The House passed its version of the Senate Health Bill and it now goes back to the Senate. We still have a big cost problem that hasn't been addressed though.
Assuming the senate uses the reconciliation procedure, the house version of healthcare insurance reform is on its way for signature by President Obama. This is the culmination of many months of arguing among democrats, as no republicans ever participated. The 2300+ page legislation focuses mainly on insurance company regulation and allowing for 32 million more Americans to be covered. My argument has never been about whether all Americans should be covered or whether onerous insurance policies should be lifted. My argument continues to be that nothing in the legislation addresses the continued cost increases that are going unabated at 6-8% per year.
As we have written in many articles and blogs, the fundamental problem in America's health care is that costs are too high (twice as high as many other western nations) and quality is average at best. Is there anything in the bill that addresses the fundamental problem? Well, I must admit I haven't read the new house bill so maybe they added some language about this, but I doubt it. We couldn't get even simple non-controversial language in the bill to simply study whether organizations implementing lean in healthcare can radically reduce costs and improve quality.
We are going to spend 940 billion dollars more over the 10 years and we will reduce medicare payments to hospitals and nursing homes by 500 billion, and increase taxes on people making more than $200,000/yr to make up the difference of a few hundred billion. These changes in and of themselves are tolerable (not cause for joy); but what happens if we don't attenuate the 6-8% increase in the medicare cost and commercial insurance costs? We will be back for more taxes and further provider cuts.
The work isn't done with this bill. We at the Healthcare Value Leaders Network are doing the real work on health reform. Let's hope we and others implementing process improvement and continuous improvement can make breakthroughs on the real fundamental problem.
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