Archive for January, 2010

When replowing old ground, expect a similar harvest.

Posted on January 19, 2010. Filed under: Health Insurance |

“The idea behind the plan was always to incorporate within it the best concepts of health economics, health insurance and health care. The attempt to reach this high goal required the application of the best efforts of many inside and outside the Government to deal with many difficult issues–issues of financing, of utilization controls, of the effect on private plans, of quality protections, of methods of administration, of fair reimbursement, of acceptability to the people providing health care and to the people receiving and paying for health care, and of the nature of the need to be satisfied. Many thousands of carefully arrived at decisions were made and incorporated in the more than 50 pages of enacted legislation crammed full with detailed provisions for putting the ideas behind health insurance into effect.

The decisions had to be made in the face of somewhat conflicting objectives: to support continuing improvement in the quality of health care but not to direct changes in care; to cover health services without barriers to their proper use but at the same time to avoid possibilities of paying for unnecessary use of the services; to cover only basic and most expensive needs but not to create an incentive to use one form of service when another, possibly less expensive one, might equally suffice; to cover institutional health services for a period of time enough to meet medical needs but not so long as to encourage hospital use to meet custodial needs; to provide for the safeguards of patient-sharing in costs through deductibles and coinsurance but not to impose undue financial burdens on the aged; to safeguard the expenditure of funds but not to involve the Government in the establishment of physicians’ fees; to provide for utilization review procedures but not to involve the Government in medical judgments.”

Does any of this sound familiar? It sounds like it could be part of the healthcare debate of today. Actually, this is from the Social Security/Medicare legislation of 1965, straight off the Social Security website.

If the Congress failed so miserably to control costs for one segment of the population 45 years ago, what makes them think they can do it for everyone now?

Just asking.

http://www.socialsecurity.gov/history/ssa/lbjmedicare1.html