Will National Health Care be Flexible?

In a post last week, Matt Lewis described a dystopian world where government would be in a position to approve or deny Americans health care. Another potential pitfall of nationalized health care is the lack of market forces or self-interest to push the government into identifying inefficiencies and finding flexible solutions. For the time being, employers can adjust their health care plans to best suit their workforce. This lets them balance the needs of employees with the company’s business interests.

I found a good example of this in a recently released report on insomnia from Center for Medicine in the Public Interest and Sanofi-Aventis. The report evaluates the reasons insomnia is costing us $42 billion a year in health care and lost productivity, but it also advocates a value-based approach to health care. CMPI’s case study describes how one particular employer – Pitney Bowes – recognized how treatable, chronic illness was costing the company money in terms of lost work time and higher health care expenses; so, they did something about it:

“The Pitney Bowes Corporation shifted from a traditional drug benefit with three tiers and increasingly higher co-pays (regardless of disease or impact on outcomes) to a value driven approach that dropped co-pays to ten percent for all drugs treating hypertension, diabetes, and asthma. As a result (after three years and despite the lower co-pays and higher employer cost per script) Pitney Bowes found that for diabetes sufferers: …average total drug costs decreased by 7 percent, … direct health care costs per plan participant for diabetes declined by 6 percent; and, the number of employees claiming short-term disability in the diabetes program dropped by about 50 percent.”

Runaway costs motivated Pitney Bowes to alter its health care plan and they had the flexibility to do it. Nationalized health care, on the other hand, would destroy the incentive to improve health care quality and efficiency by eliminating any self-interest in controlling health care costs. Does anyone really believe that government would be as committed to identifying innovative, flexible health care solutions as the free market?