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Healthcare Reform Myths - How Economists Got It Wrong!

The Senate bill is drawing favor from moderate economists on both sides of the aisle, writes Ronald Brownstein in The Atlantic. Jonathan Gruber of MIT has been a skeptic throughout the process, and was part of a group of economists earlier in the fall who wrote President Obama telling him that healthcare reform needed to "bend the curve" on costs if it was going to make a difference.

In the story, "A Milestone in the Healthcare Journey," Gruber now says: "My summary is it's really hard to figure out how to bend the cost curve, but I can't think of a thing to try that they didn't try. They really make the best effort anyone has ever made. Everything is in here."

Greg Hummer points out that in that letter to Obama, economists, led by Stanford University's Dr. Alan Garber, focused on four "pillars" of reform that needed to be in the bill in order for it to be fiscally responsible. Those were: a tax on "Cadillac" insurance plans; an aggressive pursuit of new, performance-based standards for physicians and hospitals (instead of straight fee-for-service); an independent Medicare commission looking for innovative cost-and-efficiency solutions; and a rating from the Congressional Budget Office that the bill would raise enough revenue to be deficit-neutral.

Greg Hummer says, “First off the 4 pillars do not address how to control the total yearly expenditures on healthcare.” Also, why should the government tell private doctors how to bill their patients. That’s like telling the plumber that he can no longer bill for time and material but just a fixed dollar amount for repairing any toilet!

Doctor Hummer says, “healthcare is all about making our society healthier and should focus on prevention.” At the rate we are becoming unhealthy this bill won’t help even if it spends another 2 trillion dollars!!!

We need to drive wellness by incenting patients to stay healthy… i.e. the concept of paying patients to be healthy instead of paying healthcare professionals to be sick. Dr. Hummer should know. Hummer spent years running the screening center at NASA Lewis Research center taking care of some of the countries top scientist.

As Hummer points out, Cadillac plans are most probably held by wealthy people who are most probably healthy… they have them more for peace of mind and simply because they can. Usually, the more intelligent a person the more health conscious they become.

Real healthcare reform should incent patients with “skin in the game” (i.e. Consumer Directed Health Plans, CDHP) then patients will find the best care for the least expensive cost. That alone will drive health professionals to compete and improve services without any type of “government report card” Each hospital will have its own stats like they do now… it’s up to consumers to find the best and they will.

Dr. Greg Hummer says, “The only pillars that make sense are the last two.” Eliminate unnecessary costs and make the program budget neutral. I am not sure that you had to be a brilliant economist to think of those.

The fourth pillar would be like pissing in the wind if there is no incentive to get Americans in better shape, lose weight, stop smoking, eat less sugar and exercise more! Hummer says, “Seventy percent of all chronic disease is preventable and so it the cost associated with it!”

Greg Hummer is emphatic that the correct pillars should be to Incent Wellness, Free Choice, Eliminate Waste and budget neutral policies that foster Consumerism. Let people pay whatever they want for insurance and let them have whatever plan they desire. We can solve this problem with very little of the taxpayer’s money and reap a huge return. When 70% of our youth are too overweight for the military…well look no more for a cause!

Hummer says that medical records are a good idea but won’t change healthcare costs at all. Medical records systems add cost because they take resources and time away from the doctor. Hummer says that interfacing with a true EMR system takes more of the doctor’s time then writing a note. Hummer says, “EMR won’t save a great deal of money.” All this cost is after the fact. If Hummer had his way most people would be healthy and not in need of an extensive medical record. “EMR will cost more in the long run than the money it saves. Besides the really good practitioners of medicine usually leave no stone unturned, whichmeans the more data you have the better your decision making process. So, procedures will be repeated as much as necessary regardless of how often and when they were done.” It is very unusual not to be able to have hard copy historical data on a patient for an evaluation. Having the data that prevents a surgery and its complications is always more prudent than relying on older maybe not so relev ant data.

So, why aren’t our leaders thinking of the obvious… if 70% are unfit for service…it’s not only a national security problem for the military…it should be a national healthcare problem that would draw the attention and resources of our leaders to reverse the problem.

When 70% of all healthcare expenditures are due to totally preventable disease…simply adopt measures and public policy that push wellness. I guess economist think numbers not over weight people.

Gregory J. Hummer, M.D.
Simplicity Health Plans
Consumer Directed Health Plan (CDHP)
Cleveland, Ohio