SPECIAL REPORT: Dr. Ravi Patel, managing partner, Comprehensive Blood and Cancer Center
| Thursday, May 28 2009 06:44 PM
Last Updated Thursday, May 28 2009 06:44 PM
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Dr. Ravi Patel
The Obama/Congressional health-care reform plan is still in its formative stage. However, the fundamental concept of the Obama reform is to eliminate all preexisting condition restrictions in employer and other private insurance, subsidize COBRA for workers who lose their jobs, and regulate/subsidize employer and other insurance so everyone not covered by a government program would be guaranteed either health insurance coverage or access to a government program.
The administration seems to be relying on two strategies to pay for guaranteed coverage: (1) reducing the growth rate in current public and private health-care programs and insurance, and (2) increasing taxes on households earning more than $250,000 annually.
Reducing the growth rate of spending has its own problems. One way to reduce the growth rate in spending is more aggressive utilization review, particularly of new high-tech procedures and services — the extreme form of which would be the rationing of expensive services. Another way to reduce the growth rate in spending is price controls.
Since most payers both public and private use the Medicare Fee Schedule as their payment standard, reducing Medicare fees would have the effect of reducing the fees of all payers, public and private.
A third option is to increase insurance deductibles and co-pays, which will have the direct effect of reducing consumer demand — an approach that would seem counter to the Obama reform objective.
There is no question that there are serious gaps in private sector health insurance coverage. On the other hand, the medical services available in the United States are the envy of the rest of the world.
The effect of attaining universal coverage through government regulation, price controls and enhance utilization review may be to destroy the innovation and technology that has been the hallmark of American medicine — a system of care that has significantly reduced morbidity and increased life span for the American people.
