Healthcare at the GOP debate

I didn't watch the Republican presidential debate on CNBC so I'm glad MedPage Today provided a synopsis of the healthcare discussion, which occurred at the very end. At least based on the article, some of the candidates are reasonably well grounded while others are just not.On the plus side

• Ohio's John Kasich cited his track record in slowing cost growth in Medicaid without cutting benefits of beneficiaries
• New York's George Pataki brought a dose of reality in when he said, "it's ridiculous that in the 21st century we're questioning whether or not vaccines are the appropriate way to go. Of course they are."

Neutral

• Rand Paul is correct that Medicare's problem is that people pay much less into Medicare while working than they cost as enrollees. He blames small families for reducing the ratio of workers to retirees and suggests raising the eligibility age. There is something to that approach but the problem could also be addressed by increasing immigration and boosting labor market participation.
• Rick Santorum complained about the consolidation of health plans that is being caused by Obamacare. That's a reasonable and lamentable point, especially if you extend that observation to provider system consolidation, which is also occurring. Santorum is on slightly shakier ground when he says Obamacare is making it impossible for startup health plans to thrive. He's probably talking about the CO-OP plans, which were a weak compromise to avoid the creation of a 'public option' health plan that would have forced private plans to demonstrate that they add value. Having said that, he's right that the minimum medical loss ratio rules are hard on plans that are trying to get started

Negative

• Mike Huckabee has a nice idea: eliminate Alzheimer's, diabetes, heart disease and cancer. "Eradicate those and you fix America and its economy, and you make people's lives a heck of a lot better." Amen brother, but how?
• Ben Carson wants to let people opt out of traditional Medicare and rely on the private sector, because "there are a lot of private sector things you could do with $12,500 [per person], which would get you a lot more than you get from this government program." Actually, Medicare already relies on private sector providers and Medicare Advantage managed care plans are already offered.
• Jeb Bush touted basically the same approach as Ben Carson. That should tell you something.
• Marco Rubio wants to avoid changing anything for current retirees. Although that's a nice way to avoid pissing people off, it's unreasonable to wait for the older generation to die off before doing anything to address our nation's problems

Image courtesy of Jeroen van Oostrom at FreeDigitalPhotos.net

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By healthcare business consultant David E. Williams, president of Health Business Group.