Comments on: The Politics Of Health Care Payment Reform http://commonhealth.wbur.org/wbur-posts-and-stories/2009/05/the-politics-of-health-care-payment-reform/ CommonHealth Sat, 20 Mar 2010 02:36:04 +0000 http://wordpress.org/?v=2.9.2 hourly 1 By: Martha Bebinger http://commonhealth.wbur.org/wbur-posts-and-stories/2009/05/the-politics-of-health-care-payment-reform/comment-page-1/#comment-8652 Martha Bebinger Thu, 28 May 2009 03:12:47 +0000 http://commonhealth.wbur.org/?p=1172#comment-8652 Hi "MCC is a tax" - it is interesting that you raise this point. I recall some discussion at the commission meetings about making patients more accountable in this transition, but I don't remember any specific proposals. The health coverage law says insurers can set higher premiums for smokers, for example, but last time I checked, none of the major insurers were offering such policies. I think Fallon rewards smokers who quit and reviewed a similiar plan for overweight members a few years ago but stopped because either the staff or employers thought it was too intrusive. I have a lot of questions about how you would hold patients responsible for poor choices. What's in the category of "poor choice?" Is it just eating or smoking? What about drinking too much or some reckless behaviors? How would you monitor change or compliance? How would you account for addictions or obesity that might be, in part, genetic? Anyway, good issue, thanks, Martha Bebinger Hi “MCC is a tax” – it is interesting that you raise this point. I recall some discussion at the commission meetings about making patients more accountable in this transition, but I don’t remember any specific proposals. The health coverage law says insurers can set higher premiums for smokers, for example, but last time I checked, none of the major insurers were offering such policies. I think Fallon rewards smokers who quit and reviewed a similiar plan for overweight members a few years ago but stopped because either the staff or employers thought it was too intrusive.

I have a lot of questions about how you would hold patients responsible for poor choices. What’s in the category of “poor choice?” Is it just eating or smoking? What about drinking too much or some reckless behaviors? How would you monitor change or compliance? How would you account for addictions or obesity that might be, in part, genetic?

Anyway, good issue, thanks,

Martha Bebinger

]]> By: MCC is a tax http://commonhealth.wbur.org/wbur-posts-and-stories/2009/05/the-politics-of-health-care-payment-reform/comment-page-1/#comment-8651 MCC is a tax Wed, 27 May 2009 21:23:43 +0000 http://commonhealth.wbur.org/?p=1172#comment-8651 "The idea is to spend less by rewarding doctors for helping patients stay healthy instead of rewarding them for delivering unlimted care when patients get sick." If this is the model to be utilized, then users of the system must also be punished for making poor choices. If someone chooses to smoke or eat poorly, then they should pay more into the system. This is completely equitable if you are going to reward doctors for keeping patients healthy. I think it is completely foolish to punish a doctor financially if his/her patients make poor choices. I also can see doctors and other health care providers refusing to take on patients or releasing patients who make poor lifestyle choices. “The idea is to spend less by rewarding doctors for helping patients stay healthy instead of rewarding them for delivering unlimted care when patients get sick.”

If this is the model to be utilized, then users of the system must also be punished for making poor choices. If someone chooses to smoke or eat poorly, then they should pay more into the system. This is completely equitable if you are going to reward doctors for keeping patients healthy.

I think it is completely foolish to punish a doctor financially if his/her patients make poor choices. I also can see doctors and other health care providers refusing to take on patients or releasing patients who make poor lifestyle choices.

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