Health care reform is useless without....
1. Reform that allows comsumers easy access to see how many times and how often a doctor has committed malpractice. This would drive bad doctors out of the field and reduce the number of malpractise claims.
2. Reform that limits the lawyers take in malpractice suits. It is disgusting that a person can "win" a $10 million judgement and walk away with less than $1 million after legal fees.
It is more equitable for everyone involved, except the lawyers, if the patient got $5 million dollars directly.
3. Reform that sets a national minimum standard of coverage that all insurance companies must meet to sell health insurance. The standard could include the requirement to cover preexisting conditions and any other provisions deemed needed.
4. Reform that allows insurance companies meeting the minimum standard to sell coverage in all 50 states. The potential for 1,700 insurance companies to compete across the nation is much more competition than 1 public option.
It is absolutly stupid that state and federal laws have given a handful of insurance companys monopolies in many states.
5. Reform that sets market share caps in each state so a company is prevented from buying out the competition.
6. Reform that prevents consolidation of the health insurance industry nation wide through mergers.
None of these items are in any form of the current legislation being rammed through Congress.
Amendments to add all of these items have been proposed in bi-partisen efforts by Democrats and Republicans.
All of them have shot down by the White House, House leadership and Senate leadership.
Now we have the same group of political gangsters locking out anyone who is not a Democrat from the final meetings to merge the House and Senate bills.
Where are the open meetings on CNN that candidate Obama spoke so strongly of in 2008?
C-SPAN's CEO Brian Lamb offered to provide free full and complete coverage of all health care legislation meetings and still the doors are locked. Why?
What most reporters, analysts, and pundits fail to understand about health reform is that it is already here.
And that it really is bipartisan. (Picture from the Rutgers School of Law in Camden, New Jersey.)
The two parties are not Republicans and Democrats. They are business and government. The people who pay the bills demand change, so change will come in 2010.
Changes have already been baked into the system, partly through insurers responding to the demands of their biggest customers, and partly by government actions taken in the last few years.
The most important reform is moving from a fee-for-service to a per-patient fee model. Businesses know that wellness and prevention pay dividends, that all their insureds need some services every year to minimize disease later on.
Whether we define your risks by your genes, family history, or lifestyle, we can take steps while you’re healthy to keep bad things from happening to you. And this costs less than treating you later on.
The second step, which was assured as part of the HITECH Act embedded in the stimulus package, involves getting the data.
With the passage of new rules defining meaningful use, and the creation of “beacon communities” that will model responses to the data, the ingredients for health care transformation are already in place.
That is, we’ll find what works, what the low-cost communities are doing, and we’ll use that as a model to drive change in other communities.
That’s a lot harder than it sounds. Many of our health cost drivers are based on business relationships, like the conflict of interest inherent in doctors owning hospitals and imaging centers. Those will not be broken easily, even when the need to break them becomes obvious. There are vicious fights ahead.
The debate that continues in House-Senate conference next week is really just about who pays for it. It’s not about reform itself.
Will we continue the same arrangement we have now, large businesses paying the bulk of everyone’s care costs, government paying for those that can’t pay, and consumers squeezed in between? Or will we switch to a new model in which everyone has an obligation to pay, perhaps with government aid, perhaps through government mandate?
The debate pits those who are now being subsidized — small businesses, conservative states — against those now paying most heavily — large businesses, taxpayers, healthy middle class consumers.
Reform itself is already coming.
- We will know what your health risk factors are, and push you to reduce those risks.
- We will create wellness programs that help you with issues of diet, exercise, and drugs.
- We will monitor everyone’s true health care costs with technology, and try to do what WalMart has done, changing the system in response to data.
All this will just bend the cost curve a little bit. Harder choices still need to be made:
- Bulk purchases, like those made by the Veterans Administration, to squeeze suppliers.
- Mandated changes in lifestyle, which is what most individuals fear most.
Bulk purchases could come from vertical integration, letting insurers buy their own hospitals and clinics, or contracting for services with low-cost providers like WalMart and CVS. Or it could come from government negotiating more closely for its own supplies, and pushing people toward generics instead of new drugs and treatments.
However it’s done it is going to happen. This is the story to watch in 2010. The verdict of voters this November won’t matter as much as you think.
Businesses can’t afford your fat, drunk, smoking butt any more. If you won’t follow your New Year’s Resolutions this time, ways must be found, carrots and sticks, or we have to buy your care in bulk.
