A Funny Thing Happened on the Way to Health Care Reform
The State of Vermont decided to do its own thing this week when it comes to healthcare coverage for its citizens. By 2017, they expect to have a single payer system that provides healthcare as a right to all. They’ve currently contracted with a consultant who will use complex modeling to determine what it should look like and how it should be paid for.
Single payer systems are often referred to as “socialized medicine.” Supporters say that it creates a fair and efficient system that provides healthcare for all and is significantly cheaper than current reform efforts. Detractors say that it means a “wait for care” for all, and care that is managed by politicians and bureaucrats.
Will this decision in Vermont lead to a major shift in healthcare nationally? Not likely, but Vermonters may be one of the first in the nation to experience a true single payer system. As a small state, Vermont has the ability to analyze the population, assess risk, determine costs and set appropriate provider compensation. Vermont can dismantle its existing private carrier market with relative ease too. All of this would be mind bogglingly difficult on a national level.
One need only read the headlines to see how much faith Americans would have in a government run healthcare system. Fraud and abuse stories dominate in the Medicare system and new horror stories arise every day in our Veteran’s Administration. Segments of our population refuse to allow anymore of what they consider government intrusion into their lives, and thus supporting the adoption of a government operated single payer healthcare system in this country is not reasonably foreseeable.
But don’t we all want efficiency? Consistency in costs? Predictability in expenses? We do, so how do we get there?
Like it or not, the Affordable Care Act is prompting some change that will ultimately result in greater cost transparency and improved efficiencies but more can and should be done.
A hybrid approach, a public/private partnership, may serve Americans better than any “reform” we’ve seen so far. While not perfect, Germany currently has a healthcare system that has a level of cooperation and integration between government and private insurance providers that is unrivaled. Their system provides several lessons that we’d be smart to take note of. In this hybrid system, the government plays a significant role in controlling costs while providers do what they do best – provide quality healthcare.
We’ve talked here before about the enormous disparity in costs of healthcare. A simple, no complications, procedure in one hospital can cost thousands more in another. Healthcare consumers are being encouraged, even required these days, to shop for a hospital and fight charges when the bill arrives. The enormous burden being placed on individuals would diminish with greater transparency and accountability.
The bottom line is, we don’t need to move to a single payer system to improve efficiency and outcomes. A solid public/private partnership that focuses its efforts across the board on cost controls and overall outcomes will go a long way to improving our healthcare system. We’ll no doubt learn a lot from Vermont in the next few years. Let’s take good notes.