Much to Like

The Senate Finance Committee bill is complex and touches upon many subjects of significant interest to specific stakeholders. As a person who built and refined an employer-based health care program, and who feels passionately about health-care delivery and payment reform, as well as promotion of public health, I feel there is much to like in the bill, as well as some troubling provisions.

I support the idea of universal, affordable coverage, but feel that the $750 penalty for those not purchasing insurance is too low, and will have the unintended effect of causing far more sicker and older people to seek insurance and more healthy young people to pay an insufficiently low penalty in lieu of insurance.

I like the many efforts to address payment and delivery reform, and quality improvement. As a recently retired CEO of a large, self-insured employer, I like the increased plan design flexibility the bill creates, and do not object strongly to the idea of a "Cadillac plan" tax. However, the bill reduces significantly the tax benefit of flexible spending accounts, a vital health care planning tool, and it needs refinement in defining what it considers a "Cadillac plan."

I like the idea that the bill is taking a fresh look at many obsolete and costly state insurance mandates, and that it will create additional affordable choices for consumers. However, I believe that the additional fees charged to health insurers will simply get passed on to consumers and work against the goals of the bill.

I hope that Title III, Subtitle A of the Senate Health, Education, Labor and Pension Committee bill that provided for a National Prevention, Health Promotion, and Public Health Council survive, because, ultimately, improving overall health is essential to "bending the cost curve."

By Michael Critelli  |  October 13, 2009; 6:05 PM ET  | Category:  Public policy
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