EDITORIAL: Healthcare for Whose Benefit?
September 03, 2009
From the The Daily Advertiser - Lafayette,LA
If you really want to foul something up, inject a lot of money into a policy debate. We need look no further than the Louisiana Medicaid system to see why.
Louisiana's secretary of health and hospitals, Alan Levine, has proposed a series of changes in Medicaid rules designed to leverage competition among private contractors into better, less expensive health care for more Louisiana people. We think. Before coming to Louisiana to join the administration of Gov. Bobby Jindal, Levine implemented some of the same ideas in Florida.
The basic framework for these plans comes from the Center for Health Transformation, the leader and most prominent member of which is former House Speaker Newt Gingrich. There's a touch of irony here, or maybe it's penance, because Gingrich rose to power along with his fellow Republicans in the ashes of the Clinton health-care reform proposals in 1994. In the intervening 15 years, the Republicans did little to solve the rising costs in American health care. They did propose and gain passage for a Medicare prescription drug benefit that thoughtfully refrains from using the government's purchasing power to negotiate for lower drug prices.
At any rate, the Center for Health Transformation sounds like a respectable conservative think tank devoted to conservative prescriptions for health care. And it may be just that, at least part of the time. But it also functions as a trade association for the health-care and health-insurance industries. The New York Times recently reported that center members pay up to $200,000 each for membership. According to the center's Web site, members with varying levels of membership enjoy varying levels of access to Gingrich.
The trouble is that if Americans really are paying too much for health care, the excess is going into the pockets of the people represented by Mr. Gingrich's center.
How can we be sure the center's ideas are in the national interest and not tailored to the financial interests of its members?
You can judge for yourself. Levine has proposed a system under which private insurers bid for the right to cover Louisiana's Medicaid patients. Each recipient would have a choice of three private plans and would have access to information on how well those plans perform for people with different health problems — a comparative effectiveness review, if you'll excuse the expression. A mother of an asthmatic child might pick a plan that doesn't do well treating Alzheimer's but has a better-than-average outcome in its treatment for respiratory diseases.
Levine's plan, which is currently on hold while federal policy-makers bash each other over reform plans, offers at least the prospect for better care at lower prices at a time when state government's revenue is declining. But we won't know for sure until we try it. And we'll never be sure why we tried it.
Copyright © 2009. The Daily Advertiser.
