Health System Reform Bill of Rights
Contain costs, strengthen the Utah economy, improve lives
As business leaders, we support the creation of a health reform strategic plan for the state of Utah that will apply the principles of the private market to contain costs, strengthen the Utah economy, and improve lives. We believe that, even though Utah’s health care system is among the most efficient in the nation, we can do much better. We applaud the Utah Legislature and the Governor for making health reform a top state priority and pledge our full support for the process. We believe that Utah’s strategic plan must expand accountability at all levels of the health system—patients, providers, purchasers, payers and political leaders. By so doing, every Utahn will take more personal responsibility for their health and we can realign the system to be more consumer-driven. To this end, we present this Business Bill of Rights and Responsibilities to assert our rights and responsibilities as individuals, businesses and as payers who provide health insurance to 1.8 million Utahns, 79 percent of Utah’s insured population. We commit our best thinking, efforts and selves to build upon our current strengths, transform our weaknesses and dramatically improve our health system.
We envision a health care system that will sustain a vibrant economy and enable people to live healthier, more productive lives. In such a system, every Utahn will have access to affordable, basic health insurance and care that is paid for with pre-tax dollars, chosen by the employee, portable from job to job, guaranteed issue, rated based on a broad-based risk pool and structured to incorporate cost controlling features. Health care consumers will have access to complete information that will allow them to make prudent decisions about their care and employers can make defined contributions to the health care of their employees. In such a system, we will increase accountability, eliminate waste, transform incentives, extend compassion and, most importantly, improve people’s lives.
Rights and Responsibilities
Utah businesses assert these rights and responsibilities:
- Outdated System: Employers have the right to be relieved of an outdated and flawed employer-based health payment system that limits employee choice, facilitates counterproductive health underwriting and hinders entrepreneurial activity and small business formation. Individuals, not employers, should be at the center of health care coverage and payment decisions.
- Workable transition: As we convert to a system where individuals, not employers or government, are the primary decision makers about their health care coverage, employers with health plans have a responsibility to continue to provide essential coverage until a more accountable, equitable and rational system is in place.
- Lifestyle choices: Individual responsibility is a foundational principle of health reform. Individuals who choose healthy lifestyles should benefit from their choices and not bear the financial burden of those who make unwise choices. Some of these choices may include smoking, substance abuse, lack of exercise and overeating. We acknowledge that defining limits surrounding lifestyle choices is difficult but we also believe that personal responsibility for one’s health is at the foundation of health system reform.
- Immediate and bold action: We have the right to demand that our elected officials take immediate and bold action to facilitate reform, including the creation of a regulatory environment that allows market forces to properly align incentives and eliminate waste.
- Portability: As individuals and employers, we have the right to expect that basic health insurance will be portable from job to job. This will facilitate efficient decisions by individuals as to where to work. This can also save administrative costs, improve health security and help eliminate employment distortions within the job market.
- Cost shifting: Individuals and businesses that pay for health insurance have the right to know how their money is being used to pay for uncompensated care and for government programs that do not pay their full cost. This “hidden tax” must be transparent to allow for the most efficient use of resources.
- Best practices: Medical providers who utilize best practices should be protected from unreasonable jury awards that limit access to health care or force doctors to practice defensive medicine. Providers should also have convenient access to electronic medical records that will improve care.
- Pre-tax dollars: Government and employers have the responsibility to ensure that health care benefits are paid for with pre-tax dollars. Too many employees pay much more than they should, or forego insurance altogether because employers do not provide this benefit.
- Transparency: Individuals and businesses have the right to know the cost of care prior to procedures being performed (with the exception of emergency care) and the quality of care, including the success rates of individual practitioners and facilities. The sources of funding, information about the full range of insurance products and potential conflicts of interest (self-referral) should also be disclosed. This information must be standardized, easy to understand and readily accessible. Transparency of information also includes appropriate disclosure from insurance carriers and brokers about coverage, denial rates, fees/commissions and other information that will support a vibrant health care market. Without this information, employers and health care consumers cannot make rational choices.
- Defined contribution: We affirm the right to adopt a defined contribution approach to health benefits, rather than a defined benefit. The former provides an incentive for prudent utilization; the latter encourages over-utilization.
- Choice: Individuals should have the right to choose among a wide range of competitively offered health plans. Individuals, not employers, should choose their health plans. Individuals desiring to pay cash or self-insure for a portion of procedures should be allowed to pay the same rates as if an insurance company paid for the procedure.
- Essential benefit package: We have the right to ask our government to work with the private sector to define an essential benefit package that will cover preventive, primary and emergency care. Although defining a basic benefit is complicated and difficult, it is an important step in achieving health care coverage for all Utah residents, encouraging individuals to be wise consumers of health care and allowing competition to control costs.
- Assisting those with the greatest needs: Employers have a responsibility to the broader community to work with public officials to assist those in need.
We believe that escalating health care costs are among the greatest threats to Utah and our nation’s long-term economic wellbeing and neither our state nor federal government is acting with sufficient urgency. We commit to these aspirations and will partner with all like-minded people to make progress that will contain costs, strengthen the economy and improve lives.
President and CEO, Salt Lake Chamber
Chair, Salt Lake Chamber Board of Governors
Scott L. Hymas
Chair, Salt Lake Chamber Health System Reform Task Force
Thomas E. Bingham
President, Utah Manufacturers Association
James V. Olsen
President, Utah Food Industry Association
National Federation of Independent Business, Utah State Director
Neil Smith Wilkinson
Chairman of the Board, Utah Restaurant Association