Tuesday, August 28, 2007

Government vs. Market Reform -Three Health Reform Solutions – Your Opinion Please!

This week I came upon three health care reform solutions. I’d like to know what doctor readers think about these proposals.

• One – Medicare for All, Jacob S. Hacker, “Healing Our Sicko Health Care System,” New Eng J Medicine, August 23, 2007

The author, a professor of political science at Yale, comments on Michael Moore’s Sicko! In general, he agrees with Moore that HMOs are bad and a government system is good. He only complaint is that Moore ignores Medicare. Of Medicare, Hacker says, “it has controlled expenses better than the private sector, spends little on administration, and allows patients to seek care from nearly every doctor and hospital..Medicare is the secret weapon in the campaign for affordable health care for all..but it means threatening the private coverage n which so many Americans rely and requiring our cash-strapped government to raise the highly visible taxes.”

• Two – Mary Jacoby and Sarah Lueck, “Romney’s
Federal Prescription: Health Plan Relies on Tax Incentives, not Massachusetts’s Mandates,” WSJ, August 24, 2007


The reporters describe GovernorRomney as a “successful Republican leader in a Democratic stronghold, where success required balancing on a political high wire that didn’t lean too far to the right. The Mass plan requires businesses to provide insurance for workers and all residents to have some form of coverage, even if they have to purchase it for themselves. The plan he’s pushing on the national stump differs – allowing everyone to deduct health premiums, co-pays, and out-of-pocket expenses; getting government out of people’s health-care decisions; reforming state health regulatory agencies so costs are the same from state-to-state; and allowing states the flexibility to design their own Medicaid plans.

Three – A Short Term Solution, Stephen M. Schuster, “While We Wait, A Modest Proposal,” Healthleaders News, August 24, 2007.

The author, a lawyer and health care consultant, points out the U.S. health system has a short-term problem: “Forty-five million people are uninsured and we need to quickly get them access to appropriate healthcare. I propose the following solution to the short-term problem:”

• Issue a healthcare credit card to every person nationwide.

• Set the interest rate on the credit card at a maximum of less than 1 percent annually.

• Set a limit for the credit card at $5,000.
• Limit healthcare providers to charging Medicare rates for all services paid for with the card.

• Give every credit card holder the right/option to participate in the Medicare Part D Prescription Drug program.

• Process claims for payment through the current Medicare system.

• Finance unpaid card balances through a federal government guarantee program similar to student loans or home mortgages and/or issue a tax credit to the credit card companies for claims that need to be written off.

2 comments:

Zagreus Ammon said...
This comment has been removed by the author.
Zagreus Ammon said...

Sorry for deleting the previous comment, I needed to correct a serious typo...

One: I have yet to see a study that convincingly compares private insurance administrative costs to Medicare. There's too much ideological encroachment on the data.

Two: A completely private system only works for the wealthy and the middle-class. My practice deals exclusively with people whose income is too low for them to benefit from tax deductions. Moreover, the US consumer's information level is not equal to that of providers, therefore regulation would be required to preserve a fair market.

Three: Any solution that compels the acceptance of a fee level... well, I'm opting out. Also, the moral hazard of having access to free (1% is pretty close to free) money will generate an increase in costs.

Nobody told me the US water supply was contaminated with hallucinogens...