The Health Care Speech Ryan Should Give
Try a managed cared plan that covers primary care for all.
Paul Ryan. Photo from the Office of the Speaker of the House.
The Republican Party has driven its “repeal and replace” legislation into a box canyon. It isn’t selling on the Hill or with the American people. But there is a way out.
As with many seemingly intractable problems, he needs to step back, rethink and come at the economic chaos in health care in a whole new light. I have talked with many of the great innovators in the delivery of health care over the last decade, and they have come up with a far better business model.
Based on those insights, I am offering this speech to Speaker Ryan – free of charge.
My fellow Americans:
The debate over U.S. health care has carried us way off track. For that I apologize.
We have spent far too much time on insurance reform and not enough time on real reform of the delivery and cost of care. We have not made the sale with you, the American people.
I look to my own state of Wisconsin for innovations. The breakthroughs I am about to roll out have been tested and proven to work in my state and elsewhere. We may have to take a time-out on the current impasse, take the necessary time and reset along the lines of these big ideas:
- Provide primary care for every family or individual. Rates must be kept low and affordable. Some call it a medical home. Many company plans already offer this huge benefit. They do it because it’s the right thing to do, and because it saves big money by helping them avoid the hospital.
Companies like QuadGraphics, which created its first medical home here in 1990, save 20%-30% of total costs. That is a huge number.
Every health plan, whether funded by a company, by the government or through an insurance policy, should provide proactive primary care.
- Are you frustrated with medical bills you can’t figure out? I am calling for a single price for most procedures. Car repair shops give you an estimate, and they must call back if the price is going beyond what they quoted. Clinics and hospitals must do the same. I know they can do it, because companies in my back yard are contracting for “bundled prices.” They are saving as much as 50% on elective episodes of care. Medicare also asks for all-in prices.
- Do you cringe when you enter a hospital, fearful of either an infection, a medical accident or an astronomical bill? I know my family does. There is a fix. It’s called lean health care, the same kind of disciplines that car companies have applied to sharply improve the quality of their vehicles.
Several Wisconsin hospitals have led the charge to lean practices, and they have driven out waste, sharply lowered costs and have eliminated defects, such as infections, which can prove lethal.
If you need to be in a hospital, pick a lean hospital. I will demand that the medical industry adopt lean practices forthwith.
- Regarding the current debate on access and insurance reform: First, let me say again that premiums will come down if people stay healthy through proactive primary care; if bundled, transparent prices are required; and if hospitals and clinics go lean. It’s the underlying costs, stupid!
Second, we will create insurance pools for people with catastrophic issues. A tax on each insurance policy, whether the insured is on an employer plan or individual policy, will fund the high-risk pools.
Third, we will ask employers to continue to offer coverage. By and large, they have done a great job with their plans.
- Lastly, we will scrap Medicaid for people who can’t afford care in favor of a model based on Medicare Advantage, a far better managed program. This will also drive down costs for the nation, since Medicare managers are already using some of innovations I have called for.
I am confident that we can sell this far better model to the American people and therefore to the Congress. Because the model I have described is far more affordable, we can afford to extend coverage in one form or another to all Americans.
Health care will always be a big budget item for the country and for every home. But the value delivered in this new model will be far higher. The dollars spent will be an investment in the health of our people and our nation.
Let’s change not only the content of the national debate, but also the tenor. Both parties should see a lot to like in these proven best practices. Let’s hammer out a bipartisan plan that works for all. Only a bipartisan piece of legislation will stand the test of time.
John Torinus is the chairman of Serigraph Inc. and a former Milwaukee Sentinel business editor who blogs regularly at johntorinus.com.
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Now if this “op-ed” was authored by someone with the last name of Koch it would be worth paying attention to, as Paul Ryan would be giving it his utmost attention. Unfortunately it is not. So until we get money out of politics we will continue to enjoy the best health care money can buy for those that can afford it. For the rest of us, good luck and try not to get “sick”.
I can NOT believe you printed an ALEC statement! We are not cars Ron Johnson, err John Torinus! Your plan sounds like it solves nothing and the for profit only care about money insurance corporations can rape the sick and elderly even more! Watch the stock go up as people die! I Can NOT believe you printed this garbage Urban Milwaukee.
A brilliant idea. Let us just hand over 20 percent of the economy to Congresswoman Gwen Moore. Death panels are real in Europe ask the Guard family in the United Kingdom. The doctors cannot decide how to treat the baby for its condition, their is potential for a quality life but it costs to much. Government lawyers will decide your child’s fate.
Ok Jason, the family name in the UK is Gard. The treatment they are asking for has only a 10% success rate. This child does not have a very good prognosis. The judge has said he will review the data on the treatment. This is NOT an example of a death panel. This is a tragedy. There most likely will not be a good outcome no matter what the judge decides.
A death panel is when a readily available treatment is denied because of technicalities in the way healthcare is rationed. For instance, someone experiencing an asthmatic episode is refused breathing treatment because the insurance claims they have had too many treatments already. Or someone is denied an appendectomy because they haven’t been on a policy the required 6 months. Or a cancer patient is denied chemo because they have exceeded the yearly coverage limits. These are all examples of “death panel” decisions. These were common practices prior to the ACA taking affect.
The reforms outlined in this speech sound good. But let me ask you, how does one choose a lean hospital when in a car accident and being transported unconscious to a facility for life-saving treatment? The answer is, you can’t. The market-driven mechanisms the help regulate other goods and services don’t work in healthcare because consumers don’t have the knowledge and often the ability to make economic choices. They are too busy making life and death choices. It is time we recognize what the rest of the industrial world realized long ago, that healthcare is a utility, a part of modern infrastructure. It should not be up to businesses to provide that just adds to their cost of doing business and makes them less competitive in the global marketplace. If we shift to healthcare as a utility, then we can start implementing the reforms necessary to get healthcare costs under control; implementing universal primary/preventative care, addressing the outrageous cost of malpractice insurance and out of control personal injury settlements. We can begin to get control of the cost of medical education. We can start beginning a healthcare system that is not top heavy with specialty physicians but includes more healthcare professionals who work directly with patients.
We have tried a market-based healthcare system for 30+ years and it has not worked. It is time to admit the system does not work and move on to proven systems that work.
Mary, if it was my child I would fight for him but with socialized medicine you give up your rights to health care and the government decides your fate. The Gard family has raised $2 million dollars to go elsewhere for a chance at life and the United Kingdom has said, no. Pope Francis has offered to fly the boy to the Vatican for a chance at life and the United Kingdom has ruled, no. Charlie is essential property of the state. He has no rights. JUST REMEMBER ALL YOU SUPPORTERS OF SINGLE PAYER. YOU GIVE UP YOUR RIGHTS TO THE LIKES OF GWEN MOORE..
For the TROLL, lies, lies,lies.
I think the Troll works for the insurance industry