Grandpa Harry and Grandma Louise

Word from all those town hall meetings members of Congress are having back home this week is that lots of seniors are showing up scared that all the talk of health care reform in Washington, DC might just hurt them.The seniors’ reasoning goes that Congress is getting ready to cut Medicare in order to pay for the uninsured grandkids' newfound access to a health insurance policy of their own.Watch

Will Eliminating Medical Underwriting and Merging the Small Group and Individual Market Into a New Insurance Exchange Work? Lessons From Massachusetts

Creating a universal system of health insurance is everyone’s objective. But even if we pass an expensive health care bill in 2009 we won’t achieve it. We just don’t have enough money to cover everyone. Maybe, in the most expensive proposals, we would make it possible for 90% to be covered. In others, far less.The problem is that without an absolutely seamless system there will still be people

Wyden-Bennett Touted as an Alternative

I have to say I was a bit surprised watching Meet the Press this morning to hear the pundits on both sides of the political spectrum discussing the Wyden-Bennett Healthy Americans Act as an alternative to the more partisan Democratic health care reform bills already on the table in the House and Senate HELP Committee.The Republican spin seemed to be that, "We've always been for Wyden-Bennett,

Unions May Get a Pass on Health Care Benefits Tax

There is a major bipartisan effort going on in the Senate Finance Committee to reform the health care system.Reportedly, one of the elements of that effort may be a tax on "gold plated" health insurance benefits above a certain threshold--$17,000 for family coverage is one option being discussed. The new tax could raise close to $300 billion over ten years to help pay for a health care

The Co-op Version of the Public Plan—It’s a Camel!

I am sure you have heard the story about the committee that was charged with designing a horse but, because of the bureaucratic ways of the committee process, instead ended up creating a camel.We will not see a Medicare-like public health plan as part of any health care reform bill in 2009. I know proponents don’t want to hear that but it is crystal clear to me there simply are not the Democratic

Time to Take Another Look at the Wyden-Bennett Healthy Americans Act?

This from today's Kaiser Health News:"A bipartisan proposal from Sen. Ron Wyden, D-Ore., to replace the tax exclusion for employer-based health benefits with a standard deduction would do more to contain healthcare spending than Senate Finance Chairman Max Baucus' plan to cap the exclusion, according to a recent assessment by the Joint Committee on Taxation,' Congress Daily reports. 'The

Senate Finance Scrambling to Find a Way to Pay for Health Care Reform While CBO Warns That the Congress Needs to Get Serious About Cost Containment

Toldjaso.As I have been posting, it has been my observation that the Democrats were headed for a health care bill that had a little cost containment window dressing, would take a little off the top in provider payments, and use lots of new taxes to pay for at least half of it. I also argued that would not be health care reform but just entitlement expansion.Apparently the CBO (God bless’em)

The Dumbest Thing I have Ever Seen a Health Insurance Company Do––And Three of Them Took Their Turn Doing It in Front of the United States Congress

And, I’ve been in the business for 37 years.First, let me stipulate we really need a system of universal care where everyone gets to have insurance. But we don’t yet so certain rules are unavoidable until we do.Here are a few separate clips from today's Los Angeles Times article, "Health Insurers Refuse to Limit Rescission of Coverage:""Executives of three of the nation's largest health insurers

Just Which $2 Trillion Were They Talking About?

Just two weeks after putting $2 trillion in health care cost reductions on the table, the response to President Obama's plan to cut the health care providers by a total of $618 billion over the next ten years ($305 billion in his original budget and another $313 billion this week) is startling--if not in the final analysis predictable.Given that, at present trends, we are on our way to spending $

It’s NOT the Prices Stupid!

Out here on Kent Island, the federal government says that I like to watch the Baltimore TV stations and therefore forbids my satellite provider to give me access to the local DC channels. (We’re about an hour from both Baltimore and DC.)There is reason number one never to put the government in charge of any more than absolutely necessary.While my new digital converter box had been working just

Here's an Example of a Cooperative Not-For-Profit Health Plan--North Dakota Blue Cross

North Dakota Senator Kent Conrad has proposed establishing not-for-profit cooperative health plans as an alternative to the Medicare-like public health plan President Obama supports.I will suggest Senator Conrad take a look at this one:North Dakota Blue Cross Blue ShieldFrom their website:"More than 65 years ago, Blue Cross Blue Shield of North Dakota (BCBSND) began as two separate pre-paid

Health Care Cooperatives--An Old New Idea--So What's a Blue Cross Plan?

As opposition to a Medicare-like public health plan option grows, there has been a lot of talk about the compromise idea of creating not-for-profit health insurance cooperatives that would compete on a level playing field with existing private insurers. The reasoning goes they would keep the existing insurers "honest" by introducing a new element of competition.That's a great idea.And it was a

Raising Taxes to Pay for a Health Care Bill--Apparently the Congress Wouldn't Be Able to Find a John Deere in a Hay Stack

Why Do We Need to Raise Taxes to Pay For a Health Care Bill in a System That Has $10 Trillion in Waste?White House Budget Director Peter Orszag has promised in the next few days to detail just how the administration would like to see health care reform paid for.There are some people who question whether he will play it straight or play games with those numbers—will the list really be scoreable?He

The Health Industry's Achilles Heel

by BRIAN KLEPPER and DAVID C. KIBBE"You never want a serious crisis to go to waste." - Rahm Emanuel, White House Chief of Staff.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

The House Tri-Committee Bill—The Playing Field Just Moved Back to the Middle

Just when people were getting ready to write-off the Baucus bipartisan approach to a health bill the debate has swung back to the middle on a number of critical issues.For a longtime I have been telling you two things:The final health bill will be more moderate than liberal—for example, no Medicare-like public plan, only a soft individual mandate, but including insurance exchanges and

Public Plan Option: Sustainable Growth Rate Formula On Steroids?

Everyone in the health care debate seems to agree that the biggest problem is costs and that the best way to control costs is to get at the waste in the system. To raise the money needed to cover everyone and to make the system sustainable, goes the argument, we need to convert the upwards of 30% in excess costs now in the system to savings. I think that’s right. Many of my friends in the health

Beware of Tax Increases Disguised as Good Health Policy

Many believe we need to use the tax system as a way of reforming the health care system.The idea is to use tax policy to encourage more efficient benefit plans. It seems to me such proposals make a great deal of sense as part of a more comprehensive reform.However, I am worried that the Congress will simply raise taxes to pay for health care reform--perhaps as much as half the cost of a new

$2 Trillion Sure Doesn't Buy You a Lot These Days

I know that we talk in terms of trillions and not billions in Washington these days but even by that new standard the way the Democrats are dissing the "$2 trillion stakeholders" is amazing.Not two days after the big stakeholder trade associations offered their "$2 trillion in health care savings," President Obama called on Congress to pass a health care reform bill that included the dreaded

The Health Care Reform Meter--Do the Dems Have the Money to Pay for It?

If I knew anything about computer graphics I'd post this really neat picture of a meter--sort of like a your car's gas gauge.The full point would represent the cost of a health care bill--somewhere in the $1.2 trillion to $1.5 trillion range.Each time someone put up scoreable savings I'd post it toward achieving the ultimate objective.So, you will have to imagine my meter.Here's where I think we

How to Use Comparative Research to Manage Health Care Costs

Recent proposals from the American Medical Association (AMA) to voluntarily use comparative research information ring hollow without their having any teeth to assure the information is in fact used.I thought Gail Wilensky had some thoughtful comments on the issue of using comparative research to control health care costs in today's Kaiser Health News.An excerpt from her interview with Christopher

The Health Care Affordability Model—A Plan That Will Control Costs and Improve Quality

The Health Care Affordability ModelHealth plan networks made up of insurers and providers would be required to first begin to stabilize and then control their costs. Failure to do so would mean the loss of their federal tax qualification. Premiums for a non-qualified health plan would no longer be tax deductible for individuals or plan sponsors who used these unqualified plans.The Affordability

Stakeholders Provide 28 Pages of Detail on How to Save $2 Trillion Dollars--And They Did it With a Straight Face!

America's Health Plans (AHP), the American Medical Association (AMA), the American Hospital Association (AHA), The Pharmaceutical Research and Manufacturers Association (PhRMA), the Advanced Medical Technology Association (AdvaMed), and the Service Employees International Union (SEIU) have detailed their plans to "do our part" toward achieving the administration's goal of saving $2 trillion in

Kaiser Health News Debuts Today and Features an Important Insight Into a Likely Health Care Bill

Kaiser Health News (KHN) debuted today and is a critically important addition to America's debate over health care reform.As the media has downsized in recent years, we have lost many reporters who were health care specialists. KHN will provide news outlets across the country with an important specialized source of solid reporting from an organization that has come to be known as uniquely expert