Healthcare Professionals for Healthcare Reform

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The Negotiations are Beginning

In follow-up to the prior post, there is an interesting (and troubling) article in the NY Times today entitled “Health Care Industry in Talks to Shape Policy” .

It seems that the insurance industry is having “secret talks” with Kennedy’s committee. The problem I have with this is, where are the healthcare professionals in this? Why are we getting left out again?

Gil

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February 20, 2009 - Posted by | Uncategorized

2 Comments »

  1. The concept of a three tiered system has some merit. The danger is that it propagates the for-profit insurers as the providers of Tier 2 and would not control cost as well as single payer. It would leave their administrative expenses and negate monopsony buying power allowing “excess cost growth” to continue its exponential rise. It might work better if tier two were not for-profit. Otherwise the for-profit insurers will try to cost shift and deflect risk to tier 1—the public payer in the pursuit of profit.

    Comment by EDB | April 8, 2009 | Reply

    • Hi Earl,
      You are right to fear the private insurers in the current system for all the reasons you mention. However, in EMBRACE, the administrative expenses will all but be eliminated. This is because all the approvals and payments will be predetermined by the “central computer” using the Tier 2 menu of plans and the universal billing form.
      The system takes almost all the administrative aspects of Tier 2 out of the hands of the insurers giving them control only at the time of the purchase of the plan. Unlike in the current system, the consumer who is buying the plan can compare costs with other insurance plans thus establishing real competition among the insurers, which in turn should bring down the cost.
      In fact, between the elimination of overhead (bureaucracy), the creation of competition, and the elimination of the greatest risk for the insurers (most of which will be covered by Tier 1); we believe that the prices of private insurance for Tier 2 will be very affordable.
      Finally, it is an unfortunate fact of life in the US that private insurance will become a part of any American health system. This will also be true even if HR 676 (the single payer proposal now in congress that doesn’t seem to be going anywhere) is adopted. The problem is that if we ban the private insurers in the main system they will (as they have in most single payer countries) create an alternate system that will eventually compete with the main system.
      All we want to do is keep them in one system and under control.
      Gil

      Comment by GIL | April 9, 2009 | Reply


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