Matthew Holt

Lost in the Mckinsey mire

It’s a good week for Bob Kocher, a key architect of the ACA, to be leaving Mckinsey and moving into the word of venture capital. There’s lots of fuss in wonkdom about whether Mckinsey’s survey of employers was statistically correct and peer reviewed or more of a push poll. There’s lots of fuss even apparently within the firm about the validity of the estimate that 30% of employers (or is it employees) will be moved over to the exchanges. But despite ballyhoo over the Mckinsey report, because in 2009 the White House got stuck into the mantra that “if you like your insurance you can keep it” the fact that it’s good to get employers out of providing health insurance has been missed. If you have insurance from an employer that puts you in the exchange it’s a fair bet that your coverage was anyway going to move to levels worse than that mandated by the government. And the levels of coverage and behavior of the plans in the exchange which will hopefully actually be enforced–with the threat of being booted out being a motivator. And as we all know employers are the worst purchasers of health care out there and need to be got out of the game. That was what the very sensible Wyden-Bennet plan did, but as the collective stupidity of the nation’s unions and chambers¬† of commerce is very high, we ended up with the ACA instead. Oh well, welcome to America.

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  1. Ah, the law of unintended consequences. I think this particular set of consequences is actually a very good thing, since it will drive a shift from employer-managed health insurance to CONSUMER-managed health insurance. It won’t be a pretty shift, and there will be lots of screaming and recrimination, but it’s critical that the shift occur. Consumers (commonly called patients) must take ownership of their health, and health care. Over the last 70+ years we’ve built an “other people’s money” around health care and health insurance. Time for us all to get a grip on what our health care actually costs, ask sharp questions about the cost of the care we receive, and put ourselves back in the driver’s seat. Using OUR money.

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