Tuesday, August 11, 2009

Let’s talk about health care reform

We all know that health care costs are climbing at an alarming rate, consuming a share of our Gross Domestic Product that simply cannot be sustained. Businesses are struggling to afford the cost of employee health insurance, the number of personal bankruptcies attributable to medical expenses is at record levels and mounting, and virtually every branch of government is trying to come to terms with employee benefit costs that are breaking their budgets.

Add to that the rising number of Americans who have no health insurance and instead have to forego treatment or avail themselves of hospital emergency rooms for even the most routine care, and you have a recipe for disaster.

Obama is correct in demanding that our nation reform its health care system. It’s become an enormous black hole, sucking in every available resource. And yet despite this overwhelming spending, the success at treating patients in this country lags far behind other nations that spend a mere fraction of what we do.

A real key to successful health care reform is making certain that everyone is covered. Yes, even those who believe they don’t need health insurance.

I realize that there are many who object to any laws that would force people to have health insurance. Yet virtually every state, including New Hampshire, has laws that require drivers to carry liability insurance. Admittedly, New Hampshire is a rarity, in that it doesn’t mandate that all drivers carry liability insurance. It limits the requirement to certain classes of drivers, including those who’ve been convicted of D.U.I.’s or other significant moving violations. The vast majority of states, however, insist that all drivers be insured and offer proof of insurance whenever stopped by a law enforcement official.

Moreover, every bank and/or lender requires collision insurance on any vehicle being financed. And in case you haven’t noticed, every mortgage lender requires homeowner insurance as well. From worker’s compensation insurance, to product liability insurance and even malpractice insurance, there are all sorts of insurance mandates with which individuals and businesses already comply.

Another key to successfully reforming our health care system is introducing competition. In New Hampshire there are essentially three insurance providers that cover over 90-percent of employer-based benefits. WellPoint (Anthem-Blue Cross) alone has 51 percent of the market, with Cigna and Harvard Pilgrim capturing the rest. The same scenario exists throughout the country, with only a handful of companies dominating the field.

Obama wants to offer a public option that would strengthen the competitive field and subsequently bring down costs. Naturally, the insurance companies are fighting competition. None of them are anxious to end the gravy train they’ve been enjoying.

Now, many fear government involvement in health insurance. Yet nearly all of our seniors are enrolled in Medicare, which is a government sponsored health insurance program that produces exceptional results. And many of our poor and disabled are enrolled in the government supported Medicaid program, though because of funding issues its success has been more marginal.

Add to that the Veteran’s Hospitals, the military’s health care system, and SCHIP, which covers children, and you’ve already got major government involvement in providing health insurance and health care services. It isn’t as if the government hasn’t produced a viable track record in providing health care for its citizens.

Ironically, many people express concern that health care reform will require dealing with government bureaucrats who will come between them and their doctors. Has anyone not dealt with insurance company bureaucrats? Talk about a staff trained to look for loopholes to deny coverage!

Another concern frequently heard is that government will ration health care, leaving the aged and infirm to die. Come on, people. The whole point of Medicare and Medicaid is to prevent that from occurring.

But yes, some constraints will be placed on spending, just as is true with private insurance companies which always cap the benefits they offer. Unnecessary tests that serve only to inflate the bottom line of providers will be eliminated, as will the prescription of some patented medications for which generic brands offer the same benefits at a much lower cost.

Call it rationing if you must, but from my perspective it’s good financial management. We should not be providing Cadillac coverage as part of a public program when a Chevrolet plan will achieve the same objectives, albeit without the same level of luxury. If people want a more luxurious plan, they can pay for it out of pocket.

That’s precisely what occurs now in our private health care plans. WellPoint offers several different levels of coverage, with premiums that reflect the costs of the benefits. And several insurers offer supplemental coverage above and beyond what Medicare covers. Nothing in Obama’s proposals seeks to curtail those options.

What Obama’s plan is attempting to achieve is ensuring that all Americans have access to basic coverage at a cost that doesn’t break the bank. A public option, that affords more competition in the marketplace, is a key to its success.

My advice is to learn the details of the various plans working their way through Congress, and to the president’s vision for the future of the health care industry. Oh, and don’t be motivated by fear, nor unduly influenced by those who have a vested interest in maintaining the status quo.

We know the current system is seriously flawed. Now is the time to change it while we still have a chance.

1 comment:

David Robinson said...

Hi Ron, One thing we just discussed last night is any difference that some folks say have a preference for "single payer" healthcare reform, I personally dont know much about it but we have someone working on this angle so we can all understand it. Looking forward to enduring the debate on this option for america. Dave Robinson
Conway NH.