If you think health care reform is bad, consider the alternative

Thanks to Maggie Mahar at Health Beat for writing up a two-part post by Joe Paduda at Managed Care Matters. These two posts consider what the consequences are likely to be if health care reform fails to pass Congress.

Part One of "Your life without healthcare reform" is here. In this part, Paduda relies on a report at businessinsurance.com to predict what will happen to health care costs if we don't get a health care bill that includes strong cost controls. Paduda says:

When costs increase ten percent a year, they double every seven years. With current family premiums in the $15,000 range, employers and employees will be paying $30,000 per family in 2016. And that's not including deductibles and copays, which are sure to rise.

If you're relying on so-called consumer-directed health plans to stem the tide, good luck - their costs went up two points more than 'regular' HMO and PPO plans. Industry veterans aren't surprised, as new insurance products almost always have good experience in the first couple years and as the block 'ages', claims creep up. As I've noted previously, CDHPs are not a panacea, in fact they may well drive up costs due to delayed care. (That said, with substantial changes CDHPs could be a valuable tool in cost containment.)

Eventually the US will reform its health insurance and health care delivery 'systems'. Unfortunately I don't see it happening this year due to the failure of the Democrats to put forth a program that controls costs, make a cogent argument and control the debate, and the decision by the Republicans to remain nothing more than the 'Party of No'.

In Part Two, Paduda argues that

The past is a pretty good predictor of the future; over the last eight years cost have consistently increased more than ten percent each year, with most increases well above that level. Whether we are at the bottom of the cycle or cost inflation rates will continue to decrease is unclear, but what is clear is that the inflation rate will head back up at some point in the next few years.
Back to the real world impact.

• If nothing changes, the share of the nation's budget paid by the government will be greater than that paid thru private insurers.
• 178,000 small business jobs will be lost by 2018 as a result of health care costs
• If employee contributions stay at their current level (about 30% of premiums), workers will be paying $9000 per year, or $750 per month, towards their health coverage - not including deductible, copays, coinsurance, and services not covered
• General Motors' health insurance will add about $3000 to the cost of each vehicle - if it is still in business
• In my hometown of Madison, Conn., Town employee health insurance costs are paid for with property taxes; without reform the amount of tax revenue needed to pay those bills will double by 2016, forcing tax increases and/or significant serice cuts
• More Americans will have to rely on the kindness of others for their health care
• Because 65 million of us will be without health insurance

Unlike the distortions, misrepresentations, and outright lies being spread by McCaughey, Limbaugh, Palin et al, this is the real deal. So fight against reform if you wish, but don't complain later when you can't afford insurance, your employer can't afford insurance, your taxes are going up to pay for teachers' benefits, and our economy is sinking under the weight of health care costs.

Paduda thinks the right wing will win this battle but lose the war, because eventually, without health care reform, too many of us will be in too much pain to tolerate the status quo. For my own part, I am hoping that the battle is not lost, and that with luck and hard work, we can prevent the pain that Paduda predicts.