For at least the last fifty years politicians (and others) have been trying to solve the health care issue. Doesn’t it seem curious that all of a sudden they have the answers at both the federal and state levels?
I recall in the 1980s when HMOs were the solution supported by the government. Today it is Accountable Care Organizations and who knows what else. Vermont and Massachusetts are toying with capitation payment schemes for health care providers or by default headed toward a government-run single payer system. Some politicians think denying premium increases is the answer. It may be, if your goal is driving insurers out of business
On one hand patients are promised total freedom and on the other more managed care.
The federal government is “saving” Medicare by becoming more efficient and eliminating fraud and waste, a renewed effort first identified eighteen years ago. We are told that more competition is needed, but we don’t know exactly who should be competing with whom and we don’t understand the relationship between competing health insurance organizations and our convoluted discount network payment system.
What all the strategies have in common is the promise of affordable, high quality health care for all while not spending more money, indeed lowering costs and the future cost curve. We seem to have solved one other eternal conflict; how to have your cake and eat it too.
Meanwhile employers have convinced themselves that more cost sharing is the answer, cut benefits, raise deductibles and coinsurance or use a high deductible health plan. Employees need to care more about the cost of health care. Hey, wait a minute, if health care is not affordable now, how does making it less so help? Oh, I get it, first you have to figure out affordable to whom…the federal government, the states, your employer or lastly to you.
It all makes you wonder how the solution is so apparent now when scores of past schemes at all levels have failed miserably. We should be asking, “What’s’ different today?” Why will current ideas work?
All the current efforts have one thing in common. They fail to understand the emotional and psychological aspects of being sick, receiving and paying for health care and they fail to consider that we long ago abandoned any concept of true “insurance.”
With several states going off in their own direction, Republicans trying to sink Obamacare, states coming to the realization they can’t pay for their employee and retiree health care promises, employers slashing as much as they can and the ability to dump workers into the new health insurance exchanges on the horizon, we may have created the perfect storm… Oh wait, not yet, Medicare beneficiaries haven’t seen their next premium increase or learned what an ACO may mean.
QUINNSCOMMENTARY 