By Steve Schulte of
Health Advocate Solutions
Please respond or inquire at (213) 999-1227
Forget what you thought about everything surrounding the commercial craziness of the Christmas holidays: the silly season is about to begin in earnest.
More specifically, a new Congress will imminently descend upon Washington.
Despite the buffoonery and lack of credibility (and perhaps some lack of imagination)the past Congress, expect the new ideas with this new and improved group to take your breath away.
In case you marvelled at what Speaker Pelosi was able to cook up, see what you can find edible in Congressman Boehner's servings (slightly salty, of course....).
Let's focus for a few moments on a key campaign of the new House majority: gutting or dis-establishing healthcare reform. Don't know about you, but in my view "we the people" need access to affordable healthcare. Any platform that does not have universal (or at least extremely broad) access to care is a nonstarter.
It matters little to most people whether that access comes through truly affordable and dependable coverage or diligent and efficient community clinics or insurance attainable by searching across state lines (as long as quality is standardized). Key outcomes matter: access, affordability, quality. Oh, and cost control would be nice as well.
In other words, the battle is not really about ideology. It may be Democrat or Republican depending on who's in charge at present and on the slavishness of Congressional representatives to their party (and local hack) dictums.
But any intellectually honest person would have to acknowledge that the desired results are achievable (or nearly so) in a variety of ways. In my view these lie along a spectrum of government-managed to market-reliant alternatives.
The recent bill is a pastiche relying heavily on regulation and government incentives. It is more government-related. But it is by no means pure. Please remember that the mandate started, for example, as a Republican idea. Or that cost controls are insufficient.
Those more "liberal" insist the government should guide rules and insist on these to improve coverage. Those more "conservative" want the market to rule. Great digression here would result from repeating the weaknesses in either general approach.
So, let me suggest we be quided as we follow this debate (cum mega-fireworks) by three principles.
One, anyone desiring coverage should have it. This is partly a question of affordability and proximity to care. But it is also dependent on a political commitment that all are deserving and therefore the means to good care (funding, structures, doctors and nureses, etc.)are provided for. If a proposal meets this objective---rather than insisting, for example, that only the well-off and well-heeled deserve good care---it is worthy of consideration.
Two,our national patchwork of a system does many things very well. But the system is byzantine, the insurer network is unruly and not well-regulated; costly and unnecessary procedures and hospitalizations abound. Any improvement on the current reform should address spreading best practices and focus on efficiency, effectiveness and cost control. Insurers need to be regulated---well before 2014.
Three, about one-fourth of our national output is concerned with health and welfare. That says a couple of things: a lot of Americans depend on government to help and, likewise, what the government does is not all wrong. Remember when anyone close to you turned down Medicare or Veterans benefits? Expensive, yes, but a good delivery system.
Further, the statistic says that this portion of the budget will grow and is dangerous to our national health. So finding ways to control costs is paramount. Standardized forms, streamlined processing and delivery of services, reliable electronic records, negotiated pharmaceutical prices, shared economic burden (copays, coinsurnace, taxed "cadillac" plans---all these become important. Ensuring access is only one aspect of the overall equation.
I would welcome hearing other ideas, but these three will be key quides to what is proposed seriously and what is not.
Also, let your Congressperson: Weiner, Frank, Feinstein, Rubio, Baucus, Sanders--whomever----hear from you. Or your Governor: Brown, Branstad or Kasich. These folks don't ----and, well, do----work in a vacuum.
Amidst the craziness DO stay tuned. Keep centered on what is most important.
Sources: NY Times, Bloomberg Business Week, Wall Street Jounal, Kaiser Family Foundation.
To respond to this blog, email steve6schul@yahoo.com
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