RSS Feed Menu… well, maybe not. The thing has a way of reviving when least expected. Still, yesterday’s votes in the Senate Finance committee represent large and serious defeats.
What follows now? For Republicans, one big decision: deal or no deal?
Until now, the threat of a government-run healthcare plan has deterred Republicans from negotiations with the administration. They were (reasonably) afraid of being mousetrapped into a philosophically unacceptable deal. But if the single most threatening element of such a deal has been voted down by Democrats, the field looks different. Instead of worrying about worst-case scenarios, Republicans now can begin to think: are there things we want? Might we successfully wedge centrist Democrats away from the Chuck Schumers? Until now, Republicans have clung to the untenable healthcare status quo in great measure because they feared the likeliest alternative would be worse. But what if the alternative might be an improvement over the status quo? Suddenly the deal option begins to look a lot more interesting.
balconesfault // Sep 30, 2009 at 9:42 pm
At the moment, a private physician’s office has a receptionist, two nurses, and about five people who’s sole purpose is to fight insurance red tape (which also takes several hours of the doctor’s time every day as well).
An interesting interview I heard recently with a physician described how even though Medicare reimbursements are lower – a lot of practices prefer Medicare because they know they’ll get paid as long as they fill in the paperwork correctly … while dealing with insurance companies means interative conflicts with the companies over payment for services.
What’s odd about your plan is that in order to keep government out of healthcare – you’re willing to violate principles of federalism, basically mandate business processes for the whole industry, and institute price controls.
hormelmeatco // Sep 30, 2009 at 11:01 pm
There are already standardized codes, ICD-9 and soon, ICD-10.
I was very pleased when I saw that Atul Gawande’s New Yorker piece was getting some traction. I’ve been very disappointed that no one seems to have taken it’s point to heart: the way medicine is practiced needs to change. Almost every other issue related to healthcare reform is peripheral.
hormelmeatco // Oct 1, 2009 at 1:55 am
Correction: ICD-9/10 are for diseases. They are used in conjuction with CPT codes for billing.
sinz54 // Oct 1, 2009 at 10:34 am
escapevelocity:
What you have proposed for health care, is similar to the original Baucus bill. Surprise!
The original Baucus bill wasn’t bad. It didn’t add a penny to the deficit. It didn’t set America on the path to a future single-payer system. It started up regional co-ops.
The GOP still said no.
sinz54 // Oct 1, 2009 at 10:36 am
hormelmeatco: I’ve been very disappointed that no one seems to have taken it’s point to heart: the way medicine is practiced needs to change.
I’ve been arguing that on every forum and every soapbox I can climb up on.
Nobody is listening.
Because changing how health care is practiced is going to mean that many patients will no longer get the luxurious level of care they’re used to. (At one Massachusetts hospital I stayed at, every patient–EVERY patient–gets a private room of his own. That’s absurd. It’s a hospital, not a motel.)
sinz54 // Oct 1, 2009 at 10:41 am
adude: At the moment, a private physician’s office has a receptionist, two nurses, and about five people who’s sole purpose is to fight insurance red tape (which also takes several hours of the doctor’s time every day as well).
Also hospitals.
In a major Massachusetts hospital I stayed at, the doctors told me that at least 55% of their daily workload is paperwork. That’s right, they now spend more time filling out forms than they do treating patients. Everything has to be justified for the insurer. Everything has to be written down in triplicate, here, there, and over there. And from what they said, that’s typical of modern hospitals, it’s not an outlier.
balconesfault // Oct 1, 2009 at 10:47 am
sinz: At one Massachusetts hospital I stayed at, every patient–EVERY patient–gets a private room of his own. That’s absurd. It’s a hospital, not a motel.
True, but this is a predictable result of our current system.
Because hospitals are competing for business from people who have insurance and actually can pay bills. And if people who have insurance start complaining that they’re sharing a room, insurers will make sure they get private rooms, lest they switch policies. Because I suspect the cost differential between a policy providing for a private room, and one providing for a shared room, is not enough to get people to buy the cheaper policy. Moreover, they’re going to complain to their employers if they get stuck in a shared room, and the insurer risks losing a big account. Better just to not rock the boat.
The free market comes to the best short term commercial solution – and not the best solution from a resource allocation basis. Useful in many ways to help stimulate creativity and innovation, but it has its limitations.
balconesfault // Oct 1, 2009 at 10:50 am
And that’s because insurance companies best opportunity for increasing profits is to stiff the providers. Thus, on the other side of the fence, there is a substantial bureaucracy tasked not with facilitating payment, but with denying claims.
The natural product, once again, of a free market system. Once again, as someone who is a big free market advocate in general, I have to ask if the healthcare system is best left in the hands of the free market?
balconesfault // Oct 1, 2009 at 10:51 am
urgh – let’s try that again (an edit function would be SO nice!):
Sinz: In a major Massachusetts hospital I stayed at, the doctors told me that at least 55% of their daily workload is paperwork. That’s right, they now spend more time filling out forms than they do treating patients. Everything has to be justified for the insurer. Everything has to be written down in triplicate, here, there, and over there. And from what they said, that’s typical of modern hospitals, it’s not an outlier.
And that’s because insurance companies best opportunity for increasing profits is to stiff the providers. Thus, on the other side of the fence, there is a substantial bureaucracy tasked not with facilitating payment, but with denying claims.
The natural product, once again, of a free market system. Once again, as someone who is a big free market advocate in general, I have to ask if the healthcare system is best left in the hands of the free market?
SFTor1 // Oct 1, 2009 at 1:43 pm
The problems with our current health care system are plain to see. Possible solutions are not hard to imagine. Yet nothing is done in Washington.
This must be the ultimate showcase for why corporate money must be banned from politics. Yes, yes, union money too.
EscapeVelocity // Oct 1, 2009 at 2:23 pm
I think Racist money from groups like La Raza and NAACP should be banned as well.