Comments on Advance Indiana™: Governer's Health Insurance Proposal

6:17, you're just wrong.In Indiana and in many jur...

2006-11-20T09:26:00.000-05:00

6:17, you're just wrong.

In Indiana and in many jurisdictions where the health care councils were aggressive, room costs and related hospital costs were stagnant, and in many cases, went down slightly. The experiment worked resoundingly, unless, of course, you wanted those rates to go up with the inflation of the times: remember those 18-20% CDs?

The health cost councils were cut immediatrly, as a Reagan payback to the pharmaceutical and health-care companies who funneled millions to his campaign. As always...follow the money...and that does cut both ways.

Which ER do I want? If I am unable to speak for myself, or perhaps even if I am, I want the ambulance technicians to know which hospital best-treats my malady: burns to Wishard, heart to wherever, cancer to IU or Methodist, etc. There is no compelling reason, health-wise or cost-wise, for all hospitals to have everything in a large metro area.

Rural hospitals are different. That's a can of worms.

But regional hospitals should not duplicate expensive services. The cost of doing so is inevitably passed along to consumers and employers through higher co-pays and health insurance premiums.

Ask GM, Ford and Chrysler. They supported the councils.

Which piece of "expensvie equipment" do you not wa...

2006-11-20T06:17:00.000-05:00

Which piece of "expensvie equipment" do you not want used when you arrive at the ED? Which procedures do you not want utilized when you or a family member are a patient?

As individuals and as a sociaty we must decide these questions.

The Carter councils did NOT work. In fact, the data show the late 70's were a time of particulary rapidily increasing health care costs. But a large part was driven by innovation.

The top 5% of patients are the big utilizers of health care. Smoking, obesity, diabetes, lack of pre natal care, etc.

Excellent post. Here's a short history lesson on ...

2006-11-19T21:18:00.000-05:00

Excellent post. Here's a short history lesson on hospital costs:

In 1977, Pres. Carter sought, and Congress provided, Health Care Cost Councils all over America. Made up of citizens and health care/hospital representatives, these councils (3 were in Indiana: north, central and south) had to OK any hospital expansions, or any expenditure over a certain amount.

The result was a three year moratorium on duplicitous hospital expenditures. Hospital room rates in Indiana were stable. In short, hospitals did not overbuild, because these councils did not permit it. Those councils also discovered that many specialists' fees were driven by hospitals' equipment purchases--it was a strange scenario: hospitals buy expensive equipment, specialists were almsot obligated to use it. And often when patients didn't need it.

An appeal procedure was established to the Secretary of HHS (HEW at the time), for any matters which the councils may have overlooked. It was rarely used.

One of Ronald Reagan's first acts, two hours after his inauguration, was to sign an executive order to disband the councils.

I'm not much for government control, but it's gotten out of hand. These councils worked.

And, as with so many things from the 80s, if Reagan hated it, it must've been good.

I wonder if in the preventative element there is a...

2006-11-19T19:49:00.000-05:00

I wonder if in the preventative element there is any coverage for family planning (i.e. exams, counseling, birth control pills, patch or shots, etc)

I have read that now HALF of all the births in Indiana are paid for by Medicaid. Also, a lot of us women know that a lot of health insurance doesn't even cover birth control (though births and pregnancy are?!) It would seem that is some of the pregnancies might not occur if the women had birth control (if that was what they wanted) it would be a good deal.

I hope this plan takes that into account. If they want to save money that would seem like a good idea. But I'm afraid politics is going to get in the way. There are more and more right wingers that are opposed to birth control all together (Sen. Drozda in IN has made this statement) and there have been fights and opposition to expanding Medicaid to birth control in the past based on "life begins at fertilization" (pill and IUD can prevent pregnancy after fertilization) even though it would seem the vast majority of the public favors birth control.

I hope there are enough reasonable people involved to incorporate a reasonable discussion of this.