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School’s Director of Health Sector Programs to Business Leaders in Puerto Rico: Much More Controversy over Health Care Reform Ahead

February 16, 2012
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We will see much more controversy over health care reform as new provisions of the federal Affordable Care Act move closer to enactment in 2014. That is what Steven Ullmann, director of the School’s programs in health sector management and policy, told some 300 industry leaders in Puerto Rico in February. Ullmann offered insight about the historic legislation as a keynote speaker at the Puerto Rico Health & Insurance Conference 2012: Economic Transformation in Health, which was co-hosted by the Puerto Rico Chamber of Commerce and the School of Business.

Steven Ullmann, director of the School’s programs in health sector management and policy, was the conference vice chairman and a keynote speaker

“The 2011 aspects were pretty much mom and apple pie,” noted Ullmann in describing the initial reforms, such as a requirement that health insurers provide coverage for dependent children up to 26 years of age and the rule restricting providers from denying children coverage based on preexisting conditions. “There is much more controversy to come in 2014,” he predicted. “First of all we have the individual mandate, perhaps the most controversial aspect of health care reform - the concept that every person must have health insurance or be subject to a penalty of up to $750 [per year].”

Ullmann, who also served as the conference’s vice chairman, noted that court challenges to the law, particularly related to the individual mandate, as well as the results of the fall elections may change the dynamics of the debate over reform. If the 2014 reforms are enacted as set out in the law, Ullmann said, there may be a number of unintended implications. For example, even though those without insurance from their employers must pay a fine if they do not buy it, many may still refuse.

The conference drew about 300 health sector, government and other industry leaders.

“If you don’t purchase health insurance there will be a $750 penalty come the year 2014,” said Ullmann. “But when you look at what the cost of health insurance is around the country, it’s much higher than $750. So what you might see is that people who are middle-income or lower middle-income still might not purchase insurance, because insurance is going to be much higher than $750, so they’ll still go uninsured.”

Ullmann said the requirement that organizations with 50 or more employees provide affordable coverage to their workers or pay a fee, may limit their hiring. He noted that the increased costs of covering adult children under the 2011 provisions may already be having an impact.

“This is affecting hiring decisions,” said Ullmann. “Firms are saying ‘Wait a second, this is an increased cost to us,’ and basic economics will tell you that when you increase costs, you cut down in the utilization of employees.”

On the bright side, health care spending growth was at its lowest level in 50 years between 2009 and 2010. In citing the just-released data, Ullmann said this might have a positive impact on costs for employers.

“This is perceived to perhaps lower the cost of health care reform and if these cost controls continue, maybe it will slow the growth rate of the costs of employer based health insurance.”

Carlos de Jesus, a 2011 graduate of the School’s Puerto Rico Executive MBA program, served as the conference master of ceremonies.

Ullmann was joined at the conference by more than a dozen other expert speakers and panelists including the regional director of the U.S. Department of Health and Human Services, the secretary of the Puerto Rico Health Department, and numerous business leaders. The School has been working closely with Puerto Rico’s business community in recent years as part of its commitment to the Caribbean and Latin American regions. The School launched an Executive MBA program in Puerto Rico in 2009 and also works with local firms to develop custom executive education programs. This was the second year in a row that the School of Business co-hosted the health and insurance conference with the Puerto Rico Chamber of Commerce.

“We formed this strategic alliance with the University of Miami School of Business to promote and nurture entrepreneurship in Puerto Rico in the health sector,” said Roberto Pando, chairman of the Puerto Rico Health & Insurance Conference 2012 and Medical Card System (MCS) vice-president of business development and marketing. “There are significant changes in funding and demographics, at the levels of billions of dollars, that are set to occur in the next few years and business leaders need to be ready for challenges and opportunities.”

In conjunction with the 2012 health and insurance conference, the School hosted a networking reception for its alumni and friends in Puerto Rico. The event, which was held immediately following the conference, drew nearly 50 people including the graduates of the first Executive MBA program there, as well as students in the new class, which began in October.

Steven Ullmann, director of the School’s programs in health sector management and policy, was the conference vice chairman and a keynote speaker
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