The premise for all of the reforms floating around Washington - and even in Madison - is that health care is too expensive and the costs are rising faster than we can afford to pay. I don't think that any serious person is going to argue that doing nothing is acceptable, but this rush to pass something - anything - is remarkably dangerous. As I mentioned in my last post about health care, the bills currently being written contain provisions that most people would recognize as bad ideas. And more keep on popping up.
The whole debate in the comments of that previous post bring me to something I think needs some reinforcement: According to "Anon3" - whoever that is, but who seems to have at least read parts of the bill - the bills currently in Congress would standardize all health care plans and essentially prohibit new policies from being written after 2013, but that's okay because the government has created this nice big pool of standard, government-approved policies.
Sorry, but that doesn't exactly leave me with a warm fuzzy feeling.
My point here is that no matter what the Democrats in Congress or the President call the final piece of legislation it will be a massive expansion of government control in health care. Basic economics take over at this point. If the "exchange" is a pool of approved health policies, what incentive is there to offer anything more than the standard plan? None. Eventually we will have a one-size-fits-all health care policy, the contents of which having been decided by whomever it is in the Commissioner of the Health Choices Administration's office.
That doesn't bother anyone?
Yes, as has been pointed out ad nauseum by supporters of this horrific bill, insurance companies and HMO's are already making decisions for patients and interfering with the process of getting the best care for the best price, but these bills do nothing to change that problem. All they really do is replace insurance companies and HMO's with the federal government.
The solution is not easy and certainly complex, but I see it having a much greater impact on costs and choice than any government plan. We need to require cost transparency in medical bills so that patients see where their money is going. We also need to break the control of insurance companies over which doctor and which hospital a patient can use. We need to allow consumers to purchase health insurance across state lines so that insurance companies actually have to compete and innovate. These are not silver bullets and there is certainly much more that would need to be done, but the goal has to be putting the patient in the driver's seat.
One last point for now: Any discussion of controling the costs of health care or health care reform is useless without major changes in Medicaid and Medicare. These entitlement programs are the 800 pound gorilla in the room and they need to be addressed if we are going to make any progress.