Much of the recent controversy over the funding for Rhode Island’s health insurance exchange, Healtsource RI, misses the point of how the exchange fits into a larger vision of health care reform. Hopefully, the bold reform initiative just submitted to the General Assembly by the stakeholder advocacy group HealthRIght (of which I am chairman) will lend some perspective to the reform effort in our state.
Some years ago I had a friend who was a divorce attorney. I remember him telling me how it was virtually impossible to negotiate a property settlement when one of the parties really didn’t want to get divorced. He said the first step was to get both sides to agree there was going to be a divorce.
It strikes me we find ourselves in a similar situation with the Affordable Care Act (Obamacare). We can’t make it work when one side really doesn’t want it to work.
There have been efforts to reform our health care system going back to Teddy Roosevelt’s time. There always seems to be consensus on the need for reform, but one has to wonder… does everyone really agree we have to change such a large part of our economy?
One suspect group would have to include me, people who make money off the system as it is now. My company sells medical equipment and supplies and has grown successfully for many years. So why do I support fundamental and systemic reform?
The answer lies in simple facts. We have had consistent growth in the uninsured population as health coverage has become unaffordable to more and more families. The Annals of Family Medicine in a 2012 article predicted that even with the ACA, the cost of family health coverage would exceed median family income by 2037. Reform really must succeed this time.
HealthSource RI, our own made-in-Rhode Island health insurance exchange, is the local lynchpin of the Obamacare plan. When combined with the individual mandate, which I concede can be grating to the inner libertarian in all of us, the idea of consolidating all health care financing through the exchange is both compelling and very powerful.
Most people don’t realize that much of what we call health care costs have nothing to do with providing patient care. Rather, they are administrative costs, often burdensome paperwork necessitated by the numerous and varied payment methods we use for providers. It adds more than 30 percent to the total cost of care. The exchange is a tool to fundamentally re-engineer this administrative burden and reallocate the savings to expanding coverage and improving quality. Why wouldn’t we want to do this?