Although relatively immune to recession, the business of health care will be focused on streamlining and cost containment in 2009.

Because so many Americans get their medical care through employer-supplied health plans, the industry has been stung by the ongoing recession and is scrambling to stay ahead of its problems, experts say.

As a result, employers are likely to become more, not less, involved in health-care policy debates this year, predicted Becky Cherney, chief executive of the Orlando-based Florida Health Care Coalition.
 
"The one thing that a lot of people are saying is that the larger employers are going to get out of health care -- that's not true at all," said Cherney, whose organization represents some of the biggest employers in Central and South Florida. "Employers have to have a healthy workplace."

In seeking a seat at the table, they will be joining insurance companies, small businesses, unions, pharmaceutical companies and consumer advocates as they seek to influence Congress and President-elect Barack Obama, who included health-care reform in his campaign platform.

"People are much more willing to work out a compromise . . . that changes the political equation," said Kathleen Stoll, deputy executive director of Families USA, a Washington, D.C.-based health-care advocacy group.

Cherney thinks employers will have a lot to offer as the debate over health care takes shape. "Innovation in health care comes from the private sector, not the government," she said.

More than 70 percent of U.S. employees have access to employer-sponsored health plans, though barely more than half of all workers take advantage of those plans, according to the U.S. Bureau of Labor Statistics.

Employers continue to struggle with rising health-care costs, and as they attempt to rein them in they are also transferring a larger share of burden to their employees. Health-care coverage cost the average Orlando company $7,513 per employee in 2008, compared with $4,914 in 2002, according to Hewitt Associates, an Illinois-based human-resource consultant.

For the nation's uninsured, the cost of health care is even more daunting. During the first nine months of 2008, for example, more than 40 million Americans declined to fill needed prescriptions because they couldn't afford them, according to data from Manhattan Research.

Florida Gov. Charlie Crist's new Cover Florida health-insurance program, which launched Jan. 5, is designed to help the state's 3.8 million uninsured adults afford at least basic medical coverage. The program's chief advantage is that no one can be turned away because of a pre-existing medical condition (though the insurer can refuse to cover the pre-existing condition for as much as a year).

But at the same time, the state is trying to spend less money on health care because of a multibillion-dollar budget shortfall. Hospitals are also tightening their budgets to keep their heads above water during the recession -- and to cope with the rising cost of providing care to the uninsured who can't afford to pay for emergency treatment. More than 8 percent of Florida hospitals' costs are associated with such uncompensated care, according to the Tallahassee-based Florida Hospital Association.

"I don't think hospitals have any choice but to do that," said Bruce Rueben, president of the trade group. "Beyond that, it really depends on where the new [presidential] administration can get the country in terms of getting more people covered."

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