Health Care

To more accurately reflect the diversity of views of small businesses on health care, the U.S. Public Interest Research Group has let small business owners to speak for themselves. Three hundred and forty-three small business owners and managers across the country made their views heard through a survey which investigated the impact of health care costs on their businesses.

California’s health care system is broken. Costs are rising faster than either inflation or wages, and wasteful spending is a major culprit. Inefficient and duplicative administrative systems force doctors and hospitals to spend more time and money on administrative support than is necessary, which increases costs to patients. However, by following the example of other states and streamlining key processes—such as insurance billing and payment and physician credentialing at hospitals—providers and payers in California can collectively save hundreds of millions of dollars annually and help lower the cost of health care.

As Congressional and public debate over health care reform grows more intense, comparative effectiveness research (CER) has emerged as an unlikely flashpoint of controversy. Opponents’ claims that CER results in the rationing of health care or a government takeover are belied by the true nature of such research: it is simply fundamental scientific research of medical treatments aimed at determining the most effective ways to treat sickness and injury. CER is the basis of all advancements in the field of medical science and has been used throughout history to improve medical treatment. The results of such research are used to create treatment guidelines, which are then incorporated by physicians in determining the best course of care for each individual patient.

The high cost of health care in the U.S. imposes an increasing burden on households, businesses, government, and our country’s economy – a burden made heavier by the current economic crisis. The money that insurance companies spend on inefficient administration, billing and marketing – instead of medical care for their enrollees – contributes to the high health care costs Americans must endure. To incentive efficiency and get costs under control, the U.S. should require health plans and insurers to spend at least 85 percent of revenue on health care.  Almost half of the nation’s health plans and insurers we surveyed already meet this efficiency standard, while a similar number could comply with the standard with only moderate effort.

Congress faces the challenge of transforming macro-level consensus on health care reform into detailed, workable policy. This policy primer is intended to help meet that challenge. It examines seven factors which have led to the interrelated crises in cost and quality, and prescribes specific policy remedies to tame costs and restore health professionals’ ability to provide the care on which American families rely.

As our economy weakens nationwide, Illinoisans are having a harder time accessing and affording health insurance. Illinois needs to change the way it regulates the health insurance industry to make sure residents have access to predictable and affordable coverage. An analysis conducted by the Illinois Public Interest Research Group indicates that increasing cost-containment and accountability measures for health insurance companies does not mean that the premium costs paid by consumers will increase.

Unless the new Congress and Administration act to reduce health care costs, the yearly cost of the average employer-paid family health policy in America is projected to more than double from $11,381 in 2006 to $24,291 by 2016 even after adjusting for inflation. If recent trends continue, wages and household incomes will simply not keep up with these high costs. Nor will the business sector be immune to this crisis.  Unchecked, this cost epidemic could also severely impact the small businesses that drive job creation in the American economy. This report examines three important sources of this unproductive spending.

Oregon businesses and consumers are facing unsustainable increases health insurance premiums and out-of-pocket costs, with health care costs rising at more than double the rate of inflation. Given this, Oregon officials are developing a major health reform plan to cut costs, improve health outcomes, and ensure Oregonians have access to affordable quality health care. The officials charged with this task, the Oregon Health Fund Board, released a draft reform plan for public comment in early September 2008.