September 3, 2004

Commentary

Bush Plan is a Windfall For Health Care Industry

By Terry Brauer

President Bush has been touting the virtues of his health care plan during the campaign. It took him more than 3 years to formulate one. As presidential health care plans go, his is terrible for consumers, but terrific for health care providers and insurance companies.

Bush’s plan to use association health plans (ASPs) as a means of controlling health care costs for small businesses is absurd. Even America’s largest employers are unable to control health care costs. Both General Motors and Ford Motor Co. have called on the federal government for help in reining costs in.

Other nations’ health care systems, which cover their entire populations, cost at least 50 percent less per person per year than Americans pay for their health care, and 45 million Americans aren’t covered at all. Clearly, hundreds perhaps thousands of small businesses banding together to buy health insurance will have no greater success in controlling costs.

Health savings accounts (HSAs) are the president’s second innovation. But relatively few families can afford them, what with higher deductibles, higher co-pays, and more money deducted from workers’ paychecks for premiums and HSAs.

Tax credits, another feature of Bush’s plan, work well for businesses and individuals that can afford to front monthly health care premiums. Most individuals and small businesses, however, can’t afford very expensive monthly premiums.

Medical malpractice liability tort reform is another of the president’s health care plan cornerstones. If successful, all people, regardless of the nature or extent of their injury or death from medical negligence or bad judgement would, if vindicated, be awarded a maximum fixed amount. Their pain, suffering and inconvenience — temporary or permanent — regardless of age, would be evaluated on the basis of a single maximum award amount.

Bush keeps saying that tort reform will reduce health care costs. It won’t. Insurance cost escalation for malpractice liability, property and auto insurance stem from the same source — poor returns on insurers’ market investments, mismanagement and greed.

Health care providers instead should purge their ranks of incompetent and impaired offenders, use technology to reduce medical errors and train staff to be more diligent in the care of patients. Provider organizations — physicians and hospitals — have been trying to “educate” their members for decades in an effort to reduce medical errors. It hasn’t worked. The vast majority of medical errors is caused by a tiny minority of repeat offenders, systemic defects and impaired health care professionals.

The people who oppose a rational and equitable health care system for America are stakeholders in the status quo. They invariably surface and support superficial or cosmetic and impotent changes. Bush has placed on display this election year each of the elements that serves to directly or indirectly enrich special interests — ASPs, HSAs, tax credits and medical malpractice tort reform. Under the guise of “consumer-directed health care” and “consumer choice” these elements together will add further complexity and devastation to a chaotic health care non-system that is in the process of implosion.

Bush and his supporters believe that the private sector will do a better job than government in administering and financing health care for America. But six decades of a private sector employer-based insurance system have failed to control costs, ensure quality and patient safety and guarantee universal access.

We know that the health care non-system is rife with fraud (at least $100 billion annually), waste and abuse. We know that 45 million Americans are permanently uninsured and 82 million were uninsured for various periods of time in 2002-3 for various reasons.

We know that our hospital emergency rooms are jammed with people seeking both urgent and primary care services. We know that more people are bankrupt, impoverished, physically impaired or dead (18,000/year) because of health care costs. Yet, stitching together additional mirage panaceas — ASPs, HSAs, tax credits, tort reform, etc. — constitutes the main feature of the president’s health care plan.

A single payer universal health care system for all Americans will be best for the nation and our future — for health care consumers, their families, doctors, nurses, pharmacists and thousands of employers.

Employers and individuals would pay into a general fund. The risk would be spread among the entire population. The federal government would be the payer. Consumers would select any health care providers they wanted that were approved by the federal government. Quality information would be available through the Internet and accessible by all.

The government would establish fair and equitable payment rates for products and services. Layers of unnecessary waste, fraud and abuse would be reduced or eliminated. Hundreds of billions of dollars would be reallocated to patient care. Physicians and other providers would cease spending valuable time on billing and other administrative issues unrelated to patient care.

More Americans have been temporarily or permanently uninsured and more health care special interests have been more profitable in the last few years than at any time in our history. A single payer universal health care system would be transparent and won’t enrich and reward the current roster of industry special interests and Bush supporters, which is primarily why President Bush isn’t proposing one.

Terry Brauer is the CEO of HealthCare Initiatives, Inc. and HealthCare Management Consultants, Inc.

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