$2 Trillion in Medical Cost Savings: A First Step on the Road to Reform
Today’s letter from key health industry players to President Obama promising to “do our part” to control medical care cost growth is a big deal. It sends a powerful message that “Harry and Louise,” the fictional couple who became the symbol of the medical establishment’s opposition to Clinton-era health reform, have retired to a condo in Florida.
Instead of sitting the sidelines saying “nyet” to reform, influential providers, drug and medical technology firms, and insurance companies now understand the proverbial train is leaving the station. Their role is no longer to oppose reform, it is, instead, to tailor reform to their own interests. That is a profound change.
But make no mistake, for now their promise to trim 1.5 percent off of expected health care cost growth over the next decade is little more than rhetoric. Their two-page letter contains many platitudes but no specifics. It touches all the usual bases: transparency, aligning quality and efficiency; evidence-based best practices, coordinating care, disease prevention, and health information technology. But it promises nothing.
And while the health industry is widely represented in this missive, one interest group is conspicuously missing: consumers. And in the end, unless patients are willing to accept the consequences of all these clichés—which is to say, sometimes they will not get costly treatments they think they deserve—none of these promises will be worth the price of a used bedpan. No politician will stand up to the kind of consumer revolt that sunk most of the managed care movement in the 1990s, even though the HMOs of those days promised many of the very same reforms that are in today’s letter.
And keep in mind that even the kind of massive change these groups promise is still unlikely to pay the full cost of health reform. President Obama acknowledged that in his own way today, with an expanded set of tax hikes intended to fund about half of a $600 billion health reform reserve fund. Even the full $600 billion would pay for less than half the cost of the President’s campaign version of health reform, TPC estimates.
I’ll talk some more about those tax hikes tomorrow. But for now, the take-away is this: Even with the best of intentions, it will be exceedingly difficult for providers and insurers to trim $2 trillion from expected cost growth over the next decade. The changes industry promised today are a welcome step in the right direction but won’t avoid tax increases. In many ways, they highlight just how important new revenues will be to reforming the way we all get medical care.
I was so surpised that I can help thousands of homeless or poor American over Internet cost effectively. One tool I got is this Reflexology Map that I can easily share with any one with medical problem. You can also find it by google “Reflexology Map”.
There are all kinds of medical treatment that is very cost effective, or even free, but our deeply in debt government seemed not to be able to get it. Why?
By and large, the government is like those homeless who came to me who had some kind of health problem, and eventually, spent all their fortune to whom? the docotors, the richest people in this country.
So, instead of giveing them hundreds of thousands dollars for them to throw to the richest people, I gave them Reflexology Map for them to learn and massage their palm and feet themselvers, free!
When one discovers this fantasy, they may wonder why the medical expense is so expensive?
Recently, my mom decided to go back to Taiwan because Taiwan now has all citizen medical insurance, so was my sister who just had operation in China that costed her $10,000, as she said, it would cost her nothing if she did in Taiwan as citizen.
So, you are going to be sure that once Obama makes it free to all, many non US citizens are going to come over to the US and use the wonderful medical system free.
My couson has classmate at NJIT, after obtain MS degree with his wife did not want to work (gee! can not work to qualify for the program). They had a baby free in NJ with all of us pay the bill before he, his wife and baby went back to Taiwan.
Until consumers realize that the more they consume of health care, the less income they have for everything else, they will continue to demand too much health care. The problem with cost cutting measures designed to make that connection more apparent is that to work everyone must be in that boat – and that is a hard sell.
The other problem is that even with all of the consumer responsibility you can think of, the drive for greater and greater profits will have insurance companies constantly searching for ways to avoid paying for the care they promise their policy holders. They don't care so much about the little things – what they want to avoid is paying for serious chronic illness. If you have a high BMI and are getting on in years, they will do everything they can not to cover you – since they look at these factors and see stroke, diabetes, heart attack et al. If they have to cover everyone and can't charge potentially sicker people more, their ability to increase profits over time (which seems to be the goal of privately held firms) will be greatly impacted. In the end, their business model will not handle covering everyone at a market rate. This will lead to either consolidation (until they can't consolidate anymore), bail outs or the offloading of the sickest to some kind of public fund.
In other words, single-payer insurance is almost inevitable – whether by government mandate or because of the natural tendencies of the market. Does this mean we can pass such a thing now? It would be nice, but I don't think the industry is that forward thinking. The best thing we can do is pass something now and let time do the rest. When the bottom falls out of the industry, we must simply be ready with some kind of single payer system.
“And in the end, unless patients are willing to accept the consequences of all these clichés—which is to say, sometimes they will not get costly treatments they think they deserve—none of these promises will be worth the price of a used bedpan.”
Precisely. This is the hard truth that even the most trusted politicians fear to speak. Universal coverage requires rationing by rules, as in Canada and England, or by price, which Americans probably dislike even more.
If Obama won't come out and ask us to sacrifice, how can he expect us to accept the sacrifice? Is it too much to ask to have political leaders who will level with the voters? Apparently so, at least for now. No President since FDR has asked Americans at large to sacrifice anything of any consequence. It's always free goodies paid for by the tooth fairy.