What the Republican Health Plan Gets Right

["Dave Farber" <farber () gmail com>]

Begin forwarded message:

> From: Dewayne Hendricks <dewayne () warpspeed com>
> Date: May 6, 2017 at 10:19:22 AM EDT
> To: Multiple recipients of Dewayne-Net <dewayne-net () warpspeed com>
> Subject: [Dewayne-Net] What the Republican Health Plan Gets Right
> Reply-To: dewayne-net () warpspeed com
>
> [Note:  This item comes from friend Bob Frankston.  Bob’s comment:'The author blithely offers a "let them eat cake" 
> piece of advice by saying that people with preexisting conditions can just get a job and get coverage via their 
> employer. Totally out of step with a gig and entrepreneurial economy. Or for that matter, any rational economy that 
> doesn't try to hide the true costs of healthcare.’.  DLH]
>
> What the Republican Health Plan Gets Right
> By MARC K. SIEGEL
> May 5 2017
> <https://www.nytimes.com/2017/05/05/opinion/what-the-republican-health-plan-gets-right.html>
>
> Now that the Obamacare replacement bill has passed the House and is moving on to the more centrist Senate, the real 
> debate begins. What is the true purpose of health insurance, and what is our government’s goal in ensuring we have it?
>
> I learn from my patients every day about the benefits, limitations and contradictions of their health insurance. One 
> charming 60-year-old with severe seasonal allergies insists on seeing me every few weeks this time of year, even 
> though I tell her she doesn’t need to — her antihistamines and nasal spray treatment rarely changes. But she worries 
> that her allergies could be hiding an infection, so I investigate her sinuses, throat, lungs and ears. I reassure 
> her, and her insurance (which she buys through New York’s Obamacare exchange) covers the bill.
>
> If she was responsible for more than a small co-payment for these visits, I’m sure I would see her less often.
>
> We pride ourselves on being a compassionate society, and insurance companies use this to manipulate us into sharing 
> the costs of other people’s excessive health care. Meanwhile, 5 percent of Americans generate more than 50 percent of 
> health care expenses. Why shouldn’t a patient who continues to see me unnecessarily pay more?
>
> The government’s job is to maintain public health and safety. It should ensure that insurance plans include mandatory 
> benefits like emergency, epidemic, vaccine and addiction coverage. The Republican bill would let states apply for 
> waivers to define these benefits differently; it would be a big mistake to drop such coverage entirely. But Obamacare 
> went well beyond these essentials, by mandating an overstuffed prix fixe meal filled with benefits like maternity and 
> mental health coverage that drove smaller insurers with fewer options out of the market. The few that remain often 
> have a monopoly, and premiums rise.
>
> Speaking of compassion, how about some for the 20-something construction worker who can’t afford to pay his rent 
> because his premiums help subsidize overusers like my allergy sufferer? Why shouldn’t a patient who is risk-averse 
> pay more for coverage she might never need, while that construction worker be allowed to choose a cheaper insurance 
> plan that might cover only the essentials?
>
> In addition to limiting the menu of essential benefits, the House bill would let states create high-risk pools for 
> patients with pre-existing conditions who had let their insurance coverage lapse, and who could then be charged 
> premiums more in keeping with their health care needs. This is the only way to make insurance affordable for most 
> consumers; pre-existing conditions will continue to drive up premiums if everyone is compelled to pay the same price.
>
> These risk-pool premiums can and should be subsidized by the government. A recent report from the Kaiser Family 
> Foundation found that high-risk pools can work, but have been historically underfunded. Trumpcare should change that 
> — though it will cost more than the House bill’s $8 billion in additional funding. Drastic cuts to Medicaid should 
> also be reversed, which could help the bill pass the Senate.
>
> [snip]
>
> Dewayne-Net RSS Feed: <http://dewaynenet.wordpress.com/feed/>



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