Health Care Update

By March 18, 2006Health Care

Healthcare.gifA Busy Week for Health Care – there was utterly no shortage of health care activities this week, email frequency notwithstanding. Whether it was the Senate HELP Committee’s successful markup Wednesday of S. 1955, the Health Insurance Marketplace Modernization and Affordability Act of 2005, President Bush’s stalwart road show defense of the new Medicare drug coverage or the usual assortment of ill-tempered and poorly-timed amendments to the Senate Budget Resolution … health care was at the forefront. It’s practically enough to give one a migraine…. No imported pills for me though … they’d probably be fakes.

Enzi-Nelson Bill on to Senate Floor – we were particularly pleased to see the Senate HELP Committee report S. 1955 by a vote of 11-9, rather predictably on party lines. Hopefully a majority (even the magic 60) Senators will act to approve small business health plans (SBHPs) soon … patience is waning in the small business community. Chairman Enzi’s much-negotiated bill deserves approval and conference soon.

President Bush Campaigns for Medicare Drug Coverage – while normally our nation’s chief executive … well, executes the law, attacks and misinformation bandied about the new Medicare drug coverage has forced President Bush to continue to defend a signature achievement of his Administration. As former Sen. John Breaux (D-LA) is apt to say, members of his own party have not distinguished themselves on Medicare reform … making Sen. Breaux’s job as a dutiful son advising his father all the much harder. Shame on House Minority Leader Pelosi and her colleagues….

Kudos to both President Bush and former Sen. Breaux for their stalwart defense of the new Medicare drug coverage.

HSAs, High Deductible Health Plans Growing Fast – our friends at America’s Health Insurance Plans (AHIP) latest survey data shows that some 3.2 million people are covered by HSA-eligible high deductible health plans (HDHPs). Likely 1-2 million of these people are covered by HSAs.

The demographics from enrollees show that early predictions that HSAs were vehicles primarily for the healthy young are wrong. Half of all people covered by these plans in the individual market are aged 40 or older. In the small group market, 45% of covered individuals are aged 40 or older. In the large group market, 44% of covered individuals are aged 40 or more.

40 may be the new 30 (or is it that 50 is the new 40?), but it is clear that HSAs and HDHPs are attracting individuals at varying ages and health status. Maybe HSA opponents need new talking points?

Transparency Spread – transparency in health care pricing is the modern day alternative to sunshine laws. A few rays of light can generate interesting changes in behavior. We strongly support the Bush Administration’s efforts to encourage transparency by requiring those who do business with Uncle Sam through Medicare to disclose their prices in a consumer-friendly manner. This is vital to encouraging consumers to be more cost and quality conscious in their purchasing decisions.

There is a somewhat creditable argument that employer costs will go up if their “deals” are there for everybody. But, how good are those deals in reality? One key clue is how much the hospital industry is squealing about transparency requirements. They say that they charge everyone the same price but some receive discounts and all must pay for uncompensated care. But, how much are the uninsured charged and how much goes to “profit” (even for non-profits) under the banner of cost-shifting?

I say turn the light on and let the bugs scurry as they may. They’ll likely merit further investigation … de-bug-ification … and if need be, extermination.

Health Subcommittee Chairman Deal Urges Caution on Health IT – we commend House Energy and Commerce Health Subcommittee Chairman Nathan Deal (R-GA) for his comments urging Congress to stay out of the way of private sector implementation of health information technology (Health IT). His fears are justified….

We agree that there is a role for Congress but we also think the private sector can jumpstart adoption of Health IT in a way Uncle Sam could only dream of. It’s a plausible concern, in contrast to the usual fears raised by Health IT opponents about patient confidentiality. That’s what HIPAA is there for…

Porter Bill Encourages Personal Health Records for Federal WorkersRep. Jon Porter (R-NV) is pushing to require FEHBP plans to create personal health records for workers who so request. Uncle Sam and FEHBP (Federal Employees Health Benefits Program) can set a good example for the rest of the market. We think this is another helpful step in encouraging Health IT.

Join the discussion 6 Comments

  • Neil Trautwein says:

    It’s logic like this (and consequent premium increases from mandates) that has priced so many businesses and individuals out of coverage. It’s why labor and their public policy allies have resorted to the mis-named “Fair Share Health Care” campaign to mandate employers to provide coverage, no matter how expensive. The writer’s mandate approach will kill the employer-provided health care goose.

    The lead co-sponsor to Chairman Enzi’s bill is Sen. Ben Nelson (D-NE). Nelson is a former two-term Governor in Nebraska and before that led the Nebraska Department of Insurance and the National Association of Insurance Commissioners (NAIC). This is man who understands how insurance works and what the limits of state legislated mandates are.

    Sen. Nelson opposed the old AHP (association health plan bill) but cosponsors the new Small Business Health Plan bill S. 1955 now. What’s the difference? Sen. Nelson understands that the Enzi-Nelson bill strikes a balance between state and federal perogatives in insurance to help bring down the cost of health coverage.

    With all due respect to the benefit mandate community, including the American Diabetes Association, they have been part of the problem. They have sought legislative mandates instead of persuading the employer community of the worth of their coverage. Shame on them — they’ve legislated many out of coverage.

    Employers will offer well-rounded coverage (if they voluntarily choose to do so) because it is in their interest to attract workers. We have no interest in supporting a nanny-Government that tells us which benefits to offer or how to tie our shoelaces.

  • Franklin says:

    The only reason these state regulations were passed is insurance companies WERE NOT offering coverage for things like diabetes until they were required to do so. Just assuming that every company is big-hearted and of course will offer coverage for everything currently being covered is silly.

    If there was no concern about diabetes coverage being dropped then the ADA would be endorsing this bill. But they’re not, they’re opposing it. Take a look at the laundry list of health advocacy groups covering topics from mental health to diabetes to cancer to pre-natal care who are all opposing this bill, and it’s pretty clear this bill will weaken insurance coverage.

  • Neil Trautwein says:

    What – no employer would offer diabetes coverage unless he or she was mandated to? Bunk!

    Employers well understand the benefits of having a healthy workforce. In fact, the NAM has established the Coalition on Catastrophic and Chronic Health Care Costs ( to promote wellness and disease management.

    We do this without benefit mandates … and organizations need to come to terms with encouraging coverage without resorting to governmental mandates to require it.

  • Franklin says:

    The American Diabetes Association seems to disagree with your characterization of the bill. They’ve been encouraging all Senators to vote against the bill because it would make irrelevant state mandates requiring coverage for diabetes treatment. I don’t understand how “affordable” insurance is worth anything if the companies can simply not provide coverage for certain illnesses and treatments.

  • Neil Trautwein says:

    My reader ought to get his facts straight. Yes, Republican Sen. DeWine (R-OH) supported several amendments in committee. But, I would note that Democratic Sen. Ben Nelson (D-NE)is the lead co-sponsor to this legislation.

    The states haven’t done a good job providing for affordable health coverage — passing rating laws and benefit mandates that have increased the cost of coverage for small business and individuals. We support ERISA and federal preemption.

    This has led to fewer businesses offering coverage and more businesses marginally self-insured who ought to be buying state-regulated coverage.

    The Enzi-Nelson bill strikes a good balance by allowing common benefit designs across state boundaries, more affordable coverages yet maintaining state regulation for consumer protection purposes.

  • John says:

    Enzi’s bill S.1955 is very misguided legislation, which is why a Republican (Dewine) tried to pass a bunch of amendments to address the probelems. Allowing insurance companies to simply override and ignore state regulations about coverage is a bad idea. What happened to states rights? Why override them?