IN THE NEWS: interviews Scott Golden on Healthcare Reform

A website that offers innovative solutions to todays problems, OurBlook, today posted an interview with Scott Golden, chief financial officer of Golden & Cohen, a health benefits consulting company in the Washington, D.C. area. Read on to learn more.

President Obama has made it clear he isn’t working to set up a precursor to a single-payer health care system. Meanwhile, the insurance industry says that any version of a public plan will kill private industry. Is there any precedent for a public/private partnership in health insurance?

Scott Golden: The way the proposal is being described, there are no partnerships, so the public plan would compete against private plans. There is nothing on point with this scenario to date, which is why there is great speculation as to what might happen.

If not, how could this experiment be structured?

Scott Golden: The best way to merge government and the private health insurance plans would be to mandate certain types of policies, such as plans with no pre-existing conditions or underwriting.

Government is good with respect to making rules and laws; those can be undone with relative ease. If the government created a public plan, it would be expensive to set up and expensive to break apart, if needed. The “experiment” should be based on the objectives that need to be achieved … including enacting laws that provide for the meeting of those goals and insurance company compliance.

Also, there should be a period of time to analyze results to see if the laws work. Flexibility will be essential to make sure laws can be amended as more information on effectiveness is gathered.

Proponents of a public plan insist such a program is necessary to create competition to stop the skyrocketing costs of health. Why is our current market-based system unable to cut costs without government competition?

Scott Golden: Insurance companies could cut costs if the government required it. In fact, many are already coming to the table with options. I think this is the way to go because government intervention … through a public plan … will increase costs to the government and thus the taxpayer.

Are there other forms of regulation that fall short of creating a new government program that could rein in costs?

Scott Golden: Plenty. Controlling premium increases is a good place to start. But those controls must be realistic. If the average increases were 10 percent, perhaps 8 percent caps would work but not 2 percent, because then the quality of the health care would probably suffer.

You have predicted that there will be a much greater emphasis on wellness programs. Can you elaborate on that?

Scott Golden: Most claims are driven by certain behaviors such as overeating, excessive drinking, smoking, etc. If these non-healthy behaviors are controlled more effectively, people will be healthier and not tax the medical system as much, which will obviously reduce overall costs. I believe that for those who do not have these unhealthy behaviors, incentives should be used to encourage the same, good healthy lifestyles.

The last health care debate, a la Hillary Clinton, was met by an immediate backlash from health care providers and insurance companies. This year, the debate began with a ‘strange bedfellows’ meeting on cost cutting measures at the White House. The proposal of a public plan seems to be fracturing this fragile bipartisan atmosphere. Do you think there is any room for compromise now that detailed legislation is about to be debated publicly?

Scott Golden: Yes, there has to be. In my opinion, Hillary failed because she presented an “in-your-face” / “all-or-nothing” solution. Given that strategy, people went cold on reform. I honestly believe that health reform could have happened years ago if she had initially taken a more moderate approach. In my mind, it wasn’t Hillary’s policies that failed so much as her communication process.

Will we see Harry and Louise return?

Scott Golden: No, as there will be choice in how your health care is provided under any of the proposals; lack of choice was the premise of those commercials.

Opponents of a public plan have decried a potential government program as “socialism” and “rationing.” Yet, Medicare is one of the most consistently popular programs in our history. From your perspective, do you think that people relate the two?

Scott Golden: By all accounts, Medicare is scheduled to be bankrupt in 2017. The only way for this program to be viable is to cut costs and/or services. There is a degree of rationing if the program can remain solvent. As far as the word “socialism” is concerned, I think it is overused and means many things to many people, thus rendering no common meaning to the population as a whole.

Do you think a public plan gives too much control to the government?

Scott Golden: Only if it is the only plan offered, or the intent is to make it the only plan at some point. If the plan truly competes with carriers, then the government option will be like any other carrier.

David Leonhardt, an economist and New York Times columnist, writes that rationing is already an unfortunate reality in health care, but mostly because of the way scarce resources are allocated, such as the high costs paid for experimental or unproven treatments that could be going to preventative care. Do you think there’s any reform that could increase the number of Americans covered without rationing?

Scott Golden: No, the cost will be too high not to ration in some form. The reality is that you cannot have everything.

What role do you see small business owners playing in the debate?

Scott Golden: Unfortunately, not much. It is clear from the political dialogue that people do not even know what small business is all about. Given that fact, how can those businesses be adequately represented? In health insurance, a small business is one with 50 or less employees. Insurance companies have defined that market clearly, but politicians have not. I am concerned that these small businesses will be pawns to what politicians think they should get … not necessarily what they need.

Do you feel that a public plan is necessary if reforms include mandated health coverage?

Scott Golden: No … mandates are the best and most cost effective way of achieving results. The public plan is a speculative venture with no track record except for Medicare, which is scheduled to be insolvent in 2017.

Health care reform has been on the table in Congress before, but the resulting reforms, once they meet the president’s desk, are often more tweaks then overhauls. How do you see the debate on health care reform playing out in Congress this year?

Scott Golden: There will be a stalemate that will be caused by expense analysis; it will be painful to listen to.

Do you think we will see sweeping reform at the end of the day when these proposals are negotiated?

Scott Golden: No, but moderate and incremental reform is probable.

Do you see any Republicans crossing the aisle to support a public plan?

Scott Golden: No.

Do you see any Democrats crossing the aisle to oppose one?

Scott Golden: Yes, there are moderate Democrats who will understand the cost involved; those people are the real “key players” in shaping reform.

Are there any other points you would like to make about health care reform?

Scott Golden: This will be an interesting lesson in compromise! I look forward to seeing how it will all play out.

Scott received a B.S. in marketing from the University of Maryland in 1985, an MBA from George Washington University in 1990, and later a JD and LLM in taxation from the University of Baltimore.