'Indeed there are even some very serious concerns that with a public option, most employers will dump employee benefits. (This will leave) people no choice but a government plan with no clear cut selection of plan benefits as many private insurers (currently) offer'.
Kira A. Geraci-Ciardullo M.D. MPH
in the absence of health care reform, this may happen just due to ever rising premium. folks need to be mindful of this trend.
ReplyDeleteFrom David Leonhardt, NYTimes:
ReplyDelete"Health insurers often act like monopolies ... spared the rigors of true competition, ... they end up with high costs and spotty service.
You might think, then, that a central goal of health reform would be to offer people more choice. But it isn’t.
Real choice is not part of the bills moving through (congress); Both parties are protecting the insurers."
http://www.nytimes.com/2009/08/26/business/economy/26leonhardt.html?_r=1&hp=&pagewanted=print
Crowd-out (in this case, the idea that employers will abandon coverage, driving people to enroll in the public option) is a real concern of many physicians, hospitals, and especially insurers. One possible solution to avoid crowd-out is the employer mandate. If employers are obligated to provide coverage but patients can opt out and enroll in the public plan instead, this actually drives competition. Insurers would have to keep quality high and administrative costs low (something they do horribly compared to existing public insurance options). Less money would be wasted on paying executive salaries, and a greater proportion of the premiums would go toward providing health care.
ReplyDeleteBusinesses will look at an Excel sheet and run the numbers - does the cost of present insurance coverage exceed the "tax" of HR 3200? If it's cheaper to simply pay the tax, then say good bye to benefits. Devil, meet Details.
ReplyDeleteWe have been looking at the government insurance plan as an either or. Perhaps we're wrong. Setting aside the cost estimates which probably are low ball, let's look at the nuts and bolts of running a government insurance plan. Using the Medicare example, we find that administration of payments has been subcontracted - in our area to NGS. Having NGS or its ilk as the administrator of 16% of GDP is truly frightening. I'm hoping I'm wrong.