Talk of The Villages Florida - View Single Post - It's Going To Be Tough
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Old 08-04-2009, 08:12 AM
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Default Reform...It's Going To Be Tough

I watched an interesting hour-long panel discussion on CNN last night. The moderator was Maria Bartoromo and the panelists included: Michigan Governor Granholm, Michael Milkin, two doctors who head major clinics (Cleveland Clinic was one), CEO's of two insurance companies, former Senator (and doctor) Bill Frist and the CEO of a major drug company.

After an hour of active and knowledgeable debate, there didn't seem to be very many specifics that the panel agreed on. Those that they did agree on were couched in terms that were difficult (for me anyway) to understand. If I had to summarize the main conclusions that the panel reached, they were:
  • The U.S. must reform it's healthcare system or be at risk of the cost of care overwhelming the country.
  • Doctors should be compensated based on "results", not the frequency of service.
  • Americans should be incented by the re-formed system to live healthier lives.
  • The re-forming must result in healthcare coverage for all Americans.
  • There are tremendous opportunities for cost reductions in the current system.
  • Whatever the solution is, it almost certainly should include both public and private options for healthcare.
Some of the discussion was predictable. The "corporate types" on the panel and Bill Frist resisted the idea of a "public option" vigorously, arguing that a re-formed system should be based solely on for-profit providers, not the government. The other panel members were equally effective in defending the need for a cooperative system, including a public option, not significantly different than we have today with Medicare.

Ever the politician, Bill Frist defended that massive expenditures on advertising by drug companies as their "first amendment right". He was also critical of Medicare or the idea that any public option should be included in a new plan. Among the panelists, he seemed to have the fewest specific ideas on what should be done.

Predictably, the two insurance company CEO's defended the current system. The drug company CEO similarly defended their business model, drug prices, and even the need for the extensive advertising of prescription drugs.

Michael Milkin kept hitting on the idea that Americans must live a healthier lifestyle and that alone would reduce healthcare costs dramatically. He noted that we are "too fat" and "smoked too much". His suggestion was to "incent Americans to live healthier". To me, that was a thinly-veiled suggestion that people who were overweight and/or smoked would pay dramatically higher insurance premiums than those that did not. He argued that the funding of healthcare should be placed on those who contributed most to it's cost.

Governor Granholm repeatedly used the experience of the auto companies as an example of why healthcare reform is needed. She argued that failure to act now would weaken our entire economy even more in the not too distant future. She noted that about $1,500 of the cost of every GM car was for healthcare benefits for workers and retirees. One of the panelists related the story of a phone call from Lee Iaccoa when he was Chrysler CEO. He was bemoaning the fact that the cost of healthcare for his employees and retirees had reached the point where he was spending more for insurance premiums than for the steel, glass, plastic and other materials used to build the cars and trucks. He observed that he knew how to cut materials costs, but was clueless on how to control healthcare costs.

The doctors argued that physicians should be paid more for the quality of care than the frequency. Both noted that, while it would be difficult to achieve legally, there was a distinct advantage to having doctors work as salaried employees rather than "independent contractors". They noted that doctors in some of the best healthcare facilities in the world--Mayo Clinic, Cleveland Clinic and a couple others they named--had worked for salaries for years. Of course, they noted, doctors in almost every other country in the world worked for salaries as government employees and were producing results superior to the U.S. They also noted the need to compensate primary care physicians more generously, as they were the only doctors who could be effective in providing preventative care.
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The bottom line was that this group of knowledgeable panelists didn't present anything close to a consensus set of solutions. In fact, some of the solutions they did present were couched in words that are difficult for the public to understand ("pay doctors for quality not quantity"--sounds good, but what the hell does that mean?)

I shudder to think what will come out of a Congress which is far less knowedgable and which has a greater commitment to their own self-interest and those of the special interests who pay them than to the public. And when they get finished, who's going to explain it to us in understandable terms?

The Villages Florida