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A Bipartisan Proposal for Health Reform

By February 18, 2020Commentary

God bless them, there are still some people trying to find common ground on issues.  The Bipartisan Policy Center puts out a paper making recommendations on reform of the American health system.  Didn’t we just do that in 2010?  Oh, wait, that didn’t actually work too well.   (BPC Paper)    In any event, anything called bipartisan in today’s world is pretty much DOA.  So what did the group come up with?  Here are some principles for any reform.  Everyone should have meaningful and affordable public or private insurance.  Uh-oh, a lot of Dems aren’t going for keeping a role for private insurance.  Health reform should avoid major disruptions.  You mean like forcing people out of private insurance plans and paying doctors so little that they want to quit.  Insurance markets and premiums should be financially stable.  Reform should reduce unnecessary and excessive spending growth.  Doh, its actually pretty modest right now; and when are you dunderheads going to get it through your thick heads that unit prices are the problem, or are you afraid to take on high prices.  Reform policies must be politically and financially stable over the long term.  You mean like not having an administration come in and enact a pretty unpopular comprehensive reform that results in it losing massive numbers of seats in the next Congress?

Anyway, after that pretty vanilla statement of principles, I am sure we will get some humdingers of actual reform proposals.  They based them to some extent on a poll they conducted which says people prefer to build on the existing system.  So here we go.  Provide a reinsurance program to stabilize individual insurance premiums.  Auto-enroll subsidy eligible people.  Expand subsidies.  Increase marketing and sales.  And by all means don’t pay any attention to the fact that a lot of healthy people don’t see or get any value in having health insurance and don’t need it. ((They didn’t say that, it is my usual sarcastic retort to the notion that everyone needs health insurance.  They don’t.)  Wait there is more.  Repeal the employer mandate.  Not sure how that expands coverage.  Monitor use of health reimbursement accounts.  Monitor for what?  Rationalize subsidization of employer-sponsored insurance.  Now that’s just gibberish.  But I digress, lots more to come.  Promote all-payer claims databases.  End surprise medical bills.  Promote health savings accounts.  Lower hospital costs in non-competitive markets.   I think you mean prices and OMG, are you talking rate regulation?  Eliminate barriers to drug competition.  Like monopoly-creating patents.  Getting tired yet?  For Medicare, more use of value-based payments; modernize fraud and abuse laws; reform post-acute care payments; make the Part D drug benefit more generous; fix the Part B drug mess.  Similar bland stuff for Medicaid.  So a lot of the same old ideas that haven’t gotten anywhere, not that a lot of them don’t make sense.  Maybe putting them in a report labeled bipartisan will give them renewed life, but I don’t think so.

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