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Washington Answers to Cleveland: It’s still too early to call health care reform

Insurance broker and risk manager Oswald Cos. wanted to give clients a taste of what it’s like keeping an eye on health care reform efforts in Washington. So it invited to Cleveland some folks who spend time inside the Beltway to talk about their viewpoints on reform. The results? A lot more questions than answers.

CLEVELAND, Ohio – Insurance broker and risk manager Oswald Cos. wanted to give clients a taste of what it’s like keeping an eye on health care reform efforts in Washington.

So it invited to Cleveland some folks who spend time inside the Beltway to talk about their viewpoints on reform and answer client questions at an event it called, “Washington Answers to Cleveland: Health Care Reform’s Impact on You.”

Each of the eight Oswald panelists had a different point of view, though the panelists tended to stick with two of the three big themes of health care reform: Covering more people with health insurance and slowing the growth of health care costs. Little was said about the third theme: improving the quality of care.

Most of the panelists acknowledged the nation’s health care system is complex, so solving the system’s problems is a complex process. And one cautioned against getting lost in the complexity — and the partisanship inherent in individual points of view. “We have agreement that health care needs to be reformed,” said Katie Strong Hays, executive director of congressional and public affairs for the U.S. Chamber of Commerce, “but not agreement on a public option, what to do with employers or how to pay for reform.” 

Here is a small portion of their discussion:

     ♦   On a public option— The panelists were mostly against a “public option” — a government-run health insurance plan. Representatives of employer membership groups like Strong Hays thought such an option would hurt employer health plans by siphoning healthy workers, leaving employers with high-risk workers who are more expensive to insure. In this way, a public option could threaten the viability of many employer insurance plans, said Janet Trautwein, CEO of the National Association of Health Underwriters.

Kelly McGivern, president and chief executive of the Ohio Association of  Health Plans, a statewide trade association for health insurers, gave a thumbs-down to a public option because it would create unfair competition for private insurers by offering premiums at artificially low prices. Congressman Jim Jordan, a Republican from Findlay who describes  himself as “one of the most conservative members of Congress” at his House Web page, was against a public option but in favor of insurance market reform, a more competitive private insurance market and tax credits that could help more people afford insurance.

On the other hand, Dr. Javier Lopez, health policy adviser for Congressman Dennis Kucinich, a Cleveland Democrat, likened a public option to Medicare, saying it could make health insurance affordable to most of the 46 million uninsured Americans the way Medicare made insurance affordable to the elderly and handicapped. A cancer doctor at St. Vincent Charity Hospital, among others, Lopez said it breaks his heart when patients come to him with late-stage and often incurable cancer because they didn’t have the insurance to seek treatment sooner.

Oliver “Pudge” Henkel, chief government relations officer for the Cleveland Clinic, didn’t mention a public option by name, but he said the nation has a moral imperative to cover the uninsured, and bankruptcies caused by medical bills shouldn’t be allowed to happen in the United States.

     ♦   On an individual mandate — Rep. Jordan bucked at the idea that everyone should have to buy insurance because most Americans don’t like being told what to do. He also said he wasn’t sure about the constitutionality of such a mandate. But the other panelists said a mandate that requires most people to buy insurance — some with the help of federal subsidies — is essential to help reform the insurance market. “You cannot have effective reform without some sort of mandate,” said Joel Wood, senior vice president of government affairs for the Council of Insurance Agents and Brokers.

     ♦   On rising health care costs— “We have to get serious about costs,” said Eleanor Dehoney, legislative director for U.S. Sen. Sherrod Brown, an Ohio Democrat, using tools like comparative effectiveness research to find and use the best practices for treating patients. Heidi Gartland, vice president of government relations for University Hospitals in Cleveland, said her health system was joining with others to “bend the curve” of health costs downward with a focus on innovation in technologies, care and education. Long-term, a focus on wellness and disease prevention also could help lower costs, Gartland said.

Health care delivery and payment reforms are needed to slow the rise of health care costs, Henkel said. “We pay on a fee-for-service basis,” he said. “Until we come up with an alternative, we’re going to have difficulty in reducing the trajectory of health care inflation.”

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