Many Employers Enter National Debate Over the Uninsured
The New York Times today looks at a shift in the health care debate among employers, who "have long viewed the uninsured as the responsibility of the government" but are now advocating expanding health coverage because growing numbers of uninsured people are increasing costs for their employees' health care. Some companies believe that one reason behind "double-digit" health care cost increases is that doctors and hospitals are raising rates to offset the uncompensated health care costs of treating the nation's 41 million uninsured. A study by the Urban Institute found that in 2001, employers and managed care companies paid $1.5 billion to $3 billion through higher rates to help cover the $24 billion hospitals spent providing care for people who could not pay their bills. Employers also offset the cost of health care for the uninsured through their federal taxes, the Times reports. "Employers are now subsidizing the uninsured and low-paying government programs like Medicare and Medicaid, to the detriment of their own employees," Kate Sullivan, director of health care policy at the U.S. Chamber of Commerce, said. Bruce Bradley, director of health plan strategy and public policy at General Motors -- which spent $4.5 billion on employee and retiree health care last year -- said, "As a nation, we need to expand coverage for the uninsured and reduce the burden for uncompensated and inefficient care for many payers, whether it's the government or the hospitals or employers." Many employers are planning to participate in the Robert Wood Johnson Foundation's "Cover the Uninsured Week" to draw attention to the issue, but so far "companies have made few proposals regarding the uninsured," the Times reports (Freudenheim, New York Times, 3/6).
In related news, USA Today today looks at ways that employers are offering incentives to their employees for healthy behaviors, such as eating healthy foods, exercising, refraining from smoking and wearing seat belts. About 42% of employers offer financial incentives or disincentives linked to health behavior, compared with 34% in 1996, according to benefit consulting firm Hewitt Associates. Some companies offer employees cash bonuses if they complete "health risk assessment" surveys or keep their cholesterol "in check." Others penalize employees for behaviors like smoking or not wearing seat belts. Employers say the programs have saved them money in health care costs. Johnson & Johnson, which offers a $500 insurance discount to wellness program participants, estimates it saves $8.5 million a year. However, attorneys say the programs may violate federal laws if they discriminate against workers with health problems. While "most employers say the programs are voluntary and they don't review individual data," consumer advocates are "skeptical" and worry that employers might "eventually go too far" by basing hiring decisions on people's health habits, USA Today reports (Appleby, USA Today, 3/6).
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