THE BLOG
05/04/2010 05:12 am ET | Updated May 25, 2011

Could A Solution for Healthcare Reform Be This Simple? Makes Sense Without Costing Too Many

Making sense of the byzantine behemoth of President Obama's' healthcare plan was such a challenge that I finally gave up and decided to ask someone I could trust.

He isn't a politician but a country doctor who understands the necessity of navigating politics and making difficult decisions. His name is Dr. Abe Levy and he is the Medical Director of the Mount Kisco Medical Group, one of the most successful healthcare groups in the country.

With his tuft of white hair and full mustache, his face looks as though it should be on a Smucker's jar and he speaks in a voice that is both soothing and sensible.

As he puts it, in his no nonsense way, very few Americans would disagree with the statement that all Americans should have health insurance. But most Americans would also say that they want that goal achieved with the least amount of disruption of the current system as possible. So how do you bring the people who don't have it into the system without altering the fundamentals?

Well, to solve the healthcare crisis, use the same logic that created seatbelt legislation. The government made a law that automakers must have seatbelts to protect passengers but never said it was going to start running the car companies. By shifting the focus to employers, you eliminate the political quagmire of government run healthcare which no one believes can be run efficiently.

"The company can choose what healthcare program to get just like the consumer can buy a car with a seatbelt from many different companies," says Dr. Levy.

To prevent the crippling of small businesses, make the rule that employers with more than 25 employees pay health insurance. Exxon and Walmart can certainly afford it and most consumers would pay the extra penny for gas if needed. Not perfect, not 100 percent will be covered but as Dr. Levy says, 2/3 of that 20 percent who don't have insurance will then have coverage. "We always work best as incrementalists, and can then be creative in the next round for more people," he says.

Do you know the people who are the 20 percent not covered? They are often working people, those who are pumping gas in Exxon, folding sheets at a Hyatt hotel, stocking a shelf at Walmart, taking orders at restaurants or cutting someone's hair. And they now include the mushrooming number of unemployed who will be ill-served by the Democratic plan which would burden the economy even more and stifle expansion and job growth.

Most may not realize this but there already are some safety nets for the poor, the elderly and the disabled through Medicare and Medicaid. "But there are no safety nets for people who have the misfortune of working for an employer who chooses not to provide health care insurance for all its employees," says Dr. Levy.

Dr. Levy also believes that Included in whatever plan is put together must also be mandatory insurance by all employers with over 25 employees, elimination of pre-existing condition denial of coverage (can only be implemented in conjunction with mandatory insurance for employers to pay for it), elimination of lifetime caps, insurance company competition across state lines and prior approval of health insurance company rates, which was canceled in NY state 15 years ago..


If the plans devised by Democrats came to fruition, the costs would be far more than demanding companies finance it vs. the government. In fact, the most respected medical groups in the country -- including the Mayo Clinic, Cleveland Clinic and the Kaiser Permanent Medical Group -- all agree that a government controlled system would increase costs by 30 percent and have serious negative consequences.

As Dr. Levy points out, these examples are both entrepreneurial for profit medical groups as well as not for profit medical arms run by foundations and hospitals. These are the people doing the balance sheets while serving the people and they don't want the government to run their businesses.

Mark Twain once said that the funny thing about common sense is that it is so uncommon. The doctors see the wisdom in making employers pay for healthcare as now takes place in Massachusetts and Hawaii. Except with the added tinkering learned from seeing the pioneering system's strengths and weaknesses, the system would be better if it applied to companies who have more than 25 fulltime employees.

Yes some won't be included -- yet. They include the part-time employees and those who work for companies with less people. But doctors know that healthcare rarely offers perfect solutions but often compromises. You take this pill to cure this ill but it will inevitably have a slight side effect. Perfection is not a realistic goal as much as quality of life and basic good health.

But despite its logic, the politicians aren't really listening to the doctors as they profess. They want a bouuillabaisse that is simmering with disputes and financial pitfalls.

In a bipartisan olive branch, President Obama did say that he would consider increasing payments to doctors who treat Medicaid patients. That is helpful because doctors are being squeezed like oranges in a juicer.

And yes, Obama's new plan does finally address looking for remedies to battle medical malpractice claims that is crippling the industry. It's once again the perfection thing and managing expectations with payouts that don't break doctors or hospitals.

The Republican right naturally opposes Levy's suggestion because its leaders don't want employer based insurance even if its for companies with billions or dollars at its disposal.

I get that. It is so clear from Obama's actions that he is a guy who has never worked or run a company and even Paul Volcker didn't even get - as shocking as it is - that prop trading was not the banks making trading bets on their own but 95% customer driven and bankers were facilitating those trades.

But Republicans can't excuse the big profit making companies from not insuring everyone.

If the Democrats were not demanding a single payer system and getting government too involved in taking over American businesses, mabye more Republicans will agree to come to the healthcare tent. But the insistence of the government option as an all or nothing concept or Medicare at 55 vs. 65 makes compromises more difficult. Yes, consumers are strapped to pay healthcare costs but doctors need to make a living too.

However, there is now hope that if President Obama shows true leadership,he will bring more moderates into the tent since many want a solution. But it must be a solution that makes sense and is not cobbled together by special interest groups, unions or people who haven't run a medical office and are telling their kids not to become doctors.

When Dr. Abe Levy listened to President Obama's recent speech, he was staying at a Hyatt hotel. He visits all the chains since his work takes him all over the country. And he always asks the clerks, the housekeepers, the waiters the same questions. "Do you have healthcare insurance?" The answer has always been no.

If President Obama would be practical vs. political, if he would listen to doctors like Abe Levy, problems could be solved. Healthcare provides 16-18 percent of the economy, he says. Why would a president want to do something that would take a 30 percent hit on one of America's most important industries and take away one of the best job engines we have left? "Medicine is a service industry which employs people and has been a success story in bringing more ethnicities into the middle class," he says. "We are not Europe. We are America and let businesses find ways to make this work."

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