I mentioned earlier my belief that limiting medical malpractice liability won’t do much to drive down the cost of health care. So, what will? My favorite health care futurist — ok, the *only* health care futurist I know — Joe Flower, has a list. Click through the link for the narrative, but the list is as follows:
1. Single payer.
2. “Robust” public option.
3. Limiting medical loss ratios.
4. Negotiating drug prices.
5. Bundling.
6. Publishing outcomes.
7. Publishing prices.
8. Banning discounts.
9. Giving a premium to integrated “accountable care organizations.”
10. Increasing subsidies for digitization, tied to productivity improvements.
11. Subsidizing automation.
12. Standardization and checklists.
13. Warranties.
The issue of “medical loss” is one that really captures my attention. It has to do with what percentage of health insurance premium dollars actually go toward providing health care. A high percentage suggests an efficient health care system and a low percentage suggests an inefficient system. Flower has this to say about medical loss in the U.S. versus Europe:
Many European countries dictate that health plans must return 85% or 90% or 92.5% of the premium paid in as medical services paid out. U.S. health plans, in contrast, compete on (and brag to Wall Street analysts about) how low their medical loss ratio is. Some are as low as 60%.
This is shameful, and, really, indefensible. I certainly know that the percentage of my premiums paid out (for my care) has got to be 10 percent or less. Since I don’t presently need a lot of services, I can only hope the insurance company is using my premiums, as they should, for someone who is really sick and whose premiums would never cover the cost of a really bad medical problem. Well, I know it’s not that simple, and they are likely in part to be going to shareholders and executives and worker bees. But I wish any of “my” money not needed for me is going for something for an average person, like me.
“Many European countries dictate that health plans must return 85% or 90% or 92.5% of the premium paid in as medical services paid out.”
Wow! I bet Im not the only one who never heard that statitic before. It should go to top of the list as a model for the first piece of legisaltive alternative to a public option.Keep healthcare private as long as we can make it public-friendly.That possibly might work! Very pragamatic.
You cited data when noting the small but modest role of tort reform in helping with health care. Does he (or someone) have data on any of these?
I’d guess that some of these would increase costs; some would decrease costs, but by less than tort reform; and others might drive down costs but would lower quality.
What’s “indefensible” is the idea that any of this is any of government’s business.
Government’s job is to enforce contracts and punish violent offenders; it most emphatically is NOT to “make everyone’s life better.”