LETTER TO THE EDITOR: Solutions for Controlling Health Insurance Costs
State Senate candidate Mike Barrett says now that national health insurance is a reality, keeping costs in check is the next step.
As a Democratic candidate for State Senate and a health care technologist in my professional life, I’m elated by the Supreme Court’s vindication of national health insurance. The decision pretty much ends the debate on health insurance for all (we’re going to have it). So now it’s on the next big question — how do we control the associated costs?
Guiding idea #1: Bring back the Kaiser model. Whatever you call it — staff-model ACO (accountable care organization) or staff-model HMO (health maintenance organization) – let’s re-establish the concept of doctors cooperating in integrated networks, coordinating care between GPs and specialists, and working on salary and outcomes-based bonuses rather than fee-for-service. Models today include the Kaiser Permanente system out West.
Guiding idea #2: Alter anti-competitive “scope of practice” laws. Delegate health care to RNs and other skilled non-physicians. But don’t give up on integration; these non-MDs should work within the same team environment, use the same electronic health records, and embrace the same vision of coordinated, long-term care.
Guiding idea #3: Adopt a single-payer system. Think single processor. Pare away the bureaucratic side of health care. Promulgate uniform coding systems for identifying medical conditions and for describing services rendered. Settle on unified systems for provider credentialing and for billing. Issue an RFP for the actual bill processing. Let public, nonprofit and for-profit organizations bid for the work, subject to fair labor standards for employees. Challenge health insurers to re-invent themselves as health and wellness companies.
Guiding idea #4: Retain competition for providers. Understand that single payer doesn’t mean single provider; incentivize hospitals, doctors and other care providers to compete, but on the basis of quality as well as price. And keep the pressure on. As your State Senator, I’ll revisit the issue until health care cost inflation is under control.