Beacon Hill Shocker: A Health Care Proposal that Reduces Costs
I argued elsewhere that even though President Obama is selling his healthcare proposal to the nation as a cost cutting measure, there’s almost no provision in it that will actually cut costs.
So it was a refreshing change yesterday when Republican Senate candidate Scott Brown filed a bill in the State Legislature that even his opponent admits brings costs down (http://www.brownforussenate.com/press/12-28-09/12-28-09-brown-files-legislation-control-health-care-costs). If passed, the bill puts a moratorium on new coverage mandates for insurance companies and gives the Massachusetts Connector Authority power to reduce existing mandates. In other words, the Commonwealth of Massachusetts will back off from telling insurance companies what coverage they have to provide. This is a change from current law, which requires health insurance policies sold in the Bay State to cover chiropractic services, infertility treatments, contraceptives, minimum maternity stays, mental health, “Scalp hair prostheses for cancer patients”, off-label uses of prescription drugs for cancer and HIV/AIDS, and 29 other items.
The Coakley camp responded with a press release containing several attacks on the Brown proposal, poorly reasoned, and starting with the headline: “Removing Such Mandated Coverage Across The Board Would Only Reduce Premiums By 3-4 Percent.” To put this headline into perspective, Massachusetts residents are projected to spend some $70 billion on health care next year, so the 2010 savings from eliminating state mandates is “only” $2 billion. In the same press release, Ms. Coakley boasts that Obamacare will bring an additional $500 million in Medicare and Medicaid payments to the state. It is hardly consistent to brag about a $500 million windfall, and then belittle a $2 billion dollar savings (Since Ms. Coakley admits that eliminating state mandates reduces costs, does she also admit that the federal mandates in Obamacare raises costs?).
The Coakley statement argues that a better alternative to reining in mandates is “expanding coverage, increasing transparency, and reducing health care costs for all.” The press release did not explain how the economic miracle of simultaneously expanding coverage and reducing costs will be achieved. It seems that Martha Coakley, like the White Queen in Through the Looking Glass, cultivates the habit of believing impossible things.
Near the end of the press release is a list of multi-million dollar settlements that Attorney General Coakley extorted from pharmaceutical companies, including a $2.5 million haul from Pfizer “for the company’s deceptive campaign to promote drugs for uses not approved by the Food and Drug Administration” (hey, isn’t that what “off-label use of prescription drugs” means?). I’m scratching my head as to exactly how increasing the costs of being in the drug business reduces the nation’s medical bill.
The back-and-forth between Coakley and Brown on this issue focused on dollars and cents, but there is something more fundamental at stake: freedom to choose. Today every Bay State resident must buy a one-size-fits-all policy that covers test tube babies and spine adjustments, regardless of whether they happen to want that coverage. The Brown idea is to restore freedom to the patient. If you do not want a policy that covers wigs, a psychiatrist, or the Pill, you do not have to buy one – but if you change your mind later you will have to pay for these items out of pocket. If you do want the extra coverage, it is available to you, but you will have to pay more for it; patients who don’t want it won’t subsidize you. Fair’s fair.
There are over six and a half million of us in the Commonwealth of Massachusetts. Each of us has a unique combination of medical history, family situation, financial resources, and personal preferences. Clearly, this diversity is better served when we are free to choose a health care plan suited to our individual situations, rather than being forced to fit into a standardized plan designed by a bureaucracy.
So it was a refreshing change yesterday when Republican Senate candidate Scott Brown filed a bill in the State Legislature that even his opponent admits brings costs down (http://www.brownforussenate.com/press/12-28-09/12-28-09-brown-files-legislation-control-health-care-costs). If passed, the bill puts a moratorium on new coverage mandates for insurance companies and gives the Massachusetts Connector Authority power to reduce existing mandates. In other words, the Commonwealth of Massachusetts will back off from telling insurance companies what coverage they have to provide. This is a change from current law, which requires health insurance policies sold in the Bay State to cover chiropractic services, infertility treatments, contraceptives, minimum maternity stays, mental health, “Scalp hair prostheses for cancer patients”, off-label uses of prescription drugs for cancer and HIV/AIDS, and 29 other items.
The Coakley camp responded with a press release containing several attacks on the Brown proposal, poorly reasoned, and starting with the headline: “Removing Such Mandated Coverage Across The Board Would Only Reduce Premiums By 3-4 Percent.” To put this headline into perspective, Massachusetts residents are projected to spend some $70 billion on health care next year, so the 2010 savings from eliminating state mandates is “only” $2 billion. In the same press release, Ms. Coakley boasts that Obamacare will bring an additional $500 million in Medicare and Medicaid payments to the state. It is hardly consistent to brag about a $500 million windfall, and then belittle a $2 billion dollar savings (Since Ms. Coakley admits that eliminating state mandates reduces costs, does she also admit that the federal mandates in Obamacare raises costs?).
The Coakley statement argues that a better alternative to reining in mandates is “expanding coverage, increasing transparency, and reducing health care costs for all.” The press release did not explain how the economic miracle of simultaneously expanding coverage and reducing costs will be achieved. It seems that Martha Coakley, like the White Queen in Through the Looking Glass, cultivates the habit of believing impossible things.
Near the end of the press release is a list of multi-million dollar settlements that Attorney General Coakley extorted from pharmaceutical companies, including a $2.5 million haul from Pfizer “for the company’s deceptive campaign to promote drugs for uses not approved by the Food and Drug Administration” (hey, isn’t that what “off-label use of prescription drugs” means?). I’m scratching my head as to exactly how increasing the costs of being in the drug business reduces the nation’s medical bill.
The back-and-forth between Coakley and Brown on this issue focused on dollars and cents, but there is something more fundamental at stake: freedom to choose. Today every Bay State resident must buy a one-size-fits-all policy that covers test tube babies and spine adjustments, regardless of whether they happen to want that coverage. The Brown idea is to restore freedom to the patient. If you do not want a policy that covers wigs, a psychiatrist, or the Pill, you do not have to buy one – but if you change your mind later you will have to pay for these items out of pocket. If you do want the extra coverage, it is available to you, but you will have to pay more for it; patients who don’t want it won’t subsidize you. Fair’s fair.
There are over six and a half million of us in the Commonwealth of Massachusetts. Each of us has a unique combination of medical history, family situation, financial resources, and personal preferences. Clearly, this diversity is better served when we are free to choose a health care plan suited to our individual situations, rather than being forced to fit into a standardized plan designed by a bureaucracy.
posted by Michael Isenberg at
1:29 PM
3 Comments:
The problem with putting health care in a small rational box, is that life is unpredictable! What happens if you are young and decide: "Oh I won't get cancer now, I'm young, so I won't pay for the extras." Then you get cancer, have to stop working, off label drugs don't work well for you. What then?
I had a mastectomy and reconstruction is mandated if I want. What if I had thought it won't matter to me. Then I faced that dilemma. It did matter to me! How many diseases do we have to go through? Gee, I don't have psychiatric disease in my family, then I get depressed after losing a breast. Am I heading toward bankruptcy to make myself better?
Sure, perhaps wigs, but minimum maternity stays! How much more minimum. Isn't the current two days short enough? Viagra I hope is OUT! The Fertility aspect I agree on face value seems like should be a rider. But what happens if as a young teen you are diagnosed with a thyroid disease. As a young married couple your income is such that you don't have the extra money for the fertility rider, and your chances are high that you may have a problem. Do we say "too bad"? Is that the Republican mindset?
Well at least we agree on wigs and viagra! As always, I appreciate the lessons learned from your own struggle, Suzie. I see this not so much an issue about which treatments should be covered as an issue about who gets to decide: the government or you and your insurance company. It's a very rich topic and I'll adress your comments at greater length in a future entry.
Actually, I mis-spoke about the reconstruction. It is actually required by the Wonman's Health and Cancer Rights Act of 1998 that insurance must pay for reconstruction, surgery to make the other breast symmetrical, and prostheses. Seems like insurance companies were not covering these services, and only wealthy women could afford the plastic surgery. Isn't this an example of what our health system will become? Good enough for the middle and working class, but excellent for the wealthy.
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