THE NATION'S PULSE: Frowning at Tasty Medicine
Goldberg, Robert M.
THE NATION'S PULSE Frowning. at Tasty Medicine D ON'T LOOK Nowbut one ofthose recent proverbial tipping points might have been reached in the effort to create a real health-care market....
...HenryWaxman (D-CA) said that increased price transparency "is no substitute for real coverage," adding that individuals enrolled in group health plans receive lower prices than those who purchase health care on their own...
...When faced with market- driven programs that actually expand coverage and increase affordability, liberals wind up making statements that border on the idiotic...
...Surveys done by health insurers who offer both managed-care plans and HSAs have found that consumers who switch to HSAs have lower medical costs...
...All liberals have to offer is more government health care and pricing secrecy...
...N OT THAT LIBERALS in their chronic misery have responded with anything positive...
...Paul Ginsburg, president of the Center for Studying Health System Change, another liberal think tank, said, "Consumers' experiences with markets for self-pay services.., have been romanticized and do not offer much encouragement as a model of effective shopping for health care services...
...This leaves the door wide open for free-market conservatives to own the health-care issue...
...So, for example, health plans like Humana and Aetna are now seeking out people most likely at risk of a serious chronic illness and making sure they are getting the medicines that delay or prevent such diseases later...
...And in an upcoming election season where races might be tight, taking credit for good policies that can be improved upon would also be good politics...
...percent of people who have signed up for HSAs never had health insurance before...
...And if Republicans aren't careful they might even be able to take some credit for it...
...Earth to Henry: What does he think will happen when more people in consumer-directed plans find out that they are paying more than folks in employer-based plans...
...Their response to the creation of a health-care market has been nothing short of stupefying...
...They complain that premiums are probably still too expensive because the Bay State plan does not do away with community rating, i.e., charging the same rate for age 25, say, as age 60...
...By 2010, 21 million HSAs will be covering 40-45 million people...
...How could they not like a platform that gives the average guy the same tax break on health insurance as big corporations along with advanceable tax credits...
...Conservative critics have angrily attacked the plan because it forces people to buy health insurance...
...Indeed, the plan incorporates all the elements of health-care reform that are at the heart of the Bush health-care agenda and, more specifically, Medicare modernization which conservatives also trashed...
...But pessimism as a political style is overrated and intellectually facile...
...All this is good, but still conservatives seem to grumble...
...Why aren't conservatives championing this new enlightened and holistic approach to health care...
...Finally, the plan seeks to promote disease prevention with health information systems as a way to control costs instead of relying upon rationing...
...And so the more pathbreaking HSA-type plans provide first dollar coverage for prescription medications, and do not discriminate between treating depression and heart disease because they know both are costly and a drain on productivity...
...I sometimes think conservatives never miss an opportunity to miss an opportunity to take credit for transforming health care...
...Yet here too, conservatives have mainly marketed HSAs as a cost containment tool instead of a means for providing high quality and affordable health care for all...
...Or do they?Apparently, the AFLCI0 and Families USA came out in support of the Bay State's proposal...
...group purchasing pools that let small businesses and self-employed people buy at group rates...
...And since Waxman and other liberals have accused hospitals of being able to cost shift against the poor because they don't have group coverage, why do they oppose the sort of purchasing pools now available in the Massachusetts plan...
...But don't hold your breath...
...Many conservatives did not like the idea of adding a drug benefit, but it did not make sense for Medicare not to cover the most cost-effective and innovative form of health care...
...And as part of this effort to give consumers more control over their medical choices, Medicare and managed-care plans are posting the different prices 52 THE AMERICAN SPECTATOR JUNE 2006 ROBERT M. GOLDBERG people will pay depending upon whether they are on a health plan or which plan they are on...
...Yet, in every instance when a market-driven approach to health care is adopted or succeeds-whether it is HSAs, Medicare, or the Massachusetts plan--conservatives find something to grouse about...
...Rather, it uses advanceable subsidies and tax credits scaled to income, health savings accounts, the development of purchasing groups made up of the self-employed, faith-based organizations, and small businesses to buy health care at the same price big corporations do and to create competition among plans, doctors, and hospitals based on price and quality...
...pricing transparency...
...Where has he been...
...The consumer and outcomes research conducted by health plans clearly shows that when people are given the ability to shift dollars to high value preventive care they will do so...
...They'd rather complain than be right...
...Liberals are in meltdown mode in large part because more and more people are leaving the highly regulated, employerbased system they love so dearly and there is nothing they can do about it...
...At last check, the Medicare program itself is sin'passing expectations, particularly those of liberal and conservative critics who had a stake in the drugbenefit crashing and burning...
...So far some 9 miltkm seniors have signed up for the Medicare drug plan...
...A million more are likely to sign up for Medicare managed-care plans...
...a commitment to engage the private health plans to provide individuals with programs designed to promote prevention and reduce their out of pocket costs...
...It is incomprehensible that conservatives are not claiming victory and building on the "success" of the Massachusetts plan to push hard for similar measures at the national level...
...Since lack of transparency has been used to stick the uninsured with the highest prices, how does Waxman's opposition to price competition square with his support of the poor...
...Consider the following: The enactment-by an overwhelming margin-of a law in Massachusetts that requires a universal individual mandate for health-care coverage does so not by forcing Hillarycare on people...
...expanded HSAs...
...JUNE 2006 THE AMERICAN SPECTATOR 53...
...Chronically ill consumers were more compliant with their medications after they made the switch to HSAs...
...For example, according to the Kaiser Foundation's "Capitol Hill Watch," Rep...
...In addition, Waxman said that increased price transparency might shift more health-care costs to individuals...
...This leaves the door wide open for free-market conservatives to own the health-care issue...
...What about the aforementioned Medicare program or laser surgery for eyes or the evidence that nearly 40 All liberals have to offer is more government health care and pricing secrecy...
...The additional spending and the injection of competition have accelerated the search for ways to increase the value of medicines relative to more expensive and invasive forms of care...
...They're also unhappy that it does not do away with "guaranteed issue," which sees the healthy subsidize the sick through higher premiums...
...Consumers are saving more money and spending less on premiums than expected...
...This, in turn, complements information that Medicare and such organizations as the National Council on Quality Assurance provide about the quality of care...
...Sherrod Brown (D-0H) also said that increased price transparency should include health insurers and pharmaceutical companies, as well as providers...
...r Robert M. Goldberg is vice president of the Center for Medicine in the Public Interest in New York City...
...Finally, there has been a sevenfold increase in individuals covered by health savings accounts (HSAs) in less than a year-from 430,000 to 3.2 million...
...Really...
Vol. 39 • June 2006 • No. 5
