Views 9 questions for the Trumpcare architects
By Perry Braun
As a new plan is presented for debate and discussion by the Trump administration — with the goal of building an affordable plan — here are my questions:
- With respect to healthcare costs, there are two key drivers. One is consumption, which is defined as the number of medical services and prescription drug services are consumed. The second is the price for each service. The equation is units times price equals cost. How is any new plan going to manage the units consumed — short of rationing or establishing a que system to receive services as a strategy?
- Price per unit is a function of costs borne by the provider of a service or the producer of product. Short of price controls as a strategy, what is the detail in the plan to control costs?
- As to affordability: What tax credits/deductions or subsidies exist in the future to fund the goal of insurance for everyone? What will be the insurance market reforms (specifically those that address premium rate setting and benefit mandates, which are linked to one another) in the local markets? What will be the insurance carrier reforms (selling across state lines, for example) and the state regulator involvement in the future? How will this affect the networks that consumers/patients can access? What prohibitions will exist, if any, as it relates to health savings accounts?
- Employer and employee stakeholder groups: What mandates, regulations, penalties and reporting requirements are they to own and meet?
- Individuals participating in the individual marketplace: What financial relief will be provided to purchase a product and to access their benefits? Will they be able to tailor their benefits to fit their needs or are they subject to mandated benefits?
- Hospitals and physicians: From the financial standpoint, what impact, if any, will this have on their uncompensated care costs, costs that work their way back into the insurance payment system? How is the ‘patients first’ concept translated in improvements into cost and quality?
- State insurance regulators: What level of authority will they have over the insurance reform provisions in their state?
- Technology companies (payroll, benefit administration) have made tremendous investments to conform to the rules and requirements. What happens next?
- For advisers: How do they adjust to the new world and what is the impact to their business models?
With the new administration committing to repeal and replace Obamacare, we are all left to wait and see the details of the plan — and adjust accordingly.”
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