To understand the changes introduced in the USA medical insurance program, a view of the present system must be reviewed.

Insurance in the present system is provided by privately owned insurance companies with the exception of Medicare, the government medical insurance sponsored for citizens over 65 years of age. Medicare has been successfully operating for 30 or 40 years. Also, for poor people below a certain income levels the government provides basic insurance coverage in a program called “Medicaid.”

For the population under 65, which includes most of the citizens, insurance has been offered by private insurance companies. Most larger corporations will provide medical insurance as a benefit to their employees and their families. Those working independently – artists, business consultants, farmers, etc., obtain insurance by buying a policy through a number of insurance companies offering a variety of plans. However, since the insurance company determines the qualifications required to purchase their insurance some people, with previous severe illness, chronic complaints, mental health issues may not qualify. These people have been unable to find insurance coverage.

Another large group is young people 25–40 who are generally healthy and some may not purchase insurance because they feel they don’t need it and it can be expensive. Without insurance they can go to the emergency room of hospitals and their immediate needs will be handled.

This is a brief sketch of the present system. However, people generally recognized the system wasn’t working satisfactorily and was too expensive. The United States was the only industrialized country without a universal health system. So changes needed to be made.

In 2008, President Obama was elected and one of his prime endeavors was to improve the health insurance program and “Obamacare” or the Affordable Care Act was the result. Following the passage of the law in 2010, since the changes were so far reaching, the provisions have been introduced over the ensuing years with the major changes scheduled to occur in 2014.

The basic premise is that everyone will have medical insurance. If an employer provides insurance for its employees the present program for poor people, Medicaid, will continue and expand to include those previously excluded individuals and families. If a person or family has insurance they will continue to have the same coverage. People rejected before because of medical or other reasons must be offered coverage by insurance companies.

The big change is that everyone will be required to have medical insurance and unless one meets certain exceptions, must pay for it. Thus, young people, those who don’t qualify for Medicaid, poor people, others who couldn’t afford the cost, and other groups must have insurance. To financially assist those unable to pay for the coverage, the government has a program to relieve some of the cost.

Insurance companies are pleased to have these additional groups, particularly young people who don’t require much service, because it represents a new source of business. They are offering a package of programs featuring a variety of benefits at varying costs. Also, the federal government, through individual states is offering an insurance option.

This is the basic program which keeps intact the private insurance companies participation, companies providing insurance to their employees and flexibility in programs. However, in adopting a new program and keeping intact a large amount of existing health care insurance, changes must be made and some will be pleased but many will be unhappy, disappointed and just “mad.” Also, health care providers, doctors, hospitals, etc. are finding it difficult to adjust to the new system.

To people in other countries offering medical insurance, where a “one-payer” government operated and paid through taxation, the United States program must seem unusual. However, people in the United States have always opted for a free enterprise system and less government control. The Obamacare program is an example of this.

In introducing the major changes of the new program in the last several months, it could be difficult for many to understand the changes, and then the government computer program was “botched”, not functional on the initial date, and very complicated to understand. New computer programs often contain “bugs” which have to be worked out and corrections made.

In the United States most government policies are criticized by the opposing political party and in this case exceedingly so. The Republicans have attacked the whole program as poorly conceived, unworkable, and too bureaucratic to work.

 Since retired people having Medicare and those working for companies providing medical insurance as a benefit are not affected and if the “bugs” get worked out, I hope the clamor will die down and the program will be a success in six or eight months. We shall see!

My Choices in Books I Read

Everyone makes choices in many things and books may be one of those. Choices in life are made throughout our lifetimes: where we live and work, our wife or husband, what church we attend and schools where we receive our education and training. These are major choices. What books we read are minor choices, but this and other so called minor choices are greatly influenced by other decisions, desires and experiences in our daily lives.

In our younger years we often don’t have a wide choice in our reading because school demands school texts be read. Later our career will demand study and knowledge in our chosen fields. A doctor must remain current in his field, largely through seminars, discussions and reading, a teacher through special classes and reading, a businessman through daily newspapers, discussions and reading, etc. Most fields require some or much reading. However, it is a wise person who augments this required reading with seeking to enhance his/her interests and knowledge by reading in other areas. Thus, many of our leisure or free time reading is dictated by our non professional interests.

This leisure reading can take many directions: travel, sports, mystery, adventure, biographical, religious, personal testimonies, leisure activities, cooking, crafts, improvement, etc. Talk to ten people and you will receive a variety of answers. Unfortunately, the answers may also state “I don’t read books, all my information comes from TV or the computer.” This is unfortunate and a subject for another discussion.

Now, back to me and why I read certain types of books. I enjoy reading biographies, history, adventures of a person, people, and migrations of groups of people. These are the areas of significant in depth reading. I learn and evaluate interesting facts about the subjects. I also enjoy what I call “junk reading” and that term is a misnomer because mysteries, action stories are often written by outstanding, talented writers, but I read them quickly grasping only the story and suspense and not for the wisdom or beauty of the language. This is unfair to the writer, but that is me! Also, to some degree my taste in books is produced by eliminating areas I have chosen to reject by trial and error.

One of the reasons I enjoy biographies, history, etc. is that these are stories of real people experiencing real life tests, obstacles, and conquering difficulties, no make believe. Who cannot enjoy stories of pioneers migrating to the West, or difficulties of whaling during the sailing ship days or experiences of the Marines at Iwo Jima in World War II. Two books I recently enjoyed covered the ten year period of the building of the Golden Gate Bridge in San Francisco, California and the building of Rockefeller Center in New York City during the early 1930’s. Both construction projects faced problems inherent in many projects plus building during the great depression in an urban setting. In building the Rockefeller Center they faced the complexities of acquiring land, permits to build, design and being sure a 67 story building and lesser structures were safe, attractive and rentable. In building the longest suspension bridge in the World, at that time, the Golden Gate bridge, presented problems, such as, severe winds, secure piers for the cables and financing. The Rockefeller book I bought at a used book sale, not really intensely interested me at first but after reading a few pages I was thoroughly hooked.

I find biographies of former United States Presidents fascinating. I have read books about John Adams, Harry Truman and Franklin Roosevelt written by outstanding historians and biographers. Although the times, backgrounds of the individuals, and problems were different, it is revealing how they met the political and social problems of their day: John Adams, a New England revolutionary patriot, Roosevelt a wealthy patrician from New York and Truman a down to earth Midwesterner from Missouri. Yet all are recognized as outstanding men and Presidents. Of course, I could list the many books about Abraham Lincoln encasing every phase of his turbulent, heroic life. 150 years following his death twenty or thirty books about Lincoln are written and published each year. I have read a number and have a bookshelf of his books.

I also read and find interesting books about periods in history, such as, the Roman and English Empires. What forces were at play? Why these empires were leaders and not others at the same period. This is not easy reading and one must” think” as the words on the pages are being comprehended, but I enjoy it! Will Durant wrote a ten volume “History of the World” from the beginning of civilization to the rise of Hitler and Communism. I don’t pretend to sit down and read it all, but I find it enjoyable and gratifying to keep a volume on my coffee table and read ten or twenty pages in the evening. Some famous books, such as Gibbons, “The Rise and Fall of the Roman Empire” can be read and then maintained as reference books for questions about this period.

 My admonition to the reader is to pick some subject you enjoy and pursue books, articles, movies on your chosen subject and enhance your knowledge and enjoyment. I have written about my favorite, now it is your turn to select yours. Good hunting!