Posted on 12/17/2008 3:05:57 PM PST by Canticle_of_Deborah
"I say this with good conscience: every year we don't do anything about the uninsured, we end up, by default, moving closer to a single-payer system," Louisiana Secretary of Health and Hospitals Alan Levine warned TAS in an interview. "Because every year, more people get enrolled in Medicare, more people get enrolled in Medicaid, and more people get enrolled in SCHIP... that by itself is having a death spiral effect on private insurance." And a single-payer system, he added, "would be a disaster."
Levine is the man Governor Bobby Jindal has entrusted with the Louisiana Health First Iniative, an overhaul of Louisiana's woefully underperforming Medicaid system. The plan, which has met with approval from free-market health care experts, is scheduled to reach the Louisiana legislature around the same time as a national health care overhaul advocated by President-elect Barack Obama would reach Congress.
While Jindal and Levine believe they can expand insurance coverage by fixing Medicaid, Obama advocates a comprehensive reform at the national level that would mandate universal coverage under a massively federalized system. In the past, Obama has even stated that he favors a single-payer -- meaning socialized -- system.
To forestall this process, Levine and Jindal want to move to a more market-based system. The current Medicaid model in Louisiana is fee-for-service: doctors perform procedures and then send the bill along to the state. Their incentives are terribly misaligned, rewarding the quantity of procedures performed instead of improved patient health outcomes.
(Excerpt) Read more at spectator.org ...
I agree with your post below for the most part.
I am not in favor of more government involvement in ANYTHING, but at the same time, Republicans have to offer solutions instead of just saying Government =bad. I applaud Jindal for his effort.
A degree in biology doesn't have much to do with practicing medicine or nursing.
Jindal knows more about fixing health care than ANY physician.
A completely, utterly ridiculous statement. Do you work for Jindal?
yes, Jindal gets points for effort.
That said, the plan is semi-socialization the more I think about it. The patient retains a limited choice in terms of doctors and facilities but the treating professionals have none.
If a physician is forced to take on a patient and payment is outcome based, there is little incentive to treat high acuity, time consuming patients with poor prognosis. It is more profitable to treat large numbers of healthy people. You will see the same problems in a different form that this plan wants to solve (access to care and quality of care) and an increase in passive euthanasia.
It’s a pyramid scheme like the HMOs.
Medicare and Medicaid already account for close to 60% of healthcare dollars already. It is a gravy train for the Blues. Jindal’s plan is the best I have seen so far at providing a means to corral costs. Perfect? No. Socialist? Absolutely not. The state is already picking up the tab for this segment. Something has to be done to slow rising costs. Otherwise we will indeed wind up with single-payer—administered by, guess who? Da Blues.
It does if it's taken with a view to becoming a doctor, which is what Jindal was considering. It's called "pre-med", and it is the consolation prize one graduates with if they decides not to go to med school.
"A completely, utterly ridiculous statement. Do you work for Jindal?"
No, I don't "work for Jindal", and the statement is anything BUT ridiculous. You don't manage a major state department, relating directly to running hospitals, and move it from $400 million deficit to $220 million surplus status by NOT knowing something about how to manage health care. Can you name any OTHER individual with that kind of track record???
Jindal did not go to medical school. Wishes do not translate into experience. Using your logic a degree in business would be more helpful.
People who have never touched a patient have no business telling those who do how to run their practice.
Would a mechanic tolerate the government dictating whose car he could fix in what manner and how much he could charge?
How about a computer technician?
Food? We all need it. Why not institute mandatory prices and quantities for each family at all grocery stores?
Housing? We all need it. Why not dictate mandatory prices to companies so everyone can have a home? That's fair, right?
Retail clothing? We all need it. Why shouldn't a person who makes $20,000 a year be able to shop at Saks?
All typical business freedoms go out the window when the subject is healthcare.
I doubt if that is a recognized major. And what happens if they are not accepted at any med school?
I completely agree. It is already happening. Payments are capped and completely dictated in Medicaid and Medicare. At least Jindal provides an alternative with some free market elements (choice) that does not have to lead to single payer for the entire system. Young docs could even practice a few years in a system like this to pay off their loans before going into their own practices.
What a lot of 'free-market' advocates don't quite get is that it will not work to simply let the market handle this one. The problem began when the government jumped in in the first place. At that point the market could have handled it because it was still reasonable for the church and other organizations to provide the safety net. Once the government got involved the costs began to rise exponentially and it became very difficult for the charitable groups to provide care (though some continue nobly to try). But to simply turn the market loose on the problem now would only result in a lot of dead people. An acceptable cost to the pure "Rand-esque' free marketeer, but not to me. The system must be weaned from government involvement over time. Neither single-payer nor cold-turkey will work.
“People can survive one organ system failing and even two,” the senior doctor said to me after we were finished. “But when that third one goes ...”
Primary care is delivered in a variety of settings by a variety of professionals, including nurses and physicians’ assistants, but it is anchored by family-practice doctors, general internists, pediatricians and, for many women, gynecologists.
The news got worse in September, when The Journal of the American Medical Association published a study showing that just 2 percent of graduating medical students are choosing to enter general internal medicine.
Strike one.
But a recent survey indicates that the primary care crisis may not be looming on the horizon; it may already be at our back door.
Nearly half of them said they planned in the next three years to reduce the number of patients they see or to stop practicing altogether.
Only one-third felt they had the time to fully communicate with and to treat all patients, and 60 percent felt that paperwork demands resulted in less time spent with patients.
The primary care crisis raises questions not just about future access but about current morale.
Strike two.
Mr. Obama and his team may find ways to give more Americans access to the waiting room, but what if there’s no doctor on the other side of the door? The crisis in primary care must be addressed before any real change can occur; otherwise, the flood of new patients may instead turn out to be a final strike for our ailing health care system.
And at that point for all of us, doctors and patients, the game would be over.
Excuse me, but his undergrad education IN MEDICINE (which is what pre-med is) was sufficiently good to garner him acceptance to one of the top medical schools in the country.
His credential at successfully MANAGING a medical system started at age 24, when Governor Mike Foster appointed him to be head of Louisiana's Department of Health. What you have to understand here is that Louisiana has had a combination of "socialized medicine" (the Charity Hospital System), and private medicine. As head of the state department, Jindal was DIRECTLY in charge of managing the Charity Hospital system, and regulating the private sector. Add to that his time spent as the Assistant Secretary of Health and Human Services for Planning and Evaluation under the Bush administration. NO other individual that I know of currently running for public office can match those credentials. Bill Frist might have come close, but his experience was still inferior to Jindal's.
There's no "wishful thinking" involved at all.
"Using your logic a degree in business would be more helpful. People who have never touched a patient have no business telling those who do how to run their practice."
Actually, a LOT of medical enterprises (including hospitals) are run by folks who have "never touched a patient".
Oh, it's not listed in university catalogs as such, but it's real nonetheless. Usually the undergrad curriculum is in the "liberal arts" part of the University, with courses like biology, microbiology, comparative anatomy and other "medicine related" courses, along with chemistry, some physics. Obviously, it varies from state to state. And graduating with a Bachelor's Degree in Biology (or Microbiology) is the usual academic verbiage that ends up on the diploma. But the REAL purpose is to get the undergraduate grounding to go into med school.
And many of those facilities are going under. You have no clue of the problems in them.
How many medical enterprises have you worked in?
No offense, but I normally make it a policy not to argue with people who have never worked in healthcare. I've reached my limit with you. Have a nice day.
No, it's not. There is no such undergrad major of "medicine" or "premed". Biology is not "medicine." Premed indicates a future intent. It is not a major. Take the word of people who have actually gone this route instead of spouting off nonsense.
And may of them aren't. This is called a "non-argument".
"How many medical enterprises have you worked in?"
None, but I have worked quite a bit with many people (including physicians) who have. So, in your mind it is impossible that I might accidentally have learned something in the process???
"No offense, but I normally make it a policy not to argue with people who have never worked in healthcare. I've reached my limit with you. Have a nice day."
No offense, but it is pointless to argue with idiots. Which you have just proven yourself to be. Anybody who thinks that one has to have worked in a profession in order to know something about it "is" an idiot.
Jindal care = socialized medicine. They are trying to increase coverage of the unisured by using government funds and flat fees and choice and call it ‘free market’? What a joke, this is worse then the dems plan because it is cloaked in a ‘conservative’ veil, just like the prescription medicare debacle.
We heard this exact same crapola out of Massachusetts.
Republicans: Doing the socialism the Democrats can't do.
I run into this before. Insurance, which is “pooled” by definition does tend look like a collective to some, although ideally is mostly about spreading risk, not control.
This is a proposal to add some accountability and rational cost containment to LA’s Medicaid program, which is a publicly funding social program for the poor already. Without moving to sometype of voucher program, it’s hard to imagine how they could bring less socialism,in a politically viable way, to a totally government run program.
Having said that, I WOULD love to see a modified Health Savings Account approach somewhere in the country on Medicaid. I find that many Medicaid recieptients are very savvy and know how to stretch dollars in far more intelligent ways than many leaders imagine.
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