Health Care Choices: Private Consracts as Imstruments of Health Reform - Paperback

by Clark C. Havighurst (Author)

Clark C. Havighurst adds a very needed point of view to the debate about health care delivery in the United States, particularly in light of the debate surrounding the Patient Protection Act. Havighurst explains that the biggest factor contributing to problems in health care financing rests in the fact that the financing structure of employee-based insurance de-couples consumption of services from cost.

In addition, the dominance of health care by the medical profession's vague and subjective standards regarding medical necessity, along with the American myth of health care as a right, sets up a system in which cost is not taken into account when making treatment decisions. The Congressional Budget Office estimates that the Patients Bill of Rights will cause a 4.2 percent increase in insurance premiums, about 1.7 percent of which will be "passed through" to workers in the form of less taxable income. This will result in a loss of about $22 billion in Social Security taxes over the next nine years, further straining an already weak program. The rest of the increase will cause a decrease in benefits, employers dropping coverage, and higher employee costs.

Havighurst's book outlines how innovative health care contracts can be structured to provide varied levels of coverage and pricing in order to allow real choice in benefits and costs, rather than letting the federal government dictate the degree of insurance one must purchase.

Back Jacket

How can decisions about health care in the United States - too long dominated by providers, government, and the legal system - be put back into the hands of the people? Clark C. Havighurst contends that private contracts can be sharpened to do just that and ensure universal coverage, too. Private contracts, the author states, would allow for more and genuine consumer choice, based on real differences among competing health plans in content, coverage, and cost of services. Contracts would establish the standards and obligations of all parties - instead of the courts relying on definitions of care borrowed from the medical profession that drive health plans to overspending. Voluntary economizing would replace rationing without consent. Contracts could cure a dysfunctional health care market and end a severe misuse of U.S. resources. Often with specific contract language, Mr. Havighurst offers organized health plans, employers, purchasing cooperatives, Congress, and the courts ways they can turn private contracts into effective instruments of consumer-driven health reform. He recommends explicit recognition of contracts in any health reform legislation. With changes in how health coverage is purchased, courts would respect freedom of contract. And better health care contracts could be the key to designing an appropriate and affordable form of universal coverage.