Steven Pearlstein of the Washington Post had an interesting health care reform in yesterday's paper and held an online chat to discuss his article. In his article, he mentioned three "fresh ideas" for small business health care reform:
- A plan offered by Katherine Swartz of Harvard's School of Public Health to have the federal government provide specific stop loss insurance for claims over $50,000 (subject to 10% coinsurance) funded by a tax on premiums. "This would equalize premiums and reduce the incentive for insurers to 'cherry-pick' the healthiest employee groups."
- A plan offered by Michael Porter of Harvard Business School and Elizabeth Olmsted Teisberg of the University of Virginia's Darden School of Business to price fix all hospital and physican charges regardless of payor. "That would eliminate the massive cost-shifting that favors big employers and big insurance companies." (Of course the most massive cost shifting is done by the federal government's Medicare, Medicaid, and TRICARE program not these payors, and in my view, you can date the health care cost problem from the time when Medicare shifted to a prospective payment/DRG system for compensating inpatient hospital care in 1983. But it's always easier to blame the insurance companies.)
- The recently enacted Massachusetts state mandate requiring the purchase of health insurance.