The cost of medical care — someone always pays

I have a 72-year-old friend whose wife is in her very early 60s. My friend is covered with Medicare and happy not to have any co-pays on his medical prescriptions. Carmen, on the other hand, is still working and considers herself lucky to be part of her employer’s group hospitalization plan.

Lucky that is until she goes to a doctor or picks up a prescription at the local drugstore.

Her complaint? “Why do I pay over $600 a month for hospitalization coverage for myself and still have to pay $100 a doctor visit and what seems like the entire cost of my prescriptions?”

The answer she gets from her health insurance company is simple “You must first cover the upfront $5,000 annual deductible.”

“Then I am off the hook for additional charges, right?”

“Well, no,” said the gal on the phone at her insurance company, “Remember you still have a co-pay.”

So rather than run up another big bill, Carmen goes to the local drugstore and sees an urgent care nurse for only $80. They know that prevention is far less costly than ignoring a medical condition until it gets so bad that you are rushed to the hospital in an ambulance and then face a gigantic medical bill. My friends are lucky. But she asks what about the guy without insurance?

He just sits and looks at that little festering sore on his arm hoping that the tub of over-the-counter medication he bought last year will cure the problem. He finds out a year later that it is cancer and he is in the hospital facing major surgery. Cost comparison — $500, maybe, if he saw a doctor up front. Now, it’s a few hundred thousand dollars that he can’t possibly pay. Where does he end up — Jackson Memorial Hospital, where you and I pay.

What about the family without hospitalization insurance? The husband and wife, both have full-time, minimum wage jobs — perhaps from four part-time jobs. They can’t pay for a roof over their heads, feed the three kids and still cover the cost of insurance. They must feed their children today. There’s no time to worry about medical expenses that might occur in the future. There always is Jackson.

Fortunately there is a federal program that helps cover the cost of hospital services for members of the community who cannot afford to pay. I don’t care what you say, there always will be people that cannot afford to pay for medical care. However, one way or another we will pay their bills — either through higher local real estate taxes, state sales taxes, or through our federal income taxes. One way or another we will pay.

Simply stated, it is better to pay for preventive medicine now and save the disastrous cost of care for those that hid their illnesses until it is too late.

Our state is facing this dilemma today. Florida Gov. Rick Scott is caught in the debate over letting the federal government pick up the cost under an expanded state Medicaid program. First he was against expansion. I think that was during the period of time when Florida was anticipating a large budget surplus. But, after promising a reduction in corporate taxes, after promising more money for education, the governor is back to asking where is the money coming from?

The answer is expanding the state’s Medicaid program with federal financial assistance. Like it or not, there isn’t another solution. The Florida Legislature seems to be looking favorably at expansion. Hospitals are begging the governor to take the money. It is desperately needed. We just can’t leave a few hundred thousand Floridians without medical coverage.

Our Republican-controlled legislature has accepted federal funds before. There is no shame in doing so now. We just can’t hang a sign on all our hospitals’ front doors saying: “SORRY, CLOSED TO THOSE THAT DON’T HAVE INSURANCE OR THE CASH TO PAY THE BILLS.”

We appreciate your opinions on this column whether in agreement or disagreement. Send your comments to (fax number) 305-662-6980 or email to The opinions expressed in this column are not necessarily those of this newspaper, its editors or publisher.

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About the Author

Kenneth Bluh
Kenneth has been writing a column for Community Newspapers since 1989 when he first wrote about the incorporation movement in UMSA (Unincorporated Municipal Services Area). His columns cover the political scene in Miami-Dade and Tallahassee. Educated at the Wharton School in Philadelphia, Kenneth has been a member of the banking/mortgage lending profession in Florida since 1962. Contact him at or 786-247-0547 where he manages American Bancshares Mortgage LLC’s Reverse Mortgage Department.

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