In the New Year What a New Administration May Mean for Healthcare Reform
December 2, 2020 – The incoming Biden administration could force mandates for private firms and their employees to provide for and buy health insurance. This according to Dr. Steven Goldstein on his regular podcast. The respected neurosurgeon and founder of the Houston Healthcare Initiative discussed the possibilities for healthcare reform in the coming year on his regular podcast. The Houston Healthcare Initiative podcast can be heard on: on SoundCloud, Google Play, Libsyn Feed, Stitcher, iHeartRadio, Spotify, and the Houston Healthcare Initiative web site.
Mandates Could Eliminate Opting Out
The Affordable Care Act, also known as Obama Care, made more choices for insurance available and penalized people who did not purchase health insurance. While not ideal, it was a way to get more people covered by private insurance than before. And it offered subsidies for people who could not afford insurance. But there was a downside.
The financial penalties were unpopular and made Obama Care an easy target for those who were against it. Without the specter of financial penalties, many employees chose to go without health insurance and keep the part of their pay that would normally go to help fund it. “One economic rationale for employer mandates is that the cost of care for these uninsured workers is often passed along to the insured through higher insurance premiums, taxes and other mechanisms,” Dr. Goldstein said. “Employer mandates are, in part, an attempt to eliminate those who opt out of available coverage. By adding more payers, health insurance is more affordable at the individual level. At least in theory.”
Do Less for More Or just Pay More
According to the Centers for Medicare and Medicaid, national health spending will grow at an average annual rate of 5.4 percent for the years 2019-28 and reach $6.2 trillion by 2028. Among major payers, Medicare is expected to experience the fastest spending growth of 7.6 percent per year from 2019-to 2028, largely as a result of the highest projected enrollment growth. “National health expenditures will grow 1.1 percentage points faster than the gross domestic product every year on average from now through 2028, said Dr. Goldstein. “The health share of the economy is projected to rise over a full percentage point by 2028. In other words, the costs are growing faster than the income. So, we have to do less of something or boost the gross national product.”
Make A Bad System Less Bad
If the current healthcare system remains unchanged, there will be less in the way of medical resources for the public. But according to Dr. Goldstein, that is unlikely. The overall insurance industry and its approach to paying for healthcare are very flawed in fundamental ways but unlikely to realize any dramatic reform. Working around the edges to make a bad system work somewhat better is what he believes will happen. As Dr. Goldstein told his audience, “we can spend time and money to make a bad system work better and that is probably what will happen in the near term.”
Another Possibility, Pay Cash
According to Dr. Goldstein, cash payments are accepted for most if not all medical charges and prescription drugs. But that comes with a caveat for those who do have insurance, especially catastrophic health insurance. “Do not try to get the ‘insured’ rate to put against your deductible,” he counselled. “Paying cash is much less desirable when put against the insured rate, it will cost you more but not buy any more benefit.”
Most people with catastrophic coverage will never reach their deductible amount. Better to put that money directly into care, at a much-discounted price. This arrangement is the best value for people under the current system. So, while at the doctors’ office show them your insurance card but tell them you are paying cash.
About Houston Healthcare Initiative
The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.