Health Care II

or maybe it is CXI.

Anyway, continuing my take away from the New Yorker article I wrote about yesterday.

Do not fear hospital combinations, loss of community hospitals, or the corporatization of medical practices.  This is the part of the health care system where market competition will deliver cost savings to the economy.  And it is a direct result of the Affordable Health Care Act seeking to begin a transition from pay for service to pay for outcomes.  And repealing the Affordable Heath Care Act will delay the push toward this.

What will not drive this in any way is market competition in health insurance.  Health insurance is a utility which is already regulated by government (usually a state).  Meanwhile, Medicare does the same thing and spends less than 10% on administration.  Private insurance companies spend between 18 and 20% on administration and have created a patch work system that leaves tens of millions of people outside the system while their costs remain in the system through their unpaid visits to the E.R.

We must find a way to transition to Universal Health Insurance (with everyone paying something, if they are working) and eliminating private insurance in a manner that is gradual so the employment shifts are not too dramatic on economic growth.

The costs that are breaking the back of the economy are in my mind and in no particular order:

(i) the elderly with dementia on Medicaid,

(ii) unproductive end of life care,

(iii) diabetes,

(iv) unnecessary medical tests,

(v) a failure to curb malpractice law suits,

(vi) pay for service rather than results, and

(vii) pharmaceutical solutions that are permanent and maybe fall into category ii.

I need to go to work.