March 17, 2010

"Affordable" health plan

There is legislation regarding an "Affordable" plan, that was discussed in the newspaper yesterday, that will cap doctor and hospital charges for this one product to no more then 10% above what Medicare program pays. The current average reimbursement is on average 140%. Obviously if doctors and hospitals agree to 10% above Medicare for the "Affordable" plan, it will provide relief in premiums.


This begs two questions:
  1. What doctors and hospitals agree to this reimbursement schedule and accept "Affordable" subscribers, or will they be forced to?
  2. Lets assume everyone signs up, what will happen to the average reimbursement charged to non-"Affordable" subscribers?
We do not see doctors and hospitals agreeing to this reimbursement schedule, unless they are forced to. At which point the average reimbursement for non-"Affordable" subscribers. If this is in fact the case, what will really happen? Small businesses that enroll in the "Affordable" plan will receive relief, but everyone else will pay more.

The legislation, however, prohibits cost shifting like this, which will be monitored by the Division of Health Care Finance and Policy, but how are they going monitor this or enforce it? will be impossible for anyone to stop the shifting that will occur. The "Affordable" plan will merely make health more 'affordable" for some, while making it less "affordable" for others.

There are may things, which I have written about before, that can provide relief to all employers and employees. The "Affordable" plan is not one of them.

2 comments:

T-Traveler said...

whats wrong with the connector plans? what is a bronze plan

JSF said...

Here's my 'affordable' health plan. (Note: This is health care reform - not insurance reform).

Create a new class of limited liability health care providers. Corporations formed under this new section can still be sued for malpractice, but not for non-monetary losses (no awards for pain and suffering) This plan will only cover generic medication.

#1) No more unending, expensive CYA procedures prescribed by lawyers, not doctors. If you want an MRI for an ingrown toenail, you pay for it out of pocket.

#2) Sorry, you don't get the latest and greatest medicine, but chances are there are generic (research already amortized) drugs that will treat your ailment.