Health care reform doesn't come cheap. To cover the uninsured and get the underinsured truly covered will cost between 1.3 and 1.6 trillion (with a T) dollars over the next decade.
And it doesn't come easy. Senator Chris Dodd, who is leading the Health Committee in Senator Kennedy's absence, likened reform to a Rubik's cube. All the parts need to come into line to make reform work. Avalere health policy analyst Jon Glaudemans says a good example is the requirement for insurance companies to enroll anyone regardless of pre-existing condition. That can't be done without another requirement that people buy insurance. Without that additional requirement, people might only buy insurance once they were sick, which could create a problem for the whole system.
The "agreements" that have been reached on health care reform so far strike me as relatively cheap and relatively easy. Most stakeholders agree the health care system needs to be fixed. Hospitals support reform. Though they typically fight to keep reimbursement rates from being slashed, they have agreed to $155 billion in cuts because under the reform plan they will no longer be required to treat uninsured patients once there is universal coverage. The pharmaceutical industry also has the potential to benefit from more customers covered by insurance.
But these agreements are different than the last time we had a major health care reform debate and the now-infamous "Harry & Louise" fretted on TV about a government-run health plan. Those types of ads could still pop up, but this health care reform debate is largely being hashed out less publicly. The Washington Post reports the health care industry is spending $1.4 million a day on its lobbying effort.
Comments
What is the main problem with health care? It is too expensive. Why is it so expensive? We are spending other peoples money. Who is spending other peoples money? Patients and doctors. The most expensive piece of medical equipment ever invented is the doctor's pen. Doctors are on fee for service reimbursment. Incentivize doctors to treat patients and doctors will treat patients. Solution: give every person in the US a $2,500 health care voucher to be used as their deductible on their form of health care insurance whether it be medicare, medicaid or commercial insurance. This can only be used for health care. If it is not used after one calendar year it is theirs to keep. A deterance to the waste of health care resources, a reward and incentive for patients to take care of themselves and not abuse free health care. Move doctors from a fee for service reimbursement to a base salary and reduced fee for service or to capitation. This is the fundamental problem driving the explosion in health care expenditures.
This country should be in an uproar, not because the government wants to offer a mechanism to insure the uninsured, but because many people in this great nation are uninsured. I work with uninsured people all the time and this is the typical scenario I encounter most of the time. The gentlemen has a job, a wife and children and all are uninsured except the husband. Why? It is usually cheaper to just have the employer medical insurance for the employee, to add the wife and kids would take a huge bite out of their paycheck. I come in and enroll the children into the Healthy Families Program (SCHIP - in CA), but the wife still remains uninsured. At that point I refer her to our mobile van or clinics with sliding scale fees for routine tests, ie, pap smears, breast exam, etc. This person still remains uninsured. Why do we have medical insurance? The same reason we have auto insurance. We don't expect to get in an accident, but if it occurs, we're covered from that financial burden. Most people don't realize that 8 out of 10 uninsured people are working. Imagine working, but not earning enough to get coverage for yourself and your family. Low income people get on Medi-Cal, which most of the time is at 100% of the Federal Poverty Level. People who surpass this cannot qualify. A family of 4 will have to earn no more than $1,838 gross, a month, to qualify for Medi-Cal. The benefit of Medi-Cal is that it covers both the child and parents. If the parents make more money, only the children will qualify for Healthy Families, not the parents.
Reform is needed, but most importantly the 50 million uninsured, and those who think is unfair need to be more vocal to our local politicians.
I think this is the first time I've seen the words "cheaply","high quality", "cost efficient" and "government" in the same sentence. There were scandals at Walter Reed a few years ago and within the last month there's a new scandal involving botched prostate cancer treatments at Philadelphia's VA Hospital. While there are some highly-regarded doctors who provide some level of service to VA hospitals, the overall quality of service is probably average at best. I think the VA model is a viable provider for a level of service for those who opt out of private carrier coverage, but the VA model as a stand-alone is not the answer.
There is only one way to lower health care costs enough to prevent bankrupting the United States Treasury, government owned and operated hospitals and clinics paid for by a national sales tax.
Nobody can collect the money to pay for health care as cheaply as the government can through a national sales tax, and nobody can deliver high quality care and medications as cost effectively as the VA has for years.
A civilian model of the VA is the best fix in a new dual public/private system.
If private systems work for you keep doing what you’re doing except no government funding should be spent through private systems in order to drastically lower government mandated program costs.
A new public health service could provide:
Free care and medications to everyone choosing to use public care, rich, poor, old, young, Medicare, Medicaid, no limitations, and everybody that asks for it could have it no insurance or co pays would be required the service would be free period.
Businesses that would choose the public health care service for their employees would no longer be required to pay for or be involved in health care in any way.
Think what this alone would do for the US economy.
Government cost for this new public health care system even after bringing in 50 million people currently outside of any system would still be hundreds of billions of dollars cheaper than the $2.5trillion spent last year for health care.
Why can’t we have this?