October 14, 2009

Commentary: Health care reform not complicated

Health care costs are now approximately 17 percent of our gross domestic product and rising, writes Tom Fitz, president St. Mary's Health Care System, in the Atlanta Journal-Constitution. The reasons include aging of baby boomers; the increased needs for health care services as people get older; the increasing amount of "free care" provided to the uninsured or underinsured; the higher premiums paid to insurance companies; the cost of defensive medicine provided by physicians and the cost of providing health care that Medicare and Medicaid do not cover.

Fitz offers the following solutions that, when taken together, are far less complicated than the current debate in Washington. He suggests:

oe Make health care coverage completely portable across state lines, and allow businesses to join together across state lines to increase the risk pool among small businesses and lower insurance premium costs.

oe Reform medical malpractice laws. The cost of malpractice insurance for a neurosurgeon is more than $100,000 per year in Georgia. Malpractice insurance costs are a huge barrier to lowering health care costs as are additional "defensive" medical tests ordered by physicians to avoid litigation.

oe Eliminate denial of insurance coverage because of pre-existing conditions.

oe Establish transparency of pricing and financial reporting in the insurance and pharmaceutical industries, with healthy limits on executive bonuses. There should be a "rule of reason" associated with such bonuses.

oe Increase Medicare and Medicaid payments to physicians and hospitals to fully cover the cost of care.

oe Provide direct payment to insurance companies ($10,000 per patient might be reasonable) for the approximately 2 percent of our citizens who can not afford insurance, and require those with the means to pay for their own insurance to do so. Provide a sliding scale for payment of insurance premiums for those who are underinsured.

oe Provide financial incentives for new doctors to pursue specialties providing primary care in order to increase preventive care.

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