The Sioux Falls Area Chamber of Commerce Board of Directors reviewed the following statements regarding health care reform and its impact on business and approved them on Nov. 18, 2009. Please contact Public Affairs & Communications Director Bob O'Connell at 605.373.2004 with any questions.

The Chamber takes the position that the health care services provided to the vast majority of South Dakota employees are of high quality. A large majority of South Dakota employees receive quality care through their employer group coverage. Any reform measures should be designed to continue that quality that South Dakotans have come to expect and appreciate. The reforms that are under consideration in Washington should not attempt to pass more cost on to employers who are already finding difficulty in keeping up with the rising health care expenses. Medicare and Medicaid cost shifting to employers continue to create a burden that is becoming unsustainable.

Some of the reform under consideration has a high degree of continuing the cost shift of care to employer groups. The “public option” under consideration will most likely use the already under funded Medicare and Medicaid model to reduce payments to providers. Many providers have no choice but to pass the cost of doing business on to the private pay customers who pay a higher premium to absorb the overhead of Medicare and Medicaid underpayments. The temptation for government to pass on the cost will be irresistible.  Thus the public option “reform” is not reform at all but a shift of cost, a hidden tax, to those who pay full price. The Chamber is opposed to this cost shifting proposal.   The Chamber supports consideration of the Senate Finance Committee version of a non-government, non-profit co-op in the insurance exchange.

Similarly, a tax on health benefits or premiums will once again shift the costs of care to private pay individuals and Employer groups. That is not health care reform but merely shifting the costs of care to those who already pay privately for insurance coverage. The Chamber is opposed to this cost shifting proposal.

Some of the reform proposals call for an employer mandate that require employers to offer coverage or pay a penalty. It should be noted that a survey conducted for the Zaniya project found that three-fourths of all South Dakota firms currently provide health care coverage to their full-time employees. An employer mandate may actually have a negative impact. It may allow employers on the edge to drop coverage and choose to pay a fine. It may remove the incentive of start ups, or hiring additional employees. The Chamber is opposed to this proposal.

The Chamber is concerned that proposals to eliminate existing conditions denials will result in adverse selection unless all persons are mandated to be covered. Some persons who have decided not to be covered by insurance will wait until they are injured or ill to apply for coverage thus avoiding premium payments.  If an individual mandate is adopted then the cost of providing existing condition coverage should not be shifted to already heavily burdened employer groups. Under the condition that individual coverage is mandated, the Chamber would encourage this change.

Tort reform in some fashion should be considered. The quality of care standards should be maintained so that patients who are injured have recourse for recovery. The Chamber would encourage responsible tort reform.

Coverage across state lines should be considered but only if a regulatory framework is established to ensure that coverage is adequately reserved and regulated. Minimum standards for insurance products are essential to ensure that enrollees and employers are not left without coverage because of unreserved insurance or fraud. The Chamber would cautiously encourage this change.

Prevention of fraud, overutilization, and abuse in health care should be strongly pursued. Cost containment goals, reduction of administrative burdens and other cost saving measures should be a high priority of health care reform. These measures are essential if reform is to work. These measures do not appear to be adequately considered in any of the present Bills.  Consideration should be given to alternative provider payment systems, i.e., “Outcomes” versus “Volume” payments especially in chronic care situations. Careful consideration should be given to the impact of reform measures on delicate rural health systems that already suffer from too few providers. The Chamber strongly encourages cost containment as a primary function of health care reform.

The health care system as a whole should not have inflation of costs after reform that exceeds the present inflationary curve. Instead a reduction in costs that does not interfere or restrict quality of care should be a primary goal of Reform. The Chamber supports measures to reduce the increase in health care costs.

The Chamber’s position is that the reform package passed by the House of Representatives on Nov. 7, 2009 does not meet the criteria of effective reform and exacerbates the problems of the present system. The House Bill would pass on Medicaid costs to states like South Dakota that would result in unsustainable cost increases. The Chamber supports reform that maintains quality of care, reduces cost of care, deals with unnecessary or fraudulent services and maintains the qualities of present system that are beneficial to the vast majority of Americans. The Chamber believes that reform should do no harm but should enhance the health and welfare of Americans.

   
As the leading Sioux Falls area business advocate, the Sioux Falls Area Chamber of Commerce represents its members by working to advance and promote the economic health and quality of life of the region. For more information about the Chamber and its programs, call 605.336.1620, email sfacc@siouxfalls.com or look online at www.siouxfalls.com.

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