Is legislated healthcare reform here to stay? As we watch the presidential race heat up – and look to a Supreme Court ruling this summer— no one knows for sure. Regardless, we as a nation need to realize that traditional thinking around healthcare is forever changed.
Our current view is based upon delivery of a service, rather than the patient outcome— which incented more service, and therefore more cost. This crazy reimbursement structure—based upon cost creation—dates back to 1965 when Congress first established Medicare. Every healthcare provider is required to submit cost reports for payment. The providers establish their own cost for conducting a procedure, and are reimbursed at cost plus a profit margin as long as they follow Medicare regulations.
Imagine the math when there is no standard cost for the same procedure—5,000 hospitals x 5,000 different costs = 25 million different prices. The same lack of price transparency applies to pharmaceuticals and medical devices.
So, in four decades the cost of care has never abated. While government adapted some cost control measures, it really just shifted costs right into the private sector; private and public corporations and employees picking up the expensive tab.
The shift has played a very negative role on our economy. In fact, I submit it’s been largest driver of lost manufacturing jobs (six million) and the economic struggles of today’s middle class. Why? American businesses continue to offload health insurance risk to individual employees.