Providing Universal and Affordable Health Care (1989) / Chapter Skim
Currently Skimming:
Response to Robert E. Patricelli
Response to Robert E. Patricelli
Pages 42-50
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 42... ...
Employers began to provide health insurance coverage for workers and dependents following World War II. Medicare and Medicaid were introduced in 1965 without any attempt to change the health care system or set effective limits on provider payments.
|
From page 43... ...
The argument was made that a universal, publicly financed and controlled, national health insurance plan was needed to get control of total health care spending. The Kennedy-Griffiths Health Security Act would have established area-wide budgets for health care, forcing health care providers to live within relatively tight limits on total spending.
|
From page 44... ...
• Make insurance more affordable for small and high-risk employers through the establishment of insurance pools subsidized by surtaxes on employer health plans. • Encourage the development of a low-cost employer health plan on a voluntary basis "certified" by the federal government with the following characteristics: -- Covers only minimally essential benefits; -- Is exempted from state insurance benefit requirements; -- Pays hospitals and physicians according to Medicare provider payment rates; -- Follows appropriateness guidelines developed and approved by Medicare.
|
From page 45... ...
I am not convinced that the fundamental cost problem arises because we are providing health care services that provide no benefit to patients. Rather, I think that the central cause is our failure to limit in any powerful way what we pay providers.
|
From page 46... ...
First, access to health care is a serious and growing problem in the United States. It is too urgent to be postponed for a 10-year research effort on appropriateness, and an even longer period of testing the as yet unproven theory that this strategy holds the long-sought answer to effective cost containment.
|
From page 47... ...
We should be embarrassed to argue that the United States is incapable of doing as well by its workers. Linking Private Insurance Provider Payment with Medicare One feature of the Patricelli plan that I find most intriguing is his proposal that federally approved employer plans be required to follow Medicare provider payment methods and rates.
|
From page 48... ...
With Medicare, Medicaid, and employer PPO plans all presenting hospitals and physicians with a uniform price applying to over half of the population, the United States could begin to exercise its legitimate economic power over health care providers. In exchange, my own preference would be to retain physicians' clinical autonomy to decide what care to provide to their patients.
|
From page 49... ...
It would provide the combined purchasing clout of the public and private sectors to set hospital and physician payment rates. It would add the United States to the club of industrialized nations that both guarantees access to health care for all its citizens while using its purchasing power to limit the claims on that purse by health care providers.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.