NPR has a great series starting called Health Care for All, which is going to involve in-depth looks at how five different European countries manage their healthcare systems. I just finished listening to the episode about Germany, which was very interesting. Their system has been working for over 100 years, so at the very least it seems to be a model that has some history behind it.
Stay tuned to NPR for more episodes as they come out in the next few weeks, these shows could provide some interesting context and topics for the debate about healthcare reform in the U.S.
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WHAT CONGRESS CAN DO FOR HEALTH CARE
Congress can’t fix health care this year. A single law hammered out in a few weeks won’t begin dealing with the issues of high costs, poor service, errors and mistakes, inefficiency, and disappointing outcomes plaguing health care. Those complex issues call for an elegant solution that lies beyond Congress’ grasp.
So, while providing health insurance for more people is an important stop gap measure, Congress should also start the ball rolling for permanent health care transformation. Any law they pass should establish a nonpartisan, blue-ribbon commission, like the 9/11 commission, to develop a new and uniquely American health-care system.
A uniquely American health care system would provide everyone with necessary health services at financially sustainable costs. Health services would be neither run by the government nor subject to interference from the legislative and executive branches. Individuals would have their choice of doctors, and services would be provided by free enterprise health care providers competing on the basis of patient satisfaction and superior outcomes, and profiting from innovation and efficiency.
The commission’s goal would be to develop a nonpolitical, independent regulatory agency, like the Federal Reserve to manage health services. The agency would be staffed by health care related professionals and, among its duties, would establish health services that everyone is eligible to receive and set standards of practice for health-care providers.
The commission would need to address several thorny issues currently confounding health care. The role of private health insurance companies must be reconfigured. By designing benefits packages, marketing and selling insurance, and also controlling access to and payments for services, insurance companies have intolerable conflicts of interests. They currently hold health care hostage, and significantly increase costs. Their role in a new system might be as fiscal intermediaries managing payments for services and auditing for access, outcomes, patient satisfaction, and fraud and abuse.
A second confounding issue is paying for health services. Employees’ health care is not a legitimate cost of employers doing business; any scheme mandating that employers provide insurance, or individuals purchase their own health insurance, would add yet another layer of bureaucracy to our already smothering nightmare.
There are strong conservative, moral, pragmatic and prudential arguments for having the government pay for all necessary health services. A new source of revenue must be found. A national sales tax on consumption would be a fair, simple solution.
And the commission would also need to develop a plan for transitioning into a new health care system.
We may finally have the will to reform health care. If Congress only passes piecemeal legislation this year, without initiating a process leading to systematic health care transformation, we’ll eventually end up with a different dysfunctional, high-cost patchwork system of health care.
Jim Waun
June 2009
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