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LOUISA VIRGINIA
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Home| About Us| Background | Related Links | Issues | Events | |
LOUISA VIRGINIA
The Problem:
While we in America have the best health care capability in the world, we rank way too low in many categories. Examples include that we rank about 37th in infant mortality rates (add more examples later) etc. The primary reason for these low ranking is access. For example, many poor single pregnant women have very limited access to prenatal care. The other major problem with our health care is cost. In America, average annual health care cost is at least double that of other countries.
Background:
The health care costs pie can be divided into 4 major slices:
Actual provider costs.
Waste, fraud and abuse.
Health payer administrative costs.
Profits of health insurance providers.
Over the past twenty years, health insurance companies have parlayed a decreasing percentage of the insurance dollar on actually paying provider fees and an ever-increasing percentage on company profits. Health insurance companies are flourishing as never before primarily because they take their profits from an increasing percentage of ever of increasing costs.
Another problem with health insurance can be seen if we compare it to other types of insurance. We have a robust commercial insurance industry in this country which normally helps us cope with disaster. When we wreck out cars, insurance pays to fix it. When our house burns down, insurance pays to rebuild it. But our car insurance companies do not pay for oil changes or even major repairs. Home insurance companies do not pay for a new heating system if our old one wears out. But we expect health insurance companies to pay for every check up or doctor visit over a small annual deductible.
People often complain about the inefficiency of government administered programs versus the efficiency of private industry. As it turns our, government administration costs for Medicare are far below similar costs by private insurance companies.
Waste, fraud and abuse are better avoided by government administrators than by private companies as well because private companies have little incentive to minimize these expenses because their profits are based on a percentage of the total costs.
The Solution:
There are three alternatives to resolving the high cost of health care:
1.Provide a single payer system similar to those available to most leading countries around the world.
2.Provide baseline free medical care for all paid for by the government with insurance companies providing “Cadillac Sevices” to those that want to and can pay for it.
3.Provide extensive regulation of health insurance companies including limiting their profits.
Under any of these alternatives, there is a need to address issues of waste, fraud and abuse as well as to have open discussion of degree of health care provided relative to cost versus benefit considerations.
1. My ideal position.
If I were a benevolent dictator, I would opt for a complete single payer system where most health care would be FREE (taxpayer funded) to anyone and everyone who needed basic medical and dental attention. People could still purchase "Cadillac" type policies that would cover such things as face lifts, boob jobs, braces or even accelerated attention for "selective" procedures that the basic system might have long waiting periods for such as seen on some procedures in Canada.
2. My realistic position
Since I realize that "My Ideal Position" would have no chance of being enacted, my "going in position" in today's environment would be a MOTRA position and would include such things as elimination of "pre-existing condition" loop holes and several other reforms that both parties agree are needed. I would include some Republican stands such as moderate tort reform, freedom to buy drugs abroad akin to the Dorgan/McCain Amendment and very limited allowance for abortion. It would also include some form of "public option."
3. The House Version
Major controversial issues would be listed here such as public option etc.
4. The Senate Version
Major controversial issues would be listed here such as abortion language and "pay offs" such as were granted to Lieberman and Nelson.
5. MOTRA Reconciliation
This position would be determined by discussion and compromise among Middle of the Road Americans unencumbered by special interest bribes and media hype.
NOTE! All of the above was drafted prior to passage of "Obama Care." In fact, it was drafted early on while it was being considered in Congress. Following are comments well after passage of the Patient Protection and Affordable Care Act.
My View of Obama Care:
The good thing about Obama Care is that we finally, after over 60 years of trying, have meaningful comprehensive health care for most folks in America. The bad thing is that we have a hodge-podge monstrosity, put together in the "baloney factory - the US Congress" needing significant improvement.
Since passage of this legislation over a year ago, without ANY cooperation from the Republicans, a major related event has occurred - the election in November which, thanks to the Tea Party, gave Republicans control of the House. Since that time there has been persistent effort by the Republicans to repeal the measure. To me that's a waste of time, other than politically, because it's just not going to happen. Even of the Democrats lose the Senate and the presidency in 2012, it's not going to happen. In the mean time, there could be substantial bi-partisan support to "improve" on the existing legislation. Moderate tort reform comes to mind.
One issue that irks me is that so many people fault Obama Care for rising health care costs. Actually the main driving factors for rapidly increasing health care costs include the ever-increasing number of older patients needing ever-increasing high priced improvements in health care (ie better equipment etc). These cost increases would have occurred with or without passage of Obama Care but Republicans keep blaming it on this legislation.