This Just In From the Congressional Budget Office

Blogs by definition are supposed to be short. Indeed, this one will be very short.

If you have any interest in health care reform and what will or will not work, you must read the just released Congressional Budget Office document entitled 'Health Care Reform and the Federal Budget'.

It may take you 30 minutes or more to carefully read and understand this 16 page tome. If however you are overwhelmed by the politics of health care reform and confused by the disparate points of view, would a 30 minute investment of time be worth it to get to a modicum of reality?

I beg you to read this CBO paper. Please! Then ask your friends to read it. I dare you to ask your local and state legislators if they have read it. Transformational health care public policy should be based on unfiltered unbiased information. Get informed now. Then get involved.

Thank you.

Spending on Health Care: A Couple of 'Trick' Questions

Do you know what the average life expectancy is in the United States? Now, do you know what the average life expectancy is in Canada or Great Britain? One more; do you know the average life expectancy of practitioners of the 'Christian Science' faith?

As a percentage of our GDP, we in the U.S. spend far more than any other country. Those that practice 'Christian Science' by definition spend hardly anything. I'd wager the life expectancy of all three populations is about the same. So can one conclude the amount we spend on health care does not translate to a longer life . . . . . or even better outcomes?

I think we spend so much more on health care as a nation is largely because as the richest country in the world, we can! (Perhaps I should use the past tense as something about our current financial crisis suggests we may never again have the luxury of such excess.) The 2.6 trillion dollar question becomes, who will be the governor of how much we spend going forward? And related to that, is it "fair" for some to have unlimited health care resources while others will not?

Many countries allocate their defined health care budgets equally throughout the entire population. Long waits and rationing are the means by which the budget is not exceeded. Those that can afford to do so, just go elsewhere and pay for whatever care they want and can afford.

Health care research and technology has evolved to the point where it will bankrupt our country unless limits are set. I wonder if all the talk about ways to reform health care is just a stall tactic until we dare to take on the ultimate question: how much should we spend on any one life? Our country's history suggests we will develop a unique and very special way of solving this most vexing riddle.

Penny Wise And Pound(s) Foolish!

The local papers are reporting on school districts cutting various programs in an effort to balance strained budgets. On the chopping block: physical education! How can that make sense?! With child obesity almost epidemic, shouldn't we be spending more time in schools teaching the values of exercise and nutrition? (Was there ever a more rhetorical question?)

Every health care reform proposal includes wellness and prevention as a top priority. Employers have assumed the responsibility for promoting wellness but why not start at an earlier age. This should be a top legislative priority.

Health Insurance Renewals for Small Groups: Mid Year 'Report Card'

Our Agency works with many small businesses who have health insurance primarily on a fully insured basis with one of four insurers. We've pretty much completed January 1 thru June 1 renewals so I asked for a comparison of last year's renewals to this year. Here are the mid-year results:

2008 +17.31% vs 2009 +16.86%; clients of Insurance Co. A

2008 +20.26% vs 2009 +22.08%; clients of Insurance Co. B

2008 +16.40% vs 2009 +19.88%; clients of Insurance Co. C

2008 +10.61% vs 2009 + 8.45%; clients of Insurance Co. D

All Clients Combined: +16.96% 2008; +19.18% 2009

The above increases are almost always reduced to single digits after plan design changes and/or underwriting with a new insurer. Never the less, what does it say about 'our' insurer's ability to "manage care" if during such troubled economic times and with all the political pressure to contain costs, premium increases like these are still needed to cover more expensive health care and greater utilization!?

Results like these are used by many as proof we need to move to a government run plan as the pace of health care inflation is clearly unsustainable. But such a conclusion misses the more important point. Simply changing payers will either lead to the bankruptcy of the government or rationing of care. Fortunately, as serious reform talk heats up in Washington, the brightest prospects for meaningful "change" address systemic reform of the way we deliver health care.

And might I add that under our current system, at least I have the option of moving to Insurance Company D!

More Small But Encouraging Signs Of An Economic Recovery

Yesterday's mail included one of those 'check' packets from my Master Card vendor; you know the ones I mean - the blank checks that offer you the opportunity to more easily spend money you don't have! As I tore them up, it occurred to me it had been several months since I had received one of those mailings. Coincidentally, later in the day I called a bank where I had financed an auto on a routine service issue. At the end of the call, the customer service representative offered me a new "Platinum" credit card with a significant limit and "no annual fees"!

Although almost inconsequential, would either of these occurrences have happened just a few weeks ago? Hopefully it's a sign the credit markets are loosening and more evidence the economy is turning (along with the stock market rally.) I know we're far from being out of the woods but for those of us looking for any good news to assuage the angst of recent months, it may be worth sharing. What about you? Have any good news?

It doesn't seem to have much to do with health care . . . . . . . . or, does it!?