Reform could be expensive--for providers

In theory, healthcare reform should be good for hospitals, doctors and other professional caregivers. After all, in theory providers will get more money from their patients if more of those patients have health insurance. But then, it's important to remember that all health plans aren't created equal. In reality, reform may not do much for providers at all, at least not where providing routine care is concerned.

Sure, if everyone in the country were to get coverage equivalent to even, say, Medicare, doctors and hospitals would probably do much better. At minimum, they'd probably have much fewer unpaid debts to deal with, as patients simply wouldn't incur as many. But it seems, so far, that this is not what policymakers have in mind.

But as far as I know, many of the discussions in state and federal circles are focused on implementing plans that look something like those in Massachusetts. And the Massachusetts framework involves high-deductible plans matched to health savings accounts which, let's face it, some citizens will never be able to fund. That just leaves providers back at square one when they see such patients; they're no more able to pay their routine bills with such coverage than they are without it.

The truth is, unless less-affluent (and I'm talking middle class here) citizens have plans that come with smaller deductibles, they're going to be in a pickle from day one. And providers will end up paying the price when they can't.

So, while I'd hate to call the current round of schemes an unfunded mandate, I smell something like it nonetheless, particularly given that I'm betting the feds will require providers to accept the new insurance plans. How about you? - Anne