Reform's worrisome direction

November 1, 2009 

— Some interest groups, commentators and politicians want to depict health care reform as a contest between health insurers and "everyone else." In fact, we are finding that many people - including many hospitals, doctors and experts with decades of experience in health care - are concerned that Congress is taking us in the wrong direction.

We don't apologize for speaking out on health care reform. We believe it is our responsibility - to our customers, to our employees and to North Carolinians - to speak frankly on this issue and to encourage everyone to let their elected representatives know where they stand.

We're not surprised that some activists would try to re-use our message to press for government-run health insurance. Their entire movement is based on a premise that most people don't stop to question whether health care would be affordable if only insurers could be coerced into charging lower insurance premiums.

This argument ignores the reality that insurance premiums have to rise in concert with mounting health care costs and increasing demand for the things insurance pays for: hospital stays, drugs, medical devices and diagnostic testing. Reform that doesn't address these underlying cost drivers will drive costs up, not down.

When President Barack Obama said that "bending the cost curve" was critical to controlling the deficit and aiding economic recovery, we said "Great!" But we now find that health care reform has become health insurance reform, and a debate dominated by those who see the Obama presidency as their last, best chance to put in place a pathway to a government-run system Americans have consistently rejected.

The Senate proposal would pay for this government expansion through at least $13 billion in new taxes and fees that will do nothing to make health care more affordable - the supposed central goal of reform.

A highly respected industry study and our own research suggest that current reform proposals could actually mean significantly higher costs for some North Carolinians. Within five years of reform, those buying new individual plans could pay more than 50 percent more than they would pay today, and small businesses could pay nearly 30 percent more than today - and neither of these figures includes medical inflation that is currently running at double digits.

We would suggest Congress enact a stronger individual mandate and recognize that differences in premiums between younger and older members are important, since it brings healthy people into the insurance pool to offset higher costs of older members. Under current proposals, premiums for the youngest 30 percent of the population will increase by about 69 percent. This huge price increase, coupled with a weak mandate, will mean that even more young healthy people are likely to forgo coverage.

It's simply impossible to provide coverage to 30 million uninsured Americans without the rest of us paying more in some way. Perhaps that's why a recent Wall Street Journal/NBC poll found that significantly more Americans think health care costs will increase under reform (47 percent) than believe reform will reduce costs (13 percent).

Fortunately, the activists who support a government takeover are far outnumbered by the many North Carolinians who believe we can make real changes without handing health care over to Washington politicians, who for 40 years have failed to address the fraud, waste and inefficiency that is leading existing public insurance programs toward bankruptcy. We are glad to have helped thousands of these North Carolinians let their feelings be known to Sen. Kay Hagan.

We have been consistent about what real reform should mean: getting everyone covered; improving health care quality and efficiency; focusing on better care, not just more care; and creating incentives to help us all live healthier lives and reduce chronic disease.

For more than 75 years, Blue Cross has sought to protect our members financially while improving the health of North Carolinians. We recognize that health insurance premiums are continuing to go up and these increases are driven solely by increases in medical costs. While this is occurring, our concern is that passing reforms that don't address the real issue of health-care costs will drive your premiums up even more in the future, beyond already unsustainable increases.

Bob Greczyn is CEO of Blue Cross and Blue Shield of North Carolina.

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