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Health policy expert damns House bill
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Health plocy expert damns House bill
Dr. Marcia Angell is a physician and health policy expert who has a well-earned reputation for taking on special interests like the pharmaceutical industry when their agendas threaten the scope and quality of healthcare for patients. In a recent Huffington Post, she damns the bill just passed by the House of Representatives calling it a windfall for the insurance companies that will negatively impact the majority of Americans.
For the record, Angell, an Internist and former editor-in-chief of the New England Journal of Medicine, has been in favor of using the current Medicare system to provide universal health care for all, so her bias is for that kind of “public option”. However, she sees the option provided in the House bill as an ineffective attempt to extend coverage to those uninsured Americans at the same time neglecting the real issue for healthcare reform, which is the delivery system itself.
Specifically, she says that much of the bill was constructed on the backs of seniors who will now see cuts in Medicare while their premiums will rise. And if payments to physicians are cut at the same time, it is possible that many physicians and hospitals will refuse to take Medicare. Already the Mayo Clinic in Minnesota has changed its policy about accepting Medicare patients from outside the state. It certainly will mean that even fewer medical students will consider going into the lowest paid Primary Care specialties like Pediatrics, Internal Medicine and Family Medicine if they leave school with over $200,000 of debt that could take decades to repay.
The bill does prohibit insurance companies from refusing patients because of pre-existing conditions, but it says nothing about the cost of the policies. This is a major deficiency in the legislation. Yes, individuals with heart conditions and diabetes and other pre-existing illnesses can buy insurance, but the policies may be prohibitively expensive.
Angell has a number of recommendations for a streamlined, cost efficient approach to healthcare reform. She would begin, she says, by dropping the Medicare eligibility age from 65 to 55. “This should be an expansion of traditional Medicare, not a new program. Gradually, over several years, drop the age decade by decade, until everyone is covered by Medicare.” Angell admits that this would increase Medicare costs, but argues that it would actually decrease overall costs to the health system, since Medicare has less administrative overhead than commercial insurance (only 3 percent compared to over 20 percent for private insurers) and it provides a national, uniform package of benefits.
Early on in the “debate”, the idea of Medicare for all was dropped like a hot potato. Angell makes a good argument for going back to the drawing board and considering her approach.
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