The Amazing Maze of US Health Care

There is a group of people that has not been engaged in this debate about health care reform.

Yet the debate is about this very group of people – the uninsured.

But when the dust settles, the shouting is over, the ink is dry, and the regulations are in translation, those disengaged uninsured will emerge from their shells.  Like Punxsatawney Phil their heads will rise above their immediate struggles and they will check out the new climate for health care.

Will the sun shine and point the way for a brighter future for so many who have hidden in the burrows of our society?

Or will they see no discernible change and crawl back into an indefinite health insurance winter?

A recent report by the Robert Wood Johnson Foundation and the Urban Institute attempts to answer the question, how will the current reform proposals affect the number of uninsured.

It is full of impressive numbers, but offers insufficient concrete evidence that a “reformed” maze will be any easier to navigate than the current one.

One number is instructive.  Almost 30% of the currently uninsured are eligible for some form of public health insurance programs?  Half of those are children.  Why aren’t they enrolled? Read the rest of this entry »

I have a hard time getting my arms around the public plan option debate.  As other have said far better than me, it is not central to health reform, although it clearly central in the debate around health care reform.  Instead it is a proxy for a lot of other issues.

UHCAN Rally June 25

Just about everyone in the health care debate/discussions has their lynch pin issue.  It’s what I call the “just fix this” syndrome. They range from, “If everyone would just exercise more,” to “if the government would just pay for everything.”  In between is a whole range of touchstone issues, including numerous proposals for delivery system reform, payment reform, tax reform, the list goes on. Read the rest of this entry »

Some things I don’t understand!

I just don’t quite get the “public plan option” idea.

I read Jacob Hacker’s proposal for a public plan option again.  Professor Hacker is a scholar with his heart in the right place, a rare combination.  He gained my immense respect after I heard him speak about his book, The Great Risk Shift, a couple of years ago.

Professor Hacker makes a compelling case that a public plan is not only administratively more efficient than private plans, but that they have a convincing record of introducing large scale quality initiatives and payment reforms into the marketplace.

He then goes on to describe the dismal record of private insurers in comparison to public plans.

So why are the private plans an option if the public plans are superior?

That’s what I don’t get! Read the rest of this entry »