Koller successor must bring same focus, leadership

To the editor:
An open letter to Gov. Lincoln D. Chafee:
As members of the Health Insurance Small Employer Taskforce, we wish Commissioner Koller good luck with his new position as president of the Milbank Memorial Fund. It has been a privilege to work with him over the past year towards ensuring more- affordable health insurance premiums for Rhode Island employers.
We appreciate the many sound reforms he has instituted since he became commissioner in 2005 – and the task force urges you to ensure that whoever succeeds him has the same commitment to the combination of employer engagement, consumer fairness and insurer solvency,
It was Koller who created the Small Employer Taskforce, based on his vision that raising the employer voice in the debate over lowering insurance rates and improving our health care system would help to change the system more quickly.
A year after our inception, the task force has almost 100 members and more than 1,000 interested stakeholders receiving our information and learning about our events.
After an unprecedented level of employer engagement in last year’s insurance rate review process, we saw some of the lowest rate increases in recent years.
Koller’s affordability standards, which are: expand and improve primary care infrastructure, spread the adoption of the patient-centered medical home, support CurrentCare, and work toward comprehensive payment reform across the delivery system, have also elevated the importance of both consumer fairness and insurer solvency.
Those who have worked with Koller over the past eight years know he has been honest, fair and thoughtful, and an astute regulator of the complex insurance industry.
And so, Gov. Chafee, we urge you to keep the following in mind when you choose Commissioner Koller’s successor:
The costs of health insurance are out of control, even with last year’s modest increases. We are hopeful that the Affordable Care Act and the R.I. Exchange will deliver the lower-cost alternatives that we need, but we understand that there may be some additional costs inherent in the changes.
Since we cannot afford what we pay now for health insurance, any increases are unacceptable – and we need to get a handle on the underlying health care costs. Because of these costs, we’ve cut staff, frozen salaries, chopped benefits and had to downgrade insurance payments, plans and services because of the astronomical costs.
Our involvement in the Small Employer Taskforce has taught us that we are all in this fight together. We know that we must make changes in the way we purchase insurance – and we have – but we need the state to help show insurers that Rhode Island’s economic recovery depends on them getting a handle on high costs.
We need real and lasting change.
Therefore, your decision about Commissioner Koller’s successor is crucial. We need the new commissioner to share Koller’s commitment to the Affordability Standards. He or she should be independent of health-insurance company ties, and should be a rational decision-maker who relies on facts and analysis in his or her approach.
Rhode Island needs another forward-thinking leader to make sure that the coming health care changes benefit as many individuals as possible and provide relief to the state’s businesses.
The new commissioner should understand how important his or her careful deliberations are to Rhode Island’s employer community – both for-profit and nonprofit communities – and to our entire economy. •
Steven Boyle
President, Cranston Chamber of Commerce
Vivian Weisman
Health care advocate, retired president of the Mental Health Association of Rhode Island

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