Tag Archives: Health Care Spending

With Due Respect to Sergio Leone, The Good the Bad and the Ugly from Yesterday’s Health Care Summit:

The Good
The fact that yesterday’s Health Care Summit happened at all, with both parties in attendance and (mostly) on their best behavior. If nothing else, both parties aired their positions in public, on television and radio, and gave the public two very distinct views of reform.

The Bad
That neither side appeared to offer any new ideas… both sides doggedly stuck to their talking points:  “Start over” vs “We have solutions already”.  Republicans postured for their base, while Democrats pandered to theirs.  Not enough was heard from the attendees and the President did more than his share of talking.

The Ugly
There should be no surprise the summit ended with no new bipartisan agreement. The cynical view – much in evidence in today’s reporting – is that the whole event was carefully designed by the White House to underscore the perception that the Republican Party is obstructing reform…leaving the Democrats “no choice” but to use reconciliation to move forward.

Two of the speakers did impress me:

Senator Tom Coburn, R-Oklahoma. Senator Coburn centered his comments on cost issues. He brought up the fact that 33 percent of the cost of health care simply shouldn’t be there. Part of this is due to inefficiencies in the current system, including unnecessary testing, but mostly to fraud. Reduce the fraud, bring down costs, and then let’s move on to working on prevention…WE AGREE. 

Rep Jim Cooper, D-Tennessee. One of the Blue Dog Coalition, he is considered a bit of a loose cannon by some, but I was impressed by his sincerity, and his very sober assessment of our situation.  Do not delay action; tackling the problems provides solutions, endless debate does not. WE AGREE.

Where is Clint Eastwood when we need him most?


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A New Day, A New Proposal

The President’s revised Health Care Reform proposal was released on the White House website earlier today. You can read all about it almost anywhere online: CNN; The Wall Street Journal; The New York Times

 For my own part, I do not see enough new ideas to think that the Health Care Reform on Thursday will be much other than a political event, rather than a serious attempt to come to grips with Health Care Reform.

 In particular, the creation of the “Health Insurance Authority” reflects a profound misunderstanding of the difference between “insurance premiums” and “cost of health care.” You cannot control the cost of health care simply by regulating premiums.

If, however, you throw in meaningful utilization management, reduce inappropriate and/or ineffective care, adjust reimbursement methods, and introduce tort reform, then you may have a chance at reducing skyrocketing costs.  

Read the proposals, and let us know what you think.

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Filed under Health Care Reform, Health Care Spending, Legislative Updates

This Week in Health Care Reform

There has been a lot of news this week regarding Health Care Reform, much of it focusing on upcoming legislation, and health care costs.

Legislative Efforts

News is breaking that we should expect to see a new legislative proposal on Monday, in advance of Thursday’s Health Care Reform Summit. The New York Times advises that the new legislation should be posted Monday morning, but points out “congressional Democrats…have not yet seen the proposal or signed on.” 

In theory, the prospect of a new bill should please Republicans, who have stated through the week that the existing legislation should not be the starting point.

Will we see something new? Can it break the impasse?

Controlling Costs 

No one should see the Anthem rate increases in California as an isolated event; the same story is playing out across the country for both individuals and fully insured groups.

HHS Secretary Kathleen Sebelius is critical of the rate increases; the Washington Post reports that she has accused insurers of “taking excessive profits.” AHIP pushed back; pointing out that insurance companies are battling to manage rising medical costs.

The AP ties these strings together, contending that the Obama Administration “has seized on” Anthem’s increases “as exhibit A to make his case for sweeping change…”

I’ve said it before, and I’ll say it again…there is too much political posturing, and not enough objective review of the many layered issues facing health care reform. I hope that Monday’s new legislation reflects this, but I won’t be making any bets.

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Don’t Dismiss Disease Management: Part 2

I’m still thinking about that Business Week article I posted about earlier this week…I really do think it is short sighted to dismiss the usefulness of wellness programs, based on the review of a single program that took place 10 years ago.

A quick look around today found the following from SHRM, citing two recent publications, both supporting the opposite view. See what you think!

A study in the Jan/Feb issue of “The American Journal of Health Promotion” concludes that wellness and prevention programs do make a difference…Engaged participants can reduce their costs. The key here is “engaged participants.”

Another highlight is a Harvard study, published in the February issue of the journal “Health Affairs.” The study, “Workplace Wellness Can Generate Savings,” focuses on specific case studies. Their indications are “a positive return on investment (ROI) from employer-sponsored wellness programs.” It may take some time to get there, but it does happen.

Not an overnight fix, and you need buy in from your employees, but employer sponsoered wellness plans can make a difference.

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Filed under Health Care Spending, Wellness

Don’t Dismiss Disease Management

Business Week has a questionable piece which challenges the efficacy of disease management programs.

 Reviewing a program that General Electric ran for its employees over 10 years ago, the authors conclude that the company found “scant return” on the money they spent…but then go on to tell us that GE is starting a new “outreach service” to provide disease management and wellness support to employees.

 Why take this step if disease management is a waste of time?

 The Disease Management Blog picks up on this point as well, calling the Business Week piece a “faux exposé.” They conclude that “…there is ongoing innovation, building on the lessons of what has worked and what doesn’t work…” in the world of disease management.

I certainly do not discount wellness or disease management efforts; in fact, I think that the issue of personal accountability is a missing component in the wider health care debate. By all means, seek to “build on lessons” learned, but do not dismiss out of hand.

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Filed under Health Care Spending, Health Plans, Wellness

Largest Increase on Health Care Spending in 50 Years

Most major newspapers have leapt on a CMS report, released Wednesday, that showed healthcare spending continued to grow in the US last year. The report indicates that healthcare spending now constitutes 17.3% of the country’s GDP, and is only predicted to increase more over the coming years.

The Washington Post: “Healthcare spending in the United States grew last year despite a contracting economy.” The 1.1% increase “in 2009 compared with 2008” is “the largest one-year increase since at least 1960.” The government estimates that by 2019, “healthcare spending will be $2 trillion higher than it is now, it will represent 19.3 percent of the economy, and the government will pay 52 percent of it.”

USA Today reports that the figures are “the latest indication of the nation’s mounting medical expenses and it comes as Congress has stalled on President Obama’s proposal to revamp the healthcare system.”

The New York Times  points out that “A major factor in the growth of health spending was the increase in Medicaid enrollment and Medicaid spending as a result of rising unemployment. As people lost jobs, they lost private insurance, and many turned to Medicaid.”

I have said before that the current system is unsustainable; these increases show part of the reason why…

Let us know what you think!

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