I spent about 40 minutes on the Handsoffmyhealth.org Facebook page answering questions about the impact of health care reform from about 500 people who signed in.
People wanted to know how much control the government will or would have over medical decisions. And many people with cancer wrote in, wanting to know how the health plan might affect them and their ability to get insurance.
I said that the key issue going forward is to preserve individual choice and the ability to get medical treatment based on need, not cost.
That said, the first steps being taken to implement health care legislation are as follows:
1. Allocate $10 billion to the IRS and 17000 more IRS agents to review value of health care, whether you have it and to determine if your source of healthcare exempts you from paying a fine.
2. Allocate $250 million and add FBI agents to increase the number of Strike Teams swooping into the offices of physicians who seem to be overbilling based on an audit of claims data and not based on material evidence.
3. Give the Agency for Healthcare Research and Quality an additional $600 million a year to develop guidelines for determining what technologies, services and treatments should be covered in a "quality" health plan and for how doctors should practice medicine based on comparative effectiveness benchmarks that ignore individual differences.
4. Medicare cuts to hospice and home health care services.
People at the lower end of the income scale with cancer and serious disabilities will be forced in Medicaid. By 2014 the current rush of primary care doctors retiring and opting out of Medicaid will create "hollow health care" access. For speciality care and cancer treatment, Medicaid will have the right to restrict access to care and drugs based on comparative effectiveness. If a medicine is not on the Medicaid formulary you are out of luck.
I also predicted that at some point in time a health plan will go under, prompting the administration to take it over like it did GM and the banks. A very cheap way of creating a public option. Expect a lot of bailing out of the "too big to fail" health plan. ERs will be the place of last resort for millions and millions of other people will pay the fine, get coverage when they are sick, drop it when they are well again. This churning takes places in Medicaid all the time and it will spread to health care insurance in general because the incentive to game the system is built into the bill.
Finally, I suggested that just as people pay taxes and send their kids to public schools, people who want decent health care will pay up and buy into private health associations or go off-shore, paying out of pocket when they need or with the help of new gap insurance products.
It may all that we can do is create escape routes and underground railroads to let people secure the care they want and when they need it.
In America that is called market opportunity.
People wanted to know how much control the government will or would have over medical decisions. And many people with cancer wrote in, wanting to know how the health plan might affect them and their ability to get insurance.
I said that the key issue going forward is to preserve individual choice and the ability to get medical treatment based on need, not cost.
That said, the first steps being taken to implement health care legislation are as follows:
1. Allocate $10 billion to the IRS and 17000 more IRS agents to review value of health care, whether you have it and to determine if your source of healthcare exempts you from paying a fine.
2. Allocate $250 million and add FBI agents to increase the number of Strike Teams swooping into the offices of physicians who seem to be overbilling based on an audit of claims data and not based on material evidence.
3. Give the Agency for Healthcare Research and Quality an additional $600 million a year to develop guidelines for determining what technologies, services and treatments should be covered in a "quality" health plan and for how doctors should practice medicine based on comparative effectiveness benchmarks that ignore individual differences.
4. Medicare cuts to hospice and home health care services.
People at the lower end of the income scale with cancer and serious disabilities will be forced in Medicaid. By 2014 the current rush of primary care doctors retiring and opting out of Medicaid will create "hollow health care" access. For speciality care and cancer treatment, Medicaid will have the right to restrict access to care and drugs based on comparative effectiveness. If a medicine is not on the Medicaid formulary you are out of luck.
I also predicted that at some point in time a health plan will go under, prompting the administration to take it over like it did GM and the banks. A very cheap way of creating a public option. Expect a lot of bailing out of the "too big to fail" health plan. ERs will be the place of last resort for millions and millions of other people will pay the fine, get coverage when they are sick, drop it when they are well again. This churning takes places in Medicaid all the time and it will spread to health care insurance in general because the incentive to game the system is built into the bill.
Finally, I suggested that just as people pay taxes and send their kids to public schools, people who want decent health care will pay up and buy into private health associations or go off-shore, paying out of pocket when they need or with the help of new gap insurance products.
It may all that we can do is create escape routes and underground railroads to let people secure the care they want and when they need it.
In America that is called market opportunity.
