The GOP Candidates Should Address Health Care

While a number of the Presidential hopefuls are making the rounds in New Hampshire, not too many of them have been talking about health care in anything other than sound bites:

“And when I'm elected I'll work to make health care more affordable and available to every American!”

Unfortunately that's as close as most of them come to discussing the issue. The rest don't mention it at all.

But it is one thing that they all should be discussing, and something that they should be giving a lot of thought about.

I'm not advocating “socialized” medicine, particularly after seeing how well it works in other countries, i.e. not very well. Neither is Charles Arlinghaus, though he does have some ideas of the problems that must be addressed, particularly by the Republican candidates at tonight's debate at UNH.

Simply put, insurance costs more because health care costs more. In the United States we spend about $2 trillion on health care. If you want to reduce the cost of insurance, Medicare and Medicaid, reduce health care spending. It shouldn't surprise us that the bulk of spending is spent not on administration, profits or fees, but on sick people.

Now, half the population doesn't cost anyone much at all. Fifty percent of the people use only about 3 percent of the spending. Costs are driven by the other 50 percent who spend 97 percent of the money. Of total health care spending, 75 percent goes for people with chronic diseases such as asthma, diabetes and heart disease. Chronic conditions are less likely to be one-time events like a broken leg than something that can be managed over time.

Chronic conditions represent 96 percent of Medicare spending and 83 percent of Medicaid spending.

The payment and management structure used by government programs and many insurance companies does not take into account avoided costs and treatment plans. Rather, it considers sickness as independent episodes. Under this vision, a patient with a broken leg or the flu is typical. You get sick and go get fixed -- one payment to the doctor for fixing you. Managing a patient with a chronic condition doesn't fit into this scenario.

And that may be the biggest problem with the existing health care system, one that should be addressed during this campaign, something that the GOP can use to steal the thunder from the Democrats.

It will be interesting to see the Republican candidates will even address this issue tonight.

(to be continued......)

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