Health-Care Cost Cut Possible

Article excerpt

By David Page Managing Editor A minimum benefits package for health care designed by the American Medical Association would cost an employer an average of $1,700 a year per employee. Nationally, the average employer now spends between $2,300 and $2,600 per employee for health insurance pre- miums, said John Lee Clowe, speaker, House of Delegates of the American Medical Association. Clowe, a family practitioner from Schenectady, N.Y., was in Oklahoma City and Tulsa recently to discuss health-care issues with local physicians and the Oklahoma City Medical Society and the Oklahoma State Medical Society. The minimum benefits package prop- osed by the American Medical Associa- tion is based on 70 percent of the employees having family coverage and 30 percent having individual coverage. The employer pays 80 percent of the premium. "This is one way to cover the 33 million Americans that have no health insurance coverage," Clowe said. The proposal, called Health Access America, states that employer health- care insurance should be required by federal law. The American Medical Association plan is presented as an alternative to a government-based plan. The plan would be phased in in four to five years, he said. Health Access America would start with companies with 100 or more employees and then be scaled down to smaller firms. The American Medical Association's goal was to establish a minimum benefits package affordable to employer cover- age. The package represents only the minimum that should be required, Clowe said. "It is a basic benefits package so people can have appropriate care," he said. The plan just set a minimum in required health-care benefits, Clowe said. Additional benefits could be provided or negotiated on a company- by-company basis. The Health Access American proposal includes additional recommendations regarding employer-based insurance, including:

Federal tax incentives must be provided and risk pools created so that new and small businesses can afford the cost of coverage.

State-mandated benefit laws must be preempted so that small businesses can obtain an affordable minimum benefits package of health insurance for employees.

The Internal Revenue Code must be amended so states can require self- insured companies to participate in state- operated risk pools. Small businesses and others for whom coverage is not available could use these pools to purchase minimum benefits policies at group rates.

Insurance continuation coverage must be expanded to require that employers pay the same share of an employee health benefit premium as was paid prior to termination for up to four months.

Policy provisions excluding pre- existing conditions from employee& health insurance must be eliminated. …