Health System Reform
Business
Bill of Rights and Responsibilities
Contain costs, strengthen the utah economy, improve lives
Preamble
As business
leaders, we support the creation of a health reform strategic plan for the
state of Utah that will apply the principles of the private market to
contain costs, strengthen the Utah economy, and improve lives. We believe
that, even though Utah’s health care system is among the most efficient in
the nation, we can do much better. We applaud the Utah Legislature and the
Governor for making health reform a top state priority and pledge our full
support for the process. We believe that Utah’s strategic plan must expand
accountability at all levels of the health system—patients, providers,
purchasers, payers and political leaders. By so doing, every Utahn will take
more personal responsibility for their health and we can realign the system
to be more consumer-driven. To this end, we present this Business Bill of
Rights and Responsibilities to assert our rights and responsibilities as
individuals, businesses and as payers who provide health insurance to 1.8
million Utahns, 79 percent of Utah’s insured population. We commit our best
thinking, efforts and selves to build upon our current strengths, transform
our weaknesses and dramatically improve our health system.
Vision
We envision a
health care system that will sustain a vibrant economy and enable people to
live healthier, more productive lives. In such a system, every Utahn will
have access to affordable, basic health insurance and care that is paid for
with pre-tax dollars, chosen by the employee, portable from job to job,
guaranteed issue, rated based on a broad-based risk pool and structured to
incorporate cost controlling features. Health care consumers will have
access to complete information that will allow them to make prudent
decisions about their care and employers can make defined contributions to
the health care of their employees. In such a system, we will increase
accountability, eliminate waste, transform incentives, extend compassion
and, most importantly, improve people’s lives.
Rights and
Responsibilities
Utah businesses
assert these rights and responsibilities:
Increase
accountability
·
Outdated System:
Employers have the right to be relieved of an outdated and flawed
employer-based health payment system that limits employee choice,
facilitates counterproductive health underwriting and hinders
entrepreneurial activity and small business formation. Individuals, not
employers, should be at the center of health care coverage and payment
decisions.
·
Workable transition:
As we convert to a system where individuals, not employers or government,
are the primary decision makers about their health care coverage, employers
with health plans have a responsibility to continue to provide essential
coverage until a more accountable, equitable and rational system is in
place.
·
Lifestyle choices:
Individual responsibility is
a foundational principle of health reform. Individuals who choose healthy
lifestyles should benefit from their choices and not bear the financial
burden of those who make unwise choices. Some of these choices may include
smoking, substance abuse, lack of exercise and overeating. We acknowledge
that defining limits surrounding lifestyle choices is difficult but we also
believe that personal responsibility for one’s health is at the foundation
of health system reform
Eliminate
waste
·
Immediate and bold
action: We have the right to
demand that our elected officials take immediate and bold action to
facilitate reform, including the creation of a regulatory environment that
allows market forces to properly align incentives and eliminate waste.
·
Portability:
As individuals and employers, we have the right to expect that basic health
insurance will be portable from job to job. This will facilitate efficient
decisions by individuals as to where to work. This can also save
administrative costs, improve health security and help eliminate employment
distortions within the job market.
·
Cost shifting:
Individuals and businesses that pay for health insurance have the right to
know how their money is being used to pay for uncompensated care and for
government programs that do not pay their full cost. This “hidden tax” must
be transparent to allow for the most efficient use of resources.
·
Best practices:
Medical providers who utilize best practices should be protected from
unreasonable jury awards that limit access to health care or force doctors
to practice defensive medicine. Providers should also have convenient access
to electronic medical records that will improve care.
·
Pre-tax dollars:
Government and employers have the responsibility to ensure that health care
benefits are paid for with pre-tax dollars. Too many employees pay much more
than they should, or forego insurance altogether because employers do not
provide this benefit.
Transform
incentives
·
Transparency:
Individuals and businesses have the right to know the cost of care prior to
procedures being performed (with the exception of emergency care) and the
quality of care, including the success rates of individual practitioners and
facilities. The sources of funding, information about the full range of
insurance products and potential conflicts of interest (self-referral)
should also be disclosed. This information must be standardized, easy to
understand and readily accessible. Transparency of information also includes
appropriate disclosure from insurance carriers and brokers about coverage,
denial rates, fees/commissions and other information that will support a
vibrant health care market. Without this information, employers and health
care consumers cannot make rational choices.
·
Defined contribution:
We affirm the right to adopt a defined contribution approach to health
benefits, rather than a defined benefit. The former provides an incentive
for prudent utilization; the latter encourages over-utilization.
·
Choice:
Individuals should have the right to choose among a wide range of
competitively offered health plans. Individuals, not employers, should
choose their health plans. Individuals desiring to pay cash or self-insure
for a portion of procedures should be allowed to pay the same rates as if an
insurance company paid for the procedure.
·
Essential benefit
package: We have the right
to ask our government to work with the private sector to define an essential
benefit package that will cover preventive, primary and emergency care.
Although defining a basic benefit is complicated and difficult, it is an
important step in achieving health care coverage for all Utah residents,
encouraging individuals to be wise consumers of health care and allowing
competition to control costs.
Extend
compassion
·
Assisting those with
the greatest needs:
Employers have a responsibility to the broader community to work with public
officials to assist those in need.
We believe that
escalating health care costs are among the greatest threats to Utah and our
nation’s long-term economic wellbeing and neither our state nor federal
government is acting with sufficient urgency. We commit to these aspirations
and will partner with all like-minded people to make progress that will
contain costs, strengthen the economy and improve lives.
______________________________
Lane Beattie
President & CEO, Salt Lake Chamber
______________________________
Chris Redgrave
Chair, Salt Lake Chamber Board of Governors
______________________________
Scott L. Hymas
Chair, Salt Lake Chamber Health System Reform Task
Force
______________________________
Thomas E. Bingham
Utah Manufacturers Association
______________________________
James V. Olsen
President, Utah Food Industry Association
______________________________
Candace Daly
National Federation of Independent Business, Utah State
Director
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