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Time on Health Care Dilemmas

John on June 4, 2009 at 12:25 pm

Karen Tumulty, writing for Time, has a piece about the 5 big health care dilemmas. It’s worth reading if you haven’t paid attention up to this point. If you have, here’s the most interesting bits:

It is now possible to glimpse the outlines of a Grand Deal among insurers, providers, business, labor and patients that would put most of its focus on lowering costs and establish a foundation for expanding coverage in years to come…

No other proposal has generated as much controversy as the idea of giving everyone the option of being covered by a government-run plan similar to Medicare…A public plan of this magnitude could be a powerful force to contain costs. But it could also destroy the private insurance industry, while doctors and hospitals say its lower fees would drive them out of business…many conservatives point out that the government can’t afford the Medicare program it already has, so why create a new one?


[W]here will Congress find the money, especially for the government subsidies it would take to expand coverage to the 47 million or so Americans who now lack it? Lawmakers are reluctant to squeeze Medicare and Medicaid payments to hospitals and doctors much more than they already have…The targets of the moment are the health-care benefits that employers now give their workers tax-free — an income loophole that costs the U.S. nearly $250 billion a year. “There’s a lot of money there,” says Massachusetts Institute of Technology economics professor Jonathan Gruber. “There’s certainly enough there to get to universal coverage.”… Obama attacked John McCain in last year’s election for proposing exactly such a tax on something workers believe they get for free…

The problem with American health care, those who have studied the system will tell you, is not that we get too little care but that we use too much. By some estimates, as much as 30 cents of every health-care dollar is spent on medical treatment that is unnecessary, ineffective, duplicative or even harmful. Changing all that is going to require revamping health care from top to bottom, starting with the way health-care providers are reimbursed. While the current system pays them for the amount of care they provide, real reform would put more emphasis on the quality of that care and the outcomes it achieves. If there is an ideal out there, Baucus says, it can be seen in the kind of medicine already being practiced by Kaiser Permanente, the Mayo Clinic, Intermountain Healthcare and Geisinger Health System, which manage to hold down costs and get better results.

I highlighted this last bit for one reason. All of the providers being looked to now as possible solutions for keeping down costs have one thing in common. They’re all private institutions. Remember that the next time you hear President Obama promising that more government involvement will solve our health care problems. In fact, looking at Medicare’s unfunded liabilities, it’s more realistic to say government is the problem not the solution. It’s all the more reason we should be wary of any change that could bankrupt the private insurance industry.

Kudos to Karen Tumulty for presenting a fair account of the challenges and possible solutions.

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Category: Health & Education |

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