The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Health Care Reform Odds and Ends

Posted by Alan on April 27, 2010

Depending on your perspective – and stress level – every morsel of information about health care reform is either big news or not. But regardless of whether you perceive the information beginning to emerge as substantial or just more hints about what is to come, the good news is the information is coming. This post presents some odds and ends concerning health care reform along with some interesting resources readers may want to know about.

  1. USA Today has a short (surprise, surprise) article on upcoming key dates concerning health care reform.
  2. Publicly traded companies are required to disclose about possible risks to their future earnings and performance. When a number of large enterprises began reporting that health care reform would hurt their earnings, however, some lawmakers were, as the New York Times put it “skeptical.” Now that they’ve investigated the matter, however, the Times is reporting that “House Democrats have concluded that the companies were right to tell investors and the government about the expected adverse effects of the law on their financial results.
  3. Health care reform will not lower the cost of health insurance for most Americans. In fact, given the taxes imposed on medical suppliers and carriers, restrictions on health plans ability to manage risk, the incentives for some healthy individuals to go without coverage until they need it, and a host of other provisions in the bill, it is inevitable that health insurance premiums are headed up – steeply and soon. Politicians will no doubt pound on carriers for this result, but serious lawmakers realize that the only way to restrain the cost of medical insurance is to restrain the cost of medical care. The New Hampshire legislature is showing signs of dealing with this reality. Bloomberg recently reported lawmakers in the Granite State are considering establishing a board to review hospital costs.
  4. The Centers for Medicare & Medicaid Services’ Office of the Actuary released their analysis on the Patient Protection and Affordable Care Act. The independent review is given great weight. Not surprisingly, however, what someone takes away from the report seems to reflect more about that someone than the data in the report. Just check out some of the comments about the CMS report gathered by the Kaiser Health News site. Given that no law delivers on all its promises, or on what critics fear it will bring, an objective view of the bill can’t help but provide ammunition to both sides. And the CMS report does just that.
  5. For those who need to atone for past sins, you can do penance by reading the two bills now known as health care reform.
  6. One group who will need to read the bill are insurance commissioners. They have substantial responsibilities for interpreting and refining the law. The National Association of Insurance Commissioners web site has a thorough library of information about the new reforms. It’s a great resource on various aspects of the reforms.
  7. One of the best resources around concerning health care reform is provided by the National Association of Health Underwriters to its members. If you’re a broker and not a member of Health Underwriters, you’re doing your profession a disservice. And you’re unable to get to NAHU’s resource page. Which is a shame because its definitely worth the price of admission.

There’s a lot more odds and ends out there. I’ll cover more in future posts. Hopefully, however, this is an interesting start.


5 Responses to “Health Care Reform Odds and Ends”

  1. Bob Walsh said

    I enjoy your usually even-handed and well-reasoned posts, but I have to ask about your assertion that “Politicians will no doubt pound on carriers for this result, but serious lawmakers realize that the only way to restrain the cost of medical insurance is to restrain the cost of medical care.” Given insurance industry administrative friction, which consumes a fairly large portion (23-30% in NYS) of the health care dollar, why wouldn’t a lawmaker, serious or not, look for some give from the industry?

    • Alan said

      Glad you enjoy the blog, Bob. And thanks for the question. What I was alluding to is that Congress has already looked to the industry for give through the Medical Loss Ratio requirements, requiring carriers to take all applicants. What concerns me is that some lawmakers and pundits then chastise carriers for reallocating expenses they previously treated as administration as being health related when that reallocation is called for by the law. Prior to health care reform it didn’t matter how carriers expensed disease management programs, to take a simple example. Now it does. Criticizing carriers for correctly allocating those expenses strike me as a cheap shot against an easy target — the health plans. When the cost of health insurance goes up — as it will as a result of several provisions of the new law and because of medical trend, my fear is that lawmakers will again take the easy path and attack health plans while failing to address medical costs. Attacking health insurance companies is easy. Moving from a fee-for-service model to a more cost effective model of paying for health care (to mention just one idea) is far from easy.

      A long way of saying, insurance industry administrative friction is a valid target. Addressing skyrocketing medical costs is more important target. No reason we can’t address both. My fear is that lawmakers will avoid the tougher of the two issues.

    • George Thompson said

      NY must be really bad. In Texas, the number is more like 3-5%

  2. kevin luss said

    NY District 1’s current congressman, Tim Bishop used the CBO estimates to ”prove” that the HCR bill would be deficit neutral. That can be either tragic or unethical..depending on what your perspective is, I guess.

    My question is this, how involved in the creation of the actual, ”street level” policy is Kaiser Foundation/Kaiser Health Plans?

    • Alan said

      Hello Kevin: The kaiser Foundation and the Kaiser Health Plans are two separate entitites. They were both obviously funded way back when from the same source, but they operate completely independently. I know Kaiser Permanente was actively lobbying health care reform, both as an individual company and as part of the various groups they belong to. And their CEO, George Halverson, has wrttien some very good books on health care reform (I’ve cited Health Care Reform Now! in previous posts.) The Foundation is an amazingly rich resource of data and information. I don’t know if they promote specific policies or not, but I’ve found their studies to be objective and useful.

      As for the difference between the CBO and the CMS actuaries projections, it may not be as sinister as it seems. First off, these are projections. Second, they both looked at the reform from slightly different perspectives. For example, the CBO is required to accept that the Medicare savings from reducing waste and fraud and by changing the payment system will be implemented. The Actuaries were not. Both of these sources (the CBO and the CMS actuaries) are highly regarded and relied upon by members of both parties. So while I would never say one of their projections “proves” anything (they are, after all, only educated guesses), it doesn’t surprise me when advocates on one side or another say they do.

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