Craft Insurance Center and Health Care Reform

It has passed.

2010-03-22T05:02:00.000-07:00

Well--heatlh reform (it probably shoudl be called "insurance and mandate adjustments") is now passed and on its' way to being signed into law.

What to do now? Well as we have said throughout--the important thing to keep in perspective is that the world has not come to an end. Things will be different for employers, employees and Americans in general. It will be important to spend time reviewing your options. There will be time to make appropriate plans and to unpack all of the nuances.

From a previous post, we outlined the impacts of the Senate bill. 2014 is an important year--but so is 2010 and 2011, etc. High risk pools must be formed immediately. Limits in health plans must be removed soon and insurance companies in 2011 are required to have 80% and 85% medical loss ratios.

Exactly what our recommendations will be and our complete take on all of this are unclear. As such we will be nimble and flexible and provide details as they come forward.

Update

2010-03-17T10:52:00.000-07:00

We have been deliinquent in our posting. Mainly due to the observation that not much has really changed. Good or bad the media is doing a decent job of conveying what is happening. What is it--simple math--do the Dems get enough votes to pass the Senate bill.

It appears the vote will be within the next week.

Other than this protracted process--nothing much has changed. We have commented on the Senate bill and noted some of its' impact to employers. Once (or if) it becomes law we will start to unpack what it actually means for employers and employees.

Stay tuned...

Where do things go now?

2010-01-28T07:57:00.000-08:00

Last night the President spoke about the economy, jobs, education and then health reform. So is it an important item--yes. Though it is just not quite as important as having a job and lowering debt. Nonetheless, health care reform is not dead. In fact, the shock from Mass. may just be the tonic that allows health reform to become law and be palatable to the general population.

Surveys show that Americans are skeptical of health reform. However, when separate items are broken down in these surveys, Americans move notably in favor of the individual elements of health reform. As with many things, people are concerned with broad sweeping changes that they don't understand--when it is unpacked often they are more accepting of the change.

Our take:
Leaders will take a more pro-active approach to educating on reform. This will mean largely changes in insurance regulations. Americans don't like insurance companies and will support (right or wrongly) those types of adjustments. Note the attacks on the banks and bank executives--easy targets.

Health reform will still occur in 2010--when and how we aren't sure. Unfortunately it probably doesn't involve reform of all areas of our health care system.

It will impact employers and create more administrative burden and potential liability.

The current health environment is not sustainable--this is important to remember.

Still more to come...

Vote on Tuesday--is it important

2010-01-18T11:26:00.000-08:00

The election to replace Ted Kennedy is one to watch--or so they say. If the Republican were to win then the Senate would have 41 votes and health reform may be cut off at the finish line. If the Democrat were to win--well things will probably move forward. However, if the election is close--it may sway a few (on the Senate side it will only take one) Democrats to retreat on voting for reform. Another thing to watch--if the Democrat were to win by 53% of more--watch for that to be noted as an endorsement for reform.

As for reform--one important item to watch is for the House to ultimately approve the Senate version. If this happens then there are no future roll call votes in the Senate and the President can sign the bill into law. House members may force some issues at that point in a procedural move related to the budget called reconcilation. We have discussed this in the past.

As we have said from the outset--we expect reform to happen. Granted it appears more and more like insurance reform as opposed to reforming all parts of the system.

For our clients--employers with less than 1000 employees--this means more paperwork, more rules to follow and more confusion for employees. We are intent on focusing on these issues and developing clear understandings of how to navigate through these issues. Already we are at work on education seminars for early spring.

more to come...

Health Reform on the brink...what are timelines?

2009-12-29T10:29:00.000-08:00

· Insurance Market Rules Effective Within Six Months of Enactment: Several insurance market rules take effect within six months of enactment, including review of health plan premiums by state departments of insurance and HHS, prohibition of lifetime benefit limits and “restricted” annual limits, a requirement that plans that cover dependents cover children through the age of 25, prohibition of waiting periods exceeding 90 days, a requirement that all individual and group plans cover preventive services without cost-sharing, prohibition of pre-existing condition exclusions for children under 19, and prohibition of coverage cancellation or rescission except in cases of fraud. Prior to the implementation of new market rules in 2014, the bill also establishes high risk pool provisions for individuals who can not obtain coverage due to health status and creates a reinsurance program for employer coverage of early retirees. Provisions related to lifetime and annual limits, dependent coverage, waiting periods, preventive services, and retiree reinsurance apply to insured and self funded plans.

· Insurance Market Rules Effective in 2011: The bill sets up a 80% medical loss ratio (MLR) for individual and small group plans and a 85% MLR for large group plans. Certain non-profit plans must meet higher MLR standards to be exempt from the annual fee on health insurers. The definition of small group follows current state law until 2014, when small group is defined as 100 employees unless a state limits the definition to 50 employees before 2017. These requirements apply to health plans inside and outside of Exchanges, including “grandfathered plans.”

· Insurance Market Rules Effective Starting in 2014: Reforms that require guarantee issue and renewal during an open enrollment period, establish risk sharing mechanisms (partly funded by insured and self funded health plans), prohibit annual limits (insured and self funded), prohibit pre-existing condition exclusions as well as premium variations based on health status, and limit premium variation to tobacco use, age (3:1 band), geography, and family composition apply to individuals and small groups to size 100 (states may limit small groups to 50 and may increase beyond 100 with expanded Exchange eligibility starting in 2017). States can pass legislation to form “Health Care Choice Compacts” to allow the purchase of individual insurance across state lines.

Now What???

2009-12-21T05:34:00.000-08:00

Well we are not sure how many people (if any) read this blog--but for those of you who do--it basically has happened! The senate in the wee hours of this morning made the first vote to end debate on the health reform bill. There are 2 more votes and then an actual vote to approve the bill--probably on Christmas Eve.

From there the Senate and the House will form a committee to merge the 2 documents. There are still potential fireworks in this merging--mainly due to the scope of the legislation and the notable areas of difference in the 2 bills.

Regardless, we see the President signing a bill before Martin Luther King day and the State of the Union address.

What does all this mean...well time will tell. We know there won't be a public health plan. However the increased levels of government control and the option for OMP to open up the Federal employees plan (or something similar) will be interesting.
We will start evaluating and determining the impacts to our clients in the coming weeks.

On a side note--continue to watch for an extension of the ARRA subsidy related to COBRA.

Senate begins plodding through scores of amendments related to reform

2009-12-07T07:07:00.000-08:00

The Senate has begun the cumbersome process of voting on scores of amendments already filed by the House under the Patient Protection and Affordable Care Act (H.R. 3590).

Several of these measures voted upon last week included the following:

1. Medicare Benefits Guarantee: this measure passed 100-0 and simply confirms that health reform initiatives will not reduce guaranteed Medicare benefits and that Medicare savings will be used to extend the solvency of the Medicare program;
2. Preventive Care Services Expansion: this amendment, proposed by Sen. Barbara Mikulski (D-MD), was more controversial. While it passed the Senate by a vote of 61-39, it did include a provision from Sen. David Vitter (LA) that would exclude the controversial November 2009 recommendations from the Preventive Services Task Force regarding breast cancer screening, mammography and prevention.

The Preventive Care Services Expansion would require employers to comply with these new mandates within six months of enactment of H.R. 3590 What does this mean for employers?

1.Employers would be required to offer a variety of preventive care services with no cost-sharing permitted, meaning no deductibles or coinsurance:

a. screening adults for depression;
b. intestive behavioral dietary counseling for adult patients with known risk factors for cardiovascular and diet-related chronic disease;
c. oral fluoride supplementation to preschool children older than 6 months of age;
d. screening for high blood pressure in adults aged 18 and older;
e. screening and behavioral couseling interventions to reduce alcohol misuse by adults, including pregnant women, in primary care settings.

Stay tuned for more information about potential amendments to be discussed and voted on by the Senate.

Key vote coming

2009-11-19T12:45:00.000-08:00

Today Sen. Harry Reid will release the Senate's version of health care reform.
Many of the same items in the House bill(already approved) are replicated though the specific details are different. Exchanges, employer mandates and other items are still present.
The first vote will come within the next 3 days by rule--which is simply a vote to determine if the Senate wants to consider the bill. The bill will need 60 votes.
Note this is not passage--but simply an agreement to start debate and the amendment process. We fully expect the 60 votes to accumulate so that the process continues.
From here it will be 4-6 weeks of partisan discussion and procedural moves.
Their goal will be to vote just prior to Christmas, from there a merging of the House and Senate versions with approval of the final product in each chamber just before the State of the Union address in late January.
More to come...

A Public Plan by any other name is, well something good all of a sudden!

2009-10-28T17:24:00.000-07:00

For those in the know--we have Medicare Part A, Part B and part D--supplements fill the void left by the absent letter "C". So what is left--Medicare E--that is E for Everyone--and a new name for The Public Plan.
Take a look at the link below.

http://healthcare-legislation.blogspot.com/

What is the impact to you as an employer. If 79% satisfaction can be achieved, then most likely employees will be wanting and opting to participate in that type of program--call it whatever you wish, just get me enrolled.

more to come...

Senate Democrats face tedium as they combine healthcare reform bills

2009-10-20T14:55:00.000-07:00

In case you haven't heard, there is a lot going on related to healthcare reform in Washington this week. Senate Finance Committee Chairman Max Baucus (D-MT) and Health, Education, Labor and Pension Committee Chairman Harry Reid (D-NV) will begin the complex task of blending their two bills together for debate on the floor of the Senate. These talks are set to also include Senator Chris Dodd (D-CT), Senior White House officials, including Chief of Staff Rahm Emanuel and Nancy -Ann DeParle, President Obama's chief healthcare adviser.

These individuals will attempt a balancing act. The goal: extending health insurance coverage to nearly all Americans while reforming the system to rein in run-away costs, without busting the budget. They risk losing party support at every turn. A shift to the right will result in lost votes on the left, and vice versa. While most Senators favor expanding benefits, few want to pay for the expansion with spending cuts or tax increases. They are also working to try and keep the support of lone Republican, Senator Olympia Snowe (R-ME).

Topics they will ponder as they attempt to merge these two complex and costly bills are as follows: Accountability; Inclusion or Exclusion of a Public Option; Individual Responsibility (ie: individual mandate); Employer Responsibility, and the biggie: Financing.

Lobbies of all types (Big Pharma; the AMA; Insurance Companies, etc.) are all jockeying for position to make sure that their interests are protected. Stay tuned as we learn more.....

What is going on today?

2009-10-12T14:30:00.000-07:00

Health Insurance companies are starting to balk at reform. This will be interesting to watch. They have been receptive--now that we get close insurance companies are starting to talk about increased premiums (as if we haven't had increasing premiums anyway).

The Senate Finance committee makes an important vote tomorrow on sending their bill out of committee. Watch what Olympia Snowe does.

Interesting comments from Bob Dole and Bill Frsit--they favor and expect heatlh reform.

Last--but not least--it appears the public option (or a form of it) may be gaining momementum again and that the idea of co-ops is starting a slow (maybe quick) death.

An interesting week ahead.

Senate Finance Committee begins "painful" mark-up phase

2009-09-23T14:32:00.000-07:00

Yesterday, the Senate Finance Committee began the mark-up phase on their bill, entitled "America's Healthy Future Act of 2009." The "mark-up phase" is a procedural process the Senate goes through to review and revise a piece of potential legislation. We say "painful" because negotiations began with over 500 proposed amendents from conservative, moderate and liberal members of the Senate Finance Committee. Each potential amendment must be discussed and voted on. One can only imagine how much caffeine it will take to endure the mark-up phase of this particular bill.

One component being discussed is the requirement that all individuals obtain medical insurance. The original bill provided a premium subsidy to help lower-income individuals comply with this mandate. Originally, the subsidies were designed to cap insurance premium costs on a sliding scale from 3% of household income, for those at 100% of the Federal Poverty Level (FPL), to a maximum of 13% of household income for a family earning 300% of FPL

To satisfy the concern that this would still create a significant cost burden for middle-America, the proposal was modified and expanded. The new proposal would lower the minimum cap to 2% of household income for those at 100% of FPL, and allow families earning up to 400% of FPL to participate in the subsidy. Essentially, a family of four earning $88,200 could still qualify for a minimal subsidy. Although Baucus' bill was the least expensive alternative to the bills proposed thus far in the House and Senate, it appears likely that the $850 billion cost estimate will change as the mark-up phase continues over the next few weeks.

To illustrate how the subsidies will work and to see which income levels will qualify, click on the calculator below from the Kaiser Family Foundation website. Plug in various income levels, ages and family vs. individual coverage status to create different scenarios. Pay particular attention to the increase in subsidy amounts available to different age groups and income categories.

http://healthreform.kff.org/Subsidycalculator.aspx

Great piece on how histroy may view reform

2009-09-18T14:13:00.001-07:00

http://alankatz.wordpress.com/2009/09/14/history-will-ignore-much-of-todays-health-care-reform-headlines/

Also much more to come next week--debate starts on the 22nd of this month for mark-up on Americans Healthy Future Act.http://finance.senate.gov/press/Bpress/2009press/prb091609a.pdf

The furor is starting to die down and the creation of a bill that Obama will sign is starting to take form.

More to come.

Points from Senate Finance Bill and how it might play out

2009-09-11T06:53:00.001-07:00

Max Baucus and Senate Finance have released an overview of their reform bill--which will be released in full next week. Impact to employers:

Tax credits to employers with less than 25 employees--35% for 2 years then expanded after that with credits for employees with wages under $40,000.
Creation of purchasing "Exchanges"
Elimination of "Mini Med or Limited health benefit" plans
Small group reform--less than 50 employees in 2013 and less than 100 by 2017. Requires guaranteed issue, no pre-X, etc.
Rating variations only for tobacco use (1.5:1), Age (5:1) and geography(7.5:1)
Benefit option standards and minimum benefits(including a "young invincibles policy!)
2013 individual requirement mandate--with penalties based on FPL--maximum of $3800 for a family.
200 or more employees--employer must enroll all employees (with few caveats)
Requirement for employers with more than 50 employees to pay premium or a fee. Employees can opt out if on Medicaid or cost to employee exceeds 13% of income.

There is much more--but this is an introduction. This is not law and it can and most likely will deviate. Nonetheless, this give us some insight as to what things might look like.

One other note--President Obama has created a unique situation in offering to compromise--this allows him to utilize that offer and if rejected by Republicans to be comfortable in using budget reconciliation to proceed with health care reform. Want to know more--check out this quick strategy article.

http://thehill.com/homenews/administration/58233-obama-sets-stage-for-using-budget-maneuver-to-pass-health-reform

The Baucus Health Reform Proposal

2009-09-09T12:58:00.000-07:00

U.S. Senate Finance Committee Chairman Max Baucus (D-MT) unveiled a summary of a detailed health care overhaul proposal that he and other members in the Committee's bipartisan "Gang of Six" have been negotiating over the last several months.

While this is the only significant reform proposal assembled with significant Republican input, Baucus was unable to persuade his "Gang of Six" negotiators to endorse the nearly $900 billion plan, which does not include many provisions that liberal lawmakers are clamoring to see in a final measure. The Republican most likely to sign onto the plan, Senator Olympia Snow (R-ME) said that she will wait to hear what the president has to say in tonight's joint session of Congress before making a final decision on the bill. She expressed worried about the burden that expanding Medicaid eligibility would impose on state governments. Aides to Senator Mike Enzi, (R-Wyo) another member of the "Gang of Six," said that he does not care for a plan that would tax insurance companies that sell costly policies, or for a proposal that would impose a $6 billion annual fee on insurance companies based on their share of the market.

Senator Baucus indicated today that he will put out a Chairman's Mark of legislation early to mid-next week and move the Finance Committee to mark-up health care reform the week after next.

Obama may detail "his" health reform plans soon

2009-09-02T14:53:00.000-07:00

In today's Washington Post, an article from the Associated Press commented on the likelihood that President Obama would more clearly detail his goals for what should be the "essential elements" in a healthcare reform bill. This new "hands-on" approach would signal a shift in strategy and would possibly occur before the September 15th deadline the White House gave to Senate negotiators to design a bi-partisan bill.

Many insiders feel that the President gave too much leeway to Congress. Many feel that the August recess has been more damaging to the President than helpful. General concensus is that while he will likely not offer new proposals, he will be more specific about his top priorites in a healthcare reform bill.

Check out the article at: http://www.washingtonpost.com/wp-dyn/content/article/2009/09/01/AR2009090103430.html

So they do agree on something...

2009-08-28T11:52:00.000-07:00

http://www.latimes.com/news/nationworld/nation/healthcare/la-na-healthcare-common-ground2-2009aug28,0,6609509.story

Take a look at the article above. As things have reached a boiling point, it appears that behind the scenes legislators are looking at what could they actually accomplish on health care reform. As mentioned previously on this blog--Democrats and Republicans agree maybe on 80% of the reform. Where does this put us--with lots of insurance reform and probably very little health care reform.

Is this the best solution? We think reform should occur in all areas that impact our health care...delivery, distribution, research and personal accountability. The end result of insurance only reform is more adminstrative burden for employers and most likely higher cost to cover the mandates(insurance companies won't absorb them).

September is right around the corner...

3 potentials and review of a functioning coop

2009-08-21T06:10:00.000-07:00

So another week, a lot more rhetoric. It appears that basically 3 outcomes exist.

1. A bipartisan effort that offers little in substantial reform--notable insurance reuglatory changes--but not much for the average consumer.

2. A modified version that may anger some on the left(not enough reform) and gain little to no support on the right(too much government). It appears this effort would include a cooperateive.

http://www.usatoday.com/money/industries/health/2009-08-20-group-health-insurance_N.htm

3. Finally, the Democrats may go at this alone. Using tactics such as reconcilation and using the 60 votes in Senate to stop any filibuster.

In short the month of September will be pivotal. Lots of hand wringing in between. We still feel reform will happen this year and for clients with less than 100 employees (and most likely 250 employees) the impact will be notable.

Projected cost of Health Insurance Premiums by 2020

2009-08-18T14:12:00.000-07:00

Curious as to what the world may look like without health reform? Take a look at the chart in this blog from Kaiser and the Commonwealth Fund. We continue to hear legitimate concerns about health reform, but we are also hearing loudly that employers and employees are at the end of their limits when it comes to paying for health insurance.

With renewals in the 20-30 percent range--we think our client's concerns are valid. Making plan concessions and requiring employee contributions is a solution--but not year end and year out. The medical inflation number of 10 to 12 percent is logically not sustainable. We hope that reform discussions continue to adress inequities within insurance, but also within the areas of tort reform, pharma control and what physicians and hospitals receive. Without addressing all areas--especially the "cost of care", private plans and public plans will fail equally.

http://www.commonwealthfund.org/Content/Blog/Why-Health-Reform-Must-Counter-the-Rising-Costs-of-Health-Insurance-Premiums.aspx

Is Public Plan Option Off the Table?

2009-08-17T06:50:00.000-07:00

Most news sources we are reading now indicate that the Obama administration may drop the idea of a public, or government-run healthcare plan. Health and Human Services Secretary Kathleen Sebelius said Sunday that a new, government-run health insurance program wasn't the "essential element" of any overhaul plan. She said the administration would consider a bill that includes the creation of a not-for-profit insurance cooperative as an alternative to a government-run plan.

Senator Kent Conrad (D- North Dakota) signaled Sunday that there are not enough votes in the Senate for the public option. He said that the proposed cooperative is the only plan that appears to have bipartisan support. The Wall Street Journal reported today on the White House's apparent compromise in the article below:

http://online.wsj.com/article/SB125043830465934883.html

USA Today also reported on this news in the attached article:

http://www.usatoday.com/news/washington/2009-08-16-health-care-public-option_N.htm

Stay tuned for more details and developments in the days to come!

August Heat + Health Care Reform Debate = Vigorous Debate

2009-08-11T07:07:00.000-07:00

It doesn't appear that our congressional representatives are going to get much rest during their August recess. They will be challenged to read, digest and understand many thousands of pages of healthcare proposals. This onerous task, combined with the intense heat of the summer and ever-increasing passion over the health care debate, is keeping their phones ringing and email boxes full. Some legislators have actually had their systems crash due to the onslaught of feedback from constituents on both sides of the debate. Town-hall style meetings have led to shouting matches, and even fisticuffs in some cases. I heard this morning on a national news show that a NC representative had actually cancelled a town-hall meeting due to a death threat. Unbelievable!

No matter where you stand on this issue, it's clear that healthcare is very personal and that Americans are passionate about the topic. It touches everyone - - - regardless of their income, education or social status. The implications of a massive overhaul of the current system are daunting...."how will we pay for it?," "will I still be able to see my doctor?," "can we assure that everyone be covered?" and the questions go on...

It will be interesting to hear the President speak in Portsmouth, NH today. He is going to try to counter some of the rumors about many of the proposed plans that are causing people heartburn. I believe the White House has been somewhat surprised over the intensity of the debate among ordinary Americans.

Our advice for getting through this process? Take an antacid, put on your sunscreen, and drink plenty of water. Also, take time to stay updated on this topic through our blog and enjoy the freedom that we have here in America to express our opinions about this critically important issue.

What is NC doing about reform?

2009-08-05T17:09:00.000-07:00

Our state has already participated in health reform...how so? Take a look at the following webiste:
http://www.inclusivehealth.org/

This is North Carolina's high risk pool which started in January of 2009. Response has been positive with continuing enrollment. How do you qualify? You have to have applied and been denied coverage for a traditional individual health insurance plan and have a qualifying medical conditions. Premiums are slightly more than a regular plan, but the coverage provided is sufficiently adequate and manageable from a premium perspective. There is very little insurance agent involvement in this process, but the end result provides coverage for those who previously could not obtain coverage.

Might this be somewhat similar to how the proposed "Exchanges" or "Connectors" work--time will tell.

End of July--Health Reform still moving

2009-07-31T08:48:00.001-07:00

As the week comes to an end and policy makers head out of Washington for their 5 week recess, a few interesting items to note.

It appears that the Rep. Waxman and the House committee he chairs have garnered the political support for their bill and will pass it out of committee. This opens the way for a unified bill to be voted on by congress in September. Also gives members of the house plenty to discuss at home. One key issue is to make premium concessions to families with incomes at or below $88,000--this has been agreed to and is a new benchmark to note in the impact of reform to the average American.

Meanwhile, it appears the bi-partisan efforts from the Senate Finance committee are still being hashed out. It is widely believed that this bill will be the "one to watch". With the Senate vote next week on the Supreme Court nominee, the chances that this bill gets released are diminishing--though reports say a draft may be put forth.

Finally, more pointed attacks are being made against insurance companies. Watch for ads against the insurance industry in the next month. Though we are often frustrated with insurance companies ourselves, we often hear claims made about insurance companies which are sometimes not 100% accurate. As a rule, we feel the companies that we conduct business with provide a high level of benefit and adhere to the guidelines within their policies. We have added a link to the right of our blog that BCBS of NC has put together stating their thoughts on good health reform. As other perspectives are developed we will put those forth as well.

What's Canadian Health Care Really Like?

2009-07-28T13:18:00.001-07:00

In case you missed it, National Public Radio (NPR) had an interesting program yesterday (Monday, July 27th) entitled, "What's Canadian Healthcare Really Like?" You can listen to the podcast by logging onto:

http://www.npr.org/templates/player/mediaPlayer.html?action=1&t=1&islist=false&id=111063897&m=111063892

The program outlined some of the pros and cons of the Canadian system. While many Canadians called in to praise their healthcare system, two notable interviews addressed some of the deficiencies in their system. One of the interviews was with Dr. Brian Day, former President of the Canadian Medical Association. The other was with Mr. DeSange, the former Minister of Health for Canada.

These doctors noted the following:

1. Prescription drug coverage isn't available universally in Canada. Richer provinces offer coverage and poorer provinces often do not;
2. 1 in 7 Canadians doesn't have a primary care physician due to physician shortages;
3. There appears to be variation in the administration of care among the provinces;
4. 2/3'rd's of Canadian purchase medical supplements to cover items not covered by their plans (ie: ambulance services; RX drugs; mental health, chiropractic);

It was also noted that the Canadian Government sometimes exports patients to the United States for care when it is not readily available in Canada. This might lead one to suspect that the Canadian system might not be able to meet the needs of all of its citizens without the U.S. medical system to back it up.

While both gentlemen said that there were obviously some good things about their universal system of care, Dr. Day commented that neither the Canadian system, nor the United States healthcare system, were the ideal model for healthcare. He noted that other countries like Germany, Switzerland, etc. were able to provide better quality, more efficient healthcare at a lower, more predictable cost.

All in all, it was an interesting program that helped clear up some of the myths I had heard about the Canadian healthcare system.

What happens now?

2009-07-27T12:37:00.000-07:00

Health care reform 2009 has run into some notable road blocks in Washington. By design, our intent is to not be too political here--but more of an overview of what we see going on.

In short, the Republicans and conservative Democrats are concerned about the expansive role of reform--both in cost and structure. Interestingly, what no one seems to deny is that our system is quite damaged and may be beyond repair. However, as they try to sort out payments to physicians, tax on the wealthy and creation of a public plan for those who have no other choices--politics begans to take hold.

What is the expected outcome today? We are expecting a watered-down healthcare bill. Long -noted agreement on 80 percent of health reform could be the end result by years' end. In the interim expect lots of advertising on television, radio, etc on both sides of the debate.

For you as an employer, all of this still means more administrative effort, more complexity in assisting your employees. An employer mandate, minimum benefit standards and limited underwriting can certainly be enacted. Interestingly, it is far easier to tweak the existing insurance structure and still not really solve the underlying problem--which is not the cost of insurance, but the cost of health care. Unfortunately, reform (whatever form) probably means still higher insurance cost.

Must-read article on healthcare by Dr. Atul Gawande

2009-07-22T11:58:00.000-07:00

If you haven't read the article that appeared in the June 1st issue of The New Yorker, you definitely need to read it. It will give you a new perspective as you formulate your own personal opinions about what ails the healthcare system in the United States.

www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande.

Dr. Atul Gawande is a surgeon and writer who examines the community of McAllen, Texas, one of the nation's most expensive healthcare markets. He compares the quality of care and patient outcomes in McAllen, versus other cities which provide similar quality care with better outcomes for much less money.

Dr. Gawande's assertion is that our current "fee-for-service" based healthcare system is one of the reasons that medical costs have spiraled out of control. I found this article to be extremely interesting and a confirmation that in healthcare, more isn't always "better."

President Obama's comments on health reform this week.

2009-07-20T07:31:00.000-07:00

2009-07-20T07:21:00.000-07:00

President Obama's latest comments regarding his goal to see healthcare legislation passed in 2009.

http://www.youtube.com/watch?v=mVlHq15qjTc

Health Care Reform

2009-07-19T20:39:00.000-07:00

This should be an exciting week. We will began making post on our observations, our opinions and general consensus on what the impact may be for employers and for us as brokers.