Health Care Reform for a population of 333 million people is controversial and complex. 216 million have private insurance. 73 million have Medicaid, CHIPS, or other government programs. 44 million have Medicare. Major changes in Medicare should await the effects of changes in other reform programs. Not all innovations will succeed. Monitoring and subsequent changes will be needed.
Previous articles discussed replacing government subsidies with block grants to the states, increasing state responsibility, expanding HSAs, and creating risk mitigation programs for patients with pre-existing conditions. This article will briefly discuss other innovative ideas that need to be considered.
Health Status Insurance would travel with employees who change jobs, even after the employee has developed a new disease during his or her initial employment. The new employer would pick up the cost of the higher insurance rates under reciprocal agreements between employers. This would allow employees to change jobs, and not be locked into their original employment.
Association Health Plans would allow small employers to reduce their health insurance costs by spreading insurance risk among a much wider group. These are currently being tested at the state level in many states, but require measures to minimize fraud, inadequate coverage, and other possible shortcomings.
Some health insurance innovations might include: bridge plans for people who need insurance coverage for short definable time periods; disease-specific insurance; automatic transfer of medical records from one plan to another; allowing health plans to question patients and request certain tests and treatments; no limits on HSA plan deductibles and out-of-pocket expense; use of HSAs to pay for medical phone calls, email consults, concierge physician participation, home visits, and chronic disease management; and Federal reinsurance plans.
Innovative options are numerous for reducing health care costs while preserving the availability, quality, and choice. The list will grow.
Robert F. Hamilton, M.D., FACS
(This article first published in Advantage News)