10 Health Care Reform Principles for 09

December 27, 2008

The blogosphere is buzzing with discussions about the promise of health care reform.  For a weekly poster like me, it is impossible to keep up.  As 2009 approaches, and more importantly, as 1.20.09 approaches, I thought I would offer my insights into the topic from the perspective of the administrator of an employer and union sponsored health benefit plan

If there is one thing that unites the comments it is their oppositional posture.  Insurance companies are the most common enemy, but hardly anyone escapes.

So I would like to go on the offensive and tick off a few positives that I would like to see in health care reform.  Please indulge my autocratic use of the term “will”.  

1. Every individual will be required to have health insurance.  Read the rest of this entry »

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A game of Old Maids

October 18, 2008

Approximately six months ago our office began receiving stacks of paper claims for prescription drugs.  The drugs originated in various Veterans’ Administration medical centers around the country.  They were for drugs that members in our Plan had received at VA medical centers. 

It was obvious that there had been some sort of new policy at the VA that required the VA to obtain payment from other payers when veterans had other coverage.  The problem in this case is that our Plan had just changed pharmacy benefit managers effective January 1, 2008. 

So think about this.   Read the rest of this entry »


The Amazing US Health Care System

October 14, 2008

Amazing seems a most appropriate word to describe the financing and delivery of health care services in the United States of America.

According to Merriam-Webster’s Collegiate Dictionary, 9th Edition (OK, I have an old dictionary) amazing is derived from a French word meaning “to confuse”.  Obsolete meanings include consternation, bewilderment and perplexing.

Yes, health care in the US is truly amazing.  Rube Goldberg could not have invented a more illogical maze of non-systems.  Lewis Carroll’s might have added an additional chapter on Alice’s efforts to get those pills that made her big and small.  Kafka might imagine a special Penal Colony for those responsible for this maze.

I should be careful on this last point, since I am part of that system. Read the rest of this entry »