It's been decades since the identification of challenges of skyrocketing costs of medical services and health insurance, as well as diminished access to health care and help in paying for needed care. While the stakeholders are identified, why can't we make progress and will any candidate be able to improve the system.
I can already hear it, several goals of our plan are headed for implementation....as whichever President elect identifies the end of momentum, and the relaxed security of having been elected. Tired from campaigning, a few changes will be tossed into the mix to create a list of what was done in the first hundred days, as candidate now President rests up after doing his/her real job of getting elected.
The reality that we do not have direct contact with our President will settle in as the bumper stickers on cars fade and tear and as our new President reveals over time what his/her real key issue is...and it is likely not health services.
Who can blame them? Health services reform is lose lose. Any identification of the problem of costs will anger blocs of physicians and/or insurers. Identification of utilization by patients, often for unneeded services will infuriate those who dial a doc for relief of everything from a headache to a cold because they have that option for the price of a co-pay.
So what will finally change health care? State by state pressure on our representatives and those whose political future depends on our votes...senators, congressmen, insurance commissioners...those whose names we probably don't know.
And what can we expect from the next President? Probably action on typical government lag time issues: National provisions getting "tougher" on rescission (termination of policies based on fraud of insured), this is already going on in the states so it is a low to no risk federal issue. More laws mandating health insurance election or the payment of a fee to a state entity, such as the law passed in MA. More interesting will be the play or pay provisions applied to employers (rather than those applied to consumers). Employers obviously want to be relieved of any obligation to do anything for their employees and our economy is not good. We can expect that some minimal changes that will supposedly ease the burdens for employers will be considered, such as paying into a fund. In other words, employers will get out of the health insurance business to a large extent. While this will cost consumers more in premiums, it will also open the door to new lawsuits by consumers against insurers based on contract law, with none of the protections that Federal law gives insurers now. Minnesota is trying to pass a law easing the way to suing health insurers but is including caps on recovery for damages, this is not a good idea. Limitations on recovery give health service providers an edge that they fight tooth an nail to PREVENT when it comes to what they receive...maximum amounts. If tort liability limits are legit so are wage and price controls.
And what of the gargantuan bureaucracy that is Medicare/Medicaid? It will plod on like a wooly mammoth, with slight decreases in coverage for insureds and slight raises in federal dollars paid to providers....the same old.
