Things that are good: There's just amazing ferment in health care policy these days, hard to keep track:
- Chris Dodd says there will be a health bill in a few days from the HELP committee — with a public option. Yow!
- Ted Kennedy fights against cancer — and for the public plan! Rah Rah! (Sabutai noted this a few days ago.)
- Obama's all over it — strong on the public plan and tying reform to cost control! YES WE CAN!
- Health care advocates pour in $82 million in ads! Take that, Harry and Louise!
- Bob Kuttner vs. the insurance industry — yay! (But apparently doesn't know what single-payer is. Boooo.)
- Massachusetts is still taking the lead in reorganizing care away from quantity towards quality! Boo-ya! (Well, a possible, qualified, maybe boo-ya.)
The Special Commission on the Health Care Payment System is proposing to reorganize the way more than $55 billion is spent on health care in this state every year.
… The network or organization would get one annual payment for each patient, based on age or other factors, no matter how many services you use. If you stay healthy or your doctor helps you stay healthy, the organization does well. If you don’t, the providers could lose money. The commission says there would be incentives so that doctors would not limit necessary care or reject the sickest patients.
- OK, not so good news: People go bankrupt from health care bills, even if they have insurance. It should be noted that the author of this report, Steffie Woolhandler, is a major player in the single-payer movement. Given that movement's predilections against “incrementalism”, one would assume she'd be opposed to any reform that entrenches the role of private insurers. That's the not-so-hidden subtext of this report.
Please share widely!
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p>You cannot harm me. I’m the Juggernaut.
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p>(yes that’s an Internet joke requiring youtube and headphones if you are at work)
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p>What about the cancer patient who runs up hundreds of thousands of dollars? How is that type of extraordinary expenditure covered in this type of scheme, or this the first step to “ice floe” care for the extremely sick and elderly? Going through this first hand with my brother-in-law right now, where would he fit into this type of plan? Clearly his costs would overwhelm payments on his behalf to his doctors.
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p>This looks like more of an incentive to restrict services than get “everyone healthy”. Capitation anyone?
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p>First, here’s the actual study referenced in your link.
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p>Second, these people, David U. Himmelstein, MD,a Deborah Thorne, PhD,b Elizabeth Warren, JD,c Steffie Woolhandler, MD, MPHa should be banned from future studies or at least completely ignored. Their “research” is partisan claptrap clothed in Harvard. Their significant conclusions:
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p>OH MY GOD, you say, medical costs are driving the middle class into bankruptcy!
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p>Note the nuance: “Since 2001, the PROPORTION of all bankruptcies attributable to medical problems has increased by 50%.” I actually think, based on the study, that even this very nuanced sentence is a very presumptive claim, but nevermind for now.
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p>But even assuming the statement is factual, how can any study, purporting to be objective, publish such a stunning conclusion without noting that bankruptcies have declined significantly from 2001 to 2007 such that using Harvard’s numbers from the study, medical bankruptcies, in total actually DECREASED. Yet, I dare you to find any reference to this fact in the Harvard study.
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p>One can only hope, that other researchers without partisan views successfully expose, with peer reviewed studies, this most recent Warren, Woolhandlers propaganda as reserchers have done in the past.
Health Care is a rapidly increasing segment of the GDP, and one, in itself, that does not really create wealth.
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p>There are too many conflicting goals in the industry to have an easy solution.
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p>Universal Coverage vs. Reduced Cost
Massachusetts, which supposedly has “solved” the Health Care problem, now spends over 30% of its budget on Health Care. Cost efficiencies should come concurrent with expansion of coverage to limit the total cost.
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p>More Jobs vs. Reduced Cost
How often do we hear that the Health Care Industry is “saving” us on the jobs front? But are those added jobs increasing costs more than the health benefit that results?
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p>Profit vs. Care
What drives the decisions in the Health Care Insurers’ boardrooms? What drives hospital expansions? It is not just the profit dollars that we are paying for, but the added effort that these organizations take on in order to “grow the business” and “increase their returns”.
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p>Extending Life vs. Peaceful Death
How far should the health care provider extend a terminal patient? 21% of all health care costs are incurred in the last year of life.
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p>Battery of tests vs. focused treatment
How much health care effort is added to mitigate the risk of missing something, and maybe being sued because of the omission? Reasonable limits on litigation may be advised.
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p>I pay vs. You pay
Putting the onus on those who provide jobs may not be the best economic solution. A national sales tax would affect sellers more than employers, and therefore would be better for the overall economy.
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p>Healthy Lifestyles vs. “What the Hell”
It is time to bring out some carrots and sticks, and use them effectively.
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p>The ARRA program has about $1.1B for health care Comparative Effectiveness Research (CER). If this money is to be well spent, it may help resolve some of the conflicts. It should not be a wasted effort.
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