A plan for reforming Utah's fatally flawed health-care system
26 01 08 - 14:11
Vast numbers of Utahns are without health-care coverage, costs are increasing at unsustainable rates and too many patients fail to receive proper care. Health costs are rising more quickly than our median household incomes.
From 1996 to 2005, median household incomes in Utah grew by 15 percent, while family health insurance premiums jumped 109 percent. This trend is just not sustainable. By 2028, health insurance premiums will exceed the entire yearly salary of the average Utahn.
More Utahns are ending up uninsured, some 306,000, according to the last Health Status Survey. Clearly, our system is fatally flawed and we must enact serious reform before the system collapses. This legislative session I have proposed House Bill 133, "Health System Reform," which begins a major, multi-year reform of our health-care system.
True reform will take several years to implement and must contain costs, enhance access and improve quality. I firmly believe that the only way to fix our broken system is to build a framework for health-care that is based on individual accountability and market forces.
This year we begin a six step process that will lay the foundation for reform in future legislative sessions:
1. We must provide patients with information about the cost and quality of the care they receive. Armed
with information, they can then act as savvy consumers to make health-care decisions based on value. Tools are being developed this session that will provide consumers, providers and insurers that information.
2. Behavior and lifestyles choices such as smoking, obesity and failure to receive immunizations increase health-care costs. We need to develop public policies that inform and provide incentives for the public to make healthy choices.
3. We must encourage every Utahn to enroll in our existing health-care programs, which are under capacity. Almost half of the uninsured qualify for Medicaid, the Children's Health Insurance Program or the Utah Premium Partnership. CHIP, for example, has the capacity to cover 42,000 children; however, only 32,000 are currently enrolled.
4. The plan's multi-year framework is made up of four subelements. We must empower and fund the Governor's Office of Economic Development to develop and implement policies that enable Utahns to purchase insurance coverage with pre-tax dollars. It is imperative that we develop an information portal for sharing cost and quality data, and facilitate insurance company premium payments from multiple sources. The executive and legislative branches must develop and implement a strategic plan and timeline for reform that includes innovative insurance policies incorporating best clinical practices that are portable from job to job. The plan also would maximize pre-tax benefits, and move public employees into the new market as soon as feasible.
5. To build upon existing collaborative efforts, providers and insurers will be asked to contribute in several key ways. For example, by increasing the cutoff line for the definition of "uninsurable," we will reduce the amount of underwriting allowed in small group and individual markets. All the stakeholders must stay at the table for reform to truly take hold.
6. In order for these reforms to take effect, we need to provide an economic incentive. I've proposed a $14.1 million tax cut for health care. This would create a $750 credit per household that would enable families to start changing the way they buy and use health insurance.
This reform process has many stakeholders; everyone from me to you to hospitals and small businesses. However, we cannot let one industry or stakeholder distract us from the true reform that I believe is necessary to prevent a total collapse of the health-care system.
After all, if you haven't got your health, you haven't got anything.
---
* REP. DAVID CLARK R-Santa Clara, is the majority leader of the Utah House of Representatives.