Tuesday, May 19, 2009

Creating a Middle Clas Entitlement in Health Care

From Dr. John Goodman's Health Policy blog:

Here's what's about to happen. All the special interests are ready to cave. Doctors, drug companies, big business — you name it. They're all negotiating the terms of their surrender. Republicans are in total disarray. But hope is not yet lost. This was exactly the situation 15 years ago when Hillary care was defeated by grass roots resistance. The same thing could happen to Obama.

Here's what Obama health reform will mean. The federal government will increase its spending on health care by as much as $1.5 trillion over the next ten years. Employers will face a play-or-pay mandate (to provide insurance or pay a tax). Even so, employer-provided health insurance will unravel. Today's individual market will vanish and perhaps the small group market as well. Medicaid will expand and there may be a Medicare-like plan for the middle class. In time, most people will get government subsidized health insurance through a government regulated "exchange."

What difference will Obama health reform make? Amazingly, but as previously explained at this site, the plan will not even put a dent in the three big problems of cost, quality and access. There are no realistic cost control measures being seriously considered and the additional $150 billion of annual spending will almost certainly exacerbate medical inflation. Despite all the hoopla, there is really nothing in the plan that will significantly increase quality. In fact, in the exchange there will be intense competitive pressure to underprovide to the sick and overprovide to the healthy. Although the plan will probably cut the number of uninsured in half, this will be offset by greater enrollment in Medicaid, which is only marginally better than being uninsured. Even though more people will have insurance, overall access to care may actually decrease.

Insurance will be no more portable than it is today. (Insurance obtained in the exchange will be for only one year at a time.) The medical marketplace will be no more competitive than it is today. There will be more, not less, bureaucratic interference in the practice of medicine.

Read the Rest

No comments:

Post a Comment