Healthcare

Smart people still miss the point on health care

You would think a person with the credentials such as below would be informed as to what he writes about. 

The fact is insurance companies don’t offer any care. The fact is the most generous health benefit plans are negotiated plans, especially among public unions. The fact is large employers offer (more correctly used to offer) such plans to attract and retain workers and would be quite happy to reduce the value of their plans as has been happening for years (shifting costs to workers of course). 

But the real fact missed is that these so-called generous plans among large employers and many unions are not insured at all, there is no “health insurance” as such and the insurance company that may be processing claims has no financial stake in what is spent on those claims. They are self-insured, self-funded by the employer or union and even when they are not, they are the product not of generosity, but of necessity in some manner.

And then we have “reĀ­imĀ­burse providers based on outĀ­comes and qualĀ­ity rather than inĀ­puts and quanĀ­tity.”  What makes us think we can pay doctors on that basis when we can’t even apply that criteria to teachers? 

The ā€œdo no harmā€ prinĀ­ciple exĀ­tends beĀ­yond the inĀ­diĀ­vidĀ­ual marĀ­ket, where about 1 in 6 AmerĀ­iĀ­cans get their health care, acĀ­cordĀ­ing to the CenĀ­sus BuĀ­reau. To cut cost growth and imĀ­prove qualĀ­ity, the adĀ­minĀ­isĀ­traĀ­tion will have to use other toolsā€”many of them biĀ­parĀ­tiĀ­sanā€”that have been creĀ­ated by ConĀ­gress in reĀ­cent years. These inĀ­clude deĀ­livĀ­ery-sysĀ­tem reĀ­forms in Medicare, which shift to payĀ­ment modĀ­els that reĀ­imĀ­burse providers based on outĀ­comes and qualĀ­ity rather than inĀ­puts and quanĀ­tity. 

A ReĀ­pubĀ­liĀ­can ConĀ­gress unĀ­der the leadĀ­erĀ­ship of Speaker John Boehner alĀ­ready exĀ­panded these reĀ­forms afĀ­ter they were origĀ­iĀ­nally passed as part of the AfĀ­fordĀ­able Care Act. The ā€œCadilĀ­lac tax,ā€ which enĀ­courĀ­ages inĀ­surĀ­ance comĀ­paĀ­nies not to ofĀ­fer overly exĀ­penĀ­sive care, should also stay. NeiĀ­ther of these poliĀ­cies reĀ­quires conĀ­gresĀ­sional acĀ­tion. The adĀ­minĀ­isĀ­traĀ­tion simĀ­ply has to imĀ­pleĀ­ment the law as written.

Mr. FurĀ­man, a proĀ­fesĀ­sor of pracĀ­tice at the HarĀ­vard Kennedy School, was chairman of the White House CounĀ­cil of EcoĀ­nomic AdĀ­visĀ­ers, 2013-17.Wall Street Journal 7-24-17

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