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Conservative solutions for healthcare reform

I know this sounds like an oxymoron, but stay with me. Joe writes, “…common sense health insurance reform will cost the government little to nothing.” I always liked these common sense solutions. They make me smile. The reason I smile it is that if they were so simple and easy we would’ve tried them already. Congress has been desperately looking for something simple and easy to try for the last 25 years. During this time both Republicans and Democrats have controlled the House and the Senate and could’ve passed “common sense” solutions. Especially, especially if those common sense solutions didn’t require insurance companies or pharmaceutical companies to lose money. Congress would have been all over it.

1. Allow people to band together to buy group health insurance without being an employee-based group.

This sounds nice. You have to find a way to get millions of people to band together, not just a few. As far as I know, Americans have not banded together to buy gas or to buy groceries. Small bands of Americans (a couple thousand) would be almost the same as a small business and its employees. The reason any given small business has stopped covering employees, as a rule, is cost. There’s no way a small band of Americans is going to be able to figure out how to decrease the cost. Now, the exception would be small bands of young healthy Americans. They could easily band together and cover themselves for little or nothing. Basically, this is Kent Conrad’s idea, which has been thoroughly vetted. This is about co-ops. Co-ops will not be competitive because they don’t have the numbers to negotiate drug prices and fees for service.

2. End exemptions for a self-insured plans.

If we are going to end exemptions, why isn’t that the case in the healthcare exemption? The benefit of health insurance is not taxed. Our treasury loses $110 billion every year because of this. This seems to be a much fairer solution, don’t you think?

3. Standardized insurance forms and information systems.

This will cost millions. It will cost insurance companies and doctors’ offices and hospitals millions of dollars to change from what they have to something else. Who’s gonna decide what the standard is? Clearly, we’re not gonna trust the government to do that, so we are going to wait for business to come up with a committee to do this? Expect a decision in three to four years… and a voluntary implementation of this will never happen. There’s no incentive for business to do this. Unless you want to pass regulations — no way. Conservatives hate regulations.

4. End cost shifting.

Cost shifting doesn’t end. Just because you tell them to stop it, doesn’t mean it will end. Hospitals and doctors have incentives to continue cost shifting. They get paid. Personally, as a physician, I’ve been down this road, where we “aggressively” go after those without money and those who don’t pay. The bills simply never get paid off. They end up spending a lot of money trying to track down people who have moved out of state. They end up spending a lot of money on people who are paying $25 and $50 a month on bills that are $50,000 and $100,000 or more. Neither hospitals nor physicians will willingly take this hit.

Remember, we are obligated to provide medical care for those people who are dying. This isn’t like a car dealership. No matter how badly you want a car, if you don’t have cash or financing you don’t get that car. If you come in to the emergency room because of a heart attack or a bleeding ulcer, we take care of you. This is the way it should be. It also should be that we get paid for the services that we render. How we get paid by those who don’t have money to pay is a question that society needs to answer.

So far, none of the suggestions that have been made by some conservatives that I’ve reviewed here amount to any significant cost savings. None of the suggestions will control costs. With healthcare costing $2.2 trillion in 2007, I’m sorry to say that these solutions are weak at best.

By |2009-12-13T02:21:33-04:00December 13th, 2009|Healthcare|Comments Off on Conservative solutions for healthcare reform

Public Option gets beat up in Senate Finance Committee

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So who was surprised that a committee chaired by Max Baucus would vote down the public option? Who? I’m not. Max hasn’t supported the public option from the start. Then you have Kent (“I love me some co-ops”) Conrad. He has also be anti-public option. Add Blanche Lincoln to the mix and the outcome of the vote was predictable.

McJoan has an update of where we are in the Senate after day’s voting:

One thing that that’s clear from today’s Finance Committee votes on the public option: Kent Conrad is the problem for the Dems. He provided the cover today for Lincoln, who was virtually invisible, to vote against the Schumer “level playing field” public option that would have done away with Conrad’s supposed problem with Rockefeller’s amendment–that it was tied to Medicare rates. If that was truly Conrad’s big problem with the bill, he should have had no problem with Schumer’s bill.

The action is going to take place in conference. At least that is what I see happening. This is where the action has always been. Once Obama supported the public option the only way that the Senate could support the much more liberal (thoughtful, American worker friendly) House version was in conference. The Wonk Room agrees:

Obviously, he’s the anti-public option problem in the Democratic caucus, if you take Baucus at his illogical word that he supports the public option, but had to vote against it because it didn’t have enough votes. But, on the other side, the most conservative of the committees to take up healthcare reform had 10 Dems supporting some form of public option–that’s more than I think anyone thought they’d get. Rockefeller told Ed Schultz today that he was suprised to have gotten eight votes for his.

Bottom line, the Finance Committee is going to pass out a bill without a public option, unless Rockefeller and Cantwell do indeed decide to oppose it and can find a third Dem (assuming Snowe will vote with the majority). But it’s also coming out of SFC with a strong majority of Democrats who will vote for the public option on the floor.

By |2009-09-29T20:45:39-04:00September 29th, 2009|Congress, Healthcare|Comments Off on Public Option gets beat up in Senate Finance Committee

Serious Healthcare Reform: Consumer Health Cooperatives Are Not Serious (Update)

Update: I thought this idea was dead on arrival. But No. It is still around. From TPConrad stated that the purpose of co-ops is two-fold: 1) “providing additional competition,” and 2) “being an entity that is not government-run, government-controlled.” I thought that health reform was suppose to help control costs.  If co-ops aren’t government-run then they are restructured insurance companies.  How are they going to help control costs?  Conrad admits that probably will not help control costs –

Original post: Maybe I’ve missed something, possibly because I’ve been working very hard lately (I’m a trauma surgeon). Could it be possible that the goals of healthcare reform have changed? I thought the purpose of healthcare reform was twofold — first, to improve healthcare and secondly, to decrease healthcare costs. Currently we’re spending $2.2 trillion in healthcare per year. Approximately 1/3 of expenses are eaten up by administrative expenses. So, if you do the math, eliminating health insurance companies should save you approximately $100 billion. This money could begin to cover the 46 million Americans who are currently uninsured.

Sen. Kent Conrad (Democrat — North Dakota) has floated a plan which uses customer health cooperatives or co-ops. These co-ops would operate at the state level or even the regional level. They would be not-for-profit. They would provide coverage for individuals or small businesses (with fewer than 10 employees). State rules and laws would apply to these plans. There would be “strong governance standards,” which should help focus on the customer.

I’m sorry, what the hell is this? How does this improve healthcare one iota? In order to improve healthcare, we need to pay primary care providers differently. They should be paid to keep a group of Americans healthy. The medical literature needs to focus on what is the “best” medical practice. Once that practice is decided, those physicians who adhere to the “best” practices should be financially rewarded. How do these health co-ops get us any closer to this goal?

Americans spend an overwhelming amount of money (over $280 billion) on pharmaceuticals and medical durable products (bedside commodes, pacemakers, examination tables, syringes,titanium orthopedic rods, to name a few). How do we control these costs with the combination of large insurance companies and these small health co-ops? I’m not sure who among you reading this post will be fooled by this proposal. Lawmakers? The American people? Or both?

The answer to fixing our healthcare problem is very simple. We need universal healthcare. We need the government to have the ability to negotiate prices. Would a government run system be a panacea? No, but with the right legislation, it could be the right solution for all Americans.

From TP:

This morning on MSNBC, former Gov. Howard Dean rejected Conrad’s proposal, saying it is “not a real compromise.” “This is a fix for the Senate problem,” he said, “this doesn’t fix the American problem.” After heaping praise on Conrad, Dean explained:

He’s wrong about this. The co-ops are too small to compete with the big, private insurance companies. They will kill the co-ops completely by undercutting them, using their financial clout to do it. In the small states like mine and like Senator Conrad’s, you’re never gonna get to the 500,000 number signed up in the co-op that you need to in order for them to have any marketing [power].

This is a compromise designed to deal with problems in the Senate. But it doesn’t deal with problems in America. And I think it’s time for the Senate to stop playing politics, do what has to be done. … If the Republicans don’t want to get on board, then we can do this without the Republicans.

By |2009-08-19T15:14:04-04:00August 19th, 2009|Domestic Issues, Healthcare|Comments Off on Serious Healthcare Reform: Consumer Health Cooperatives Are Not Serious (Update)
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