Health Care Reform, Part 2

In an earlier post, I highlighted a column discussing some details of proposed health care legislation.  As I said, it is a very complicated area.

One very important (and highly contentious) issue in health care reform is whether the health insurance industry needs more regulation and/or more competition, i.e. “a public option.”  For a special view of an insider, I recommend the July 10th episode of Bill Moyers Journal.  This TV program had an extended interview with Wendell Potter, who is the former head of Public Relations for CIGNA, one of the nation’s largest insurance companies.

In a change of heart, Potter decided to speak out against the insurance industry. Here is a salient quote from the program’s description.

Looking back over his long career, Potter sees an industry corrupted by Wall Street expectations and greed. According to Potter, insurers have every incentive to deny coverage — every dollar they don’t pay out to a claim is a dollar they can add to their profits, and Wall Street investors demand they pay out less every year.  Under these conditions, Potter says, “You don’t think about individual people.  You think about the numbers, and whether or not you’re going to meet Wall Street’s expectations.”

Conclusion

I am all in favor of corporations making a profit.  That judgment assumes that a competitive market exists and that consumers have real choice.  In general, if companies have an incentive to provide a better product or service, shareholders can prosper and consumers will benefit.

But there is very little competition in the health insurance marketplace.  If insurance companies have perverse incentives to deny coverage and to game the system, consumers are obviously harmed.  The insurance that you thought you had may be a costly illusion.

Watch the video or read the transcript, and decide for yourself.

Health Care Reform, Part 1

I have shied away from a discussion of health care reform, because I felt that the issue is too complicated.  And once I’ve started down the road to try to make some sense of the debate, I’d probably have to make a full-time job of it – it would suck me right in.

And, in truth, the topics that interest me most are quite contentious.  Why is the United States the only developed country that does not provide universal health care?  How can we change the incentives of citizens and medical care providers so that we reduce costs and improve outcomes?  Do we have a health care system now, or is it a “sick care” industry?  Why are we not paying more attention to prevention?

I’m sure that very smart people are thinking and writing about these issues, but I have just not taken the time to identify them and sort everything out.

However, there is one columnist who is readily available and discusses some practical issues that are worth mentioning, and that is David Leonhardt.  His weekly column, Economic Scene, appears on Wednesdays in the New York Times. He is also a contributor to the Times Magazine on Sundays.  I’ve been a fan of his for a long time, and in a previous post I discussed an article he wrote on President Obama’s Economic Agenda.

Wednesday’s column, Falling Far Short of Reform, discusses some very practical issues reflected in the two different health-care bills currently working their way through the House of Representatives and the Senate.

If you’ve been following the health care debate and are interested in a sensible discussion, I can recommend this column.  And if you’ve not been following the debate, but would like to catch up on what all the hoopla has been about, I can still recommend this column.

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I would love to hear from others on recommendations of articles that appeal to them.  I’m specifically not interested in articles that rail against “a government takeover of health care” or call efforts at reform “socialized medicine.”  I am interested in articles that discuss what works in improving health care and/or in reducing costs – priorities, both, for the majority of Americans, I should think.