Tuesday, November 17, 2009

Health Care Costs Money: Who Knew?

Noted online yesterday morning:

A report by the Centers for Medicare and Medicaid Services sent Democratic staffers scrambling over the weekend after the 31-page study revealed potentially damaging findings about the cost and coverage of the health care bill passed by the House of Representatives Saturday night. The report said, among other things, that rather than cutting costs, the bill would increase them by $289 billion over 10 years…

…the analysis from CMS's chief actuary, Richard Foster, found that the House bill will achieve its primary goal of significantly helping uninsured Americans by providing new access to affordable health insurance. However, Foster also warns that the expansion will come at a cost to the federal deficit, which will likely increase, and to seniors, who could lose access to some of their own doctors under the plan as cuts to Medicare force some providers out of the market.

Patricia Murphy, The Capitolist, November 16, 2009

I’ve always thought that out of every relationship, good or bad, you find something of value. Originally this thought came to me over an eel roll, when I recognized that were it not for being totally tossed over by a certain dark-haired girl, I’d still not know the joys of sushi, nor have anything but a passing acquaintance with female cosmetic paraphernalia such as the eyelash curler. (Such knowledge has served me well in understanding of the makeup toolkit of my bride.) And so I must thank the worst boss I ever had for at least introducing me to the following equation, one which effectively summarizes the entire problem of any health care system.

Access x Quality = Cost

(Access is the number of people who have entry into the health care system, while quality represents the number of services provided. Cost is, well, cost.)

Given that this equation is true…and while I could go into excruciatingly painful details as to why, just for the moment accept that it is…is the recent report by the Center for Medicaid Services really a surprise? You increase health care access to an unrestricted level of services, and costs go up. You could have seen this coming a mile away.

It seems to me that the fact that this report is somehow startling or controversial is simply because nobody wants to make any hard choices. Hard choices require hard thought, which is anathema to our increasingly polarized, sound-bite democracy. (One wonders if Henry Clay would have succeeded in holding the Union together given the current media frenzy.) The hard choice here is to figure out what we really want. We can’t have increased access to care, increased services provided, and cost containment. You can have increased access or quality of care, but only at increased cost. You can lower costs, but only at the expense of denying people access to the system or by restricting benefits.

My suggestion: Policymakers should listen en masse to the fifth cut on Meat Loaf’s legendary Bat Out of Hell.

Don’t be sad…in health care reform, two out of three ain’t bad.

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