Wednesday, April 1, 2009

The 'Is Health Care A Right' Debate: How to Tell Which Side Folks Are On

Maybe it was the wine, but the Disease Management Care Blog had an interesting dinner conversation tonight over the 'is health care a right?' debate. The three physicians, two risk management professionals and a chief financial officer didn't answer the question, but we may have come up with a litmus test to figure out which way people are leaning.

If a person believes it is a 'right,' they'll signal it by believing that there should be a mandated and standard insurance 'benefit' (the package of 'medically necessary' services that are covered, such as annual physical exams, CAT scans, chemotherapy for cancer, cardiac stents and transplants with a standard deductable and a standard network). Part of the current health care reform debate is whether there should be a public plan and if all other insurers should compete on the basis of the price (premium) for that benefit package.

For those that are troubled by casting healthcare as a 'right,' they'll signal it by supporting a widely available but optional and minimum insurance benefit. That won't necessarily cover 'medically necessary' services, but they'll like the idea of providing a financial safety net that protects persons against bankruptcy. The role of the other private insurers here would be to provide additional layers of benefit for those persons that can afford it. Examples include covering hospitalizations and catastrophic care needs only with many deductables and a restricted network, while persons can go out and buy options like cancer screening, check ups, lower deductables and less precertification.

For an example of this kind of debate, look here.

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