NH Poll of Primary Voters Shows Bright Red & Blue Lines

The Boston Globe’s poll of likely voters in the January 8, 2008 Presidential Primary in New Hampshire shows bright blue and red lines between the Democratic and Republican voters: 80% of Democratic voters believe providing health care is the government’s responsibility versus 30% of likely Republican voters.

The importance of the poll findings is two-fold: one, it is of likely voters, which is the people that politicians actually listen to, and two, it shows a fairly significant divide that seems to not be easily bridged — one side wants the government to provide health coverage, the other does not.

There is a way to have a bi-partisan solution. It is a fairly simple and straight-forward solution: have the government finance the purchase of private health insurance — that the person who needs the insurance chooses.

The failure of Hillarycare spooled up strong, grassroots opposition to a government managed health care system.

Unless we want another running political battle on health care reform that lasts years, allowing the government to finance the purchase of health insurance is the only compromise that is politically viable — as this poll demonstrates.

PriceWaterhouseCoopers Predicts Three Trends in 2008 to Impact Health Savings Accounts

The rise of cash based care — those who pay cash for their care — either because of their deductible or because they are uninsured, is a trend that will impact health care in the United States in 2008 because retailers who are used to providing goods and services for cash (it is their day job, you see) are moving aggressively to provide basic medical services, in conjunction with their existing health care services, like pharmacies. What this means for the existing health care services industry is that the world’s retail experts are moving into their space, and will likely and quickly dominate.

In consultant-speak, PriceWaterhouseCoopers predicts:

“Retail Health Clinics Will Challenge Primary Care Models: Driven by consumer demand for convenient and lower-cost medical care, the number of retail clinics in discount chain stores, grocery stores and drugstores throughout the U.S. is expected to quadruple, from 700 today to more than 3,000 in five years. In the year ahead, U.S. states, payers and policymakers will be crafting legislation and policies applicable to this new breed of healthcare provider, which lacks uniform regulation and quality controls. The growth of retail healthcare could create opportunities for providers, or it could threaten the primary care delivery model. Pharmaceutical companies may choose to step up marketing directly to nurse practitioners who staff the clinics.”

These new clinics have the advantage of using the existing retail infrastructure — you know, pick something out from the store and pay for it with cash, check or credit card — and do not have to engage in the expense, frustration and full-time employees needed to deal with filing claims and collecting from insurers. These retailers will be much more efficient than current primary care doctors and therefore will offer their services at a much lower price. This will cause a self-reinforcing trend of winning business from primary care doctors, because these clinics are faster and less expensive, and less hassle than trying to get an appointment and waiting around to see a doctor. In fact, if you are sick with a chest cold or a sore throat or strep, then you will be healthier sooner if you go to a one of these clinics — instead of waiting for your appointment with your doctor. These clinics will deliver faster, cheaper health care — and once rolled out on a national scale, they will have a deflationary effect on health care prices. Just like the price of Lasik surgery has dropped like a rock. This is the classic impact of market forces on the cost of a service, when a new competitor can provide the same service, faster and for a better price.

The second prediction made by PriceWaterhouseCooper is that:

“Individual Health Insurance Could Take Off: Typically more expensive than group health insurance, individual health insurance could see market growth as more states mandate health insurance such as Massachusetts has done, and if an individual mandate or additional tax incentives come to fruition from proposals by Republican and Democratic presidential candidates. Hospitals and other providers may suffer if these plans offer limited benefits, but in the long run would benefit from fewer uninsured Americans. Look for insurers to tailor products and distribution strategies to individuals in the year ahead.”

It is interesting to note that Health Savings Accounts are the largest and fastest growing product among individual health insurance policies sold.

Finally, their last prediction has to do with the pressure that hospitals are coming under from the IRS to justify their non-profit, tax-exempt status. Since most hospitals treat Health Savings Account patients that do not have a doctor’s network or insurer’s discounts as self-pay patients, they get charged the same high prices that the uninsured get tagged with; and when you are a large corporation and you charge people for necessary health care services a huge mark up above cost, and these people find out about it — they complain. Politician listen to these complaints. Especially when the corporations doing it are tax-exempt. Lets just say it creates a political dynamic that even hospitals — the largest employers in many Congressional districts, with an angelic public face — will find uncomfortable. To wit, PriceWaterhouseCooper states:

“IRS to Seek Full Accounting of Hospital Community Benefit: The Internal Revenue Service wants hospitals to submit a full accounting of the benefits they provide to the community, reported in a uniform manner, as part of their annual tax return to the IRS, submitted on the proposed 2008 Form 990 and available for public inspection. Many hospitals document their community benefit, but have done so inconsistently. In 2008, tax-exempt hospitals will need to start tracking community benefit efforts so that, when and if required, they can accurately report their activities for the year.”

The dollars going to Community Benefit will be tracked by watchdog groups and politicians eyeing revenue raisers (increasing taxes) to help fund other health care expenses. Ultimately, this publicly available 990 data will be used to create a standard rule of thumb of the amount of money that needs to be flowing to the Community’s Benefit, for non-profit hospitals to keep their tax-exempt status.

Automakers Fund $30 Million in UAW Health Care Lobbying

Anyone who has seen “Thank You for Smoking” (a really great movie and if you haven’t seen it you need to as soon as you can) will understand what the following report from The Detroit Free-Press means: “the union’s deal with Detroit’s automakers includes a boost to its lobbying efforts though a $30-million pledge toward a new think tank called the National Institute for Health Care Reform.”

The math on this funding of the new Institute is really pretty simple. The Unions and Automakers spend $52 billion on health care every year. They are spending $30 million to get the unions to lobby Congress to create a national health care benefit so their $52 billion expenditure can be shifted to the U.S. government and the taxpayers, and off the books and backs of the automakers and unions. Only in the casino called Washington, D.C., could you spend $30 million to save $52 billion.

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