Reimbursement rates aren’t so much the problem as the reimbursement system itself — especially for standard health-care delivery. The third-party payer system interferes with the normal pricing mechanism that allows supply to meet demand and on-time delivery. The more that primary-care business depends on arbitrary reimbursement rates at all, the less likely that doctors will choose to meet that demand, instead selecting other disciplines where their services get compensated more honestly and appropriately.
We’re about to make the problem worse by creating an even greater artificial shortage of providers than we currently have. That won’t help the people that ObamaCare purports to serve, and will only make it worse for the rest of us.
What’s the Best Fix for Health Care? - Scott Rae
Well, first of all, I’m not in favor of the government taking it over. In my view, that’s a cure that’s worse than the disease. I think that there are some fairly simple things that can be done that can make a big difference. First, there is no reason why insurance companies shouldn’t be allowed to compete across state lines. That would go a ways toward bringing the cost of insurance down. Second, the law should change so that all medical savings accounts roll over year after year — allowing for a long-term savings account rather than an annual account. There are some states where they do allow that, but we need to make that universal across the country. Third, I think we need to reconfigure how we view insurance. I don’t expect my auto insurance to pay for oil changes and tire rotations and alignment. But I do expect my auto insurance to pay for major accidents, acts of God, that kind of thing.
The combination of medical savings accounts that roll over and competition for higher-deductible insurance that would protect people from catastrophes would go a long way toward controlling the costs. Part of the thing that keeps the costs inflated is that somebody else is paying for it. I would do all sorts of things for my car if somebody else was paying for it, but I don’t because I’m paying for it. I think taking the third-party payer out of it to some degree would bring incentives back to individuals to ration care for themselves. The other thing — and this is not a simple thing — but the tort system where people can basically win the lottery through malpractice lawsuits has to be changed. Doctors won’t stop practicing defensive medicine until that’s changed. I would favor some sort of cap on malpractice settlements.
Oh, THOSE Death Panels! - John Hinderaker
The New York Times explains the thinking behind Obamacare:The federal government is now starting to build the institutions that will try to reduce the soaring growth of health care costs. There will be a group to compare the effectiveness of different treatments, a so-called Medicare innovation center and a Medicare oversight board that can set payment rates.James Taranto adds:
But all these groups will face the same basic problem. Deep down, Americans tend to believe that more care is better care. We recoil from efforts to restrict care. ...
From an economic perspective, health reform will fail if we can't sometimes push back against the try-anything instinct. The new agencies will be hounded by accusations of rationing, and Medicare's long-term budget deficit will grow.Having taken on, over the objections of the public, the responsibility for everyone's medical care, the federal government may not be able to keep its promise: "Eventually, we may well have to decide against paying for expensive treatments with only modest benefits."
Oops, sorry about that, Gramps!
It seems as though this is a pretty strong argument against ObamaCare. But we need to encapsulate it in a pithy phrase. What would you call governmental institutions that empower bureaucrats to decide when to deny medical treatment--panels, as it were, that have the authority to determine when a patient's death is necessary for the health of the fisc?
