"If we do not act to bring down costs, everybody's health care will be in jeopardy," the president said during last month's online town hall event on health care reform. "We've got to stop clinging to a broken system that doesn't work."
As we approach autumn, the longer we go without a final bill mean the chances for reform fall as quickly as the leaves on the trees. As such, benefits stakeholders are making their final pitches for what they most want from health care reform.
In this month's "View from the Andes," Contributing Editor Karrie Andes - who, God bless her, tried to read all 600-some pages of the Affordable Health Choices Act - offers up a practitioner's reform wish list. Among other components, Andes would like to see lawmakers:
Mandate disease management, case management and health advocacy.
Eliminate medical underwriting.
Overhaul provider networks.
Preserve FSAs, HRAs and HSAs.
Andes has a unique perspective to consider, having spent part of her childhood without health insurance. Read her full list and rationale for reform on page 8.
Over the last several months, I've heard from employers and consultants on their views about health care reform and asked them to handicap the odds for bill passage and for their opinions on the must-haves in the final legislation.
Among them are Karen McLeese, vice president of regulatory affairs at consulting firm CBIZ, and Scott Keyes and Katherine Sullivan, health care benefits consultants in Watson Wyatt's Stamford, Conn., office.
McLeese favors maintaining the employer-based system, noting that employers have "a captive audience with [their] employees, and can incent [them] to have health coverage that the individual might otherwise do without. For this reason, if no other, the employer-based model is important."
However, much of the argument centers around what the employer-based system should look like, and Keyes and Sullivan address some of these points. Employers, they say, should be interested in "controlling the increase in the cost of medical services, [which] is more important than controlling the amount of services used. Except for the pharmacy component, health care costs are being driven by the increase in the cost of service and the intensity of services, not greater use of services. Other authors have supported this claim, pointing out that the U.S. health care cost problem is related to the cost of service, not because there are too many services."
They continue that health care reform provisions that may help employers with this problem include:
Revised payment methodology for professional and facility care, including bundled approaches to paying for episodes of care that would include the facility and physician components.
Mandatory use of electronic medical records and IT infrastructure to: make provider quality and cost data transparent; reduce administrative costs and billing errors, provider errors, and redundant tests and procedures; and improve provider care by utilizing computer-based resources.
Read more from McLeese, Keyes and Sullivan, who wrote guest blog entries on Aug. 1 in EBN's blog, the Daily Diversion. Visit the Daily Diversion at ebn.benefitnews.com/blog/daily_diversion. Leave your comments with your own ideas and opinions on how health care reform should proceed. I look forward to hearing from you.
Send letters, queries and story ideas to Editor-in-Chief Kelley Butler at kelley.butler@sourcemedia.com.
