My Quick Response to this Morning’s News

My quick response to this morning’s news. I intend to write our House and Senate leaders again.

The House went first and it passed. Now it’s the Senate’s turn. We may have health reform legislation yet this year. Based upon my understanding, this new Federal Legislation would trump State Legislation and bring new “reform” to prior health “reform” initiated at the State level. As such, higher costs are on the way.


Currently in Ohio, groups with 2 to 50 employees already cannot be denied coverage. Pre-existing conditions are covered immediately if individuals can show proof of prior coverage. Groups are rated based upon medical history and rated up with a guaranteed maximum cost. Many groups are not rated up because they are blessed with healthy employees or they have worked to improve the risk of their employees via wellness programs and incentives.

Groups over 100 are rated based upon their claims experience. Is this medical history? In the words of Sarah Palin – “You bet’cha!”

Without medical underwriting to give credit for small groups’ “good health,” pricing will rise dramatically for companies in states that have health reform already. If insurance companies can only use age demographics to renew large groups, costs will rise for companies that have been active with wellness and other risk management programs.

What rewards will accrue to owners and individuals for their personal contribution for keeping costs low? Few rewards for risk management; fewer still for personal responsibility. Will companies see a need to offer wellness programs in the future? Will employees be encouraged to eat right, eat less, and exercise more?

I am fearful that government, rather than market forces, will bring costs up for all; and medical rationing will be the only tool left to reduce costs. Less for more -- was this the goal?


- Mark Alder, President, Herbruck Alder - malder@herbruckalder.com - http://www.herbruckalder.com/