I managed employer health plans for nearly fifty years. During that time I was always under pressure to manage costs even as benefits were improved over the years.
We tried every tactic that came along, every consultants new idea. We shifted costs to workers, we gave them skin in the game as they say.
In the early years we tried things that seem silly today. We gave workers time off for pre-admission testing, we paid for second opinions, promoted HMOs and PPOs, offered choices to workers, promoted and provided incentives for generic drugs, etc. Back in the 1980s I even served on the Boards of four HMOs.
Nothing worked and still doesn’t, including high deductible health plans, FSAs, HSAs and HRAs.
What’s left? Is there any way to manage our costs and assure every American has coverage for necessary medical expenses.
I made a proposal a few months ago that included a public and private role, reasonable cost sharing, use of HSAs, private supplemental coverage, employer and citizen funding and universal coverage.
How can we settle for anything less? How do we guarantee every American can receive and afford decent health care according to their means?