Health Care Reform Challenging Yet Vital

Posted on | July 15, 2009 |

Mary Ann Miller

I believe I’m qualified to talk about health care reform from a user’s standpoint.  My father was ill for 14 years before he died.  In the last two years of his life he was admitted to the hospital 18 times, which doesn’t count doctor’s visits, outpatient treatments, twice weekly dialysis and the midnight emergency room visits.  My mother has had two strokes, and was hospitalized for five weeks with the last one.   We regularly see six doctors for her care.

My father was 44 and self-employed when he had to stop working.   Finding, keeping and negotiating his insurance coverage became my mom’s other full-time job.   Mom retired at 70 after years with a major drug store chain.  While transitioning to a medicare PPO was confusing, it’s been a relatively easy experience since then.

Meanwhile, every year I look for insurance plans for the staff of the Tempe Chamber.    Because we’re so small, we’re age rated, which means that my insurance costs more than my customer service rep’s.   The insurance rates rise faster than our income, forcing me to regularly change plans in order to continue coverage.  And if someone leaves, they’re not covered under COBRA.

So why would I oppose a government-run public option?  After all, wanting to insure folks who can’t find coverage is a noble goal.  But as with any plan, implementation is often different than the idea.  Let’s run through the scenario.Let’s say the government creates a plan that competes with private insurers, as they’re discussing.  Through cost savings, including reducing the reimbursement rates, they’re able to offer plans at a lower rate than the market.  This allows some folks who can’t currently afford insurance to gain coverage.  But it will also attract people currently paying for coverage at a higher rate.  They will leave the private market for the public one, swelling the ranks.

There are many studies that show that Medicare reimbursements don’t cover the actual costs of care, transferring the cost burden to other users.  There’s no reason to think that public option reimbursements would be any different.  As the rolls in the public option grow it will push more costs to the private sector, which will in turn raise the costs of premiums and drive more people to the public option, making the private sector even less competitive until it implodes.

Meanwhile, doctors, who graduate with hundreds of thousands of dollars of debt and pay tens of thousands of dollars in malpractice insurance premiums each year, will be seeing more patients for less money.  That’s not a good recipe for attracting doctors and quality care.

There are no easy answers to health care reform, and a lot of hard questions to be answered, but most of us agree that something needs to be done.  We at the Tempe Chamber have long advocated at the State level for health care reform that increases access, allows portability, and lowers costs.  Federal reform should consider this as well.  We do not believe the creation of a government/public option will achieve these goals.

Mary Ann Miller is the President/CEO of the Tempe Chamber of Commerce

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