EBRI Hosts DC Health Plan Debate

In a recently released article fromEmployee Benefit Research Institute (EBRI), meanwhile, another health expert claims hospitals could be left with crippling amount of unpaid bills run up by sick patients who haven’t chosen a plan with enough hospital coverage.

The October issue of “EBRI Notes’ features two views on this issue: Dr. Donald Palmisano of the American Medical Association (AMA) presents the case for DC health benefits, while Dr. James Bentley of the American Hospital Association (AHA) presents the case against.

Palmisano’s arguments included that:

·          patients would become more cost-conscious about plans and, ultimately, about physician services, referrals, prescriptions, etc. They would expect value from all of their health care transactions. Performance measures for individual physicians would emerge for both cost and quality.

·          providers would be encouraged to compete for patients. That would lead to new insurance products that may offer advantages to patients who otherwise might be uninsured.

Bentley said he opposed the idea because:

·          providers might flee the market if only chronically ill customers sign up for their services

·          the number of uninsured in the US could leap by 35% if 10% of those covered by an employer plan chose not to replace it in a DC environment

·          hospitals have to provide a common standard of care regardless of whether a patient had chosen enough coverage to pay his or her bills.

– Fred Schneyer                 editors@plansponsor.com