Cinematic shopping
Don’t mess with any taxman

The doctor is in

Most of my morning was consumed by a medical appointment. I'm not gravely ill (so quit freaking out, Mom, if you're reading this), just trying Caduceusto keep that from happening with some preventative care. It was a interesting experience, as is usually the case when you go to the doctor.

First, I got lost. In my defense, I've only been here in Austin for about six months and most of the time, I'm a passenger in the car, not the driver. Thank goodness for a cell phone and a friendly (and highway knowledgeable) doctor's office manager. Once I finally arrived (15 minutes late), there was the requisite half hour needed to confirm that I have insurance coverage.

Then my doctor decided I needed to see some of his medical colleagues for "just to be sure" followup. Tres coincidence: Those other physicians just happen to be in the same office building, so I'm sure there's a quid pro quo in referrals going on here. And, of course, my insurance coverage will take care of these added medical opinions.

Don't get me wrong. I'm glad I have medical insurance. But more often than not the whole process makes me a bit uneasy. What happens to you if you walk into a doctor's office without insurance? Do you have to wait even longer to see the doctor while his business office checks your credit rating? Does anyone ever get turned away? You like to think you can count on a hospital to take you in, no (or at least fewer) questions asked, but what about a run of the mill exam?

The dilemma: If you don't have health insurance, you don't go to the doctor for routine treatment or minor ailments, possibly leading to a serious illness that will land you in an ER where your uninsured costs will be larger than any preventative or early care measures you skipped because you didn't have insurance. Are you dizzy yet? Should I call a doctor? Maybe not. And we haven't even looked at trying to decipher insurance and medical bills after the fact.

While the debate about universal care provided by the federal government rages on, people keep getting sick and not going to the doctor and companies cut back or eliminate health benefits in an effort to meet their bottom lines. As a self-employed person now footing my own full health care costs, I admit I'm for universal coverage. And as a person who knows and is related to folks who can't afford their own insurance coverage or work for companies that don't offer the benefit, I'm also for universal coverage.

Even a major business-oriented publication, Forbes, recognizes the problem. In an on line article this week the ezine looks at the escalating costs: "The U.S.' health care bill is expected to reach $1.9 trillion this year. That's 15.6% of the economy. Yet 45 million Americans are not covered by insurance and on average Americans can expect to live until the age of 77. Compare that to other industrialized nations like Sweden, where health care spending is 9.4% of the economy and folks live an average of 80 years."

The need for a structural change in our insurance coverage system appeals to me even more as I age. I'm still a good distance from that  Forbes' cited 77-year-old average, but when I get there or close to it, how on earth will I be able to pay ever-escalating health care and insurance costs in my retirement? That's the conundrum Barbara Whelehan examines in one of her recent "Boomer Bucks" columns.

Meanwhile, there's definitely a tax aspect to the health insurance issue. Currently, payments by employees and employers (including the self-employed like me) toward health insurance premiums are exempt from tax. Among the recommendations of the President's Panel on Tax Reform is a cap on how much of these payments should stay tax free; the Panel suggests the cap be set at the average cost of a policy in 2005 and then index that amount annually for inflation. Opponents of the change say that a cap would encourage employers to reduce employee benefit offerings. Plus, they argue, the value of any remaining health care benefits would quickly erode because health care costs tend to rise faster than costs in other economic sectors.

Whether this or any other Tax Reform Panel suggestions get serious consideration remains to be seen given budget and 2006 election concerns. Until any changes are made, take advantage of existing tax law to help with your health care costs. When you do have to shell out for treatments, keep track of the specifics because you might be able to get some relief by claiming your medical expenses as a tax deduction.   

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