CARL SCHRAMM PRESIDENT HEALTH INSURANCE ASSOCIATION OF AMERICA TOPIC: HEALTH-CARE REFORM
Author: Today's interview was conducted by insurance reporter Paul
Dykewicz.
Article Text:
If, in the end, major health-care reform will come, it will take a long time to produce it. The history of Congress - and we've seen this ever since World War II - is that it takes four or five years of gestation before a major piece of health legislation either becomes law or is thrown on the junk heap. By my lights, we're in the first or second year of a five-year process.
Q: : What about the solutions that have been offered by President Bush and other political leaders?
A: President Bush has a very good plan, and he has done a very important thing in advancing the debate by weighing in. He is supportive of the right kind of change. Namely, his focus is squarely on the 13 percent of the population without health insurance. His proposal is based on the advantages and the strength of the present health insurance market, and it is particularly well focused around the important promise of managed care.
Q: What about the "play-or-pay" proposal, which would create a risk pool that would require contributions from employers who don't provide private health insurance to their employees?
A: It's a bad idea from the insurance perspective. As it is conceived in Washington, it is a "back-door" approach to national health insurance to establish a government authority that will operate at rates subsidized by new taxes and will eventually take all our business away. A play-or-pay approach would be the last chapter written on private health insurance.
Q: What about national health insurance?
A: In national health insurance, there is no role for private health insurance companies. Those who favor a national health plan would put us out of business, and they're explicit about that.
Q: Less extensive changes in the existing system have been offered by Sen. Lloyd Bentsen (D-Texas), chairman of the Senate Finance Committee, and other congressional leaders. What do you think of these ideas?
A: They're headed in the right direction, provided they let reform of the insurance market take place at the state level.
Q: Why do you favor state solutions?
A: There is no national delivery system. It's all done on a regional or local basis. Many insurance companies operate nationally, but you still have a state-by-state focus. Our industry has always been regulated on the state level. The state legislators have been very active in this area and will continue to do so.
Q: What needs to be included as part of major health reform?
A: Cost containment, managed care, small-group employers health reform and reform of Erisa through the exemption of state-mandated benefits for insured
plans. There has to be a revisitation of the tax treatment for self-employed individuals who now do enjoy only a 25 percent deduction in insurance costs whereas a big employer gets 100 percent.
The last thing I would point out is that the president is heading in the right direction with medical malpractice reform.
Caption:
SCHRAMM
PHOTO
Memo:
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Copyright (c) 1992 The Journal of Commerce
Record Number: 9201080074
Q: : Do you view this heightened attention on health care as an opportunity, and what do you plan to do to take advantage of it?
A: : We plan to educate the Congress and to use this opportunity to increase the appreciation of Congress about this industry and what we can do. Eighty- seven percent of the population is insured now, since 1945 when the industry began.
Q: What about the problem of the uninsured?
A: : We've proposed a program that we've been pushing at the state level. It focuses on small-group reforms, corrections in the tax law as it regards individual employers and the deductibility of health insurance, and Erisa (Employee Retirement Income Security Act of 1974) reform. It should go some distance in solving the problem.
