A quick mention to Peace:   I think there may be a bit of confusion of terms. I wasn't aware until just a bit ago that the Canadian health care system is referred to as "Medicare."

In the United States, "Medicare" is the word that is used when referring to health care reserved for people over age 65 (or is it now 67?) who are receiving Social Security benefits (and part of which, the SS recipient must pay for out of their monthly SS check). "Medicaid" is for very low-income people. Both Medicare and Medicaid pay some to health care providers, but barely adequately. And as noted above, many private physicians refuse to take Medicare and Medicaid recipients because they pay so little, and there is a mountain of paperwork involved. Incidentally, in most states, both Medicare and Medicaid are administered, not by government bureaucrats, but by private insurance companies under contract to the state government.

So much for the contention that it's "government bureaucrats" who render a system unwieldy.

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I haven't had a chance to research this yet, so if someone has the skinny on it, perhaps you can parse it for us.

There are "health care costs" and then there are "health care costs." I think most people consider the amount of their income that they have to pay for health insurance (either directly, or deducted from their paycheck by their employer—plus the employer's contribution, which, in reality, also comes out of the employee's paycheck) as "health care costs." Often this amounts to a couple thousand dollars a year, sometimes even more. Add all of that together, and it comes to many billions of dollars placed into the hands of insurance companies.

Now. When we refer to "health care costs," are we referring to the money paid to insurance companies in health insurance premiums plus money paid directly to health care providers by patients? Or are we referring to the money that is actually paid to the health care providers, by both insurance companies and by patients directly?

I think that needs to be clarified when we talk about "health care costs."

What prompted me to wonder about this is that within recent weeks, there has been a flurry of commercials on the radio and television in this area against Referendum 67, slated to appear on the Washington State ballot in the next election.

From the Seattle Times:    "Under the new law [Referendum 67], courts can approve triple damages if an insurance company is found to have unreasonably denied coverage or payment of claims."

This law was proposed as a result of an "abnormal" number of denials of payment by insurance companies, often despite what the contract and the sales literature says the insurance company covers. Basically, Referendum 67 is an attempt to get the insurance companies to honor their promises, with a punitive charge of triple damages if a court determines that they are in default.

Insurance companies are pouring vast amounts of money into a campaign to defeat the referendum. The ads are claiming that the referendum is being proposed by "unscrupulous trial lawyers" and "ambulance chasers" in search of huge fees, and using a further scare-tactic of claiming that if the law is passed, it will cause insurance rates to skyrocket.

Two local insurance companies, Safeco and Pemco, are declining to join the campaign, saying that they consider the law to be fair, and that the campaign to defeat the referendum is being financed by a number of large out-of-state insurance companies.

So, again:    How much of America's health care costs go to insurance company profits and how much actually goes to pay health care providers?

Don Firth