The Business Roundtable has issued an enlightening and informative report on health care financing reform. The Roundtable is concerned primarily with reducing the cost of health care, not with expanding coverage to the uninsured. The Roundtable's position and the contents of the report are summarized below.
The Business Roundtable describes itself as follows:
Business Roundtable is an association of chief executive officers of leading U.S. companies with more than $5 trillion in annual revenues and more than 12 million employees. Member companies comprise nearly a third of the total value of the U.S. stock markets and pay more than 60 percent of all corporate income taxes paid to the federal government. Annually, they return more than $167 billion in dividends to shareholders and the economy.
In September of 2008 the Roundtable issued a press release announcing its support for comprehensive reform of our country's system of paying for health care. The "four pillars" of the Roundtable's Plan are:
• Creating Greater Consumer Value in the health care marketplace by using health information technology and empowering consumers with more information about good, quality health care.
• Providing More Affordable Health Insurance Options for All Americans by creating an open, all-inclusive private market for health insurance, replacing today's highly fragmented, state-by-state market with multi-state markets. This would create more choices for more health care consumers through broader, more competitive markets.
• Placing an Obligation on All Americans to Obtain Health Insurance, either through their employer or the private market. Americans would also be encouraged to participate in employer or community-based prevention and chronic care programs.
• Offering Health Coverage and Assistance to Low-Income, Uninsured Americans, creating a stable and secure public safety net. This assistance would be financed from the cost savings and efficiencies generated by a more competitive and value-driven health care system.
Here is a link to the Roundtable's September, 2008 Plan for Health Care Reform in America.
On November 12 the Roundtable issued another report prepared by Hewitt Associates entitled "Creating a Sustainable Health Care Marketplace" assessing the effect that pending legislation would have on health care expenditures in America. The report is admittedly concerned with limiting health care costs of large employers and their employees and not with expanding coverage – it is not aimed at securing health care for the millions of Americans who are currently uninsured or with helping small businesses pay for health care - but, with those limitations in mind, the report makes a valuable contribution to our understanding of the underlying problems we face and the legislative initiatives we must choose from.
In a press release announcing the new report, it states:
“The crippling spike in health care costs makes it harder for America’s companies and workers to compete in the world economy. In this challenging economic environment, we need to make sure we improve, not erode, U.S. competitiveness,” said Ivan G. Seidenberg, Chairman of Business Roundtable and Chairman and CEO of Verizon Communications. “We can do that by implementing the broad-based delivery system reforms approved by the Senate Finance Committee and avoiding ill-advised proposals such as the public option.”
According to the press release, the key findings of the Roundtable report find much to like about the bills pending in Congress:
Delivery system reforms, such as value-based purchasing; Innovation centers that identify alternative methods of provider reimbursement; Accountable care organizations that realign financial incentives to improve the quality and the value of the care delivered; Financial penalties for failing to avoid preventable hospital re-admissions; Increased individual accountability for health care spending decisions, including health reimbursement arrangements and health savings accounts; Cost and quality of care data that is easier for patients and providers to access and use; Elimination of sharp regional variations in practice patterns; Promote wellness and prevention programs and expand financial incentives to participate in specific programs to reduce lifestyle related illness; and Insurance market reforms that promote competition and choice.
The Roundtable objects to provisions of the Democratic bills that would delay implementation of many of the cost-saving measures that they contain, that fail to include a strong enough penalty for individuals who fail to purchase health insurance, and that fail to increase the tax exemption for health spending accounts. The principal report also proposes that insurers should be able to sell health insurance across state lines and that the tort reform measures in the current bills do not go far enough to restrict liability. The most serious objections that the Roundtable has are to provisions of the Democratic bill that passed the House of Representatives (H.R. 3962) that would enact a "public option" while at the same time reducing payments to medical providers under Medicare – both of which, according to the Roundtable, would result in "cost-shifting to the private sector."
In a future posting I will make a more detailed assessment of the Roundtable's findings.
Visit Professor Huhn's website on health care financing reform for links to information about proposed legislation, studies and reports, public agencies, and private organizations concerned with this issue.
