If you want to know why the Bush health care plan will not work, you need look no further than the individual insurance cancellation brouhaha in California.
Blue Cross of California and other carriers stand accused of combing through high cost members’ application forms to find any mistake, inadvertent or not, and then using that to cancel their coverage.
While Blue Cross’ practice (which they have admitted) is reprehensible, it’s also understandable in today’s dysfunctional insurance market.

Continue reading The Bush health care plan’s problem and the real world

The ICD may have not been fully functional when the President was working on his health plan.
Thanks to SST for the tip!

There are over a dozen state and federal health care reform initiatives on the table today. To evaluate the various proposals, we have to agree on what we want to accomplish. Otherwise, we’ll spend our time debating which road to take when we don’t even know our destination.
What are we trying to accomplish with health care reform?
Lower costs today? A sustainable trend rate so care is affordable for the foreseeable future? Better outcomes, defined as healthier people and/or fewer avoidable deaths and/or higher levels of functionality? Coverage for all so no one goes without? Equitable reimbursement? Less interference in the doctor-patient relationship? Greater self-responsibility on the part of consumers? A reduced financial burden on employers, especially small ones and really big ones with lots of retirees? Ever healthier, longer-lived citizens?
All of the above?

Continue reading Let’s start from the beginning

Confirming my long-held opinion that Jason Shafrin is the smartest health care economist blogging these days is his post on the implications of Bush’s tax cuts…I mean health insurance reform policy.
Jason’s insight on the trillion dollar excess policy is brilliant.
He also provides a chart illustrating the financial implications of Bush’s plan – no surprise here; “the value of the health insurance tax deduction is worth more than 2x the value for the individual making $10,000,000 as for the person making $10,000.”

Elected officials considering health care reform would do well to adopt the “first, do no harm” rule. So far, they haven’t.
Health care reform proposals circulating among the States run from the broad and all-encompassing (California) to the very narrow (Texas). The big ones suffer from an inherent problem – the broader they are, the more oxen they will gore. As every constituency works to protect and advance their agenda, the big proposals run the very real risk of the death by a thousand cuts (a particularly gruesome, excruciatingly painful Chinese execution, and therefore a perfect analogy).
Narrow, specific initiatives to address discrete issues have the opposite problem – they tend to fix problems caused by the system, instead of fixing the underlying problem.
Look at Texas.

Continue reading Misguided reform

So a lot of folks are finding good things in Pres. Bush’s plan to use tax policy to help uninsured people get health insurance.
Not me. I see it as the worst kind of incrementalism, on a par with consumer-directed health care. To the naive, it promises a quick solution using financial gimmickry that will not cost anyone very important much of anything, and may help a few folks get coverage thru a state program.
But it won’t do anything to fix the underlying problem – people who need insurance can’t get it, and if they can, many can’t afford it, leaving the rest of us to pay for their health care. Meanwhile, insurance companies compete not on the basis of how healthy they can keep us, but on how good they are at denying coverage to anyone who may have a claim.
Arrggh!

Continue reading Bush’s blithe ignorance

It looks like Pres. Bush is going to announce a major new health plan initiative during his State of the Union address, one that actually may make some sense. The pre-views indicate the plan will be individually-focused (not employer-focused), say very little about cost control, underwriting, or health care providers, and concentrate instead on tax policy.
I don’t like to disagree with people whom I highly respect, but I don’t see how Bush’s plan will work (defined as increase coverage and control expenditures).

Continue reading The Bush health care/tax plan

You have to love idealistic students. Medical students in California, working with a prominent legislator, are pushing for a state-run single-payer system that would end the health insurance industry’s role in the system.
The students have a solid case, but single payer will never succeed in the US.

Continue reading A single payer initiative in California

I’m continuing to follow the fortunes of Revolution Health, the Steve Case venture into health care, consumerism, education, wellness, and peripheral matters. Not much new news since my last query; the website is still under construction, but you can enter as a “test guest” here.

Continue reading MySpace for hypochondriacs

One of the more thoughtful articles I’ve seen on medical tourism is at the Miami Herald.