I grew up in California, went to college in California, and like most West Coast parents, I was conditioned to view the large private universities and University of California institutions as the gold standard of college education. I readily admit that I was wrong and can now see the glaring deficiencies of my college experience at UC Davis. The deficiencies are not a failure of the any of the large universities. They are just the nature of the system trying to push through five or ten thousand students each year to graduation.
If you think regular health insurance is filled with loop-holes and caveats to avoid paying health care claims, read the fine print on the HCSM. It can be difficult to know if the HCSM will pay on certain claims under certain conditions. Then there is the wild card of denial because of how the injury or illness occurred that is not explicitly included or excluded in the plan. For example, if you are at a gay bar and are dancing, then trip and break your ankle, will it be covered if the HCSM does not approve of activities involving the gay community?
Where a primary source of confusion starts to creep into the preliminary eligibility determination for either Medi-Cal or Covered California hinges on when the new FPL amounts are considered for eligibility. This is where the rules concerning determining eligibility are not necessarily aligned between Medi-Cal and Covered California. The rules put forth by the ACA govern how Covered California applies the FPL amounts for determining eligibility for the Premium Tax Credit subsidy, which are slightly different than Medi-Cal. The Department of Health Care Services, the agency that administers Medi-Cal, must abide by older federal rules for eligibility determinations.
The single payer proposals I have read deal mainly with the consumer side regarding access to care and reduced patient costs. What seems to be missing is recognition that medical groups and hospital have built their budgets around the existing health insurance plan reimbursement rates. There is no mechanism in the single payer proposals to limit the costs such as the cost of labor (nurses) which is a significant financial element for hospitals. Until we get a handle on the cost of health care, health insurance rates will continue to rise and a viable single payer proposal, where you have more than one or two hospitals participating, will only be a dream.
Imagine for a moment that the day you born your religion, political party affiliation, and occupation were chosen for you. It was official. You could not change what had been entered into those fields on your birth certificate. You were designated a Roman Catholic, Democrat, Farmer. Your destiny and life had been chosen. The government would only recognize what was entered on the birth certificate.
As her 78 year old father ate the breakfast she had prepared for him, she picked up the family shotgun, pointed it at the back of his head, and pulled the trigger. She then poured kerosene in the living room, kitchen, and on some of her clothes tossed on the floor, and set the house ablaze. She later recalled she had every intention of dying in the fire along with her father. Death was the only way out of the dilemma she had created as she saw it.
2020 was the year I was hoping to replace my 2002 CRV with 285,000 miles on it for new hybrid car. I don’t feel particularly optimistic about any significant revenue gains in 2020. While I picked up some new clients for 2020, I also lost just as many who have decided that health insurance is just too expensive.