HEALTH PLANS/POLICY: Meter Reading–How Regulation Might Fail

Today I’m up at Spot-on in a piece about the influence of big health plans on reform efforts called Meter Reading: How Regulation Might Fail.

Maybe, just maybe, we’re getting serious about health care.

This week’s news says yet more unlikely allies are advocating healthcare overhaul.

The alliance between the Business Roundtable, unions and interest groups – an even more unlikely bunch of reformers than Republican Gov. Arnold Schwarzenegger and the insurance association  (both already out with their own plans) –  are all saying, loudly and clearly, that something must be done. It’s all leading to an odd sense of optimism – one I don’t, sadly share.

Forces outside of health care are starting to talk the talk about
forcing change. Former Massachusetts governor and Republican
presidential hopeful Mitt Romney’s health plan, the election of a
Democratic majority in Congress, and ever- increasing costs are all
forcing everyone to get those old reform plans out again. And as
evidenced in this discussion even political columnists from the
WaPo think that something is going to happen – although they do tend to misread the light at the end of the proverbial tunnel. Continue

As ever come back herre to comment

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richard smithScottMGjdBarry Carol Recent comment authors
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richard smith

Managed Care; Anatomy of a Mass Medical Movement. 2000. The Rise and Fall of Managed Care: A Comprehensve History of a Mass Medical Movement. 2001. Rise and Fall of Managed Care: History of the Mass Medical Movement. 2002. “The author documents that despite promises of managed care zealots, we have a sad healthcare landscape of crippled academic medical centers, dissatisfied patients, uninsured, chronically ill and elderly citizens, and demoralized physicians: with NO cost savings. Managed care produced, however, ‘monetarization’ of medicine, multi-million dollar consulting firms, and Wall Street riches. Dr. Smith wisely reminds us that the best way to care… Read more »


Intersting viewpoints. Did anyone know that 1/10 of 1 cent = billions of dollars?
Check out this post http://positivecfc.blogspot.com/


I am willing to bet that the larger insurers (Wellpoint, United, Aetna, Cigna) are looking at the CA and MA plans as this: lose a little now vs. potentially losing alot more in the near future if some kind of single-payer system gains real political viability. Plus, none of these state plans affect the cash-cow of Medicare Part D and Advantage plans. The CA plan is less preferable to health insurers due to the 85% medical loss ratio and mandatory coverage issues. While these state plans may help to address access and the uninsured rate, no one really seems to… Read more »


Barry, I second all of your points. I would add that even the big for-profit insurers aren’t going to fight very hard this time (or at all) so long as they are guaranteed a place at the table (or the trough). The Massachusetts model opened the door for health plans to get behind universal healthcare. Not just opened the door, but flung it open and jammed a door stop in it. Where I tend to agree with Matt is that I don’t think universal healthcare is coming soon at the Federal level. Congress is not going to get its act… Read more »

Barry Carol
Barry Carol

Matthew, I am more optimistic than you are. While Wellpoint is one of the two largest health insurers (along with United HealthGroup), the company only has 42,000 employees. Approximately 150 million people get their health insurance through their employer, and at least 50 million of those are from employers who self-insure. Most of these employers would like to either get out of the business of providing health insurance for their workforce and switch to taxpayer financing or at least sign on to a package of reforms that might be able to reduce cost growth (per insured person) to something closer… Read more »