Public health plan could save $ faster.

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Registered: 08-30-2002
Public health plan could save $ faster.
2
Wed, 06-24-2009 - 4:38pm

Health policy group comparison of three potential plans.


http://news.yahoo.com/s/nm/20090624/ts_nm/us_insurance_options


WASHINGTON (Reuters) – A nationwide health insurance exchange that includes a Medicare-like government option could save $1.8 trillion more than if only private plans are offered, a prominent private U.S. health policy group said on Wednesday.


Federal spending on health-related costs would still rise from 2010 to 2020, but they would be less with a plan that pays doctors and hospital rates similar to the Medicare program for the elderly and disabled, according to a report by the Commonwealth Fund.


The New York-based health policy research group compared possible savings a health insurance exchange could bring under three different scenarios. One would include a Medicare-like plan along with private insurance. Another would instead offer a government-run plan with rates somewhat higher than Medicare. The final one would be private insurance with no government plan at all.


Such an exchange would offer a central point for consumers to shop for and compare health plans.


An exchange that instead offered a plan with rates slightly higher than Medicare but below current private plan rates would save nearly $800 billion over one with only private options, according to the Commonwealth Fund's analysis.


"Offering a public plan choice and the design of this choice makes a difference in the pace of change," said Cathy Schoen, the group's senior vice president.


Whether Democrats' plan to revamp the U.S. health care system and provide coverage to the roughly 46 million uninsured Americans includes a government-run insurance plan is a major sticking point as Congress finalizes its proposal.


Supporters say such an option would offer Americans an affordable alternative. Most people with health insurance in the United Stated get it through their employer or the government. But those who do not have coverage through work and do not qualify for Medicare or the Medicare program for the poor can face a tough time buying a policy.


The Commonwealth fund echoed those sentiments, saying private plans could lower premiums as more people seek insurance and that lower administrative costs with the government-run options may force private plans to streamline.


"It would provide a strong incentive for private plans to innovate and compete," Schoen told reporters.


Opponents say a cheaper, government plan will make it impossible for private plans to compete and may drive some out of business. It could also encourage employers to drop coverage and make employees buy a government-backed plan, they say.


Overall, an exchange with a Medicare-like plan will save nearly $3 trillion through 2020, saving consumers up to $2,200 per household, Commonwealth found. About $2 trillion of that would come after about five to six years, it said.


In comparison, an exchange including a government plan with higher rates would save $1.97 trillion and a private plan-only exchange would save almost $1.2 trillion. Both options would save a household $1,600.


Still, an exchange won't keep health costs from rising, the report added.


The increase in federal budget costs from 2010 to 2020 with the Medicare-like public plan would be $112 billion, it found. That is compared to $232 billion under the public plan with somewhat higher rates and $360 billion under a private plan-only exchange.


All three options would help insure nearly all Americans, it said, with the number of uninsured dropping to about 4 million people by 2012.


The group's analysis assumed other changes would also be made to the U.S. healthcare market. These include payment reforms to the Medicare program, an expansion of existing government coverage and new regulations that would require insurers to cover a wider range of consumers.


Hospitals and doctors would also see their revenues grow with any of the three exchanges but at a slower rate, the report said.



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Registered: 03-18-2000
Thu, 06-25-2009 - 10:59am

8 Myths About Health Care Reform


And why we can't afford to believe them anymore


http://www.aarpmagazine.org/health/8_myths_about_health_care_reform.html


Americans spend more on health care every year than we do educating our children, building roads, even feeding ourselves—an estimated $2.6 trillion in 2009, or around $8,300 per person. Forty-five million Americans have no health insurance whatsoever. These staggering figures are at the heart of the current debate over health care reform: the need to control costs while providing coverage for all. As John Lumpkin, M.D., M.P.H., director of the Health Care Group for the Robert Wood Johnson Foundation, says, "There is enough evidence that it is now time to do something and to do the right thing." The key is to focus on the facts—and to dispel, once and for all, the myths that block our progress.


Myth 1: "Health reform won't benefit people like me, who have insurance."
Just because you have health insurance today doesn't mean you'll have it tomorrow. According to the National Coalition on Healthcare, nearly 266,000 companies dropped their employees' health care coverage from 2000 to 2005. "People with insurance have a tremendous stake, because their insurance is at risk," says Judy Feder, a professor of public policy at Georgetown University and a senior fellow at the Center for American Progress, a Washington, D.C.-based think tank. What's more, in recent years the average employee health insurance premium rose nearly eight times faster than income. "Everyone is paying for health increases in some way, and it's unsustainable for everyone," says Stephanie Cathcart, spokesperson for the National Federation of Independent Business (NFIB). "Reform will benefit everyone as long as it addresses costs."


“There are many ways to tackle our health care problem, but we will come up with a uniquely American solution.”


Myth 2: "The boomers will bankrupt Medicare."
If you're looking to blame the rise in health care costs on an aging population, you'll have to look elsewhere. The growing ranks of the elderly are projected to account for just 0.4 percent of the future growth in health care costs, says Paul Ginsburg, president of the Center for Studying Health System Change. So why are health care costs skyrocketing? Ginsburg and others point to all those fancy medical technologies we now rely on (think MRIs and CT scans), as well as our fee-for-service payment system, in which doctors are paid by how many patients they see and how many treatments they prescribe, rather than by the quality of care they provide. Some experts say this fee-for-service payment system encourages overtreatment (see "Why Does Health Care Cost So Much?" from the July-August 2008 issue of AARP The Magazine).


Myth 3: "Reforming our health care system will cost us more."
Think of health care reform as if it's an Energy Star appliance. Yes, it costs more to replace your old energy-guzzling refrigerator with a new one, but over time the savings can be substantial. The Commonwealth Fund, a New York City-based foundation that supports research on health care practice and policy, estimates that health care reform will cost roughly $600 billion to implement but by 2020 could save us approximately $3 trillion.


Myth 4: "My access to quality health care will decline."
Just because you have access to lots of doctors who prescribe lots of treatments doesn't mean you're getting good care. In fact, researchers at Dartmouth College have found that patients who receive more care actually fare worse than those who receive less care. In one particularly egregious example, heart attack patients in Los Angeles spent more days in the hospital and underwent more tests and procedures than heart attack patients in Salt Lake City, yet the patients in L.A. died at a higher rate than those in Salt Lake City. (Medicare also paid $30,000 for the L.A. patients' care, versus $23,000 for the care of the patients with better outcomes in Salt Lake City.)


Myth 5: "I won't be able to visit my favorite doctor."
Mention health reform and immediately people worry that they will have fewer options—in doctors, treatments, and diagnostic testing. The concern comes largely during discussions of comparative effectiveness research (CER): research on which treatments work and which don't. But 18 organizations in a broad coalition, including AARP, NFIB, Consumers Union, and Families USA, support CER—and believe that far from limiting choices, it will instead prevent errors and give physicians the information they need to practice better medicine. A good example: Doctors routinely prescribe newer and more expensive medications for high blood pressure when studies show that older medications work just as well, if not better. "There is a tremendous value in new technology, but in our health care system we don't weigh whether these treatments work," says Feder. "Expensive treatments replace less expensive ones for no reason."


Myth 6: "The uninsured actually do have access to good care—in the emergency room."
It's true that the United States has an open-door policy for those who seek emergency care, but "emergency room care doesn't help you get the right information to prevent a condition or give you help managing it," says Maria Ghazal, director of public policy for Business Roundtable, an association of CEOs at major U.S. companies. Forty-one percent of the uninsured have no access to preventive care, so when they do go to the ER, "they are most likely going in at a time when their illness has progressed significantly and costs more to treat," says Lumpkin. Hospitals have no way to recoup the costs of treating the uninsured, so they naturally pass on some of those costs to their insured patients.


Myth 7: "We can't afford to tackle this problem now."
We may be in the middle of a recession, but as Robert Zirkelbach, spokesperson for America's Health Insurance Plans, says, "the most expensive thing we can do is nothing at all." If we do nothing, the Congressional Budget Office projects that our annual health costs will soar to about $13,000 per person in 2017, while the number of uninsured will climb to 54 million by 2019. Already more than half of Americans say they have cut back on health care in the past year due to cost concerns. Roughly one in four of us say we put off care we needed, and one in five of us didn't fill a prescription. Clearly, the urgency is greater now than ever before.


Myth 8: "We'll end up with socialized medicine."
Some experts favor a single-payer system similar to Medicare or the health program offered to federal-government employees. Yet all the proposals being discussed today would build on our current system, Feder says—which means that private insurers and the government are both likely to play roles. Says Lumpkin: "There are many ways to solve our health care problem, but we will come up with a uniquely American solution, and that solution will be a mixed public and private solution."


 


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iVillage Member
Registered: 02-19-2008
Thu, 06-25-2009 - 3:43pm

"Myth 4: "My access to quality health care will decline."
Just because you have access to lots of doctors who prescribe lots of treatments doesn't mean you're getting good care. In fact, researchers at Dartmouth College have found that patients who receive more care actually fare worse than those who receive less care. In one particularly egregious example, heart attack patients in Los Angeles spent more days in the hospital and underwent more tests and procedures than heart attack patients in Salt Lake City, yet the patients in L.A. died at a higher rate than those in Salt Lake City. (Medicare also paid $30,000 for the L.A. patients' care, versus $23,000 for the care of the patients with better outcomes in Salt Lake City.)"

What this seems to be saying is yes your access will decline but you'll be better off.