Preamble

The National Council of Chain Restaurants (NCCR) is the national trade association exclusively representing the chain restaurant industry.  NCCR member companies and their franchisees operate more than 125,000 restaurant facilities under their respective trademarks and employ over 3 million workers.  NCCR works to advance sound public policy that best serves the interests of both chain restaurants and their employees.

Our members believe that healthy employees are vital to the health and well-being of our business and to the US economy. Appropriate healthcare is a necessary component to ensure the well-being and productivity of individuals, families, and communities.

Individual access to health care is a public policy issue confronting our society and as corporate citizens and responsible employers we are compelled to assume a more proactive role on this matter. Thus, as an organization representing major employers, it is necessary and appropriate for us to have a ‘seat at the table’ and engage constructively in the public policy discussions regarding this issue. 

NCCR believes this issue is broader than “health insurance”, which is merely a financing mechanism.  We should focus on a set of issues including the development of strategies to improve our employees’ health through information and education, and efforts to improve access to care.

We believe that the dialogue on these issues must engage many sectors of our society, as we all have a role to play in making our healthcare system more efficient and effective. Further, we believe that any health reform proposal and associated public policy changes should be evaluated against certain principles. NCCR’s view of the appropriate roles and accountabilities for individuals, providers of care, health insurers and plan administrators, employers, and government are articulated below under Generally Supportable Principles.

General Definitions

• “Coverage” refers to some form of health benefit product.
• “Access” refers to the ability of an individual to receive care, and encompasses logistical and cultural elements.
• “Quality” is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. (from the IOM)
• “Affordability” is a fluid concept relating to the ability to pay for health care.
• “Choice” refers to a range of options that an individual may have access to.

Recommendations

NCCR believes that our health care system should be market-based, voluntary and patient-centric.  It should be focused upon the improvement of patient access, better and transparent health information and quality-driven.  NCCR believes that our health care system should be based upon shared responsibility with a healthy lifestyles approach at its core.  Finally, government requirements placed on employers, including those dealing with plan design as well as the amount of company subsidy, should be avoided.

Relative to the role and accountabilities of employers

Health benefits are but one element of a total compensation package. Employers recognize that employees vary with regard to the type of benefits that they value. We should preserve the voluntary nature of, and the ability of employers to offer a choice of benefits to their employees.

Public policy initiatives should recognize the varying ability of employers to offer benefits.

Given that local and state mandates impede the delivery of efficient and cost-effective healthcare, we should preserve ERISA and the ability of multi-state employers to offer a range of benefits to all employees.

In the near-term, we should build on the strengths of the current public-private system.  Additional market-based reforms should continue to be considered and evaluated.

Relative to the role and accountabilities of individuals

Every individual should be accountable for taking all reasonable steps to preserve his/her health, including accepting offers of health insurance coverage pursuing available health care information and treatment alternatives.

Relative to the role and accountabilities of providers

Every provider should be accountable for delivering high value care.

To promote better patient outcomes at the most efficient cost, every provider should practice evidence-based medicine.

To promote efficiency and transparency, providers should adopt standard administrative processes and electronic reporting.

Relative to the role and accountabilities of the insurance industry

Insurers should respond to market forces and encourage development of flexible individual and group insurance products.

To accelerate the movement to a more patient-centric healthcare system, insurers should work to provide individuals with easily understood health information.

To facilitate transparency and promote best practices, insurers should work with government to develop standardized processes for aggregating and mining outcome data and provide relevant information to patients and providers.

Insurers should actively engage with business and all stakeholders in efforts to reduce and eliminate barriers that inhibit employers from securing affordable coverage for their employees.

Relative to the role and accountabilities of the public sector (government)

Health information technology should be broadly implemented as a means to promote information flow, coordination of care and quality, and help reduce errors, inefficiency, and waste.

The public education system should promote health literacy transparency regarding cost and quality information that is understandable.

Government should encourage and support providers to:

• Make cost and quality information available to the public in a format that is comprehensible and meets their needs;
• Adopt evidence-based medical protocols;
• Adopt standardized administrative processes.

The medical liability system should be reformed as a step in promoting cost- containment.

Elected officials, regulators and other relevant policymakers should reduce and eliminate barriers that inhibit employers and individuals from securing affordable coverage for their employees.

Government requirements placed on employers, including those dealing with plan design as well as the amount of company subsidy, should be avoided.