As I gear up to review our family's 2008-2009 fiscal budget -- we've oddly stayed on a May-June fiscal since my husband's graduate school days -- we'll have to increase that health care budget category once again. With pretty good health insurance, we still spent several thousand dollars last year thanks to a couple of surgeries, 35 physical therapy visits (post-achilles repair, nasty-long recovery) and pediatrician visits with the two kids. Those 20 percent co-pays add up fast.

Frighteningly, health care is forecasted to eat away even more of our budget in years to come. Politicians must come up with a more affordable solution in the future. Unfortunately, socialized medicine is a dirty word for many on Capitol Hill. Yet seniors benefit from Medicare ... another name for socialized medicine.

Here are the numbers: in 2006, citizens and the U.S. government spent $2.1 trillion on health care, averaging $7,026 a person. Fast forward to 2017 and health care is estimated to cost $13,101 a person -- $4 trillion in health care totaling $1 for every $5 spent. Sobering. At that point, kiss the gym membership goodbye.

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Just when it seemed like things couldn't possibly get any more crazy in this year's election, this past weekend Ralph Nader decided to throw his hat into the ring.

The third-party, independent candidate made his announcement this past Sunday. If he is able to get enough signatures, Nader's name will once again appear on the presidential ballot. What does Nader bring to the table that the other candidate's don't? Well, according to Mr. Nader, there are several things. But, what many people find most intriguing is his proposed "Medicare for All" program.

Whereas all other candidates have not supported single payer health insurance, Nader is a proponent of such a system. On his website, www.votenader.org, he states that he supports a "Canadian style, free choice, Medicare for all health care system."

How do you feel about Mr. Nader's efforts to join the race for the presidency? And, do you think his Medicare for all program is a good idea?

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In a move that is sure to make hospital administrators feel slightly uneasy, medicare is implementing a no-pay policy for hospital errors that could have been prevented. These eight medical mistakes are not going to be reimbursed to facilities which mess up and do things like leave objects inside people after surgery.

Other insurers are starting to catch on as well. This could lead to better patient care because hospitals will want to mitigate any chance of extraneous costs -- especially if they aren't getting paid back for it. Another item on the do-not-pay list is urinary tract infections from catheters.

Twenty-five percent of patients get one of these, yet only ten percent or less of hospitals check every day to see if they're even necessary. So someone could end up with a catheter for days on end without even needing it -- which leads to urinary tract infections. Tacked on costs for these types of mistakes can run up your hospital bill by $10,000 or more! It will be interesting to see if (and how much) this improves medical care to those people in such facilities.

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Sleep studies are undoubtedly uncomfortable. Dozens of wires attached to multiple locations across the head, face, neck, and body; a strange bed in a strange room with new environmental sounds; the knowledge that a technician is watching you sleep -- it's enough to give anyone temporary insomnia.

Those aren't exactly the reasons that Medicare is pushing at-home testing for sleep apnea. Instead, they cite the fact that lab testing is expensive and sometimes inaccessible. Home testing is around $500, compared to $1500 in a sleep clinic, and patients get to sleep in their own beds.

But the idea has its critics. At-home testing for sleep apnea can diagnose severe cases of the condition, but can't give patients the reassurance of a clean bill of health, because it doesn't test for any other sleep disorders. Sleep experts acknowledge that home testing may have its place for certain patients, but are reluctant to recommend it for everyone. Still, if you think you might have sleep apnea and don't have access to a sleep clinic evaluation, it might be worth mentioning to your doc.

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Some doctors nationwide are facing a 10 percent rate cut next year when newer Medicare laws go into effect January 1st. However, U.S. lawmakers this week gave that group another six months before the rate declines would have gone into effect, although exact reasons were unknown.

The proposed Medicare changes would have given doctors a 0.5 percent raise when elderly and disabled patients were treated, but that would now be phased out come June 30, 2008.

That gives lawmakers six more months to find a workable, long-term solution that won't give Medicare recipients the unpleasant experience of higher premiums to pay each month.

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Try this on for size -- in 2006, the Medicare system took a $32 billion dollar hit based on the number of drug prescriptions given to seniors in the U.S. under the Medicare Part D prescription drug benefit program.

That's $32 billion -- more than the annual sales of most Fortune 500 companies. It's amazing to see how many drug prescriptions are in use by older citizens in this country. The amount, to me, is amazing.

What did this nation do 50 years ago when there was no pharmaceutical drug industry to supply this "need?" Hard to say, but the amount now taken from the paychecks of all of us is sure fueling quite a few drug needs these days.

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Is Medicare actually considered quality care by those in the know? Sure, some consider Medicare decent, but a research study just released has concluded that the quality of care is, at best, barely acceptable.

A care study that looked at the health of elders looked at 43 specific types of care received by more than 100,000 people of an average age of 81. All the subjects were from California.

The conclusions found that only 65 percent of recommended tests were given to those at risk of death or functional decline (in other words, in bad shape).

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In 2003, Medicare laws changed the way oncologists are reimbursed for treating cancer patients, and any perception by patients that the quality of care they received for cancer going down were out to rest by a new survey this week.

All in all, the survey found very little to no changes in the way cancer patients perceived the quality o care they received, nor the amount of time cancer patients waited to see their doctors or the time it took to start chemotherapy treatments.

This is a nod in the direction of Medicare changes not really changing treatment options for the better or worse, which was contrary to the overriding feeling years ago that changes in the Medicare system regarding oncology would cause some cancer patients to be denied access to medical resources. According to this survey, that is simply not the case.

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Is the Medicare system broken and/or corrupt? That notion has been bandied about for quite a long time now, although the reasons lean more toward incompetence rather than outright dishonestly.

Dual-elegibles -- those seniors who are disabled and therefore also qualify for Medicaid -- were never told that they were eligible to seek reimbursement for some drug-related expenses. Result: tens of millions of dollars never flowed to those that needed it most.

Federal investigators looking into the problem stated that "given the vulnerability of the dual-eligible population, it seems unlikely that the majority of these beneficiaries would have contacted their (insurance plan) for reimbursement if they were not notified of their right to do so." Yep -- why contact anyone for reimbursement when youhave no idea what you are actually entitled to? Yet another communications misstep from the U.S. government in a series of health-related flubs in recent years.

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This past Thursday, a bill was approved by a U.S. Senate Finance Committee that would give the government the power to negotiate for better Medicare prescription drug prices.

This means that the pharmaceutical drug industry may have to tone down those 1,000% markups on many major drugs and settle for, gasp, lower profits. So be it, I say.

Since President Bush threatened to veto an earlier House bill on the same subject, this new Senate bill would require (not just permit) direct negotiation over prices by the government with drug companies.

What do you think? Should the government get involved in the private drug industry like this?

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