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Critics Of Obama-Care Speak Out In Philly
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| President Obama at an event focused on advancing his healthcare reform agenda. (AP) |
By Bradley Vasoli, The Bulletin
PHILADELPHIA — A lineup of medical and government experts examined President Barack Obama’s health-care proposal Tuesday and reported that it may worsen what ails America’s medical-care system.
Mr. Obama wants a litany of changes to the already heavily regulated industry to boost quality and reduce costs. Among those changes are mandatory coverage, disease management, expanded public insurance and comparative effectiveness research. The last has become particularly controversial because it would entail government signing off on the use of medicines after factoring in their costs.
“They are every bit as likely to raise costs as the opposite,” the Heartland Institute’s Consumers for Health Care Choices Director Greg Scandlen told an audience at the Philadelphia Downtown Courtyard Marriott. Heartland co-hosted the discussion with the Harrisburg-based Commonwealth Foundation.
None of these measures, he said, is likely to mitigate the major problem with America’s health-care system, which he believes to be third-party payment. The fact that most Americans obtain their medical services through an insurer creates a “triangular relationship”: The consumer pays the insurer who pays the provider who treats the consumer. The doctors and nurses who care for the patient thereby become chiefly accountable not to the patient but to the insurance company.
Mr. Scandlen sees an emerging market-based solution to this, but he worries that Mr. Obama’s plan to expand government health care will stifle it. It’s called consumer-driven health care (CDHC) and involves medical savings accounts and high-deductable insurance plans.
Because consumers of health care perceive the expense of the services they purchase under this model, Mr. Scandlen says they’re more likely to shop around and demand more information. He reports that over 20 percent of U.S. workers under 65 are enrolled in such a plan.
Jeff Bolmeyer, director of Lyons Companies’ Employee Benefits Consulting, agreed with Mr. Scandlen that CDHC plans have the potential to drive costs down even as their enrollees don’t forgo coverage.
“Behavior is changing when someone gets involved in a high-deductible health plan or a health savings account,” he said.
While clearly favoring private health coverage over a government-run system, panelists posed the question of whether the latter kind of system deserves all the praise heaped upon it by Mr. Obama. Can government truly provide health care at a lower cost than the private sector?
Research by former federal health officials Kerry N. Weems and Benjamin E. Sasse indicates government health insurance is in fact quite expensive for the quality of care it delivers. They’ve written that while national health-care proponents lament the hefty administrative costs of private insurance, they ignore what these expenses accomplish for the insured.
For one thing, unlike public plans (e.g. Medicare) cannot exclude substandard providers, whereas private insurers build networks of doctors and other professionals with an eye toward quality. For another, much of the extra cost paid by private plans combats waste and fraud, problems that Medicare is not known for mitigating. Additionally, public plans don’t have the burden of marketing their product.
Some of the most severe criticism of the president’s vision for health care came from Dr. Richard Cooper, who teaches medicine at the University of Pennsylvania. He said it concerns him that Mr. Obama wants to financially reward health-care providers for cost-efficiency. The problem, he said, is that certain areas where money is spent profusely on medical care have much poorer demographics than areas where people spend less on it.
“What is the incentive to take care of poor people if you’re done for doing it?” Dr. Cooper said.
Mr. Obama wants a litany of changes to the already heavily regulated industry to boost quality and reduce costs. Among those changes are mandatory coverage, disease management, expanded public insurance and comparative effectiveness research. The last has become particularly controversial because it would entail government signing off on the use of medicines after factoring in their costs.
“They are every bit as likely to raise costs as the opposite,” the Heartland Institute’s Consumers for Health Care Choices Director Greg Scandlen told an audience at the Philadelphia Downtown Courtyard Marriott. Heartland co-hosted the discussion with the Harrisburg-based Commonwealth Foundation.
None of these measures, he said, is likely to mitigate the major problem with America’s health-care system, which he believes to be third-party payment. The fact that most Americans obtain their medical services through an insurer creates a “triangular relationship”: The consumer pays the insurer who pays the provider who treats the consumer. The doctors and nurses who care for the patient thereby become chiefly accountable not to the patient but to the insurance company.
Mr. Scandlen sees an emerging market-based solution to this, but he worries that Mr. Obama’s plan to expand government health care will stifle it. It’s called consumer-driven health care (CDHC) and involves medical savings accounts and high-deductable insurance plans.
Because consumers of health care perceive the expense of the services they purchase under this model, Mr. Scandlen says they’re more likely to shop around and demand more information. He reports that over 20 percent of U.S. workers under 65 are enrolled in such a plan.
Jeff Bolmeyer, director of Lyons Companies’ Employee Benefits Consulting, agreed with Mr. Scandlen that CDHC plans have the potential to drive costs down even as their enrollees don’t forgo coverage.
“Behavior is changing when someone gets involved in a high-deductible health plan or a health savings account,” he said.
While clearly favoring private health coverage over a government-run system, panelists posed the question of whether the latter kind of system deserves all the praise heaped upon it by Mr. Obama. Can government truly provide health care at a lower cost than the private sector?
Research by former federal health officials Kerry N. Weems and Benjamin E. Sasse indicates government health insurance is in fact quite expensive for the quality of care it delivers. They’ve written that while national health-care proponents lament the hefty administrative costs of private insurance, they ignore what these expenses accomplish for the insured.
For one thing, unlike public plans (e.g. Medicare) cannot exclude substandard providers, whereas private insurers build networks of doctors and other professionals with an eye toward quality. For another, much of the extra cost paid by private plans combats waste and fraud, problems that Medicare is not known for mitigating. Additionally, public plans don’t have the burden of marketing their product.
Some of the most severe criticism of the president’s vision for health care came from Dr. Richard Cooper, who teaches medicine at the University of Pennsylvania. He said it concerns him that Mr. Obama wants to financially reward health-care providers for cost-efficiency. The problem, he said, is that certain areas where money is spent profusely on medical care have much poorer demographics than areas where people spend less on it.
“What is the incentive to take care of poor people if you’re done for doing it?” Dr. Cooper said.
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