Will Health Reform Happen?

By Hannah Wallace October 31, 2009

›› Holmes Beach resident Chuck Slater is senior vice president and east market lead for WellPoint, Inc., in charge of Maine, New Hampshire, Connecticut, New York, Virginia and Georgia. WellPoint is the nation’s largest health benefits company with 35 million medical members; one in nine Americans is covered through one of the company’s health plans.

How can we address the problem of the uninsured? Somewhere in the range of 47 million people are without insurance. One-third of them make more than $50,000 a year and are eligible for insurance and choose not to take it. One-third are eligible and do not enroll in SCHIP (State Children's Health Insurance Program), Medicaid and Medicare and programs for the disabled. And then truly one-third of the 47 million doesn’t have access and can’t afford healthcare. So that’s the size of the problem. The issue is financial. Do we rip the current system totally apart in order to insure just the ones who are not eligible or can’t afford insurance?

Should reform make sure that everyone is insured? Everyone should have insurance. If that happens, you can get rid of pre-existing conditions. Think about auto insurance. You don’t wait until you have an accident to sign up, and you can’t wait until you get sick to get health insurance. If you have everybody insured, the price would be fairly borne by everybody. Remember, the sickest 20 percent of the insured population generates 80 percent of the cost.

Will the healthcare proposals out there increase costs? Most of the health reform benefit proposals are very rich, meaning they offer less deductible and more coverage. The plans that the senators have are FEP plans (Federal Employee Programs), and they are 130 percent richer than the market is selling today on average. When they talk about providing that level of coverage to everyone, you’re increasing the costs overall. Medical inflation is 5 percent to 7 percent a year. Add to that medical innovation and technology and the cost shifting, and you’re up to 12 percent to 14 percent inflation for healthcare insurance. We don’t believe the costs will be neutral going forward under any of the scenarios. Additionally, little is being done to address the tort reform issue surrounding malpractice insurance costs.  

How much will businesses be paying for employee healthcare in five or 10 years if nothing is done? Costs will double under today’s process. Cost shifting from government programs, advanced technology, healthcare cost inflation and our population’s desire for convenience medicine will fuel this increase in costs.  

Are there any measures out there that are working, any creative ways of cutting costs and ensuring good plans for employees? Stress wellness. There are employers now that are charging in their deductions for smokers and overweight employees. And there are consumer-driven plans where the consumer needs to ask questions: Do I need this drug or can I use the generic? Do I need to go to this hospital or is there another hospital? What are the cost differences? Is there a difference in drug prices between Walgreens vs. CVS? Consumer information regarding health issues is everywhere, and we need people to begin using it. As employers we also need to establish rewards for healthy lifestyles and choices. ■

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