Friday, July 17, 2009

Column on Public Option

I have a column in today's News and Observer arguing that government insurance (Medicare) is an innovator that private insurance often follows. This is in contradiction to what many assume is true. The study referred to in the column that shows that hospice saves Medicare money is here.


  1. Thank you for your article in the N&O today 7-17-09. It raises an excellent point about the success of hospice and why Medicare pays for it. It's interesting that only after Medicare took this initiative did the private companies follow suit. I'd be interested in an article comparing amounts of time and money being spent by public and private companies on researching such inovative ideas.

  2. interesting thoughts and perhaps true...but how do we continue to pay for all of these programs, well-meaning and well-intended thought they may be, Professor Taylor? We already have a $11 trillion national debt black hole staring ourselves right in the face...are you suggesting the Medicare continue to add on programs ad infinitum as a means to spur on private actions without any regard to any fiscal consequence?

  3. The point of the column was that Medicare has been the primary innovator in the insurance inudstry over the past 30 years or so, not private insurance. For example, prospective payment for hospitals driven by Medicare, created DRGs that private insuers then adopted, RBRVS for good and bad developed a physician payment approach that at least allows one to try and incentive primary care v. procedure based care, etc. All these innovations are from Medicare (for good and bad; not saying Medicare is perfect). I got several emails saying this just can't be true that anything gov't could is totally opposite to the 'gut' of many Americans. The gut is just wrong in the case of health care. And I am not saying Medicare is perfect. I will write over the next few days and longer about some of these questions related to Medicare, affordability, and why it might be that Medicare innovates and private insurance follows. Thanks for writing.