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Private health insurers may get greater role in healthcare reform

19 06 09 - 12:38



Private insurers step into spotlight on health-care reform
Health insurers use President Barack Obama's speech to AMA to highlight their role, downplay government-run proposal
By Bruce Japsen - Tribune Newspapers

Don't expect the private insurance industry to go away under any kind of health-care reform initiative.

That's because most key health-reform measures gaining momentum in Washington not only leave private health plans intact but also may give them a greater role.


In addition, the health insurance industry got to ride the coattails of the attention brought by President Barack Obama's speech Monday to the American Medical Association as he sought the physicians' support of his health-care reform initiatives. Throughout the AMA's five-day policy meeting that ended Wednesday, doctors -- fearful of a government-run plan that they say would underpay them -- maintained their support of the private health insurance system.

Standing before the AMA, the president dismissed the single-payer form of health insurance, a government-run initiative that would greatly reduce the role of private health plans. Obama said his "public option" proposal to cover the nation's 46 million uninsured isn't a "Trojan horse" for a government-run system.

Health insurers took note. America's Health Insurance Plans launched a blog Wednesday and quoted media reports from AMA immediate past president Dr. Nancy Nielsen espousing the importance of private health plans.

"We want private insurers to remain," Nielsen is quoted as saying.

The federal government may have a role in a newly formed health-care system, and the health insurance industry continues to worry about a publicly funded option that would offer a lower-priced product to consumers, but health plans were happy that the AMA stripped the words "public option" from a resolution.

"It highlights the fact that a government-run plan would have a significant impact on physicians and hospitals across the country," said Robert Zirkelbach, spokesman for America's Health Insurance Plans, which represents Aetna Inc., Humana Inc. and UnitedHealth Group among its powerful membership. "The AMA can speak for themselves, but there is evidence that a government-run plan would significantly impact providers across the country."

Doctors are not in favor of expanding government-run health plans like the Medicare health insurance program for the elderly or Medicaid for the poor. Physicians maintain Medicare cuts their fees and is headed for insolvency; hospitals and doctors say Medicaid rates are low, forcing providers to shift costs to those with private coverage by raising prices on private employers and health plans.

Still, Medicaid and Medicare are not expected to go away under the government's health-care reform: Obama said any package will allow patients to keep the plan they want.

And Obama and Democrats who control Congress are pushing bills to limit insurers' ability to deny coverage. Some legislation being discussed also would force more insurance competition by setting up exchanges, purchasing pools or nonprofit cooperatives.

A bipartisan proposal would keep Medicaid and Medicare in business, adding an option that would fund coverage through insurance-purchasing pools. To win support of Republicans worried about a government-run system, it would have states rather than the federal government establishing the pools for what the health insurance industry would see as more competition.

Analysts see private plans also being involved. "These private plans are big stakeholders," said Linda Havlin, worldwide partner at Mercer, a benefits consulting firm. Lawmakers "may make them offer individual coverage. These plans want to keep building their market share, so there is going to be a lot of quid pro quo."


 

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