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March 13, 2010

 

Health Care and the Supply Chain (Part 3): Maybe John Kerry was Right

While President Obama deserves credit for wanting to fix healthcare, he'd do well to understand that more people would feel better about his bold plans if we had some kind of track record on which to judge his performance. But he has already spent us into decades of debt with no proof that any of his ideas is anything more than a well intentioned wish. Last week, he pulled a Bush and announced that the stimulus package accomplished its mission. He should have paid more attention to President Bush's Mission Accomplished speech several years back and noted how that worked out.

In and of itself, passing legislation fixes nothing in the same way that simply signing a new procurement contract saves no money. Money is saved in procurement by effectively using the contract to insure that lower prices are paid. I once followed a person in a procurement job who announced savings when he signed a contract but then never followed through on the details to be sure the savings were actually achieved.



If the President and Congress are serious about improving health care there are intermediate steps that can be taken apart from monstrous legislation that no one understands. One of them is the creation of a catastrophic health care cost safety net as proposed by Senator John Kerry in his 2004 campaign for President. According to the June 4, 2009 issue of Business Week, Harvard researchers reported that 62% percent of all personal bankruptcies in 2007 were caused by health problems and that 78% of those filers had health insurance.

The fact is that health insurance plans have lifetime maximum caps and once the insurance company pays out an amount equal to the cap they are done paying. Some diseases and health conditions are incredibly expensive and will exhaust an insured's benefits. When that happens today, even if Medicare is involved, it will still leave a growing balance that is the responsibility of the patient and the patient's family.

Senator Kerry maintained that no one should have to go bankrupt over health care costs. This could be achieved if the government were to create a Catastrophic Cost Safety Net that stepped in and covered one hundred percent of health care costs once an insured's lifetime maximum was exhausted. There are obviously many details that would have to be explored but surely it would be a place to start before we just guess at what will fix health care.



- Lynn James Everard

Comments
Great point on on the safety net. What happens to good people is tragic. But isn't the other half of the equation to use the technology to create a competitive market for health services? I for one would love to hear about maybe the biggest procurement opportunity in the next decade. Isn't it ripe for a marketplace of some sort? The only other alternative is government set price controls which could lead to lower levels of service quality.
# Posted By Sir Donald | 7/6/09 10:12 AM
Senator Kerry's plan was to pull all catastrophic cases out of group insurance plans in order to reduce the premiums for everybody. What happens now is that group plans with a sick person in it has high premiums. The younger, healthier people find cheaper insurance. If you can't leave the group plan because of your job, you're stuck paying higher premiuims because of one person with cancer, for instance. His plan was to cover all catastrophic cases, not just after a person's maximum is hit.

As for Obama saying the stimulus worked, he's said nothing of the sort. He continually reminds us of the challenges we face and that very little of the stimulus money has actually gotten into the economy. I do agree he should do more about the deficit though. First thing being repealing the $1.3 trillion of Bush tax cuts which is almost double the stimulus and the exact money the rich "invested" into these ponzi schemes that sent the economy crashing down.
# Posted By Sandy | 7/6/09 5:00 PM
Truly great news on this topic from the non-partisan CBO. If they can make this happen then prices would come down. The underinsured would still be a problem.

http://www.nytimes.com/2009/07/06/opinion/06krugma...
# Posted By Sir Donald | 7/7/09 3:10 AM
Sir Donald,

Thanks for your comments. Regarding technology and e-procurement, which is what I think you meant, the turn of the century saw over 100 e-procurement platforms fighting for survival yet now barely a handful exist. The largest is owned by the largest manufacturers and and the two largest GPOs. Although they were originally intended to create a competitive marketplace for hospital purchasing they quickly became transaction focused rather than savings focused. The few independent third parties entrants who were focused on lowering costs were relegated to also ran status when they could not find truly independent investors.

I am not convinced that we need government run health care but we sure do need a whole lot more oversight than we have now and we need clear rules and a way to enforce those rules. I believe in free markets but not in markets where the players are free to break the rules or make up their own with impunity.
# Posted By Lynn James Everard | 7/7/09 12:21 PM
Yes and just maybe the day has come when the stick the feds can wield to mandate participation by healthcare providers in a safety net is also big enough to force them to follow the rules of a well run e-marketplace. It seems to me there is an enormous opportunity emerging and I can't be the only one who sees it.
# Posted By Sir Donald | 7/7/09 4:23 PM
Case in point on this link after a 60 second google search.

http://www.nur-unr.be/R-Bay_leaflet_v111.pdf
# Posted By Sir Donald | 7/7/09 4:29 PM
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