Facebook Pixel

Is a Public Plan the Answer?

Rate This

Like everything else in Washington, health care reform discussions seem to have devolved into “left” vs. “right” and talking heads. Attributed to the left is the wish for a public plan. Attributed to the right is a refusal to accept that alternative. Like everything else in life, the debate is more complex once you get past the pundits and into the people who know.

Former secretary of Health and Human Services Michael Leavitt was interviewed by the Washington Post.

The man who helped oversee Medicare in the last administration describes the nation’s biggest government-run health plan as a fiscal disaster, and he says reform proposals that would build on it are a prescription for failure.

The federal program for the elderly and disabled provides uncoordinated care, it is indifferent to quality and “every incentive in the system is to provide more care, not better care,” said Michael O. Leavitt, who served as secretary of health and human services under President George W. Bush, in an interview yesterday.

That could be dismissed as a critic from the right, if the head of Kaiser Permanente, whose clients are many of the large unions, hadn’t said largely the same thing, according to Merrill Goozner, long-time health reporter:

“We need to accelerate the pace of actual delivery reform in the package,” he told a press briefing following his presentation to the second annual meeting of the Kaiser Permanente Health Care Institute at the National Labor College in Silver Spring, Maryland. Setting goals like those in the House bill is “directionally correct,” but “we can get to those goals much faster,” he said.

About a third of Kaiser’s nine million enrollees are union members and this year’s conference is dedicated to promoting greater use of integrated care models. Both Halvorson and John Sweeney, president of the AFL-CIO, who jointly addressed the opening session of the day-long meeting, backed using Medicare to drive greater efficiencies through the entire system and setting up a government-run commission like the Medicare Payments Advisory Commission to reorganize payment policy.

“Congress should be considering an independent process,” Sweeney said.

Both the left and the right know that the delivery system is as much at fault as the insurance companies, and that neither public nor private reform will work if the compensation systems and incentives in health care don’t change, too. Integrated health care services (with excellent reputations) such as Cleveland Clinic and Mayo Clinic have been agitating for reforms that make the American health care system look more like what they provide, which offers high quality care at lower costs.

The Cleveland Clinic is a not-for-profit medical research and treatment center that is considered one of the country’s best and most prestigious medical institutions.

President Obama, as part of his fight to change America’s health care system, visited the clinic on July 23, 2009. At a news conference the previous night, he called it a model of efficient care, saying its patient care system “works so well” because it has “set up a system where patient care is the number-one concern, not bureaucracy.”

Like the Mayo Clinic in Rochester, Minn., the Cleveland Clinic pays its doctors a salary, rather than piecemeal, and delivers excellent results for relatively little money.

In 2009, U.S. News and World Report rated the Cleveland Clinic as the fourth best hospital in the United States. The magazine has for the last 15 years said the clinic offers the best heart care in the country.

In light of all this, it would be helpful if we got beyond public plan vs. no public plan to what kind of plan we really want and can afford.

Link to blog: http://ushealthcrisis.com/2009/07/is-public-plan-answer/

Add a Comment2 Comments

According to the scoring of CBO on the prevention & wellness program, all fitness centers around the world should close down immediately and all media have to end reporting health tips about prevention.

Immune System & Levee System :

All of the excellent health systems seem to have one thing in common, a expansive, systematic preventative program requiring immense investments. I think a prevention system works as a 'levee' built against flood by the government, similarly, it also needs non-profit investments from the government 'on a large scale'.

This might offer us the clue of why all of the free states have public insurance policy in place.

It won't be easy to draw some specific numbers on the economic effect of the 'levee' , but the flood measure lacking a stable 'levee' would be a house on sand, as the too high level of 'preventable' chronic diseases in America shows.

At present, about 75 percent of each health dollar goes to treating chronic conditions.
When tests reveal patients are at risk of a chronic disease, physicians have no benefit to help them make necessary changes to stay healthy. Rather, the system today is designed around treating patients once they become sick.

If current health care system could shift a small percentage of total spending into programs that help prevent people from getting sick in the first place, it would dramatically reduce the overall cost of care.

Thankfully, the health care reform bill currently before Congress makes several key investments in preventive care, and those pieces of the PUBLIC OPTION must be maintained.

"An ounce of prevention is worth a pound of cure.", said Benjamin Franklin , and 'Early Detection' goes beyond monetary value as we see the recent case.

As far as I'm concerned, the congress affected by the special interests has impeded the budget request for prevention program in Medicare & Medicaid. Let's imagine the costs and invaluable lives following the levee breach.

Thank You !

August 7, 2009 - 2:43am

The 'innovative' idea of a 'pay for value / outcome' pack came after the CBO had previously pointed out this health care reform wouldn't work without 'fundamental' change in the out of date system. It is said that as much as 30 percent of all health-care spending in the U.S. -some $700 billion a year- may be wasted on tests and treatments that do not improve the health of the recipients, and this 700 billion dollars a year can cover a lot of uninsured people.

The expected Benefits of this 'innovative idea' are as follows ;

1. Meet the objective of revenue-neutral.
Supporters of the agreement say it could save the Medicare System more than $100 billion a year and 'improve'
care, that means more than $1trillian over next decade, and virtually needs no other resources including tax on the
wealthiest. Supposedly even the 'conservative' number of such savings might be able to meet the objective of

2. Quality and affordability.
If you are a physician, and your pay is dependant upon your patient's outcome, you will most likely strive to
prescribe the best medicine earlier in the process, let alone skipping the wasteful, unnecessary risk-carrying

3. No intervention in decision-making.
The innovative idea of 'a pay for outcome' will more likely prompt team approach and decision, as at Myo clinic.
Under the 'pay for outcome' pack, for good reason, best practices as 'recommendations' would simply help them
make a better decision, and the government won't still have to meddle in the final, actual decision-making
process as a non-expert.

4. Speed up the introduction of IT SYSTEM.
The pay for 'Outcome' pack is most likely to expedite the introduction of Health Care IT SYSTEM.
The synergy effect of the combined Health Care IT & a pay for 'outcome' system may allow the clinicians to
'correctly' diagnose and effectively treat a patient earlier in the process so that it can measurably scale back the
crushing lawsuits and deter the excuse for unnecessary cares to make fortunes.

5. Accelerate the progress in medical science, in return, it saves more cash.

6. Settle the regional disparity.

7. Reduce the emergency room visits & save immense costs.
Public health insurance plans such as Medicare and Medicaid paid for more than 40 percent of U.S. emergency
room visits in 2006, according to government figures released recently. Many experts say reducing these hospital
visits would be an important way to lower the enormous, and growing, expense of U.S. health care.

I share the opinion that unlike the insurer-friendly senate plan by 'some' members, only a strong public option will be capable of getting the premium inflation under control and saving the U.S in turbulence.
To my knowledge, a dual system tends to deliver better results than a pure single payer system. Supposedly, to be or not to be might be up to the innovations like a pay for value program, otherwise, the forthcoming start-ups may fill the void with competitive deals. The competition based on 'fair' market value would be a beauty of true capitalism, not monopoly, an objective for anti-trust.
Thank You !

August 7, 2009 - 2:43am
Enter the characters shown in the image.
By submitting this form, you agree to EmpowHER's terms of service and privacy policy
Add a Comment

We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.