June 8 - Potpourri



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Methods of cost control: Capitation

As I have mentioned previously, the extension of health insurance to all Americans by 2013, as proposed by President Obama, will, by itself, do nothing to control the escalating costs of health care. Rather, by increasing demand without correspondingly increasing supply, there is every reason to believe that it will put additional upward pressure on the cost curve. A point of general agreement among health care economists is that the prevalent fee for service model for the delivery of physician, hospital and other professional services is a significant source of the cost problem. This model gives strong incentives to providers to direct patients toward more, and more intensive, services, and for both patients and providers to select services and procedures that have any possibility of a marginal positive result, even if the cost is vastly out of proportion to the possible benefit. Further, economically speaking, the patient and the payer (whether the government or private insurance co...
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Go Wyden Go!

What If They Passed Single-Payer and Didn't Tell Anyone? - WashingtonPost.com : The Wyden folks quietly slipped in an amendment giving states enormous flexibility to experiment upward. Essentially, states can ask the federal government for a waiver that allows them to keep the federal funds they're receiving and do pretty much anything they want with them, so long as the coverage they provide is "at least as comprehensive as required under the Chairman’s Mark" . . . . If we don't end up with a public option at the federal level, at least have the ability for states to broaden the public participation in the system. The states are often considered, and allowed to be, crucibles of experimentation for policies like this. It's got the potential to do some real good.
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Facebook Health Care Status Message Petition

Right now, there is a status message petition cycling around Facebook : No one should die because they cannot afford health care, and no one should go broke because they get sick. If you agree, please post this as your status for the rest of the day. I went ahead and "signed" this, because it's good as a strong, clear statement of a guiding principle. I have some issues with it as a statement of absolutist philosophy. When ever you get into absolute statements , you get to the question of health care as a human right. Break down the statement above: "No one should die because they cannot afford health care". Interpreted one way, that's true - no one should die because they can't afford basic preventative care, well established and effective curative medicine, etc. But what about someone who is in a vegetative state that can survive an extra week only if they have a heart and lung transplant that costs a million dollars? Laying aside the scarcity of orga...
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