Cmon, all the cool kids have one and well
so does everyone else. Not too long ago, I coined the new saying Opinions are like health care reform proposals everybody has one. As proof, heres the latest, this one from Samuel H. Fleet, president of AmWINS Group Benefits. Policymakers are missing many of the key opportunities to address what is really broken about the system.
To pick up where he believes lawmakers have left off, Fleet recently released a health care reform position paper, The Six Ways to Fix Our Healthcare System. Boiled down, Fleet writes that reform must:
1. Restore competition in the marketplace.
The four largest carriers in the country have 99% of providers in the network and in most states, the No. 1 carrier has 60% to 70% market share. In any other industry, this would raise antitrust issues, he writes. But for health care, no one seems concerned. His solutions: break up the BUCA monopoly (Blue Cross Blue Shield, United Healthcare, CIGNA and Aetna) and restore competition to the marketplace.
2. Enable consumer to become astute buyers of health care.
Fleet insists that the key to cost control is to bring transparency to pricing. For example, a California patient who needs a chest X-ray is charged anywhere from $120 to $1,519; in fact within a few blocks in Sacramento the price climbs from $451 to $790 from one hospital to the next. The fix? Every provider must disclose the net prices that they charge and consumers need to know how to find high-quality care.
3. Eliminate hidden revenue streams.
PBMs must fully disclose all sources of revenue or profit, block doctors from owning the diagnostic machines they refer their patients to, ban trips, money and other incentives from drug companies to doctors and force hospitals to disclose profitability and markup to implant devices.
4. Promote wellness.
The nation is hysterical over 18,000 cases of Swine Flu, yet we have 100 million obese people in this country, said Fleet. He contends that the current administration should create an aggressive public campaign to promote a healthy lifestyle, restore funding for physical education in schools, as well as institute the use of prevention-based healthcare.
5. Facilitate administrative efficiency.
Real savings can be realized by ensuring that the government define a standard for claims submissions between providers and payors, drive a set of rules for dealing with pended claims that makes sense, among others.
6. Protect the risk pool.
Fleet stresses that the only way to make universal coverage work is mandate that all employers offer insurance or force them to contribute to a government fund. In addition, Fleet asserts, we need to limit coverage to basic minimums set nationally, and to ensure that everyone can afford coverage, we should require carriers to pool risk above a certain amount per claimant.
So what do you think of Fleets proposal and the scads more out there from lawmakers and laymen alike? Do you have one of your own? If so, Id love to hear it.
