Healthcare. Okay. Now What Do We Do?
Craig Hasday
President, National Employee Benefits Practice | Directing Strategic Employee Benefit Growth | epicbrokers.com
What a week it’s been. I am not sure why President Trump thinks that his latest attempt to coerce the Republican Congress will work better than his past efforts. The Democrats relied on 50 votes to get the Affordable Care Act (ACA) through and now the Republicans are trying to rely on 50 votes to make their mark. The Congressional Budget Office scoring on repeal and replace was a disaster. And it doesn’t take a lot of reflection to realize that there is no turning back on some of the ACA changes – for example, guaranteed issue and Medicaid expansion – which the states are going to have a hard time backpedaling on politically. With reality setting in perhaps we can now collectively agree that we need bipartisan commitment to fix healthcare.
Here are some thoughts:
- Increase the individual penalty so that the free riders get hurt if they aren’t in the system. Medicare does this very effectively and can be a model.
- Increase rating bands from three to five. 27-year-olds simply can’t afford to subsidize older Americans to the extent that we have asked them to do so.
- Create a federal system to backstop high cost claimants. The luck of the draw should be spread evenly, not just to the risk pools where they fall.
- Rein in pharmacy inflation and mandate transparency.
- Can we do something about tort reform?
There’s a start. Hopefully it will get some traction.
I write weekly about healthcare in America and employee benefits in Frenkel Benefits' blog.
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Pathologist at Associates in Pathology
7 年Agreeing on what benefits should be included is actually preety simple madicare and medicaid do it every year. The issue is cost control of which the lowest hanging fruit is allowing the health system to negotiate drug prices. They already do it with Drs and hospitals by imposing DRGs. Having a single payer should knock 15 to 20% off costs right off the bat since that is the bottomline difference in administrative costs between medicare and private insurance.
Employers: Cost-effective health insurance benefits in the USVI & FL | Local Service backed by Global Resources
7 年Completely agree - single payer or Medicare for all sounds great except no one can agree with a "basic" or baseline benefit. A lot can be done - too fragmented. Washington is a joke - posturing and playing with such a serious and difficult issue. Love your writings - thank you and keep it up! Warmest regards.