Consensus on Health Care Begins to Emerge
A national fix for health care costs? It may not be that far off.
By Martha Lynn Craver, Associate Editor, The Kiplinger Letter
July 11, 2007
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Expect a concerted effort to bring health care costs under control soon after the 2008 elections, no matter who succeeds President Bush in the White House. Momentum is growing, with such varied stakeholders as employers, unions, consumers, providers and insurers agreeing that health costs are still rising too quickly, even if they disagree on precisely how to bring them under control.
Businesses are pressing especially hard to ease what they view as a big burden. Firms are tired of premiums pushed ever higher to cover the cost of care for the uninsured -- now over 45 million and growing. Big U.S. companies pay more than do rivals in Europe and Asia, making it harder to compete in global markets.
Consumers are also clamoring for a fix. Even those who currently have health coverage worry about being able to find it or afford it in the future. That insecurity is a big change from 1994, when the Clinton administration's effort ran into a storm of opposition.
Plus states are adopting their own plans, adding to the pressure on employers, who prefer a national approach to a hodgepodge of state rules.
What will a national plan look like? Details will depend on results in states already implementing programs. Massachusetts has begun one, and California is getting close. The makeup of Congress and the winner of the presidency will also have an influence.
Among the likely key components:
- Cost containment, with a focus on prevention, disease management, electronic records, promotion of healthy lifestyles and, later, reimbursement rates based on the effectiveness of treatments.
- Universal coverage, probably phased in, starting with children. The poorest will get free care. The working poor will receive subsidies. The Massachusetts plan aids families with incomes up to triple the poverty level.
- A shared burden. Companies will have to offer and help pay for health coverage, or else pay fees to help subsidize coverage for the needy.
- Exemptions for small firms with few workers. Individuals who can afford to buy coverage will likely either be required to do so or have to pay a fee.
- Employer-based coverage. Any new health plan will be built on the system that exists now.
Neither of the extremes -- establishing a new, government-run plan or forcing consumers to buy individually on the open market -- has much chance of receiving serious attention in Congress.
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Reader Comments (6)
Posted by: Chad Paul at 07/11/2007 12:26:15 PM
The "free market" or effective competition is the key to fixing America's burgeoning healthcare crisis. Unless Americans actually pay for the services they receive, there will be less incentive to curb costs. We always spend our own money much more carefully than we spend someone else’s. Universal coverage is not an acceptable answer. Read Healthy, Wealthy, & Wise by John F. Cogan, R. Glenn Hubbard, and Daniel P. Kessler for a very insightful solution. Additionally, The Cure: How Capitalism Can Save American Health Care By Dr. David Gratzer, Senior Fellow, Manhattan Institute with a forward by Milton Friedman, a Nobel Laureate economist, also provides a very convincing argument.
Posted by: GERARD MILLER at 07/12/2007 09:12:17 AM
IT IS EXTREMELY HARD FOR ANY DOMESTIC BUSINESS TO COMPETE IN THE WORLD MARKET WHEN OTHERS BENEFIT FROM A UNIVERSAL GOVERNMENT HEALTH CARE PLAN. LET'S EXAMINE AND ADOPT THE THE BEST IN WORLDWIDE PLANS AND DISCARD THE ONES THAT DON'T WORK WELL AND ARE NOT COST EFFECTIVE. WE OWE THIS TO OUR CHILDREN.
Posted by: Karen at 07/12/2007 01:10:15 PM
I would like to see "cafeteria style" medical plans, where people can choose which coverages they want instead of having to take everything vs catastrophic-only which is normally offered by employers. Some younger folks may want pregnacy coverage; some older folks may not and instead want prescription drug coverage. It should allow people to decide on coverage based on their specific situation. Of course, that would mean the insurance plans would have to calculate premium amounts on each piece of coverage.
Posted by: Ralph Herndon at 07/15/2007 11:00:54 PM
I have a quick little story that will be of interest to you: I was recently in an auto accident. A lady rear ended us while we were waiting for the car ahead of us to turn into a driveway. I laid on a transport stretcher in the hallway of a local hospital emergency room for several hours. For that privilege, my health care provider received a bill for over $3500 dollars. Let’s not even begin to talk about doctor fees, x-ray fees, etc, etc, etc. Am I missing something here? We need to go after the root of the problem, which is in fact, obviously, the medical industry itself. It is no wonder the insurance companies keep raising rates. After all, they are not going to absorb these ridiculous fees.
Posted by: KDavis at 07/16/2007 12:11:23 PM
To me this is simple...go back to making hospitals not for profit, do not allow hospitals to write off the PPO discount as a loss, do not allow direct to consumer advertising of prescription drugs. These things alone would save over $100 billion a year before anything is done to change how health care is delivered, paid for, or acquired. State plans are more costly and restrictive. The Tenn. state plan is half of their entire budget and the benefits minimal at best.
Posted by: Susan at 08/30/2007 07:03:05 AM
Profiteering appears to be away of life in the health care industry. Increasingly physicians are refusing to take Medicare because of what it pays and the difficulty in getting paid. Medicare part D added more bureacracy and administrative costs. This was done to appease pharmacetucal companies. The people we have been sending to Washington are not representing the welfare of the people, but of themselves and the deep pockets that keep them in power. How does the ordinary citizen fight this? How do we stop a government by the people that is no longer representing the people? Maybe it is time for even a greater reform on a more basic level. Something that addresses the lack of loyalty to the American people as jobs, and taxpayer dollars are sent everywhere outside of the nation. We are wasting billions due to the incompetence of our current leadership and the promotion of fear and scandal instead of working on real problems.