In baseball parlance, sometimes its the trades you don’t make that are the best ones. And it looks like the much-ballyhooed Health Week has ended with the trade deadline slated to pass with no blockbuster moves. As discouraging as that might be for those really interested in health care reform, at least Washington won’t screw it up any more.
That’s because once again, politicians are focusing on the fringes, ignoring the real cost drivers in health care, playing politics with statistics, and getting nowhere in the process. Health Week was supposed to be Congressional Republicans’ public policy win, a series of bills that would show the nation they were serious about health care reform. Were they serious?
To quote Hertz ads, “Not exactly.”
Let’s look at medical malpractice reform and the Association Health Plan Bill.
The Enzi Association Health Plan bill aimed to eliminate most state mandated benefits and replace them with minimal requirements for coverage. According to the bill’s backers, the benefit of the bill would be to allow small employers to band together to buy benefits, thus reducing administrative expenses and increasing the number of insured by one million. Why one has to eliminate mandated benefits to set up a group purchasing co-op is beyond me. In fact, one of the bill’s features will allow insurers to do much tighter underwriting, thereby making it even harder for individuals with health problems to obtain coverage. So, the bill may actually increase the number of uninsured, not reduce it.
But that’s not all. Enzi’s bill would actually kill state initiatives designed to increase coverage, initiatives that many politicians are pointing to as valuable experiments in the quest for real answers to health care reform. These include the recent successful passage of universal coverage in Massachusetts, Tennessee’s new program, and Maine’s Dirigo plan.
Next on the docket was med mal reform. I’ve noted before that this “crisis” is anything but, and in fact statistics indicate there are a large number of potential med mal cases that are never pursued by the victims.
Supporters of med mal reform have cited some highly questionable statistics, including one noting that “Four out of 10 Ohio physicians have retired or plan to retire in the next three years due to rising liability insurance premiums”.
Let’s suspend reality and assume that this statistic is correct; I’m not sure exactly how this impacts health care costs or the number of uninsured in Ohio. Especially when studies indicate that physicians, not consumers, drive demand. That being the case, one could, and I will, argue that decreasing the number of docs will reduce health care expenses while having an unknown effect on health care quality, coverage, and access. (of note, the study indicates that over half of specialty surgeons plan to retire due to med mal; these docs include a lot who do spine surgery, a procedure that may well be over-utilized).
So where does Health Week leave us?
Without a bill that would have killed some very promising state initiatives while likely increasing the number of uninsured, and without reform of the med mal insurance system, thereby possibly reducing the number of practicing docs and the number of procedures they would have performed.
Sometimes political gridlock is not such a bad thing.
You are a health policy expert? Please.
“Why one has to eliminate state-mandated benefits to set up a group purchasing co-op is beyond me” — well, how would one set up a national plan without the ability to establish uniform benefit packages across state lines? And one can’t do that without freedom from state mandates, which vary greatly even within a particular category (e.g. 46 state mandates for coverage of diabetes supplies, and each one is slightly different from the next).
Guess what, guy? Running some workmen’s comp program for UnitedHealth doesn’t make you an expert on all things health.
And what exactly in the Enzi bill would have “killed” the “promising state initiatives”? Did you read the bill? And what’s comical is that you cite Maine’s Dirigo program and TennCare as shining examples, when both are unraveling before our eyes.
Nothing like half-assed policy review. Thanks for sharing, pal.
well, we seem to have struck a nerve here. First, I’ll allow this post but the next one will not be allowed unless the poster uses a real name. If you want to criticize, at least have the courtesy and courage to so so in person.
You make several assumptions, which reflect your half assed reading of the original post. For example, I never stated that a national plan was necessary, so that blows your first point. Association health plans, known variously as METs and MEHPs were state-specific and worked well for a time in the eighties and early nineties; why not bring them back?
Second, if you had bothered to read my website you would have seen my experience is somewhat more extensive than running a workers (not workmen’s) comp program.
Third, the Bill itself would have precluded these initiatives by moving regulation to the state level, eliminating mandated benefits, etc.
Finally, I did not cite the Maine or tennCare programs as “shining examples”, but as good examples of state initiatives to solve the problem that Enzi’s bill would have exacerbated – the number of uninsured.
Your tone, lack of research or scholarship, and snide comments do you no credit. Or perhaps they do.