"One Cannot Measure What One Does Not Manage": Wrong Bottom Line (Part XIII-f)

The United States was observed to have spent 52% more per capita on health care than the next highest spending "economically competitor country with above-average per capita national income, and 90% more than many competitor countries."

Source: "Health Care Costs: A Primer; Key Information on Health Care Costs and Their Impact" The Henry J. Kaiser Family Foundation, March 2009 (15 pages)

Private plans now cover about 170 million Americans. By all accounts, it isn't working well; in the end game, for profit and not for profit health plans are more about financial security then they are about patient care. Unfair statement? When 'push comes to shove,' medical business-administration says unless you generate sufficient revenue and enjoy favorable patient selection, pretty soon you're out of business. Makes one wonder what is the business of medicine? The whole deal is like the greedy landlord who won't reinvest in their property or the Bernie Madoffs of the world who 'beg from Peter to pay Paul.'

A recent report from the Lewin Group suggests a cheaper, universal health insurance option for middle class families is in the offing. Could it be true? It seems so because the skeptics are already wincing; they say any such a public plan means "government-run medicine."

I'm more than ready for that. The Lewin Group projects that "if such a plan were open to all employers and individuals, and if it paid doctors and hospitals.... Medicare rates, the government plan would be able to set premiums well below what private plans charge.... Monthly premiums for family coverage would be $761 in the government plan, compared with an average of $970 in private plans.... Employers and individuals would flock to the public plan to cut costs. … [And it] would quickly grow to 131 million members." They add: "A public plan designed for small employers and individuals that paid Medicare fees would have nearly 43 million members. [If, however, it was] designed like a private plan, paying higher fees to doctors and hospitals, it would only enroll 17 million members, [and] it would help reduce the number of uninsured by about 24-28 million persons, depending on its design." (For instance, Obama's health care proposal doesn't require all Americans to have coverage.)

Alonzo-Zaldivar R."Study raises questions about public health plan." Associated Press, April 6, 2009 [Note: order changed within the text]

Recently, HMOs were threatened by legislation that would force them to be good citizens (eg, single payer); in an attempt to cut their anticipated loses, they sent a signal that patients with pre-existing conditions would be covered without waiting periods and other hassles. Besides wondering what the H*ll business they think they are in, they're already lobbying for ways around this magnanimous offer (example, gerrymandering). Can't trust them. In this context, is Lewin disingenuous when they pronounced that the above forecasting isn't as sweeping as their own study had suggested? What's their real agenda?

They claim they are impartial when it comes to health policy, legislation or reform; I'm not so sure.