Recently in Politics Category

Positive effects, deep flaws - Health Care Rx Panelists

Positive effects, deep flaws

| No Comments

The passage of the health insurance legislation has two overriding positive effects: it brings more clarity to the health insurance issue and it demonstrates the President's ability to govern.

The legislation also affirms that Americans should not face financial ruin from being unable to afford health insurance. It also makes good progress on prevention, on increasing the supply of health care professionals, on eliminating the flawed "doughnut hole" in the Medicare prescription drug system, and on beginning to address the long term care crisis. These are the good elements of this legislation.

As health insurance system restructuring, the legislation has deep flaws that must be addressed in subsequent legislation. We cannot guarantee coverage, prevent people from being subject to pre-existing condition exclusions, and prohibit insurers from canceling policies for those who become ill during the policy period without significantly increasing costs for all policyholders unless we cause healthy uninsured people to buy insurance, reduce what we pay health care providers, or levy more taxes on people to pay for increased subsidies.

The penalties for healthy people refusing to buy insurance are far too low and do not take effect for several years. Reducing payments to doctors and hospitals either drives them out of the system or causes them to drop Medicaid patients. Raising taxes on everyone to pay for these increased costs worsens our economic situation.

One situation illustrates my point: in the 8th Ward of Washington D.C., there is a severe shortage of specialists, including one urologist for a large population. Most people have health insurance or Medicaid. After this legislation passes, there will be even more people with insurance, but still a severe physician shortage. We have more work to do before our health care system is viable. Health insurance affordability does not produce health care access.

Leave a comment

About this Archive

This page is a archive of recent entries in the Politics category.

Employer health plans is the previous category.

Health costs is the next category.

Find recent content on the main index or look in the archives to find all content.

Chin up and get this done - Health Care Rx Panelists

Chin up and get this done

| 2 Comments

At one of many low moments of World War II, a breathless young aide barged in on Winston Churchill to report bad news. Churchill responded: "I've heard worse." That's the resilience Democrats need this week.

Democrats lost their filibuster-proof Senate majority, but this should not undo their tremendous achievement in passing a landmark bill through both houses of Congress. We need to settle our nerves here. From the perspective of both politics and policy, the smartest course is for the House to pass the Senate bill, and then to use the reconciliation process to fix the bill's major shortcomings.

So chin up everyone, and let's get this done. By the way, I'm not the only one saying this. As you can see by clicking here, this is the consensus of most key figures in the health policy community.

2 Comments

Wrong. I especially liked your list of important, influential people that want to endorse this hoax of a bill. LMFAO.

Here's a newsflash: every single individual citizen - including those too young to vote - are the most important and influential.

NEW: Health Care Mandates are Constitutional? Not Even Close


“The claim that the Founding Fathers would have thought the Constitution allows Congress to impose health care mandates is little short of absurd."
--Rob Natelson, Professor of Constitutional Law, Legal History, and Advanced Constitutional Law


http://www.tenthamendmentcenter.com/2010/01/25/health-care-mandates-are-constitutional-not-even-close/


Our elected representatives could fix 90 percent of the problems with health insurance by ending the federal law allowing states to ban health insurance sales across state lines.

If we had a free market in health insurance, it would be inexpensive and easy to buy insurance for "pre-existing" conditions before they exist. The vast majority of "pre-existing" conditions that currently exist in a cramped, limited, heavily regulated insurance market would be "covered" conditions under a free market in health insurance.


Leave a comment

About this Archive

This page is a archive of recent entries in the Politics category.

Insurance is the previous category.

Malpractice is the next category.

Find recent content on the main index or look in the archives to find all content.

Reflecting on 2009 - Health Care Rx Panelists

Reflecting on 2009

| No Comments

Looking back over the past year of health-care legislation, I would make the following observations:
• The Obama Administration made remarkable progress on health information technology, prevention and wellness and health-care quality in the February 2009, stimulus legislation.
• Although the House and Senate health-care reform bills were not bipartisan and some of the compromises were not particularly good ones, I am pleased that the Senate discarded the public option, the logic for which was never compelling.
• Relative to what the bills attempted to accomplish, the goal of enabling universal health insurance would be achieved. However, there are some structural flaws in the design of the insurance systems that, if not corrected, will put our country at serious financial risk.
• Structural health-care payment and delivery reform could avoid a financial crisis, but it is not clear that any level of government has the political will to tackle these issues, and they were addressed in these bills. Raising taxes to fund health insurance will cripple the economy, and cutting Medicare payments in our existing flawed system will simply drive doctors and other providers out of the system, which will create shortages. At this stage, it is unclear how we will create universal insurance that is affordable and financially sustainable.
• I commend Senators Harkin and Dodd and their colleagues for some excellent work on prevention and wellness. I also believe that the foundation has been laid for supporting more community health centers, a vital tool for health care delivery. Nevertheless, the good pieces of the legislation are relatively under-developed nuggets, not full-blown health care transformation solutions.

Politically, this legislation went as far as Congress could probably go, but much remains to be done.

Leave a comment

About this Archive

This page is a archive of recent entries in the Politics category.

Economic crisis is the previous category.

Employer health plans is the next category.

Find recent content on the main index or look in the archives to find all content.

Congress is not doing enough to cut costs - Health Care Rx Panelists

Congress is not doing enough to cut costs

| No Comments

Congress has not come close to addressing the drivers of health care spending. We have to understand, as pointed out in Dr. Deborah Cohen and Dr. Tom Farley's book, "Prescription for a Healthy Nation" and former Surgeon General Dr. David Satcher's comment that over 80 percent of what drives health happens outside the health care system. How we design communities, price food, educate people, and create peer groups supportive of healthy behaviors will drive down health care spending far more than tinkering with health insurance coverage or negotiating lower rates with insurance plans.

When Congress intervenes in the health care system, the best thing it could do would be to support more integrated health care, with a focus on building community-based health care teams led by a trusted clinician in a medical home. The current legislative proposals are far too timid in moving in this direction. The President got it right when he mentioned great examples like Kaiser-Permanente, Intermountain Health and Geisinger in his health care speech to Congress in September. These integrated systems are most likely to reduce cost increases over time.

Unfortunately, the multiple bills passed through various House and Senate Committees do not go far enough to create a broad-based payment system that rewards integrated, low-cost, high-quality care. The fundamental flaw in all of these proposals is that they are based on the assumption that if everyone has health insurance, they will get more and better health care. However, health insurance access is not the same as health care access, and getting easier access to health care does not significantly improve population health. Until we make people so much healthier that they do not need to use the health care system as much, we will not reduce cost increases.

Leave a comment

About this Archive

This page is a archive of recent entries in the Politics category.

Employer health plans is the previous category.

Health costs is the next category.

Find recent content on the main index or look in the archives to find all content.

A Public Plan Is a Bad Idea - Health Care Rx Panelists

A Public Plan Is a Bad Idea

| 6 Comments

The only reason to have a public health plan is to ensure that those not able to covered by private health insurance plans have some kind of coverage. If health reform legislation required private insurance plans to accept every applicant without excluding pre-existing medical conditions and if every individual were required to purchase health insurance, virtually all currently uninsured Americans would have coverage.

I cannot imagine that any public health plan operated under the same rules as a private insurance plan could be competitive. The public plan would be subject to all sorts of political interventions and would be required to delay making changes in health plan until it had solicited extensive public comments. A public plan would not be allowed to operate as flexibly with respect to labor work rules or to invest in much technology innovation as a private insurance carrier. Therefore, it would naturally be less competitive if left alone.

So what would happen? Taxpayers would be forced to subsidize the public plan, which would be subject to less onerous law and regulations, and it would operate with different accounting and tax rules to enable it to offer competitively attractive insurance coverage. Based on my experience with non-U.S. postal services allowed to compete outside their national postal monopoly spaces, national governments gave extensive and illegal state aid to post offices, subjected them to more favorable accounting rules, and imposed labor rules on private sector competitors to "level the playing field."

In a great book entitled "Competing with the Government: Anticompetitive Behavior and Public Enterprises" edited by R. Richard Geddes, a whole series of articles describe a range of anti-competitive public enterprises in a wide variety of markets. We do not need to create the material for another chapter in a future edition of this book.

6 Comments

There are far to many powerful opponents to allow a public option to get a fair hearing. To-date the opponents of a government option have spent $53 billion with false information trying to sink even a fair debate. This amount of money is only spent when the threat is real and they know there monopoly is under serious competition

When a government as hold of the purse strings, insurance company’s have no choice but to get real and stop taking there clients/customers to the cleaners with unfair costs and exclusions.

There is more than enough evidence to prove beyond doubt, people get better health care and live longer when there is a Government option. Surely its about giving people a choice, and if the insurance company’s are treating there customers fairly, then they have nothing to worry about. America as 1 in 7 people without insurance, and another 2 in 7 with exclusions, due to pre existing illness.

Where is the fair choice for these people? insurers have no risk they just price people out of health care and exclude them. Call this competition? This why a public/people's plan will work

Why not have a people's plan, and see how it goes, it cant be any worse than the existing system. Why are the opponents frightened of such a system be given a try????. Of course they wont be able to fleece all there customers for much longer.

Health is more about people than profits “Well in every country other than America” Why do Canadians and Europeans live longer, they have access to health-care, that’s not based on the means to pay, but based humanity and fairness, no-matter what your current health or financial position.

There are far to many powerful opponents to allow a public option to get a fair hearing. To-date the opponents of a government option have spent $53 billion with false information trying to sink even a fair debate. This amount of money is only spent when the threat is real and they know there monopoly is under serious competition

When a government as hold of the purse strings, insurance company’s have no choice but to get real and stop taking there clients/customers to the cleaners with unfair costs and exclusions.

There is more than enough evidence to prove beyond doubt, people get better health care and live longer when there is a Government option. Surely its about giving people a choice, and if the insurance company’s are treating there customers fairly, then they have nothing to worry about. America as 1 in 7 people without insurance, and another 2 in 7 with exclusions, due to pre existing illness.

Where is the fair choice for these people? insurers have no risk they just price people out of health care and exclude them. Call this competition? This why a public/people's plan will work

Why not have a people's plan, and see how it goes, it cant be any worse than the existing system. Why are the opponents frightened of such a system be given a try????. Of course they wont be able to fleece all there customers for much longer.

Health is more about people than profits “Well in every country other than America” Why do Canadians and Europeans live longer, they have access to health-care, that’s not based on the means to pay, but based humanity and fairness, no-matter what your current health or financial position.

There are far to many powerful opponents to allow a public option to get a fair hearing. To-date the opponents of a government option have spent $53 billion with false information trying to sink even a fair debate. This amount of money is only spent when the threat is real and they know there monopoly is under serious competition

When a government as hold of the purse strings, insurance company’s have no choice but to get real and stop taking there clients/customers to the cleaners with unfair costs and exclusions.

There is more than enough evidence to prove beyond doubt, people get better health care and live longer when there is a Government option. Surely its about giving people a choice, and if the insurance company’s are treating there customers fairly, then they have nothing to worry about. America as 1 in 7 people without insurance, and another 2 in 7 with exclusions, due to pre existing illness.

Where is the fair choice for these people? insurers have no risk they just price people out of health care and exclude them. Call this competition? This why a public/people's plan will work

Why not have a people's plan, and see how it goes, it cant be any worse than the existing system. Why are the opponents frightened of such a system be given a try????. Of course they wont be able to fleece all there customers for much longer.

Health is more about people than profits “Well in every country other than America” Why do Canadians and Europeans live longer, they have access to health-care, that’s not based on the means to pay, but based humanity and fairness, no-matter what your current health or financial position.

Kathy-Ellen - "Although I am convinced a public option will work if you look at over 50 years of success in other countries."

Name me another country that has a public OPTION. They all require basic coverage, written and priced by the government for everyone. Like Medicae for All.

To date there doesn't seem to have been enough incentive for private insurance companies to create plans more palatable to the American people. The threat of losing their monopoly may just get them to step back into the ball park. Although I am convinced a public option will work if you look at over 50 years of success in other countries.

I agree that a public option would not work and for some of the same reasons you offer. But the solution is just the opposite of what you propose.

The goal of a well run corporation is to make money for shareholders. In the case of health insurance companies this is in conflict with providing good efficient health care to the country.

The for profit insurers have learned that the way to get a high stock price is to have a low Medical Loss Ratio which is the percentage of inflow (premiums) paid out in medical benefit to patients. Notice that they consider medical benefits as "losses."

They do this in two ways. They make the numerator smaller by making it difficult for doctors and patients to collect. They make the denominator larger by obscene executive compensation, high profits, billions spent processing complicated forms they require of physicians and patients, and still more billions spent on fighting with doctors and patients over coverage and payments.

What we need is HR676, Medicare for all. I am a mathematician. If you look at the figures, you will see that because of the waste of for profit insurers and the maketing costs of the drug companies, we can easily give an improved Medicare to everyone at no more than we are now paying.

Leave a comment

About this Archive

This page is a archive of recent entries in the Politics category.

Employer health plans is the previous category.

Health costs is the next category.

Find recent content on the main index or look in the archives to find all content.

About this Archive

This page is a archive of recent entries in the Politics category.

Pharmaceutical Companies is the previous category.

Prescriptions is the next category.

Find recent content on the main index or look in the archives to find all content.