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Health care: Law school offers reform that really is simple
By Charles Swenson
Ed Bell doesn’t think health care should be a political issue. But the premise of a reform plan he pitched to the state’s U.S. senators is at odds with President Trump, who called the process “unbelievably complex.”
“It is such a simple solution,” said Bell, head of the Bell Law Group in Georgetown and president of the Charleston School of Law.
He boiled it down to five pages for the congressional delegation and can sum it up in one sentence: “The general premise behind the ‘Ultimate Fix’ proposes to remove the costs associated with catastrophic coverage out of the cost for insurance premiums, and allot the medical costs for these particular illnesses to be protected by Medicare.”
The proposal Bell drafted along with Gabrielle Sulpizio, a lawyer at his firm who was president of the Healthcare Law Society at the Charleston School of Law, says that the solution to changing the Obama-era Affordable Care Act, “while so obvious, has become masked with political ideology.”
The Senate last week failed to bring a reform plan to a vote after Republicans failed to agree on the details. Democrats oppose the package. It was a similar scenario in the House earlier this year that led the president to admit that the process was more complicated than he thought.
While Bell thought senators would be interested in some alternatives, he had no response from either Sen. Lindsey Graham or Sen. Tim Scott. “We have received lots of ideas/proposals from constituents, health care professionals, retirees, think tanks, etc.,” a spokesman for Graham said in an email. He didn’t say whether those ideas contributed to the process or how Bell’s proposal was received.
Similar questions asked of Scott’s press office were forwarded to a staff member who works on health care issues. There was no reply.
But Bell said his idea is under review by the Medical University of South Carolina and the Children’s Hospital of Philadelphia. “It’s the perfect time now,” he said. “It’s a way to innovate without the influence of insurance and drug companies.”
When a faculty member at the law school died of breast cancer, it saw a jump in employee health insurance premiums. Bell started talking with friends at MUSC, which had helped set up the law school’s student health center. He was told the $1.6 million in care for the faculty member would have cost $325,000 under Medicare. The difference was that the charge to private payers helps cover the cost of care for those who can’t afford to pay. “We started looking into it,” Bell said.
“It is estimated that without catastrophic coverage, health care premiums would go down by at least 40 percent, and possibly more,” he and Sulpizio concluded.
That would also allow coverage of people with pre-existing conditions and allow children to stay on their parents’ insurance policies until age 35, they said.
While health insurance covers a wide range of services, they realized that it is the catastrophic illness that raises costs for individuals and insurance companies. The large, uncertain costs of catastrophic care also reduced competition in the insurance industry.
Of course, shifting the cost of that care to Medicare will raise the cost of that program. But the cost of care will be less for the federal program than for private payers, Bell said. To make up the difference, he proposes a $25 a month Medicare premium for working people that would be matched by their employers. “It’s not too much to ask young people to pay $25 a month,” Bell said, and that would bring more healthy people into the system, one of the goals of the Affordable Care Act.