Health care reform continues to dominate both political and social debate. Hewitt's Global Health Management Leader, Ken Sperling, recently wrote a point of view paper on health care reform that focuses on the merits of the "public plan" option and "all-payer" system.

A public plan would be a government-run health plan similar to Medicare. It would not turn a profit, would enjoy large-scale purchasing efficiencies, could offer standardized, easy-to-understand benefits, and be regulated by the government. But while this prospect looks appealing, Ken points out that a public plan option could ultimately force employers to discontinue providing health care benefits.

Instead he recommends that the Federal government put an end to cost shifting once and for all by setting a single set of rates that everyone pays — Medicaid, Medicare, and private insurance companies. This "all-payer" system would encourage healthy competition by creating a true level playing field for both public and private plans.

An "all-payer" system has the potential to:

• End the Cost Shifting Game. An all-payer system would establish a single set of rates that everyone pays. It would encourage competition by creating a level playing field for both public and private plans.
• Heal the Entire Health Care System. This system could help fix the troubled health care system by ending provider networks, and eliminating locally derived fee schedules.
• Encourage Innovation. An all-payer system would enable new companies to enter the health insurance space encouraging innovation and efficiency. In this model, health plans would compete on customer service, accuracy of claims payments, and their ability to improve the health of their members.

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