Healthcare bill of rights stalled in Congress


Huge liability repercussions loom for small businesses; issue will resurface

Washington-Employer groups contend that a human healthcare "billof rights" may be very costly to small business owners, including veterinarians.

But by all accounts, a "healthcare bill of rights" won't makeit through this session of Congress, but it will likely resurface. And theemployer liability cap could likely bankrupt most veterinary practices.

Paul Dennett, vice president of health policy for the American BenefitsCouncil, a group that represents Fortune 500 companies, tells DVM Newsmagazine,that even though S. 1052 passed the Senate and a version passed the Houseof Representatives there is currently a logjam on the language of the twobills, which have to be consolidated into one before the full House andSenate vote on it.

Dr. Dean Goldner, assistant director for AVMA's Governmental RelationsDivision, says there's no need to panic just yet. He says the legislationhas a long way to go to before it becomes law, but it's an issue AVMA iskeeping an eye on. AVMA has not actively lobbied for or against this legislation.

Just dormant

Make no mistake the legislation is certainly not dead, officials say,just dormant.

Look for a comeback after the November elections.

If passed, S. 1052 would allow people to sue health plans and employersin state courts for damages over disputes involving medically reviewableclaims and sets no limits at all on the amounts of state court awards. TheHouse bill has set a limit of $1.5 million, which still would likely bankruptmany veterinary practices. President Bush reportedly favors the milder Houseversion of the legislation.

Dennett says both bills call for additional employer liability, one isjust worse than the other.

The impact? The increased liability would likely cause small businessesto forego employee healthcare coverage altogether, Dennett says.

"For smaller businesses it would increase the regulatory burdens.I'm sure it will very likely result in smaller companies dropping healthcarecoverage altogether, because they are already experiencing healthcare costsincreasing 20-25 percent annually."

He says, "The impact on small businesses tends to be much more absolute.You get to the breaking point much more quickly. Fundamentally, it resultsin an issue of whether they can afford to provide health benefits to employeesanymore."

No employer organizations "are actively encouraging that these billsare passed into law," he adds.

According to Dr. Marsha Heinke with OEM Inc., an accounting firm basedin North Olmsted, Ohio, the rising costs of human healthcare insurance premiumsand the uncertainty in Washington regarding a healthcare bill of rightswould make it tough on veterinarians to remain competitive.

When you factor in wage inflation due to the competitive job market,rising pharmaceutical costs and evolving standard of care and technology-allhave increased the costs of providing veterinary care.

"Now you are looking at the costs in terms of wages, salaries andbenefit programs as well. Small businesses have always struggled in balancingwhat it offers to keep an employee base that satisfies client need."

Heinke adds that veterinary practices have been fortunate that peoplehave wanted to work in veterinary hospitals because of their love of animalsand willingness to work for less because of the contribution to helpingcare for animals.

So, the question begs: how do you maintain competition with other smallbusinesses in the community and with other veterinary practices when youare faced with these escalating costs?

Heinke says there are no easy answers.

"The tendency has been to beef up the wage structure as much aspossible to keep people, and, unfortunately, that takes away from benefitprograms," she explains.

If veterinary practice owners are subjected to additional liabilitiesin offering this coverage, it makes it even tougher.

Industry estimates have been that about one-third of veterinary practicesdon't provide healthcare coverage to rank and file employees. Heinke addsthat in recent years more and more practices seem to be adding some kindof healthcare coverage for employees.

Another issue

While veterinarians are using many different plans for employees, thecost structure is also an issue.

Typically, practices are paying between 50-80 percent of coverage, butsome practices are even picking up 100 percent of healthcare coverage.

Heinke adds, "Now you have the patients bill of rights, and if youaren't providing for employees now, should you do it? Based on this pendinglegislation, it's almost scary to add health insurance coverage to the mix.It certainly looks like what Congress may have intended from the start hasturned into a monster. And if this thing gets through, it is going to havea horrible, horrible impact on small businesses because of the risks ofliability if an insurance provider disallows a claim made by an employee."

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