February - April 2010 National Discussion Topic (all chapters are required to reply here)
How will health care reform affect the veterinary industry?
As small business owners, veterinarians have a vested interest in the state of the healthcare system. Because of their higher health care costs, small businesses are far less likely to provide health insurance for their workers than larger businesses and the fraction of small businesses who offer health insurance has been declining in recent years.
Some goals of the current health care reform legislation:
• Small businesses that meet certain criteria would be able to purchase health insurance through an "insurance exchange" – allowing them to choose among a multitude of plans that would provide better coverage at lower costs than they could find in the current small group market.
• The creation of an insurance exchange would also provide better and lower-cost options for workers in small businesses that do not offer health insurance. Low-income individuals and families would receive sliding scale subsidies to help them purchase insurance. Additionally, health insurers would not be allowed to screen potential enrollees for pre-existing conditions.
• Many small businesses that provide health insurance for their employees would receive a small business tax credit to alleviate their disproportionately higher costs and encourage coverage.
• The current reform options include financial incentives for medium- and large-sized firms to provide health insurance coverage through so-called "pay-or-play" provisions. Firms with payrolls or employment levels below a certain threshold, which would include the vast majority of small businesses, would be exempt from the pay-or-play provisions. (From the Council of Economic Advisors)
How do you think health care reform will affect your business? Comment on any of these points, or make your own points. As future vets, it is crucial that we understand how government activity will affect our industry and this legislation in particular, will have a huge impact on veterinary medicine. Let us know how you feel!
Be cautious
While I agree that premiums are becoming too costly for the average worker I'm not sure if I want the government paying for it. My main concern is where the government is going to get the money to run the health care system. New government programs usually equal new taxes which could have a detrimental effect on private practice veterinarians. If you are looking at owning a multi-doctor private practice or even a smaller practice you could very well be in the upper bracket for taxes which is usually the bracket that gets hit the most with tax increases. Health care for all sounds great right now when we’re not the ones paying the taxes but we all need to think ten or fifteen years down the road and think about the impact on our bank accounts then.
Morgan Watkins
Treasurer
Auburn CVM VBMA
Optimistic
While the bill that was eventually proposed isn't the way I would have preferred it to pan out, I am modestly optimistic that it will help to provide a better situation for practice owners.
I think the trend without reform is for most practices to offer limited health insurance because the doctors can be insured by the GHLIT. Techs would generally have to buy into the individual market. I think the premiums in many states are just getting too high for the practices to cover a few employees. As practice size grows, though, it gets less expensive.
Looking at the provisions in the new bill, it seems intended to widen the risk pool in the individual market. This will be a good thing for the employees of veterinary practices because they will find better, cheaper plans. The bill is intended to lower prices for workers who make less than $44,000 per year, which includes most techs. If the practices can get a tax break by buying the plans for the employees, it looks like a no-brainer.
I do worry with any sweeping overhaul of regulations that there will be loopholes in it that can have unintended consequences. It will be interesting to see how this pans out.
To be honest, I wish that we had just gotten rid of the employer-based system altogether.
John Duncan
UGA VBMA President
Class of 2012
Wow. I really didn't expect
Wow. I really didn't expect this forum to step into such a "hot" topic.
I know that the current proposed health care reform will affect veterinarians across the nation. Many people believe that the reform is much needed, some stand firmly against it. My position is almost to sit on the fence between the two sides. (Which I guess is the politically correct term for being undecided on my opinion) =)
If the government is going to regulate the price gouging that is currently happening through an insurance exchange, that would be wonderful. But on the other hand, why is the government having to regulate this? And if the government chooses to regulate one area of commerce, why not another as well (and then where does the slippery slope stop)? How would the government decide what is a "fair" price for insurance? Would the government then have a hand in deciding what a "fair" treatment is? Would the insurance companies have any adjustment into what claims they pay or do not pay?
My father is a human physician. This summer I had the opportunity to work with him for a month and learn a little more about insurance companies. It amazed me exactly how little he was paid for his services. The insurance companies decide what is a fair price for his time, knowledge and abilities. They also decided what tests he should be performing on his patients, how much time he should spend with his patients and basically what he could or could not do. Now granted, these steps were probably originally put in place to safe guard the patients, but they have become a road block to the doctors. For these reasons, I worry not about the Americans that are without health insurance, but for medicine as a whole. And for these reasons, I do not think that the current health care reform is what American needs. It might make it cheaper for small business owners, such as myself in 5 years, to provide insurance for my employees. But in the long run, does it help elevate a problem? Or just provide a bigger one? Sometimes I find that the "cheaper/short term" solution is not the best one.
I am sorry if my rant/soapbox went in a slightly different direction that it was intended.
Ashley Craig
Tuskegee University School of Veterinary Medicine
2012 DVM Candidate
VBMA President
AAEP Vice President
Health Care Reform and the Veterinary Industry
Here are some thoughts on the proposed legislation...
• Small businesses that meet certain criteria would be able to purchase health insurance through an "insurance exchange" – allowing them to choose among a multitude of plans that would provide better coverage at lower costs than they could find in the current small group market.
• The creation of an insurance exchange would also provide better and lower-cost options for workers in small businesses that do not offer health insurance. Low-income individuals and families would receive sliding scale subsidies to help them purchase insurance. Additionally, health insurers would not be allowed to screen potential enrollees for pre-existing conditions.
I feel that as long as our profession continues to pay paraprofessionals such a low wage, these first two options would be beneficial to veterinary staff members and potentially allow veterinarians to retain valued employees who would otherwise leave the industry for jobs offering better benefits. I am not sure that I agree with the stipulation of not screening for pre-existing conditions as this may lead to an abuse of the health care system and increased costs to all in the long run (insurance companies having to pay out more and therefore having to charge the customers more to make up the difference).
• Many small businesses that provide health insurance for their employees would receive a small business tax credit to alleviate their disproportionately higher costs and encourage coverage.
Again, I feel like this would encourage veterinarians that do not currently offer health insurance to begin offering plans for staff members and improve employee retention.
While these changes all sound positive for small businesses, I am opposed to the proposed changes on a personal level. I do not feel that a panel of doctors in Washington should be able to decide what kind of medical treatment I receive based on "standard procedures". I would prefer that my doctor, who knows me and is familiar with my case history and went to medical school to be able to diagnose and treat patients, be the one who decides what kind of medical treatment I receive.
Jennifer Darby
KSU CVM c/o 2012
KSU VBMA President
KSU CVM Canine Club Secretary