Summa Health System responds to healthcare reform

Sep 18 2009

As the health insurance reform debate continues in Washington, D.C. and around the country, Summa Health System provides the following response to the latest developments in the debate and the potential impact on Summa. As a system, Summa continues to inform the debate by sharing its perspective on various policy changes and urges adoption of policies that would impact its patients' health in a positive way, including efforts to expand affordable health insurance to those without coverage.

The President's Speech

President Obama's speech last week was a call to action for both Congress and the public. Although, as he noted, there are many details yet to be worked out under the broad proposal outlined, there could be substantial new opportunities for Summa to build on what we do best -- provide outstanding, innovative care at a reasonable cost. The President outlined the following concepts in his speech:

For those with health insurance coverage, the President proposed the following:

• Individuals who like their current coverage -- whether through their employer, a government program, or other source -- would be able to keep their current coverage.
• New regulations for insurance companies would require the elimination of pre-existing condition exclusions, a cap on out-of-pocket expenses, and the elimination of cost-sharing for preventive care.

Summa has supported many of these changes in our health reform policy principles. In fact, in our Nine for '09 principles document, we focused on many of the same insurance market reforms outlined by the President.

For those without health insurance coverage, the President proposed the following:

• A new insurance exchange would allow people without health insurance and small businesses to compare plans and buy coverage at competitive prices.
• Tax credits would be available to certain individuals and families that need assistance buying health insurance and to small businesses to cover their employees.

The President discussed his support for a public health insurance option that could exist to create additional competition and accountability in insurance markets, although he suggested that he remains open to alternative proposals to accomplish these goals. We are closely monitoring the contentious debate surrounding the public option, consistently evaluating the potential impact of its outcome on Summa and staying in close contact with our Congressional representatives as the policy options rapidly evolve.

In addition, the President's plan would create a low-cost "high-risk" pool to cover individuals with preexisting conditions during the transition period until a national insurance exchange could be created.

Financing the President's Plan

In his speech, the President emphasized that his approach to health insurance reform would not add to the deficit. He proposes to pay for his plan by achieving savings in the current health system, including reductions in the rate of growth of Medicare payments, and by producing new revenues, including fees on insurance companies that sell the most expensive plans.

We remain concerned about how the proposed reductions in future Medicare payments may impact Summa and are actively engaged in the debate about the size and scope of these changes. Nonetheless, we welcome the President's enthusiastic support for efforts to test new payment models aimed at reforming the health care delivery system in ways that better emphasize quality of care over the quantity of services delivered. We believe that the work we do every day at Summa is a model for reforming our health system, and we are anxious to help lead the charge in these new pilot programs being proposed.

Finally, the President announced that his Administration will immediately explore ways to reform medical malpractice through medical malpractice demonstration grants. We share the view that malpractice reform is an important component of a reformed system.

Congressional Developments

Of the five committees in the House and Senate working on health insurance reform legislation, the Senate Committee on Finance is the only committee that has yet to consider and pass a bill. Senator Baucus (D-Mont.), Chairman of the Senate Finance Committee, released his legislative proposal for health reform on September 16, 2009 with Committee markup scheduled for the week of September 22, 2009. Many observers consider the Finance Committee process pivotal, as it has been the one committee with health care jurisdiction that has negotiated its proposal in a bipartisan manner. Highlights of this proposal include:

• Tax credits to help low- and middle-income families purchase insurance in the private market;
• Tax credits for small businesses to help them offer insurance to their employees;
• Reforms of the insurance market to end discrimination based on pre-existing conditions and health status;
• Elimination of yearly and lifetime limits on the amount of coverage provided by health plans;
• Opportunities to create and choose non-profit, consumer-owned and oriented plans (CO-OP);
• Standardization of Medicaid coverage for everyone under 133 percent of the federal poverty level;
• Initiatives for Medicare to reward better care, not just more care; and
• Measures to encourage all of a patient's doctors to coordinate care and reduce duplication and waste.

Although there are many details yet to be worked out, Summa is well-positioned to continue providing quality, affordable care and also to expand the population we serve as more Americans get coverage and seek care. We have the capacity in place to create the kind of new care models called for by this legislation and remain committed to ensuring that those in our community receive the affordable, quality health services they need.

Regardless, there are many issues we must continue to assess as these policies take shape. For example, the issue of coverage for illegal immigrants has become increasingly prominent. Our mission and the law require us to provide care for all, regardless of their immigration status or their ability to pay. We will continue to do whatever possible to provide essential services to everyone in our community.

Final Thoughts

We continue to carefully monitor and influence the policy proposals being considered by Congress. We are in close communication with our Congressional delegation and are sharing the impacts of draft policies on Summa and the people we serve. We will continue to work with our elected officials to ensure that whatever legislation is passed will help Summa strengthen its position as a leader in providing outstanding care to our community.