ARTICLES

VIEWPOINT ~~ Health insurance reform: Don't reinvent the wheel

By Shelly Anderson/Amelia Island

Health insurance continues to be a burning issue at every level. Having been in the insurance business all my professional career and now focused on "senior planning," I am stunned by the overwhelming need for reform and the ramifications of the simplest of changes. No easy answers.

My business helps clients protect their families, themselves and their assets. We strive to find cost-effective ways of providing for long-term care, a guaranteed life income and health care coverage. A portion of my time is spent trying to find health care solutions for my clients. The challenges grow as insurance coverage is declined for pre-existing conditions. As an independent broker, my first concern is for my client. The best care for the least amount of expense with the best provider.

Most people in their middle years have some health history that may result in coverage exclusions or being totally declined by reputable insurance companies. The insurance companies simply cannot and will not cover an individual when they may have to pay out hundreds of thousands of dollars in claims. This has to change. Pre-existing conditions such as cancer, heart disease and diabetes need to be covered.
To do this insurance companies must be able to spread the risk over a broader population base to provide a bigger pool of insured people. This is Insurance 101. Like home insurance and car insurance, health insurance should not be a choice. In addition, we need to implement comprehensive medical liability reform.

Home and auto insurance are not nationalized and it works. It is not necessary to socialize medicine. To do so in our country would create nightmares. People would wait months for critical tests, surgery and medical care. It is not necessary to reinvent the wheel. Major health
insurance companies have said that they will insure people with pre-existing conditions if all people have coverage.

There are 46 million uninsured people in America. Ten million are not U.S. citizens and another 18 million could afford health insurance but choose to go uninsured. If those people have a health crisis or accident, who pays? Our hospitals and doctors do. And we do. Uninsured people who don't pay drive up costs. Yes, we do need to find a way to cover these people who have no options - inability to pay and critical health needs. This can be accomplished through Medicaid and low-income assistance.

What about the rest of the uninsured population? As proposed health reform is debated, the public has become more and more wary of the lack of option choices and increases in taxes.

Despite the trillions of dollars projected, there has been little information about actual premiums, prescription formularies and policy specifics.
Some states offer programs that attempt to address some of the most critical of health care needs. Recently, Florida has initiated its "Cover Florida" program, which is an inexpensive health care program providing guaranteed coverage. It is limited both in expense and coverage. It's a start.

We cannot walk away. It is not an option. None of us welcomes a house fire or an automobile accident but if the worst happens, we are covered by insurance.

I talk to clients every day. My heart goes out to those people who cannot qualify for any health insurance. Things have to change. We do not need another national experiment. We need reforms to our existing system.
Sheldon "Shelly" Anderson, CLU, ChFC, operates The Anderson Group, an independent insurance agent offering life, long-term care and health insurance based on Amelia Island.

Sheldon "Shelly" Anderson, CLU, ChFC, owns and operates Anderson Group in Fernandina Beach.

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VIEWPOINT ~~ Health care: There are affordable options

By Shelly Anderson/Fernandina Beach

One of the hot buttons in the upcoming election is health care. The two presidential candidates have very different approaches. One advocates a universal health care system while the other would seek to make changes in a system that is struggling. As an independent broker representing the very best companies in the health care insurance business, I wanted to share my perspective.
We represent our clients and not a specific insurance company. My entire professional career has been in the insurance industry. Prior to establishing an agency on Amelia Island, I worked in major metropolitan areas like Kansas City, Atlanta and Ft. Lauderdale to name a few. Our demographics in Nassau County are quite different. There are few large employers. The majority of those needing health care coverage are small businesses, self-employed individuals or early retirees. Make no mistake; I am on the front line. Health insurance is serious business and I take it very seriously.
My clients are individuals and small businesses and my focus is on life insurance, annuities, long-term care, group and individual health insurance. A great deal of my time is spent answering questions and providing assistance to people who are looking for affordable health insurance and are not sure where to turn. Some have turned to the Internet or responded to the aggressive television ads that make big promises, but bottom-line do not deliver.
Medical economics are complex and have changed significantly in the last few years. Who pays and how we pay for our health care can be very confusing. We all want affordable, timely medical care from doctors and medical facilities we know and trust. My goal is to match clients with the companies that can provide the coverage they seek and at a cost they can afford.
Many of us remember when companies were able to offer health insurance benefits to their employees. Times have changed.
More people are self-employed and employ-
ers can no longer afford the high cost of providing health insurance benefits to their employees.
When I read a hard luck story about someone who has no health insurance, it is frustrating. Yes, there may be situations where someone absolutely can not get coverage but more often then not they do not understand the current options that are available. We don't think twice about insurance for our cars and homes, but fail to step up when it comes to our own medical care. If my wife and I did not have adequate insurance on our home we would have been financially challenged by our house fire in May 2007.
But how in tough economic times can we afford to pay for the insurance we need? There is good news. There are ways to get health insurance for yourself and your family. Health insurance is not a luxury, it is a necessity. To have it is a reverse lottery. If you are not covered by health insurance and have a catastrophic illness or accident you may lose everything and not get the best of care and treatment.
One option is a Health Savings Account or an HSA, as it is most often called. Created by Congress in 2004 it is underwritten by the insurance industry. The economics make a lot of sense. What is a HSA? It is very different from traditional plans of the past with low deductibles and high premiums. In fact, it is exactly the reverse. Most people tell me they can handle the smaller medical bills, but what they fear are those that may run into the tens of thousands. We have all heard the horror stories.
A Health Savings Account offers a higher deductible and lower monthly premium. The insured pays the deductible. The company pays 100 percent thereafter up to $5 million. The premium goes into a non-taxed deferred savings account that can be used for health care expenses or taken out at age 65 like an IRA. All expenses that include prescriptions, tests, doctor visits and hospitalization apply to the annual deductible. Bottom line, you pay less for the coverage you need and don't pay for coverage you don't need. Pre-existing conditions may preclude you from getting a HSA, but other options exist.
The facts: 47 million Americans lack any form of health insurance. Eighty percent of these people are employed and 16 million earn more then $40,000 a year per family. The good news is that millions of these uninsured working Americans can now afford to buy health insurance.

Sheldon "Shelly" Anderson, CLU, ChFC, owns and operates Anderson Group in Fernandina Beach.