prescription Benefit program that health insurance companies would not lose money. (I’d have to research to confirm if this was a year or longer.)
      • The further privatization of Medicare, scheduled to start in 2010 as per the same Medicare Modernization Act, is also scheduled to pay billions of dollars to for-profit health insurance companies to “encourage” (!) them to participate. Another case of guaranteeing companies that they will not lose.
  • Reductions in taxes for employers who provide health insurance to their employees; this is an indirect payment of private health insurance by the government
  • A variety of additional existing programs are unfortunately associated with (and/or directly include) an amazing bureaucracy of programs and grants and grant-writing and more activities that have nothing to do with the actual activity of delivering health care; the following list is all that I have gathered so far. If I learn of more, I will add them. It is not my intent to research all of these, nor defend them being on the list or not. It is my intent to give some tiny indication of the massive opportunity for simplicity and efficiency.
    • Rural Assistance Center
    • Rural Health Clinics
    • Federally Qualified Health Centers
    • Community Health Centers (CHCs)
    • Migrant Health Centers
    • Health Care for the Homeless programs
    • Public Housing Primary Care programs
    • Urban Indian and Tribal Health Centers
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