Health Care Reform Debate Goes to House Committee this Week; Senators Wait in the Wings

There are now four major health care reform bills in the hopper in the House and Senate-with more to come. The Gov's bill, Health Solutions, is, of course, the big banana.  It's a hybrid public-private plan with 98 pages of insurance reforms, a health care authority and mechanisms for coverage (i.e. mandates for individuals and employers).  The Health Security bill is a different approach resembling Medicare on a state level, and it has many supporters.  For the second year in a row, Dr. JR Damron, a Santa Fe radiologist and former Republican gubernatorial candidate, has proposed the Health Exchange,  essentially a state brokerage to simplify the selection of private insurance policies.  Rep. Danice Picraux and I have suggested another version of a Health Care Authority to present a plan for universal to the legislature for debate during next year's long session. There's also a bill to plan for electronic claims submission by '09 and a plan for electronic medical records by '10.

There's more to come, including insurance reforms to prevent insurance companies from denying preexisting conditions and raising the price when subscribers get sick.  I've introduced some funding to retain and recruit health care professionals and a task force to plan for chronic disease management, and thus control rising medical costs. Those are important pieces of the puzzle regardless of what happens elsewhere.

It's a health policy wonk's dream, and I plead guilty to that charge… but for most legislators it's complex, arcane, scary stuff, and almost any excuse will do to put it off, tune out or beg off. That leaves fertile fields for those who'd like to preserve the status quo-and they are beginning to plow old grounds with claims that reform will "drive insurance companies from the state," "enslave doctors," ( this from the Rio Grande Foundation) and "create huge waiting lines" for urgent operations.   Refuting these bogus claims takes valuable time "off message," and diverts attention from the major fact of 430,000 people without insurance in NM, premiums rising at four times the price index, and studies repeating the conclusion that doing nothing is more costly than taking action.

It will take real citizen involvement, focus and leadership to move this issue forward.  But today's a good day-and I have faith.

The House Health and Government Affairs Committee will be tackling the bills this week in Room 309, and it should be a good show. Look out for amendments and substitutions.  Check out the legislative web site at www. legis.state.nm.us for more details.   Meanwhile the Senators have been caucusing and reviewing the proposals.  Stay tuned when they swing into action the following week. 

Comments

[Briana Spillers]

health care in general is a sore subject I think across the US. I have been one of the fortunate one's to have had continuous coverage but I have notice the lengths that insurers have gone to to pass the buck my way. I went from having no deductible to having a 7500$ in the matter of a couple years, and thats not including copays and non covered expenses. I do think something needs to be done to lower these cost and provide health care for people who do not have the ability to be covered or able to pay. Even with insurance and I can say I have pretty good Insurance, the out of pocket copays and costs to me are still astronomical. Kids should all be covered and not have to worry about it and adults should all be covered as well and not have to think of the worse if they get sick or hurt.

as far as the medicade program, I think it is a good program for those who actually need it. But being that I work in a health care profession (pharmacy), I see plenty of people who abuse the system as far as they can, and not much is done. I think that if this program is available to those in need then the system needs to do more to watch or check on those who have this or open it up for everyone else to use. It is a highly abused system which is costing everyone else and I think I would like the same benefits as the ones who don't deserve to be one the program in the first place.

[Ski]

It’s good to hear there are some health care reform bills up for debate in the coming week. I liked the issues that you brought up, Senator Feldman. From keeping insurance companies from denying people with preexisting medical conditions to retaining and recruiting health care professionals. It seems to be there needs to be major reforms for insurance companies.

I hope at least some of these bills pass because I know a few people who could use health insurance. A close friend of mine currently has no health insurance but she is lucky to be healthy and takes care of herself. She is a college student and it’s too expensive for her to get the student health insurance through her college. She told me recently that it has been a few years since she’s been to the doctor.

I think people who have poor access to health care are low-income people. Some of these people work in lower paying jobs where they can’t afford the health insurance or make too much money to qualify for state assistance. From my social problems class, it is known that lower income individuals also have poorer health because of eating and health habits. These type of people probably need the most health attention.

[Jedwards12]

Health care is a very sensitive subject for me. I think that getting health care is next to impossible in this state if you have something wrong with you. If you are able to get health insurance with your pre existing conditions than you will be paying a extremely high premium. I myself was one of these people who tried getting health insurance through one of the local companies here in town. I answered the questionnaire truthfully and because I had asthma I was denied coverage and was unable to get insurance. Thankfully I got a job that provided insurance and I was able to get insurance through them. If i did not have this job than I would be uninsured today.

I think the people that would have the hardest time getting insurance would be people that have been recently laid off and have to get individual insurance. I also think that self employed people would have a hard time and also people that are below the poverty line. People that have been laid off and are self employed would have a hard time because they probably have pre existing conditions that will keep them from being picked up from an insurance company. I think that people that are barely making it in this state will have a hard time because even though they qualify for insurance the premiums will be so high they will not be able to afford it.

Of the few solutions that I have seen so far i think that being able to get the insurance companies to drop their so called preexisting insurance policy is one of the best ones. I think that this would open up so many doors for people here in this state(me being one of them) to get insurance. I also think that if we do come up with a program that way we can have everyone in this state be on insurance. I know that there is medicaid but not everyone qualifies for medicaid and the people who do not are still left in the dark. If we are able to get everyone insured that lives here that would be a good thing.

[Joy D.]

It would be nice to see families that do not have any health care to speak of be able to actually go to a doctor and receive the care that they need. But even with that we still have the problem of doctors with terrible bedside manners and the lack of desire to listen or answer a patients questions. On more than one occasion of late I have had the unfortunate experience of sitting in with a doctor who refused to listen or answer my questions. The one was a specialist, when I brought it up to my primary care doc. he read me the other doctors notes, and decided that I must have been the problem. And all of this was over a pre-existing issue that we have been unable to find a way to better manage.

You should not be able to sit in a hospital or urgent care room next to another person with the exact same complaints that you're having and noticeably see that the other is getting better care because they have better insurance. (Lovelace Woman's Hospital)

My point is if we do managed to pass anything through that would be another state run program we need to be sure that along with it comes a clear understanding that sub-standard care will not be accepted.

[Myranda Beighey]

With the information that I know right now. I think that Health Care can be improved a lot. I think that we can provide care for thoses that don't have any and I don't think that we should deny it to anyone.

[Ahmad Tarif Rashad]

I've been very fortunate and maintained health insurance of one type or another for past 25 years, although I have watched my costs go up and coverage decline during that period. Clearly the economically poor are being hardest hit and least likely to be able to afford insurance. And that brings me to my position on what changes I see need to happen.

First off I believe profit needs to be removed from the equation all together. Britain, Germany and Japan approach health care this way (at least in the areas most directly affecting patients) and have statistically more successful health care systems, and appear to have high marks from their own general populations. I'm a realist and understand capitalist forces are going to govern aspects of health care in the U.S. and New Mexico.

For NM though I believe a good start would be universal health care paid for through a combination of taxes on certain income levels and sliding scale fees to residents. I also believe pre-existing health conditions should be covered with "pre-existing" becoming essentially a non-issue if true universal care is implemented.

[Samantha O'Dell]

I work in the health care field and see many people abusing state run healthcare, such as medicaid programs. They often times do not care what they are costing the state and act as though they are entitled to things that no one else is. I know several people who are not able to afford health insurance or good health insurance and just hope that they don't need it. By doing this, they are not receiving any preventative care either which could end up costing more in the long run. The more that I learn about universal health care with government taxes, the more that I think it is becoming a better option than the current options.

[Infinita Romano]

In New Mexico we have New Mexikids which covers our most deserving citizens and I am proud of this program. Aside from my comments above, the hardest hit by our Health care system are uninsured working families.

[Infinita Romano]

I have watched many people receive expensive care payed for by Medicade and their maladies were all due to personal abuse such as smoking, non exercise, prescription and other drugs and obesity from insane eating habits. A completely free health care system paid for by taxation will most certainly be abused. There must be personal responsibility incorporated into this plan as well as education about personal healthy living. I support a system similar to UK with government run hospitals and clinics without profit propelled private insurance companies and facilities. However, everyone pays based on their income with the huge deficit covered by taxation. (Including raising sin tax) Health conscious living must be taught in our schools, welfare and food stamps must accompany education and accountability of health conscious eating and living habits for people to retain their benefits.

[S. Sierra]

What I dont understand is why this is even a debate when it comes to kids. I can see both points we it comes to work able adults. When comes to a child there should be no ifs, ands, or buts about receieving the best health care. A child should not pay for their parents poor chioces or lack of responsibility. Maybe if we incorperated a universal cost free health care plan for children we might be able to see how it will work across the board. But this does not mean that we cut it if we dont like it (for the kids). I dont think very many if any people would care if we payed a little more to provide free health care for kids. I know I wouldnt.