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Democrat health plan could work, group rejects public option health insurance choice

Once the best of five major bills emerge, a leading business group said Thursday that Democratic health care reform can work.

And President Barack Obama was quick to embrace the report, urging the U.S. Senate to conclude its work.

The Business Roundtable, comprised of America's leading CEOs, said in a report that key components of health care reform could slow the growth of health care costs and offer real savings for companies and their employees.

"Health Care Reform: Creating a Sustainable Marketplace," states that effective reforms now moving through Congress can slow health care costs by as much as $3,000 per employee in 2019.

The report "underscores what experts and businesspeople have told us all along -- comprehensive health insurance reform is one of the most important investments we can make in American competitiveness," said a statement from the White House. "It finds, for example, that if reform passes this year, businesses could see health care costs reduced by as much as $3,000 per employee in 2019. And that means more than savings for businesses: it will be vital boost to American competitiveness."

The Business Roundtable also noted that things could still go wrong, such as adding a public option health insurance choice.

"The report also shows that reform done wrong won't work and could make a bad situation much worse, in which case Business Roundtable could not support the bill," said Antonio Perez, chairman of the Business Roundtable's Consumer Health and Retirement Initiative. "Making the right choices as the final health care bill gets crafted is essential, and we are committed to working with Congress and the administration toward a bill we can support."

Problems could come from delayed or watered-down cost-saving efforts, failure to implement a strong individual mandate for health insurance, increases in the cost of health care to individuals from changes to consumer spending accounts or cost-shifting to the private sector from reductions in federal reimbursements to providers and from a public option.

The U.S. Senate's version should make those corrections, Christina Romer, chairwoman of Obama's Council of Economic Advisers, told reporters in a conference call Thursday.

"They point out as risks things we're actually dealing with," Romer said. Public option "could be a problem if they use Medicare rates in the public option. Well, that's not what either the House legislation or the Senate Finance Committee legislation."

Obama "has said he wants any public option to stand on its own two feet to be on a level playing field," Romer said. "That is a concern that has very much been addressed."

Other differences arising in the Senate should create a better overall bill, Romer said when asked about the 39 Democrats who voted against the House health care reform bill last weekend. One was House Agriculture Committee Chairman Collin Peterson, DFL-7th District.

"We need health care reform and we need to control and reduce costs," Peterson says. The House bill fell short of those objectives, he said.

"Everybody's been thinking about cost containment and how we slow the growth rate of costs," Romer said, referring to the three House bills and two Senate bills addressing health care reform. Payment reforms and bundling of care should emerge in a final bill.

"The difference, though, is that the Senate does have two things that the president has emphasized," Romer said. One is the provision of an independent Medicare advisory council to determine best practices that can slow the growth rate of costs and in finding waste.

The other, she said, is a Senate Finance Committee provision which places an excise tax on high-priced health plans.

"I feel confident that as we go through the Senate, as we go to conference, we will end up with a bill that does genuinely does slow the growth of costs as it brings all these good ideas into one bill," Romer said.

The provision of an excise tax should also promote consumer choice in the marketplace, she said. "Part of the idea why that's going to work is because it does empower consumers. It empowers each of us who have employer-sponsored plans to call our HR office and say would you negotiate harder, is this the most efficient plan out there, because I don't want my plan paying an excise tax."

The Business Roundtable report cites as reforms that would help curb costs as:

- Delivery system reforms, such as value-based purchasing.

- Innovation centers that identify alternative methods of provider reimbursement.

- Doctor-led accountable care organizations that realign financial incentives to improve the quality and the value of the care delivered.

- Financial penalties for failing to avoid preventable hospital re-admissions.

- Increased individual accountability for health care spending decisions, including health reimbursement arrangements and health savings accounts.

- Cost and quality of care data that is easier for patients and providers to access and use.

- Elimination of sharp regional variations in practice patterns.

- Promote wellness and prevention programs and expand financial incentives to participate in specific programs to reduce lifestyle related illness.

- Insurance market reforms that promote competition and choice.