Thursday, October 08, 2009
Don't rush into a trillion-dollar problem
From the RoundTable blog
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Dick Robers
Robers, of Roanoke, is a consultant at The One O2 Institute.
Now is the time for everyone who is concerned with health care reform to take a deep breath. There is so much information and misinformation in the public forum that even the most knowledgeable experts cannot make sense of any of the proposals, let alone understand what parts of the various proposals would fit together to build a viable plan.
One thing is certain and that is the proposed plans will cost hundreds of billions of dollars. No matter how it is presented, the money to pay for the plans comes from the U.S. taxpayers. Yet, to date, no one can understand the financial implications of the plans as it relates to individuals and families.
If as proposed by some, including President Obama, the plans can be paid for by savings from reducing fraud, abuse and waste in Medicare, Medicaid and VA programs (each of which is funded by tax dollars), then these problems should be fixed before any new programs are put into operation.
One way to fix the problem would be by requiring all health care providers to publish outcomes for every type of procedure they perform. These outcomes would then be measured against established medical and financial standards as determined by best-in-class providers such as the Mayo Clinic, Cleveland Clinic and Johns Hopkins.
Since the dollar amount associated with the proposed health insurance plans approximates $1 trillion and it is said that we can pay for it from savings in fraud, abuse and waste in the government-run health systems, we have a real big problem that should alarm every citizen. As discussed, this fraud, abuse and waste is in government-run health care systems. We must also consider the fraud, abuse and waste in other government programs such as HUD and welfare etc.
We must also consider that the vast majority of the 85 percent of hard-working Americans who are presently covered by health care insurance do not want the government to interfere with their coverage. Many fear that they will lose their current coverage -- this, by the way, is not out of the question.
Of the remaining 15 percent without health insurance coverage (estimated to be 40 million) about half are illegal aliens, and the president said they would not be covered. An estimated 5 million of the remaining 20 million are people who could afford coverage but choose not to enroll, thus leaving 15 million who would need coverage and could not afford coverage. These people, referred to as the permanent underclass, could use public health centers for primary care and catastrophic care could be provided by nonprofit hospitals as is the case presently.
Moving forward in this manner we would save the trillion dollars in health care fraud, abuse and waste, and only a fraction of it would be needed to help provide for the permanent underclass.
Regarding the illegal population, I would not deny them care for serious medical needs. But they should be treated and, if truly illegal, they should then be returned to their native country after recovery. I would then bill their country for services provided or at least deduct any costs for services rendered from any foreign aid assistance given to their country.
We must recognize that our country is very generous, but that we do have a procedure to follow for those who wish to immigrate and we should enforce our regulations in this matter.
For the sake of the already overburdened U.S. taxpayers, let's take our time and be certain we have considered all possibilities before we rush forward spending a trillion dollars along the way with no way being proposed to measure our success or failure.
