Tag Archives: health reform law

OPEN LETTER TO CEOs: PART 2 – YOU MUST DRIVE HEALTH CARE STRATEGY

HOW TO DO IT

Dear CEO:

In Part 1, I wrote about why you must take the lead to drive a new health benefits strategy for your company. Now, I’d like to talk about both the short- and long-term components of that strategy.

Short-Term: Turn your employees into savvy medical purchasers.

1. Implement universal High-Deductible Health Plans (HDHPs). Your current rite of annual, bit-by-bit increases in deductibles and copayments is like cutting off a dog’s tail an inch at a time. Stop doing that. Move all your employees now to HDHPs and health savings accounts (HSAs). Ideally, implement the maximum medical-cost-sharing allowed by the new health reform law (i.e., same as current HSA maximums of $5,950 for individuals, $11,900 for families), and get rid of all fixed-dollar copayments in favor of deductibles and coinsurance to communicate actual medical prices.

2.    Maintain employee premium contributions. Despite the much lower premiums for the new HDHPs, don’t reduce employee premium contributions. Keep them at current levels.

Posted in Prevention | Tagged , , , , | 5 Comments

HOW HEALTH REFORM CAN WORK: PART 4

A REAL FIX FOR PREVENTABLE DISEASES

Despite deep flaws that will have to be corrected, the Patient Protection and Affordable Care Act (ACA) has three aspects that make me optimistic about medical entrepreneurs being able to surmount the law’s barriers and create a consumer-dominated, market-based system of medical care and health insurance that will ultimately deliver high-quality, affordable medical care to everyone:
1.    The creation of consumer value
2.    The rise of high-value local health plans
3.    The achievement of effective disease prevention

In Part 2, I discussed the creation of consumer-value as an unplanned result of ACA’s forcing people—rather than insurers—to pay for their own normally consumed medical services. In Part 3, I described how new local health plans built around these providers will be able to displace national PPO-based carriers by creating a virtuous cycle of ever higher medical quality and constantly improving affordability. In this fourth of five installments, I address how these innovative health plans can dramatically move the needle on effective disease prevention.

Posted in Prevention | Tagged , , , , | 4 Comments

HOW HEALTH REFORM CAN WORK: PART 3

THE RISE OF LOCAL, HIGH-VALUE HEALTH PLANS

Despite its deep flaws, the new health reform law, ACA, has three aspects that make me optimistic about medical entrepreneurs being able to surmount the law’s barriers and create a consumer-dominated, market-based system of medical care and health insurance that will ultimately deliver high-quality, affordable medical care to everyone:
1.    The creation of consumer value
2.    The rise of high-value local health plans
3.    The achievement of effective disease prevention

In Part 2, I discussed the creation of consumer-value as a result of ACA eventually forcing most people to pay for their own, normally consumed medical services in lieu of their insurers. In this third of five installments, I address the promise of local health plans sponsored by high-value medical providers.

Posted in Prevention | Tagged , , , , | 6 Comments

HOW HEALTH CARE REFORM CAN WORK: PART 2

Part 2: The Emergence of Consumer Value

Despite its deep flaws, the new health reform law, ACA, has three aspects that make me optimistic about medical entrepreneurs being able to surmount the law’s barriers to create a consumer-dominated, market-based medical care system that will deliver high-quality, affordable medical care to everyone:

1.    The creation of consumer value
2.    The rise of high-value local health plans
3.    Effective disease prevention

This second of five installments discusses consumer value.

Medical Consumer Value
The word “value” appears more than 200 times in ACA. The law’s architects clearly liked it and felt that the bill should strive to achieve it. Too bad they never bothered to clearly define it. If they had, they could have created a much more direct approach to fixing our dysfunctional medical care system, and without all the counter-functional, top-down bureaucracies that will actually impede it and force medical costs higher than they need to be.

Posted in Health Costs, Health Insurance, Medical Quality, Prevention | Tagged , , , , | 6 Comments

HOW HEALTH REFORM CAN WORK: PART 1

Part 1: Even a Blind Pig Finds an Occasional Truffle

I’ve made no secret of my disdain for the Patient Protection and Affordable Care Act (ACA), the new health reform law. It is a bad bill that focuses the wrong “solutions” on the wrong problems and promises to visit unnecessary economic distress and destruction on America’s providers, consumers, taxpayers, and insurers. Even the IRS is protesting.

Yet, rather than continue to bash it, I’ve taken my summer hiatus from writing this blog to focus on a more constructive approach. The law is a fact we have to deal with, and despite a lot of talk about a subsequent Congress overturning it, I’ve concluded such an action to be both unlikely and unwise. The opposition has nothing better on the table and the ACA situation is actually far from hopeless. The focus needs to be on repairing, not revoking it.

Posted in Government vs Markets, Health Costs, Health Insurance, Medical Quality, Prevention | Tagged , , , , | 3 Comments