In a perfect world there would be perfect solutions. Coming from the healthcare world it is known that 40 different healthcare systems exist on this planet. Not one of them is perfect.
In a very interesting piece appearing in the Wall Street Journal today Governor Phil Bredesen of Tennessee writes a great article about a solution he orchestrated in his state in an attempt to address the problem of the uninsured.
He pens the following: What I realized was this: Everyone proposing solutions or criticizing unfairness was doing so from the comfortable vantage point of having good health insurance. While we work to build a better system, wouldn't it also be responsible to find a way to get something -- not a perfect solution, not even a long-term solution -- into the hands of the more than 46 million uninsured Americans who don't share our good fortune?
We need a national health-insurance solution, but isn't it sensible in the meantime to make sure everyone has a basic health plan before we give a few more people a perfect but expensive one?
CoverTN, which began in 2006, is a health-insurance plan for those who are self-employed, or who work for small businesses that can't afford a traditional policy.
It is not free health care. Rather it is a limited plan with shared costs. In devising this plan, we didn't start out the usual way -- by defining what benefits we wanted -- but instead set how much we wanted to pay. And then we began a competitive-bidding process to see how much health care we could buy. We initially set the amount we would pay at an average of $150 a month, and split the responsibility for that premium three ways. The company would be responsible for $50, the individual for $50, and the state for the final $50.
The bidding was vigorous. It was ultimately won by BlueCross BlueShield of Tennessee with a benefit package that meets a great many -- not all -- of the real needs of the uninsured at a cost far below conventional plans.
At these premium levels -- less than half of what a conventional plan might cost -- the benefits are limited. But the benefit structure is also different than in a conventional plan. Most limited plans achieve their savings with high front-end deductibles, requiring a person to spend often thousands of dollars out-of-pocket before benefits kick in. But when we asked our customers -- uninsured Tennesseans -- what they actually wanted, we found that they were most interested in some help with the more common things; a doctor's visit, prescriptions, a short hospital stay.
CoverTN emphasizes covering these front-end costs. It features free checkups, free mammograms and $15 doctor visits without deductibles, for example. And it achieves its savings on the back end, with relatively low limits on hospital stays and an overall $25,000 benefit limit in any one year. It does not cover truly catastrophic events.
This makes medical sense. Good access to a doctor and a drugstore when you first have a problem can avoid a lot of cost and heartache later.
Tom Daschel's writings so far are not in this direction. He wants to create the same type of bureaucracy known as Medicare and Medicare Part D. Ask any senior who navigated the Medicare Part D maze about the experience. Each and every year seniors have to search for a plan. It is an exercise in futility.
Obama would do himself a favor if he took a good look at this Tennessee plan. So would the Democrats in Pennsylvania. One last quote from Bredesen, "This fall we added some benefits: The number of primary care visits doubled from six to 12, for example. Best of all, we added them without increasing rates. When did you last hear of a health-insurance plan whose annual update was a benefit improvement but no rate increase?"
Another fair and balanced piece.