What Can We Fix; What Can We Wreck?

In the current push to fix the American health care system, Washington legislators are attempting to tackle these items:

1. Increase the number of covered Americans to about 98% of the population--in the process bringing about 47 million uninsured Americans and illegial aliens under coverage.

2. Control ever growing costs in a way that won't create further damage to the rapidly growing US public debt. Here is a projection of Medicare expenditures from the Office of Management and Budget (OMB).

It's a huge challenge. What seems to get lost in the debate are a number of constructive things which could help the situation.

For example, over-utilization of health services.

The current tax exclusion for employer-sponsored health care:

• Benefits the rich and those who a have negotiated lucrative labor contracts,
• Arbitrarily ties insurance to employment, and
• Results in over-utilization because the exclusion rewards employees who opt for high cost plans with few incentives to discourage unnecessary or wasteful health care use.
  

Economists say this could be replaced with a refundable tax credit or standard deduction for the purchase of health insurance.

Things can be wrecked if costs get out of control--as they currently are with the Medicare & Medicaid programs.

The Congressional Budget Office (CBO) says Kennedy-Dodd bill will cost up to $1.5 trillion over 10 years. The cost over-run is similar for other proposed bills.

No government entitlement has saved money. Medicare and Medicaid both cost far more than originally anticipated. Once money starts flowing from Washington, special interests groups lobby hard to keep their fair share.

Here is an interesting example of a current national TV campaign to convince everyone to move ahead soon on the current health care bill in Congress. Please notice who paid for this ad--then recall my July 23 blog, 10 Questions About Health Care Overhaul, to see who stands to benefit significantly from new federal legislation (Q&A #7).




Instead of treating those 47 uninsured Americans as some great monolith, we could concentrate on those who need help the most. Only about 10-12 million can't afford to buy health insurance and don't qualify for public programs or work for businesses that don't offer health insurance.

We can eliminate waste and fraud in Medicare and Medicaid. Experts estimate that Medicare alone may lose $60 billion a year to fraud.

According the US Department of Health & Human Services, Most health care providers are doing the right thing and providing care with integrity. But sadly, due to the illegal actions of a small but active group of heath care fraud perpetrators, billions of dollars are stolen from taxpayers each year. Medicare fraud schemes have grown bolder and more elaborate, resulting in billions of dollars in false billings and fraud schemes which are robbing Medicare and Medicaid blind.