Board Policy
Healthcare Reform
March 12, 2003
The Chamber supports change in employee health plans and Medicare reimbursement structures that will give greater personal incentives to help manage health care costs by introducing market forces as a factor to help control unbridled medical expenses. Medical costs are most effectively controlled when the individual consumer has cost awareness and noticeable financial responsibility for the services. This may include increased co-pay and deductible obligations for employees. We are convinced that when individuals are conscious of costs and their own financial obligations it changes behaviors and choices in ways that help control medical costs. We are satisfied, too, that when medical providers appreciate the patient is budget conscious physicians are more inclined to be cost sensitive.
Disclosure of health care services costs and quality related information are an essential component to allowing consumers to be more accountable and responsible for health care costs. The Chamber supports reporting by providers of health care services of quality, cost and efficiency standards, patient experiences, clinical performance and safety to health care consumers. Such information must be readily available, comparative and cost efficiently provided to allow consumers to make informed decisions about their health care purchases.
The Chamber opposes coverage mandates and attempts to dictate policy provisions within an employer's healthcare plan. Mandates reduce flexibility and innovation and increase the costs of health insurance to employers and their employees. Current mandates should be sunset and a cost/benefit analysis provided. For every dollar such mandates increase costs, employees who are asked to share a significant part of the increase, opt out of coverage because it is becoming too expensive.
The Chamber supports reform of medical malpractice and health plan liability including limits on awards for non-economic damages. In recent years, physicians are increasingly leaving medical practice, employers are discontinuing plans, and employees are declining participation in plans because of increasing costs resulting from frivolous lawsuits and unbridled civil awards.
The Chamber supports efforts to improve quality of care and retention of tools and strategies that reduce or eliminate unnecessary and inappropriate care and expenses. The Chamber seeks to preserve the ability of employers to contract with providers of health care in an environment that is not burdened with government intervention. The Chamber opposes legislation that seeks to protect medical providers at the expense of employers and their employees. Under the guise of "patient protection," certain provider organizations are encouraging enactment of expensive, unneeded proposals that protect specialist physicians' incomes and drive up the cost of care for all consumers… anti-trust exemptions for price-fixing and contract regulation that impairs the ability of employers to use networks and effectively establish and maintain relationships with providers in a cost-efficient manner. The Chamber opposes initiatives known as "any willing provider" because these proposals seek to eliminate the ability of employer health care plans to be selective about the providers with whom they work and undermine the ability of employers, insurance carriers and other entities that review the appropriateness of medical procedures and services.
The Chamber supports legislation and/or regulatory flexibility on the part of the Illinois Department of Insurance to allow the insurance industry to develop and offer health care policies that are designed to provide simpler and more limited coverage at affordable costs. The Department should have the authority to approve innovative and flexible health insurance products as needed in the marketplace. We believe greater flexibility in the health insurance policy offerings will allow more employers to continue to provide health insurance benefits to employees. It will also increase the opportunities for employers who do not currently provide health care to access more affordable products.
The Chamber supports changing the federal Medical Financial Assistance Program (FMAP) formula to increase the Illinois allocation to something greater than 50% reimbursement currently in effect. FMAP rates vary from state to state with some states receiving matching rates as high as 83 percent, while Illinois receives only the minimum FMAP rate of 50 percent. Increasing the FMAP rate in Illinois to 55 percent would result in an increase of $430 million in federal funding;
The Chamber support initiatives to build on the opportunities provided by federal employer ERISA protections. Employers must be allowed to operate in a uniform multi-state environment which is critical to employers operating in multiple states. Penalties or disincentives should not be imposed on employers that chose to self-insure. Innovation in benefit design and cost containment should be encouraged for employers of all sizes.
The Chamber supports honest budgeting for health care services. We support increased funding reimbursement of Medicaid benefits to health care providers to better reflect a payment schedule that approximates the actual cost of service. As an alternative, the Chamber recommends narrowing the richness of the Illinois Medicaid assistance program offerings so that the medical assistance that is offered is aligned with the available funding. In short, the state should be an honest budgeter and not promise or obligate service the state cannot afford, as is now the case. The state’s failure to adequately pay for the medical services provided the indigent has contributed to the rising cost of medical insurance due to cost shifting by medical providers to the insured population.
As healthcare costs continue to rise, an unfortunate and important component of these cost increases is fraud and abuse. The Illinois Chamber supports legislation that strengthens current law to protect entities from liability for providing information regarding acts of insurance fraud. The Chamber also supports creation of a Medical Fraud Enforcement Fund to direct more resources to the Illinois Attorney General to enforce medical fraud statutes. Fines and restitution penalties would be used to support the Fund.
As a significant part of the nation’s health care needs the Chamber supports programs that encourage individual responsibility for personal wellness and preventative care.
We support the efforts of the U.S. Chamber to modernize Medicare by 1) implementing quality measures such as disease management, disclosure of outcomes, case management, wellness and other similar initiatives, 2) placing Medicare in a financially solid position, as well as 3) implementing a drug program which is comprehensive and affordable for all , covers all Medicare participants, privately administered and is the “primary payer” of benefits.
|
