Reform

Making health care work

Back Commentary Sep 1, 2009 By Winnie Comstock-Carlson

This summer we saw the debate over health care reform heat up. The result has been partisanship, too little dialogue and too much misinformation. As a small-business owner, I’m concerned about reform, reform that will protect the country’s millions of small companies against skyrocketing health care costs. My own research has led me to a few basic conclusions.

Yes, we do need to expand health care to most Americans. No, we do not need to provide a public insurance plan or launch nationalized health care to do so.

Our current system grew out of a historical reality: World War II wage controls led companies to compete for scarce workers by offering private health insurance as a benefit. Every other industrialized nation built its health care system based on its own social and economic circumstances. Ours is uniquely American and should stay that way.

There is no reason to abandon employer-based private insurance. Give employers the flexibility to offer a variety of benefit plans without government mandates.

Implement reforms that we can agree on as part of current proposals: Accept all applicants, don’t charge higher premiums because of a person’s medical history or current illness and offer a minimum package of benefits. Those reforms are based on the assumption that nearly all Americans would be required to buy health insurance with government help for the truly poor.

Give employers the flexibility to offer a variety of benefit plans without government mandates.

The cost of health care — and its rate of inflation — must be reduced drastically. Our current cost burden is driving up government deficits, forcing employers to cut or drop benefits and leaving workers and their families with unaffordable bills.

We need to provide consumers with well-researched information on the quality and effectiveness of care: which procedures work best, which physicians and hospitals provide the best treatment, and how and why medical practices and costs vary widely between say Sacramento (lower than average) and Las Vegas (higher than average).

Consumers, in other words, need the same kind of information on health care as they need to make intelligent decisions in any other part of their lives, from selecting a car to buying a house. With that information, all of us can take greater responsibility for choosing, using and financing our own health care.

Most important, we need to change the incentives for physicians and hospitals. Pay them for overall outcomes — for keeping people healthy and helping patients recover quickly — not for the number of procedures and tests they perform. In cities such as Rochester, Minn., the home of the Mayo Clinic, medical care ranks among the best in the country and costs the least. Why? There is a strong local presence pushing quality and integrated care at affordable prices.

As employers, we also have an important role in health care reform. We can do our homework in choosing health care plans for our employees and selecting those that focus on outcomes. We can influence our employees’ health care choices by rewarding individuals for staying healthy and managing their health care costs effectively. We can lobby, while there is still time, for the brand of reform that we think will work best.

We simply cannot fail at reasonable reform of health care. If we do, we jeopardize our employees, our companies and our country’s economy.

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Griselda Barajas (left) provides health care insurance to her 10 employees at Griselda's Catering in Sacramento. Her small business is in the minority of those that can offer such benefits.

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