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The Federal Government Wants to Mess with Texas

Thursday, February 25th, 2010

texas health insuranceThe Dallas Morning News recently reported that President Obama has proposed for the federal government to regulate all health insurance premiums in an effort to regulate price increases. With Texas health insurance and other states’ premiums continuing to increase as more and more people become uninsured, this proposal suggests that the federal government should review all premiums in order to stop cost increases the government believes are unnecessary. Though price increases must be addressed, should the federal government be the final arbiter of health insurance premiums?

In Texas, the Department of Insurance does not routinely review health insurance premium increases unless a complaint is brought before them. Therefore, it’s argued that Obama’s proposal could protect many insured citizens from unnecessary and inflated health insurance premium costs.  However, each state differs in which health insurance carriers, plans, and benefits are available.  Paired with the fact that health insurance carriers are confined to only sell within state lines, how can the federal government adequately determine if a premium increase is unreasonable for the citizens of a particular state, much less regulate those that are deemed unreasonable?

Rather than spending more money on further regulation, how about some measures that would actually lower health insurance costs?  Measures like deregulating health insurance across state lines, so that market competition can naturally lower costs; or imposing tort reform to cut down on junk lawsuits, like we’ve done here in Texas; or increasing accessibility to health care, through more options like Texas health savings accounts and other consumer driven health plans that empower consumers to take control of their health care costs.

American health care reform cannot happen overnight, but until the right questions are asked, the wrong answers will continue to be proposed.

10 health care reform ideas for Obama

Friday, February 12th, 2010

health care reformRecently President Obama said he wants to meet with both Democrats and Republicans to sift through the best health care ideas from both sides.  He challenged Republicans—who to this point have opposed Obama’s health care bill—saying, “if you have a better idea, show it to me.”  In an attempt to answer the call, former Speaker of the House Newt Gingrich and John Goodman, CEO of the National Center for Policy Analysis, laid out ten ideas for Obama to consider in a recent Wall Street Journal op-ed.

The WSJ article begins by stating that “the best ideas out there are not those that were passed by the House and Senate last year, which consist of more spending, more regulations and more bureaucracy. If the president is serious about building a system that delivers more quality choices at lower cost for every American, here’s where he should start:”

Make insurance affordable – The current taxation of health insurance is arbitrary and unfair, giving lavish subsidies to some, like those who get Cadillac coverage from their employers, and almost no relief to people who have to buy their own. More equitable tax treatment would lower costs for individuals and families. Many health economists conclude that tax relief for health insurance should be a fixed-dollar amount, independent of the amount of insurance purchased. A step in the right direction would be to give Americans the choice of a generous tax credit or the ability to deduct the value of their health insurance up to a certain amount.

Make health insurance portable – The first step toward genuine portability—and the best way of solving the problems of pre-existing conditions—is to change federal policy. Employers should be encouraged to provide employees with insurance that travels with them from job to job and in and out of the labor market. Also, individuals should have the ability to purchase health insurance across state lines. When insurers compete for consumers, prices will fall and quality will improve.

Allow doctors and patients to control costs – Doctors and patients are currently trapped by government-imposed payment rates. Under Medicare, doctors are not paid if they communicate with their patients by phone or e-mail.  Medicare pays by task—there is a list of about 7,500—but doctors do not get paid to advise patients on how to lower their drug costs or how to comparison shop on the Web. In short, they get paid when people are sick, not to keep them healthy.

So long as total cost to the government does not rise and quality of care does not suffer, doctors should have the freedom to repackage and reprice their services. And payment should take into account the quality of the care that is delivered. Once physicians are liberated under Medicare, private insurers will follow.

Inform consumers – Patients need to have clear, reliable data about cost and quality before they make decisions about their care. But finding such information is virtually impossible. Sources like Medicare claims data (stripped of patient information) can help consumers answer important questions about their care. Government data—paid for by the taxpayers—can answer these questions and should be made public.

Eliminate junk lawsuits – Last year the president pledged to consider civil justice reform. We do not need to study or test medical malpractice any longer: The current system is broken. States across the country—Texas in particular—have already implemented key reforms including liability protection for using health information technology or following clinical standards of care; caps on non-economic damages; loser pays laws; and new alternative dispute resolution where patients get compensated for unexpected, adverse medical outcomes without lawyers, courtrooms, judges and juries.

For the full list of GOP proposals to President Obama, click here.  And if you’ve got some ideas of your own, we’d love to hear them; just leave a comment below.

Obama Invites Republicans to Health Care Debates

Monday, February 8th, 2010

Barack Obama health care reformSince Scott Brown’s win in the Massachusetts Senate race broke the Democrats’ filibuster-proof Senate majority, President Obama’s health care bill has been reeling.  In an attempt to revive his health care agenda, Obama has invited both Democratic and Republican leaders to discuss possible compromises in a televised gathering on February 25th.

The Associated Press reports that “Obama’s move came amid widespread complaints that efforts so far by him and his Democratic allies in Congress have been too partisan and secretive.”  Backlash stems from closed door deals that gave kickbacks to secure favorable votes, especially glaring since Obama initially suggested that health care debates should be televised on C-SPAN.

As the AP reports, “The meeting’s prospects for success are far from clear. GOP leaders demanded Sunday that Democrats start from scratch, and White House aides said Obama had no plans to do so.”

Many liberal groups want Congress to employ their lawmaking muscle to enact health care reform by reconciliation, a measure that can bypass Republican support.  But while President Obama has remained adamant about passing a health care bill similar to what passed in the House and Senate, lately he’s shown more willingness to consider Republican input.  In an interview with CBS’s Katie Couric, Obama said that he wants to look at the best ideas from both parties and arrive at some agreements.

But such agreements won’t come easily.  The White House maintains that “Obama does not intend to restart the health care legislative process,” whereas Senate Minority Leader Mitch McConnell speaks for many Republicans when he says that “if we are to reach a bipartisan consensus, the White House can start by shelving the current health spending bill.”

How Healthy is the State of Texas?

Friday, February 5th, 2010

texas health insuranceEach year the United Health Foundation, the American Public Health Association and the Partnership for Prevention collaborate to publish an assessment of the nation`s health on a state-by-state basis.  The annual rankings look at 22 indicators of health, from how many children receive vaccinations to the percentage of uninsured residents to the prevalence of obesity, smoking and cancer deaths.

In 2009, Texas climbed one spot to rank as the 39th healthiest state in the nation, proof that things are slowly looking up, but that we still have a ways to go as a state.  What follows are some of Texas’s best and worst rankings, among the measured indicators.

The good news is that Texas ranks in the top one third of the country in its rate of cancer deaths, but particularly frightening is the amount of citizens without Texas health insurance.  Texas ranks last in the country with an uninsured population that reached 25.1 percent in 2009.

Rankings:

  • Cancer deaths – 16th
  • Immunization coverage – 17th
  • Poor mental health days – 19th
  • Infant mortality – 20th
  • Public health funding – 43rd
  • Children in poverty – 43rd
  • Infectious disease – 44th
  • Lack of health insurance – 50th

By analyzing all 22 health indicators, the 2009 report highlights the following strengths, challenges and significant changes for the state of Texas.

Strengths:

  • High immunization coverage
  • Few poor mental days per month
  • Low rate of cancer deaths

Challenges:

  • High rate of uninsured population
  • High percentage of children in poverty
  • Low per capita public health funding

Significant Changes:

  • In the past year, the rate of preventable hospitalizations decreased by 7%
  • In the past five years, geographic disparity within the state increased by 25%
  • Since 1990, the prevalence of smoking decreased by 40%
  • Since 1990, the prevalence of obesity increased by 135%

States Want to Ban Health Insurance Mandates

Wednesday, February 3rd, 2010

Health insuranceAs the push for health care reform has stalled since the election of Republican Scott Brown in Massachusetts, conservative lawmakers across the country are advocating constitutional amendments to ban government health insurance mandates.

The mandates in question, separate bills passed by the U.S. House and Senate, would impose fines on people who elect to go without health insurance.  Their aim is to expand the pool of insured citizens by making coverage mandatory, which could help to offset the high costs of insuring those with preexisting conditions and more serious health care needs.  But those wanting to ban such mandates believe that the federal government has no authority to force citizens to purchase anything, including health insurance.

The Associated Press reports that according to the American Legislative Exchange Council, “legislators in 34 states have filed or proposed amendments to their state constitutions rejecting health insurance mandates.”  In many states, “the proposals began as a backlash to Democratic health care bills in Congress.  Instead of backing away after a Massachusetts election gave Senate Republicans the filibuster power to halt the health care legislation, many state lawmakers are ramping up their efforts with new enthusiasm.”

So while federal health care legislation has slowed, conservative state legislators have stayed busy, trying to thwart the Democrats’ efforts to force coverage upon Americans. “We need to move ahead no matter what kind of maneuvering continues in Washington, D.C.,” said Missouri Senator Jane Cunningham.

Healthcare Reform: Thoughts from Both Sides

Saturday, January 30th, 2010

us capitol buildingJust one week removed from Republican Scott Brown’s lopsided win in the Massachusetts Senate race, healthcare reform is more confusing than ever.  The administration has vowed to press ahead with healthcare legislation, while opponents of the bill are urging President Obama to simply start over.

According to the LA Times, White House senior advisor David Axelrod said that the “president will not walk away from the American people, will not hand them over to the tender mercies of health insurance companies who take advantage of them.”  Equally strong words were issued by Senate Minority Leader Mitch McConnell of Kentucky, who counters that “what we need to do is start over and get it right.”

Both Republicans and Democrats continued to dispute the message and effect of Scott Brown’s win last week. The loss has shaken Democrats, who lost a Senate seat entrenched in the Democratic Party for nearly 50 years, but don’t see the loss as public disapproval of the health care bill, as Republicans do.  Senator Jim DeMint, a South Carolina Republican and a vocal opponent of the healthcare plan, said that “Massachusetts was a rejection of the president’s massive policies of spending and debt.”

Obama’s 2008 campaign manager, David Plouffe, wrote in a Washington Post op-ed that Democrats must “pass a meaningful health insurance reform package without delay.”  But according to McConnell, “Republicans want to start over on a bipartisan basis with legislation that would reduce malpractice lawsuits and allow individuals to deduct the cost of their coverage from their taxes the way corporations can.”  So the existing legislation, “with its huge price tag, is a nonstarter,” he said.

Bipartisan Health Care Reform is Still an Option

Wednesday, January 27th, 2010

health care reformFollowing Scott Brown’s victory in the Massachusetts’ Senate race, there has been much speculation on whether health care reform is dead.  General consensus is that reform is not dead, but that the brand of reform being championed by Democrats is too partisan and flawed to be enacted, especially now, as Scott Brown gives the Republicans another needed vote in the Senate.

For health care reform to be achieved, our government needs to be bold and offer new ideas, rather than simply rehash old ones.  According to Robert E. Moffit, director of the Center for Health Policy Studies at the Heritage Foundation, “very little in the Obama health plan is new or original.  Many of its policy initiatives are recycled from the ill-fated Clinton health plan of 1993 and the Kerry health plan of 2004 and strongly resemble a detailed proposal by the Commonwealth Fund, a prominent liberal think tank.”

Elizabeth MacDonald of Fox Business News outlines some ideas for health care reform that didn’t make the cut in President Obama’s plan:

Tort Reform – In last year’s meeting with the American Medical Association (AMA), President Obama stated, much to the chagrin of his audience, that he does not advocate “caps on malpractice awards.”  The AMA estimates that medical malpractice costs and defensive medicine (ordering extra, unnecessary tests for fear of being otherwise sued for negligence) costs upwards of $200 billion each year.  Certain states, including Texas, have taken it upon themselves to curb these costs.  From the Fox Business article:

Texas voters approved a constitutional amendment in 2003 capping damage awards in medical malpractice lawsuits. In turn, doctors are swarming to Texas, swelling the ranks of specialists at Texas hospitals and bringing professional health care to some long-underserved rural areas, reports the New York Times.  All but 15 states have adopted some limits on medical damage awards, according to the National Conference of State Legislatures. But Texas went further than many states. Malpractice insurance premiums dropped an average of 21.3% annually since reform.

Less costly insurance premiums for doctors can lead to cheaper Texas health insurance premiums for consumers.

Interstate Competition – An interstate market in health insurance would deliver more competition than a public option.  If the insurer’s monopoly were broken and people were allowed to buy insurance across state lines, as they are with auto insurance and life insurance, costs would decrease as competition increases.

State-Based Reform – Because states face varying degrees of health care costs and uninsured citizen rates, health reform won’t work as a federal, one-size-fits-all solution.  A federal-state partnership would allow states to devise a health reform plan that works for them.”

As Elizabeth MacDonald states, “health reform is not dead. There are bipartisan ideas out there to fix it. And that means to enact reform, the only route out is the bipartisan way.”  It’s time for elected officials to stop pursuing an agenda so extreme and flawed that it takes a supermajority of one party to pass it.