Post by AztecWilliam on May 10, 2013 11:49:48 GMT -8
ObamaCare's roll out has been rocky, to say the least. More and more, it is becoming clear that the ACA was poorly thought and will cause far more problems than is solves. Here are some interesting comments (from the New York Times) that touch on some of the the new law's negatives . Two of the three writers are themselves MDs.
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To the Editor:
I am quizzed daily by my patients regarding health care reform. I point out that the problem is not Obamacare in particular, but rather the entire concept of using insurance to cover small financial transactions, thus warping normal market pressures and driving medical costs through the roof. I say, “Imagine what a gallon of milk would cost if we insured groceries.”
Rather than a quick financial transaction at the front desk to cover my service and office overhead, I have armies of people processing my claims, and the insurance companies have theirs.
The answer to much of our health care woes? Marry the Democrats’ insurance mandate to the Republicans’ health savings accounts. Our culture will not refuse care, so everyone needs to participate; thus the mandate. The health savings account provides the structure for people to spend their own money on everyday medical expenses, returning market forces to rising costs.
DOUGLAS HAMMERSTROM
Colorado Springs, May 5, 2013
The writer practices family medicine.
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To the Editor:
The RAND study comparing groups each receiving a different amount of health insurance coverage and finding “the level of insurance had no significant effect on the participants’ actual wellness” led Ross Douthat to propose a variety of remedies for the seeming overexpenditure. Each related to today’s common fee-for-service mode of paying for health care.
Fee-for-service is inflationary and has resisted efforts at cost control for decades. Only through risk-adjusted capitation and accountability through primary care physicians will this country get to cost control, and where quality of care and patient satisfaction are also achieved.
MITCHELL T. RABKIN
Milton, Mass., May 6, 2013
The writer, a professor of medicine at Harvard Medical School, is president emeritus of Beth Israel Deaconess Medical Center, Boston.
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To the Editor:
Ross Douthat describes the central dilemma of the health care system: expanded insurance doesn’t improve health outcomes. Unfortunately, Obamacare just doubles down on the dysfunctional system.
The underlying flaw is that the incentives are perverse on all three sides of the health care triangle. Patients, often divorced from costs, overuse. Health care professionals overcharge, and insurance companies try to deny claims.
Mr. Douthat’s solution — that health insurance policies operate like normal insurance to protect people from financial catastrophe — makes a lot of sense.
JANICE GEWIRTZ
Mountain Lakes, N.J., May 6, 2013
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www.nytimes.com/2013/05/10/opinion/the-health-law-and-its-incentives.html
One of the worst features of ObamaCare, touched on a bit in one of the above comments, is that it is not really insurance at all. Real insurance uses actuarial tables and other means of predicting the likelihood that a given event will happen. ObamaCare, by including all sorts of coverage that should be considered optional, throws those accepted practices in the trash.
Were ObamaCare's concept to be extended to auto insurance, we would have policies that covered tires, brakes, oil changes, headlights, steering gear, etc. Clearly, if that were so, the cost of our insurance would go way up. And needlessly so, since the features mentioned should be considered regular wear-and-tear items. You buy insurance to cover you against unexpected and serious occurrence: accidents, falling trees, vandalism, etc.
Whoever designed this contraption owes us an apology. No, that would not be enough. How about Hari Kiri? Okay, maybe not that.
AzWm
=====
To the Editor:
I am quizzed daily by my patients regarding health care reform. I point out that the problem is not Obamacare in particular, but rather the entire concept of using insurance to cover small financial transactions, thus warping normal market pressures and driving medical costs through the roof. I say, “Imagine what a gallon of milk would cost if we insured groceries.”
Rather than a quick financial transaction at the front desk to cover my service and office overhead, I have armies of people processing my claims, and the insurance companies have theirs.
The answer to much of our health care woes? Marry the Democrats’ insurance mandate to the Republicans’ health savings accounts. Our culture will not refuse care, so everyone needs to participate; thus the mandate. The health savings account provides the structure for people to spend their own money on everyday medical expenses, returning market forces to rising costs.
DOUGLAS HAMMERSTROM
Colorado Springs, May 5, 2013
The writer practices family medicine.
======
To the Editor:
The RAND study comparing groups each receiving a different amount of health insurance coverage and finding “the level of insurance had no significant effect on the participants’ actual wellness” led Ross Douthat to propose a variety of remedies for the seeming overexpenditure. Each related to today’s common fee-for-service mode of paying for health care.
Fee-for-service is inflationary and has resisted efforts at cost control for decades. Only through risk-adjusted capitation and accountability through primary care physicians will this country get to cost control, and where quality of care and patient satisfaction are also achieved.
MITCHELL T. RABKIN
Milton, Mass., May 6, 2013
The writer, a professor of medicine at Harvard Medical School, is president emeritus of Beth Israel Deaconess Medical Center, Boston.
============
To the Editor:
Ross Douthat describes the central dilemma of the health care system: expanded insurance doesn’t improve health outcomes. Unfortunately, Obamacare just doubles down on the dysfunctional system.
The underlying flaw is that the incentives are perverse on all three sides of the health care triangle. Patients, often divorced from costs, overuse. Health care professionals overcharge, and insurance companies try to deny claims.
Mr. Douthat’s solution — that health insurance policies operate like normal insurance to protect people from financial catastrophe — makes a lot of sense.
JANICE GEWIRTZ
Mountain Lakes, N.J., May 6, 2013
====================
www.nytimes.com/2013/05/10/opinion/the-health-law-and-its-incentives.html
One of the worst features of ObamaCare, touched on a bit in one of the above comments, is that it is not really insurance at all. Real insurance uses actuarial tables and other means of predicting the likelihood that a given event will happen. ObamaCare, by including all sorts of coverage that should be considered optional, throws those accepted practices in the trash.
Were ObamaCare's concept to be extended to auto insurance, we would have policies that covered tires, brakes, oil changes, headlights, steering gear, etc. Clearly, if that were so, the cost of our insurance would go way up. And needlessly so, since the features mentioned should be considered regular wear-and-tear items. You buy insurance to cover you against unexpected and serious occurrence: accidents, falling trees, vandalism, etc.
Whoever designed this contraption owes us an apology. No, that would not be enough. How about Hari Kiri? Okay, maybe not that.
AzWm
