Bill sheds light on association health plans

If a provision in the patients' bill of rights moves forward, legislativelanguage could ease efforts of national associations like the AVMA in offeringcomprehensive health coverage for members' staff.

By all accounts, the bill is far from approved and awaits lawmakers'endorsement. And while American Veterinary Medical Association (AVMA) leadersrealize the profession's need for economical group rates - often reducinghealth insurance costs by up to 30 percent - their efforts are in preliminarystages, too, says Dr. Janet Donlin, AVMA associate executive vice president.

"This is a real high priority for us," she says. "Veterinarystaff are becoming such key members to the practice, we want to be ableto provide coverage for them."

Politics create obstacles

The problem, Donlin says, has a lot to do with red tape as each stateemploys an insurance commission to accept, reject and oversee insuranceoperations, often making national programs unwieldy to operate.

The provision, which passed in the House of Representatives but has nocompanion in the Senate, calls for the acceptance of association healthcareplans (AHP) by all states should one state give the go-ahead.

"It looks like this bill could be the answer to our prayers in thisrespect," Donlin says. "This way, our plan wouldn't have to meetthe standards of 50 different states and Puerto Rico. It would automaticallybe accepted in all the states."

Don't get your hopes up

Dr. Ann Clark, a representative with AVMA's Group Health and Life InsuranceTrust, is not as optimistic. She says officials with the Trust, the proposedinsurance backer, have been exploring ways to implement an AHP for years.

"We're looking at the market, cost, availability and a lot of otherfactors that would go into this," Clark says. "The last thingI want to do is get anyone's hopes up. This, if it even comes about, isgoing to be a very slow process."

Searching for direction

But veterinarians like Dr. Mike Riegger, owner of the Northwest AnimalClinic, Hospital and Specialty Practice in Albuquerque, New Mexico, aredesperate for change.

"Lots of veterinarians are having trouble with this," Rieggersays. "Insurance is so expensive for the small businessperson thata lot of veterinarians can't afford to offer it. That's tough because talentedemployees want health insurance coverage and if they don't get it at theclinic, they'll move on."

Riegger has carried employee insurance since opening his practice inthe 1970s. Back then, AVMA offered group coverage, but due to rising costsand lack of interest, the association had to drop the plan.

"When AVMA ended our coverage, I registered dismay and disappointment,"he says. "We were delighted with the AVMA's plan and most important,my staff was delighted with it.

"With private companies, I think all we have now are different levelsof disappointment. If AVMA provides any program, you can bet I'm going tojoin it."

Dr. John Swengel, owner of Swengel Animal Hospital in Indianapolis, offersa similar sentiment.

"I provide staff insurance, but it's high. A single mom with twokids can pay $200 to $300 a month," he says. "Now most of my staffgets spousal insurance or I see 30-year-olds with no coverage at all. Idon't understand why AVMA can't help us out by offering a cost-effectiveway to cover staff."

Other issues

But the problem is several-fold, says Dr. Bruce Little, AVMA executivevice president.

By definition, AHPs offer the same level of coverage nationally, whichis difficult to provide. For example, he says, hospitals in rural areasoften don't have access to the same managed health care programs and thatcauses premiums to skyrocket.

"For that reason, you would have to rate the premiums on location,"Little says. "And that's a major hoop to jump through."

Big, influential insurance companies also don't want to deal with thelobbying arms of national associations, he says, and play on politics tothwart their efforts.

"If I had it my way, we would offer staff insurance," Littlesays. "I say we should have an insurance commission at the federallevel to make sure each state has the same laws and requirements. That couldhelp us make this a reality."