So Far, Health Reforms Are More of the Same
If less is more, today’s post is a lot more.
Through legislation and executive order, the Biden administration is bringing health insurance to millions of additional people. These efforts include continuation into the summer of Affordable Care Act (ACA) sign-ups and sweetened subsidies to help pay for the plans.
Efforts include extending a financial olive branch to Republican-led states to encourage them to provide expanded Medicaid coverage to their residents, millions of whom have lost health insurance because of pandemic layoffs.
While the ACA and Medicaid sound a lot like government-run health care, private health insurers are offering nearly all the expanded coverage. They’re always been providers of ACA plans and, increasingly, dominate Medicaid managed care plans.
So, if you think private health insurers are part of the problem and not part of the solution, nothing much has changed.
Hospitals, which collect more than 30 percent of our health care dollars, run the gamut from struggling rural systems to bloated health-care hotels with opaque billing systems that often charge several times as much for privately insured care as the rates allowed under Medicare rules, and even higher multiples than charges in other developed nations with health outcomes superior to those in the U.S.
New hospital pricing rules took effect January 1 that require public posting of hospital prices. To date, hospitals largely have thumbed their noses at the new rules and the still-evolving team or Biden health-care leaders has yet to invoke the law’s non-compliance penalties, paltry as they may be at $300 a day.
As rural hospitals await expanded government funding to help them stay afloat, their better-heeled fat cats are waiting to greet and continue over-charging people who have avoided elective surgeries and deferred care due to fears of COVID-19 and related hospital-borne illnesses.
There are no signs of reforms for this sector of health care, either.
Doctors, nurses, and other health-care workers are today’s pandemic heroes, and nearly no one wants to cut their numbers or compensation. Just the opposite is true, given the enormous staffing shortcomings uncovered by the virus. This is another 20 percent of the nation’s bloated health-care spend that is off the table.
Even drug companies no longer top the most-wanted lists of health care villains. Their spectacular work in quickly devising and producing effective COVID-19 vaccines has restored their Teflon coatings and protected the industry from meaningful pricing curbs.
Plus ça Change, plus c’est la même chose.
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