Health Care

WPC's Center for Health Care develops patient-centered solutions to reduce costs and improve the availability and quality of health care for businesses and individuals, providing the only detailed, independent critique of health care issues available in the Northwest.

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Democrats’ Proposed Health Plan Leaves 17 Million Uninsured

July 15, 2009 in Blog

The new health care reform plan unveiled today by Democrats in Congress is not universal care.  The Democrat-proposed plan provides for 17 million people to go without health care coverage.  The plan carries other risks, such as:

  • It raises taxes during a recession.  Higher taxes, even on the so-called rich, means there would be less money available for investment and job creation, delaying the recovery and increasing hardship for people who are out of work.  Business owners would slow or stop hiring, as they wait to see what their new payroll tax will be, and whether they will be forced to pay the proposed 8% “pay-or-pay” penalty each year.
  • The government option would crowd out private coverage.  Many workers would be forced onto the government plan against their will, as employers drop their current coverage in an effort to shift health costs to taxpayers.  Yet the President’s family and those of Members of Congress would not be forced onto the government option plan; as dependents of federal employees they would continue to receive first-class coverage.
  • Eight million people with Health Savings Accounts (100,000 in Washington) might lose their coverage if it doesn’t meet the federal definition of mandated insurance.  Innovative patient-centered medical practices in Washington, such as Dr. Erika Bliss’ Qliance clinic in Seattle, would be forced to close.

Here's a good illustration of how the proposed health care plan would work was released by the Joint Economic Committee.

House-Democrats-Health-Plan

The House Health Care Bill - The Whole Enchilada

July 15, 2009 in Blog

The three committees controlling health care legislation in the US House released their health reform bill yesterday with the usual fanfare. Basically every bad proposal kicking around Washington, D.C., is included in the 1018 page document. Debate on the House floor is scheduled to begin next week.

The lead-off provision is a government "option", ala Medicare,  to compete with private health insurance. Never mind that Medicare started as a "competitive government option" in 1965, ran insurance for seniors out of business by 1970, and currently has a $67 trillion dollar unfunded liability. 

The House leadership then stuffed an insurance  "connector" into the bill to dictate the kinds of benefits people can select and how much they must pay for them. Massachusetts has had a connector plan in place for the past three years. The state is now running almost a $1 billion deficit for its health care spending. It didn't work for Massachusetts, but then a state, unlike the federal government, can' t print money or run deficits for very long.

A lot can be placed in 1018 pages, but other significant provisions include an individual mandate so everyone in the country must buy health insurance or pay a fine, an employer mandate that requires them to purchase insurance for their employees or pay an 8% payroll tax, a class warfare tax on the rich, and a schedule for decreasing provider reimbursement on Medicare and Medicaid patients.

The overall cost is estimated to be $1.5 trillion over the next ten years. Of course, Medicare was 300% over budget by 1990. So much for confidence in the bureaucratic budget process.

Health Care Reform is Losing Steam

July 14, 2009 in Blog

A new Rasmussen national telephone survey just released shows the country is shifting to opposition of the Administration and Congressional health care reform plans. Those opposed or somewhat opposed now total 49% with 46% in favor or somewhat in favor of the proposed health care reforms currently under debate in Washington, D.C.

Two weeks ago, Rasmussen polling revealed 50% in favor and 46% opposed. This is almost a 10% shift toward opposition.

As more Americans understand the magnitude and the expense of the proposed reforms, the negative impact of government controlled health care is starting to take hold. A prolonged debate gives more people the opportunity to see these reform plans for what they really are - an attempt to move our entire health care delivery system into the control of government bureaucrats.  

"Best Practices"

July 7, 2009 in Blog

Researchers at Dartmouth Medical School have pointed out the disparity in health care spending and outcomes for Medicare patients throughout the country. (here) Although there are many variables that account for these differences, the health care reformers in Washington, D.C. are now using them as an argument for legislating "best practices".

The bottom line on the concept of "best practice" is a government bureaucratic committee deciding what kind of health care and how much health care each patient can receive. Since, in the current government reform plans, the government would be paying for health care,then it seems only correct that the bureaucracy should be able to dictate who gets what and how much.

There are a number of other euphemistic names, "comparative effectiveness research" and "evidence based medicine" for example, but they all boil down to faceless bureaucrats - not doctors - telling us what treatments and medicines we can receive. It is a short leap to then ration health care in the interest of what the government believes is cost effective.

England has had this type of program (The National Institute for Health and Clinical Excellence) in place for several years. It has led to delays in treatment, denial of treatments, and has served as a gatekeeper mechanism to ration new therapeutics. 

The solution to treatment and cost disparities in this country is to give the patient, as a consumer, more control over his own health care dollars. Allowing the patient, not the employer or government, to control his own health care funding would provide the incentive for the patient to work with his providers and determine the most cost effective treatment courses. Likewise, providers wouldn't be locked into cook-book medicine that may not be in patients' best interests. 

2009 Health Care Conference

July 6, 2009 in Publications

Washington Policy Center hosted its 7th annual health care conference on June 3rd in SeaTac with a crowd of over 300 people. The event provided a thorough discussion with various perspectives represented on every panel. The conference opened with a panel discussion about the 2009 legislative session and then explored health care solutions more thoroughly with speakers from the health care industry. The panel before lunch discussed current facts about the uninsured, as well as updates on successful current heath care policies.

Medicare Administrative Costs Are Higher, Not Lower, Than Private Insurance

July 1, 2009 in Blog

Since rising health care costs are the number one issue in the health care reform debate, it is essential that any reform addresses this problem. The Heritage Foundation published an interesting study that found administrative costs to be higher, not lower as frequently cited by proponents of a public plan, than private insurance.

"On a per-person basis Medicare's administrative costs are actually higher
than those of private insurance--this despite the fact that private
insurance companies do incur several categories of costs that do not
apply to Medicare."

You can read about it here , from June 25th.

Massachusetts' Health Care Plan for the Nation?

June 30, 2009 in Blog

Many of the national health care reform measures currently under debate in Congress have been in place since 2006 in the state of Massachusetts. Major reform was implemented that year in a bipartisan fashion with a Republican governor and a Democratic legislature.

Those reforms include:

   *  Individual mandates - all residents must purchase health insurance.

   *  Employer mandates - each employer must purchase health insurance for his employees or pay a fine.

   *  An insurance "connector" to offer a "market place" for insurance plans. The state then dictates benefit mandates and pricing of the plans within the "connector".

   *  State subsidies for the poor.

   *  A goal of universal coverage.

Since these same reforms are now being debated in Washington, D.C., it is reasonable to see how they have worked in Massachusetts? A recent Rasmussen Report found that only 26% of the state's residents view the program as a success, with 37% convinced it is a failure and 37% unsure. Only 10% feel that the quality of their health care is better, while 29% believe it is worse and 53% see no change.

Michael Tanner at the CATO Institute has found that although the number of uninsured has decreased in MA, this decrease is mainly the result of the generous state subsidies and not the individual mandate. Costs have spiraled out of control and the state is currently lobbying the federal government for upwards of $1 billion dollars to cover cost over-runs. Access is also an issue, especially in the area of primary care.

Congress has to look no further than Massachusetts to see that more government control of our health care will not lead to more access and patient satisfaction, better care, and cost containment. Instead, the  Massachusetts experience should be used as a model of what not to do to reform our health care system.

Government Plan Takes the Competing Aspect Out of Competition

June 26, 2009 in Blog

As I listened to President Obama describe the prospect of a government run health care plan at his press conference Tuesday, I thought that his proposal sounded reasonable enough. After all, the public plan would offer among other things, "a better range of choices, make the health care market more competitive, and keep the insurance companies honest." This all seems well and good, but one important detail the president failed to mention is how the inherent structure of the public plan would create an environment that would destroy competition. The public plan would not have to compete with anyone, because it is impossible for private insurers to compete with the United States Government.

Scott E. Harrington, a professor of health care management and insurance and risk management at the Wharton School of the University of Pennsylvania, wrote on this exact problem and the possible ramifications in this article from The Wall Street Journal on June 15th. 

As Mr. Harrington notes, a government run health insurance plan would soon be nothing more than a single-payer system.

Government Option? - Look no Further Than Medicare

June 26, 2009 in Blog

Congress currently has three bills under consideration that all include a government-run option to private health insurance.

In 1964, over 60% of seniors had private health insurance. Medicare was passed in 1965 as a government option health care plan for seniors. By 1970,the private market for senior health insurance, except for co-pays and deductibles, was gone. For the past forty years, seniors have had the government-run Medicare plan as their only option.

Medicare now has an unfunded liability of at least $67 trillion and is rapidly becoming financially insolvent. Access for seniors to health care is now being limited by decreasing provider reimbursements and lack of provider participation. The paper work and regulatory burden for hospitals and doctors has reached formerly unimaginable levels.

Using Medicare as an example, the currently proposed government option for non-senior health insurance would unquestionably destroy the private health insurance industry. Likewise, there is absolutely no reason to believe that a government-run option health care plan for non-seniors would ultimately be different than the financially unsustainable Medicare model.  

The House Health Care Reform Plan

June 19, 2009 in Blog

The US House of Representatives released its 850 page bill for health care reform today. Although the details at the margin are different than the Kennedy-Dodd bill in the Senate, there are some fundamental similarities:

   *  A government-run health insurance exchange.

   *  A government-option health insurance plan to "compete" with private insurance.

   *  Subsidies for the purchase of health insurance up to 400% of the federal poverty level.

   *  Guaranteed issue - i.e. anyone, regardless of prior illness, must be offered health insurance.

   *  A cap on out-of-pocket expenses.

   *  An individual mandate - everyone must have health insurance.

   *  An employer pay-or-play with a penalty fee of 8% of payroll. To avoid the fee, employer-       sponsored plans must meet minimum benefit and contribution requirements set by the government.

The one glaring item not addressed in the bill is how to pay for all of this government-run health care. As the House leadership has stated, however, everything is "on the table" - read increase taxes and further deficits.

Now that the reform proposals in Washington, D.C., are actually coming out on paper, the taxpayers of the nation are starting to understand the real impact of these broad sweeping health reform plans. The debate is just now starting as more people understand the restrictions of liberty and the costs of government controlled health care.