Just before the holidays, I had my annual dinner with longtime friends — all political liberals.

My friends' son, now in college, asked me a health care question as I munched on a delicious dish of short ribs. "If you're against government health care insurance, what should poor people do? What, just screw 'em?"

Having known him since birth, I was taken aback by not just the question. I knew that, like Custer, I sat surrounded by liberals. But the harshness of the question surprised me.

Because Republicans, like me, reject the John Kerry-esque argument that "health care is a right … not a privilege," liberals believe we see a bipolar world — those with the money have health care, and to hell with those who don't.

So I said, "This is a somewhat complicated question, but the short answer is free enterprise."

"Free enterprise?"

"The reason health care isn't accessible to so many people is because of government interference. For example, a medic in Iraq who attends to fallen soldiers — but is not an M.D. — could not return stateside and open a practice. My aunt worked for over 30 years in a maternity ward. She told me that many times the new interns would say, 'Nurse Maggie, what drug should I use, and what kind of dosage?' Yet laws would prevent my aunt from opening up a pharmacy."

"Do you think something like this will happen?"

"It already is," I replied. "Several pharmacies like Walgreens now open up many clinics and provide cheap health care for low-income people."

At this point, his father jumped in and said, "Really? I never heard of that."

"You never heard," I said, "that drug stores like Walgreens now have in-house, walk-in medical clinics so that people can get care for medical problems, the kind of treatment that most people need — noncomplicated, nonsurgical procedures?"

"No, I never heard of that."

And so it went. But for the record, big drug store chains like CVS, Rite Aid and Walgreens, along with the largest U.S. retailer, Wal-Mart, are expanding walk-in clinics in their stores. Hundreds will be opened this year, and thousands over the next decade. Staffed by nurse practitioners who can examine patients, administer vaccines, and prescribe medications for minor illnesses, these clinics charge much less than a traditional doctor's office visit. Besides increasing access to health care and reducing costs, such clinics reduce the burden on overflowing, ridiculously expensive, we-have-to-treat-you-even-if-you-can't-pay hospital emergency rooms. Available, convenient, affordable walk-in care also catches some illnesses before they become serious and costly. And doctors will have more time available for complex cases.

Despite a growing and aging population, no new for-profit medical school has been constructed in the United States since the early 1900s. In 1980, the Department of Health and Human Services survey predicted a huge surplus of doctors by 2000. State governments stopped building new medical schools, and almost all 126 medical colleges cut back enrollment, and medical graduates declined. The American Medical Association just reported an increase in first-year medical school enrollees for 2006 — the first increase in decades . The U.S. still has only 126 M.D.-granting medical schools, but some experts predict we need at least 90 more to meet the doctor shortage predicted for 2020.

How many people also don't know that laws prohibit interstate health insurance sales, preventing people in state A from getting medical insurance from a company in state B? According to The Wall Street Journal in 2005, "eHealthInsurance … compared the cost of a standard family insurance policy ($2,000 deductible with a 20 percent co-insurance) across that nation. … (A) non-employer-based family policy for four in Kansas City, Missouri, costs about $170 per month, while similar coverage in Boston tops more than $750 a month." Why? Most states mandate the type of services that must be covered — podiatrists, acupuncturists, massage therapists, etc. — whether the patient wants it included or not.

Some states force insurers to sell to all applicants at the same price, regardless of their age or health. The result? "Faced with higher premiums for insurance they seldom use, the young and healthy drop their coverage, leaving an insurance pool of older, sicker people — and even higher premiums. After a decade of such political meddling, the average monthly cost of a family policy in New Jersey bests the monthly lease of a Ferrari."

"Finally," I said to my friends' son, "people with little money still manage to afford cars. And people with little money can, if government set the market free, afford health care coverage. It won't be the type a resident in Beverly Hills gets, but there would be some bare-bones type of coverage if only government got out of the way.

"Now," I said, "can I have another glass of orange juice?"

Larry Elder is a syndicated radio talk-show host and author. His nationally syndicated radio program airs 3 p.m. to 6 p.m. PST and can also be heard on X-M and Sirius satellite radio. To find out more about Larry Elder, visit his web page at www.larryelder.com.

2007 LAURENCE A. ELDER

This snapshot examines trends in employer-sponsored health insurance costs in the United States. It looks at the percentage of businesses offering coverage, the growth of insurance premium costs relative to salaries and wages, and the proportion of payroll that is taken up by premium contributions.

Key findings include:

• While wages and salaries increased by 39% between 1996 and 2005, health insurance costs to employers rose 97%.
• At businesses that offered insurance, the share of total compensation paid as health insurance rose from 6 to 8% from 1996 to 2005. As health insurance costs increased, the share of compensation paid as wages fell.
• Premium contributions as a share of payroll were highest for unionized businesses, businesses with a high share of full-time workers, and low-wage businesses.

California Group Health Insurance

Here are some tips to guide you in finding the best health plan for your budget and health insurance needs.

1. Know the right questions to ask

Here are examples of key questions when shopping for California health insurance

• What is the annual out of pocket maximum per calendar year?
• What co-payment applies to services?
• What benefits require me to pay a deductible before the insurance policy pays and what is the deductible amount?
• Does my plan deductible count towards my annual out of pocket maximum?
• What hospitals are covered by the health insurance policy?
• Am I covered at my preferred hospital by my preferred health practitioner?
• Regarding the prescription benefit; what are the co-pays for brand name and generic drugs?
• Are brand name drugs covered?
• Is there a separate prescription deductible I must meet?
• Is there a limit or ceiling per year on the prescription benefit?
• Are there waiting periods for any treatment?
• What about pre-existing conditions, are they covered?

2. Talk to your health provider.

It’s a good idea to speak with your current doctor first to determine which plans their office accepts and also what conditions to be sure the health plans covers. Your doctor is intimately familiar with your health history, including immediate family members and what you are most likely to experience in the future. 3.

3. Shop around using a broker

Using an independent broker allows the shopper to get independent comparative information on several California health insurance plans. California health insurance plan features and the prices offered from many companies can be considered. Buying your California health insurance through a broker can help take away the anxiety of shopping for health insurance. Brokers can present many choices and comparisons on what's available for your individual health insurance circumstances. Using a broker costs you nothing because they are paid a fee by the California health insurers — which are essentially standard across the health insurance industry. The important thing to remember is that the rates through a broker will be the same as if you called the California health insurance companies yourself so why not take advantage of a professional who can illustrate all companies’ plans, benefits and rates and who is motivated to find the best health plan for your medical needs and family budget.

4. Replacing your health insurance plan

There are great deals out there and don't be afraid of switching your California health insurance plan. People don't usually switch health plans because they falsely believe they'll have to go through a new waiting period, however, legislation governing California health insurance plans guarantees that if you switch to another health insurance policy with the same level of coverage, you will get continuity of coverage. In fact when switching within the same California health insurance company to a plan with an equal or lower benefit level, typically no application or underwriting is required.

5. Narrow down the plans you are considering by eliminating those offering coverage you can do without.

Many consumers opt for hospital coverage as well as ancillary cover for dentistry, physiotherapy, optical requirements and others. Excluding coverage for maternity or brand name drugs can reduce your premium substantially. There is a wide variation between California health plans on what benefits you'll get back, so be sure the California health plans you consider are competitive. Price of the policy must be weighed up with what you'll get back in real terms. Excluding coverage for maternity or brand name drugs can reduce your premium substantially.

6. Cut the cost of prescription drugs
Prescription costs can eat up a large portion of your budget if you take prescription drugs regularly. Fortunately, it's not hard to find ways to save money. For example, try ordering your prescriptions through the mail, using a traditional or online pharmacy. If you belong to a prescription drug plan (e.g. through your health insurance), you may be able to get a three-month supply of your prescription drug through the mail for the same price you would pay for a one-month supply at your neighborhood pharmacy. You can also ask your pharmacist or doctor to recommend a less expensive generic drug whenever possible.

7. Measure the quality of competing California health insurance plans?

When shopping for California health insurance, it is critical to consider the monthly premium and whether the family's doctors participate in the plan's network. However, there are other criteria to use. Accreditation groups, such as the National Committee for Quality Assurance, measure plans using a variety of quality standards. Ratings companies, such as Standard and Poor's, A.M. Best and Moody's, give you a picture of a health plan's financial strength. "Report cards" published by consumer groups, independent Web sites and state insurance officials are another good measurement of consumer satisfaction with health plans.

8. Consider a HSA – California Health Savings Account

An HSA is becoming a very popular means to obtain affordable health insurance in California. Premiums charged by California health insurance companies for HSA qualified plans are lower than many other plans because they shift the initial cost of medical treatment to you during each calendar year. Currently you may contribute a maximum of $2,850 for yourself only or $5,650 if you have a HSA qualified family health insurance plan to your HSA trust account.

You are issued a debit card to access the funds in your HSA Trust account to pay for qualified medical expenses. Fund contributed to your HSA trust account may also provide savings for the future. Money put into the account can be used either during the year or accumulated in the account. Allowable medical expenses are defined by the IRS, and are much broader than most insurance carriers (i.e. includes dental, vision). Individuals can deduct dollars contributed to the HSA account from their gross income, resulting in tax-free medical dollars. These funds can also be used for other purposes such as paying the premium on long term care or Medicare supplement insurance. The account is similar to an IRA account; however it is for qualified medical expenses only.

9. Get to know your health insurance
Your health insurance offer many additional benefits you may not be aware of. Lately many California health insurers are offering many benefits designed to help you live a healthier life. Some examples of some additional benefits to California health plans are: Alternative medicines, free health and wellness programs, vision discount programs, health club membership discounts, acupuncture, mental illness, no exam term life insurance, You may also be surprised at the range of coverage your health plan offers. For instance, it may cover dental care

10. Use the power of the internet. Finding affordable California health insurance plans has never been easier. With the advent of the internet, comparing premiums, insurance companies and benefits has become much easier. Many websites now offer the ability to not only shop for health insurance but to actually apply online. Use the vast resources of the internet to research the best health plan options available to you.

Hey Guys; I saw on the news up here in Canada where Hillary Clinton introduced her new health care plan. Something similar to what we have in Canada. I also heard that Michael Moore was raving about the health care up here in Canada in his latest movie. As your friend and someone who lives with the Canada health care plan I thought I would give you some facts about this great medical plan that we have in Canada.

First of all:
1) The health care plan in Canada is not free. We pay a premium every month of $96. for Shirley and I to be covered. Sounds great eh?
What they don't tell you is how much we pay in taxes to keep the health care system afloat. I am personally in the 55% tax bracket. Yes
55% of my earnings go to taxes. A large porti on of that and I am not sure of the exact amount goes directly to health care - our #1 expense.
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2) I would not classify what we have as health care plan, it is more like a health diagnosis system. You can get into to see a doctor quick enough so he can tell you "yes indeed you are sick or you need an operation" but now the challenge becomes getting treated or operated on. We have waiting lists out the ying yang some as much as 2 years down the road.
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3) Rather than fix what is wrong with you the usual tactic in Canada is to prescribe drugs. Have a pain - here is a drug to take - not what is causing the pain and why. No time for checking you out because it is more important to move as many patients thru as possible each hour for Government reimbursement
4) Many Canadians do not have a family Doctor.
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5) Don't require emergency treatment as you may wait for hours in the emergency room waiting for treatment.
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6) Shirley's dad cut his hand on a power saw a few weeks back and it required that his hand be put in a splint - to our surprise we had to pay $125. for a splint because it is not covered under health care plus we have to pay $60 for each visit for him to check it out each week.
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7) Shirley's cousin was diagnosed with a heart blockage. Put on a waiting list. Died before he could get treatment.
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8) Government allots so many operations per year. When that is done no more operations, unless you go to your local newspaper and plead your case and embarrass the government then money suddenly appears.
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9) The Government takes great pride in telling us how much more they are increasing the funding for health care but waiting lists never get shorter. Government just keeps throwing money at the problem but it never goes away. But they are good at finding new ways to tax us, but they don't call it a tax anymore it is now a user fee.
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10) My mother needs an operation for a blockage in her leg but because she is a smoker they will not do it. Despite her and my father paying into the health care system all these years. My Mom is 80 years of age. Now there is talk that maybe we should not treat fat and obese people either because they are a drain on the health care system. Let me see now, what we want in Canada is a health care system for healthy people only. That should reduce our health care costs.
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11) Forget getting a second opinion, what you see is what you get.
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12) I can spend what money I have left after taxes on booze, cigarettes, junk food and anything else that could kill me but I am not allowed by law to spend my money on getting an operation I need because that would be jumping the queue. I must wait my turn except if I am a hockey player or athlete then I can get looked at right away. Go figure Where else in the world can you spend money to kill yourse lf but not allowed to spend money to get healthy.
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13) Oh did I mention that immigrants are covered automatically at tax payer expense having never contributed a dollar to the system and pay no premiums?
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14) Oh yeah we now give free needles to drug users to try and keep them healthy. Wouldn't want a sickly druggie breaking into your house and stealing your things. But people with diabetes who pay into the health care system have to pay for their needles because it is not covered but the health care system.
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I send this out not looking for sympathy but as the election looms in the states you will be hearing more and more about universal health care down there and the advocates will be pointing to Canada. I just want to make sure that you hear the truth about health care up here and have some food for thought and informed questions to ask when broached with this subject.

Step wisely and don't make the same mistakes we have.