April 7, 2017
By Silver Krieger
New York, NY – On Thursday, April 4th, LaborPress and AM970 The Answer partnered on a Labor Appreciation Day special event, presenting panels on vital labor topics ranging from worker safety to education to the politics of labor.
“Health Care – What’s on the Horizon,” featured panelists Karen Ignagni, President and CEO of Emblem Health, Tom Canty, Vice President and General Manager for Labor, Government, and Special Accounts at Empire BlueCross BlueShield, Phil Barbaro, Vice President, Public and Labor Sector and Health Plan Partnerships at One Medical Group, Sharon Zelkind, Chief Executive Officer and President at Healthplex, Inc., and Suzanne Taranto, Principal and Consulting Actuary at Milliman. The panel was moderated by Frank Morano of AM970 The Answer, as the scheduled moderator, Lou Tobacco, was delayed.
The panel began with a discussion about the Affordable Care Act and its standout issues, since it remains in place due to the failure of the Trump Administration’s efforts to “repeal and replace.” Canty said that the ACA was very important. “My company had a commitment under Obama. Now there are some states without a lot of choices. That should be addressed by legislation.” Zelkin said, “The ACA has good and bad. For the first time, we had a mandate for pediatric dentistry, which focuses much on preventive care. But I ask, why do we have this only for children? Why is there no mandate for adults? More needs to be done; we need to expand.” Barbaro said that the base reality is that “the system is buckling,” and that “the underlying cost of health care is the reason.” Taranto concurred, and said that “bills are inflated,” and that “a true understanding of the cost of the care law is not solved in the ACA.” Ignagni, referring to the current Administration’s failure, said, “It’s easy to run against something, but how do they replace what they’ve been running against? Can we tweak what we have now, to address costs and preserve access? Families not sponsored by unions are worried if they will have access in the future. Medicaid costs worry Cuomo.”
Morano then asked the panel about the value of Health Care Savings Accounts, or HSA’s. A HAS is a tax-advantaged medical savings account that is available to taxpayers in the U.S. who are enrolled in a high-deductible health plan (HDHP). The funds contributed to an account are not subject to federal income tax at the time of deposit. Ignagni said, “HSA’s are positive if you can put money in the account, and save for a rainy day. The down side is, of course, if you don’t have the money in the first place to put in the account.” Barbaro said, “We need to move toward creating a more consumer-friendly environment; there is not enough information available for consumers [to make an informed decision about these types of choices].” Zelkind said, “HSA’s are not the answer for everybody, only for some, so we need to advocate for different vehicles.” Canty said, “HSA’s can’t be used as subsidies and as Medicaid, if you can’t fund an account.”
Morano also asked the panel about the unique challenges of providing health care in New York as opposed to other states. Canty said, “There has been a trend toward hospital consolidation, that has had an effect on the industry. In New York, there used to be about 40, now there are only 5 hospital systems in New York.” Zelkind spoke of the differences of health care – specifically, dental care – availability in upstate versus downstate New York. She said that, “downstate, there is an abundance of dental care providers,” which is not true further north. Barbaro said that the consolidation of the primary care marketplace has led to a shortage of primary care doctors, and that the primary care doctors are used primarily to refer patients to a lot of unnecessary specialists, which leads to great costs. “Primary care doctors should be more independent,” he said.
Morano then brought up the continuing conflict between doctors and insurance companies. Taranto said, “The influx of managed care and care management started the practice of telling doctors what to do.” This was driven, she said, by the effort to control costs. Ignagni said, “A health plan should be a partnership between companies and physicians. [At my company] we have a strong collaboration with our physician partners.” Canty said that there was a “natural” adversarial relationship between companies and doctors.
Finally, Morano asked if there was one thing health care customers need to know that they don’t. Barbaro said, “This shouldn’t be an ideological argument. It’s important to get the best value for every dollar spent.” Zelkind said, “You need to be an educated consumer to understand your plan and benefits.” Taranto said, “The unions of New York City and membership can change the way healthcare is delivered by becoming powerful consumers, by coming together for change.” Ignagni said, “Know your numbers – for example, your cholesterol, and your blood pressure, and where they need to be. We have to start with ourselves.” Canty said, “There are only so many dollars to go around. We are trying to get the best band for your buck. There is a limited amount of capital. We all have to work together.”