As Congress lurches forward in its campaign to “reform” a deeply flawed health care system by making it a grievously flawed system, moderate “blue dog” Democrats are emerging as a key swing constituency that can make or break any deal. In the Senate, that puts the spotlight on Mark Warner and Jim Webb.
While Virginia’s two senators support expanding coverage to more Americans, they share a common concern, according to Olympia Meola with the Richmond Times-Dispatch: the cost of health care.
Webb has focused on the expense of individuals’ insurance premiums. Ever the populist, he spoken out against insurance companies and their “off the charts” profit margins. His ideal approach would be a system of not-for-profit insurance companies, Meoloa says. Insurance companies, of course, are a favorite target of national Democrats, mainly because of their high administrative costs. It is not clear, however, how converting the for-profit insurance system into a not-for-profit system would do anything to bring down those costs. Stripping the industry of its profits wouldn’t accomplish much either. According to Yahoo Finance data, industry profits amount to only 3.3% of revenue.
In contrast to the bureaucratic monstrosity emerging from the Senate, however, Webb stresses the need to create incentives that would value the quality rather than the quality of care. He does not want an “overly cumbersome, bureaucratic system.” While that mindset makes him preferable to the geniuses who want to foist layers of new bureaucracy onto the health care system via 2,000 pages of mind-numbing verbiage, I don’t sense from Meola’s article that Webb puts the emphasis fully where it really belongs.
To my mind, Warner does. According to spokesman Kevin Hall, “The cost curve is his priority in health-care reform.” The senator has introduced amendments that would target better use of data to drive down costs and increase transparency. Says Hall: “We have a health-care system right now that rewards bad practices. We have a health-care system that rewards hospitals for multiple readmissions rather than a low admission rate. We have a health care system that rewards volume of care rather than quality of care.” Bingo.
Rather than hobble the system with more bureaucracy and more mandates — a “solution” guaranteed to ruin productivity and quality — Warner looks for examples of what works. As one example, he cites a Virginia Commonwealth University program that assigns a primary care physician to oversee the health of uninsured patients with the goal of increasing coordination between doctors and hospitals. The program increases accountability, reduces costs and improves quality. One metric of progress: Between 2000 and 2005, emergency room visits have dropped 14%.
Warner has emerged as a champion of the kind of win-win reform initiatives that I’ve advocated in Bacon’s Rebellion. Measures that redistribute the wealth, the obsession of most Democrats, creates losers for every winner. That zero-sum thinking may well end up sinking reform. As a former businessman, Warner understands that greater productivity and improve quality will improve the system for everyone and, in the process, make it more affordable and accessible to all.