Friday, March 24, 2017

Nothing to Get Excited About

Of the two hospitals here in Oshkosh, which one has the lower price for delivery of a baby?  What is the cost of an arthroscopic surgery on a knee?  What medical practitioner has the lowest rate for an annual physical?  If you aren't able to answer these questions definitively, you understand the root cause of what's usually described as the "health care crisis".

And because you likely won't be able to answer those questions definitively after the Republican health insurance bill passes (or doesn't pass) in Congress, you can see why that is not a real solution to the problem either.  I'm starting to hope that the bill does fail this week, so that everyone can go back to the drawing board and craft a plan that will actually work.

While the GOP bill would do away with the "employer mandate" it doesn't provide the incentives to get health insurance completely out of the "benefits package"--where it no longer needs to be.  Why do you have the health insurance plan you have?  Not because you went out and shopped for the best rates or the services that you need.  Instead, someone in HR in the front office decided that was the insurance you were going to have.  What if your employer just paid you what they currently pay for their share of the premiums and you found the insurance that best serves you?

The House bill also fails to put the onus on health care providers to inform patients of what their care actually costs.  Current rates are a delicate balance between the maximum hospitals and doctors can get--and how much insurance companies are willing to pay.  What if clinics and physicians had to provide you with written estimates like auto mechanics--detailing the actual "labor costs", "parts" and "service charges"--and you could choose which one offers the best results for the best price?  I bet the prices for over-the-counter pain medications and gauze would come down sharply at the doctor's office.

And what if health insurance was actually run like an "insurance" program--and not a "subsidy" program?  Actuarial tables could be used again to determine fair rates--rather than federal mandates and laws to treat everyone the same--even though a small percentage of the population are the ones racking up the major medical expenses.  There would be less pressure on the young, healthy population to overpay for insurance plans providing services the actuarial tables show they are highly unlikely to need.  And like bad drivers find out with auto insurance rates, those who choose to engage in habits detrimental to their health will pay more--because that is actually "fair"--not everyone paying the same.

When a bill comes before Congress that sets us on the path to truly containing our consumption of health care services--and lowering the costs--then we should get excited.

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