Stanley Feld M.D.,FACP,MACE
Healthcare policy definitions are easy to confuse. I am an advocate for universal healthcare coverage. I am not an advocate for a single party payer. I believe the only way to be successful in repairing the healthcare system is to remove control of the healthcare dollar from the healthcare insurance industry. Consumers must be in control of their health care dollars. The ideal Medical Savings account can motivate patients to be responsible for their health.
Patients with chronic disease must be motivated to control their chronic disease. If they are motivated to control their disease healthcare costs would decrease. Using the ideal medical savings account a patient with diabetes for example would be expected to spend $4000 dollars a year. It they controlled their disease well and avoided hospitalization their employer or the government could afford to provide a bonus. If they controlled their disease and avoided hospitalization they would have $2000 to put in a retirement account. They could be eligible for an additional $2000 bonus. The result is a savings of $4000 into their retirement account. Patient responsibility and motivation are the only way we have a chance to Repair the Healthcare System.
President Obama healthcare plan is going to make patients more dependent on government and less responsible for their care and choices. In fact choice will be rationed. His allies in the single party payer camp are complaining that he has “caved” in to hospitals and healthcare insurance companies.
They claim he was elected to install a single party payer system. They ignore the point that the government cannot afford to pay for the Medicare single party payer system much less universal coverage for the entire population as the single party payer.
The function of the government should be to make appropriate rules to align the incentives of all the stakeholders in the healthcare system. President Obama is confusing everyone with his position on healthcare reform in order to decrease resistance to his plan. My guess is he is doing it intentionally.
“Although Barack Obama was elected on a health care reform platform, his version ignores single payer. Nor is single payer advocated by his allies in the well-funded coalition called Health Care for America Now, composed of MoveOn, USAction, ACORN, Americans United for Change, the unions SEIU and UFCW and other liberal heavy hitters.”
President Obama is a clever politician. He understands that it would be political suicide to directly advocate a single party payer system. The American public wants choice. They do not want to have healthcare rationed. The American public understands the government cannot afford a single party payer system for all. The public outrage would dominate the debate. His healthcare plan is designed to arrive at a single party payer system by default.
The advocates of a single party payer do not understand the subtlety of President Obama’s positioning in the healthcare reform debate. .
“Journalist Russell Mokhiber, founder of the new group Single Payer Action, notes that no advocate of a single payer system was invited to the recent White House summit on health care reform. Only protests by Progressive Democrats of America and others won an invitation for Congressman John Conyers, sponsor of the United States National Health Care Act: H.R.676.”
The advocates of single party payer system are now attacking President Obama. They are accusing him of caving in to the demand of powerful vested interests.
“Mokhiber quotes Dr. David Himmelstein of Physicians for a National Health Program: “The President once acknowledged that single payer reform was the best option, but now he’s caving in to corporate health care interests and completely shutting out advocates of single payer reform," even though "the majority of Americans favor single payer, and it’s the most popular reform option among doctors and health economists."
This is political spin. President Obama is not caving into anyone. The majority of Americans are do not want rationing of health care that usually follows the high cost of a single party payer by government that exists in other western countries.
The President knows the best way to achieve a single party payer system. His plan is to get there by default.
The Obama healthcare reform plan is create a National Health Insurance Exchange to help individuals who wish to purchase a private insurance plan. The Exchange will act as a watchdog group and help reform the private insurance market by creating rules and standards for participating insurance plans to ensure fairness and to make individual coverage more affordable and accessible.
I believe his National Health Insurance Exchange will drive the private insurance companies out of the healthcare insurance business. This might not be a half bad idea since the healthcare insurance industry controls healthcare cost and earns a grotesque amount of money.
It could change the healthcare insurance industry but I doubt it. It should become a 6% broker as the administrative service organization instead of 15% broker in a private insurance system. However there is no price transparency. In reality the government pays 18% for Medicare administrative services. President Obama healthcare reform proposals will not repair this abuse. Nothing will change. The government will restrict access and ration healthcare.