Health Financing and Health Outcomes

This week was a little scary for me. Thank god its over. I just had the last presentation of my MPH career. :o)

The link is to the first article I was going to do my individual oral presentation on, but did not because I felt it was not "global" enough.

"An Innovative Proposal for the Health Care Financing System of the United States"
https://blackboard.usc.edu/courses/1/20071_pm_565_41128/uploads/_398412_1/1093.pdf

The main points are:

The authors propose a "Federal Health Insurance Reserve System (FHIRS) to reduce ingrained errors and enhance the positive aspects of both the market and the government systems."

Problems with our health financing system that requires solutions:
1. The uninsured and underinsured.
2. Politically and litigiously mandated benefits.
3. Unequal tax treatment for health financing.
4. Lack of individual choice of plans and providers.
5. Perverse financial incentives for the insurance industry.
6. Underfunded and confused Medicaid programs
7. The Ponzi-type Medicare scam of cross-generational financing.
8. Insufficient national clinical trails and lack of constraint of unnecessary malpractice suits.
9. Unfair competition by hospitals charging their own patients different amounts for identical services and pharmaceutical companies charging individuals and small organizations more than large organizations, increasing the number of uninsured.
10. Excessive costs threaten the national economy, access to quality medical services, and federal and state budgets partly because of the lack of economic incentives to limit health care expenditures.
11. Lack of a national program to coordinate, analyze, and recommend optimizing medical are and controlling costs.

The authors propose that "Congress create individual tax incentives, mandate universal catastrophic coverage, and charter an independent FHIRS protected from direct political, commercial, and legal pressures to establish regulatory controls and productive incentives for a competitive market-based system."

This FHIRS would be charged to "encourage efficient use of health care dollars for the public good, increase freedom of individual choice coupled with acceptance of individual responsibility, ameliorate inflation, and stimulate innovative and fair competition."

The article goes on to explain how the FHIRS proposal would ameliorate the problems with our health financing system.

The most interesting solution is for the problem of lack of a national program to coordinate, analyze, and recommend optimizing medical care and controlling costs. As we know the United States is ranked really low in how our health system performs and ranked the highest in how much our health system costs. The authors seem to believe that because FHIRS will be an apolitical agency free from commercial pressures, it would be in an ideal posotion to lead and encourage efforts to carefuly assess the overall effets of both new and traditional medical modalities. FHIRS computers will collect insurer's data, hospital outcome data, and longitudinal data on chronic conditions and costs. These data would be shared with various private and government reserach institutions, academia, and organized medicine while assuring patient confidentiality. Whether it is possible to have an apolitical agency is one thing but how to sustain its apolitical character is another.

The authors end with "America does respond to crisis so we anticipate that by calling attention to some of the underlying causes crippling the medical care system, articles such as this will increase awareness that reasonable reform is possible. There may be a FHIRS in our future!" What do you guys think? This article was written in 2003. Where are we now? Financing is such a hot topic in elections now. Where will the future of our health care financing be? FHIRS or another new creative acronym?