Amid one of the most contentious federal policy debates in recent history, local industry leaders are themselves grappling with the issues surrounding comprehensive health care reform.

The frequently revised America’s Affordable Health Choices Act offers, among other things, a government-funded health insurance option, coverage regardless of pre-existing conditions, and expanded Medicaid coverage. It would require all Americans to become insured, penalizing individuals 2.5 percent of their gross income for non-compliance. It also requires businesses with payrolls of more than $250,000 to provide health care to their employees.

The Congressional Budget Office estimates this plan as drafted would cover 97 percent of the nation’s citizens by 2015. The cost of that is expected to exceed $1 trillion over the next 10 years, paid for in part by tax surcharges on wealthy Americans – those in the top 1.2 percent of income levels.

Washington Policy Center has launched a new project focused on analyzing federal health care reform proposals. Other business organizations across the country are also looking carefully at several of the plans’ specific provisions.
“I think that business is very concerned about health care reform and, in particular, about the aspects that hit them on a day-to-day basis in the cost area,” said David Graybill, president and CEO of the Tacoma-Pierce County Chamber.

“Businesses are concerned about the increasing level of cost that they’re currently experiencing, but they’re also concerned about any new mandates that might be placed on them at a federal level.”

Graybill said he gets several e-mails every day from the U.S. Chamber of Commerce, a national business organization he said has taken a very aggressive, high-profile role in the debate.

“They’re currently running radio ads in Washington and have opined that they are very much in favor of health care reform,” he said. “However, reform would need to be based on some concentration on cost control. It’s not only about access, it’s also about affordability. Both those items are important.”

While Graybill stressed the views of the national chamber and Tacoma-Pierce County Chamber are not necessarily one and the same, he said he has heard from local business owners who are confused and anxious over the overwhelming amount of information and emotion-fueled debates coming out of the “other” Washington.

“It does concern business people that there seems to be a rush to pass a bill,” he said. “In the overall business community, I don’t know if there’s a one-size-fits-all answer. At the end of the day, there are some fundamental issues the nation needs to grapple with.”

Meanwhile, the Olympia-based Association of Washington Business recently hosted a Web-based seminar intended to give local business owners an overview of some of the bills’ business-specific provisions.
According to AWB, Congress must avoid “throwing the baby out with the bath water” – reforms should address only the 5 percent of Americans who can’t afford existing coverage.

The AWB’s presentation concluded that business owners should be most concerned about employer mandates, cost control and the bills’ “public option.”
Dr. Cliff Robertson, chief operating officer for Franciscan Health System, said it’s impossible to know where health care reform is going to land – but the fact that it’s being discussed is a step in the right direction.

“We’re pleased that this has got the national spotlight,” he said. “It’s a conversation, it’s a debate, a dialogue that as a country we need to have.”
Robertson said the issues are incredibly complex.

“Even for those of us who are inside the health care industry, it is incredibly complex,” he said. “I guess, ultimately, what we at Franciscan believe would be the yardstick of meaningful reform would be some movement that improved access and the ability to make sure that a reimbursement system is fair to doctors and patients.”

Chris Free of Tacoma’s Rapport Benefits Group, an insurance brokerage, said that in order for any reform to work, it can’t be centered on the special interests of the few.

Free traveled to Washington, D.C., in April and met with four members of Congress to discuss the reform on the horizon.

“Every single one of them had a different opinion,” he said. “That just kind of framed the whole thing right there. There aren’t a lot of people that even agree on what’s in that proposal. I would be surprised if we saw any reform go through.”

One thing Free said he’d like to see is an understanding of the difference between health care reform and health insurance reform.

“This is not about insurance,” he said. “This is about the cost of health care, including how insurance companies operate, how doctors operate, how hospitals operate, how pharmaceutical companies operates, how the government operates, how brokers operate and how patients operate. There are so many moving pieces. Unfortunately, so many players in the system are pointing the finger at each other. Every single piece needs to be reformed, if we’re going to have a system that works.”

Free, himself a broker, admitted that there are problems in the insurance broker and consulting system.

“In my industry, there’s a lot of people interested in keeping the status quo, because a lot of brokers out there made a lot of money,” he said.
To summarize his concerns, he said, insurance companies are not transparent enough, doctors and hospitals need to focus on coordinating care, and the government needs to focus on regulations.

“The public plan option, in my opinion, isn’t going to be nearly as effective as a mandate,” he said.

“The government should not be involved in private business. They should be involved in regulating private business.”

The final piece of the reform pie, Free said, is breaking through patients’ sense of entitlement.

“We want to take the shiniest pill, we want expensive tests for no reason, we want to stay alive forever and, best of all, we don’t want to pay for any of it.”