One on One with University of Miami Health Care Expert Steven Ullman
Thursday, September 10, 2009
|
|
|
|
SUSIE GHARIB: President Obama was talking up the need for health care reform today, a day after his blunt address to Congress. Speaking to an audience of nurses the president said the number of uninsured Americans rose by six million in the past year because of the recession, bringing the total to 46.3 million. So did the president's speech to the nation make a difference in the health care debate? I talked with University of Miami health care expert Steven Ullman a short while ago and asked him if President Obama made a convincing case last night.
STEVEN ULLMAN, PROF., UNIV. OF MIAMI/SCHOOL OF BUSINESS ADMIN.: I think he elucidated to a much greater extent what he wanted to get across in terms of health care reform, something that has not really come forth to date. A lot of it had been left up to Congress. This was his first time that he actually laid out a lot of the plan.
GHARIB: Steve, when you examined the president's proposal, what do you think that the president is promising that is right and what is the president promising that is wrong in your view?
ULLMAN: In terms of what is right, 47 million people currently uninsured is what he is trying to get at. And to try to get them access to health care is one of the right aspects of it. Also his crackdown on Medicare fraud and abuse and also issues associated with efficiency, bringing about greater efficiency are the strong points in terms of the plan. In terms of concerns or weaknesses that I perceive in the plan, one of them is the issue associated with a primary care network. If you are bringing all these new people into the plan, are there going to be providers, physicians, nurse practitioners who are providing primary care to serve this increased population or will they end up instead right back in the emergency room, our highest form of health care. That's of concern.
GHARIB: The president said last night that the plan would not add to Federal deficits and the cost would come from savings. When you do the math, do the numbers add up? Do the costs get balanced out by savings?
ULLMAN: There is a question mark there. The concept is that if you are going to increase a provision of care to people who are currently uninsured, costs will indeed go up. What the Obama administration is currently indicating is by dealing with fraud and abuse and trying to bring about greater efficiencies, a lot of that will be offset by those new innovations. What the net effect will be I think is one of the question marks. If you listen carefully to the speech, there is an out that President Obama has and that is the indication that if indeed, all the cost savings are not realized, that there could be adjustments in terms of how health care by the government is provided in terms of some of their other programs.
GHARIB: Steve, as you know, there is still a lot of debate about the so-called public option, a government insurance plan as an alternative to private insurance companies. Do you think that the government can do a better job?
ULLMAN: I think the government can provide a competitive edge in terms of programming, in terms of health care insurance provision. But I don't think it's mission critical. I think that there are other means also that are available to bring about a more competitive marketplace so that is just one option.
GHARIB: And what about small businesses? A lot of them right now are struggling with the high cost of providing health benefits to their employees. Is there anything in this plan or should be in this plan to help out small businesses?
ULLMAN: The concept is that they are going to have basically a consortium of small businesses that will reduce the risk pool and allow access to private insurance through this risk pool. And if that should help alleviate some of the problems in terms of some of your smaller companies not being able to a afford right now, health care insurance, not only the small employers but also the self-employed as well.
GHARIB: Some of the feedback coming out from Washington today reveals that the Democrats and Republicans are still digging in their heels on this whole debate about health care reform. Do you think a compromise is possible?
ULLMAN: I think a compromise will come about. I think that you will see that there will be give-and-take on this, that certain aspects of the plan will probably fall by the wayside in terms of excess ability, in terms of perhaps the government provision of care, in terms of perhaps the mandatory aspects of the plan, in terms of mandatory participation by employers and also by private citizens. Some of those are going to be some of the areas that are going to be probably hotly debated over the next few months but I do think that something will be coming out of Congress at this point in time.
GHARIB: If something doesn't come out of Congress, what is the threat to the economy?
ULLMAN: Significant, significant threat. You are looking at from estimates I've seen, upwards of 68 million uninsured by the year 2015. You are looking at per capita expenditures for health care going up to about $12,000 for every man, woman and child and in certain metropolitan areas as high as $25,000 for every man, woman and child. That is an untenable situation. It reduces our competitiveness internationally.
GHARIB: We'll see what happens. Steve, thank you so much for coming on the program tonight.
ULLMAN: I appreciate it. Thank you.
