There’s what I think is a solid analysis of some of the shortcomings of healthcare reform as it’s being conceived that I wanted to commend to your attention. The author is Mark Hamister who, as best as I can determine, is a moderate Republican who is the owner and operator of a chain of assisted living and skilled nursing facilities in upstate New York. He has both praise for H. R. 3200, the House healthcare reform bill:
Some, including myself, would argue that many of the requirements of Bill H. R. 3200 are admirable.
and constructive criticism. The criticisms include an undue focus on punishment:
Clearly, those who steal, cheat or act inappropriately should be punished in accordance with the law. However, the fact that hundreds of pages are devoted to punitive measures rather than reform measures made me skeptical about the bill’s actual focus.
which he says makes up several hundred pages of the thousand page plus bill. Another problem with punishment as a focus is that it presumes enforcement. Without rigorous enforcement regulation is little more than wishful thinking. Mr. Hamister also comments on the Republican bête noire, malpractice claim reform. My own view on the subject is that although I believe that some reform is in order I suspect the supporters of malpractice claim reform are overestimating the benefits drastically. A reform that might be considered in this area is that cases should be reviewed by an authoritative panel to ensure that actual malpractice (rather than merely adverse outcome) is involved before cases are allowed to come to court at all. The sad truth is that genuine malpractice does take place, the medical profession is not policing itself as rigorously as its members are ethically required to do, and judgments serve both as remediation and deterrence. Limits on judgments mean that the latter function be diminished in effectiveness. Still, conscientious physicians should not be afraid of malpractice suits which is the rationale behind the approach I’ve suggested.
He also brings up an extremely interesting point about the public option. Essentially, he characterizes it as a “loss leader”. I honestly don’t see how that can be the case. What other product would the government look to for profitable sales?
I think the legitimate fear is that, rather than being a loss leader, the public option would actually be an instance of predatory pricing, intentionally priced below the prevailing market to eliminate competition. As I see it that’s the primary complaint about the public option and I think it’s a legitimate one. The polls are pretty consistent on the public option: people tend to support it as a vehicle for increasing choice AKA competition but not as the only alternative.
Read the whole thing.
His estimates on tort reform are awfully high. I am in favor of tort reform, but I expect it will just be one small part of what is needed. I would prefer something like tax courts where the judges and attorneys who practice in that area are required to have real expertise. I am unsure how effective malpractice is in altering behavior, since European countries have little in the way of malpractice litigation and the equivalent quality.
Steve
“I think the legitimate fear is that, rather than being a loss leader, the public option would actually be an instance of predatory pricing, intentionally priced below the prevailing market to eliminate competition.”
Might I humbly suggest that – dealing as I currently am with an HSR issue – that this proposal would have about as much chance of getting through the FTC or DoJ today as an ice cube making it through the day in Houston this summer.