<Back
|
Written
by: Kurt Hahn
As an active participant in the recent debate on National Health Care Reform I believe there were a large number of missed opportunities.
First, if competition was an objective, the Feds, CMS in particular, should have restructured its accounting to adjust the claiming or billing code amount to something resembling actual provider costs not something on average more than 250% of actual costs.
Secondly, if Congress was really interested in cost savings they might have followed the suggestions of the New England Journal of Medicine and others who proposed elimination of most prescription drug advertising, allowing re-importation and elimination of new drug patents for minor dosage changes. Savings here alone have been estimated as high as $800 billion over 10 years. This is more than any that have been proposed by Congress. This would have really reduced premiums for health insurance.
Another cost saving, widely acknowledged by healthcare experts, was the realm of tort reform. The Pelosi-House bill would have gone in the opposite direction eliminating California’s current limit on compulsory damages. And the Senate only suggested pilot programs. Outrageous Medical Malpractice insurance costs make it extremely difficult to attract doctors to California's rural hospitals and clinics and drive up insurance premiums for all. Tort reform was estimated to save $300 billion over 10 years.
Congress could have facilitated a State Regulatory Consortium for Health Insurance, like those already existing for other insurances like fire insurance. That might have facilitated interstate competition and broad affordable group plans for small businesses that, in turn, could cover over half of the uninsured.
Congress could have tackled current Medicaid funding inequities for high cost of living states such as California, which places an unachievable demand on our State's budget, especially, if accompanied by a large expansion in Medicaid enrollment. Existing SCHIP and State plans for high risk individuals might be expanded first.
Also, one size fits all payments to doctors and others based on whether they were placed in a Federally designated urban or rural county decades ago lack any rationality and might be better adjusted to our cost of living and the actual cost of doing business.
Finally, Congress could have seriously addressed fixing over time Medicare funding by gradually adjusting retirement or enrollment ages as well as upper taxable income limits so the baby boomer generation has confidence Medicare will be there when they enroll...
We need to recognize any broad coverage expansion, be it for preexisting conditions or geographic discrimination based on age practiced in California must be accompanied by including, by incentive not penalty, large numbers of the uninsured or it simply is not feasible.
About the author:
Kurt Hahn is a longtime board member of the North Sonoma County Healthcare District and recently completed a term on the Board of Directors of the California Hospital Association. He was the recipient of CHA's 2009 Board Outstanding Leadership award and previously the City of Hope's Outstanding Community Leadership award.
Long involved in health care reform, he helped draft the 1973 Reagan-Moretti Welfare and Medical Reform initiative and testified before Congress on the Clinton proposal. He authored several guest editorials for newspapers and spoke at numerous venues on Obamacare. He has appeared twice as a CSRHA conference speaker.
Comments or feedback? Email us at advocate@csrha.org.
|
