Excellent article on the new Vermont healthcare bill

The following is a very good article by an Vermont internist. It lays out the problems with taking an incrementalist approach to healthcare reform -- especially one that ignores the major driving force behind the escalation of healthcare costs: the private insurers that lobby to preserve their existence in every universal healthcare bill that gets passed. He lays out the most compelling arguments for a single-payer system. How long will it take before our elected officials start listening to those with the public interest in mind, not the profits of private insurers?

Catamount Health offers little in the way of reform
By MARVIN MALEK, MD

... The Medicaid program will be under sustained pressure because it serves as the bottom of the safety net. The sickest — and most expensive people to insure – end up insured through the Medicaid program when they become too ill to work and exhaust their savings.

While you're adding a new population for the state to insure by not taking on the insurance and pharmaceutical industries, you are leaving aside the best tactic to reduce costs. The current system of multiple private health insurance companies adds enormous amounts of administrative expense. I see it every day as we contend with complex insurance company policies which attempt to avoid paying any and every medical bill, and I can only imagine the parallel expense taking place at the other end of the phone line at the insurance company. And by not consolidating into one large insurer for the entire population, we fragment our ability to get serious about negotiating down the prices of medical supplies and prescription drugs — and to create a better coordinated system of care for those with chronic illnesses. ...

What does that mean to me? Yet more sets of rules for our practice to contend with. And I can only imagine the administrative burden the chronic care initiative will place on primary care practices.

Worse yet, I fear the passage of the Catamount bill will sideline the push for more meaningful health reform. We'll all be asked to give the new program a chance to work, likely putting the brakes on effective health reform for at least three, and maybe four or five years. Meanwhile, there will be ever more underinsured patients, ever higher health costs, ever greater Medicaid deficits. ...

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