With national health reform still out of reach, state governors were more than willing to discuss how they've made progress in their own jurisdictions to reduce healthcare costs and improve quality.
To date, Massachusetts' universal healthcare plan, which builds on a “strong private insurance market,” has insured nearly 98% of its residents, Gov. Deval Patrick said during a session on healthcare and the economy at the National Governors Association's meeting in Washington.
“I don't think there's any other state that can catch us.”
Patrick acknowledged that cost control remains a challenge for all states, and that the country needs to be moving away from a “sick care” system, to a nation where individuals become responsible for their health.
West Virginia Gov. Joe Manchin III said his state has tried to promote that idea through its Mountain Health Choices program, which provides additional benefits to people that make healthier lifestyle choices. Other governors said they've been able to rein in costs by better managing chronic disease.
Pennsylvania Gov. Edward Rendell said his state now requires that emergency department facilities provide a non-emergent care facility that's accessible around the clock. Having a nurse or physician's assistant stitch up a dog bite within half an hour is far less costly than waiting four hours in an emergency department for a high-priced physician to do the same procedure, Rendell said.
Even with these state success stories, some governors continued to push for a wider-scale reform effort.
Colorado over the years has made a great deal of progress on almost every type of healthcare reform initiative, including health information technology, transparency, hospital report cards, medical homes for children, and payment reforms, offered its governor, Bill Ritter. “We did tort reform in 1988 before it was cool. We put in place caps on non-economic and economic damages.” And yet, Colorado is still the seventh most expensive state in terms of healthcare costs, much of which is driven by uncompensated care, he said.
“There seems to be a great deal of consensus among states” on how to get reform done, something that hasn't been achievable on Capitol Hill, Ritter said. Given the rising cost of care and its contribution to the gross domestic product, as a nation, “we can't fail” on reform, he said. “We have to do what's necessary to come to a bipartisan solution on healthcare.”
Indiana Gov. Mitch Daniels, whose state enacted a plan several years ago through a federal Medicaid waiver to enroll more low-income people in health insurance, said he didn't have “a whole lot of confidence” in current legislative proposals on Capitol Hill.
Lawmakers should just start over, instead of imposing new taxes on consumers through a government-run plan, Daniels said in an interview. To date, Indiana has enrolled nearly 50,000 of its uninsured through its Healthy Indiana Plan, he noted. What do you think?
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