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Pa. Business Group Gets Tough on Health Insurance Reform
PITTSBURGH -- Health insurance purchasers should work together on needed reforms, insisted Cliff Shannon, president of SMB Business Councils, a nonprofit trade association representing 4,300 small business owners in Pennsylvania.Speaking to business and labor leaders at a conference yesterday, Shannon described skyrocketing health insurance costs as a "direct threat to employment-based health insurance, and a guarantee that the number of uninsured working Americans will grow. Incrementalism is no longer relevant or realistic, given the magnitude of the crisis."Shannon outlined a series of steps advocated by SMC in order to halt rising health insurance costs, some of which are significant departures from previous positions take by the council and the Pennsylvania business community:Prescription drug costs. "Pennsylvania's state government leaders should follow -- immediately -- the lead of other states that are actively facilitating re-importation of cheaper prescription drugs in order to help their citizens. Inaction betrays a lack of real concern for the plight of those who are struggling to pay for needed medications."Medical malpractice. "Further efforts to amend the Pennsylvania constitution and enact caps on medical malpractice awards for pain and suffering are a waste of time. Pennsylvania business and labor leaders should work together on reforms that will compensate injured patients fairly and expeditiously, cap outrageous attorney fees, and encourage health care providers to acknowledge and fix health care delivery flaws that injure patients, rather than hiding them in order to avoid legal liability."Insurance market reforms. "By any analysis but their own, Pennsylvania's Blue Cross Blue Shield affiliates' reserves far exceed prudent need. The Pennsylvania Insurance Department should impose upper limits on these reserves immediately, and work with health insurance purchasers - from whose payment of premiums all reserves emanate -- on divestiture of unneeded funds.The General Assembly should also pass legislation this fall to restrict or prohibit insurers' use of so-called medical underwriting for small businesses -- using otherwise confidential medical information about insured workers and families, in order to avoid insuring people who are not perfectly healthy."Pay for performance. "Pennsylvania health insurance purchasers pay hundreds of millions of dollars each year for health care services that injure or kill patients (e.g., preventable hospital-acquired infections, medication errors, etc.). Then they pay hundreds of millions of dollars more to fix the problems caused by preventable patient injuries. This is crazy. Purchasers should be willing to pay more for perfectly-delivered health care -- and should pay nothing for health care services that inflict preventable harm on patients."Employers, employees, and individual responsibility. "Employers have a right -- even an imperative, in order to preserve coverage for all of their employees -- to apportion costs to their employees based on two key principles: (1) individual employees who don't practice healthy behavior, or who decline to engage in activities aimed at achieving healthier behavior (e.g., smoking cessation, weight loss for obesity, effective chronic disease management), should contribute more to their health insurance coverage costs; and (2) employees who choose to use health care providers other than those that deliver the best quality and value, should pay a larger share of their health care expenses."Visit SMC Business Councils: www.smc.org"