Health Care Reform--The Devil Is In The Details

It's been 16 years since legislation has been considered that would fundamentally reform the nation's troubled health care system. But a new bill spearheaded by Sen. Edward Kennedy is taking shape. Proponents want to pass it in a lightning-fast time frame of just a few months, with little time for the careful consideration such major legislation warrants.

The U.S. Chamber has been a consistent advocate for health care reform. While most people agree that reform is vital, the devil has always been in the details. So where does the U.S. Chamber stand on the broad outlines of the Kennedy bill and the current reform effort?

We should start by saying that there is common ground on many issues. The Chamber agrees that the time for health care reform is now. We have been a consistent advocate for the expansion of health care IT, an emphasis on prevention and wellness, and pay-for-performance. Sen. Kennedy's bill has some positive aspects, such as health care Gateways (allowing one-stop shopping for health insurance) and guaranteed coverage without regard to preexisting conditions.

But the Chamber has serious concerns about three aspects of the Kennedy bill that would imperil millions of jobs and place new burdens on small businesses—an employer mandate, a minimum benefits package, and a government-run plan.

An employer mandate would force employers who cannot afford health insurance to reduce their payrolls and not hire new workers. Employers already voluntarily pay $500 billion annually for health benefits for employees.

A minimum benefits package might force all health plans to be expensive "gold-plated" plans. Health reform needs to be affordable, or it will not be successful.

Most worrisome is the creation of a new government-run insurance plan that would compete unfairly with private insurance. One recent study suggested that 130 million Americans would drop their current coverage for this government plan. This would lead to a huge new liability for the government, and there would be tremendous pressure to bring costs under control. Inevitably, unelected bureaucrats—not patients and their doctors—would have the power to dictate medical treatments and ration care. We oppose this.

To accomplish our shared goal of improving our nation's health care system, any legislation must not burden America's job creators. The Chamber is committed to ensuring that the concerns of employers—especially small businesses—are heard in this debate. We believe that there is a real opportunity to pass a health care reform package this year that the business community can support, as long as Congress follows the oldest principle in health care: do no harm.