Tag: health insurance

February 24, 2010 Uncategorized Post a Comment

What I’m doing tomorrow by Frank S. Joseph

Watching TV.

All day.

Well, six hours anyway. I wouldn’t miss tomorrow’s health care political extravaganza. I’m planning to crack open a brewski and a bag of Cheet-Os, and splay out in front of the boob tube for the full six excruciating hours. C-Span on steroids.

What’s wrong with me? Don’t I know health reform is dead? Don’t I know the Obama administration was dumped into the dustbin of history following election to the Senate of Massachusetts Republican Scott Brown, which overturned what all viewed as a permanent Democrat/Kennedy lock on the ultimate safe seat?

Oops, there I go, getting wonkish. Well, that’s what it is with me. I used to cover health policy – wrote, edited and published a newsletter called “Health Policy Week,” for God’s sake – and I can’t get it out of my blood. The issues I covered during 1982-86 are, basically, the same issues as today. They weren’t resolved then – indeed, the solutions of the ‘80s and ‘90s (managed care, prospective payment) may have made things worse – and there’s a fair chance they won’t be resolved this time.

But that doesn’t have anything to do with my plans for tomorrow. Sure, I believe passionately that health reform must pass or this great nation will go bankrupt. And yes, in my opinion the current compromise pretty much stinks, may not work, needs the public option or something like it, yada yada yada. Health policy does indeed matter to me. But the reason I’ll be glued to the TV tomorrow has more to do with spectator sports. What NFL football and NBA basketball are to others, health reform is to me. Even if I had a full schedule, I’d cancel all engagements.

Now, as it happens, I don’t have any engagements tomorrow. The decks are clear for stultifying TV. I’ve been home from the hospital since last Friday, recovering from total knee replacement.

Click Here to view the complete Frank S. Joseph commentary on Health Care Reform

February 13, 2010 General Ag News and Notes Post a Comment

Health Care Reform – Patient Delivery and Care Delivery

Amazing seems a most appropriate word to describe the financing and delivery of health care services in the United States of America.
James L. McGee, CEBS--On Health Care Reform

An improved patient delivery system is a necessary pre-condition for affordable and quality health care.

What do I mean by a “patient delivery system”?

Understanding  patient delivery system means recognizing that people without health insurance do not receive treatment until they are in an immediate life-threatening situation.

I cannot back this up with a scientific study, only my daily experience.  But that experience contradicts an oft cited myth that no one who needs health care is turned away.  One of the most common reason that people call our office is because something happened to their health insurance that lead to a denial of treatment.

It may be as simple as the doctor calling the wrong number or it may be that the member has failed to pay their share of their health insurance premium.  But the reasons don’t make the stories any the less heart breaking.

Please Click Here to Read the Complete Article by Jim McGee » The Amazing Maze of US Health Care » Health Care Reform – Patient Delivery and Care Delivery

January 31, 2009 Uncategorized Post a Comment

The Amazing Maze of US Health Care » Do we want employment based health insurance?

Amazing seems a most appropriate word to describe the financing and delivery of health care services in the United States of America.
James L. McGee, CEBS--On Health Care Reform

Do we want employment based health insurance?

Why is there not more support for an expanded employer role in providing health insurance to all Americans?  I sense a certain exhaustion among decision makers and employee benefit professionals as they grapple with costs that just defy control. I notice at professional conferences an increasing openness to the single payer model.

We have seen one cost control fad after another.  More and more employers are dropping health benefits in order to stay afloat.  In this game of Old Maid, those employers who do provide benefits struggle to maintain their social compact with their employees without footing the bill for the rest of the world.

The rest of the world? How does that occur?  In a number of ways.

Please Click Here to Read the Complete Article by Jim McGee » The Amazing Maze of US Health Care » Do we want employment based health insurance?

January 24, 2009 Uncategorized Post a Comment

The Amazing Maze of US Health Care » Barack Obama – Can we re-imagine health insurance?

Amazing seems a most appropriate word to describe the financing and delivery of health care services in the United States of America.
James L. McGee, CEBS--On Health Care Reform

Barack Obama – Can we re-imagine health insurance?

With the election of Barack Obama, there is a lot of hope and optimism about the potential for health care reform.

There is also some nervousness.

The nervousness originates from those who think that the current economic crises will inhibit reform efforts.  That somehow the price tag of reform will scare people away from health care reform.  I am encouraged by an insightful article by Ezra Klein on Obama’s choice of Director of the Office of Management and Budget.

According to Klein, Peter Orszag believes that health care reform is the key to the fiscal future.  Since it his office that will pin the price tag on any health care proposal, his biases matter.

Others are worried that Obama might be soft on insurance companies.

I am not a great friend of the insurance companies.  I deal with them every day.  But neither am I a knee-jerk opponent of insurance companies.

Insurance companies reflect the markets they operate in.  And health insurance companies function in a market that brings out their worst qualites.

Unlike home insurance, or auto insurance, there is no legal or market mandate to have health insurance.  This allows health insurance companies to avoid insuring the very people that need it the most – high risk (read sick) individuals.

Outside of the Medicare supplemental insurance market, there are very few limitations on what should be covered or not covered in a health insurance plan.  This gives insurance companies the license to put restrictions and exclusions in their policies as they, or their customers, see fit.

Please Click Here to Read the Complete Article by Jim McGee » The Amazing Maze of US Health Care » Barack Obama – Can we re-imagine health insurance?

December 20, 2008 Uncategorized Post a Comment

The Amazing Maze of US Health Care » Health Care Reform in Germany

Amazing seems a most appropriate word to describe the financing and delivery of health care services in the United States of America.
James L. McGee, CEBS--On Health Care Reform

Health Care Reform in Germany

This past spring, Health Affairs, the premier health policy journal, had an interview with the German Minister of Health, Ulla Schmidt.  The interview focused on reforms to Germany’s health system instituted principally in 2007.  Minister Schmitt was asked what were the goals of the reforms. Her answer – she wanted to preserve the principles of social solidarity and affordability that had always been a part the German health system.

In comparison to health care in the United States, the Germans system could hardly be called a system in crises.  The per capita costs were about half of  what they were in this country $3,200 per person in Germany compared to $6,400 here.  But they did have too many uninsured – about 0.2% of the population.  The United States, by comparison has 15% uninsured.

So the question is, What do Germans understand by social solidarity?  Minister Schmitt explained that everyone in Germany has guaranteed access to health care and everyone contributes to the financing based on their ability to pay.  Well, if that is social solidarity, where does affordability fit in?  For Minister Schmitt, if the entire system is not affordable, the social solidarity begins to break down. 

Too much of the health care debate in this country is muddled by ideology on both sides.  For many in this country, European health care sytems smack of “socialism.”  Yet, two of the defining characteristics of the German system are not real popular among progressives in this country.  The Germans have an individual mandate and they rely on insurance companies, although in Germany they give them a more accurate name, Krankenkassen, or Sickness Funds.

Please Click Here to Read the Complete Article by Jim McGee » The Amazing Maze of US Health Care » Health Care Reform in Germany

December 3, 2008 Uncategorized Post a Comment

The Amazing Maze of US Health Care » Administrative Cost Savings Is No Myth

Amazing seems a most appropriate word to describe the financing and delivery of health care services in the United States of America.
James L. McGee, CEBS--On Health Care Reform

Since November 4th, interest in health reform proposals has understandably intensified.  I like to flatter myself that this blog might make a small contribution.  But I do have a day job and so the horn I blow here only has one note; if we simplify the system we can find the money we need to cover the people without health insurance and increase product satisfaction among all stakeholders. 

I am not a policy wonk who views the health care system wonderfully distilled through the glorious abstraction of statistics; nor am I encumbered by practical politics.   I view the system from the bottom looking up.  I have a stake in the present system, but that stake is poorly represented in these musings.  I am a gatekeeper to the health care maze.  In my ideal world there would be far less need for the work I am doing.

I know from daily encounters just how daunting that maze is for people needing care.  I tend to demonize piece rate physicians who are too quick to deny care rather than trust the maze.

So when I read others who write about health care reform I look for my theme.  On Sunday, November 23, 2008, the Washington Post published an opinion piece by Shannon Brownlee and Ezekiel Emanuel, 5 Myths About Our Ailing Health-Care System. The authors are right on target with four of the five myths that they debunk.  They drive home the point that we are paying a lot of money for our health care, that we are paying a lot of money for not particularly good health care, that we really are paying the price through premiums, taxes, and lost wages, and that Americans are ready for a change.

Please Click Here to Read the Complete Article by Jim McGee » The Amazing Maze of US Health Care » Administrative Cost Savings Is No Myth