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Article added or updated:
02/03/2008 |
Health Care Solutions for the Self Employed and Small
Business Owner
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HSA / HRAs For Dummies |
Costs, availability, discrimination, rich vs. poor, employed vs.
unemployed, new technology and incurable diseases are among the issues
plaguing the health care system that scream for solutions. None are
easy, few are inexpensive. Indeed, there seem to be as many different,
often disparate, at times conflicting solutions as there are those
offering them.
Nevertheless, some of the finest minds and most adroit politicians in
America and many other parts of the world, and many of the leading
thinkers in the medical, pharmaceutical and public policy communities,
have dedicated themselves to arriving at some answers to these often
bewildering, at times painful, questions.
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From Washington, there are bills pouring on the floors of both houses of
Congress with such optimistic names as the Healthy Americans Act (from
Sen. Bob Bennett, R-Utah, and Sen. Ron Wyden, D-Ore.) Former Senate
Majority Leader Tom Daschle, D-S.D., is proposing a Federal Health Board
modeled on the Federal Reserve. Sen. Sheldon Whitehouse, D-R.I.,
believes a personal electronic health record of every American should be
stored centrally and all prescriptions written electronically rather
than scribbled by hand. Leslie Norwalk, who administers the federal
Medicare and Medicaid systems, thinks the $674 billion that's spent
needs to be dispensed more proactively.
At the same time, some former officials from both sides of the aisle
believe there are some innovative solutions that are cost-effective as
well. Paul H. O'Neill, former treasury secretary in the Bush
administration and now a special adviser to the Blackstone Group,
advocates a law "mandating every American purchase catastrophic
health
insurance."
Another Republican, former House Speaker Newt Gingrich and founder of
the Center for Health Transformation, advocates new payment systems
making all health care "paperless." Dr. Julie Louise Gerberding,
director of the Centers for Disease Control and Prevention, says, "Our
children may be the first generation in more than a century with a
shorter life expectancy than their parents."
Health and Human Services Secretary Mike Leavitt's Value-Driven Health
Care Initiative wins the endorsement of David R. Carlucci, chairman and
chief executive of IMS Health, a monitor of pharmaceutical intelligence.
Leavitt's initiative "is moving stakeholders toward greater transparency
and access to health care information," Carlucci believes.
On the other side of the aisle, John Podesta, chief of staff to
President Clinton, and Jeanne Lambrew, who worked on health policy in
the Clinton White House, have developed a concept called the Wellness
Trust to "bring resources to bear on high-priority services." Podesta is
now president of the Center for American Progress, where Lambrew is a
senior fellow. They believe the nation needs "a new paradigm for
prevention" of diseases and other health issues that can be financed
through the Wellness Trust, a public-private system.
In the private sector, Fred Hassan, chairman and chief executive of
Schering- Plough, believes that a top priority is protection of
intellectual property when it comes to pharmaceuticals, since
"innovation happens when people and companies take big risks. When it
comes to pharmaceuticals, those risks are enormously expensive."
Michael J. Critelli, executive chairman of Pitney Bowes, "looks at
investing in
health care as we do any other investment, with a payback in
terms of not only lower costs for
health care but reduced absenteeism."
And he believes "the employer is in a unique position" to help increase
the nation's wellness. Karen Ignagni, chief executive of America's
Health Insurance Plans, believes in public subsidies for working
families that can't afford to purchase health care coverage."
Princeton professor Uwe Reinhardt points out that the U.S.
health care
system "is really expensive for what it delivers"--twice as expensive
per capita as Canada. He also notes that "only 53% of the time do
American patients get the right kind of health care for the condition
they have." His solution? "Spend money on an information infrastructure,
[which] would address the cost and quality issue substantially." Then he
advocates $100 billion a year in federal subsidies, particularly for the
uninsured poor.
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| American health
care consumers "are in a war for control of $2.2 trillion that "we have
turned over ... to those who manage our
health care, without holding
them accountable," according to Harvard Business School professor Regina Herzlinger. At the same time, Margeurite W. Kondracke, chief executive
of America's Promise Alliance, says, "Our No. 1 priority is to see that
all kids have access to adequate
health care." She believes this can
happen by enrolling 6 million children who are eligible, but not
enrolled, in the State Children's Health Insurance Program and Medicaid.
Duke Law School professor Clark C. Havighurst believes that consumers
are given the choice "between a Lexus, Mercedes or BMW" in
health
coverage. "You don't have the choice of buying
health coverage that isn't
outlandishly expensive," giving people an incentive to find lower cost
health plans. "The old managed competition idea from the Clinton years
is still a pretty good one," he says.
This article first appeared
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