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4 trends and concepts on healthcare reform

1. In terms of Health Care Reform there tends to be three major schools of thoughts or camps. There is the “Medicare for All” camp; there is the "Public Option" camp; and there’s the "free market" camp. Two thoughts on free market healthcare and Medicare for All:

a. Free Market. Things are never quite going to be truly “free market” because even now 30, 40, 50 percent of most provider revenue comes from Medicare or Medicaid and that number will continue to expand as the population ages. This camp tends to favor looking at options that largely leave things as they are versus a public option or Medicare for All.

b. Medicare for All. The big downside from a provider’s perspective to Medicare for All is simply reimbursement. From a provider perspective, physician, hospital or surgery center, most believe they don’t get paid well enough under Medicare to thrive or keep the margins they need to keep. In contrast, commercial payers subsidize what Medicare pays and allow surgery centers, hospitals and physicians to make incomes that are satisfactory. Providers are almost universally accepting of the concept of wanting better access to care and better quality care. The greater concern is how that’s paid for and reimbursed.

2. Most polls show the general public is very much in favor of the concept of not preventing someone from getting insurance because of a preexisting condition. Everybody has a family member or knows somebody that' has a preexisting condition that otherwise would make it very difficult for them to get coverage.

3. We find people are increasingly enthused about some sort of public option whether you’re rich or poor, regardless of demographics. There is a concern that if you only have one insurance option or if you go to the market to get insured and you’re not employed by a major employer that your insurance will be crazily expensive. We increasingly think of the public option like the post office versus UPS or Federal Express; i.e., it just gives you different alternatives.

4. Those concepts, preexisting conditions and a public option, seem to have great national support and at some point one would think that Republicans and Democrats would find some middle ground on healthcare reform to solve what are very real problems for individuals, consumers, and the provider universe.

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