Saturday, November 15, 2008

What's the Matter with Baucus? 

Senate Propsal is Wishful Thinking

By Greg Scandlen

Filed As:  Health Care

I haven't had time to read the 90 pages of Sen. Max Baucus' new heath reform proposal, but I just looked at his Executive Summary and fear he is misdiagnosing the problems. To wit --

He talks about “the underinsured.” That is a euphemism for CD Health, but CD health is the ONE success story out there. It is actually reducing HC spending, increasing knowledge, and improving patient behavior.

He talks about uncompensated care and blames it on the uninsured. But the greatest source of uncompensated care is underpayment by Medicare and Medicaid. The uninsured is a trivial contributor.

He talks about expanding Medicaid and SCHIP. But one-third of the uninsured are already eligible for those programs, but don’t bother to enroll. He does not say how he will change that.

He hopes that wellness and prevention will lower costs. But there is no evidence to support any of that. In fact wellness and prevention RAISE costs.

He wants to focus on wellness and prevention “RATHER THAN on illness and treatment.” YIKES!!! So he will deny treatment of illness so that a 30-year-old can get an annual physical???????????

He bemoans that fact that people wait till they need coverage to enroll, but he will add costs to the young and healthy by eliminating “discrimination” against people with Pre-Ex.

He wants a Medicare buy-in for people of age 55. But he ignores the facts that 1. Medicare already has $34 trillion in unfunded liabilities. 2. That people on Medicare already pay 20%+ of their incomes in OOP spending (speak of “underinsured”). 3. That it pays only half of the elderly’s HC spending, and 4. That is is a massively clumsy and inefficient program that could never be sold on the private market.

He wants employers who don’t provide coverage to pay for the uninsured. But he ignores the effect on job creation and wages.

He thinks Health IT will solve a lot of problems despite all the evidence that it doesn’t.

It is just a laundry list of wishful thinking. All those folks who insist that medicine be “evidence based” should apply the same standard to public policy.

• posted by Greg Scandlen
• 10:35 am
• 0 comment