Nebraska insurers join push for health care changes Steve Jordon Omaha World-Herald, Neb. McClatchy-Tribune Regional News

Mar. 6--When Harry and Louise battled Hillary over health care in the 1990s, Mutual of Omaha had a lead role in stifling the Clinton administration's proposals.

Today the issue is back in the spotlight, Mutual is out of the private health insurance business, and the fictional Harry and Louise are absent.

But this time Nebraska's health insurers, as well as the state's medical community and other stakeholders, are joining the push for change.

They say the state can help speed the process if President Obama and others in Washington listen to their proposals, including:

--Requiring everyone to purchase private health insurance unless they have Medicare or Medicaid, with subsidies provided for lower-income people.

--Requiring employers to provide insurance or to pay fees.

--Requiring insurers to cover and provide reasonable rates to anyone who applies.

--Coordinating care and finding other ways to improve medical quality.

--Reducing costs and promoting efficiency through improved billing and record-keeping.

Steve Martin, chief executive of Blue Cross and Blue Shield of Nebraska, said Midwestern states like Nebraska could become laboratories for cutting costs, improving quality and making health care accessible to everyone.

"It's my hope that the Senate will bring a rationality to the process over the next year or two that will give us the best possible solution that common sense will allow," said Martin, who has emerged as a local business leader as well as head of the state's largest private health insurer.

He speaks regularly with the head of the Blue Cross network, who was one of more than 120 people at the health care forum in Washington Thursday.

The 38 Blue Cross affiliates agree that reform is essential, Martin said. He said a report by the Nebraska Medical Association could serve as a framework for successful reform.

Martin said that because problems aren't as serious in Nebraska as in some other states, business and government could tackle and solve them more quickly here, providing lessons that would help other states.

About 10 percent of Nebraskans are uninsured, half the rate of some other states. Costs are rising but still below average.

He also said the method of billing for medical services is too complex and encourages excessive pricing for new services.

Martin said Blue Cross encourages Nebraska's congressional delegation to support changes that would improve the health care system in the state and nationally, including those recommended by the Nebraska Medical Association.

A proposal containing many of the association's recommendations, Legislative Bill 656, is due for a hearing at the Nebraska Legislature later this month.

Nationally, Martin suggested a "hybrid" system with federal provisions but leeway for each state to manage its own plan.

Dr. Richard O'Brien, co-chairman of the state medical association's task force on health care reform, said the group's 2007 report is one of more than 30 state reports recommending reforms.

By now, he said, the possibilities are well-defined.

"The menu is there," said O'Brien, a professor at Creighton University and an internal medicine physician. "The various people and groups that are looking at health care reform are picking and choosing from the menu."

Passage of LB 656 would "push us way ahead" and serve as an example of a state making improvements, he said.

The association's proposals, reflected in the bill, include ideas from consumers, employers, hospitals, lawyers and other interested groups.

"I'm confident that the people in Washington are aware of what we have recommended," O'Brien said.

National reform would be somewhat different than changes on a state level, he said. For example, a national system might have a public insurer in addition to the private insurers recommended for Nebraska.

"There are only a small number of ways to change things for the better," O'Brien said. "Everybody who's looking at ways to reform health care is looking at the same things and essentially choosing among those various ways.

"It's hard to say what will happen. I'm fairly optimistic that we're going to see some action this year, or in this Congress. But then I was pretty optimistic when I saw what was introduced in 1993-94."

Martin said the goal is to find a way to provide affordable health coverage for all Americans.

"Everybody's got to give up something to do that."

--Contact the writer: 444-1080, steve.jordon@owh.com
(c) 2009, Omaha World-Herald, Neb. Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA. Mar. 6--When Harry and Louise battled Hillary over health care in the 1990s, Mutual of Omaha had a lead role in stifling the Clinton administration's proposals.