Health Care for All: Big Business to the Rescue?

[Guest guest]

Sen. Kennedy seeks universal health plan By KEVIN FREKING,

Associated Press Writer

Wed Jan 10, 4:44 PM ET

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WASHINGTON - The federal government should join the state of

Massachusetts in enacting universal health coverage, said Sen.

Kennedy (news, bio, voting record), the new chairman of the

Senate committee with jurisdiction over numerous health issues.

Kennedy's home state is the first to require everyone to have health

insurance, just as drivers must have automobile coverage.

Kennedy has his own version of what universal health coverage would

look like. He wants to extend Medicare to all. In his first hearing

Wednesday as chairman of the Senate Health, Education, Labor and

Pensions Committee, the Massachusetts Democrat called on 10

witnesses from all over the country to talk about how to make health

care more affordable.

" Insurance coverage is down. Costs are up. And America is heading to

the bottom of the league of major nations in important measures of

the quality of care, " Kennedy said.

Kennedy emphasized how Democratic legislators in his home state

worked last year with Republican Gov. Mitt Romney in crafting

universal coverage there. He wants the same spirit of compromise to

take hold in Congress.

However, the hearing also showed that finding agreement won't be

easy. While all the witnesses agreed that health care is becoming

less affordable every year, they often had very different solutions.

For example, the Business Roundtable renewed its calls to change

medical liability laws and for the federal government to give

consumers more information about the cost and quality of the care

they get, two priorities often cited by the Bush administration.

" High health care costs are affecting job creation, and high health

care costs are hurting our ability to compete in global markets, "

said Larry Burton, the roundtable's executive director.

But Stern, international president of the Service Employees

International Union, called for much more dramatic change. He told

lawmakers that it's time to recognize that employer-based

coverage " is dead. " The statement infers a much more active role for

the federal government in funding health care.

of the Commonwealth Fund, which conducts health

research, told lawmakers to look at Denmark as a model for the U.S.

She said that nation's government pays doctors a capped rate for

each of their patients, plus additional amounts when they perform a

service. Each doctor handles about 1,500 patients, and they can

handle walk-ins and same-day appointments. And Denmark residents

love their health care system, she said.

Most of the witnesses agreed on two points:

First, Congress should expand funding for a health insurance program

that now provides health insurance to about 5 million children. The

children live in families that make too much to qualify for

Medicaid, but not enough to afford the monthly health insurance

premiums offered through the private sector.

Second, Congress should not get in the way of states trying to grow

the number of residents who have health insurance.

The state of Massachusetts employs a combination of subsidies and

penalties to make insurance more affordable and to force people to

buy it. The law requires employers with 11 or more full-time

employees to offer health coverage or be subject to a $295 fee for

each employee, as well as face being billed for services their

uninsured employees get.

California Gov. Arnold Schwarzenegger this week proposed a

plan that would extend health care to 6.5 million uninsured

Californians. Under the proposal, all Californians must have

insurance, although the poorest would be subsidized.

Some of the committee's Republicans would like the committee to

renew its attention to help for small businesses. They support a

plan that would let businesses buy insurance through regional or

national trade associations. The insurance would be free of many

state mandates. That could make it a cheaper alternative, but would

also provide scaled-back coverage in some instances.

" My primary interest is to provide health insurance reform for small

businesses and working families, and I believe that 1 million more

people will be insured if we enacted the (small business health

plans), " said Sen. Mike Enzi, R-Wyo.

Also, Wednesday, the Children's Defense Fund called on Congress to

provide health insurance for all children in the U.S. About nine

million live in families without insurance. The organization said

all children in Medicaid or the State Children's Health Insurance

Program should be automatically enrolled in one program that

provides all medically necessary care.

Children in families with incomes over 300 percent of poverty could

also pay premiums that would allow them to participate.

" A child's chance to survive and thrive should not depend on the

lottery of geography, " the organization said.

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Your Health

Health Care for All: Big Business to the Rescue?

As unlikely as it seems, big business may be the force that brings

about universal health insurance.

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By Gross

January 2007

" It's an outrage that any American's life expectancy should be

shortened simply because the company they worked for went bankrupt

and abrogated health care coverage. And now we have a company like

Ford virtually being bankrupted by the problem of rising health care

costs, and yet you've got tens of millions of people with no health

insurance. "

These words of frustration weren't uttered by a union leader

standing on a picket line. Instead, they came from billionaire

Wilbur L. Ross Jr., number 322 on the Forbes 400, the former

chairman of the International Steel Group and a major investor in

U.S. textile, coal and auto parts companies. Ross made much of his

fortune in recent years by restructuring bankrupt industrial

companies, many of which were swamped by the escalating costs of

insuring their aging work forces. He sees a need for some kind of

government involvement in health care, and he's not alone.

As unlikely as it seems, big business could emerge as the force that

finally brings about universal health insurance. In the first week

after the November elections, the CEOs of General Motors, Ford and

Chrysler met with President Bush to discuss issues they faced,

including health care costs. That same week, America's Health

Insurance Plans, a trade group of large insurers, released a 10-

year, $300 billion proposal to provide health insurance for all

children and 95 percent of adults—through a combination of tax

breaks for individual taxpayers and the expansion of government

programs such as Medicaid.

" I think we're getting to a tipping point where this country is

going to be willing to move on health care, " said Wal-Mart CEO Lee

in an appearance on the Charlie Rose show last year. " Business

and labor are going to have to participate and probably play even

more of a leadership role than government ... and then bring the

political side along with them. "

To Ross, the solution to America's health care crisis is relatively

simple. " We need some form of universal coverage that would be

funded centrally by the government, but delivered privately through

existing mechanisms like HMOs, " he said. The program, he suggested,

could be funded by a tax on imports.

The discussion is clearly being prompted by bottom line issues:

Soaring health care costs are a major problem for business.

Companies in the United States compete against rivals in developed

countries (Japan, Germany and France) where the government funds

health care, and against developing countries (China, India) where

neither business nor society at large is responsible for health

insurance. Either way, American companies that provide health

insurance are at a competitive disadvantage.

In 2005 money-losing General Motors spent $5.3 billion to cover the

health costs of 1.1 million employees, retirees and dependents. Ross

noted that, on a per-car basis, General Motors spends more money on

health insurance than on steel. But Old Economy behemoths like GM

aren't the only ones suffering. " Since the beginning of this decade,

health insurance premiums for average employers have increased 87

percent, compared with overall inflation of 18 percent, " said

, vice president of operations at the Washington-based

National Coalition on Health Care (NCHC), a nonprofit alliance of

business, unions and consumer groups. These higher costs cut into

operating margins and reduce the capacity of businesses to grow.

Thus far, the response from business has been to pass costs on to

employees and reduce coverage. According to U.S. Census statistics

for 2005, nearly 47 million Americans lacked health insurance, up

from 40 million in 2000. And only 60 percent of Americans had job-

based coverage, down from 63.6 percent in 2000—this after five

straight years of robust economic growth.

Business leaders have traditionally been reluctant to call for a

national effort to confront the issue. " We have people who map the

genome or conquer the Internet who seem rather timid about speaking

out on what's good for the country, " said Andy Stern, president of

the 1.8 million-member Service Employees International Union.

That reluctance began to change in 2004, when the NCHC—which

includes large employers like Exelon, General Electric, Duke Energy

and American Water—issued a report calling for comprehensive

universal health coverage. The report laid out a range of options,

such as expanding government programs like Medicare or letting

people or businesses buy into the federal worker health plan. But

while the organization's corporate members endorsed the plan, its

prominent CEO members haven't publicly called for universal health

care.

Experts like Drew Altman, president and CEO of the Henry J. Kaiser

Family Foundation, say that personal ideology and lack of knowledge

tend to block discussion on the subject. Case in point: Business

leaders savaged the Clinton administration's fruitless effort to

create universal coverage in 1993. " Another factor, " said

Altman, " is that these business leaders spend a small amount of time

on the complex issue of health care. And many don't really

understand it. "

In addition, because most CEOs are focusing on creating returns for

shareholders—and not on producing benefits for society at large—they

tend to approach the question of rising health care costs as a

business problem, not a social or political one. Some companies

experiment with chronic disease management, ban smoking, invest in

wellness programs, and depend on technology to manage costs. Others

implement so-called " consumer-driven " reforms, like high-deductible

policies or health savings accounts, which place responsibility for

spending decisions in the hands of individuals, not insurers. The

theory: Turning patients into consumers will help contain costs.

But now there are signs—including the NCHC report—that business is

coming out of its shell and taking a receptive look at universal

health care. Among the most vocal is Schultz, chairman of

Starbucks, which in May 2004 sponsored the Wood

Foundation's " Cover the Uninsured Week. " " We can't be the kind of

society we aspire to be when we have 50 million people uninsured, "

Schultz told Fortune recently. " It's a blemish on what it means to

be an American. "

Gross writes the Moneybox column for Slate and is a regular

contributor to The New York Times.

[Guest guest]

Insurance companies keep 30 cents out of each health care dollar...Thats

money that could go to better care.

They are seeing record profits..

We all need to keep that in mind as we go into this debate.

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