Published Jun 1, 2009
Health reform would be expensive. So would no health reform
A lot of the debate about reforming health care revolves around a false choice-the simplistic idea that transforming the health system would be far more expensive than sticking with the current system.A growing body of scholarly evidence points to the fallacy of that argument. Two new studies underscore that doing nothing would carry significant new costs in both the short and long terms.A study in the journal Health Affairs estimates that by next year, the number of uninsured Americans could top 52 million-not counting those who lost coverage when they lost their jobs in the current recession.A second study predicts that figure probably will reach at least 57 million people in a decade, about 10 million more than were uninsured in 2007. That research, by the Robert Wood Johnson Foundation, suggests the number of uninsured could easily reach 66 million by 2019 if worst-case assumptions about the economy are met.Meanwhile, business spending on health insurance for workers would more than double, as would spending for Medicaid and the State Children's Health Insurance Program.
A growing body of scholarly evidence points to the fallacy of that argument. Two new studies underscore that doing nothing would carry significant new costs in both the short and long terms.
A study in the journal Health Affairs estimates that by next year, the number of uninsured Americans could top 52 million-not counting those who lost coverage when they lost their jobs in the current recession.
A second study predicts that figure probably will reach at least 57 million people in a decade, about 10 million more than were uninsured in 2007. That research, by the Robert Wood Johnson Foundation, suggests the number of uninsured could easily reach 66 million by 2019 if worst-case assumptions about the economy are met.
Meanwhile, business spending on health insurance for workers would more than double, as would spending for Medicaid and the State Children's Health Insurance Program.
herring_RN, ASN, BSN
Medicare for All (Single-Payer) Reform Would Be Major Stimulus for Economy with 2.6 Million New Jobs, $317 Billion in Business Revenue, $100 Billion in Wages
The number of jobs created by a single-payer system, expanding and upgrading Medicare to cover everyone, parallels almost exactly the total job loss in 2008.
even Republicans are starting to agree that we can't afford not to reform healthcare:
From "Republicans for Single-Payer" website:
"Universal Healthcare with Informed Choice Reforming Healthcare – Why Bother?
How does our existing healthcare system perform?
- It’s not universal health care. 15% uninsured, 50% underinsured, and hundreds of plan variations.
- Almost everyone is one unexpected, unpredictable catastrophic event away from disaster.
- Consumers lack free choice of providers and coverage as long as employers select plans.
- Consumers must abide by the guidelines of 3rd party payers, often limited to provider panels.
- Consumers and providers lack accurate cost data on alternative healthcare options.
- Aside from Medicare and costly individual plans, healthcare is linked to employers.
- Businesses entail huge costs of selecting insurance plans and managing them, and costs are rising.
- Healthcare is subject to excessive political and 3rd party payer guidelines and regulation.
How is our current healthcare system funded?
- Over 50% of our current healthcare expenses are funded by government revenues.
- 15% of Americans are uninsured and pay out-of-pocket or apply for Medicaid when sick.
- 56% of personal bankruptcies are due to medical expenses, with consequences to providers/creditors.
- Bad Debts, or uncompensated charges, are mostly paid by the rest of us through higher premiums.
- Adverse selection results in cost-shifting by carving out risk pools and excluding high-risk conditions.
- Overall healthcare expense is 16% of GDP, projected to exceed 20% by 2020.
- Administrative expense in the US exceeds 30% due to redundant and wasteful process.
- Businesses are forced to reduce benefits and shift costs to employees, due to rising costs.
What is the current process for handling claims and payments?
- Providers have hundreds of 3rd party payers to bill, resulting in high administrative costs.
- Claims are submitted to 3rd party payers with payments often delayed for months.
- Providers negotiate “contractual adjustments” with 3rd party payers so actual charges are unknown.
- Uninsured patients are charged “list price”, far in excess of 3rd party rates.
- Claims are often covered by multiple policies, resulting in conflicts and excessive payment delays.
- Endless debate and litigation to determine medical liability adds to costs and additional complexities.
What is the level of quality of our current healthcare system?
- Healthcare data is fragmented into thousands of inaccessible databases, many proprietary.
- National databases are based on samples and produce “snapshots”, often delayed by years.
- Providers maintain their own medical records, with multiple duplications, usually on paper.
- Financial incentives favor specialists, resulting in excessive, high-cost treatments and risks.
- Incentives to become specialists result in shortages of primary, family practice MDs.
- Payment system encourages over 30% redundancy of service, outside of best practices.
- Patients receive less than 50% of recommended care, according to best practice guidelines.
- Providers fail to follow evidence-based guidelines to inform clinical decision-making.
- Quality data is not available to consumers to facilitate informed, value-conscious decisions.
- Communities lack data to facilitate effective and economic health services to residents.
- Providers’ credentials and practice profile data is not accessible to the public.
- Public Health is compromised by lack of timely access to integrated data repositories.
- Key performance indicators (eg Healthy People 2010, JCAHO Oryx) are not widely used.
- According to WHO and OECD, the US is far from the healthiest country in the world.
- Health disparities persist for many dis-advantaged minorities, resulting in high costs to society."
Single-payer system has its advocates
by Dale Davenport Saturday June 27, 2009, 5:05 AM
The core issue in the health care reform debate is, of course, money.
But it is not just the costs of care and, by extension, insurance, which have risen three times the rate of inflation during the last three decades, busting family, corporate and government budgets.
The personal incomes of millions of Americans who provide care or who work for the insurance plans that pay for it also are at stake in any change to the status quo. ...
...Advocates say single-payer would save $400 billion a year in insurance-related expenses, he said....
...No easy answers or agreements. But the debate continues, and the more we know, the better informed the debate will be....
As I read these debates on healthcare reform, I can't help but notice that the reasons why Americans are so sick is rarely mentioned (processed foods, environmental pollution). All I see is a demand for healthcare. If we are going to demand that government do anything, I think it would be more cost-effective to demand that they quit subsidizing the corn industry (which in turn is used to produce high fructose corn syrup which is put in EVERYTHING and is linked to liver disease and obesity), demand that they take aspartame (linked to Alzheimer's) off the market, etc. The list goes on but I think you get the point. Imagine the savings on pharmaceuticals alone.
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