Posts Tagged health care costs

Affordable Care Act — the right to health care

boxersPresident Obama vs. Republican Congress.  Another grudge match, the sweaty pugilists in the corners, puffs of smoke from the cigars in the front row, the referee  holding the mike, saying  it’s the 8th round, the clang of the bell, the jabs, the left hook, bam – a hard right to the teeth, finally the round ends with a flurry of punches under the belt.  We now interrupt the show for an important announcement.

HEALTH CARE IS NOT A CONTEST.  We are not in a reality show, this is real life.   The consequences are life and death.  Why is there an argument or a fight?

The sky-box view.  Look down at the basic arguments of the two sides:

  • Obama — health care is a right
  • Republican congress — health care is not a right
  • Both agree — health care costs too much

The punches and counter punches.

Punch:  The southern US has poor health care
Counter:  Not our problem, don’t fix it with our money

Punch:  Insurance companies are unethical
Counter:  They are just businesses trying to make a profit

Punch:  Primary care is better and more efficient
Counter:  The market determines what is better or more efficient

Punch:  Everybody should have access to health care
Counter:  Only those who have money should have access

Punch:  If everybody has insurance the system would be more fair
Counter:  Don’t tell me to buy insurance, I will do what I want.

Punch:  Raise taxes to pay for the uninsured
Counter:  We can’t afford higher taxes

Punch:  We already pay enough to provide good health care for everybody
Counter:  We don’t want regulations.  Some of us get great health care already

Punch:  U.S. health care only ranks 30th in the world
Counter:  Poverty and old age are the fault of individuals, don’t count them

Punch:  We need government oversight of health care quality
Counter:  That’s what lawyers are for

Punch: Women need care for female health problems
Counter:  What is good enough for men is good enough for women

Punch:  The constitution gives the right to life, liberty and the pursuit of happiness.  You can’t have any of those things  without being healthy.
Counter:  The Constitution says nothing about a right to health care.

Punch:  All this fighting makes me forget about poor health care quality and high cost
Counter:  Me too.

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ACA and Insurance Cost — no surprise

Lightning Bolt

According to Louise Radnofsky of the Wall Street Journal 7/1/13 “Insurance Costs Set for a Jolt“.  Should this really come as a surprise?

No surprise indeed, because very little has been done to reduce health care costs.  The ACA has 2 important financial provisions:

  1. Everyone must purchase insurance
  2. Insurance companies can’t cherry pick healthy people and dump the rest on public institutions.

The rise in total cost of US health care will continue but those who pay for it will change.  The bizarre system the US now has which forces hospitals to care for the uninsured by cost-shifting to private insurance will stop.  The cessation of cost-shifting will make costs more transparent but not smaller.

The problem is in the transition from one method of finance to another.  As the transition proceeds hospitals get a windfall profit, insurance companies raise rates due to uncertainty but score a profit with so many new policies,  premiums rise for many, and taxes go up for some.  Eventually, the system finds a new equilibrium.

Sadly,  Congress has been paralyzed by partisan issues so no improvements to the ACA have been made and no actions taken to make health care more efficient.  Other countries with health systems seem to steer the ship of healthcare but the US can’t seem to disengage the autopilot.

It seems likely that each State and even some large cities will need to act without help from the federal government.   We need ACOs to reduce cost and States could help that system grow.

That’s my view, what’s yours?

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