Health Care Reform

NABE members were asked to consider the effectiveness of current health-care reform proposals in meeting their objectives. When asked to assess whether those proposals’ combined effects on the cost, quality, and access to care would improve our current health-care system, only 46 percent of survey respondents thought it would. The Survey Panel was then asked a series of questions on each element of reform separately.

Nearly two-thirds of our panel (65 percent) think that health insurance reform meant to expand access to high-quality care at an affordable cost would not meet this objective. As far as the impact of health insurance reform on the cost and quality of care is concerned, 44 percent expect a decrease in quality and an increase in cost. Only 19 percent think that such reform will increase quality and lower cost.

When asked which particular reform proposals would offer the best chance of improving health care quality at an acceptable cost, the highest-ranked option was the creation of insurance exchanges where small businesses, selfemployed, and unemployed persons can purchase coverage. Moreover, eighty percent of respondents think that a combination of such reforms would generate a superior outcome to any single option. Importantly, despite respondents’ pessimism about the prospects of current proposals to improve the system, the lowest-ranked option to improve quality at an acceptable cost was to not implement any reform at all.

The survey also asked respondents which reforms they thought would most effectively reduce the cost of health care without compromising its quality. The most popular choice was to limit patent protection of prescription drugs in order to reduce their cost, followed by basing reimbursement to providers on a per-patient basis rather than maintaining the current fee-forservice model. The lowest-ranked choice was the imposition of a tax on high-cost (“Cadillac”) insurance plans.

When asked about the likely impact of the current proposals on the long-term cost growth of health care, 44 percent of survey respondents expect a somewhat or significant reduction of costs, while 40 percent expect costs to increase.

While slightly more than half of respondents are not optimistic about the current proposals’ prospects for achieving their objectives, the vast majority of them are concerned about US business competitiveness due to health-care costs. Seventy-nine percent of survey participants think that rising health-care costs have a somewhat or significant adverse impact on the ability of US businesses to compete.

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