Friday, December 24, 2010

What Will Happen To The Obama's Health Care Reform Legislation In 2011

The results of the midterm elections, as they relate to the survival of the Obama’s Health Care Reform Legislation bring excitement to some, and a sense of forboding to others, depending on what lens you are looking through, as we enter the New Year.

The Republicans won more than 60 seats and took control of Congress. How this could have happened in a country only two years ago where Republicans were seen as villains is indicative of Republican ingenuity and marketing skills.
Meanwhile, as the celebration goes on and confities are still flying, there remains across the nation an uneasy sense that the Obama’s health care legislation will be gutted, and health premiums will continue to rise putting affordable health insurance out of the reach of the majority of Americans.
Leading to the passage of the Hearth Care Reform Bill, the discussions were centered on who will control the premiums paid by policy holders. Because no definitive decision was made on this issue, the Health Care Reform Legislation that passed essentially left the old system in place. With this problem unsolved, we are, in effect, moving toward an approaching national health care crisis.

Talking about who should run the health insurance business, private companies are designed to run efficiently. An investment is made with the expectation that more than was invested will be realized. In this business model, the company’s primary concern is its own survival through generating profits. It will cut wages, lay off workers, reduce benefits and increase co-payments, modify its products, or relocate to reduce it cost of doing business in order to survive.
There is nothing sinister in all this, nor could one say companies are evil by their very nature. To produce the employment, wages and benefits on which society depends, companies must first survive by pursuing profits. It goes without saying that when private companies run the health insurance business, health premiums will continue to rise far beyond where they are today.
The alternative is to give control of health insurance to a non-profit organization designed to run efficiently, but without the profit motive. This organization will aim at keeping costs and premiums even, and whenever an unintended profit is made, it is given back to policy holders in the form of lower premiums.
So far we are doing good until we come to the question, what will happen to the revenues of the companies currently running the health insurance business, as it is being taken over by a non-profit organization.
Any attempt to drastically reduce the revenues of these companies will ignite a fight in the halls of Congress that will spill over into the streets. It will be a fight that will leave all wounded, and no winners. It is a fight that must be avoided.
A compromise could be reached where the companies that currently run health insurance will retain their present levels of revenues, but a change in their function. Following the change, their revenues will no longer come from premiums paid by policy holders, but from providing health information directly to patients and their doctors.
As the baby boomers move into their sixties and seventies, no more is needed than current statistics to indicate that the demand for health services will increase significantly. Accurate and regularly updated health information that is easily accessible by doctors and patients will become crucial than any other time in the past.
Health insurance companies like Blue Cross Blue Shield, United Health Care and Aetna already have this information, and have in place state of the art systems to protect the privacy of their customers. They should have no problem continuing what they are already doing.
I am looking at a business model in which health insurance companies will set up for their customers individual web pages, we shall called, “My Health Page” or “My Wellness Page”. Here, the full medical history of each patient will reside, pertaining to medical procedures he or she has done, current prescriptions and known drugs and activities that may conflict with them.
Doctors will be mandated to consult the health or wellness web pages of all patients treated by them to avoid duplication of medical procedures, or prescribing conflicting drugs and activities for their patients. The owner of the health or wellness page may also access it at any time after meeting certain security requirement. For this service both doctors and patients will pay a small fee.
Because the use of the health information system will be mandatory, doctors as well as patients who are curious to know about the current state of their health will use it with the result that the new health information companies will be guaranteed a steady flow of revenues.
Still, in any major reorganization, there will always be some dislocations: a short period of time where the companies affected adjust to the new realities of their corporate lives. The non-profit organization that takes over health insurance, will look to the laid off workers of former health insurance companies for the skilled staff it will need to run it operations.
In tandem with removing the profit motives from health insurance, the number of policy holders should increase beyond current levels, which is to say, everybody earning an income should contribute to the health insurance pool with figures ranging from 2% to 6%, or some other computation of taxable income.
This guarantees not only that the health insurance system will remain solvent into the future, but as the number of policy holders increases, health premiums will remain low and affordable for the majority of Americans.
There will always be detractors who will argue that turning over control of health insurance to a non-profit organization is government take-over of the National Health Care system, and will eventually lead to the rationing of health care services.
People who make this argument do so because they have the means to pay for health premiums at whatever price. Average Americans who grapple daily with the decision to buy food for their families, or to buy health insurance are not so lucky, and they go to bed every night praying they or their children will not wake-up with a cold.
The suggestion that Americans who cannot afford health insurance could be helped by health vouchers is a smokescreen. So long as the upward pressure remains on health premiums, everytime premiums go up, they will be passed onto the patient or the government agency paying the premiums, and nothing would have changed.
In the end, the last word on health insurance will be affordability, even as the nation watch the remaking of the Obama's Health Care Reform Legislation in a new Republican Congress.

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