Health Care Issue Jam follow up: a message from Brian Klepper
Thanks to the attendees, both for the keen interest in the topic and the rollicking discussion.
Its clear that you're all dealing with difficult health care regional policy issues. Among the most alarming is that small business is getting priced out of the coverage market and, for those who are still in the game, being required to pay more for coverage - due to mandates and premium taxes - than mid-sized and large businesses that can self-insure.
Even so, I'd urge you to keep your eye on the ball. The biggest costs in health care aren't due to mandates, premium taxes or medical malpractice, but from excess at every level of the system. That excess is promoted by a fee-for-service reimbursement system that rewards doctors and hospitals for providing more, rather than the right, care, and by a lack of pricing/performance transparency that makes it difficult to see who's doing a good job and who isn't, what works and what doesn't, who needs care. We often can't identify opportunities, or problems, even when they're dangerous.
There were two take-aways I hoped you got from the discussion yesterday. One is that real, meaningful policy change is still very unlikely. Even though health care economists generally agree that between 1/3 and 1/2 of health care cost is unnecessary or inappropriate, health care special interests are the nation's biggest and richest industry - one dollar in seven - and they have a firm grip on Congress and the legislatures. They're unlikely to agree to reforms, even reasonable ones, that undermine their revenues and profitability.
Second, the changes that ARE possible are most likely to come through the marketplace. The single thing that Chamber members can do to have the most impact is to leverage your strength to make the health care marketplace more transparent. Transparency is the ONLY approach that can help make health care behave like a market. Encourage your larger members to pool and mine their claims data to identify the problems and opportunities, and then share that information with the smaller employers.
Please feel free to contact me anytime to discuss this or other health care issues.
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