From Concord Monitor of Concord,NH




Editoral


In the 1970s, Muhammad Ali, one of the greatest boxers of all time, used a tactic he dubbed the "rope a dope." It involved lying against the ropes and letting rivals pound away until they tired themselves out. Then Ali would go in for the kill. Forgive the cynicism, but there's a fair chance that the six health-care industry groups that met with President Obama this week and pledged to reduce health-care costs by $2 trillion over 10 years were using a version of the rope a dope to kill true health-care reform.

The meeting was historic and welcome. It is a sign that insurers, pharmaceutical makers and health-care providers all recognize that the ever-increasing costs are near a breaking point. They admitted they could charge less and agreed to take their licks. But since World War II, four attempts have been made to reform America's health system and all have come to naught.

The need to reform health care, which now consumes nearly 18 percent of the nation's economy, has never been greater. Some 47 million Americans are uninsured, including approximately 144,000 New Hampshire residents. Health care-related expenses are the leading cause of bankruptcy, and they're driving people out of their homes. A $2 trillion reduction in health-care spending over the next decade will slow the march to system collapse, but not halt it. It amounts to an estimated reduction of 1.5 percent in health care costs that are increasing at the unsustainable rate of 6 to 7 percent per year.

The key word, of course, is "estimated." The health industry groups made no firm promise to achieve their goal and gave little information about how they would go about doing it. What they offered is a promise that's been broken before, and that's nothing to take to the bank.

The groups were moved to come to the table by fears that Obama would succeed in convincing Congress to create a public health plan that would compete with private plans. Their fear is justified, particularly since polls show that the public, by a good margin, wants a public plan to be part of the mix.

The group also opposes many of the things that must be done if health-care costs are going to be brought under control. They don't want Medicare reimbursements to be reduced, and they don't want to have to prove, as Robert Pear pointed out in The New York Times, that new drugs and medical devices are more effective than older, less expensive ones.

The industry is right when it says that Medicare in particular, is not as efficient as many claim. It's drowning in red ink. True health-care reform will require reform of the Medicare, Medicaid and Veterans Administration health care systems that provide care to more than one-quarter of all Americans.

The health care industry is also right to fear that government won't keep its bargain to keep the playing field level if a public plan is created.

At some point, government could use its clout and ability to print money to ultimately put them out of business. But that isn't a given. If the industry can control costs and provide equal or better service, many people will choose a private over a public will or should.

Health care, however, is not subject to free-market rules. Competition between insurers or providers, for example, has failed to achieve cost savings.

Perhaps competition with a public plan, one whose administrative costs are low and profit motive absent, will. The current health-care debate, which may not come around again for another two decades, can't be based on a need to guarantee that insurance companies survive.

What health insurers must do is prove to patients and employers that in the face of a public option, they offer enough value to justify their existence.





This article is: 0 days old.




--------------------------------------------------------------------------------
Print article Letter to editor Send and share

Email to a friend Del.icio.us Digg Newsvine FacebookMySpace Hyperlink

--------------------------------------------------------------------------------

Comments
So what's YOUR solution?
By Anonymous on Wed, 05/13/2009 - 16:37
20090513/OPINION/905130326
905130326
article_title: Believe the savings when you see them
article_pubdate: 20090513
Anon @ 15:37, while I happen to agree with your second paragraph, it really has nothing to do with the health insurance debate.

As to your first paragraph, the problem right now is not that people feel entitled to health care, it is that health care has become unaffordable. My monthly premiums are $1300 (2 adults, no kids), with $5000 out-of-pocket before insurance even kicks in, with 20% co-insurance (what a joke that term is) and only 50% of my durable medical equipment is paid for, no dental, and no vision. And as chriscollier just wrote in his reply, some people are paying $2700 for this kind of insurance. Don't you think these rates are getting out of control? Don't you think they are unaffordable?

It seems to me the rates are what they are because health insurance companies charge far too much for coverage. Why? Because a public company in the private sector exists to make money for their shareholders, not to pay out claims to covered customers. I certainly have no problem with capitalism but there are some instances where a service is beyond the means of the private sector. There's a lot of examples of this from building roads, to space exploration, to defending the country, and that sort of thing. There are large social programs that I personally disagree with, but the large "programs" I just mentioned I believe to be things that we as a country need to do together, and that doesn't make them socialism. (Socialism is really the control of the production of goods by the government and I would never be for that, and that's a different topic anyhow.)

People always seem to have this knee-jerk comment: "well, health insurance costs are out of control, but government-run health care is not the way to go." And usually from people that say that I never hear a proposed solution. Well the single-payer idea seems to be the most reasonable way to contain costs given are large existent health insurance company infrastructure. It would make health care expenses relatively affordable and also require people to "pay to play" and have no free rides (which I can fully agree with). For those too lazy to Google "single-payer health insurance" here you go:

https://www.nhchc.org/singlepayer.html

If you don't think a single-payer system is the way to go, then what is YOUR solution to unaffordable health care costs?

"Some 47 million Americans are uninsured"
By Anonymous on Wed, 05/13/2009 - 15:37
20090513/OPINION/905130326
905130326
article_title: Believe the savings when you see them
article_pubdate: 20090513
Forgive my frankness, but "so what?" Why do people think that they are entitled to health care as some sort of right? There is no constitutional right to health care, legal services, car repairs, your own home, etc.

PLEASE stop this "I'm entitled to ___" mentality. You're not! Our country became the greatest in the world because its citizens were allowed to succeed AND FAIL all on their own. For some reason, people what the government to ensure that NOBODY fails at the expense of those who are able to succeed. Time to take responsibility for yourself - which includes your failures.

For-Profit Health Insurance
By chriscollier on Wed, 05/13/2009 - 14:58
20090513/OPINION/905130326
905130326
article_title: Believe the savings when you see them
article_pubdate: 20090513
Health Care: Mission Kinda Almost Maybe Accomplished "We Pledge"

Reading this makes me want to do something unspeakable.

This is why people are fed up with the guv'ment men comin' around! JesusChristAlmighty people if you squeeze the toothpaste here it's going to come out that other end.

If you squeeze the middle of the tube it's coming out both ends...that's what a tube is supposed to do. Insurance Companies are no different! They take money, health care money...and provide no care...that's what they were designed to do...no matter where, or how, or who else you squeeze!

Now, the guv'ment men are tellin' me these steps,..."prioritize preventative care, manage chronic illnesses, curtail unnecessary tests and procedures, standardize insurance claim forms and use electronic medical records could save the nation 1.5 percent a year, or $2 trillion over the next 10 years", and this will produce health care reform.

Quiet please, calm down folks, here's the really good news! "By 2014, a family of four in NH could save $2,500 a year."

Well, we can all go home now, problem solved. Except for this one family on the seacoast..."$2,681.11 monthly premium for family of three (small business group insurance rate) $32,173.32 annual premium NO vision, NO dental, $3000 family deductible, 20% co-pays."

Help me out here...how do those steps lead to health insurance coverage for 318 million Americans in any way that is any different than what we have now?

And, isn't what we have now the reason we needed to have this conversation? Yeah, that's what I thought.

318 million are still being held hostage by the for-profit insurance conglomerates.

All due respect. What's this all about!!? Insurance reform! Call congress - "Don't let insurance companies dictate the terms of reform!

Single-Payer
By Free Bird on Wed, 05/13/2009 - 14:03
20090513/OPINION/905130326
905130326
article_title: Believe the savings when you see them
article_pubdate: 20090513
Socialized medicine is not the answer. The same people that run the post office, Social Security, and medicare will be running the health care. The stimulus bill also included a board (probably politicians) to make health care decisions for individuals. Your medical decisions will be taken our of your hands and your doctor's hands. People in countries with socialized medicine are denied procedures, and there is a long wait to see doctors. Socialism has not worked in any country. It did not work when the pilgrims tried it. Something needs to be done about the health care, but government running it is not the answer.

Health insurance companies are the problem
By Anonymous on Wed, 05/13/2009 - 13:58
20090513/OPINION/905130326
905130326
article_title: Believe the savings when you see them
article_pubdate: 20090513
So, anon 12:03, how does anything you have said justify the existence of health insurance companies? Nobody said that a visit to the Dr.'s office should cost a simple co-pay. Nobody said anything about socialized medicine. And nobody said anything about not having responsibility for one's own health.

Today, insurance companies make medical decisions that they have no business making. Every operation then deny--correctly or not--is more money that goes to their bottom-line to satisfy shareholders. Why do we allow shareholders in private corporations dictate who can and cannot receive medical care? Why must the administration of insurance payments be done for a profit? Private companies are not allowed to administer a department of motor vehicles, yet the handling of insurance payments--a far more important thing than cars--is handled by a private organization who by definition seeks to eek out the maximum amount of money from our insurance funds for their shareholder's profits.

Single-payer
By Anonymous on Wed, 05/13/2009 - 12:03
20090513/OPINION/905130326
905130326
article_title: Believe the savings when you see them
article_pubdate: 20090513
Single-payer, you are precisely the reason why our system is failing. What if auto repairs were made with a simple copay? Would you even think about what needs to be done - of course not - just fix it all! Damn the costs, I just have to pay a few bucks.
Today, too many people have no concern for costs when it comes to care. If you have the sniffles, you go to the doctor and pay a modest copay. What if you had to pay half of the bill, or the whole bill, you probably would wait to see if the doctor's visit was truly warranted. And probably get better without the visit.
Doctors will naturally recommend a pill or procedure that they know will work, but don't always think of cost. Until everyone in this country is forced into a plan that charges deductibles and coinsurnaces, no meaningful cost reforms can occur. Only when people have to consider what a visit, procedure, or medication will cost, so that they can go over all alternatives with their doctor, will there be any positive, meaningful change.
And if the government takes over, you will be forced to wait for services, necessary or not. Socialized medicine is definitely not the answer.

Single-payer
By Anonymous on Wed, 05/13/2009 - 07:52
20090513/OPINION/905130326
905130326
article_title: Believe the savings when you see them
article_pubdate: 20090513
The time of health insurance companies has come and gone. The idea that a company should make a PROFIT from our medical dollars is just plain wrong. They provide nothing to the health care process except expense. Only doctors should be allowed to decide what medical procedure, or pill, or whatever, an individual requires. Health care is such a large industry that people currently working at health insurance companies can find useful jobs in the industry, rather than the financially parasitic and profit-driven role they have today.