Ask the Experts: Health care reform should focus on costs
For months I have worried that the battle over health reform would devolve into a partisan and political battle, pitting ideologies against one another, all the while losing sight of the larger goal. President Obama campaigned on a promise of reducing health care premiums by $2,500 for every family in America. That message appears lost in the bills working their way through Congress.
This past week’s house vote, which by all accounts became a frenzied race to count and recount yes’ and no’s until the magic 218 was reached, highlighted a concern shared by so many small and large employers, struggling to afford healthcare for their employees. It was unfortunate that the major controversies surrounding the bill, centered around federally funded abortions and the coverage of illegal immigrants. Both important topics no doubt; but abortion is a $350 procedure, and allowing illegal aliens to purchase unsubsidized coverage should be a revenue neutral proposition. Very little if any time was focused on the unfortunate fact that $1 plus trillion House Bill would dramatically increase the costs of health premiums for my clients while restricting their ability to offer and creatively develop plans that are competitive and affordable.
The house bill layers on tens of billions in taxes on insurers, med device companies, and pharmaceutical firms. Those costs will go directly to my clients premium costs. Further, employer mandates will result in the typical company threading the needle between offering a program that is too rich, thus triggering a Cadillac tax, and not rich enough, triggering a federal pay or play penalty. Health reform is about covering the uninsured, but apparently at the expense of the currently insured in a significant way.
Where is the federal government’s position on the 90% costs of healthcare, the out of control pricing and utilization variances in hospitals across America? To be effective at controlling costs, reform needs to give consumers access to real outcomes data, so the typical patient can choose a better hospital who will keep them healthy and not overcharge the employer for care by as much as 40%. Doctors and hospitals must have access to the best clinical data, so it doesn’t take 5 years for a best practice to make it in the hands of a provider. Serious focus needs to given to the fact that the federal government allows fraud and abuse to exist in the Medicare system to the tune of $100s of billions of dollars a year. True health reform would focus on the cost of care, not simply the delivery of taxes and subsidies to add millions to a terribly flawed cost system.
The House’s can celebrate the accomplishment of 218 votes, but many on the front lines are watching the opportunity of true cost controls slip away.