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Health Care's Hidden Costs
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12139 |
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Section : |
CURRENT ISSUES
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| Issue
Date : |
3 / 1994 |
2,803 Words |
| Author
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James A. Rice
James A. Rice is strategy and public affairs officer for
HealthSpan Health Systems Corporation in Minneapolis. |
It has become politically correct to call for major reforms of the U.S. health sector, but it is not at all clear what the cost of such reforms would be, nor upon whose shoulders the costs are likely to be borne. While much of the debate has been appropriately focused upon the scope and nature of these reforms, it is now also important to fuel the debate by considering the practical consequences and issues of implementing the reforms--in particular, what are the likely costs of the reforms for certain key stakeholders?
Many observers now realize that the reform we finally get will be not so much a cautiously designed overhaul of one-seventh of our economy as it will be a rapidly crafted political solution to a tough issue that can no longer be avoided. An increasing number of pundits and analysts are betting on a political compromise becoming clear by summer, with enough votes amassed for passage in the autumn and rollout next year.
What are the likely dimensions of this compromised reform package? It is unlikely that any of the various current proposals would pass as drafted, but certain common themes are likely to be reflected in the compromise package.
According to Robert Lasewski in the autumn 1993 edition of Healthcare Maintenance Quarterly:
Clinton needs conservative Democratic votes, particularly in the House, and he needs moderate Republican votes, particularly in the Senate. For a comprehensive reform package to pass, a compromise will have to be achieved among these three camps.
From a distance, the Clinton plan, the conservative Democratic plan and the moderate Republican plan have a number of significant similarities. These similarities can form the basis for compromise. They include a commitment to:
1. passing a package in the next year;
2. supporting the evolution away from the fee-for-service system to a more organized financing system where providers of care are more at risk for the cost and quality of health care;
3. insurance market reforms;
4. administrative simplification, causing Medicare and Medicaid programs to take better advantage of
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