Consumers, doctors need insurance relief

As health-care costs have raced far ahead of inflation over the last decade, broad access to quality care has become a predominant issue across the country, nowhere more so than in Pennsylvania.

Here, the state government has reacted in several ways but, incredibly, has yet to bring health care insurers and medical malpractice insurers into the equation.

The government — state taxpayers — has assumed $220 million in annual premium payments into the state-run catastrophic loss fund for doctors in the highest-risk specialties. After this year, that bill will have exceeded $1 billion.

It has failed to enact true rate regulation and to force the insurance industry to spread the risks and costs of malpractice coverage.

Meanwhile, the state and federal governments have stood by while physicians are squeezed on the other side of the ledger — revenue.

Now, a national survey of physician fees, reported in Physicians Practice magazine, details declining reimbursements by private and public insurers. According to the survey, payment levels in 2006 were 17 percent lower than in 2002 and 36 percent lower than in 2004.

At at time when governments should be advocating broader competition within the health insurance industry, the opposite is happening to the direct and indirect detriment of physicians and consumers.

Meanwhile, even as Gov. Ed Rendell promotes a massive state program to ensure coverage of all Pennsylvanians, the administration and the attorney general are twiddling their thumbs as the state’s two largest health insurers — Highmark, of Pittsburgh; and Independence Blue Cross, of Philadelphia, move toward a merger. Consolidating the state’s two largest markets is likely to make the reimbursement situation only worse, without promising any rate relief to consumers.

Pennsylvania’s government cannot expect to improve the health of the health-care system if it allows unfettered insurance industry consolidation to continue to squeeze physicians and other providers. It should move aggressively to stop the Highmark-Independence merger, and to legislate and regulate in favor of enhanced, rather than restricted competition for all aspects of health-care-related insurance.
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