Re: WLP - anybody likes this health insurers.What got my attention is that they
Here's an article by the Institute of Hawaii describing Safeway's aco I love the Safeway program. But the savings are vastly overstated. A Washington Post writer did a little fact checking:
But a review of Safeway documents and interviews with company officials show that the company did not keep health-care costs flat for four years. Those costs did drop in 2006 -- by 12.5 percent. That was when the company overhauled its benefits, according to Safeway Senior Vice President Ken Shachmut. The decline did not have anything to do with tying employees' premiums to test results. That element of Safeway's benefits plan was not implemented until 2009, Shachmut said.
After the 2006 drop, costs resumed their climb, he said.
Even as Burd claimed last year to have held costs flat, Safeway was forecasting that per capita expenses for its employees would rise by 8.5 percent in 2009. According to a survey of 1,700 health plans by the benefits consultant Hewitt Associates, the average increase nationally was 6.1 percent.
www.washingtonpost.com/wp-dyn/content/article/2010/01/15/AR2010011503319.html
Also note Safeway's unions forbade participation. Unions tend to diametrically oppose anything which rewards individual action. And if you think President "we'll tax Cadillac medical plans, oops, except for UAW members" Obama is going to implement a plan the unions don't want then a serious discussion is really not possible.
There are no silver bullets. ACOs, single payer, healthy living incentives, tort reform, etc. can all be part of the solution but none by itself will have meaningful impact if they operate within a broken system. The only thing that ever slowed our manic health care cost growth was the move to HMOs back in the '80s. And that fizzled after a few years because health care customers didn't like being told "no, a battery of expensive tests for your sore elbow is not cost-effective".
Those who push single payer typically oppose incentives because they penalizes poor people (who, after all, are just innocent victims of the evil snack food and tobacco industries). Those who like incentives don't want the government involved (forcing them to eat broccoli). Left wingers feel health care is a human right, and can be freely available to all if we just eliminate for-profit insurers. Right wingers like to pretend health care can operate as a free market, ignoring the massive distortions (e.g. ER must serve rules) which make this impossible.
A bipartisan commission can design a workable system. Our politicians cannot. |
