[Oe List ...] Here is my understanding of needed health care reform. Dave Thomas

[Dave Thomas]

Let's Attack Private Health Insurance?

 

Private health insurers and their supporters continually attack public
health insurance, mostly with lies about government interference in the
patient's relationship with his health providers and about the effectiveness
of public health insurance in other countries.  Why shouldn't we supporters
of public health insurance attack private health insurance?  It is easy to
do so while sticking to the truth.

 

I was glad to watch Senator Christopher Dodd deliver an impassioned speech
on C-Span, in which he eloquently described various abuses by private health
insurers:

*       They refuse to insure people with pre-existing conditions

*       They accuse ill customers who make claims of having pre-existing
conditions (rescission), such as arguing that headaches noted on an
application indicated the presence of multiple sclerosis.  More.
<http://www.slate.com/id/2223680/> 

*       They invisibly, vaguely, or in small print, deny coverage of various
illnesses

*       They delay approval, such that people become sicker or die due to
lack of treatment.

*       They deny coverage of various treatments, claiming they are
experimental contrary to the judgment of his patient's physician.  Rationing
done by publicly unaccountable private bureaucrats.

*       They offer a bewildering array of deductions, co-payments,
underpayments, and limits, such that insured patients end up with enormous
bills.

*       Their priority is increasing profits instead of serving their
customers.

Obama
<http://www.whitehouse.gov/health-insurance-consumer-protections/?e=9&ref=te
xt>  sent me an email describing consumer protections to be included in
health care reform.

 

In addition:

*       Private health insurance is much more costly than public health
insurance, due to marketing, the cost of disqualifying customers and
treatments, and profits.  There
<http://www.businessweek.com/magazine/content/09_31/b4141022519011.htm>  is
little competition with just 1 or 2 private insurers dominate many state
markets.

*       Private health insurance costs are increasing more rapidly than
costs of medical products and services.  And more rapidly than increasing
public health insurance costs.

*       People with private health insurance frequently find their insurance
cancelled or treatments denied, often without just cause.  The resulting
medical costs often lead to mortgage foreclosure and bankruptcy.  Something
that doesn't happen in countries with universal coverage.

*       People with private health insurance are much less satisfied with
their insurance than people with public health insurance.  A majority of our
people prefer public health insurance.  If we didn't have private health
insurance lobbyists backed by campaign contributions, we would have public
health insurance like less corrupt democratic European countries.  For
benefits of Medicare. <http://pr.thinkprogress.org/2009/07/pr20090730> 

Note that no Canadians run up large debts, lose their homes or become
bankrupt due to illness.

 

We need to provide public health insurance coverage of necessary medical
treatments, allowing people to buy additional private health insurance for
optional medical treatments.  To reduce costs of public health insurance, we
need to implement:

*       Low-cost single payer administrative system, monitored to prevent
fraud

*       Bargaining with health care providers to create appropriate prices

*       Payment for health outcomes instead of procedures, including
preventive, chronic and hospice care

*       Various local, state and national strategies to stimulate healthier
lifestyles (such as dieting
<http://www.usatoday.com/news/health/2009-07-27-costofobesity_N.htm> ,
exercise, addiction prevention and treatment)

*       Coordinated care beginning with a primary care physician, including
shared electronic patient charts (as done excellently by our Washington
Group Health Cooperative)

*       Evidenced based care, based on recommendations (or mandates) by
health care specialist committees (with members employed by providers or our
government) based upon comparative
<http://www.npr.org/templates/story/story.php?storyId=106828530>
effectiveness health care research.  For more.
<http://effectivehealthcare.ahrq.gov/>   This will result in rationing by
physicians instead of private insurance clerks.  For
<http://www.washingtonpost.com/wp-dyn/content/article/2009/07/24/AR200907240
2079.html>  more.
<http://www.tnr.com/politics/story.html?id=bf602cf2-dbf1-4c93-b168-3708dc415
4e3> For more.

*       Eliminating payment disparities between regions, resulting from
congressional responses to special interests.  Instead of congress, a
non-political commission should decide payment rates.  

*       For
<http://www.washingtonpost.com/wp-dyn/content/article/2009/07/25/AR200907250
2380.html?hpid=topnews>  more.

 

The congressional delay in passing health care reform bills may have
beneficial consequences.  Many of the cost containment measures that are
needed were not sufficiently included in the various bills, due to their
negative impact on various special interests in various congressional
districts.  I expect including some of the measures will be a high priority
during and after the congressional recess.  For
<http://blogs.tnr.com/tnr/blogs/the_treatment/archive/2009/07/26/yes-reform-
can-control-costs-and-that-s-not-all-that-matters.aspx>  more.  I still
believe that health care reform has plenty of congressional support and will
be passed.  Democrats won't let Max Baucus almost single-handedly stop
Health Care Reform.  Dave Thomas

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