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National health care debate continues

Wednesday, June 3, 2009
Written By
Dave O'Brien

Thanks to everyone for the many responses I received about my recent articles regarding national health care. I can’t stress this enough: This is a debate we all need to be diving into because things are moving quickly. I received a number of e-mails expressing disbelief at the government’s inability to recognize the good of what is in place and the vital role of the broker. Bobby Horn of Regions Insurance summed it up best:

“There has to be a way for the powers that be in Washington to realize that a very efficient distribution system for health care insurance is already in place. Many business people trust the Broker and look to us for advice on many health issues, some related to health plans and others for advice for their employees for things such as going from a health plan to a Medicare plan, which hospitals are in the network, etc.”

To Bobby and the others, I can state with certainty Congress does not recognize what a broker does. It was probably the most surprising and biggest wake-up call to every broker attending last week’s Council session. It is up to each of us and all employees who represent the brokerage marketplace to make sure our voice is heard. Do not assume that Congress knows. Contacting your representative is imperative and couldn’t be easier: NAHU has ready-to-use letters that you can e-mail to your representative directly from their site. Enter your zip code to send one of their many letters to the corresponding representative. Write to your representative immediately and make sure your voice is heard, and invite your clients to do the same.

Others wrote wondering why the government doesn’t fix what they have before they expand. Ben Olsen from Old Colony states:

“The biggest problem that we face as advisors in the private insurance arena is the cost-shifting done by providers. Why isn’t there ANY discussion of a mechanism for all types of insurance and the uninsured to be charged the same rate by a provider for the same service? Until we get the cost-shifting eliminated and put everyone on the same playing field, there will repeated calls for the government to take over.”

This question was raised by brokers at the Council meeting to both Daschle and Dean. Both said that there is discussion on this topic, they agreed that it is a problem that needs to be fixed, yet neither had answers on how to do it. Dean did go as far as to say that both the public and private should be at the same reimbursement rate, but recognizes the difficulty in getting there. Based on the discussion, it is believed that primary care providers are not paid enough however specialists will have a battle on their hands. Congress wants to focus on payments to them and have more efficiencies in place. Again, no further details on that point.

Finally, many wrote to me asking what these people think the role of the broker will be. Diana Rosales from SEBS wrote:

“Regarding the following comment from Dean, ‘For brokers doing group business, he would be nervous, but sees potential big opportunity. However, it will demand different thinking and our business will change.’ If employers can push all the employees off into the public plan, then what incentives would they have to offer health insurance to their employees at all? Dean does not have the answers but what is your gut on this? What are some possibilities and opportunities for brokers — be they far-fetched or seem crazy today?”

To Diana and everyone else, you are right that Congress does not have answers other than “things like this have worked in other countries, so I’m sure it will work here as well.”

My personal view is that this could represent a tremendous opportunity for brokerage operations, but it will mean recreating the mold. While I know we would all prefer for this to go away and not have to deal with it, change is upon us. How agencies react to it will make all the difference in the world. I have spoken to overseas brokers who deal with government plans and have been giving an interesting perspective. In addition, we have seen U.S. firms already anticipating these types of changes and have begun the process of reinventing themselves.

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