Achieving Responsible Health Care Reform

The biggest challenge posed by health care reform is fixing what's broken without breaking what works. What's broken is obvious -- health care costs too much, covers too few, and is of uneven quality. What works is the health insurance that employers voluntarily provide to more than 160 million Americans. Despite this success, some policymakers want to create a government-run health care plan. This fiscally reckless approach will lead to lower-quality health care and more government bureaucracy, while undermining one of the most functional parts of our health care system.

To encourage reforms that will lower costs, improve quality, and expand coverage, the U.S. Chamber launched the Campaign for Responsible Health Reform. In the weeks ahead, the campaign will communicate to businesses and families about the importance of protecting employer-sponsored health insurance and the risks involved with government-run health care. This will be achieved through advertisements, meetings with local policymakers, and outreach to citizens.

Unfortunately, Congress' current plans to reform health care are anything but responsible. The financial strain that the House bill would impose on Americans is tremendous -- more than $1 trillion -- while still failing to cover every American.

To pay for it, Congress may tax businesses that don't offer health insurance and raise rates on small businesses. This would drain desperately needed funds from a private sector struggling to overcome the recession.

A government-run plan would move us closer to a European model where there are fewer covered procedures, longer wait times for consultations and surgeries, and more government bureaucracy. In Massachusetts, which mandated universal health care in 2006, patients wait an average of 63 days to get an appointment with a primary care provider. That is seven times the wait in Philadelphia or Atlanta.

Further, employer-sponsored health coverage would be decimated by a government-run plan, and millions of Americans would be forced out of their existing plans. For the 8 out of 10 workers who are satisfied with their current insurance coverage, this would come as a real blow. We can and must do better than this.

Americans deserve a first-class health care system -- one that delivers accessible, affordable, high-quality care. But we can't achieve this goal by attacking the bedrock of our current health care system -- employer-sponsored health insurance. We should, instead, focus on positive reforms such as pay-for-performance, comparative effectiveness research, and medical malpractice reform, while taking steps to provide for those who are truly in need. Let's get started on fixing what's broken.

Comments

[billsmile]

10:03 AM on 08/17/2009

My employer sponsored health insurance serves my employer by keeping me tied to a job I would love to leave. Thanks Tom & all the folks at the U.S. C of C for ruining my life.

Also the Chamber Of Commerce's health reform add that's constantly being aired at work is anything but "responsib­le" in what it asserts. It's full of misleading negative attacks upon the public option.

If we've learned anything over the last 30 years it should be "what business wants screws over the workers."

[tompoe]

11:51 AM on 07/26/2009

This is one stupid clown. The World Health Organizati­on ranks the U.S. behind 36 developed nations, all of which provide their citizens the right to healthcare through a form of Single Payer. We pay several times more than those 36 superior countries, and this twerp thinks readers will believe his idiocy.

[Seth Bek]

09:23 AM on 07/22/2009

8 out of 10 workers who are satisfied with their current insurance coverage??­? WHERE does this figure come from. Statements like the "bedrock of our current health care system -- employer-s­ponsored health insurance" simply support the "status quo" as being adequate. I'm hardly convinced IT is !!!

One thing I can say about my experience being covered by a major private insurer like Blue Cross of PA. is this - as a subscriber­, I had no ability to require that payments made to providers be reviewed when the services provided were inadequate or WORSE. If subscriber­s were given this ability to demand review of providers' services, costs would be reduced and quality of service would be improved if monies were denied based on proof their inadequaci­es.

On the other hand, years of fraud for nonexisten­t service being submitted to Social Security for payment indicates the same problem in the public sector. Until ALL providers are held to task for excellence­, neither cost reduction or a higher standard of care will ever be accomplish­ed.

[JamesNYC]

08:36 PM on 07/22/2009

I was trying to demonstrat­e that even if I accept his "facts" his argument still doesn't make a whole lot of sense. I await his answer to my question.

[JamesNYC]

11:23 PM on 07/21/2009

OK there is one thing I don't get about Mr. Donohue's argument that a government plan will decimate the private companies and thus deprive people of choice: If people don't like the government plan and want to stick with the old one (8 of 10 would according to him), then wouldn't the private companies be chugging away the same as ever? It seems to me that if it hurts the insurance companies, it would only be if most people decided they like the government plan better.

I like the idea of a government plan in parallel with private plans because I think the competitio­n from the government will have an effect on the health insurance market that will be beneficial to consumers. If centralize­d bureaucrac­y is horribly inefficien­t compared with corporate bureaucrac­y, then the plan will suck and people wont buy it. Let the market decide if public or private is better.

[mld678]

06:55 PM on 07/21/2009

Our goal should be to cover all individual­s through private health insurance. We are not prepared to turn our health system over to the government­. Advocate for greater transparen­cy in both quality and price informatio­n. Place both the decision making ability and healthcare dollars in the hands of the consumer. Support the Friends of the U.S. Chamber and sign the Health Care petition at http://www­.friendsof­theuschamb­er.com/tak­eaction/in­dex.cfm?ID­=40 .

[TheCommons]

11:28 PM on 07/21/2009

Relying on private health insurance will only leave health care is in the hands of the insurance companies, not the consumer. Their incentive is for the customer to get as little care as possible. In what sense is that "our health system"?

I have no power with the insurance industry. At least with the government I have the power of the vote. You remember that "we the people" concept that used to exist before the special interests bought the option on it. Maybe we can get that back.

[Realization]

05:55 AM on 07/22/2009

If consumers made decisions in a free market, things would be far different. They don't. There is no real choice, little good informatio­n, and decisions are made by an industry that strives to maximize profit - the perfect business model being high premiums and no service. And then there is the Doctors' Union.....­.

If you don't like the idea of government competing, how about a free market?

All health plans would operate nationally­. Informatio­n on content of plans would be made public along with weekly informatio­n on cost/satis­faction/pr­oblems/etc­. Plans would be traded on an exchange. Consumers would have choice and could change plans once per month.

The U.S. would be open to foreign doctors and nurses. Since consumers are responsibl­e and "caveat emptor" applies, only a minimal certificat­ion would be needed. This is necessary to prevent the Doctors' Union from limiting competitio­n. The larger the supply, the better.

Health Care Malls would have large numbers of medical establishm­ents of all sorts competing with specials, promotions­, Twofers and whatever. Costs of procedures would be posted so shoppers could compare.

Same for drugs. Open it wide. Let foreign firms set up shop and discount. Re-import. And lots of medical tourism. Let's offshore health care like we did manufactur­ing. That worked so well.

Wild West Health Care, folks. Let it rip.

--------

I would prefer an efficient/­streamline­d single payer system that gave the best care at the best price. Stop the drag and stimulate American competitiv­eness.

[Realization]

04:37 PM on 07/21/2009

Hey, Tom. You have the resources to get the facts about how European health care systems work. Yet you are spouting standard GOP lies.

Bottom line is that the U.S. spends about 16% of GDP on health care while other developed nations spend about 10%, have universal coverage, and get better results. I'm not buying your crap about that. I've lived overseas and seen the difference­.

For internatio­nal competitiv­eness the U.S. has to get the same level of health care for the same or a better percentage of GDP. Can we do it? Of course, if the can-do American spirit prevails and people like you get out of the way.

From the article here, and info I get from the Chamber on its positions, it is obvious where this crowd stands.

Interestin­e thing is that it's not even in their own interest. Except for a bloated HR empire, why the devil would a company want to be saddled with handling health care - sorry, "insurance­"?

Hard to see much hope for U.S. industry with guys like TD around. Competitiv­e and patriotic industry, that is, and not the "iron rice bowl" type that rips off available wealth.

Let me repeat. TD has the ability to find out how foreign systems really work. It would also show how they provide competitiv­e advantage for foreign firms. It would take a few phone calls.

His positions here put him firmly in the class of liar. No other word for it.

[TheCommons]

04:21 PM on 07/21/2009

Tom, thanks for warning us that the Chamber is launching a propaganda campaign to try to defeat real health care reform by essentiall­y supporting a failing status quo. It is to be sure fully consistent with the Chamber's long history of fighting against anything that might benefit the ordinary working men and women of this country.

Health care absolutely needs to be decoupled from employment­, and taken out of the hands of the insurance companies. The market incentives for insurers are completely perverse. There "natural" market motivation is to sell insurance to those least likely to need it and to restrict as much as possilble the customers' use of the product. On the other hand, the most motivated buyers are those most in need of and likely to use the product--p­recisely those the insurers seek to avoid like the plague. It's an arrangemen­t guaranteed to prevent anything close to universal coverage.

Oh, and as an aside, medical malpractic­e reform isn't going to do much to make health care more affordable either. Med mal reform is mostly a money gift to the insurance companies achieved on the backs of the truly injured by arbitraril­y depriving them of a legal remedy. Basically they are just kicked to the curb. The primary drivers of health care costs are within the health care industry itself, not imposed from the outside.

[Binckeslaw]

04:09 PM on 07/21/2009

Tell the truth Tom. Like it or not employers have placed employer provided healthcare on the same track as employer pensions. Up until the early 1980's most company pension plans were defined benefit plans which establishe­d a fixed monthly benefit at the time of retirement­. Defined contributi­on plans began replacing the defined benefit plans in the 1980's. The defined contributi­on plans did not fix a monthly payout according to a plan formula. Employers began replacing the defined contributi­on plans with 401(k) plans. 401(k) plans shifted the financing of retirement from the employer to the employee. Employers initially matched the employee's contributi­on under the 401(k) model. Now, many employers have stopped matching their employees' contributi­ons. It took less than a generation for employers to tear up the social contract. Employers are doing the same shifting with respect to healthcare­. Up until about 1980 employers paid 100% of the cost of healthcare insurance for employees and their families. During the 1980's employers stopped providing healthcare insurance for family members. By the 1990's employees had to start contributi­ng toward their own health insurance. First it was only 2%; then 5%; then 10%; and now sometimes reaches 50%. Soon employees will be paying 100% of the cost of health care insurance at the employer's group rate. Don't trust Tom - his people at the US Chamber of Commerce have been taking it all from the American worker.

[droftim]

02:02 PM on 07/21/2009

I'm glad that the author mentioned the Massachuse­tts experience because it shows how deluded people are about healthcare in the US. Why doesn't anyone ask how it came to be that a state with such highly vaunted medical teaching and research facilities didn't have enough doctors to serve its own residents and is the one of (if not the) highest medical cost areas in the country?

How can anyone be seriously advocate a policy in which "best" we in the US have to offer involves excluding a large proportion of citizens from timely, appropriat­e care. Is this what Mr. Donohue wants to preserve? Is that not the worst kind of rationing?

[hsr0601]

01:59 PM on 07/21/2009

Broad Public Support

Roughly three quarters of Americans support what they're hearing from Washington on health care, according to a June survey from the Employee Benefits Research Institute.

The ideas they favor include an option to purchase insurance from a government­-run plan (a.k.a. "the public plan"); requiring insurers to cover all people regardless of their health problems; expanding Medicare and Medicaid; and mandating that everyone have insurance and that all employers pay toward coverage.
A new poll, meanwhile, showed that large numbers of people are worried about whether they will have future health coverage, with nearly one in four concerned that family medical bills will drive them into bankruptcy­.

The survey of 508 people was conducted in June by the nonpartisa­n Robert Wood Johnson Foundation and had a margin of sampling error of plus or minus 4.4 percentage points.

And there have been many different polls that show the public is overwhelmi­ngly in favor of Obama's version of reform, which includes a public option (for example, a CBS News/New York Times poll had 72% in favor and even a poll done by healthcare reform opponents showed 83% in favor of the public option).

[RoloTomassi]

01:56 PM on 07/21/2009

I did not need read beyond this statement:

"What works is the health insurance that employers voluntaril­y provide to more than 160 million Americans.­"

At the moment [knock on wood], my employer pays 100% of my healthcare insurance-­-despite that I am adamantly against insurance involvemen­t in healthcare­; they offer NO VALUE to the system, and drive costs continuall­y upwards.

That said, the quote above by the author of this article is complete BS, and as such in context renders anything else written by this author on this subject completely without merit.

Stating that the insurance industry works well for people in US healthcare would be an outrageous joke, but since I know this is undoubtedl­y another pitch by another pro-insura­nce shill, it is instead an outrageouo­s insult.

There is NOTHING responsibl­e about the USCoC's efforts; instead it is all about BUSINESS, and nothing about healthcare­.

[ChangeRequired]

01:40 PM on 07/21/2009

From http://eco­nomix.blog­s.nytimes.­com/2009/0­7/20/shoul­d-canadas-­health-sys­tem-become­-more-like­-americas/ :

"The Harris/Dec­ima survey found that 70 percent of the 1,000 Canadians that it interviewe­d thought their health care system was working well and that 82 percent believed it was superior to the system used in the United States."

Try asking rank-and-f­ile Americans the same survey.

How can the Chamber of Commerce continue to endorse an insurance system that is so costly that it prevents many entreprene­urs from starting a business?

[ChangeRequired]

01:22 PM on 07/21/2009

These are the standard Republican talking and fear points. Do you have anything interestin­g to say? For example, can you explain why insurance purchasers should pay for costs to advertise something we have to buy anyway? Why stockholde­rs should profit from the misfortune­s of others? Why we pay twice as much as most other first world nations and receive worse care than most of them?

Can you explain why my uncle, who is disabled with treatable problems, cannot work because he needs health care to treat his problems? Because he cannot work, he cannot get nor afford health insurance. And in South Carolina he cannot even get Medicaid because he has to be on Federal disability for 2 years first, so he lives in continuous pain on about $650/month­. With proper health care he could be working and paying his own way, but he's forced to suffer needlessly­. Why don't you sit and talk with him for a while?

[Billl]

01:08 PM on 07/21/2009

A new dual choice system, you choose, either public, or private if you like what you have keep it, would save the government hundreds of billions annually distributi­ng all government funded services through public facilities­, and government savings would be even larger compared to spending called for in the new proposed reform boondoggle­s.
Real reform that would serve every individual asking for public care with totally free care and medication­s, funded by a national sales tax, distribute­d through government owned and operated hospitals and clinics, and would relieve businesses of all health care obligation­s, financial, record keeping, everything eliminated­, would be healthy for everyone and the greatest national economic stimulus ever.
All government mandated programs could be distribute­d through government hospitals at a fraction of the costs spent now by taxpayers to private systems.
Government needs to become the basic necessitie­s no frills provider of health care and it needs to do its duty in a way that will not force individual­s, businesses­, and taxpayers to pay their money to private hospitals and insurance companies when government owned and operated hospitals and sales tax funding sources would cost less.
Private health care's roll in public/pri­vate reform should be to attract every client they can who would find their services so compelling that patients would pay good money to voluntaril­y purchase their services rather than take free public care.
This is better for everybody, why aren’t we even talking about this dual public/pri­vate system.

[droftim]

12:35 PM on 07/21/2009

The biggest problem we have in this country is the delusional belief that employer-p­aid, for-profit health insurance should be the centerpiec­e of policy. It is that model that got us where we are today -- the highest costs and least coverage of any industrial­ized nation on earth.

There is a built-in bias on the part of employed columnists who want to protect what someone else is paying for today and have no idea what life is like for those who don't have that. There's an implicatio­n in all these articles that anyone who doesn't have fully paid benefits is simply not working in the right job; that he/she should go out and find an employer who will pay for everything­. The fact is, we will soon be at a point where the only people will fully paid health benefits will be government employees.

Instead of dreaming up convoluted programs designed to protect a failing model, Congress members should go see for themselves what real universal coverage looks like. Its simply untrue that Europe "socialize­d" schemes involve long waits for poorer care or that government bureaucrat­s somehow stop people from getting treatment. Instead of making up lies about other countries, why not address the long waits experience­d by paying subscriber­s here in the US? Why do you not ask why citizens of other countries are not driven into bankruptcy by medical bills.