Dr. Denis Cortese, head of the Mayo Clinic, in an interview with David Ignatius in the Washington Post, argues that healthcare system reform can be experimented with in the public options for health care that already exist: Medicare, Medicaid, military medicine, the VA, the Tricare system of military retirees, and the Federal Employees Health Benefits Program.
If liberals really want to show they are serious, they should begin with our existing single-payer behemoths, Medicare and Medicaid. Cortese argues that the White House should mandate that, within three years, these programs will shift from the current fee-for-service approach to a system that pays for value — that is, for delivering low-cost, high-quality care. If doctors performed unnecessary tests that ballooned costs, their compensation would be reduced. And doctors would be compensated by regional formulas, to encourage them to work cooperatively in local networks where they could all make more money by practicing better medicine.
When you add the employee healthcare benefits paid by state and local governments and the healthcare systems run by state and local governments to the mix, these various public or publicly financed healthcare plans account for more than 50% of all healthcare in the United States. It’s always puzzled me that so many people view our system in which something like 60% of healthcare is socialized as a private system while France’s system, in which 80 to 90% is socialized is socialized medicine.
I think Cortese is on the right track. It certainly meshes with what I see in practice. What he describes is what my partner and I have been predicting for a couple of years now. It would take a lot of political will to accomplish and risk alienating the oldsters, so while it needs to be done, I think it unlikely.
Steve
“It’s always puzzled me that so many people view our system in which something like 60% of healthcare is socialized as a private system while France’s system, in which 80 to 90% is socialized is socialized medicine.”
I’m not sure they do. Rather, they look at the private protion as private, and point to mess that the socialized portion is, and say don’t pollute the private part.
Drew, 39% of Americans don’t realize that Medicare is “the government”.
That’s a hilarious poll, Dave. 25% of people don’t believe Obama was born in the United States, but only 90% believe Hawaii to be part of the United States.
Please, Dave. You are so far above this. Polls, polling and their distortive tactics render this meaningless.
Further, the question could be interpreted to mean stay out of Medicare as it currently exists.
Probably because the French government role effectively touches and helps all its citizens in getting care, whereas the US role is more of a “if you’ve got a problem” type of thing, like being old, poor, etc.
I find it odd that you include state provision of health coverage for state employees as “socialized” health coverage. Don’t most of those guys simply contract with private insurance plans?
Do we even have a working model on how to do this? I suppose you could simply have the system pay out a flat payment for every Medicare user, but expect massive political arguments over how large the payment could be, and considerable bitching from the elderly about the government trying to short them.
Medicaid would be easier (if only because it doesn’t have a massive political constituency), but since it’s a mixed federal-state program administered by the states themselves, you’d have to either change the laws governing federal Medicaid funding to try and pressure the states into changing how they operate their state Medicaid programs, or simply pay out a flat amount per patient.