A group of 40 corporations added its collective voice to the health care debate on Monday, May 7, but like other coalitions trying to influence reform, it stated principles—like a market-based system and universal coverage—while avoiding specifics.

In a Capitol Hill news conference, the Coalition to Advance Healthcare Reform emphasized that all Americans should have health insurance and they should take personal responsibility for maintaining a healthy lifestyle.

The group also says that financial assistance should be provided for those who can’t afford coverage and people buying insurance on their own should get the same tax advantages as corporate purchasers.

The coalition is seeking to spur political action on health care in the current session of Congress, which will end in late 2008, b ut it is not backing specific legislation.

“We intend to be an active participant in the debate,” Steve Burd, CEO of grocery chain Safeway Inc. and chairman of the coalition, said during the Capitol Hill event. “We think we can make a real difference in the health of Americans. We can make a real difference in the health of our employees. There is a lot of momentum building, and we are determined to solve this problem.”

Sen. Ron Wyden, D-Oregon, said that the coalition is changing the political calculus of health care from where it was in 1994 when the Clinton administration proposed an overhaul of the system.

Back then, Wyden says, corporate America argued that reform was too expensive; now it’s saying that the status quo is harmful.

“What you’re seeing today is how the business community has transformed the health care debate in America,” he says.

One of the reasons the coalition has jumped into the health care fray is because costs are rising inexorably. In a Washington Times opinion piece published May 7, Burd wrote that health care spending for an average Fortune 500 company will exceed its net income next year.

But he is not advocating that companies stop providing coverage for employees.

“We’re not looking for a way out of health care,” he says.

Instead, he asserted that costs will decrease if the right incentives for healthy lifestyles are put in place and the quality of care improves.

“There’s really a net reduction in the nation’s health care bill if you design the system correctly,” he says.

General Mills, a member of the coalition, wants to promote the success it has achieved with wellness and disease management initiatives and health savings accounts, according to CEO Steve Sanger.

The company has kept health care spending at or below the inflation rate and has no plans to drop coverage.

“We’ve delivered value for employees in the system,” Sanger says. “We’re not anxious to get out of that.”

Wyden’s bill, the Healthy Americans Act, would remove employers from the health care equation. Under his measure, individuals would purchase coverage directly from private insurers.

Companies would make contributions into the system based in part on the number of people they employ. The bill also establishes incentives for prevention and wellness. Companion legislation was introduced in the House on May 2.

The primary Senate Republican sponsor of the bill said that if the link between employment and health coverage is severed, it will empower individuals as consumers. They will have greater incentive to find high-quality, affordable health plans—a different motivation than companies have.

“The employer has made the choice on economic grounds rather than quality grounds,” Sen. Robert Bennett, R-Utah, said during a Capitol Hill event last week.

Another advantage of the Wyden approach is that it puts all businesses on a level playing field, according to Rep. Brian Baird, D-Washington and author of the House version of the Wyden bill.

“There’s no more cost shifting from the uninsured to the insured,” he says.

But prospects for getting employers out of the health care business anytime soon may be slim, according to one of the key players in the health care debate on Capitol Hill.

“I don’t see this Congress moving on that point this year,” Sen. Max Baucus, D-Montana and chairman of the Senate Finance Committee, said during a meeting with reporters on May 7. “Those employees who work for big companies have good health care coverage, and they don’t want to lose it.”

Baucus also doubted that President Bush’s proposal to end the health care tax deduction for corporations and treat the benefit as income would be approved.

Baucus is an advocate of universal coverage that involves a combination of private and public funding. Steps toward that goal likely will start with expanding coverage for children.

“I think we should go as far as we can in this Congress,” he says. “In the interim, children’s health insurance is an important part of this process.”

Wyden vows action before the 2008 presidential election.

“We’re going to make a big push to fix health care in this session of Congress,” he says.

But Wyden and others advocating reform might want to tread carefully. A recent poll by the National Business Group on Health showed that employees value health care more than any other benefit they receive—and they’re loath for employers, or the government, to tinker with it.

“They will not be eager for a change that is scary and might be complex for them to understand,” Helen Darling, president of the organization, said at an April 12 event where the poll was released. “A proposal to move to an individual market is not going to be very popular.”