Public sector health care purchasers convene in Washington, D.C.: state and local governments and pension plans provide health benefits to 16 million working and retired American and their families. It is imperative that they begin identifying what is needed for effective health care reform.

• Author: Berger, Barrie Tabin
• Position: Federal Focus

Now in its third year, the Public Sector HealthCare Roundtable (Roundtable) held its annual conference in Washington, D.C., in late October. The Roundtable, a nonprofit national organization established to advocate for public sector health care issues on Capitol Hill, brings together local governments, state governments, and pension systems, large and small, to represent their common interests as purchasers of health care benefits. By working closely with other national associations that advocate on behalf of public purchasers, such as the GFOA, the National League of Cities, and the National Conference of State Legislatures, the Roundtable's goal is to ensure that the interests and concerns of public sector purchasers are heard and considered as the President, members of Congress, and presidential contenders offer their proposals for reforming the health care system in the United States.

The public sector spends more than $12 billion annually on health benefits for millions of active and retired public employees and their families. Moreover, health care is now the fastest growing portion of state and local budgets and governments have cited rising health benefit costs as one of the main contributors to budgetary pressures. These costs limit spending on other important public needs such as education, infrastructure, and economic development. Further, the impact of the disclosure provisions required by the Governmental Accounting Standards Board (GASB) Statement 45, Accounting and Financial Reporting by Employers for Postemployment Benefits Other Than Pensions, which mandates that state and local governments disclose their future health care obligations for retired employees and their families, will exacerbate these concerns. In light of this information, it is essential that public purchasers are actively involved in policy discussions to reform our national system of health care.

In 2006, the GFOA adopted a health care reform policy which "urges the administration and Congress to work together with state and local governments on initiatives to reform the nation's health care delivery system in order to contain the growth of health care costs and expand access to health care for all." Like the Roundtable, the GFOA policy encourages a federal approach that considers public purchasers as well as the private sector in any proposed legislation addressing quality, delivery, affordability, and accessibility to health care. (1) The two-day Roundtable conference...