Posts Tagged ‘affordable healthcare’

In my original post titled “So, Republicans Don’t Have Any Better Ideas, Huh?“, I explained some of the healthcare reform ideas proposed by Congressmen Paul Ryan, R-WI, and Tom Price, R-GA. I also mentioned the “GOP Solutions for America” document given the President by John Boehner, R-OH. One of my readers reminded me that Sen. Judd Gregg, R-NH, had also presented a number of ideas on healthcare reform. Gregg isn’t always the most consistent conservative, but I decided it only fair to give his set of proposals, known as “Coverage, Prevention and Reform” (CPR), a look, too.

Sen. Judd Gregg

Sen. Judd Gregg of New Hampshire

Like his GOP colleagues, Sen. Gregg would like to start from scratch on crafting reform legislation. “There are a whole series of things that would improve the health care delivery system that both sides can agree on,” he said this week. “When the president said he was looking for ideas, I sent him some. I think all those ideas could be agreed on in a bipartisan way.” As per Holly Ramer, reporting for the Associated Press:

“Gregg’s plan… parallels some of the key ideas in the Democratic plans, but it is more aggressive in trying to control costs and less ambitious in extending the federal government’s role as an insurance regulator.

Similar to that the Democrats, Gregg’s plan would require everyone over 18 to carry at least basic coverage. And he would provide federal subsidies for households making up to three times the federal poverty level, or about $66,000 for a family of four.

The plan would be financed by taxing employer-sponsored coverage above certain limits. That’s a nonstarter for many Democrats, but economists say adopting such a policy would begin to push down health care spending, allowing for expanded coverage without busting the budget.

Gregg would also encourage employers to offer discounted premiums for workers who take steps to live healthy lives, and his plan shifts payments for hospitals and doctors to reward quality care rather than sheer volume of procedures and visits.

Though he would like to apply a projected $500 billion in 10-year Medicare savings to a Medicare solvency fund, Gregg said he would be willing to split the difference with Democrats, using $250 billion to shore up Medicare and using the rest to fund expanded health coverage.”

I’m not crazy about a couple things there (e.g., federally mandated insurance coverage), but overall I think Gregg has presented some interesting ideas. As yet, Sen. Gregg has not been invited to this week’s health care summit, but it’s possible that Senate Republican leader Mitch McConnell, R-KY, may ask Gregg to be part of the GOP delegation.

Newt Gingrich

Former Speaker of the House, Newt Gingrich

On another front, former Speaker Newt Gingrich has joined with Dr. John Goodman, President and CEO of the National Center for Policy Analysis (NCPA), to answer President Obama’s challenge for “better ideas”. In a recent article published in the Wall Street Journal, they presented their “Ten GOP Health Ideas for Obama” as the foundation for a patient-centered system. Here’s the (somewhat) condensed version:

1) Make insurance affordable. “…tax relief for health insurance should be a fixed-dollar amount, independent of the amount of insurance purchased…. choice of a generous tax credit or the ability to deduct the value of their health insurance up to a certain amount.”

2) Make health insurance portable. “The first step toward genuine portability—and the best way of solving the problems of pre-existing conditions—is to change federal policy.”

3) Meet the needs of the chronically ill. Educate & supply family caregivers. Facilitate more Health Savings Accounts (HSAs), as well as self-management of custodial services and medical care for the homebound disabled. Encourage providers to offer specialized plans for those with chronic diseases.

4) Allow doctors and patients to control costs. Doctors are typically not paid for well-care advice or consultations not given in person. They get paid for treating the sick, not preventative care. “[D]octors should have the freedom to repackage and reprice their services. And payment should take into account the quality of the care that is delivered.” (See my post “Convenient AND Affordable Healthcare?” about ‘concierge medicine’.)

5) Don’t cut Medicare. Obamacare would cut Medicare funding by roughly $500 billion. Sure, Medicare desperately needs fixing, but “cutting Medicare in order to create new unfunded liabilities for young people” won’t do it.

6) Protect early retirees. Need to a) allow employers to obtain individually owned insurance for their retirees at group rates; b) allow them to deposit some or all of the premium amount for post-retirement insurance into a retiree’s HSA; and c) give employers and younger employees the ability to save tax-free for retirement healthcare.

7) Inform consumers. The public should have access to (genericized) Medicare and government data about costs and quality of care before making their own healthcare decisions.

8) Eliminate junk lawsuits. The time for studies and tests is over. The federal government should follow the lead of states like Texas, which have already implemented effective civil justice reforms (e.g., caps on non-economic damages, loser pays laws, alternative dispute resolution, etc.).

9) Stop health-care fraud. Fight the $120 billion in annual healthcare fraud with “responsible approaches such as enhanced coordination of benefits, third-party liability verification, and electronic payment.”

10) Make medical breakthroughs accessible to patients. Cut bureaucratic red tape in FDA’s review process and implement quality-monitoring technology in the marketplace.

Sounds pretty darn sensible to me!

Yet, despite various Republican/conservative groups & individuals presenting their alternatives, the President still makes statements like, “The Republicans say that they’ve got a better way of doing it. So, I want them to put it on the table,” as he did at a recent campaign event for Sen. Reid. Either he has the memory-span of a goldfish, or he is intentionally misleading the public (via the MSM) to perpetuate the “no ideas” myth, or he will only consider such ideas “serious” if they are presented in 1000+ pages of detail. Somehow, I don’t think even that would be sufficient to get him to change his Big Government / big spending / nanny-state mindset.

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Ever had a problem finding a time to see your doctor that was convenient for both you and them? Sometimes it’s even hard to reach them by phone or email to make that appointment. Ever resorted to “stopping by” the ER when s/he is on duty, despite the likely added costs and wait, just because that was the only way you could see them after hours? Recent studies in the U.S. revealed that it is getting even  harder for some people to get to see their primary care physician than it was a few years ago.

Although email has been around and available to the general public for a couple decades, less than one-fourth of U.S. physicians communicates with patients electronically (though the number is growing).  An office visit is usually required for even the most routine things, like having a simple medical question answered or a prescription written. The reason, of course, is that it is extremely rare for an insurer to reimburse physicians for phone or e-mail consultations.

In addition, this lack of communication (and reduced time spent with patients) is perceived by many — roughly three-fourths of those surveyed by the New England Journal of Medicine — to result in lower quality care, including medical errors that would otherwise be preventable.

So, what’s the alternative?

Enter: “concierge medicine”. That is one of many terms used, but it refers to physician practices that structure their pricing & services in ways that improve accessibility and convenience for their patients but are not normally covered by 3rd-party insurers. They have been around for years in some places, though many people are not aware of them. Most have a cash-only policy, which works fine for many uninsured. Others will work with those few health insurers who recognize the value these practices provide and agree to reimburse for them. This works well for those with Health Savings Accounts (HSA) and the like.

For more information read this Brief Analysis by Devon Herrick, a senior fellow with the National Center for Policy Analysis (NCPA).