Repeat after me: it's only a plan - Bill Clinton's health reform plan - From the Editor - Editorial

Business & Health, Oct, 1993 by Joe Burns

For the past several months, I've been worried about what the Clinton reform plan will do to health care. I'm concerned that employers will no longer have an incentive to focus on cost containment strategies, to measure and manage quality, or to offer health promotion programs. I worry that employers paying more than 9% of payroll for health care would leap at the chance to provide government-sponsored health care to their workers for the low cost of a payroll tax of 7% to 8%. I fretted that a government-sponsored system would--as the saying goes--have the compassion of the Social Security Administration, the efficiency of the U.S. Postal Service, and the cost effectiveness of the Defense Department.

So now the plan is out, and regardless of whether you favor it, oppose it, or--more likely--are somewhere in between, you may find it useful to remind yourself, as I do, that this plan is only a proposal. It will not be passed by Congress and become law next week. It will take at least a year--and mabye two--of political horse trading before Congress passes a plan. And, what will be passed will most likely have little resemblance to the current Clinton plan. It will be the end of the decade before the most serious implications of the plan are felt.

Businesses are not waiting. They are continuing to adopt strategies to control health care costs and to improve quality. In fact, even small businesses and those in non-metropolitan areas are revising their health plans and finding success.

It's refreshing to find examples like those of Kent M. Bank, president of Minneapolis Washer and Stamping Inc. (see "Solutions for small businesses," page 44). Employing 45 workers, Bank was expecting a 20% increase in premiums this year, not unusual for many companies. Instead, he insured through a coalition and got no increase.

Here's another example (see "making health care work in rural communities," Mid-September.) In February, five employers in Red Wing, Minn., about 50 miles southeast of Minneapolis, put a PPO together. The employers are relying on group purchasing power and their own analysis of providers' patterns to improve the quality and efficiency of health care delivery. The five employers have some 1,200 employees and 2,400 covered lives. Donald E. Gerhardt, president of Community Health Systems Inc. a health care consultant in Minneapolis, says the companies' average health insurance cost increases will be 4% in 1993, compared with 12% to 20% in previous years.

Writing about these efforts helps me to remember that whatever is proposed in Washington, one simple fact remains: It's only a plan.