As the national healthcare reform debate rages, insurance industry professionals are contemplating their role in the changing landscape of health insurance. At the Bacara Resort & Spa, on September 22, about 30 insurance company representatives, human resource professionals, health insurance brokers, and healthcare advisors met for the 2009 Tri-County Health Summit, tackling the difficult question of how to get spiraling healthcare costs under control.

“It seems like health insurance is pushing more cost to the employee, but there’s only so much the employee can bear,” said Debbie Horne, the human resources director for CenCal Health, which administers MediCal for the state. One option they discussed was raising employee deductibles but also offering supplemental insurance policies, called gap insurance. This was posited as a way to keep employees covered and at the same time reduce employers’ health insurance costs-which currently account for 30 to 40 percent of many payroll budgets.

Many of the insurance providers at the meeting questioned the role of the public insurance option that President Barack Obama and many Democratic congressmembers have touted as a viable way to provide healthy competition to private insurance companies. “There’s a propensity to have the same concerns and pitfalls as exist in Medicare,” said Jim McCabe, vice president of business development for Neovia Integrated Insurance Services. “I think there’s an opportunity to better align the business model with the healthcare model.”

Although McCabe asserted that a public healthcare option, based upon Medicare’s track record, is likely to be inefficient, he acknowledged a need for serious change within the private insurance industry as well. Traditional healthcare spending is focused on critical conditions and their expensive treatments, he said, but overall wellness and encouragement of healthy lifestyle choices should be the goals for the healthcare industry to reach for.

In its current state, HR 3200-America’s Affordable Health Choices Act, the controversial federal legislation now wending its way through Congressional debate-was viewed skeptically by several conference participants, but McCabe expressed excitement over the prospect of having so many more people to work with if everyone is required by law to have some form of health insurance. “30 million people will need help navigating the system. That’s awesome for us,” he said.


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