Thursday, July 12, 2012

More evidence that John Kowalko and Earl Jaques did not do their homework on single-payer

It is getting truly amazing to discover all the stuff that John and Earl didn't know what was in HB 392 when they submitted it.

For example, here's an important (and, frankly, amazing) line:
(9) Fully fund, install and utilize the seven components of the health care fraud-control strategy explained by Dr. Malcolm Sparrow in his publication titled "License to Steal: How Fraud Bleeds America's Health Care System" and a minimum of ten percent of our state's health care funds will be saved from fraud. Dr. Sparrow, Professor in the School of Government at Harvard University, is our nation's recognized authority on health care fraud.
I found it singularly interesting that we would have a peice of legislation that committed the State of Delaware to creating a fraud-control system based specifically on one book, no matter how prestigious the author.

So I cast around and found a copy of the book.  (Order one yourself.)

The good news:  Dr. Malcolm K. Sparrow is in fact one of our nation's recognized authorities on health care fraud.

The bad news:

1.  The system he describes is theoretical, has never been attempted before, and the book is--by its own admission--an inadequate guide to building such a system.

2.  Even Dr. Sparrow does not know how much such a system would cost.

3.  The system was designed specifically for implementation by private insurers rather than use in a single-payer environment.

4.  The system requires, to be functional, at least two years of paperwork history on the providers submitting bills through it.  Which means that in implementing it as a new system in Delaware, it would be a full two years before it could function.

5.  And, finally, as other health care fraud experts would point out, nobody is rushing to implement Dr. Sparrow's recommendations en masse; other experts like parts of his program, but also point out different elements from different sources, or problems with implementing his model.

It is pretty much the height of irresponsibility for Mr. Kowalko, Mr. Jaques, and Mr. Crane (remember his short-lived advocacy of single-payer before he scrubbed his campaign website) to introduce legislation with crap like this in it, even if they are merely pretending to "start a conversation."

But it's also what we've come to expect.

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