Updated on 5 March 2010 at 8:30AM: I added a few more questions that were written down at the office.

It seems like I have a lot of answers about healthcare, but I really don’t. However, I do have some anecdotes and a few facts. And I have done some research when prompted or to fact-check other people’s claims. I even have a lot of opinions that I usually try to keep to myself.

But mostly I have a lot of questions and a rubric for evaluating options. I have a lot of questions. That’s what I do: I ask myself questions that I’d love to have answered before I come up with a firm opinion, if I come up with one at all.

I’ll tell you what I wonder, and I would love to know your questions about healthcare reform and costs.

Here are some of my questions, which I’ll number in case you want to provide your own answer:

  1. How should we pay for insurance?
  2. How much should individuals have to pay for their healthcare? Should everybody pay the same amount? Should we have tiers of service? Should it be tied to income? Is the important thing equality of coverage or equality of access?
  3. How would allowing health insurance competition across state lines impact costs, benefits, and outcomes?
  4. Would cross-border insurance competition lower insurance premiums? If so, what are the mechanisms? Would it cause a “race to the bottom” in covered services?
  5. What are “health insurance compacts?” Are they run by states, nonprofit organizations, or for-profit companies? Would they promote competition, lower costs, lead to cuts or improvements in covered services, etc.?
  6. What’s the proper amount of regulation of insurance companies and healthcare costs and services?
  7. How would simplification — going from 51 or so different regulatory schemes and hundreds of insurance plans to a dozen or fewer — affect costs, coverage, and patients’ health?
  8. What should be mandated? Why should this vary by state? What’s the right way to determine what’s covered?
  9. If we continue to have a system with different mandates, aren’t we going to end up exactly where we are now, with some people covered for some illnesses and others not?
  10. What’s the proper role for federalism in healthcare?
  11. Does actively preventing chronic illness cost more than treatment?
  12. How much of our healthcare spending is attributable to “unnecessary” incentive-based, fee-for-service activities? What are these “unnecessary” services?
  13. Is radiology too expensive? Do hospitals buy the appropriate power of scanner? Is there a point where spending more doesn’t get us better results?
  14. What impact would electronic health records have on costs and outcomes?
  15. What is the cost to hospitals, governments, and the insured for “uncompensated care” provided to the under-insured?
  16. Is it okay to bring currently healthy individuals into the insurance pool (thus lowering premiums per capita) without enacting a plan to reduce total healthcare costs at the same time? How will we sustain momentum for cost containment if we don’t?
  17. What are the subsidies for insurance premiums and/or healthcare costs that are part of the (current) Democratic plan? How much are they? Who would get them? Where do the funds come from?
  18. How do the plans proposed by the House and the Senate reform delivery to “ensure better outcomes” as Kent Conrad (D-ND) said they would on “Meet the Press?”
  19. How does the Medicare pricing and reimbursement model impact providers, patients and costs?
  20. What does the Congressional healthcare plan do to Medicare? Would the President’s plan move people to Medicaid, as the GOP says? How would it affect taxes, the costs to the states, insurance premiums?*
  21. Why does everyone hate Medicaid?
  22. Will the fees in the President’s plan increase the cost of healthcare, as John Kyl (R-AZ) suggests? What are these fees?
  23. How much healthcare do we really need? Is there a target number?
  24. What is the rationale for more government involvement? How do we know its influence won’t mess everything up or politicize coverage?
  25. Why aren’t the administrative costs and overhead lower for private insurance companies?
  26. With as many people paying so much for care, everybody must know someone who is having a hard time or paying a large part of their income. Why isn’t there something like a “pink ribbon campaign” to mobilize for lower healthcare costs?

Okay, now it’s your turn. Feel free to give voice to what you know in the comments, and please share your own questions. Opinions are fine, but data/evidence-based opinions are even better. Everything civil is welcome.


* — Senator Lamar Alexander (R-TN) said some rather unflattering things about the Democrats’ plan Sunday on ABC’s “This Week.” They’re all unsourced, so I’m going to leave the actual claims unstated. But it’s worth checking them out.