By: Health Insurance
Submitted: 2009-10-02 15:39:06 | Word Count: 844
State health care reform is important, they say
Chris Day
It may not be as controversial as Obamacare, but Oklacare is just as important.
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What is Oklacare? Health care reform at the state level. State Reps. Lee Denney, R-Cushing, and Cory Williams, D-Stillwater, focused on Oklahoma’s health-care problems Thursday evening at a town meeting at the Sheerar Museum auditorium.
Oklahomans for Health Care Reform sponsored the meeting. Nancy Thomason, founder and president of the Oklahoma Brain Tumor Foundation, served as moderator for the town meeting that drew five residents.
Stillwater resident J.T. Moore called the meeting informative and said he wished more Stillwater residents had attended.
Oklahoma already has created a health-care safety net for children. It’s called State Children’s Health Insurance Program and pays for a child’s doctor appointments, prescription medicines, hospital stays and other health-care services if the child’s family falls under its income guidelines.
The state also initiated a low-cost health-care plan that allows small businesses to provide health insurance for their employees. It’s called Insure Oklahoma and is available for companies with 99 employees or fewer. The plan is a public/private partnership. The small business pays 30 to 40 percent of the premium. The employee pays 15 percent, and the state pays the rest, Denney said.
The program is funded through tobacco tax revenues and matching federal money. Insure Oklahoma needs additional money to keep growing. Now, it’s capped at about 30,000 and is approaching that threshold quickly.
What’s ahead for the state?
Denney proposes three areas:
• Holding insurance companies accountable for pricing. Currently, a person with medical insurance pays $5,000 for some type of surgery, while a rich person without insurance pays $2,000, and a poor person without insurance pays nothing for the same surgery. “The $5,000 is paying for the person who pays nothing,” she said. “It’s why we pay super high health-insurance premiums.
• Lawsuit reform to reduce the number of doctor-ordered tests. The doctors order extra testing to protect themselves from a lawsuit, but it drives up costs, she said.
• Increased reviews to reduce Medicaid and Medicare fraud, which costs America billions of dollars every year.
Williams would like to see:
• The American Medical Association do a better job of regulating doctors. “Not a lot of doctors are making mistakes. It’s a small percentage of doctors making the same mistakes over and over and over again,” he said. Those doctors drive up the cost of medical malpractice insurance and should be sent back to medical school for more training.
• Requiring up-front pricing for medical procedures and making hospital bills easier to read and understand. “No one can read a medical bill. You have all these medical codes and you don’t know what they mean,” he said. Williams agrees with Denney, saying medical procedures should have a flat fee that is paid by all consumers.
• The use of appropriate medical techniques and equipment. For example, a 90-year-old woman needs a hip replacement. The hospital uses a titanium hip that will last a lifetime. However, a fiberglass hip, which will last 10 to 20 years, is much cheaper. “The fiberglass hip would have been just fine for that patient, but the patient didn’t even get to make a choice on which replacement hip to use,” Williams said.
Audience questions
Stillwater resident DeAnna Homer said a doctor’s bill may be more than what Medicare or Medicaid pays for a procedure. The doctor accepts the Medicare/Medicaid payment. “Why can’t everyone have this privilege?” she asked.
Doctors often accept the Medicare/Medicaid payment, but turn around and charge other patients with private insurance higher rates to make up for Medicare/Medicaid losses. Also, some doctors don’t accept Medicare/Medicaid patients anymore because of the lower payments, Williams responded.
Homer also asked what would happen to the state health-care proposals if federal health-care reform is made law.
Moderator Thomason said she doesn’t have high hopes for a federal plan that will accomplish all of President Barack Obama’s campaign goals.
It will leave plenty of room for states to have a role in health-care reform.
Williams agreed.
“Government is a great motivator in a marketplace,” he said, citing the 1960s push that forced automakers to put seat belts into cars. Automakers said it would make cars too expensive. Today, every car has seat belts.
“Sometimes government can be a good thing and do right,” he said.
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