State Insurance Regulators Say Health Care Reform Must Address Costs

May 12, 2009

  • May 12, 2009 at 10:50 am
    Bill Watson says:
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    This option should discussed.

    Businesses choosing national health care would free themselves from all financial burdens or any involvement in any way for the health services their employees receive.

    This would apply to companies the size of General Motors or as small as Joe’s Pizza.

    Two options should be offered to individuals and businesses to either use:

    A free, government, owned and operated, VA style civilian National Health Care System, funded by a national sales tax, no insurance, no co pays, and free period.

    Or the alternate choice would be for individuals or businesses to choose private systems for care.

    Private care would allow for the unlimited choice of doctors, clinics, hospitals, timing, and treatments, Ford Fiesta or Rolls-Royce, but it would require the user to pay privately for their health services, either by self pay, company pay, private insurance, whatever, but no government payments should be paid to private providers for private care.

    Costs of health care paid for by government programs, (Medicare-Medicaid etc.) could be reduced, to a fraction of their current expenditures, with better outcomes, if the services for these programs were delivered from a utilitarian VA style National Health Care System.

    If these real changes were made not only would health care be fixed but money saved by taxpayers, individuals, families, and businesses using this system would be instantly and perpetually recycled back into the economy.

    The system could be jump started by acquiring health delivery systems around the country that would choose to sell to the new National Health Care System.

    This article, (The Best Care Anywhere by Phillip Longman)

    http://www.washingtonmonthly.com/features/2005/0501.longman.html

    documents how the VA was transformed by Dr. Kizer, into a system that is producing the highest quality health care in the country.

  • May 12, 2009 at 11:28 am
    Jim Harburger says:
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    Hospitals and doctors currently do many unnecessary and very costly medical tests as preventive actions in case a patient decides to sue because something did not turn out as well as expected. Tort reform is needed to add caps on malpractice liability so as to take away the current incentives to sue and settle. This can greatly reduce the cost of health care. The lower costs for doctor’s malpractice insurance, fewer medical tests, as well as lower legal expenses for hospitals, doctors and insurance companies will be passed on to all consumers.

  • May 12, 2009 at 12:45 pm
    Whimp Stomper says:
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    Yes, just use the VA system, but many who are eligible choose NOT to utilize their benefits, they prefer more choice in treatment and prescriptions, and the VA system is quite sparse, so people would be forced to seek treatment hours away from where they live? The VA system may deliver low-cost, high quailty benefits, but still not at a trade off, or cost.

    1. Tort reform (where the VA has substantial immunity, private systems do not) is needed to reduce defensive medicine.

    2. Providers need to be limited in expanding services, too many providers buy MRI’s or open oncology centers to pull away profit centers from hospitals, at the expense of the entire system, paid for by the average insurance policy.

    3. Consumers need some skin in the game. Regulators have demanded extravagant coverage including mandates where the consumer can live a sedentary un-healthy lifestyle with little financial consequence. The industry needs to be allowed to offer a low-cost policy.

    4. Competition, fuel more competition by stimulating opportunities to offer coverage, not stifling competition with over-regulation.

    5. Demand regulators require Guaranteed Issue coupled with a mandate for coverage with limited pre-existing exclusion period for late entries, or allow underwriting, but with still a coverage mandate, those declined must buy State High Risk Pool.

    6. Change Federal Tax Laws, make a more even playing field between employer contributed coverage vs individual purchase.

    7. If you must demand there be a public option, the public entity MUST play by the same rules, (an impossibility over time).

    8. Stop cost-shifting from Medicare and Medicaid, and revolutionize Standard Medicare coverage to be incentive/ Value Based coverage/ wellness rather than go anywhere once bad enough for an expensive fix.

    This is a very complex system, no solution will be a simple solution. Many facets need addressed.

  • May 12, 2009 at 12:47 pm
    Former Status Quo says:
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    Or just make it so people cannot sue the doctor. It’s called practicing medicine, not the art of medicine. Unless you can prove gross negligence beyond reasonable doubt, a malpractice suit shouldn’t be allowed to go to court. People wonder why the number of doctors in the US is shrinking…

    One of the reasons the medical costs are so high is because doctors have outrageous premiums to pay. Last time I checked you didn’t see convicted felons suing their lawyers for “practicing law…”

  • May 12, 2009 at 1:12 am
    Health Guy says:
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    The problem is the cost of health care for sure. We spend $600 a month for every person in the country. So there are only two ways to reduce this, ration health care and reduce the amount health workers make, neither of which is going to be popular. Good luck with that socialism.

  • May 12, 2009 at 1:22 am
    Bob says:
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    This quote was from the article “private Medicare plans has led to fraudulent and abusive marketing practices that would have been prevented under state law, bringing considerable harm to thousands of seniors,” Can anyone tell me what this harm was? My parents have had private Medicare for 5 years (United Health Care Advantage) and it has worked well through two major surgeries (one for each). The two of them have saved a net of $20,000 over 5 years (including the deductibles they paid) by dropping their Blue Cross Med sups. Should they switch back to regular Medicare and Medicare Sups? Thanks

  • May 12, 2009 at 1:27 am
    Whimp Stomper says:
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    There are docs from around the world coming to American in droves who would jump at a lower pay-off level, even established providers… if there is a trade-off.

    Again, give them tort reform, give them less administrative nightmares, pay Primary’s more (Medicare sub-standard fee schedules), give them insured people (coverage mandate) and they’ll take it.

    Right now, most providers hang out there on their own, subject to potential $40,000,000 negligence suits (an actual case in my small Oregon home town, there’s NO way for a PCP to insure for that).

    Down the street, a local doc makes a good salary working for a Federally Chartered Community Health Center, provided Federal Tort Claims Immunity. He sees dozens of people a day providing primary care (many without insurance) and that system works.

    We can fix this. We just have to make good decisions, take the time to follow each change down stream, leaving the current private system intact. (The current private system delivers innovation, competition, the prospects for profit at the peril of complete loss (bankruptcy) if not satisfactory to consumers and stake holders.) A system delivering benefits at cost lower than any government program (in Oregon, the private health industry delivers benefits at an average administrative cost (including agent commissions and state premium taxes too) of $222 per member per year.

  • August 27, 2009 at 3:11 am
    Bill J says:
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    I would like to think that if the NAIC is interested in cost control, they’d work with Washington to eliminate the restrictions found in the McCarron-Ferguson Act of 1945. When we can’t buy insurance across state lines, we loose competition and therefore in effect, cost controls…..



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