quinnscommentary

If you want to read a most convoluted view of health care in America take a look at “Unhealthy America” in the November 5th New York Times. The writer provides a litany of statistics about the low ranking of US health care compared to the rest of the world and then concludes that it is the lack of universal coverage causing those statistics even noting that Americans 65 and older have a longer life expectancy than the rest of the world because of Medicare.

He concludes that leaving a hospital as soon as possible is bad and even calls negative the many hernia surgeries done on an outpatient basis. Needless to say he takes the usual shot at insurance companies for denying care (an insurance plan may deny payment for a service, buy they never deny care – I know we can’t afford to pay ourselves, well sometimes that’s true, but isn’t that the point it’s the cost of care stupid!).

I have managed health benefits covering 40,000 lives for over 45 years and never once did I get a complaint about a person being arbitrarily kicked out if the hospital or being denied payment for care When denial did occur there were clear medical reasons for such action and confirmed by independent medical experts (and often the treating doctor as well who told a different story to the patient because it was less aggravation).

The views expressed in this editorial serve to enforce the myth we can have it all and we can afford to have a government program just write a check for any claim presented, hey just like Medicare. How’s that working out?

No doubt some people without any health insurance coverage receive less than optimum care and do not have access to the very best (to be determined) providers but even if that were true for every uninsured person who needed medical care (many do not) it would not support the statistics presented.

What this article does is condem the medical community for providing lousy health care and if that’s true there is nothing in pending legislation that changes any of that. In addition, the same providers render care to Medicare patients and to the 70 million Americans with self-insured employer coverage and to everyone else as well.

Perhaps we should accept the fact that a physician’s integrity, skill and credibility is based solely on the payment he or she receives.

One can only wonder what point of view can conclude that a government run health care system will automatically correct every flaw in health care delivery. I have it, we are going to import a new cadre of doctors from Canada, Germany, Ireland and even Slovania.

http://www.nytimes.com/2009/11/05/opinion/05kristof.html?_r=1

The House health care reform bill includes a provision that limits an employer’s ability to reduce retiree health benefits. The legislation says that employers cannot lower the benefits or raise premiums.  However, it also says that as long as any reduction is not substantial it is okay.  So, what does substantial mean?  There is some general discussion but clearly, if this provision remains it will require substantial regulatory clarification.  A substantial decrease in benefits is one that is greater than a 5% reduction in actuarial value.  Likewise, premiums in terms of dollars and percentage of premium cannot be raised by more than 5%; interestingly any Cap on employer costs in effect at the time of retirement can be honored.

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