Healthcare News & Insights

Health reform jumps first hurdle, but has anything changed?

While politicians continue to make noise over the recent passage of a health reform bill in the House, the situation health care providers face in the trenches seems unlikely to change much.

Assuming the Senate also passes a bill, and the politicians manage to get a compromise bill to the President’s desk, the bottom line is that most of the “health care” debate has focused on the dollars and cents of insurance.

Mostly ignored by Congress are concerns about the quality of patient care, the need for wellness, prevention and health education programs, or improving access to health care in under-served populations.

No matter what end of the political spectrum you’re on, everyone can agree, there’s a lot of room for improvement in our current system.

If you could write the final version of the health reform bill, what would be on your priority list? Share your thoughts in the comments.

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Comments

  1. Steve Kuehn says:

    Health Care Reform is:
    1) Allow Health Care Insurance Companies to competer Nationwide.
    2) Immediate and extensive Tort reform
    3) Develop a powerful Fraud Squad.
    4) Congress and the White House must pay for their own Health Insurance.
    5) All illegal immigrant must be deported now. They cannot continue to received free healthcare.
    6) Doctors liability insursance must be capped by speciality.

  2. Home Care is part of the solution.

    Home Health Care and Home Medical Equipment minimize expenses and costs and deliver positive results.
    If you add telemedicine to Home Health Care and Home Medical Equipment, you end up with patients that can be seen by their doctors at home. You minimize emergency room visits. You minimize hospital admissions.

  3. Lee Loy jr says:

    1. Tort reform – without it, there will be no chance in reducing costs or making health care affordable.
    2. Health Insurance reform – address some of the abusive policies that insurance companies practices today (i.e. dropping a long-time policyholder after a serious illness; repeatedly changing administrative procedures to confuse doctors so that reimbursements will be delayed; changing levels of coverage without notice or with confusing notice; etc.)
    3. Improve methods for increasing competition amoung health insurance providers.
    4. If possible, make health insurance policies transportable. As people move from job to job and location to location, have it so that people can bring their policies with them.
    5. Provide incentives for healthy living. Lower premiums for non-smokers, and non-drug users.
    6. Keep the government option out of the picture. Government bureaucracy will only make things worse. If the government option is implemented, it will mean that we will be paying for health care for illegal aliens. Language in any health care bill that forbids participation by illegal aliens would be struck down in courts as unconstitutional (see Phyler vs Doe).

  4. If I had my input, I would request that, if families had double insurances, that the doctor’s office would be not required to bill the secondary insurance for the copay. I would ask the insurance companies not to suggest that the doctor’s office “coded the encounter wrong” and that’s why the insurance didn’t pay for the services. People should realize that first dollar coverage is the most expensive. Since they don’t expect their car insurance to pay for the first dollar, their health insurance shouldn’t either. Prior to the advent of PPO’s,HMO’s, CCPPOs, etc in the mid-1980s, people knew they had major medical and that their insurance would not pay for a regular doctor’s visit. Billing was minimal in those days. The more hoops the insurance companies throw at doctor’s offices, the more expensive healthcare is. The President and his advisors should visit doctor’s offices to see what actually goes on in an office; i.e., referrals, copays, etc., and then try to come up with solutions.

  5. Instead of a public option limited to the high-risk pool of people who can’t get insurance, I would open up Medicare to anyone who can buy into it.
    Secondly, I would require all insurance companies as well as Medicare to full reimburse without copays or deductibles for all preventive and wellness services, including holistic health practices such as homeopathy, naturopathy, acupuncture, chiropractic, nutritional counseling, excerices programs, etc. I would reminburse primary care physicians at a much higher rate and specialists at a lower rate. I would highly regulate for-profit medical providers and insurance companies to limit executive compensation and profits, something like regulated utilities, where rate hikes would have to be approved. I would elminate all restrictions on buying pharmaceuticals from Canada and for Medicare to negotiate lower drug rates. I would include full reimbursement for herbal and nutritional supplements prescribed by any licensed health practitioner.

  6. James Ludwg says:

    Get government out, do not treat those that are here illigally, Tort reform.

  7. leonard reich says:

    Four insurance guanrantees. Everybody must have healthcare. You take wherever you go from job to job or unemployment or to senior status. No limitation on medically necessary care including mental healthl and substance abuse. No limits on preexisting conditions.
    Provider changes. Push integrated care through electronic medical records and transfer of information. Develop provider systems of a continuum of care, including expansion of the medical home. Change the payment system from capitation and case rates and care rates from straight fee for service. Develop prevention and disease management programs to be coordinated by insurers and partnership with providers. Pays providers meaninful bonuses for improved patient outocmes and success in chronic disease maangement and prevention successes.
    Consider a single payer system in which individuals and groups employers pay into the system. Develop a base plan to which everyone is entitled and a pemiere plan into which people may buy in directly or their employers may pay into as part of a benefti package.

  8. Duane Tamura says:

    Typical government process. Starts off with a lot of promises, what all is needed to make everything perfect, and then wham bam, thank you ma’am, get it done whatever it costs or looks like. I need some political face-saving out of this!!!! Another “notch” in the gun butt for the ego. I hope the news agencies saved all of the video of the President’s promises to replay when this is done because it aint going to look like anything he was promising to get elected. Not to mention the additional cost to the 85% of those who had insurance. He may be lucky if he turns out to be a one term president because when the S_ _ T starts hittin the fan, he may not be able to find a hole to hid in. Can you imagine how long it will take the economy to absorb the cost of this program even in a phase-in process? Bend over and grab your ankles folks…….the fun or, the you know what, is about to begin.

  9. After 26 years in Dietetics practice there is still little progress being made in the area of prevention. I am hoping that as a country we would show greater interest and monetary support for it. It’s so much easier and cheaper to pay for education in prevention than to pay for costly by-pass or gastric banding surgery downstream. We are not encouraging a healthful lifestyle – we encourage procedures and pills, over portioning and obesity. It is totally backwards and embarrassing.

    Misuse of the ER’s in Houston and across America is another area of concern. Laws requiring every patient be triaged that inappropriately uses the ER like a clinic or instead of calling their MD is wrong. It is a major problem in Houston and for our healtcare system as a whole. Something needs to bechanged to address this via clinic networks for referrals on a sliding scale payment basis and patient education.

  10. Tort Reform,
    Nationwide competition for Insurance Companies
    Allow pre-existing conditions, could you imagine removing the exclusion that dead people could not buy life insurance, or purchasing auto insurance after a wreck?
    NO GOVERNMENT…..NO ILLEGAL IMMIGRANTS
    Penalize poor life health choices, ie. smoking, obesity, etc.
    Make senators and congressmen buy insurance like everyone else

    Finally, require our legislators to read the bill they are voting on!

  11. First off I am not for this health care plan that is being jammed down our throats. Bigger government is not the answer to our health care problems that now exist in our system.If fraud and waste in medicare and Fanny mae is an example of how government runs things then we are in big trouble. First clean up the waste and fraud in medicare , this in it self will save millions of dollars .Then cut out some of the pork that is being promised to get the necessary votes to approve the socialized health care program that is being offered ,we would save enough money to come up with a better health care plan that is affordable with out bankrupting our country.

  12. Chris Meyer says:

    The debate about “Healthcare reform” is not about reform but rather about expanding coverage to more people and I believe government expansion. To date we haven’t been shown how “Healthcare reform” it will improve quality or lowered costs or continue to attract the best individuals into medicine.

    We are on the path to creating another entitlement. I don’t disagree with the aim of increased coverage (I work for a not-for-profit Catholic health system), but I think it would be far more efficient and effective with the free market and personal responsibility than governmental entitlements.

    Things to change that will help improve healthcare and lower costs are:
    1) Focus on individual responsibility. You may not be able to prevent some health issues (genetic, etc) but certain conditions can be managed well at low cost if you follow what your doctor tells you to do. Allow and encourage incentives and dis-incentives to shape individual’s healthcare actions so the person bears some of the financial consequenses for what they do or do not do.
    2) Allow choice of the benefits individuals want (eliminate mandates) with or without various services.
    3) Tort reform should occur as with todays system it strongly encourages defensive medicine resulting in over utilization of tests to avoid being sued.
    4) Look at how to provide care to those who do have exceptionally bad health histories: high risk pools that are subsidized; minimum coverage polices that are affordable.
    5) Acknowledge that the world isn’t fair; encouarge a world of opportunity but don’t prescribe that all results must be equal. If we pursue that route what is the best about US healthcare will cease to exist, lowering the overall level of healthcare we’d like to offer.

  13. Let’s see, do I want government involved in my health care, or should I leave it to insurance companies? Government can at least get voted out if we don’t like them. Insurance companies are only accountable to those who are trying to profit off of my illness. They are the ones who have kicked the sick out of hospitals. They are the ones who take one third of every health care dollar. They are the ones who will not cover pre-existing conditions and who will drop me from coverage if I get sick enough to really need it badly. The government’s role should be as small as possible, but only the government can protect people who are dying and being pushed into bankruptcy every day. After all, in America the government is us – of the people, by the people, FOR the people.

  14. Knowledge about healthy living is no longer an issue. Millions and millions of people go to gyms now as compared to 1979, thats thirty years of healthier living. EVERYONE knows smoking is bad and everyone knows taking drugs is bad for us, so lets ease up on the health education talk and get real. People will choose to live healthy or not, everyone will get sick or have injuries at some point and thus, how to pay for it. Should I pay for everyone or should each of us pay for ourselves as we see fit for ourselves and our families? Changing the regulations for health insurance companies is the place to start. We all pay into it and some will unfortunately need it more than others. If that’s not working, putting another layer of everyone paying for it even more through the government is not going to solve the problem. Do away with employer based plans. See how fast premiums come down when insurance companies have to come after each and everyone of us individually. Competition, it does not happen at most work places and won’t even if you open up the market across State lines, you’re company has what it has, no choice there. Each individual or Family should be able to buy whatever insurance they want, nothing to do with their employer. That’s the only way that’s going to work, that’s competition, take the employer out of the equation.

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