With health-care premiums rising at a rate faster than the rate of inflation and wages, health-care costs have been among the top concerns for members of the Pennsylvania Chamber of Business and Industry for the past several years.

The PA Chamber supports the administration’s efforts to increase access to health-care coverage, improve the quality of medical care and better control the cost of services. These goals are consistent with the PA Chamber’s member-driven health-care policy, which supports a health-care system in the Commonwealth that provides necessary, appropriate, accessible and effective health care to employers and employees at a reasonable cost.

While it is too early to assess the complete impact of the governor’s proposal on business, the PA Chamber has developed recommendations it is taking directly to elected officials as the debate progresses.

The Rendell Administration’s approach to increasing access to coverage involves both the public and private sectors. On behalf of purchasers and consumers of health care, the PA Chamber believes such a proposal should focus on a private health-care delivery system as a means to provide all Pennsylvanians with access to cost-effective, quality health care. As in any business, competition among health insurance companies and health-care providers impacts the cost of health-care premiums. With real competition, employers and employees should have a greater choice of health plans, enabling them to select an appropriate health plan and provider that provide the level of coverage needed at an affordable price.

Any health-care reform plan should empower people to make informed health-care decisions through the use of Health Savings Accounts in combination with high deductible plans. Policies mandated by or offered by the government should be HSA-type policies, with high deductibles, co-insurance, and incentives for wellness and health lifestyles, and premiums should include an extra amount for investment in individual HSA accounts in order to maximize these effects.

Government insurance subsidies for low-income individuals and families should come from general tax revenues and not from businesses in the form of a payroll tax. A payroll tax simply raises the cost of each employee to the business and gives it added incentive to reduce its workforce or otherwise compensate to the detriment of workers. There is no guarantee this tax would remain at the 3 percent rate proposed by the governor, especially if the drivers of health-care costs are not adequately addressed.

Relative to costs, the business community is also interested in knowing how the Rendell administration will address declining revenue sources (i.e. Tobacco Settlement Fund), knowing that its plan relies heavily on built-in revenue assumptions that may or may not materialize. Proposed cost reductions should be implemented and proven effective before a new government insurance entitlement program is adopted, as their effectiveness is critical to the new program’s financial viability and success.

Along those same lines, more emphasis needs to be placed on addressing the drivers of health-care costs. The governor’s focus on hospital infections is a good start, as reducing medical errors/hospital infections is a way to improve both the quality and cost of health care. But noticeably absent from the plan is talk of reforming our costly legal system or limiting mandated health insurance benefits only to those in which the benefit outweighs the costs.

As one business owner recently related:

“No matter what the plan, if costs continue to rise at the rate they are, NO ONE will be able to afford it, personally or for their employees.”

Recognizing that Pennsylvania faces a health-care crisis was easy. Now lawmakers face the challenging task of developing effective solutions to a complex problem. Key to the success of this effort will be the ability to resist the urge to enact quick fixes that solve immediate concerns, but rather work to develop effective long-term solutions so we don’t find ourselves faced with many of the same problems a few years down the road. The PA Chamber welcomes the opportunity to work with the Rendell administration on those aspects of the proposal that address quality and patient safety activities, greater access to information, promotion of medical innovation, improving state licensing programs, and greater use of health information technologies, many of which are core components of the chamber’s health-care agenda.