USA Today Editorial Says Lawmakers Must Get Serious About Reform

Last week's announcement by the California Public Employees' Retirement System that its members' premiums will increase 25% next year is a "clarion call" for lawmakers to undertake fundamental reform of the U.S. health care system, USA Today writes in an editorial. As health costs for businesses rise nationwide, the number of uninsured will likely rise and employees who retain coverage will see their own costs increase. "Yet while this cost crisis moves quickly toward the boiling point," USA Today writes, "the federal government, ideologically paralyzed and newly beset by budget deficits, shows no inclination to take on such a costly and difficult problem." The editorial adds, "Rather than focus on the resources that would be required to reform the health-care system, bring costs under control and expand coverage to everyone, lawmakers have frittered away the budget surplus on aimless tax cuts and spending increases with far less urgency," leaving business to deal with the "pending health-cost crisis." Given that managed care's ability to hold down costs has seemingly run its course, businesses are now looking to place greater responsibility for health care on employees in the form of increased cost sharing. While giving individuals a "greater role in health care makes sense to a point," USA Today states that "shifting to a consumer-driven health care system creates a host of new risks that will demand the immediate attention of lawmakers," such as whether premium inflation will outpace workers' ability to afford coverage and whether consumers will have enough information to make sound health care decisions. The editorial concludes, "CalPERS' massive premium hike is a clanging wake-up alarm. This time around, the public can't afford to have lawmakers hit the snooze button" (USA Today, 4/22).

Instead of resorting to a "blame game" about rising costs, lawmakers should both remove the "red tape" that is preventing managed care plans from employing cost-saving tools and take health care "out of the courts," Karen Ignagni writes in an opposing USA Today opinion piece. Ignagni, the president and CEO of the American Association of Health Plans, writes that managed care plans have promoted preventive and coordinated care and "pioneered" disease management programs, all of which help to keep costs down. But, she writes, the industry's ability to mitigate rising costs is limited because it is "awash in regulatory micromanagement," as a "mishmash of more than 1,500 state and federal mandates currently dictate how services are to be provided regardless or whether they're needed or effective." Ignagni also says that malpractice litigation and class-action lawsuits add to overall consumer costs and dissuade providers from offering information about mistakes and errors, thereby limiting the ability to reduce them. She concludes: "This week the American Association of Health Plans will release a new study to help jump-start a substantive national conversation about health-care costs. The challenge for the nation will be to move beyond the blame game" (Ignagni, USA Today, 4/22).