The Washington Times December 18, 2001 by Guy Taylor “Sparks flew yesterday at the D.C. Council’s public oversight hearing on the D.C. Health Care Alliance, a group of private health care contractors hired by the city last may to replace D.C. General Hospital as the District’s main provider of public health services.” Washington, D.C. council member David A. Catania, at-large Republican: When D.C. General closed, the residents of the District “were promised 34 percent more care at 25 percent less cost – what we’re getting instead is 18 percent less care than we were getting last year at no cost reduction.” http://www.washtimes.com/metro/20011218-27752680.htm Comment: When the conservative Washington Times quotes a Republican council member complaining about a system of privatized health care, we know that history has been made. Now that we agree that the government can increase the efficiency of our health care system, let’s get on with defining the precise role that it should play. (Hint: a publicly administered program of universal health insurance.) This message from Dr. Quentin Young to PNHP members and friends is being forwarded to the members of the “Quote of the Day” list. For many of you, this is a duplicate message, and please accept our apologies for that. Surveys suggest that there is strong support amongst physicians for replacing our defective, inefficient, inequitable, wasteful, fragmented system of health plans with a national health insurance program. The prevailing rhetoric suggests that physicians remain uncomfortable with this approach. There is a pressing need to change the rhetoric to reflect the true level of physician support for reform. This is the purpose of this campaign. For health care justice for all, Don McCanne, M.D. President-Elect, Physicians for a National Health Program ***************************************************** December 18, 2001 Dear PNHP Members and Friends, We need your help. The next issue of the PNHP newsletter (52 pages of articles, updates, and analyses of current health policy and politics) is finally put to bed and at the printer. We hope that you’ll find it as valuable as past issues. While we plan to continue our impressive coast-to-coast educational program, we believe the devastation inflicted by for-profit corporate ascendancy over the health care system has moved a critical mass of our profession into readiness to support single-payer national health insurance. The time is at hand for a major expression from America’s doctors. In 2002, PNHP intends to launch an ambitious new campaign to reach America’s 700,000 physicians with our updated proposal for national health insurance. Obviously this is a great undertaking which will require major resources. Our present funds will allow us to reach only one out of seven doctors. Our goal is to reach every physician.Your tax-deductible gift will allow us to reach more physicians. Please consider donating on-line at www.pnhp.org or through the mail to PNHP, 29 East Madison, Suite 1412, Chicago, IL 60602. Your newsletter packet will also include a card and return envelope, but with the holiday mail rush, we wanted to make sure you could donate before the end of the tax-year if you wish. Thank you in advance for your generous support. Quentin Young, MD PNHP National Coordinator pnhp@aol.com (312) 782-6006 P.S. For every $100 donated, we can reach 250 more physicians. Please help us reach out and give voice to our profession! ******************************************************* PNHP National Physician Outreach Project, 2002 – Gift Card 29 East Madison, Suite 1412, Chicago, IL 60602 Enclosed is my contribution of: _____ $1000 _____$500 ______$250 _____$100 $_______ Other Form of payment: _____ Mastercard ______ Visa ______ Check (make payable to PNHP) Card # _________________________________________ Exp._______________ Name________________________________________ (e-mail or phone)__________________________ Address ____________________________________ __________________________________________________________________ (If you wish to be removed from the “Quote of the Day” list, please return this message with the word “Unsubscribe” in the subject line.)
Emergency Medicaid
The New York Times
December 17, 2001
Excerpt from the letter of David Jones, President, Community Service Society of New York:
“In New York, there have been more than 100,000 new Medicaid applicants since the state began its disaster-relief Medicaid program after the events of Sept. 11. This dramatic response brings to the fore a significant problem: the many people in need of health coverage but not enrolled in programs.”
Comment: Current political approaches to the problem of the uninsured are limited to the concerns of those individuals losing coverage because the September 11 disaster and because of the recession. Attempts to expand public programs for the chronically uninsured, especially Medicaid and S-CHIP, are failing because of balanced-budget mandates at the state level.
If a publicly administered program of universal health insurance had been in place, we would not be concerned about these issues since everyone would already have coverage. Instead, the political debate would be over debt management and taxation, a debate that we already have and always will have. Wouldn’t it be better to assure health care coverage for everyone and then go back to the tables and limit our debate to tax policy?
Uninsured in Fits and Starts: How Stable Is Health Insurance Today, and What Difference Does It Make?
Alliance for Health Reform
December 12, 2001
Washington, DC
During Q & A:
Edward Howard, Executive Vice President, Alliance for Health Reform:
“I do have a couple of questions that have been submitted in advance, and let me try one of those, if I can. The questioner starts by noting the inability of employers to protect themselves from rising health insurance premiums compared to, for example, their domestic competitors who provide nothing, their global competitors who have access to a universal system. Also the lack of effective cost containment in a highly fragmented system. Given that, whatever merit employer-sponsored health insurance offered to spread risk equitably through the population, isn’t this a good time to create more equitable risk pools at the state or community level? Lynn, you sort of had some notions along that line.”
Lynn Etheredge, an independent health policy consultant:
“Thanks, Ed. All I can say is that, what we’ve discovered in health insurance debates is that one person’s-when people start talking about equity, they’re talking about reallocating costs to someone else. And, while it may, for the person who’s suddenly hit with a double digit rate of increase after several years of single digit, the idea that it’s more equitable to shift that cost to someone else, to the person to whom it’s shifted, who’s already also facing a double digit rate of increase, the willingness to think it’s equitable to pay someone else’s bill on top of theirs is somewhat diminished. So I’m not sure that it’s-theoretically, it might be a good time to do it but, in practice, we-it makes it somewhat harder I think.”
And later,
Mr. Howard:
“Stuart, you were talking about a voluntary system, and I wonder if you have any current thoughts about the idea of an individual requirement for insurance purchase, in the way that many states have individual requirements for auto insurance purchased for those who want to have licenses to drive, and whether or not that idea is getting any sort of receptivity from that broad spectrum of folks that you were talking about earlier.”
Stuart Butler, Ph.D., Vice President, Heritage Foundation:
“Well, you know, the wounds I suffered when I last proposed that are only just beginning to heal now! I mean, look, in principle-I’m a conservative. In principle, I have no problem with the idea of saying that the rest of society should be protected against individuals who use our existing laws and good nature to provide them with a service that they’re not prepared to pay for. I think that we should have a requirement for at least that. Whether we should have it beyond that, is much more open to question. But I still think that there are other kinds of soft ways in which one can achieve the same kind of objective. I mean, the various tax proposals that are on the table and other subsidies basically say, unless you get at least a minimum protection, you don’t get any of these. You don’t get any subsidy for your prescriptions, for your-you know, for your visit to the doctor or anything. That’s an inducement.”
“There are proposals from, I think NCPA and others that say, okay, what-let’ s take the people who just, whatever you try to do, still don’t sign up. Well, let’s calculate some of those and give the state the equivalent money and let them deal with those people directly, which at least is better than we have today. So I think there are ways. But I certainly feel that there ought to be a requirement for at least a minimum protection, much like, as you said, third party insurance for automobiles, because I don’t see why I should pay because somebody runs into me. And, you know, those kinds of things I have no problem with.”
Comment: These unprepared responses during the question and answer session demonstrate the difficulty that those who are opposed to a program of universal insurance have with the concept of equity. It seems that achieving equity or fairness should be at the forefront in our efforts to reform health care. A suggestion for the topic of the next forum: “Health Care Equity: How Can We Achieve it?”
Tom Mainor, Pastor of Shady Grove Presbyterian Church in Memphis, responds to Jeff Huebner’s comments on the ACP-ASIM proposal:
These observations are helpful. There really seems never to have been a lucid and rational national discussion, with helpful media coverage, of what we mean by “single payer approach.” They are always side-tracked by the opponents of a universal system, and mis-characterizations by entrenched financial interests who want to get control of community-provided health resources for profit.
The suggestion re/ modeling them after the Canadian provincial system parallels my thinking that regional health systems, globally budgeted, with regional health councils that look at everything from prevention, to trauma, to cure and rehab, nursing home care and good public health structures–such an approach can blunt the objections to universal coverage, and remind us that “government” is “we the people” working together to do what needs to be done for the commonweal. We would not suggest that only those citizens who can afford it have safe drinking water, or fire and police, or Coast Guard or a competent and ready national defense force. Why should health care be left to the vagaries of a market place whose purpose is to create more customers rather than a healthy people?
Tom Mainor
The next big health care crisis is now. HEALTH SCARE
The New Republic
December 24, 2001
by Jonathan Cohn
“As The New York Times reported last week, several major insurers, including Aetna, Humana, Cigna, and the UnitedHealth Group, are rolling out a new type of plan that fundamentally changes the way insurance works. Under the new schemes, which some call ‘health savings accounts,’ an employee would receive an ‘allowance’ of $2,000 or $3,000 to spend on medical care. If the employee ran up bills larger than that, he or she would have to pay them out of pocket, as much as $5,000, at which point the employer would pick up the rest.”
“It’s not too hard to see why this sort of insurance would appeal to the employer and to the insurance company: They’d both be spending less money. Employees who don’t go to the doctor’s office often would come out ahead too, at least in the short term. But if you happen to be one of those unlucky souls who has an expensive medical condition, the new accounts could spell disaster.”
“In other words, the plans would take financial risk off the healthy and put it onto the sick–exactly the opposite of the social role insurance is meant to perform. The fact that so many of the nation’s big insurance companies are introducing these plans suggests that, unlike medical savings accounts–a related idea hatched in right-wing think tanks that never really took off commercially–this new scheme has market appeal. Over time, it’s not hard to imagine this style of insurance completely taking over, in the same way managed care swept through the market in the ’90s.”
“About the only consolation might be that this new system would probably prove highly unpopular. The funny thing about illness is that it’s pretty democratic–it affects everyone you know at some time, and some people you know all the time. A health insurance system that made illness such a crushing financial burden would inevitably affect not just the working poor, but large chunks of the middle class. And that would eventually produce a political backlash, even if Washington didn’t immediately recognize it.”
“… for the last eight years, the Democrats have only nibbled around the problem of inadequate health insurance–a program for poor children here, a drug benefit for seniors there–and the Republicans, for the most part, have tried to avoid it altogether. But in the next few years, we are in store for another upheaval in American health care–and it might just shake up American politics as well.”
Comment: In this excellent article, Jonathan Cohn discusses the enthusiasm for reform of a decade ago, and the events since. He demonstrates trends that have moved us to the threshold of another great opportunity for reform. The expanding inequities developing before us can provide the contrast that we need to demonstrate the value of health care equity. This time, instead of trying to sell the nation private health plans, let’s show them how we can deliver health care equity for all of us.
Jeff Huebner, M.D., Jack Rutledge Fellow of the American Medical Student Association, responding to the message on the ACP-ASIM request for proposals for health care reform:
I was interested in your closing comments after the ACP-ASIM post. Have you received any responses? You were absolutely correct that we must present our own vision. However, I believe it is vitally important for those groups that support single-payer to develop a plan for implementation (something that might pattern Canada’s gradual, province-based implementation) over time, so as to not allow people to be scared of “sweeping, government” reform. Mobilizing support for the Tierney and/or Wellstone bills (gives money to the states and ERISA clearance to develop their own plans) might be considered initially.
It has been demonstrated through both public opinion research and through the history of both national and state initiatives that the public becomes easily fractured in their support when universal coverage or single payer is framed as a “large, government-based takeover” or that people will lose the benefits they’re familiar with. I think this second concern (as The New Republic and New York Times articles in the past week demonstrate) has begun to dissipate and is easier to exploit right now, but the first concern is not.
For single-payer, then, to become an option during a national debate about universal coverage (which we do seem headed for again), the public must realize that health care DELIVERY will remain private (but be non-profit and publicly accountable), that people will have the option to see the doctor of their choice, etc. A discussion about the prioritization of health services resources also must be held. Focus groups should be conducted in order to explore how to frame the issue of single-payer with the public (I’m not sure if this ever has been done? Does anyone know?).
More importantly, I think those groups that support single-payer must develop a concrete, grassroots plan for how we will mobilize at least health professionals, as well as the public, in support of single-payer. By saying “mobilize,” I think it implies a sequence of events, e.g., having a plan where people raise their voices (rallies, town meetings, etc.), write their representatives, and developing press “events” (via new reports, rallies, and more — the single-payer feasibility stories have been a good start) that inject single-payer into the public debate. Continuing to support Maine’s efforts (via contacts we have, volunteering to work for them, finances, etc), remains important. Transforming the white paper from the Physicians’ Working Group on single-payer (
These are not trivial issues. It will take a committed group of leaders, strategic planning, financial resources, and a willingness to build coalitions. A multi-year plan that recognizes the importance of educating and mobilizing activists and lays the foundation, so we are ready when the political landscape becomes fertile once again (which certainly is not right now) is necessary too. Only then will we be able to effectively advocate for the much anticipated “Medicare-for-all” bill.
The American Medical Student Association (long-time single-payer supporter) has funded the Rutledge Fellow to work full-time on this issue, and contribute toward a movement that would make “Everybody In, Nobody Out!” a reality. Any other takers?
To Holiday Cheers and Health Care for All, Jeff Huebner, M.D. AMSA Rutledge Fellow
Medicare Reform, NEJM Letter to the Editor
The New England Journal of Medicine
December 13, 2001
Correspondence
To the Editor:
Why must the debate about Medicare reform be limited to the offering of two narrow choices? The proposals of both Vladeck and Wilensky (see comment) will reduce health coverage and add to beneficiaries’ costs; both authors acknowledge that the current Medicare benefit package is already inadequate and probably underutilized.
Medicare currently spreads its costs widely through the use of general income taxes. Its benefits, however, go only to a segment of the population, whereas everyone else must have health care coverage purchased by employers or themselves, leaving a large fraction of the population uncovered or undercovered. National health coverage with a defined-benefits model would spread the costs and benefits widely, and thus the high costs and high utilization among the elderly would be balanced by the low costs and low utilization among younger, healthier persons.
Shifting coverage of the elderly into the commercial insurance market would improve insurance companies’ business but would actually reduce coverage, since commercial insurance has administrative costs that account for at least 20 percent of their expenditures, whereas the administrative costs of Medicare account for only about 3 percent of expenditures. The experience with commercial Medicare health maintenance organizations has shown that the savings they achieve by reducing utilization are outweighed by administrative expenses and increasing prices paid to providers.
Using the for-profit insurance market to reform Medicare or keeping it unchanged except to tinker with the benefit package cannot be the only choices. National health coverage would solve the problems associated with Medicare and would address the needs of the 40 million people who currently have no coverage at all. Why not consider this approach?
Robert Clark, M.D. University of South Florida Tampa, FL 33612
Excerpts from the responses of the authors:
I agree with almost everything (he) says.
Bruce C. Vladeck, Ph.D. Mount Sinai School of Medicine New York, NY 10029
I disagree with Clark… I do not believe this country will adopt national health insurance for a variety of reasons, not the least of which involves the tremendous shift in power that would result from transfering the $1.3 trillion health sector to the federal government.
Gail R. Wilensky, Ph.D. Project HOPE Bethesda, MD 20814-6133
Comment: Who said anything about transferring the health sector to the federal government? Dr. Clark is suggesting national health coverage, and Dr. Vladeck essentially agrees. Except for equity, national health coverage (social insurance) has very little in common with a nationalized health care delivery system.
In the original articles (NEJM, Aug. 9, 2001), Dr. Vladeck indicated that we could have corrected the deficiencies in the Medicare program by accepting a smaller tax reduction, while Dr. Wilensky advocated for a premium support approach to reform, stating that it would be readily accepted by newer retirees since they have different expectations by virtue of their experiences with managed care health plans.
Dr. Wilensky seems to suggest that adapting to mediocrity in health care is the price that we must pay to fulfill her libertarian agenda.
Dr. Vladeck suggests that we would have the resources to improve the quality of our Medicare program but for our newly enacted tax policies.
Dr. Clark suggests that we should dilute the Medicare risk pool with low-cost healthy individuals, and that we should reduce administrative waste through public administration of a program of universal coverage. Of course, he is right. Not only should we demand comprehensive coverage for the Medicare population, we should now demand it for everyone. Accepting quality care for all of us is the price that we are going to have to pay for rejecting the libertarian agenda.
Pay Up, Patient!
The New York Times
December 12, 2001
To the Editor:
“A New Health Plan May Raise Expenses for Sickest Workers” (front page, Dec. 5) points out the downside of a new approach to corporate expense reduction. The employers’ share of a new health care product would decrease, as would the average premium, but the burden would be shifted to sick people!
This is unwise public policy. When seriously ill, most patients are not working, and their families are burdened by additional expense already. And if the major costs of modern medicine are shifted directly to patients, they are more likely to defer diagnostic procedures and filling prescriptions, and therefore get sicker. Sooner or later, we will all get the bill.
When are we going to realize the humanity, and the wisdom, of community-wide risk pools, which would spread the burden fairly to all? When will we realize the economy and efficiency of a national insurance system?
Steven Wolfson, M.D.
New Haven, CT
It's all about the money, say frustrated health care consumers, providers and agencies
The Times-Standard Eureka, California
December 09, 2001
by Jennifer Morey
“When an insurance company executive has the audacity to admit to a state senator that his company doesn’t offer drug and alcohol treatment coverage because it simply doesn’t want to spend the money, it’s a clear illustration of the severity of the health care crisis. Studies have shown that treatment is cost-effective and saves companies millions of dollars, but that doesn’t matter to this executive.”
California state Sen. Wesley Chesbro, quoting the executive:
“It’s fairly simple. We are an investor-owned company. The decision is based on actuarial data. By the time the catastrophic costs are incurred, the person will no longer be employed.”
Comment: Sen. Chesbro’s hearing was held in rural Humboldt County, a region that is partially dependent on the fragile economy of the fishing and lumbering industries. Managed care plans have failed to enable affordable access to care in Humboldt County and in other rural areas of California. Rather than seeking solutions on how to make managed care plans work for rural communities, we should be advocating for equitable distribution of our resources. A publicly administered program of universal health insurance would assure rural communities that adequate health care resources would always be available to them, and to the rest of us as well.
It’s all about the money, say frustrated health care consumers, providers and agencies
The Times-Standard Eureka, California
December 09, 2001
by Jennifer Morey
“When an insurance company executive has the audacity to admit to a state senator that his company doesn’t offer drug and alcohol treatment coverage because it simply doesn’t want to spend the money, it’s a clear illustration of the severity of the health care crisis. Studies have shown that treatment is cost-effective and saves companies millions of dollars, but that doesn’t matter to this executive.”
California state Sen. Wesley Chesbro, quoting the executive:
“It’s fairly simple. We are an investor-owned company. The decision is based on actuarial data. By the time the catastrophic costs are incurred, the person will no longer be employed.”
Comment: Sen. Chesbro’s hearing was held in rural Humboldt County, a region that is partially dependent on the fragile economy of the fishing and lumbering industries. Managed care plans have failed to enable affordable access to care in Humboldt County and in other rural areas of California. Rather than seeking solutions on how to make managed care plans work for rural communities, we should be advocating for equitable distribution of our resources. A publicly administered program of universal health insurance would assure rural communities that adequate health care resources would always be available to them, and to the rest of us as well.
Request for Comments on Draft ACP-ASIM Seven Year Plan to Provide Affordable Coverage to All Americans
American College of Physicians American Society of Internal Medicine (ACP-ASIM)
Available at the link below is “a draft seven-year sequential plan for expanding access to health insurance for all Americans. Your review of this document is requested. The Health and Public Policy Committee of the American College of Physicians – American Society of Internal Medicine has developed this draft policy paper with the view that a sequential series of steps within a specific time frame are needed to achieve the goal of access to health insurance coverage for all Americans.”
“We would appreciate your comments by January 11, 2002, so that we may incorporate them into a final draft that will be further reviewed by our committee in February 2002 and then brought to our Board of Regents for final approval.”
The ACP-ASIM request for comments is available at:
And from the draft of the proposal:
“We recognize that some will argue that the College’s proposed reforms don’t go far enough… Others will likely argue that they go too far… Some will question the political feasibility… ”
“ACP-ASIM welcomes such comments, but requests that those who disagree with some or all of the steps recommended in this paper present an alternative plan of action that would achieve affordable coverage for all Americans within the next seven years. Debate should no longer center on whether all Americans should have access to affordable coverage, but on the means to achieve that end within a reasonable period of time.”
“ACP-ASIM also recommends that the ideas in this paper, as well as alternative proposals to achieve the same objective, be discussed in community forums throughout the country. History has shown that health care reform cannot be a top down proposal emanating from Washington, D.C. Rather, the changes that are needed must be understood, guided, and supported by citizens in communities throughout the country.”
The full draft of the proposal is available at:
Comment: ACP-ASIM proposes a seven year sequential path to reform as follows: (1) A sense of the Congress resolution, (2) Expansion of Medicaid to all below 100% of poverty, and premium subsidies for public or private programs for those up to 200% of poverty, (3) Covering all remaining uninsured through premium subsidies of plans offered and approved by purchasing groups, using FEHBP as the model, and, finally, (4) Enacting legislation “to discourage individuals from voluntarily choosing not to obtain coverage” (individual mandates enforced by financial penalties).
ACP-ASIM is very serious about leading the charge to universal coverage. Although they previously supported a single payer approach, they are now adopting the Clinton approach that we must bring all parties together, including the health plans. This approach can only perpetuate the waste and inequities that are inherent in our fragmented system.
It is easy to respond to the ACP-ASIM proposal with a critique of the flawed health policies perpetuated by their plan. The ACP-ASIM policy committee already fully understands the implications of its proposals, both positive and negative. They need to hear much more from us than a mere critique. They have challenged us to provide “an alternative plan of action that would achieve affordable coverage for all Americans,” a plan that “must be understood, guided, and supported by citizens in communities throughout the country.”
The challenge is ours. We have the policy. We understand the policy applications that would bring equity to health care, while maintaining affordability. We now need to create a specific action-plan document that we can present to the ACP-ASIM, and, more importantly, to the nation. The alternative is sequential incrementalism that will address only the issue of coverage while perpetuating and solidifying the inequities and flawed policies of our current system. For us to accept sequential incrementalism by default would be a greater moral transgression than that of those that are merely manipulating our system for their own personal gain.
A Health Maze: Which Way Out?
The New York Times
December 9, 2001
Opinion
Excerpts from letters in response to the article, “A New Health Plan May Raise Expenses for Sickest Workers” (New York Times, Dec. 5):
JOHN GLASEL, Secretary, Health Care for All, New Jersey:
“Most other advanced countries have universal health systems financed by more equitable taxation. We need the same here, to end the worsening health care apartheid that belies our American traditions of freedom and equality.”
SHEILA FEIT, M.D., Syosset, N.Y.:
“A description of a user of this plan says it best: ‘He used most of his health savings account this year, but does not expect to do so next year.'”
“Who does? When will we learn?”
SUSAN SCHEER, Executive Director, Center for Independence of the Disabled in New York:
“What a concept – medical insurance that only covers the needs of healthy people and discourages people with disabilities and their family members from pursuing healthy and independent lives (and jobs)!”
ROBERT JAFFE, Deputy Director of the New York affiliate of the National Abortion and Reproductive Rights Action League:
“It would be unfortunate, and financially foolhardy, for employers and health insurers to embrace a plan that makes families defer going to the doctor for basic primary care because they are trying to hold down their out-of-pocket expenditures.”
RONALD A. WILLIAMS, Executive Vice President, Aetna:
“‘A New Health Plan May Raise Expenses for Sickest Workers’ (front page, Dec. 5) did not mention that consumers are demanding more choice and flexibility in how they use their health benefits.”
“Those who do not find that the product meets their needs can select a more appropriate plan design.”
Comment: Quoting from the original article, “Pressed by employers, some of the nation’s biggest insurers are introducing a new kind of health plan… ” and “Eventually, however, consultants expect many employers to offer only the new type of plan.”
Aetna and the other insurers must cater to their customers, the employers that purchase their plans. It is disconcerting to see the EVP of Aetna using dishonest rhetoric to placate the patient-consumers who are being shafted by these innovative insurance products. This detrimental co-conspiracy of the employers and the insurers has established clearly the fact that they have abandoned their ethical obligation to assure that patients will always have access to health care whenever needed. It is time to dismiss them and establish a public process that will assure that our abundant health care resources will be distributed equitably based on patient needs.
Status of the Medicare Plus Choice Program
United States House of Representatives
Committee on Ways and Means
December 4, 2001
Representative Pete Stark (D-CA):
“I’d say, Madam Chair, that it’s perhaps time that we recognize that less than 15 percent of the seniors have signed up for these Plus Choice plans. They have caused more problems than all the rest of Medicare put together. The premium support plan that the Medicare Commission came up with is a blatant attempt to shove people into these Medicare Plus Choice plans. So when you don’t have one in eight people who like them, why don’t we just can them, use the money to support the Medicare system, provide perhaps a federal Medigap policy that would cover all of our beneficiaries fairly? And, one of these days, we might even get around to a drug benefit, if we stop giving big tax breaks to wealthy people.”
Consumer-directed coverage promoted by policy group
American Medical News
November 5, 2001
by Amy Snow Landa
Wye River Group on Healthcare, a “broad-based policy group that represents employers and other health care stakeholders is encouraging companies to adopt a ‘consumer-directed’ approach to funding their employee health benefits — a move that has been welcomed by the AMA.”
“The group — whose sponsors range from Wal-Mart to the American Hospital Assn. — has developed a 60-page ’employer’s guide’ that advises companies on how they can offer their workers ‘consumer-directed health care benefits,’ more commonly known as defined contribution plans.”
“The Wye River Group has begun promoting its ideas on consumer-directed health care benefits to the White House and to Congress.”
“A number of tax and regulatory changes would not require congressional action but could be made through executive order, according to Jon Comola, an Austin, Texas-based health care consultant who chairs the Wye River Group.”
Mark McClellan, MD, a member of the President’s Council of Economic Advisers:
“I think the Wye River Group proposals fit in very well with our overall direction.”
For the Wye River Group’s “Employer’s Guide to Patient-Directed Healthcare Benefits”:
Comment: The “Employer’s Guide” produced by the Wye River Group describes “Patient-Directed Healthcare Benefits,” especially through “Personal Health Accounts” and/or “Flexible Spending Accounts.” These are variations of the Medical Savings Account theme which enable employers to pass inflationary health care costs on to their employees. It is no wonder that the Wye River Group is supported predominantly by business interests.
Insurance companies, not to be outdone, are now creating plans that also incorporate the Medical Savings Account theme within the structure of their plans.
Providers, in no position to negotiate, will be forced to accept the dictates of the “insurance-industrial complex.”
And patients? If they need care, their accounts will be depleted and many will exhaust their personal funds before catastrophic coverage begins. At that point the patient is free to direct his or her own health care benefits.
But this will solve health care problems for employers by controlling their costs and for insurers by reducing their risks. Did we forget anyone?
