Oh for predictions, when it comes to the costs of ignoring the lack of cost controls on health insurers and providers, there is no PREVENTIVE medicine. So here's my prediction: In the next few years more people will be on Medicaid, the old folks will see little change in Medicare, more people will opt into the cheapest form of health insurance meaning the expansion of the health savings account and the health savings account as a tax avoidance tool for the rich will be expanded by the removal or raising of dollar amounts permissible to be put into such accounts (currently around 6 grand a year for a family). What else? Look for a boom in the reverse mortgage market as people take up this product to come up with the cash to pay for health care and perhaps a lowering the age of eligibility in that product from 62 to 55. This will leave homes in the hands of banks that will sell them to the next generation of home buyers through contracts with realtors. Why?
The health care reform dialog is a one tune tilly: It's all about FEAR. We are afraid we won't have health insurance so we've buckled under, given in and will continue to do so until the "insurance" we get gets us nothing in terms of INSURANCE, the coverage of the RISK OF THE COST of illness.
Consumers who argue for a free market should try to better inform themselves. This environment wasn't created by a free market, it was created by businesses making deals with government, influencing legislation and making their interests the law of the land. Failure to consider this has been the death knell for consumers because we've ignored the fact that WE, our representatives made it legal for health insurers to insure so little that one illness can bankrupt a family.
Exploiting the American people through a system of passing laws that accommodate the threats of physicians not to take on new patients unless they get paid more...(and so we have the 2% raise on Medicare providers instead of the reduction in their salaries) and that gives into the billions of dollars worth of pressure being exerted by insurance company lobbyists (and so we have the focus on providing low cost or finite health "coverage" to children, the healthy, or the famous pay your premium for a year and get a free physical preventive care philosophy) and politicians who successfully play the American people for fools as they talk about the "number" of people who have insurance rather than talking about who is getting insurance coverage and of what QUALITY that coverage is, (sort of like examining the number of unemployed always grossly underestimated because it excludes those whose unemployment benefits have expired and it excludes those who are grossly underemployed), has hopelessly ignored the fact that our health is being dictated by businesses.
Report after report comes out talking about the "complications" of reforming the industry but the dirty little secret is that it's about reining in greed and Obama's spoken intention to change things is not matching up with his actions.
Like his approval of a budget giving a 3.9% to civil servants in the Federal government when unemployment is flirting with double digits.
Like his promise to provide the option of the same benefits his family receives as Federal workers to the rest of the American people while tweaking this promise into some distant goal that will not occur until millions of those who voted for him based on the first version of this promise die.
Like refunding the cheapest insurables, children, rather than addressing the middle class, aging, possibly starting to get sick population that has supported him, the health insurers and the health providers for all the years before they actually needed medical care.
On March 12, today, MSNBC.com printed an Associated Press "Report: Health care 'value gap' hurts US, Americans spend a lot more than top countries but aren't as healthy" (www.msnbc.msn.com).
This article informs us of what we knew: The "study" "compares statistics on life expectancy, death rates and even cholesterol readings and blood pressures. The health measures are factored together with costs into a 100 point 'value' scale."
Here's how the US fares: "The United States is 23 points behind five leading economic competitors."
But the angle of this report, the devil is in the details. The report was sponsored by the "BUSINESS ROUNDTABLE". Without knowing anything more, we could have predicted the result of this abysmal state of affairs, their conclusion: "The cost-benefit disparity is even wider---46 points--when the US is compared with emerging competitors: China, Brazil and India."
First off, those countries are our competitors because US business shipped our jobs overseas to save money, but we'll ignore that one for now. Second, look at the focus of business, the cost-benefit...not getting enough bang for their health care dollars." What does this mean? I think it's obvious.
Health care changes will continue on the trend that has bankrupted individuals when they are actually ill and need medical care and need help paying for that care in accordance with their health insurance which is supposed to cover the RISK OF THE COST of illness while business will continue to support non-risk costs such as physicals and "wellness" checkups. There will be far more consideration of the COST of care given to a patients based on the likelihood of success and we don't need to look into a crystal ball to predict this expansion of insurance company determination of patient survival, just read the quote by H. EDWARD HANWAY, Cigna's CEO: "What's important is that we measure and compare actual value---not just how much we spend on health care, but the performance we get back in return."
Remember this blog of December 27, 2007 Nataline Sarkisyan Liver Transplant: The child who died because of delays in okaying insurance coverage for her transplant. Yup, that was CIGNA.
Fear is not endless, eventually, we will become fearless as our homes, our jobs, our health and our security are all ravaged because we wanted to make the insurance companies happy. We hoped Presdient Obama would be a new face on a growing problem but so far he is not.
President Obama could have shown some good faith and suspended the current handout to Federal employees of superior benefits packages to the people they serve (the American public) by adopting the go it alone and see what you can get for yourself approach pushed on the American people, but he didn't.
President Obama could have acknowledged that SCHIP and CHIP failed for lack of funding rather than throwing more money at programs that are far outspending their needs whether that is because of waste, fraud, or simply too many people needing assistance, but he did not. He could have made states more accountable for the federal dollars being filtered through their systems, but he did not.
President Obama could have made it mandatory that IF we spend billions on electronic health records THEN such records must be relied upon by all medical providers so that in exchange for our privacy we are assured NON-DUPLICATIVE testing, but he didn't.
President Obama could have made it mandatory that his billions of dollars saved be passed onto the consumers in the form of some sort of price reduction in costs based on these savings to insurers and health providers, but he didn't.
He could have stated that there would be penalties for non-compliance with technology goals instead of rewarding those technological advances for insurers and providers to the tune of incentive payments if such changes are made but he didn't (though there's more carrot and stick garbage that if they don't comply in 2011 there'll be a price to pay).
President Obama could have addressed the LARGEST group of uninsured, young adults, instead of 'the children' meaning the cheap and youngest of our citizens who are uninsured because their families don't have insurance, but he didn't.
I voted for President Obama, but I didn't vote for him because he spoke well, I voted for him because of what he promised and it certainly was NOT for him throwing money at every business and government agency and department with no oversight and telling the American people to wait a long while and maybe they'll see results. President Obama promises to be the best thing that has happened for the Republican party in years.
