As we
worry about the reform not adding to the deficit of the Federal
Government, we don't discuss the fact that reform saves trillions in
the overall cost of health care by slowing the growth in cost, both
inside and outside of the Federal government.
William Chirolas -- World News Trust
July 20, 2009 -- C-SPAN this Sunday morning showed the Governor of Montana, Brian Schweitzer, a Democrat, telling the the National Governors Association meeting in Biloxi that the the legislation currently making its way through Congress would unfairly burden states by requiring them to help pay for the reform by way of the state obligation to partially fund the expanded availability of Medicaid cost -- budgets are tight and I guess there is that bond rating to worry about.
Schweitzer said, "The second problem we have is that one of the least effective programs in terms of health care, in the history of this country, is something called Medicaid.… Now Medicaid is a system that isn’t working, almost everyone agrees. But what Congress intends to do is increase the number [of people] on Medicaid so they could do it for the cheap. It is not working for anybody.”
Of course this is the same Democratic Governor that said "As
Governor of the state of Montana, I am focused on ensuring affordable
and accessible health care is a reality for all Montanans with special
concern for our citizens that are the last and have the least …
approximately 19 percent of Montanans are uninsured. This level is
unacceptable to me," as he proposed a Medicaid waiver to expand
coverage to the poor.
Since surveys of participant satisfaction
among both patients and providers show large majority support for and
satisfaction with the Medicaid program, the Governor's comments are a
lie. But just how important is the program? Perhaps the "dual
eligibles" -- those on Medicare but too poor to pay its deductibles and
who, per the Kaiser Commission on Medicaid and the Uninsured, account
for more than 45 percent of Medicaid spending for medical services --
find it important? A survey developed by University of Kentucky's
Martin School of Public Policy and Administration and sent to 10,000
randomly selected Medicaid recipients in 1997 found that more than 60
percent of dual
eligibles and just regular eligibles not just "satisfied" with the
program but, indeed, "very satisfied with Medicaid."
Now federal
versus state responsibility and control, who funds what and what
coverage is offered, is the basis for all those waivers that states
have asked for so as to kept the Medicaid benefits, and costs, lower in
their state. Perhaps that is the "problem" that the Governor refers to?
I
doubt that the trend, via the waivers, to moving from fee for service
to fee for a persons total care - the HMO model - is "failure" that the
Governor is referring to as that is the Mayo model that has resulted in
such great care at such a low cost that Obama cited the Mayo Clinic in
one of his "do reform now" speeches.
This is not "single payer,"
but this "reform" is all we have a chance at getting. Well, then, is it
really all that stands between us and a coming economic disaster?
Well
it is needed for National Defense since the military and military
retired, dependents and survivors -- more than 9 million people -- cost
$42 Billion in 2008, or 6 percent of total defense spending, with the
Congressional Budget Office forecasting that TRICARE will consume 13
percent of total defense spending by 2026, crowding out weapon systems.
And
in non-defense, check out our competitiveness in selling our products
and services when we compete with nations that have single-payer. Our
business must price in a cost that businesses in other countries need not
worry about -- and with the projected growth in health care costs in the
US if no reform, there is a corresponding projection of the destruction
of our economy as we are priced out of the marketplace.
As we
worry about the reform not adding to the deficit of the Federal
Government, we don't discuss the fact that reform saves trillions in
the overall cost of health care by slowing the growth in cost, both
inside and outside of the Federal government. Indeed we do not discuss
the irony involved in our need to keep a fat and happy insurance
industry causing us to spend more in order to move from our current
situation of having poorer care in terms of lifespan and medical
outcomes at a cost 50 percent higher than the per-capita price paid for
medical care in those countries that have the better care we are
striving for. But in those other countries they limit the activities of
health insurance companies to selling policies that provide extra
benefits beyond that provided by their universal coverage plan. Indeed
our insurance industry has proposed, with a straight face, that the
solution to the high cost of our insurance company premium increase
problem is MORE INSURANCE -- everyone will have to buy an additional
insurance policy that will pay cash to you if your insurance premium
increase over time exceeds some annual amount that you find acceptable
as an increase.
Meanwhile the Insurance industry surrogates -- call the "GOP" and "conservative Democrats" -- claim a need to slow walk
the reform bills so as to get the time they need to kill the whole idea
of any "reform" that is more than a welfare check to the industry to
modernize its computers and processes. Now I agree the current "reform"
is the absolute minimum that can be done -- and that we as a nation
would be better served by the Sen. Bernie Sanders, I-Vt., bill that
would set up a single-payer universal system to replace Medicaid,
Medicare, the Children's Health Insurance Program, and the federal
employees benefits plan, with rules that prevent private-sector health
insurance by prohibiting the sale of health insurance that duplicates
benefits provided under the single-payer plan. But let's at least do
the absolute minimum that is the House reform plan.
***
William Chirolas brings 40 years of real-world business experience in local, state, national, and international tax, pensions, and finance to the world of blogging. A graduate of MIT, he calls the Boston area home, except when visiting kids and grandkids.
