Letters: Neither party has health care solution

I would like to respond to Congressman Bill Cassidy’s letter to the editor dated Sept. 11, endorsing the Romney/Ryan Medicare plan.

A meaningful analysis of the health care debate must start with this fundamental inquiry: Are all Americans entitled to access to quality affordable health care?

If the answer is yes, then the discussion necessarily shifts to determining how do we make it affordable.

Despite each of the major parties’ attempts to differentiate themselves, the health care plans offered up by Obama and Romney/Ryan have the shared feature that both will eventually bankrupt America due to their failure to meaningfully address the ever-escalating costs associated with health care.

The fact is that health care costs have increased faster than the economy as a whole for 31 of the past 40 years.

A recent report by the Institute of Medicine found that 30 cents of every health care dollar is wasted in the form of unnecessary services, inefficient delivery of care, excessive administrative costs, inflated prices, prevention failures, and fraud.

The result: $750 billion wasted health care dollars each year.

This number is staggering when you consider that the amount of waste in the heath care industry is greater than the total Department of Defense annual budget!

This annual waste in the health care industry is greater than the 10 years of savings promised under the Obama or Romney/Ryan plans.

Clearly, these escalating costs will not be reversed without clear-eyed serious reform.

To solve these problems is going to require a move away from fee-for-services reimbursement schemes, greater patient involvement in health care decisions, increased transparency in costs and outcomes and more cooperation between the health care providers by the enhanced use of modern technologies.

For more information, I invite the readers to visit the National Academies’ website (national-academies.org). I ask everyone to avoid getting caught up in the idea that the solution lies in either of the current proposals offered by the Republicans or Democrats.

It is going to require a paradigm shift in the way the health care industry conducts its business.

Rufus Craig

lawyer

Baton Rouge

Comments

1) Comment by ScotB - 20/09/2012

The solutions you listed in your third to last paragraph are exactly right. No other product people buy involves just walking into the service providers business and getting the service without ever asking the prices. With a system like that and built in cost shifting, it is no surprise that costs are escalating out of control. I would also add tort reform to your list, which would reduce a compulsion for over testing beyond need and reduce malpractice insurance costs, which are unbelieveably high. That is primarily why you will never, ever see an OB/GYN in any rural community. $90K year, if you never had a claim! The incredibly low rates paid to providers by Medicaid make it impossible to cover costs (in Louisiana, 50% of births are paid for by Medicaid). The Affordable Care Act is over 2,000 pages and gets a lot wrong. This is an extraordinarily complicated problem that does not lend itself to a gigantic, single solution. Rather than put all our eggs in one giant basket, it would be best to use our states as laboratories for solutions for beta testing so we can limit the size of our mistakes. The ACA hasn't even really begun yet, and already the cost projections have doubled. We already spend more than all federal revenues combined on entitlement programs. How can we afford to create another one? This would be like the household that's existing expenses are already more than the entire family income that goes out and buys an new car anyway, saying - well, we really needed a new car.

2) Comment by palefire - 20/09/2012

If one could afford it. I have two jobs and attend classes at LSU. I would say the moral of the story is our "free market" is sham, and has failed us on all fronts.

3) Comment by bourbon-soda - 20/09/2012

Then it's all free, especially if Obama picks up the tab.

4) Comment by DMJ - 20/09/2012

Moral of the story: get insurance. Pay one premium.

5) Comment by palefire - 20/09/2012

True story: I went to an after care clinic for a sore throat and fever with no insurance to boot. The nurse took my blood pressure and temperature. The doctor later came in, looked at my throat and said we can run a strep test. I explained to him I had no insurance and would rather not. He understood, gave me a prescription and I went on my way 60 dollars shorter than I came in. But hey, I got well. Three weeks later, I was experiencing the same symptoms again. I return to the same place. Everything goes exactly the same way as before except with a different doctor this time. I go to pay my bill, and the nice lady says that will be 140 dollars. I told her of my previous visit and costs, and she explains to me the doctors just coded it differently and there was nothing she could do. I asked to speak to the doctor. She left and came back saying he was with another patient and there was nothing he could do anyway. I paid over twice what I paid the first time for the exact same treatment at the same clinic, and we wonder why our health care lags behind most of the world.

6) Comment by bourbon-soda - 20/09/2012

Bughug - I meant to include that under "patient's seeing services as free."

7) Comment by ex-louisianian - 20/09/2012

Just make Medicare universal for all adults (+18), leave Medicaid as a children's (newborn to 18) program, and fund both through payroll taxes on compensation with no arbitrary preset caps. As mentioned, all adults will be insured (they have to be to diversify risk), and doctors who refuse Medicare reimbursements simply won't be paid. Elective surgeries like breast enlargements can be paid out of pocket or through private insurance companies regulated like utility companies. Oh, and set up a pricing board for bulk prescription drug purchasing like Australia does.

8) Comment by Bighug - 20/09/2012

It is true that fear of litigation is responsible for some unnecessary procedures, but that isn't what I was referring to. An RN who is a relative of mine explained years ago how patient info was color-coded to let the hospital employees know which ones had the insurance or money to pay, and which ones were probably getting care gratis. There were three levels. Guess which ones got the expensive procedures? There was an interview on LPB yesterday with someone who discussed how some hospitals gave doctors a quota to fill by requesting expensive treatments and exams.

9) Comment by phil - 20/09/2012

The question "Are all Americans entitled to access to quality affordable health care?" is a good one but needs to be followed by some other questions. Can Americans even afford the existing Obamacare plan? Does having access to quality health care also mean that everyone who has money should be forced to buy health insurance and also pay for those who do not have money? Should Americans be forced to buy something that will be furnished for free to others? Should more emphasis be placed on getting rid of corruption in Medicaid (and Medicare)? Do we really want to continue forward with a 2-tier health insurance system - one run by private companies and one run by the government (Medicaid)? Should people who paid into Medicare for years possibly have to help finance the new healthcare system?

10) Comment by bourbon-soda - 20/09/2012

How many of the unnecessary services are driven by the threat of litigation by lawyers like the one who wrote this opinion, and by patient's seeing the services as free because they are paid for by someone else?

11) Comment by DMJ - 20/09/2012

I agree that getting away from fee-for-service is part of the solution (good luck selling that politically). I do take issue with the idea that services are "unnecessary." Sure, there are doctors who see someone with good insurance and then run a bunch of tests to cash in, but most doctors are not so brazenly greedy. Is an MRI that doesn't happen to find anything unnecesssary? Some would argue that a negative test result is just that....a result. I would propose that tests and procedures that do not find or cure the problem cost less, retroactively. An MRI that finds a brain tumor costs X dollars; an MRI that finds nothing costs $3/4X. This would lower costs instantly without drastically changing the current system and without "rationing" procedures and tests. Of course, requiring all Americans to contribute to the risk pool is a key component to lowering costs as well. Hospitals won't have to charge those with insurance more to make up for caring for those without insurance....because everyone will be insured. Requiring all private doctors and hospitals to accept Medicare and Medicaid (even if reimbursement rates are lower than they'd like) would help as well. Greater protection for doctors in the form of tort reform would lower their insurance, but jdk44, this would require the federal government to write standards that supercede the individual states' standards for this sort of thing. Isn't this the very thing conservatives are against?

12) Comment by tradewinns - 20/09/2012

we truly cannot afford universal health care. not in a capitalist society. we have too many people who need care that cost hundreds of thousands of dollars in the current scale. while not a good situation, it is an honest assesment.

13) Comment by jdk944 - 20/09/2012

Bighug, the issue you raised is also caused by the "sue" happy society we are in today where too many are looking for a opportunity to bring up charges against the health care industry for NOT running certain tests etc. Malpractice insurance rates are rising, in some cases, where doctors etc. cannot even afford the premiums anymore!!

14) Comment by dday198 - 20/09/2012

here here

15) Comment by Bighug - 20/09/2012

The writer of the letter is correct. The health care industry should be stopped from requiring unneeded, expensive treatments for patients merely for running up the bill. Yes, it is a common practice. Ask anyone you know who works in the health care industry. Some hospitals code patient info as to ability to pay and/or amount of insurance so nurses and doctors will know whether to add more costly treatment to that patients bill.