Broad sweeping changes to the nation's healthcare system could just be on the horizon. This time it's a little different though, than back in the '90s when the Clinton Administration first tried to implement change to the structure.

During a special conference call with journalists sponsored by BMO Capital Markets (New York) Karen Ignagni, president/CEO of America's Health Insurance Plans (AHIP; Washington), pointed out some key differences between health reform of the '90s, and President Obama's new plan.

One of those key issues is the level of involvement that industry leaders and insurance companies have had during the great healthcare reform debate.

"Our board, our leaders, believed very strongly that we needed to enter this debate with tangible proposals to [healthcare reform]."

To date, Medical Device Daily has reported in depth on proposals from the Insurance industry. Most recently AHIP and Blue Cross Blue Shield Association (Chicago) offered a proposal from commercial insurers that would lower the higher premiums that sick customers have to pay (Medical Device Daily, March 26, 2009).

The plan also would call for insurers to provide discounted rates for those who engage in healthier behaviors. But insurers still would be able to change rates based on age, family size and geography.

Ignagni did not discuss this proposal during the call, but she did say that she was very encouraged by the response.

"Whenever you have industry leaders who take the responsibility to offer solutions I think it's normally greeted very positively by members of Congress on both sides of the aisle," she said.

She said that another key driving factor that separated this attempt at reform from the Clinton Adminstration's was that there was more of a strong economic factor.

"The focus was primarily on what are the social policy reasons for pushing for healthcare reform [during the Clinton Administration]," she said "But also this time there is an economic rationale that's being pro-offered and I think quite rightly and sensibly that the most expensive option is to do nothing at all."

Chronic illnesses suffered by those with no health insurance, which rely on care from hospitals, has put a tremendous strain on the system, she said. That strain has translated into a sur tax that insurance providers, employers and employees have had to pay.

Since 1994, the U.S. has seen nearly 9 million more people become uninsured, according to the Robert Wood Johnson Foundation's (New Brunswick, New Jersey) latest study. The foundation also said that nearly one in five working Americans are uninsured. There has been shown to be a direct correlation between chronic illness and the lack of healthcare.

A study titled "Chronically Ill and Uninsured: A National Study of Disease Prevalence and Access to Care in U.S. Adults," published in the Aug. 5 edition of Annals of Internal Medicine, reported that more than 11 million Americans with chronic physical illnesses aren't getting the medical care they need because of a lack of health insurance (MDD, Aug. 8, 2008).

Dave Shove, a managed care analyst for BMO and also moderator of the event asked if AHIP's suggestions were being taken into account by legislators.

"Is your voice, I know it's being heard, but is it – is it being listened too," Shove asked.

"In terms of our voices being listened to we have had very positive conversations with leaders from both sides of the aisle," Ignagni said.

The debate over healthcare might be in its beginning stages but legislators all remain poised for changed.

Just a few scant days ago, Reuters reported that President Obama and Democratic lawmakers said they aim to push healthcare reform legislation through the House of Representatives by the end of July.

Over all the House and Senate said they hope to pass their respective bills before Congress' August recess. If this were to occur, Obama could be signing a healthcare reform bill by the end of this year.