Ted Simons: Tonight on "Horizon" we conclude our week-long series of interviews on health care reform. Joining us is Suzanne Taylor, senior vice-president of Public Policy for the Arizona Chamber of Commerce and Industry. Good to see you. Thanks for joining us.
Suzanne Taylor: Thank you Ted, pleasure to be here.
Ted Simons: Let's start again as we do -- as we've done all week, with the basics. Is health care reform necessary?
Suzanne Taylor: It is necessary. The Arizona chamber represents employers of all sizes and all industries. We represent the providers as well as the insurers and one thing they all agree on is that we do need to reform the current system.
Ted Simons: How urgent is the problem?
Suzanne Taylor: What we believe is that the problem could be best addressed in an incremental fashion. There are urgencies to it, but we're dealing with something that affects a sixth of the United States economy. So we'd like to see focus on those areas where we can see the greatest gains.
Ted Simons: I would guess that the chamber would like the idea of free market ideas being used as far as reform is concerned. The concept of free market delivery, free market payment, these sorts of things, is that how the chamber sees the reforms should move?
Suzanne Taylor: Well, that's correct. We would really like to see the focus of reform on how we bring down cost first of all. That's a huge issue for large employers, from a global competitiveness standpoint, smaller ones. We'd also like to see the issue of the uninsured as well as access to care addressed.
Ted Simons: So how would you like to see the free market more involved in that?
Suzanne Taylor: We do believe it's important to bring everyone into the system. Everyone should have insurance. And we think that can be accomplished through the free market. It may in fact be necessary to provide some sort of a sliding scale of subsidies to low-income people, or those that work for small employers, but rather than creating a new government plan, we think that could be accomplished through the free market.
Ted Simons: Critics will say the free market and private insurance is there now, but preexisting conditions and other things are keeping people -- whatever the numbers, 30, 40, 50 million whatever they are, folks from having insurance. How do you address that?
Suzanne Taylor: Well, we do not have a truly free market system right now. The industry is heavily regulated and we have a lot of people that are not in the system. We have a lot of healthy people that don't have insurance right now because they think they don't need it, and we do have a serious issue with preexisting conditions. It's interesting to note insurance industry has said they're willing to do away with that and provide coverage to anyone regardless of their conditions as long as everyone is in the system.
Ted Simons: I was going to say, way back at the beginning of the debate the idea of everyone has to have health insurance was floated out there. And the shots started being taken. What does the chamber think about that idea?
Suzanne Taylor: We believe everyone should have health insurance. It's tough -- it's a tough issue to deal with. Because you are saying -- you are putting a mandate on people, but we think there's a way to accomplish that with a variety of incentives, and a variety of ways to reduce the cost so it is more affordable.
Ted Simons: Back when the -- they first started, the idea was that if it's not mandated, it's never going to work. The dam will never hold if there are a few holes here and there.
Suzanne Taylor: Well, I think that's exactly right. Because if we do move down the path of what's called guaranteed issue, that means insurance company would have to provide coverage regardless of preexisting condition, and could not charge more for that, then we do need something that's going to bring those healthy people into the system, so they're not just purchasing it after they get sick.
Ted Simons: The public option plan. Against it?
Suzanne Taylor: We are. That is the area where we have the greatest concern. We do not believe that a government-run health plan is going to actually do anything to improve costs or access to care.
Ted Simons: Explain, please.
Suzanne Taylor: Well, there's a number of reasons for that. One is that the government plans that we have right now, meaning Medicare and Medicaid, which provide insurance to a large number of Americans, are actually underpaying providers significantly for the care that is rendered. And Arizona Medicare pays about 89% of costs, and Medicaid about 79. What happens is that incremental difference between what they pay and what actually costs has shifted to the private sector by way of increased premiums. It's over $1,000 a year for a family policy that we pay for that. If we move to a full government plan, we're going to see that really skyrocket, and at the end of the day that's going to mean a couple of things. Increased taxes, we'll have to pay for somehow, and probably some rationing of care. Neither of those are attractive solutions.
Ted Simons: Administration I believe says that the cost will wind up coming down for health care if the public option were included. You disagree?
Suzanne Taylor: I disagree with that. It doesn't actually address the issue of cost. It's an attempt to bring more people in. We think there are better ways to do that that would be more effective in lowering the costs.
Ted Simons: Vouchers, tax credits, these sorts of things. Can there be enough to get those tens of millions who don't have insurance right now and will never be in a position to get employer-based insurance, is there enough vouchers and tax credits to take care of those folks?
Suzanne Taylor: Possibly. It depends on how it's structured. We don't have a great model right now. That's why we're a little concerned about this complete overhaul all at once. There's some pilot projects in different states we'd like to give a little more time to take a look at, see how those work, but I do believe that there are ways to bring everyone into this system.
Ted Simons: What about the co-op idea?
Suzanne Taylor: The co-op is an intriguing idea as well. The jury is still out on how that would function. One of the concerns we have is that if a certain minimum set of benefits is required, we want to know how that's defined, because if that is a much richer set of benefits than what a lot of companies are offering now or individuals are choosing, than that would also increase the costs.
Ted Simons: The concept of employer-based insurance. Health insurance. How does the chamber look on not only where it is now, but the future?
Suzanne Taylor: The majority of large employers, about 97%, do offer health insurance to their employees as a benefit. It makes sense for them to do that. Healthy workers are productive workers. Smaller businesses generally are struggling to do that. So what's working well, we want to see capped and tacked and not dismantled, but we definitely need other options to make it more affordable for those small businesses to offer.
Ted Simons: What would an option be?
Suzanne Taylor: Again, in some cases it will have to be somewhat subsidized. There are simply folks that have serious preexisting conditions that aren't going to be able to opt in. That's one thing. But also, making more choice available so that the smaller companies can buy a policy that makes sense for them, rather than being told exactly what they have to buy, which may not be affordable.
Ted Simons: About 30 seconds left. Some critics say the profit motive needs to be erased from health care. Your thoughts?
Suzanne Taylor: Health care is an industry. We have for-profits and not-for-profits. So it's part of the system. I don't think it's the focus of the problem right now.
Ted Simons: All right. Very good to have you on. Thanks for joining us.
Suzanne Taylor: Thank you, Ted.