Health insurance companies like some of Obama’s proposals

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Published: December 15,2008

President-elect Barack Obama might get a honeymoon with health insurance companies. The two largest such companies in Mississippi appear cautiously optimistic about some of the healthcare reforms proposed by Obama.

Glen Golemi, CEO for UnitedHealthcare of the Gulf States, the second-largest provider of health insurance in Mississippi covering 187,000 lives, said details on Obama healthcare reforms are still sketchy. But there are elements of the plan that are appealing.

“We should be striving for comprehensive and continuous reform, which we hope begins in 2009, and continues over the next four years and beyond,” Golemi said. “Given the sensitive, complex, social and commercial nature of our health system — and its central role in the ability of American business to be competitive — any reform should be taken in thoughtful stages.”

Obama recommended expanding health coverage for youth through State Children’s Health Insurance Programs (SCHIP), which is endorsed by UnitedHealthcare. Golemi said providing health coverage for children should be a priority.

“By passing SCHIP legislation, we will be able to better serve the needs of millions of children who are currently eligible, but not enrolled in the program,” he said. “That would be a good first-stage step as part of a broader reform effort.”

Obama has proposed that insurance companies be required to cover pre-existing conditions “so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums.” That could be a very expensive proposition for insurance companies. But Golemi said it is not really possible to assess the impact of expanded coverage options until greater specifics are provided.

“Steps that increase coverage options and make these options simpler to pursue may be popular for many because they offer the ability to respond to immediate healthcare and financial needs,” Golemi said. “However, this approach represents a good example of a response that addresses a symptom and not the root cause. The opportunity for broader and durable reform lies in improved, system-wide dynamics around basic healthcare system costs. To address those core cost issues requires focus on the central cost drivers across the entire system viewed as a whole and then taking actions that will better contain those costs without compromising appropriate care, access or quality.”

Golemi said the prospect of health reform actually provides a sense of optimism. The central concern for UnitedHealthcare and others is how to best to achieve it.

“It needs to be approached broadly and thoughtfully with a whole-system perspective and a standard of fairness,” he said. “Even the best change is disruptive and needs to be planned and managed. So how reform is considered, planned, executed and adjusted is key. It will require consistent, vigilant assessment and re-adjustment to achieve the goals we all believe should be possible.”

Blue Cross & Blue Shield (BCBS) of Mississippi, the largest health insurance provider in the state with a market share of 40.5 percent, said some Obama proposals closely mirror initiatives already proposed by the BCBS Association early in 2008.

“The Association recommendations are simple: every American should have health insurance, individuals should be fully-informed with regard to the cost of healthcare and the quality of healthcare they receive and there should be cooperation between the public and private sectors to maintain affordable coverage,” said John L. Sewell, director of corporate communications for BCBS of Mississippi.

Sewell said there are two key issues that can dramatically impact the cost of health care. First, individuals need to focus on health and wellness and the value of preventive medicine. It is far more cost-effective to identify a potential health risk early through a preventive wellness visit, than to deal with the costs of managing a serious health issue later.

Second is addressing waste in healthcare spending. Approximately 30 percent of the current healthcare provided has been identified as being inappropriate or redundant.

Contact MBJ contributing writer Becky Gillette at 4becky@cox.net.

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