The majority of the stakeholders now agree that something must be done. They appear to recognize if action is not taken, then the government will determine what is to be done and dictate terms. It is the general consensus not to turn the issue over to the legislators.
1. Some type of legislation is going to pass.
a. It is the liberal side of the Congress that wants the legislation to be vague so they can come back and write each section of the law as it best fits the needs of the American people. (Tom Daschel, 6/5/2009)
b. If there is no agreement, instead of a legislative solution the Dems will turn to a budgetary solution which they can pass with 50% of the Senate. Problem with using this option is the requirement for them to balance the budget spending which will hamper their plans
2. Small Business Owners are being completely left out of the discussion as is the consequences legislation will have to the small business community.
a. One of the discussion issues is the requirement of all Americans to have health insurance. They can obtain insurance either through a Connector like program OR their employers program. EEs get to chose based on what is best for their situation.
b. There appears to be NO provision for an employers plan should they have a large claim within their employee population that subsequently drives up their insurance rates. When this situation occurs, employees who are healthy and want a less expensive plan can go to the ‘Connector’ leaving just those employees with conditions to be on the employers plan. Higher the claims the higher the premiums, it becomes a viscous circle.
c. By structuring the healthcare programs in this manner, eventually small employers will discontinue their plans due to cost. This would move everyone to a government run plan.
3. On the Liberal side of the legislator, there appears to be no distinction between healthcare and health insurance.
a. Kevin Counihan, CMO for the Commonwealth Health Connector Authority and James Roosevelt, Jr., JD President and CEO, Tufts Health Plan gave a presentation on the Massachusetts Connector. They touted the number of residents that are now covered by insurance. I asked them what the Connector has done for the healthcare in their state; was the health of their residents better? Could they make a claim to the improvement of the health of all now insured?
i. The answer was they were not tracking this data. BUT they did have a story of a young female who had breast cancer and would not have had coverage if it had not been for the Connector. The entire focus appears to on signing residents up for insurance, NOT to increase the healthiness of the population.
ii. Is there a better way to obtain healthcare for those who do not currently have coverage than through a government run health insurance program?
b. The stated answer all through the conference is to take cost out of the system. One of the ways the Massachusetts Connector did this was to cut Agent commission. This does not eliminate cost, it just shifts costs.
The remainder/majority of the Conference discussed real change using efficiencies that are available but not currently being used.
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