Comments on: Pros And Cons Of A Public Insurance Plan http://healthaffairs.org/blog/2009/06/19/pros-and-cons-of-a-public-insurance-plan/ The Policy Journal of the Health Sphere Fri, 20 Nov 2009 20:04:42 -0500 hourly 1 By: Economics Arguments for a Public Option | The Incidental Economist http://healthaffairs.org/blog/2009/06/19/pros-and-cons-of-a-public-insurance-plan/comment-page-1/#comment-31422 Economics Arguments for a Public Option | The Incidental Economist Thu, 05 Nov 2009 18:41:03 +0000 http://healthaffairs.org/blog/?p=1445#comment-31422 [...] a few more-than-incidental economists have said something sensible in defense of a public option in a remade health system. I’ve been looking for such arguments for some time. Last week, [...] [...] a few more-than-incidental economists have said something sensible in defense of a public option in a remade health system. I’ve been looking for such arguments for some time. Last week, [...]

]]> By: Results of the public opinion poll: the public option is a good one « Raising Women’s Voices http://healthaffairs.org/blog/2009/06/19/pros-and-cons-of-a-public-insurance-plan/comment-page-1/#comment-26115 Results of the public opinion poll: the public option is a good one « Raising Women’s Voices Mon, 22 Jun 2009 17:37:17 +0000 http://healthaffairs.org/blog/?p=1445#comment-26115 [...] Check out the full article here. Health Affairs and the Robert Woods Johnson Foundation did a brief about the public [...] [...] Check out the full article here. Health Affairs and the Robert Woods Johnson Foundation did a brief about the public [...]

]]> By: Ellen R. Shaffer http://healthaffairs.org/blog/2009/06/19/pros-and-cons-of-a-public-insurance-plan/comment-page-1/#comment-26088 Ellen R. Shaffer Sun, 21 Jun 2009 16:00:08 +0000 http://healthaffairs.org/blog/?p=1445#comment-26088 Health Affairs authors (Anderson, Reinhardt and others) have long documented that the high and steadily increasing cost of health care in the U.S. is attributable to higher prices – for drugs, physician fees and hospital services – despite the fact that Americans use less of all of these than our counterparts in other countries (with the exception of provider-driven technology). The administrative costs of multiple private insurance companies are also a factor. It is ironic to note that these health-related industries now suggest that competition among private insurance companies will be key to constraining their incomes, and that the main threat of a strong public plan that crowds out such competition would be greater inflation in health care costs. More likely, a stonly public insurance plan with broad standards for eligibility that uses Medicare’s reimbursement rates would provide the needed leverage to control costs, and revive the public’s eroding access to coverage and care. Fragmented sources of financing for health care contribute to our fragmented delivery system. No reimbursement method in itself produces the right amount of quality care. Expanding public sector coverage would help integrate and apply the information and systems needed to address both the overuse of medical services driven by fee for service reimbursement, brilliantly described most recently by Atul Gawande, and the underuse that can result from capitation or salaries. Sound proposals by Congress and the Administration to improve the delivery system, and the quality of care it provides, include incentives for health care teams, and support for primary care. They should be widely applied. Health Affairs authors (Anderson, Reinhardt and others) have long documented that the high and steadily increasing cost of health care in the U.S. is attributable to higher prices – for drugs, physician fees and hospital services – despite the fact that Americans use less of all of these than our counterparts in other countries (with the exception of provider-driven technology). The administrative costs of multiple private insurance companies are also a factor. It is ironic to note that these health-related industries now suggest that competition among private insurance companies will be key to constraining their incomes, and that the main threat of a strong public plan that crowds out such competition would be greater inflation in health care costs. More likely, a stonly public insurance plan with broad standards for eligibility that uses Medicare’s reimbursement rates would provide the needed leverage to control costs, and revive the public’s eroding access to coverage and care.

Fragmented sources of financing for health care contribute to our fragmented delivery system. No reimbursement method in itself produces the right amount of quality care. Expanding public sector coverage would help integrate and apply the information and systems needed to address both the overuse of medical services driven by fee for service reimbursement, brilliantly described most recently by Atul Gawande, and the underuse that can result from capitation or salaries. Sound proposals by Congress and the Administration to improve the delivery system, and the quality of care it provides, include incentives for health care teams, and support for primary care. They should be widely applied.

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