Healthcare Reform

In 1993, Hillary Rodham Clinton's unsuccessful proposition for a universal healthcare system, a blueprint for forcing managed competition, was declared a "disastrous" plan—one that would induce healthcare rationing. Clinton denoted the experience as indicative of the "importance of bipartisan cooperation and the wisdom of taking small steps to get a big job done." Now, 15 years later, a new host of advocacy for reform of the massive system has developed out of a coalition of Fortune 500 companies, and the coalition, along with state legislatures across the country, is attempting to take those smaller steps.

The CAHR (Coalition to Advance Healthcare Reform) is composed of a wide range of companies, including Aetna, Inc., the H.J. Heinz Company, Del Monte Foods, General Mills, Longs Drugs Stores, Safeway, Inc., and the Wm. Wrigley Jr. Company, among many others across a variety of fields. Their intentions involve five core principles for reform outlined in detail on their website:

1) Market-Based Healthcare System:

a) Control spiraling costs
b) Block negative impact (of spiraling costs) on U.S. business competitiveness in the
global market
c) Make healthcare cost and quality information transparent for customers

2) Universal Coverage with Individual Responsibility

a) Mandatory care when needed
b) Individuals' responsibility to carry insurance regardless of employment status
coupled with affordable access and no exclusions for pre-existing conditions
c) Government, business, and individual cooperation in achieving universal coverage

3) Financial Assistance for Low-Income Individuals

a) Financial assistance to low-income participants over free coverage
b) Encouragement of traditional healthcare (physicians, clinics) over emergency rooms

4) Healthier Behavior and Incentives

a) Healthcare plans designed to drive healthy behaviors
b) Adoption of prevention, wellness, and full-care management programs
c) Strong personal finance incentives for adopting healthy behaviors

5) Equal Tax Treatment

a) Individual access to purchasing healthcare with same tax advantages as business currently has
b) Enable individual responsibility

The CAHR is, in part, attempting to spearhead a movement to save its members massive dollar amounts from spiraling premiums. However, because each state has the opportunity to create its own unique program with similar goals in mind, there is great opportunity to refine a program that might score for a system that is broken nationwide. According to www.governing.com, 46 million Americans currently lack insurance. And the looming question remains "Who will pay their bill?"

Three states have successfully created universal coverage programs. These are Vermont, Maine, and Massachusetts. These trailblazers have comparatively low uninsured numbers—below 11% compared with California's almost 20% (which works out to more than the total population of Massachusetts). Governor Arnold Schwarzenegger is proposing a plan that resembles Massachusetts' which would distribute the cost of insurance among patients, employers, and providers. This would, in most cases, include subsidizing low-income individuals.

One potential implementation in several states is an additional tax charged to small-business owners who don't currently offer health benefits. Many of these employers worry about the financial stress of an additional tax and have valid concerns about the increased premium prices small businesses are charged in comparison to large corporations. Individuals' concerns include benefit wait periods associated with new employment in large corporations. (These often last between one and three months, as they do with several of the coalition's members.)

Schwarzenegger's proposed plan shares elements with the coalition's as well as plans proposed by both Republican and Democratic legislators in the State of California. These threads hint at potential bipartisan cooperation in California's model, which will have a large impact on the nation as a whole.

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Healthcare Reform