If you have "no place to go," come here!

Oh hai, Uwe. I fix ur congressional testimony 4 u. Kthnxbai.


[via PNHP]

Statement of Uwe E. Reinhardt, Ph.D., James Madison Professor of Political Economy and Professor of Economics and Public Affairs, Princeton University, Princeton, New Jersey

Testimony Before the House Committee on Ways and Means

April 22, 2009

My name is Uwe E. Reinhardt. I am Professor of Economics and Public Affairs at Princeton University, Princeton, New Jersey. My research work during the past several decades has been focused primarily on health-care economics and policy.

As a director of Boston Scientific, a medical devices company, and Amerigroup, a managed care company specializing in Medicaid, SCHIP and Medicare, I have been paid more than $1 million in the past 3 years. In addition, I'm paid fees of $30,000-$50,000 for my talk on the German health care system, among other topics.

I would like to thank you, Chairman and your colleagues on this Committee for inviting me to present a statement on the problems of structuring a market for individually purchased health insurance in the United States.

After some remarks on the interface between social ethics and health reform, my statement will focus for the most part of ways of reforming the market for health insurance.

He starts off by describing how social insurance works [it's a good description, you should read it] and how this model fits in with Obama's plans for health care reform [it does]. He then gives some highlights of the pros and cons of including the choice of a public plan [meh] and finally he describes how we could keep our insurance system totally private, without any pesky competition from a public plan, by following the German model.

We could do worse. Germany has a much better health care system than we do, and a much more affordable one too.

On the other hand, in his testimony, Reinhardt sort of glosses over just how much all these other countries control costs by regulating their insurance industries, and setting prices that doctors, hospitals, drug companies, etc can charge. Unfortunately, guaranteed issue [they can't turn you down for pre-existing conditions] and modified community rating [they can't charge you more because you're sick, but we'll probably allow them to charge you more if you're older] and premium subsidies [yeah that worked well in Massachusetts] are about the only facets of "affordability" that all the Very Serious People here in the US are looking at, and none of these measures controls health care spending, they only expand access to insurance [which provides more of that delicious corporate welfare for the insurance companies].

Not to mention one thing that nobody will tell you: in none of these other countries do the payers, be they insurance companies or governments, micromanage the medical care you get the way that the insurance companies do here [sometimes even to the extent of forbidding your doctor to discuss any possible treatments for what ails you if your insurance company doesn't cover said treatments]. Gee, maybe they're all healthier than we are because doctors, instead of bean counters, make the treatment decisions.

Bring on the Popeye's!

Oh, and one other little factoid: Reinhardt cites our largely fee-for-service payment system as being a major culprit for our outlandish health care costs, but he fails to mention that diverse countries such as France, Canada, Germany, and Japan have all managed to control their costs using [guess what] fee-for-service payment systems.

Well, I've wandered a bit from my original intent of pointing out Reinhardt's possible conflicts of interest here, but if you'd like to contact the House Ways and Means Committee to give them an earful, you can call, fax, email, or snail mail the Committee Chairman, Charles Rangel.

[yes, i totally made up the underlined paragraph in the blockquote above, though if the interwebz are to be believed, the linked information is real]

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Submitted by Paul_Lukasiak on

Germany is, in fact, a taxpayer financed single-payer system. From his times Op-Ed....

The health insurance premiums [actually taxes paid by workers and employers, supplemented by general revenue] paid by Germans are collected in a national, government-run central fund that effectively performs the risk-pooling function for the entire system.

the German government then allows its citizens to enroll in "private" sickness funds that provide them with health care services, and reimburses those funds based on the actuarial risk of each citizen.

Submitted by hipparchia on

depending on where you set the goal posts, germany can be considered either a single payer or a multi payer system [same for france and many other european systems].

the insurance companeis in germany all have more autonomy than would blue cross being hired to administer a self-funded govt program here, but compared to how our insurance companies operate, the european companies are so tightly regulated by their govts that they really aren't much more than checkwriters hired by the govt, so yeah, germany looks like a single payer compared to us [but less so when compared to canada].

but yeah, he's being incredibly disingenuous here, implying that with a few modest tweaks that the insurance industry finds acceptable, we'll voila! suddenly have affordable, universal, european-style health care.