What's next in health care?

Tuesday, March 24, 2009

By Lucas Presson

While Wall Street and Main Street are laden with Prozac pill-popping patients, it might just be in your best interest to take a second look at the latest health care news. In light of the recent White House health care summit and the Obama administration's campaign to reform health care, now is the time to evaluate what health care reform is being proposed.

Recently the president released his new fiscal-year budget and outlined a new health care program in which $634 billion would be allocated to a nationalized health care program over 10 years. However, the administration has noted actual spending on this program will likely exceed the initial amount. By the administration's own admission, this $634 billion will be a "down payment."

In recent weeks we have seen unparalleled government spending through the Troubled Asset Relief Program (TARP), stimulus bill, and omnibus spending bill -- not to mention the expansion of the State Children's Health Insurance Program (SCHIP). In total thus far, Congress has spent around $2 trillion dollars before interest. There's no question that health care reform is extremely important. Quality and affordable health care is a nonpartisan issue. Nevertheless, how do we intend to fund a massive overhaul of the health care system in this time of economic uncertainty? Furthermore, is government controlled health care really the best solution?

Ceci Connolly recently reported in the Washington Post that a member of the Obama administration outlined the financing of this nationalized health care program, calling for "trimming tax breaks for the wealthy and squeezing payments to insurers, hospitals, doctors and drug manufacturers."

First, while there is no doubt that real reform of the health care system needs to take place, I question whether taxing individuals who have money to invest in this economic downturn is really the best method for funding such a massive program. With the Dow-Jones industrial average cut nearly in half over the past year, I'm highly skeptical of increasing taxes.

Second, I'm perplexed and skeptical of the "squeezing payments" plan to help fund the expansion of health care. As reported by Modern Healthcare in the March 2 edition, physicians are looking at a 21 percent cut on Medicare payments in 2010 barring congressional intervention. However, if the administration's plan is to squeeze payments on physicians, why would Congress intervene and prevent the substantial cut scheduled for 2010? To say there is consensus on the subject of Medicare payments is far from the truth. In fact, the Medicare Payment Advisory Commission has made its recommendation to Congress to boost Medicare payments to physicians 1.1 percent in the current year. Now is not the time to drive highly intelligent individuals out of the medical field. And if Congress does decide to make further cuts, this will be one more step in the penalization of physicians.

Third, cutting hospital payments and squeezing insurance companies is not a viable solution. Unlike private-practice physicians, hospitals cannot refuse to see patients. Many patients who do not have health insurance treat their local emergency room as their primary health care provider. This trend forces hospitals to make very difficult financial decisions. Health insurers are forced to increase co-payments or decrease patient options. In the end, business owners and individuals who pay for health insurance are hit with greater premiums, higher co-pays and less coverage options.

Health care, however, is more than cost. America has for years been on the cutting edge of medical breakthroughs. Our system is the envy of the world. However, when the federal government controls pricing to such a large degree, the quality is bound to deteriorate. Need further proof? According to the Fraser Institute, access for U.S. patients compared to Canadian patients is considerably better for complex medical treatments such as open heart surgery, MRIs, CAT scans and catheterization procedures. Canada, of course, has moved to a government-controlled health care system.

There are solutions to be had in the health care industry. To see a variety of free-market ideas, go the Center for Health Transformation website, www.healthtransformation.net. Now is not the time to let the government that operates the license bureau run the country's health care system.

Lucas Presson is a student in the Southeast Missouri State University MBA program (health administration emphasis) and a student associate of the American College of Healthcare Executives.

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