Problem is, the folk who should be 'doing something' are more worried about refilling their election war chests than cutting out the cancer they've inflicted on the body public. For all the rhetoric, the foot soldier reality is that the numbers don't work in application. I had the privilege of serving on a panel addressing HCR's impact on the medical and business communities this week for the Association for Strategic Planning in Los Angeles. Two of the panel members belonged to the medical profession: one a chief hospital administrator, the other a senior Kaiser physician. BOTH of them highlighted the financial disaster HCR represents even while recognizing the benefit of electronic recordkeeping. For example:
HCR imposes serious new liabilities on hospitals as 'accountable care' organizations, all of which mean higher expenses;
HCR threatens to cut Medicare and Medicaid reimbursement rates to a level roughly 50% of cost.
- even more doctors dropping out of goverment programs
- higher negotiated reimbursement rates from private insurance companies
- higher fees AND premiums for patients
Regardless of composition, the simple numeric fact is that this 49% represents the intractibly uninsured. No amoung of high-minded rhetoric is going to convince people who are accustomed to free on-demand medical treatment to start paying for the service. If they intended to, there are at least four (4) existing public programs designed specifically to insure this group. Yet this 49% remain uninsured - even when it doesn't cost them anything at all! So what magic wand does Washington expect to wave to suddenly change their minds?