Tag: After Reform

“Reform” Means Higher Costs, Not Lower


A reader asks: “If the current bill passes are my health insurance costs likely to go up, down, or remain about the same?”

If the form that I believe most likely to pass actually passes (insurance reforms, individual mandate, weak or no public option or co-ops), I believe that they will continue to go up. There simply is nothing in the bill that would make things more affordable. In health care markets, for a convoluted nest of reasons, more competition causes prices to go up, not down.

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Winners and Losers – Strategy in a Post-Reform World


Most health policy experts are focusing
on the daily ups and downs in the political battles over health reform.
Within the health care industry, however, there is a
about who will be
the winners and losers after health reform passes.  A.M. Best’s U.S. Health and HMO Insurance Index has been
volatile since last November, reflecting high uncertainty about the
effect of health reform.  Earlier this summer, there was some speculative
analysis about the potential impact
of reform
on health care stocks.  Will health insurers come out as winners?
What about hospitals, doctors, drug manufacturers, and insurance agents?

It’s good to look ahead, but I think
most people are asking the wrong question.  Each of these health
industry sectors – in aggregate — will probably do just fine in the
post-reform world, as Bob Laszewski points out in his recent blog post.  The more important question is: who
will be the winners and losers within each sector?

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No Country for Old Men

As we enter summer, the health reform process is moving into its Newtonian phase: irresistible forces meeting immovable objects.   In both health cost and access, the trend is not our friend.  There is ample evidence not only of intolerable inequities, but also intolerable waste and inappropriate use of expensive clinical tools.  President Obama embodies the need for change. He has assembled a very talented and politically savvy crew of helpers.  He confronts the sternest test of any Presidency, fixing a poorly tuned and fragmented health system that is, by itself, larger than either the French or British economy.

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The Health Industry’s Achilles Heel

“You never want a serious
crisis to go to waste.”

– Rahm Emanuel, White House Chief of Staff

ALP_H_BK_0010 Timing matters. The health industry has demonstrated steadfast
resistance to reforms, but its recently diminished fortunes offer the Obama
Administration an unprecedented opportunity to achieve meaningful change. The
stakes are high, though. The Administration’s health team must not miscalculate
the industry’s goals, or waver from goals that are in the nation’s interest.
The two are very different.

Aligning the forces of reform will be the first challenge. The White House and Congressional Democrats appear to be
to develop a unified reform design. Even so,
the effort is hardly pure. Lawmakers have been receptive to industry influence.
The non-partisan Center for Responsive Politics
reports that, in 2009, health care interests have already spent $128 million on
Congressional lobbying contributions, more than any other sector
The tide now turned, most of that largess has gone to Democrats.

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A Shakespearean Approach to Health Care Reform

With the opening of the new Congressional session, the latest  health care reform effort is off and
running, with HHS Secretary-designate Tom Daschle telling senators at his confirmation hearings of his desire to work collaboratively and listen to diverse ideas.

One thing about Washington DC, there’s never a shortage of diverse ideas, and with the possibility of passage of some version of reform, there’s an especially impressive number. Daschle’s problem is going to be how to pick and choose among them.

Every reform plan—whether from Baucus, McCain, Obama, Clinton, Wyden-and-Bennett, Kennedy, Stark, Dingell, or elsewhere—comes with its own strengths and weaknesses, and cross-aisle consensus is certainly missing. But maybe it’s possible to take a little of this plan, a little of that, and so on, to create the magic mixture that can reform our system and achieve the critical sixty vote support in the Senate.

Perhaps it’s time to consider a recipe from Macbeth:

Eye of newt, and toe of frog,
Wool of bat, and tongue of dog,
Adder’s fork, and blind-worm’s sting,
Lizard’s leg, and howlet’s wing…

Shakespeare’s witches didn’t provide precise measures, and we may have to substitute for some of the ingredients, but we’ll go ahead and start adding items to our cook pot anyway…

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