March 24, 2005

Prevention Means Socialism

Yes, I'm acting like a nerdy health care wonk. I am a nerdy health care wonk, though. Anyhow, now that that's out of the way, there was one part of the CAP's big health care plan, namely, the part discussing how to entice health providers to place a greater emphasis on preventive care, that was very, very, interesting:
The U.S. health insurance system now focuses on treating diseases instead of reducing their incidence in the first place. With no guarantee that enrollees will remain in their plans, insurers have little incentive to invest in keeping enrollees healthy over time.

We propose a new model for preventive care and health promotion. Coverage for preventive services would be carved out of private health insurance and financed through a new nationwide preventive benefit. A process for determining and updating the core preventive services would be established, based on recommendations from the U.S. Preventive Services Task Force.... Physicians and other providers would continue to deliver both preventive and other medical services as they do today, but they would be reimbursed for preventive services by the new benefit.
Would this work? Actually, I'm having a hard time figuring out what, exactly, is being proposed here. Are they suggesting that most medical services would be paid for via insurance purchased on the private market, but preventive services would be paid for by the government, financed via taxes? In other words, everyone gets coverage that's half single-payer and half "market-based"? Maybe I misunderstand. (Hey, I never said I was a smart health care wonk!) If so, that's awfully novel, and oh-so intriguing. By the by, read Philip Longman's old essay on why the private market cannot provide good preventive care (though CAP gave the gist of the argument in that first paragraph quoted above).
-- Brad Plumer 3:13 AM || ||