spendmatters
 

February 09, 2012

 

Healthcare and the Supply Chain: How the Public Option Will Become the Only Option

The threat of the public option in the Democrat plan remains a lightning rod in the ongoing health care reform debate. Those in favor of the public option suggest that it will stimulate competition and help keep rates down among private insurance companies. The President promises that if you like your current insurance plan and your doctor you can keep them both. On the surface it sounds simple enough. But our national experience should have taught us that our politicians are not detail people and the devil is always in the details.

Various organizations have predicted that the public option will result in anywhere from 83 million to 139 million people losing their private insurance and moving to the public option. How would this happen? First, because the federal government can tap taxpayers for more money or create money out of thin air it will have the ability to low ball pricing anywhere it competes with a private insurer. Large employers facing increases in insurance costs from private companies will feel compelled to choose the lower priced public option in order to protect their own ability to compete in their own vertical markets. No employer large or small can afford to pay more than their competitors for health care insurance. As employers of all sizes peel off from their private insurers and move to the public option, the remaining private insurers will have smaller volumes of members and their buying power will erode. This loss of buying power will increase their own costs forcing their rates up sharply. And this will lead to further losses until most if not all will have no choice but to close down because they will no longer be able to compete with the public option.



While all of this is happening, most patients are likely to sit idly by believing that their ability to choose their own doctors will continue as if it were an inalienable right. Many will be content that the big bad insurance companies will have had their comeuppance. But their contentment will quickly fade when those once easy to get doctor's appointments will be harder to come by than front row seats to a Jonas Brothers concert. Estimates are that there are currently 100,000 too few physicians than needed to care for the existing population and those numbers will rise dramatically in the wake of a proposed 21.5 percent cut in Medicare reimbursement to physicians in 2010.

The public option simply sounds too good to be true if you just look at the insurer side. But if you've spent any time in the health care neighborhood, you know that the provider component requires at least as much simultaneous scrutiny and reform for the system to work -- let alone improve.

- Lynn James Everard


Commodity Edge Conference

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Comments
Alexc's Gravatar There is nothing related to supply chain or materials management in this article. Shouldn't the article be more centered around how a public option and the comparative cost studies in the bills going forward will effect spend on hospital and medical center materials?
# Posted By Alexc | 7/22/09 8:45 AM
Sir Donald's Gravatar The missing detail that is the most important is what should be the true cost of providing health care services. I'm tired of watching doctors and many others get rich off of the suffering of the American people. The system is tragically rigged to jack up true costs whenever possible to enrich the providers. How many Americans went bankrupt again due to a health care hijack even though most actually had insurance. It's a very high number.
# Posted By Sir Donald | 7/22/09 1:09 PM
Not so fast's Gravatar Alexc,
I must beg to differ. What is more important than the vital spend on health care insurance that so many U.S. citizens now pay up to 75% out of pocket if employer supplied and 100% if they must go it alone. Who the insurers are and the supply chain they rely upon to provide "reasonable care" is of the utmost importance -- this is a procurement issue of the highest relevance.
# Posted By Not so fast | 7/22/09 1:31 PM
KD's Gravatar Take a good look at how well the gov't manages the medicare, veterans, and state medicaid plans and ask yourself if you really believe they will do a better job when they have total control over the healthcare system of the country.

Personnal I think we are being sold a bill of goods!
# Posted By KD | 7/23/09 5:02 AM
PDN's Gravatar If the 'public option' is anything like Medicare then it would be expected that underpaying public option will shift underpaid bills to the privately insured, as Medicare has done for decades. Our government administration would like people to think that the health insurance companies are the cause of the healthcare crisis when in reality our Medicare payment system is a bigger contributer to higher healthcare cost and medical inflation than the private market.

Put in simplier terms if the government puchased 15% of your inventory at 80% of the cost, then you would realize a loss, unless you pass on the loss to your paying customers (private health insurance customers). With the public option and additional Medicare cuts, the government now wants to purchase 60% of your inventory at 70% of the cost, shifting all losses to paying customers (private health insurance customers). Your paying customers will be not be happy, even if they get better service with private insurance, eventually most people can only afford is a government plan.
# Posted By PDN | 7/24/09 8:07 AM
Lynn James Everard's Gravatar Thanks to all for your comments. On the relevance to the supply chain it is important to note that the health care supply chain itself is quite complex. It suffers from many forms of inefficiency with financial inefficiency being among the most serious.

In most companies a dollar saved in the supply chain goes to the bottom line. But for hospitals a dollar saved in the supply chain may not stay in the hospital. Because Medicare tracks downward trends in the cost of products and uses those trends to justify future reimbursement cuts, hospitals may be little more than middlemen in the transfer of wealth from suppliers to the Government. Such an arrangement provides little real incentive to hospitals to cut their supply and equipment costs.
# Posted By Lynn James Everard | 7/24/09 8:55 AM
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