Access to Health Insurance: Public and Private Employers' Experience With
Purchasing Cooperatives (Letter Report, 05/31/94, GAO/HEHS-94-142).

One of the few areas of widespread agreement in the health care debate
is that small businesses and other small organizations have a tough time
buying and keeping health insurance for their employees. Some small
groups cannot obtain health insurance at any price because of the health
status of just one of their workers. Even those able to secure coverage
may face extremely high premiums. One response to this problem is to
pool the buying power of individual small firms. Under insurance
purchasing cooperatives, large numbers of relatively small organizations
band together to reduce their administrative expenses, pool their
insurance risk, and increase their clout to get a better deal. GAO
believes that the criticism of coops as too regulatory and too
bureaucratic has been overstated. Coops are a proven and economical way
for firms to buy insurance. Coops generally operate with small staffs
and have greater regulatory authority than many health reform proposals
would allow. They rarely, however, administer subsidies for the poor or
the unemployed, a key requirement under many health care reform bills.
GAO suggests that more attention needs to be paid to several governance
issues, including the composition of coops' governing boards,
representational safeguards, and the potential for politicization of
appointments. GAO summarized this report in testimony before Congress;
see: Health Reform: Purchasing Cooperatives Have an Increasing Role in
Providing Access to Insurance, by Mark V. Nadel, Associate Director for
National and Public Health Issues, before the Subcommittee on Human
Resources and Intergovernmental Relations, House Committee on Government
Operations. GAO/T-HEHS-94-196, June 30, 1994 (13 pages).

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  HEHS-94-142
     TITLE:  Access to Health Insurance: Public and Private Employers' 
             Experience With Purchasing Cooperatives
      DATE:  05/31/94
   SUBJECT:  Health care cost control
             Insurance premiums
             Health insurance cost control
             Health care services
             Employee medical benefits
             State-administered programs
             Non-government enterprises
             Administrative costs
             Health maintenance organizations
             Health insurance
IDENTIFIER:  California
             Florida
             Minnesota
             Ohio
             Wisconsin
             Medicaid Program
             National Health Care Reform Initiative
             Clinton Health Care Plan
             Health Security Act
             CalPERS Health Benefits Program (CA)
             
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