Oh boy. Republicans are proving once again that they know little or nothing about health care...big surprise. Not only that, they keep pushing "single payer" health care ideas, without even knowing they're doing it.
Under the proposed change, the state would create a list of set prices for workers’ compensation medical procedures. Forty-four states have those lists, which are called "fee schedules." The prices in Wisconsin would be based on average prices negotiated by group health plans in the state.
Even the enemy of hard working Wisconsinites, Wisconsin Manufacturers and Commerce, thinks this is a good idea. Except once again, this is part of universal, single/all payer health care systems worldwide, a not-so-free market, money saving plan:
"In all-payer rate setting, all of the insurers negotiate jointly with all of the health care providers, and set on one specific price for each procedure."
Scott Walker's Single Payer Government Health Care Idea: It wasn't so long ago Walker wanted to go single-payer statewide for public employees. Of course his band of plundering Republican pirates whined that it would destroy the unaffordable free market system we have now:
WSJ: The Walker administration is considering switching 236,000 state employees and family members from a competitive HMO model, in place since 1984, to a self-insured program … Self-insuring, paying benefits directly and assuming the risk, instead of buying insurance, can save money while maintaining strong benefits, an organization of self-insured employers said.
If Walker is talking about what is essentially a single payer system for state employees, and now Republicans want to save money by establishing lower set fees, what the hell is the disconnect? I am seeing an incredible irony in what Walker and now Republicans are proposing.
To start, here's what I've been saying for some time:
All payer, single payer, Medicare for all, universal health care is simple: All doctors are your doctors, all hospitals are your hospitals. No bills, co-pays or deductibles. We could cut costs by a third to half of of what we're paying now. We won't. Are we insane?
And yet, as this reaction to a recent story about Medicare Advantage demonstrates, many people don't seem to understand our health care system...at all:
MSNBC's Ali Velshi gave us the best presentation yet showing us how backward and downright bizarre the Republicans free market idea of health care is; we're the only country doing it. He followed that up with the effect cut backs on Medicaid would have on dementia and Alzheimer's seniors on Medicare:
My favorite candidate running against Paul Ryan recently tweeted this simple truth:
Another great look at the myth of health care greatness before the ACA was discussed belwo on WPR's On Point. I edited the discussion to hit on the main points, especially the "free market" control wielded by insurance companies, which is anything but:
The Ted Cruz ACA "Poison Pill" Con: The Senate's BCRA is going to get passed, even if 22 million people will lose their health care insurance.
The Ted Cruz plan will please his GOP base; by purposely making ObamaCare's plans collapse. When they do, Cruz can say, "I told you so:"
Sen. Mike Lee (R-UT) conditioned his support (of the BCRA) on an
amendment proposed by his colleague Cruz. The gist is this: Health insurers
could sell non-Obamacare plans as long as they also sold Obamacare-compliant
insurance. The proposal does (eventually) erode Obamacare's protections for
people with preexisting medical conditions, because it would likely segment the
insurance market into healthy and sick pools. Healthy people would buy
non-Obamacare plans, while sick people would buy the more robust Obamacare
coverage. That would drive up premiums for the ACA marketplace.
Clever. It would also make people appreciate their stripped down high deductible junk insurance policies.
Not Letting the Free Marketplace Work: For a party touting the wonders of the free marketplace, they sure know how to mess with it. While complaining about some insurers leaving the ObamaCare marketplaces, they never waited around to see other insurers take their place. That's what markets do:
Centene fills Missouri's empty counties. You might have missed it in the rancor over the health care debate in Washington, but health plans have been stepping in to fill Obamacare's bare-shelf markets. Missouri is now the latest state to benefit, after Centene announced it would sell plans there next year.
That's right, the latest state.
Republican "Health Care" Tax Cut Plan and Stock Market Payoff: If you're going to make insurers lots of money, buy their stock:
Health industry stocks, including insurance giants like UnitedHealth, have surged as Republicans have moved forward with their repeal effort, which rolls back broad taxes on healthcare firms while loosening consumer regulations. Republican Sen. James Inhofe of Oklahoma purchased between $50,000 to $100,000 in UnitedHealth stock ... Rep. Mike Conaway, a Texas Republican and member of Speaker Paul Ryan’s leadership team, added a health insurance company to his portfolio ... An account owned by Conaway’s wife made two purchases of UnitedHealth stock, worth as much as $30,000, on March 24th, the day the legislation advanced in the House. As we’ve reported, the House of Representatives has actively fought efforts to enforce the law after the Securities and Exchange Commission attempted to investigate one congressional staffer accused of passing healthcare information to a set of hedge funds.
Here's one former Republican making an amazing admission:
Republicans are really great time wasters, debating how little health care coverage should be allowed before voters turn on them. Reelections matter to them. When the Democrats passed the ACA, they knew what the risks were, and it didn't turn out well for them.
But there is a solution, and it's part of the discussion they don't want to have.
All-Payer: I used to describe all-payer as a national health care plan of mandated coverage and prices. It was a common element of universal or single payer systems worldwide:
Daily Kos: As Vox's Sarah Kliff rightly highlighted, "France, Germany, Japan, the Netherlands, and Switzerland all use some version of all-payer rate setting." Even with hundreds or thousands of private insurance plans, since 1980 all five countries have experienced much slower growth in health care spending than the United States (see chart below). All-payer rate setting is a powerful reason why: In all-payer rate setting, all of the insurers negotiate jointly with all of the health care providers, and set on one specific price for each procedure...Single-payer health care systems save money in two ways: reducing administrative costs and increasing the bargaining power of health insurers. This is true of all-payer rate setting systems, too.
Even without insurance, the lower row of prices wouldn't bankrupt most American families:
In contrast, the Republican vision for health care is a return to the Hobbesian struggle of each against all in the American health care ecosystem. And that means more pain for consumers, insured and uninsured alike. Or as Vox founder Ezra Klein put it in March: “American health care can be free market or cheap. It can’t be both.”
Before the ACA:
A 2011 report by the Department of Health and Human Services found that before the ACA took full effect “62 percent of individual market plans did not cover maternity care, 34 percent did not cover substance abuse services, 18 percent did not cover mental health coverage and 9 percent did not cover prescription drugs.”
The Four Basic Health Care Systems: This is what we should be debating:
Sick Around the World describes the four basic models including the "out of pocket" approach, the completely government-run system implemented in the UK, the Bismarckian social insurance strategies in Germany and Japan, and the single-payer system in Canada that’s emulated by South Korea and Taiwan:
Reid reports next from Japan, which boasts the second largest economy and the best health statistics in the world. The Japanese go to the doctor three times as often as Americans, have more than twice as many MRI scans, use more drugs, and spend more days in the hospital. Yet Japan spends about half as much on health care per capita as the United States. One secret to Japan's success? By law, everyone must buy health insurance—either through an employer or a community plan—and, unlike in the U.S., insurers can neither turn down a patient for a pre-existing illness, nor are they allowed to make a profit. Reid's journey then takes him to Germany, the country that invented the concept of a national health care system. For its 80 million people, Germany offers universal health care, including medical, dental, mental health, homeopathy and spa treatment. Professor Karl Lauterbach, a member of the German parliament, describes it as "a system where the rich pay for the poor and where the ill are covered by the healthy." As they do in Japan, medical providers must charge standard prices. This keeps costs down, but it also means physicians in Germany earn between half and two-thirds as much as their U.S. counterparts.
Republicans are pushing a "buy what you can afford" health care insurance model. The list of physicians below shows you how difficult it would be to make those choices. And don't be naive either, insurers will charge much more for the popular choices, since they aren't about to lose money on cheap stripped down policies. And how cheap can prices go to maintain the yearly incomes below? AnnualPhysician Compensation Report:
