In 2008, healthcare costs accounted for 17% of GDP, reaching a staggering $2.4 trillion. [1] Pair this with the 11.6 million Americans unemployed, and over 46 million lacking health insurance in January 2009, and the government’s projected $1.75 trillion deficit, it’s clear that the country can no longer write a blank check for a mediocre healthcare system. [2], [3], [4] Reform that reduces the economic burden of healthcare on all paying parties and ensures universal access to coverage for quality care is essential in improving the economy, as well as health of this nation; a system in which all people can maintain their health without financially crippling themselves and/or their employers, keeps people in the workforce, keeps them spending money into the economy, and keeps expensive emergency healthcare costs down. In light of the current economic climate, Obama’s healthcare reform must focus on reducing unnecessary healthcare costs and offering a universally accessible, quality and affordable healthcare option. Eliminating unnecessary government spending, emphasizing preventative care, and improving management systems all are necessary steps in greatly reducing healthcare costs. The government must cut unnecessary Medicare spending by paying Medicare Advantage plans the same as that of equivalent care through traditional Medicare, instead of the excess 12% MA currently receives. In addition to straining a tight government budget and increasing premiums for elderly enrolled in traditional medicare, MA’s higher cost has done little to expand minority and low income enrollment and coverage as initially intended. [5] Further, the administration needs to repeal the ban on Medicare’s direct negotiation with drug companies. The savings realized by both these actions should be used for further healthcare reform. In addition to cutting unnecessary Medicare spending, the new administration needs to enact policies and initiatives that reduce inefficient healthcare and management practices by emphasizing primary care and investing in electronic health management technology. Obama’s new public plan must emphasize primary care by aligning provider reimbursement with quality of care, not quantity of services, and providing coverage for preventative care and integrated chronic condition management. Including this in his public plan will expand access to regular screenings, physicals and chronic condition care, improving beneficiaries’ health and reducing avoidable and expensive hospital services. [6] Introducing an electronic health information system will eliminate costly and inefficient management work and provide more accessible, current medical histories, reducing duplicative procedures and other unnecessary health services. [7] Although these attempts at reducing healthcare costs are essential, greater reform of the current system is needed to fully realize these savings and address problems of financial burden and accessibility of health care. Obama’s proposed National Health Insurance Exchange (NHIE), although not the radical overhaul necessary to insure universal health coverage, is an essential action for multiple reasons. [8] First, it greatly expands access to quality health coverage, reducing the uninsured population and financial burden of buying into healthcare. By promising universal access, regardless of preexisting conditions and offering tax credits to both individuals and employers, NHIE could offer comprehensive coverage to a growing number of the currently uninsured and underinsured without financially crippling small businesses or families. [9] Second, the NHIE is a microcosm of effective healthcare reform, with standards regulating quality and comprehensiveness of care, eligibility, and cost-sharing for participating insurers. [10] Its emphasis on transparency in spending, ensuring that participating insurers justify above-average premiums and disclose cost of services, speaks to a new focus and value placed on accountability and ethical uses of people’s money, a necessity in today’s economic climate. [11] If this plan comes into existence, it will act as stark contrast to the market tendencies of the current health insurance industry and hopefully fuel a serious and critical reevaluation of the effectiveness of our current market model of healthcare. All of these steps at reforming this country’s current health system will come up against strong opposition. Negotiation of drug pricing and the NHIE jeopardize the profit margins and competitive edge of the insurance and drug industries, both of which have deep pockets and strong lobbying power on Capitol Hill. [12] Further, establishing the NHIE will meet strong resistance from Republicans who have long had an individualist approach to healthcare reform, stressing HSAs and little government involvement. [13] Future Republican resistance of the Exchange may be foreshadowed by the party’s strong resistance to the economic recovery package, and the ultimate cutbacks made to the bill’s expansion of Medicaid to the unemployed. [14] However, the bills passage through congress may also foreshadow Democrats by-passing much Republican support when passing healthcare reform. Bipartisan, effective health care reform will be a struggle; however, in light of the current economic crisis and the state of the federal budget, policies to reduce unnecessary government spending on Medicare may garner bipartisan support in an attempt to control the federal deficit. The conversation about healthcare in this country needs to change and perhaps the country’s current economic state and Obama's proposed health reform will generate a more critical dialogue. The egregious actions of the banking and credit industries have demonstrated how corporations force financial risk onto the public to maintain their personal profits. Our healthcare industry has similar problems concerning socialize risk and privatized profits. Insurers collect individuals’ premiums on the pretense that these monthly down payments will protect beneficiaries in times of need, then deny claims, limit benefits and increase cost-sharing, all in attempts to push the risk towards the ill and maintain their substantial profits. Obama’s health plan changes this market system, but it does not eliminate it. What it may do is help the country realize the inherent faults of competitive healthcare and generate a serious conversation about social insurance, moving our country towards true universal healthcare.
_____________________________________ [1] National Coalition on Health Care, “Health Insurance Costs,” The National Coalition on Health Care. 2009. 20 Feb. 2009. <http://www.nchc.org/facts/cost.shtml>
[2] Bureau of Labor Statistics, “The Editor’s Desk: Increase in unemployment rate in January 2009,” February 10, 2009. 21 Feb. 2009. <http://www.bls.gov/opub/ted/2009/feb/wk2/art02.htm>
[3] National Coalition on Health Care, “Health Insurance Costs,” The National Coalition on Health Care. 2009. 20 Feb. 2009. <http://www.nchc.org/facts/cost.shtml>
[4] Calmes, Jackie, “Obama Plans Major Shifts in Spending.” New York Times 26 Feb. 2009, 26 Feb. 2009. <http://www.nytimes.com/2009/02/27/us/politics/27web-budget.html>
[5] Angeles, January and Edwin Park, “Curbing Medicare Advantage Overpayments Could Benefit Millions of Low-Income and Minority Americans,” Center on Budget and Policy Priorities. 19 Feb. 2009. 26 Feb. 2009. <http://www.cbpp.org/2-19-09health.htm>
[6] Davis, Karen et al. “Slowing the Growth of U.S. Health Care Expenditures: What are the Options?”
Commonwealth fund. January 2007.
[7] “Barack Obama and Joe Biden’s Plan to Lower HealthCare Costs and Ensure Affordable, Accessible Health Coverage For All,” Barackobama.com. <http://www.barackobama.com/pdf/issues/HealthCareFullPlan.pdf>
[8] Holahan, John and Linda J. Blumberg. “An Analysis of the Obama Health Care Proposal,” The Urban Institute Health Policy Center. 2008, 20 Feb. 2009.
<http://www.urban.org/UploadedPDF/411754_obama_health_proposal.pdf>
[9] Ibid.
[10] “Barack Obama and Joe Biden’s Plan to Lower HealthCare Costs and Ensure Affordable, Accessible Health Coverage For All,” Barackobama.com. <http://www.barackobama.com/pdf/issues/HealthCareFullPlan.pdf>
[11] Ibid.
[12] “What Now Mr. President?,” BBC Panorama. Narr. Hilary Anderson. BBC One, 19 Jan. 2009.
[13] Healthcare: 2008 Republican Platform Healthcare, 2008. 26 Feb. 2009.
<http://www.gop.com/2008Platform/HealthCare.htm>
[14] Herszenhorn, David and Carle Hulse, “Details of a Trimmer Stimulus Emerge,” New York Times 12 Feb. 2009, 20 Feb. 2009. <http://www.nytimes.com/2009/02/13/us/politics/13stimulus-web.html?pagewanted=2&fta=y>
|
.jpg){kind=small}
