Health Care Reform
We need to confront his unsubstantiated impressions and start looking at facts while there is still time to do it.
Just as one example,
Want to look back at 1965 when Medicare was first introduced to see how good the government is at projecting health care costs?
In writing about current proposed Health Care Reform Bill cost estimates, USA Today came up with
“As eye-popping as those numbers are, the real cost will likely be higher. Long-range projections are notoriously inaccurate. When Medicare, the government’s health care system for the elderly and disabled, was first enacted in 1965, lawmakers predicted it would cost $9 billion by 1990. In fact, it cost $67 billion that year.”
OOPS! There MUST have been a good reason for missing by that much …. don’t you think? I’ll bet somebody is already thinking up some really good reasons for the current cost estimates.
The moral of this story is, “If you are projecting long-term costs, make sure the projection year is past your date of retirement…..or your term of office.”
Another example is what will really happen if there is a Public Option or a Public Option clone? Every actuary in health care financing knows there will be a selection spiral leading to a Single Payer System. This needs to be brought into the debate.
The suggestion to allow entry into Medicare at age 55 (a back-door to a single payer system) when Medicare is on the verge of bankruptcy, and $500 billion is to be cut from it, has moved us from the sublime to the ridiculous.
This is what happens when nobody questions unsubstantiated statements, and facts and reality are left in the dust.
The principles of health care financing and risk cannot be changed by wishful thinking. Risk always acts in the same way …without exception …every single time. It does not care if we are nice people, if we can’t afford an unexpected consequence, if we ignore it. Remember the financial crisis of September, 2008? Risk was there, acting as it always does.
The sad effect of the fabricated deception of “financial tricks”, then and now, will simply result in our children saying someday, “How could they have been so foolish.” The most blatant example is to give us 10 year financial estimates using 10 years of income and only 6 years of cost.
The bottom line is if we make a mistake in Health Care Reform, we will not be able to reverse it, we will not get another chance to “do it right”. And the permanent adverse consequences to quality, access, and cost will be with us for generations.
Effective Health Care Reform is not about making speeches and promises and waving fingers in the air. It is tough. It demands a clear, rigorous understanding of how health care financing and risk work. Just as one more example, interstate health insurance competition will not work out the way we thought either.
Right now, momentum is building to pass virtually any kind of Health Care Reform that will get enough votes from Congress. Right now, we still have the best health care system in the world. Are we willing to let it slip away so easily?
I urge anyone who is interested in preserving our health care system to go to 29thday.org and read Chapter 8. I hope you will find it understandable, but I will warn you in advance, it is a lot more than a “sound bite.” In it, you will find information and facts about health care financing and possible solutions. For example, there is a way to reduce health care costs by $6 trillion (yes, trillion) over 10 years AND improve quality. My objective is simple. I want to provide you with the tools to say to anybody who just offers “impressions” about what will work in Health Care Reform, “This is why what you are suggesting won’t work … and this is what will work.” I am not trying to say that I have all of the answers. But, as an actuary, I do know about health care financing and risk.
If anyone is going to get Health Care Reform back on track, it looks like ordinary Americans like you and me will have to do it. But we will have to act with knowledge and facts … and we will have to act quickly.
We are talking about our future … and our children’s, and our grandchildren’s. This is not some TV reality show. It is real life. What we actually do to redirect the future is what counts. There are people who want to dictate our future for us. They think we might complain but that in the end we will not actually do anything that can change the direction in which they have decided we should go.
Join with me to prove that they are sadly mistaken. Let’s fight for a health care system our children can be be proud of.
Thank you for your posts and web site.
Excellent reference, thanks! I agree with everything I read in Chapter 8 (I only skimmed it for now, but will revisit when I have more time). I’ve been reading and writing about healthcare reform for quite a while now. I’ve come to the conclusion that healthcare “reform” of some sort will likely be passed in the near future, but it will tend merely to accelerate us along our already unsustainable course. Nothing new here; it just seems what our government has been doing for decades. I hope we can change our course, but fear we may simply have to wait until the system eventually crumbles, and then rebuild. Still, I continue the fight…
Sad as it is I believe the fastest way to fix it is to accelerate the collapse. This will be necessary for most people to really understand what is wrong with the system…..even then I wonder if the masses will truly understand?? Most just want something with little to no effort.