Physicians Practice - July/August 2008 - (Page 36)

HEALTHCARE REFORM Washington, D.C., is even less optimistic about major systemic reform in the near term, regardless of which party controls Washington in 2009. Blumberg does think a system in which “a certain level of coverage,” ﬁnanced through taxation or other governmental means and agreed upon from a political and social standpoint, could be feasible via a public/private partnership. This basic coverage might be provided by insurers reimbursed by the government. Individuals wanting broader coverage could purchase supplemental insurance. “I think that is deﬁnitely a possibility and that we could make it work,” says Blumberg. But she adds, “You would have to think really hard about how to make sure that any supplements that individuals buy outside that system don’t impose greater costs on the public system.” Also essential, says Blumberg, would be creating additional incentives for insurers being paid the same amount for the government-mandated “minimal package” of care. Such incentives, says Blumberg, are necessary to encourage providers who are not competing on price to deliver high-quality care in an efﬁcient and effective manner: “There are ways to do it, but it’s not simple. You need to think hard about the incentives you’re setting up to maintain and create efﬁciencies in health insurance purchasing.” Blumberg admits she’s a bit jaded. “So I think the most likely scenario is that nothing is going to change very signiﬁcantly,” even if the White House changes parties next year, she says. “Comprehensive health insurance and universal coverage is, to me, a very worthy goal for us as a nation, and I hope we are moving in that direction,” she says. “But we can’t go into it thinking that it’s not going to require signiﬁcant new government revenues. And I’m not quite sure that the country is willing to commit to that, given the other issues we need to deal with ﬁnancially.” “But,” Blumberg adds, “I hope I’m wrong.” WHAT THE CANDIDATES ARE SAYING Breaking Down Obama, McCain Proposals BY SHIRLEY GRACE Healthcare is a right all Americans should enjoy. That’s virtually the only point on which Barack Obama and John McCain agree when it comes to healthcare reform. Beyond that, each candidate’s proposed trip down Reform Highway varies distinctly. For example, should the American people have to buy health insurance? No way, says McCain. He believes that any mandates smack of socializing our system — that would ruin it, he says. Obama wants to mandate coverage for children and young adults up to age 25, while the rest of us would face no requirement to buy insurance. (Hillary Clinton, before losing the nomination and endorsing Obama, argued for a national mandate that would apply to everyone.) The Chicagoan also wants to create a national insurance program that would provide coverage to everyone who wants it, with employers not already providing workplace coverage forced to chip in. Price tag: between $50 billion and $60 billion, by Obama’s own estimate, partly ﬁnanced by a rollback of the Bush tax cuts. McCain ridicules the plan as leading inevitably to a government healthcare monopoly. McCain has a different idea: He says universal coverage will emerge not through mandates and subsidies but by altering the tax code. Replacing the current tax exemption on employer-sponsored insurance with a tax credit — $5,000 for families and $2,500 for singles — to purchase individual insurance will encourage the development of a more robust market, he argues. Democrats say that if the tax exemption for employer health beneﬁts were lost, many employees would lose their coverage at work, yet the price of insurance on the individual market would still be too high. According to the Kaiser Family Foundation, the average annual premium for employer-sponsored health coverage last year was about $12,000, with about $4,000 coming out of the employee’s pocket. Neither candidate is a fan of the current insurance/pharma/employer trifecta that underpins much of healthcare in the U.S. Indeed, this model has done much to hamper healthcare accessibility and delivery. McCain believes that better access to drugs, especially for seniors, is in order. His record shows him working hard to help 36 | PHYSICIANS PRACTICE | JULY/AUGUST 2008 WWW.PHYSICIANSPRACTICE.COM http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - July/August 2008

Physicians Practice - July/August 2008 Contents The Bigger Picture: Battle Royale in the EMR Market Letters Physicians Practice Pearls: Hire Right Noteworthy Cover Story: Healthcare Reform: Voting for Change Patient Relations: Dealing with Problem Patients The tech Doctor: Is Self-Service Medicine Inevitable? Technology: Do EMRs Make You a Better Doctor? The Guide Idealab: Cash-Only Care Still Works The Administrators Desk: Who’s in Charge? Ask The Experts What Went Wrong: ‘Why Our Great Idea Didn’t Work’ Coding Start It Up: How to Launch a Practice: Operations Partnership: Don't Let Partner Conflict Destroy Your Practice Appraisals: What’s Your Practice Worth? Getting Advice: How to Hire a Consultant Classifieds Advertiser Index

Physicians Practice - July/August 2008

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