Panelists at an MGMA Conference forum on health reform came to quick consensus on two key points. First, without reform, the health care system would be caught in an unsustainable spiral of increasing costs and decreasing quality. Second, the reform legislation recently passed in Congress falls far short of the mark in addressing either issue.

"The list of unintended consequences is long," noted Michael McCallister, president and CEO of insurer Humana Inc., during the Oct. 25 discussion. He and other panelists underscored the point, noting that expanding Medicaid eligibility may indeed broaden the pool of the insured. At the same time, Medicaid payments usually do not cover costs, thus shifting the burden increasingly onto private health plans. McCallister added that smaller health insurance plans will likely lack the resources to expand and upgrade their information systems to meet what could be a deluge of new enrollees as the insurance mandate kicks in.

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