Healing American Healthcare [PODCAST]

Mike Passanante: Hi. This is Mike Passanante, and welcome back to the award-winning Hospital Finance Podcast. Today, we’re recording live at the New Jersey Metro Philadelphia Annual HFMA Meeting here in Atlantic City. And joining me is Ed Eichhorn who is the co-author of a book entitled Healing American Healthcare. Ed, welcome to the show.

Ed Eichhorn: Thank you, Mike. It’s great to be here.

Mike Passanante: So, Ed just gave a dynamic keynote talk here at the conference. And just to give you a sort of an idea of the flavor of that, Ed took us through current proposals that are out there, both by the republican candidates for president as well as the democratic candidates; some background on what’s driving costs in the healthcare system; as well as some of the suggestions that were made in his book, Healing American Healthcare for getting us to a point where we have universal healthcare coverage in the United States.

So Ed, I’m going to ask you to maybe just talk a little bit about some of the proposals that are out there and how they contrast with what you’re suggesting in the book. So why don’t we start there?

Ed Eichhorn: Well, I think the proposals that we see in the newspapers and on the debate stage of the democratic candidates are the ones that people are becoming most familiar with. And that is primarily Medicare for All or enhancing ObamaCare. Those are the two that get the most traction right now.

And Medicare for All is a bit controversial because it provides much improved benefits and much lower costs for individuals with great changes in the way we do things in our country. So it would put everyone on Medicare. It would provide vision, hearing, long-term care as well. There will be no co-pays, no deductibles… which people would really like. But on the other hand, everyone would have to pay a healthcare tax.

According to Bernie Sanders’ plan, anyone who is extremely wealthy would be paying 70% of their income to support this. And stock transaction taxes would be at the rate of the seller. So if you’re at the 30% rate, you would pay 30% when you sell stock.

Also, it would eliminate the insurance industry and a significant number of healthcare jobs, which will be in the range of 2 million jobs that will be eliminated. It would also, although it’s not discussed much, control all of the budgets for all of the hospitals in the United States and all of the staffing for nurses and doctors in all of the hospitals. And I think that’s something Americans might not really like too much.

And the other important thing to consider is there’s a lot of discussion about what the cost might be. The estimates for the cost of Medicare for All vary from an increase of $3.2 trillion a year to a reduction of $600 billion a year. And I think that has to be refined a whole lot more.

Mike Passanante: Yeah. And so, when you contrast that with what the republicans have (or perhaps may be talking about in the coming months as some litigation unfolds) related to ObamaCare, what do you see there, Ed?

Ed Eichhorn: Well, they are really not sharing a universal healthcare plan. They are talking about reducing the cost of drugs. They’re talking about helping Americans to be better shoppers for healthcare and drug therapies to reduce costs, expanding Health Savings Account opportunities, so people could pay for care with pre-tax dollars. And these are all good things, but they really aren’t discussing a comprehensive plan at this time.

And other evaluators and people who write commentary for major newspapers say things that I agree with. And they say two things.

One is the republicans really don’t want to develop a plan until they know who they’re actually running against. And the second thing is, until the constitutional challenge to ObamaCare is finalized in the 5^th district court and in the Supreme Court, they won’t really know if the constitutionality of ObamaCare has been eliminated or is supported.

So, knowing those two things would allow them to decide how they want to position where they want to be on healthcare in the next election.

If it’s Medicare for All, I believe they have one set of strategies, probably calling it a socialistic healthcare system that the supporters and members of their party really wouldn’t want.

The Biden Plan is really an expansion of ObamaCare by bringing back the proposals for a national healthcare option that was in the original plan that didn’t make it through the legislative process. And he also wants to provide subsidies for people who earn less than $110,000 a year. And also, he would like to provide free healthcare for uninsured people who live in the red states that have rejected ObamaCare’s expansion of Medicaid.

But his plan is also pretty expensive. It would cost $750 billion over 10 years.

Now, these increases in costs are in a country where we already have the highest cost of healthcare in the world. Our per capita cost is doubled the average cost of the Organization for Economic and Cooperative Development of the United Nations.

So, I think they’re doing the right thing in not broadcasting their plan until they know what they’re actually competing against.

Mike Passanante: And so, with both of these plans, depending on which angle you approach this from, we can look at it through a lens I think of four healthcare Improvement goals that you stated in your talk. And it seems as though some of the plans addressed some of those goals; and others’, another set of those goals.

Once you talk to us about what those four goals are. And then, we can transition into all-care which you discuss in the book.

Ed Eichhorn: Sure! Well, we believe—and many others believe. In fact, Ezekiel Emanuel at the University of Pennsylvania who is part of Obama’s team that developed ObamaCare has said that we should have universal healthcare. We should reduce the cost of healthcare. We should reduce the cost of bureaucracy in our healthcare system. And we should work to improve outcomes. And we believe those four goals are the ones that we should be focusing on as we design a new healthcare system

Now, the proposals from the democratic candidates generally provide universal healthcare. However, they are more expensive. They will increase the cost of healthcare. And Medicare for All will also increase the bureaucratic nature of healthcare because they would like to control how hospitals are staffed and what their budgets are. They would have to add staff to the Department of Health and Human Services to accomplish that. So, that’s where they are.

The republicans have proposed things that I mentioned earlier that might help to reduce the cost of healthcare, but they haven’t talked about a bureaucracy or improving outcomes or universal healthcare.

Mike Passanante: So, in your book, Healing American Healthcare, you suggest a program called All-Care which you’ve taken a look at which extensively looks at those four goals and attempts to address them all. So why don’t you walk us through that and tell us a little bit about what you’re proposing there.

Ed Eichhorn: Sure! Okay, I’m happy do that. There are two basic ways that countries provide healthcare—one is through the British system. And the British system is basically healthcare is provided by tax collection, and there’s no primary health payer other than the government; and the German plan, which is all employers have to provide health insurance. And that plan is one that we believe would work in the United States.

So, we designed a plan based on the German healthcare plan. All employers would have to provide insurance. And they could provide All-Care which would be 30% less than the private insurance, or they could buy private insurance (they could be self-insured). But that would reduce the cost of healthcare for companies by about $180 billion a year. Essentially, individual health insurance would be reduced by about 30% which would be a significant savings for Americans.

The other thing that occurs if everyone has to provide health insurance is that the people who are on Medicaid who are employed would get coverage through their employers rather than the government. And that would mean that the government is saving another $200 billion a year on that program. That could be used to offset the deficit or help to pay for the increase in Medicare patients because it’s been reported that 10,000 baby boomers a day sign up for Medicare.

So, a savings on Medicaid could be used in a couple of ways that would really help the government. It would reduce bureaucracy. It would increase efforts to reduce the cost of pharmaceuticals by developing a national negotiation program. We would simplify medical billing. That would reduce the cost of billing for hospitals and insurance companies. And we would work with physicians to reduce waste.

So, if you do all of those things, and do them in a committed way, you could save a trillion dollars a year in the United States and improve outcomes, have universal healthcare, lower costs and lower bureaucracy.

Mike Passanante: We appreciate you adding to this very broad discussion that we really do need to have in the country I think that to lead us forward to a better place with regards to our healthcare and how it’s delivered.

If you’d like to get a copy of Ed’s book, it’s called Healing American Healthcare. It is available on Amazon. Anywhere else they should look for it, Ed?

Ed Eichhorn: It’s available. If you live in the New York area, it’s in all of the Barnes & Noble stores. It’s available on Barnes & Noble online and iTunes. And also, it’s available from my website which is HealingAmericanHealthcare.com.

We look forward to people reading the book and telling us what they think because we believe our plan is a plan about which people could debate and find whatever the best solution is. We believe our solution is a good one. And we’d like people to give us some feedback to help us develop a better plan for our country.

Mike Passanante: Ed Eichhorn, thank you so much for joining us on the podcast today.

Ed Eichhorn: It was my pleasure. Thank you very much.

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