As the political debate on health reform heats up, it’s helpful to examine why businesses across Maine should get behind the push for reform now. As someone who spent the last 15 years of my career managing a health care benefit program and working on controlling health care costs for a large employer in Maine, I know why businesses, providers and patients must join together to support reform. The answer is clear — we can’t afford the status quo any longer.
Maine businesses are increasingly struggling to provide affordable health insurance to their employees. About 780,000 Maine people get health care coverage through their employer. But the rapidly rising cost of care is making affordable coverage harder to maintain. From 2007 to 2008, the average total health benefit costs for Maine businesses rose 8 percent from $8,680 per employee to $9,392. These increases consume profits and make it harder for Maine businesses to compete in a national and global marketplace.
Some say we can’t afford health care reform that provides affordable care to every American. I’d argue that delaying reform is something Maine businesses can’t afford any longer. Employers and individuals with health insurance already shoulder the cost of caring for people who are uninsured. We just don’t realize it.
The Center for American Progress recently estimated that Maine businesses and families pay a “hidden health tax” of $800 per year in additional premium costs to subsidize the cost of care for the uninsured. If health care reform makes coverage available and affordable, it should eliminate this additional cost. What Maine busi-ness wouldn’t welcome these additional resources to fuel more investment, product development, training and marketing?
Maine businesses should also push for reform that changes the way we pay for care. Doctors, hospitals and other providers now get paid for providing more and more services. As part of my job, I could tell when a new specialist moved into the area. Suddenly there would be a spike in new referrals and procedures. Arguably some of this may have reflected legitimate, needed care, yet studies suggest about one-third of the care we pay for is unnecessary, inappropriate or poorly prescribed. Payment reform should promote preserving and improving health instead of just paying for procedures and visits.
Health care reform cannot be successful in the long run unless we rein-in costs and get people involved in staying healthy and being wise consumers of health care. A few years ago, I worked with labor and management to make sure everyone agreed to have a little “skin in the game” as part of our health care program. This moti-vated workers to get engaged and make informed choices about their care, and it made sure management embraced prevention and wellness programs to keep people healthy and on the job.
I used to think our health care system was the best in the world. But I’ve learned that the only place where the U.S. ranks first is in having the most costly health care system in the world. But our high spending doesn’t get us the best care — or the best value — that money can buy.
This value gap has made me skeptical of those who continuously push market-based reforms as the way to lower costs and make coverage more affordable. It seems that market forces have yielded the most costly health system in the world with just mediocre health outcomes. If the status quo isn’t getting us the results we want, doing more of it won’t help. It’s time to try another strategy.
Our health care system requires serious reform. Without it Maine businesses can expect a pretty predictable future of continued rising premiums, higher costs of care and smaller bottom lines.
Richard Marston of St. Agatha is a retired manager of human resources for the Madawaska operations of Fraser Papers Inc. He is a member of the board of the Maine Health Access Foundation.