In search of true health reform
There are too many Americans without health insurance. For those with health insurance, the escalating cost of keeping it is unsustainable. Unfortunately, the current legislation being debated in Congress is neither sustainable nor practical.The legislation fails to address the true drivers of health insurance rates. They rise by double digits each year because the amount insurance companies spend on medical care rises by double digits. We should not be surprised by this. Every year, our state becomes less healthy than the year before. According to the Centers for Disease Control, nearly a quarter of our state is obese, and the percentage of adults diagnosed with diabetes in New Hampshire has nearly doubled since 1997.Government payments to hospitals and doctors are lower than the actual cost to treat patients. To offset these losses, providers need increasingly higher payments from health insurers. According to the New Hampshire Center for Public Policy Studies, the total volume of losses associated with government underpayments and charitable care increased by 127 percent from $179 million in 2001 to $406 million in 2007, about 15 percent per year.The cost of a screening colonoscopy in the Manchester area can range from $1,619 to $4,213 depending on where the colonoscopy is performed. One would not buy a car, a computer or even a gallon of milk without comparing the price. Yet, as consumers we often buy health care without any knowledge of price.Unfortunately, instead of finding ways to lower health insurance rates, Congress has proposed legislation that will actually raise health insurance rates for many in New Hampshire.According to a recent actuarial study performed by our company, New Hampshire rates for health insurance premiums could rise as much as 93 percent for healthy young purchasers and as much as 27 percent for small employers unless important changes are made.The proposals create an incentive for people to buy insurance only when they are sick, driving up the costs for all. In the Senate Finance Committee bill, the penalty for failure to obtain health insurance is just $200 for adults in 2014 ? well below the annual premium an adult would pay for health insurance. Although this amount increases to $750 in 2017, it is still a fraction of the amount someone would pay for coverage, even after reforms are enacted. Congress must raise the penalties for those who decide not to buy insurance to encourage all Americans to purchase the insurance they need.The proposed ?public option? will not succeed in lowering medical costs or health insurance premiums. Medical cost increases drive health insurance rate increases. If the name of the front of our building changed from ?Anthem Blue Cross & Blue Shield? to ?Property of the United States Government? there would be no change in the acceleration of medical costs or health insurance rates. Only sustainable and practical reform focused on the underlying cost issues can address our challenges.As members of Congress move to combine pending proposals into one piece of legislation, they need to remember that everyone has to be part of the plan from the outset to share the costs fairly. Most importantly, we must address the rising costs of medical care by improving the health of our state and nation, reducing the effects of cost-shifting and creating greater transparency for consumers. If we do not, then we will still be talking about how to reform our system 20 years from now.
Douglas J. Wenners is president and general manager of Anthem Blue Cross and Blue Shield in New Hampshire.