Insuring Resources Commentary:
My apologies for getting this news to you all this late. Please call your Senators to have the language below reintroduced during the conference committee negotiations. We must, at the very least, get a pilot or demonstration in place illustrating the cost savings of the lean methodology. Thank you Senator Kohl for introducing this amendment.
The amendment introduced by Sen. Herb Kohl did not pass and is not contained within the Senate bill that was passed Dec. 24th.
Amendment language:
On page 731, between lines 16 and 17, insert the following:
‘‘(xix) Implementing the lean methodology through a network
of provider systems across the country in varying geographic
areas and across sites of care that offer a patient-centered
approach to improving quality, reducing medical errors, and
enhancing value to patients.
http://www.createhealthcarevalue.com/data/blog/ThedaCare%20amendment.pdf
Source: The Congressional Record- Dec. 15th
Wednesday, December 30, 2009
Saturday, December 26, 2009
Mayo Clinic wants payment reform
Insuring Resources Commentary:
It still baffles me how so many people, including Pres. Obama knows what health care reform should include and what models work best and yet they did very little to make it happen.
Mayo Clinic Supports Bill But Seeks More Action on How Care Is Paid For
By RON WINSLOW - Wall Street Journal
The Mayo Clinic, often cited by the Obama administration as a model for high-quality, cost-effective health care, generally supports key provisions of the legislation approved by the Senate, an official said Thursday, but he called for more aggressive steps to change how care in the U.S. is paid for.
"The concerns are whether the legislation will be strong enough to change the incentives in the system today, which are mostly around paying for volume" and not for "value" of care, said Jeffrey Korsmo, executive director of health policy center at the Rochester, Minn., clinic.
The dominant system of reimbursement in the health-care system, known as fee-for-service, pays doctors and hospitals for each test and procedure they perform or order, rewarding providers based on delivering more--rather than better--care, Mr. Korsmo said.
The Senate measure includes provisions for Medicare pilot programs to test the effect of bundling all of the care provided in such big ticket procedures as hip replacement surgery, where hospitals and doctors currently bill separately for their services. Paying a single "bundled" fee is intended to encourage doctors and hospitals to work together to provide more efficient care. Other pilots include treatment for, say, a year of care for a person with diabetes.
"These pilots need to go quickly beyond demonstration programs and become part of the way we pay for care," Mr. Korsmo said.
Led by Denis Cortese, its recently retired chief executive officer, the Mayo Clinic has taken an unusually activist stance in the health-overhaul debate, making arguments for expanding coverage, coordinating patient care and paying for better results rather than volume of care. The nonprofit clinic reported revenue of $7.22 billion in 2008, of which $6.14 billion came from medical services. In addition to its Rochester headquarters, it has operations in Jacksonville, Fla., and Scottsdale, Ariz.
Despite its reputation for treating patients with complex, big-ticket medical problems, the clinic is routinely included among the nation's most efficient health-care providers. One reason: Its doctors are all on salary so their incomes aren't based on the number of procedures they do. Another is the clinic's sophisticated electronic medical-record system, which helps improve coordination of care for its patients and reduces orders for duplicate tests.
That helps explain why President Barack Obama and a host of other political leaders and health-care experts extol Mayo as a model citizen in the health-care system.
That isn't to say Mayo officials and Democrats hammering out the health-care bill see eye-to-eye on all issues. The clinic opposes a government-run health plan, known as the public option, that is favored by many Democrats. That provision was cut from the Senate bill, but it is included in the House legislation and is one of several potentially thorny conflicts to be resolved as House and Senate negotiators seek to come up with a final, common version of the legislation.
The clinic also was against the proposal, raised and then scuttled in the Senate, to allow people aged 55 to 64 to buy into the federal Medicare plan for the elderly. "Medicare isn't the model we ought to be pursuing [to expand coverage]," Mr. Korsmo said. "It's been part of what's gotten us into the trouble we're in."
Mayo is also concerned about the potential for Medicare to impose across-the-board cuts in payments to health-care providers without differentiating for cost-effective doctors and hospitals. It worries that such Medicare cuts would punish the Mayo Clinic and other organizations known for delivering good care at reasonable prices.
Clinic leaders, however, do favor a mandate requiring people to purchase health coverage to make sure young and healthy people participate in the insurance system. And they like the idea of health-insurance exchanges, also a prominent feature of both the Senate and House bills, where consumers can shop for health plans.
"There is a role for government--it ought to create the exchanges and subsidize premiums where there is a financial need," Mr. Korsmo said.
Two other issues aren't getting sufficient attention in the current legislation, Mayo officials believe. Changes in medical malpractice policy are needed to encourage more open discussion of medical errors, Mr. Korsmo said. And with estimates that 40% of medical costs are the result of personal behavior such as smoking and diet habits, more attention needs to be focused on that problem, he added.
It still baffles me how so many people, including Pres. Obama knows what health care reform should include and what models work best and yet they did very little to make it happen.
Mayo Clinic Supports Bill But Seeks More Action on How Care Is Paid For
By RON WINSLOW - Wall Street Journal
The Mayo Clinic, often cited by the Obama administration as a model for high-quality, cost-effective health care, generally supports key provisions of the legislation approved by the Senate, an official said Thursday, but he called for more aggressive steps to change how care in the U.S. is paid for.
"The concerns are whether the legislation will be strong enough to change the incentives in the system today, which are mostly around paying for volume" and not for "value" of care, said Jeffrey Korsmo, executive director of health policy center at the Rochester, Minn., clinic.
The dominant system of reimbursement in the health-care system, known as fee-for-service, pays doctors and hospitals for each test and procedure they perform or order, rewarding providers based on delivering more--rather than better--care, Mr. Korsmo said.
The Senate measure includes provisions for Medicare pilot programs to test the effect of bundling all of the care provided in such big ticket procedures as hip replacement surgery, where hospitals and doctors currently bill separately for their services. Paying a single "bundled" fee is intended to encourage doctors and hospitals to work together to provide more efficient care. Other pilots include treatment for, say, a year of care for a person with diabetes.
"These pilots need to go quickly beyond demonstration programs and become part of the way we pay for care," Mr. Korsmo said.
Led by Denis Cortese, its recently retired chief executive officer, the Mayo Clinic has taken an unusually activist stance in the health-overhaul debate, making arguments for expanding coverage, coordinating patient care and paying for better results rather than volume of care. The nonprofit clinic reported revenue of $7.22 billion in 2008, of which $6.14 billion came from medical services. In addition to its Rochester headquarters, it has operations in Jacksonville, Fla., and Scottsdale, Ariz.
Despite its reputation for treating patients with complex, big-ticket medical problems, the clinic is routinely included among the nation's most efficient health-care providers. One reason: Its doctors are all on salary so their incomes aren't based on the number of procedures they do. Another is the clinic's sophisticated electronic medical-record system, which helps improve coordination of care for its patients and reduces orders for duplicate tests.
That helps explain why President Barack Obama and a host of other political leaders and health-care experts extol Mayo as a model citizen in the health-care system.
That isn't to say Mayo officials and Democrats hammering out the health-care bill see eye-to-eye on all issues. The clinic opposes a government-run health plan, known as the public option, that is favored by many Democrats. That provision was cut from the Senate bill, but it is included in the House legislation and is one of several potentially thorny conflicts to be resolved as House and Senate negotiators seek to come up with a final, common version of the legislation.
The clinic also was against the proposal, raised and then scuttled in the Senate, to allow people aged 55 to 64 to buy into the federal Medicare plan for the elderly. "Medicare isn't the model we ought to be pursuing [to expand coverage]," Mr. Korsmo said. "It's been part of what's gotten us into the trouble we're in."
Mayo is also concerned about the potential for Medicare to impose across-the-board cuts in payments to health-care providers without differentiating for cost-effective doctors and hospitals. It worries that such Medicare cuts would punish the Mayo Clinic and other organizations known for delivering good care at reasonable prices.
Clinic leaders, however, do favor a mandate requiring people to purchase health coverage to make sure young and healthy people participate in the insurance system. And they like the idea of health-insurance exchanges, also a prominent feature of both the Senate and House bills, where consumers can shop for health plans.
"There is a role for government--it ought to create the exchanges and subsidize premiums where there is a financial need," Mr. Korsmo said.
Two other issues aren't getting sufficient attention in the current legislation, Mayo officials believe. Changes in medical malpractice policy are needed to encourage more open discussion of medical errors, Mr. Korsmo said. And with estimates that 40% of medical costs are the result of personal behavior such as smoking and diet habits, more attention needs to be focused on that problem, he added.
Tuesday, December 22, 2009
The Insurance Industry's Senate bill analysis
Insuring Resources Commentary:
Sometimes it takes a practical analysis from an insider who cares about getting reform right to set the record straight. For those who read this blog routinely that is what I have tried to achive. You'll see my viewpoints are largely the same as those from AHIP. Yes I do a lot of consulting and authoring/editing of insurance textbooks for them but I also share with them a practical approach to health care reform as you'll see by reading below.
These points are valid, insurance premiums will increase because there is no comprehensive cost containment (comprehensive provider efficiency incentives) in the bill. What the bill does include is cost-shifting as Medicare reimbursement is reduced and high value health plans like mine are taxed. When this is enacted I'd hate to be a small business owner -- even those who get a subsidy will most definitely pay more than they do today.
Its really sad what an opportunity we are missing. Yes I called Sen. Feingold's office today, again, and he's voting in favor of your premium increase.
-------------------- --------------------
AHIP Statement On Senate Health Care Reform Legislation
America's Health Insurance Plans (AHIP)
Karen Ignagni
December 22, 2009
Karen Ignagni, President and CEO of America’s Health Insurance Plans (AHIP), released the following statement today on the Senate health care reform legislation:
“The debate before us today is not whether insurance market reforms are needed. In fact, health plans proposed and support a complete overhaul of insurance market rules and new consumer protections to ensure all Americans have guaranteed access to affordable, portable coverage. The critical policy questions are whether the current legislation can bend the cost curve and result in a sustainable system. While the bill makes important improvements in access and takes steps towards cost-containment, it lacks accountability to ensure that costs are brought under control. Moreover, this bill includes provisions that will increase costs for families and small businesses and disrupt the quality coverage on which millions of Americans rely today.”
Barriers to affordability:
A new $70 billion premium tax that will increase the cost of health care coverage for millions of Americans and fall primarily on small businesses and those who purchase coverage in the individual market.
More cost shifting to patients with private coverage as providers are forced to make up for hundreds of billions in reduced Medicare payments.
New market and rating rules that will increase premiums for individuals and small businesses with coverage today.
Disruptions for current policyholders:
New regulatory requirements and benefit mandates that go into effect beginning next year – before access provisions go into effect – that will cause major disruption for millions who have already enrolled in their plan for next year.
A new federal plan that would preclude many high-quality plans from participating and increase complexity in the exchanges.
Arbitrary caps on administrative costs that will undermine essential health care services, such as disease management and care coordination programs, investments in health information technology, programs to root out fraud and abuse in the health care system, and new administrative simplification requirements.
Major cuts in Medicare Advantage benefits beginning next year that will ultimately result in millions of seniors losing their current coverage.
“These issues need to be resolved if the country is to make health care coverage more affordable and put the system on a sustainable path. Health plans will continue to work to solve the problems that have been identified.”
Sometimes it takes a practical analysis from an insider who cares about getting reform right to set the record straight. For those who read this blog routinely that is what I have tried to achive. You'll see my viewpoints are largely the same as those from AHIP. Yes I do a lot of consulting and authoring/editing of insurance textbooks for them but I also share with them a practical approach to health care reform as you'll see by reading below.
These points are valid, insurance premiums will increase because there is no comprehensive cost containment (comprehensive provider efficiency incentives) in the bill. What the bill does include is cost-shifting as Medicare reimbursement is reduced and high value health plans like mine are taxed. When this is enacted I'd hate to be a small business owner -- even those who get a subsidy will most definitely pay more than they do today.
Its really sad what an opportunity we are missing. Yes I called Sen. Feingold's office today, again, and he's voting in favor of your premium increase.
-------------------- --------------------
AHIP Statement On Senate Health Care Reform Legislation
America's Health Insurance Plans (AHIP)
Karen Ignagni
December 22, 2009
Karen Ignagni, President and CEO of America’s Health Insurance Plans (AHIP), released the following statement today on the Senate health care reform legislation:
“The debate before us today is not whether insurance market reforms are needed. In fact, health plans proposed and support a complete overhaul of insurance market rules and new consumer protections to ensure all Americans have guaranteed access to affordable, portable coverage. The critical policy questions are whether the current legislation can bend the cost curve and result in a sustainable system. While the bill makes important improvements in access and takes steps towards cost-containment, it lacks accountability to ensure that costs are brought under control. Moreover, this bill includes provisions that will increase costs for families and small businesses and disrupt the quality coverage on which millions of Americans rely today.”
Barriers to affordability:
A new $70 billion premium tax that will increase the cost of health care coverage for millions of Americans and fall primarily on small businesses and those who purchase coverage in the individual market.
More cost shifting to patients with private coverage as providers are forced to make up for hundreds of billions in reduced Medicare payments.
New market and rating rules that will increase premiums for individuals and small businesses with coverage today.
Disruptions for current policyholders:
New regulatory requirements and benefit mandates that go into effect beginning next year – before access provisions go into effect – that will cause major disruption for millions who have already enrolled in their plan for next year.
A new federal plan that would preclude many high-quality plans from participating and increase complexity in the exchanges.
Arbitrary caps on administrative costs that will undermine essential health care services, such as disease management and care coordination programs, investments in health information technology, programs to root out fraud and abuse in the health care system, and new administrative simplification requirements.
Major cuts in Medicare Advantage benefits beginning next year that will ultimately result in millions of seniors losing their current coverage.
“These issues need to be resolved if the country is to make health care coverage more affordable and put the system on a sustainable path. Health plans will continue to work to solve the problems that have been identified.”
Monday, December 21, 2009
Health Care Reform Almost a Reality... but
Insuring Resources Commentary
So we are one big step closer to health care reform. But it includes special deals for key Senators in other states like Louisiana, Nebraska, etc.
So we're going to cut Medicare reimbursement. Hmmm.
To expand health insurance to 30 million more Americans we're going to set up non-profit health insurance exchanges. ----- Ok, that could be could good, as long as the health CARE portion is also non-profit because that will be more efficient. Does it include that?- doubt it.
I'll read the bill when its available and let you know what's in it as far as efficiency and lean processes. I assume we'll have voluntary, Medicare-only pilots again like in the original Reid/ Baucus bill.
Call me a cynic but this appears to be doomed to fail as far as reducing American's health care and health insurance costs.
----------------- ----------------------
Democrats’ health bill passes key Senate vote
Final outcome uncertain as measure must be harmonized with House bill
Senate Democrats won a crucial test vote on President Barack Obama's health care overhaul, putting them on track for passage before Christmas of the historic legislation to remake the nation's medical system and cover 30 million uninsured.
All 58 Democrats and the Senate's two independents held together early Monday against unanimous Republican opposition, providing the exact 60-40 margin needed to shut down a threatened GOP filibuster.
The vote came shortly after 1 a.m. with the nation's capital blanketed in snow, the unusual timing made necessary in order to get to a final vote by Christmas Eve presuming Republicans stretch out the debate as much as the rules allow. Despite the late hour and a harshly partisan atmosphere, Democrats' spirits were high.
"Today we are closer than we've ever been to making Sen. Ted Kennedy's dream of universal health insurance coverage a reality," Sen. Tom Harkin, D-Iowa, said ahead of the vote, alluding to the late Massachusetts senator who died of brain cancer in August.
"Vote your hopes, not your fears. Seize the moment," Harkin urged colleagues.
Kennedy's widow, Vicki, watched the vote from the visitor's gallery along with administration officials who have worked intensely on the issue. Senators cast their votes from their desks, a practice reserved for issues of particular importance.
Lieberman, Nelson won over
The outcome was preordained after Senate Majority Leader Harry Reid, D-Nev., wrangled his fractious caucus into line over the course of the past several months, culminating in a frenzy of last-minute deals and concessions to win over the final holdouts, independent Joe Lieberman of Connecticut and conservative Democrat Ben Nelson of Nebraska.
Obama's oft-stated goal of a bipartisan health bill was not met, despite the president's extensive courtship of moderate Sen. Olympia Snowe of Maine, the only Republican to support the bill in committee. Obama called Snowe to the White House for lengthy in-person meetings both before he left for climate talks in Copenhagen and after his return on Saturday. In the end Snowe said she was "extremely disappointed" in what she called a rushed process that left scant time for her to review, much less amend, the bill.
Even so, the vote represented a major victory for Democrats and Obama, who's now clearly in reach of passing legislation extending health coverage to nearly all Americans, a goal that's eluded a succession of past presidents. The legislation would make health insurance mandatory for the first time for nearly everyone, provide subsidies to help lower-income people buy it, and induce employers to provide it with tax breaks for small businesses and penalties for larger ones.
Click for related content
Winners and losers in the Senate bill
NYT analysis: Obama accepts 'pyrrhic victories'
Two more procedural votes await the Senate, each requiring 60 votes, the first of these set for Tuesday morning. Final passage of the bill requires a simple majority, and that vote could come as late as 7 p.m. on Thursday, Christmas Eve, or the day before if Republicans agree.
Although Democrats are expected to prevail in the votes over the next several days, the final outcome remains unpredictable, because the Senate measure must be harmonized with the health care bill passed by the House in November before final legislation can be sent to Obama's desk.
There are significant differences between the two measures, including stricter abortion language in the House bill, a new government-run insurance plan in the House bill that's missing from the Senate version, and a tax on high-value insurance plans embraced by the Senate but strongly opposed by many House Democrats.
After Monday's vote a number of Senate Democrats warned that the legislation could not change much and expect to maintain support from 60 senators. House Democrats are sure to want to alter it but may have to swallow it mostly whole.
"It took a lot of work to bring this 60 together and this 60 is delicately balanced," Lieberman said.
‘Day of accounting’
Republicans are determined to give Democrats no help, eager to deny Obama a political victory and speculating openly that the health care issue will hurt Democrats in the 2010 midterm elections.
At their core the bills passed by the House and pending in the Senate are similar. Each costs around $1 trillion over 10 years and is paid for by a combination of tax and fee increases and cuts in projected Medicare spending. Each sets up new insurance marketplaces called exchanges where uninsured or self-employed people and small businesses can compare prices and plans designed to meet some basic requirements. Unpopular insurance practices such as denying people coverage based on pre-existing conditions would be banned, and young adults could retain coverage longer under their parents' insurance plans — through age 25 in the Senate bill and through age 26 in the House version.
Reid cut numerous last-minute deals to get the votes he needed and powerful Democrats also inserted home-state provisions in a 383-page package of amendments Reid filed this weekend to the 2,074-page bill.
Among other items, Senate Finance Committee Chairman Max Baucus, D-Mont., included a provision allowing residents of the town of Libby, Mont., who are suffering asbestos-related illnesses from a mining operation to get Medicare benefits. Nelson won a list of benefits for Nebraska including a commitment for the federal government to pick up the full tab of an expansion of Medicaid. And Sen. Christopher Dodd, D-Conn., who faces a difficult re-election, inserted a $100 million item for construction of a university hospital that his spokesman said he hopes to claim for the University of Connecticut.
So we are one big step closer to health care reform. But it includes special deals for key Senators in other states like Louisiana, Nebraska, etc.
So we're going to cut Medicare reimbursement. Hmmm.
To expand health insurance to 30 million more Americans we're going to set up non-profit health insurance exchanges. ----- Ok, that could be could good, as long as the health CARE portion is also non-profit because that will be more efficient. Does it include that?- doubt it.
I'll read the bill when its available and let you know what's in it as far as efficiency and lean processes. I assume we'll have voluntary, Medicare-only pilots again like in the original Reid/ Baucus bill.
Call me a cynic but this appears to be doomed to fail as far as reducing American's health care and health insurance costs.
----------------- ----------------------
Democrats’ health bill passes key Senate vote
Final outcome uncertain as measure must be harmonized with House bill
Senate Democrats won a crucial test vote on President Barack Obama's health care overhaul, putting them on track for passage before Christmas of the historic legislation to remake the nation's medical system and cover 30 million uninsured.
All 58 Democrats and the Senate's two independents held together early Monday against unanimous Republican opposition, providing the exact 60-40 margin needed to shut down a threatened GOP filibuster.
The vote came shortly after 1 a.m. with the nation's capital blanketed in snow, the unusual timing made necessary in order to get to a final vote by Christmas Eve presuming Republicans stretch out the debate as much as the rules allow. Despite the late hour and a harshly partisan atmosphere, Democrats' spirits were high.
"Today we are closer than we've ever been to making Sen. Ted Kennedy's dream of universal health insurance coverage a reality," Sen. Tom Harkin, D-Iowa, said ahead of the vote, alluding to the late Massachusetts senator who died of brain cancer in August.
"Vote your hopes, not your fears. Seize the moment," Harkin urged colleagues.
Kennedy's widow, Vicki, watched the vote from the visitor's gallery along with administration officials who have worked intensely on the issue. Senators cast their votes from their desks, a practice reserved for issues of particular importance.
Lieberman, Nelson won over
The outcome was preordained after Senate Majority Leader Harry Reid, D-Nev., wrangled his fractious caucus into line over the course of the past several months, culminating in a frenzy of last-minute deals and concessions to win over the final holdouts, independent Joe Lieberman of Connecticut and conservative Democrat Ben Nelson of Nebraska.
Obama's oft-stated goal of a bipartisan health bill was not met, despite the president's extensive courtship of moderate Sen. Olympia Snowe of Maine, the only Republican to support the bill in committee. Obama called Snowe to the White House for lengthy in-person meetings both before he left for climate talks in Copenhagen and after his return on Saturday. In the end Snowe said she was "extremely disappointed" in what she called a rushed process that left scant time for her to review, much less amend, the bill.
Even so, the vote represented a major victory for Democrats and Obama, who's now clearly in reach of passing legislation extending health coverage to nearly all Americans, a goal that's eluded a succession of past presidents. The legislation would make health insurance mandatory for the first time for nearly everyone, provide subsidies to help lower-income people buy it, and induce employers to provide it with tax breaks for small businesses and penalties for larger ones.
Click for related content
Winners and losers in the Senate bill
NYT analysis: Obama accepts 'pyrrhic victories'
Two more procedural votes await the Senate, each requiring 60 votes, the first of these set for Tuesday morning. Final passage of the bill requires a simple majority, and that vote could come as late as 7 p.m. on Thursday, Christmas Eve, or the day before if Republicans agree.
Although Democrats are expected to prevail in the votes over the next several days, the final outcome remains unpredictable, because the Senate measure must be harmonized with the health care bill passed by the House in November before final legislation can be sent to Obama's desk.
There are significant differences between the two measures, including stricter abortion language in the House bill, a new government-run insurance plan in the House bill that's missing from the Senate version, and a tax on high-value insurance plans embraced by the Senate but strongly opposed by many House Democrats.
After Monday's vote a number of Senate Democrats warned that the legislation could not change much and expect to maintain support from 60 senators. House Democrats are sure to want to alter it but may have to swallow it mostly whole.
"It took a lot of work to bring this 60 together and this 60 is delicately balanced," Lieberman said.
‘Day of accounting’
Republicans are determined to give Democrats no help, eager to deny Obama a political victory and speculating openly that the health care issue will hurt Democrats in the 2010 midterm elections.
At their core the bills passed by the House and pending in the Senate are similar. Each costs around $1 trillion over 10 years and is paid for by a combination of tax and fee increases and cuts in projected Medicare spending. Each sets up new insurance marketplaces called exchanges where uninsured or self-employed people and small businesses can compare prices and plans designed to meet some basic requirements. Unpopular insurance practices such as denying people coverage based on pre-existing conditions would be banned, and young adults could retain coverage longer under their parents' insurance plans — through age 25 in the Senate bill and through age 26 in the House version.
Reid cut numerous last-minute deals to get the votes he needed and powerful Democrats also inserted home-state provisions in a 383-page package of amendments Reid filed this weekend to the 2,074-page bill.
Among other items, Senate Finance Committee Chairman Max Baucus, D-Mont., included a provision allowing residents of the town of Libby, Mont., who are suffering asbestos-related illnesses from a mining operation to get Medicare benefits. Nelson won a list of benefits for Nebraska including a commitment for the federal government to pick up the full tab of an expansion of Medicaid. And Sen. Christopher Dodd, D-Conn., who faces a difficult re-election, inserted a $100 million item for construction of a university hospital that his spokesman said he hopes to claim for the University of Connecticut.
Tuesday, December 15, 2009
The End Game and Lasting Disappointment
Insuring Resources Opinion:
So how did the Obama Administration get here? Here's where we're at and my answers on how bipartisan support could have been achieved:
1) Virtually no discussion on reigning in health care costs has occurred.
This should have been discussion point #1 daily by every liberal and THE basis for all proposals. The Conservatives can't argue against this. Obama and the liberals gave up on this argument in the Spring. This is the greatest disappointment because it encompasses the greatest promise of true reform.... provider incentives to get lean and efficient. What we have now in the bill is a weak voluntary, Medicare only pilot that provides provider incentives of a 1% higher reimbursement to increase efficiency. I bet the paperwork required eats up more than the 1%.
2) Improper focus on the public option. Yes, it could be included for individuals and small busineeses under ten employees as competition for private insurers. There could be language added to make it impossible to expand it into a single payer system by capping enrollment at 20-30 million members or similar mechanisms until whatever year is chosen (2100?).
3) Individual mandate to purchase coverage through an Exchange... The Senate Bill does have this. This provision eliminates the concept of adverse selection-- i.e. people waiting to purchase coverage until they're ill. The industry needs the individual mandate to streamline medical adversity.
4) Eliminate pre-x conditions. What a hollow victory if none of the rest happens but these last two items.
5) Employer mandate- yeah they botched this one, it doesn't exist except in the house bill which has been dead since the day it was passed. The penalty was miniscule compared to the cost of group insurance.
6) Medicare buy-in... Yep that one appears to be dead too thanks to Sen. Lieberman-- for once I agree with him. So the current compromise expands Medicare (expect this to be pulled from the compromise package soon) for 55 and up when the program already doesn't reimburse doctors enough and is responsible for huge cost-shifting on to the private employer-sponsored coverage side?? Dumb idea unless we somehow raise Medicare reimbursement by 15-20%. Oops, the bill actually cuts some Medicare reimbursement.
My solution:We should have a Health Insurance Exchange with regional / private sector insurance contracts administered by the feds with efficiency mandates based on CURRENT best practices that exist in Wisconsin and numerous other places. See (www.healthcarevalueleaders.org) Start with an initial five year competitive contract period for health plans to implement Efficiencies. From then on we should have revolving Three year COMPETITIVE contracts with efficiency teeth. If health plans fail on efficiency in the first two years, the contract ends after the third year and its opened to competition again, except that insurer or health plan is barred for say, 10 years. Period.
Mandate employer coverage for businesses with 10 + employees. Provide graduated subsidies for businesses with 10-49 employees. For businesses with 9 or fewer employees they can access coverage through the Health Insurance Exchange where individuals are mandated to get coverage or pay a graduated penalty based on income. If there is a public plan option it should be housed within the regional HIEs as an option for coverage.
Premiums will be less because of the power of large purchasing pools spreading the risk and the mandated coverage of individuals means they're in the pool also. And all providers must meet efficiency standards to get preferred reimbursement rates above current Medicare levels. Keep the paperwork easy and give them enough incentive to make it worthwhile- 5% let's say as a guess but whatever the Actuaries come up with. Oh and add bonuses for quality health outcomes achieved by the top 10% of insurers. But the bonuses don't go to the CEOs. They should be split evenly between the insurers and the member employers and individual insureds.
Final Analysis- But none of that above will happen. Its hard to say what the final product will look like... I'm scared to fathom it at this point. We'll probably cut the uninsured from about 47 million to 25 million or so and costs will go up because of it for the INSURED because there are no legitimate cost restraints anywhere. Add 20+ million insured persons with no health care cost restraints/ efficiency standards in place.
You ain't seen premium increases like those to come folks.
So how did the Obama Administration get here? Here's where we're at and my answers on how bipartisan support could have been achieved:
1) Virtually no discussion on reigning in health care costs has occurred.
This should have been discussion point #1 daily by every liberal and THE basis for all proposals. The Conservatives can't argue against this. Obama and the liberals gave up on this argument in the Spring. This is the greatest disappointment because it encompasses the greatest promise of true reform.... provider incentives to get lean and efficient. What we have now in the bill is a weak voluntary, Medicare only pilot that provides provider incentives of a 1% higher reimbursement to increase efficiency. I bet the paperwork required eats up more than the 1%.
2) Improper focus on the public option. Yes, it could be included for individuals and small busineeses under ten employees as competition for private insurers. There could be language added to make it impossible to expand it into a single payer system by capping enrollment at 20-30 million members or similar mechanisms until whatever year is chosen (2100?).
3) Individual mandate to purchase coverage through an Exchange... The Senate Bill does have this. This provision eliminates the concept of adverse selection-- i.e. people waiting to purchase coverage until they're ill. The industry needs the individual mandate to streamline medical adversity.
4) Eliminate pre-x conditions. What a hollow victory if none of the rest happens but these last two items.
5) Employer mandate- yeah they botched this one, it doesn't exist except in the house bill which has been dead since the day it was passed. The penalty was miniscule compared to the cost of group insurance.
6) Medicare buy-in... Yep that one appears to be dead too thanks to Sen. Lieberman-- for once I agree with him. So the current compromise expands Medicare (expect this to be pulled from the compromise package soon) for 55 and up when the program already doesn't reimburse doctors enough and is responsible for huge cost-shifting on to the private employer-sponsored coverage side?? Dumb idea unless we somehow raise Medicare reimbursement by 15-20%. Oops, the bill actually cuts some Medicare reimbursement.
My solution:We should have a Health Insurance Exchange with regional / private sector insurance contracts administered by the feds with efficiency mandates based on CURRENT best practices that exist in Wisconsin and numerous other places. See (www.healthcarevalueleaders.org) Start with an initial five year competitive contract period for health plans to implement Efficiencies. From then on we should have revolving Three year COMPETITIVE contracts with efficiency teeth. If health plans fail on efficiency in the first two years, the contract ends after the third year and its opened to competition again, except that insurer or health plan is barred for say, 10 years. Period.
Mandate employer coverage for businesses with 10 + employees. Provide graduated subsidies for businesses with 10-49 employees. For businesses with 9 or fewer employees they can access coverage through the Health Insurance Exchange where individuals are mandated to get coverage or pay a graduated penalty based on income. If there is a public plan option it should be housed within the regional HIEs as an option for coverage.
Premiums will be less because of the power of large purchasing pools spreading the risk and the mandated coverage of individuals means they're in the pool also. And all providers must meet efficiency standards to get preferred reimbursement rates above current Medicare levels. Keep the paperwork easy and give them enough incentive to make it worthwhile- 5% let's say as a guess but whatever the Actuaries come up with. Oh and add bonuses for quality health outcomes achieved by the top 10% of insurers. But the bonuses don't go to the CEOs. They should be split evenly between the insurers and the member employers and individual insureds.
Final Analysis- But none of that above will happen. Its hard to say what the final product will look like... I'm scared to fathom it at this point. We'll probably cut the uninsured from about 47 million to 25 million or so and costs will go up because of it for the INSURED because there are no legitimate cost restraints anywhere. Add 20+ million insured persons with no health care cost restraints/ efficiency standards in place.
You ain't seen premium increases like those to come folks.
Tuesday, December 8, 2009
Senate Dems Compromise- public plan is out
Insuring Resources Commentary
The Senate Dems reached a compromise today (the details of which I predicted three months ago on this blog). I said back then that the final bill would not have a gov't run public plan but instead would use private plans heavily regulated by the Feds much like Medicare Advantage.
In addition the Senate Bill now includes a Medicare buy-in program for persons age 55 and up to buy in to Medicare early. This particularly helps early retirees.
The bill also requires insurance companies to spend at least 90 percent of their premium income providing benefits. By the way, according to the Wisconsin Association of Health Plans (WAHP) their 16 member health plans pay out 91% of premium in benefits. I've long touted those companies (Dean, GHC, Gunderson and others) as models on which to build the foundation of health care reform. Perhaps this is the stick that incents plans to base reimbursement on quality outcomes and efficiency.
From WAHP's website: "In 2007, the Association-member health plans participating in the commercial health insurance market in Wisconsin paid out approximately 91 cents in health care services for every $1 of insurance premium taken in. They spent less than 10 cents on administration, and profits remained among the lowest in health care: less than 2 cents for every $1 in premium."
http://www.wihealthplans.org/inner.iml?mdl=about_us.mdl
So what does Sen. Feingold think about this compromise (copied from below). "I do not support proposals that would replace the public option in the bill with a purely private approach. We need to have some competition for the insurance industry to keep rates down and save taxpayer dollars," Feingold said.
Competition may reduce premiums 1-2% while waste reduction, payment reform and quality incentives could have ten times the impact.
Time for my FIFTH phone call to his office staff.
---------------------------------------------
Dems reach deal to drop gov't-run plan
Dec. 8, 2009
After days of secret talks, Senate Democrats tentatively agreed Tuesday night to drop a full-blown government-run insurance option from sweeping health care legislation, several officials said, a concession to party moderates whose votes are critical to passage of President Barack Obama's top domestic priority.
In its place, officials said Democrats had tentatively settled on a private insurance arrangement to be supervised by the federal agency that oversees the system through which lawmakers purchase coverage, with the possibility of greater government involvement if needed to ensure consumers of sufficient choices in coverage.
Additionally, the emerging agreement calls for Medicare to be opened to uninsured Americans beginning at age 55, a significant expansion of the large government health care program that currently serves the 65-and-over population.
At a hastily called evening news conference in the Capitol, Majority Leader Harry Reid, D-Nev., declined to provide details of what he described as a "broad agreement" between liberals and moderates on an issue that has plagued Democrats' efforts to pass health care legislation from the outset.
With it, he added with a smile, the end is in sight for passage of the legislation that Congress has labored over for months.
The officials who described the details of the closed-door negotiations did so on condition of anonymity, saying they were not authorized to discuss them publicly. Several officials stressed that so far, Democrats had technically agreed only on submitting proposals to the Congressional Budget Office for their impact on the bill's cost and other analysis.
At its core, the legislation would expand health care to millions who lack it, ban insurance companies from denying coverage on the basis of pre-existing medical conditions and rein in the rise of health care spending nationally.
The developments followed a vote on the Senate floor earlier in the day in which abortion opponents failed to inject tougher restrictions into sweeping health care bill, and Democratic leaders labored to make sure fallout from the issue didn't hamper the drive to enact legislation. The vote was 54-45.
Taken together, the day's developments underscored the complexity that confronts the administration and Reid as they seek the 60 votes needed to overcome Republican opposition and pass a bill by Christmas. Despite their reluctance, some senators had talked openly and in detail earlier in the day about the progress of the negotiations.
The provision in the legislation to be dropped under the emerging agreement provides for a government-run insurance option to be available to consumers, with individual states permitted to drop out. Liberals have long sought such as arrangement, as a means of forcing competition on insurance companies.
One participant in the talks, Sen. Tom Harkin, D-Iowa, referring to a deal among the negotiators, told reporters he didn't like it, but added, "I'm going to support it to the hilt" in hopes of securing passage of the health care bill.
Another senator involved, Sen. Russ Feingold, D-Wis., issued a statement saying, "I do not support proposals that would replace the public option in the bill with a purely private approach. We need to have some competition for the insurance industry to keep rates down and save taxpayer dollars." But he did not rule out voting for the measure.
The White House quickly applauded the developments. "Senators are making great progress and we're pleased that they're working together to find common ground toward options that increase choice and competition," said a spokesman, Reid Cherlin.
In his comments to reporters, Reid said the emerging compromise "includes a public option and will help ensure the American people win in two ways: one, insurance companies will face more competition, and two, the American people will have more choices."
It wasn't clear what he meant by a "public option," the Medicare expansion or a fallback in case private insurance companies declined to participate in the nationwide plan envisioned to be overseen by the Office of Personnel Management. One possibility was for the agency to set up a government-run plan, either national in scope or on a state-by-state basis.
Under the tentative agreement, liberals lost their bid to expand Medicaid, the federal-state program that provides health care for the poor, elderly and disabled. But they prevailed on the Medicare expansion, and the negotiators appeared ready to maintain a separate health care program for children until 2013, two years longer than the bill currently calls for, according to officials familiar with the details.
Additionally, there was consensus support for a requirement long backed by Sen. Jay Rockefeller, D-W.Va., and other liberals for insurance companies to spend at least 90 percent of their premium income providing benefits, a step that supporters argue effectively limits their spending on advertising, salaries, promotional efforts and profits.
The Senate Dems reached a compromise today (the details of which I predicted three months ago on this blog). I said back then that the final bill would not have a gov't run public plan but instead would use private plans heavily regulated by the Feds much like Medicare Advantage.
In addition the Senate Bill now includes a Medicare buy-in program for persons age 55 and up to buy in to Medicare early. This particularly helps early retirees.
The bill also requires insurance companies to spend at least 90 percent of their premium income providing benefits. By the way, according to the Wisconsin Association of Health Plans (WAHP) their 16 member health plans pay out 91% of premium in benefits. I've long touted those companies (Dean, GHC, Gunderson and others) as models on which to build the foundation of health care reform. Perhaps this is the stick that incents plans to base reimbursement on quality outcomes and efficiency.
From WAHP's website: "In 2007, the Association-member health plans participating in the commercial health insurance market in Wisconsin paid out approximately 91 cents in health care services for every $1 of insurance premium taken in. They spent less than 10 cents on administration, and profits remained among the lowest in health care: less than 2 cents for every $1 in premium."
http://www.wihealthplans.org/inner.iml?mdl=about_us.mdl
So what does Sen. Feingold think about this compromise (copied from below). "I do not support proposals that would replace the public option in the bill with a purely private approach. We need to have some competition for the insurance industry to keep rates down and save taxpayer dollars," Feingold said.
Competition may reduce premiums 1-2% while waste reduction, payment reform and quality incentives could have ten times the impact.
Time for my FIFTH phone call to his office staff.
---------------------------------------------
Dems reach deal to drop gov't-run plan
Dec. 8, 2009
After days of secret talks, Senate Democrats tentatively agreed Tuesday night to drop a full-blown government-run insurance option from sweeping health care legislation, several officials said, a concession to party moderates whose votes are critical to passage of President Barack Obama's top domestic priority.
In its place, officials said Democrats had tentatively settled on a private insurance arrangement to be supervised by the federal agency that oversees the system through which lawmakers purchase coverage, with the possibility of greater government involvement if needed to ensure consumers of sufficient choices in coverage.
Additionally, the emerging agreement calls for Medicare to be opened to uninsured Americans beginning at age 55, a significant expansion of the large government health care program that currently serves the 65-and-over population.
At a hastily called evening news conference in the Capitol, Majority Leader Harry Reid, D-Nev., declined to provide details of what he described as a "broad agreement" between liberals and moderates on an issue that has plagued Democrats' efforts to pass health care legislation from the outset.
With it, he added with a smile, the end is in sight for passage of the legislation that Congress has labored over for months.
The officials who described the details of the closed-door negotiations did so on condition of anonymity, saying they were not authorized to discuss them publicly. Several officials stressed that so far, Democrats had technically agreed only on submitting proposals to the Congressional Budget Office for their impact on the bill's cost and other analysis.
At its core, the legislation would expand health care to millions who lack it, ban insurance companies from denying coverage on the basis of pre-existing medical conditions and rein in the rise of health care spending nationally.
The developments followed a vote on the Senate floor earlier in the day in which abortion opponents failed to inject tougher restrictions into sweeping health care bill, and Democratic leaders labored to make sure fallout from the issue didn't hamper the drive to enact legislation. The vote was 54-45.
Taken together, the day's developments underscored the complexity that confronts the administration and Reid as they seek the 60 votes needed to overcome Republican opposition and pass a bill by Christmas. Despite their reluctance, some senators had talked openly and in detail earlier in the day about the progress of the negotiations.
The provision in the legislation to be dropped under the emerging agreement provides for a government-run insurance option to be available to consumers, with individual states permitted to drop out. Liberals have long sought such as arrangement, as a means of forcing competition on insurance companies.
One participant in the talks, Sen. Tom Harkin, D-Iowa, referring to a deal among the negotiators, told reporters he didn't like it, but added, "I'm going to support it to the hilt" in hopes of securing passage of the health care bill.
Another senator involved, Sen. Russ Feingold, D-Wis., issued a statement saying, "I do not support proposals that would replace the public option in the bill with a purely private approach. We need to have some competition for the insurance industry to keep rates down and save taxpayer dollars." But he did not rule out voting for the measure.
The White House quickly applauded the developments. "Senators are making great progress and we're pleased that they're working together to find common ground toward options that increase choice and competition," said a spokesman, Reid Cherlin.
In his comments to reporters, Reid said the emerging compromise "includes a public option and will help ensure the American people win in two ways: one, insurance companies will face more competition, and two, the American people will have more choices."
It wasn't clear what he meant by a "public option," the Medicare expansion or a fallback in case private insurance companies declined to participate in the nationwide plan envisioned to be overseen by the Office of Personnel Management. One possibility was for the agency to set up a government-run plan, either national in scope or on a state-by-state basis.
Under the tentative agreement, liberals lost their bid to expand Medicaid, the federal-state program that provides health care for the poor, elderly and disabled. But they prevailed on the Medicare expansion, and the negotiators appeared ready to maintain a separate health care program for children until 2013, two years longer than the bill currently calls for, according to officials familiar with the details.
Additionally, there was consensus support for a requirement long backed by Sen. Jay Rockefeller, D-W.Va., and other liberals for insurance companies to spend at least 90 percent of their premium income providing benefits, a step that supporters argue effectively limits their spending on advertising, salaries, promotional efforts and profits.
Monday, December 7, 2009
Reaction from Insurance Industry to Current Bills
Insuring Resources Commentary:
Readers know I do not push the health insurance industry's agenda except when they are correct on an issue. In Wisconsin, we're very lucky to have several health insurance plans who focus on quality outcomes and effcient care -- Group Health Coop, Gunderson Lutheran, ThedaCare, Dean Health Plan and others. These plans have very low administrative costs and are very efficient in the care they provide. They have assessed the waste in their systems and make every attempt to extract it. The rest of the nation is not so lucky.
This is why AHIP is right and I said these same things that AHIP mentions in this space months ago. Voluntary pilot waste reduction programs do not go far enough, We need fundamental health CARE and PAYMENT reform.
Insurance reforms like eliminating pre-x conditions are vital to improving access and insurance for as many American;s as we can. A public plan option for those shut out of the system and for the smallest of employers would be great.
But, all the insurance reforms will matter very little if we do not CHANGE the WAY WE PAY for HEALTH CARE. In fact if health care reform does not change the financing of health care, insurance premiums will go up with 30-40 million more people seeking more care and Medicare will be in danger.
AHIP is right and the data from Mercer on health plans avoiding the tax that will help finance the expansion sends up a huge warning flag.
----------------------- ------------------------
Health insurers push back as debate heats up
Reuters) - The health insurance industry on Thursday struck back at provisions in Congress' healthcare proposals that it said would do little to curb the nation's spiraling costs or provide people more affordable coverage.
U.S. | Healthcare Reform
Congress is tip-toeing toward incremental healthcare reform that does not address what insurance companies see as the major issue -- containing costs, America's Health Insurance Plans president Karen Ignagni said in a speech in Detroit on Wednesday.
"The bills before Congress settle for timid pilot programs, rather than requiring major changes; creating incentives that apply only to Medicare, rather than across the board; and establishing a new oversight body, but severely limiting its scope of review," Ignagni, a top lobbyist for the health insurance industry, told the Detroit Economic Club.
The group represents 1300 insurers such as Aetna Inc, Cigna Corp, UnitedHealth Group Inc, among others.
Her comments come as the Democrats try to make good on President
Barack Obama's goal of expanding health insurance coverage to tens of millions of more Americans without adding to the nation's deficit. The Senate is debating an $849 billion bill that, if passed, must be merged with the House of Representatives' $1 trillion bill passed last month.
Ignagni visited Michigan, the state with the highest unemployment rate, as part of a national outreach to convince Americans of the need for lower medical costs.
Michigan, also home to the ailing U.S. auto industry, has more than 1 million people without healthcare insurance, or nearly 12 percent of its population, according to a Kaiser Family Foundation report. Nationally, about 46 million people, or about 15 percent, are uninsured in the United States where most working-age people get coverage through their employer.
True reform to cut healthcare costs has been sidetracked this year by too much emphasis on whether congressional bills will include a "public option," Ignagni said, echoing concerns heard from many others who both support and oppose the bill.
"Indeed, as far as cost containment is concerned, it's as though the house is on fire and the strategy is to rush to the scene with an eight-ounce glass of water," she said.
Democrats and other supporters acknowledge there are some areas that could be strengthened but argue the reform plans are a good first step toward reining in the nation's $2.5 trillion healthcare sector that is growing at a rate far surpassing inflation.
The Obama administration separately on Thursday blasted an industry analysis that said the Senate bill would raise health insurance premiums for individuals and small groups that try to buy policies.
The report, released by insurance network Blue Cross Blue Shield Association, said the bill will drive more sick people who need costly treatment into the system while not enticing younger, healthier customers into the insurance pool. It will also raise costs by requiring insurers to provide more minimum benefits, it said.
Whitehouse spokesman Dan Pfeiffer, in a blog posting on the White House's website, said the study did not take a number of the bill's provisions into account, including subsidies to help people afford insurance policies as well as protections included for people to keep their current insurance plan.
"We're closer than ever before to passing meaningful health insurance reform," Pfeiffer wrote. "And you can bet as we continue to make progress, the insurance industry will continue to try and distract and misinform because they know their very profitable status quo is in grave danger."
In a separate study on Thursday, employee benefit manager Mercer said nearly two-thirds of companies would trim the health benefits they offer if final legislation includes a tax on more generous, so-called "Cadillac" health insurance plans.
Mercer, a Marsh & McLennan Companies Inc company that serves many Fortune 500 companies, surveyed 465 employers of all sizes, with 63 percent saying they would reduce benefits to avoid the tax.
Readers know I do not push the health insurance industry's agenda except when they are correct on an issue. In Wisconsin, we're very lucky to have several health insurance plans who focus on quality outcomes and effcient care -- Group Health Coop, Gunderson Lutheran, ThedaCare, Dean Health Plan and others. These plans have very low administrative costs and are very efficient in the care they provide. They have assessed the waste in their systems and make every attempt to extract it. The rest of the nation is not so lucky.
This is why AHIP is right and I said these same things that AHIP mentions in this space months ago. Voluntary pilot waste reduction programs do not go far enough, We need fundamental health CARE and PAYMENT reform.
Insurance reforms like eliminating pre-x conditions are vital to improving access and insurance for as many American;s as we can. A public plan option for those shut out of the system and for the smallest of employers would be great.
But, all the insurance reforms will matter very little if we do not CHANGE the WAY WE PAY for HEALTH CARE. In fact if health care reform does not change the financing of health care, insurance premiums will go up with 30-40 million more people seeking more care and Medicare will be in danger.
AHIP is right and the data from Mercer on health plans avoiding the tax that will help finance the expansion sends up a huge warning flag.
----------------------- ------------------------
Health insurers push back as debate heats up
Reuters) - The health insurance industry on Thursday struck back at provisions in Congress' healthcare proposals that it said would do little to curb the nation's spiraling costs or provide people more affordable coverage.
U.S. | Healthcare Reform
Congress is tip-toeing toward incremental healthcare reform that does not address what insurance companies see as the major issue -- containing costs, America's Health Insurance Plans president Karen Ignagni said in a speech in Detroit on Wednesday.
"The bills before Congress settle for timid pilot programs, rather than requiring major changes; creating incentives that apply only to Medicare, rather than across the board; and establishing a new oversight body, but severely limiting its scope of review," Ignagni, a top lobbyist for the health insurance industry, told the Detroit Economic Club.
The group represents 1300 insurers such as Aetna Inc, Cigna Corp, UnitedHealth Group Inc, among others.
Her comments come as the Democrats try to make good on President
Barack Obama's goal of expanding health insurance coverage to tens of millions of more Americans without adding to the nation's deficit. The Senate is debating an $849 billion bill that, if passed, must be merged with the House of Representatives' $1 trillion bill passed last month.
Ignagni visited Michigan, the state with the highest unemployment rate, as part of a national outreach to convince Americans of the need for lower medical costs.
Michigan, also home to the ailing U.S. auto industry, has more than 1 million people without healthcare insurance, or nearly 12 percent of its population, according to a Kaiser Family Foundation report. Nationally, about 46 million people, or about 15 percent, are uninsured in the United States where most working-age people get coverage through their employer.
True reform to cut healthcare costs has been sidetracked this year by too much emphasis on whether congressional bills will include a "public option," Ignagni said, echoing concerns heard from many others who both support and oppose the bill.
"Indeed, as far as cost containment is concerned, it's as though the house is on fire and the strategy is to rush to the scene with an eight-ounce glass of water," she said.
Democrats and other supporters acknowledge there are some areas that could be strengthened but argue the reform plans are a good first step toward reining in the nation's $2.5 trillion healthcare sector that is growing at a rate far surpassing inflation.
The Obama administration separately on Thursday blasted an industry analysis that said the Senate bill would raise health insurance premiums for individuals and small groups that try to buy policies.
The report, released by insurance network Blue Cross Blue Shield Association, said the bill will drive more sick people who need costly treatment into the system while not enticing younger, healthier customers into the insurance pool. It will also raise costs by requiring insurers to provide more minimum benefits, it said.
Whitehouse spokesman Dan Pfeiffer, in a blog posting on the White House's website, said the study did not take a number of the bill's provisions into account, including subsidies to help people afford insurance policies as well as protections included for people to keep their current insurance plan.
"We're closer than ever before to passing meaningful health insurance reform," Pfeiffer wrote. "And you can bet as we continue to make progress, the insurance industry will continue to try and distract and misinform because they know their very profitable status quo is in grave danger."
In a separate study on Thursday, employee benefit manager Mercer said nearly two-thirds of companies would trim the health benefits they offer if final legislation includes a tax on more generous, so-called "Cadillac" health insurance plans.
Mercer, a Marsh & McLennan Companies Inc company that serves many Fortune 500 companies, surveyed 465 employers of all sizes, with 63 percent saying they would reduce benefits to avoid the tax.
Thursday, December 3, 2009
Dear Orszag: Please come to Wisconsin
Insuring Resources Commentary:
Perhaps Peter Orszag should take a visit to Wisconsin and witness what is happening daily at ThedaCare, Gunderson Lutheran, Group Health Coop and others. If 20 some health plans are already doing it why is it sooo hard that it will take 20+ years for others to catch on.
Visit www.createhealthcarevalue.com
or
http://www.healthcarevalueleaders.org/
Orszag knows these exist so why is his head in the sand?
-------------- -----------------
Orszag: Health Care Efficiencies May Take Decades Associated Press
Charles Babington
December 03, 2009
The White House budget director said Wednesday that it may take decades for America to have an efficient health care system even if Congress passes a major overhaul this year.
"It will be years to decades" before the nation has a properly working health care system that rewards quality over quantity, Peter Orszag told reporters. He said improving the quality of health care "is more like a lifelong nutrition or diet, not studying for an exam," but he added that continuous progress is a crucial goal.
Orszag is one of President Barack Obama's top aides in urging Congress to overhaul the U.S. health care system in the coming weeks. He acknowledged that many key elements of the pending House and Senate bills would not take effect for several years, but he urged Americans to embrace a gradual process.
The House-passed bill would bar insurance companies from denying coverage to sick people starting in 2013. A bill being debated in the Senate would do so in 2014.
The bills would create new government subsidies for buying insurance starting in 2014. Fines for individuals who refuse to buy insurance would begin in 2014, and increase in later years. Other provisions, such as subsidizing long-term care, also would be years away.
Orszag noted that some improvements to the health care system are already in the works. The economic stimulus bill enacted early this year included money to modernize medical record-keeping and to identify the most effective ways to address various medical needs. Both efforts should lead to better care, he said.
Orszag said the nation must move away from its long tradition of fee-for-service health care that tends to reward the number of procedures performed rather than the quality of care. The pending legislation includes pilot projects meant to reduce the number of patients who are quickly readmitted to hospitals, and to restructure payments to hospitals to discourage unnecessary procedures.
Orszag said limits on medical malpractice awards -- which many Republicans favor, but are not in the bills -- would do little to reduce health care costs.
Perhaps Peter Orszag should take a visit to Wisconsin and witness what is happening daily at ThedaCare, Gunderson Lutheran, Group Health Coop and others. If 20 some health plans are already doing it why is it sooo hard that it will take 20+ years for others to catch on.
Visit www.createhealthcarevalue.com
or
http://www.healthcarevalueleaders.org/
Orszag knows these exist so why is his head in the sand?
-------------- -----------------
Orszag: Health Care Efficiencies May Take Decades Associated Press
Charles Babington
December 03, 2009
The White House budget director said Wednesday that it may take decades for America to have an efficient health care system even if Congress passes a major overhaul this year.
"It will be years to decades" before the nation has a properly working health care system that rewards quality over quantity, Peter Orszag told reporters. He said improving the quality of health care "is more like a lifelong nutrition or diet, not studying for an exam," but he added that continuous progress is a crucial goal.
Orszag is one of President Barack Obama's top aides in urging Congress to overhaul the U.S. health care system in the coming weeks. He acknowledged that many key elements of the pending House and Senate bills would not take effect for several years, but he urged Americans to embrace a gradual process.
The House-passed bill would bar insurance companies from denying coverage to sick people starting in 2013. A bill being debated in the Senate would do so in 2014.
The bills would create new government subsidies for buying insurance starting in 2014. Fines for individuals who refuse to buy insurance would begin in 2014, and increase in later years. Other provisions, such as subsidizing long-term care, also would be years away.
Orszag noted that some improvements to the health care system are already in the works. The economic stimulus bill enacted early this year included money to modernize medical record-keeping and to identify the most effective ways to address various medical needs. Both efforts should lead to better care, he said.
Orszag said the nation must move away from its long tradition of fee-for-service health care that tends to reward the number of procedures performed rather than the quality of care. The pending legislation includes pilot projects meant to reduce the number of patients who are quickly readmitted to hospitals, and to restructure payments to hospitals to discourage unnecessary procedures.
Orszag said limits on medical malpractice awards -- which many Republicans favor, but are not in the bills -- would do little to reduce health care costs.
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