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XMFHelical (< 20)

Healthcare Reform - Lets take that one step back now



August 27, 2009 – Comments (2)

Healthcare reform has always followed the 'Frog in a Well' paradigm.  Progress is often balanced by setbacks.  I think it is great that there has been so much dialougue of late on the topic, but if one thing has been made clearest, it is just how uninformed we are regarding the costs and issues surrounding healthcare.  Government has itself to blame for this, as healthcare is delivered (at least to the employed) in a manner so as to make its costs as invisible as possible.

Its time to start removing the viel.  Current efforts need to be focused not on jamming through a reform that many see as not needed, but on communication of healthcare problems and other models that are used eslewhere.  One place I'd start is by having the amount of the employer based benefit listed on W-2 forms.  It should take at least a couple of years of focused PR.

Some links:

Setbacks and Fissions — Reconsidering the Scope and Timing of Reform

Another in the Perspective series from the New England Journal of Medicine, aslo calling for a step back in the push for healthcare reform.

Some sobering data on the costs individual countries pay for healthcare as compiled by the OECD.  US data is here. This includes some commentary on value recieved for the dollars spent (it is worth checking the commentaries on some other countries).

Finally, thans to home fool TMFWysocki for posting in Income Investor this Washington Post article that provides a nice summary of the US healthcares quilted system in comparison to the systems used in other countries.



Home Coverage Team






2 Comments – Post Your Own

#1) On August 27, 2009 at 12:27 PM, caterpillar10 wrote:

Good idea. I would like to add some additional clarity to the debate. I am a retired medical claims examiner. I worked on an array of plans, all in the private sector in including Medicare, ERISA, and TriCare.   

Most every competent adjuster and underwriter I ever worked with was of the opinion that all health coverage would go single payer, one day, for reasons I'll leave for another time. I respected many of these but never bought into that view - I wrestle w/ the issue to this day.

I can tell you this: The whole private vs public argument is NOT AT ALL CLEAR and needs to take a whole new tack to make make any sense at all. 

If there is such a thing as a Dept. of Medicare it is a cubicle with a few bean counters in the SSA that coordinates with the Congressional Budget Office. No government employee works 'for' Medicare.  It is an act of congress. Just like ERISA - Employee Retirement Income Security Act of 1970somthin'. It defines and sets standards for the Health & Welfare plans  of self insured entities like unions or large PRIVATE Co.s like Motorola, just for example. Except for a few HRS wonks no Motorola employee works for the Employee/Retiree Benefit Plan.

All of this stuff is run by private insurers and TPAs (third party administrators) many of which are subsidiaries of insurers. Depending on the risks involved and how they are managed, contacting can be just as lucrative and usually more stable than underwriting the stuff yourself. 

If the federal government went 'in-house' with just what they have now, a large part of the private sector would vanish in a blow that could bring down most of the rest of it. I'm real sure they don't want to.  

Health care finance is already a public-private partnership and a productive one. The mechanics, definitions, standards, and practices developed for Medicare are to one extent or another the foundation of every plan out there. Waste fraud and abuse are definitely a shared responsibility. 

Whatever the 'sides' are to the public vs private argument, they are probably not what you think they are.  

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#2) On August 27, 2009 at 1:27 PM, XMFHelical (< 20) wrote:



Thank you for your comments and added insight.  



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