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3/19/2007
Kagen's Das Kapital
Rep. Kagen, again this weekend, proclaimed that “Congress should write a federal standard health insurance policy that each and every insurance company must sell.”
According to Porter and Teisberg (Redefining Health Care, Harvard Bus. School Press, 2006), universal, mandatory health coverage is an important element of health care reform in America.
But it’s critical that first
- our health care system becomes less costly via value-based competition,
- health coverage becomes truly mandatory for life, so risk is shared by all,
- access to primary care (as opposed to more expensive emergency care) is available to all at reasonable costs.
And lastly, it’s critical that mandatory coverage be accompanied by tightened rules for the needy, whereby “public assistance is provided only to the truly needy,” as “ideally everyone would pay something toward his or her health care” (Porter and Teisberg).
That’s way too simplified a review of universal health coverage. But the point is, universal coverage requires first a major shift to involve all consumers in their own health care, a system, again, of value-based competition.
Government Issue Standard Health Insurance Policy, ala Representative Kagen, without incorporating the consumer and competition in health care delivery – will result only in an inefficient, extremely costly government controlled national health care system. He’s got to think this one through.
COMMENTS
Let's remember that our glorious competition driven system has given us the lowest health care results for the highest cost of any industrial nation on the planet. Imagine how good the Canadian system could be if they doubled their expenditures per capita (something we already do). Health care does not have the same economics vis a vis competition that other goods do. Just look at all the empty MRI machines and hospital beds that abound around this area. Competition in health care often drives costs up not down.
Ooh Dave. I disagree. Our current health care system isn't competition in the capitalist sense, as it's not driven by informed consumers. Consumers have to have a clue what all this is costing them - and must have information too, about quality and value. When true consumers (not "third party pay consumers") are leashed upon the system, health care costs should decline and quality increase. One trick however, is to maintain adequate access - and 'adequate' to all of us may have a different definition. JE
dave allen (Mon Mar 19 15:45:10 2007)
So while you wait around waiting for our system to magically meet these requirements you have Billy, who is not great at math anyway, home from school for the 7th day with strep throat and you lose another opportunity to make this country better by getting him back in school. Or if you do you use a $500 emergency room visit instead of a $100 visit to a clinic.
Well, I don't think the system will 'magically' meet these requirements. First, health care consumers must be incented to make good choices. HSA's are a tool that move in that direction, for example. But you're right, access is part of the system that must work. Certainly Billy must be able to get in for a clinic visit immediately. Consumers will drive that requirement, service providers will want to meet it. JE
Vic (Mon Mar 19 16:03:51 2007)
Could it be that Comrade Kagen dosen't want value-based competition? When the government gets involved in areas such as this it is Katie bar the door in things like this. Follow the money.
Richard H. Griesser (Mon Mar 19 18:44:31 2007)
Jo, I have an HSA and I can tell you that as long as there are insurance companies that are allowed to solicit their market there will be no possibility of the clarity that you espouse. I have fought the insurance companies and the doctors on so many fronts. As long as they can exploit differences between people to define their profitable market there is no incentive for them to disclose anything. Even if they do disclose their incentive is to cost shift which (amongst other things) adds to the 30% overhead in our market (compared to 10% for Canada). In fact, our overhead bill per capita is about 60% of the Canadian total health care bill per person. How efficient is that? No, capitalism is not efficient as an absolute rule. If it were, we would privatize roads, police protection, schools, etc. People in most industrialized countries express a much higher satisfaction with their health care system then we do here. And, it costs less and they are healthier. What makes us so special that somehow we have a unique mission to show the world how wrong they are. I think the rest of the world is correct and we are wrong.
I take your points Dave. Disclosure is critical, and you're correct, we are fighting to have it occur. Yes, extensive cost-shifting is occurring, caused by an artificial control on (Medicaid/Medicare) prices. Lots of things to fix. JE
dave allen (Tue Mar 20 17:52:44 2007)
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