If you get a bunch of people in a room to talk about the federal Patient Protection and Affordable Care Act, that discussion is going to go a lot of places.
Greater Louisville Inc., the metro chamber of commerce, held a roundtable discussion Tuesday on the health insurance premium tax, which was ushered in as a part of the health care reform law.
The discussion was led by Vickie Yates Brown, an attorney with Frost Brown Todd LLC and chairwoman of GLI’s health care task force. She explained that the tax is paid by insurance companies. The Congressional Budget Office has said that insurers are likely to pass the tax onto the companies and consumers buying their policies, which could raise premiums by 1.9 percent to 3.7 percent by 2023.
Sarah Davasher-Wisdom, GLI’s vice president of government affairs and public policy, told me that GLI held the discussion to gain a little insight into whether this issue should be a legislative priority. But those at the table said it was hard to isolate this one aspect of the health reform law and talk about its impact without looking at the whole picture.
So the discussion went in a lot of different directions. Here are three of the most interesting things I overheard Tuesday. I plan to have more on this soon.
Single-payer health care in the U.S.?
Could universal Medicare be America’s answer to single-payer health care? Michael Kaelin, president of employee benefits for RH Clarkson Insurance Group, thinks so. Think about it. It generally has lower out-of-pocket costs for the patient than most private plans, he pointed out, at least for hospital stays. He also said there would still be competition in the marketplace because Medicare plans would be administered by private companies such as Humana Inc. and Anthem Inc.
Employers react to doctor shortage
I know that universal health care mention probably got you thinking about the doctor shortage. That’s something people already are worried about because the Affordable Care Act already has brought more patients into the system. Gwen Cooper, vice president of external affairs at behavioral health nonprofit Seven County Services Inc., said the Medicaid expansion (ushered in by federal reform) has brought 300 new patients in the door each month, for example. As a result of all these new patients coming into the system, many businesses and organizations are establishing in-house clinics to ensure that workers have access to health care, said J. Roy Mattingly Jr., vice president and business development manager for BB&T Insurance Services.
Consolidation driving up costs?
Mattingly also made a point about the effect of health care provider consolidation. I’ve written plenty before about how the three big acute health care systems in Louisville — KentuckyOne Health Inc., Norton Healthcare Inc. and Baptist Healthcare System Inc. — all are buying physician practices to help increase referrals (not always with great success.) Mattingly said that consolidation could be inflating health care costs. When doctors are making referrals, they’re likely referring patients to their employer, which might not be the most economical option.