A new report from the Congressional Budget Office explores the various proposals on the table for reforming the nation's health care system and concludes there aren't many options that will overwhelmingly benefit both employers and employees.
Although most surveys find employers in favor of health reform, among the proposed options to increasing the number of Americans with health coverage -- essentially, premium subsidies and/or individual or employer mandates to obtain/provide coverage -- most would increase costs, CBO finds. And higher costs for employers likely would ultimately mean lower pay for workers (and less taxable income for the government).
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Thursday, January 8, 2009
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4 comments:
What efforts are being made in terms of tackling what I believe is the core issue at hand - addressing obesity and poor lifestyle choices? Switching to a universal healthcare system, keeping the current system or a hybrid will do nothing to address costs until as a nation we change behaviors.
How about a sin tax? What is the problem with taxing cola or fast food? It is your choice as an individual to select these unhealthy choices just as it is to smoke or drink, which are already taxed.
Until we attack the root of the problem it really doesn't matter if we try and shift costs from employers and private payers to all tax payers. How will this happen when the food giants are getting rich hand over fist by injecting junk into the system. I realize everyone has the individual choice of their actions, but we are not on a level playing field to make rational decisions so long as the food giants have so much control over our lives.
Example - I was amazed to learn that the FDA seal can simply be purchased! When you look at a sugar cereal such as Coco Puffs you will find an endorsement from the FDA - making one think, well it must be ok right? I mean come on!
I am working with a local MD who runs a free clinic. He treats 6000+ patients a year for a total cost of $163,000 for staff salaries rent etc. He provides basic Dr visits, Rx, xray & lab and all but in hospital charges are covered. He has a very cost efficient way to cover the uninsureds. We are exploring a way to open this to small employers to help defray costs. Certainly beats a government run program on cost and efficiency.
I'm no expert or genius. I have only a few thoughts / ideas that might lead to some solutions.
My first thought is to follow the money. Who is really profiting in the health care industry? Is it the doctors, insurance companies, hospitals, clinics, pharmacy benefit management companies, pharmacies, drug companies, etc.? If the profit is reasonable and is being spread to all those involved in providing health care or benefits, then this may not be helpful. But if the profit is out of line in some area, there should be a way to control or regulate the way they do business so they are not making money at the expense of the ultimate destruction of the whole system. Everyone needs to make a fair profit. People need to be fairly compensated for their work. But who is really raking it in so as to cause the whole system to be endangered? Target those areas first.
Next, providing preventative care and wellness programs pays off overall. It may cost a little more on the front side, but the savings on the back side will more than compensate. And recognizing mental health has a lot to do with physical health and providing parity in coverage is a step in the right direction. Although a person can only do so much to maintain their health, we need to provide coverage for any care that will help individuals make healthy lifestyle choices, maintain overall mental health and manage their health risks intelligently so as to prevent as much catastrophic illness as possible.
I don't know that a government health care system is the answer as this is not especially successful in the countries who have this kind of system (long waiting lists, minimal care, restricted care, etc.). But a supplemental federally funded system that would provide a base level of preventative care for all individuals might be advantageous. Often, indigents who have been unable to obtain needed regular health care are those who tax the system the most heavily as they experience a health crisis that could have been avoided.
Cutting back on coverage seems a little like cutting off the nose to spite the face, so to speak. The cost burden is going to have to be shared, but the underlying deficiencies need to be addressed. And it's going to take an intense joint effort to really make a difference and find solutions. I have yet to see government work together this way and the private sector isn't big on cooperation either. I don't think there are any easy answers.
Thanks for the comments, all. I agree with Jeff that lifestyle change (healthier eating and living, in addition to Anonymous's point about preventive care) is the key to changing the health care system from the bottom up. Not sure a sin tax is the answer, but at this point we're overdue for a little creativity!
Also, Anonymous makes a great point about following the money -- which to my eyes leads straight to insurers. Granted, they are taking on the risk and should reap the reward. But they also should use that "reward" to make a better product -- better coverage, better services, better support -- for their members.
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